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Volume 50, Issue 1
Displaying 1-9 of 9 articles from this issue
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Hua Li1997 Volume 50 Issue 1 Pages 1-10
Published: 1997
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSSerum levels of a novel tumor marker, NCC-ST-439, were determined in 76 patients with primary colorectal carcinoma. Serum levels of NCC-ST-439 were positive in 17 of 76 patients. Serum levels of NCC-ST-439 correlated closely with serum leves of carcinoembryonic antigen, lymph node metastasis (p=0.01), liver metastasis (p<0.01), and clinical stage of the disease (p<0.01). NCC-ST-439 in tumor tissues was negative in 8, showed apical staining in 7, and showed diffuse cytoplasmic staining in 61 patients. Diffuse cytoplasmic staining of NCC-ST-439, correlated with tumor penetration and lymph node metastasis but did not correlated with recurrence of the disease. Positive serum NCC-ST-439 indicated a high risk for tumor recurrence.A multivariate analysis disclosed that posi-tive serum NCC-ST-439 and extensive lymph node metastasis were significant and inde-pendent variables predicting tumor recurrence.View full abstractDownload PDF (352K) -
Y. Harada, Y. Ogata, M. Hiraki, Y. Akagi, K. Inuzuka, J. Konishi, H. O ...1997 Volume 50 Issue 1 Pages 11-16
Published: 1997
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSThe expression of vascular endothelial growth factor (VEGF) was studied by immunohistochemical analysis human colorectal cancer. A total of 152 human colorectal carcinomas were fixed by formalin and embedded into paraffin wax and 3μm sections were examined by the avidinbiotin peroxidase complex method. The intensity of staining for VEGF was assessed on the expression in a group of cancer cells or a unit of adenoduct. VEGF was noted in the cytoplasm of adenocarcinoma cells, normal glandular cells, monocyte-macrophages, fibroblast cells, and vascular endothelial cells in colorectal cancer tissue. VEGF expression by monocyte-macrophages and fibloblast cells was observed in almost all cases, but the incidence of VEGF expression in tumor cells was relatively low at 49.3% of the cases. However, in all cases where tumor cells were positive for VEGF, the tumor cells were considered as the main cell source for VEGF production. Since the cell counts of VEGF expression in cancer cells were greater than tumor infiltrating cells such as monocyte-macrophges, fibroblast cells and vascular endothelial cells. These results suggest that VEGF may play important roles in tumor progression and in angiogenesis via autocrine and paracrine mechanisms in colorectal cancer tissues.View full abstractDownload PDF (341K) -
Their Relationship with Postoperative Abdominal Symptoms and Anal FunctionT. Nakamura, M. Ohya, H. Ishikawa1997 Volume 50 Issue 1 Pages 17-32
Published: 1997
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSThe purpose of this study was to investigate the influence of total and segmental colonic transit time on postoperative abdominal symptoms and anal function after anterior resection of colorectal cancer. Thirty-three patients who had been followed-up for at least 6 months after anterior resection of cancer in the sigmoid colon or rectum were studied. Fourteen patients were studied preoperatively as well. Normal volunteers as controls and patients after right hemicolectomy were also studied. Patients were given 3 sets of radioopaque markers on 3 consecutive days, and on the 4th day, an abdominal flat plate was taken. Total and segmental transit time were calculated using Arhan-Metcalf's method from the numbers of markers in each segment. Anorectal manometry was also performed in 19 patients after low anterior resection. Total colonic transit time became significantly longer after anterior resection. Total colonic and segmental colonic transit times were significantly longer in patients after anterior resection than in controls. Patients having abdo-minal symptoms had significantly longer total colonic transit time than those without abdominal symptoms. In patients having a large neorectal capacity exceeding 80ml, longer total and left-sided transit time were associated with poor anal function.View full abstractDownload PDF (514K) -
T. Hattori, K. Fukuchi, K. Gomi, R. Fujita1997 Volume 50 Issue 1 Pages 33-40
Published: 1997
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSFecal occult blood testing has been the mainstay of screening for colorectal cancer. In the present study, using Mutant-Allele-Specific amplification (MASA) for the first step of genetic screening, 46 colorectal cancers were analyzed for point mutation at codons 12, 13, and 61 of the K-ras gene in stools and tumor tissues. Mutant ras genes were detected in DNA purified from stools in 15 of 46 colorectal cancer patients(32.6%). In patients whose cancers contained mutant ras genes, the mutants were detected in 15 of 18 cases(83.3%). There was no apparent correlation between the detection of K-ras mutations in the stool of these patients and the size, anatomical location, or stage of progression of the cancer. The rate of detection of K-ras mutation in the stool of these patients was high in early-stage cancers (Dukes A)(100%) and proximal colon cancers (85.7%). On the other hand, this frequency tended to decrease in cancers smaller than 3cm in diameter. These results support the notion that stool analysis of genetic alterations may be a new approach for detecting the presence of colorectal cancers.View full abstractDownload PDF (2178K) -
M. Fukuchi, Y. Nagamachi, N. Akiyama, M. Ishizaki, H. Katoh, H. Sasamo ...1997 Volume 50 Issue 1 Pages 41-44
Published: 1997
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSSchwannoma of the digestive tract is rare in the large intestine, especially. Recently we experienced a case of malignant schwannoma of the transverse colon.
A 69-year-old male came to our department on 10th, July 1995 because of positive fecal occult blood on medical examination. Barium enema examination revealed an elevated lesion with a broad base and smooth surface, five cm in diameter in the splenic flexure of the transverse colon, so that the lesion was diagnosed as a submucosal tumor. Colonoscopic pictures showed a ulcerated tumor which occupied half of the lumen, and the result of the biopsy was Group 3. This patient was admitted to our hospital on 14th September and transverse colectomy for the submucosal tumor was done on 26th September. At the time of the operation, we suspected that the tumor was a leiomyosarcoma. Histological logical diagnosis of the tumor revealed it to be a 'neurogenic' malignant schwannoma, because immunostaining for s-100 protein showed a positive reaction in the tumor cells, but that for actin showed a negative reaction.
Forty-one cases of schwannoma of the large intestine have been reported in Japan between 1939 and 1995, including this case, 11 of which were malignant. In this present study, a case of malignant schwannoma of the large intestine was reported and confirmed histologically, because the reported cases were rare at this time.View full abstractDownload PDF (2232K) -
H. Nakasaki, H. Moriya, M. Ohta, J. Soeda, H. Tokunaga, H. Hirakawa, S ...1997 Volume 50 Issue 1 Pages 45-52
Published: 1997
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSTwo case of chronic idiopathic pseudo-obstruction caused by a degenerative disorder of the myenteric plexus are reported. A 63-year-old male and a 56-year-old female were admitted after suffering from abdominal distension, pain, anorexia, and constipation for 3 years and 5 years respectively.
On physical examination, markedly distended abdominal wall was noticed. Barium enema test revealed distended transverse colon, and narrowing of descending colon-colonoscopic examination revealed no pathological findings with erosion, ulcer, and tumor in descending colon.
Enterogram using a mecholyl test was positive in both cases. Preoperatively segmental aganglionosis was diagnosed. At laparotomy, a markedly dilated transverse colon and the following narrowed segment were excised.
Both patients underwent colonresection. The surgical specimens of both patient's resected colon were diagnosed aganglionosis. The postperative courses were uneventful in both cases.View full abstractDownload PDF (5312K) -
S. Katayanagi, T. Miyashita, K. Tanifuji, K. Kasuya, T. Hara, K. Tanif ...1997 Volume 50 Issue 1 Pages 53-58
Published: 1997
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSA case of ischemic colitis with gangrene of the entire large intestine is reported. A 90-year-old male was admitted to our hospital complaining of severe abdominal pain with muscular defence and Blumberg's sign. Operation was performed on the admitted day for panperitonitis. Purulent ascitis, necrotic smelling, and dusky serosa from the cecum to the rectum was observed and resection of the total colon, the upper rectum and the terminal ileum was performed because of panperitonitis due to acute gangrenous ischemia of the entire large intestine. The lesions were multi focal and of irregular shape which did not have any definite vascular distribution. Macroscopically hemorrhagic and/or flat changes in folds were revealed in the mucosa. Histological findings showed atrophy of mucosa (ghost-like disappearance) and a capillary proliferation and small venous dilatation with marked fibrin thrombus in the muscularis propria and the submucosa of the ileum, colon and rectum and tenia. However, arteriole stenosis, obstruction, and inflammation were not revealed. Based on these findings, it was suggested that this case was in the early phase of ischemic colitis with gangrene which was caused by infarction of the venules.View full abstractDownload PDF (4198K) -
T. Ochiai, T. Okada, H. Noguchi, K. Yasuda, T. Sakakibara, M. Moriwaki ...1997 Volume 50 Issue 1 Pages 59-64
Published: 1997
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSRecently, low anterior resection of rectal cancer by the use of the double stapling technique which preserves the anus, taking into consideration the safety of the auto suture technique and quality of life, has been actively performed.
On the other hand, there have been many reports on complications of this method, but there have been very few reports on therapy for anastomosis stenosis. A new therapy for anastomosis stenosis is reported.
A 43-year-old female underwent surgery in June 1995. In March 1996, she was admitted to our hospital with ileus. By colonoscopy, a diagnosis of anastomosis stenosis was made after low anterior resection using the double stapling technique. Ileus was caused by anastomosis stenosis. Colonoscopic retrograde bowel drainage(CRBD)was performed. Ileus and anastomosis stenosis were impoved by CRBD, because the drainage tube cut the anastomosis stenosis. Since CRBD is a very simple and effective therapy for ileus and anastomosis stenosis after low anterior resection using of double stapling technique, it should be tried first.View full abstractDownload PDF (3254K) -
K. Maeda, M. Maruta, M. Hashimoto, Y. Hosoda, Y. Morikawa1997 Volume 50 Issue 1 Pages 65-70
Published: 1997
Released on J-STAGE: December 03, 2009
JOURNAL FREE ACCESSAnterior levatorplasty was performed to enforce the rectovaginal septum in 5 cases of rectocele with clinical symptoms. The mean age of the patients was 61 years. Two cases had concomitant fecal incontinence, and three cases had urinary incontinence. Anterior levatorplasty with excision and anastomoses of the vaginal wall was the standard operation. Sphincter plication was added in two cases with fecal incontinence. Clinical symptoms and urinary or fecal incontinence were improved in all cases after surgery. Manometric study did not reveal marked changes as a whole, however, minimal distending volume, maximum tolerate volume and resting pressure decreased after surgery in cases which demonstrated abnormal high levels of these parameters before operation. Improvement in resting pressure and the length of high pressure zone were observed in cases with fecal incontinence. However, study on more cases was considered necessary for confirmation and discusions of these changes. Postoperative defecography showed improvement of rectocele in all cases. Anterior levatorplasty for rectocele was suggested to be a procedure which improved the clinical symptoms and morphological disorders.View full abstractDownload PDF (1569K)
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