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Volume 50, Issue 5
Displaying 1-10 of 10 articles from this issue
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K. Maeda, M. Maruta, T. Utsumi, K. Toyama, H. Sato, Y. Okumura, M. Has ...1997 Volume 50 Issue 5 Pages 307-310
Published: 1997
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSExfoliated cancer cells in the rectum were studied to clarity the possibility of implantation methastasis in early rectal cancer. Twelve patients with rectal cancers and one with sigmoid colon cancer at an early stage who underwent transanal local excision were entred in the study. Cells were collected from three different areas of the mucosa around the tumor (right, left and anal side), and from the center of the tumor before excision. Exfoliated cancer cells were examined cytologically. Scratch cytology was performed from the tumor in 11 of the 13 patients following excision. Exfoliated cancer cells were confirmed in one of 39 specimens collected from the mucosa (2.6%). Cancer cells were identified in 9 of the 13 patients (69.2%) by contact cytology. Scratch cytology revealed cancer cells in 10 of the 11 patients (90.9%). It was considered that intraoperative preparation like rectal washout is not necessary because the possibility of exfoliated cancer cells in the mucosa of the rectum was very low.View full abstractDownload PDF (144K) -
H. Fuke1997 Volume 50 Issue 5 Pages 311-317
Published: 1997
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSDuring the past 16 years, we experienced 689 cases with advanced colorectal cancer lesions, 18 cases (2.6%) of which had small cancer lesions less than 2 cm in diameters. Among these 18 cases, 10 were male and 8 were female with a mean age of 64.3 years. These 18 lesions were investigated macroscopically and histologically. Eight cases were diagnosed as colorectal cancer by positive fecal occult blood, and 16 cases showed normal serum CEA levels. The cancer lesions were found mainly in the left colon or rectum and complicated by adenoma and so on. As for the gross form, 16 lesions were NPG type and the other 2 lesions were PG type. The relationship between the macroscopic type and the depth of invasion were examined. Most of the invasive lesions of the elevated type were propria muscle. Among the depressed types, according to the increase of the depressed lesions (from IIa+IIc type to IIc type), the depth of invasion increased. Lymph node metastasis was found in 4 cases whose cancer lesions were all NPG type. Those macroscopic types were mainly IIa+IIc or IIc, with deep invasion.
These data suggested that even these small lesions should not be ignored or over-looked because of the high malignancy potential there of.View full abstractDownload PDF (408K) -
T. Masaki, T. Muto, M. Yasutomi1997 Volume 50 Issue 5 Pages 318-330
Published: 1997
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSTo clarify clinicopathological characteristics of sigmoid colon and rectal cancers with central node involvement and feasibility of extended lymphadenectomy for those cases, a multi-institutional questionnaire study was conducted. Para-aortic lymphnode dissection was performed with curative intent in 75% of the institutions in Japan. Hypogastric nerves were usually sacrificed in those cases. Central node positive cases were more frequently accompanied with deeper penetration of bowel wall, higher malignancy of cells, and more peritoneal dessemination, hepatic metastases, or distant organ metastases than usual cases. Para-aortic lymphnode dissection was assumed to be beneficial in sigmoid colon cancer cases with para-aortic node involvement, however, no survival improvement was observed in sigmoid colon caner cases with inferior mesenteric node involvement or rectal cancer cases with central node involvement. Prospective randomized study is considered to be necessary for reaching conclusions about the feasibility of extended lymphadenectomy in advanced sigmoid colon and rectal cancer cases.View full abstractDownload PDF (310K) -
T. Yoon1997 Volume 50 Issue 5 Pages 331-338
Published: 1997
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSLymph node metastasis positive cases of colorectal cancer (Dukes C) were classified by the mode of lymph node metastases into intranodal and extranodal types, and their correlation with the prognosis and rates of hepatic metastases were investigated.
The subjects were 451 out of 492 cases of primary colorectal cancer which underwent surgery between 1977 and 1990.
The lymph node metastasis positive cases were classified into the following 2 groups : 1) The intranodal type (IN) in which metastatic cancer was localized in the lymph nodes with no capsular or extracapsular infiltration, and 2) the extra nodal type (EN) in which the metastatic cancer was extended to the extracapsular adipose tissue or the extracapsular vessels (blood or lymph vessels).
The 5-year survival rate was 62.3% for the IN type and 26.0% for the EN type, and the rate of hepatic metastases was 6/52 (11.5%) for the IN type and 49/145 (33.8%) for the EN type with a significant differences between the rates for each type in both tests.View full abstractDownload PDF (1564K) -
M. Mitsutsuji, T. Ichihara, T. Urakawa1997 Volume 50 Issue 5 Pages 339-343
Published: 1997
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSA 71-year-old female was admitted to our hospital with complaints of sudden fresh blood bowel discharge and abdominal pain. Ischemic colitis at the transverse colon was diagnosed after colonoscopy. Abdominal pain and constipation continuued for two months. Barium enema showed stenosis of the transverse colon. Laparoscopy assisted transverse colectomy was perfomed due to diagnosis of ischemic colitis of stenotic type. Laparoscopy assisted operation is considered to be an effective treatment especially for ischemic colitis of stenotic type.View full abstractDownload PDF (3666K) -
M. Shiozawa, S. Suzuki, D. Takahashi, I. Tamura, F. Fukano, R. Matsuda ...1997 Volume 50 Issue 5 Pages 344-349
Published: 1997
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSLiver abscess in Crohn's disease is very a rare, and only 4 cases have been reported in Japan.
This paper reports a patient with Crohn's disease who developed solitary liver abscess which was treated by percutaneus transhepatic drainage. The case was a 26-year-old male with persistent ferver of 39°C and dyspnea. Solitary liver abscess in the right lobe was recognized by abdominal computed tomography and ultrasonography. First, antibiotic therapy was done, but it was not efficient and the clinical status did not change. Therefore, percutaneus transhepatic drainage was performed along with ultrasonography 4 days after diagnosis. This therapy was effective and the persistent fever forwered the next day. He was discharged 26 days after drainage. Inflammation of the portal vein was suspected to be the source of abscess formation. He had diabetes mellitus which was controlled with HbAlc of 8.7% and on admission, the blood sugar concentration was 322mg/d l because of glucose resistance to inflammation. After drainage, the blood sugar rate was lowered and the control of blood sugar was good.
In this case, early diagnosis and treatment were carried out, so there were no problems.
Diabetes and use of steroids have been implicated as a contributing factor in abscess development by inhibiting natural host defences.View full abstractDownload PDF (2705K) -
H. Bando, M. Kosugi, H. Nakashima, K. Ietsugu1997 Volume 50 Issue 5 Pages 350-354
Published: 1997
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSColitis cystica profunda is a benign disease in which mucus-filled cyst are found beneath the muscularis mucosae of the colon. The cases are divided into three groups, localized, segmental, and diffuse. It is usually located in the rectum showing polypoid lesions. A case of colitis cystica profunda of the ascending colon is reported. A 64-year-old male visited our hospital because of fecal occult blood, without any symptoms. Total colonoscopy revealed a pedunculated polyp distal to Bauhin's valve. Its surface was smooth, and its color was slightly faded and mottled red like telangiectasia. It was resected by endoscopic polypectomy. Its size was 11×8×8mm. Microscopic examination revealed an increase of smooth muscle and collagen in the lamina propria, so-called fibromuscular obliteration, and displacement of gland and cystic diltation in the submucosal layer. The diagonosis was colitis cystica profunda. A year later, colonoscopy revealed no signs of recurrence.View full abstractDownload PDF (3130K) -
Y. Sobao, K. Koganei, H. Ike, K. Eguchi, R. Shizawa, K. Ookubo, M. Kik ...1997 Volume 50 Issue 5 Pages 355-359
Published: 1997
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSThis is a report of a case with adenoma of the appendix, which was detected by screening colonoscopy. The case was a 73-year-old male without any symptom. The adenoma was observed as a polyp protruding from the orifice of the appendix. He was admitted to our hospital, and appendectomy and partial resection of the cecum was done.
In the resected specimen, the adenoma was a pedunculated polyp : the head was 6mm in diameter and the stalk 2mm in length. The base of the stalk was in the proximal site of the appendix.
Histological examination showed a typical tubular adenoma.
Adenoma of the appendix is rare; the frequency is 0.02-0.08% in resected specimens. In Japan, only 9 cases had been reported and this is the tenth case. It is difficult to diagnose preoperatively, and most adenomas of the appendix are discovered after resection due to appendicitis. Adenoma of the appendix should be resected, because villous adenoma is the most frequent type that has high malignant potentiality.View full abstractDownload PDF (1534K) -
H. Takasaka, K. Sasaki, M. Nakamura, S. Koide, T. Hosikawa, S. Tsuchid ...1997 Volume 50 Issue 5 Pages 360-364
Published: 1997
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSColon carcinoma in children is rare and it has been reported that its prognosis is very poor. A case of a 15-year-old male with descending colon cancer is reported. He came to our hospital with the complaints of left adbominal pain, vomitting and appetite-loss. Lapalotomy was performed after the diagnosis of bowel obstruction. An obstructing tu-mor was encountered in the descending colon. Left colectomy with lymph-node dissection was performed. Histological examination revealed that the tumor was moderately diffe-rentiated adenocarcinoma, s, n(-), ly1, v0, ow(-), aw(-), TNM-stage II. The patient is well and has had no sign of recurrence for six years since operation.
Among 60 patients with carcinoma of the colon in children under 15 years old re-ported in Japan, only 8 patients have survived for more than 5 years after the initial diag-nosis. The poor prognosis may be due to the fact that most cases were poorly differentiated adenocarcinomas and were in the advanced stage of the disease.
Early diagnosis and curative operation are necessary to obtain good prognosis even in young patients with colorectal carcinoma.View full abstractDownload PDF (1532K) -
1997 Volume 50 Issue 5 Pages 365-382
Published: 1997
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSDownload PDF (1444K)
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