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Volume 51, Issue 10
Displaying 1-12 of 12 articles from this issue
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M. Nogaki1998 Volume 51 Issue 10 Pages 1061-1066
Published: 1998
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSNumerous fine ioplovements of the original procedure hae been tried to obtain better results for nearly 40 years since the ligature and excision operalion was adopted. As a result, the current operalion is considerably different from the original procedure. In this article, details of the operation are described and the recent results are reported. Postoperative complications were experienced in 22/535 cases (4.1%). Details of these complications and the cause of each complication are discussed.View full abstractDownload PDF (407K) -
J. Iwadare1998 Volume 51 Issue 10 Pages 1067-1075
Published: 1998
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSI have been performing a newly devised semi-closed method using a continuous suture with two different tightnesses. A continuous interlocking suture is applied tightly up to the anal verge, to prevent early postoperative bleeding. After the first knotting, the suture is continued a little more outward, with light tension that is enough to approximate the skin, and it is knotted again. Regarding postoperative results, the wound healing in patients with the semi-closed method was faster than in those with the open method (3 weeks, 6 weeks, respectively). Only 7.39% of patients who underwent the semi-closed method needed an analgesic injection on the operative day, as compared with 68.4% of those who underwent the open method. A postoperative survey revealed that 96.4% of the semi-closed method patients were satisfied with their postoperative condition. In terms of the degree of satisfaction, there was no significant difference between in the semi-closed method patients followed-up for less than 5 years and those followed-up for more than 5 years.View full abstractDownload PDF (305K) -
Y. Matsuda, S. Nakamura, O. Ishihara, T. Fujii, S. Satoh, K. Kimura, K ...1998 Volume 51 Issue 10 Pages 1072-1082
Published: 1998
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSOur operative method is so-called plastic surgery, originating from the concept of Parks' submucosal hemorrboidectomy by Milligan & Morgan. Completely closed hemorrhoidectomy was performed in 471 patients (cases in Male 241 : cases in Female 230: mean age : 53.9 years) from January 1997-May 1998. The operating method was the ligation and excision method in three directions, and wound closure was done by running suture of 2-0 or 3-0 Vicryl suture. Complication rate was 8.3% (39 out of 471 cases), and mean complete healing time was 27.8 days in case of no complication, on the other hand, 34.7 days in cases of complication. The results were as follows : Skin tag occurred in 26 cases (66.7%), wound dehiscence in 6 cases (15.4%), postoperating hemorrhage in 3 cases (7.7%), prolonged wound healing in 2 cases (5.1%), and stenosis and wound infection in 1 case (2.6%) each.
In conclusion, the completely closed method has merits in early wound healing and preveating postoperative bleeding, however, the only demerit was skin tag as the main complication.View full abstractDownload PDF (270K) -
H. Hidaka1998 Volume 51 Issue 10 Pages 1083-1086
Published: 1998
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSHemorrhoidectomy has changed the conventional White head method to ligation and excision and further to the semiclosed method. Recently, preserving the anoderm and the function, as well as shortening of recovery time, is demanded in day surgery.
Among 55 cases undergoing complete anoderm-preserving operation in our hospital, there were 17 cases had skin tag and 4 cases of swelling except cases of bleeding and pain after operation space. The recovery time in complete anoderm-preserving hemorrhoidectomy was 22.4 days on average which was shorter than that of ligation and excision method (about 30 days).
Complete anoderm-preserving hemorrhoidectomy is effective for cases with undeveloped accessory hemorrhoids because internl and external hemonrroids are excised separately.View full abstractDownload PDF (216K) -
Y. Masuda, A. Kurokawa, Y. Hata1998 Volume 51 Issue 10 Pages 1087-1093
Published: 1998
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSSince the era of Hippocrates, ligation procedure has been applied to treatment of hemorrhoid. Divided ligation of hemorrhoid has been used by S. Hanaoka, G. Honma and K. Hata in Japan. We carried out the divided ligation of hemorrhoid with some modified fashion on 477 patients from April 1997 to Marc 1998. The number of female patients was 249 (52.2 %) and that of male patients was 228 (47.8%).
The results were satisfactory. Mean length of healing was 35.5days. The operative procedure is simple. Under local anesthesia hemorrhoid is transfixed and ligated separately in both sides. The ligated part of the hemorrhoid develops necrosis and dropps off in 2 weeks. It is charactaeristic that the healing scar is elastic and soft. The operative wound heals in 2 to 3 weeks. As for postoperative complications, four patients developed minor bleeding and one needed to have catheterization for urination. So far no patient has complained of incontinence to feces or gas, soiling or painat the scar.View full abstractDownload PDF (269K) -
[in Japanese]1998 Volume 51 Issue 10 Pages 1094-1100
Published: 1998
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSDownload PDF (257K) -
K. Matsuda, T. Yokoyama, M. Shinozaki, K. Suzuki, T. Watanabe, T. Masa ...1998 Volume 51 Issue 10 Pages 1101-1108
Published: 1998
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSSurveillance colonoseopy (SCF) has been performed to detect dysplasia and surgically treatable carcinoma in patients with ulcerative colitis (UC). SCFs have been carried out in 208 patients with longstanding UC of total or left-sided type since 1979. All patients who had carcinoma or HGD detected by surveillance colonoscopy are alive and well postoperatively during 6-year period of follow-up. Contrarily prognosis of non-SCF cancer cases was very poor, and 3 of the 5 cases (60 %) died within 2 years and 5 months. These results suggest the usefulness of SCF for early detection of carcinoma in long-standing UC. The frequency of p53 overexpression was as follows ; UC-associated cancer : 89 % (8/9), HGD : 70 % (7/10), LGD : 57 % (13/23), adenoma : 0 % (0/8), IND : 0 % (0/9), NEG : 0 % (0/37), and non-IBD cancer : 69 % (59/86). p53 immunostaining have proved to be useful not only in diagnosing dysplasia and cancer associated with UC but also in differentiating dysplasia from adenoma.View full abstractDownload PDF (455K) -
T. Hattori, R. Fujita1998 Volume 51 Issue 10 Pages 1109-1112
Published: 1998
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSFecal occult blood testing (FOB) has been the mainstay as a screening test for colorectal cancer. However, the efficacy of FOB testingremains controversial, and the development of more reliable markers for colorectal cancer are needed. Recent advances in cellular and molecular biology have led to genetic screening for colorectal cancer with potential for clinical application by noninvasive methods. Several preliminary data from recent investigations suggest that assays of several gene mutations in exfoliated fecal colonocytes can detect colorectal cancer. The Early Detection Branch, Division of Cancer Prevention and Control, Cancer Institute has created a program called The Early Detection Research Network. The objectives of genetic colorectal cancer screening are to (a) make prenatal and presy mptomatic diagnosis for hereditary colorectal cancer, (b) detect cancer cells for mass screening (c) enhance the understanding of the molecular basis of tumorigenesis in relation to screening In this report, it was shown that molecular diagnosis of colorectal cancer might open the way to future mass screening.View full abstractDownload PDF (127K) -
Y. Kinouchi, N. Hiwatashi, M. Chida, S. Kumagai, S. Takagi, K. Negoro, ...1998 Volume 51 Issue 10 Pages 1113-1117
Published: 1998
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSTelomeres are tandem-repeated DNA sequences located at the ends of eukaryotic chromosomes. Telomere length in human somatic cells gradually decreases with the number of cell divisions and is regarded as a marker of somatic cell turnover. Activity of telomerase, a ribonucleoprotein enzyme, is found in most cancer tissues and is generally undetected in normal human somatic tissues. Thus, detection of telomere length and telomerase activity have utility in the early diagnosis of colitic cancer and colorectal cancer respectively, and telomerase may be a new target for therapeutic intervention.View full abstractDownload PDF (277K) -
H. Onodera, S. Arii, M. Imamura1998 Volume 51 Issue 10 Pages 1118-1124
Published: 1998
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSRecent developments of molecular biology were outlined in terms of prediction of liver metastasis from colorectal cancer. It was previously reported that the depth of venous invasion enables prediction of liver metastasis from colorectal cancer. As sequential steps of the metastatic process have been elucidated, this fact was confirmed by several molecular biological approaches. Analysis of 66 patients with colorectal cancer indicated that VEGF, MMP-9, and MT-MMP mRNA expression were significantly higher in patients with hepatic metastases than in those without. The presence of cytokeratin mRNA in circulation may also be a useful indicator for the screening of advanced colorectal cancer patients with a high risk of recurrence. Adhesive molecule immunohistochemical analyses of sialyl Lewis X and CD44 have been reported to be good for prediction of hepatic metastases. The advantage of such molecular biological research is not only distinguishment of high risk patiets but also establisment of preventative and therapeutic strategies for metastatic diseases. To assess the value of prediction in hepatic metastasis, multivariate statistical analysis is needed including putative factors that influence distant metastases.View full abstractDownload PDF (3776K) -
N. Tomita, T. Ohnishi, M. Tada, M. Ohue, M. Sekimoto, I. Sakita, Y. Ta ...1998 Volume 51 Issue 10 Pages 1125-1131
Published: 1998
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSRecently, several PCR-based assays have been reported to be useful for detection of micrometastasis of cancer cells. Among them, RT-PCR using gene markers whose expression are thought to be specific for epithelial cells is one of the most sensitive and promising method in clinical application. However, the gene markers which are currently used for the detection of micrometastasis of colon cancer cells, such as CEA or cytokeratin, are not strictly specific for epithelial cells and sometimes lead to the false positive results. In order to obtain the specific gene markers for detection of colon cancer micrometastasis, we utilized 3'directed cDNA library for screening the colon specific DNA marker. Out of 8 candidate markers selected by comparison of expression profile of 3'directed cDNA library from normal colon mucosa with those from other organs, one marker, GS04094, was shown to be expressed in normal colon mucosa and colon cancer, and neither in skin, lymphnode, peritoneum, nor normal liver by RT-PCR. Further analysis revealed that GS04094 was expressed not only in colon but also in stomach or ileum, therefore, its expression was thought to be specific for epithelial cells of gastrointestinal tract. The upstream sequence of GS04094 was determined by 5'RACE method, and was identified as a homologue of bovine ion channel-associated molecule. The RT-PCR using GS04094 primers was highly specific and sensitive so that we could detect one colon cancer cell among 105-6 lymphocytes. We are now analyzing the micrometastasis of colon cancer cells in peritoneum (peritoneal disseminaton) or lymphnodes using this RT-PCR method. Finally, 3'directed cDNA library technique was thought to be very useful for the screening of tissue-specific gene markers.View full abstractDownload PDF (2293K) -
H. Muramatsu, Y. Niitu1998 Volume 51 Issue 10 Pages 1132-1137
Published: 1998
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSAs of March 1998, over 150 protocols of cancer gene therapy have been approved and approximately 2, 000 patients have been enrolled in clinical trial mainly in USA and Europe.
As for colorectal cancer, however only a few protocols which include both direct and indirect killing strategies of tumor cells have been approved.
A typical clinical protocol of direct tumor cell killing (suicide gene therapy) utilzing gene of cytosine deaminase which converts 5-FC (nontoxic prodrug) into 5-FU (cytotoxic agent for GI tract) has been started for treatment of multiple liver metastases, though its outcome has not been reported yet. Another direct therapy utilizing the p53 gene has also beeh conducted for liver metastasis, but there isnon information on the results. In animal models, the CEA promotor to drive these cytotoxic genes specfically in CEA expressing tumor has been successfully employed.
As for indirect therapy, the genes for IL-2, IL-7, HLA-B7, and CEA have been utilized to transfect the tumor cell (tumor vaccine), but evaluation of these strategies has not been completed.View full abstractDownload PDF (352K)
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