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Volume 51, Issue 1
Displaying 1-9 of 9 articles from this issue
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N. Oshitani, Y. Jin-no, H. Yamahami, S. Sasaki, N. Hamasaki, S. Sawa, ...1998 Volume 51 Issue 1 Pages 1-5
Published: 1998
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSModerately severe attacks of UC in 6 outpatients (5 males and 1 female) were treated by steroid-pulsed therapy. Two patients had total colitis and 4 had left-sided colitis type. The ages of pafients range from 25 years to 49 years, with a mean of 34 years. For one course of the treatment, 1g of methylprednisolone was administered intravenously in 500 ml solution over a 2 hr period as the daily dose for each of 3 consecutive days, and was not administered on the next 4 days. Three patients received 1 and 2 courses of the treatment respectively. As a result, 3 patients had clinical remission, 1 patient responded, and 2 patients did not respond to the therapy. Four patients that responded and had remission avoided becoming inpatients.View full abstractDownload PDF (268K) -
M. Yamada, T. Sakurai, H. Furukawa, T. Matsui, T. Yao1998 Volume 51 Issue 1 Pages 6-17
Published: 1998
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSEnteral nutrition (EN) has been shown to control the activity of Crohn's disease. Therefore, the purpose of this study was to clarify factors influencing the induction of remission.
From 1985 to 1992, 87 active patients (25 ileitis, 31 ileocolitis, 11 colitis, 17 ileocolostomies, and 3 with only aphthoid lesions) treated with EN were analyzed. These 87 patients were divided into two groups (67 patients with remission and 20 patients without) based on clinical response to the treatment. Remission was defined as CDAI<150 and ESR <20 mm/hr. after 4weeks of treatment. Clinical characteristics and radiographic findings (scored severity of the findings) were compared between the two groups. Furthermore, multiple logistic regression analysis was performed to clarify the relative importance of various clinical or radiographic factors associated with remission.
Remission rate at 4weeks with EN was 77%. From multiple variable analysis using 11 factors which were significant by single valuable analysis, only four factors (times of previous nutrition therapy, melena, high level of CDAI, and severe cobblestone appearance of the large intestine) were selected as significant valuable factors.
From the above-mentioned results, it was concluded that patients, who underwent frequent nutritional therapies, had severe clinical activity, and had severe colonic lesions tended to be resistant to enteral nutrition. Both clinical and radiographic features are important prognostic factors in predicting response to nutritional therapy.View full abstractDownload PDF (784K) -
S. Miura, M. Nishioka, K. Nozawa, M. Fujita, H. Aoki, H. Wada, T. Shat ...1998 Volume 51 Issue 1 Pages 18-23
Published: 1998
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSA 22-year-old male-to-female transsexual was admitted to our clinic with a complaint of gas and fecal discharge from the neo-vagina. Sex reassignment surgery, including construction of the neo-vagina, had been performed 22 months previously. Contrast radiography and endoscopy revealed a high fistula located near the vault and partial loss of the epithelial lining of the vagina.
Transsacral route excision of the fistula was performed with layer closure plus interposition of the mesorectum. The patient has been recurrence-free for more than 3 years since the repair. Vaginal function was not restored in the present case because he refused to allow his body to be injured. Repair of rectovaginal fistula as a complication of sex reassignment surgery seems difficult due to the obturator decubitus caused by protracted use of a stent to prevent vaginal shrinkage and wide dissection of the perineum. The incidence of this complication may be underestimated because of shortness of the observation period.View full abstractDownload PDF (2883K) -
H. Sato, M. Maruta, K. Maeda, T. Utsumi, K. Tohyama, Y. Okumura, K. Ma ...1998 Volume 51 Issue 1 Pages 24-29
Published: 1998
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSMultiple carcinoid tumors of the rectum is rare and the accumulated number of the cases in Japan is 13. Carcinoid tumors less than 10 mm in diameter have little metastasis. A case of multiple carcinoid tumors 9mm in maximal diameter with node metastasis was reported herein.
A 64-year-old male with abdominal discomfort visited our hospital. Colonoscopic examination showed several carcinoid tumors of the middle rectum, and low anterior resection was carried out. The resected specimen demonstrated 9 separate carcinoid tumors from the mid-rectum to rectosigmoid colon. Three of 14 examined lymph nodes were found to be metastatic, and all tumors were less than 10 mm in diameter. The patient is doing well 12 months after surgery, without evidence of recurrent or metastatic disease.View full abstractDownload PDF (3159K) -
K. Koseki, K. Yaegashi, R. Ohno, N. Hoshino, M. Ito, K. Sugihara1998 Volume 51 Issue 1 Pages 30-34
Published: 1998
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSA 43-year-old male was admitted to our hospital complaining of right lower abdominal pain. An elastic hard mass with tenderness was palpable. Barium enema revealed the mass between the ileum and the cecum, but failed to show the appendix. Colonoscolpic examination revealed an elevation at the orifice of the appendix. Operative findings proved that the hard mass, 7×6cm in diameter, was attached to the surrounding organs, including the appendix. Right hemicolectomy was performed. Histopathologically, the tumor consisted of proliferation of fibroblasts and inflammatory cells. These histopathological findings revealed that the tumor was inflammatory pseudotumor (IPT) in the appendix vermiformis.
IPT in the appendix is rare, and the etiology and pathogenesis are not known to have the same natural history as that in other gastrointestinal tract cases.View full abstractDownload PDF (2973K) -
M. Arita, M. Okajima, T. Asahara, R. Kobayashi, Y. Ojima, K. Toyota, M ...1998 Volume 51 Issue 1 Pages 35-40
Published: 1998
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSA 69-year-old female was admitted to our hospital because of lower abdominal pain and bloody stool. Barium enema and colonoscopy revealed type 2 sigmoid colon cancer, so sigmoidectomy was performed. Histologically, the tumor was moderately differenciated adenocarcinoma invading the subserosa (ss, n1+). Retrospectively, the barium enema taken 23 months before showed a type Isp elevated lesion, sized 0.6cm, at the same site. Furthermore, the film taken 8 months before showed a type 1 advanced tumor, sized 3.1cm. The tumor doubling time was very short, 76.4 days, and the doubling time of the late stage was 117.9 days, longer than that of the early stage, 64.4 days. Overexpression of p53 protein and strong activity of Ki-67 were suggested to be related to the rapid growth. In the future, further study on the relation between the tumor doubling time and molecular biological examination was considered to be important.View full abstractDownload PDF (4097K) -
Y. Funayama, I. Sasaki, H. Naito, K. Fukushima, C. Shibata, N. Ohtani, ...1998 Volume 51 Issue 1 Pages 41-46
Published: 1998
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSPyoderma gangrenosum (PG) is a rare complication in inflammatory bowel disease. The characteristics and the treatment of PG for two patients treated in our hospital were discussed.
One patient, a forty-two-year-old female, underwent ileal J pouch anal anastomosis and loop ileostomy for intractable colitis. Peristomal PG and cuff abscess developed 2 months after the operation. Two months later, she had complications of aortitis syndrome and deteriorated peristomal ulcer. She was administered 6 mg/day of dexamethasone and given an epidural block during the change of appliance. The other patient, a fifty-four-year-old female, underwent subtotal colectomy, rectal mucous fistula, and ileostomy for severe attack of colitis. She visited our clinic 2 months after the operation for peristomal PG. She was administered 30 mg/day of prednisolone. In both cases, no improvement was obtained by stoma care alone. After the start of steroid treatment, PG was healed in 3 to 4 months. Stoma care was performed using irrigation, powder and paste, and skin barrier appliance. Parastomal PG has the characteristic changes of the skin, which showed painful cyanotic swelling initially and then undermining serpiginous ulceration with poor granulation in the ulcer base. Histopathological findings showed perivascular infiltration of lymphocytes in erythematous skin and non-specific inflammation at the ulcer edge.View full abstractDownload PDF (2971K) -
K. Nakagawa, S. Momono1998 Volume 51 Issue 1 Pages 47-51
Published: 1998
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSSeven adult cases of intussusception which had been resected within the past twelve years was reported. Their mean age was 64.7 years, and male-female ratio was 3 : 4. Preoperative examinations led to a diagnosis of intussusception caused by an intestinal tumor in all the patients. Preoperative and intraoperative reduction of intussusception was successful in 6 cases, the remaining case underwent colonoscopic reduction after transanal resection of the prolapsing tumor. Two patients with malignant lymphoma of the ileum underwent right hemicolectomy. One patient with lipoma of the transverse colon underwent transverse colectomy associated with lapar scopy. One patient with cancer of the descending colon underwent left hemicolectomy. Two patients with sigmoidal cancer underwent sigmoidectomy, and one patient with prolapsing sigmoidal cancer from the anus underwent tumor resection. For prognosis, all patients have survived except one who died of cancer. Although it is genenally agreed that resection without reduction is preferable for the treatment of adult colonic intussusception because of the high probability of malignancy, in some cases of poor risk such as an advanced age, initial reducion seems necessary so as to minimize surgical intervention.View full abstractDownload PDF (2521K) -
Y. Shibata1998 Volume 51 Issue 1 Pages 52-55
Published: 1998
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSElevan patiens (Group A) who underwent drainage and transient loop colostomy with idiopathic perforation of colon, perforetion of colom diverticulosis, or iatrogenic perforation of colon by colonofiber were examined by serial anal sphincter measurements. Values were recorded, and barium enema was studied before colostomy closure. Five healthy subjects (B group) were also examined. Resting anal pressure was 84.lmmHg (median) (A) and 129.3mmHg (B), respectively (p<0.05). Anal squeeze pressure was 163.4 mmHg (A) and 212mmHg (B) (p=NS) . Anal pressure at increasing intra-abdominal pressure was 94.8mmHg (A) and 153mmHg (B) (p<0.05) . Anal pressure at cough was 122.4mmHg (A) and 162mmHg (B) (p=NS) . By barium enema, 7 a diameter of anal colon of colostomy tended to be narrow. Anal sphincter tones after transient loop colostomy were decreased, but functional disorders during consciousness were not observed.View full abstractDownload PDF (243K)
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