Nihon Daicho Komonbyo Gakkai Zasshi
Online ISSN : 1882-9619
Print ISSN : 0047-1801
ISSN-L : 0047-1801
Volume 52, Issue 6
Displaying 1-13 of 13 articles from this issue
  • -Retrospective Investigation into Exciting Cause and Natural Course-
    M. Asano, T. Mori, K. Takahashi, M. Yasuno
    1999 Volume 52 Issue 6 Pages 473-478
    Published: 1999
    Released on J-STAGE: October 16, 2009
    JOURNAL FREE ACCESS
    Seventeen cases of obstructive colitis secondary to colorectal carcinoma were retrospectively analyzed to investigate the exciting cause and natural course.
    The resected specimens were classified into three groups according to macroscopic appearance, spreading type, irregular type, and longitudinal type. The length of the ulcer and the pathological finding of each type showed healing and cicatrization occur in this order.Clinical onset of obstructive colitis was identified in seven cases, and the interval between clinical onset and operation of each type was 2.0, 16.6, and 37.5 days, respectively. Four of the seven cases underwent bowel treatment (enema, cathartic, or their combination) just before the clinical onset, and bowel treatment was thought to be the exciting cause of obstructive colitis.
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  • T. Yamana, M. Oya, H. Ishikawa
    1999 Volume 52 Issue 6 Pages 479-488
    Published: 1999
    Released on J-STAGE: October 16, 2009
    JOURNAL FREE ACCESS
    The aims of this study were to evaluate postoperative defecatory function after low anterior resection with colonic J-pouch reconstruction for middle or lower rectal cancer and to analyze the relationship of postoperative defecatory function with the results of preoperative and postoperative anorectal physiological study. Clinical assessment using a standard questionnaire about defecatory function, combined with anorectal physiological studies before and after operation were carried out in 31 patients. At 6 and 12 months after operation, mean bowel frequency was 4.3/day and 3.4/day, respectively. The incidence of minor fecal incontinence was 64 % and 58 %, and that of urgency was 45% and 39%. Evacuation difficulty was found in 46% and 24%, respectively. Although maximum basal pressure (MBP) and maximum tolerable volume of the rectum (MTV) significantly decreased at 6 months after operation, those at 12months after operation did not differ from preoperative values. Patients having low postoperative MBP had poor defecatory function. Univariate and multi-variate analysis showed that the risk of postoperative minor incontinence was predictable from patients' age, gender, the extent of pelvic autonomic nerve perservation, preoperative irradiation, and preoperative MBP, rectal sensory threshold, and MTV.
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  • K. Ishii, T. Fujimura, K. Taniguchi, E. Bando, T. Miyashita, Y. Michiw ...
    1999 Volume 52 Issue 6 Pages 489-494
    Published: 1999
    Released on J-STAGE: October 16, 2009
    JOURNAL FREE ACCESS
    A rare case of goblet cell carcinoid of the vermiform appendix was reported. A 90-year-old male complained of right lower abdominal pain. Physical examination revealed a 4-cm hard mass in the right iliac region, but there were no findings by image examination and follow-up was done. He was admitted due to tarry stool after 3 weeks. Upper gastrointestinal endoscopic examination revealed multiple hemorrhagic gastric ulcers and possible endoscopic hemostasis Distal gastrectomy was performed because of incomplete hemostasis. Since the tumor was found in the ileocecal region, ileoceal resection was performed at the same time.Histological investigation revealed a goblet cell carcinoid of the appendix because mucin-producing goblet cell and endocrine cell that was positive in chromogranin stain mixed. A goblet cell carcinoid has a course almost worse than common carcinoid and its histological malignancy is similar to cancer. Therefore, it is necessary to investigate histologically and observe its course sufficiently.
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  • K. Takizawa, M. Maruta, K. Maeda, T. Utsumi, M. Fujisaki, T. Takahashi ...
    1999 Volume 52 Issue 6 Pages 495-498
    Published: 1999
    Released on J-STAGE: October 16, 2009
    JOURNAL FREE ACCESS
    Successful management of hemorrhage aneurysm of the ileocolic artely by transcatheter arterial embolization (TAE) is described herein.
    A 80-year-old woman with a history of sigmoid colon polyp and cerebral infarction was admitted to our hospital because of acute intestinal bleeding. Emergent colonoscopy revealed massive fresh bleeding on the oral side of the Bauhin valve.
    Angiography of the superior mesenteric artery showed a small aneurysm of the ileocolic artery and extravasation of contrast medium into the intestinal lumen. TAE with gelform was immediately carried out successfully. The patient was discharged from the hospital on the 9th day.
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  • K. Yamada, T. Maeda, T. Chisa, R. Fukuda, H. Nozaki, R. Makizumi, T. S ...
    1999 Volume 52 Issue 6 Pages 499-504
    Published: 1999
    Released on J-STAGE: October 16, 2009
    JOURNAL FREE ACCESS
    Dermatomyositis is associated with a high frequency of malignancy and characterized by a cutaneous paraneoplastic syndrome. An association between dermatomyositis and malignancy have been discussed. In this case report, a patient who had dermatomyositis and colon cancer with liver metastasis is described. A 58-year-old male with dermatomyositis was admitted to our hospital in order to examine the malignancy. Stool specimens were positive for occult blood and the serum CEA level was high. Colon examination and abdominal CT scanning indicated colon cancer with liver metastasis. Following successful surgical treatment, there was improvement in muscle strength and the aldolase level was normalized. Previous cases with malignancy were reviewed in order to investigate the association between dermatomyositis and malignancy. Seventeen cases of recent Japanese literature of dermatomyositis associated with colon cancer revealed that these symptoms were improved after surgery in most cases. These results suggested that colon cancer may cause dermatomyositis or may worsen dermatomyositis in some cases.
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  • T. Hagimoto, K. Ohdera, K. Nakata, M. Seo, M. Okada, A. Tomita, Y. Yam ...
    1999 Volume 52 Issue 6 Pages 505-511
    Published: 1999
    Released on J-STAGE: October 16, 2009
    JOURNAL FREE ACCESS
    A 74-year-old female was admitted to our hospital with a complaint of abdominal pain and vomiting. Double contrast study on the small intestine revealed segmental concentric narrowing in the ileum. Bowel resection was performed because her symptoms continued and repeat double contrast study indicated severe stenosis.
    Macroscopically, the resected specimen had segmental annular narrowing and marked thickening of the wall. Histologically, the resected specimen had UI-II ulcer, inflammatory cells infiltration and fibrosis mainly in the submucosa. Many hemosiderin-laden macrophages were found in all layers. These findings were compatible with those of ischemic enteritis.
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  • K. Koda, K. Yanagisawa, N. Kanazawa, H. Taniguchi, K. Fukao
    1999 Volume 52 Issue 6 Pages 512-518
    Published: 1999
    Released on J-STAGE: October 16, 2009
    JOURNAL FREE ACCESS
    A novel reconstruction method following pelvic exenteration was reported. A 60-year-old male with sigmoid colon cancer that infiltrated to the seminal vesicle, middle rectum, and trigone of the bladder underwent curative pelvic exenteration with preservation of urinary and anal sphincter functions. Ileal neobladder was anastomosed to the urethra close to the external sphincter, whereas the double stapling method was used for the anal canal and descending colon anastomoses, resulting in stomaless reconstruction. Several types of tube drainage, especially the use of tube caecostomy and trans-gastric ileus tube that prevented defecation and flatus for 14 days following the operation, were employed for protection against anastomotic leakage.Major omentum was packed in the pelvis for fixation of the anastomoses and for prevention of postoperative pelvic abscess. The quality of life of this patient was significantly better than that usually seen in conventional reconstruction using double stoma. The technical issue and indication of this reconstruction method were discussed.
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  • Y. Tsuji, M. Takano, J. Kuromizu
    1999 Volume 52 Issue 6 Pages 519-523
    Published: 1999
    Released on J-STAGE: October 16, 2009
    JOURNAL FREE ACCESS
    one hundred seventy-three cases of hemorrhoids were operated on in our hospital from September 1993 to December 1995. Intense pain in 4$ of the hemorrhoid cases was investigated, and the results were as follows
    1. Intense pain occurred 27.7 % of the hemoeehoid cases.
    2. The incarcerative hemorrhoid cases had a higher incidence rate of intense pain than normal hemorrhoid cases.
    3. When the relationship between pain and anal resting pressure was investigated there were many cases with intense pain when the anal pressure is higher than normal. Therefore, for cases with high resting pressure preoperatively, partial sphincterotomy should be recommended.
    4. As for postoperative intense pain, 89.6 % occurred either on the day of or one day after operation. Therefore, it was thought that analgesics should be administered on both days.
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  • H. Tomochika, S. Nakamura, S. Fujii, O. Ishihara, K. Kimura, S. Sato, ...
    1999 Volume 52 Issue 6 Pages 524-528
    Published: 1999
    Released on J-STAGE: October 16, 2009
    JOURNAL FREE ACCESS
    Sphincter-preserving surgery for low intersphincteric anal fistulas is performed to maintain the shape and function. This technique has undergone various modifications in order to obtain a high cure rate in addition to the above advantages. In our basic procedure, the primary focus is dissected from the secondary opening so as to minimize the defect in the internal sphincter that is created by dissection of the fistulous tract from the primary opening.Then the primary opening is closed by suturing.
    In patients with little damage to the internal sphincter, the fistulous tract does not recur easily even if the primary opening is not reconstructed. Therefore, 40 patients were treated by a method in which the fistulous tract within the internal sphincter was not dissected and the sphincter was left intact as a screen. With this method, favorable results have been obtained so far without suturing the primary opening. This method is also advantageous with regard to the maintenance of anal function.
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  • [in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    1999 Volume 52 Issue 6 Pages 529-530
    Published: 1999
    Released on J-STAGE: October 16, 2009
    JOURNAL FREE ACCESS
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  • [in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...
    1999 Volume 52 Issue 6 Pages 531-532
    Published: 1999
    Released on J-STAGE: October 16, 2009
    JOURNAL FREE ACCESS
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  • 1999 Volume 52 Issue 6 Pages 533-540
    Published: 1999
    Released on J-STAGE: October 16, 2009
    JOURNAL FREE ACCESS
    Download PDF (1626K)
  • 1999 Volume 52 Issue 6 Pages 541-579
    Published: 1999
    Released on J-STAGE: October 16, 2009
    JOURNAL FREE ACCESS
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