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Volume 58, Issue 3
Displaying 1-8 of 8 articles from this issue
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A. Matsumoto, S. Hiranuma2005 Volume 58 Issue 3 Pages 133-140
Published: 2005
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESS -
R. Mori, K. Koganei, A. Sugita, H. Shimada2005 Volume 58 Issue 3 Pages 141-145
Published: 2005
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSA 46-year-old man was diagnosed as having ulcerative colitis in 1989. Because his medical treatment was not effective, total colectomy with Heal pouch anal anastomosis was performed. Four months later, ileostomy was performed because of late fistula at the anastomotic site, and it had not been closed as he did not want an operation. A giant ulcer emerged on the peristomal skin in June 2001, and was diagnosed as peristomal pyoderma gangrenosum (PPG). Predonisolone and cyclosporin were administered but were not effective, but clofazimine was effective and signs of his ulcer diminished by using clofazimine. After this therapy, he had local treatment with ointment containing steroid only. PPG complicating ulcerative colitis can arise even long after a total proctocolectomy. PPG as a significant complication of ulcerative colitis with stoma should be considered.View full abstractDownload PDF (260K) -
S. Yoshitani, Y. Tanaka, K. Kishimoto, H. Harada, S. Takashima2005 Volume 58 Issue 3 Pages 146-151
Published: 2005
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSA case of malignant lymphoma of ileocecal origin with an unusual macroscopic appearance is described. The patient was a 47-year-old woman who came to our institution due to right lower abdominal pain. A mobile mass measuring 5.0×3.0 cm was palpable in the right lower abdomen. A filling defect with an irregular surface was seen in the cecum on barium enema, and small bowel follow-through revealed multiple filling defects of various sizes closely spaced over the last 15 cm of the terminal ileum. Based on preoperative biopsy results indicating B-cell lymphoma, a right hemicolectomy was performed. In addition to a Borrmann I tumor in the cecum, a total of 22 polypoid lesions were seen over the last 15 cm of the terminal ileum. These lesions ranged in size from 1 to 3 cm and had a morphology similar to multiple lymphomatous polyposis (MLP). Histopathological examination revealed that the tumor cells were small lymphoid cells, with no lymphoepithelial lesions. On immunohistological staining, the lesions were positive for the B-cell surface markers CD20 (L-26) and CD10, with overexpression of BCL2. Thus, a diagnosis of low grade follicular B-cell lymphoma was made. This case showed an extremely unusual morphology with a Borrmann I tumor in the cecum and MLP-like lesions in the terminal ileum.View full abstractDownload PDF (475K) -
Y. Moritani, T. Ishii, T. Takiue2005 Volume 58 Issue 3 Pages 152-158
Published: 2005
Released on J-STAGE: March 03, 2010
JOURNAL FREE ACCESSA case of von Willebrand's disease (vWD), which is a bleeding disorder diagnosed by postoperative bleeding of internal hemorrhoids, is presented. The patient was a 53-year-old female who had received conservative therapy for anal prolapse and bleeding at a near-by clinic. Subsequent ligation of internal hemorrhoids resulted in difficult hemostasis and she was sent to our hospital because of excessive anal bleeding.
On the 11th and 17th days after ligation and excision of the internal hemorrhoids, postoperative bleeding occurred. A decrease in factor VIII activity and decrease in von Willebrand factor were observed, which led to the diagnosis of von Willebrand's disease. The patient was given dry human blood coagulation factor VIII concentrate agent (Confact®F) with favorable outcome. Von Willebrand's disease is a bleeding disorder in which primary hemostasis is impaired due to an abnormality of the von Willebrand factor.
In Japan, there have been 22 reported cases of surgeries in patients with vWD since 1987 including ours.
No case of surgery for anal disease in a patient with vWD has been reported.View full abstractDownload PDF (3080K) -
A. Matsuda, K. Takahashi, T. Yamaguchi, H. Matsumoto, H. Miyamoto, K. ...2005 Volume 58 Issue 3 Pages 159-163
Published: 2005
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSWe experienced a case of advanced rectal cancer with polycythemia vera (PV) . A 56 years old woman had been treated for PV for about four years. Barium enema and colonoscopic examination were performed because of lower abdominal pain. She was detected to have an advanced rectal cancer locating in the rectosig-moid. Preoperative blood examination revealed red blood cell count ; 765×104/μl, white blood cell count ; 22.0×103/μl, platelet count ; 65.2×104/μl, hemoglobin ; 14.9g/dl, hematocrit ; 49.4%. On June 2, 2004 anterior resection with D3 lymphnode dissection was carried out. Fresh bloody discharge from the abdominal drain and from the anus was seen since 24hous after operation. We considered that this bleeding tendency was derived from the abnormalities of the platelet function induced by anesthesia and the surgical stress. After the platelet transfusion, no hemorrhagic complications occurred. For the prevention of postoperative he-matological complications in PV cases, it seemed that postoperative severe management of coagulation and fibrinolytic system is as important as preoperative hematological control.View full abstractDownload PDF (1875K) -
K. Watanabe, M. Watanabe, H. Masuda2005 Volume 58 Issue 3 Pages 164-168
Published: 2005
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSIt has been reported that LSIS is a good surgical indication for patients with high MARP. However, de-tailed studies on the relation between the indication and MARP have not been reported.
Patients and Methods : This study included 154 patients with anal fissure, who underwent LSIS, between September 1998 and March 2003. Based on the value of preoperative MARP, the 154 patients were divided into four groups : group A, less than 100mmHg ; group B, 100mmHg to 150mmHg ; group C, 150mmHg to 200mmHg ; group D, more than 200mmHg. MARP was measured at three additional points in time : after local anesthesia, immediately after LSIS and healing stage. In addition, the rate of decrease of MARP was calculated after each treatment.
Results : The rate of decrease of MARP after local anesthesia in group A was 33.8±18.1 %, which was significantly lower than that of the other three groups. In group D, the rate of decrease of MARP at the healing stage against preoperative MARP was the highest (52.9±21.6%), and there was a tendency that, as the preoperative MARP was higher, the rate of decrease of MARP at the healing stage was higher.
Conclusion : We think that continual measurement of MARP is important for determining the surgical indication of LSIS.View full abstractDownload PDF (333K) -
T. Utsunomiya, O. Shibata, S. Kikuta, Y. Horichi2005 Volume 58 Issue 3 Pages 169-174
Published: 2005
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSWe investigated the effects of low-frequency electrostimulation on 19 male and 42 female patients who suffered from chronic intractable anorectal pain. Electrostimulation was applied in the anal canal of these patients for 5 minutes once or twice a week. Anorectal manometry was used to assess the ratio of male and female patients with anorectal dysfunction, which did not seem to evoke chronic anorectal pain directly. In addition, 9 of the male and 12 of the female patients were measured for anal tissue blood flow using a non-invasive laser blood flow meter. Blood flow and velocity in the anal canal tissue were significantly enhanced by electrostimulation (p<0.01). Ninety-eight percent of the patients were successfully relieved of pain by the low-frequency electrostimulation at an average time of 3.5±1.6. It is concluded that low-frequency elec-trostimulation is an effective means of relief from intractable anorectal pain by direct resolution of the pain and an increase of anal tissue blood flow.View full abstractDownload PDF (480K) -
2005 Volume 58 Issue 3 Pages 175-178
Published: 2005
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSDownload PDF (555K)
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