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Volume 59, Issue 10
Displaying 1-14 of 14 articles from this issue
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[in Japanese]2006 Volume 59 Issue 10 Pages 819-821
Published: 2006
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSDownload PDF (204K) -
A. Kurokawa, K. Kitsuki, M. Shimotani2006 Volume 59 Issue 10 Pages 822-826
Published: 2006
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSIn Japan, though infectious anorectal disease, especially STD, is tending to increase recently, reports on lesions, including STD are very few. Consequently there are complicated cases of diagnosis and treatment. By far the most common disease is fungal infection (73.6%), followed by condyloma acuminatum (12.1 %) and herpes simplex virus infection (10.3%) in infectious anorectal lesions confirmed at our proctological clinic. Recently, amebiasis STD is increasing in Japan, but condyloma lata as syphilis has not yet disappeared. While there is a lot of interest in anorectal disease as an opportunistic infection supervened AIDS (acquired immunodeficiency syndrome) in the USA, there are few reports in Japan. However, we recently had four cases of opportunistic infections.
Research has shown that contagion of condyloma acuminatum and amebiasis between the same sex and contagion of herpes are unexpectedly common among Japanese who travel overseas.View full abstractDownload PDF (4636K) -
T. Yamana2006 Volume 59 Issue 10 Pages 827-831
Published: 2006
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSTo clarify the prevalence of HIV infection in patients with benign anal diseases, we analyzed the preoperative HIV antibody tests (CLEIA, Western blot) in 8, 609 patients (5, 585 men) at our institution. There were 38 HW positive men. Eight patients had been followed as HIV infection and were referred from other hospitals. The remaining 30 patients were first diagnosed as HIV infection at our institution by preoperative check (0.5% in preoperative male patients). Most patients were in their 20's and 30's, and two thirds of the patients were men who had had sex with other men. Among HIV positive patients, the most frequent preoperative diagnosis was anal warts (20 patients), which is one of the common STDs caused by human papilloma virus infection. The second most frequent preoperative diagnosis was anal fistula (15 patients). HIV positive rate in the patients with anal warts was 29%. HIV positive patients with anal fistula and perianal abscess are considered to be at high risk of developing anal dysplasia and squamous cell carcinoma, and it seems necessary to follow those patients.View full abstractDownload PDF (456K) -
M. Sawamura2006 Volume 59 Issue 10 Pages 832-835
Published: 2006
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSBased on the prominence of sexually transmitted diseases (STDs) experienced at a downtown urological clinic, this paper presents considerations for daily clinical situations. With more people having sex in different ways, STDs are now found not only in the genitals but also in the mouth, pharynx, eyes, and even around the anus. Many STDs initially cause little or no subjective symptoms, and tend to become prolonged if the initial treatment is inappropriate. On the other hand, STDs generally respond well to early and appropriate treatment, and this fact emphasizes the importance of understanding STDs by clinicians, regardless of specialty. At Shinjuku Sakura Clinic, gonococcal infec-tions are seen both in males and females at about the same rate, which is not consistent with the nationwide statistics in Japan. Genital herpes and condyloma acuminata show remarkable increases in recent years, as well as broad-ening of infectious sites including the mouth and anus. The most clinically important STDs are syphilis and anal condyloma due to their possible indication of HIV infection.View full abstractDownload PDF (3024K) -
Y. Fujiwara2006 Volume 59 Issue 10 Pages 836-840
Published: 2006
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSProctogenic sexually transmitted diseases (STD) are outlined from the standpoint of gynecological management. Brief accounts, diagnosis and treatment of vulvovaginal candidiasis, amebiasis, syphilis, genital herpes, and genital warts are given. These pathogens can cause proctitis or proctocolitis in persons who participate in receptive anal intercourse. Treating one of these STDs, strong consideration should be given to the probability of other STDs. Especially in patients co-infected with HIV, the clinical course of the original STD is sometimes deteriorated.View full abstractDownload PDF (387K) -
K. Okawa, T. Aoki, W. Ueda, K. Sano, H. Oiya2006 Volume 59 Issue 10 Pages 841-845
Published: 2006
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSThis paper reports the characteristics of amebic colitis and Chlamydia trachomatis proctitis, which are representative sexually transmitted diseases of the rectum and anus encountered in the department of gastroenterology.
Since amebic colitis is usually transmitted sexually among male homosexuals, it is essential to check patients with it for complications of other sexually transmitted diseases, especially HIV infection. The diagnosis of amebic colitis can be made endoscopically by experienced physicians. However, definitive diagnosis requires the combination of findings from biopsy with the results of serum antibody test, fecal tests and other examinations. Chlamydia tra-chomatis proctitis is a sexually transmitted infection encountered in male homosexuals and female heterosexuals. In Japan, it is relatively common among young females. Although it is currently considered rare overall, the possibility cannot be ruled out that there are many undetected cases of it, and its prevalence is expected to increase in the future. One endoscopic feature of it is salmon roe-shaped elevated lesions affecting the lower segment of the rectum, and inflammation of lymphatic follicles is a principal lesion in affected patients. Definitive diagnosis of this disease requires detection of Chlamydia trachomatis antigen or DNA by exfoliative cytodiagnosis of the rectum.View full abstractDownload PDF (3166K) -
Y. Matsuda2006 Volume 59 Issue 10 Pages 846-850
Published: 2006
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSA special edition on sexually transmitted diseases (STD) of the anus and rectum was planned by a mediator to identify differences of STD among five specific institutes such as rural clinics, speciality coloproctological hospitals, and general hospitals. According to the data of national health care authorities and author's papers, STD has become prevalent among those in their 20s and 30s, especially young women.
In general, recent STDs include gonococcal infection, genital Chlamydia infection, genital herpes, condyloma ac-cuminatum, syphilis, and AIDS. Although gonococcal infection and genital Chlamydia infection have been decreasing in number, genital herpes and condyloma accuminatum have been increasing steadily.
The recent tendency of STD indicates higher prevalence among young women aged 15 to 20 then men, except for gonococcal infection. Further more, not only a single infection but also double or triple infections are characteristic. STD has extended not only to the genito-anal region but also the oral cavity and pharyngeal site, so the upper or lower digestive tract should be investigated hereafter.View full abstractDownload PDF (380K) -
A Study from the Japanese Society for Cancer of the Colon and RectumH. Kobayashi, Y. Hashiguchi, H. Ueno, M. Ishiguro, H. Mochizuki2006 Volume 59 Issue 10 Pages 851-856
Published: 2006
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSThe aim of this study was to clarify the characteristics of relapse of patients followed up intensively after curative resection for colorectal cancer. We enrolled 5, 317 patients who underwent curative resection at 14 hospitals from 1991 to 1996. The relapse rates of stage I, II, IIIa and IIIb were 3.7%, 12.5%, 24.1% and 40.8%, respectively. The relapse rate in patients with stage I colorectal cancer was constant during the 5-year follow-up. On the other hand, those in other stages increased rapidly during the first 3 years and gradually for the next 2 years. The relapse rate 5 years or later was less than 1 %. As for surveillance tools, the combination of clinical visits, physical examination and tumor marker measurement detected approximately half of the cases of relapse. The earlier the relapse occurred, the worse the prognosis after curative resection for colorectal cancer. The prognoses of the patients with curative resection for relapse were better than those without resection. However, the time to relapse made no difference in prognosis after curative resection for relapse. Further studies will be necessary to validate the efficacy of these intensive follow-up and surveillance tools.View full abstractDownload PDF (453K) -
T. Higuchi, M. Enomoto, K. Sugihara2006 Volume 59 Issue 10 Pages 857-862
Published: 2006
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSConsecutive 1, 599 stage I patients, who underwent curative resection at 16 institutions in Japan of the Study Group on Postoperative Follow-Up of Colorectal Cancer Patients from 1991 to 1996, were enrolled. The median follow-up period was 89 months.
Recurrences were observed in 20/814 (2.5%) patients with colon cancer and 57/785 (7.3%) with rectal cancer. The median period of the recurrences was 26 months. Cumulative appearance rates of recurrence were 68% and 92% within 3 and 5 years after surgery, respectively. Four of 488 (0.8%) with T1NO colon cancer had recurrences. All patients passed away due to a specified cancer. Sixteen of 326 (4.9%) with T2NO colon cancer had recurrences. Fourteen of 338 (4.1%) with T1NO rectal cancer had recurrences. Forty-three of 447 (9.6%) with T2NO rectal cancer had recurrences.
There were small numbers of recurrences in T1NO colon cancer, but once recurrence occurred, the prognosis was very poor. Follow-up may not benefit cases with T1NO colon cancer. In T2NO colon cancer, it may be reasonable that the follow-up system targets liver recurrence. T1NO and T2NO rectal cancer may be recommended to be followed up for liver, lung, and local recurrences.View full abstractDownload PDF (166K) -
M. Ishiguro, H. Mochizuki, K. Sugihara, K. Hirata, A. Murata, K. Hatak ...2006 Volume 59 Issue 10 Pages 863-868
Published: 2006
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSA total of 5, 358 patients with colorectal cancer who underwent curative resection from January 1991 to December 1996 were studied for the incidence of multicentric colorectal cancers and multiple primary cancers of other or-gans.
There were 211 cases of metachronous multiple primary cancers, and gastric cancer was most frequent (24%). The prevalence of synchronous multiple primary cancers was 3.5%, and that of synchronous gastric cancer was 1.6%, which was higher than that of gastric cancer found in mass screening in Japan. Screening for gastric cancer before surgery for colorectal cancer can be considered.
As this study did not demonstrate that patients after surgery for colorectal cancer had a high risk of metachro-nous multiple primary cancers, surveillance for metachronous multiple primary cancers may not need to be included in the follow-up program after surgery for colorectal cancer. The patients are recommended to receive mass screening.
The incidence of metachronous colorectal cancers after colorectal surgery was higher, so periodic follow-up for metachronous multicentric colorectal cancers should be recommended.View full abstractDownload PDF (203K) -
A Computer Registration and Administration SystemK. Shirouzu, H. Murakami, S. Ogou, Y. Akagi, Y. Ogata2006 Volume 59 Issue 10 Pages 869-873
Published: 2006
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSHigh-quality follow-up is important not to overlook the postoperative recurrence of colorectal cancer. We intro-duced a follow-up system using a personal computer, and briefly describe the oncologic results of our data. The software used was Visual dBASE (ver 5.6, Borland Company). The construction of this system made the registration, editing, and search very easy. An important point is to correctly input the clinical and pathological findings, the final confirmation date, the presence or absence of recurrence, the organs of recurrence and the recurrence confirmation data. In addition, it is important to try to reduce blank data and untraceable cases. The results of the follow-up based on this registration and administration system made it possible to precisely capture information of the recurrence organs and recurrence time with the follow-up rate of 98%. A computer registration system is very useful for high quality follow-up.View full abstractDownload PDF (323K) -
S. Tsuda2006 Volume 59 Issue 10 Pages 874-879
Published: 2006
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSThe main purpose of follow-up after endoscopic resection of colorectal cancer is to detect local residual lesion, recurrence, overlooked synchronous multiple cancer and metachronous multiple cancer. The present status of follow-up after endoscopic resection of colorectal submucosal cancer was analyzed with reference to re-ported papers to look for an appropriate method of surveillance.
Results : (1)To detect local residual lesion and overlooked synchronous multiple lesion, a strict examination is to be performed within one year, preferably within three to six months after treatment. (2)To detect local recurrence, a strict examination is to be performed within three to five years after treatment. (3)It was clarified that follow-up for a longer period is required to detect metastasis and metachronous multiple cancer. However, an appropriate method of surveillance according to respective risk of recurrence was not found. A more effective and efficient follow-up approach including financial cost should be established soon.View full abstractDownload PDF (237K) -
I. Hirata, S. Yasumoto, T. Nishikawa, K. Toshina2006 Volume 59 Issue 10 Pages 880-884
Published: 2006
Released on J-STAGE: March 03, 2010
JOURNAL FREE ACCESSWe have evaluated the optimal follow-up program after colonoscopic removal of colorectal neoplasia (adenoma and cancer), analyzing 354 cases who had undergone a colonic polypectomy and mucosectomy. To avoid overlooking lesions, we should perform at least two consecutive follow-up TCS (total colonoscopy) after the endoscopic resection of lesions. Based on our results, we advocate a follow-up program as follows. For the cases who have less than 3 le-sions with only adenoma at two follow-up TCS, we should perform one follow-up TCS every five years. On the other hand, for the cases who have less than 3 lesions with cancer, more than 4 lesions with adenoma or cancer at two follow-up TCS, we should perform follow-up TCS once every three years.View full abstractDownload PDF (183K) -
2006 Volume 59 Issue 10 Pages e1
Published: 2006
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSDownload PDF (17K)
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