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Volume 27, Issue 12
Displaying 1-18 of 18 articles from this issue
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A Study of Endotoxemia of Post Operative Period in Esophageal Varices Patients by Using Limulus TestDiscrepancy between Toxicolor and EndospecyMitsuru Kikuchi, Masatoshi Watanabe, Ryuji Nakamura, Kazuyoshi Saito, ...1994 Volume 27 Issue 12 Pages 2517-2522
Published: 1994
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSRecent advances in Limulus coloremetric testing have made it possible to quantitatively differentiate serum endotoxin specific activity (Endospecy: ES) from non-specific activity (Toxicolor: TOX) including the quantity via the other action pathway (factor G activating factors: G PAF) in addition to ES. We studied postoperative canges in the values of ES and G PAF in 13 patients with esophageal varices. Blood was takenbefore the operation and on postoperative days (POD) 1, 3 and 5, and treated before measurement by a new perchloric acid (PCA) method that we recently developed. G PAF increased on the first POD (130.6 pg/ml) from the preoperative value (46.3 pg/ml) (p<0.05), and decreased thereafter. Heating (100°C120 min) the samples (n=5) and removing lipid from them decreased their G PAF value only slightly. The new PCA pretreatment and the conventional PCA method showed the same degree of increase in G PAF in the supernatant on POD 1. As the above experiment results show, postoperative transient endotoxemia is seemed to cause by non-endotoxic Limulus reactive substances by surgical injury.View full abstractDownload PDF (11018K) -
Junichi Hasegawa, Kazuyasu Nakao, Masaaki Nakahara, Nobuo Ogino, Toshi ...1994 Volume 27 Issue 12 Pages 2523-2529
Published: 1994
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSThe utility of nucleolar organizer regions-associated proteins (AgNORs) for estimating proliferative activity and prognosis of gastric non-Hodgkin's lymphomas (NHL) was examine. Formalin-fixed and paraffin-embedded sections of 31 patients with gastric NHL were used. AgNORs count was taken as a mean dot number of 100 nuclei. The AgNORs count revealed a good correlation with S-phase fraction measured by flow cytometry (p<0.01). Several histologic and clinical factors including AgNORs count were evaluated as prognostic factors by single variant analysis, and it was proved that Naqvi classification, AgNORs count and resectability were significant prognostic factors (p< 0.01). Among these factors, Cox's multivariate analysis indicated that AgNORs count was a most important prognostic factor (p<0.05). In patients with curative surgery, AgNORs count of relapsed cases after operation were higher than that of not relapsed cases (p<0.01). These results suggest that AgNORs count reflects proliferative activity and is useful as a prognostic index of gastric NHL.View full abstractDownload PDF (12577K) -
Kaoru Ohashi, Gotaro Orihata, Hiroshi Kanda, Shinsuke Ohura, Kuniaki K ...1994 Volume 27 Issue 12 Pages 2530-2535
Published: 1994
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSThe clinical features and surgical results were studied in 19 cases of solitary gastric varices. Blood supply to the gastric varices was classified into the following three groups: Group I (left gastric vein dominant type), two cases; Group II (left and posterior, short gastric vein equivalent type), six cases; and Group III (posterior, short gastric vein dominant type), eleven cases. Gastrorenal shunt was found in 18 of the 19 cases. The Groups I and II showed significantly higher NH3 levels in peripheral blood than Group III (p<0.05). In groups I and II, the serum NH3 level in the inferior vena cava showed significant elevation above the influx of the renal vein (p<0.05); however, in Group III the caval NH3 level was almost the same above and below of the renal vein. Devascularization of the upper half of the stomach blocked completely inflow and outflow routes forming the gastric varices. In this clinical study, gastric varices disappeared without recurrence after Hassab's operation. The 5-year cumulative survival rate was 52.14%.View full abstractDownload PDF (12624K) -
Takao Suzuki, Takenori Ochiai, Matsuo Nagata, Yoshio Gunji, Kazuaki Na ...1994 Volume 27 Issue 12 Pages 2536-2542
Published: 1994
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSIn order to evaluate the immune response of patients with gastric cancer, immunological examinations including an analysis of Imyphokine-activated killer (LAK) activity were performed. Materials were mononuclear cells derived from regional lymph nodes, the spleen and peripheral blood of 20 patients with gastric cancer. Spleen and peripheral blood LAK activities were higher than regional lymph node LAK activity (p<0.05). The percentage of suppressor T cells was lower in lymph nodes than in peripheral blood (p<0.05). In contrast, the percentage of killer T cells was almost the same among these tissues. Peripheral blood LAK activity induced without interleukin-2 was lower in patients with lymph node metastasis than in those without metastasis (p<0.05). The percentage of memory helper T cells was lower in group 1 lymph nodes of patients with lymph node metastasis than in those of patients without lymph node metastasis (p<0.05). However, LAK activity and the subpopulation of mononuclear cells were not influenced by serosal invasion. The present study reported the usefulness of immunological examinations including an analysis of LAK activity in patients with gastric cancer.View full abstractDownload PDF (12338K) -
Naoki Takahashi1994 Volume 27 Issue 12 Pages 2543-2550
Published: 1994
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSThe efficacy of an anticancer drug-containing lipiodol emulsion administered for the prevention of hepatic metastasis was investigated in relation to the route of administration. Epirubicin at 0.5 mg/kg emulusified with lipiodol was given to rebbits via the hepatic artery (IA) or portal vein (IP), and changes in tissue concentration and blood biochemical parameters were determined. One million VX2 tumor cells were then transplanted via the portal vein, and the emulsion was given via the IA or the IP 3 days (settlement phase) or 10 days (occult hepatic metastasis phase) later. The efficacy of the drug was evaluated in terms of the number of metastatic foci on the hepatic surface 16 days after transplantation. The concentration of the drug in hepatic tissue persisted at 1μg/g for more than 5 h after administration, regardless of whether it was given via the IA or the IP. Both administration routes were associated with an increase in GOT and GPT, although this was transitory. The number of metastatic foci was significantly lower (p<0.05) in animals treated via the IA or Ip than in controls during the settlement phase. Howerver, in the occult hepatic metastasis phase, only the IA group showed a significant difference (p< 0.05) from the control group. These results indicate that both the IA and IP routes are effective in the very early stage of hepatic metastasis, whereas the IA route alone is effective against foci of subsequent occult hepatic metastasis.View full abstractDownload PDF (17037K) -
Ryouichi Tomita, Yasuhiko Kurosu, Masaru Isozumi, Katsuhisa Tanjoh, Ke ...1994 Volume 27 Issue 12 Pages 2551-2556
Published: 1994
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSTwelve patients with ulcerative coliltis (UC) and adenomatosis coli (AC) were manometrically studied and compared with 15 healthy volunteers as controls. All of these 12 patients underwent total colectomy, mucosal proctectomy, and ileal J pouch-anal anastomosis (short rectal cuff). There was 8 men and 4 women, aged 14-56 years (mean 39.2 years). The median follow-up time from closure of the diverting ileostomy was 53.9 months (ragne 20-106). No patient experienced any major complications in the postoperative course. Five patients did experience a small amount of occasional soiling, and compared with the remaining seven and 15 healthy volunteers, the group of five patients with soiling showed the lowest results in the anaorectal manometry (anal sphincer dysfunction; shorten of anal canal length, lower resting and squeeze pressure, anorectal sensory dysfunction; increase of sensory threshold volume, rest-rectal capacity dysfunction; decrease of complicance). These results are probably due to remaining inflammation at the rectal cuff in the UC group and injury to the anorectal apparatus caused during the operation.View full abstractDownload PDF (10740K) -
Tsutomu Nomura, Koji Sasajima, Masao Miyashita, Yuuichi Sugisaki1994 Volume 27 Issue 12 Pages 2557-2563
Published: 1994
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSIt has been suggested that phospholipase A2 (PLA2) plays an important role in the development of shock in patients with endotoxemia. The PLA2 activity was reported to be elevated in the serum of patients with endotoxin shock. To determine the origin and mechanism of the elevated PLA2 activity, we made an endotoxin shock model in rats by injecting 5 mg of lipopolysaccharide (LPS) per kg, intravenously. Serum PLA2 activity increased from 194±25 to 359±56 pmol/ml/min (mean±SEM) 30min after the LPS injection. The PLA2 activity in the liver homogenates also increased from 7.8±0.6 to 10.2±0.2 pmol/mg protein/min after 30min. The increased PLA2 activity was shown to be heat labile and calcium-ion dependent. Ultrastructural enzymehistochemically, PLA2 activity was found in the lysozome membrane of damaged hepatocytes and Kupffer's cells. These results suggest that the increase in heat labile and calcium-ion dependent PLA2 activity is related to tissue damage in the endotoxin shock model.View full abstractDownload PDF (14166K) -
Akira Hayashibe, Hajime Tanaka, Hideki Kitoh, Kazutsugu Sakamoto, Eiji ...1994 Volume 27 Issue 12 Pages 2564-2568
Published: 1994
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSThree patients with unresectable esophageal cancer were treated with silicone-coated selfexpandable metallic stents. Patient 1 was a man aged 49 years with unresectable cancer of the proximal esophagus owing to esophagobronchial fistula and intrabronchial dissemination. He was treated with a silicone-coated self-expandable metallicstent as palliative therapy. Patient 2, a man aged 61 years, was diagnosed with cancer of the proximal-middle esophagus, but we could not perform a radical operation because of his severe pulmonary disfunction. Thus we found it necessary to use a metallic stent. Patient 3 was a woman aged 85 years with proximal esophageal cancer. We couldn't perform a radical operation because of her cardiopulmonary disfunction. Therefore she underwent palliative treatment with a metallic stent. After stenting, all patients were able to ingest a semi-solid diet, and quality of life (QOL) was much improved. This improvement has been sustained for 27-56 days (mean 42 days). Further trials seem needed to evaluate the clinical role of this palliative treatment of esophageal cancer stenosis.View full abstractDownload PDF (9683K) -
Kazuya Kato, Minoru Matsuda, Kazuhiko Onodera, Shinichi Kasai, Michio ...1994 Volume 27 Issue 12 Pages 2569-2573
Published: 1994
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSMalignant lymphomas of the stomach are infrequently encountered.They represent one percent of all gastric neoplasmas.We report a case of malignant lymphoma of the stomach with reactive lymphoreticular hyperplasia (RLH) that was very difficult to diagnose histologically and even by immunohistologically. The patient was suffered from herpes zoster infection, which developed to encephalomyelitis. A 76-year-old man presented with upper abdominal pain.Upper gastrointestinal study (barium, endoscopy and abdominal CT) revealed a submucosal tumor of the stomach. Histological findings of the biopsy specimen showed RLH or low grade mucosa-associated lymphoid tissue (MALT) lymphoma.Surgery was performed.The final diagnosis was malignant lymphoma of the stomach (B cell type lymphoma, small cell type) by using the immunohistologically technique.This case suggested that RLH may be an early stage lesion of malignant lymphoma of the stomach.View full abstractDownload PDF (9744K) -
Shin-ichi Murakami, Yuzo Uchida, Nobuhiro Kubo, Yoshinori Hiraoka, Thu ...1994 Volume 27 Issue 12 Pages 2574-2577
Published: 1994
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSA 73-year-old woman visited the Oita Medical University Hospital with a complaint of dysphagia. Esophagectomy and total gastrectomy were performed. The patient was alive 51 months after the operation without any sign of recurrence. Pathological examination of the resected specimen showed a Borrmann type-2 lesion measuring 5.0×5.0cm and a IIc lesion measuring 10.9×9.0cm located close to each other in the cardia of the stomach. Microscopic examination revealed a collison tumor consisting of poorly differentiated squamous cell carcinoma and malignant lymphoma. The serial sections showed that there was no histological transition between the two components. With respect to metastatic sites in the lymph nodes, only one component from each tumor was seen. The constituent cells of the squamous cell carcinoma demonstrated positive immunoreactivity for keratin and EMA. Lymphoma cells showed positive immunoreactivity for LCA. Thus, the histological findings of the two tumors confirmed a collison tumor.View full abstractDownload PDF (8982K) -
Diagnosis by Doppler UltrasonographyMasashi Narita, Kazuyasu Nakao, Masaaki Nakahara, Katsuaki Maeda, Nobu ...1994 Volume 27 Issue 12 Pages 2578-2582
Published: 1994
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSWe report a 50-year-old man with gastric cancer and celiac axis compression syndrome (CACS) which was diagnosed by preoperative ultrasonography. The patient had suffered from pain once or twice a month since his boyhood. He was admitted to our hospital because of dysphagia, and endoscopic examination revealed cancer of the cardia. Preoperative ultrasonography showed stenosis of celiac origin and hepatofugal blood flow of the common hepatic artery. Total gastrectomy, splenectomy and division of the median arcuate ligsament were performed. Intraoperative electromagnetic flowmetry showed an increase in the flow of the common hepatic artery from 40 ml/min to 115 ml/min after decompression of the celiac artery. The abdominal pain disappeared after surgery, and postoperative ultrasonography revealed hepatopetal blood flow of the common hepatic artery. Thus, Doppler ultrasonography is useful in a noninvasive diagnosis of CACS.View full abstractDownload PDF (10419K) -
Shiho Natori, Jun-ichi Wakasugi, Itaru Endo, Shinji Togo, Hiroyuki Yam ...1994 Volume 27 Issue 12 Pages 2583-2586
Published: 1994
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSA 49-year-old man was admitted to the hospital because of epigastralgia. Gastroscopy revealed IIc + III like advanced gastric cancer [O' (IIc + III) T2] in the wall of the middle portion of the stomach. CT showed metastases of No.7 and 16b1 lymph nodes. Preoperative laboratory findings showed a high serum level of CA19-9 (460 ng/ml). Total gastrectomy with lymphadenectomy D4 was performed. Histologically, the primary tumor of the stomach showed poorly differentiated adenocarcinoma up to the subserosa, but the metastatic lymph nodes (No.7 and 16b1) showed the structure of hepatoid carcinoma. Immunohistochemical staining of Ca19-9 was negative in the primary lesion, but positive in hepatoid carcinoma of the metastatic lymph nodes. It was though that hepatoid carcinoma produced CA19-9. Because the serum level of CA19-9 may be related with lymph node metastasis, it is necessary to perform extensive lymph node dissection in cases showing a high preoperative level of serum CA19-9.View full abstractDownload PDF (8607K) -
Ryuji Hirai, Nobuyoshi Shimizu, Hiroyuki Soga, Naoshi Usuki, Sumiji Sa ...1994 Volume 27 Issue 12 Pages 2587-2591
Published: 1994
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSInflammatory pseudotumor of the liver is a rare disease with only 55 cases reported throughout the world. It is difficult to distinguish this condition from malignant liver disease. We present a case of inflammatory pseudotumor of the liver and a review of the literature. A 46-year-old woman was referred to us for a liver tumor that had been discovered with ultrasound and CT scan in another hospital. She complained of epigastralgia and fever of 10 days duration, and was administrated antibiotics. On admission, her white blood cel count was 17, 000/mm3. On physical examination, no palpable mass was found. A hyperechoic tumorous lesion was displayed in the left lateral segment, and gall stone was discovered. CT scan revealed a hypodense mass that was enhanced. Hepatic angiography exhibited a hypervascular lesion with a tumor stain. Endoscopic cholangiography showed stenosis of the left main hepatic duct and dilatation of the peripheral bile duct in the tumorous lesion. A common bile duct stone was also discovered. These findings were interpreted as a benign lesion, but malignant disease was not completely excluded. Left sided hepatic lobectomy, cholecystectomy and choledocho-lithotomy were performed. The cut surface of the resected material showed an ill-defined yellow mass lesion (7cm at its greatest axis). Dilated intra-hepatic bile ducts were included in the lesion. The pathologic diagnosis was hepatic xanthogranuloma, which is compatible with so-called inflammatory pseudotumor of the liver.View full abstractDownload PDF (8617K) -
Hiroyuki Yasuda, Atsuyoshi Onitsuka, Tomoyuki Miyata1994 Volume 27 Issue 12 Pages 2592-2595
Published: 1994
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSA 49-year-old man sustained an injury in a car accident while under the influence of alcohol. The patient was clinically stable and was observed under conservative management. On the sixth days after the trauma, total bilirubin increased to 5.0mg/dl. Computed tomography enhanced with Biligraphin (DIC-CT) revealed extrabiliary accumulation of contrast medium, indicating injury of the extrahepatic biliary system. ERC revealed extrabiliary opacification from the gallbladder. Laparotomy 16 days after the trauma showed bile-like ascites in the peritoneal cavity. The gallbladder was dissected traumatically from its bed and a performation was seen on the body of the gallbladder. There were no other injuries, and cholecystectomy with abdominal drainage was performed. The sresected specimen showed no hematoma in the wall of the gallbladder. It is considered worthwhile to perform DIC-CT to diagnose biliary injury in patients withabdominal trauma.View full abstractDownload PDF (6922K) -
Yuji Yoshioka, Osamu Kojima, Ryouji Iizuka, Tetsuro Yamane, Toshio Tak ...1994 Volume 27 Issue 12 Pages 2596-2599
Published: 1994
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSFamilial adenomatous polyposis (FAP) surgically treated by the same department through three generations has not been previously reported in Japan. Studying eleven cases of FAP distributed through three generations, we came to the following conclusions: 1. Since carcinogenesis occurred earlier in later generations, sreening should begin at 15 to 20 years of age. 2. Postoperative follow-up of these patients is necessary for long-term monitoring of the upper gastrointestinal tract. 3. Examination of hypertrophy of the retinal pigment epithelium is considered to be effective for the early screening of FAP. 4. Chemoprevention of carcinogenesis of the unrescted rectum is considered to be essential after ileorectal anastomosis.View full abstractDownload PDF (6930K) -
Takeo Iwama, Mahito Imajo, Masayuki Enomoto, Masahiro Toyooka, Hiroshi ...1994 Volume 27 Issue 12 Pages 2600-2604
Published: 1994
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSDelivery is an important factor by which to evaluate the quality of life of women after ileo-anal anastomosis. We reported three cases of pregnancy and delivery after ileo-anal anastomosis due to familial adenomatous polyposis. Changes of defecational function and complications during pregnancy were evaluated on these three cases. Their maximal resting anal canal pressure was more than 70cmH2O (normal, >100cmH2O). All deliveries were uneventful with help of cesarian sections, and their indications were transverse position, frequent laparotomy, and laparotomy during pregnancy because of ileus. Their defecational frequency before pregnancy was 6 to 8/day, and they showed no soiling. They showed no exacerbation of their defecational condition during pregnancy. All three newborns were normal. Ileo-anal anastomosis carries pregnancy and delivery safely. Pregnancy and delivery exert no adverse effect on defecational condition after ileo-anal anastomosis. We should pay attention to ileus during pregnancy.View full abstractDownload PDF (8987K) -
Masakazu Tada, Hiroshi Kanamaru, Yoshiaki Horie, Akio Odaka, Mamoru Mu ...1994 Volume 27 Issue 12 Pages 2605-2608
Published: 1994
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSIntrasigmoid hernia is a very rare type of internal hernia and has no pathognomonic findings, making the preoperative diagnosis extremely difficult. An 83-year-old man was admitted with complaints of left lower abdominal pain and vomiting. He had neither past history of surgery, injury, abdominal attack, nor clinical or laboratory findings of strangulation ileus. Conservative treatment was not effective. Laparotomy revealed intrasigmoid hernia. The herniated small bowel was about 10cm in length in the ileum, and was easily reduced from the mesenteric defect of the sigmoid colon. Following reduction, the hernia orifice was sutured. The patient's recovery was uneventful.View full abstractDownload PDF (6919K) -
Satoshi Ohki, Shinichi Kakinuma, Teruo Kusaba, Susumu Ohwada, Yasuo Mo ...1994 Volume 27 Issue 12 Pages 2609-2613
Published: 1994
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSA case of splenic metastasis from colon carcinoma without any other organ metastases is reported. A 73-year-old man was admitted for surgery under the diagnosis of descending colon cancer associated with a splenic tumor. It was difficult to determine preoperatively whether the splenic tumor was primary or metastatic. At laparotomy there was neither liver metastasis nor peritoneal carcinosis. A left hemicolectomy associated with splenectomy and partial pancreatectomy was performed. The histological diagnosis of both the colon and splenic tumor was moderately differentiated adenocarcinoma. Solitary metastasis to the spleen from colorectal carcinoma is rare. Only eight patients including ours have been reported in Japan. As some patients with solitary splenic metastasis from colon carcinoma survive for a long time, radical surgery is recommended for patients who have colorectal carcinoma with solitary splenic metastasis.View full abstractDownload PDF (8904K)
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