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Volume 27, Issue 3
Displaying 1-17 of 17 articles from this issue
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Kunio Okajima1994 Volume 27 Issue 3 Pages 725-734
Published: 1994
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSGrowth and advance of gastric cancer and colo-rectal cancer were investigated by the following two methods. 1. Biochemical Studies: Collagen and collagenase activity in the cancerous tissue were examined to clarify the etiology of scirrhus cancer of the stomach, which is characterized by diffuse cancerous invasion and remarked proliferation of fibrous connective tissue in the cancerous tissue. Collagenase activity of cancer cells and fibroblasts was markedly high at the growing edge of the cancer, where collagen fibers were decomposed and replaced by the invading cancer cells and the markedly proliferating collagens promoted by fibroblasts. This leads to the characteristic appearance of scirrhus cancer of the stomach. 2. Immunohistochemical Studies: The biological characteristics of cancer were investigated immunohistochemically to clarify the growth and advance of cancer. Abnormal expression of the “growth factor-receptor system” or oncogenes was closely related to advance of the cancer. The HLA antigen, as one of the factors of the “cancer vs host interaction”, was proved to be correlated to advance of cancer through the immune response of the host. This correlation was supported by the finding that the cancer was apt to advance especially when the HLA antigen was only slightly expressed (“escape theory”).View full abstractDownload PDF (19267K) -
Implication for Gastroinetstinal CancerEiichi Tahara1994 Volume 27 Issue 3 Pages 735-742
Published: 1994
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSEach of esophageal, gastric and colorectal cancers shares characteristic genetic alterations in oncogenes and tumor suppressor genes. We transferred these molecular data to clinical practice and made a new strategy of molecular diagnosis of gastrointestinal cancer as a routine work which has started at Hiroshima City Medical Association Clinical Laboratory since August this year. We believe that this strategy may contribute not only to the development of powerful diagnosis but also to understanding of patient prognosis or therapeutic approaches.View full abstractDownload PDF (13737K) -
Hisanao Ohkura1994 Volume 27 Issue 3 Pages 743-752
Published: 1994
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSThe aims of clinical use of tumor markers are following-up high risk persons, differentiating cancer and/or its subclasses, stagrng and predicting the outcome, monitoring and evaluating therapies, detecting recurrence and metastases earlier, and targeting tumors in vivo. Knowing profile of markers from a cancer is helpful in differentiating a tumor subclass that may suggest a worse prognosis, higher metastatic ability or better response to a special therapy' The preoperative levels of serum markers correlate with clinical stage, risk of distant metastasis and prognosis. Success or failure of therapy is easily monitored by markers. Detecting markers in surgically removed specimens tells us that they will appear in serum prior to diagnosing recurrence by X-ray or ultrasound examinations.View full abstractDownload PDF (19103K) -
Mitsuru Kikuchi, Masatoshi Watanabe, Masaru Ogawa, Ryuji Nakamura, Kaz ...1994 Volume 27 Issue 3 Pages 753-758
Published: 1994
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSThe recent discovery of a non-endotoxic reactive pathway in the conventional Limulus test has indicated that serum endotoxin (Et), being derived from the intestinal bacterial flora, may become pathogenic (endogenous entotoxemia) under some conditions. Revaluation of postoperative endogenous entotoxemia was done by an endotoxin-specific chromogenic assay (Endospecy, Seikagaku Kogyo, Tokyo, Japan) using 32 patients with esophageal varices and liver disease (cirrhosis; 26, idiopathic portal hypertension: 6). In addition, the effects of oral polymxin-B sulfate (PL-B) and/or tindiazol (TDZ) administration prior to surgery (esophageal transcetion: 27, Hassab's operation: 5) were estimated on the basis of changes in bacterial flora in the rectum after administration and the postoperative serum Et level. Et was increased on the 1st postoperative day (POD) (7.4±5.3pg/ml) compared with the preoperative period (5.8±4.6pg/ml). Thereafter, it was decreased on the 3rd and 5th POD. PL-B administration (300million units/day) reduced the increase in Et level. However, administration of a large quantity of PL-B (600million units/day) or adding TDZ (1000mg/day) to PL-B failed to cause a further reduction in the Et level. Based on the change in the bacterial flora of the rectum, an increase in anaerobic bacteria (in PL-B administration) or E. coli (in PL-B + TDZ administration) may be the cause of the failure. No apparent septic manifestion occurred during the postoperative course. Surgical stress on patients with liver impairment caused the serum Et level to increase up to within the normal limit. If additional postoperative morbidity occurred, the endogenous endotoxin level would probably increase enough to be pathogenic. Oral PL-B administration was effective in reducting the Et level.View full abstractDownload PDF (11127K) -
Osamu Hosokawa, Shin Yamazaki, Jouji Tsuda, Kunishige Watanabe, Yutaka ...1994 Volume 27 Issue 3 Pages 759-767
Published: 1994
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSFrom 1963 to 1982, 756 cases of early gastric cancer were resected in our hospital. Of them, 717 cases (94.8%) were treated with limited operation without extended dissection of lymph nodes and omentobursectomy. These cases were followed up more than 10 years. A total of 202 patients died from the following diseases: recurrent gastric cancer (23 patients, 11.4%), cancer of other organs (42 patients, 20.8%) and non-cancerous diseases (137 patients, 67.8%). Concerning macroscopic types, were found a high recurrence rate (7.3%) and a low survival rate (88.1%) in the cases with mixed type. Cases with lymph node metastasis had a high likelihood of recurrence (18.8). The 10-year relative survival rate with lymph node metastasis was lower than without lymph node metastasis, 84.1% and 100.8% respectively. The recurrence rate with limited operation for early gastric cancer was 3.2%, and 2.9% for curative resection. The 10-year relative survival rate was 99.2%. We concluded that the limited operation should cure most cases of early gastric cancer and we should select the cases for extended dissection of lymphnodes.View full abstractDownload PDF (18955K) -
Lipid Peroxidation of Liver RemnantKenji Fukuhara, Kiyoaki Ouchi, Seiki Matsuno1994 Volume 27 Issue 3 Pages 768-774
Published: 1994
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSExperimental studies were performed to clarify why bile peritonitis after partial hepatectomy inhibits hepatic regeneration. Rats underwent 70% hepatectomy (Hx group), bile peritonitis after Hx (Hx+P group), and Hx+P with administration of catalase and recombinant human SOD (S group). The labelling indexes at 24 and 48 hours after hepatectomy were 22.4% and 7.5% in the Hx group, 4.4 and 8.8% in the Hx+P group, and 6.4 and 24.5% in the S group, respectively. An initiation of DNA synthesis delayed and a peak level of it diminished in the Hx+P group, but the former improved in the S group. Lipoperoxide (LPO) of the liver remnant did not increase in the Hx group throughout 48 hours after hepatectomy. In contrast, LPO in the Hx+P group showed significant, continuous elevation from 12 hours after hepatectomy. In the S group, however, LPO was reduced to almost half that in the Hx + P group. The energy charge of the liver remnant in the Hx+P group was significantly lower than that in the Hx group, and systemic endotoxin levels were high only in the Hx + P group. In conclusion, bile peritonitis after partial hepatectomy induced delayed initiation and a diminished peak level of DNA synthesis. Although an elevated level of endotoxin may play a partial role in increased lipid peroxidation, accumulated bile components may cause acceleration of lipid peroxidation and inhibited hepatic regeneration because of mitochondrial membrane damage.View full abstractDownload PDF (14868K) -
Yoshitaka Wakizaka, Syuichi Sano, Yoshimi Nakanishi, Yoshinobu Koike, ...1994 Volume 27 Issue 3 Pages 775-780
Published: 1994
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSI studied the indications for laparoscopic cholecystectomy (LC) and values of preoperative imaging findings in 82 patients who underwent preoperative imaging diagnostic tests (abdominal echogram, abdominal CAT scan, ERCP). I analyzed mainly patients who were considered to be indicated for LC but whose gallbladders could be removed by open laparotomy, or whose gallbladders were removed by open laparotomy but were considered indicated for-LC from retrospective study. I found the following results: 1) LC can be easily performed in patients with a history of severe acute cholecystitis if they have no findings of a thickened wall or negative gallbladder signs. 2) Abdominal echogram and CAT scan were the best preoperative imaging tests for determining the gallbladder's state, especially for obstruction of the cystic duct. These results are important today when the operative indications of LC are extremely indefinite because of the accumulation of operative experience and technological improvements.View full abstractDownload PDF (12576K) -
Nobuhiko Harada1994 Volume 27 Issue 3 Pages 781-788
Published: 1994
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSPostoperative digestive functions and secretion of gastrointestinal hormones were studied in 15 patients with duodenum preserving pancreas head resection (DpPHR) in comparison with those in 14patients who had pylorus preserving pancreaticoduodenectomy (PpPD) reconstructed by gastro-pancreatico choledocho-jejunostomy. Postoperative integrated integrated secretion of secretin two hours after taking the test meal was 9.0±1.5 ng-min/ml in patients with DpPHR, higher than that in patients with PpPD (7.5±0.8 ng-min/ml). Pancreatic function one year after the operation decreased to 64% of the level on the preoperative value in patients with PpPD, but was preserved in patients with DpPHR (88%). No significant difference, however, was noted in postoperative evaluation of gastrin secretion after taking the test meal or in gastric acid secretion. These data show that DpPHR can preserve pancreatic exocrine function at the late postoperative period better than PpPD.View full abstractDownload PDF (14330K) -
Fumio Konishi, Kazuhiro Furuta, Yukio Saito, Takashi Kataoka, Hiroshi ...1994 Volume 27 Issue 3 Pages 789-796
Published: 1994
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSTo investigate the effectiveness of hyperthermia in the preoperative combined treatment of radiation, chemotherapy and hyperthermia for rectal carcinoma, two groups were compared. Group A consisted of 18 patients in whom hyperthermia, radiation and chemotherapy were performed. Group B consisted of 18 patients in whom only chemotherapy and radiation were performed. The total dose of radiation in both of the two groups was 40.5 Gy, and a radiation field covering the whole pelvis was used. Hyperthermia was performed using 8 MHz radiofrequency waves (Thermotron RF8, Yamamoto Vinyter, Japan), and tumors were heated at about 42 degrees C for 50 minutes. Hyperthermia was repeated five times during the preoperative treatment. Chemotherapy was performed by giving 5-fluorouracil suppositories to a total dose of 3400 mg. Mean tumor reduction rates on barium enema were 31.8% in group A and 18.2% in group B. The difference was statistically significant. The result of the histological assessment of tumor necrosis showed that there was a significantly higher degree of necrosis in group A than in group B. These results showed that the addition of hyperthermia enhanced tumor necrosis. It was concluded that the addition of hyperthermia would be an effective preoperative treatment of rectal carcinoma.View full abstractDownload PDF (16897K) -
Yoshihiro Sakai, Kazuo Hatsuse, Takashi Ichikura, Shouetsu Tamakuma, T ...1994 Volume 27 Issue 3 Pages 797-800
Published: 1994
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSHemobilia secondary to a percutaneous liver biopsy developed in a 77-year-old man with chronic hepatitis type C. He had hematemesis. Endoscopic examination revealed coagula in the duodenum. Computed tomography (CT) showed high density areas suggesting coagula in the common bile duct and doudenum. Celiac angiography revealed an arterioportal (AP) shunt supplied by the posterioinferior branch of the right hepatic artery. Transcatheter arterial embolization (TAE) directed selectively into the involved hepatic artery was successfully performed. TAE may provide a simple, safe, and effective treatment for hemobilia.View full abstractDownload PDF (7432K) -
Masaru Konishi, Munemasa Ryu, Taira Kinoshita, Noriaki Kawano, Hiroshi ...1994 Volume 27 Issue 3 Pages 801-805
Published: 1994
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSWhen amputation neuroma causes biliary stricture, it is difficult to distinguish it from bile duct cancer. A case of amputation neuroma of the right hepatic duct after cholecystectomy is reported. A 68-year-old woman was hospitalized with complaints of back pain. She had undergone cholecystectomy 13 years previously. She was diagnosed as having bile duct cancer because percutaneous transhepatic cholangiography revealed obstruction of the right hepatic duct. We performed extended right lobectomy. Histological examination revealed amputation neuroma in the obstructive portion as a result of the previous cholecystectomy. Analysis of 27 cases reported in Japan indicated that cases of stricture of the bile duct with jaundice were difficult to distinguish from bile duct cancer. A detailed past history, cholangioscopy and intraoperative histological examination will lead to accurate diagnosis, and resection of the bile duct with the tumor is standard therapy.View full abstractDownload PDF (9908K) -
Manabu Futamura, Naoki Yokoo, Ryouji Okamoto, Takashi Shiroko, Hidekaz ...1994 Volume 27 Issue 3 Pages 806-810
Published: 1994
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSWe report a case of Gardner's syndrome with intra-abdominal desmoid 7 years after total colectomy. A 42-year-old male underwent a total colectomy because of Gardner's syndrome in 1986. An ascending colon cancer was found then, and a1, n1, P0, H0, M (-), stage III according to the General rules of colorectal cancer. He experienced a painless tumor in the left epigastral lesion since March 1992. Its size was enlarging during the last 9 months. Lip pigmentations; hyperplastic polyp in stomach and rectum; osteomas, impacted teeth, supernumerary tooth, cyst in the maxilla and the mandible were found as his physiological symptoms. Abdominal CT showed enhanced tumor. Angiography showed streteches and encasement of the jejunal arteries. In laparomomy, it was about 10 cm in size, and was thought to have originated from the mesenterium. But only biopsy was performed due to severe adhesion and fear of short bowel syndrome. Histological diagnosis was desmoid. He is now being treated with UFT and Tamoxifen.View full abstractDownload PDF (9630K) -
Nobuo Takenouchi, Tetsuya Miura, Setsuyuki Ootake, Takafumi Kusaka, Ma ...1994 Volume 27 Issue 3 Pages 811-815
Published: 1994
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSWe present a rare case of lymphangiomyomatosis of the mesenterium. A 28-year-old woman was referred to our hospital with the chief complaint of left side abdominal pain. CT scan revealed a giant mass in the mesenterium from the renal level to the pelvic space. At laparotomy, the tumor was localized in the mesenterium, but invaded to the jejunum. The tumor was completely excised with jejunum resection. The resected specimen included a cystic tumor and was 3kg in weight. Histological examination of the tumor revealed lyphangiomyomatosis. Lymphangiomyomatosis is a very rare disease that occurs predominantly in women of reproductive age, mainly in the mediastinum, lung and retroperitoneal space. Only four other cases of lymphangiomyomatosis arising from the mesenterium have been reported in the world literature.View full abstractDownload PDF (9531K) -
Masayuki Suzuki, Yoshimasa Kurumi, Kazuyoshi Hanasawa, Akihiro Kishida ...1994 Volume 27 Issue 3 Pages 816-819
Published: 1994
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSWe report a rare case of small intestinal cancer with a propensity for extramural growth that was diagnosed before surgery. A 61-year-old woman was admitted to our hospital because of melena. Small intestinal cancer with extramural growth propensity was diagnosed by various clinical and histological examinations. Examinations revealed that it was located about 10 cm proximal to Bauhin's valve and showed Borrmann 2 type appearance. The histological diagnosis was moderately differentiated adenocarcinoma of the small intestine. Distal ileal resection and right hemicolectomy with group 3 lymph node dissection were performed, and adjuvant chemotherapy was added after the operation. Ileal cancer is very uncommon among malignant tumors of the gastrointestinal tract, and few cases are diagnosed correctly before surgery. Therefore we suggest more aggressive investigation in cases of small intestinal cancer to improve curability.View full abstractDownload PDF (7635K) -
Kazuya Kato, Minoru Matsuda, Yasuhiro Yamamoto, Toshihide Arai, Kazuhi ...1994 Volume 27 Issue 3 Pages 820-823
Published: 1994
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSThe feasibility of performing a sigmoidectomy with laparoscopic technique using a triple stapling technique (TST) was demonstrated in the current study. A 55-year-old man had a sigmoidal colon polyp, which was pathologically diagnosed as group 4. Sigmoidectomy was performed with a laparoscopic technique using an endopath lenear cutter 60®. The laparoscopic technique for anastomosing the procedure to be performed completely within the abdominal cavity using a curved detactable head (CDH) ®. The procedure appears to be safe, and there is no compromise in the standard sigmoidectomy.View full abstractDownload PDF (7710K) -
Makoto Kaneda, Tamotsu Hirota, Makoto Iwasa, Hisao Tamaki1994 Volume 27 Issue 3 Pages 824-828
Published: 1994
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSA 75-year-old man was admitted to our hospital because of prolapse of a tumor from the anus, which had developed over three years. Rectal examination revealed a soft tumor 5-6 cm proximal to the anal verge. Barium enema study showed a tumor, about 7 cm in diameter and having a cauliflower-like appearance, in the lower rectum. Endoscopic study revealed a lobulated tumor with a granular surface, which was coated with copious mucus. CT scan showed a homogeneous tumor whose margin was similar in appearance to brain gyrus. Endoscopic ultrasonography was suggestive of tumor invasion to the muscularis propria. Ulceration and induration of prolapsed tumor were not observed. Pull-through operation was performed. The resected specimen showed a wide-base tumor measuring 8.5×8.0 cm. Histological findings confirmed it to be a villous adenoma with no evidence of malignant change.View full abstractDownload PDF (9948K) -
Masaaki Arai, Susumu Ohwada, Yasuo Morishita1994 Volume 27 Issue 3 Pages 829-833
Published: 1994
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSA 54-year-old woman with a previous history of low anterior resection for rectal carcinoma in October 1989 was admitted in May 1992 because of a hepatic tumor. The serum levels of CEA and CA19-9 were elevated. Computed tomograms and ultrasonograms identified an irregular tumor in the caudate lobe and right posterior superior segment infiltrating the inferior vena cava (IVC) and the posterior segment duct. Endoscopic retrograde cholangiograms showed a filling defect in the anterior segment duct and obstruction of the posterior segment duct. Hepatic angiograms revealed a fine tumor stain. These findings could not differentiate cholangiocellular carcinoma from metastasis attributed to rectal cancer. The right and caudate lobes of the liver were resected, together with partial resection of the IVC wall, the defect of which was repaired with a horse pericardium. The tumor, 4.0×3.5 cm in size, was histologically determined to be metastasis from rectal cancer with infiltration of the NC and the biliary tract.View full abstractDownload PDF (10986K)
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