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Volume 28, Issue 1
Displaying 1-21 of 21 articles from this issue
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Keishiro Aoyagi, Kikuo Kohfuji, Issei Kodama, Yoshiaki Tsuji, Tetsu Su ...1995 Volume 28 Issue 1 Pages 1-6
Published: 1995
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSCell proliferation kinetics of the non-neoplastic mucosa and carcinoma cells in 19 cases of resected remnant stomach were investigated by examining the number of nucleolar organizer region associated proteins after staining by silver colloid (AgNOR). The mean numbers of AgNOR in the nucleus were 1.38±0.14 in the mucosa at the proximal margin, 1.82±0.24 in the anastomotic region (p<0.001). Hyperplasia in the foveolar gland, the gland with invasion into the submucosa, and the gland with cystic dilatation were frequently recognized in the mucosa in the anastomotic region after Billroth II reconstruction. The mean numbers of AgNOR were 2.17±0.13 in the region of hyperplasia of the foveolar gland, 2.03±0.04 in the gland invading the submucosa, and 1.94±0.14 in the gland with cystic dilatation. All three of these mean numbers of AgNOR were significantly higher than in normal mucosa. These results suggested that the mucosa in the region of anastomosis promoted these activities probably in part due to the incidence there of duodenal reflux.View full abstractDownload PDF (11015K) -
Takahito Nakagawa, Yoshie Une, Tsuyoshi Shimamura, Toshiya Kamiyama, T ...1995 Volume 28 Issue 1 Pages 7-11
Published: 1995
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSMolecular markers of blood coagulation and fibrinolysis were studied in seventy-five patients with hepatocellular carcinoma (HCC) who underwent hepatectomy in the past 3 years. The serum concentration of thrombin-antithrombin III complex (TAT), plasmin-α2-plasmin inhibitor complex (PIC), and D-dimer were analyzed. We investigated the relation between those markers and the clinicopathological findings. The average levels (±S.E.) of TAT, PIC, and D-dimer were 4.49±0.58μg/l, 1.36±0.07μg/ml, and 1.325±0.270μg/ml, respectively, all slightly above the normal ranges. The serum levels of the molecular markers closely correlated with the tumor stage and intrahepatic metastases. However, there was no correlation with the pathological degree of chronic changes of the liver parenchyma, differentiation of HCC cells, capsular formation, or portal vein involvement. Progression of the intrahepatic metastases of HCC are suggested to be related to the acceleration of blood coagulation and fibrinolysis.View full abstractDownload PDF (9220K) -
Yoshiyuki Yamaguchi, Kousuke Noma, Eiji Miyahara, Mahito Funakoshi, Ik ...1995 Volume 28 Issue 1 Pages 12-16
Published: 1995
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSAugmentation by CDDP of susceptibility of a human pancreatic cancer cell line, PH101, to lysis by effector lymphocytes was studied in vitro. Susceptibility of PH101 against lysis by lymphokine-activated killer (LAK) cells was significantly augmented after treatment of tumor cells with interferon (IFN)-gamma or CDDP. Flow cytometric analysis revealed that the HLA-class 1 and ICAM-1 antigens on PH101 cells were upregulated by IFN-gamma but not by CDDP treatment. Cold target inhibition assay showed that lysis of CDDP-treated PH101 cells was significantly suppressed by the addition of CDDP-treated, but less by CDDP-untreated cold targets at the effector phase of the cytotoxicity assay. It is suggested that modulation of unknown target determinant (s) on tumor cells was involved in the CDDP-induced augmentation of tumor cell susceptibility to lysis by anti-tumor effector lymphocytes.View full abstractDownload PDF (8578K) -
Kentaro Nakao1995 Volume 28 Issue 1 Pages 17-24
Published: 1995
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSThe effect of splenectomy on dimethylhydrazine (DMH)-induced colon cancer in rats was studied. Tumor doubling time in the splenectomy group was significantly shorter than that in the control group. The PCNA labeling index was significantly higher in the splenectomy group than in the control group. In the analysis of DNA ploidy pattern of tumor, aneuploidy appeared only in the splenectomy group. At autopsy, the incidence of early cancer in the splenectomy group was more frequent than that in the control group, although the difference was not significant. NK activity in the blood was significantly lower one week after surgery in the splenectomy group than in the control group. On the basis of these results, splenectomy may act to promote tumor growth in DMH-induced colon carcinogenesis.View full abstractDownload PDF (15131K) -
Kazutaka Yamada, Kiyoshi Niwa, Takashi Sameshima, Shigeya Hase, Jun'ic ...1995 Volume 28 Issue 1 Pages 25-31
Published: 1995
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSWe studied on postoperative dysfunctions and quality of life (QOL) in 96 patients with rectal cancer by a questionnaire survey. We asked them whether they discontented with having stoma or the postoperative dysfunctions in defecation, urination, and sexual function. Incidences of patients discontented with the dysfunctions were 65% in defecation, 72% in having stoma, 71% in urinary dysfunction, 85% in erection dysfunction and 50% in ejaculation dysfunction. Furthermore the postoperative QOL was assessed as five grades for subjective condition of health, appetite, sleep, life activity, and anxiety about the disease, respectively. Significant decline of the postoperative QOL (Grade I, II) in patients with having stoma was manifest, although tendency to decline of the QOL was recognized in patients with urinary or erection dysfunctions. The results suggested that patients with the postoperative dysfunctions, especially having stoma, erection and urinary dysfunctions, were degraded the evaluation of QOL. Consequently, patients with rectal cancer should be considered to receive sphincter saving operation or autonomic nerve preserving operation as far as possible.View full abstractDownload PDF (12748K) -
Takamori Nakayama, Masahiko Watanabe, Takao Katsumata, Tatsuo Teramoto ...1995 Volume 28 Issue 1 Pages 32-39
Published: 1995
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSThe present study investigated the expression of cancer-associated carbohydrate antigens in rectal carcinoma and determined whether expression of antigens was correlated with the prognosis. One hundred and five primary rectal carcinoma (mp ss and al) and 124 metastatic lymph nodes were obtained from patients undergoing curative surgery between 1981 and 1988. Immunohistochemical studies were performed using monoclonal antibodies to the carbohydrate antigens (Lewisa, sialyl Lewisa, Lewisx and sialyl Lewisx). Expression of sialyl Lewisa (SLA) in primary tumors correlated with lymph node metastasis (p<0.025) and recurrence (p<0.005). SLA in the metastatic lymph nodes was also correlated with recurrence (p<0.05). Analysis of survival indicated a statistically significant difference between patients with and without SLA in both the primary tumor (p<0.001) and metastatic lymph nodes (p<0.05). Other carbohydrate antigens failed to demonstrate these associations. These results demonstraed the significance of SLA in colorectal carcinoma in association with evaluating the prognosis of patients.View full abstractDownload PDF (14409K) -
Mitsuyuki Matsumoto, Toshiomi Kusano, Yoshihiro Muto, Tohru Segawa, Ka ...1995 Volume 28 Issue 1 Pages 40-47
Published: 1995
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSA clinical study on the significance of polymorphonuclear leukocyte elasase (PMNE) in gastrointestinal surgery was carried out. The subjects were 24, 7 and 21 patients undergoing pancreatoduodenectomy, total thoracic esophagectomy and total gastrectomy respectively. The plasma levels of PMNE-α1-protease inhibitor (API) complex were measured using commercially available enzyme linked immunosorbent assay method and regarded as PMNE values (PMNE-API). The correlations between rises of PMNE-API or PMNE index (PMNE-API [fg/ml] /number of neutrophilic leukocytes [cell/ml]), and several intra-postoperative factors were statistically analyzed. The exaggerated rises of PMNE-API and PMNE index preceded the clinical onset of postoperative multiple organ failure. Postoperative complications induced statistically significant elevation and prolongation of both PMNE-API and PMNE index responses, but appropriate treatment reduced them immediately. PMNA-API and PMNE index responses after uncomplicated pancreatoduodenectomy and total gastrectomy showed that the individual capacity for major surgery was not uniform. The results of this study suggested that postoperative measurement of PMNE-API and PMNE index were objective means by which to evaluate the individual capacity for major surgery, and the beginning, degree and therapeutic responsiveness of postoperative complications.View full abstractDownload PDF (13771K) -
Tsunemasa Takishima, Hiroyoshi Mieno, Yoshisuke Nakayama, Hideto Tsuka ...1995 Volume 28 Issue 1 Pages 48-52
Published: 1995
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSWe report a patient with successful conservative therapy for spontaneous esophageal rupture who was admitted 7 hours after onset with stable vital signs. The patient, a 59-year-old man, vomited several times followed by severe epigastralgia. Both plain chest X-ray and CT on admission revealed pneumomediastinum and a small amount of pleural effusion without pneumothorax. UGI using watersoluble contrast medium or 20% barium showed no extravasation from the esophagus. On day 3, although UGI revealed obvious contrast extravasation from the lower esophagus, the contrast medium did not leak beyond the mediastinum into the pleural cavity. Bacteriological study of the pleural effusion was negative. Therefore, conservative therapy was continued and diet was started on day 64, when UGI and endoscopic examinations showed nearly the healing stage. He was discharged on day 78 in good general condition. The majority of previous reports have mentioned that conservative therapy for spontaneous esophageal rupture is indicated when the definite diagnosis has been delayed for several days or more, or when the patient's general condition is poor on admission. We conclude that conservative therapy would be successful when mediastinal contamination is localized without mediastinal abscess and pyothorax in the acute phase of this disease.View full abstractDownload PDF (10250K) -
Michihiro Narikiyo, Toshifumi Kanaizumi, Saiho Ko, Toshiyuki Fukuoka, ...1995 Volume 28 Issue 1 Pages 53-56
Published: 1995
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSA surgically resected case of primary hepatic malignant lymphoma, an extremely rare malignant neoplasm of the liver, is reported. A 67-year-old woman was admitted to our hospital complaining of general fatigue. She was diagnosed with small liver cancer with hepatitis C in segment V by computed tomography, celiac angiography, and other methods. Therefore, she underwent percutaneous ethanol injection therapy after needle biopsy of the tumor. The tumor, however, was histologically diagnosed as non-Hodgkin lymphoma of the liver and was removed by subsegmentectomy of the liver (S5). One year after surgical treatment, there was no evidence of recurrence.View full abstractDownload PDF (6957K) -
Hisao Wakabayashi, Koutaro Matushita, Isao Hamamoto, Setsuo Okada, Tak ...1995 Volume 28 Issue 1 Pages 57-61
Published: 1995
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSA case of hepatocellular carcinoma is reported here, in which hepatectomy including resections of a metastasis to the 11th rib and the gastric lymph node was performed after increasing the remnant liver volume by embolizing the right branch of the portal vein. The patient was a 59-year-old man. The hepatocellular carcinoma, which had tumor thrombuses in the anterior segment branch of the portal vein and middle hepatic vein, was found to have metastasis to the rib. As no other metastasis was found on clinical examinations, surgical resection was considered. However, liver functionwas evaluated to be insufficient, when extended right lobectomy or right trisegmentectomy was considered. Therefore, extended right lobectomy was performed, after the remnant liver volume had been increased by percutaneous transhepatic portal vein embolization (PTPE). In the operation a metastasis of the gastric lymph node was found and resected. The post-operative course was satisfactory, and the patient is alive over 1 year after the operation without any evidence of reccurence. It was thought that even in advanced cases of hepatocellular carcinoma, positive surgical resection may make it possible for patients to obtain a better prognosis.View full abstractDownload PDF (10416K) -
Yukoh Kin, Akihiro Yamaguchi, Masatoshi Isogai, Akihiro Hori1995 Volume 28 Issue 1 Pages 62-66
Published: 1995
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSA surgical case of hepatocellular carcinoma associated with marked retention onthe ICGtest (retention rate at 15min, 70%) isreported. Since laboratory data except for the ICG test were normal, the patient was diagnosed with constitutional ICG excretory defect. To estimate preoperative liver function, we performed two further exainations. One was laparoscopic observation of the liver with subsequent non-tumorous Iiver biopsy, which showed chronic active hepatitis. The other was in trahepatic blood flow assessment using color Doppler ultrasound, which demonstrated normal flow paterns. During surgery, we measured the arterial blood ketone body ratio under hemihepatic vascular occlusion, and judging from the results of these examinations, left hepatic lobectomy was done folowed without any postoperative trouble. Since to decide extent of hepatectomy is difficult in the case with the ICG excretory defect, more experience with this disorder and new techniques for evaluating liver functional reserve might be necessary.View full abstractDownload PDF (10300K) -
Kenji Katsumata, Chiaki Tani, Tadashi Nakayama, Kouichiro Kato, Shinji ...1995 Volume 28 Issue 1 Pages 67-71
Published: 1995
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSWe experienced 2 cases of intestinal schwannoma presenting massive melena. Case 1 was a 48-year-old woman visiting our hospital due to sudden massive melena. Because of the diagnosis of bleeding of the superior mesenteric artery by hemorrhagic scintigraphy, laparotomy was performed, and an extravascular tumor was located about 30 cm from treitz's ligament. This tumor was pathologically diagnosed as Antony A benign schwannoma, although heteromorphic nuclei were observed. Case 2 was a 48-year-old woman visiting our hospital due to abdominal pain and massive melena. On superior mesenteric arteriography, tumor stain was detected in the solid phase. Thus laparotomy was performed under suspicion of intestinal tumor, and a tumor 70 cm from Treitz's ligament was detected. This tumor was pathologically diagnosed as malignant schwannoma due to the presence of karyomitosis. Hemorrhagicscintigraphy and angiography were useful for diagnosis of these cases because of abundant tumor vascularity, and they had histopathologically intersting features.View full abstractDownload PDF (9219K) -
Shuzo Kohno, Tadakazu Shimoda, Toshio Iino, Takashi Nikaido, Koumei Um ...1995 Volume 28 Issue 1 Pages 72-76
Published: 1995
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSA 63-year-old woman was admitted with a painful left groin lump on July 18, 1993. Under a clinical diagnosis of incarcerated left inguinal hernia, herniorrhaphy was performed. The sac was found to contain nests of cells consistent with a metastatic adenoccarcinoma. The patient was readmitted for further work up. Gynecological examination was within normal limits. Computed tomographic (CT) scans of the chest, abdomen, and pelvis were also negative. Gastrointestinal and colon fiberscopy was perfor-med, but was also netative. On September 13, 1993, the patient underwent exploratory laparotomy, following a laparoscopy. Laparotomy revealed multiple and polynesic cicatrices in the omentum. Omentobrusectomy was performed. The pathologist diagnosed the omental and inguinal tumoras a peritoneal serous papillary adenocarcinoma. Tumors within hernial sacs are rare. Peritoneal serous papillary adenocarcinoma is relatively rare, but is occasionally diagnosed due to abdominal tumor or distension. We have described the unusual case of inguinal hernia-sac cancer. To the best of our knowledge, this is the first report of peritoneal serous papillary adenocarcinoma in an inguinal hernial sacView full abstractDownload PDF (10445K) -
Kazuya Miyoshi, Takeshi Matsui, Junichi Gangi, Toshihiko Waku, Kunzo O ...1995 Volume 28 Issue 1 Pages 77-81
Published: 1995
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSHepatic portal venous gas is a rare condition due to numerous etiologies, and has been regarded as an ominous prognostic sign. The acute superior mesenteric artery occlusion associated with hepatic portal venous gas has a grave prognosis particularly, only four cases having been recorded as surviving that event. A 64-year-old man with a past history of Buerger's disease was admitted complaining sudden crampy abdominal pain. A plain radiograph showed dilated loops of the small intestine in the right upper quadrant of the abdomen. Computed tomography of the upper abdomen demonstrated peripheral distribution of air in the hepatic portal vein. An emergency laparotomy was performed 13 hours after the onset revealed segmental necrosis of the ileum. Then 40cm of the ileum was resected, and end-to-end ileoileostomy was performed. The patient made an uneventful recovery.View full abstractDownload PDF (9885K) -
Takashi Aiko1995 Volume 28 Issue 1 Pages 82-87
Published: 1995
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSRecently in Japan more than 40% of gastric cancers, including mucosal and submucosal carcinoma, have been detected at an early stage. Since data of the nationwide registry show a significantly lower rate (2.1%) of metastasis to lymph nodes of mucosal tumors, limited surgery is recommended. In order to establish criteria for selecting rational surgery for early gastric cancer, we conducted a study of lymph flow draining from stomach and metastatic route of perigastric lymph node.Analysis of the relationship between lymph mode metastasis and clinicopathological findings led to our new policy of surgical treatment for early gastric cancer. In our study, lymph node metastasis was not observed in the following cases: 1) mucosal cancer with elevation of less than 20mm among differentiated adenocarcinomas, 2) mucosal cancer with depression of less than 10mm, 3) submucosal cancer (sm-1) of less than 10 mm. In these cases, it is possible for rational limited surgery to be performed, with curability for early gastric cancer. Conversely, submucosal massive cancer (sm-2) has not only lymph vessel permeation but also nodal metastasis. Thus, limited surgry should not be carried out in submucosal cancer. As another limited procedure, a functional preserving operation, pylorus-preserving gastrectomy (PPG), should be applied to cases of early gastric cancer occurring in the middle third of the stomach. PPG should be considered a physiologically advantageous procedure. In selecting limited surgery, it is important to know to what extent we can make an accurate preoperative diagnosis of depth of cancer invasion or lesion size. The decision should be made taking into consideration the macroscopic findings, histological type and tumor size.View full abstractDownload PDF (12129K) -
Yoshihiro Moriya1995 Volume 28 Issue 1 Pages 88-92
Published: 1995
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSLocal excision, total nerve-sparing operation, endoscopic mucosal resection and LAC are thought to be limited surgical procedures for rectal cancer, if nerve-sparing operations with lymphadenectomy are defined as standard procedures. Among those limited operations, local excision and total nerve-sparing operation are explained in terms of operative indications, techniques and functional results. Local excision consists of trans-anal, trans-sphincteric (Mason') and trans-sacral approches (Kraske'). These operations should be applied to early rectal cancer in which depth of invasion is mucosal or sm1. In cases showing a risk factors for lymphnode metastasis, radical surgery should be applied as an initial treatment. Eligibility criteria for this surgery are more strictly limited in Japan than in Western countries. Total preservation of the autonomic nerves should be applied to early or mp rectal cancer. Long-term urinary and sexual function is good after a total nerve-sparing operation. Rigiscan for NPT is important to estimate erection objectively. We would like indications for limited surgery for rectal cancer to be more frequently applied, based on the progress of adjuvant radiochemotherapy.View full abstractDownload PDF (10779K) -
Seiki Tashiro1995 Volume 28 Issue 1 Pages 93-98
Published: 1995
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSResection of the extrahepatic bile duct, central hepatic resection or hilar hepatic resection is included in limited surgery for carcinoma of proximal bile duct. Limited surgery is ordinarily performed with dissection of the regional lymph nodes and resction of the caudate lobe. This limited surgery is applied for patients who are Type 1 or Type 2 in Bismuth's classification of the located portion of tumor, macroscopically papillary type or nodular type without invation of serosa and liver, lymph node metastasis and cancer that is histologically limited to the mucosa and fibromuscularis layer. Limited surgery includes simple cholecystectomy, full thickness cholecystectomy, wedge resection of the liver or S4a5 segmental resection of the liver for carcinoma of the gallbladder. Dissection of the regional lymph nodes and/or resection of the bile duct are undertaken according to the extent of spreading with this limited operation. First, in cases of m cancer, simple cholecystectomy can be applied. Second, in cases of pm cancer, full thickness cholecystectomy or wedge resection of the liver with R2 dissection of the lymph nodes can be applied. Third, in cases of ss cancer, wedge resection of the liver or S4a5 segmental resection of the liver with resection of the bile duct and R2 dissection of the lymph nodes including paraaaortic lymph nodes can be applied.View full abstractDownload PDF (10979K) -
Yuji Nimura1995 Volume 28 Issue 1 Pages 99-103
Published: 1995
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSRecent progress of preoperative diagnostic techniques have led to show an accurate information of cancer extension and to apply the smallest necessary resection of the organ and dissection of the lymph nodes and autonomic nerve plexus. Pylorus preserving pancreatoduodenectomy (PpPD) has been performed for periampullary carcinoma: carcinoma of the pancreas head, distal bile duct, papilla of Vater and duodenum, and provided better quality of life than that after standard pancreatoduodenetomy (PD). Furthermore early detection of a small cancer, mucosal cancer and borderline lesions have led to develope a duodenum preserving pancreas head resction and several kinds of partial resection of the pancreas head to preserve the functional capacity of the involved organ. However there is continuing controversy as to the technical problems concerning the functional maintenance of the stomach after the pylorus preserving operation, and particular postoperative complications related to the reductive surgery still remain unsolved.View full abstractDownload PDF (9946K) -
Kyoshi Tsuji, Shigetoyo Saji, Katuyuki Kunieda, Hiroshi Uenishi, Tunea ...1995 Volume 28 Issue 1 Pages 104
Published: 1995
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSDownload PDF (2079K) -
Yusuke Nagata, Hirofumi Tokuoka, Akira Gouchi, Kunzo Orita1995 Volume 28 Issue 1 Pages 105
Published: 1995
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSDownload PDF (1954K) -
Masahiko Orita, Nobuyoshi Morita, Shinji Noshima, Tsuyoshi Takahashi, ...1995 Volume 28 Issue 1 Pages 106
Published: 1995
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSDownload PDF (2181K)
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