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Volume 28, Issue 12
Displaying 1-15 of 15 articles from this issue
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Koichi Tanaka, Chiaki Sano, Ryunosuke Kumashiro, Shigemichi Yamasaki, ...1995 Volume 28 Issue 12 Pages 2227-2235
Published: 1995
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSAn immunohistochemical study on the expression of epidermal growth factor (EGF) and epidermal growth factor receptor (EGF-R) was performed on 36 cases of superficial carcinoma of the esophagus and 32 advanced cases. Immunoreactivity was classified into 2 groups according to the extent of the stained area in cancer tissue. A significant correlation was observed between depth of invasion, lymphatic invasion and EGF staining (p<0.05, p<0.001). The survival rate of patients with positive EGF staining was lower than that of those with negative staining (p<0.05). Both EGF and EGF-R positive staining were correlated with lymphatic invasion (p<0.005), and poor prognosis. EGF staining of recurrent carcinoma was positive in all cases. These data suggested that the expression of EGF and EGF-R was already present in superficial carcinoma of the esophagus, and EGF expression was of greater prognostic significance in superficial carcinoma of the esophagus.View full abstractDownload PDF (16700K) -
Koichi Sato, Takeo Maekawa, Takanori Haba, Kiyotaka Yabuki, Yoshiaki O ...1995 Volume 28 Issue 12 Pages 2236-2241
Published: 1995
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSThe physiological and morphological changes that were present more than twenty years after selective vagotomy with pyloroplasty (SV+P) were studied. Percent reductions in basal and maximal acid output were well maintained similar to the level of early stage after SV+P (78.2 and 75.8% of preoperative values, respectively). Basal and test meal-stimulated gastrin concentrations were also higher than corresponding preoperative levels, and many patients exhibited hypergastrinemia. The histological findings for gastric acid hypersecretors showed that no expansion of intracellular canaliculi was seen and microvilli were well mainteined the same as those before surgery, while in hyposecretors, intracellular canaliculi were expanded and microvilli were disordered and decreased in both number and length. Gastrin producing cell (G-cell) hyperplasia was observed on electron microscopic and immunohistochemical examination. In addition, Ωshaped emiocytotic granule release by G-cells was observed following test meal stimulation. These findings demonstrated that G-cell hyperfunction had been maintained more than twenty years after SV+P.View full abstractDownload PDF (13861K) -
D1Versus D2 Lymph Node Dissection for Early Gastric CancerTsuguo Fujioka, Kiyoshi Sawai, Miyakatsu Ohara, Hiroshi Minato, Yuichi ...1995 Volume 28 Issue 12 Pages 2242-2247
Published: 1995
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSEarly results and postoperative quality of life (QOL) in patients with early gastric cancer who underwent gastrectomy with D1 lymph node dissection (D1 group, n=69) were compared with those who underwent gastrectomy with D2 dissection (D2 group, n=179). The incidence of preoperative complications was significantly higher in the D1 group (75.3%) than that in the D2 group (53.0%) (p<0.001). Mean operative time was significantly shorter in the D1 group (175 min) than in the D2 group (211 min). Mean intraoperative blood loss was also less in the D1 group (379 g) than in the D2 group (426g), but the difference was not significant. The incidence of intra-abdominal complications, including anastomotic leakage and intestinal obstruction, was nerver seen in the D1 group. There were no differences in performance status or occurrence of dumping between the two groups. We devised a QOL score that was composed of nine categories of quality of life. The QOL score was classified into three degrees (good, fair and poor). We could not find any difference according to the QOL score between the two groups. It was concluded that gastrectomy with Dl dissection can be done with minimal morbidity but has no other merit compared with gastrectomy with D2 dissection.View full abstractDownload PDF (10167K) -
Toshio Imada, Toshitaka Takehana, Yasushi Rino, Makoto Suzuki, Makoto ...1995 Volume 28 Issue 12 Pages 2248-2255
Published: 1995
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSClinicopathological evaluation of lymph node metastasis was undertaken to determine the indications for pylorus preserving gastrectomy for patients with early gastric cancer. Lymph node involvement was investigated in 583 patients with early gastric cancer located in the lower and middle third of the stomach who had undergone conventional gastrectomy with D2 lymph node dissection. It is essential that this limited operation is performed in cases without metastasis to the right pericardiac and suprapyloric lymph nodes. By analysis of the relationship between lymph node metastasis and histologic type, macroscopic type, tumor size, or depth of invasion, the indications for pylorus preserving gastrectomy were determined to be as follows: (1) cases with mucosal cancer and submucosal cancer smaller than 30 mm when the histologic type is differentiated.(2) cases with mucosal cancer smaller than 30mm and submucosal cancer smaller than 10 mm when the histologic type is undifferentiated and the macroscopic type is depressed.View full abstractDownload PDF (14408K) -
Masami Ikeda, Sumito Takagi, Kuniyoshi Yamagata, Akio Hara, Hiroshige ...1995 Volume 28 Issue 12 Pages 2256-2264
Published: 1995
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSRecently, active oxygen has been identified as a factor in intestinal ischemic-reperfusion injury. The authors have reported on chemical mediators such as blood-platelet activating factor (PAF) and leucotrienes (LTB4·C4) as important factors. These together with active oxygen cause mucous disorders after reperfusion, but, to investigate the injury as it appears during ischemia, we prepared intestinal ischemic-reperfusing dogs. An endoscope was used to observe the mucous membrane during ischemia over a period of time, and PAF and LTB4·C4 were measured. During intestinal ischemia, PAF increased in the tissue, and after reperfusion. LTB4·C4 appeared. Endoscopic observation revealed that intestinal ischemic-reperfusion injury showed a state of preparation with ischemia that became more marked with reperfusion. In contrast, during ischemic-reperfusion under the administration of highly concentrated oxygen, there was no increase in PAF during ischemia, and the mucous problem was slight. We emphasize the importance of the role played by PAF during the entire course of ischemic-reperfusion.View full abstractDownload PDF (15527K) -
Masaharu Takeuchi, Akihiro Toyosaka, Yoshiyuki Nakai, Shusaku Habu, Ki ...1995 Volume 28 Issue 12 Pages 2265-2269
Published: 1995
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSA 43-year-old man was admitted to our hospital following 5kg weight loss and 3 weeks of dysphagia. An X-ray examination showed a giant, nodular and elevated tumor measuring 15 cm in length in the upper esophagus. An endoscopy identified a large submucosal tumor with an ulceration at the distal end. An endoscopic biopsy from the ulcerated area showed no malignancy. Carcinosarcoma, however, was suspected because of an extraordinary size of the tumor and also of the ulcer formation. The lesion, therefore, was surgically removed by means of a total thoracic esophagectomy. As a result, the tumor proved to be, histologically, a fibrovascular polyp contrary to our pre-operative diagnosis. A fibrovascular polyp is relatively rare in an esophagus. So far, only abot 70 cases have been reported in the world including 26 in Japan. Only two fibrovascular polyps measuring more than 10cm each have been reported in Japan. Various aspects of our case are described in detail in this report with the reasons for the misdiagnosis. Appropriate therapeutic approach are also discussed.View full abstractDownload PDF (9664K) -
Yoshihiro Kanbara, Yoshio Ishikawa, Tetsuya Wada, Yohko Maekawa, [in J ...1995 Volume 28 Issue 12 Pages 2270-2274
Published: 1995
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSA case of primary leiomyosarcoma of the liver in a 65-year-old man is reported. The results of laboratory studies including α-fetoprotein were within normal limits except for a slightly elevated serum level of CEA (5.9ng/ml). Ultrasonography demonstrated a sharply marginated, round hypoechoic lesion in hepatic segments IV and V, which was 5.5×4.2 cm in diameter. The plain CT scan demonstrated a hypodense mass in the right lobe. During portovenous contrast medium distribution, peripheral enhancement and capsular structures appeared, accenting the capsular structures. Because malignant hepatic tumor was suspected preoperatively, and S5S4 segmentectomy was done. At histological study (including immunohistological study), the lesion was revealed to be leiomyosarcoma with many mitotic figures and micro-capsular invasion. Postoperative gallium scintigraphy showed no abnormal lesion. The diagnosis of primary leiomyosarcoma of the liver was made.View full abstractDownload PDF (9800K) -
Hirohide Iwata, Kanji Miyata, Tatsuo Hattori, Yoichiro Kobayashi, Shin ...1995 Volume 28 Issue 12 Pages 2275-2279
Published: 1995
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSThe patient, a 20-year-old man, was admitted with a complaint of high fever, Laboratory findings revealed raised platelets and erythrocyte sedimentation rate, elevated serum cross-reactive protein, and alkaline phosphatase.Abdominal ultrasonography revealed a hypoechoic mass localized in the right posterior lobe of the liver.Abdominal computed tomography disclosed it as a low density area. Celiac arteriography revealed a hypovascular tumor in the liver.Right posterior segmentectomy of the liver was performed.The tumor was clearly distinguished from normal liver tissue, colored yellowish white and measured 5cm in diameter.Histopathologically the tumor was diagnosed as the inflammatory type of malignant fibrous histiocytoma.Fever disappeared and laboratory findings became normal after the resection.Malignant fibrous histiocytoma rarely arises in the liver.Our case is the 20th in the literat.View full abstractDownload PDF (9190K) -
Naoto Senmaru, Sin Okajima, Takando Sakairi, Morio Tsukada, Hiroyuki K ...1995 Volume 28 Issue 12 Pages 2280-2284
Published: 1995
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSA case of amputation neuroma of the common bile duct after cholecystectomy and choledochotomy is reported. A 78-year-old man was hospitalized with the complication of jaundice. He had undergone cholecystectomy and choledochotomy four years previously. Percutaneous transhepatic cholangiography and cholangioscopy showed stenosis of the middle bile duct and a choledochal stone. The biopsy specimen revealed adenocarcinoma. Under a diagnosis of bile duct cancer, the common bile duct was resected and choledocho-jejunostomy was performed. The white tumor 1 cm in size was observed at the stenotic lesion of the choledochus and was histologically diagnosed as amputation neuroma. Amputation neuroma is rare, and as far as we investigated, only 30 cases have been reported in Japan. Cases of stricture of the bile duct were difficult to distinguish from bile duct cancer. When the patient has choledochal stenosis after choledochotomy, the possibility of amputation neuroma should be considered.View full abstractDownload PDF (7824K) -
Yoshiyori Ishii, Katsuyuki Hashimoto, Tetsuji Fujita, Hiroshi Takeyama ...1995 Volume 28 Issue 12 Pages 2285-2289
Published: 1995
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSPresented here is the case of a 56-year-old woman with mucin-producing cholangiocarcinoma which we missed at the first surgery. She visited out hospital with the chief complaints of jaundice and fever. Ultrasound (US) and Endoscopic retrograde cholangiography (ERC) revealed a markedly dilated common bile duct and dilated left intrahepatic bile ducts, and a defect in the common bile duct. Based on the above findings, surgery was performed under the diagnosis of choledocholithiasis. At incision of the common bile duct, a large amount of jelly-like substance was excreted, but choledochoscopy failed to reveal abnormal findings in the common bile and intrahepatic bile duct. Postoperatively, the bile and jelly-like substance were drained continuously via a T-tube, but cytology of the bile provided no finding of malignant cells. Choledochoscopy via the T-tube demonstrated a papillary tumorous lesion in the left hepatic duct, and a diagnosis of papillary adenocarcinoma was established by biopsy. Therefore, resection of the left lobe of the liver, left caudate lobe and extrahepatic bile duct was performed. Cystic dilatation of the intrahepatic bile duct was observed on the resected specimen, but the induration and tumor were not palpable. The histopathological diagnosis was mucin-producing cholangiocarcinoma of the intrahepatic bile duct.View full abstractDownload PDF (9590K) -
Michiya Kobayashi, Keijiro Araki, Seiya Nakamura, Eisuke Kashiwai, Kim ...1995 Volume 28 Issue 12 Pages 2290-2294
Published: 1995
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSA 59-year-old man, who had been treated for chronic pancreatitis for 7 years, complained of vomiting and loss of appetite. Barium meal study, hypotonic duodenography, and endoscopic examination revealed stenosis of the descending duodenum. Tumor markers carcinoembryonic antigen and carbohydrate antigen 19-9 were within normal range. Barium meal study which was performed 7 years earlier also revealed duodenal stenosis at the same site, which suggested benign stenosis due to chronic pancreatitis rather than pancreatic cancer. Endoscopic retrograde pancreaticography showed dilatation of the main pancreatic duct without irregularity; however the duct of Santorini was not demonstrated. Abdominal CT showed no mass or calcification in the pancreas head. Laparotomy findings supported the diagnosis of groove pancreatitis and the patient underwent duodeno-duodenostomy.View full abstractDownload PDF (10113K) -
Shigenori Sugihara, Tetsuhiro Egami, Shigeyuki Tsurusaki, Hideo Ayame, ...1995 Volume 28 Issue 12 Pages 2295-2298
Published: 1995
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSA 73-year-old woman was hospitalized with the chief complaint of episodes of unconsciousness. Endocrinological tests suggested insulinoma. During surgery for cholecystectomy, however, meticulous exploration did not detect any tumor. Four months later, the patient was readmitted. Magnetic resonance imaging (MRI) and arterial stimulation and venous sampling (ASVS) showed a tumor of 10mm in diameter at the middle of the pancreas. Laparotomy was again performed. Intraoperative ultrasonography visualized two 5 mm tumors as low echoic masses at the middle of the pancreas, and these tumors were enucleated. Immunohistological examination for insulin, glucagon, gastrin and somatostatin gave the interesting result that one was insulinoma, and the other glucagonoma.View full abstractDownload PDF (8177K) -
Isao Saitoh, Kenichi Watanabe, Shusaku Takahashi, Shigehito Yoneyama, ...1995 Volume 28 Issue 12 Pages 2299-2303
Published: 1995
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSA case of inflammatory pseudotumor of the spleen is reported. During observation of the course of cerebral infarction at the Department of Medicine, Fukagawa Municipal General Hospital, a 69-year-old male patient was found to have high levels of serum and urine amylase. Abdominal examinations by ultrasonography, computed tomography, magnetic resonance imaging, scintigraphy and angiography showed a hypovascular spherical mass with a diameter of 39 mm at the hilus of the spleen. Under a preoperative diagnosis of benign tumor such as hemangioma or hamartoma and with some possibility of a malignant tumor, splenectomy was performed on March 25, 1994. Macroscopically, the tumor (3.8×3.5cm) was white and nodular, with surrounding capsule. The tumor was diagnosed histologically as a plasma cell granuloma type of inflammatory pseudotumor. The patient was discharged from the hospital in good condition on Arpil 20, 1994.View full abstractDownload PDF (9248K) -
Jun-ichi Nakamura, Kazuyasu Nakao, Satoru Miyazaki, Masaaki Nakahara, ...1995 Volume 28 Issue 12 Pages 2304-2307
Published: 1995
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSWe present a rare case of small intestinal angiolipoma. A 66-year-old woman was referred to our hospital with the chief complaint of a large amount of bloody stool. Small intestinal contrast X-ray seriesshowed a filling defect at the proximal jejunum. Partial resection of the jejunum was performed. The tumor was 6.5×3.5×3.5cm in size, and ulceration was observed at its top. Histological examination showed increased thick-walled capillaries and typical adipose tissue and, the diagnosis was a small intestinal angiolipoma. Angiolipoma occurs in the late teens as a subcutaneous nodule. The report of angioglipoma in the digestive tract is extremely rate, and this is first report of the small intestinal angiolipoma in the world.View full abstractDownload PDF (6398K) -
Akira Kamasako, Syunsuke Kawamoto, Reichirou Tanaka, Singo Shibasaki, ...1995 Volume 28 Issue 12 Pages 2308-2311
Published: 1995
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSA case of adrenal metastasis from colon carcinoma without any other organ metastases is reported. A 71-year-old woman was admitted complaining of abdominal pain. She was diagnosed as having sigmoid colon cancer associated with a right adrenal tumor. It was difficult to determine preoperatively whether the adrenal tumor was primary or metastatic. At laparotomy there was direct invasion to the uterus from the colon tumor, but was neither liver metastasis nor peritoneal carcinosis was present. A sigmoidocolectomy and hysterectomy associated with right adrenectomy and partial hepatectomy was performed. the histological diagnosis of the colon and adrenal tumor was well differentiated adenocarcinoma. Solitary metastasis to the adrenal gland from the colorectal carecinoma is rare.View full abstractDownload PDF (7992K)
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