All issues
Volume 52 (2019)
- Issue 12 Pages 695-
- Issue 11 Pages 611-
- Issue 10 Pages 551-
- Issue 9 Pages 485-
- Issue 8 Pages 405-
- Issue 7 Pages 345-
- Issue 6 Pages 281-
- Issue 5 Pages 239-
- Issue 4 Pages 191-
- Issue 3 Pages 137-
- Issue 2 Pages 83-
- Issue 1 Pages 1-
- Issue Special_Issue P･･･
- Issue Supplement2 Pag･･･
- Issue Supplement1 Pag･･･
Volume 29, Issue 3
Displaying 1-24 of 24 articles from this issue
- |<
- <
- 1
- >
- >|
-
Gizo Nakagawara1996 Volume 29 Issue 3 Pages 661-669
Published: 1996
Released on J-STAGE: August 23, 2011
JOURNAL FREE ACCESSIslet transplantation in Type I insulin-dependent diabetus mellitus (IDDM) has some advantages over vascularized pancreas organ transplantation, such as the easy and safe technique of transplantation, and the possibility of immunomodulation of the graft. But data from clinical studies have shown that some scrious problems still need to be overcome. One of the problems islet transplatation is the islet storage. There are some preservation methods, including culture, low temperature preservation, and cryopreservation, but cryopreservation may be the only possible method of long-term preservation. Islets can be cryopreserved without loss of their biological activity by using the cooling rate of 1°C/min and 25°C/min. And cryopreserved isolets can normalize the blood glucose level of diabetic hamsters in isogenic trnasplantation. To reduce the immunogenicity of the islets, isolated pancreatic islets were dissociated into islet cells and cryopreserved. There was a significant prolongation of survival of dissociated and cryopreserved islet cells in allogenic transplantation in rats. Irradiation of islets and encapsulation of islets were also examined and these methods were useful for controlling rejection in islet transplantation. We believe these approaches will permit application of these methods to the treatment of diabetes in human with allorgrafts xenografts.View full abstractDownload PDF (18549K) -
Itsuo Miyazaki1996 Volume 29 Issue 3 Pages 670-676
Published: 1996
Released on J-STAGE: August 23, 2011
JOURNAL FREE ACCESSThe clinical significance of radical surgery for carcinoma of the head of the pancreas was reviewed from the standpoint of neural invasion. Since 1973 extended radical pancreatectomy has been performed for pancreatic cancer in our institute on the basis of clinicopathologic study. Pancreatectomy by a translateral retroperitoneal approach was developed in 1977. Based on the three-dimensional analysis, the main mode of tumor invasion was neutral invasion around the superior mesenteric artery. Desmoplastic cancer infiltration was observed mainly around the portal vein and inferior vena cava. A detailed chinicopathologic study of carcinoma of the head of the pancreas indicated that it is necessary to perform complete dissection of the extrapancreatic plexus around the superior mesenteric artery, including extensive lymph node dissection of the superior mesenteric nodes and para-aortic lymph nodes. The mechanism of neural invasion of pancreatic cancer, modes of tumor spread, and the correlation between neural invasion and other clinicopathologic factors were reviewed. Three-dimensional studies of the retroperitoneal invasion by pancreatic cancer were reviewed on the basis of complete histologic serial section analyses. The main mode of tumor invasion was neural invasion around the superior mesenteric artery. These findings suggest that it is necessary to perform complete resection of extrapancreatic plexus.View full abstractDownload PDF (13288K) -
Katsuyuki Kunieda, Tooru Kageyama, Kyoushi Tsuji, Takashi Suhara, Tosh ...1996 Volume 29 Issue 3 Pages 677-683
Published: 1996
Released on J-STAGE: August 23, 2011
JOURNAL FREE ACCESSUsefulness of preoperative serum CEA level and tissue CEA location as prognostic factors of gastric cancer was evaluated. Preoperative serum CEA level were measured in 450 patients who underwent gastrectomy for gastric cancer in our department in the past 8 years. Also, the postoperative outcome of 78 CEA-positive patients and 372 CEA-negative was compared. In 150 patients who had undergone gastrectomy more than 5 years earlier. CEA immunohistochemical staining by the ABC method was performed, and the patients were divided into 4 groups, negative (GO), apical (GI), cytoplasmic (GII) and stromal (GIII). Results: (1) The outcome of the serum CEA-positive group was significantly poorer than that of the serum-negative group.(2) The serum CEA-positive group showed more advanced cancer, such as liver metastasis.(3) The outcome of the tissue CEA-positive group was poorer than that of the tissue CEA-negative group.(4) The survival curves according to tissue CEA location revealed significantly shorter survival in the GI, GO, G (II+III) groups in that order, in both the positive and negative serum CEA groups. These results suggest that preoperative serum CEA and tissue CEA staining (especially tissue CEA location) might be useful indicators for postoperative prognosis of gastric cancer.View full abstractDownload PDF (12218K) -
Mitsugi Shimoda1996 Volume 29 Issue 3 Pages 684-690
Published: 1996
Released on J-STAGE: August 23, 2011
JOURNAL FREE ACCESSObstructive jaundice is closely associated with endotoxemia. Bacterial endotoxin (LPS) and proinflammatory cytokines induce nitric oxide (NO) synthase in various organs in vivo as well as in a variety of cells in vitro. I investigated whether NO production is increased in obstructive jaundice by determiningNO-2/NO-3 levels in portal plasma of common bile duct-ligated rats. While the NOZ/NO3 levels in portal plasma of control rats did not change during the observation, a gradual increase up to day 7 was seen after the ligation. Although the NO synthase mRNA in the liver was undetectable before the bile duct ligation, it was substantially induced by day 7 following the ligation. A decreased peripheral blood flow in the liver was observed in the bile duct-ligated rats, which was further reduced by treatment of the rats with the NO synthase inhibitor, L-NAME. I also investigated the effect of bile acids on the induction of NO synthase in LPS-stimulated J774 macrophages, Whole bile from control rats and, to a Iesser extent, from the bile duct ligated-rats inhibited NO synthase induction in macrophages. Five different bile acids (cholic acid, lithocholic acid, chenodeoxycholic acid and ursodeoxycholic acid), alI inhibited NO synthase with similar dose dependency. In conclusion, obstructive jaundice is associated with increased NO production which is derived from induced NO synthase. Elevated NO may play an important role in obstructive jaundice, especially in the peripheral blood flow in the liver.View full abstractDownload PDF (13572K) -
Yuichi Hatakeyama, Toshiyuki Ono, Rikiya Abe1996 Volume 29 Issue 3 Pages 691-698
Published: 1996
Released on J-STAGE: August 23, 2011
JOURNAL FREE ACCESSLiver resection is the most effective method of therapy for hepatocellular carcinoma. We need accurate information about the liver function before liver resection, because most patients with hepatocellular carcinoma have associated liver cirrhosis in Japan. It has recently been reported that Transforming Growth Factor-β (TGF-β), which promotes liver fibrosis and suppresses the growth of hepatocytes, is related to the development of liver cirrhosis. So we focused our attention on liver fibrosis resulting from TGF-β, and investigated whether the extent of hepatic fibrosis (hepatic fibrosis index) might be correlated with hepatic regeneration activity after partial hepatecotmy in rats with thioacetamide-induced liver disease. Two groups of male Wistar rats (5 wk old) (10 to 30/group) were treated for 10 wk by weekly intraperitoneal administration of thioacetamide (200mg/kg, 3times/wk) or saline. All rats then underwent 70% hepatectomy under pentobarbital anesthesia. Hepatic regeneration activity was determined 24 and 48 hours after parital hepatectomy by means of bromodeoxyuridine incorporation into DNA. The hepatic fibrosis index was semiquantitatively calculated at the time of partial hepatectomy by automated images analysis on Azan-stained liver tissue. A significant inverse correlation was found between the hepatic fibrosis index and DNA synthesis in all rats (thioacetamide-treated and saline-treated) 24 and 48 hours after partial hepatectomy (r=-0.64 and-0.60, respectively; p <0.05), and also an inverse correlation existed even in the rats with treated thioacetamide (r=-0.50 and-0.53 at 24 and 48 hr, respectively). In conclusion, it is considered that the preoperative quantitation of hepatic fibrosis by automated image analysis will enable us to predict hepatic regeneration activity after cirrhotic liver resection.View full abstractDownload PDF (16177K) -
Nozomi Idota, Kazuo Hatsuse, Satoshi Shouno, Tsukasa Aihara, Michinori ...1996 Volume 29 Issue 3 Pages 699-703
Published: 1996
Released on J-STAGE: August 23, 2011
JOURNAL FREE ACCESSWe investigated the effect of prostaglandin E1 (PGE1) on rats with liver dysfunction induced by endotoxin. The dose of PGE1 did not exceed 0.1μg/kg/min, which did not affect the circulation adversely. The rats were divided into three groups as follows: the Ex-group was given endotoxin alone; the Ex+0.02 PGE1-group was given endotoxin and 0.02μg of PGE1; the Ex+0.1 PGE1-group was given endotoxin and 0.1 μg of PGE1. We compared the liver function (T-Bil, GPT, LDH, ALP), arterial blood pressure (BP) and liver tissue blood flow (TBF) in these groups. In the Ex+PGE1-group liver function was exacerbated though in the Ex+0.02 PGE1-group T-Bil was improved. BP and TBF showed little difference among these groups. These results suggested that both doses of PGE, had an adverse effect on liver dysfunction induced by endotoxin.View full abstractDownload PDF (9962K) -
Comparison with Cases of Cancer in Adenoma and Advanced Cancer of the ColonMakoto Ikenaga, Yoshimasa Ohtani, Osamu Naitou, Hiroshi Sasamoto, Yosh ...1996 Volume 29 Issue 3 Pages 704-709
Published: 1996
Released on J-STAGE: August 23, 2011
JOURNAL FREE ACCESSTen cases of colonic villous tumors composed of 10 villous adenoma components and 5 villous carcinoma components were investigated in terms of p53 expression and Ki-67 proliferative activity to determine their biological characteristics on the basis of comparison with 18 cases of cancer in adenoma and 39 cases of advanced cancer. Over expression of p53 was detected in none of the villous adenoma components, in 20% of the villous carcinoma components and in 33% of adenomas and 61% of carcinomas in patients with cancer in adenoma, Ki-67 lalbeling indices of the villous adenoma components were significantly lower than those of any carcinomas examined in the present study, and also significantly lower than those of adenomas in patients with cancer in adenoma. However, the villous carcinoma components had an index similar to that of carcinoma of patients with cancer in adenoma. These findings suggested that the villous adenoma component has a low grade malignant potential compared with adenoma in patients with cancer in adenoma in terms of over expression of p53 and the Ki-67 labeling index. In contrast, villous carcinoma has a diverse malignant potential different from that of villous adenoma, but resembling that of carcinoma in patients with cancer in adenoma.View full abstractDownload PDF (12676K) -
Hirokazu Yada, Kiyoshi Sawai, Miyakatsu Ohara, Masataka Shimotsuma, Hi ...1996 Volume 29 Issue 3 Pages 710-716
Published: 1996
Released on J-STAGE: August 23, 2011
JOURNAL FREE ACCESSIn order to determine the extent of D2 surgery for colon cancer in each location, we reviewed the angiograms of 344 colon cancer patients and lymph node metastasis of 63 colon cancer patients with n2 metastasis. Our findings were summarized as follows: Since the ileocecal artery always branched from the supeiror mesenteric artery and n2 metastasis of cecum cancer was limited to No.202, D2 surgery for cecum cancer can be carried out using ileocecal resection. As the right colic artery had variant origins and ascending colon cancer had n2 metastasis in various n2 stations, D2 surgery for ascending colon cancer requires right hemicolectomy. The middle colic artery forked into the right and left branches and each branch had different branching variations. When the right colic artery and the middle colic artery has a common trunk, D2 surgery for D2 surgery for transverse colon cancer on the right side should be performed usin right hemicolectomy. When the left branch of the middle colic artery has an independent replaced origin, lymph node dissection should be modified according to the variant origin. When the left colic artery and the first sigmoidal artery have a common trunk, lymph node dissection should include No.242-1 for descending colon cancer and No.232 for sigmoid colon cancer respectively. D2 surgery for sigmoid colon cancer should include dissection of No.252, because 39% of sigmoid colon cancer with 2 metastases showed metastasis of that station.View full abstractDownload PDF (13431K) -
Makoto Kamimori, Toshihisa Ogawa, Masanori Hashimoto, Ichiro Konagaya, ...1996 Volume 29 Issue 3 Pages 717-721
Published: 1996
Released on J-STAGE: August 23, 2011
JOURNAL FREE ACCESSThe occurrence of an esophageal inlet patch of gastric mucosa in Japan is 4.0% in males and 2.6% in females, most of which are reported to be located near the esophageal inlet patch. However, the number of the cases of adenocarcinoma developing from an inlet patch reported in Japan is only 5, as a for as we know, and its occurrences quiterare. Here, we report a case of a 74-year-old woman who had no particular past history or familial history. She had an episode of upper abdominal discomfort on December 27, 1993, and was admitted to our hospital for examination on January 17, 1994. Upper gastrointestinal X-ray examination showed a pediculate tumor of 3 cm in the cervical esophagus. Upper gastrointestinal endoscopy revealed a polypoid lesion of Yamada Type III in the left side of the posterior wall of the cervical esophagus, about 14 cm from the teeth. Biopsy was performed and it was revealed to be a papillary adenocarcinoma. The depth of this tumor was considered from endoscopic ultrasonography to reach the muscular layer of the mucosa. Resection of the mucosa of the cervical esophagus including the tumor was performed on February 15, 1994. Its histology revealed the tumor be a well-differentiated adenocarcinoma of the esophagus developing from an inlet patch of gastric mucosa. Here, we report this quite rare case of early adenocarcinoma of the cervical esophagus with a brief review of the literature.View full abstractDownload PDF (8164K) -
Yoshihiro Kagawa, Wataru Takiyama, Toshiaki Saeki, Shigemitsu Takashim ...1996 Volume 29 Issue 3 Pages 722-726
Published: 1996
Released on J-STAGE: August 23, 2011
JOURNAL FREE ACCESSRecent advanced treatment for esophageal cancer may contribute to the prolongation of survival for esophageal cancer patients. On the other hand, a second cancer on the stomach used as a reconstructive organ occasionally has been found. We performed gastrectomy and intra-thoracic esophago-jejunostomy in two patients who had esophagectomy with reconstructive surgery using a portion of the stomach. The first case was a 65-year-old patient who had esophagectomy for type 3 esophageal cancer located on the lower esophagus. After esophagectomy, on the stomach, a giant ulcer with malignant appearance was observed by endoscopy, and histological examination of the biopsy specimen revealed poorly differentiated adenocarcinoma. Clinically, the patient was diagnosed with primary gastric cancer. The second case was a 50-year-old patient treated with esophagectomy. Five and a half years after surgery, the patient underwent routine endoscopic examination and diagnosed with gastric cancer on the gastric tube. The major problem in surgery for these patients was removal of the reconstructive esophagus from the retro-mediastinum, since the adhesion was extremely tight. Howerver, surgery was successful, suggesting that surgery for gastric cancer on the reconstructive esophagus might be recommended. Japan has been reported to have one of the highest incidences of double cancer in both the esophagus and stomach. Intensive follow-up for esophageal cancer patients may be necessary for the early detection of second cancer on the stomach and for improvement of the prognosis.View full abstractDownload PDF (9862K) -
Takanori Aoki, Kazuaki Nakanishi, You Kamiizumi, Tomoyuki Takagi, Muts ...1996 Volume 29 Issue 3 Pages 727-731
Published: 1996
Released on J-STAGE: August 23, 2011
JOURNAL FREE ACCESSA case of squamous cell carcinoma in the middle body of the stomach is reported. A 73-year-old male was admitted to Wakkanai Municipal Hospital because of epigastralgia. Endoscopic study revealed a Borrman type 2 gastric cancer, on the posterior wall to the lesser curvature side of middle body of the stomach. Distal gastrecotmy, partial colectomy and cholecystectomy was performed on December 24, 1993. On histopathological examination of all specimens of the cancer, there was no adenocarcinoma, only squamous cell carcinoma. The deepest layer invaded was the subserosa. There was no evidence of lymph node metastasis. Conclusive stage grouping was Ib and curability was A. There is no symptom of recurrence 1 year and 3 monthes after the operation. Squamous cell carcinoma of the stomach are very rare, reported incidence only 0.09% of all resected stomach. We report this case with studying 17 cases of Japan.View full abstractDownload PDF (8397K) -
Tsuneaki Fujiya, Takahiko Ohgoshi, Junnichi Mikuni, Yoichiro Kakugawa, ...1996 Volume 29 Issue 3 Pages 732-736
Published: 1996
Released on J-STAGE: August 23, 2011
JOURNAL FREE ACCESSA 79-year-old woman was admitted to our hospital for surgical treatment of gastric cancer. A man-fist-size tumor was palpated in the left hypochondrial region. The serum AFP level was increased to 990 ng/ml. X-ray and endoscopic examinations of the stomach revealed a lesion with a shallow depression combined with an elevation (IIa + IIc type, Japanese classification of gastric carcinoma), on the posterior wall of the antrum and a protruded lesion on the subcardia. Although a round tumor was revealed by contrast medium in the subcardia of the stomach, liver metastasis was not demonstrated by X-ray examination. A regional lymph node along the lesser curvature of the stomach enlarged to 70mm in diameter, which was oppressing on the subcardia, was found intraoperatively. Distal gastrectomy with D2 lymph node dissection was performed. The main pathological feature of the gastric lesion was moderately differentiated adenocarcinoma which was limited to the submucosa of the stomach. Positive immunohistochemical staining of AFP was demonstrated in about 10% of the total amount of the cancer with eosinophilic granular cytoplasma. The serum AFP level decreased to normal after the operation. The prognosis of the patient with AFP-producing gastric cancer has been reported to be poor because of advance of the disease in most of the cases, but this patient is alive without recurrence 14 months after surgery.View full abstractDownload PDF (9998K) -
Tetsuya Takahashi, Shinji Togo, Hirohiko Mochizuki, Akira Nakano, Shig ...1996 Volume 29 Issue 3 Pages 737-740
Published: 1996
Released on J-STAGE: August 23, 2011
JOURNAL FREE ACCESSA 56-year-old woman was admitted to our department complaining of epigastralgia, and was endoscopically diagnosed with early esophageal cancer. Preoperative computed tomography (CT) showed multiple low density areas in the right lobe of the liver. Abdominal ultrasonography (US) showed the characteristic findings of small, low echoic lesions with multiple high echoic spots. Needle biopsy could not determine the histological finding preoperatively. We diagnosed metastasis of the liver from the early esophageal cancer. Operative findings included multiple yellow-white nodules 1-3 mm in diameter scattered throughout the liver, and histological study of the wedge biopsy specimen revealed benign microhamartoma. Microhamartoma of the liver, which is a rare disease, may be mistaken for diffuse hepatocellular carcinoma or multiple metastases due to their similar appearance in imaging. But findings of a mixture of small low echoic lesions and multiple high echoic spots on US and enhanced small low density areas on CT would indicate microhamartoma of the liver.View full abstractDownload PDF (7873K) -
Shinsaku Funamoto, Sanshiro Kigawa, Syuji Hirai, Takashi Nakakuma, Sei ...1996 Volume 29 Issue 3 Pages 741-745
Published: 1996
Released on J-STAGE: August 23, 2011
JOURNAL FREE ACCESSA 56-year-old woman with known situs inversus totalis preseneted with leftsided discomfort in the back. Abdominal ultrasonography confirmed the diagnosis of a gallstone, as well as situs inversus with the liver and gallbladder on the left side and the spleen on the right. Laparoscopic cholecystectomy was performed. This paper shows that this technique can be safely and effectively applied in the setting of situs inversus, although attention must be paid to the details of left-right reversal.View full abstractDownload PDF (7740K) -
Kazutsugu Sakamoto, Kiyotaka Yukimoto, Akira Hayashibe, Hajime Tanaka, ...1996 Volume 29 Issue 3 Pages 746-750
Published: 1996
Released on J-STAGE: August 23, 2011
JOURNAL FREE ACCESSA 74-year-old woman was admitted to our hospital because of intermittent epigastric discomfort. Abdominal ultrasound examination and a CT scan showed that the gallbladder with stones, visualized as an irregular wall thickening, continued deirectly with a tumor of the anterior section of the right lobe of the liver. Abdominal angiography revealed an encasement and stenosis in the cystic arteries and a tumor stain in the right lobe of the liver. The patient was diagnosed with the gallbladder cancer with direct invasion to the liver, and underwent extended cholecystectomy. Pathological examination led to a diagnosis of malignant fibrous histiocytoma (MFH). MFH originating from the gallbladder is very rare, and only 7 cases have been reported in Japan so far. This is the eighth case in Japan.View full abstractDownload PDF (8818K) -
Iwao Ikai, Yasuo Matsutani, Toshio Kamata1996 Volume 29 Issue 3 Pages 751-755
Published: 1996
Released on J-STAGE: August 23, 2011
JOURNAL FREE ACCESSA 33-year-old man, who had received a distal partial gastrectomy, underwent an emergency laparatomy with pancreatic drainage because of acute hemorrhagic pancreatitis. Two weeks later, a pancreatic abscess was diagnosed by CT scanning and fistulography. On the 54th post-operative day, gastro-, duodeno-, and jejuno-cutaneous fistulas were detected on a fistulogram. After external drainage with systemic administration of antibiotics and total parenteral nutrition, the fistulas were closed. However, 3 weeks later, enlargement of the pancreatic abscess and enlargement of the pancreatic abscess and reappearance of gastro-and jejuno-cutaneous fistulas were observed. The patient was given a laparatomy with drainage of the pancreatic abscess and simple closure of the fistulas. The jejunal fistula remained, but it closed spontaneously in 6 weeks. This is a rare case of pancreatic abscess complicated with upper gastrointestinal fistulas.View full abstractDownload PDF (8591K) -
Michiya Kobayashi, Kimio Matsuura, Keijiro Araki, Eisuke Kashiwai, Nao ...1996 Volume 29 Issue 3 Pages 756-760
Published: 1996
Released on J-STAGE: August 23, 2011
JOURNAL FREE ACCESSA 52-year-old woman had had abdominal pain and sequential constipation and diarrhea since March 1989. She complained of abdominal pain and vomiting, and was admitted to the hospital with the diagnosis of ileus. Barium enema study demonstrated a colonic obstruction at the splenic flexure. She was diagnosed as having colon cancer and was transferred to our hospital. The level of tumor markers carbohydrate antigen 19-9 and ferritin were 1, 260 U/ml (<38) and 150ng/ml (10-80), respectively. Transverse colostomy was performed on June 26, 1989. Endoscopic examination of the colon showed marked stenosis. However, endoscopic biopsy of the colonic mucosa did not reveal any cancer cells. She underwent surgery on July 11, 1989. Cancer of the pancreas tail invading to the spleen, colon, and renal capsule wasrevealed by frozen section. Distal pancreatectomy with left hemi-colectomy, left nephrectomy, and intraoperative irradiation of 25 Gy with 10 MeV around the paraaortic region including renal artery were performed. She is alive without recurrence of pancreatic cancer 6 years after the operation.View full abstractDownload PDF (9525K) -
Akihiko Tachibana, Eisuke Fukuma, Nobuyasu Kano, Tatsuo Yamakawa1996 Volume 29 Issue 3 Pages 761-765
Published: 1996
Released on J-STAGE: August 23, 2011
JOURNAL FREE ACCESSA case of primary splenic malignant lymphoma and its rarity in the literature is presentedin this paper. The patient, a 52-year-old man, was admitted to our hospital with the complaint of epigastralgia through his practitioners and a diagnosis of gastric submucosal tumor was made by an upper GI series. With examinations at our institution, no lesion was found in the stomach, but a tumor of the spleen was detected. Surgery performed under a diagnosis of a malignant tumor of the spleen. A tumor was exposed at the splenic hilum and invading the body of the stomach and the tail of the pancreas. Total gastrectomy with splenectomy and resection of the tail of the pancreas was performed. Histological study revealed a malignant lymphoma, diffuse medium sized type. It has been reported that the prognosis of primary splenic malignant lymphoma is extremely poor. The patient reported here, however, is leading a normal social life without any findings suggesting recurrence sign during four years after the surgery combined with postoperative adjuvant chemotherapy.View full abstractDownload PDF (9285K) -
Makoto Mizuta, Hisashi Tani, Noritake Iwai, Yosuke Miyano, Toshiya Wam ...1996 Volume 29 Issue 3 Pages 766-769
Published: 1996
Released on J-STAGE: August 23, 2011
JOURNAL FREE ACCESSWe experienced a successful case of pseudomyxoma peritonei treated with continuous hyperthermic peritoneal perfusion (CHPP) after surgery for the purpose of preventing recurrence. A 74-year-old man visited our hospital because of a sensation of fulness in the lower abdomen. He was diagnosed as having pseudomyxoma peritonei due to perforated mucocele of appendix. His primary lesion was resected, and gelatinous mucoid material in the abdominal cavity was removed surgically. Postoperative histological examination revealed a mucinous cystadenocarcimoma of the appendix. After surgery we carried out CHPP. In 1 hour, 10, 000ml of physiologic saline solution heated to 45°C was infused into the peritoneal cavity through a silicon tube placed in the left subphrenic cavity and drained out through tubes placed in the pelvic cavity and right lower quadrant. CHPP was carried out several times within 2 weeks after surgery. There has been no sign of recurrence for more than 5 years after CHPP. Therefore, we think that CHPP is effective in preventing the recurrence of pseudomyxoma peritonei.View full abstractDownload PDF (7880K) -
Kiyohiko Shuto, Katsuya Kuga, Nobuyuki Tokumoto, Toru Fukunaga, Hirosa ...1996 Volume 29 Issue 3 Pages 770-774
Published: 1996
Released on J-STAGE: August 23, 2011
JOURNAL FREE ACCESSA 66-year-old woman was admitted to the hospital with sudden melena. Hb was 8.8g/dl and Ht 27.8%. Blood chemistry and tumor markers were in the normal range. A substantial tumor, measuring 8.5cm×7.6cm, was detected in the small intestinein in the pelvic cavity by ultrasonography and computed tomography. Superior mesenteric angiography showed neovascularization over the tumor. Laparotomy was performed on suspicion of leiomyosarcoma of the small intestine. The tumor was located in the ileum 100cm on the oral side from the end of the ileum without a malignant appearance. A curative operation which included a partial ileum resection was performed involving the extra growing tumor. Histologically the tumor consisted of spindle cells with tubular proloferation and a palisading pattern. Immunological staining of the tumor cells was negative for S-100 protein but positive for NSE. The tumorwas a mixed Antoni A and B type of schwannoma of the ileum. Schewannoma of the small intestine is particulary rare. Only 48 cases have been reported in the Japanese literature. We herein report this case with discussion of the relevant literature.View full abstractDownload PDF (9763K) -
Kozo Koshizuka, Kouichiro Nishida, Syunji Mutoh, Hiroshi Nakagomi, Kun ...1996 Volume 29 Issue 3 Pages 775-779
Published: 1996
Released on J-STAGE: August 23, 2011
JOURNAL FREE ACCESSWe report a case of T-cell-derived malignant lymphoma of the colon, and discuss this case in relation to the literature. Case A 84-year-old female. Chief complaint: Lower abdominalpain and fever. On the bisis of the barium enema and abdominal CT findings, cancer of the ascending colon was diagnosed. Surgery was performed on October 18, 1991. Operative findings: Right hemicolectomy and lymph node dissection in accordance with D2 colon cancer were performed, including all of the enlarged lymph nodes. Resected specimen: The tumor was 5×5.5cm in size. Histopathologically the tumor cells were positive for UCHL-1 (T-cell marker), but negative for L26 (B-cell marker). It was surmised that the tumor was a malignant lymphoma of T-cell origin. Discussion: Primary malignant lymphoma of the colon is a rare disease. It is thought that almost all malignant lymphomas of the digestive tract are the B-cell origin, and malignancies of the T-cell origin are extremely rare. Prognosis of the T-cell origin is much worse than that of B-cell origin. And this case was died dur to the recurrence of the lymphoma at two years after surgery.View full abstractDownload PDF (9515K) -
Yoshikazu Fukuda, Kazuma Tsukioka, Fumihiro Kawasaki, Yoshio Matsuo, T ...1996 Volume 29 Issue 3 Pages 780-784
Published: 1996
Released on J-STAGE: August 23, 2011
JOURNAL FREE ACCESSA 51-year-old woman with acute abdominal distension was transferred to our medical center because of shock 6 hours after the onset of the disease. Her abdomen was extremely distended and digital examination revealed massive clayey feces. As computed tomography revealed gas in the mesenteric veins, an emergency laparotomy was performed. The bowel from the sigmoid colon to the jejunum of the distal 280cm over the terminal ileum was totally necrotized. A normal segment 15 cm in length was detected between the necrotized bowel and the fecal mass of the rectum. All the major mesenteric vessels were pulsating normally at the operation. After the entire necrotized bowel was resected, jejunostomy and sigmoid colostomy were performed. The patient started per os 20 days postoperatively. So far as we could find in the literature, only two cases of severe necrotizing obstructive colitis extending tothe ileum have been reported. Therefore our case might be the first one with extension to the jejunum. In our case, the bowel had been in the chronic ischemic state due to the diabetic microvascular lesion. In addition to the condition, the massive bacterial reflux intothe jejunum from the colon caused the capillary vasoconstriction of the bowel and that made her so critical.View full abstractDownload PDF (9677K) -
Yukoh Kin, Akihiron Yamaguchi, Masatosh Isogai, Akihiro Hori, Shuhei T ...1996 Volume 29 Issue 3 Pages 785-789
Published: 1996
Released on J-STAGE: August 23, 2011
JOURNAL FREE ACCESSA 68-year-old man suffered from the postoperative complication of an esophagectomy to prevent esophageal carcinoma, that revealed necrosis in the reconstructed colon due to blood flow insufficiency. For this case, early resection of the necrotic colon wlas performed anda second reconstruction was made by using the pedunculated jejunum with additional microvascular anastomosis (supercharge method) between the jejunal and internal mammary vessels. The postoperative course was uneventful and a satisfactory outcome was obtained. This supercharge method would be effective for a worrisome case in which the circulation of the distal part of the reconstructed substitute might be poor.View full abstractDownload PDF (9450K) -
Hideaki Kawashima, Masanori Hirao, Motoya Kashiyama, Jun Chiba, Hideto ...1996 Volume 29 Issue 3 Pages 790-794
Published: 1996
Released on J-STAGE: August 23, 2011
JOURNAL FREE ACCESSWe report a new procedure that was local resection of the colonic tumor using a colonoscopy in the peration. We called it Colonoscopy-assisted Operation. This method was started atKin-Ikyo Central Hospital in February 1995. The indications for this procedure are a benign colonic tumor, carcinoma in situ and carcinoma which minutely invaded the submucosal layer. Additionally, this method was adapted cases in which polypectomy (mucosal resection) by colonoscopy was difficult or not successful. The most remarkable points of this procedure were as follows: first, the site of the skin incision was just above lesion and its scarwas very small: second, the distance to the lesion was very short by colonoscopy: third, pneumoperitoneum was not necessary. The benefits of this method were less surgical stress than the conventional operation and shorter operating time than the laparoscopic operation, and enyone can do this operation very easily. It is suggested that this procedure is a reasonable method for adaptation to colonic non-invasive tumors.View full abstractDownload PDF (9077K)
- |<
- <
- 1
- >
- >|