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 7
Displaying 1-24 of 24 articles from this issue
- |<
- <
- 1
- >
- >|
-
Jun Yamashita, Akihiko Watanabe, Hidetomo Sawada, Yukishige Yamada, Yo ...1996 Volume 29 Issue 7 Pages 1583-1590
Published: 1996
Released on J-STAGE: August 23, 2011
JOURNAL FREE ACCESSTo determine the significance of epidermal growth factor receptor (EGFR) overexpression in human esophageal carcinoma, we immunohistochemically analyzed 60 tumors which were obtained from patients who underwent surgery. EGFR overexpression, located on the cancer cell membrane, was observed in 48% of these tumors. In a comparison with clinicopathological findings, significant correlations were observed between EGFR overexpression and lymph node metastasis, histologic stage or cumulative survival rate. On the other hand, to study the relationship between EGFR overexpression and the proliferative activities, we stained serial sections immunohistochemistrically by using the antiproliferating cell nuclear antigen (PCNA), and determined the PCNA labeling index (LI). There was no significant assosiation between EGFR overexpression and PCNA LI. Moreover, 34 tumors were transplanted into nude mice subcutaneously, and no significant association was found between EGFR overexpression and transplantability, growth type or doubling time of these transplanted tumors. These results suggest that the malignant potential of esophageal carcinoma with EGFR overexpression did not result from acceleration of the proliferative activity and EGFR seems to act as an enhancer of metastatic mechanism.View full abstractDownload PDF (16186K) -
Yukihide Kanemitsu, Takehiro Hachisuka, Yasushi Kato, Masayuki Miyauch ...1996 Volume 29 Issue 7 Pages 1591-1596
Published: 1996
Released on J-STAGE: August 23, 2011
JOURNAL FREE ACCESSWe investigated the standards for determining the limited operation (D1+No.7 lymph node dissection) for early gastric cancer according to the clinicopathological features, and the relationship between the degree of lymph node dissection and prognosis of the disease. The subjects were 320 patients suffering from early gastric cancer. The rates of lymph node metastasis of mucosal and submucosal cancer were 2.7% and 30.9%, respectively. The lymph node metastatic rate of submucosal gastric cancer was significantly higher than that of mucosal gastric cancer. However, for tumors less than 4.0cm in diameter, distribution of lymph node metastasis was confined to the area adjacent to that in which the tumor existed. Metastasis to the lymph node in the second group could be seen only in lymph node No.7. As for the relationship between the degree of lymph node dissection and outcome of the disease, there was no difference between lymph node dissection in the first group (D1) with lymph node No.7 and in the second group (D2). Consequently, we assumed that the limited operation could be indicated in most cases of early gastric cancer. But the incidende of recurrence in the advanced type was significantly higher (37.5%) than in other types. Furthermore, in patients with the elevated, depressed, flat and mixed types of tumor, which were 4.0cm or more in size, there was a high incidence of lymph node metastasis in the second or beyond group. We concluded that we should select these patients for extended dissection of lymph nodes.View full abstractDownload PDF (11514K) -
Takafumi Bandoh, Hiroshi Toyoshima, Mutsunori Fujiwara1996 Volume 29 Issue 7 Pages 1597-1602
Published: 1996
Released on J-STAGE: August 23, 2011
JOURNAL FREE ACCESSControversy remains as to whether or not DNA ploidy correlates with venous invasion in gastric carcinomas.We evaluated the relationship between DNA ploidy and the extent of intravenous tumor thrombosis in different histological types of gastric carcinoma.The DNA content of 150 advanced gastric carcinomas was analyzed by flow cytometry, and the extent of tumor thrombosis was categorized into four grades by calculating the number of tumor thrombi in the veins.83.6% of differentiated carcinomas were aneuploid, and 66.3% of undifferentiated carcinomas were diploid with a significant difference (p<0.0001).Extensive tumor thrombosis was seen in 85.2% of differentiated carcinomas and 65.2% of undifferentiated carcinomas with a significant difference (p<0.002).Extensive tumor thrombosis was seen in 82.7% of aneuploid tumors and 62.3% of diploid tumors with a significant difference (p<0.001). Differentiated carcinomas with DNA aneuploidy showed more invasion of the veins than those with DNA diploidy (p<0.01).Aneuploid and diploid tumors are predominant in the differentiated and undifferentiated types, respectively.Tumor thrombosis is marked in differentiated carcinomas, and in aneuploid tumors.Differentiated gastric carcinomas with DNA aneuploidy invade the veins most frequently.View full abstractDownload PDF (13791K) -
Ken-ichi Tanaka, Takeshi Nakamura, Shiro Nakae, Yoichi Saitoh1996 Volume 29 Issue 7 Pages 1603-1609
Published: 1996
Released on J-STAGE: August 23, 2011
JOURNAL FREE ACCESSExpression of proliferating cell nuclear antigen (PCNA) and the c-met proto-oncogene product in gastric cancer lesions was examined immunohistochemically. The expression of PCNA was related to histological type, tumor size, depth of cancer invasion, vessel invasion and stage. The expression of the c-met proto-oncogene product was related to depth of invasion, vessel invasion, and stage. The rate of c-met expression was significantly higher in the group with a high labeling index of PCNA than in the group with a low labeling index. The group with expression of c-met and with a high PCNA labeling index had a significantly greater depth, a higher grade of lymph-node metastasis, a higher grade of vessel invasion and more advanced stage than the group without expression of c-met and with a low PCNA labeling index. These results suggest that c-met and PCNA are closely related to the progression of gastric cancer and that combined examination for both of them could yield further information about the grade of advance in gastric cancer.View full abstractDownload PDF (12885K) -
Eiji Nomura, Kunio Okajima, Hiroshi Isozaki, Eiji Nakata, Tadashi Ichi ...1996 Volume 29 Issue 7 Pages 1610-1616
Published: 1996
Released on J-STAGE: August 23, 2011
JOURNAL FREE ACCESSWe investigated the utility of pylorus-preserving gastrecotmy (PPG) with preservation of the vagal nerve (hepatic branch, pyloric branch and celiac branch) in early gastric cancer. The study was designed to determine the postoperative quality of life (QOL) and functioning of several organs 1 year after the operation in 15 patients who underwent PPG and 15 patients who underwent conventional distal gastrectomy (DG) with truncal vagotomy as a control of radical lymph node dissection. Body weight loss, loss of appetite, reflux gastritis and esophagitis in the gastroscopic findings, and decrease in RBC and Hb in the laboratory findings were less frequent in the PPG than in the DG group. The abdominal symptom after meal was characteristic of the PPG group, which had neither diarrhea nor abdominal pain. The pattern of gastric emptying, contraction of the gallbladder and hormonal secretion resembled their preoperative patterns more closely in the PPG than in the DG group. PPG has a high potential of maintaining the QOL and the nutritional condition in gastric cancer patients. These virtues result from the following procedures: 1) preservation of the pyloric ring. 2) reduction of the extent of gastrectomy. 3) preservation of the vagal nerve.View full abstractDownload PDF (12437K) -
A Study om Recurrence of Resected CasesMinoru Tanada, Nobuji Yokoyama, Shigemitsu Takashima1996 Volume 29 Issue 7 Pages 1617-1622
Published: 1996
Released on J-STAGE: August 23, 2011
JOURNAL FREE ACCESSTo choose an adequate and safe surgical treatment for small hepatocellular carcinomas (less than 3 cm in diameter), 60 patients who underwent curative surgery were examined clinicopathologically. Thirty-eight of them had recurrent liver tumors after hepatecotmy, while no tumors were observed in the other 22. Among the 38 patients diagnosed as having a recurrence of hepatocellular carcinoma (HCC), 22 had a solitary tumor and 16 had multiple tumors. The overall five-year survival and disease-free survival rates were 60% and 22%, respectively. There is a statistically significant difference in tumor size, histological type, involvement of the portal vein, and intrahepatic metastasis between solitary and multiple tumors. In addition, among the patients who have these clinicopathological factors, a significant difference was observed in overall survival rate between a negative tumor margin and a positive tumor margin, however, no significant prognostic improvement was found between sub-or segmental hepatic resection. In conclusion, a negative tumor margin may be the most important prognostic factors for the resectable small HCC.View full abstractDownload PDF (9748K) -
Nobuhisa Ando, Akio Harada, Motoshi Yasui, Toshiaki Nonami, Akimasa Na ...1996 Volume 29 Issue 7 Pages 1623-1628
Published: 1996
Released on J-STAGE: August 23, 2011
JOURNAL FREE ACCESSWe divided surgically resected multiple hepatocellular carcinomas (Mul HCCs) that limited to 2cm or less in diameter into two groups; sMO (multicentric occurrence; 19 nodules) and sIM (intrahepatic metastases; 28 nodules) by our pathological criteria. The sMO group was compared with the sIM group for features of images including ultrasonograms, post-contrast computed tomograms (pc-CT) and angiograms, and an association between the images and the pathologic findings was discussed retrospectively. A hyperechoic pattern was more frequent in the sMO group (13 cases, 68%) than in sIM group (6 cases, 21%). Tumors without typical findings on pc-CT and angiograms were more frequent in the sMO group (pc-CT: 14 cases, 74%; angiograms: 13 cases, 68%) than in the sIM group (7 cases, 25%; 10 cases, 36%). On the other hand, in the sMO group, well-differentiated HCCs accounted for 16 cases (84%) and a fatty change or clear-cell formation was detected in 15 cases (79%). From our criteria for the sMO group it follows that tumors show these pathologic findings, and the features of images were considered to be associated with the pathologic characteristics. We suggest that taking these results into account is useful in selecting the appropriate treatment for a patient with Mul HCCs.View full abstractDownload PDF (11749K) -
Norio Yasuda, Masaru Miyazaki, Katsuhiro Iinuma, Masayuki Ohtsuka, Nob ...1996 Volume 29 Issue 7 Pages 1629-1635
Published: 1996
Released on J-STAGE: August 23, 2011
JOURNAL FREE ACCESSIn situ isolated liver perfusion was done during liver ischemia for 60 minutes in the rats. The effect of various perfusates and nafamostat mesilate (NM) on hepatic ischemic damage, especially on sinus endothelial cell damage, was assessed. Five different perfusate groups were assessed: group A (lactated Ringer [LR] at 25°C), group B (LR at 4°C), group C (LR with NM of 10μg/ml at 25°C), group D (LR with NM of 10μg/ml at 4°C), group E (University of Wisconsin solution at 4°C). The addition of NM in liver perfusion markedly inhibited the increases in GOT, TXB2, 6 keto PGF1α in the perfusate. The swelling of hepatocytes was significantly suppressed in group E. However, the sinus endothelial cell damage was most remarkably reduced by addition of NM (group C and D). Hepatic perfusion with NM might achieve its hepatoprotective effect by reducing sinus endothelial cell damage during liver ishcemia.View full abstractDownload PDF (14458K) -
Masamitsu Harada, Shiro Yogita, Toshihide Takagi, Manabu Sakai, Takama ...1996 Volume 29 Issue 7 Pages 1636-1642
Published: 1996
Released on J-STAGE: August 23, 2011
JOURNAL FREE ACCESSRelationship between preoperative, intraoperative and postoperative factors and massive ascites was studied retrospectively in the early postoperative state following hepatectomy for hepatocellular carcinoma. Seventyseven patients were divided into two groups by amount of ascites postoperatively. Fiftythree patients had ascites of less than 500ml/day from intraabdominal drains (group A), and 24 patients had ascites of more than 500ml/day (group B). Preoperative cholinesterase (A; 0.58±0.21 vs B; 0.45±0.15ΔpH), ICGRmax (A; 1.15±1.01 vs B; 0.78±0.42mg/kg/min), Total Risk (A; 2.35±0.64 vs B; 2.65±0.43), operation time (A; 447±114 vs B; 553±114 min), amount of intraoperative bleeding (A; 892±873 vs B; 1895±1557 ml), blood transfusion volume (A; 427±780 vs B; 1122±1162ml), infusion volume (A; 198±58 vs B; 243±74 ml/kg) and histological degree of liver cirrhosis were significantly different between groups A and B. Approach method in operation, type of liver ischemia, ischemic time, liver mobilization, resected area and weight of resected specimen were not the main reason for massive ascites. Cholinesterase, ICGR max, Total Risk and histological findings were the main prognostic factors for massive ascites in the early postoperative state. Ascites were recognized in the cases with a long operation time, massive bleeding, massive blood transfusion and infusion. Good control of intake-output balance, protection of the liver function and careful management of postoperative complications were very important because ascites is liable to be haven after hepatectomy for hepatocellular carcinoma with liver cirrhosis.View full abstractDownload PDF (12627K) -
Hidenori Sumida, Makoto Kataoka, Yoshiyuki Kuwabara, Hiroyuki Kawamura ...1996 Volume 29 Issue 7 Pages 1643-1651
Published: 1996
Released on J-STAGE: August 23, 2011
JOURNAL FREE ACCESSIn order to assess the immune activity in patients with cancer patient, the lymphocyte subsets of 73 gastroenterological cancer (45 gastric cancer, 16 colon cancer, 6 esophageal cancer, 3 hepatoma, 3 pancreatic cancer) patients and 17 non-cancer patients were analyzed with monoclonal antibodies. In T cells, CD3 (+) HLA-DR (+) (activated T) cells and CD8 (+) CD11b (+) (suppressor T) cells tended to increase in cancer patients and with advance in stage. Natural killer (NK) cells increased in cancer patients and in the subsets of NK cells, CD57 (+) CD16 (-) [minimal lytic activity] cells and CD57 (+) CD16 (+) [moderate lytic activity] cells tended to increase with advance in stage. Lymphokine activated killer (LAK) cells and an increase in CD3 (+) CD16 (-) CD56 (+) (T-LAK) cells tended to increase with advance in stage.View full abstractDownload PDF (16602K) -
Seiji Haji, Makoto Usami, Akihiro Hirai, Kazuya Sakata, George Kotani, ...1996 Volume 29 Issue 7 Pages 1652-1657
Published: 1996
Released on J-STAGE: August 23, 2011
JOURNAL FREE ACCESSFungemia in patients after gastrointestinal surgery was investigated. Twenty-two patients after major surgery including 6 with esophagectomy, 12 with total gastrectomy and 4 with pancreatectomy, were entered in the evaluation. Blood samples were collected before the operation and 2 and 10 days after the operation (POD). Candida antigenassay by the LA method (Cand-Tec test), β-D-glucan level by the Limulus test (the difference between Toxicolor and Endospecy test) and blood culture were performed. Both Cand-Tec and β-glucan levels at POD 2 were positive in 42.8% of the patients without obvious foci of fungal infection (p<0.01), suggesting microbial translocation. Blood culture of all samples were negative. Patients after esophagectomy showed high positive rates in Cand-Tec and β-D-glucan levels among the different operation methods without a significant difference. A Positive rate in the Cand-Tec test was associated with operative blood loss, increased white blood cell counts and poor nutritional state after the operation, indicating surgical stress and malnutriton as a cause of microbial translocation. It is concluded that transient microbial translocation occurs after gastrointestinal surgery.View full abstractDownload PDF (11909K) -
Hirofumi Ota, Nobuhisa Ueda, Seiichi Matsunaga, Yoshiichi Maeura, Eiji ...1996 Volume 29 Issue 7 Pages 1658-1662
Published: 1996
Released on J-STAGE: August 23, 2011
JOURNAL FREE ACCESSA 50-year-old woman following gastric ulcer underwent resection of the jejunum and distal gastrectomy as an emergency operation for jejunal perforation in August 1992. After the operation, gastrinoma was suspected because the fasting serum gastrin level was 1224 pg/ml and the secretin provocation test was positive. Ultrasonography and CT scanning failed to reveal the presence of any tumor in the pancreatic region. We performed a selective arterial secretin injection test, and confirmed that microgastrinomas were present in the feeding region of gastroduodenal artery. Pancreatoduodenectomy was performed in December 1992. We confirmed the radicality with an intraoperative secretin provocation test, and carried out reconstruction in a manner that preserved the gastric remnant. Although the serum gastrin level remained normal, the anastomotic stoma became stenotic by anastomotic ulcer. Resection of the stenotic part and truncal vagotomy were performed in order to reduce vagal gastric hypersecretion. Recently a stomach-preserving method has been chosen due to the develolpment of the localization method for gastrinomas. When we select the stomach-preserving operation, we should add truncal vogotomy considering the possibility of anastomotic ulcer due to vagal gastric hypersecretion.View full abstractDownload PDF (9509K) -
Tetsushi Morita, Takeshi Tono, Hidewaki Nakagawa, Kazuhiro Fukuda, Eis ...1996 Volume 29 Issue 7 Pages 1663-1667
Published: 1996
Released on J-STAGE: August 23, 2011
JOURNAL FREE ACCESSA 61-year-old woman was referred to our hospital because of a hepatic mass detected by abdominal ulttrasonography at a medical examination. The mass was diagnosed as cavernous hemangioma of the liver by abdominal computed tomography (CT). After 9 months, we performed CT again because of chest and abdominal pain. This CT revealed enlargement of the hepatic tumor. Abdominal angiography showed a peripheral stain in addition to the cotton wool appearance and magnetic resonance imaging showed heterogeneous intensity on the T2 image. We diagnosed her condition as hepatic hemangiosarcoma and carried out transcatheter arterial embolization (TAE), hepatic arterial infusion of interleukin-2 (IL-2) and steroid therapy. Her condition was markedly improved for several weeks. However, the symptoms appeared again thereafter and she died of respiratory failure 4 months after the appearance of the symptoms. The autopsy revealed that the right lobe is occupied nodular tumors and histologically the tumors was diagnosed as hepatic hemangiosarcoma. Although hepatectomy should be performed as the first choice for hepatic hemangiosarcoma, TAE, hepatic arterial infusion of I1-2 or stroid therapy can be beneficial for unresectable tumors.View full abstractDownload PDF (9228K) -
Daisuke Minabe, Akira Kubo, Masazumi Takahashi1996 Volume 29 Issue 7 Pages 1668-1672
Published: 1996
Released on J-STAGE: August 23, 2011
JOURNAL FREE ACCESSA case of primary biliary cirrhosis (PBC) complicated by common bile duct carcinoma is reported. A 50-year-old woman who had been treated medically for asymptomatic PBC for 7 years was hospitalized because of jaundice and skin itching. She was diagnosed as having obstructive jaundice, and underwent percutaneous transhepatic cholangiodrainage. Ultrasonography and computed tomography revealed a pancreas head tumor. On laparotomy, the tumor was found to have invaded the second portion of the duodenum, and pancreotoduodenectomy was performed. The histological findings indicated a welldifferentiated adenocarcinoma of the common bile duct. Although PBC complicated by malignancy is common, PBC complicated by common bile duct carcinoma is very rare. To our knownledge, there is no report of PBC with common bile duct carcinoma in Europe and the United States. Only one autopsy record of PBC with hilar bile duct carcinoma is available in Japan.View full abstractDownload PDF (8828K) -
Yoshiro Matsuba, Masatshi Suzuki, Yoshimasa Ono1996 Volume 29 Issue 7 Pages 1673-1677
Published: 1996
Released on J-STAGE: August 23, 2011
JOURNAL FREE ACCESSA case of cystic artery pseudoaneurysm is reported. A 72-year-old woman consulted a private medical doctor for right hypochondral pain and vomiting. Biliary colic was suspected and she was sent to our hospital. Before admission, she had no melena or hematemesis. Her serum total bilirubin, transaminase, alkaline phosphatase, and γ GPT levels were slightly elevated. Abdominal US revealed a tumor-like lesion about 3 cm in diameter at the neck of the gallbladder. In its center, there was a cystic, pulsating area. Color Doppler US showed flow signals in the cystic area. An abdominal CT scan revealed a round mass at the gallbladder neck. The cystic area was markedly enhanced on early phase dynamic CT. High density contents in the gallbladder and dilated common bile duct were also demonstrated. An arteriogram of the proper hepatic artery revealed cystic artery pseudoaneurysm. On the 2nd day after admission, open cholecystectomy was performed and a T-tube was placed in the common bile duct. Histological examination of the resected specimen revealed a deep ulceration at the neck of the gallbladder with a ruptured cystic artery at the bottom. A round hematoma with a fibrous cavity filled with blood was situated on the ulceration.View full abstractDownload PDF (8604K) -
Tomotake Satoh, Tatsushi Ide, Tetsuo Morita, Toshiya Itoh1996 Volume 29 Issue 7 Pages 1678-1682
Published: 1996
Released on J-STAGE: August 23, 2011
JOURNAL FREE ACCESSA very rare case of carcinoid tumor coexisting with adenocarcinoma of the gallbladder is reported. A 70-year-old woman was admitted to the hospital because of urgent dyspnea due to pneumonia. Her general condition was improved with antibiotics, but ultrasonography, CT and ERCP examiantions revealed a papillary tumor suggesting cancer in the neck of the gall bladder. The operation consisted of cholecystectomy with dissection of regional lymph nodes. Macroscopically, two tumors, a papillary tumor and a smooth-surfaced elevated lesion, were observed in the neck and fundus of the gallbladder respectively. Pathohistopathologically, the former tumor was well-differentiated adenocarcinoma and the latter was carcinoid (positive for Grimelius reaction, chromogranin A, NSE and S-100). She is doing well 10 months after surgery without reccurrence. To our knowledge, this is only the second reported case of carcinoid coexisting with adenocarcinoma of the gall bladder.View full abstractDownload PDF (8472K) -
Takayuki Kinoshita, Kiyoshi Kubochi, Hideo Matsui, Takashi Ohishi, Yoh ...1996 Volume 29 Issue 7 Pages 1683-1687
Published: 1996
Released on J-STAGE: August 23, 2011
JOURNAL FREE ACCESSA 57-year-old woman was found to have splenic tumors by ultrasonography at a physical checkup, and was admitted to our hospital. She had no subjective symptoms and there were no particular problems in her medical history. Laboratory data onadmission were normal. Abdominal ultrasonography and computed tomography showed numerous hypoechoic and low density solid masses in the spleen. In contrast and dynamic studies, they were enhanced. The magnetic resonance image showed isointensity masses on Tl-weighted images and slightly high intensity masses on T2-weighted images. In a Gd-DTPA study, they were found in slightly high intensity areas. Splenic angiograms showed numerous hypervas cular tumors and a splenic aneurysm. The splenic artery was winding and dilated. The splenic aneurysm was resected in addition to splenectomy. The cut surface of the resected spleen showed numerous well-circumscribed, but unencapsulated white tumors. The histological diagnosis of the splenic tumors was hamartoma cosisting of red pulp components. The same histological findings were also detected in accessory spleen.View full abstractDownload PDF (9799K) -
Masayuki Muramoto, Shizuo Usami, Takashi Okubo, Akira Satake, Keiji Ma ...1996 Volume 29 Issue 7 Pages 1688-1691
Published: 1996
Released on J-STAGE: August 23, 2011
JOURNAL FREE ACCESSWe experienced a case of marked metabolic acidosis as a severe clinical state during total parenteral nutrition after jejunal cancer procedure. Vitamin B1 deficiency seemed to be the cause of the acidosis because a bolus injection of vitamin B1 improved the clinical condition of the patient with prompt improvement in the base excess. Overconsumption of vitamin B1 by intravenous carbohydrates is considered to, be the mechanism of metabolic acidosis during total parenteral nutrition. Most case reports revealed latent vitamin B1 deficiency conditions such as malignant disease, chemotherapy or irradiation in addition to no administration of vitamins. We concluded that supplementation of vitamin B1 should be recommended during TPN after surgery.View full abstractDownload PDF (6850K) -
Toshiki Rikiyama, Yoshinobu Takahashi, Syun-ichi Kimura, Seiki Matsuno ...1996 Volume 29 Issue 7 Pages 1692-1696
Published: 1996
Released on J-STAGE: August 23, 2011
JOURNAL FREE ACCESSA63-year-old man visited our hospital complaining of severe upper abdominal pain and was admitted with adiagnosis of intestinal obstruction. Abdominal X-rayfilms showed several air-fluid levels located on the Th12 and L1 vertebrae, and interruption of small-bowel gas on the right side of the L1 vertebra. An enema examination with water-soluble contrast medium revealed adistal ileum crossing the transverse colon and tapering on the right side of the L1 vertebra. With the preoperative diagnosis of intestinal herniation through the foramen of Winslow, an emergency laparotomy was performed. Operative findings showed that a loop of distal ileum was incarcerated through the foramen of Wnslow into the lesser sac. The gangrenous ileal segment approximately 70cm in length wasresected. Only 16 patients with hernia through the foramen of Winslow have been reported in Japan, and in these patients it was difficult to make apreoperative diagnosis. In this case, we could make the diagnosis preoperatively from abdominal X-ray films and the valuable findings of an enema examination.View full abstractDownload PDF (9088K) -
Yoshikazu Fukuda, Kazuma Tsukioka, Fumihiro Kawasaki, Yoshio Matsuo, T ...1996 Volume 29 Issue 7 Pages 1697-1701
Published: 1996
Released on J-STAGE: August 23, 2011
JOURNAL FREE ACCESSGas in the portal venous system (GPVS) can rarely be detected in various digestive diseases. And GPVS is commonly accepted as one of the signs of poor prognosis. We had four cases of GPVS revealed on admission in the 10 months after the opening of our hospital. All the patients were saved by emergency laparotomy. The ages of the one male and three female patients ranged from 20 to 75 years. Two patients were in shock when they arrived at our hospital. The definitive diagnoses were necrotizing enteritis of the ileo-cecal region, obstructive jejuno-colitis due to fecal impaction, strangulated ileus and non-occlusive mesenteric infarction. In all cases, GPVS was associated with bowel necrosis and GPVS was noted on the preoperative CT scan (Cases 1 & 4 in the intrahepatic portal vein, Cases 2 & 3 in the mesenteric vein). The microscopic findings of case 4 showed pneumatosis cystoides intestinalis. GPVS clearly suggests severe bowel necrosis, so a laparotomy should be performed as early as possible in such cases. An abdominal CT scan is always extremely useful for detecting GPVS. Therefore, by adjusting the window level we have to try to show GPVS on the CT scan in case of acute abdomen. Finally, it is also essential to keep GPVS in mind, especially when the patient is suspected of having bowel necrosisView full abstractDownload PDF (12055K) -
Norimasa Koide, Yuji Nimura, Junichi Kamiya, Satoshi Kondo, Masato Nag ...1996 Volume 29 Issue 7 Pages 1702-1705
Published: 1996
Released on J-STAGE: August 23, 2011
JOURNAL FREE ACCESSA case of early postoperative intestinal intussusception in an adult patient is reported. The patient, a 59-year-old woman experienced abdominal pain and vomiting on 5th day after transperitoneal left nephrectomy for renal cell carcinoma. Her symptoms resolved after continuous gastrointestinal suction with a long tube. An intestinal barium study on the 18th postoperative day showed a long narrow jejunum with a giant filling defect. Ultrasonography revealed an intestinal dilatation with a multiple concentric ring sign which led to a diagnosis of intestinal intussusception. She underwent reoperation on the 19th postoperative day. A jejuno-jejunal intussusception was found in the left upper abdomen. After reduction of the intussusception, it was suspected that strong adhesive band at the lead point caused kinking of the jejunum. Therefore the jejunum including the lead point was resected. The resected specimen revealed no tumor. This case is a very rare early postoperative intestinal intussusception due to intestinal adhesions. Intestinal barium study ultrasonography are useful for the preoperative diagnosis of this disease.View full abstractDownload PDF (7732K) -
Shota Kodama, Takashi Hirai, Tomoyuki Kato, Kouji Makibuchi, Yasunobu ...1996 Volume 29 Issue 7 Pages 1706-1710
Published: 1996
Released on J-STAGE: August 23, 2011
JOURNAL FREE ACCESSA 47-year-old male consulted a nearby physician, with anal bleeding and prolapse of an anal tumors as chief complaints, and underwent transanal local excision of the tumor. Histopathological examination of the resected specimen revealed well-differentiated adenocarcinoma invading as far as the muscularis propria and accompanied with perianal pagetoid spread, the extent of which had to be evaluated by skin biopsies. The patient is well and disease-free 7 months after undergoing abdomino-perineal resection with adequate incision of the perianal involved area. Cancer of the anal canal is seldom accompanied by pagetoid spread and only nine such cases, including ours, have been reported. The extent of perianal spread of the disease was not properly evaluated in any of the cases reported so far, and adequate management of the rare disease is described in the present case report with references to the literature.View full abstractDownload PDF (8723K) -
Osamu Kawamata, Akira Nakashima, Shizou Sato, Youichi Kurozumi, Masahi ...1996 Volume 29 Issue 7 Pages 1711-1715
Published: 1996
Released on J-STAGE: August 23, 2011
JOURNAL FREE ACCESSPulmonary embolism (PE) has been recognized as a cause of sudden death. We encountered four cases of acute PE after gastroenterological surgery between January 1993 and December 1994. These case represented 0.45% of all gastroenterological surgically treated patients for the same period. PE was diagnosed by pulmonary angiography. Intrapulmonary infusion of urokinase (UK) and continuous heparin injection cured all of the patients. No complications occurred in any patients with PE treated with thrombolytic therapy. Intrapulmonary infusion of UK and continuous heparin injection are useful in treatment of PE.View full abstractDownload PDF (7896K) -
Kazuya Miyoshi, Takeshi Matsui, Junichi Gangi, Susumu Shinoura, Kunzo ...1996 Volume 29 Issue 7 Pages 1716-1720
Published: 1996
Released on J-STAGE: August 23, 2011
JOURNAL FREE ACCESSWe performed gastroenterological surgery on eight schizophrenic patient administrated antipsychotic agents for more than 20 years during a period of three years from 1992 through 1994. All of the operations were performed under general anesthesia induced by enflurane or isoflurane. Two postoperative complications were observed in two patients each. One was insufficiency of choledeochojejunostomy and the other was paralytic ileus. There were no suddedn deaths, regarded as the most serious adverse effect of antipsychotic agents. Oral administration of antipsychotic agents was continued until the day before surgery except for one patient with intestinal obstruction due to cancer of the transverse colon. An intramuscular or intravenous preparation of antipsychotic agents just before bedtime was given from the day after the operation and oral administration with meals was restarted. A postoperative paranoid state was found in four patients, but was not too troublesome for surgical treatment. We could perform the surgical procedure for schizophrenic patinets satisfactorily with mental management by the psychiatrists.View full abstractDownload PDF (9781K)
- |<
- <
- 1
- >
- >|