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Volume 34, Issue 1
Displaying 1-15 of 15 articles from this issue
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Naoyuki Tanaka, Kazuhito Miyachi, Masakatsu Sunagawa2001 Volume 34 Issue 1 Pages 1-8
Published: 2001
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSThe correlations between telomerase activity in gastric cancer and two groups of factors, hTR and hTERT, and TRF1 and TRF2 were compared and analyzed. Telomerase activity was semi-quantatively measured by the F-TRAP technique in 51 gastric cancer patients, and hTR and hTERT activity was quantified by the real-time PCR technique. TRF1 and TRF2 were also analyzed immunohistochemically to determine the frequency of these factors in cell nuclei. Telomerase activity was detected in 78.4% of the cancer tissue samples, and the mean activity value was 88.7. hTR activity was detected in 98.0% of the cancer samples, and its mean activity was 8.349: hTERT activity was detected in 96.0% of the cancer samples, and its mean activity was 3.05. TRF1 and TRF2 were detected in the cell nuclei of 45.1% and 42.9%, respectively, of the cancer samples. The frequency of telomerase activity detection was significantly higher among the samples with high hTR activity (p=0.04), and the frequency of telomerase activity detection was significantly higher among the samples with high hTERT activity (p=0.03). However, no correlations were observed between telomerase activity and either TRF1 or TRF2 expression. These findings suggested that hTR and hTERT are correlated with the expression of telomerase activity.View full abstractDownload PDF (91K) -
Emiko Yanadori, Hidetoshi Oguma, Tuyoshi Sasagawa, Youichi Kitamura, K ...2001 Volume 34 Issue 1 Pages 9-14
Published: 2001
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSBetween 1968 and the end of 1994, 447 cases of synchronous multiple gastric cancer were treated surgically in our institution. The incidence of multiple cancer was 6.7%, and when compared to solitary cancer, elderly men predominated, and the main lesions were typically described as a protruding early cancer that was a tubular adenocarcinoma histologically. Early-early cancer was a more frequent combination of main and secondary cancer than early-advanced cancer. In about 90%, multiple lesions were present in the same and or in neighboring portions of the stomach. The accuracy of the preoperative diagnosis of multiple gastric cancer was 40%. The secondary tumors were mucosal cancers and less than 10 mm in size. The 5-year survival rate of the multiple cancer patients was similar to that of the solitary cancer patients in every stage, and the incidence of metachronous cancer in the remnant stomach (4.7%) was differed significantly from that of the solitary cancer (1.7%), but it was less than 5%. In conclusion no special strategy seemed to be necessary when planning surgery for synchronous multiple gastric cancer. The extent of surgery should be determined by tumor characters such as tumor depth and tumor site likewise solitary gastric cancer, but an even more discreet attitude might be required in the follow-up period.View full abstractDownload PDF (43K) -
Yukio Aomatsu, Yoshiyuki Nakajima, Hiromichi Kanehiro, Michiyoshi Hisa ...2001 Volume 34 Issue 1 Pages 15-20
Published: 2001
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSAn expandable metallic stent (EMS) for the palliation of malignant biliary obstruction has been used for improving the quality of life. In this study, we examined its long-term efficacy in cases with the locally advanced or recurrent carcinomas of the bile duct, gallbladder and pancreas. From January 1988 to March 1999, EMSs were placed in 37 patients who had been diagnosed as having locally advanced or recurrent cholangiocarcinoma (n=17), gallbladder carcinoma (n=10) and pancreatic carcinoma (n=10). The median survival of the patients with cholangiocarcinoma (7 months) and gallbladder carcinoma (4 months) was significantly longer than that of those with pancreatic carcinoma (2 months) after EMS implantation. The discharged percentage of patients of the pancreatic carcinoma (20%) was significantly lower than that of those with cholangiocarcinoma (94%) and gallbladder cancer (80%) discharged from the hospital. In conclusion, EMS is a relatively low-invasive therapy that offers a better quality of life to patients with locally advanced or recurrent cholangiocarcinoma and gallbladder cancer. We should consider whether the EMS or a plastic stent is the better choice in patients with the locally advanced or recurrent pancreatic carcinoma.View full abstractDownload PDF (59K) -
Sakae Miyamoto, Sadao Anazawa, Yoji Yamazaki2001 Volume 34 Issue 1 Pages 21-26
Published: 2001
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSFollowing the initial CEA increase after primary resection in patients with colorectal cancer, the correlation between CEA doubling time and survival was examined in the patients who developed liver metastasis but received no further treatment (n=15). There was a significant correlation between the two (correlation coefficient r=0.7754). The mean survival after the initial CEA increase expressed in multiples of the individual CEA doubling times was 8.5±3.1. The survival of patients who developed liver metastasis from colorectal cancer after primary resection but received no further treatment can be presumed if the CEA doubling time is measured.View full abstractDownload PDF (56K) -
Satoshi Mizutani, Takao Inada, Yukio Tsuura, Seiji Igarashi, Tsutomu I ...2001 Volume 34 Issue 1 Pages 27-31
Published: 2001
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSWe report a rare case of adenocarcinoma arising from Barrett's esophagus after an operation for esophageal achalasia. A 55-year-old man was referred to our center with dysphagia. He had undergone the fundicpatch procedure for esophageal achalasia 28 years previously, and had remained well thereafter, except for reflux esophagitis. A gastroendoscopy and biopsy specimens revealed the presence of a type 2 adenocarcinoma surrounded by Barrett's epithelium in the lesion of the gastroesophageal junction. A partial esophagectomy with upper gastric resection and a splenectomy was performed. Histological examination showed a papillary adenocarcinoma that had extended through the subserosal layer and that had surrounded by the columnar epithelium of Barrett'esophagus.View full abstractDownload PDF (122K) -
Masaru Saitoh, Hirohiko Onoyama, Koji Nishimura, Ken Sagayama, Masanor ...2001 Volume 34 Issue 1 Pages 32-35
Published: 2001
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSThis parer describes a case of traumatic choledochal stenosis of which diagnosis was difficult to differentiate from malignant disease. A 70-year old man had a traffic accident with fracture of the ulnar bone but without abdominal symptom. Two weeks after the accident he developed obstructive jaundice. Ultrasonography and computed tomography revealed no findings of tumor. However, percutaneous transhepatic cholangiography showed lower bile duct stenosis which persisted continued 4 weeks after biliary drainage. Cytology of the bile jiuce was suggestive of cancer. He underwent pancreaticoduodenectomy with a diagnosis of lower bile duct cancer. However, the surgical specium and histology showed stricture of bile duct due to blunt abdominal injury.View full abstractDownload PDF (88K) -
Ryuichiro Ohashi, Kouhei Hara, Eisuke Matsuda2001 Volume 34 Issue 1 Pages 36-40
Published: 2001
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSAbdominal bronchogenic cysts are rare abnormalities. We report a unique case of retroperitoneal bronchogenic cyst with malignant change. A 67-year-old woman who complained of abdominal fullness was admitted for further examination. A CT scan showed the presence of a cystic mass whose wall contained solid portions and was located below the left side of the diaphragm. Percutaneous needle aspiration from the mass yielded a large amount of mucus that contained malignant cells, and the patient's serum CEA and CA-125 levels were elevated. A diagnosis of malinant retroperitoneal cystic tumor was made and the tumor was resected. On entering the abdomen, the tumor was observed in the retroperitoneal cavity and was easily dissected from adjacent organs, including the diaphragm, posterior abdominal wall, pancreas, left kidney, and left adrenal gland. Histological examination of the resected specimen showed mucinous adenocarcinoma in the solid portion of a bronchogenic cyst. The tumor markers decreased to within their normal ranges after the operation.View full abstractDownload PDF (106K) -
Yoshiaki Ikuta, Shigenori Sugihara, Hiroaki Kobayashi, Takayuki Kaneko ...2001 Volume 34 Issue 1 Pages 41-44
Published: 2001
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSA case of complete Intussusception induced by cancer of the appendix is reported. The patient was a 74-year-old woman. Barium enema and colonofiberscopy were performed because of a positive occult blood on a fecal examination. A diagnosis of colon cancer was made preoperatively, and laparoscopic-assisted ileocolec-tomy with dissection of regional lymph nodes was performed. Intussusception of the appendix was found intraoperatively and in the postoperative specimen. Microscopic examination revealed well differentiated ade-nocarcinoma limited to the proper muscle of the appendix. Since cancer of the appendix is rare, and diagnosis of Intussusception with cancer of the appendix is very difficult, this disease should always be taken into con-sideration when diagnosing diseases of the cecum.View full abstractDownload PDF (72K) -
Toshihiko Waku, Wataru Osawa2001 Volume 34 Issue 1 Pages 45-48
Published: 2001
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSSimple ulcer of the small intestine is rare, and although it is being increasingly reported, it has not been established as an independent disease entity. We report a case of simple ulcer of the small intestine with gas-tric ulcer that caused multiple perforation of the small intestine. A-49-year-old man was admitted to our hospital because of recurrent vomiting. Computed tomography showed ileus with thickening of the wall of the il-eum and dilatation of the entire small intestine. Endoscopy was performed because of tarry stools, and it showed a refractory gastric ulcer of ul-IV in depth. The patient experienced sudden onset of abdominal pain, and the ileus was successfully treated conservatively. A diagnosis of perforative peritonitis was made, and emergency operation was performed. At laparotomy, two punched-out perforated ulcers were observed in the terminal ileum opposite the site of attachment of the mesentery, and two punched-out perforated ulcers were seen in the jejunum near the Treitz'ligament opposite the site of attachment of the mesentery. Ileoce-cal resection and simple closure of the perforated ulcers were performed. Since histological examination of the sites of perforation revealed only non-specific inflammation and no signs of Behcet's disease, the final diagno- sis was simple ulcer of the small intestine.View full abstractDownload PDF (59K) -
Yu Takahashi, Hiroshi Hasegawa, Seiji Ogiso, Masaya Shiomi, Masato Mom ...2001 Volume 34 Issue 1 Pages 49-53
Published: 2001
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSProctocolectomy and ileoanal canal anastomosis (IACA) is a standard procedure for the treatment of ul-cerative colitis, but problems of reccurrence and canceration of the surviving rectal tissue often occur. We re-port a case in which ulcerative colitis recurred accompanied by a massive hemorrhage in the surviving rectum. The patient was treated by resection of the abdominoperineum. A 21-year-old man who undergone a proctocolectomy and IACA for total ulcerative colitis in 1996 was admitted to the hospital complaining of melena and anal pain in September 1999. Two days after admission, the patient was found in hemorrhagic shock with a systolic blood pressure of 60 mmHg and 5.0 g/dl of hemoglobin after experiencing severe melena. En-doscopic diagnosis and therapy was difficult because of the severe anal pain and massive hemorrhage, so an operation was immediately performed. On entering his abdomen, a considerable number of adhesions between the ileal pouch and the pelvic wall were found. An ileoanal anastomosis and an abdominoperineal resec-tion of the surviving rectum and ileostomy was therefore performed. The mucosa of the resected rectum was dropped out. The histopathological diagnosis was no-malignant, active phase ulcerative colitis.View full abstractDownload PDF (116K) -
Takafumi Aoki, Mitsuru Sasano, Daisuke Ikeuchi, Fuyuki Izumi, Hiroyuki ...2001 Volume 34 Issue 1 Pages 54-58
Published: 2001
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSA 70-year-old man admitted to our hospital for abdominal pain was found, upon physical examination, to have a nonfixed tumor on the anterior rectal wall but no systemic lymph node swelling. No abnormalities were seen in laboratory findings. Barium enema showed an irregular filling defect in the ascending colon and a protruding tumor in the rectum. Colonoscopic examination showed a circumferential narrowing in the as-cending colon and a flatly elevated rectal tumor 2 cm in diameter. Biopsy from the rectal tumor showed well differentiated adenocarcinoma. Abdominal Computed Tomography showed no hepatolienal tumor or retroperitoneal lymph node swelling. Right hemicolectomy with lymph node dissection and anterior rectal resec-tion showed a 5×7.5 cm tumor in the ascending colon and a 2.7×1.8 cm tumor in the rectum. Histopathologic examination showed the colonic tumor to be a B-cell malignant lymphoma, consisting of diffuse medium-sized lymphoid cells. The rectal tumor was well differentiated adenocarcinoma. Two of the regional lymph nodes removed from the ascending colon were involved in the lymphoma. Primary colorectal malignant lymphoma is rare, and the coexistence of colorectal malignant lymphoma and adenocarcinoma has been reported in only 15 cases. In 7 of these, malignant lymphoma and adenocarcinoma were found at different sites of the large in-testine, ours is the eighth such case. Rectal malignant lymphoma thus appears to be found more frequently in tumor coexistence than in noncoexistence, but not to a statistically significant degree.View full abstractDownload PDF (86K) -
Hiroki Shinkawa, Takashi Inoue, Takahisa Fujita, Tohru Nojiri, Yoshita ...2001 Volume 34 Issue 1 Pages 59-63
Published: 2001
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSWe encountered a rare complication of ventriculo-peritoneal shunt (VP shunt) in which the peritoneal end of the shunt had perforated the rectum and protruded outside the anus. A VP shunt had been implanted in a 74-year-old man in the previous hospital to treat normal pressure hydrocephalus caused by intracerebral bleeding. Ten months later, he was admitted to the neurosurgery department of our hospital for meningitis and was treated successfully with antibiotics. Three months after admission, the peritoneal end of the cathe-ter was found to be protruding from his anus. The abdomen was soft, and there was no tenderness or signs of peritoneal irritation. Laboratory studies revealed a white blood count of 6, 400/mm3 and C-reactive protein of 1.9 mg/dl. Colonoscopy showed the peritoneal end of the catheter protruding through the rectal wall on the right side, 10 cm from the anal verge. The catheter was successfully extracted from the anus without subse-quent signs of peritonitis. One week later, a gastrografin enema X-ray study revealed no leakage of gastro-grafin, and oral feeding was started. Bowel perforation by a VP shunt is rare, but it is a complication that should be borne in mind.View full abstractDownload PDF (101K) -
Makoto Okazaki, Jun Yamamura, Yasuhito Kawasaki, Minoru Ohturu, Kiyosh ...2001 Volume 34 Issue 1 Pages 64-67
Published: 2001
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSA 76-year-old woman was admitted to our hospital because of anal bleeding, and emergency sigmoid co-lostomy was performed for severe vomiting on admission. Abdominal CT scanning revealed a rectal carci-noma invading the uterus and urinary bladder, and although on judged the difficult case to operate, because of the patient's poor condition, we operated on her request. Pyometra was found at operation, and there was no evidence of invasion of the uterus or urinary bladder by the rectal cancer. Low anterior resection and hys-terectomy were performed. This is an extremely rare case of a rectal cancer associated with pyometra.View full abstractDownload PDF (95K) -
Takami Fukui, Naoki Yokoo, Takahiro Yoshida, Chihiro Tanaka, Hisaya Az ...2001 Volume 34 Issue 1 Pages 68-72
Published: 2001
Released on J-STAGE: August 23, 2011
JOURNAL FREE ACCESSWe treated successfully a case of ischemic colonic necrosis with septic shock in a patient of very-advanced age by a massive colectomy. A 102-year-old woman was admitted to our hospital because of vomit-ing and abdominal pain. On admission, she was critically ill, presenting symptoms of septic shock. Under the diagnosis of strangulated ileus, an emergency laparotomy was carried out. On laparotomy, a massive necrosis of the colon between the hepatic flexure and the distal end of the descending colon was revealed, and, was his-tologically proven to be caused by ischemic colonic necrosis. Since the patient had many risk factors, including dehydration, septic shick, advanced age, and a highly invasive operation, her hemodynamic and respiratory condition after the operation was quite unstable. Therefore, a close watch on these states was kept for 7 days after the operation, using an S-G catheter. During postoperative treatments, attention was focussed on main taining a hyperdynamic state based on accurate hemodynamic and respiratory parameters. Owing to these meticulous postoperative treatments, a successful outcome was achieved.View full abstractDownload PDF (98K) -
Hirotoshi Hasegawa, Masahiko Watanabe, Kentaro Yamamoto, Seiichiro Yam ...2001 Volume 34 Issue 1 Pages 73
Published: 2001
Released on J-STAGE: June 08, 2011
JOURNAL FREE ACCESSDownload PDF (22K)
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