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Volume 51 (1991)
- Issue 6 Pages 601-
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Volume 51, Issue 6
Displaying 1-14 of 14 articles from this issue
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[in Japanese]1991 Volume 51 Issue 6 Pages 601-611
Published: December 28, 1991
Released on J-STAGE: September 09, 2010
JOURNAL FREE ACCESSDownload PDF (6975K) -
Hidehumi KODAMA, Akira AOKI, Tomoyuki UMEDA, Kouichi MIZUNO, Keiichiro ...1991 Volume 51 Issue 6 Pages 612-619
Published: December 28, 1991
Released on J-STAGE: September 09, 2010
JOURNAL FREE ACCESSChronic liver disease is characterised by increased liver fibrosis, a pathological condition that influences the clinical condition of the patient. Different components of collagen metabolites (type IV collagen 7S-domain (7S), type III procollagen N-peptide (P3P), type I procollagen C-peptide (P1C), prolyl hydroxylase (PH) ) were simultaneously measured in serum, to identify the diagnostically most useful liver fibrosis marker. Serum concentrations of these markers in chronic liver diseases (chronic inactive hepatitis (CIH), chronic active hepatitis (CAH), liver cirrhosis (LC), and hepatocellular carcinoma with liver cirrhosis (HCC) ) were evaluated. Serum concentrations of liver fibrosis markers, except PH were higher in CAH, LC and HCC than in CIH, and mean values of 7S were in the descending order of CIH, CAH, LC and HCC, but the difference between LC and HCC was not significant. P3P had the highest mean value in CAH, and P1C was normal in CIH. PH was not significantly different in any group. We concluded that serum 7S concetnration reflects the deposition of fiber in the liver, and when the 7S value is extremely high, we should consider severe liver fibrosis and the coexistence of hepatocellular carcinoma. P3P and P1C concentrations are influenced by the inflammation and necrosis of liver cells, in addition to the deposition of fiber. There are no interrelations among these serum fibrosis markers, between these markers and clinical serum biochemical laboratory data. Because the concentrations of these fibrosis parameters are distributed over a wide range, their measurement cannot replace histological findings. However serum concentration of these fibrosis parameters may afford better information in understanding the activity of chronic liver disease with sufficient knowledge of their respective characteristics.View full abstractDownload PDF (841K) -
Yoshiharu URANO, Hitoshi NISHIDA, Taiji KAWADA, Yoshio HATTA1991 Volume 51 Issue 6 Pages 620-626
Published: December 28, 1991
Released on J-STAGE: September 09, 2010
JOURNAL FREE ACCESSTo evaluate the structure of upward collateral veins and blood flow in portal hypertension, we examined 44 patients (26 with liver cirrhosis and 1.8 with hepatocellular carcinoma) and 24 controls with Color Doppler-Endoscopic Ultrasonography (CD-EUS) . The CD-EUS consisted of a Color Doppler display system (TOSHIBA SSA-270A) and a linear 7.5 MHz scanner EUS (TOSHIBA-MACHIDA EPE-703FL) to visualize the vessels, and their flow speeds and directions. We detected intra- and extramural vessels in the gastroesophageal wall, and an azygos vein and measured its diameter at the middle. The following results were obtained. 1) An azygos vein, intra- and extramural blood flow and the flow directions were detected by CD-EUS in the physiological state. 2) The intra- and extramural blood flow in patients with portal hypertension were centrifugal, and intramural blood flow was detected in the submucosal (sm) layer. The veins of the stomach were connected directly to their respective esophageal veins. 3) The azygos vein diameter was 3.10±0.98 mm in the control, and was significantly larger in patients with portal hypertension than in controls. 4) The intra and extramural blood flow patterns were constant in the cases with mild varices but they became pulsatile in severe cases. The azygos venous blood flow pattern was constant in most controls, but it was pulsatile in patients with portal hypertension. In conclusion, CD-EUS is useful for evaluating the structure and hemodynamics of upward collateral veins.View full abstractDownload PDF (3426K) -
Yayoi FURUMATSU1991 Volume 51 Issue 6 Pages 627-643
Published: December 28, 1991
Released on J-STAGE: September 09, 2010
JOURNAL FREE ACCESSThe author measured 111 old females (63-87 years old) and 111 young females (19-24 years old) anthropometrically in 1988-89. To determine the old upper trunk surface development, we applied the tight fitting technique. Principal component analysis was applied to : 18 indices relative to stature for expressing whole body form, 12 indices for expressing upper trunk form, and 9 measurements for expressing lower trunk form. To explain variations in the body form, 5 components of the whole body form, 3 components of the upper trunk form, and 4 components of the lower trunk form were extracted and interpreted. There were differences between young and old in the actual proportions of the measurements. The indices of posterior shoulder length/bust girth, anterior waist length/posterior waist length of the old were smaller than those of the young. The indices of posterior chest length/posterior shoulder length of the old were larger than those of the young. Compared to the young, the old had extremely large waist girth and hip girth, and their anterior length from waist to floor was longer than their posterior length from waist to floor. Individual differences of the old were larger than those of the young. Large differences between young and old were found as a result of cluster analysis. Variables that contributed predominantly to classification were selected by canonical discriminant analysis, and there were differences between the young and old. The meaning of principal components expressing characteristics of old upper trunk form, and the characteristics of each cluster of the upper body form were expressed by upper trunk surface development.View full abstractDownload PDF (1547K) -
Takerou MIZUNO, Hitoshi NISHIDA, Niichi MIYAMOTO, Yoshio HATTA, Seiich ...1991 Volume 51 Issue 6 Pages 644-650
Published: December 28, 1991
Released on J-STAGE: September 09, 2010
JOURNAL FREE ACCESSIn general, chronic pancreatitis has been diagnosed by morphological and functional methods, endoscopic retrograde pancreatography (ERP), and the caerulein-secretin (CS) test based on the Japanese Society of Gastroenterology clinical criteria for chronic pancreatitis. However, the degrees of morphological change and exocrine dysfunction are not related, especially in cases of mild to moderate chronic pancreatitis, and this discrepancy is thought to be explained by the fact that pancreatic function reflects parenchymal abnormalities. To estimate the relations of pancreatic function and morphology, we used 7.5 MHz linear and radial scanning endoscopic ultrasonography (EUS), by which we could detect parenchymal abnormalities more exactly than by other methods. The ability of diagnosis by EUS was compared to that of the CS test in 13 cases of normal controls and 43 cases of chronic pancreatitis diagnosed by ERP. The chronic pancreatitis was divided into two groups, diffuse (D) and local (L) . EUS findings, such as pancreatic margin, parenchymal echo level, and ductal system, were investigated. The results were: 1) Abnormality of the ductal system has slight relation to the CS test. 2) The ductal system and margin could be observed well by EUS, and change of the margin was not specific to chronic pancreatitis. 3) Among the EUS findings, parenchymal echo level was closely related to results of the CS test. As dysfunction indicated by the CS test progresses, the parenchymal echo level changes from a spotty high echo to a mixed pattern of spotty high echo with patchy low echo, and finally becomes a diffuse low echo pattern. 4) EUS could detect changes in both pancreatic morphology and function, and is useful in the diagnosis of chronic pancreatitis.View full abstractDownload PDF (3668K) -
Masami OZAKI1991 Volume 51 Issue 6 Pages 651-661
Published: December 28, 1991
Released on J-STAGE: September 09, 2010
JOURNAL FREE ACCESSFew patient with cleft lip and palate complain of postoperative nasal obstruction. The author repairs cleft lip by Onizuka's method about three months after birth, and cleft palate by the push-back method at about one year. Despite operation by accepted procedures, nasal obstruction and deformity may occur. The extent of the cleft, degree of development of external nose and maxilla, operative influence, and other anatomical problems may be responsible. Thus, before cleft lip repair we carried out computed tomography of 36 patients who were separated into four groups: bilateral cleft lip and palate [Group A] ; unilateral cleft and palate [Group B] ; unilateral incomplete cleft lip and palate [Group C] ; and unilateral incomplete cleft lip [Group D] . Comparative examinations were made of nasal deviation, nasal septal shape, degree of curvature and difference in area between right and left nasal cavities: the nose was deviated always to non-cleft side; the nasal septum was S-shaped for right and reverse S-shaped for left cleft lip; and the nasal cavity was always narrower on the cleft side with a greater difference in area for a higher degree of cleft.View full abstractDownload PDF (4689K) -
Kenji SAIKI, Susumu TAGUCHI, Yoshio HATTA1991 Volume 51 Issue 6 Pages 662-669
Published: December 28, 1991
Released on J-STAGE: September 09, 2010
JOURNAL FREE ACCESSThe effects of intravenous administration of the protease inhibitor, nafamostat mesi-late (FUT-175), on pancreatic exocrine secretion were studied in conscious rats. FUT-175, at two different doses, 0.5 and 1 mg/kg/h, was infused intravenously for four hours in rats. Some 150 ng/ml and 300 ng/ml FUT-175 was excreted into the bile after venous administration of 0.5 and 1 mg/kg/h respectively. Pancreatic flow and protein output were not altered by intra-duodenal infusion of bile-pancreatic juice containing FUT-175. Injection of 300 ng, 600 ng and 0.01 mg/h of FUT-175 into the duodenum for four hours did not significantly increase pancreatic exocrine secretion, or release of CCK. Pancreatic exocrine secretion increased significantly 1.5 hours after intraduodenal administration at 0.1 mg/body/h of FUT-175, whereas plasma CCK levels did not change from basal levels. Although the pancreatic exocrine was dose de-pendently secreted in response to intraduodenal administration of FUT-175, the doses were much higher than the in vivo thereapeutic dose. It was concluded that a therapeutic dose of FUT-175 will not induce pancreatic exocrine secretion in conscious rats.View full abstractDownload PDF (807K) -
Kenta SUGIMURA, Kiyotaka NAKAJIMA, Tsuyoshi OGAWA, Etsuo FUJIMAKI1991 Volume 51 Issue 6 Pages 670-672
Published: December 28, 1991
Released on J-STAGE: September 09, 2010
JOURNAL FREE ACCESSA 63 year old male was admitted with complaints of tumor in his right knee. The tumor, measured 1.5×1.5 cm, was tough, elastic, and mobile. Operation was performed to resect the tumor including svnovia. Pathological findings were pigmented villonodular synovitis (PVS) . Localized PVS is difficult to diagnose. A differential diagnosis is almost impossible other than the history and physical examination. For this reason, arthroscopy is recommended for diagnosis.View full abstractDownload PDF (3315K) -
Nobuhiro KOJIMA, Hisashi OKA, Naoyasu KITAMURA, Junkichi KIM, Yoshiya ...1991 Volume 51 Issue 6 Pages 673-677
Published: December 28, 1991
Released on J-STAGE: September 09, 2010
JOURNAL FREE ACCESSAdult intussusception is characterized mostly by its secondary origin from cancer, for example, as revealed by endoscopy, enema and surgery during hospitalization. The case was a 61-year-old housewife with intermittent abdominal pain, who was suspected from her family doctor's enema results of having cecal cancer. She was examined in our department. She had a history of intussuscepeion and had had repeated abdominal pain for 2 years. Colonofiberscopy during hospitalization revealed a tumor in the transverse colon, and injection of contrast medium from the forceps aperture revealed a crab-neil picture outline. Re-enema the next day revealed the tumor lobe in the cecum with the intussuscepeion being released. Abdominal pain re-appeared the night before operation, and intraoperatively, a three-cylindrical invaginated intestinal canal, with a carcinoma as its presentation, was confirmed. Mobile cecum was noted, but no circulatory disturbance of the canal. After manual reduction of the mobile cecum, right hemicolectomy was per-formed. The carcinoma, as the presentation, was a localized ulcer type, well differetiated adenocarcinoma.View full abstractDownload PDF (3595K) -
Yuji AOYAGI, Eimi KURUMATANI, Hitoshi NISHIDA, Hiroyuki YOSHIDA, Hitos ...1991 Volume 51 Issue 6 Pages 678-682
Published: December 28, 1991
Released on J-STAGE: September 09, 2010
JOURNAL FREE ACCESSA 67-year-old female complaining of abdominal fullness was admitted to our hospital. Physical examination revealed the accumulation of ascitic fluid, and laboratory data showed non-specific inflammatory changes with the elevations of adenosine deaminase (ADA) and CA-125 levels in both serum and ascites. Definite diagnosis of tuberculous peritonitis was made by laparoscopy, which showed disseminated tuberculous nodules, and was confirmed by the histological examination of concomitantly obtained biopsied specimens. Clinical symptoms and signs improved with anti-tuberculous therapy, and serum levels of ADA and CA-125 normalized. It was suggested that determinations of ADA and CA-125 in serum and ascitic fluid was useful for the diagnosis of tuberculous peritonitis, and moreover for the longterm follow up study.View full abstractDownload PDF (3752K) -
—USEFULNESS OF COLOR DOPPLER ULTRASONOGRAPHY FOR THE DETECTION OF CAVERNOMATOUS TRANSFORMATION—Takerou MIZUNO, Seiichirou TAKAHASHI, Noboru TAKAYAMA, Yasushi AKITA, ...1991 Volume 51 Issue 6 Pages 683-686
Published: December 28, 1991
Released on J-STAGE: September 09, 2010
JOURNAL FREE ACCESSA 77-year-old male had chronic hepatitis and hepatocellular carcinoma (HCC) . He had received transcatheter arterial embolization therapy (TAE) four times. He was re-admitted for abdominal pain. Enlargement of the HCC, and bloody ascites on abdominal puncture suggested rupture of the HCC. Although a tumor thrombus in the main portal vein, which is generally a contraindication for TAE, appeared in ultrasonography, TAE was uneventfully performed in this case, because development in a collateral vein, such as cavernomatous transformation of the portal vein (CTPV), was detected by color Doppler ultrasonography. The man finally died of recurrence of the HCC rupture, but the TAE was thought to be successful treatment for the HCC bleeding and generally improved his condition for a while. It is suggested that TAE is the preferred therapy, even in a case with a main portal thrombus, if CTPV develops, and color Doppler ultrasonography seems to be useful for detection of CTPV.View full abstractDownload PDF (3403K) -
Minoru SHIBATA, Yoshio HATTA, Yukihisa UENO, Shigeyasu UCHIBORI, Ikue ...1991 Volume 51 Issue 6 Pages 687-691
Published: December 28, 1991
Released on J-STAGE: September 09, 2010
JOURNAL FREE ACCESSAs a precaution against lung dysfunction after endoscopic injection sclerotherapy (EIS), blood gas analysis and 99mTc-MAA lung perfusion scintigraphy were performed before and after EIS when a case of liver cirrhosis complicated by bronchiectasis was treated with EIS. EIS was performed twice with an interval of about a week, and 24 hours after EIS a transient decline in PaO2 (arterial oxygen tension) and repeated widening of A-aDO2 (alveolar-arterial oxygen difference) appeared. PaO2 reached a low of 56 Torr during this course, but the patient had no subjective symptoms and no abnormality was found in lung perfusion scintigram. Additional observation of lung function before and after EIS were then performed on 6 cases, all of which showed transient, asymptomatic, and significant decline in PaO2 and significant widening of A-aDO2. In two of 4 cases, lung perfusion scintigrams without flow were produced. Because pulmonary infarction as a post-EIS complication is generally very rare, little attention is given to lung functioning after EIS. In our experience, however, asymptomatic and transient lung dysfunction was recognized in a high proportion of cases. These results indicate the necessity for blood gas measurement during EIS for early detection of complications.View full abstractDownload PDF (3112K) -
—WITH SPECIAL REFERENCE TO THE DIAGNOSTIC VALUE OF COLOR-DOPPLER ULTRASONOGRAPHY FOR LIVER TUMOR—Hiroaki KAWAI, Sachiyo KAETSU, Kenichi HIGUCHI, Makoto ISHII, Hitoshi ...1991 Volume 51 Issue 6 Pages 692-697
Published: December 28, 1991
Released on J-STAGE: September 09, 2010
JOURNAL FREE ACCESSAn 81-year-old female with an abdominal tumor was admitted to our hospital. An elastic child's head sized tumor with irregular surface was palpable around the right upper abdomen on physical examination. This tumor was an irregular highly echoic mass on ultrasonography and was connected to the liver. For abdominal computed tomography, the tumor was partially enhanced by contrast medium and no blood flow could be visualized in the tumor by color-Doppler ultrasonography. This tumor had the appearance of cotton-wool like stain, and celiac angiography showed it to be fed by the right hepatic artery. After the diagnosis of giant liver hemangioma with extrahepatic growth, an extirpation of the tumor was performed. The resected tumor was 14×10 cm, weighed 1, 300 g, and was histolo-gically compatible with cavernous hemangioma. Shch a giant liver hemangioma showing extrahepatic development is rare. The usefulness of color-Doppler ultrasonography for differential diagnosis of liver tumor is discussed.View full abstractDownload PDF (4991K) -
Miki SHIBUSAWA, Akira TSUNODA, Hiroto YOSHIZAWA, Kiyoaki TAMURA, Hirot ...1991 Volume 51 Issue 6 Pages 698-702
Published: December 28, 1991
Released on J-STAGE: September 09, 2010
JOURNAL FREE ACCESSA 35-year-old woman complained of abdominal pain and constipation. On digital examination, a rectal tumor was palpated and barium enema exmination revealed obvious diffuse stenosis of the rectum. Left leg edema was caused by inguinal lymph node swelling. Histology of the colonoscopy biopsy specimens disclosed poorly differentiated adenocarcinoma. Only sigmoid loop colostomy was performed since the tumor was fixed in the pelvic organs and Virchow lymph node metastasis was already evident. She died of cachexia 34 days after operation. Autopsy revealed diffuse peritoneal dissemination and widespread metastasis to the pelvic and paraaortic lymph nodes. A cancerous wall about 20 cm thick was located from the anus to the colostomy, and invasion was found in the vagina, uterus and urinary bladder. Primary, diffuse, infiltrating type of colorectal cancer has shown a particularly high malignant potential and a bleak prognosis, compared to ordinal carcinoma of the large bowel. Early diagnosis and treatment are therefore desirable for this type of carcinoma.View full abstractDownload PDF (3901K)
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