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Volume 61, Issue 1
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[in Japanese]2001 Volume 61 Issue 1 Pages 1
Published: February 28, 2001
Released on J-STAGE: September 09, 2010
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[in Japanese]2001 Volume 61 Issue 1 Pages 2-7
Published: February 28, 2001
Released on J-STAGE: September 09, 2010
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[in Japanese]2001 Volume 61 Issue 1 Pages 8-11
Published: February 28, 2001
Released on J-STAGE: September 09, 2010
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[in Japanese]2001 Volume 61 Issue 1 Pages 12-18
Published: February 28, 2001
Released on J-STAGE: September 09, 2010
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[in Japanese]2001 Volume 61 Issue 1 Pages 19-23
Published: February 28, 2001
Released on J-STAGE: September 09, 2010
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[in Japanese]2001 Volume 61 Issue 1 Pages 24-28
Published: February 28, 2001
Released on J-STAGE: September 09, 2010
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[in Japanese]2001 Volume 61 Issue 1 Pages 29-33
Published: February 28, 2001
Released on J-STAGE: September 09, 2010
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Aya HATANO, Rika TAJIMA, Yoshiaki MORI, Masazumi MIZUMA, Nobuyuki KAWA ...2001 Volume 61 Issue 1 Pages 34-41
Published: February 28, 2001
Released on J-STAGE: September 09, 2010
JOURNAL FREE ACCESSFifty-one limbs of 46 patients (35 males, 11 females) who were referred to our department for amputation were studied for contents of the consultation, underlying diseases, the level of amputation, complications, prognosis and the ability to ambulate. Most subjects, 93.5%, suffered from vascular diseases such as arteriosclerosis obliterans (ASO), diabetes mellitus (DM) and Buerger's disease. Referral for amputation and perioperative management has increased in number while postoperative orthotics was more common in the past. The mean age was young in trauma patients and old in patients with vascular diseases. The majority of patients with ASO and ASO accompanied by DM were males ; however, among patients with DM there was no difference in sex. A considerable number of subjects with DM managed to avoid amputation by conservative treatments. Amputation was performed at the level of the thigh in most cases with ASO and below the knee in cases with DM. Cardiac and cerebrovascular complications were encountered in patients with ASO ; however, there was none in patients with Buerger's disease. Of the subjects who underwent amputation, 78.3% recovered becoming ambulatory with prosthesis and 71.7% were discharged. Of the 25 patients who were contacted after discharge, 90.9% were still ambulatory and patients without amputation showed no deterioration. Perioperative management by a rehabilitation physician, careful consideration for indication of amputation and thorough orthotics and follow-up are indispensable.View full abstractDownload PDF (738K) -
Nobuhiko OKAWA, Yutaka ENDO, Rikiya FUJITA2001 Volume 61 Issue 1 Pages 42-49
Published: February 28, 2001
Released on J-STAGE: September 09, 2010
JOURNAL FREE ACCESSA total of 740 colorectal cancers have been treated at our hospital during the past five years (early cancer: 422 ; advanced cancer: 318) . In order to find treatment methods for colorectal cancer with submucosal invasion (sm cancer), we evaluated the clinicopathological features and lymph node metastasis of 114 cases of sm cancer. Lymph node metastasis was found in 10.0% of this series. The presence of lymphatic vessel permeation and massive cancer invasion into the submucosal layer were each significant risk factors for lymph node metastasis. In the patients whose histology at the front of the submucosal invasion showed moderately or poorly differentiated adenocarcinoma, lymph node metastasis tended to be more frequently observed ; however, this difference was not significant. Among the colorectal cancer patients who had none of the three factors, that is, those who did not have massive cancer invasion, lymphatic vessel permeation nor histology of moderate or poor differentiation at the invasive front, none had lymph node metastasis and we assumed that additional surgery was not necessary. Among the patients who had colorectal cancers with two or three of the three factors, the percentage of cases with lymph node metastasis was high (18.9%), and we felt that additional surgery including lymph node dissection was necessary. Among those who only had massive submucosal invasion and were negative for the other two risk factors, only one case (5.9%) had lymph node metastasis. In this case, the absolute depth of the vertical invasion below the muscularis mucosae was approximately 3, 000 μm. None of the cases with submucosal invasion less than 1, 750μm had lymph node metastasis. It was considered that additional surgical bowel resection was not necessary for those cases with submucosal invasion less than 1, 000 μm and who were negative for the other two risk factors.View full abstractDownload PDF (997K) -
—Comparison with 3D-MR Angiography—Setsuko SAKIOKA, Satoshi WAKASUGI, Shigeyoshi OOGURI, Tatsuya YAMAGAMI ...2001 Volume 61 Issue 1 Pages 50-59
Published: February 28, 2001
Released on J-STAGE: September 09, 2010
JOURNAL FREE ACCESSObject: The detectability of collateral vessels of the portal vein by color Doppler sonography (CDS) was evaluated and compared with that by 3D-magnetic responce angiography (3D-MRA) in 31 patients suspected of having portal hypertension.
The left gastric vein was detectable in 11 patients by CDS and in 11 patients by 3D-MRA and in 8 patients by both methods, while the paraumbilical vein was detectable in 5 patients by CDS and 4 patients by 3D-MRA and 4 patients by both methods. However, esophageal varices, splenorenal shunt and defects of in portal flow were detected in 3, 2, and 9 patients, respectively, by CDS, and in 8, 9, and 3 patients, respectively, by 3D-MRA, and this difference was probably due to interference by gastrointestinal gas and slow portal blood flow in CDS.
However, CDS was uniquely important in assesing reversal portal blood flow in 4 cases, which were not detectable by 3D-MRA.
Thus, CDS is clinically useful not only for the delineation of collaterals, but also for the detecion of abnormal blood flow in patiens with portal hypertension.View full abstractDownload PDF (9171K) -
Naoyuki URAGAMI, Norihiro KAMINAGA, Yasuhiro FUNATSU, Kenji KATO, Taka ...2001 Volume 61 Issue 1 Pages 60-69
Published: February 28, 2001
Released on J-STAGE: September 09, 2010
JOURNAL FREE ACCESSTo study the abnormal immune response to peroral antigens in patients with active Crohn's disease (CD), the surface antigens of lymphocytes in Peyer's patches (PP) and peripheral blood lymphocytes (PBLs) were examined. The subjects were 6 adults with CD and 6 normal adults. The PP in the terminal ileum were biopsied endoscopically, and PP lymphocytes (PPLs) were isolated. Lymphocytes were also isolated from a peripheral blood sample. The lymphocytes were stained using monoclonal antibodies to CD4, CD8, CCR4 and CCR5 ; CCR4 and CCR5 are selectively expressed on the surface of Th2 cells or Thl cells, respectively. The samples were analyzed by flow cytometry. In the normal subjects, among the CD8-positive PPLs, the percentage of CCR5-positive cells was significantly higher than the percentage of CCR4-positive cells (p<0.05) . In the CD patients, the percentage of Th1 (CCR5-positive, CD4-positive) cells or Tc1 (CCR5-positive, CD8-positive) cells among the PPLs was significantly higher than the respective percentage among the PBLs (p<0.01, p<0.01) . Comparison of the PPLs from the patients with CD and those from the normal controls showed that the percentage of Thl cells or Tcl cells in the patients with CD was significantly higher than the respective percentage in the normal controls. As to the PBLs, there were no significant differences in the percentage of Th1 cells or Tc1 cells between the CD patients and the normal subjects. These results suggest that the immune response of the PPLs of CD patients to peroral antigens is altered, in that Thl-type PPLs are excessively produced. These immunologic changes may be related to the etiology of CD.View full abstractDownload PDF (941K) -
Atsuki NAGASHIMA, Rikiya FUJITA, Yoshiharu SATAKE, Toshiyuki MITUYA2001 Volume 61 Issue 1 Pages 70-77
Published: February 28, 2001
Released on J-STAGE: September 09, 2010
JOURNAL FREE ACCESSIn order to study the mechanism of the origin and growth of colorectal cancer, the histopathology of the adenomatous component of early colorectal cancer was studied and correlated with the shape, size and depth of tumor invasion. Among patients with early colorectal cancer, 84.5% of the tumors were associated with an adenomatous component. Most of the early colorectal cancer patients (74.4%) had the protruded type of tumor (Ip, Isp, Is) . Among patients with submucosal invasive cancer (sm cancer), 52.2% has the protruded type associated with an adenomatous component. Of these patients, 61. 9% had cancer that is categorized as“sm cancer with greater depth”according to the Japanese Classification of Colorectal Carcinoma (sm II cancer) . Among patients with early protruded type of colorectal cancer with an adenomatous component, 81.4% has tumor a size greater than 20 mm and 66% had sm II cancer. Among the patients with sm II cancer, 60.9% had what is considered to be “adenomatous type”cancer. Among patients with sm II cancer, 8.6% had de novo type superficial cancer with a size less than 10 mm. These results suggest that a significant number of colorectal cancers are derived from adenoma and invade the submucosal tissues even at an early stage with a tumor size of less than 20 mm.View full abstractDownload PDF (3621K) -
—Investigation of the Localization of Regulatory Center in the Central Nervous System—Masami NAKAZAWA, S.Y. GUS, Takao SATO, Tadashi HISAMISTU2001 Volume 61 Issue 1 Pages 78-83
Published: February 28, 2001
Released on J-STAGE: November 19, 2010
JOURNAL FREE ACCESSIn the present study, we investigated the localization of the regulatory center in the central nervous system responsible for intraocular pressure (IOP) by microinjection of α2-adrenoceptor agonist, clonidine, into the brain of rats. Male Wistar rats weighing 200-250 g were used in all experiments. The influence of 0.1% clonidine 2μl injection into the medial vestibular nucleus (MVN) area was examined. TOP showed a significant decrease after clonidine injection into the MVN area. TOP-lowering effects of clonidine were abolished by previous application of 0.1% yohimbine 5 μl into the MVN area. TOP was not significantly affected by the 0.1% clonidine 2 μl injection into the regions surrounding the MVN. It is suggested that one of the regulatory centers for IOP is located at the MVN area in the central nervous system of rats.View full abstractDownload PDF (554K) -
COMPARISON BETWEEN VARIOUS LABORATORY INDICATORS AND ENDOSCOPIC FINDINGSYasuhiro FUNATSU, Norihiro KAMINAGA, Naoyuki URAGAMI, Akiko CHINO, Mot ...2001 Volume 61 Issue 1 Pages 84-93
Published: February 28, 2001
Released on J-STAGE: September 09, 2010
JOURNAL FREE ACCESSTo determine whether endoscopy can be used to diagnose remission and relapse of Crohn'sdisease (CD), the endoscopic findings of the ulcers of patients with CD were compared with the results of various laboratory tests including IOIBD scores, CDAI, ESR, and CRP. The subjects were 23 patients with CD who were treated with elemental diet therapy. Endoscopy was performed at the time of remission, which was diagnosed based on normalization of the laboratory tests described above. One month after normalization of the laboratory parameters, endoscopic examination showed that the ulcers of 18 patients revealed changes characteristic of the “healing stage”, while the ulcers of 5 patients showed changes characteristic of the “scarring stage”. In all 23 cases, it took several months before the ulcer completely healed and showed endoscopic findings characteristic of S2 stage scarring tissue. Further analyses of the relationship between the length of the remission period and endoscopic findings of the ulcer at the time of remission showed that the remission period of patients who had an S2-stage ulcer was 23.6±31.0 months, which was significantly longer than that of patients who had an-S1S2 stage ulcer (7.6±6.3 months) or an S1-stage ulcer (p<0.05, p<0.05) . These results suggest that actual healing of the ulcer (as evidenced by scarring on endoscopic examination) takes a much longer time than normalization of laboratory parameters. To prolong the remission period in CD, it is important to continue to treat patients even after the laboratory tests indicate remission, until endoscopy shows that the ulcer has reached the S2 stage. In the majority of patients in remission who subsequently suffer a relapse of the disease, changes in endoscopic findings preceded the changes in laboratory parameters. These results suggest that endoscopy is useful for detecting a relapse of CD and for determining the therapeutic strategy.View full abstractDownload PDF (2480K) -
Toshiyuki YOSHIZAWA, Hideyo MIYAOKA, Masanori NAKAMURA, Fumio SUKEZAKI2001 Volume 61 Issue 1 Pages 94-101
Published: February 28, 2001
Released on J-STAGE: September 09, 2010
JOURNAL FREE ACCESSWe evaluated the clinical and radiographic results of Kyocera Bioceram type THA (total hip arthroplasty) in subjects more than 10 years after surgery in our hospital. Our study focused on 31 joints in 26 patients, the postoperative observation period was an average follow-up of 145 months, the average age at the operation was 56.8 years. The JOA score at the time of the final observation was an average of 70.2 points. We evaluated the clear zone with Nagaya's classification and defined as loosening those X-ray findings in stages 3 and 4. Loosening was seen in 12 joints (38.7%), and at 5 joints (16.1%) we performed revisional THA. The survival rate of Bioceram type THA in which loosening and revisional THA were presumed as the end point were 52.1% and 55.3%, respectively. There was no difference between this study and the survival rate of Charnley Möller (57.3%) type THA in our hospital. The long term results of Bioceram type THA were not as good as was expected. It is concluded that long-term results are influenced by not only the implant design, but also the patient's background, operative techniques, and the preoperative management.View full abstractDownload PDF (5635K) -
Masayuki HOSAKA, Nobuyuki KAWATE, Masazumi MIZUMA, Yoshiaki MORI2001 Volume 61 Issue 1 Pages 102-106
Published: February 28, 2001
Released on J-STAGE: September 09, 2010
JOURNAL FREE ACCESSWe reported on the rehabilitation in a 63-year-old male with acute spinal epidural hematoma and paraplegia who had suffered from concurrent diseases and complications. The patient had dorsal pain and adynamia in the lower limbs while bending and stretching and was taken to our hospital. The patient was diagnosed by MRI as having acute spinal epidural hematoma and underwent conservative treatment. Because palsy had not improved, surgery for decompression was performed and the patient began to receive rehabilitation. The initial aim of rehabilitation was to resume daily activities at home using a wheelchair and to live independently. Because of concurrent diseases (angina, abdominal aortic aneurysm, ischemic enteritis, and stomach cancer), and complications (nugina, abdominal aortic aneurysm, ischemic enteritis), the patient could not use a wheelchair and live independently. However, receiving increased social support, he was discharged to his nome from the hospital.View full abstractDownload PDF (2220K) -
Naohiko YABUKI, Shu OBARA, Kei TATENO, Atsushi KUSABA, Yoshimi OSAKABE ...2001 Volume 61 Issue 1 Pages 107-110
Published: February 28, 2001
Released on J-STAGE: September 09, 2010
JOURNAL FREE ACCESSWe treated five cases of necrotizing fasciitis. All patients suffered from poor diabetic control. Three out of five patients died of possible multiple organ failure and two patients survived. Early diagnosis is essential for necrotizing fasciitis. When a local inflammatory lesion due to infection exists in a patient with poor diabetic control, necrotizing fasciitis should be added into a differential diagnosis. In conclusion, early use of a broad spectrum antibiotic, early extended surgery, and the appropriate treatment for the underlying diseases seem to be important factors that influence the prognosis.View full abstractDownload PDF (2920K) -
Takeshi METORI, Souitirou TAKIGAWA, Katunori INAGAKI, Kazuo FUKUSHIMA, ...2001 Volume 61 Issue 1 Pages 111-114
Published: February 28, 2001
Released on J-STAGE: September 09, 2010
JOURNAL FREE ACCESSA 49 years old male had noticed a tumor on the palmar side of the right wrist 25 years ago, however, he did not seek treatment because there was no pain. The patient visited our hospital for the first time on August 25 1998 because the tumor had recently increased. The tumor existed on the palmar side of the right wrist and size was 7×4 cm. The surface of the tumor was smooth and had an elastic hardness. A plain X-ray revealed a calcified spot in the tumor. We removed the tumor on September 28, 1998, the tumor was diagnosed as vascular leiomyoma from the pathological organization. Since treatment no tumor has reappeared and the patient does not suffer any pain. Vascular leiomyoma occurring to the wrist joint, according to a report of Morimoto, etc, account for only 0.8% of cases, in addition, leiomyoma of over 2.0cm account for only 9.1%. A report of leiomyoma over 5 cm such as we experienced is extremely.View full abstractDownload PDF (6070K) -
Masayuki TATEIWA, Hitosi UCHIDA, Hideyo MIYAOKA2001 Volume 61 Issue 1 Pages 115-117
Published: February 28, 2001
Released on J-STAGE: September 09, 2010
JOURNAL FREE ACCESSSpontaneous acute spinal epidural hematoma is uncommon. The clinical characteristic symptom consists of abrupt spinal paralysis, and an early diagnosis and immediate decompressive surgery are imperative to obtain a better neurological outcome. An 82-year woman developed severe back pain followed by progressive weakness in her legs. MRI showed a thoracic epidur al hematoma.because of her rapid improvement, conservative observation was performed. At 6days after the onset, her symptoms recovered completely. In this paper, we report this interesting case and review cases of acute spinal epidural hematoma previously reported in the literature.View full abstractDownload PDF (2243K) -
Kousaku OKADA, Hajime SAKAGAWA, Kazunobu ISHIKAWA, Manabu MOROOKA, Mun ...2001 Volume 61 Issue 1 Pages 118-121
Published: February 28, 2001
Released on J-STAGE: September 09, 2010
JOURNAL FREE ACCESSA 54-year-old man with a feeling of disorder and tumor mass in the left inguinal region as the chief complaint was seen at the Department of Surgery of our hospital and then referred to our department. Neurological deciduous symptoms were not found. An elastic, hard, egg-sized tumor mass, with a flat margin was palpable. On CT and MRI for the inguinal region, a schwannoma originating from the obturator nerve was suspected. After informing the patient that he may suffer from sensory disturbance or movement disturbance after surgery, we removed the tumor mass. Rapid pathological examination during the operation revealed the tumor to be a benign schwannoma. To our knowledge, there are no reported cases of the schwannoma of the obturator nerve in the inguinal region. We report a case of benign schwannoma of the obturator nerve in the inguinal region.View full abstractDownload PDF (5481K)
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