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HIROYASU IJUIN
1998 Volume 45 Issue 1 Pages
1-5
Published: April 01, 1998
Released on J-STAGE: August 11, 2009
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Zinc absorption in alcoholism was studied by a combination of zinc tolerance tests in 382 male patients with alcoholism (more than 140 g/day of ethanol) who had alcoholinduced disease of the liver or pancreas. In study 1, the serum zinc level was measured in all patients, and serum zinc and fecal chymotrypsin levels were compared in various disease groups. In study 2, 14 patients with liver cirrhosis (LC), 15 with chronic pancreatitis (CP), 7 with LC+CP, and 7 controls underwent oral zinc tolerance and zinc dipicolinate tolerance tests, zinc absorption and disorders of pancreatic exocrine functions were examined. In study 1, the serum zinc concentration was significantly lower in the CP and LC groups than in the control group, and the fecal chymotrypsin activity was significantly lower in the CP than in the control groups. In study 2, during the oral zinc tolerance test, the serum zinc concentration 3 hours after administration was significantly lower in the LC, CP and LC + CP groups than in the control group. In these groups, the serum zinc concentration was significantly lower in the abnormal fecal chymotrypsin group than in the control group at 2 and 3 hours after administration of zinc sulfate. In the oral zinc dipicolinate tolerance test, the serum zinc levels 2 and 3 hours after administration were significantly elevated in the control and all disease groups; there were no significant differences between the control and each disease group. These results suggest that reduction of pancreatic exocrine functions by alcohol and chronic reduction of synthesis of ligands such as picolinic acid in the liver are involved in the reduction of serum zinc in alcoholism.
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MASAHARU KINOSHITA, HISASHI WATANABE, MASAO ICHIKI, SHINYA SUMITA, YO ...
1998 Volume 45 Issue 1 Pages
7-9
Published: April 01, 1998
Released on J-STAGE: August 11, 2009
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The utility of cytokeratin fragment (Cyfra) 21-1, a new tumor marker, was investigated in 100 patients with lung cancer. Sandwich enzyme immunoassay detected Cyfra 21-1 in the sera of 60% of patients. Sensitivity of this marker was especially high (86.4%) for squamous cell carcinoma, exceeding that of a similar marker, squamous cell carcinoma antigen (SCC, 54.5%). In contrast, sensitivity of Cyfra 21-1 was relatively low for adenocarcinoma (52.6%) and for small cell carcinoma (50%). We conclude that Cyfra 21-1 is of value in diagnosis of lung cancer, particularly squamous cell carcinoma.
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RIKO OGATA
1998 Volume 45 Issue 1 Pages
11-20
Published: April 01, 1998
Released on J-STAGE: August 11, 2009
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Type IV collagen and laminin, major components of the basement membrane, are involved in several biologic activities. In malignant tumors, cell-matrix interactions are very important for tumor invasion and metastasis. In hepatocellular carcinoma, these matrices are present around hepatoma cells. However, there is little known how these matrices influence on the behavior of hepatoma cells. In this study, we investigated the participation of type IV collagen and laminin in the motility, adhesion, and proliferation of hepatoma cells using three different human hepatoma cell lines (KYN-1, 2, 3). The production of type IV collagen and laminin was investigated by immunoelectron microscopy. The effects of type IV collagen and laminin on hepatoma cell migration, adhesion, and proliferation were evaluated by the haptotactic migration assay, phagokinetic track assay, an adhesion assay, and a
3H-thymidine incorporation assay. Immunoelectron microscopy showed the production of type IV collagen and laminin by hepatoma cells. Type IV collagen and laminin enhanced haptotactic migration, chemokinesis, adhesion, and thymidine incorporation by hepatoma cells. The combination of type IV collagen and laminin had the most pronounced effects on these biologic activities. These results indicate that type IV collagen and laminin promote hepatoma cell motility, adhesion, and proliferation in an autocrine manner, suggesting enhancement of invasion and metastasis of hepatoma cells by these basement membrane components in vivo.
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TOYOAKI YAMANOUCHI
1998 Volume 45 Issue 1 Pages
21-25
Published: April 01, 1998
Released on J-STAGE: August 11, 2009
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I evaluated the contractions of the muscles of the lower extremities during baseball pitching using video imaging and simultaneous surface EMG. The subjects were 10 members of a high school baseball club and, for contrast, 10 students without any baseball club experience . I divided their pitching movements into two phases determined with respect to the landing of the nonpivot leg. The EMG signal intensities over the 2 seconds prior to landing, and over the 2 seconds after landing, were then integrated to give an EMG value to each phase. I then computed this value as the % MMT. The abductor and adductor of the hip muscles of both lower extremities in the players were strongly contracted, especially the adductor. This finding was consistent with the observation that pitching tends to lead to adductor muscle disorders. Strengthening the adductor and its antagonist abductor can therefore directly influence the capability for pitching, and can reduce the risk for the adductor disorders.
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SATORU MOTOMURA
1998 Volume 45 Issue 1 Pages
27-32
Published: April 01, 1998
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Gonadotropin releasing hormone (GnRH) agonist suppresses the growth of the cancer cells in vitro. To evaluate the effect of a GnRH agonist (GnRHA) in ovarian carcinomas, we investigated the interactions of GnRHA with the KOC-2s human ovarian cancer cells. The addition of GnRHA (10
-810
-6M) produced an increase 20-30% in the number of cells (p<0.05). GnRHA (10
-5M) produced a slight, statistically insignificant decrease of <10% in the cell count. No DNA fragmentation was produced by GnRHA (10
-8-10
-6M). However, GnRHA (10
-5M) produced internucleosomal cleavage of DNA into fragments with multiples of 180 to 200 bp. This DNA “ladder” pattern is characteristic of a poptosis. The amount of Fas antigen was reduced by each concentration of GnRHa. The addition of GnRHA (10
-6M and 10
-5M) significantly increased the secretion of TNF-α (p<0.001). The time- and dose-dependent effects of GnRHA might be confined to the KOC-2s cells as demonstrated by growth inhibitions and characteristic internucleosomal DNA fragmentation. However, the effects of GnRHA on secretion of TNF-α and the expression of Fas antigen differed. The present results provide a basis for future studies on the mechanism of apoptotic effect of GnRHA.
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SHINICHI KUBOYAMA
1998 Volume 45 Issue 1 Pages
33-37
Published: April 01, 1998
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Plasma levels of interleukin-1 receptor antagonist (IL-1ra), a potent inhibitor of IL-1, were measured in patients with inflammatory bowel disease. Plasma IL-1 ra levels in patients with active ulcerative colitis and Crohn's disease were higher than in normal controls. No significant difference was noted in plasma IL-1 ra concentrations between active ulcerative colitis and Crohn's disease patients. The levels in patients with inactive disease were lower than in active patients, but were higher than in normal controls. Plasma IL-1ra levels correlated significantly with clinical disease activity and laboratory parameters such as C-reactive protein or leukocyte count. In conclusion, circulating IL-1ra in patients with inflammatory bowel disease may be a useful marker of disease activity.
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MICHIO SATA, TATSUYA IDE, SEIJI NOGUCHI, HIROSHI SUZUKI, YUMIKO NAGAO, ...
1998 Volume 45 Issue 1 Pages
39-43
Published: April 01, 1998
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To determine whether hepatitis C virus (HCV) replicates in bone marrow, we investigated positive-and negative-strand HCV RNA in bone marrow cells and fluids, and sera from patients with HCV infection. The study population consisted of 15 patients positive for antibodies to HCV (anti-HCV). Positive- and negative-strands HCV RNA were detected using highly strandspecific rTth reverse transcription-polymerase chain reaction (rTth RT-PCR) followed by Southern blotting analysis. Positive-strand HCV RNA was detected in 12 (80%) serum samples, in 13 (86.7%) bone marrow fluid specimens, and in 6 (40.0%) bone marrow cell samples. Negativestrand HCV RNA was detected in 9 (60.0%) serum samples, 11 (91.7%) fluid specimens, while it was not detected in bone marrow cells. The absence of negative-strand HCV RNA in bone marrow cells suggested that HCV does not replicate in these cells. Negative-strand HCV RNA detected in serum and bone marrow fluid samples may have been due to contamination with circulating HCV RNA from hepatocytes.
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KOHEI OGAWA
1998 Volume 45 Issue 1 Pages
45-51
Published: April 01, 1998
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Endoscopic mucosal resection (EMR) for mucosal gastric carcinoma without lymph node metastases has been widely accepted as a curative procedure in Japan. We consider patients with elevated type well-differentiated adenocarcinoma less than 20 mm in size, as well as those with depressed type intramucosal carcinoma without ulcer and less than 10 mm in size, to be absolute indications for treatment by EMR. In this study, we evaluated 26 patients (68.4±9.7yrs) with absolute adaptive lesions who underwent EMR as an initial treatment, resulting in incomplete resection of lesions. We performed laser therapy on patients with residual lesions, and examined the effects of this treatment. Eighteen cases with elevated type lesions (90%) have not exhibited recurring lesions treated by initial laser therapy alone following EMR over a period of 24 months. However, among patients with depressed type lesions, only 1 (16.7%) did not experience recurrence. There was a significant difference between the two groups (p<0.001). These recurring lesions were treated by additional laser therapy. The results were more satisfactory in patients with elevated type lesions (95.5%) than in patients with depressed type lesions (80%). No patient died of gastric cancer during follow-up. Endoscopic laser irradiation is useful in treating patients with residual lesions after EMR.
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Outcomes in 56 Patients
XIAOHUA XU, MINORU SHIGEMORI
1998 Volume 45 Issue 1 Pages
53-57
Published: April 01, 1998
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Fifty-six patients with craniopharyngiomas were operated by microsurgical techniques during a 20 - year period. Of the 56 patients, 28 were males and 28 were females, with a mean age of 33 years (range 1 to 78 years). Twenty patients (35.7%) were less than 15 years of age. Remission was defined as clinical improvement with stable ophthalmological and neurological status, CT and/or MRI evidence of a decrease in tumor size or tumor disappearance when a patient was discharged from hospital. Ineffectiveness was defined as lack of change in the preoperative clinical status. The mean follow-up period in this study was 6.9 years, with 11 patients monitored. The most common presentation was visual dysfunction (69.6%). 33.9% of the patients presented with headache. The most frequent preoperative finding was a visual field defect, with 55.4% of the patients so affected; 39.5% of patients had preoperative hypothyroidism and 40% had hypoadrenalism. Diabetes insipidus was found preoperatively in 7.1%. Three female patients had amenorrhea. Hydrocephalus was uncommon, being present in only 10.7%. Unruptured aneurysms were found incidentally in 2 cases. A pterional approach was used in 29 patients (52%), a transcallosal approach in 13 (23%), a transcortical approach and a transsphenoidal approaches in 3 (5%), and a lamina terminalis approach in 1 patient. Multiple procedures were required in 8 patients in order to provide significant relief of compressive symptomatology. Overall, 12.5% of the tumors were completely resected. 92.9% of our patients were in remission, 2 had ineffectiveness result, and 2 died of postoperative complications. Except for the completely resected cases, all the other patients underwent radiotherapy postoperatively. The results of this series show that microsurgical management of craniopharyngiomas yields good operative results.
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TATSUYA ISHITAKE, HIDEO ANDO, YUZO MIYAZAKI, FUMIKA MATOBA
1998 Volume 45 Issue 1 Pages
59-62
Published: April 01, 1998
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To clarify the effects of whole-body vibration (WBV) on visual performance, visual acuity and a self-rated assessment of difficulties in visible perception were determined after various frequencies of vibration in six healthy males. Two different sitting postures, an erect posture and a muscle-relaxed posture, were used. Sinusoidal vertical vibrations at ten frequencies (8, 10, 12.5, 16, 20, 25, 31.5, 40, 63.5 and 80 Hz) were applied to the seated subjects for 20 sec. The magnitude of acceleration at each vibration frequency was maintained at 2.5 msec
-2 (r.m.s.). The visual performance was evaluated by a standard visual acuity test and a self-rated assessment for difficulties in visible perception. The disturbances of visual performance were dependent on the vibration frequency (p<0.01, ANOVA) with a maximum reduction of visual acuity at a frequency of 12.5 Hz. The disruption of the visual performance was more severe with the erect posture than with the muscle-relaxed posture. In conclusion, short-term WBV exposure can affect visual performance, depending on the vibration frequency and the sitting posture. The visual acuity and self-rated assessment of disturbances of vision may be influenced by the resonance frequency of the eyeball.
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AKIRA SHIRACHI
1998 Volume 45 Issue 1 Pages
63-67
Published: April 01, 1998
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Enhanced production of proinflammatory cytokines has been described in inflammatory bowel disease. The effect of interleukin (IL)-10, a cytokine with antiinflammatory activity, or anti-IL-10, on cytokine production by cultured colonic mucosa or blood mononuclear cells from patients with active inflammatory bowel disease was evaluated. Addition of IL-10 to the culture medium of colonic tissues or blood mononuclear cells resulted in inhibition of both IL-1β and tumor necrosis factor-α production and augmentation of IL-1 receptor antagonist production. Conversely, neutralization of endogenous IL-10 was found to augment both tumor necrosis factor-α and IL-1β production and inhibit IL-1 receptor antagonist production. In addition, the production of IL-10 by mononuclear cells was suppressed by prednisolone. In conclusion, IL-10 and related molecules may be useful in the treatment of inflammatory bowel disease.
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TOMOHISA SAIKI
1998 Volume 45 Issue 1 Pages
69-73
Published: April 01, 1998
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Neutrophils play a predominant role in inflammatory and immune reactions in inflammatory bowel disease. It is well established that the level of myeloperoxidase, a constituent of neutrophil azurophil granules, reflects the number of neutrophil. We examined the usefulness of determining stool levels of myeloperoxidase in patients with inflammatory bowel disease. Myeloperoxidase levels in stool extracts were measured using a radioimmunoassay in 33 patients with ulcerative colitis, 32 with Crohn's disease, 9 inflammatory disease controls and 15 normal controls. Stool levels of myeloperoxidase in active inflammatory bowel disease patients increased significantly, and correlated with laboratory parameters and endoscopic grade of inflammation. A paired analysis showed a decrease in myeloperoxidase levels after the resolution of disease exacerbation. These results suggest that stool myeloperoxidase is a simple, noninvasive, and relevant marker of disease activity.
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KENICHIRO MIYAZAKI
1998 Volume 45 Issue 1 Pages
75-80
Published: April 01, 1998
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We studied impact loading on the foot and ankle at heel strike during level walking. Cadaveric testing was carried out on a skin-mounted accelerometer to estimate the bone or joint impact, and gait analysis was performed to evaluate the impact on the foot and ankle and its attenuation during level walking. Simulation using a rigid-body model estimated the impulse at landing during level walking. The skin-mounted accelerometer showed the same tendency as the bone-mounted accelerometer in cadaveric testing. In the gait analysis, impact at the calcaneus was attenuated at the medial malleolus and was less attenuated with the ankle fixation. In the simulation, impact became greater if the foot and ankle functions were eliminated. These results suggest that the foot and ankle are directly involved in attenuating the impact at heel strike during level walking.
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MIKI SHIRACHI, MICHIO SATA, HIROSHI SUZUKI, KUNITAKA FUKUIZUMI, KYUICH ...
1998 Volume 45 Issue 1 Pages
81-85
Published: April 01, 1998
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We examined the characteristics and usefulness of a third generation anti-HCV test kit, SYNPEP
TM HCV-EIA II (Kyokuto Pharmaceutical Inc., Tokyo, Japan). The sera of inhabitants from a hepatitis C virus (HCV) hyperendemic area were used. The kit had even or more anti-HCV detection sensitivity and reproducibility than ORTHO HCVIII ELISA Test System
TM (Ortho-Clinical Diagnostic K.K., Tokyo, Japan) or HCV PHA 2nd Generation
TM (Dinabot Co., Ltd., Tokyo, Japan). SYNPEP
TM HCV-EIA II needed less total reaction time than other EIA kits, resulting in a simple procedure. Also, HCV RNA was detected in 90% of subjects who had a 7.5 or greater cut-off index (COI) of SYNPEP
TM HCV-EIA II kit. In conclusion, SYNPEP
TM HCV-EIA II require cheap cost and simple procedure and it could be applied to mass screening to find out HCV RNA positive persons who may need clinical care.
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YUICHIRO TSUJI
1998 Volume 45 Issue 1 Pages
87-94
Published: April 01, 1998
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The usefulness of magnifying endoscopy was assessed by examining the extent to which a magnifying endoscope can provide images of pits and by analyzing the consistency of the pit patterns visualized by magnifying endoscopy with the pit patterns visible under a stereomicroscope. Study materials consisted of 83 cases of tumorous colorectal lesions. Under a magnifying endoscope, pits were visible across the entire surface of the lesion in 46 (55.4%) of the 83 cases. The pit pattern visualized by magnifying endoscope in 32 (69.6%) of the 46 cases was identical to the pattern observed under a stereomicroscope. Of various pit patterns, type Ills (tubular, round pit that is smaller than normal pit), type IllL (tubular, round pit that is larger than normal pit) and type IV (dendritic, gyrus-like type pit) were relatively well visualized under a magnifying endoscope. It was difficult to obtain images of type V (irregular or amorphous pit) with a magnifying endoscope. It seems therefore easy to distinguish tumors from non-tumorous lesions using a magnifying endoscope. This imaging technique may provide information more useful for the diagnosing tumorous colorectal lesions and selecting therapeutic strategy, if staining methods and mucusremoving methods are improved.
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SHIRO MIYAZAKI
1998 Volume 45 Issue 1 Pages
95-103
Published: April 01, 1998
Released on J-STAGE: February 08, 2010
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We evaluated the diagnostic efficacy of high-frequency (20 MHz) ultrasound probe (HFUP) for the staging of invasive depth of colorectal tumors. The subjects were 27 patients with colorectal tumorous lesions who were treated by endoscopic or surgical operation (11 patients with lesions remaining in the mucosa, 13 patients with submucosal cancer, and 3 patients with cancer invading the muscularis propria or deeper layers). Considering the previous reports that endoscopic mucosal resection (EMR) is indicated in cases of tumors remaining in the mucosa or cancer slightly invading the submucosal layer, we divided the submucosal layer vertically into three equal areas (most superficial, middle and deepest areas which were referred to as sm1, sm2 and sm3, respectively). The depth of tumor invasion in histological specimens was compared to the depth of tumor invasion as assessed preoperatively using the HFUP. The HFUP-based diagnosis was identical to the histological diagnosis in 86.4% of all cases, when the depth of tumor invasion was rated on a three-point scale: (i) m-sm1, (ii) sm2-sm3 or (iii) mp or deeper. These results indicate that the HFUP is very useful in selecting a therapeutic method for colorectal tumors.
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KENSHI KOGA
1998 Volume 45 Issue 1 Pages
105-111
Published: April 01, 1998
Released on J-STAGE: August 11, 2009
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Clinical features of hepatocellular carcinoma in 22 patients without serum HBsAg, HBV DNA, anti-HCV antibody and HCV RNA were characterized and possible pathogenic factors for this cryptogenic hepatocellular carcinoma were prospectively assessed. Twenty-two patients were selected from 434 patients with hepatocellular carcinoma (HCC) who were treated at the Second Department of Internal Medicine, Kurume University Hospital between January 1994 and December 1996. Serum samples collected from these patients were all negative for HBsAg, HBV DNA, anti-HCV antibody, and HCV RNA. Patients were evaluated based on past history, present illness, history of habitual alcohol consumption, results of the serological and biochemical laboratory tests at diagnosis of HCC, Anti-HBc antibody, autoantibodies, GBV-C/HGV RNA, and histopathologic findings of non-cancerous portion of the liver were also evaluated. Among 22 patients with non-B non-C HCC, 16 patients (72.7%) had a history of alcoholic liver disease, 6 patients had an infection of schistosomiasis Japonica, and 1 patient had Budd-Chiari syndrome. Nine patients (40.9%) were positive for anti-HBc antibody, but their titers were low in all cases. Among 22 patients, positive for auto antibody, 7 patients (31.8%) were positive for anti-nuclear antibody, and 17 patients (77.3%) were positive for anti-smooth muscle antibody. Only 1 patient was positive for GBV-C/HGV RNA. Histopathologic examination was performed in 3 cases for noncancerous portions of the liver. Liver cirrhosis and liver with passive congestive fibrosis were diagnosed in 2 cases each. The remaining one case showed normal feature of the liver. In conclusion, the majority of the 22 patients with non-B non-C HCC had a history of alcoholic liver disease. Many were also positive for auto antibodies. These results suggest that patients with alcoholic liver disease or hepatic disease with autoantibodies may be defined as the high-risk group of developing non-B non-C HCC and should be periodically underwent a complete medical examination.
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TAKU KUSABA
1998 Volume 45 Issue 1 Pages
113-120
Published: April 01, 1998
Released on J-STAGE: February 08, 2010
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Lens culinaris agglutinin-reactive fraction of α-fetoprotein (AFP-L3), which is a fucosylated variation of AFP, is not only sensitive and specific for localization of hepatocellular carcinoma (HCC) but also a prognostic factor for patients with HCC. The relationship between status of AFP-L3% in serum and pathological findings was studied using 48 resected HCC specimens. AFP-L3 fraction was measured by lectin-affinity blotting using an AFP Differentiation Kit L (Wako, Osaka, Japan), and was expressed as AFP-L3% (AFP-L3 /total AFP×100%). A cut-off level of 15% was used. Pathological findings of HCC such as histological grade (well, moderately and poorly differentiated HCC), vascular invasion, and Ki67 (MlB1), p53 (DO7) and α-catenin immunohistochemical staining were studied. According to the results of serum AFP concentrations and AFP-L3%, the 48 patients were divided into the following three groups: AFP greater than or equal to 20 ng/ml and AFP-L3 positive (group A, n=14), AFP greater than or equal to 20 ng/ml and AFP-L3 negative (group B, n=14) and AFP less than 20 ng/ml (group C, n=20). Ki67 labeling index of HCC tissue in group A was 27.8±18.9%, which was significantly higher than those of group B (9.6±10.1 %, p<0.024) and group C (11.1±11.2%, p<0.03). In group A, p53 expression was higher and α-catenin staining was reduced significantly compared with those of group B or C, respectively. The results of the study suggest that the proportion of AFP-L3% in serum reflects some biological features of HCC.
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YUTAKA OGATA, YASUSHI HARA, YOSHITO AKAGI, AKIRA OHKITA, TATSUHISA MOR ...
1998 Volume 45 Issue 1 Pages
121-125
Published: April 01, 1998
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Nude mice have been used to grow subcutis (s.c.) growing human colorectal tumors, but these tumors rarely metastasize. This is a problem for studies into the biological behavior of metastatic subpopulations of human colorectal cancers. We have followed the evolution of the parental line and of a variant of human colon carcinoma KM12 cells, that were both tumorigenic, following implantation into the s.c. or cecal wall of nude mice. The tumors growing s.c. did not produce visceral metastases, whereas the cecal tumors metastasized to the regional mesenteric lymph nodes and to the liver. However, the incidence of liver metastases was different between the parental cell line KM12C cells and the in vivo selected cell line KM12SM cells after orthotopic inoculation. The morphological findings of KM12 cells proliferating in a monolayered sheet revealed that these two cell lines consisted of various cell populations. These results suggest that in the orthotopic colon cancer models, liver metastasis is defined by difference in subpopulations of metastatic phenotypes to the liver with early dominance of its growth in the implanted organ. As a result, our new model using orthotopic implantation of KM12SM cells, which produce a 50% incidence of liver metastasis, can help to provide a technique to study the biological behavior of metastatic subpopulations of human colon cancers.
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A Case Report
AKIO KATAOKA, TAKASHI NISHIDA, YOSHITO TOMIOKA, NOBUYUKI HIRAI, MORIO ...
1998 Volume 45 Issue 1 Pages
127-131
Published: April 01, 1998
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Metastases to the nasal tip from gynecological malignancies are extremely rare. We present a case of a tumor metastatic to the nasal tip from a carcinoma of the uterine cervix. We administered high-dose focal irradiation to the site of the tumor. The literature on metastases to the nose, maxillary sinuses, and paranasal sinuses from gynecologic malignancies is reviewed.
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Report of a Case
NAOFUMI ERIGUCHI, SHIGEAKI AOYAGI, MASAO HARA, EIJI TANAKA, MITSUO HAS ...
1998 Volume 45 Issue 1 Pages
133-136
Published: April 01, 1998
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Gastric angiodysplasia that caused continuous gastrointestinal bleeding is reported in a 75-year-old woman who had been treated with repeated blood transfusions because of severe anemia. Endoscopic examination was performed and revealed a bright-red lesion on the anterior wall of the upper gastric body. Injection therapy was performed at first, but the follow-up endoscopy showed a recurrent red lesion in same place. Selective angiography revealed a dense stain suggestive of a hypervascular lesion, measuring about 1 cm in diameter. Partial gastrectomy including resection of the lesion was performed. During a follow-up period of more than 12 months, there was no sign of recurrence of bleeding.
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NAOFUMI ERIGUCHI, SHIGEAKI AOYAGI, MASAO HARA, EIJI TANAKA, MITSUO HAS ...
1998 Volume 45 Issue 1 Pages
137-141
Published: April 01, 1998
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A 63 year-old-man was admitted to our hospital with the chief complaint of dyschezia. Digital examination revealed a large solid mass on the posterior wall of the rectum. Endoscopically, the tumor was covered by an intact mucosal layer. Under the diagnosis of rectal leiomyosarcoma, abdominoperineal resection of the rectum was performed. The tumor was 10×9×8 cm in size, and its cross section showed a gray-white tumor with central necrosis. Microscopically, the large tumor of the rectum was mainly located in the proper muscle layer and adventitia, and showed cellular proliferation of spindle-shaped and mild pleomorphic stromal cells, arranged in interlacing fashion, and focal necrosis. The histologic findings support the diagnosis of leiomyosarcoma. Leiomyosarcoma of the rectum is a relatively uncommon disease. We report our case with reference to the literature.
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NAOFUMI ERIGUCHI, SHIGEAKI AOYAGI, MASAO HARA, KOUJI YOSHIDA
1998 Volume 45 Issue 1 Pages
143-145
Published: April 01, 1998
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Laparoscopic cholecystectomy is widely accepted by patients and physicians despite the lack of controlled trials comparing this technology with conventional cholecystectomy. The cystohepatic ducts represent accessory bile ducts of variable size which frequently travel within the gallbladder fossa or in the posterior wall of the gallbladder. These ducts can be injured during laparoscopic cholecystectomy and can result in bile collection if transected. Recently, we have experienced two cases of injury to the bile duct during operation. One case was a transection of the accessory bile duct, the other one was an injury to the common hepatic duct. We present herein the clinical course of the two cases, in which biliary leakage, following laparoscopic cholecystectomy, was successfully managed by the end to end anastomosis of the bile duct.
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MASAYUKI NAKAMURA, AKIRA TANGOKU, MASAAKI OKA, TAKASHI SUZUKI
1998 Volume 45 Issue 1 Pages
147-150
Published: April 01, 1998
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A 43-year-old woman presented to our department with left breast lump, measuring 10 mm×10 mm×6 mm. On physical examination and mammography, the lump was suspected to be due to mastopathy, but malignancy could not be excluded based on ultrasonography . Excisional biopsy showed that it was an invasive lobular carcinoma. A modified radical mastectomy was performed after obtaining informed consent. She remained disease-free seven years after surgery.
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Report of Two Cases
YOSHIHIKO TAKAHASHI, TOSHI ABE, SHINICHI UENO, TATSUO YUGE, HIKARU MAR ...
1998 Volume 45 Issue 1 Pages
151-154
Published: April 01, 1998
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Clinicopathological features of intraorbital neurinomas were investigated in two patients. Magnetic resonance imaging (MRI) findings in Case 1 were similar to those in Case 2. The central region of the neurinomas showed a slightly high intensity area with a marginal low intensity on T1-weighted images (T1WI), whereas on T2-weighted images (T2WI), the central area of the tumor was very low intensity with a marginal high intensity area. After gadolinium-DTPA (Gd-DTPA) injection, these areas were homogeneously enhanced in both cases. The deference in enhancement after Gd-DTPA injection reflected the distribution of cellularity and vessels in the tumor.
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NAOFUMI ERIGUCHI, SHIGEAKI AOYAGI, MASAO HARA, HISANORI NAITO
1998 Volume 45 Issue 1 Pages
155-160
Published: April 01, 1998
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We report three cases of giant gastric leiomyosarcoma. Diagnosis was made prior to surgery using various diagnostic modalities. The patients were two women (77 and 77 years old) and one man (40 years old) whose chief complaints were abdominal pain, anorexia, and tarry stool. All patients presented with a large palpable mass in their upper abdomen at the time of admission. Based on characteristic findings from a gastric barium study, computed tomography (CT), and angiography, the patients were diagnosed as having gastric leiomyosarcomas displaying extramural growth. In the first case, a patient received a total gastrectomy, while local resection was performed in the second case because of pedunculated extragastric development. In the third case, total gastrectomy was combined with splenectomy and resection of the pancreatic tail. Twenty-two months after the original operation, the first case had multiple liver metastases. We present the three cases here, and review the literature.
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MASARU SASAKI, MICHIO SATA, HIROSHI SUZUKI, KYUICHI TANIKAWA
1998 Volume 45 Issue 1 Pages
161-163
Published: April 01, 1998
Released on J-STAGE: August 11, 2009
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The patient was a 55-year-old male with no history of heart diseases. He was administered recombinant IFN α-2b under the diagnosis of chronic hepatitis C. Since sinus Bradycardia (heart rate 40 bpm) appeared in the fourth week of administration (cumulative dose; 240 M.U), IFN was discontinued. Bradycardia was resolved 1 week after discontinuation of IFN and the treatment was resumed with a change of the regimen to IFN-β. Since no bradycardia was noted thereafter, IFN therapy could be completed (total dose; 108 M. U). These observations suggest that the type of IFN or total dose contributed to the appearance of cardiotoxicity.
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