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Volume 47, Issue 2
Displaying 1-15 of 15 articles from this issue
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KEISHIRO AOYAGI, KIKUO KOUFUJI, SHOJIRO YANO, NAOTAKA MURAKAMI, HARUKO ...2000 Volume 47 Issue 2 Pages 97-103
Published: June 15, 2000
Released on J-STAGE: August 11, 2009
JOURNAL FREE ACCESSA retrospective study of 25 patients treated for primary gastric lymphoma was made to investigate a number of problems related to treatments and report the factors influencing prognosis. In the 5-year-survival rate according to Working Formulation classification, either survival rate of low-grade type or intermediate-grade type was higher than that of high-grade type. Both the 5-yearsurvival rate of cases without lymph node metastasis and that of cases that involved perigastric lymph nodes were higher than that of cases that involved distant gastric lymph nodes. Those surviving five years after perigastric lymph node metastasis had received D3 or D4 dissection and postoperative multicombined chemotherapy. Tumors invading only to the submucosal layer had received D2 dissection and were not treated by postoperative multicombined chemotherapy, and recurrence was not recognized in these cases. Of 9 cases infiltrating into the musclaris propria or serosa without lymph node metastasis, 8 cases were treated by postoperative multicombined chemotherapy and were alive without recurrence, but one case without postoperative multicom bined chemotherapy died by recurrence. Therefore, adequate therapy for gastric lymphoma with infiltrating into submucosal layer is gastrectomy with D2 lymph node dissection, and postoperative multicombined chemotherapy is not necessary. The cases with perigastric lymph node metastasis, or the cases with invading from muscularis propria to serosa require D3 or D4 lymph node dissection with postoperative multicombined chemotherapy. But the cases with distant gastric lymph node metastasis or invading adjacent structure or high-grade type histologically (WF classification) require preoperative chemotherapy.View full abstractDownload PDF (1051K) -
HISAFUMI KINOSHITA, HIROYASU IMAYAMA, KOTARO HASHINO, SHIGEAKI AOYAGI2000 Volume 47 Issue 2 Pages 105-108
Published: June 15, 2000
Released on J-STAGE: August 11, 2009
JOURNAL FREE ACCESSWe studied cholelithiasis that occurred after gastrectomy in 52 patients (35 males and 17 females) encountered at our department between January, 1978 and December, 1998. Gastrectomy had been performed for gastric or duodenal ulcer in 35, gastric cancer in 14, gastroptosis in 2, and gastric trauma in 1 of these patients. Reconstruction after gastrectomy was performed by the Billroth II method (B-ll method) in 31 patients, Billroth I method (B-I method) in 17, Roux-en-Y method (Roux-Y method) in 3, and esophagogastrostomy in 1. The period between gastrectomy and discovery of gallstones was 1-5 years in 9, 5-10 years in 10, and 10 years or longer in 33, or more than 60% of the patients. Gallstones were present in the gallbladder alone in 33, bile duct alone in 9, gallbladder and bile duct in 10; the percentage of bile duct stones was high. The type of stones was bilirubin-calcium stones in 21, black stones in 12, pure cholesterol stones in 1, combined stones in 4, mixed stones in 12, and others in 2; pigment stones accounted for 63.5%. Gallstones were symptomatic in 78.8% of the patients, and abdominal pain was the most frequent symptom. Bile was positive on bacterial culture in 68.4%, and Gram-negative bacilli were the most frequently isolated. Lymph node dissection, vagotomy, cholestasis, and biliary tract infection are considered to be related to cholelithiasis after gastrectomy.View full abstractDownload PDF (689K) -
AKIKO FUJIMATSU2000 Volume 47 Issue 2 Pages 109-114
Published: June 15, 2000
Released on J-STAGE: August 11, 2009
JOURNAL FREE ACCESSWe compared newly developed radionuclide cystography with conventional contrast voiding cystography (VCG) with regard to their diagnostic usefulness of intrarenal reflux (IRR) in children. Based on the imaging findings, we assessed the role of IRR in the pathogenesis of reflux nephropathy (RN). Among the ureters which revealed IRR diagnosed by radionuclide cystography, 38.9% (7 out of 18 ureters) of the cases examined by VCG had IRR. In the case of VCG, the sensitivity and specificity of IRR detection were 33.3% and 100%, respectively. There was a statistical correlation between the presence/absence of IRR and vesicoureteral reflux (VUR). RN was significantly correlated with advanced grade of VUR associated with IRR. Among 9 kidneys of the subjects who had suffered from urinary tract infection (UTI) only once, IRR was detected in 33.3% (3/9) and RN in 66.7% (2/3). From these findings, conventional contrast VCG is considered not effective for the diagnosis of IRR. Moreover, it is suggested that VUR complicated with IRR is deeply associated with the development of RN. In addition, it is suggested that UTI might be related to the onset of IRR.View full abstractDownload PDF (2032K) -
KAZUHITO MINAMITANI2000 Volume 47 Issue 2 Pages 115-124
Published: June 15, 2000
Released on J-STAGE: August 11, 2009
JOURNAL FREE ACCESSOsteosarcoma cells are useful for investigating bone metabolism as malignant counterpart of osteoblasts. In hematogenous metastases of osteosarcoma cells, the cells need to adjust to various changes in pericellular environment. The changes in pericellular environment may change intracellular environment and consequently the secretion of matrix metalloproteinases (MMPs) which destroy extracellular matrices. In this report, a new cell line, KOS-1, derived from human osteoblastic osteosarcoma was established, and we assumed various culture conditions containing ingredients of the extracellular matrix to make a comparative study on MMPs detected from the culture supernatants. A wide spectrum of MMPs, including MMP-1 and -3 which were increased in the presence of interleukin 1β, was detected in this cell line. Production of MMP-1, the enzyme which decomposes types I, II, III and X collagen, by the cells, was increased in the presence of type I collagen. MMP-3 (stromelysin-1) which degrades types III and IV collagen, laminin, fibronectin, proteoglycan, etc. was produced more abundantly in the presence of type IV collagen. MMP-2 (72-kd type IV collagenaselgelatinase A) activity was found to be increased in the presence of gelatin and type IV collagen. The MMPs production in cultured osteosarcoma cells was changed depending on the culture conditions. This indicates that the same osteosarocma cells produce different amounts and kinds of enzymes involved in local infiltration and remote metastases and increase the production of the enzymes most required under a specific environment.View full abstractDownload PDF (17810K) -
MITSUO KAKIZOE2000 Volume 47 Issue 2 Pages 125-134
Published: June 15, 2000
Released on J-STAGE: August 11, 2009
JOURNAL FREE ACCESSAlthough giant cell tumor of bone (GCT) is characterized by the extensive multinucleated giant cells among mononuclear stromal cells, proliferation of these cells and multinucleation are not without limit in certain cases. Few studies on oncogenesis of GCT have focused on the negative growth control, including growth arrest and apoptosis. The purpose of this study was to investigate the mechanism of cell death in multinucleated giant cells and stromal cells of GCT. In this study, we have demonstrated that GCT cells can undergo apoptosis. The cells in surgical specimen were positively stained in situ nick end labeling methods, and electron micrographs showed the morphological changes associated with apoptosis in some of stromal cells and multinucleated giant cells. A candidate responsible for this apoptosis was then examined using cultured GCT cells. We focused on Fas that is a major trigger of apoptosis. Cultured GCT cells expressed detectable amount of Fas on their surface. Although GCT cells did a little undergo apoptosis following treatment with anti-Fas alone, combination treatment with cyclohexamide led to an increase in apoptosis of the GCT cells. These data suggested that the sensitizing activity of cyclohexamide on anti-Fas mediated cytotoxicity could happen in vitro.View full abstractDownload PDF (12330K) -
KAZUMASA ISHIBASHI2000 Volume 47 Issue 2 Pages 135-145
Published: June 15, 2000
Released on J-STAGE: August 11, 2009
JOURNAL FREE ACCESSMorphological changes in the cervical spine were evaluated using radiography in 140 patients with cervical myelopathy who underwent expansive Laminoplasty by sagittal splitting of the spinous process. We assessed the influence of these observed changes- on the postoperative clinical results. The mean follow-up period was 33±19 months. Intervertebral body union occurred in 18%, and interlaminal union in 80% of the patients. The factors influencing the bony union in these were not identified. Bony union did not significantly influence the clinical results. There were changes in cervical alignment in 29 (21%) patients after the operation. Correlation between the spinal curvature and the clinical results was the strongest for the sigmoid-type curvature. The number of patients in whom preoperative ROM was maintained was only 8 (7%). The range of cervical spine motion decreased by approximately 50%, and there was no correlation with the clinical results. The surgical method described in the current study for compression myelopathy was associated with postoperative morphological changes and decreased ROM in the cervical spine, but nonetheless provided good postoperative results unless extreme morphological abnormalities occurred. This surgical technique was safe and gave satisfactory results in patients with preoperative morphological abnormalities in the cervical spine.View full abstractDownload PDF (8962K) -
YOUICHIROU KUGA2000 Volume 47 Issue 2 Pages 147-149
Published: June 15, 2000
Released on J-STAGE: August 11, 2009
JOURNAL FREE ACCESSWhile alcohol abuse is a possible etiologic factor in osteonecrosis in the femoral hea (ON), the relationship between alcoholic liver dysfunction and ON is uncertain. Among 336 patients with alcoholic liver dysfunction who had radiographic examination of the hip at two hospitals for alcohol abuse treatment in southern Japan, the records for 291 men and 1 woman (mean age, 47.8 years; range, 24 to 72 years) had adequate information available concerning daily and cumulative alcohol intake, duration of intake, serum concentrations of liver enzymes, and platelet count. These variables were investigated for any correlation between the 8 patients with radiographic evidence of ON and the 284 without. Liver biopsy was performed in 223 patients. Except for alanine aminotransferase, liver enzyme concentrations were significantly lower in patients with ON than in those without. Histologically, 2 patients with ON were diagnosed with cirrhosis; 1 with pre-cirrhotic changes; and 2 with fibrosis. These results suggested that ON occurred in the late stages of liver disease when serum enzyme concentrations had returned to normal or were only mildly elevated.View full abstractDownload PDF (2289K) -
TERUKAZU KOBAYASHI2000 Volume 47 Issue 2 Pages 151-157
Published: June 15, 2000
Released on J-STAGE: August 11, 2009
JOURNAL FREE ACCESSCD9 is a tetra-membrane-spanning glycoprotein involved in cell adhesion, migration, growth signaling and tumor cell metastasis. In this study a CD9 cDNA clone has been isolated from chick cDNA library. The chick CD9 clone contains an open reading frame of 224 amino acids. The deduced amino acid sequence from chick CD9 shows 63.3% identity with the human counterpart. Human and monkey CD9 upregulate the diphtheria toxin (DT) binding activity of human heparinbinding EGF-like growth factor, while chick CD9 lacks the ability to upregulate the DT binding activity. Comparison of the amino acid sequence of chick CD9 with that of human CD9 gives a clueto understanding the upregulation mechanism.View full abstractDownload PDF (2612K) -
HIROSHI FUJITA2000 Volume 47 Issue 2 Pages 159-164
Published: June 15, 2000
Released on J-STAGE: August 11, 2009
JOURNAL FREE ACCESSViral strains obtained during the same period which were asymptomatically shed into the saliva of patients with oral cancer after surgery or isolated from the focus of patients with herpes simplex virus type 1 (HSV-1) infection after first visit to hospital were analyzed using molecular epidemiology. There were 10 subjects in each group. Viral strains used were from 3 to 5 strains (mean: 3.4 strains) in the malignant patients and from 3 to 8 strains (mean: 5 strains) in the herpetic patients. One of 10 patients with oral cancer showed a different DNA cleavage pattern in viral strains shed into saliva at the last day. In 10 patients with HSV-1 infection, all viral strains in each of the cases showed identical DNA cleavage patterns. These results suggested the existence of a latent multiple infection and a simultaneous reactivation of HSV-1.View full abstractDownload PDF (5836K) -
TERUO SASATOMI, YOSHIAKI TSUJI, TOSHIAKI TANAKA, HIROYUKI HORIUCHI, SH ...2000 Volume 47 Issue 2 Pages 165-168
Published: June 15, 2000
Released on J-STAGE: August 11, 2009
JOURNAL FREE ACCESSSchwann cell tumor occurring in the intestines is rare . A 68-year-old female came to our hospital because of hematemesis. Barium enema and colonoscopic examination revealed submucosal tumor in the sigmoid colon. Laboratory data showed mild anemia . No other abnormal finding was found in the blood chemistry. Tumor marker levels of carcinoembryonic antigen (CEA), CA19-9, alpha feto protein (AFP) and neuron specific enolase (NSE) were within normal limits. The exploratory laparotomy confirmed a large sigmoid colon tumor. She received sigmoid colectomy. The resected specimen was a submucosal tumor with central depression, measuring 4.7×3.5×3.0cm in size. The cut surface of the tumor was yellowish hue with necrosis. Histological examination showed spindle-shaped tumor cells with palisading comma-shaped nuclei and the nuclear pleomorphism. Immunohistochemical examination revealed that the tumor was positive for S-100 protein staining, and negative for Actin and for H.H.F. staining. These findings showed that this tumor was of Schwann cell origin. We report here the case in detail of a schwannoma in the sigmoid colon.View full abstractDownload PDF (5740K) -
NAOFUMI ERIGUCHI, SHIGEAKI AOYAGI, MASAO HARA, KOJI OKUDA, TSUYOSHI TA ...2000 Volume 47 Issue 2 Pages 169-171
Published: June 15, 2000
Released on J-STAGE: August 11, 2009
JOURNAL FREE ACCESSPancreatic cancer carries a poor prognosis, especially invasive ductal carcinoma of the pancreas. We present here the case of a 76-year-old man who developed synchronous double cancers of the stomach and pancreas. He was referred to our hospital in December, 1997, with a provisional diagnosis of carcinoma of the stomach. Laboratory data on admission showed normal levels except for the serum carcinoembryonic antigen level. Abdominal ultrasonography revealed a low echoic mass anterior to the pancreas, suggestive of a nodal metastasis. Intraoperative histological findings from the pancreatic nodule confirmed a primary pancreatic cancer. The diagnosis of double cancers of the stomach and pancreas was made, and subtotal gastrectomy and distal pancreatectomy with lymphnodes dissection were carried out. The histologic sections from the stomach showed a moderately differentiated tubular adenocarcinoma, whereas those from the pancreas showed a well to moderately differentiated tubular adenocarcinoma. Double carcinomas in this association are relatively rare.View full abstractDownload PDF (2892K) -
NOBUHIKO HAYASHIDA, TAKEMI KAWARA, KOJI AKASU, EIZO KAI, TOMOKAZU KOSU ...2000 Volume 47 Issue 2 Pages 173-175
Published: June 15, 2000
Released on J-STAGE: August 11, 2009
JOURNAL FREE ACCESSA 73-year-old man with myasthenia gravis required quadruple coronary artery bypass grafting due to triple-vessel disease. Anesthetic management was performed with general anesthesia using a reduced dose of muscle relaxant with the aid of a neuromuscular transmission monitor. He was extubated 14 hrs after surgery without difficulty under this monitor. His postoperative course was uneventful. A patient with myasthenia gravis who required coronary artery bypass surgery was successfully performed by the deliberate preoperative evaluation of patient's myasthenic and cardiac status, and by the careful perioperative management.View full abstractDownload PDF (591K) -
KEISHIRO AOYAGI, KIKUO KOUFUJI, SHOJIRO YANO, NAOTAKA MURAKAMI, YASUHI ...2000 Volume 47 Issue 2 Pages 177-182
Published: June 15, 2000
Released on J-STAGE: August 11, 2009
JOURNAL FREE ACCESSWe have experienced two cases of unresectable advanced gastric cancer effectively treated by chemo-Immunotherapy. One case was of a 68-year-old male patient diagnosed as having inoperable advanced gastric cancer with liver and lung metastasis. This patient was treated by combined chemo-immunotherapy of MMC 10mg/M, 5'-DFUR 800mg/day and OK-432 5 KE/2W. At 6 months later, a computed tomography (CT) scan and upper gastrointestinal (GI) series revealed that the metastatic liver tumors and stomach lesion were remarkably decreased in size, and endoscopic biopsy confirmed no cancer cells in the stomach lesion. Moreover, the metastatic lung tumor had disappeared on chest X-ray. The other case was of a 68-year-old female patient with unresectable advanced gastric cancer treated by combined administration of MMC 10mg/M, 5-FU 200mg/day and OK-432 5 KE/2W. At 2 months after commencing the treatment, there was a reduction in the serum carcinoembryonal antigen (CEA) level. At 6 months later, the CEA had decreased to normal, the primary and metastatic sites had completely disappeared on CT, and endoscopic biopsy confirmed no cancer cells in the stomach lesion. This patient has survived to date for 5 years and 6 months after commencing the treatment. These results suggested that combined chemo-immunotherapy of MMC, antimetabolite, and OK-432 was an effective treatment for unresectable advanced gastric cancer.View full abstractDownload PDF (10451K) -
HISAFUMI KINOSHITA, HIROYASU IMAYAMA, MITSUO HASHIMOTO, SHINJI SATO, K ...2000 Volume 47 Issue 2 Pages 183-187
Published: June 15, 2000
Released on J-STAGE: August 11, 2009
JOURNAL FREE ACCESSPatient No. 1 was a 66-year-old male who was diagnosed as having cancer of the caput pancreatis, and underwent percutaneous transhepatic biliary drainage (PTBD). Since the tube slipped out, percutaneous transhepatic gallbladder drainage (PTGBD) was performed. After PTGBD, biliary hemorrhage was observed for two to three days, then hemorrhage disappeared and bile flowed smoothly. Since the tube was likely to slip out, the tube was replaced. After replacement of the tube, biliary hemorrhage was noted for two to three days, then spontaneously subsided again. After icterus was reduced, pancreatoduodenectomy was performed. During surgery, a number of massive blood clots were noted in the bile duct. The PTGBD tube was removed, and a transjejunal tube was placed. On the 11th day after the surgery, hemorrhage occurred in the bile duct tube, and the patient went into shock. Emergency abdominal angiography was performed. A false aneurysm was detected in A6 and embolized using a microcoil. After transcatheter arterial embolization (TAE), hemorrhage stopped, and the patient was discharged. Patient No. 2 was a 68-year-old male who was diagnosed as having cholelithiasis and underwent PTBD. On the 21st day after PTBD, biliary hemorrhage occurred and the patient fell in shock status. Emergency abdominal angiography was performed. A false aneurysm was detected in A3 and embolized using a microcoil. After TAE, cholangioscopic lithectomy was performed and the disease alleviated. Thereafter the patient was discharged. It is necessary to consider false aneurysm when biliary hemorrhage occurs after PT(G)BD.View full abstractDownload PDF (10442K) -
YOSHIMASA HIRAI, KOH-ICHI YAMAKI, TSUYOSHI SAGA, TETSUSHI HIRATA, MINA ...2000 Volume 47 Issue 2 Pages 189-192
Published: June 15, 2000
Released on J-STAGE: August 11, 2009
JOURNAL FREE ACCESSThis report describes an arterial anomaly case in the celiaco-mesenteric region, which was encountered in a Japanese male cadaver in the dissecting room at Kurume University School of Medicine in 1999. In this case, the usual celiac trunk was not identified, and the hepato-splenomesenteric and the gastro-phrenic trunks were independently arising from the abdominal aorta. In addition, the common hepatic artery divided into the left hepatic, the right hepatic, and the gastroduodenal arteries simultaneously, then, the accessory gastric artery arose from the left hepatic artery. This type of arteral anomaly belongs to the Type III of Adachi's classification and the Type II of Morita's classification.View full abstractDownload PDF (3347K)
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