Nippon Shokakibyo Gakkai Zasshi
Online ISSN : 1349-7693
Print ISSN : 0446-6586
Volume 104, Issue 1
Displaying 1-12 of 12 articles from this issue
Review article
Monthly report; Current knowledge on the pathophysiology at gastro-esophageal junction
Case Report
  • Toshikazu KURIHARA, Shigeaki ISHII, Tatsuo OZAWA, Katsurou TSUBO, Yosh ...
    2007 Volume 104 Issue 1 Pages 23-29
    Published: 2007
    Released on J-STAGE: January 17, 2007
    JOURNAL FREE ACCESS
    A 57-year-old man was admitted because of abdominal fullness. An abdominal ultrasonographic study disclosed multiple space-occupying lesions (SOL) in the liver. On blood examinationC the serum levels of CEA and CA19-9 were significantly highC while those of AFP and SCC were within normal ranges. Endoscopically biopsied specimens of the lower esophagus histologically revealed poorly differentiated squamous cell carcinoma. Pathohistologically similar findings were obtained from the needle biopsied specimen of the SOL in the liver. Thus the patient was diagnosed as having squamous cell carcinoma of the esophagus with liver metastasis. On the 41st hospital dayC the patient died and an autopsy was performed. Although multiple metastases were recognized, cancer cells were limited within the submucosa of the esophagus. Immunostaining of CEA and CA19-9 was positive on the carcinoma cells both in the esophagus and the liver. Thus a relation between the biological malignancy of esophageal cancer and serum levels of CEA and CA19-9 was suggested.
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  • Ken OKAMOTO, Michiya KOBAYASHI, Kengo ICHIKAWA, Tsutomu NAMIKAWA, Take ...
    2007 Volume 104 Issue 1 Pages 30-35
    Published: 2007
    Released on J-STAGE: January 17, 2007
    JOURNAL FREE ACCESS
    A 76-year-old man was admitted for treatment of gastric cancer that causing anorexia. Endoscopy showed the stenosis in the antrum of the stomach and multiple small nodules with erosion from the upper body to the corpus of the stomach. Total gastrectomy with Roux-en-Y reconstruction was performed. On the resected spiecimen, there were at least 28 nodules with erosion in the submucosal layer of the entire stomach. The lesions had no continuity with one another and were the same histological type, poorly differentiated adenocarcinoma. We diagnosed these lesions as intramural metastases of gastric cancer.
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  • Takashi NISHIMURA, Hirozumi OBATA, Hiroko FUJINO, Ayano SONODA, Kenich ...
    2007 Volume 104 Issue 1 Pages 36-41
    Published: 2007
    Released on J-STAGE: January 17, 2007
    JOURNAL FREE ACCESS
    We experienced a case of drug-induced hypersensitivity syndrome (DIHS) for salazosulfapyridine (SASP). After we started administration of SASP in a 26-year old man with ulcerative colitis (UC), he had symptoms resembling infectionus mononucleosis, high fever, skin eruption, cervical lymphadenopathy, elevate white blood cell count with atypical lymphocyte, and liver dysfunction. We diagnosed the illness as drug-induced hypersensitivity syndrome (DIHS) due to SASP. We halted SASP and started administration of methylprednisolone and prednisolone but his condition deteriorated. We changed to administration of betamethasone and he recovered. In cases of DIHS accompanied by UC, we should administer drugs carefully and recoginize serious complications.
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  • Daisuke KUBOTA, Takanori KANAI, Fumiro YUI, Tomoko MATSUMOTO, Takahiro ...
    2007 Volume 104 Issue 1 Pages 42-46
    Published: 2007
    Released on J-STAGE: January 17, 2007
    JOURNAL FREE ACCESS
    A 44-year-old women developed marked myopathy one year earlier, when she was treated with intravenous prednisolone for acute severe exacerbation of ulcerative colitis. When she was admitted to our hospital for another severe exacerbation, intravenous cyclosporine A was administered as monotherapy because she could not tolerate corticosteroid. The treatment was successful and she obtained complete remission. Cyclosporine A monotherapy is considered to be a valuable alternative to proctocolectomy for severe ulcerative colitis patients who cannot tolerate corticosteroid.
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  • Tatsuya SHONAKA, Nobuaki KURAUCHI, Yumi OKAWA, Kazuhito MISAWA, Hideka ...
    2007 Volume 104 Issue 1 Pages 47-51
    Published: 2007
    Released on J-STAGE: January 17, 2007
    JOURNAL FREE ACCESS
    In a 72 years old woman, abdominal computed tomography (CT) disclosed multicentric hypervascular tumor in S4 of the liver, and it was T1·T2 by the MRI, and a high signal was presented together. Stenosis was shown by ERCP at the same site. Cholangiocellular carcinoma was suspected before operation, but malignant change was not recognized by frozen section, so the operation was finished. Later, a diagnosis of solitary necrotic nodule of the liver was established by pathological diagnosis. Solitary necrotic nodule of the liver is a benign tumor.
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  • Kazumichi ABE, Hironobu SAITO, Atsushi TAKAHASHI, Tsuyoshi RAI, Junko ...
    2007 Volume 104 Issue 1 Pages 52-56
    Published: 2007
    Released on J-STAGE: January 17, 2007
    JOURNAL FREE ACCESS
    A 20-year-old woman given a diagnosis of hyperthyroidism (Basedow's disease) had been subsequently treated with methimazole since 1999. As she could not be made euthyroid, surgery was planned to relieve the symptoms. Because of liver dysfunction after discontinuation of methimazole and administration of iodine, she was admitted to the hospital. She was negative for hepatitis A, B and C virus serologies, but positive for anti-nuclear antibodies. A liver biopsy, which showed features of chronic active hepatitis, led to the diagnosis of autoimmune hepatitis (AIH). Interestingly, normalization of serum T4 correlated with improvement of serum aminotransferases. This leads us to speculate that this patient's liver dysfunction may have been AIH exacerbated by the liver dysfunction of hyperthyroidism rather than acute deterioration of AIH itself.
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  • Yoshihito IMAI, Toshiki TAKEMURA, Masanori MATSUSHITA, Yasushi SUGANO, ...
    2007 Volume 104 Issue 1 Pages 57-63
    Published: 2007
    Released on J-STAGE: January 17, 2007
    JOURNAL FREE ACCESS
    We present the case of a 67-year-old man with primary malignant fibrous histiocytoma (MFH) of the diaphragm. He was admitted to our hospital with anorexia and loss of body weight. High serum levels of AST, ALT, ALP and γ-GTP were observed. Several imaging studies disclosed a large tumor on the right side of the diaphragm to the right lobe of the liver. The entire tumor was resected, and histopathological examination of the specimen revealed the characteristics of MFH. MFH originating from the diaphragm is very rare, and we present the case of this patient in addition to a discussion of previous literature.
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  • Tatsuya TOYOKAWA, Kin-ichiro SUWAKI, Morihito NAKATSU, Koichi IZUMIKAW ...
    2007 Volume 104 Issue 1 Pages 64-70
    Published: 2007
    Released on J-STAGE: January 17, 2007
    JOURNAL FREE ACCESS
    A 72-year-old man with diabetes mellitus and hypertension was admitted for further examination and therapy of diabetes. In order to evaluate his pancreas, abdominal computed tomography (CT) was performed, showing a space-occupying lesion (SOL) in the pancreatic uncus. He did not show any symptoms related to the pancreas or gastro intestinal tract. Three-dimensional CT (3D-CT) indicated that the SOL was not a solid tumor but a vessel fistula, fed by the superior mesenteric artery and the gastro duodenal artery, drained by the superior mesenteric vein. Abdominal angiography also showed its peculiar vessel structure, confirming arterio-venous (A-V) malformation in the pancreas. Pancreatic A-V malformation is a rare condition but should not be forgotten in the differential diagnosis of pancreatic SOL. Our case showed the advantages of 3D-CT with its low invasiveness and convenience for the diagnosis of A-V malformation in the pancreas.
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Round-table discussion; Current knowledge on the pathophysiology at gastro-esophageal junction
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