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T Fuchigami

Publications and source records attributed to T Fuchigami.

At least 73 records · Page 4Linked to original sources
PubMed1991

[Long-term prognosis of Crohn's disease].

Two hundred and three patients with Crohn's disease seen at our clinics and affiliated centers from April 1973 to August 1988 were followed for 4.4 +/- 3.2 years (mean +/- SD), in order to evaluate the prognosis of Crohn's disease in Japan. These 203 patients (142 males and 61 females) fulfilled the following criteria; 1) they have been followed at the outpatients clinic for more than six months or 2) they have been admitted to us for more than a month. Of these, 83 (40.9%) had ileitis, 60 (29.6%) ileocolitis, 25 (12.3%) colitis, 15 (7.5%) miscellaneous types and the remaining 20 (9.9%) had undergone bowel resection. Cumulative survival rate and cumulative probability of surgery were calculated by life table method. Cumulative survival rate in these patients was compared with expected survival rate of sex and age matched general population. Cumulative survival rates five and ten years after diagnosis were 98.9% and 98.9%, respectively. There were no significant differences in the survival rates between two groups. Cumulative probability of surgery five and ten years after onset of symptoms were 16.2% and 39.1%, respectively. Cumulative probability of surgery five and ten years after diagnosis were 25.9% and 46.9%, respectively. From these results, the prognosis of Japanese patients with Crohn's disease appears to superior to that in European and American literatures.

Adult↗
PubMed1991

Endoscopic findings in carcinoid tumor of the duodenum.

The endoscopic findings in six patients with carcinoid tumor of the duodenum were analyzed. Radiographic and endoscopic examinations revealed a smooth and round elevation (measuring 5-20 mm in diameter) in the duodenal bulb. In three patients, the lesion was accompanied by an irregularly shaped erythematous depression, a characteristic endoscopic finding of this tumor. Because the endoscopic forceps biopsy technique led to an accurate diagnosis, we wish to stress the clinical value of the endoscopic modalities.

Adult↗
PubMed1990

Barium meal study for amyloidosis of the small intestine: measurements on radiograph.

In order to determine barium meal radiographic findings characteristic of amyloidosis, we measured the jejunal diameter, valvular width, and intervalvular distance in 25 patients with small bowel amyloidosis and in 30 control individuals, and compared the two groups with each other. As a result, jejunal diameter demonstrated no difference between amyloidosis cases and controls, while there was a significant difference in valvular width or intervalvular distance between the two groups. Our results indicate that objective estimates of the thickening of the valvulae and the shortening of the intervalvular distance by means of measurements of the given roentgenograms greatly contribute to the clinical diagnosis of this disease.

Adult↗
PubMed1989

A clinicopathological study of synchronous multiple gastric cancer.

In a 7 1/2-year period (from 1 January 1980 to 30 June 1987), 997 patients with gastric cancer underwent gastric resection at the Department of Surgery, Matsuyama Red Cross Hospital, Japan. We studied clinicopathologically 83 patients (182 lesions) with synchronous multiple gastric cancer and compared them with patients who had solitary cancers only in the same period. We found that elderly men had a relatively high incidence of multiple gastric cancer, and that early cancer of the elevated well differentiated type was the most common. Of the 182 lesions, as many as 42 (23.1 per cent) were missed in the preoperative examination. Eighteen of these 42 lesions were found only with the aid of a microscope in sections almost incidentally excised. Small flat lesions tended to be missed. We should always be conscious that other gastric lesions may be present when treating patients with gastric cancer.

Female↗
PubMed1989

The value of double-contrast barium enema in amebic colitis.

We report here our findings on the double-contrast barium enema given to 8 patients with amebic colitis and a comparison is made with endoscopic features. A definite diagnosis of amebic colitis was made by fecal examination or by endoscopic biopsy. Radiologic findings included fine marginal serration, aphthoid ulcers, minute barium flecks, marginal defects, loss of haustration, and deformities of the bowel. Aphthoid ulcers and marginal defects are both characteristic of amebic colitis. The double-contrast barium enema is most useful for differentiating amebiasis from other forms of colitis.

Adult↗
PubMed1989

The relationship between the radiological and clinical features in patients with Crohn's disease.

A study has been made of 93 Japanese patients with Crohn's disease who had not undergone bowel resection at the time of diagnosis during the years 1969 to 1983. Ninety had longitudinal ulcers or a cobblestone appearance or both of the small intestine or colon or both on double contrast barium examination. The incidence of longitudinal ulcers in the small intestine was significantly higher than in the colon (P less than 0.001). Conversely the incidence of cobblestoning was higher in the colon than in the small intestine (P = 0.065). In patients with longitudinal ulceration, there was significantly lower Crohn's disease activity index (CDAI), ESR, and C-reactive protein. Patients with cobblestoning had a significantly higher CDAI, ESR and C-reactive protein, and significantly lower values of albumin, cholesterol in serum, serum iron, haemoglobin, and relative body weight. Our findings indicate that cobblestoning closely correlates with the disease activity of Crohn's disease, and that longitudinal ulceration has a negative correlation. Moreover, our results suggest that the high incidence of cobblestoning and low incidence of longitudinal ulcers in the colon and the reverse in the small intestine reflects the fact that colonic involvement renders the disease more severe than small intestine involvement only.

Adolescent↗
PubMed1989

Linear erosions on Kerckring's folds may be diagnostic of Zollinger-Ellison syndrome.

Endoscopy of the upper gastrointestinal tract was performed in eight patients with Zollinger-Ellison syndrome (ZES) and in 20 patients with stomal ulcer (non-ZES). All ZES patients had hypergastrinemia and a positive secretin provocation test. In three ZES patients studied before gastric surgery, edematous or erosive changes were present in the second portion of the duodenum. In the seven ZES patients studied postoperatively, examination revealed erosive changes in the distal portion of the duodenum and/or upper jejunum. These changes were frequently in a line on the uppermost part of Kerckring's folds. In the non-ZES patients, however, endoscopy revealed no erosive change in the distal part of the duodenum. We propose that such linear erosions on Kerckring's folds may be diagnostic of ZES.

Adult↗
PubMed1989

Spontaneous regression of primary malignant lymphoma of the stomach in two nontreated Japanese.

Two patients with primary malignant lymphoma underwent spontaneous regression. One was a 40-year-old woman with a large ulcerating tumor on the greater curvature of the gastric antrum. This tumor shrank spontaneously, leaving only a small shallow ulcer. The resected specimen showed a minute focus of malignant lymphoma in the ulcer base. The other was a 73-year-old man who had a tumor with central ulceration on the posterior wall of the gastric antrum. Endoscopic biopsy revealed a malignant lymphoma. This tumor disappeared 60 days later. The patient refused surgery and remains well with no evidence of recurrent disease at this writing, 44 months later. Although there have been several case reports of spontaneous regression, partial or complete, of gastric malignant lymphoma, our cases seem to be the ones best proven.

Adult↗
PubMed1989

[A case of massive hepatoma which responded to SMANCS/Lipiodol regimen with intra-arterial infusion].

Transcatheter arterial chemotherapy (SMANCS/lipiodol) was applied to massive hepatoma, which had a high AFP 213,000 ng/ml, A-P shunt, tumor thrombosis and metastatic lung cancer. After 3 months, the AFP value reduced to 18 ng/ml, massive hepatoma and the A-P shunt disappeared, but AFP-negative nodular hepatoma recurred around initial hepatoma. Each time, we injected SMANCS/lipiodol to the recurring hepatoma. The therapy in the initial stage was not so effective. The portal vein was not observed in the initial stage, but appeared after the second dosage. Metastatic lung cancer was declining in the initial dosage and 23 months later disappeared after the third dosage. The massive hepatoma occupied entirely the rt. lobe of the liver. The patient lived for 4 years, had total admission periods of 190 days and could return to life in society. In this case, we considered that transcatheter arterial chemotherapy (SMANCS/lipiodol) had remarkable effects.

Antibiotics, Antineoplastic↗
PubMed1989

Factors influencing the healing rate of gastric ulcer under treatment with cimetidine.

Factors influencing the healing rate were evaluated by multivariate analysis on 148 patients with gastric ulcer who were under treatment with cimetidine at a daily dose of 800 mg. Factors used were age, sex, therapeutic environment, duration of present ulcer pain, past history of gastric ulcer, the amount of tobacco, alcohol, and coffee consumed before and during the treatment, the period until symptoms disappeared after the commencement of the treatment, and the characteristics of the ulcers themselves. Of these factors, the five factors that had a significant delaying effect on the healing of gastric ulcers were: 1) having a past history of gastric ulcers, 2) symptoms not disappearing within 1 wk after the commencement of the treatment, 3) size over 20 mm, 4) ulcer located in an angle, and 5) round or oval shape of the ulcer. The patients with less than one of the unfavorable factors (n = 36) had the best healing rate (97.2%), compared with those with two (n = 61), three (n = 39), or four or more (n = 12) unfavorable factors. The healing rate of the latter three groups was 75.4%, 53.8%, and 33.3%, respectively (p less than 0.01). Thus, a prognostic score based on these five factors represents the severity of gastric ulcers with regard to the healing in patients prescribed cimetidine.

Cimetidine↗
PubMed1988

Endoscopic diagnosis of lymphangioma of the small intestine.

In three patients with lymphangioma of the small intestine, the preoperative diagnosis of lymphangioma was made by endoscopy with biopsy and radiology. A typical endoscopic finding was an elevated polypoid tumor, yellowish-white to tan. The surface was smooth, often with white specks, and could be impressed by touching lightly with biopsy forceps. Endoscopic examination revealed satellite lesions not detected radiologically. Lymphangioma has heretofore been successfully diagnosed preoperatively by endoscopy in the duodenum. This report of accurate preoperative diagnoses of lymphangioma in the small intestine, other than the duodenum, using endoscopy, may be the first to be documented.

Aged↗
PubMed1988

[Surgical problems encountered in cases of S0 (serosal invasion-free) gastric cancers].

In this paper we have studied 649 resected cases of S0 (macroscopically negative serosal invasion) gastric cancer, this number of S0 gastric cancer resections experienced from a total number of 1692 patients treated at our hospital during the previous 16 years. The five-year survival rate of S0 cancers was 94% for patients given curative resections. Most of S0 cancers were histologically restricted within the pm layer but a few had reached the ss gamma or se layer. Non-curative factors in S0 cancers we recomposed of cancer positive stumps in the IIb-like margin, liver metastasis in the differentiated type carcinomas with ss invasion, and surgically left lymph node metastasis in the advanced carcinomas. As for lymph node dissections, our study reveals that an R2 dissection in the C and M regions, and a R3 or R2 + No.12 dissection for the A region are recommended. Modes of recurrence were characterized by liver or other hematogeneous metastasis in pm cancers or lymph node-positive cancers at the antrum, and by a peritoneal recurrence at the corpus in cases of advanced cancers. Histological ps(-) cancers showed a different survival result than did the S0 cancers and S(+) cancers.

Aged↗
PubMed1987

Anatomical involvement and clinical features in 91 Japanese patients with Crohn's disease.

Ninety-three patients with Crohn's disease who had not undergone bowel resection at the time of diagnosis (during the years 1969-1983) were selected for the study, to elucidate whether initial anatomical involvement correlates with clinical manifestations, complications, laboratory findings, and prognosis. Forty-one patients had isolated small intestine disease (44%), 37 ileocolic (40%), 13 colonic disease alone (14%), and two rectal or appendix involvement (2%). Statistically significant symptoms were fever and rectal bleeding with colon involvement, and number of liquid or very soft stools in 1 week with ileocolic or colon involvement. Statistically significant complications included intestinal obstruction with ileocolic disease, perianal fistulas, and arthritis with colonic disease. Increases in ESR, C-reactive protein, and white blood cell in patients with colon involvement were among the statistically significant laboratory findings. Gammaglobulin was significantly higher in patients with ileocolic or colon involvement than in those with small intestine disease. Red cell count and hemoglobin were significantly lower in patients with ileocolitis than in patients with small intestine involvement. Crohn's disease activity index (CDAI) was significantly higher in patients with ileocolic or colon involvement than in those with small intestine involvement only. These findings confirm that colonic involvement renders the disease more severe than involvement of the small intestine. Surgery was required for 22 patients (24%) during a 2.8-year follow-up, but the difference among the three groups was not significant.

Adolescent↗
PubMed1986

Clinical features of nongangrenous ischemic colitis. A comparison of stricturing and transient forms.

Forty cases of nongangrenous ischemic colitis were studied to find the different clinical features between stricturing form and transient form. Clinical and laboratory findings were compared between two groups, 15 cases of stricturing form and 25 of transient form, which were diagnosed by follow-up barium enema radiography. The following four items, of the nine studied, were significantly different between the two groups; namely, patients of stricturing form were older in age, had longer time intervals from the onset of disease to disappearance of subjective symptoms and to normalization of white blood cell count and/or erythrocyte sedimentation rate, and showed an increase in 1-h erythrocyte sedimentation rate on day 5 or earlier of the disease. Our observations indicate that the age and 1-h erythrocyte sedimentation rate might be useful indicators to differentiate the stricturing and transient forms early after the onset of the disease.

Adult↗
PubMed1986

Ischemic colitis: serial changes in double-contrast barium enema examination.

Serial double-contrast barium enema examinations were performed in 40 patients with nongangrenous ischemic colitis, 15 with the stricturing form and 25 with the transient form. Thumb-printing was observed in 30 cases (75%); it appeared within 9 days after the onset of the disease in patients with the stricturing form and within 6 days in those with the transient form. Thumb-printing disappeared about 10 days after the onset, but it lasted considerably longer in two patients with the stricturing form (21 and 29 days, respectively). Longitudinal ulcers were observed in 24 patients (60%), and healing was confirmed on day 20 or later in patients with the stricturing form and on day 9 or later in those with the transient form. Eccentric deformity was found in 19 patients (48%), sacculation in 12 (30%), and transverse ridging in five (13%). These results indicate that longitudinal ulcers and thumb-printing are both characteristic findings of ischemic colitis. The double-contrast study is useful for visualization of the ulcer.

Adult↗