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Takahiro Fujii

Publications and source records attributed to Takahiro Fujii.

At least 19 recordsLinked to original sources
PubMed2006

Primary signet-ring cell carcinoma of the colon at early stage: a case report and a review of the literature.

A 67-year-old man, who had undergone surgery to resect multiple gastric cancers 4 years ago, visited our hospital for surveillance colonoscopy. Colonoscopy revealed a discolored, 7-mm in diameter, flat-elevated lesion with central depression in the transverse colon near the splenic flexure. Although the findings of endoscopy and barium enema were suggestive of submucosal invasion, the patient chose to undergo endoscopic mucosal resection. Pathological examination of the resected specimen revealed signet-ring cell carcinoma and a positive surgical margin. A second operation was performed, and no residual tumor or metastasis to lymph nodes was found in the resected specimens. Primary colorectal cancers composed of signet-ring cell carcinoma detected and treated at an early stage are extremely rare. We present a case and review the literature.

Aged↗
PubMed2006

Depressed-type (0-IIc) colorectal neoplasm in patients with family history of first-degree relatives with colorectal cancer: A cross-sectional study.

AIM: To investigate the correlation of depressed-type (0-IIc) colorectal neoplasm and family history of first-degree relatives (FDR) with colorectal cancer (CRC). METHODS: This cross-sectional study was conducted from June 2000 to October 2002 at National Cancer Center Hospital East. Eligible patients undergoing initial total colonoscopy were surveyed regarding family history of CRC among FDR by a questionnaire prior to colonoscopic examinations. All endoscopic findings during colonoscopy were recorded and the macroscopic classification of the early stage neoplasm/cancer was classified into two types (0-IIc vs non 0-IIc). Odds ratios (OR) and 95% confidence intervals (CI) were calculated by univariate and multivariate logistic regression to estimate the association between macroscopic features and clinicopathological data including gender, age, and family history of FDR with CRC. RESULTS: The OR of an association between family history of FDR with CRC and overall early stage neoplasm adjusted by gender and age was 1.85 (95% CI: 1.31-2.61, P = 0.0004), that for non 0-IIc neoplasm was 1.71 (95% CI: 1.22-2.41, P = 0.0017) and for 0-IIc colorectal neoplasm was 2.78 (95% CI: 1.49-5.16, P = 0.0031). CONCLUSION: Our study shows a significant association between a family history of FDR with CRC and 0-IIc colorectal neoplasm. When patients with a family history of FDR with CRC undergo colonoscopy, colonoscopists should check carefully for not only polypoid, but also depressed-type (0-IIc) lesions.

Aged↗
PubMed2006

Magnifying colonoscopy as a non-biopsy technique for differential diagnosis of non-neoplastic and neoplastic lesions.

AIM: To clarify whether mucosal crypt patterns observed with magnifying colonoscopy are feasible to distinguish non-neoplastic polyps from neoplastic polyps. METHODS: From June 1999 through March 2000, 180 consecutive patients with 210 lesions diagnosed with a magnifying colonoscope (CF-200Z, Olympus Optical Co., Ltd., Tokyo, Japan) were enrolled. Magnification and chromoendoscopy with 0.2% indigo-carmine dye was applied to each lesion for mucosal crypt observation. Lesions showing types I and II crypt patterns were considered non-neoplastic and examined histologically by biopsy,whereas lesions showing types III to V crypt patterns were removed endoscopically or surgically. The correlation of endoscopic diagnosis and histologic diagnosis was then investigated. RESULTS: At endoscopy, 24 lesions showed a type I or II pit pattern, and 186 lesions showed type III to V pit patterns. With histologic examination, 26 lesions were diagnosed as non-neoplastic polyps, and 184 lesions were diagnosed as neoplastic polyps. The overall diagnostic accuracy was 99.1% (208/210). The sensitivity and specificity were 92.3% (24/26) and 99.8% (184/186), respectively. CONCLUSION: Magnifying colonoscopy could be used as a non-biopsy technique for differentiating neoplastic and non-neoplastic polyps.

Adenoma↗
PubMed2006

[Adrenal ganglioneuroma in a 14-year-old girl: a case report].

A 14-year-old girl was referred to our hospital for examination of a right adrenal tumor, incidentally found by abdominal ultrasound sonography. Computed tomographic scan and magnetic resonance imaging showed a 44 x 20 mm solid tumor in the right adrenal region. Endocrinological examination were within normal limits except for slightly increased serum aldosterone. Laparoscopic adrenalectomy was performed and the tumor was histologically diagnosed as ganglioneuroma originated from the right adrenal medulla.

Adolescent↗
PubMed2006

[Arterial injury associated with tension-free vaginal tape procedure successfully treated by radiological embolization: a case report].

A 75-year-old woman underwent a tension-free vaginal tape (TVT) procedure for urinary stress incontinence. The patient complained of lower abdominal pain, a feeling of lower abdominal distension and nausea three hours after the operation. In addition, systolic blood pressure decreased gradually to 80 mmHg. Enhanced computed tomography revealed a retropubic hematoma sized up to 16 cm X 12 cm X 11 cm and bleeding from a vessel running through the posterosuperior aspect of the pubic bone. Successively, arteriography was performed. The arteriogram also confirmed arterial injury, which was successfully treated by selective embolization using a gelatin sponge and pushable coils. Postoperative course was uneventful requiring neither blood transfusion nor surgical removal of the hematoma.

Aged↗
PubMed2005

Incidence and localization of lymphoid follicles in early colorectal neoplasms.

AIM: To investigate the incidence and localizations of lymphoid follicles (LFs) in early colorectal neoplasms in human beings. METHODS: From July 1992 to September 1999, a total of 1,324 early colorectal neoplasms were removed endoscopically or surgically at our hospital; 1,031 (77.9%) were available for analysis in this study. Localization of LFs was defined histologically: as submucosal LFs, if located under the muscularis mucosa; and as intramucosal LFs, if located across or over the muscularis mucosa. RESULTS: Histologically, the materials included 903 intramucosal neoplasms and 128 submucosal cancers. Overall incidence of LFs was 27.2% (280/1 031). The incidence of LFs was significantly higher in females (33.6% vs 24.9%, P=0.0064), the right-sided colon (32.2% vs 25.6%, P=0.0403) and in flat or depressed type lesions (34.6% vs 25.2%, P<0.0001) as compared to males, left-sided colon and protruding type lesions, respectively. The incidences of intramucosal neoplasms and submucosal cancers were 24.3% and 43.8%, respectively (P<0.0001). Localizations of LFs (intramucosal LF/submucosal LF) in depressed, flat, and protruding types were 1/24, 14/36, and 131/74, respectively. CONCLUSION: The incidence of LFs in early human colorectal neoplasms significantly differs by gender, location, macroscopic type, and histology. Moreover, localization significantly differs by macroscopic type.

Animals↗
PubMed2005

Pneumoscrotum: a rare manifestation of perforation associated with therapeutic colonoscopy.

Pneumoscrotum is uncommon and also rarely reported as a complication associated with colonic perforation. A case of colonic perforation in delayed fashion associated with EMR, revealed by pneumoscrotum, is reported and the associated literatures are reviewed. A 52-year-old male received piecemeal EMR for a laterally spreading tumor 35 mm in size in our hospital. He complained of enlargement of the scrotum and revisited our hospital the day after the procedure. A diagnosis of pneumoscrotum was made, and as most such cases have been reported to be associated with pneumoperitoneum, colonic perforation was suspected. Free air but no fluid collection was found by abdominal computed tomography, and delayed colonic perforation was diagnosed. However, as there were no clinical signs of peritoneal irritation, conservative treatment was administered and the patient recovered uneventfully. Pneumoscrotum could be a sign of colonic perforation after EMR, and treatment should be carefully chosen.

Colonic Neoplasms↗
PubMed2005

Angiogenesis in colon hyperplastic polyp.

Despite the significance of tumor angiogenesis and the extensive knowledge on the molecular basis of blood vessel formation in carcinoma of colorectum, no data exist in hyperplastic polyp. This prompted us to examine angiogenesis in hyperplastic polyp. Eleven small hyperplastic polyps, 13 large hyperplastic polyps and their adjacent normal mucosas were included in this study. Angiogenesis was assessed by immunohistochemistry using monoclonal antibody against CD34. Angiogenic factor, thymidine phosphorylase was also examined by immunohistochemistry. Intra-tumoral microvessel density (IMD) in large hyperplastic polyp was significantly higher than that in small hyperplastic polyp (P<0.01) and that in normal mucosa (P<0.01). DAD in small hyperplastic polyp was also significantly higher than that in normal mucosa (P<0.01). Expression of dThdPase was almost observed in stromal cells in normal, small and large hyperplastic polyp. In addition, the proportion of the stromal cells expressing dThdPase in large hyperplastic polyp was significantly higher than that in small hyperplastic polyp and normal tissue (P<0.01, respectively). The proportion of the stromal cells expressing dThdPase in small hyperplastic polyp was significantly higher than that in normal tissue (P<0.01). The present study provides that angiogenesis may have an important role(s) in the development of hyperplastic polyp and dThdPase in stromal cells may support angiogenesis in hyperplastic polyp. Anti-angiogenic therapy might be available for suppression of hyperplastic polyp.

Antigens, CD34↗
PubMed2005

Practical uses of chromoendoscopy and magnification at colonoscopy.

New technologies in the form of high-magnification or zoom colonoscopy complemented by chromoscopic agents permits early detection of neoplastic colorectal lesions, particularly flat and depressed types. Establishing suitability for endoscopic resection or surgical excision can be enhanced using these techniques. Chromoscopic colonoscopy may play an important role in the routine endoscopic colorectal cancer surveillance programs in patients assuming a high risk of colorectal neoplasia. This article summarizes recent data regarding the prevalence and histopathologic characteristics of flat and depressed colorectal lesion in Western cohorts and describes how their detection and management can be improved by chromoscopy and magnification technology. The techniques required for chromoscopic colonoscopy and magnification imaging are outlined along with a review of the literature on these subjects.

Adenoma↗
PubMed2005

Effectiveness of glycerol as a submucosal injection for EMR.

BACKGROUND: EMR traditionally is performed by using normal saline solution (NS) as the submucosal fluid cushion. It is thought, however, that NS does not maintain the proper mucosal elevation for EMR of large, flat lesions. We investigated the efficacy of glycerol as the submucosal injection solution. METHODS: A total of 110 colorectal laterally spreading tumors (LST) were treated by EMR with glycerol. For comparison, 113 LSTs treated by using NS were studied. The en bloc resection, complete resection, and associated complications rates were evaluated retrospectively. OBSERVATIONS: The en bloc resection rate in the glycerol group was 63.6% (70/110) compared with 48.9% (55/113) in the NS group (p < 0.05). The complete resection rate in the glycerol group was 45.5% (50/110) compared with 24.6% (28/113) in the NS group (p < 0.01). The associated complications rate was similar in both groups. CONCLUSIONS: It technically was easier and as safe to perform EMR of colorectal LSTs when using glycerol as the submucosal injection solution.

Colonoscopy↗
PubMed2005

A new sinker-assisted endoscopic submucosal dissection for colorectal cancer.

BACKGROUND: Endoscopic submucosal dissection (ESD) is accepted as a minimally invasive treatment for early gastric cancer, but it is not widely used to treat the colorectum because of its degree of technical difficulty. Thus, a noninvasive tool that facilitates the direct visualization of the submucosal layer is needed. METHODS: Traction-assisted dissection was performed on 4 superficial lesions. The system consisted of a metallic clip attached by a nylon line to a sinker 6 x 4 x 4 mm in size and weighing 1 g. After partially dissecting the submucosa, the clip was attached to the edge of the exfoliated mucosa and the weight of the sinker pulled down the partly resected lesion. OBSERVATIONS: In all 4 cases, the sinker allowed direct visualization of the cutting line, and en bloc resection was successfully accomplished. CONCLUSIONS: These preliminary results suggest that sinker-assisted ESD is effective for the complete removal of selected superficial early colorectal cancer.

Aged↗
PubMed2005

Distribution and prevalence of colorectal hyperplastic polyps using magnifying pan-mucosal chromoendoscopy and its relationship with synchronous colorectal cancer: prospective study.

BACKGROUND AND AIM: Patients with multiple (hyperplastic polyposis) or large hyperplastic polyps (HPs) predominantly in the right-sided colon, have been reported to have an increased risk of colorectal cancer (CRC). This prospective study was conducted to clarify the distribution of various sized HPs using magnifying pan-mucosal chromoendoscopy and its relationship with synchronous CRC. METHODS: Patients eligible for this study had an initial total colonoscopy. Indigo carmine dye was sprayed throughout the whole colon and rectum, and diagnoses were made using magnifying colonoscopy. RESULTS: A total of 263 patients were enrolled, and a total of 3060 HPs were observed in 226 (86%) patients. The prevalence of patients with intermediate size (> or = 6 mm) HPs was 8.7% (n = 23) and that of patients with large HPs (> or = 10 mm) was 0.8% (n = 2). Of 3060 HPs, the numbers of diminutive (< 6 mm), intermediate size and large HPs were 3020, 38 and two, respectively, and 5.0%, 42.1% and 100% of these were located in the right-sided colon, respectively. Synchronous CRC was observed in 64 (24%) of 263 patients. Compared to patients without HPs, patients with intermediate size HPs showed a significant increase in odds ratio (OR) for synchronous CRC (OR = 4.9: 95% CI [1.3-18.2]), but there was no significant association between synchronous CRC and patients with diminutive or large HPs. CONCLUSIONS: Compared to diminutive HPs, intermediate size and large HPs were predominantly located in the right-side colon. Moreover, intermediate size HPs were significantly correlated with synchronous CRC.

Adult↗
PubMed2005

Vascular virtual endoluminal visualization of invasive colorectal cancer on MDCT colonography.

OBJECTIVE: The purpose of this study was to assess the utility of vascular views for visualization of invasive colorectal cancers on contrast-enhanced MDCT colonography. CONCLUSION: By means of Hounsfield-transparency settings, we obtained virtual endoluminal images that show vascular structures and delineate invasive cancers of the colorectal wall, and we call these images "vascular views." Using this technique for contrast-enhanced MDCT colonography, we found that the increase in flow and pooling of blood related to angiogenesis of cancerous lesions is easy to identify and that this finding is useful in the detection of invasive colorectal cancers.

Adult↗
PubMed2004

A novel endoscopic device for retrieval of polyps resected from the colon and rectum.

BACKGROUND: Retrieval of polyps resected from the colorectum is time consuming, despite the availability of various devices, such as grasping forceps, nets, and suction traps, for this purpose. A novel device for retrieval of polyps was developed and tested. METHODS: Patients with polyp(s) less than or equal to 6 mm in diameter were included in this study. The effectiveness of the device for polyp retrieval was evaluated. OBSERVATIONS: In total, 180 of 184 polyps were retrieved from 100 patients. Four polyp specimens (2.2%) were lost after polypectomy. None of the retrieved specimens were damaged. All retrieved polyps could be assessed histopathologically, and a definitive diagnosis was made. CONCLUSIONS: The newly developed device proved to be reliable when used in clinical practice.

Adult↗
PubMed2004

[Intraarterial chemotherapy with bladder preservation in patients with invasive bladder carcinoma].

Intraarterial chemotherapy (IAC) was carried out on patients with invasive bladder carcinoma to treat the bladder carcinoma while preserving the bladder. Fifteen patients with bladder carcinoma at stage T2-T4 were treated with intraarterial cisplatin (CDDP: 70 mg/m2) and adriamycin (ADM: 30 mg/m2) every 3 to 4 weeks. The response was observed in all 15 patients. Ten (66.7%) achieved a complete response (CR), and 3 (20.0%) obtained a partial response (PR). With a mean follow-up of 22.6 months, the overall survival rate was 86.7% and 12 patients were alive with functioning bladder. One patient received radical cystectomy. Although further studies and long-term follow up are required to clarify its effectiveness, IAC for patients with invasive bladder carcinoma might be an effective therapy with a preserved bladder.

Adult↗