日本消化器内視鏡学会雑誌
Online ISSN : 1884-5738
Print ISSN : 0387-1207
ISSN-L : 0387-1207
19 巻, 2 号
選択された号の論文の12件中1~12を表示しています
  • 上地 六男
    1977 年 19 巻 2 号 p. 85-95
    発行日: 1977/04/20
    公開日: 2011/05/20
    ジャーナル フリー
    The origin of the gastric epithelium in the duodenal mucosa were studied clinically and histologically.Material and Methods: Biochemical, histological analysis and autoradographic studies of gastric metaplasia in the duodenal bulb were performed using biopsy specimen taken from 200 cases.Results; 1) The gastric epithelialial metaplasia in the duodenal bulb were observed endoscopically in 174 among 200 cases (about 87%); about 50% of them showed ulcerous changes. Hepatocholangeal disorders were associated frequently. 2) Gastric juice analysis was found to be hyperaciditic in 40 among 53 cases with gastric metaplasia. 3) most of the gastric epithelial metaplasia in the duodenum showed strongly reddish villous-like structure and appeared around ulcer, or around pylorus. 4) The gastric epithelial metaplasia in the duodenum occurred frequently in the healing process of the duodenal ulcer. 5) Histologically the cells were quite same to the original gastric epithelialcells; They consisted almost of the epithelium, however parietal cells were also observed partially. In the pyloric area aberration was seen in 5 cases. 6) Jn 17 of 25 resected cases with gastric epithelial metaplasia, the ulcer were UL III or IV. 7) In the tests with 3H-tymidine, 35SO4, and 3H-glucoose autoradigraphy it was confirmed that the gastric epithelial metaplasia occurred in generative zone. In the mucin metabolism test with 35SO4 and 3H-glucose, the cells of gastric epithelial metaplasia showe d the characteristics of regenerated cells of intestinal mucosa. 8) From these observations it was suggested that the gastric epithelial metaplasia in the duodenum would have some relation with mucous barrier as well as well as Brunners glands.
  • 中沢 三郎, 内藤 靖夫, 山本 義樹, 山瀬 裕彦, 祖父江 国雄, 市川 正章, 梶川 学, 山本 皓正, 山田 憲一, 肥田野 等, ...
    1977 年 19 巻 2 号 p. 96-107
    発行日: 1977/04/20
    公開日: 2011/05/09
    ジャーナル フリー
    During the six years, pancreatogram were taken in 25 patients with pancreatic cyst. Etiologically, there were 17 chronic pancreatitis, 2 acute pancreatitis, 4 posttaumatic, 1 postoperation and 1 cystadenocarcinoma. All patients complained of abdominal pain and abdominal mass was palpable in 17 cases (68%). The pancreatograms of pancreatic cyst were classified into 5 types, the filled type (60%), the obstructed type (12%), the displaced type (4%), the mixed type (20%) and the normal type (4%). The differential diagnosis between pancreatic cyst and other pancreatic diseases in each type of pancreatograms, were discussed. The diagnosis of pancreatic cyst and other pancreatic diseases can be made with high accuracy in most patients by x-ray studies of hypotonic dnodenography, but by cholangiography it is difficult unless the cyst is large, in size. By EPCG (endoscopic pancreatocholangiography), abdo-minal angiography and new addition of ultrasound and CT (computerised tomngraphy), clinical problems of accurate preoperative diagnosis of pancreatic cyst will be resolved.
  • 田畑 育男, 田島 強, 富田 志郎, 松川 昌勝
    1977 年 19 巻 2 号 p. 108-115
    発行日: 1977/04/20
    公開日: 2011/05/09
    ジャーナル フリー
    Endoscopic retrograde cholangiopancreatography was performed to 1500 patients, in those including 15 cases of carcinoma of the gall bladder and 29 cases of carcin-oma of the extrahepatic bile duct which were proved by operation or autopsy. Endoscopic retrograde cholangiography (E. R. C.) was succeeded in 13 cases with carcinoma of the gallbladder and opacified areas of those were as follows ; gallbladder and bile duct in 4, cystic duct and bile duct in 1 and bile duct alone in 8. In 5 cases of them the carcinoma of the gallbladder was easily diagnosed for the appearances of distinct filling defect in the gallbladder and in the remaining 8 cases appearances of irregular stenosis or obstruction at triangular portion of the bile duct indicated the diagnosis of malignancy in the biliary tract. E. R. C. was successfu lly performed to all of the 29 cases of carcinoma of the extrahepatic bile duct and correct preoperative diagnosis have been made to all cases with the exception of 2 cases which weve diagnosed as sclerosing cholangitis and choledocholithiasis. The appea-rances of E. R. C. were classified into stenotic type (11 cases) and obstructed type (18 cases). This paper emphasized that E. R. C. was the most valuable procedure for preoperative diagnosis of carcinoma of the extrahepatic bille duct.
  • 須藤 洋昌, 加藤 三郎, 本井 重博, 下野 道広, 小林 顕彦, 郡 大裕
    1977 年 19 巻 2 号 p. 116-121
    発行日: 1977/04/20
    公開日: 2011/05/09
    ジャーナル フリー
    With recent advances in gastrointestinal rentogenology and endoscopy, ulcerative colitis has been diagnosed more frequently. But the accurate criteria of diagnosis of this disease has not been established. Therefore, its follow-up observation is important because of its chronic relapsing nature. In this paper, fundamental and endoscopical trials are presented for recognizing the architecture of microvessels of colonic mucosa. As a fundamental study, India ink was continuously dripped into Wistar rat at a constant pressure 100 cm H2O via thoracic artery after lavage by saline solution Tncluding heparin, and the microvessels were examined stereomicroscopically and histologically. Clinically, the endoscopical closed-up observation was applied to 28 cases of control and 39 of ulcerative colitis, histopathologically classified into three stages. Further, for recognizing the fine network pattern of regularly arranged microvessels of colonic mucosa, fluorescence method with magnifying observation was applied to 12 cases of ulcerative colitis and 8 of control.The obtained results were as follows; 1) Histologically, the microvessels of colonic mucosa filled with India ink were observed to run up along each colonic gland to make fine networks just beneath the mucosal surface. 2) Stereomicroscopically, it appeared as regularly arranged "honeycomb" like fine network pattern. 3) By usual endoscopy, arborescent vascular appeara-nces were obscure in 11 cases, and remarkably proliferat-ed and/or dilated microvessels in 12 among 13 cases of active stage of ulcerative colitis. 4) These findings were improved with diminishing mucosal inflammation, but the alteration of microvascular appearanbe remained for longer period than that of arborescent vessels. 5) By magnifying fluorescence method, the fluorescent fine network pattern could be seen obscurely and irregu-larly in 7 cases among 8 of active and almost quescent stages of ulcerative colitis, whereas in quescent stage, the fine network pattern appeared regularly in 1, slightly irregularly in 2 and irregularly in 1. From these results, the fluorescence method might be concluded to be useful in the follow-up study of ulerative colitis.
  • 岡崎 幸紀, 竹本 忠良
    1977 年 19 巻 2 号 p. 123-129_1
    発行日: 1977/04/20
    公開日: 2011/05/09
    ジャーナル フリー
    A case Who died of cardiac arrest soon after gastrosopic examination is reported. A 61 year old man visited our department complaining of repeated nausea and voniting. Upper gastro-intestinal X-ray series revealed a small fleck of anglar portion and a deformity of duodenal cap. The gastroscopic examination showed pyloric stenosis due to duodenal ulcer. Soon after the endoscopic examination, irregular deep breath was noted for a couple of minutes, and then unconsiousness developed. Cardiac sounds were not audible. Cardiac massage and other resuscitation efforts were not successful. He had been treated with medication under diagnosis of hypertension, myocardial ishemia and arrythmia with atrial fibrillation in another hospital. The cause of death seemed to be sudden cardiac arrest, although autopsy was not performed. The number of elderly people has been in creasing who had not only the disease of gastro-intestinal tract, but also cardiovascular disorders. There might occur similar com-plication, therefore, the endoscopist must alweys pay attention to the anamnesis and physical examination, especially a complication of cardiovascular disorders. Moreover, electrocardiogram and a kind of medication for cardiopulmonary resuscitation should be prepared at hand in the endoscopy-room for emergency.
  • 多田 正大, 宮岡 孝幸, 赤坂 裕三, 竹村 周平, 横江 信義, 下野 道広, 本井 重博, 須藤 洋昌, 加藤 三郎
    1977 年 19 巻 2 号 p. 130-139
    発行日: 1977/04/20
    公開日: 2011/05/09
    ジャーナル フリー
    Four cases of anal beleding which were similar to the early phase of ulcerative colitis were described as acute hemorrhagic colitis. Several hours or days after admini-stration of antihistaminics or antibiotics against common cold, four young adults were admitted to our hospital complaining of watery diarrhoea followed by severe anal bleeding similar to ulcerative colitis. Occult blood was positive, however, no pathogenic bacteria or viruses were detected in their stool. White blood cell counts showed within normal limits and no specific abnormal findings were detected in their liver function test, immunological studies and so on. Endoscopic examination by magnifying colonoscope type CF-MB-M (Olympus) were carried out within several hours after the onset of anal bleeding and revealed mul-tiple hemorrhagic spotts, edema and congestion on the surface of the mucosa in the so-called "left colon". Normal vascular pattern was completely disturbed, however, remarkable ulceration, friability of the mucosa and mucopurulent exudate which were commonly seen in ulcerative colitis were not inspected endoscopically. These findings were similar to stage I of acute phase (early stage) of ulcerative colitis which was describec by Roth. Histological studies by biopsy specimens showed marked congestion, vascularity and edema of the mucosa, however, infiltration of inflammatory cells and erosion were not so remarkable. No crypt abscesses were detected. These histological findings revealed non-specific inflammtory pattern of the colon. Symptom of anal bleeding cured easily without any therapy within one or two days and the mucosal inflam-mation was also confirmed to subside endoscopically. No recurrence of symptoms occured during our follow up observation from eight months to three years. Concerning to the pathogenesis of this disease, no remarkable factors could be demonstrated in our series. It is not clear whether symptom of common cold is one of the symptoms of this disease or only allergic reaction by the administration of drugs causes the inflammation in the left colon. According to these clinical, enidoscopical and histological points of view, acute hemorrhagic colitis seems to be similar to the early stage of ulcerative colitis in some features. Several clinical points of acute hemorrhagic colitis, however, such as easy healing without any therapy and no recurrence of symptoms are quite different from ulcerative colitis. Therefore, the pathogenesis of acute hemorrhagic colitis is suspected to be different from those of ulcerative colitis and considered strongly to be a new entity inflammatory colon disease. Moreover, it is emphasized that more additional documentation of this disease should be neces-sary to resolve the pathogenesis or to differentiate from other inflammatory colon disease.
  • 河村 奨, 永富 裕二, 原田 俊則, 冨士 匡, 清水 道彦, 児玉 隆浩, 岡本 佳干, 野田 健一, 水田 実, 竹本 忠良
    1977 年 19 巻 2 号 p. 140-148
    発行日: 1977/04/20
    公開日: 2011/05/09
    ジャーナル フリー
    Primary sclerosing cholangitis is a rare disease of unknown etiology, a diffuse obliteration and fibrosis of the extra and intrahepatic biliary tree in the abscence of biliary stones, recent operative trauma, cancer or in-fection. Diagnosis of this disease has been made at operative cholangiogram and histological survey, in most of the cases, and only a few cases diagnosed by ERCP so far reported. By performing ERCP in 3 jaundiced patients, we experienced the interesting radiographic appearance of P. S. C. and other similar diseases. Case l; a 49-year-old woman with episodes of pruritis and general fatigue also complained of several episodes of anal bleeding. Highly elevated value of serum alk. alive phosphatase in contrast to slight degree of hyper-bilirubinemia. was noted. Symptoms, laboratory data indicates the diagnosis of P. S. C. and ERCP showed beaded appearance. Final diagnosis was made as P. S. C. with association of ulcerative colitis. Case 2; A 56-year-old male with painless jaundice and general fatigue. The blood chemistry was not so charact-aristic of P. S. C. but ERCP showed segmental narrowing of the hilar bile duct and histological findings of the wedge-type resection was suggestive of segmental S. C.. Case 3; A 43-year-old male with severe jaundice died of renal failure after the one year history of jaundice. ERCP showed string-like caliber of the common hepatic duct and both hepatic ducts with area of striking proximal dilatation. The findings of ERCP and his clinical course suggested that this case might have a .scirrhous carcinoma, although autopsy. was unable to be performed.
  • 山中 桓夫, 吉田 行雄, 井戸 健一, 関 秀一, 高橋 邦生, 古川 哲夫, 土谷 昌久, 酒井 秀朗, 木村 健
    1977 年 19 巻 2 号 p. 149-153
    発行日: 1977/04/20
    公開日: 2011/05/09
    ジャーナル フリー
    The institute of gastroenterology Jichi medical college. The pre-mixed gas (30% N20, 70% O2) was used on laparoscopic examination to relieve patients from pain and anxiety. The pre-mixed gas was administered through face-mask during laparoscopic examination of twenty patients with hepatic disorders. In fifteen, it was effective i, e, total analgesia. In one patient, in whom subcutaneous emphysema accidentaly developed early in the examination, the pre-mixed gas was ineffective. In seven patients, no side effect of the pre-mixed gas was encountered. The pre-mixed gas proved markedly effective as an analgesic on laparoscopic examination with no serious side effect.
  • 1977 年 19 巻 2 号 p. 154-181
    発行日: 1977/04/20
    公開日: 2011/05/09
    ジャーナル フリー
  • 1977 年 19 巻 2 号 p. 182-183
    発行日: 1977/04/20
    公開日: 2011/05/09
    ジャーナル フリー
  • 1977 年 19 巻 2 号 p. 184-207
    発行日: 1977/04/20
    公開日: 2011/05/09
    ジャーナル フリー
  • 1977 年 19 巻 2 号 p. 208-209
    発行日: 1977/04/20
    公開日: 2011/05/09
    ジャーナル フリー
feedback
Top