巻号一覧
20 巻, 1 号
選択された号の論文の12件中1～12を表示しています
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鈴木 千秋1978 年 20 巻 1 号 p. 1-13
発行日: 1978/01/20
公開日: 2011/05/09
ジャーナル フリーIt is very important to classify the stages of duodenal ulcer by using endoscopy in order to elucidate the life cycle, natural history or clinical course of this disease. Moreover, it is also necessary for evaluation of anti ulcer agents. Therefore, author tried to prepare the new classification of healing process of duodenal ulcer from the new points of findings of ulcer and adjacent mucous membrane by using front view type-panendoscope. In comparison with histology of operatively resected specimen duodenal ulcer was classified endoscopically as follows ; active stage, healing stage I, II, III, and IV, and scarring stage I and H Then, author applied clinically this new classification to the further observation of duodenal ulcer in each case, and concluded that this new classification was useful for observation of life cycle of duodenal ulcer. However, this may be tentative trial until generally accepted classification of duodenal ulcer is established.抄録全体を表示PDF形式でダウンロード (3254K) -
Erlangen papillotomeの使用経験浦上 慶仁1978 年 20 巻 1 号 p. 14-19
発行日: 1978/01/20
公開日: 2011/05/09
ジャーナル フリーExperience of endoscopic papillotomy (EPT) with using Erlangen papillotome is discussed. The tip of Erlangen papillotome can be bent into a curve by pulling the handle part, so it is easy to settle the direction of cutting segment of the papilla of Vater as compared with Sohma probe. From June '76 to March '77 EPT has been performed in 32 cases with using Erlangen papillotome. The results are as follows. Indications of EPT were common duct stones after cholecystectomized patients, choledocholithiasis with poor risk patiants, papillary stenosis and others. These indications and number of the patients are shown in Table I In our series selection of patients subjected to EPT mainly depended on their age. Table 2 shows age distribution of patients. The stones of the common bile duct disappeard in 19 out of 28 cases. The spontaneous delivery of the stones was seen in 11 patients and in 6 cases the basket extraction of the stones was performed. In 2 cases combined use of both process was necessitated. Complications developed in 5 patients. Perforation ocurred in 4 cases and resulted in 3 deaths. One patient developed a cholangitis that was required surgical treat-ment. EPT is in doubt effective procedure for the treatment of the common bile duct stones, but further investigastion has to be needed to protect it's complications. Acknowledgement The author wish to thank Prof. E. Seifert (West Germany) for his kind cooperation and advice.Adress of the author 2nd Dept. of Internal Medicine, School of Medicine, Tokushima University Kuramotocho, Tokushima City, Japan.抄録全体を表示PDF形式でダウンロード (1329K) -
-MorphineによるPharmacological EPCG-戸松 成, 大井 至, 土岐 文武, 小幡 裕, 竹本 忠良1978 年 20 巻 1 号 p. 20-25_1
発行日: 1978/01/20
公開日: 2011/05/09
ジャーナル フリー1t is not always easy to have complete visualization of the intrahepatic bile ducts of the cases which have normal gallbladders and biliary ducts by EPCG. We have developed ‘Pharmacological EPCG’ with Caerulein or CCK-PZ which showed better visualization than present EPCG. Now, we have developed and investigated Pharmacological EPCG' with morphine, which makes Sphincter of Oddi contract tightly and prevents the contrast medium injected by EPCG from flowing back out of the orifice of the duodenal papilla and demonstrates complete visualization of the intrahepatic bile ducts. We have compared three groups of the visualized intrahepatic bile duct branches. The groups are: (1) 15 cases with injection of morphine, (2)18 cases with injection of Caerulein or CCK-PZ and (3)45 cases without any injection. All cases have normal gallbladders and biliary ducts. The result: the best visualization of the intrahepatic bile duct branches was obtained in group (1)(injection of morphine), the second-best visualization in group (2)(injection of Caerulein or CCK-PZ). The poorest visuali-zation in group (3) (without any injection). However, I should point out that one patient in a group (1)developed acute pancreatitis.抄録全体を表示PDF形式でダウンロード (1757K) -
吉本 信次郎, 別府 真琴, 宮地 知男, 由利 秀久, 土居 幸子, 松尾 導昌, 川井 啓市1978 年 20 巻 1 号 p. 26-33
発行日: 1978/01/20
公開日: 2011/05/09
ジャーナル フリーWe devised a method of the colonoscopy carried out by injecting indigocarmin into the mesenteric artery and it was used in one case of the villous tumor and two cases of the colon carcinoma. In villous tumor of 9 cm in diameter observed in the sigmoid colon, the tumor was stained deep blue uniformly and disappearance of the dye was simultaneous and rapid. This case was shown histologically to be papillary adenoma. In one case of carcinoma of the descending colon, the tumor was stained blue irregularly, disappearance of the dye was delayed and in a part of the tumor, it was seen stained blue for a long time. This was considered to be due to extravasation of the dye owing to increased vacular permeability on the lesion and may be corresponding to the findings called tumor blush, tumor stain or increased contrast accumula-tion in the angiography. In another case of carcinoma observed on rectosigmoid region, the tumor was not stained at all and delayed disappearance of the dye was noted in thr surrounding normal colonic wall suggesting an intense degree of vascular invasion of the tumor. In this case, liver metastasis and carcinomatous peritoneal dissemination were found at the time of operation and resection of the lesion was impracticable. Thus, it is made possible by this method (1) differentia-tion of the protruding lesion whether it is benign or malignant, (2) diagnosis of the depth of carcinoma of the large intestine to a certain extent, and (3) estimation of the degree of vascular invasion, helping determination of prognosis. This method is considered to be significant as a sup-plementary diagnostic method which extends the range of possible diagnosis of ordinary endoscopy and angiography.抄録全体を表示PDF形式でダウンロード (2794K) -
― LeadingTube法の開発について―北野 厚生, 小林 絢三, 田中 吉之介, 片山 照義, 桑島 士郎, 山口 勝治1978 年 20 巻 1 号 p. 34-38
発行日: 1978/01/20
公開日: 2011/05/09
ジャーナル フリーRecent progress in colonof iberscope has made the possible understanding of the direct observation on the entire colon by the application of Sliding Tube Method. In some cases, however, it is difficult to introduce the scope into the right sided colon because of the alongation and the adhesive condition of a sigmoid segment. We devised an over coat-tube equipped with a channel apparatus for pressing down the marked loop formation and for turning counterclockwise to achieve an alpha(a) conf igration in the sigmoid segment. A "leading tube" we named is an elastic tube of which diameter is 1.8 (inside) and 2.2 cm (outside) and which is 88 cm in length. This tube is changeable into three formes, that is flexible, straight, and S-shaped. We have applied the "leading tube" to 12 cases and obtained some satisfactory results. This paper shows the frame and the method of this tube and the mesults which we experienced.抄録全体を表示PDF形式でダウンロード (807K) -
小林 世美, 吉井 由利, 杉浦 弘, 春日井 達造1978 年 20 巻 1 号 p. 39-43_1
発行日: 1978/01/20
公開日: 2011/05/09
ジャーナル フリーA review has been made of 29 cases of diverticulosis of the sigmoid colon during the seven year period from June 1970 to May 1977. Of these cases, 8 with 10 lesions of carcinoma (3 of the sigmoid colon and 7 of the rectum), 6 with 6 lesions of polyp and one with melanosis coli were found in association with the diverticulosis. A total of 12 (410) of the 29 cases had carcinoma or polyp adjacent or distal to the diverticula. Barium enema failed in diagnosing one carcinoma and two polyps which were later detected on endoscopic examination. As to the gross appearance of carcinoma, there were 7 protruded (2 pedunculated and 5 sessile) and 3 depressed lesions. Surgical treatment was attempted in 6 patients of whom a radical operation was done in 4 patients. All lesions resected were classified into Dukes' A staging.In conclusion: (1) The incidence of carcinoma or polyp is considerably high in the area adjacent or distal to the diverticula if they were seen in the sigmoid colon. (2) Carcinoma or polyp may be overlooked if diverti-culosis of the sigmoid colon is overestimated in diagnosis. The possibility of complicating carcinoma or polyp should be considered when a patiant complains of rectal bleeding. (3) Such complicated carcinoma is, in most instances, an elevated lesion which can be small and of early malignancy, easily missed on x-ray examination. There-fore, endoscopy is of great value in detecting early carci-noma associated with diverticulosis of the sigmoid colon. (4) The patients with diverticulosis of the sigmoid colon should be followed up periodically as being at high risk for colorectal carcinoma.抄録全体を表示PDF形式でダウンロード (2044K) -
藤田 潔, 岡崎 幸紀, 青山 栄, 有山 重美, 東 光生, 前谷 昇, 竹本 忠良, 吉井 隆博1978 年 20 巻 1 号 p. 44-49
発行日: 1978/01/20
公開日: 2011/05/09
ジャーナル フリーLeiomyosarcoma of the stomach is comparatively rare occurrence. We experienced a case which was so difficult in establishing the diagnosis of whether leiomyosarcoma or leiomyoma clinically and pathologically. The patient, a 53 years old man, came to the hospital, complaining of a bout of hematemesis and melena. Clinically, the tumor assumed the form of leiomyoma, except comparatively large 2 ulcerations on the top of this lesion which were strongly suspected of leiomyosarcoma. Histology showed slight immature myogenic tumor cells with large nuclei and slightly eosinophilic cytoplasm. But, atypism and cell division were rarely observed. Therefore, histologically, we could not diagnose of malignant tumor. However, from the clinical view point, leiomyogenic tumor originating from digestive tract is more or less malignant, because of the presence of the metastasis to the general, in spite of the lack of atypism. Therefore, we suspected this case was boderline between leiomyoma and leiomyosarcoma.抄録全体を表示PDF形式でダウンロード (2874K) -
浜田 義之, 中村 克衛, 小田原 満, 渡辺 正俊, 青山 栄, 藤田 潔, 竹本 忠良, 藤田 良樹1978 年 20 巻 1 号 p. 51-57
発行日: 1978/01/20
公開日: 2011/05/09
ジャーナル フリーTwo cases of solitary colonic tuberculosis were diagnosed by positive culture of tubercle bacilli from the specimen, biopsied through colnof iberscopy. Case 1 is a 52 year-old female. The lesions were present at the proximal part of the ascending colon and the coecum. Roentgenographic and endoscopic findings suggested the presence of colon tuberculosis. Histology of biopsied specimen showed Langhans giant cells, but there was not caesation necrosis. Case 2 is a 27 year-old female. The lesions located at the both of transverse and ascending colon. Roentgeno-graphic and endoscopic findings were also suggestive of tuberculosis. However, histology did not show the typical views of the tuberculosis. Chest X-ray was within normal findings in both cases. These 2 cases were diagnosed finaly by cultured tubercle bacilli from biopsied specimen and were responsive to anti tuberculous chemotherapy. Following procedures should be necessary for the diagnosis of colon tuberculosis without operation ; the presence of tuberculous granuloma, positive acid-fast bacillus stain or positive culture of tubercle bacilli using biopsied specimen. In general, positive acid-fast bacillus stain for tubercle bacilli is rare, and biopsy is not always successful in picking up the tuberculous granuloma. Therefore, it seems to be very important for the diagnosis of colon tuberculosis to prove the presence of the tubercle bacilli in the biopsied specimen which were taken by colonofiberscope, using culture system for tubercle bacilli.抄録全体を表示PDF形式でダウンロード (2086K) -
1978 年 20 巻 1 号 p. 58-60
発行日: 1978/01/20
公開日: 2011/05/09
ジャーナル フリーPDF形式でダウンロード (453K) -
1978 年 20 巻 1 号 p. 60-62
発行日: 1978/01/20
公開日: 2011/05/09
ジャーナル フリーPDF形式でダウンロード (420K) -
1978 年 20 巻 1 号 p. 62-64
発行日: 1978/01/20
公開日: 2011/05/09
ジャーナル フリーPDF形式でダウンロード (435K) -
1978 年 20 巻 1 号 p. 65-80
発行日: 1978/01/20
公開日: 2011/05/09
ジャーナル フリーPDF形式でダウンロード (2253K)
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