GASTROENTEROLOGICAL ENDOSCOPY
Online ISSN : 1884-5738
Print ISSN : 0387-1207
ISSN-L : 0387-1207
Volume 21, Issue 9
Displaying 1-14 of 14 articles from this issue
  • HAJIME KUWAYAMA
    1979 Volume 21 Issue 9 Pages 1025-1038_1
    Published: September 20, 1979
    Released on J-STAGE: May 09, 2011
    JOURNAL FREE ACCESS
    Intestinal metaplasia in the human gastric mucosa commonly occurs and continues to progress with age. However, it has also been pointed out to have a very close relationship, histologically and epidemiologically, with various diseases of the stomach. It was a purpose of the present study to analyse and to clarify the distinction between the intestinalized gastric mucosa and the small intestinal mucosa. Nuclear DNA content and disaccharidase activity were investigated in various gastric diseases accompanied with intestinalization and normal small bowel. The results are summarized as follows. 1) The mean DNA content of normal stomach was 10.34±1.52 (diploid was equal to 10.0 Fluorescence Unit) and it was a complete mass of diploid. The histograms of normal stomach and normal small bowel were similar to each other. The mean DNA content and the frequency of polyploid over tetraploid in various gastric diseases were; 10.71±2.17, 0 % in gastric polyp; 11.04±2.10, 0% in the atrophic gastritis; 11.59±2.14, 0% in gastric ulcer (healing stage), 12.83±2.83, 4.36% in atypical epitherium (ATP) ; 21.79±9.30, 24.21% in early gastric cancer, and 28.37±13.31, 58.36% in advanced gastric cancer. 2) The nuclear DNA content of the intestinalized gastric mucosa was so-called hyper diploid. In the surrounding intestinalized gastric mucosa of early gastric cancer, polyploid or aneuploid was seen only on the oral side. Disaccharidase activity was essentially in parallel with the histological degree of intestinalization and maltase activity had the best correlation with it. The activity was approximately one-tenth that of the small bowel. There was no significant difference in disaccharidase activity of the intestinalized gastric mucosa between malignant and benign diseases. 3) There was a great difference in the histogram pattern of nuclear DNA content between early and advanced gastric cancer, even in the same types of differential adenocarcinoma histopathologically, i.e. polyploidor aneuploid was found in both. Early cancer, however, had a stem line on the diploid and the variation was much narrower than advanced cancer. The disaccharidase activity was not apparent in either.
    Download PDF (2903K)
  • KIYOHIRO KAWAHARA
    1979 Volume 21 Issue 9 Pages 1041-1057_1
    Published: September 20, 1979
    Released on J-STAGE: May 09, 2011
    JOURNAL FREE ACCESS
    138 cases of early cancers and 45 cases of “early-looking” advanced cancers of the stomach were studied with the following results. 1) Most of the cases with failed preoperative diagnosis on the depth of cancerous invasion were small lesions of 1-2 cm in the greatest diameter or lesions with a wedge-shaped infiltration. If all the characteristic clues which may suggest a malignant invasion into the submucosal layer are looked for carefully, the accuracy of macroscopic judging the depth of cancerous infiltration may be as high as 72.5%. 2) A type-classification of an early gastric cancer in the resected specimen differed occasionally from that previously made by endoscopic examination. The study in cases of IIa + IIc or IIc + IIa showed that one of the reasons was the difficulty in interpreting a low elevation at the edge of IIc as malignant or not. This difficulty may be overcome by taking biopsy from that part. 3) 76.8% of 138 early gastric cancers were seen in the pyloric gland area, 13.8% were in the transitional area and 9.4% in the fundic gland area. The endoscopic atrophic border shifted from C-I type to O-III type as the age of the patients increased. 91.3% of 46 macroscopically elevated lesions were differentiated adenocarcinoma, and mostly located in pyloric gland area. There were 13 early cancers in the fundic gland area and all of them were of undifferentiated type, while 87 out of 106 cancers in the pyloric gland area were of differentiated type. 4) There were 44 minute gastric cancers with the diameter less than 10mm, in which 35 lesions were detected preoperatively by endoscopy as abnormal and 9 lesions were overlooked until the examination of resected specimens. The smallest lesions endoscopically diagnosed was 4mm in diameter.
    Download PDF (3212K)
  • -A 5-YEARS RETROSPECTIVE STUDY OF 425 PATIENTS AND DIAGNOSTIC VALUE OF EMERGENCY ENDOSCOPY-
    HAJIME WATAHIKI, SATOSI NAKANO, KIMIO KITAMURA, ISAO TAKEDA, MASAMI IM ...
    1979 Volume 21 Issue 9 Pages 1058-1065
    Published: September 20, 1979
    Released on J-STAGE: May 09, 2011
    JOURNAL FREE ACCESS
    Acute upper-gastrointestinal hemorrhage is one of the most common medical emergencies. Emergency endoscopy is the most accurate diagnostic method, and contributes to assess the prognosis in the individual patient. Four hundred and twenty-five patients admitted to our hospital due to acute uppergastrointestinal bleeding in the past 5 years. (during 1973-1977) One hundred and ninety-eight patients underwent emergency endoscopy within a few hours after hospitalization, and others early endoscopy or roentgenography. 1) In 96.2% of them, the causes of bleeding were confirmed. Bleeding from gastric ulcer was most common (47.1 %), and duodenal ulcer was seen in 24.9%, and then gastric cancer, esophageal varices, and acute gastric mucosal lesion were seen in 8.9%, 8.7%, and 4.9% respectively. 2) A correct diagnosis was established by emergency endoscopy in 94.9% of all. 3) Marked anemia below 7.9 g/dl in hemoglobin value was detected in 40% and moderate anemia below 9.9 g/dl was in 30%, and blood transfusion was required in 38.8%. 4) Surgery was needed in 28.9% and emergency operation was done in a half of them. 5) The overall mortality rate was 5.9% and almost all of them were the patients with gastric cancer and liver cirrhosis with esophageal varices. The mortality of gastro-duodenal ulcer was only 0.3%.
    Download PDF (1177K)
  • YASUHIRO TAKASE, KAZUO ORII, TORU TAKESHIMA, AZUSA OZAKI, KATASHI FUKA ...
    1979 Volume 21 Issue 9 Pages 1066-1070
    Published: September 20, 1979
    Released on J-STAGE: May 09, 2011
    JOURNAL FREE ACCESS
    Venous pressure in esophageal varices was measurred using a technique of endoscopic embolization which had been developed at our institute. Observing esophageal varices with a fiberesophagoscope, an injecting needle was punctured into varices, which was connected with transducer P231D (Gould-Statham, U. S. A.) and Recorder 120 System (Saneisokki, Japan). In two cases of severe esophageal varices the renous pressure was successfully recorded using this technique for a few minutes continuously. This method seems one of the best approaches which will elucidate the pathophysiology of esophageal varices.
    Download PDF (3625K)
  • KAZUO HARIMA, SHIGEMI ARIYAMA, NOBORU MAETANI, SUSUMU KAWAMURA, TADAYO ...
    1979 Volume 21 Issue 9 Pages 1071-1077_1
    Published: September 20, 1979
    Released on J-STAGE: May 09, 2011
    JOURNAL FREE ACCESS
    In spite of tremendous progress made in the diagnosis of early gastric cancer, many problems remains still unsolued in the accurate diagnosis of Type III early gastric cancer. Type III early gastric cancer can be interpreted as III+II b type, not associated with distinct IIc. In retrospective study three cases of type III early gastric cancer were examined in detail. But even macroscopically, it was almost inpossible to differenciat Type III from benign gastric ulcer on the diagnosis of Case (1) and (2), As a matter of fact, clinical differenciation of the type III from a benign gastric ulcer is extremely difficuet.
    Download PDF (7116K)
  • KAZUYA MAKIYAMA, YUKINOBU MISHIMA, KEIZO KIKKAWA, KAZUYUKI IMAMURA, AK ...
    1979 Volume 21 Issue 9 Pages 1078-1085
    Published: September 20, 1979
    Released on J-STAGE: May 09, 2011
    JOURNAL FREE ACCESS
    Vascular spider as well as palmar erythema is one of the signs closely related to liver cirrhosis. It appeare frequently in the skin of the chest, neck and shoulder along the vena cava superior, sometimes in the arms, back and face, and rarely also in the mucous membrane of the nasal cavity, oral cavity and pharynx. A common concept is that the site of occurrence is limited to the upper half of the body. However, we often observed in the rectal mucous membrane the findings of capillary vascular dilatation which closely resembled vascular spider in the skin. We designated it "rectal vascular spider" and examined the rectal membranes of 28 cases of liver cirrhosis, 1 case of CRST syndrome with liver fibrosis, and 7 cases of chronic hepatitis. As the result, rectal vascular spider was verified in 9 cases or 32.1% of the 28 cases of liver cirrhosis. The size ranged from approximately 1.5 to 2.0mm. The morphology of rectal vascular spider was closely observed with a magnifying colonofiberscope type FCS-ML II (MACHIDA) and it was classified into the spider type and the non spider type. Rectal vascular spider had some relationship to vascular spider in the skin, but no specific relationship to palmar erythema and hepatoma, was noted. A relation of an estrogen level in the urine to the incidence of rectal vascular spider was not significant. It is unlikely that the rectal vascular spider is a cause of massive hemorrhage, and its clinical significance will have to be clarified by future studies.
    Download PDF (1799K)
  • TAKASHI MISHIMA, SHIGERU OKUDA, AKIRA OSHIMA, KEIKO SO, TSUTOMU HIROKA
    1979 Volume 21 Issue 9 Pages 1086-1093_1
    Published: September 20, 1979
    Released on J-STAGE: May 09, 2011
    JOURNAL FREE ACCESS
    It will provide an important information for a research on gastric cancer to know how long and it will take for an early gastric cancer to progress to an advanced cancer and what type of advanced cancer it will be if left untreated. However, it is not allowed to follow and observe such a progress from the practical aspect, because such an early gastric cancer must be surgically operated on as soon as possible once the diagnosis has been established. Therefore, investigations on a developmental process of early gastric cancer have been conducted based only on a retrospective study. But this method does not help to find out whether a lesion was carcinoma from the beginning because biopsy was not performed in the past. The results of this retrospective study will therefore, never go beyond the scope of speculation. The following results were obtained by a prospective study on the development of early cancer to advanced cancer by observing those cancer patients for over 6 months who refused or postponed operation due to complications after they were diagnosed to have an early gastric cancer by X-ray and endoscopic examination. 1. We were able to follow up 22 cases of early gastric cancer over 6 months, of which 8 cases remained in the early stage, 13 cases progressed to advanced cancers, and 1 case was unknown. 2. The time required of the early gastric cancer to develop advanced cancer was calculated on 21 cases with a known clinical course according to the method of Kaplan and Meier. In this method, a curve of survival rate was plotted by designating those remained at the early stage as survived and those developed into advanced cancer as dead, and the median value (50% midpoint) obtained was 36 months. Therefore, it is assumed that it requires 36 months for early cancer to become advanced one. 3. The following courses of macroscopic changes were confirmed in the path of shift from early gastric cancer to advanced cancer: (i) II cul (-)→Borr. I(1 case), (ii) II cul (+)→-Borr. III (4cases), (iii) II c + III→-Borr.III(5case), (iv) III + c→Borr. III (1 case), (v) IIa→Borr. II (1 case), (vi) I, II cul (-)→Borr. I (1 case)
    Download PDF (2890K)
  • TOMOAKI YAGUCHI, TOMOYOSHI NOGUCHI, KAORI HASEGAWA, YOKO MIWA, HIROAKI ...
    1979 Volume 21 Issue 9 Pages 1094-1101
    Published: September 20, 1979
    Released on J-STAGE: May 09, 2011
    JOURNAL FREE ACCESS
    In the past 10 years, 116 cases of ulcerative colitis were experienced in the Institute. Six cases among them (2.6%) were three different family pairs. These three family pairs were made up of a parent and an offspring respectively. They suffered from the disease one after the other at an interval of two to five years while living in the same house. The entire large bowel was involved in two pairs. There was no consanguineous marriage in all the paris. One of the three family Paris was examined on HLA typing, but no significant information was obtained so far. The letters of inquiries on the health of other family members were sent to all the other 107 patients, to which 65 patients (about 60%) replied. There was no additional definite familial ulcerative colitis, but four patients (6.1%) stated that some members of their families had expeienced bloody mucous stools of unknown etiology. This may suggest that the actual incidence of familial ulcerative colitis might be a little higher.
    Download PDF (4581K)
  • MASAHIRO TADA, YOSHIKAZU SUYAMA, TADAO SIMIZU, ISOO INATOMI, HIROSHI F ...
    1979 Volume 21 Issue 9 Pages 1102-1110
    Published: September 20, 1979
    Released on J-STAGE: May 09, 2011
    JOURNAL FREE ACCESS
    Although recent colonoscopy is improved with the advances in fiberoptics and insertion techniques, patients still suffer much discomfort during the examination. During the last four months, three types of colonoscope i.e. CF-TB, CF-P and CF-T (their diameters of the insertion tube are 13.7mm, 8.8mm and 16.0mm respectively) were used clinically to determine how thick a colonoscope must be in favour of patients. The results obtained were as follows; 1) Successful insertion rate to the ileocecal area with CF-TB and CF-T was 100%, whereas that with CF-P was 80%. 2) Discomfort of the patients was much more lessened with CF-P than with other two. Eighty per cent of the patients with CF-P had less discomfort than by barium enema, whereas 46% with CF-TB and 31% with CF-T. Therefore, a colonoscope is desirably designed to be more slender than CF-TB and thicker than CF-P.
    Download PDF (6646K)
  • TETSUO MORISHITA, TOSHIHIKO YASUMI, NAOMICHI MASHIZU, HITOSHI ASAKURA, ...
    1979 Volume 21 Issue 9 Pages 1111-1116_1
    Published: September 20, 1979
    Released on J-STAGE: May 09, 2011
    JOURNAL FREE ACCESS
    A 27-year-old female with staphylococcal enterocolitis following oral administration of AB-Pc was reported. She was treated with AB-Pc for watery diarrhea (2-3 stools per day) and abdominal pain, which disappeared temporally. Seven days later she was admitted because of bloody mucous diarrhea (7-S stools per day) and lower abdominal pain. The stool culture on admission was positive for Staphylococcus aureus. Endoscopic examination of the colon disclosed multiple erosions, shallow ulcers and reddened spots scattered from the sigmoid colon 30 cm far from the anus, to the mid portion of the ascending colon. The mucosa of the caecum was reddish without erosions and no abnomality was seen in the rectum. Histopathologic study of the mucosal biopsy specimens showed erosions, infiltration of small round cells, Goblet cell depletion, without crypt abscess and eosinophile infiltration. The symptoms disappeared on the 4th hospital day and stool cultures became negative after the fluid replacement therapy, PSL enema and administration of NA. The barium enema taken on the 12th hospital day revealed no abnomal findings in the colon. The roles of the pathological changes seen in the acute stage of the staphylococcal enterocolitis remain unknown. Further studies into this problem are indicated.
    Download PDF (4793K)
  • YUKIFUMI SAITO, TOSHIYUKI KATO, MASAYUKI NIWA, KAZUEI OGOSHI
    1979 Volume 21 Issue 9 Pages 1119-1126_1
    Published: September 20, 1979
    Released on J-STAGE: May 09, 2011
    JOURNAL FREE ACCESS
    Since pseudomembranous colitis induced by Lincomycin or Clindamycin was reported, iatrogenic colitis induced by antibiotics not infrequently has been observed endoscopically. Three cases of antibiotic-induced colitis were observed in our hospital for these 3 years. Two cases were given Ampicillin and one was given Penicillin-G to primary diseases. Bloody diarrhea, lower abdominal pain and slight fever were common symptomes. In 3 cases, these symptomes developed on 5-15 days after administration of antibiotics. In two cases, eosinophilia was observed. Barium enema examination revealed no abnormal findings in all cases. Typical acute hemorrhagic colitis was observed in 3 cases by colonofiberscope. Scattered mucosal bleeding and irregurality of blood vessels were distinctively observed colonoscopically from the sigmoid colon to the transverse colon. Vasculature was vaguely observed in some involved area. Symptomes of three cased improved shortly after treatment with the Salazosulfapyridin medication and stopping of antibiotics. Endoscopic findings of colonic mucosa were also turned to normal within 15 days. Generally, antibiotic-induced colitis is easily treated if it is found in early stage, therefore early diagnosis by colonofiberscope in such cases is mandatory.
    Download PDF (2545K)
  • 1979 Volume 21 Issue 9 Pages 1127-1138
    Published: September 20, 1979
    Released on J-STAGE: May 09, 2011
    JOURNAL FREE ACCESS
    Download PDF (1905K)
  • 1979 Volume 21 Issue 9 Pages 1139-1153
    Published: September 20, 1979
    Released on J-STAGE: May 09, 2011
    JOURNAL FREE ACCESS
    Download PDF (2778K)
  • 1979 Volume 21 Issue 9 Pages 1155
    Published: 1979
    Released on J-STAGE: May 09, 2011
    JOURNAL FREE ACCESS
    Download PDF (96K)
feedback
Top