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Volume 23, Issue 11
Displaying 1-19 of 19 articles from this issue
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OSAMU KATO, TAKASHI SUZUKI, FUMIO TACHINO, TOMOYO YUASA, KAZUHIKO HATT ...1981 Volume 23 Issue 11 Pages 1511-1516
Published: November 20, 1981
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSOne hundred and one gastric polyps in 88 patients were removed by endoscopic polypectomy with high frequency current snare method. Prior to polypectomy, significant clinical symptoms related to polyp itself were seen in only two patients. One was mild anemia and the other was partial pyloric stenosis. After polypectomy, a slight bleeding with resultant mild anemia, was experienced in one case with leiomyoma. Histological studies of the 88 polyps recovered revealed that 83 of them were hyperplastic polyps. In the remaining five cases, lipoma, leiomyoma, atypical epithelium, focal carcinoma in atypical epithelium and atypical epithelium in hyperplastic polyp were encountered in one case, respectively. One to four years after polypectomy, endoscopic observation was performed in 25 cases. In twenty cases, no paticular findings such as scar were detected. Residual stalk was seen in three cases, and recurrence of polyp on the previously polypectomized site and new growth of polyp on other site were observed in one case, respectively. Although endoscopic polypectomy of the stomach is profitable procedure as a total biopsy in detecting occult carcinoma in benign looking elevated lesions, it is not always necessary for the majority of benign asymptomatic polyp of the stomach except for a few occasions.View full abstractDownload PDF (314K) -
YOSHIAKI ITO, HIROSHI SUGIURA, YOSHIAKI HIRAOKA, TOMOYUKI KANO, TATSUZ ...1981 Volume 23 Issue 11 Pages 1517-1529
Published: November 20, 1981
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSIt is the purpose of this presentation reporting the efficacy and safety of Nd: YAG laser (Olympus Co.) treatment of mucosal tumors of the stomach. Before applying to clinical trials, series of animal experiments were carried out. Firstly, the results indicated that the laser probe with a low beam divergent angle (5°) was applicable to endoscopical use because the working distance was not critically important in determining the depth of tissue damage. Secondly, a multiple pulse with 1 to 2 sec. with 5-sec. cooling interval was less injurious if the same total incident laser energy was applied on any one spot. In final series of experiments, a multiple pulse with 40w of power was applied to an area of canine stomach supposing the irradiation to tumor, and histological consequence was observed. Laser-induced ulcers were usually reepithelized after 2 to 3 weeks and no perforation was complicated. On the basis of these results, endoscopic laser treatment was attemped in 8 cases of borderline lesion and 10 cases of early gastric carsinoma (Type I 1 case, IIa 4 cases, IIc 5 cases) under certain conditions, resulting in complete eradication of the lesion. The effect of laser treatment was confirmed histologically in 4 cases, in which partial irradiation was performed before surgery. The clinical course of the remaining cases was uneventful and no evidence of tumor recurrence has been observed. Endoscopic laser treatment is an available method for patients with broad-based protruded lisions in which snare ectomy might be hazardous, and localized early gastric carcinomas whose surgical risk might be critical, as being weighed against the risk of regional lymphnode metastasis.View full abstractDownload PDF (1119K) -
HIDEYUKI YABE, EIJI HANAFUSA, FUMIKO KOCHI, TOYOHIKO NAKAMURA, MASATOS ...1981 Volume 23 Issue 11 Pages 1530-1535
Published: November 20, 1981
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSComparative studies on gastric secretory function and exocrine pancreatic function were made in nine healthy controls, six patients with gastric ulcer and 10 patients with duodenal ulcer by means of biochemical analysis of gastric juice and endoscopically obtained pure pancreatic juice (PPJ). Gastric juice was obtained through a Rehfuss tube at 10 minutes intervals for 60 minutes before AOC-tetra-peptide stimulation and for 60 minutes following the stimulation (4ug/kg). PPJ was obtained by endoscopic retrograde catheterization of the papilla at one minute intervals for 20 minutes after a rapid intravenous injection of secretin (Eisai, 1 U/kg) and for 10 minutes after CCK-PZ injection (Boots, 1 U/kg). Following results were obtained : patients with duodenal ulcer showed significantly raised basal acid concentration (BAC), basal acid output (BAO) and maximal acid output (MAO); patients with duodenal ulcer showed significantly raised bicarbonate concentration in the initial fraction of PPJ and raised bicarbonate output during secretin phase; a significant correlation was noted between bicarbonate concentration in the initial fraction of PPJ and BAC, BAO and MAO; a significant correlation was also noted between bicarbonate output and BAC, BAO and MAO. These results suggest that the bicarbonate secretion of the pancreas is proportionally raised in patients with duodenal ulcer to neutralize the raised gastric acid secretion. These findings were discussed in relation to the pathogenesis of duodenal ulcer.View full abstractDownload PDF (312K) -
CHIHIRO SEKIYA, YASUYUKI YAZAKI, ATSUSHI TAKAHASHI, MINORU ONO, MASAYO ...1981 Volume 23 Issue 11 Pages 1536-1542
Published: November 20, 1981
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSWe designed a disposable liver biopsy needle which is safe to obtain enough specimens at one procedure and fits an apparatus to stop bleeding. So far we used this needle in 521 cases with liver diseases under laparoscopy and could obtain satisfactory results. Handling of this needle was very easy and liver specimens were obtained enough for diagnosis at one procedure, even if an operator was bigginer. Bleeding was smaller in quantity as an outer diameter of this needle was smaller than that of VimSilverman needle for almost the same size specimen, and liver tissues were not damaged so much structurally. We usually injected 8% -sodium polymannuronate in the needle after biopsy and hemostasis was more effective. Regarding rates of success is biopsy and morbidity, this needle was superior to other needles reported previously. We thought that this disposable needle would be desirable for prevention from viral hepatitis.View full abstractDownload PDF (727K) -
YOSHIYUKI WATANABE, YUZURU KAJIWARA, GENTSU UOZUMI, KUNIHIKO KOYAMA, K ...1981 Volume 23 Issue 11 Pages 1543-1547
Published: November 20, 1981
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSRecently colorectal cancer has been increasing in Japan. Therefore, the early detection of this disease is necessary. A newly designed colonofiberscope, type CF-PM, with 8.8mm in outer diameter, was applied to 212 subjects. Before colonoscopy, all subjects were forced to evacuate the bowles with glycerin enema without laxatives and limitation of diet. The rectum and sigmoid colon were visualized clearly in all subjects and even all parts of the descending colon were observed in 80 percent of them. It took about 4.6 minutes to examine one case in this study. During the examination 92 percent of the subjects complained of no pain or slight pain. It is emphasized that the pain by the newly designed CF-PM was much less than by the conventional sigmoidof iberscope. Because the “left colon” where there are over 70 percent of colorectal cancer was observed surely in a short time without pain or with slight pain by CF-PM, CF-PM is very useful for the screening of colorectal cancer.View full abstractDownload PDF (375K) -
TETSUO ARAKAWA, KENZO KOBAYASHI, HAJIME NAKAMURA, SHINJI CHONO, HIROAK ...1981 Volume 23 Issue 11 Pages 1548-1551_1
Published: November 20, 1981
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSThe mucosal prostaglandin E2 (PGE2) levels in the fundus, the pyloric antrum and the margin of ulcers were determined in patients with gastric ulcer. In some intractable gastric ulcers, the mucosal PGE2 levels were extremely low. To assess the effect of PGE2 on the management of intractable gastric ulcer, PGE2 was perorally given in daily doses of 3.0 mg to 10 patients suffering from intractable ulcer, and in 6 (60%), the ulcer healed completely within 4 to 14 weeks. These results suggest that a deficiency in mucosal PGE2 plays a role to make ulcer intractable to heal. Therefore, PGE2 administration may be benefitial in such cases.View full abstractDownload PDF (302K) -
NOBUHIRO SAKAKI, YOZO IIDA, HIDEO AMANO, KEN TAKEUCHI, MASAHIRO TADA, ...1981 Volume 23 Issue 11 Pages 1552-1558_1
Published: November 20, 1981
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSMagnifying endoscopic observation of the stomach were applied for clinical diagnosis, especially for diagnosis of minute gastric lesions. The fine gastric mucosal patterns, which were complicated patterns consisting of various shapes of gastric pits, were classified into 7 types; A (characterized by dotted gastric pits), AB (mixed pattern of A and B), B (short linear pits), BC (mixed pattern of B and C), C (continuous striped grooves), CD (mixed pattern of C and D), and D (round mesh-like grooves). In addition, irregularity of type C or D might be available for differential diagnosis of gastric cancer. One hundred and sixty nine localized gastric lesions, 30 small red spots and 65 minute gastric lesions were observed clearly by magnifying endoscopy. Therefore, it was considered as a approach for endoscopic diagnosis of minute gastric cancers. In conclusion, we consider that the magnifying endoscopy is useful for the diagnosis of minute gastric cancer.View full abstractDownload PDF (745K) -
SHOGO YAMADA, TETSUTARO TAKEDA, JUN YAMAGATA, MASARU TAKAHASHI, KOICHI ...1981 Volume 23 Issue 11 Pages 1559-1565
Published: November 20, 1981
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 43 year-old man was admitted to our hospital with pain in the right hypochondrium. X-ray and endoscopic examinations of the stomach revealed IIc-like lesion on the anterior wall of the angle. On subtotal gastric resection chylous transudate from the oral edge of the resected stomach was observed, and immediately total gastric resection was performed because the smear of the chyle was diagnosed cytologically as adenocarcinoma. Histological study of the resected stomach was as follows; Early IIc-type cancer was seen on the anterior wall of the angle ; Massive cancer cell invation into lymphatic channels, that was lymphangiosis carcinomatosa type infiltration, was founed widely in the corpus; Mucosal carcinoma accompanied with Iymphangiosis carcinomatosa was observed in several part of the corpus ; And the IIc focus was separated from the lymphangiosis carcinomatosa lesion. X-ray and endoscopic views were studied retrospectively, but no abnormal findings were obtained in the corpus.View full abstractDownload PDF (544K) -
TADASHI KODAMA, KENJI TSUJI, TAKAHIRO KATOH, SHINICHIRO FUKUDA, EIJI N ...1981 Volume 23 Issue 11 Pages 1566-1570_1
Published: November 20, 1981
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSIn spite of recent advances of diagnostic abilities for various kinds of biliary system disorders, it is still difficult to diagnose a resectable small cancer of biliary system. In this paper, we presented a resected case of carcinoma of common bile duct. A 66-year-old female admitted to our hospital complaining of r-hypochondralgia. X-ray pictures of DIC and ERC revealed a dilated common bile duct showing a polypoid filling defect. Direct visualization of the polypoid lesion of the common bile duct was successfully performed using peroral cholangioscopy (PCS) and biopsy material from this lesion were taken. Histologically, biopsied specimens showed adenocarcinoma. At operation, the tumor of common bile duct was completely removed. Operative findings showed neither metastasis nor direct invasion to the regional lymph nodes, liver and pancreas. Macroscopic findings of the resected specimen revealed a firm and protruded lesion, measuring I3 ×I3 ×6mm in size. Microscopic diagnosis was adenocarcionma arising from the common bile duct.View full abstractDownload PDF (570K) -
HIDEKI TADA, OSAMU MASAMUNE, YOSHINOBU TAKEDA, KAZUHIKO IWAKOSHI, YASU ...1981 Volume 23 Issue 11 Pages 1571-1577
Published: November 20, 1981
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSThis is a case presentation of strongyloides stercoralis who developed marked malnutrition. The patient was 48-year-old male who was admitted to Osaka Medical College with chief complaints of anorexia and loss of weight. He was born in Amami-oshima island (near Okinawa) and moved to Osaka at the age of 7. He has suffered from schizophrenia since 22. He developed postprandial nausea and vomiting associated with loss of weight since one year prior to the admission. Laboratory findings on admission revealed decreased total protein and low cholesterol. 50g OGTT showed diabetic pattern associated with low response of IRI. Marked shortening of turn-over of I-RISA and slight increase of fecal fat were found. excretion. X-ray examination showed moderate dilatation of the stomach and duodenal bulb. Irregular barium spots suggesting shallow ulceration were found in the descending portion of the duodenum. X-ray film showed the more distal duodenum and proxima ljejunum were narrowed and almost absent from the normal mucosal pattern. The rest oft he small intestine including the terminal ileum was completely normal. Endoscopically, the disappearance of valvulae conniventes and atrophy of the mucosa associated with erosion were found. Biopsied specimen taken from the duodenum showed typical larvae of strongyloides stercoralis in the lamina propria. Stool examination showed also positive for strongyloides stercoralis. The patient was treated with 160mg/day of pyrvinium pamoate for 5 days, and then three times with 30mg/kg/ day of thiabendazole for 2 days. Clinical symptoms as well as x-ray and endoscopic pictures improved considerably after these treatments.View full abstractDownload PDF (562K) -
KAZUYA MAKIYAMA, KEIZO KITUKAWA, MASUHO HARAGUCHI, HIROHIDE FUKUDA, NO ...1981 Volume 23 Issue 11 Pages 1578-1584_1
Published: November 20, 1981
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA case of colonoileac Crohn's disease in a 21 years old male was experienced. This was a non-enterectomized case and the diagnosis was made by X-ray examnation, endoscopy and biopsy. In Crohn's disease, complication with rectal change is reportedly very uncommon, but minor changes such as aphthoid ulcer are often recognized and micro-granuloma is found in biopsy specimen of normal rectal mucosa. For detailed investigation of fine changes of the rectal mucosa in Crohn's disease, we closely examined the rectal mucosa of this case by usual magnifying endoscopy and by magnifying endoscopy after 0.2% methylene blue spray. The findings were reddening at the periphery of aphthoid ulcer indicating vascular proliferation and so-called worm-eaten appearance of papillae wherein several papillae and pits of epithelial tubule were destroyed. Serial sections of forceps biopsy specimen from this region revealed microgranuloma histologically and consequently discussion was made on the relation of these findings with the pathophysiology to see if they are specific to Crohn's disease.View full abstractDownload PDF (799K) -
WEIMING LI, HIROYUKI OKA, OSAMU MASAMUNE, KAZUHIKO IWAKOSHI, KATSUO YA ...1981 Volume 23 Issue 11 Pages 1585-1589_1
Published: November 20, 1981
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSOnly a few cases of villous adenoma in the colon have been reported in Japan. This is a presentation of a case with villous adenoma showing flat protuberance, with proceeded to adenocarcinoma at the central part. The patient was 79-year-old housewife who was admitted to Osaka Medical College with a chief complaint of constipation for about half year. Physical examination revealed no abnormalities except for a palpable mass in the rectum by digital examination. Barium enema showed filling defect which was clearly demarcated by surrounding tissue. Surface of the filling defect was irregular and the pooling of barium was found at the center of the defect. Endoscopically, a protuberant mass with gyrus-like appearance was observed. The center of the mass was depressed, and the surface of this area was irregular and covered with dirty coating. Biopsied specimens taken from the protuberant and depressed areas showed villous adenoma and tubular adenocarcinoma, respectively. The consecutive section of the resected mass showed villous adenoma which proceeded to adenocarcinoma at the center of this mass. Infiltration of the carcinoma cells reached to the muscle layer. In addition to our case, we discussed frequency, age, symptoms, morphology and complications of villous adenoma inthe colon described in the literature.View full abstractDownload PDF (565K) -
SEIYO IKEDA, MASAO TANAKA, HIDEO YOSHIMOTO, HIDEAKI ITOH, INSHUEN GO1981 Volume 23 Issue 11 Pages 1590-1599
Published: November 20, 1981
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA new model of therapeutic duodenoscope equipped with a large catheter channel (7 French) and an objective lens tilted 15° backwards was used for various diagnostic and therapeutic procedures such as endoscopic sphincterotomy, basket catheter extraction, emergency decompression of the obstructed common bile duct, intracholedochal indwelling of a 7 French tube for external drainage, balloon catheter cholangiography and microtransducer manometry of the pancreatic and common bile ducts in a total of 353 endoscopies in 162 patients, a considerable proportion of whom had each procedure performed repeatedly or underwent two or more different methods. The slight reverse tilt of the objective lens allowed easier selective bile duct cannulation. The large channel facilitated safe manipula tion of the fragile tip of a balloon or microtransducer catheter. It also permitted prompt aspiration of intraduodenal air and contents; this was practically of great benefit in carrying out. these rather complex procedures quickly. This model, particularly the improved type, JF-1T, was found to be suitable for multi-purpose use due to its superior functions and maneuverability.View full abstractDownload PDF (796K) -
1981 Volume 23 Issue 11 Pages 1602-1614
Published: November 20, 1981
Released on J-STAGE: May 09, 2011
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1981 Volume 23 Issue 11 Pages 1614-1629
Published: November 20, 1981
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSDownload PDF (923K) -
1981 Volume 23 Issue 11 Pages 1630-1636
Published: November 20, 1981
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSDownload PDF (434K) -
1981 Volume 23 Issue 11 Pages 1636-1642
Published: November 20, 1981
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSDownload PDF (651K) -
1981 Volume 23 Issue 11 Pages 1643-1647
Published: November 20, 1981
Released on J-STAGE: May 09, 2011
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1981 Volume 23 Issue 11 Pages 1648-1683
Published: November 20, 1981
Released on J-STAGE: May 09, 2011
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