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Volume 24, Issue 11
Displaying 1-19 of 19 articles from this issue
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Hiroyuki SASAKI1982 Volume 24 Issue 11 Pages 1663-1673
Published: November 20, 1982
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSTo clarify the binding of sucralfate in gastric ulcer and gastritis, the author observed endoscopical and histochemical distribution of sucralf ate using gastroscopy or biopsy specimen and assayed sucrose sulfate ester and aluminum in biopsy specimen obtained from ulcer or nonulcer areas in 47 patients with peptic ulcer and in gastric mucosa associated with gastritis obtained from nonulcer areas in 10 patients who were operated on for recurred or unhealed ulcer. With regard to gastric ulcer, sucralfate was selectively found in the lesions (Table 1. 2, Figure 1-1, Figure 2-B), and sucrose sulfate ester and aluminum were detected in the lesions (Table 4, Figure 3). In chronic gastritis, there were no correlation between histological changes and the binding of sucralfate (Figure 6), though in gastric superficial imflammatory reactions a significant correlation could be demonstrated between sucrose sulfate ester and adhesive mucus or congetion (Figure 7).View full abstractDownload PDF (4326K) -
Masahiro IGARASHI, Hideo ATARI, Muneyasu TAKEMIYA, Atsushi KIYOHASHI, ...1982 Volume 24 Issue 11 Pages 1674-1683_1
Published: November 20, 1982
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSIn our hospital, colonoscopic polypectomy was done 130 times in 103 patients (176lesions) since 1975. There are neither death nor operation cases resulted from the polypectomy in our series. In 18 cases, patient developed abdominal pain, bleeding, fever and so on after the polypectomy. In order to elucidate the causable factors of these complications, the 18 cases were analized. The following results were obtained.1) The frequency of complication was 13.8% of all polypectomy, and treatment was needed in 10 cases (7.7%).2) Abdominal pain was complained in 12 cases, four of which were accompanied by fever, 2 of urinary tenesmus and one of rebound tenderness.3) In the polypectomy of the sessile polyps, complication rate was significantly higher than in that of the other types of polyps.4) In the multiple polypectomy, frequency of complication was twice as many as in the single polypectomy. But in the multiple polypectomy, there was no relationship between the number of the polypectomized lesions and occurrence of complication.5) In the submucosal tumor and polypoid carcinoma, rather many complications were observed.6) Histologically, deep damage extended to the muscle layer was demonstrated in the polypectomized site.7) Significant changes of the laboratory examinations (WBC, ESR and CRP) was found in the cases with complications resulted from the polypectomy. We concluded that although there were no severe complications, the factors above mentioned might be important and valuable when actively performed the colonoscopic polypectomy.View full abstractDownload PDF (11163K) -
Masahiro TANAKA, Masahiko HORIGUCHI, Sadao NAGASAWA, Hideaki SAKAI, Ke ...1982 Volume 24 Issue 11 Pages 1684-1693
Published: November 20, 1982
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSEndoscopic examination of the stomach and duodenum was carried out in 4 cases (25 y. o. male, 20 y. o. female, 27 y. o. male & 22 y. o. female) consecutive of Crohn's disease which had already involved the small and/or large intestine. The characteristic endoscopic features are summarized as 1) patchy erythema (multi ple focal erythematous spots, about 3-4 mm in diameter), 2) aphthoid erosion, 3) elevated lesion with central depression, 4) solitary verrucous lesion and 5) radial linear erosion. In 12 of 48 biopsy specimens obtained directly from these lesions, sarcoid granulomas were histologically confirmed (25%). The histological detection rate of sarcoid granuloma in each lesion was 75% in patchy erythema, 50% in aphthoid erosion, 27% in elevated lesion with central depression and 20% in verrucous lesion and null in radial linear erosion, respectively. These lesions were all located in the antral area and considered as early gastric manifestation of the gastric involvement of Crohn's disease without producing any upper GI symptom clinically. These results suggest that the 4 gastric lesions except for the last one would be directly caused by the gastric involvement of Crohn's disease.Endoscopic detection and follow up of the “early” gastric lesion would be extremely significant for morphological understanding of the developmental process of the disease.View full abstractDownload PDF (11226K) -
Yasuyuki YAZAKI, Chihiro SEKIYA, Atsushi TAKAHASHI, Yoshiharu TOMINAGA ...1982 Volume 24 Issue 11 Pages 1695-1707
Published: November 20, 1982
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSFindings of endoscopic retrograde cholangiopancreatography (ERCP) in 12 patients with relatively early stage of primary biliary cirrhosis (PBC) were evaluated. Endoscopic retrograde pancreatogram (ERP) were normal in all patients . Cholelithiasis was found in only one patient. In six cases in which intrahepatic bile ducts were opacif ied up to the forth branches (the first branch means right and left hepatic bile ducts), endoscopic retrograde cholangiogram (ERC) showed no characteristic findings as PBC in all cases. In the other six cases in which intrahepatic bile ducts were sufficiently opacified up to more distal branches than those of the fifth, periductal oozing of urografin from the intrahepatic bile ducts were observed in all cases, and dotted line appearance of the intrahepatic bile ducts were seen in three cases. Histologic examination of liver biopsy specimen in these 12 patients revealed diffuse destruction of interlobular bile ducts (40-80μ in diameter) including typical chronic non-suppurative destructive cholangitis (CNSDC), and the bigger bile ducts (200μ250μ in diameter) were also injured . Periductal oozing of contrast medium around the intrahepatic bile ducts might occur from such destructed portion of relatively bigger branches of intrahepatic bile ducts . A dotted line appearance of intrahepatic bile ducts seemed to suggest opacification of segmentally injured intrahepatic bile ducts . These two abnormal ERC findings were not observed in the 32 patients of control group whose intrahepatic bile ducts were opacif ied up to more distal branches than those of the fifth.View full abstractDownload PDF (17398K) -
Yukio EMA, Shigekazu HAYASHI, Kazuo ICHIKAWA, Eiji KOBAYASHI, Mitumasa ...1982 Volume 24 Issue 11 Pages 1708-1713
Published: November 20, 1982
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSThe use of endoscopic retrograde pancreatography (ERP) has been usually avoided in acute stage of pancreatitis (pancreatic trauma). However, for the past year we have applied ERP to five patients who were suspected to have pancreatic damage due to abdominal injury. The results reported herein have been very favorable . Case 1 caused by a car accident (hit against the steering wheel). ERP showed a lesion in the main pancreatic duct. The main pancreatic duct was cut off in the body of the pancreas (Figure 1). Cane 2 shows the damage received by a motorcycle collision. ERP showed the main pancreatic duct to be normal . However, the fact that residual contrast medium was detected in the subtunica suggested that the pancreas itself was damaged. Case 3 caused by a car accident (hit against the steering wheel). ERP showed the contrast medium leaked into the abdominal cavity, revealing that the pancreas in this area had been severely twisted and crushed. Fig 4 showed ERP obtained one month after operation. The main pancreatic duct remained in the head of the pancreas. Case 4 shows an injury incurred during a fight. ERP showed the contrast medium leaked from the branch to the uncus. Case 5 caused by a car accident (run over). ERP showed the contrast medium leaked in the abdominal cavity or the pancreas itself. In all the five cases the severity of damage to the main pancreatic duct and to the pancreas itself, etc. were clearly demonstrated. Not only was ERP found extremely useful in making a decision on the operative methods, but also no special complication occurred. It is concluded that more urgent endoscopic retrograde pancreatography should be more positively performed as a method for diagnosing pancreatic damages.View full abstractDownload PDF (5367K) -
Makoto ITO, Masami INUKAI, Kohei KATSUMI, Yoshifumi YOKOYAMA, Naoji YA ...1982 Volume 24 Issue 11 Pages 1714-1720_1
Published: November 20, 1982
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSHemostatic effect of topically applied thrombin on upper gastrointestinal hemorrhage was evaluated by the combined method of endoscopic spray and oral administration. As a preliminary examination, we endoscopically sprayed bleeding site after gastric biopsy with 10 ml of phosphate buffer solution containing 10, 000 units of thrombin. Bleeding time was significantly reduced by spray of thrombin (58.0±31.5 sec) as compared with phosphate buffer only (138.0±47.5 sec) (P<0.005). Based on these results, thrombin spray technique was applied to eighteen upper gastrointestinal hemorrhagic cases in which obvious bleeding was observed by emergency endoscopic examination. These included thirteen cases of gastric ulcer, two cases of duodenal ulcer, a case of stomal ulcer, esophageal varices and Mallory-Weiss syndrome. Methods were as follows : On the first and second day, endoscopic spray of thrombin was performed as above, followed by oral administration of 20, 000 units of thrombin diluted with phosphate buffer every eight hours, twice a day. On the third day, similar amount of thrombin was given orally every eight hours, thrice a day. Hemostatic effect was determined endoscopically on the fourth day. As a result, hemostatic effect was obtained in 15 of 18 cases (83.3%), which included 13 cases of permanent hemostasis (72.2%) and 2 cases of temporary hemostasis. No effect was observed in 3 cases. In conclusion from our study, it seemed that this method using thrombin was effective on hemostasis in upper gastrointestinal hemorrhagic cases.View full abstractDownload PDF (4043K) -
Takashi KITAGAWA, Shinzi SATO, Yoshimi SIBATA, Hideki HAYASHI, Kazumic ...1982 Volume 24 Issue 11 Pages 1721-1726_1
Published: November 20, 1982
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA case of gastric leiomyoma with a peculiar appearance extending to the esophagus is presented. A 36-year-old man visited our department for a detailed examination because an abnormality in the lower esophagus had been found on UG1 series taken elsewhere. The chief complaint was a pharyngeal discomfort. Roentgenography and endoscopy done at our department revealed a polypoid, smooth-surfaced, protruding lesion associated with a bridging fold in the lower esophagus, and a large protuberant lesion undulating over the whole area with a bridging fold in the area immediately below the esophagocardiac junction. The tumor in the lower esophagus invaded the stomach, assuming a cord-like shape. The patient was diagnosed to have a huge submucosal tumor extending from the esophagus to the stomach. Operation was performed for a strong suspicion of sarcoma, based on the size and shape. The resected specimen revealed a huge tumorous mass with an undulating surface which extended from the lower esophagus distal to the esophagocardiac junction, with a part of the mass protruding into the serosal side. Histologically, a diagnosis of leiomyoma was established. It is thought that this tumor originated from the cardiac area, because this tumor lost the tunica muscularis propria most markedly in the cardiac area with the tumorous tissue extending into the subserosal tissue.View full abstractDownload PDF (10387K) -
Kazuichi OKAZAKI, Nobuyuki BAN, Akio IGARASHI, Fuminori MORIYASU, Tomi ...1982 Volume 24 Issue 11 Pages 1729-1735_1
Published: November 20, 1982
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSThe patient is a 39-year-old woman who had recurrent cholangitis. An anomalouspancreatico-biliary ductal union was observed under cine-ERCP. It showed that there was an abnormal crossing union communicated with several small branching ducts between common bile duct and pancreatic duct derived from dorsal pancreas. A pancreatic duct derived from ventral pancreas was not found. This abnormality seemed to be the cause of recurrent cholangitis and so cholecystectomy and hepatic ducto-jejunostomy were performed. There were high amylase (19, 200 Somogi Unit) and E. coli in the bile juice.The present case is named "abnormal crossing type" in the Tenri's classification of anomalous pancreatico-biliary unions.View full abstractDownload PDF (10615K) -
Hirofumi KOYOSHI, Tadashi SHIBUE, Atsumasa YAMAGUCHI, Susumu MIYATA, S ...1982 Volume 24 Issue 11 Pages 1736-1742_1
Published: November 20, 1982
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA case of the esophageal cancer with striking invasion to the pancreas is reported. The patient was a 54 years old man complained of epigastralgia. The barium meal examination of the stomach showing a compression in the lesser curvature of the upper body suggested the pancreatic cancer. By ERCP, the main pancreatic duct of the body revealed remarkable irregularity 5.5 cm in length, and slight dilatation was seen in the caudal portion. From these findings of ERCP, pancreatic cancer was suspected. After admission to our hospital, close investi gation of the upper alimentary tract was performed. In the lower portion of the esophagus, a small protruded lesion containing a central ulcer was shown unexpectedly. The endo scopic biopsy specimens revealed well differentiated squamous cell carcinoma. By laparotomy, thickened and hard portion of the lower esophagus was palpated. One mass, like a hard ball consisted of the thickened lower esophagus, lymph nodes (1, 3, 7, 8, 9, 11, 12) and pancreatic body and tail was observed. The mass was not able to be extirpated. The metastatic carcinoma of the pancreas is not so rare, however, a case as reported in this paper is very rare.View full abstractDownload PDF (9904K) -
Kathuhisa SATO, Shigeru ASAKI, Kenichi HAZAMA, Yukihisa MASUDA, Kei OT ...1982 Volume 24 Issue 11 Pages 1745-1749_1
Published: November 20, 1982
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 77-year-old female was admitted to our hospital complaining of upper abdominal discomfort. Marked dilatation of the common bile duct was seen by ultrasonography and computed tomography. At endoscopic retrograde cholangiopancratic examination, hemobilia was found and ERCP showed a filling defect at the distal portion of the common bile duct. Cytological examination of bile juice was positive for malignant cells. At operation, the tumor of the distal common bile duct was completely removed and easily separated frome the pancreas. Neither metastasis nor direct invasion to the lymphnodes, liver and pancreas was found. Histological findings showed well differentiated papillary adenocarcinoma localized within the bile duct wall. The importance of hemobilia shoul be emphasized on the diagnosis of choledochal cancer.View full abstractDownload PDF (8156K) -
Kenichiro FUJII, Tadahiko FUCHIGAMI, Hirotaka IMAMURA, Hideaki OHGUSHI ...1982 Volume 24 Issue 11 Pages 1750-1754_1
Published: November 20, 1982
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA patient, 62 years old female, had two episodes of massive gastrointestinal bleeding. Upper gastrointestinal series, small intestinal X-ray examination, barium enema and gastroduodenoscopy revealed no responsible lesion. Superior mesenteric arteriography showed an arteriovenous malformation supplied by a branch of the right colic artery. The dilated and tortuous abnormal vessels were observed in the distal portion of the ascending colon by colonoscope. About 20 cm length of the involved colon was resected. The diagnosis of arteriovenous malformation was confirmed by histological examination of the resected specimen. Fifteen cases with arteriovenous malformation of the gastrointestinal tract were reported in Japan. This is the first case reported in Japan that the lesion was observed by colonoscope preoperatively.View full abstractDownload PDF (5962K) -
Tetsuo TAKAYAMA, Yoshiyuki SUGIMOTO, Yutaka OGAWA, Yasuo KOYAMA, Hiros ...1982 Volume 24 Issue 11 Pages 1755-1760_1
Published: November 20, 1982
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSCystic lymphangioma seldom involves the large bowel. Thirteen cases, including our case, are all that have ever been reported in Japan. This report presented a case of lymphangioma of the transverse colon in a 36-year-old woman, which was diagnosed preoperatively by the barium enema examination and the colonof iberscopic examination. She was referred to our hospital because of watery diarrhea. Barium enema examination of the colon demonstrated a sharply defined, smoothly and easily compressible filling defect of the transverse colon. Colonofiberscopic examination revealed a cystic tumor with fluctation of the transverse colon. The surface of this lesion was smooth and the color was same as that of the surrounding mucosa. The bridging folds were clear. Endoscopic biopsy of this tumor showed the normal colonic mucosa. After the biopsy, exuded a clear fluid from the tumor and the tumor schrank. This tumor was believed to be a cyst. The tumor was removed by segmental resection of the transverse colon. The resected tumor was pale yellow, soft, smoothly defined and measuring 2×2×1.5 cm. Histopathologically the tumor was covered with normal colonic mucosa and the dilated lymphatic spaces were separated by fibrous connected tissue septa. These findings were typical of lymphangioma.View full abstractDownload PDF (5807K) -
[in Japanese]1982 Volume 24 Issue 11 Pages 1766-1775
Published: November 20, 1982
Released on J-STAGE: May 09, 2011
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[in Japanese]1982 Volume 24 Issue 11 Pages 1776-1778
Published: November 20, 1982
Released on J-STAGE: May 09, 2011
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[in Japanese]1982 Volume 24 Issue 11 Pages 1779-1780
Published: November 20, 1982
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSDownload PDF (280K) -
1982 Volume 24 Issue 11 Pages 1781-1799
Published: November 20, 1982
Released on J-STAGE: May 09, 2011
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1982 Volume 24 Issue 11 Pages 1800-1822
Published: November 20, 1982
Released on J-STAGE: May 09, 2011
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1982 Volume 24 Issue 11 Pages 1823-1836
Published: November 20, 1982
Released on J-STAGE: May 09, 2011
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1982 Volume 24 Issue 11 Pages 1836-1847
Published: November 20, 1982
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSDownload PDF (1421K)
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