GASTROENTEROLOGICAL ENDOSCOPY
Online ISSN : 1884-5738
Print ISSN : 0387-1207
ISSN-L : 0387-1207
Volume 24, Issue 2
Displaying 1-23 of 23 articles from this issue
  • JIRO MIXAMOTO
    1982 Volume 24 Issue 2 Pages 193-203
    Published: February 26, 1982
    Released on J-STAGE: May 09, 2011
    JOURNAL FREE ACCESS
    Angiographic examination has many advantages for the diagnosis of stomach cancers and at the same time can detect the nature and the metastases to the liver or to the neighboring organs. But angiographic findings are not useful in the evaluation of the blood flow in the tumor. So we measured gastric blood flow using endoscopic method with hydrogen electrode and investigated the blood flow distribution in the center, marginal wall of cancer and its surrounding normal mucosa. Results of our examination were as follows, 1) In the advanced gastric cancers, the blood flow in the marginal wall of cancers was increased when compared with that in the normal surrounding mucosa, and the flow in the marginal wall was also higher than that in the center of cancers. 2) The blood flow in the marginal wall of Borrmanns type-1 and type-2 advanced gastric cancers was slightly higher than that of Borrmann's type-3 and type-4 cancers. 3) In the advanced cancers the blood flow in well differentiated adenocarcinomas was slightly higher than that in poorly differenciated adenocarcinomas or signetring cell carcinomas. 4) In the early gastric cancers, the blood flow in the cancerous area was slightly higher than that in the surrounding norman mucosa, and this was especially manifest for type-I and type-IIa early cancers. 5) In the early gastric cancers there were no remarkable differences in the blood flow of well differenciated, poorly differenciated or signet ring cell carcinoma. 6) No particular differences weer found in the blood flow from the viewpoint of patients' age or the location of gastric cancers.
    Download PDF (1429K)
  • Chuan-Pau Siauw
    1982 Volume 24 Issue 2 Pages 204-217
    Published: February 26, 1982
    Released on J-STAGE: May 09, 2011
    JOURNAL FREE ACCESS
    Download PDF (5580K)
  • MASAHIRO TADA, YOZO IIDA, KEN TAKEUCHI, HAJIME HARADA, MARIO SATAKA, M ...
    1982 Volume 24 Issue 2 Pages 218-222_1
    Published: February 26, 1982
    Released on J-STAGE: May 09, 2011
    JOURNAL FREE ACCESS
    Regarding absorbative function of gastric intestinal metaplasia, we investigated electronmicroscopically and histochemically the morphological variation of the microvilli using biopsy specimens after giving oleic acid perorally. Electrnmicroscopic findings of the microvilli revealed variation of the microvilli. From the bottom of the gland to the top, the microvilli maturate in morphology. In immature intestinal metaplasia, immature microvilli of which the height is low and its distribution is scarce, recognized in wide portion. After peroral oleic acid load, its uptake was made clear using the biopsy specimens. Oleic acid uptake was recognised widely than in ALP positive area.
    Download PDF (4105K)
  • MASAHITO OHIDA, NOBUYUKI OKADA, TOMOE KATSUMATA, KATSUNORI SAIGENJI, H ...
    1982 Volume 24 Issue 2 Pages 225-233_1
    Published: February 26, 1982
    Released on J-STAGE: May 09, 2011
    JOURNAL FREE ACCESS
    As a purpose to determine the size of gastric ulcer endoscopically, an experimental model was designed and basic experiment was done. Rubber disk, 5mm in diameter was used as a marker. This marker disk was set in the center of a round object, 25mm in diameter, simulating an ulcer. Using endoscope, this model was photographed at various Lens-Object-Dis-tance (LOD). At first, the ratio of the object to marker disk area on the pictures enlarged in cabinetsize were calculated. An aberration ratio was less than 10% by using GTF-B100 in over 3cm of LOD and in over 5cm of LOD by GIF-P2, so that the precise area of the object disk was calculated without correcting optical distortion (Table 1, 2). However, the aberration ratio to the true ratio was more than 10% by using GTF-B100 in less than 3cm of LOD and in less than 5cm of LOD by GIF-P2. The increasement of the aberration ratio in the latter was due to more marked optical distortion of wide angle lens used for the fiberscope. Secondarily, in order to correct the optical distortion of fiberscope, a transparent board traced an endoscopic photograph of graph paper in the same LOD was employed in measurement when GTF-B100 was used in less than 3cm of LOD and when GIF-P2 in less than 5cm of LOD (Table 5). By use of the board, the aberration ratio became less than 10%. Therefore, it became possible to determine the precise area of the object disk endoscopically even in such short LOD. Accordingly, it became possible to determine the precise area of gastric ulcer by this marker disk method.
    Download PDF (3106K)
  • II: CLINICAL APPLICATION AND HEMOSTATIC EFFECT
    MASANORI HIRAO, TAKASHI KOBAYASHI, KAZUHIKO MASUDA, SHUJI YAMAGUCHI, K ...
    1982 Volume 24 Issue 2 Pages 234-243
    Published: February 26, 1982
    Released on J-STAGE: May 09, 2011
    JOURNAL FREE ACCESS
    For the purpose of arresting hemorrhage from the upper digestive tract, endoscopic local injection of hypertonic saline epinephrine (HS-E) solution has been performed at our hospital since October 1978. During emergency endoscopy, a total of 47 cases underwent local injection of HS-E solution under endoscopic procedure. Among fourty-seven cases were included gastric ulcer (28), stomal ulcer (6), duodenal ulcer (4), post-operative gpstric bleeding (4), gastric cancer (3) and Mallory-Weiss syndrome (2). Serious systemic complications were observed in approximately 60% of fourty-seven cases. Amount of blood transfusion required and the hematocrit value at time of bleeding showed a significant negative correlation, thus enabling estimation of necessary amount of blood transfusion from the hematocrit value at time of bleeding. Types of bleeding were classified as frterial, oozing and blood coagula forming. According to our criteria for the assessment of hemostatic effect, permanent and temporary arrest of hemorrhage were demonstrated in 85.1% and 10.6%, respectively. No apparent hemostatic effect was seen in only 4.3%. In order to prevent re-bleeding after initial arrest of hemorrhage in emergency, we have been employing prophylactic local injection of HS-E solution, which has hitherto been quite helpful. From the standpoint of simple maneuver and reasonable cost, endoscopic local injection of HS-E solution for arresting hemorrhage from the upper digestive tract seems to be an effective therapeutic method.
    Download PDF (3818K)
  • HIROFUMI FUKE, TOSHIO AKIYAMA
    1982 Volume 24 Issue 2 Pages 245-250
    Published: February 26, 1982
    Released on J-STAGE: May 09, 2011
    JOURNAL FREE ACCESS
    The surface of the gastric mucosa is lined with mucous foveolar epithelial cells, forming the mucous barrier against gastric juice digestion. When intestinal metaplasia (I. M.) appears in the gastric mucosa, foveolar epithelial cells disappear. This study was made to observe whether or not the site of I. M. in the gastric mucosa is subject to ulcer. Specimens were obtained from around ulcers by endoscopic biopsy and were examined for comparison. As a result, I. M. was found more significant in the distal portion of the ulcer than in the proximal portion; in the edge than in the anterior or posterior portion 2 cm distant from the edge; and in the scarring stage than in the active stage; in the recurrent ulcer than in the initial ulcer in patients of the same average age. On the other hand, resected specimens of gastric ulcers were examined by the Tes-tape method, which is used to observe appearance of sucrase, to recognize the sites of I. M. Then, the relationship between the ulcer and I. M, was studied As a result, it proved that I. M. in the gastric ulcer developed from the antrum as I. M. in the stomach without ulcer developed and that ulcer was found in the proximal edge of I. M.. From these observations it was indicated that I. M. was not subject to ulcer and that ulcer enhanced the development of I. M..
    Download PDF (2054K)
  • KAZUHIDE YAMAMOTO, SATOSHI ISHIKAWA, HIDEHARU SAKODA, KOICHI OMURA, TA ...
    1982 Volume 24 Issue 2 Pages 251-257
    Published: February 26, 1982
    Released on J-STAGE: May 09, 2011
    JOURNAL FREE ACCESS
    Microvasculature of normal human and rat liver surface was studied by scanning electron microscopy of liver vascular casts and by a dye injection method. On the human liver surface, branched portal veins, 0.5-3mm in length, were regularly arranged at a constant interval, 1-2mm. Between the branched vessels, sinusoids showed centripetal arrangement forming a complex network. Lobular marking was formed with these branched portal veins and sinusoids. Central veins were not observed on the liver surface and were situated just under the surface. On the rat liver surface, portal veins were not observed, however, central veins, Y-shaped or straight vessels, were observed in the center of the lobule. It appears that rat liver surface microvasculature is much different from that of the human liver.
    Download PDF (7123K)
  • TERUO KOUZU, KATSUYA KUGA, TOSHINOBU TAKAHASHI, TETSUSHI TANIGUCHI, YU ...
    1982 Volume 24 Issue 2 Pages 258-264_1
    Published: February 26, 1982
    Released on J-STAGE: May 09, 2011
    JOURNAL FREE ACCESS
    A fundamental study on the application of YAG laser to the treatment of esophageal diseases was carried out using a dog, there was an obvious difference between the change of the esophaeal wall and the change of the gastric wall following laser irradiation: While the degeneration appeared first in mucosal side of the gastric wall, the degeneration appeared first in muscularis propria layer, then did in mucosal layer and in submucosal layer in esophageal wall. In esophageal wall, the irradiation with the energy which was small enough not to cause any change in mucosal layer when being irradiated in 90 degree angle, could cause the degeneration in mucosal side when being irradiated in smaller angle. The depth of the change of the wall immediately after the irradiation was estimated based on the endoscopic findings such as white elevation, white concavity of the surface and carbonized ulcer as the standard mark. It seems to be reasonable to consider that white concavity indicates the irreversible degeneration deep into the part of submucosal layer and that carbonized ulcer indicates the irreversible degeneration to proper muscle layer. The degree of the degeneration was severer when cancer in situ of human esophagus was irradiated after the sprinkling of 1 % Toluidine Blue than when irradiated without it. In both cases, the cancer lesion could be completely degenerated by the laser irradiation with the energy of 64W. The paper also reported on two cases of polyp in esophagogastric junction successfully treated with laser irradiation.
    Download PDF (6121K)
  • KENICHI IDO, HIDEAKI SAKAI, MASAHIKO HORIGUCHI, KEN KIMURA, NORIO HIRO ...
    1982 Volume 24 Issue 2 Pages 265-268_1
    Published: February 26, 1982
    Released on J-STAGE: May 09, 2011
    JOURNAL FREE ACCESS
    An argon laster light (Power: 300mW, Wavelength: 488nm) induced an autofluorescence in the human and rat hepatocellular carcinomas, when observed with a filter which transmitted the light of wavelength over 520nm. In human hepatocellular carcinoma, an autofluorescence was observed heterogeneously, strongly in some parts and compelely not in other parts of the liver with carcinoma. When observed with the day light, the former was identified as the part of hepatocellular carcinoma, whitely yellowish in color, and the latter as a necrotized part, dark black in color. In rat hepatocellular carcinoma, on the other hand, a yellowish autofluorescence was observed almost homogeneously on argon laser light irradiation. When observed by the day light, the part of hepatocellular carcinoma was hemogeneously white in color. The findings were samely observed both on the liver surface covered with paritoneal capsule and the cut surface of the cross section. The autofluorescence phenomenon induced by an argon laser light would be an useful supplemental method for the laparoscopic diagnosis of the hepatocellular carcinoma.
    Download PDF (4270K)
  • KAZUHIKO IWAKOSHI, HIROYUKI OKA, KATSUO YAMAMOTO, SHIZUO MIZUTA, SHUJI ...
    1982 Volume 24 Issue 2 Pages 269-275_1
    Published: February 26, 1982
    Released on J-STAGE: May 09, 2011
    JOURNAL FREE ACCESS
    The purpose of this study is to report the clinical experiences of newly-devised two types of colonofiberscope (CF-6a and CF-6b). These fiberscopes were designed to lessen discomfort of the patient during examination. The common characters of both fiberscopes were as follows; Outer diameter was 6.1mm, and metallic olive-shaped hood was attached to the tip of the fiberscope. Biopsy equipment was not connected. The difference of both fiberscopes was width of the angle movable at the tip, that is, 60° and 120° in CF-6a and CF-6b, respectively. Twenty-five and twenty-one cases were examined with CF-6a and CF-6b, respectively. Quality of both fiberscopes was compared from the following standpoint; form of the loop made in the sigmoid colon, portion inserted, average time of examination, and degree of discomfort of the patient during the examination. Following results were obtained. 1) Satisfactory results were obtained by both equipments concerning the discomfort of the patient during the examination. 2) Insertion into more distal portion was possible by examination with CF-6b than that with CF-6a though insertion ratio into the cecum was both quite low. Therefore, further improvement of equipment and combined use of sliding tube were desired.
    Download PDF (5319K)
  • HIROMICHI FUKUSHIMA, MASANORI SODA, SHOJI HONDA, KENICHI MATSUNAGA, FU ...
    1982 Volume 24 Issue 2 Pages 276-281_1
    Published: February 26, 1982
    Released on J-STAGE: May 09, 2011
    JOURNAL FREE ACCESS
    A 45-year-old man was admitted to Nagasaki University Hospital with a chief complaint of dysphagia. He had a history of many alcohol consumption and recurrent epigastric pain due to previous chronic pancreatitis. On admission, the tenderness was found in epigastrium, and laboratory data showed hyperamylasuria. Upper G-I series revealed distal esophageal compression by a mediastinal mass. Also, in CT scan, water density fluid collection surrounded by enhanced wall which compressed heart and esophagus was found in posteriour mediastinum. At inferior level, the fluid collection connected with the cyst of pancreatic body was noted. Longitudinal ultrasonogram (US) at the midline exhibited the pseudocyst was extending into the posteior mediastinum through the aortic hiatus. The findings obtained from CT scan and US made a diagnosis of the pancreatic pseudocyst with mediastinal extension confirm eventually. By the reason discribed above, US and CT scan are valuable to make a diagnosis of pancreatic pseudocyst and to confirm the extended direction. Extension into the mediastinum by a pancreatic pseudocyst is a relatively rare manifestation and so far only 26 cases were reported in the literature.
    Download PDF (6790K)
  • YUICHI FUYUHIRO, MICHIO SOWA, YASUYUKI KATO, EIJI TARUYA, TERUO KITAMU ...
    1982 Volume 24 Issue 2 Pages 282-290_1
    Published: February 26, 1982
    Released on J-STAGE: May 09, 2011
    JOURNAL FREE ACCESS
    The patient was fifty-six years old man, and three years before he had undergone BillrothIl subtotal gastrectomy for early gastric carcinoma in IIa+IIc type at the antrum of the stomach. Roentgenograms and endoscopic findings revealed the picture of a. protruded early gastric carcinoma at the fundus of the remnant stomach. Pathological examination revealed a poorly differentiated adenocarcinoma located within the mucosa. No metastatic lymphnode was found. The postoperative course was uneventful and the patient is alive and well one year after this total gastrectomy. This paper describes a case of early carcinoma of the gastric remnant diagnosed by endoscopic examination and reviews the late evidence of early gastric carcinoma following the partial gastrectomy for benign and malignant disease. From these findings we would like to emphasize that earlier diagnosis should be made by wareness of possibility of such lesion in patients having undergone gastric surgery and the performance of endoscopic studies with target biopsies.
    Download PDF (7678K)
  • YASUAKI HARAGUCHI, TAKASUKE YOSHIDA, HIROAKI KATSUYA, TAKASHI KOGA
    1982 Volume 24 Issue 2 Pages 293-299_1
    Published: February 26, 1982
    Released on J-STAGE: May 09, 2011
    JOURNAL FREE ACCESS
    A case synchronously documented quadruplicate carcinomas, well differentiated squamous cell carcinoma and small cell carcinoma in the lung, adeno-squamous cell carcnoma in the esonhgus and well diffrentiated adenocarcinoma in the stomach, is reported. Occupation, smoking habit and alcohol consumption seems to play an important role as a carcinogenesis in this case. Increases of the frequency occurrng either synchronously or metachronously, as a second or a third independent carcinoma may become a serious problem in the near future, since the ratio of aged people has been increased in recent years.
    Download PDF (6477K)
  • HIROHUMI NIWA, MASAO ICHINOSE, HIDEO NAKARAI, YOJI HIRAYAMA
    1982 Volume 24 Issue 2 Pages 300-308_1
    Published: February 26, 1982
    Released on J-STAGE: May 09, 2011
    JOURNAL FREE ACCESS
    The authors experienced a case of so-called double pylorus. The patient is a 41-year-old male. He has been followed up endoscopically for these two years. During the followup period, ulcers were recognized on the both sides of the fistula, that is, in the stomach and in the duodenum. Apart from the significance of ulcers as the pathogenesis of double pylorus, the authors think that ulcers appear more often in the region near the fistula. So-called U-turn technique with a small-caliber panendoscope in the duodenal cap is very useful to confirm the presence of fistula and to make a diagnosis of double pylorus. Ninety-three cases of double pylorus including this case are reported up to the present. On the literatures, the authors investigated the feature of this disorder in some aspects.
    Download PDF (6358K)
  • KOZO ASADA, MORIKAZU ONJI, YOSHIMASA YAMASHITA, SHINICH OKADA, MICHIHI ...
    1982 Volume 24 Issue 2 Pages 309-315
    Published: February 26, 1982
    Released on J-STAGE: May 09, 2011
    JOURNAL FREE ACCESS
    The patient is a 28-year-old man in whom an ectopic liver was observed at the upper and internal surface of the gallbladder under peritoneoscopic examination. A bile duct cyst was found in a liver biopsy specimen of the main liver. The total number of ectopic livers reported in Japan was twenty, all of which were observed during an operation or an autopsy by chance. The present case is the first observed by peritoneoscopy.
    Download PDF (2661K)
  • AKIMICHI IMAMURA, TAKASHI BETSUYAKU, JUN IBAYASHI, KUNITSUGU ISHIKAWA
    1982 Volume 24 Issue 2 Pages 316-322_1
    Published: February 26, 1982
    Released on J-STAGE: May 09, 2011
    JOURNAL FREE ACCESS
    Only 20 cases of colonic carcinoma with tuberculosis have been reported so far in Japan. A case of carcinoma of the ascending colon and cecum associated with old bowel tuberculosis was described. A 74-year-old female was addmitted to our hospital on Oct. 30, 1978, complaining of the ileocecal mass with pain. Chest X-P showed a calcification in the right upper lobe of the lung. Culture of the feces and biopsy specimen were negative for T. B., Barium enema and endoscopy including biopsy demonstrated malignant villous tumor of the ascending colon and cecum. The lesion of the operated specimen, measuring 10.5×7.8cm, macroscopically showed the villous surface. Histological findings disclosed a well differentiated adenocarcinoma, showing a villous and tubulo-villous feature in the surface. Moreover, several granulomas close to the carcinoma in the colonic wall, consisting of Langhans' giant cells, epitheloid cells and lymphocytes, were seen. And the same glanulomas with central caseation in the lymph nodes were also seen. Therefore, this case was regarded as an association with colonic carcinoma and old tuberculosis.
    Download PDF (7227K)
  • TSUTOMU HACHIYA, TOMOO KOMIBUCHI, TAKU HIGUCHI, NAOMI TOMONO, TAKAYUKI ...
    1982 Volume 24 Issue 2 Pages 325-329_1
    Published: February 26, 1982
    Released on J-STAGE: May 09, 2011
    JOURNAL FREE ACCESS
    A 27-year-old female who was admitted with a complaint of melena discharged a lump of teratoma from the anus. By the surgical operation, ovarial teratoma penetrating into the sigmoid was confirmed, and a part of tumor was discharged from the anus. Since this patient was considered to be a rare case, this paper includes a review on similar cases reported in Japan.
    Download PDF (5280K)
  • KIYOSHI FUJITA, MASATOSHI WATANABE, TAKASHI HARIMA, YOSHIHITO UCHIDA, ...
    1982 Volume 24 Issue 2 Pages 330-335
    Published: February 26, 1982
    Released on J-STAGE: May 09, 2011
    JOURNAL FREE ACCESS
    We used a eolonoscope, type FCS-L3 (Machida) with a wider view field in 84 procedures in 71 patients during the last 5 months in our clinic. A successful insertion rate to the distal colon and insertion time were related to stiffness of the insertion tube. For lessening patients discomfort, a more slender insertion tube is better to use. FCS-L3 was designed to be slender at the tip (12.0mm) and gradually enlarged to the control unit, and the tip is soft and the control unit becomes gradually hard. This scope have a wider view (100°) field. As a result, the average insertion time to the ileocecal area was 10.6 minutes, and no patients complained of severe discomfort during the examination. It is concluded that, this scope, is very useful for colonic examination.
    Download PDF (2963K)
  • 1982 Volume 24 Issue 2 Pages 336-339
    Published: February 26, 1982
    Released on J-STAGE: May 09, 2011
    JOURNAL FREE ACCESS
    Download PDF (640K)
  • 1982 Volume 24 Issue 2 Pages 339-340
    Published: February 26, 1982
    Released on J-STAGE: May 09, 2011
    JOURNAL FREE ACCESS
    Download PDF (318K)
  • 1982 Volume 24 Issue 2 Pages 341-367
    Published: February 26, 1982
    Released on J-STAGE: May 09, 2011
    JOURNAL FREE ACCESS
    Download PDF (4634K)
  • 1982 Volume 24 Issue 2 Pages 368-374
    Published: February 26, 1982
    Released on J-STAGE: May 09, 2011
    JOURNAL FREE ACCESS
    Download PDF (904K)
  • 1982 Volume 24 Issue 2 Pages 374-379
    Published: February 26, 1982
    Released on J-STAGE: May 09, 2011
    JOURNAL FREE ACCESS
    Download PDF (881K)
feedback
Top