GASTROENTEROLOGICAL ENDOSCOPY
Online ISSN : 1884-5738
Print ISSN : 0387-1207
ISSN-L : 0387-1207
Volume 25, Issue 12
Displaying 1-19 of 19 articles from this issue
  • Yuji NAGATOMI
    1983 Volume 25 Issue 12 Pages 1901-1911
    Published: December 20, 1983
    Released on J-STAGE: May 09, 2011
    JOURNAL FREE ACCESS
    Polypous bud is an important key to clarify the appearance and the growth of hyperplastic polyp of the stomach. Investigations concerning characteristics of polypous bud and its growth were performed endoscopically and histopathologically with a follow-up study. The following results were obtained. 1) Polypous bud is defined as slight mucosal elevation with red tone with 3 mm in size. And it is thought to be the earliest stage of the hyperplastic polyp detected endo-scopically in the process of polypous growth. 2) Histological finding of polypous bud is different from that of hyperplastic polyp. And that of polypous bud is presumed to progress to typical one of hyperplastic polyp as polypous bud grows up. 3) Fifty-two lesions of polypous bud were followed up more than 6 months. It was observed that 10 lesions enlarged in the size. In these lesions gastric antrum was the favorite site of occurrence. As growth pattern of those lesions, there are speedy and gradual tvpes and the latter type was observed more commonly. 4) Some hyperplastic polyps grow up definitely from polypous bud. 5) Preceded mucosal change of the stomach was not detected endoscopically, but it was presumed to take less than 10 months till appearance of polypous bud.
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  • Kang-yi WANG, Hitoshi SHIRAHASE, Takashi MATSUNAGA, Wonjoe YOON, Masah ...
    1983 Volume 25 Issue 12 Pages 1913-1919
    Published: December 20, 1983
    Released on J-STAGE: May 09, 2011
    JOURNAL FREE ACCESS
    By means of a hydrogen gas clearance method using contact electrode, rectal mucosal blood flow was determined at different stages of ulcerative colitis (13 cases, 34 times) and normal controls (17 cases) with good reproducibility. In active stage of ulcerative colitis, with no referance to steroid treatment, rectal mucosal blood flow was significantly (p<0.001) increased (68.0±19.6 ml/min/100 g ; mean±S. D. ; n=19) compared with remission stage (43.1±11.9 ; n=15) and control group (43.6±8.3 ; n=17 ), and the blood flow correlated well with the clinical disease activity. In proctitis type ulcerative colitis, there is little difference in the blood flow between active and remission stage, and the blood flow is normal or reduced. In seven patients, blood flow was measured at two to six different times over the period of 4 to 18 months, and blood flow reflected the clinical state such as stool frequency well. Measurement of rectal mucosal blood flow appears to be a good method for assesing the severity and studying the pathophysiology of ulcerative colitis.
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  • Kazumasa MIKI, Ching-Ming CHANG, Masao ICHINOSE, Hirohumi NIWA, Hirosh ...
    1983 Volume 25 Issue 12 Pages 1920-1927
    Published: December 20, 1983
    Released on J-STAGE: May 09, 2011
    JOURNAL FREE ACCESS
    The relationship between the types classified endoscopically by the distribution of the glandular border at Congo red test during the panendoscopy examination, and the serum pepsinogen levels detected by the radioiinmunoassay method as previously reported (Clin. Chim. Acta 122 : 61 and 126 : 83, 1982) has been studied in 64 patients at Tokyo University Hospital. Fifty-seven patients of them received the gastric analyses on the other day. The results were obtained as follows: 1) The serum %PG I (group I pepsinogen level/group I pepsinogen level+group II pepsinogen level×100) dropped gradually from the C0 -type (closed-type by the classification of the endoscopic glandular border) to 03 -type (open-type by the same classification), and the C0 -type showed the statistically significant differences against C2 and O1-type with p<0.01, respectively, and against O2 and O3 -type with p<0.001, respectively, according to the Student's t-test. 2) The serum %PG I values are more useful than the serum group I pepsinogen (PG I) absolute levels or the examination of the gastric analyses when we want to know the degree and extent of the atrophy of the gastric mucosa. It is suggested that there is the possibility the %PG I be a tool for the so-called "serologic boipsy", which is claimed by Samloff and his collegues.
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  • Ryodo KOIZUMI, Shuichi INOUE, Hiromichi ARAKAWA, Nobuyuki Kubo, Makoto ...
    1983 Volume 25 Issue 12 Pages 1928-1934_1
    Published: December 20, 1983
    Released on J-STAGE: May 09, 2011
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    Gastric erosions associated with gastric ulcer were examined endoscopically in 125 cases with gastric ulcer. According to Walk's criteria, the gastric erosions are classified into fwo types of varioliform and punctiform. Gastric erosions were found in 42.4% of gastric ulcer patients. As the gastric ulcer improved, the punctiform of the co-existent gastric erosion improved or disappeared. Varioliform erosion associated with gastric ulcer did not improve in spite of ulcer healing. Endoscopic follow-up examination after ulcer healing over 1 year revealed that recurrence of punctiform of gastric erosion without ulcer recuurence was not seen.
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  • Hanzo KUROSAKA, Kazuhide TAKEZOE, Takeshi OOHARA, Giichi AONO, Kohji I ...
    1983 Volume 25 Issue 12 Pages 1937-1941_1
    Published: December 20, 1983
    Released on J-STAGE: May 09, 2011
    JOURNAL FREE ACCESS
    Detailed examination of minute pathological changes is necessary for the accurate evaluation during gastrofiberscopy. Various methods employing dye spray techniques have been developed but the possibility of harm to the human body caused by these methods cannot be denied and the procedares are very troublesome. It is also important to take into account the fading of human color sensitivity that is particularly noticeable as a result of continuous gazing at reddish colors. We found that results compatible with those of the dye spray techniques could be obtained by the use of suitable filters and that these were effective in mitigating the fading of color sensitivity.
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  • Masanori HIRAO, Takashi KOBAYASHI, Yoshio HASE, Yoshihiro IKEDA, Kimio ...
    1983 Volume 25 Issue 12 Pages 1942-1953
    Published: December 20, 1983
    Released on J-STAGE: May 09, 2011
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    We have developed a new method of endoscopic resection of early gastric carcinomas and other gastric lesions with malignant potential. Characteristics of the new method are summarized as follows. 1. In order to prevent bleeding after endoscopic resection of the gastric lesion, local injection of hypertonic saline epinephrine (HS-E) solution containing 3.7% sodium chloride and 0.005% epinephrine was applied to the lesion. Even a depressed lesion like IIc type early gastric carcinoma was artificially protruded by local injection of HS-E solution. 2. Instead of single f iberscope, double fiberscopes were employed simultaneously for endoscopic resection of the lesion. 3. Prior to resection of the lesion by high frequency current snare method, incision of the mucosa along the marking line around the lesion was performed, enabling the extension of the area to be resected precisely. 4. Because tissue damage is mild, resected materials with drawn are suitable for adequate pathological study. Endoscopic resection was performed for a total of 30 gastric lesions in 29 patients. Thirty lesions consisted of early gastric carcinoma (25), ATP (4) and gastric ulcer scar (1). The size range of the resected lesions was 4-25 mm (mean 13.4 mm). The time required for endoscopic resection per lesion by this method was 15-120 min (mean 51 min). Twenty-five early gastric carcinomas resected consisted of IIc (16), IIa(6), IIa+IIc (2) and I (1). Invasion of carcinoma to the submucosa or to the resected margin was demonstrated in 10 patients. Five of them underwent gastrectomy and the rest are now under follow-up observation. Despite of repeated biopsies, no evidence of residual carcinoma or recurrence has been obtained from the follow-up group. Endoscopic resection associated perforation was complicated in two cases. In no case was observed bleeding from the resected site. Endoscopic resection by our method seems to be profitable for the treatment of early gastric carcinomas in patients at high surgical risk. It should be emphasized that endo-scopic resection by this method can be applied to depressed lesions like IIc as well as protruded ones.
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  • Seiji SAITO, Takashi SHIBUYA, Shuji INATSUCHI, Hiroyuki NOJIRI, Yoshik ...
    1983 Volume 25 Issue 12 Pages 1954-1961
    Published: December 20, 1983
    Released on J-STAGE: May 09, 2011
    JOURNAL FREE ACCESS
    Endoscopic retrograde cholangiopancreatography (ERCP) is a widely popularized technique for the diagnosis of the pancreatobiliary diseases. It is a problem which should be improved that ERCP often give considerable distress to the subjects in comparison with other noninvasive diagnostic procedures such as ultrasonography and computed tomo-graphy. The purpose of this study is to clarify the degree of distress of the subjects in ERCP and to know how to minimize the distress. The inf ormations about the distress were obtained through questionnaries sent to 103 patients who underwent routine ERCP exami-nations. The results were as follows. 1: The degree of the patient's distress was increased by prolonging the examination time of ERCP. The subjects whose examination time were shorter than 15 minutes complained very little distress. 2 : The degree of distress was obviously lower in the patients examined by stretching method than those by pushing method. 3 : The majority of the cases with intravenous administration of diazepam before ERCP complained more slight distress than that by the routine upper gastrointestinal endoscopy without sedativa. 4 : A new type of thin and short duodenoscope (PJF : Olympus) could not relieve patient's distress sufficiently without administration of sedativa. In conclusion, adequate administration of sedativa, shortning of examination time, devising the technique for scope insertion and improving the structure of duodenoscope are needed to minimize the patient's distress in routine ERCP.
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  • Akinori SUGIYAMA, Mamoru SUGURO, Tatsuki IGARASHI, Tomohiro TODA, Yosh ...
    1983 Volume 25 Issue 12 Pages 1962-1967_1
    Published: December 20, 1983
    Released on J-STAGE: May 09, 2011
    JOURNAL FREE ACCESS
    In our hospital, 2 cases of primary duodenal cancer were experienced. One case was a 72-year-old man, who was pointed out to have a polyp of type IV of Yamada's classi-fication in the duodenal cap. The biopsy specimen was histologically diagnosed as adenoma. However, the patient wanted to have operation and gastrectomy was performed later. Histology of the resected specimen revealed tubular adenocarcinoma localized in the duodenal mucosal layer (m). The other case was a 54-year-old woman. She received upper GI series periodically, which showed an abnormal shadow in the duodenal bulb. Endoscopic examination and biopsy revealed a large polyp with slight atypism. The resected specimen revealed histologically early duodenal cancer (sm). Though endoscopic polypectomy is becoming popular, we had better perform opration for such a large polyp in the bulb over 2 cm in size.
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  • Hitoshi YAGISAWA, Masafumi KOMATSU, Tsuyoshi MUKOJIMA, Fumio Tobori, Y ...
    1983 Volume 25 Issue 12 Pages 1968-1974_1
    Published: December 20, 1983
    Released on J-STAGE: May 09, 2011
    JOURNAL FREE ACCESS
    A 46-year-old male was admitted to Akita University Hospital because of hematemesis and abdominal distension. He was alcoholic (total ethanol consumption was 1, 700 kg). A smooth semispherical protrusion on the lateral inferior area of left lobe of the liver with liver cirrhosis was found under laparoscopic examination. Abdominal CT study showed a protuberant lesion on the liver surface. Abdominal ultrasonography showed an echogenic mass with posterior enhancement in the liver. Tumor could not be detected by celiac angiography. Enucleation of mass and subcardial transection with splenectomy were performed. Mass was measured 10 mm in diameter and surrounded by a thin capsule. Histologic appearance revealed trabecular arrangement of Grade II tumor cells.
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  • Yoshiyuki SUGIMOTO, Tetsuo TAKAYAMA, Hiroshi SANO, Naoyuki KATADA, Yut ...
    1983 Volume 25 Issue 12 Pages 1975-1978_1
    Published: December 20, 1983
    Released on J-STAGE: May 09, 2011
    JOURNAL FREE ACCESS
    A forty-two year old woman admitted to our hospital with complaints of abdominal pain and diarrhea. Ba enema examination of the colon showed obstruction due to intus-susception with a sausage-like mass lesion in the area of the splenic flexure of the descending colon. Colonoscopic examination showed a round mass lesion in the same portion of the colon. The surface of the mass lesion was edematous with erosion and a little hemorrhage. But it was normal colonic mucosa. As the colonoscopy was inserted into the colon toward the mass lesion, we felt as if the colonoscopy was pulled out. Indeed, this phenomenon resulted from reduction of the intussusception. Surgical findings revealed that the tumor existed in the area of the hepatic flexure of the transverse colon and that the intussusception was completely reduced. Resected tumor measuring 4.0×4.0×3.5cm was soft and not pedunculated and its surface was yellowish and like fatty tissue. Histological findings showed the well-differentiated submucosal lipoma of the colon.
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  • Takeo KOSAKA, Keiichi UENO, Takurou UEMURA, Hokaichi KATAYAMA, Ichirou ...
    1983 Volume 25 Issue 12 Pages 1981-1985
    Published: December 20, 1983
    Released on J-STAGE: May 09, 2011
    JOURNAL FREE ACCESS
    A 65-year-old male with transurethral resection for a bladder tumor received anti-microbial chemotherapy such as CET i. v., DKB i, m., and PPA p. o. after operation. He developed high fever and watery diarrhea, ten times a day on the third day of operation. Clostridium difficile was isolated from his stool, and endoscopic findings showed pseudomembranes in the rectum, so he was diagnosed to have pseudomembranous colitis. Then all the anti-microbial agants were discontinued and Metronidazole was admini-strated. After a week of treatment the diarrhea and fever subsided. On the 14th day of therapy no C. difficiles could be isolated, but pseudomembranes were still seen in whole areas of the rectum, endoscopically disappeared on the 46th day of therapy. Our case suggests the discrepancy between the clinical course and endoscopic findings, and it may be important to follow up them endoscopically even after all the symptoms have subsided and laboratory Batas have normalized.
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  • Hiroshi SAKAUE, Koichi AKAMATSU, Syuji YAMAGUCHI, Koji TADA, Kozo ASAD ...
    1983 Volume 25 Issue 12 Pages 1986-1990_1
    Published: December 20, 1983
    Released on J-STAGE: May 09, 2011
    JOURNAL FREE ACCESS
    The patient is a 34 year-old male with complaints of weight loss and diarrhea. Laboratory tests revealed the following results ; numerous acanthocytes in the peripheral blood smear, serum cholesterol, 60 mg/dl (normal, 113-233), triglyceride, 8 mg/dl (normal, 66-213). Electrophoretically recognizable beta- and pre-beta-lipoprotein were absent, and the diagnosis of abetalipoproteinemia was confirmed by demonstrating the lack of Apo-B in the serum by immunoelectrophoresis. Roentgenographic examination of upper gastrointestinal tract revealed no specific findings. But endoscopically the duodenal mucosa showed a diffuse whitish discoloration beginning at the second portion of the duodenum and continued up to the end of the duodenum. Duodenal biopsy revealed the accumulation of fat droplets in the epithelial cells at the sides and tips of the villi. Electron microscopic examination revealed that no changes in microvilli, mitochondria and endoplasmic reticulum of duodenal epithelial cells. Fat malabsorption and lactose intolerance were found, but serum Vitamin A, D, E and B12 were almost normal. Abetalipoproteinemia is a very rare, recessively inherited disease. We reported one patient with abetalipoproteinemia and evaluated his gastrointestinal abnormality func-tionally and morphologically.
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  • Manabu MASUZAWA, Mitsuhiko KUBO, Michio KATO, Akira TERADA, Masafumi A ...
    1983 Volume 25 Issue 12 Pages 1991-1996_1
    Published: December 20, 1983
    Released on J-STAGE: May 09, 2011
    JOURNAL FREE ACCESS
    A panendoscope is widely used for general routine examination as well as emergency examination of the upper GI tract. The three kinds of panendoscopes are now available ; forward-viewing, oblique-viewing and forward/side view-switching types. According to the utility, many kinds of forward-viewing type panendoscopes are used widely. But any of them is not completely satisfactory, A new wide and oblique-viewing panendoscope has been recently developed. Fujinon model UGI-G proto type has the visual angle of 125° with deviation of view by 45° oblique, the bending capacity 150° up, 130° down, 100° right/left, the distal end diameter 12.0 mm, the insertion tube diameter 11.3 mm, the forceps channel size 2.8 mm and the working length 1, 110 mm. The lightguide has a goggle-eye lens on the distal end for uniform illumination within the wide view range of 125°. This protruded goggle-eye lens, coupled with a rounded-off edge of the distal end, has permitted soft and easy insertion of the scope. The capability of forceps-bending mechanism added another utility in endoscopic treat-ments. Our experiences with this UGI-G proto type has shown smooth and easy insertion from esophagus to duodenum and very good coverage of observation due to wide and oblique view with bending manipuration. Although it has a few points to be improved, such as, the tube diameter should be less than 10.0 mm, it sould have electrical safety and so on. The easy and correct treatments are available due to largesized forceps channel and forceps-bending mechanism. UGI-G proto type is a useful and effective model as panendoscope for both upper and lower GI tract.
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  • [in Japanese]
    1983 Volume 25 Issue 12 Pages 1999-2019
    Published: December 20, 1983
    Released on J-STAGE: May 09, 2011
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  • [in Japanese]
    1983 Volume 25 Issue 12 Pages 2020-2048
    Published: December 20, 1983
    Released on J-STAGE: May 09, 2011
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  • [in Japanese]
    1983 Volume 25 Issue 12 Pages 2049-2088
    Published: December 20, 1983
    Released on J-STAGE: May 09, 2011
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  • [in Japanese]
    1983 Volume 25 Issue 12 Pages 2089-2121
    Published: December 20, 1983
    Released on J-STAGE: May 09, 2011
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  • [in Japanese]
    1983 Volume 25 Issue 12 Pages 2122-2124
    Published: December 20, 1983
    Released on J-STAGE: May 09, 2011
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  • [in Japanese]
    1983 Volume 25 Issue 12 Pages 2125-2192
    Published: December 20, 1983
    Released on J-STAGE: May 09, 2011
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