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Volume 25, Issue 3
Displaying 1-19 of 19 articles from this issue
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Yuichi FURUTA1983 Volume 25 Issue 3 Pages 359-371
Published: March 20, 1983
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSMagnifying observations were performed on normal mucosa and 91 lesions in the stomach using Cresyl Violet Staining. Ninety-one lesions were consisted of 75 carcinomas 50 of which were in early stage, 11 benign ulcers and 5 flat adenomas. Cresyl Violet selectively stains the nuclei of the cells, i, e. a fine gastric mucosal pattern obtained is considered as visible nuclear arrangement of each mucosal cell. In pyloric gland area a foveolar-sulciolar pattern was dominant and a foveolar patter in fundic gland area. In the case of metaplastic intestinal epithelium of the stomach, not only nuclei but also cytoplasm were stained red-purple and its fine mucosal patterns were classified into four types; a pattern resembling duodenal villi (Type-V3), resembling normal gastric mucosa (Type-G) and intermediate types of each (Type-V2, V1). Fine surface structures of early gastric carcinomas were classified into four types; a ruined sulciolar pattern resembling normal gastric mucosa (Type-1), a ruined foveolar pattern resembling normal gastric mucosa (Type-2), a monotonous structure (Type-3) and other. Papillary adenocarcinoma in histological classification of early gastric carcinoma prefered a Type-1 fine surface structure. Moderately to well differentiated tubular adenocarcinoma prefered Type-2; early carcinomas of these three histological types had a correlation with fine surface structure classification. Cresyl Violet Staining is considered to be useful for 1. detection of a minute carcinoma, 2, decision of the area of IIb or IIc type mucosal spreading. Furethermore, this staining should be applied to magnifying endoscopy in the clinical diagnosis.View full abstractDownload PDF (7673K) -
Toshio OOIWA, Keizo SUGIMACHI, Hiroyuki KUWANO, Akinori IWASHITA1983 Volume 25 Issue 3 Pages 373-381_1
Published: March 20, 1983
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSAcute gastritis is a clinical entity often encountered in daily practice, but has only vaguely been categorized on the histopathologic basis. Among the subjects complaining of sudden epigastric pain, nausea and vomiting, 27 cases were selected for this study as having acute gastritis. All patients were diagnosed after an upper GI series and endoscopic examination with gastric biopsies, which were carried out as soon as possible after the onset. Based on the findings of upper GI series and endoscopy, changes in acute gastritis were classified clinically into six types with the following histopathologic features. 1. Slight edema and hyperemia of the mucosa were observed in the edematous type of antral gastritis, showing no other characteristic change. 2. Hemorrhage, necrosis and neutrophil infiltration were the findings in the hemorrhagic erosion type antral gastritis. 3. In the early stage of the ulcer type, the histologic changes were very similar to those in the hemorrhagic erosion type in the early stage. Ulcer formation was was recognized on the 4-7th day of the onset. 4. Slight hyperemia with a small number of neutrophils as seen in the type A corpus gastritis (Raddish type), severe hemorrhage and necrosis with neutrophils were present in the type B (Erosive type with hemorrhage), and all those findings were most prominent in the type C (White coated type with erosion).View full abstractDownload PDF (13701K) -
Mitunori SAITO, Hideyuki FUSAMOTO, Yutaka SASAKI, Masuki FUKUDA, Akino ...1983 Volume 25 Issue 3 Pages 382-391
Published: March 20, 1983
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSTo investigate the clinical and endoscopic characteristics of acute duodenal ulcer, 62 cases with acute duodenal ulcers in critically ill patients were compared with 94 cases with active chronic duodenal ulcers. In clinical signs and symptoms, only four of 62 patients (6.5%) with acute duodenal ulcers complained of abdominal pain. On the other hand, 79 of 94 patients (84.0%) with chronic duodenal ulcers noticed abdominal pain. Gastrointestinal hemorrhage occurred in 51 of 62 patients (82.3%) with acute duodenal ulcers, and more than 2, 000ml of blood transfusion were required to stabilize vital signs in 30 of 62 patients (48.4%). Emergency operation to seize bleeding was performed in 13 cases, and 9 cases could not be operated because of its serious conditions. On the other hand, gastrointestinal bleeding from chronic duodenal ulcer was found in 12 of 94 patients (12.8%) and the emergency operation for bleeding was performed in only one case. Perforation occurred almost the same frequency in both groups. However, prognosis was worse in the acute duodenal ulcer group than in the chronic duodenal ulcer group. An emergency endoscopy revealed that acute duodenal ulcers had a tendency to be multiple and irregular form. 18 cases (29.0%) of acute duodenal ulcers localized at postbulbar portion, while all except one of chronic duodenal ulcers localized at bulbus of the duodenum. Thirty six of 62 cases (58.1%) with acute duodenal ulcers had concomitant acute upper gastrointestinal lesions. In conclusion, most patients with acute duodenal ulcers were asymptomatic and followed by massive gastrointestinal bleeding which were often uncontrolled by massive gastrointestinal bleeding which were often uncontrollable with conservative therapy.View full abstractDownload PDF (4041K) -
Tomohiko YOSHIDA, Sadao FUKUDA, Noritoshi IWASAKI, Tatsuya KOJIMA, Osa ...1983 Volume 25 Issue 3 Pages 392-399
Published: March 20, 1983
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSOn the assumption that the endoscopic and histopathologic findings in the obstructed part of bile ducts serve as an extremely significant diagnostic clue in patients with obstructive jaundice, we tried PTCS and PTCB on 23 patients utilizing the external biliary fistula formed by percutaneous transheptatic cholangio-drainage (PTCD). In patients with cancer, endoscopy revealed such changes in the obstructed part as ulceration, protrusion, irregular surface, redness, bleeding and discoloration. However, with the limited number of cancer patients in the present study, it is not certain whether these changes are characteristic of cancer or not. PTCB provided a positive cancer diagnosis rate far higher than that of the cytologic examination of bile. Since the cytologic examination was highly diagnostic in some occation, we thought it crucial to use PTCB and cytologic examination in combination with each other. With further studies such as comparison between other diagnostic procedures involving imaging and PTCS or meticulous comparative study of data obtained by endoscopy, biopsy and gross as well as histopathologic examinations of surgically removed tissues, which will be conducted in parallel with the improvement of instruments and techniques, both PTCS and PTCB will become a safe, reliable and extremely useful procedure for the examination of biliary passages.View full abstractDownload PDF (3371K) -
Kiyoshi SAWAGUCHI, Masayoshi MAI, Ryuichi AKIMOTO, Tomomi OGINO, Hiros ...1983 Volume 25 Issue 3 Pages 400-407_1
Published: March 20, 1983
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSDuring the past six years and seven months endoscopic polypectomy of the colon and rectum was performed for 86 lesions in 58 patients at our Hospital. The histology of these polypectomized polyps disclosed adenoma in 78 (90.7%), metaplastic polyp in 4 (4.7%) and others. All adenomas were classified into four degrees of epithelial dysplasia by Muto's histological grading (Grade 1; minimal dysplasia, Grade 2; mild dysplasia Grade 3; moderate dysplasia, Grade 4 ; severe dysplasia indicating carcinoma in-situ or focal cancer). In 13 out of 76 adenomas there were 11 lesions with Grade 4 (focal cancer in adenoma) and 2 early invasive cancers. As for the size and the histological grading all lesions under 5 mm in size showed benign histological features of Grade 1, 2 and 3. Only one adenoma in 34 lesions ranging from 6 to 10 mm in diameter had focal cancer in adenoma. In 19 adenomas over 10 mm, 12 (63.2%) were histologically found to have cancer and two of them invaded the submucosa, thus suggesting that an adenoma over 10 mm has the posibility of malignant transformation. Concerning the relationship between its gross appearance and the histological grading, we could not find so much differance in shape, but both of two invasive cancers showed a flat elevation with surface erosions. With regard to the location of colonic polyp, most of adenoma with severe dysplasia located in the sigmoid clolon and the rectum. This suggests that adenoma arising from the rectosigmoid colon has a higher malignant potential compared with that of the right slide colon. It is concluded that endoscopic polypectomy should be indicated for all polyps over 5 mm in the greatest diameter.View full abstractDownload PDF (8407K) -
Mitsuyoshi KASHITANI, Eizo OKAMOTO, Keiji KUWATA, Tadayuki HIDA, Akio ...1983 Volume 25 Issue 3 Pages 408-412
Published: March 20, 1983
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSThe therapeutic effect of cimetidine, and prophylactic effect of cimetidine and vagotomy on the post-operative stress ulcers were evaluated. 1) Bleeding stopped in 19(58%) of 33 patients with cimetidine-treatment, and in 8(29%) of 28 with conventional antacid-treatment. Cimetidine controlled successfully massive bleeding from stress ulcer, but had no significant improvement for mortality . Particularly in hepatoma with cirrhosis, we had only poor results of conservative treatment of stress ulcers following surgery. 2) Prophylactic cimetidine-treatment and vagotomy to gastric hypersecretors of hepatoma with cirrhosis prevented effectively post-operative gastoduodenal bleeding caused by stress ulcer. Prophylactic treatment may be the most beneficial approach to decrease the mortality of post-operative stress ulcer .View full abstractDownload PDF (493K) -
Masahiro TADA, Yoshikazu SUYAMA, Yoshinori TANAKA, Teiichi NISHITANI, ...1983 Volume 25 Issue 3 Pages 413-420
Published: March 20, 1983
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSRemarkable advances in fiberoptics and its insertion technique have made it possible to observe all parts of the colon mucosa. On the other hand, several new approaches to perform colonoscopy with more ease, safety and exactitude have been discussed. One of the most difficult points during colonoscopy is to straighten the sigmoid colon which tends to make a large loop. In order to keep the sigmoid colon in a straight position, a sliding tube made of plastics was devised and it has been widely used in colonoscopy . However, it has been desired to perform colonoscopy without any subsidiary instruments. Thus colonoscope, type CF-VS (Olympus), which has a van-stiffness in its insertion tube was devised. During the last 3 months, 75 cases were examined with this colonoscope . Changing the stiffness of the insertion tube during the insertion, all cases were exanined with ease without marking a large loop formation in the sigmoid colon . Therefore, CF-VS is useful as an improved scope to examine the whole parts of the colon .View full abstractDownload PDF (5185K) -
Yoko MIWA, Atsushi MAEDA, Akira AKAGAMI, Yayoi ITO, Masae KAWAMURA, Mu ...1983 Volume 25 Issue 3 Pages 421-427
Published: March 20, 1983
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSHydrogen gas clearance method was used for the measurement of mucosal blood flow in man and rats. The means(±SD) of mucosal blood flow recorded from the sigmoid colon and splenic flexure in normal subjects were 45.5±15.4 (n=17) and 65.1±17.9 ml/min/100 g tissue (n=7), respectively. In cases with irritabe bowel syndrome (IBS), mucosal blood flow was significantly lower in constipation-predominant cases (30.1±7.5) than normal, in contrast, relatively high value was recorded in diarrhea-predominant cases (62.36±22.97). The effects of cigarette smoking, codeine phosphate, and meals on the colonic mucosal blood flow was then studied. Colonic blood flow was significantly decreased after the load, which suggests the restriction in mucosal blood flow by the increased tonus of muscular layer. On the contrary, sublingual nitroglycerine resulted in the significant increase in blood flow in the splenic flexure, as well as decrease in the sigmoid colon. It appears from this study that alterations in colonic mucosal blood flow may be form the basis of the colonic physiology, as well as the myogenic.View full abstractDownload PDF (709K) -
Hanzo KUROSAKA, Takeshi OOHARA, Kazuhide TAKEZOE, Giichi AONO1983 Volume 25 Issue 3 Pages 428-434
Published: March 20, 1983
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSOne of the characteristics of diagnostic endoscopic evaluation of the digestive tract in the evaluation of changes in the color of the mucosa. At the same time it cannot be denied the conventional evaluation of such changes has depended on the subjective judgement of the endoscopist. However, no attention has been paid to the question of the stamina of the endoscopist, i. e. how time and fatigue affect his perception of color. Therefore, we have studied the fading of human color sentation and got several interesting results as follows; 1. the fading values of the color sensation at a one minute and a two minutes after eight minutes exposure to red paper showed larger values than thoe immediately after the exposure. 2. the use of the complementary filter was very effective in order to protect the fading of the color sensation. 3. the fading degree of the color sensation after 10 times gastrofiberscopies (3 minute examination with one minute rests) was 78% value of non-fatigue condition. 4. there were little differences on the recovery between the group with the exposure of complementary color anticipating the recovery and the group without.View full abstractDownload PDF (600K) -
Hanzo KUROSAKA, Takeshi OOHARA1983 Volume 25 Issue 3 Pages 435-441
Published: March 20, 1983
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSOne of the characteristics of diagnostic endoscopic evaluation of the digestive tract is the evaluation of changes in the color of the mucosa. For diagnosis of early stage gastric cancer, minute changes in color can be extrmely important. However, it cannot be denied that evaluation of color changes has heretofore been a subjective matter. We developed a colorimeter and endoscope system that achieved effective rusults in objectively displaying the color of the gastric mucosa.View full abstractDownload PDF (3882K) -
Hironobu KOHDA, Yuji ISHIKAWA, Hitoshi SATOH, Yoshimi SHIBATA, Fiji MU ...1983 Volume 25 Issue 3 Pages 442-447_1
Published: March 20, 1983
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSThe patient, a 72-year-old male, was subjected to X-ray examination of esophagus, which revealed extramural oppression from outside of esophagus. The esophagoscopy revealed a stenosis as a major finding and biopsy was carried out because there was rough mucosa which looked like cancerous infiltration in some part of the lesion. Although tumor cells were found in the tissue, definite diagnosis was difficult. Through CT scan, soft tissue density mass was noted at posteroior mediastinum and it was found that esophagus was oppressed out by the mass. From the above findings, malignant mediastinal tumor was suspected, however by autopsy it was proved to be oat cell carcinoma at periphery of the right lung (S6) which was in primary at the side of mediastinum. The difficulty in swallowing not accompanied by findings indicative of lung cancer are very rare initial manifestation. In addition, the fact that esophagoscopy was useful for approach to definite diagnosis, was thought to be of importance.View full abstractDownload PDF (8562K) -
Junichi OKUDA, Wataru IMAOKA, Keishi TAKECHI, Kazunori IDA1983 Volume 25 Issue 3 Pages 448-452_1
Published: March 20, 1983
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 81-year-old male, who had been operated because of an advanced gastric cancer on the posterior wall of gastric lower body 6 months before, visited to our hospital in April 1981 complaining of anorexia. Radiological and endoscopical examinations revealed a recurrent advanced gastric cancer, approximately 70 mm in size, on the cardia of remnant stomach. The patient was considered inoperable because of advanced age . YAG laser beam was endoscopically irradiated twenty nine times for the gastric cancer . As results of endoscopic laser treatment, tumor size decreased and the complaint disappeared . The patient is still under observation. The endoscopic laser technique was effective for the treatment of inoperable advanced gastric cancers.View full abstractDownload PDF (8669K) -
Kazunori HOSHIKA, Norio MIYASHIMA, Yoshinori FUJIMURA, Fumihiko SUMA, ...1983 Volume 25 Issue 3 Pages 453-457_1
Published: March 20, 1983
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSThis case report describes a patient with cutaneous blue rubber bleb nevus associated with esophageal hemangioma. A 66-year-old female was admitted to our hospital on Oct. 21, 1981, complaining dysphagia. She had received iron therapy to anemia in 1976. Large blue rubber bleb nevi was found on the left scapular region on physical examination (Figure 1). On gastrointestinal roentgenograms, a protruded lesion had been recognized in the upper esophagus (Figure 2). Endoscopical examination of the esophagus showed it hemangioma (Figure 3). Both hemangiomas were resected surgically. Histological finding of the both hemangiomas disclosed cavernous hemangioma (Figure 4, 5). Only 15 cases of Blue rubber bleb nevus syndrome have been reported so far in Japan. The diagnosis of the esophageal hemangioma was established by esophagoscopy, which is rather rare association in this syndrome.View full abstractDownload PDF (5655K) -
Toshiyuki KUSUHARA, Shyunichi MORITA, Yousuke KAKITSUBATA, Takao KODAM ...1983 Volume 25 Issue 3 Pages 458-461_1
Published: March 20, 1983
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSFourty three years old female and thirty nine years old male visited with upper abdominal pain. Both patients had abnormal findings at the gastric antral region by upper GI series. In both cases, endoscopic examination revealed a foreign body penetrated into the gastric wall at minor curvature of the antrum. These foreign bodies (toothstick in case 1, bamboostick in case 2) were successfully removed with a biopsy forceps without remakable bleeding or other complication. Endoscopic removal of the foreign body penetrated into the gastric wall is considered to be safe and useful method.View full abstractDownload PDF (7639K) -
Atsushi MAEDA, Kohaku IGVCHI, Ryuichi IIDA, Yukiko YAMASHITA, Tetsuya ...1983 Volume 25 Issue 3 Pages 462-468_1
Published: March 20, 1983
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 72 years old man was admitted to our hospital because of a duodenal diagnosed by routine upper gastrointestinal endoscopy . The biopsy specimen was histologically diagnosed as a differentiated adenocarcinoma . A pedenculated polypoid lesion, 1.8×1 .3×0.9cm in size, was surgically removed. Histological finding were recognized differentiated papillary adenocarcinoma . The depth of invasion was as fav as submucosal layer . No metastic lesion in the liver, lymph nodes, peritoneum were found during operation. Case reports of a primary early cancer of duodenum are rare . We collected 21 cases of early duodenal cancer from the Japanese literature and referred to the present state of early duodenal cancer.View full abstractDownload PDF (8361K) -
Michio KAMINISHI, Osamu YAMAMOTO, Chiharu WATANABE, Koji KANEKO, Takes ...1983 Volume 25 Issue 3 Pages 471-476_1
Published: March 20, 1983
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSThe concept of small pyloric area in the treatment of duodenal ulcer has been adovocated in recent years as a possible cause of incomplete gastric vagotomy . In this condition, the area of fundic gland expands into the normal area of pyloric gland, resulting in the smaller area of antral mucosa. The following is a typical case of postbulbar duodenal ulcer associated with small pyloric area. A 54 year old man was admitted to the Tokyo University Branch Hospital with complaints of epigastralgia and melena. X-ray films and endoscopic examinations revealed two ulcers at descending duodenum and an ulcer scar at duodenal bulb. The gastric analysis revealed high acid concentration . The level of serum gastrin was lower than normal . A selective vagotomy and antrectomy with gastrojejunostomy was performed . Histological studies of the resected stomach revealed a small pyloric area, in which the area of pyloric gland demonstrated an irregular boundary and limited within 3 cm . from the pyloric ring. It will be reasonable to presume in such a small pyloric area that hyperacidity is a result of impaired regulation of acid secretion and a cause of postbulbar ulcer . A selective vagotomy and antrectomy is a choice of procedure .View full abstractDownload PDF (5669K) -
Yasuo SOEJIMA, Yohko DENPOH, Gen FUKUSHI, Masakatsu MATSUKAWA, Tadashi ...1983 Volume 25 Issue 3 Pages 477-481_1
Published: March 20, 1983
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSHere is reported a case of intraluminal duodenal diverticulum (I.D.D.) diagnosed radiologically and endoscopically. The patient with epigastralgia visited and admitted to Hirosaki University Hospital on October 20th, 1980. The patient was a 16-years-old male whose past history and femilial history had nothing contributory. The double contrast picture of the duodenum showed a pear-shaped diverticulum filled with contrast medium in the second portion of the duodenum and characteristic radiolucent line formed by the diverticular wall. The orifice of the diverticulum was identified in the anterior wall of papilla Vater by endoscopy. Diverticulum moved up and down in the duodenal canal with peristalsis. E.R.P, and D.I.C. showed that the divertuculum did not affect the biliary and pancreatic system. The diverticulum was resected for his symptom. The microscopic appearance of the resected specimen was that of normal duodenal mucosa lining both sides of the sac. There was incomplete muscular tissue between both sides of the sac. Therefore, the cause of I. D.D. in this case seemed residual of incomplete duodenal diaphragm.View full abstractDownload PDF (5888K) -
Yuji KADO, Kiwamu OKITA, Keijiro ANDO, Wakako TSUBOTA, Yoshinori NUMA, ...1983 Volume 25 Issue 3 Pages 482-489
Published: March 20, 1983
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSWe reported a case of Wilson's disease who was a 11-year-old girl whose elder sister died of the same disease at the age of 11. Soon after the diagnosis was made, treatment with D-penicillamine and Predonine was initiated. Thease treatments showed remarkable effect, for she has become work normally and tha liver function tests returned to almost normal. We cound portem laparoscopic examination before treatment and one year after treatment. Laparoscopic findings showed a macronodular liver cirrhosis both times. With improvement of the liver function and general condition each nodule was found to become flattened. Eventually we observed morphological improvement of the liver surface. In Wilson's disease, sequential observation of the liver surface by laparoscopy during of the course would be useful for the evalution of therapeutic effects.View full abstractDownload PDF (4198K) -
Tsugio HIGUCHI, Masayuki ONAI, Makoto MOTOYAMA, Rinjiro HOSHINO, Ken I ...1983 Volume 25 Issue 3 Pages 490-497
Published: March 20, 1983
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSPre-operative endoscopic duodenobiliary drainage was carried out in two patients of papillary cancer to reduce obstructive jaundice. Two different techniques were available. One was a method for placing an internal duodenobiliary tube (endoprosthesis). And another was an external drainage, the endoscopically introduced transpapillary tube passed through the stomach and left the patient through his nose. Serum bilirubin level and WBC decreased to almost normal range in both cases after drainage and pancreato-duodenectomy was carried out.View full abstractDownload PDF (8908K)
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