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Volume 25, Issue 7
Displaying 1-21 of 21 articles from this issue
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Hajime KUWAYAMA, Katsuhiro TAKEUCHI, Yuko IKEDA, Masakazu Matsuda, Yos ...1983 Volume 25 Issue 7 Pages 995-1005
Published: July 20, 1983
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSThree cases of pancreatic pleural effusion were reported with endoscopic retrograde pancreatography (ERP). The first Patient, a 41-year-old man, had acute pancreatitis and his pleural effusion was small and self-limited on the right side. This disappeared as the acute attack of pancreatitis subsided. ERP showed no abnormality. The second patient, a 48-year-old man, was admitted because of shortness of breath. A roentgenogram of the chest showed massive left pleural effusion and he was treated medically. ERP, however, failed to show the leakage of contrast medium although a big pseudocyst on the head of pancreas was seen. The third patient, a 46-year-old man, was admitted, the chief complaint being shortness of breath and cough. ERP successfully demonstrated a pancreatic duct disruption and pleuromediastinum fistula which was trucked up along the aortic hiatus. Because effusion recurred deispite repeated taps, Roux-en-Y pancreaticojejunostomy was performed. The effusion subsided after the operation. It was emphasized that ERP was an essential procedure in this chronic pancreatic pleural effusion entity. On the other hand, in the setting of self-limited effusion, which has few clinical problems and subsides soon, ERP has a minimum value.View full abstractDownload PDF (10705K) -
Hisao TAJIRI, Masayoshi YOSHIMORI, Kozo NAKAMURA, Daizo SAITO, Atsushi ...1983 Volume 25 Issue 7 Pages 1006-1012
Published: July 20, 1983
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESS2, 2-dihydroxy-di-N-propylnitrosamine (DHPN) 250 mg/kg (body weight) was injected subcutaneously into 28 male Syrian golden hamsters once a week. They were then sacrificed and dissected every 2 weeks beginning 8 weeks later until the 28th week. Pancreatography was performed on every hamster and the time course changes of their panceatograms were compared with the histological findings. Marked atypical hyperplasia that was difficult to differentiate from carcinoma in situ was seen histologically beginning the 16th week, and the invasive growth of adenocarcinoma was seen on all the hamsters on and after the 24th week. The pancreatography made it possible to grasp even the most minute changes at an early stage that corresponded to the histological findings. Anexample of this was the detection of a slight stenosis in the branch during the 16th week and the picture of stenosis or displacement was observed in the main pancreatic duct during the 20th-22nd week. This was followed by obstruction on and after the 24th week. These findings promoted the consideration of a great possibility that early lesions of pancreatic neoplasms in a hamster's pancreas occur at the branch region level earlier than at the main pancreatic duct level.View full abstractDownload PDF (4996K) -
Yasushi YOKOYAMA, Masahito OHIDA, Sumio MATAMA, Katsunori SAIGENJI, Ha ...1983 Volume 25 Issue 7 Pages 1013-1021_1
Published: July 20, 1983
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA comparative study was made on biopsied specimens of depressed type early gastric cancer of 79 caces, 84 lesions. Each biopsy specimen was obtained after conventional, dyescattering and magnifying endoscopic examination. Comparison among these three techniques was made on positive ratio. Results were as follows. 1) An average positive ratio by conventional endoscopic examination was 65.0%. Each positive ratio of the specimens from discolored area and reddened area was 71.3% and 59.1%, respectively. Histologic examination revealed that most of the biopsied specimens from reddend area were well differentiated adenocarcinoma and most from discolored area were poorly differentiated adenocarcinoma. 2) An average of positive ratio by dye scattering method was 84.9%. This was significantly higher (p<0.001) in comparison with that by conventional endoscopy. 3) An average 300153_002of positive ratio by magnifying endoscopy was 81.3 % and was significantly higher (p<0.01) compared to that by conventional endoscopy. Each positive ratio of the biopsied specimens obtained from the mucosa characterised by patternless mucosal appearance, nodular mucosal appearance and irregular nodular mucosal appearance was 95.5%, 76.8%, and 82.2%, respectively.View full abstractDownload PDF (3248K) -
Junichi OKUDA, Kazunori IDA, Keiichi KAWAI1983 Volume 25 Issue 7 Pages 1022-1025_1
Published: July 20, 1983
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSThe diagnostic sensitivity and specificity of the endoscopic methylene blue (MB) method for intestinal metaplasia was discussed. From the stain patterns of the gastric mucosa by the MB method, staining intensity and magnified patterns were studied. Staining intensity was evaluated by conventional endoscopy and a total of 176 biopsy specimens were collected from stained and non-stained sites of 52 cases. Magnified patterns were evaluated using a magnifying fiberscope (fifteen magnifications) and a total of 84 biopsy specimens were collected from stained and non-stained sites of 20 cases. Both staining intensity and magnified patterns were examined for consistency with biopsy specimens. The values of sensitivity and specificity were 0.89 and 0.66 respectively when these were calculated using staining intensity as the indicator. However, these values increased to 0.99 and 0.71 respectively when magnified patterns were used as the indicator. It may be said that if presence of MB staining is evaluated using magnified patterns as the indicator in the MB staining method, then stained and non-stained sites correspond to intestinal metaplastic and non-metaplastic sites respectively at almost perfect consistency.View full abstractDownload PDF (2622K) -
Hanzo KUROSAKA, Takeshi OOHARA, Takashi ANDOH1983 Volume 25 Issue 7 Pages 1026-1030_1
Published: July 20, 1983
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSSlight color changes can be overlooked during fiberoptic endoscopic examination procedures and one possible cause is the diminishing color sensitivety of the eyes of the endoscopist in relation to the time required for the procedure. As an aid to prevent such slight color changes being overlooked we devised a prototype color monitor which triggered an audiosignal when it detected differences in the color of the two halves of the endoscopic image. However, it was found impractical in terms of the noise it caused and the resulting discomfort occasioned the endoscopist. The device was, therefore, modified for use with an endoscopic TV monitor system, such that if more than a preset difference in the color of the two halves of the endoscopic image occurred, a green warning signal appears on the upper right-hand side of the screen. While this device has not yet been applied clinically in gastrofiberscopy procedures, it has been shown to be extremely sensitive in extracorporeal tests. We plan to further refine this instrument and employ it as a supplemental diagnostic aid in gastrofiberscopic examinations.View full abstractDownload PDF (2612K) -
Kiyohiro KAWAHARA, Seiji MIYAZAKI, Tomoharu YOSHIDA, Masataka ODA, Kiw ...1983 Volume 25 Issue 7 Pages 1033-1042_1
Published: July 20, 1983
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSThirty patients who had esophageal varices with R-C sign were treated with injection sclerotherapy. The aim of our method was to perform an intravascular injection of ethanolamine oleate (15ml). Their tentative result and prognosis were evaluated. Twenty-two of 30 cases (73.3 %) were good cases showing no R-C sign after injection sclerotherapy. Eight of the 30 cases (26.7%) were unchanged cases in which R-C sign did not disappear completely after injection sclerotherapy. In good cases, 12 cases (54.5%) required one procedure and 10 cases (45.5%) required more than two procedures. The complications were retrosternal pain (33.3%), pyrexia (25.0%) esophageal ulcer (21.7%), hemoglobinuria (3.3%), dyspnea (1.7%) and severe hepatic failure (1.7%). Endoscopically, 14 cases were followed up for more than 6 months. The recurrence of R-C sign was recognized from 7.5 to 21 months. The mean interval of the recurrence was more than 10.8 months. From the above mentioned, we conclude that in order to prevent bleeding of esophageal varices, we should perform endoscopy every 6 months after injection sclerotherapy, and if R-C sign recurs, we use this procedure to improve R-C sign.View full abstractDownload PDF (2959K) -
Tadasu FUJI, Hideo AMANO, Shigemi ARIYAMA, Tsuyoshi AIBE, Yuji NAGATOM ...1983 Volume 25 Issue 7 Pages 1043-1049
Published: July 20, 1983
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSEndoscopic retrograde internal biliary drainage (ERIBD) has been developed in our country as a non-surgical biliary drainage in recent years. This new procedure has become to be highly appreciated as well as PTCD which was the best biliary drainage, because this is safe, effective, internal biliary drainage. However, we could not succeeded in ERIBD in all cases of pancreato-biliary carcinoma with obstructive jaundice. Now we have to find out some indications of ERIBD. We have performed ERIBD in five cases of carcinoma of the duodenal papilla, and succeeded without endoscopic sphinctero-papillotomy in all cases in our clinic. It has been used with great effectiveness as a non-operative biliary drainage before the operation in four cases and as a permanent drainage one case. It is concluded that ERIBD is the most non-invasive biliary drainage in cases of pancreato-biliary carcinoma, and especialy, it is the first approach to treatment in cases of carcinoma of the duodenal papilla.View full abstractDownload PDF (4266K) -
Naokazu HAYAKAWA, Yuji NIMURA, Junichi KAMIYA, Hiroshi HASEGAWA, Kenzo ...1983 Volume 25 Issue 7 Pages 1050-1056
Published: July 20, 1983
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSYag Medical 100 (ALM) was applied for this study. We investigated the effect of cholangioscopic irradiation on resected human gall bladder mucosa and dog's gall bladder mucosa. This study was summarized as follows. 1. Yag Medical 100 can be used safely in the bile duct according to our method without gas jet flow system. 2. In the case of internal irradiation on the gall bladder, although the histological changes were only minimal at the mucosa but severe at the submucosal tissue, on which care must be taken. 3. At irradiation for points of erosion, bleeding, and/or blackened by dye, the change of the tissue is fast and severe. The difference depending on color is useful for clinical application.View full abstractDownload PDF (7456K) -
-REPORT OF A CASE-Tadashi KODAMA, Shinichiro FUKUDA, Kenji TSUJI, Eiji NAITO, Yoshinobu ...1983 Volume 25 Issue 7 Pages 1057-1060_1
Published: July 20, 1983
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSWe experienced a case of early esophageal cancer with 21 months follow-up study. A 54 year-old woman visited our clinic with a complaint of mild epigastralgia. The first upper x-ray revealed no abnormality in the esophagus, but a small filling defect was retrospectively detected in the middle esophagus. Rapid growth of the lesion was observed by the second examination 21 months later. Endoscopic study revealed a protruded lesion with irregular surface at the 30cm from upper incisors. The dye scattering method using 5% of Lugol's was applied. The normal epithelium was positively stained light or dark brown with Lugol's solution, but protruded lesion was unstained and confirmed by biopsy specimen as a squamous cell carcinoma. The resected specimen showed an elevated type of early cancer invading the submocosa. The patient is doing well 20 months after operation.View full abstractDownload PDF (3632K) -
Kenji TSUJI, Shinichiro FUKUDA, Yoshinobu FUSE, Eiji NAITO, Shozo YORI ...1983 Volume 25 Issue 7 Pages 1061-1067
Published: July 20, 1983
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSAn unusual case of eosinophilic granuloma of the stomach was presented. The patient was admitted to our hospital, complaining of epigastric pain. Upper G-I series showed a sharply demarcated defect on the anterior wall of the antrun, which appeared to be an unusual form like penis by endoscopy. Ono month later, the shape of the tumor turned to be a smoothly elevated lesion with central ulceration. Histologically, the resected speci-men showed an eosinophilic granuloma.View full abstractDownload PDF (5042K) -
Shohei KOYAMA, Shoki SAI, Akinori YANAKA, Nobutaka TAKANO, Junko TOGO, ...1983 Volume 25 Issue 7 Pages 1068-1073_1
Published: July 20, 1983
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA case of Barrett's ulcer treated effectively with Cimetidine was reported. The patient was 76-year-old female, and she admitted to our hospital with a complaint of dysphagia. Laboratory findings on admission showed no abnormality except high secretion of gastric acid and pepsin by stimulation of gastrin. Radiological and endo-scopical findings showed shallow ulcerations surrounded by redness, erosion and bleeding in lower esophagus with hiatal hernia. Biopsy specimen taken from ulceration of the esophagus disclosed columnar-lined epithelium. The patient was diagnosed to have Barrett's ulcer of the esophagus. Lower esophageal shincter pressure by station pull-through method and 24 hour esophageal pH monitouring revealed objective evidence of gastroesophageal ref lux. These findings suggest that etiology of Barrett's epithelium and Barrett's ulcer might be correlated with gastroesophageal reflux. Esophageal inflammation and ulcers healed within 2 weeks of Cimetidine treatment as documented by endoscopy. Esophageal stricture did not respond to Cimetidine. It is concluded that Cimetidine is helpful in treating the inflammed mucosa in patient with Barrett's ulcer.View full abstractDownload PDF (6030K) -
Hidenori NAKATA, Toshihide NAKATANI, Yoshio DOI, Shingo NISHIOKA, Isao ...1983 Volume 25 Issue 7 Pages 1074-1078_1
Published: July 20, 1983
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSThe patient was a 70-year-old man, who had an excision of the left great toe in Dec. 1979 and was diagnosed to have histologically malignant melanoma, 2 years later he was hospitalized to our dermatologic department because of the metastases spread to the left leg. On 27 Jan. 1982 he was referred to our clinic for evaluation of roentgenographic abnormality in the stomach. The occult blood in the stools was positive. Endoscopic examination of the stomach revealed a submucosal tumor, 3 × 4cm in size, on the posterior wall of the middle body. The central area of the tumor ulcerated and showed black pigmentation. A biopsy taken from the floor of ulceration confirmed the diagnosis of malignant melanoma. He died of acute free perforation on 5 March 1982. At autopsy the perforation was found to be located on the site of a malignant melanoma metastatic to the stomach. Histologically melanoma cells infiltrated to the gastric wall. Except for single gastric metastasis there were no metastatic lesions in the other alimentary tract. Metastatic malignant melanoma of the stomach is not infrequent, but few of these have been diagnosed during life. The perforation is also rare and we think that the metastatic lesion became ulcerated because of the action of gastric digestive juice.View full abstractDownload PDF (4245K) -
Mikihiro TSUTSUMI, Ryuichi KANAYAMA, Jinichi NET, Nobuhiro TOKIKUNI, H ...1983 Volume 25 Issue 7 Pages 1079-1083_1
Published: July 20, 1983
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 16-year-old female was admitted to the Kanazawa Medical University Hospital because of pain on the right hypochondrium. The double contrast X-ray picture of the duodenum revealed many small polypoid lesions with coarsely widened mucosal folds and reflux of contrast material into the pancreatic duct. On the endoscopic examination of the duodenum, several sizes of polypoid lesions were seen on the duodenal mucous membrane. The orifice of the duodenal major papilla was kept open and a continuous flow of the bile was observed during the examination. Histological changes of biopsy specimens from the duodenal mucosal epithelium were minimal except for infiltration of a few inflammatory cells in the interstitial space. Since she was one-year old, the patient has had many recurrent episodes of bronchitis and pneumonia. Numerous reticulo-nodular shadows were seen at both lung fields of the chest X-ray film. Labial minor salivary glands showed dilatation of the ducts, accumulation of mucin, and atrophy of acinal cells. Sodium and chloride concentrations of the sweat increased markedly.View full abstractDownload PDF (5290K) -
Yutaka INAGAKI, Hisashi KIDANI, Hitoshi KITANO, Manabu YONESHIMA, Tais ...1983 Volume 25 Issue 7 Pages 1084-1088_1
Published: July 20, 1983
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 70-year-old man admitted to our hospital because of epigastralgia and body weight loss. He appeared well and laboratory data were normal except for the positive finding of urinary amylase output. Ultrasonography and CT scan disclosed solid mass lesions around the pancreas and in the posterior segment of the right lobe of the liver. Endoscopic retrograde pancreatography (ERP) showed only minimal narrowing of the main pancreatic duct and rarefaction of the branches. Cytologic examination of the pure pancreatic juice by endoscopic cannulation of the papilla of Vater resulted in class V (adenocarcinoma). Endoscopic retrograde pancreatic parenchymography (ERPP) revealed the finding of pancreatic field defect. This case indicates that the active trial of cytologic examination of the pure pancreatic juice can be available even in the diagnosis of the pancreatic field defect type of pancreatic cancer which has been generally considered to be difficult to diagnose.View full abstractDownload PDF (5439K) -
Yasutoshi KONNO, Nobuo HIWATASHI, Kazundo KOBAYASHI, Masao OHTSUKI, Hi ...1983 Volume 25 Issue 7 Pages 1091-1098_1
Published: July 20, 1983
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 53 year-old housewife developed ulcerative colitis involving the entire colon at the age of 45. Four years later, she presented with generalized pruritus and low-grade jaundice. An endoscopic retrograde cholangiopancreatography and a laparoscopic exam-ination led to the diagnosis of primary sclerosing cholangitis. In 1981, she complained right hypochondralgia. A barium enema and a colonoscopic examination revealed an area of stenosis in the mid-ascending colon, and biopsy specimens from this area showed adenocarcinoma. Subtotal colectomy was performed. The tumor was well and moderately differentiated adenocarcinoma. The other area of colonic mucosa showed evidences of chronic ulcerative colitis macro-and microscopi-cally. No epithelial dysplasia was found in representative sections except in a very limited area adjacent to the tumor. This case is considered to develop colonic cancer complicating ulcerative colitis.View full abstractDownload PDF (9151K) -
Fukunori KINJO, Masanori UEZU, Keizo KADENA, Hidetoshi SHIOHIRA, Kinzo ...1983 Volume 25 Issue 7 Pages 1101-1107_1
Published: July 20, 1983
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSTwo cases of pseudomembranous colitis associated with antibiotics were reported. Casel: A 52-year-old woman with malignant lymphoma was given CMZ and ABPC for fever. After 21 days of chemotherapy diarrhea, tenesmus and anal pain developed. On the 9th day after the onset of the disease colonofibrscopy was done and revealed pseuno-membranous colitis. Stool was not examined for Clostridium difficile and its toxin. Fluid infusion therapy after discontinuance of chemotherapy relieved her from the disease. Case 2: A 59-year-old man underwent operation for aortic stenosis and insufficiency. After the operation CET, CPZ, CTX, CTM and CFS were administered for prevention or treatment against infection. On the 16th day after the opesation diarrhea, abdominal pain and fever developed. On the 21st day after the onset of the disease colonofiberscopy was done and made a diagnosis of pseudomembranous colitis. Stool cultures during 3 days after endoscopy were positive for toxin-producing Clostridium difficile with Klebsiella pneu-moniae. Enema of prednisolone and oral administration of Vancomycin with fluid infusion therapy were effective to relieve him from the disease. It is concluded that colonofiberscopy is available to diagnose and study pseudo-membranous colitis.View full abstractDownload PDF (5258K) -
[in Japanese]1983 Volume 25 Issue 7 Pages 1108-1111
Published: July 20, 1983
Released on J-STAGE: May 09, 2011
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[in Japanese]1983 Volume 25 Issue 7 Pages 1111-1115
Published: July 20, 1983
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSDownload PDF (759K) -
[in Japanese]1983 Volume 25 Issue 7 Pages 1115-1128
Published: July 20, 1983
Released on J-STAGE: May 09, 2011
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[in Japanese]1983 Volume 25 Issue 7 Pages 1128-1134
Published: July 20, 1983
Released on J-STAGE: May 09, 2011
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[in Japanese]1983 Volume 25 Issue 7 Pages 1135-1147
Published: July 20, 1983
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSDownload PDF (2177K)
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