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Volume 26, Issue 2
Displaying 1-20 of 20 articles from this issue
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Shigeru ASAKI, Toshiaki NISHIMURA, Yo SHISHIDO, Akira SATO, Katsuhisa ...1984 Volume 26 Issue 2 Pages 175-183
Published: February 20, 1984
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSWith extension of application of high frequency polypectomy, reports op successful endoscopic resection of submucosal tumors have increased in number. However, differing from ordinary polypectomy, the use for polypectomy is associated with higher risk of bleeding or perforation, which has limitied its application. We studied on endoscopic treatment of submucosal tumors of the stomach. Since 1974 we have treated 44 cases by (1) resection at one procedure using high frequency snare or by (2) resection at two procedures by which submucosal tumors are resected partially using a high frequency snare and the residual tumors are treated utilizing foreign body excretion capacity and digesting property of gastric juice. Twenty-two cases were treated at one procedure and 20 cases at two procedures. In 2 cases a complete treatment could not be performed. The first case underwent an operation and the second case was placed under observation. Both cases were at the early stage of this series. Massive bleeding or perforation occurred in none of the cases. These favourable results were obtained by selected indication by use of submucosography which is a growth type assessing method for submucosal tumors developed by us and the topical infusion of pure ethanol as an endoscopic hemostatic method. Especially, in vivo fixation of residual tumorous tissue accelerates falling off of tumors, and prevents bleeding at the time of the tumor falling, with a great importance in safety and extension of the indication. There appears a possibility that among intragastric or mural dependent tumors which account for about 85% of submucosal tumors those up to about 6 cm in diameter can be safely treated endoscopically in the future.View full abstractDownload PDF (3913K) -
Tatsuo OHTANI, Yukinori OKAZAKI, Tsuyoshi AIBE, Shuji MIZUMACHI, Masah ...1984 Volume 26 Issue 2 Pages 184-193
Published: February 20, 1984
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSWe have treated carcinoma of the stomach by endoscopical photocoagulation using MBB Medilas YAG laser, Aroka YML-801 YAG laser and Spectra Physics model 770 Argon laser since December '80, and investigated the effects of laser therapy for the carcinoma. Twentyseven lesions in 22 cases of gastric carcinoma were endoscorically photocoagulated. After the first irradiation, 8 of 27 lesions were observed to have residual cancer cells. Cancer cells disappeared in 3 out of the 8 lesions after the second irradiation. In 2 of the rest 5 cases, failure in treatment was caused by technical problems, and 2 cases were advanced cancer like early gastric cancers, and the treatment was discontinued in the other because of the patient's poor condition. Two problems were raised. The one is mechanical and technical problem, and the other is that the effects of laser therapy for advanced cancer and a large lesion is insufficient. So we are trying improvement of the instruments, the measurement of laser effects by endoscopic ultrasonotomogram and the application of phototoxic reaction for the treatment of advanced cancer. It is concluded that laser phtocoagulation for early gastric cancer is effective to cure the lesion and it will become one of the useful treatment for inoperable gastric cancer by resolving some problems.View full abstractDownload PDF (4380K) -
Keishi TAKECHI, Haruo MIYAGAWA, Masayuki OZAKI, Junichi OKUDA, Kazunor ...1984 Volume 26 Issue 2 Pages 194-200_1
Published: February 20, 1984
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSThe areae gastricae of fundic mucosa were examined on 165 cases with and without gastro-duodenal diseases by dye spraying endoscopy. Areae gastricae of fundic mucosa were classified to 4 types ; type F0 is small and fine areas arranging closely to each other. Area of type F1 is largest in size, round and tall. F2 is large in size but not so tall. F3 is small and flat areas arranging loosely to each other. Gland atrophy, f oveolar hyperplasia, intestinal metaplasia, cell infiltration and lymph follicle of biopsied specimen of each area type were studied. None or mild changes were seen in F0, but more severe changes were observed in order of F1, F2 and F3. F0 and F1 were seen in the stomach with large fundic mucosa and F2 and F3 were with small fundic mucosa. F0 and F1 were frequently observed at the greater curvature of the middle body, center of the fundic mucosa. On the other hand F2 and F3 were at the lesser curvature or at near to the mucosal border. Considering the patterns of areae gastricae and histological findings, we can suspect as follows : 1) Area of Fo are formed by mechanical accomodation to the stomach movement such as peristalsis, then gradually changed to F1, F2 and F3 by inflammation, erosions and atrophic changes of the fundic mucosa and so on. 2) Atrophic changes of the fundic mucosa arise at the lesser curvature or at near to the mucosal border. As the fundic mucosa become small in extent, atrophic changes progress even to the greater curvature of the middle body in parallel with atrophic changes of the pyloric mucosa.View full abstractDownload PDF (2951K) -
Junji YOSHINO, Saburo NAKAZAWA, Hiroshi KOZAWA, Shozo OKAMURA1984 Volume 26 Issue 2 Pages 201-212_1
Published: February 20, 1984
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSOK-432, a Streptococcus hemoliticus preparation was administered into tumor and an area around the tumor in the stomach under the endoscopic observation, and clinical and pathological changes were studied. In 12 cases of resected gastric cancer in which this preparation was administered preoperatively, the granulation was noted at the site of administration and particularly characterized by a marked increase in histiocyte-like cells. In 25 cases of unresectable gastric cancer, endoscopic administration of OK-432 simultaneously with systemic immunochemotherapy was carried out and morphological changes were observed in eight cases. In one case out of them, tumor mass disappeared and cancerous tissue was no longer obtained by biopsy. In other seven cases, some inproved findings were found, such as flattening of elevated lesion, disappearance of ulceration and flattening of the base of ulceration. Biopsy was performed continuously in ten cases of unresectable cancer. In two out of them a pattern of degenerative changes in cancerous tissue along with a pattern of infiltration of inflammatory cells was observed. The 6-month survival rate was 55.1% and the 13-month survival rate was 27.2%. The survival rate of endoscopic injection group was significantly better than that of the group whose patients were treated only with systemic immunochemotherapy. The effect of in-flammatory cells, especially macrophage, are suggested as the significant role of the mechanism of OK-432 injected endoscopically.View full abstractDownload PDF (6766K) -
Tomoyuki KANO, Kumiko KURIMOTO, Hiroshi SUGIURA, Yoshiaki ITO, Tatsuzo ...1984 Volume 26 Issue 2 Pages 213-223
Published: February 20, 1984
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSPostoperative stricture of the upper gastrointestinal tract is one of the most difficult complications to be managed. Bougienage is useful as the primary therapy for benign esophageal strictures . But reoperation is chosen for the patient with a gastric anastomotic stricture whidh could not be relieved by conservative treatment. The purpose of this report is to introduced a new method using an endoscope and balloon dilator based on our experience with 5 patients with a benign stricture of the upper gastrointestinal tract. The patients in this trial were unable to take a liquid diet, even after a 2 to 3 week postsurgical period. The location of stricture were the gastrointestinal anastomosis after gastrectomy in 2 patients, the proximal small intestine after hemicolectomy in 2 patients and the pyloric ring of the stomach after papilloplasty in a patient. All patients were successfully dilated by the initial series of the dilation, and were remained to be asymptomatic during an average follow-up period of 7 months (range from 2 to 14 months). No complications were encountered. In the patient with a benign stricture who was considered to be reoperated in, endoscopic balloon dilation should be attempted as primary procedure .View full abstractDownload PDF (6186K) -
Kazuhiko IWAKOSHI, Ichiro HIRATA, Shuji ASADA, Hiroyuki OKA, Masahiro ...1984 Volume 26 Issue 2 Pages 224-229
Published: February 20, 1984
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSTreatment with SSP (silver spike point) as the premedication for endoscopic examination is characterized by simplicity of the acupuncture, ease of the usage and no complications.The purpose of this study was to apply SSP to alleviate the discomforts during the colonofiberscopic examinations. The subjects selected for this study were divided into three groups ; the first was the control group containing 21 cases, the second being the pentazocine group containing 17 cases to whom pentazocine of 30 mg was administerred, the third being the SSP group containing 43 cases to whom SSP treatment was performed as the premedication. The following results were obtained ; 1) Discomforts in the SSP group were less than that in the control group and pentazocine group. 2) Score of discomforts calculated objectively was 7.81 ± 2.54, 7.41 ± 2.40 and 4.28 ± 2.75 (mean±S. D.) in the control group, pentazocine group and SSP group, respectively. Score of discomforts in the SSP group was statistically lower (p<0.05) than that in the control group and pentazocine group. 3) The decrease of the score correlated to the time of induction of SSP. Therefore, it was concluded that SSP treatment was effective as the premedication for the colonof iberscopic examinations.View full abstractDownload PDF (1826K) -
Keisuke KIYOTA, Hidekazu MUKAI, Kazuhiko NISHIMURA, Eisai CHO, Masao K ...1984 Volume 26 Issue 2 Pages 230-234_1
Published: February 20, 1984
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 38-year-old woman was admitted to our hospital complaining of hematemesis. She had drunk a cup of liquid toiletbowl cleaner that contained hydrochloric acid in a suicidal attempt. Emergency endoscopy was done and numerous hemorrhagic erosions were seen throughout the esophagus and stomach. Endoscopic examination was performed eight times until endoscopy can not be done due to esophageal stenosis. And we observed the change of the mucosal damage and the extent of esophageal and gastric involvement. Esophagogastrostomy and gastrojejunostomy was performed on the 114th hospital day and postoperative course was uneventful and she was discharged 51 days after the laparotomy. It is included that endoscopical examination would be necessary for the accurate evaluation of caustic injury and permitting rational operation.View full abstractDownload PDF (4565K) -
Makoto UTSUMI, Kiyoshi OKAMURA, Kazumichi HARADA, Iwao KAJI, Noriyuki ...1984 Volume 26 Issue 2 Pages 237-242_1
Published: February 20, 1984
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSWe reported a case of esophageal cancer associated with the proximal margin of an esophageal ulcer located in the middle esophagus, relatively rare disease. Diagnosis of this case was very difficult because of the special clinical course. The patient was a 56-year old woman who visited us with a chief complaint of precordial pain. By X-ray examination of the upper gastrointestinal tract and esophageal endoscopy, she was admitted under a diagnosis of an acute middle esophageal ulcer. The ulcer healed rapidly in about 2 weeks after admission, but the proximal margin of the ulcer tended to gradually increase in size. Macroscopically, the proximal protuberance was surmised to be a carcinoma, so biopsies were performed several times but without detection of any malignant cells. About 1 month later, the protuberance became clearer and squamous cell carcinoma was confirmed by biopsy obtained from a small concavity in the center of the lesion. An operation was thus performed. Postoperative histopathological examination showed that the carcinoma located beneath the protuberance. The carcinoma was mostly covered with normal mucosa and only a part of it was exposed. The morphology of the carcinoma and the timecourse changes in the acute ulcer were thought to be the factors which made diagnosis difficult.View full abstractDownload PDF (4999K) -
Toyohiko HONDA, Yoshio OONISHI, Shinji KATSUSHIMA, Yasutaka TOKUDA1984 Volume 26 Issue 2 Pages 243-246_1
Published: February 20, 1984
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSGastric ulcers in general are depressed lesions. In rare cases, ulcer scars may become elevated. Recently, we encountered a patient with elevated gastric ulcer scars . The patient was a 27-year-old male. He complained of epigastric pain . Endoscopic examination (Aug., 20, 1982) showed kissing ulcers in the antrum . The second endoscopic examination was performed (Sept., 30, 1982) and revealed elevated lesions accompanied by fold convergency on the anterior and posterior wall of the antrum . Four months later, the elevated lesions disappeared and red scars were found on the anterior and posterior wall of the antrum. Histological findings of biopsy specimens from the elevated lesions were following Mucosal glands were hyperplastic. The interstitial tissue was edematous and infiltrated by inflammatory cells. No histological evidence of malignancy was obtained .View full abstractDownload PDF (3541K) -
Tokushi OSATO1984 Volume 26 Issue 2 Pages 247-252_1
Published: February 20, 1984
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSTwo patients with bezoars (the maximum diameter : 6cm) complicated with gastric ulcer were reported. The bezoars could be removed by a one-channel f iberscope. Case I : A 70-year-old female was admitted to our hospital due to epigastric indisposition, anorexia, and hunger epigastric dull pain following the intake of persimmons. A henegg-sized bezoar found in her stomach was excised and orally removed using Olympus GIF-D3 with basket forceps . Case II: A 21-year-old female, who had taken a large amount of seaweed for several years, experienced nausea, pyrosis and hunger epigastric pain several months before comming to our hospital. An eagle's egg-sized bezoar found in the patient's stomach was excised and orally removed by Olympus GIF-Q with snare forceps and basket forceps. With these cases, we confirmed the feasibility of a one-channel open fiberscope for the removal of bezoar, that was previously thought difficult due to the mobility of bezoars.View full abstractDownload PDF (6406K) -
Kazuo INUI, Yoshiyuki NAKAE, Junichi KANO, Taichiro SATO, Takehito KAT ...1984 Volume 26 Issue 2 Pages 255-260_1
Published: February 20, 1984
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 47-year-old male with gastric ulcer or duodenal ulcer has been follwed up at our hospital for seven years. Thirty five years ago he underwent gastrojejunostomy for pyloric stenosis. Gastrof iberscopy on June, 1982, revealed a reddish, shallow depressed area with a white coat on the lesser curvature of the antrum. Biopsied specimen of the lesion revealed adenocarinoma. Radical gastrectomy was performed on August, 1982. The lesion, 30 × 37 mm in diameter, 25 mm distant from anastomosis. Histologically, moderate differentiated tubular adenocarcinoma was limited in the mucosal layer and no lymphnodes were involved. Gastric carcinoma after gastroenterostomy is rarely seen and only 3 cases were reported as early carcinoma in the Japanese literatures. We discussed 12 cases of gastric carcinoma after gastroenterostomy reported in the Japanese literatures in comparison with gastric carcinoma after gastrectomy. For early detection of gastric carcinoma after gastrectomy or gastroenterostomy, the patient must be follwed-up by periodic endoscopic examination even if there is no sign or symptom of gastric diseases.View full abstractDownload PDF (3904K) -
Yukio HIROUCHI, Yoshimi MIYANO, Shineo KUSUMOTO, Hiroaki YAMAMOTO, Shi ...1984 Volume 26 Issue 2 Pages 261-265_1
Published: February 20, 1984
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 73-year-old female was admitted to our hospital on January 14, 1982 for evaluation of epigastralgia, anorexia and nausea. Stool examination showed Ascaris lumbricoidesova. A partial body of the roundworm was found in the Vater's papilla by using a forwardviewing fiberscope (Machida FGI-SD). During the endoscopic observation, the roundworm prolapsed from the Vater's papilla and migrated to the second portion of the duodenum. The roundworm was pinched by the forceps and removed under the endoscopic observation. Another two ascarides were seen in the stool by administration of pyrantel pamonate. About the middle of June, 1982, she complained of epigastralgia again, and ova in stool specimen became positive: Gastrointestinal X-ray series showed the filamentous radiolucent area in the barium-filled upper portion of the jejunum . After readministration of anthelmintics, two ascarides were detected in the stool and her complaints disappeared . Endoscopic retrograde cholangiopancreatogram showed the mild dilatation of the main pancreatic duct and the worm-shaped radiolucency in the duct. A rare case which the roundworm was removed by the endoscopic procedure was reported.View full abstractDownload PDF (5012K) -
Tomonori IMAOKA, Yosiro KIYOHARA, Noriko TAKEDA, Kentaro KISHI, Satosh ...1984 Volume 26 Issue 2 Pages 266-273
Published: February 20, 1984
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSThis is a case report of a colonic lipoma. A 51-year old man was admitted to our hospital complaining of right upper quadrant abdominal pain. Barium enema examination revealed an oval, sharply marginated and smoothly contoured polypoid lesion (24×34 mm) in the descending colon. The contour and conf igulation of the tumor was often altered during examination. The colonoscopy revealed a sessile, ball-like tumor covered by smooth mucosa with normal color, vascular pattern and bridging folds. The tumor showed a “cushion sign” phenomenon, and, was therefore, considered to be a submucosal tumor containing liquid. Radiologically and endoscopically, the tumor was thought to be a cystic lymphangioma of the descending colon and was resected by colonoscopic polypectomy. The removed tumor was measured 29×20 ×18 mm in greatest diameter and consisted of submucosal yellow fat tissues.View full abstractDownload PDF (4441K) -
Wataru KOYAMA, Masato MAEDA, Shigemi SAKAMOTO, Seisaku KOIZUMI, Masaak ...1984 Volume 26 Issue 2 Pages 274-280_1
Published: February 20, 1984
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSCase I was a 40-year-old male patient and a history of heavy alcoholic intake (about 900 ml of Japanese Sake per day) for 15 years. Case II was a 42-year-old male patient and had received transfusion at the age of 27 ; he was also a heavy drinker and consumed about 720 ml of Japanese Sake per day for 22 years . Serum HBs antigen was negative in both cases by radioimmunoassay. Serum HBs antibody was negative in case I and positive in case II. Neither HBs antigen nor HBc antigen was demonstrated in liver biopsy specimens of the two patients by peroxidase labeled antibody method . Serial laparoscopies with liver biopsies revealed transition from micronodular cirrhosis to macronodular cirrhosis for the periods of about 5 years in case I and 2 years in case II. High levels of serumy-glutamyl transpeptidase activity (over 500 IU/L) and moderate increase of serum glutamate oxaloacetic transaminase actvity (50-120 IU/L) persisted for the 5 years without marked aggravation of liver function in case I. On the contrary, repeated aggravations of liver function were recognized in case II. The present study suggests that not only repeated aggravations of liver function due to alcoholic ingestion but also persistent moderate liver injury from alcohol ingestion play an important role in the progression from micronodular cirrhosis to macronodular type in alcoholics.View full abstractDownload PDF (7358K) -
Seiji SUZUKI, Atushi KANO, Fumio MATUYA, Seishi ORII, Eiji FUJIMAKI, S ...1984 Volume 26 Issue 2 Pages 281-288_1
Published: February 20, 1984
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSWe have recently encountered a case of lymphangioma coexisting with adenoma in the sigmoid colon excised by endoscopic polypectomy, which was diagnosed preoperatively by the colonoscopic examination. The patient, a 61-year-old man, was in our hospital with cerebral infarction, presently showed anemia and Guaiac-positive stool on laboratory findings. Double contrast radiograph of the colon demonstrated a hemisheric shadow with smooth surface and partial lobulation, and also revealed a polypoid lesion at the anal site of the shadow. Colonoscopy revealed a hemisheric, grey pale coloured, smooth tumor with fluctation and transparancy. The shape of the tumor after biopsy turned to be a pedunclated tumor for exuding fluid, and excised by endoscopic polypectomy with the other polypoid lesion. The excised tumors mesured 1.1 × 1.0 cm and 0.6 × 0.5 cm. Histopathologically, the tumor was dilated multiloculated cystic spaces, which were lined by flattend epithelium and separated by fibrous connected septae ; a diagnosis of cystic lymphangioma was made and the coexisted polypoid lesion was adenoma. The pathology and clinical findings of lymphangioma of the colon in the literature including the 40 cases reported in the world, especially about useful endoscopy and endoscopic polypectomy, were discussed.View full abstractDownload PDF (4997K) -
1984 Volume 26 Issue 2 Pages 291-297
Published: February 20, 1984
Released on J-STAGE: May 09, 2011
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1984 Volume 26 Issue 2 Pages 298-312
Published: February 20, 1984
Released on J-STAGE: May 09, 2011
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1984 Volume 26 Issue 2 Pages 313-321
Published: February 20, 1984
Released on J-STAGE: May 09, 2011
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1984 Volume 26 Issue 2 Pages 321-323
Published: February 20, 1984
Released on J-STAGE: May 09, 2011
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1984 Volume 26 Issue 2 Pages 324-332
Published: February 20, 1984
Released on J-STAGE: May 09, 2011
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