GASTROENTEROLOGICAL ENDOSCOPY
Online ISSN : 1884-5738
Print ISSN : 0387-1207
ISSN-L : 0387-1207
Volume 28, Issue 7
Displaying 1-22 of 22 articles from this issue
  • Tomoharu YOSHIDA
    1986 Volume 28 Issue 7 Pages 1491-1503
    Published: July 20, 1986
    Released on J-STAGE: May 09, 2011
    JOURNAL FREE ACCESS
    The safety and the mechanism of action of 5% etanolamine oleate (EO) used in endoscopic injection sclerotherapy (IS) were studied. Thirty-six canine models, 47 canine cephalic veins, clotting parameters of 17 human cases before and after IS, and 9 human autopsy cases after IS were used in this study. The following results were obtained.1. EO is a safe sclerosant if it is injected into esophageal varces with total amount of less than 0.5 ml/kg in a single IS.2. Thrombus that obliterates vein occured not immediately, but within 1-6 hours after intravenous injection, and intravenous injection was more effective than perivenous one.3. Damage of venous endothelium was the first histological change after intravenous injection of EO, and this change should be evaluated as the most important role of EO.4. In one autopsy case died 6 days after IS, "bronze varices" which is proved to be the varices obliterated by thrombus was recognized.5. Clotting parameters were examined before and 24 hours after IS. But, no influences were noted on coaglation system.
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  • Sei TOMATSU, Kenichiro INOUE, Fumitake TOKI, Itaru OI, Hiroshi OBATA
    1986 Volume 28 Issue 7 Pages 1504-1510
    Published: July 20, 1986
    Released on J-STAGE: May 09, 2011
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    Adverse effects of urografin used in endoscopic retrograde cholangiopancreatography (ERCP) were studied in 20 patients with positive results on the intravascular urografin pretest, and 27 patients with adverse reactions to intravascularly administered contrast media on the past examination and with no urografin pretest (group A), and 139 patients with no adverse reactions at the past and with negative results on the urografin pretest (group B). The incidence of adverse reaction of urografin after endoscopic retrograde cholangiography ('ERC') was extremely low (zero and 3% in group A and B, respectively), while the incidence after endoscopic retrograde pancreatography ('ERP') showed a tendency to be higher in group A (25%) than in group B (5%). After endoscopic retrograde cholangiopancreatography ('ERCP') also, the incidence in group A (22%) was higher than that in group B (1%). There was no patients with severe adverse reaction. The incidences in the groups were considered to be lower than that of adverse reaction observed during excretory urography or intravenous cholangiography. Excretory urograms were also confirmed in some of the patients with 'ERCP' or 'ERP'. It was considered that urografin injected into the pancreatic duct got into the blood vessels via the pancreas and was excreted into the urinary tract. There was no difference in the frequency of ERCP-induced diarrhea between groups A (13%) and B (9%).
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  • Yugo NAGAI, Masaharu KATSUMI, Katsuyoshi TABUSE, Yoji TABUSE, Osamu AO ...
    1986 Volume 28 Issue 7 Pages 1511-1518_1
    Published: July 20, 1986
    Released on J-STAGE: May 09, 2011
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    The endoscopic microwave coagulation therapy devised by us was evaluated in 25 patients with early gastric cancer. Fourteen of them recieved microwave coagulation preoperatively, and the effect of the treatment was histologically investigated in the resected specimens. In 7 cases in which tumors were partially coagulated, the cosgulated area developed an ulcer (ul II-IV) with no viable cancer cell on the ulcer floor. In 3 of the other 7 cases in which tumors were almost completely coagulated, no malignancy was seen in the histopathologic series of the resected specimens. But in the other 4 cases, a few cancer cells were left viable. In two of them cancer cells were recognized partly on the ulcer circumference, and in the remaining 2 cases in the submucosal layer of the ulcer floor. Since almost all of whom were unable to undergo operation for some reasons, eleven patients recieved the endoscopic treatment by microwave coagulation therapy. One to 6 sessios of the treatment were needed before malignant findings disappeared in biopsy, and only 2 cases developed recurrence during 2 to 50 month (17 months on the average) follow up. These results suggest that the endoscopic microwave coagulation therapy may be applicable for early gastric cancer, even if it invades the submucosal layer especially in cases which are unable to undergo radical operation. Another point of interest is that local cure of early gastric cancer by microwave coagulation therapy may be expected.
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  • Jun SHIMIZU, Shinobu SAKURABAYASHI, Fukashi SUGIURA, Hideki TAKIZAWA, ...
    1986 Volume 28 Issue 7 Pages 1519-1527
    Published: July 20, 1986
    Released on J-STAGE: May 09, 2011
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    The hepatic impedance was determined for 7 rats with liver cancer, 22 patients with primary hepatocellular carcinoma and 8 patients with metastatic liver cancer. A statistically significant difference (p<0.01) was detected between rats with liver cancer and control rats in low frequency region (3 to 3 KHz), most conspicuously at 3 KHz where the value was 1.91±0.18 (×103 ohm cm) for the liver cancer group and 6.35±1.38 for the control. Clinically, the hepatic impedance at 3 KHz was 0.86 + 0.03 for primary hepatocellular carcinoma, 0.69±0.06 for metastatic liver cancer, 1.27+0.19 for liver cirrhosis and 2.24±0.30 for the control group, with a significant difference between either type of liver cancer and liver cirrhosis or the control group (p<0.01), as well as between primary hepatocellular carcinoma and metastatic liver cancer (p<0.01). In differential diagnosis of liver cancers, the hepatic impedance determined under laparoscopy was definitive for 76% of primary hepatocellular carcinomas nd 75% of metastatic liver cancers. Difference in the hepatic impedance between liver cancers and the control or liver cirrhosis or that between primary hepatocellular carcinoma and metastatic liver cancer seemed to be associated with the electric characteristics of the liver tissue and the local blood flow in the liver.
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  • Shigeo NISHIMURA, Kiyohiro KAWAHARA, Seiji MIYAZAKI, Tomoharu YOSHIDA, ...
    1986 Volume 28 Issue 7 Pages 1528-1536_1
    Published: July 20, 1986
    Released on J-STAGE: May 09, 2011
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    One hundred and seventy patients were treated with endoscopic injection sclerotherapy from August 1980 to August 1985. The aim of our method was to perform an itravascular injection of 5 per cent ethanolamine oleate. Complications after injection sclerotherapy were considered minimal if they did not represent an immediate threat of life and were cured with symptomatic treatment. Major complications were related to more serious potentially lethal events, requiring blood transfusion and so forth. Minor complications were chest pain (40.2%), hemoglobinuria (36.0%), esophageal ulcer (31.7%), fever (25.9%) and dyspnea (0.5%). Major complications were noted in 6 cases (3.5%) in which 2 cases (1.2%) died due to these complications. As a cause of death, one was massive bleeding from esophageal ulcer and the other was bleeding from esophageal varices in a patient with hepatocellular carcinoma with A-P shunt. Immediately after injection, arterial oxygen pressure decreased (p<0.05), but arterial carbondioxide pressure, serum potassium, sodium, creatinphosphokinase and hemogrobin were not changed. These changes suggest the presence of a transient pulmono-circulatory disorder. On the occassion of injection, LDH and indirect bilirubin in the serum elevated, which were considered due to hemolysis. It is suggested that the injection sclerotherapy is a relatively safe treatment, if injected exactly into the varices and angiography is performed before injection sclerotherapy except for urgent cases.
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  • Hiroki OKADA, Seiji SHIMIZU, Atsuo IWASAKU, Masato YOSHINAKA, Isoo INA ...
    1986 Volume 28 Issue 7 Pages 1537-1545
    Published: July 20, 1986
    Released on J-STAGE: May 09, 2011
    JOURNAL FREE ACCESS
    Various hemostatic measures are available today, and their usefulness has been so far established. The heat probe method was originated by Protell et al. (1978) as one of the hemostatic measures for upper GI bleeding ; the bleeding vessels are coagulated by electric heat. Recently, a heat probe unit (HPU, Olympus) was devised by application of his theory ; its clinical utility was evaluated in this article. The heat probe method was employed in 19 cases of upper GI bleeding during the past one year, including 11 cases of gastric ulcer, 5 cases of duodenal ulcer, and 3 cases of stomal ulcer. The bleeding was effectively stopped in 18 cases (94.7%) ; follow-up revealed that permanent hemostasis was obtained in 16 cases (84.2%), and temporary hemostasis in 2 cases (10.5%). Electric heat energy required for hemostasis ranged from 15 to 150 J. No complications were encountered. These data confirmed that the heat probe method is equal or superior to other various methods of endoscopic hemostasis in its reliability, operability, safety, and portability.
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  • Junji YOSHINO, Saburo NAKAZAWA, Hirosato OHTA, Tuneya NAKAMURA, Toshih ...
    1986 Volume 28 Issue 7 Pages 1546-1552
    Published: July 20, 1986
    Released on J-STAGE: May 09, 2011
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    Twelve cases of scirrhous type carcinoma were studied in order to investigate their endoscopic ultrasonographic findings. The ultrasonogram of scirrhous type carcinomas was observed the five ultrasonic layers resembling that of the normal gastric wall. The length from the first layer to the fourth layer and the thickness of the fourth layer were measured near primary foci in nine resected scirrhous type carcinomas. And they were also measured at non-cancerous portions in 13 resected stomachs as a control. The length was 13.8±2.5 mm and the thickness was 6.2±1.3 mm in scirrhous type carcinomas. But the length was 4.3±0.6 mm and the thickness was 1.0±0.3 mm in non-cancerous portions. Accordingly the gastric wall of the scirrhous type carcinoma was significantly thicker than that of non-cancerous portions. Furthermore the echoic pattern of the third layer was slightly hypoechoic than in usual, and that of the fourth layer showed as low echoic pattern with high echoic spotts. These findings were obviously different from those of medullary type carcinoma, hypertrophic gastritis or malignant lymphoma. Fibrosis accompanied by the scirrhous type carcinoma was thought to play an important role in the findings of the ultrasonic echogram. The scirrhous type carcinoma will come to be detected in the earlier stage by the endoscopic ultrasonography.
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  • FROM AN ANALYSIS OF WRONGLY DIAGNOSED CASES AS EARLY GASTRIC CANCER AND FOLLOWED-UP CASES
    Daizo SAITO, Shigeaki YOSHIDA, Hajime YAMAGUCHI, Hisao TAJIRI, Atsushi ...
    1986 Volume 28 Issue 7 Pages 1553-1561
    Published: July 20, 1986
    Released on J-STAGE: May 09, 2011
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    Out of the 292 cases of scirrhous carcinoma of the stomach resected at the National Cancer Center Hospital from 1962 to October, 1981, 241 underwent endoscopic examinations prior to surgery. Out of them, five cases (2.1%) were endoscopically incorrectly diagnosed as early gastric cancer. Another case was wrongly diagnosed as early gastric cancer found to be scirrous carcinoma of the stomach at the time of surgery for esophageal cancer. There are 13 cases followed-up endoscopically. From the analysis inclusive of all above 19 cases, the growth of scirrhous carcinoma of the stomach is considered as follows ; (1) The period of distensable state of gastric wall before rigidity ensues is relatively brief. (2) The rigidity of the gastric wall widespread within a remarkably short period of time. Considering the mechanism of this change, we have to think about the role of some kind of inducer which functions as a trigger rather than the quantity of collagen or fibrosis.
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  • Michiro OHTAKA, Masafumi KOMATSU, Fumio TOBORI, Hitoshi YAGISAWA, Hito ...
    1986 Volume 28 Issue 7 Pages 1562-1566_1
    Published: July 20, 1986
    Released on J-STAGE: May 09, 2011
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    A 42-year-old man with alcoholic liver cirrhosis was admitted for the treatment of his esophageal varices. Following the endoscopic injection sclerotherapy, esophageal varices disappeared immediately, but thrombocytes were also rapidly reduced. Immunological examinations, including antiplatelet antibody test and lymphocyte transformation test to administrated agents revealed no abnormality. Sonography showed marked increase of spleen size, and portography demonstrated interception of injected esophageal varices and tortuous dilatation of splenic vein. We could conclude, on the basis of radiological and immunological findings, that, in our case, this procedure could intercept the blood flow of injected varices, important collateral circulations of the portovenous system, but it induced, on the other hand, rapid increase of splenic vein pressure and marked decrease of thrombocytes due to splenic hyperfunction.
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  • Toru NAKANISHI, Yasuaki SAKATA
    1986 Volume 28 Issue 7 Pages 1567-1573_1
    Published: July 20, 1986
    Released on J-STAGE: May 09, 2011
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    This report presents a case of minute gastric carcinoid with type A gastritis which was suspected of gastrinoma and pernicious anemia in the beginning because of the remarkable hypergastrinemia and pancytopenia. A 35-year-old woman were admitted to our hospital for further examination of her pancytopenia. After we ruled out aplastic anemia and pernicious anemia, radiologic and endoscopic examination of total GI tract were done, suspecting of iron deficiency anemia. In the process of examinations, we detected a minute (diameter 5 mm) gastric carcinoid on the anterior wall of middle-gastric body by endoscopic biopsy. Because of her very high serum gastrin level (1, 900ρpg/ml), we suspected gastrinoma initially, however, achlorhydria of gastric juice and a positive test for parietal cell antibody revealed that this hypergastrinemia were due to autoimmnune gastritis (type A gastritis). Though there have been only five reports of gastric carcinoid with type A gastritis including our case in Japanese literatures, the association between both diseases were documented in several Japanese and English literatures, and our case which revealed multiple argyrophil cell hyperplasia and neoplasia of positive Grimelius-stain aound the main lesion was thought to support this hypothesis.
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  • Yasuji HIRATA, Yoshiro NIITSU, Chikara ADACHI, Junji KATOH, Takuji NIS ...
    1986 Volume 28 Issue 7 Pages 1574-1580_1
    Published: July 20, 1986
    Released on J-STAGE: May 09, 2011
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    The authors have experienced two cases with complaints of abdominal pain and diarrhea suddenly developed after the intake of specific food, suggesting gastrointestinal allergy. Case 1, a 36-year-old man, showed a high level of IgE, 2, 800 ng/ml, in the peripheral blood after eating roast beef. Case 2, a 25-year-old man, with a history of pollinosis, an egg manifested a positive result in the RAST (radioallergosorbent test). Biopsy specimen from the duodenal bulb revealed remarkable infiltration of eosinophils in both cases. These two cases fulfilled the criteria of eosinophilic gastroenteritis listed by Greenberger, et al. The requirements were as follows : (1) infiltration of the gut wall with eosinophils, (2) increased number of eosinophils in the peripheral blood, and (3) abdominal symptoms or signs following the ingestion of specific foods. Both patients improved spontaneously with rosponse to the elimination of specific foods (allergen) even without corticosteroid therapy.
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  • Makoto NIWA, Ken SAITO, Takehiko SOENO, Hiromichi ARAKAWA, Osamu MASAM ...
    1986 Volume 28 Issue 7 Pages 1583-1589_1
    Published: July 20, 1986
    Released on J-STAGE: May 09, 2011
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    An autopsy case of angiosarcoma (suspicous of gingival origin) with metastases in the esophagus, stomach, sigmoid colon and other organs was presented. A 72-year-old male consulted a dentist complaining of pain in the left mandibular region. After extraction of teeth in this region, there was formed a nonhealing gingival ulcer with contact bleeding. Then, the patient was admitted to our hospital and received radiologic and endoscopic examinations of the stomach because of severe anemia (Table 1). X-ray photographs and endoscopic view revealed an elevated lesion (Borrmann, type II-like), ca. 2.5×2 cm in size at the gastric body along the lesser curvature (Figure 3, 4). After 50 hospital days, hemoptysis and respiratory distress appeared, and the patient died of respiratory failure at the 81st day. In this case, gingival and gastric biopsies were done. However, both of the examina-tions did not give the correct diagnosis, so that the tumor tissues in the biopsy specimens as well as those in the autopsy organs were histopathologically and immunohistologically reexamined. The tumor consisted predominantly of non-specif iable, undifferentiated components in both the gingival and metastatic lesions (Figure 1-a, 5), although it contained some parts that formed irregular vascular channels and showed positive immunostaining for the Factor VIII-related antigen by the peroxidase-anti-peroxidase method (Figure 10, 11). Angiosarcoma was reported to metastasize to the gastrointestinal (G-I) tract in a rare instance ; no further descriptions were found in the literature. Hence, radiologic and endoscopic appearance of the metastases in the G-I tract of this case was described here in detail and compared with that of another metastasic G-I tract tumors so far reported.
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  • Junichi SUETSUNA, Toshio FUJIOKA, Kazunari MURAKAMI, Ryusuke SHUTO, Ke ...
    1986 Volume 28 Issue 7 Pages 1590-1594_1
    Published: July 20, 1986
    Released on J-STAGE: May 09, 2011
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    The patient is 66 year-old man. He admitted to our division in this hospital with a complaint of jaundice. ERCP showed a normal ventral pancreatogram of 5 cm length and a cholangiogram with stenosis of the middle and inferior portion. Thus, pancreas divisum was suspected and cannulation was carried out into the minor papilla by tapered catheter. The findings of dorsal pancreatogram were irregular stenosis from head to body portion and chain-of-lakes appearance of the tail side. The diagnosis of dorsal pancreatic cancer with pancreas divisum was made and operation revealed pancreas head cancer (stage 4). Histological examination from metastatic lesion, revealed moderatery or poorly differentiated adenocarcinoma.
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  • Makoto WATANABE, Kazunori UEKI, Kyoichi ADACHI, Tatsuya MATSURA, Hideh ...
    1986 Volume 28 Issue 7 Pages 1595-1602_1
    Published: July 20, 1986
    Released on J-STAGE: May 09, 2011
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    We experienced a case of hepatoma of 2-3 mm in size and named hepatoma of a few millimeter in diameter as mm hepatoma, which could not be detected by imaging diagnostic procedures such as echogram, scintigram, abdominal CT, angiogram etc, and could be diagnosed only by peritoneoscopic examination. The patient was a 42-year-old male and had suffered from cirrhosis of the liver. He had been frequently hospitalized because of recurrent attack of hepatic encephalopathy. Peritoneoscopic examination revealed advanced stage of liver cirrhosis (Shimada's code No. 530, 2 e), a yellowish nodule of 2-3 mm in size, which was histologically proven to be hepatocellular carcinoma of clear cell type after aimed biopsy, and a larger nodule of about 1 cm in size. This larger nodule was also biopsied and proven to be not hepatocellular carcinoma. He died of intraperitoneal bleeding after a year and 8 months, when the larger nodule was evidenced to have grown and ruptured, of which histology was well-differentiated (Edmondson II) hepatocellular carcinoma.
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  • Shin OHNISHI, Hiromu AOYAMA, Takahide NAGASE, Hitoshi NAKAGAMA, Takash ...
    1986 Volume 28 Issue 7 Pages 1605-1609_1
    Published: July 20, 1986
    Released on J-STAGE: May 09, 2011
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    Four cases of Wilson's disease including three asymptomatic cases were reported with special reference to peritoneoscopic findings. Two of three asymptomatic patients happened to be found because of the elevation of serum alkaline phosphatase. In all cases, hypocupremia and hypoceruloplasminemia were present and urinary copper excretion was increased. Peritoneoscopy showed yellowish or dark smooth liver in asymptomatic patients. That of symptomatic case showed mixed nodular post-necrotic liver cirrhosis with yellowish degenerative nodules. Histological findings showed nuclear vacuolation and fatty degeneration of hepatocytes. In the cirrhotic case the regenerative nodules were surrounded by wide fibrous stroma. Rhodanine stain was negative in one case. There was a discrepancy between liver copper levels and Rhodanine stain of the liver tissue.
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  • -REPORT OF A CASE AND CLINICO-PATHOLOGICAL REVIEW OF JAPANESE LITERATURE-
    Hiroshi SATAKE, Masao NAOKI, Masahiro AMENOMORI, Hidetoshi FUJII, Hiro ...
    1986 Volume 28 Issue 7 Pages 1610-1618_1
    Published: July 20, 1986
    Released on J-STAGE: May 09, 2011
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    A 52 years-old man with no abdominal complaints was recommended further precise examination of the duodenum after upper GI series. Roentgenographic examination of the upper GI tract revealed a polypoid lesion more than 30 mm in diameter at the first portion of the duodenum. Endoscopic examination showed a smooth elevated lesion like IIa+IIc without erosion or bleeding. The biopsy specimens showed papillary adeno-carcinoma. Pancreato-duodenectomy and lymph node dissection were performed. Surgical specimens showed a smooth elevated IIa +IIc like lesion, measuring 35 × 30 mm in diameter at the duodenal bulb to the second portion. Histological examination of the resected specimens showed papillary adenocarcinoma located within mucosa and submucosa without lymph node metastasis. Case reports of primary early cancer of the duodenum are rare. The authors collected 31 cases of primary early carcinoma of the duodenum in Japanese literature (1968-1984) excluding the cancer at the area of papilla Vater. As far as the characteristics of the tumor surface, gross appearance, and histology were concerned, the early duodenal cancer reported in Japan was rather similar to the early colon cancer comparing to the early gastric cancer. The 14 cases (40.6%) were asymptomatic, and were detected by mass survey. The pre-operative biopsy diagnosis showed group III in 10 cases. If the diagnosis of the biopsy specimen of duodenal tumor reveals group II or III, careful treatment is necessary. It is appropriate that a definition of early duodenal cancer implies mucosal and submucosal cancer of duodenum, because the prognosis of cancers defined as this is good, and metastases are rarely found. Histo-pathological studies show the two types of duodenal cancer : one is "cancer in adenoma", the other is "de novo cancer". It is not yet conclusive if the duodenal cancer arises from the adenoma or from the mucosa of the duodenum itself.
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  • Masanori IWASE, Mitsuo IIDA, Fumio NANISHI, Akihiro SHIGEMATSU, Masato ...
    1986 Volume 28 Issue 7 Pages 1619-1624_1
    Published: July 20, 1986
    Released on J-STAGE: May 09, 2011
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    Two cases of colitis associated with mefenamic acid were reported. Case 1 was a 69 -year-old woman who had taken mefenamic acid 500 mg three times daily for trigeminal pain. One year later she developed diarrhea, bloody stool, and edema. Laboratory findings revealed severe anemia and hypoproteinemia. Increased protein loss from the intestine was confirmed by 125I-PVP test. Barium enema showed thumb-printing in the descending colon and colonoscopy showed reddish-edematous mucosa with hemorrhage in the colon and rectum. Biopsy specimen revealed inflammatory infiltrates and epithelial erosions. These abnormalities disappeared immediately after withdrawal of mefenamic acid, and lymphocyte stimulation test induced by mefenamic acid was positive. Case 2 was a 68-year-old woman who had taken mefenamic acid 500 mg three times daily for knee joint pain intermittently. Ten years later she developed diarrhea and a weight loss of 6 kg for 3 months. Laboratory findings revealed mild anemia and hypo-proteinemia. Barium enema showed no abnormality, but spotty reddness with hemorrhage was seen throughout the colon endoscopically. Histological finding of biopsy specimen was almost similar to that in case 1. Repeated endoscopy was normal immediately after withdrawal of mefenamic acid. Challenge test revealed the recurrence of the similar abnormalities. Clinical features and etiology of mefenamic acid induced colitis were discussed in our two cases and other 10 cases previously reported in the literature. More attention should be paid to the possibility that usual dose of mefenamic acid for long term can cause colitis.
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  • Koichi MATSUMOTO, Kazutoshi MATSUMOTO, Kenji TAKEUCHI, Kazuo MATSUMOTO ...
    1986 Volume 28 Issue 7 Pages 1627-1632_1
    Published: July 20, 1986
    Released on J-STAGE: May 09, 2011
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    A 67-year-old man presented with crampy abdominal pain. A barium enema performed by an attending physician disclosed that he had an intussusception. The intussusception was reduced by the barium enema and the patient was referred to our clinic for further investigation. A barium enema and a barium meal study carried out at our clinic disclosed a polypoid lesion in the terminal ileum. A colonofiberscopic examination revealed that there was a white-yellowish polypoid lesion, the size of which was about 2.5 cm in diameter, at 10 cm oral to the ileocaecal valve. Histopathological diagnosis of biopsied specimen was tubular adenoma with villious change. Ileocaecal resection was done and six polypoid lesions were found in the resected specimen. The size of the polypoid lesions ranged from 0.2 to 2.5 cm in their diameter. All the polypoid lesions were tubular adenoma with villous change. Problems in the diagnosis of small bowel tumors were briefly discussed.
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  • Hiroshi NISHIDA, Tatsuyuki SATO, Hitoshi OKANO, Kyouhei MARUYAMA, Toor ...
    1986 Volume 28 Issue 7 Pages 1633-1641
    Published: July 20, 1986
    Released on J-STAGE: May 09, 2011
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    Four cases of acute hemorrhagic rectal ulcer were reported. All patients were aged and/or incapable of standing. All cases had sudden onset of fresh anal bleeding without pain. Local injection of ethanol absolute was needed in one case. In three cases, ulcers healed with improvement of the general condition, but one was dead due to renal failure. Ulcers occupying one third to all circumference of the rectum were broad, serpiginous and multiple from the dentate line to 5 cm portion in three cases. One case had a round ulcer on 10 cm portion from the dentate line. It is suspected that the stress due to the lesions in the central nervous system is related to the formation of acute hemorrhagic rectal ulcer, because patients with cerebral vascular diseases sometimes have this disorder. In patients at poor risk or incapable of standing, such lesion is also found. The differential diagnosis between acute hemorrhagic rectal ulcer and solitary ulcer of the rectum is possible in the factors of histological and endoscopic findings.
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  • [in Japanese]
    1986 Volume 28 Issue 7 Pages 1642-1644
    Published: July 20, 1986
    Released on J-STAGE: May 09, 2011
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  • [in Japanese]
    1986 Volume 28 Issue 7 Pages 1645-1667
    Published: July 20, 1986
    Released on J-STAGE: May 09, 2011
    JOURNAL FREE ACCESS
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  • [in Japanese]
    1986 Volume 28 Issue 7 Pages 1668-1743
    Published: July 20, 1986
    Released on J-STAGE: May 09, 2011
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