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Volume 29, Issue 2
Displaying 1-21 of 21 articles from this issue
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Hiroshi NAWATA1987 Volume 29 Issue 2 Pages 235-245
Published: February 20, 1987
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSLaparoscopical studies were made on the liver surface among the 136 cases bearing chronic liver diseases, by means of staining method with indocyanine green (ICG). First of all, comparison was made on the relationship between intensity of the stain with ICG and the values of ICG test in chronic hepatitis, revealing positive correlation. Furthermore, it was examined whether ICG staining method contributed to increase diagnostic ability of chronic hepatitis as compared with ordinary laparoscopic examination. In succesion, although it is well known that ICG staining method is very valuable for the diagnosis of fatty liver and hepatocellular carcinoma (HCC), our experiment using the rats bearing fatty liver induced by ingestion of CCl4 showed similar eridence. ICG staining was also performed among the rats fed 2-acetylaminofluorene which is known to be hepatocarcinogen. HCC was not stained with ICG even in the rat as well as liver cancer in human. It was very interesting finding that in hyperplastic nodules focused as premalignant lesion of HCC some nodules were stained, but the others not. Any histological differences were not observed between ICG stained and not stained hyperplastic nodules. Based upon the data that HCC can not be stained with ICG, it can be said that stained hyperplastic nodules should be under remodeling to the normal hepatocytes. Thus, if ICG negative nodules can be observed in cirrhotic nodules, these lesions should be focused as HCC or border line lesion of HCC.View full abstractDownload PDF (8981K) -
Masami YAMADA, Eizo KANEKO, Junichi KUMAGAI, Mitsumasa NAWANO, Fumitos ...1987 Volume 29 Issue 2 Pages 247-253
Published: February 20, 1987
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSNine cases of achalasia were treated with the pneumatic dilator attached to a panendoscope which was deviced by us. The pneumatic dilator was inflated 180 to 300 mmHg for one minute and then repeated twice in the first treatment. A few days later, the next treatment was performed at the same range of pressure and duration of inflation. A total of four attempts were made. A balloon with a diameter of 30 mm is used at the first 2 procedures and at each subsequent procedure the caliber of the balloon was 40 mm. After treatment, a significant decrease in a mean resting lower esophageal pressure was obtained (from 60.3 to 20.3 mmHg in 4 cases, p<0.05). The mean increase rate of body weight one month after treatment was 10.5 percent. This method appears to be easier, safer than the conventional method and a successful method of treatment.View full abstractDownload PDF (6801K) -
Tetsuo ARAKAWA, Hiroshi SATOH, Takashi FUKUDA, Kazuhide HIGUCHI, Hajim ...1987 Volume 29 Issue 2 Pages 254-258_1
Published: February 20, 1987
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSSix healthy volunteers were tested the effect of indomethacin in a dose of clinical use on gastric mucosal damage and the levels of mucosal prostaglandins (PGs). In three out of 6 subjects, gastric mucosal lesions induced by indomethacin were endoscopically found ; two spotty hemorrhagic erosions in gastric antrum in one of the subjects ; five linear hemorrhagic erosions in angle and corpus in another one ; multiple hemorrhagic erosions in whole stomach in the last one. The PGE2 level determined from biopsy specimens was significantly reduced by the administration of indomethacin both in corpus and antrum of the stomach. The level of 6-keto-PGF1α (the final metabolite of PGI2) was also reduced by indomethacin, but not significant. These results suggest that clinical dose indomethacin decreases mucosal integrity in relation to the reduction of prostanoids in gastric mucosa of healthy subjects.View full abstractDownload PDF (4225K) -
Kazuhide KUMAGAI, Akira YASUI, Yoshiaki NISHIDA, Minoru KURIHARA1987 Volume 29 Issue 2 Pages 261-267_1
Published: February 20, 1987
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSThe majority of the depressed carcinoma of the stomach have the ulceration in the lesion. We sometimes observe the healing of the malignant ulceration. By the rise and fall of the ulceration in the cancerous lesion, the depressed floor showed all kinds of morphological change. According to this fact, we carried out the study of the relationship between the depth of invasion and macroscopical status with the ulceration in the cancerous lesion. The objects were 33 depressed type gastric carcinomas with the ulceration. The comparative study was carried out between macroscopical and microscopical findings. The results were as follows; 1. The cases in mucosal cancer showed the granular pattern on the depressed floor. 2. According to increasing the cancer volume below submucosal layer, macroscopical findings of the depressed floor became rough. 3. Histopathological findings of the mucosal cancer showed the stratum and sanctuary type by the status of malignant cycle.Consequently, there is a strong relationship between the healing cource of the malignant ulceration and cancer invasive volume below the submucosal layer.View full abstractDownload PDF (4474K) -
Yutaka MORITA, Takayoshi MATSUI, Takasi ANDO, Junichi Okuda, Kazunori ...1987 Volume 29 Issue 2 Pages 268-274
Published: February 20, 1987
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSPreliminary studies on photodynamic therapy (PDT) with hematoporphyrin derivative (HpD) and dye laser were performed and the following results were obtained. 1. N2 and Ar dye lasers were irradiated at dog's liver surface after HpD administration to examine which one is more effective in PDT. Under the same average power (50mW), N2 dye laser (pulse wave laser) was about 10% more effective than Ar dye laser (continuous wave laser). 2. The relation between condition of laser irradiation and effect of PDT with N2 and Ar dye laser were also studied by the same method. The larger the total energy became, the deeper the tissue damage. The depth of tissue damage was not always in proportion to the total energy. Low power and long time irradiation is more effective than high power and short time irradiation under the same energy. 3. To assess the infulence of PDT on non-cancer tissue after HpD administration, N2 dye laser was irradiated at normal dog's gastric mucosa and ulcers made by Nd-YAG laser. Shallow ulcers (U1-II) were formed in normal mucosa, but the ulcers irradiated with dye laser became worse and some ulcers extended to serosa. When PDT applicated to a cancer lesion with ulceration, it is necessary to pay attention to perforation of the lesion.View full abstractDownload PDF (7261K) -
Eiji FUJIMAKI, Atsushi KANO, Takahiko KAWATA, Hiroki KAMATA, Hiromi KA ...1987 Volume 29 Issue 2 Pages 275-281
Published: February 20, 1987
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSIn this report, the relationship between endoscopic findings and upper gastrointestinal bleeding was investigated in 126 cases of liver cirrhosis and esophageal varices. The source of upper gastrointestinal bleedings was disclosed by performing an emergency endoscopy and the incidence of bleeding was analysed in relation to the source of bleeding. The results were as follows : 1. Bleeding from esophageal varices was well correlated with red-color signs, teleangiectasia and form of varices. 2. Negative correlation was recognized between bleeding rate of gastric varices and the severity of esophageal varices. No manifest signs for foresight of bleeding could be found on the gastric varices. 3. The incidence of peptic ulcer in patients with liver cirrhosis and esophageal varices was about 30%. The rate of ulceral bleeding was 60% in associated cases and it was higher than that of variceral bleeding. 4. The incidence of bleeding from peptic ulcer was well correlated with the severity of esophageal varices. 5. In comparison with ulcers in patients without complication, those in patients with liver cirrhosis and esophageal varices were found more frequently at anal side of gastric angle, especially in bleeding cases. It seemed that total upper gastrointestinal endoscopy was very important for patients with liver cirrhosis and esophageal varices.View full abstractDownload PDF (791K) -
Keiichi OHDATE, Hideo MIYAMOTO, Ichiro TANAKA, Koji GOCHOU, Kyoji YAMA ...1987 Volume 29 Issue 2 Pages 282-287_1
Published: February 20, 1987
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSEndoscopic injection sclerotherapy (EIS) was performed in 9 cases of esophageal varices, using a new type of 2 channel esophagofiberscope (FE-34TH). In the conventional 2 channel fiberscope (FG-36T), the biopsy channels were located only in the lower half of visual field. It was difficult to inject an upward varices by it in our experiences. We also felt it's too long to treat esophageal varices. However, the new model of fiberscope (FE-34TH) has 2 biopsy channels which are separated at the upper and lower half. The working length is 750 mm, which is convenient for EIS. This new f iberscope was particularly useful in the emergency EIS. We studied the usefulness of split hood which was attached at the tip of the fiberscope in EIS. Intravasal injection of varices was done in 53% procedures with the split hood attached fiberscope, but it was done in 44% procedures without split hood attachment. By holding the target varices with the split, EIS was performed easily. We concluded that the new 2 channel fiberscope (FE-34TH) allowed a good result of EIS, but further study is necessary to ascertain the true efficacy of split hood attachment.View full abstractDownload PDF (8581K) -
Kenichi TERAMOTO, Kimiya TAKESHITA, Hideyasu KIYOHARA, Tougo AOI, Kuni ...1987 Volume 29 Issue 2 Pages 288-295
Published: February 20, 1987
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSIn recent years early esophageal carcinoma has been reported with increasing frequency. This study is to report a case of an early esophageal carcinoma concomitant with an early gastric carcinoma. A 62-year-old man, who was diagnosed as early gastric carcinoma was admitted to our hospital for further observations. By upper GI endoscopic examination, there revealed a reddish small lesion in the lower esophagus as well as a gastric carcinoma. The biopsied specimen showed esophageal carcinoma. Lower esophagectomy and total gastrectomy were performed. On gross inspection of the resected specimen, there were flat lesion (0.5 × 0.7 cm) at the lower esophagus in addition to IIc lesion (1.8 × 5.0 cm) at the gastric antrum. The esophageal lesion showed a well differentiated squamous cell carcinoma at the mucosal layer, whereas the qastric lesion consisted of signet-ring cell carcinoma at the mucosal layer extending to the submucosa. There was no metastasis to lymph nodes. Concomitant association of an early esophageal carcinoma and an early gastric carcinoma is rare and only 10 cases have been reported in Japan up to present.View full abstractDownload PDF (9290K) -
Toshiaki TAKEICHI, Kazuhiko MASUDA, Shigeo WATANABE, Takuji OHARA, Hir ...1987 Volume 29 Issue 2 Pages 296-301_1
Published: February 20, 1987
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 57-year-old woman with Behcet's disease who had recurrent episodes of oral ap superior vena caval thrombosis re-admited to our hospital because of recurrent fever and right hypo-chondralgia. Laboratory data including ICG retention rate, platelet count, TTT, ZTT, γ-globulin were normal but serum alkaline-phosphatase activity was slightly elevated (Table 1). Cholecyst-hepatolithiasis was found by abdominal echography and CT, and seemed to cause her symptoms. Esophagogram (Figure 4) and endoscopic examination (Figure 5-7) revealed varices localized in upper-two-thirds of the esophagus (so called "downhii varices"). Thrombosis of distal inferior vena cava was also shown by abdominal CT and RI-angiography (Figure 3). Nine cases of downhill varices associated with thrombosis of the superior vena cava have been reported in the literatures (Table 2), including 4 cases of vasculo-Behcet's disease. Such high incidence in Behcet's disease must be paid attention. Thus, the occurrence of it should be taken into account in Behcet's disease with superior vena caval thrombosis, especially in Japan where high prevalent rate is found. There were reported 3 cases complicating thrombosis of the inferior vena caval system, indicating advancing process of downhill varices. Therefore, anti-coagulant therapy should be given carefully to patients with downhill esophageal varices associated with superior vena caval thrombosis.View full abstractDownload PDF (9292K) -
Katsuaki SUGIURA, Taturo SIGESAWA, Shuzo YOSIDA, Rie HIRATA, Akira EBA ...1987 Volume 29 Issue 2 Pages 302-304_1
Published: February 20, 1987
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSThe management of gastrointestinal hemorrhage of two cases with hemophilia A and one with hemophilia-like syndrome due to factor VIII inhibitors was tried using pure ethanol injection. here was no submucosal hemorrhage as a side effect. It is effective to stop bleeding of ulcer if combined with supplying deficient factors of the coagulation system.View full abstractDownload PDF (4116K) -
Tetsuya YANO, Norihide TAKEHARA, Tetsuo YOKOTA, Yukio YORIMITSU, Yoshi ...1987 Volume 29 Issue 2 Pages 305-308_1
Published: February 20, 1987
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 41-year-old female was pointed out to have a polypoid lesion in the stomach at the mass survey and visited our hospital for further examination. Endoscopic polypectomy was performed in March, 1981. But the polyp recurred at the same region as initially observed in Descember, 1982, and the second endoscopic polypectomy was performed. The polyp recurred again in August, 1984 and the third endoscopic polypectomy combined with laser photocoagulation was performed. The histology of three polypectomized polyps showed hyperplastic foveolar epithelium. The recurrent mechanism of the polyp was thought that the epithelium regenerated excessively for the mucosal defect after polypectomy.View full abstractDownload PDF (7434K) -
Kiyoshi ASHIDA, Shigeki KOYAMA, Minoru KIZU, Hiroshi TAKADA, Saburou O ...1987 Volume 29 Issue 2 Pages 311-317_1
Published: February 20, 1987
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA case of pancreas divisum complicated with pancreatic cancer was reported. The patient is 75-year-old female. She has been treated for diabetes mellitus for 7 years with good control. Recently, she began to complain of equivocal abdominal pain and weight loss and was found to have increased level of fast blood sugar. Moreover, rigid mass about 5 cm in diameter was palpated in her epigastrium. ERCP showed no communication between Wirsung's duct and Santorini's duct. Furthermore, ERCP revealed that the ventral pancreatic system was found normal appearance but the dorsal pancreatic duct was interrupted in site of 5 cm apart from accessory papilla orifice. From this finding, carcinoma in the dorsal pancreas was diagnosed. She underwent non curative operation. She died about 6 months after the operation. These findings of ERCP completely consisted with pancreatogram at autopy. Histological findings of pancreas tumor showed poorly differentiated adenocarcinoma. This carcinoma widely invased beyond the capsule of pancreas. On the other hand, carcinoma was not found in the ventral pancreas. Therefore, it was persumed that carcinoma arised from dorsal pancreas. It might be recommended that it should be made an effort to obtain dorsal pancreatogram, because pancreas divisum might be complicated with pancreatic cancer such as our present case.View full abstractDownload PDF (11447K) -
Kunio SATOH, Atsushi KANO, Chisato HAMASHIMA, Hidemasa SEKI, Hiromi KA ...1987 Volume 29 Issue 2 Pages 318-327
Published: February 20, 1987
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA case of double pylorus was reported. A 62-year-old male visited our hospital with the complaint of epigastralgia. Upper gastrointestinal fluoroscopic and endoscopic examination revealed double pylorus having a second opening on the lesser curvature with an active duodenal ulcer. An endoscopical film of this patient, taken 10 years ago, showed only deformity of the prepyloric region but not a double pylorus. We considered this case to be an acquired type of double pylorus. Forty-three cases (male 32, female 11) of double pylorus, including this case, are reported in Japan up to 1985. The mean age was 61.4 years and the genesis was considered to be congenital in 2 cases, acquired in 33 cases, and undetermined in 8 cases. The second opening in these cases were located on the lesser curvature side of the pylorus in 33, 6 on the greater curvature and 1 on the anterior wall and 3 cases were not explained clearly. Seventeen cases were treated surgically and 26 cases conservatively. The term of double pylorus includes all abnormalities which have an opening, other than original pylorus, between the gastric antrum and duodenal bulb. We therefore suggest that this acquired type of double pylorus should be called a perppyloric gastroduodenal fistula.View full abstractDownload PDF (6849K) -
Tadashi IWAO, Fumihiko YAMASHITA, Shinichi KUBOYAMA, Tsukasa KATSUKI, ...1987 Volume 29 Issue 2 Pages 328-332_1
Published: February 20, 1987
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 57-year-old male was admitted to our hospital because of intestinal obstruction. He had a history of repeated intestinal obstruction due to a narrowing of the sigmoid colon in recent three years. A barium enema study in Nov. 1982 revealed a slight narrowing of the sigmoid colon and it gradually progressed. Finally, a marked stenosis with granular appearance was recoginized at the last examination on Aug. 1985. A colonoscopy in Nov. 1982 disclosed a sessile elevated lesion with normal mucosa and edematous change. Multiple reddish small elavted lesions with narrowing of the lumen were endoscopically found in Aug. 1985. The histological study of the biopsy specimens revealed normal mucosa and the surgical operation was carried out for making a definite diagnosis and treatment. Histologically, there were many cystic lesions which were covered with endothelial cells in the propria mucosa and submucosa. A diagnosis of lymphangiectasia with chronic visceral peritonitis of the sigmoid colon was subsequently made. We discussed this case with a review of some literatures and lymphangiectasia of the coon has been very rarely reported.View full abstractDownload PDF (6561K) -
Takashi AOKI, Tsugio HIGUCHI, Masayuki ONAI, Makoto MOTOYAMA, Rinjiro ...1987 Volume 29 Issue 2 Pages 333-338_1
Published: February 20, 1987
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSAlthough endoscopic sphincterotomy (EST) was developed originally for non-surgical removal of common bile duct stones, indication for this procedure has recently been extended to some other purposes. We apllied EST for the diagnosis of bile duct cancers which diagnoses were not confirmed with other methods ; 3 of 4 cases were cancers of inferior common bile duct and one was cancer of the ampulla of Vater. Symptoms of these patients were iaundice, epigastralgia, right hypochondralgia and fever. ERCP showed a dilatation of the common bile duct with a filling defect and irregular stenosis in the distal third. In all patients periampullary mucosa showed no abnormalities, though in one case the ampulla of Vater was slightly enlarged. The diagnoses of these patients were made with histological examination of specimens obtained by endoscopic biopsy after EST. We concluded that this procedure is very useful and necessary in establishing diagnoses of these diseases.View full abstractDownload PDF (8826K) -
Toshiaki NAKATSU, Toshiyuki AIBIKI, Yoshihito UCHIDA, Hiroyuki KAGAWA, ...1987 Volume 29 Issue 2 Pages 341-346
Published: February 20, 1987
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSENBD was carried out using particular instruments of 7.2 Fr pig tail tube and a guide wire in 7 cases with malignant obstructive jaundice. Then, this tube was able to be inserted beyond the obstruction of bile duct in 5 cases. The mean value of total serum bilirubin before ENBD was very high in our successful cases. After ENBD, bilirubin level had been decreased efficiently comparing with cases treated by PTCD. Regarding to complication of this technique, mild pancretitis occurred in only one case, but this complication might be attributed to EPT rather than ENBD. Moreover, there were no cases whose tube clogged or deviated during clinical course. ENBD using 7.2 Fr pig tail tube is an effective and safe method for reduction of severe obstructive janudice which had not been reduced by previous technique using 5 Fr tubeView full abstractDownload PDF (7321K) -
[in Japanese]1987 Volume 29 Issue 2 Pages 347-382
Published: February 20, 1987
Released on J-STAGE: May 09, 2011
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[in Japanese]1987 Volume 29 Issue 2 Pages 382-409
Published: February 20, 1987
Released on J-STAGE: May 09, 2011
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[in Japanese]1987 Volume 29 Issue 2 Pages 410-417
Published: February 20, 1987
Released on J-STAGE: May 09, 2011
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[in Japanese]1987 Volume 29 Issue 2 Pages 417-426
Published: February 20, 1987
Released on J-STAGE: May 09, 2011
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[in Japanese]1987 Volume 29 Issue 2 Pages 426-435
Published: February 20, 1987
Released on J-STAGE: May 09, 2011
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