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Volume 29, Issue 7
Displaying 1-19 of 19 articles from this issue
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Kazuya MATSUDA1987 Volume 29 Issue 7 Pages 1367-1379
Published: July 20, 1987
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSIn 102 patients with acute gastric erosion, it was examined by biopsy whether the surrounding gastric mucosa of the erosion has intestinal metaplasia. A ratio that the surrounding mucosa of the erosion has intestinal metaplasia was low (18.6%). This result seem to indicate that it is not likely to occur acute gastric erosion from intestinal metaplasia. The gastric electrical potential difference (PD) and mucosal blood flow (BF) of intestinal metaplasia tend to decrease. The vascular architecture of gastric intestinal metaplasia appeared sparse and irregular. It was suggested that these findings cause a decline of BF in intestinal metaplasia. By loading taurocholic acid to intestinal metaplasia, changes in PD and BF were studied. In intestinal metaplasia, BF increased and PD decreased. But a dropping ratio of PD in intestinal metaplasia was lower than that in normal mucosa. Superoxide dismutase (SOD) content of intestinal metaplasia (154.4±17.5 μg/g tissue) measured by ELISA using monoclonal antibody increased significantly compared to that of normal mucosa (130.5±16.2 μg/g tissue). From these result, it was suggested that gastric intestinal metaplasia tends to resist to mucosal injury.View full abstractDownload PDF (3255K) -
Kentaro KOBAYASHI1987 Volume 29 Issue 7 Pages 1381-1395
Published: July 20, 1987
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSRelationship between acute and chronic gastric ulcers was studied clinically and experimentally. Clinically, patients with acute gastric ulcer were followed for prolonged periods to clarify if acute ulcer could change to chronic ulcer, while the clinical pictures of acute and chronic gastric ulcers were compared with each other. In the experiment, chronic gastric ulcer was produced according to the method by Okabe et al. using male Wistar rats. The rats were restrained and immersed in water as described by Takagi et al. until they developed acute gastric mucosal change superimposed on chronic ulcer, and relationship of the chronic to the acute lesion was studied by endoscopic and histologic examinations. The results were as follows : 1) Acute and chronic gastric ulcers vastly differed from each other in clinical picture. 2) The follow up results suggested that acute and chronic gastric ulcers proceed a different course. 3) Acute gastric ulcer was not a predisposing factor for chronic gastric ulcer. 4) Recurrence of acute gastric ulcer was detected in 4.6% of the patients. There was no particular tendency in the site of recurrence. 5) In the experiment, the endoscopic and histologic evidences suggested, as in clinical observation, that there was no correlation between chronic gastric ulcer and acute gastric mucosal change or ulcer induced by immersion in water with restraint.View full abstractDownload PDF (3546K) -
Hideo YANAI1987 Volume 29 Issue 7 Pages 1396-1407
Published: July 20, 1987
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSStrip biopsy is a newly developed safe and easy technique of endoscopic gastric mucosal resection (M. Tada, et al). In comparison with endoscopic polypectomy, this method can be applied not only for polypoid lesions, but also, large scale superficial lesiimens. As both the quantiy and quality of specimens for final pathological diagnosis is provided by strip biopsy, the Japanese grouping system of conventional bite biopsy is generally not required. This method is also very important for early gastric cancer diagnosis and treatment, because many early gastric cancers are of a superficial type. Since its development in 1983, we have used strip biopsy with early gastric cancers and lesions of atypical epithelium (so-called bordre line lesions). Using this method, 30.2% (19 of 63 lesions) of group III lesions, 60.0% of group IV lesions (6 of 10 lesions) and all of group V lesions were pathologically diagnosed as early gastric cancer. The pathological depth of cancer invasion could be diagnosed. Scuenty five percent of all early gastric cancers and 77.6% of lesions of atypical epithelium were completely resected by strip biopsy. Strip biopsy is very useful in differential diagnosis, depth diagnosis and therapy of gastric epithelial tumors, and it is recommended that strip biopsy be used for all lesions in group III, IV and V.View full abstractDownload PDF (2683K) -
Yuji AMANO, Shiro FUKUMOTO1987 Volume 29 Issue 7 Pages 1408-1415
Published: July 20, 1987
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSThe relationships between the endoscopic finding and the alteration of mucosal cell kinetics and gastric mucosal blood flow (GMBF) were evaluated in the canine stomach with mucosal lesion induced by chronic administration of aspirin and ACNU (anticancerous agent). A charateristic pattern in the alteration of mucosal cell kinetics such as an initial suppression and a following recovery was demonstrated when mucosal lesion developed. The formation of mucosal lesion and the adaptating process were more closely related with cell kinetic alteration than with GMBF, because the mucosal lesion observed by endoscopy became severe after an initial suppression of mucosal cell kinetics and gradually remitted after a recovery of cell kinetics to the normal level in spite of the continuation of drug administration.View full abstractDownload PDF (2099K) -
Tomoki HATORI, Yutaka SAGAWA, Kozo MIZUIRI1987 Volume 29 Issue 7 Pages 1416-1422_1
Published: July 20, 1987
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSThirty four patients with bleeding ulcer were treated by local injection of pure ethanol and compared with 28 patients treated with other conventional treatment. To determine the injected amount and site, indocyanine green (ICG) was also mixed with ethanol, and the benefit of the mixture was evaluated. A rate of re-bleeding in the group treated without ethanol was 21.4%, whereas it was 14.7% in the group treated with ethanol. In the latter group, the causes of re-bleeding were projectile bleeding in one case, 2 exposing vessels within each ulcer in 2 cases, one of which was overlooked, and a new exposed vessel in the ulcer in 2 cases. The mixture of ICG and ethanol was useful to determine the proper amount and site of ethanol injection and for preventing ulcer enlargement due to the injection.View full abstractDownload PDF (2772K) -
Kazuo TARAO, Shigehiko MATSUMOTO, Kenzo OKADA, Yubo OIKAWA, Setsuo TAM ...1987 Volume 29 Issue 7 Pages 1423-1433
Published: July 20, 1987
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSThe thirty patients with alcoholic liver fibrosis diagnosed by liver biopsy under laparoscopic examination were subdivided into 3 groups (slight, moderate, severe stage) according to the severity of fibrosis, and laparoscopic findings in each group were studied. In 8 patients with slight stage of alcoholic liver fibrosis, the fine spotty or branching white markings were found in 4 patients. In 15 patients with moderate stage of alcoholic liver fibrosis, fine mesh like structure (0.5-1.5 mm in diameter) were found in 7 (46.7%), and small prenodular elevation (0.5-2.0 mm in diameter) were found in 6 (40.0%). In 7 patients with severe (precirrhotic) stage of alcoholic liver fibrosis, fine mesh like structure were found in 6 (85.7%), and small prenodular elevation in all cases (100.0%). It is concluded that, although laparoscopic changes in alcoholic liver fibrosis showed the same process as chronic viral hepatitis ; that is (1) block formation of the liver surface, (2) prenodular elevation (3) nodule formation, the size of all these three process is far more smaller in the alcoholic liver fibrosis as compared with chronic viral hepatitis.View full abstractDownload PDF (9192K) -
-BI-PLANE TV MONITORING SYSTEM-Hitoshi OKANO, Tadashi KODAMA, Tatsuyuki SATO, Shinichi FURUYA, Hideha ...1987 Volume 29 Issue 7 Pages 1434-1441
Published: July 20, 1987
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESS"Bi-plane TV monitoring system" using TV-endoscope (Toshiba-Machida) was made that allows simultaneous display of present and previously recorded images. Various findings of both examinations could be precisely compared using this system. Detailed assessment of healing process of peptic ulcers could be obtained. In addition, the effects of various endoscopic therapies could be accurately evaluated. In endoscopic injection sclerotherapy for the esophageal varices, a new varices (or recurrent varices) could be differentiated. In laser therapy for early gastric cancer, a precise margin of lesion for radiation could be decided and the therapeutic effects were more accurately evaluated. These results show the diagnostic as well as therapeutic usefullness of this system. Furthermore, for the examination of the lower digestive tract, X-ray images were incorpo-rated into this system. This is useful modality for diagnostic and the repeutic procedures of the diseases of the colon.View full abstractDownload PDF (3663K) -
Kazuto HARA, Seiji MIYAGISHI, Kazutoshi YAMAMOTO, Yoshinori KIYOMITSU1987 Volume 29 Issue 7 Pages 1442-1447
Published: July 20, 1987
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSTo elucidate clinical features of drug-induced ulcer, comparative study of 23 patients with gastric ulcer induced by non-steroidal anti-inflammatory drugs (NSAID group) and 152 patients with ordinary peptic ulcer (control group) was made. In this study, we excluded the patients with prior history of peptic ulcer, rheumatoid arthritis and collagen disease. We also excluded the lesions undetermined endoscopically whether ulcer or erosion. The mean age (61.3±18.8 years) of the NSAID group was older than the control group (P<0.005) and there was significantly higher proportion of women in the NSAID group. Twenty cases of the NSAID group were caused by Diclofenac which was most frequently used as NSAID at our hospital. The main underlying disorder for medication of NSAID was painful skeletal disease (low back pain, 8 cases ; cervical spondylosis, 6 cases etc.) and 56% of the NSAID group had been treated by NSAID for a month. Thirty-eight persent of the NSAID group complained epigastric pain while 29% of the NSAID group complained no GI symptoms. Forty-three percent of gastric ulcers induced by NSAID located in the antral portion and the incidence of antral ulcer was statistically higher than that of the control group. The size of ulcer in the NSAID group was significantly smaller than that of the control group. The NSAID group tended to have multiple ulcers. Therefore, we should pay careful attention to drug-induced gastric ulcer in patients, especially elderly, treated by NSAID.View full abstractDownload PDF (705K) -
Shinichi NAKAHARA, Kengo SHIMOTATARA, Muneharu TOKUSHIGE, Norihiro SAK ...1987 Volume 29 Issue 7 Pages 1448-1454_1
Published: July 20, 1987
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSThe authors evaluated the incidence of ulcers in the upper portion of the stomach in 159 cases with 181 ulcers and determined gastric mucosal hemodynamics and hemoglobin oxygen saturation in 45 healthy adults using an organ-reflectance spectrophotometer. Locations of ulcers in the upper portion of the stomach were divided into 4 sections ; "the watershed" Figure 1. (a) ; a line formed between the posterior wall of the upper body and the fundus observed on the occasion of the enddoscopic examination, the cardia, the anterior wall opposite to the watershed and fundus. Distribution of the ulcer lesions showed that 72.4% of them were located on the watershed, 12.7% in the cardia, 9.4% on the anterior wall and 5.5% in the fundus. The majority of the ulcers in the upper portion of the stomach occurred on the watershed. We measured the gastric mucosal hemodynamics and hemoglobin oxygen saturation, in terms of gastric hemodynamics, in the watershed and fundus to show that the mucosal blood volume in the watershed was higher than in the fundus, while, on the contrary, the hemoglobin oxygen saturation in the watershed was lower than in the fundus. The watershed is the commonest location of ulcers in the upper portion of the stomach. Disturbance of aerobic energy metabolism of the gastric mucosa among aged people brought on following even slight local circulatory insufficiency has been supposed to be one of the causes of this tendency.View full abstractDownload PDF (2423K) -
Soichi KAGIYAMA, Kazuichi OKAZAKI, Yoshiya SAKAMOTO, Satoru TAMURA, Hi ...1987 Volume 29 Issue 7 Pages 1455-1462_1
Published: July 20, 1987
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSIn order to clarify the pathophysiology of choledochocele, we measured the pressure through the endoscope in the cele as well as the orifice zone in three of four patients with choledochocele. The motility of the orifice of the cele was similar to that of the papillary sphincter zone in all of the three cases. In two cases, the motility of the orifice of the cele was similar to that of the papillary sphincter zone in normal subjects, and the pressure in the cele was normal. However, in one case, the very high frequency of motility of the orifice of the cele (spastic movement of the cele) was observed, and the pressure in the cele was high (27 mmHg). These data suggest that in the cases with normal pressure its pathogenesis may mainly depend on congenital factors. And that in the case with elevated pressure probably due to the spastic motility of the orifice, congenital dilatation on the distal end of the common bile duct may grow larger, or congenital local weakness of the wall of the common bile duct may result in dilatation, according with elevation of the pressure in the bile duct.View full abstractDownload PDF (4612K) -
-THE INFLUENCE ON PANCREATICO -BILIARY DISEASE AND EST-Tetsuji AKIYAMA, Tadasu FUJI, Kayoko ADACHI, Toshiyuki SASAKI, Shinya ...1987 Volume 29 Issue 7 Pages 1465-1471_1
Published: July 20, 1987
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSTwelve thousand and twenty five cases of ERCP and 254 cases EST were performed since 1978 at our institute. We have investigated on the incidence and influence of juxta papillary diverticula in our cases which performed ERCP or EST. One hundred seventy six out of 1225 cases (14.4%) performed ERCP were complicated with diverticula. Especially, it was seen frequently in the cases of bile duct stone or benign papillary stenosis. Many of those diverticula were located at supra-papillary, and a few of them were seen at infra-papillary region. In 7 out of 43 cases with juxta-papillary diverticula EST was limited on the width and the direction of cutting. All cases of recurrent stones in our EST had juxta-papillary diverticula. EST is often interrupted by complicated juxta-papillary diverticula, but it is necessary for such cases to be cut as widely and carefully as possible.View full abstractDownload PDF (2403K) -
Masaki MIYAMOTO, Hideki MITOOKA, Yoshitaka KONDA, Kohichi NAGATA, Shig ...1987 Volume 29 Issue 7 Pages 1472-1479
Published: July 20, 1987
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSWe designed endoscopic mechanical lithotripter (EML) equipped with handle torque meter and investigated the effect and safety of EML by crushing stones of the common bile duct. When the torque was increased by turning the handle of the manipulator, basket tension significantly increased. Thus, basket tension was evaluated by the handle torque at the moment the stone was crushed. The safety limit of the basket catheter calculated by the value of the torque meter was 6.8 Kgf ⋅cm at snapping the basket wire. Some calcium carbonate rich stones could not be crushed within this limit. In 19 cases, we crushed stones in the common bile duct using EML. The results of the maximal torque to crush the stones and their composition were in accordance with those of the fundamental examination in vitro. Therefore, their composition could also be assumed by knowing the value of the handle torque at crushing the stones. We concluded that if we perform EML within the safety limits of the values of the handle torque, we can avoid snapping the basket wire and thus avoid injury to the bile ducts during the procedure.View full abstractDownload PDF (4234K) -
Hiroshi NAKANO, Eiko TAKANO, [in Japanese], [in Japanese], [in Japanes ...1987 Volume 29 Issue 7 Pages 1480-1484_1
Published: July 20, 1987
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 61 year-old man with chief complaint of epigastric discomfort was admitted to our hospital on June 4th 1981, for precise examination and operation of esophageal lesion. We found a small submucosal mass in the lower esophagus endoscopicaly one year and four months before admission. At that time, no cancer cells were demonstrated in the biopsied-specimen taken from the lesion. After hospitalization, we found tiny erosion on the top of this polypoid lesion in which cancer cells were demonstrated. Resection of the esophagus was performed on June 25th 1981. Small nodular submucosal masses with erosions gathered in the area messuring 3.2 cm × 2.2 cm were observed in the lower esophagus. Histological diagnosis was basal cell carcinoma. This type of carcinoma was extremely rare in esophagus. Cancerous invasion was limited to the submucosal layer, whereas metastasis were found in the adjacent lymph nodes. Patient developed peritonitis carcinomatosa and died a year after surgery. A small submucosal lesion which we found in the first endoscopy seemed to exhibit the early feature of this type of basal cell esophageal carcinoma. This type of lesion should keep in mind on the differencial diagnosis of small submucosal tumor of esophagus.View full abstractDownload PDF (5604K) -
Kazuhiko NISHIMURA, Takayoshi MATSUI, Keisuke KIYOTA, Hidekazu MUKAI, ...1987 Volume 29 Issue 7 Pages 1485-1490_1
Published: July 20, 1987
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSOn routine barium upper gastrointestinal Xray series, a 52 years old asymptomatic male patient, was found to have a large pedunculated trilobed filling defect in the esophagus. On upper gastrointestinal endoscopy this was a large pedunculated and lobulated polyp covered with normal esophageal mucosal lining. A successful complete endoscopic polypectomy was performed in three stages. At first the most distal lobe C with its stalk was resected. Histologic examination of this lobe revealed fibro-fatty tissue with capillaries covered by normal squamous epithelium. This established a diagnosis of Fibrovascular polyp. During stage 2 and 3 the lobe B and lobe A with its stark were successively removed in that order. Thus a trilobed pedunculated fibrovascular polyp of approximately 18 cros in length was completely removed endoscopically. According to our literature search, this probably represents the case of the largest esophageal fibrovascular polyp removed endoscopically.View full abstractDownload PDF (6905K) -
Hitoshi SHIMA, Hiroyuki WATANABE, Hiroshi NASU, Hiromichi ARAKAWA, Osa ...1987 Volume 29 Issue 7 Pages 1491-1496_1
Published: July 20, 1987
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 66-year-old male was admitted to our hospital because of protruded lesions in the esophagus detected by further evaluation after mass survey. X-ray examination revealed two protruded masses projecting into the lumen in the right-sided wall of the esophagus at the position from the upper edge to the lower edge of bifurcation of the trachea. Endoscopic examination demonstrated two polypoid masses with smooth surface covered by normal mucosa at 27 cm distal to the incisor. Leiomyoma was strongly suspected from chest CT and echogram in addition to the findings of X-ray and endoscopic examinations, although biopsy specimen showed only necrotic tissue. The operated specimen demonstrated two semi-oval, solid, elastic-hard, intramural masses with size of 22×25×23mm and 12×7×7mm, respectively. Diagnosis of multiple leiomyomas was made from the histological findings revealing spindle formed smooth muscle cells arranged in the interlacing bundles without atypia or mitosis. In addition, cases with multiple leiomyomas of the esophagus reported in Japan were briefly reviewed.View full abstractDownload PDF (3642K) -
Masao WATANABE, Kazuhiko MASUDA, Tateki ASANUMA, Toshiyuki KOU, Yoshih ...1987 Volume 29 Issue 7 Pages 1499-1505_1
Published: July 20, 1987
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSTwo cases of acute myocardial infarction occurring at upper gastroscopic examination and resection were reported. Case 1 is a 73-year-old man who was pointed out that he had early stomach cancer on upper gastroscopic examination by chance in admission for acute myocardial infarction. Upper gastroscopic examination was performed again on the 138th day from the firtt attack, and finished with no complication. However, about three hours later, he developed recurrence of myocardial infarction and five days later died. Case 2 is a 74-year-old man who had admitted for the purpose of endoscopic resection of his early stomach cancer. In twenty-five minutes from the beginning of endoscopic resection he complained of chest pain, so we stopped that procedure and diagnosed as having acute myocardial infarction based on changes in the electrocardiogram and in serum enzymes. Later, he was discharged without further complications. The number of elderly people has been increasing who had not only the disease of gastro-intestinal tract but also cardiovascular disorders. We, endoscopists, should always pay attention to the complication of cardiovascular disorders. Moreover, it is necessary to prepare the complete sets of equipments for emergency at the endoscopy room.View full abstractDownload PDF (6163K) -
Jenq-Her CHANG, Fumitake TOGI, Hisataka ISIGURO, Sei TOMATSU, Itaru OI ...1987 Volume 29 Issue 7 Pages 1506-1512_1
Published: July 20, 1987
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSOn ERCP examination, we experienced 4 cases who had wide dilated orifices with retention of mucinous material in the papilla of Vater. The diagnosis of these 4 cases were 2 cases of pancreatic cancer, 1 case of pancreatic cystadenoma, and 1 case of cholan-giocarcinoma (adenocarcinoma in adenoma). It was said that the endoscopic finding of papilla of Vater like above statement, in association with uniformed dilatation of the main pancreatic duct and amorphous filling defect inside it on ERP, were the characteristic findings of mucin producing pancreatic cancer. We experienced 1 case of intrahepatic cholangiocarcinoma (adenocarcinoma in adenoma), who showed the same apperance in the papilla of Vater. In 1 case of pancreatic cancer, the orifice of papilla of Vater was found extremely dilated at the initial examination. However, it was found to be almost normal in size at the subsequent examination. We consider that, when a peculiar endoscopic finding at the papilla of Vater like above statement, both pancreas and biliary tract shoud be thoroughly checked. And because of its potential malignancy, these cases should be treat surgically even though the provement of malignancy may be difficult in some cases.View full abstractDownload PDF (7861K) -
Kiyotaka OKAWA, Atsuo KITANO, Akishige OBATA, Nobuhide OSHITANI, Katsu ...1987 Volume 29 Issue 7 Pages 1515-1521_1
Published: July 20, 1987
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSRutter proposed a term "solitary ulcer syndrome of the rectum" to solitary ulcer of the rectum, as these ulcers are not always solitary and occasionally, not even true ulcers. This syndrome is relatively rare and appear various endoscopic views. We reported three cases which appear three different endoscopic views, polypoid type, ulcer and polypoid type, and ulcer type. Particulary, endoscopic views of Case 2 were followed-up for two years. Histological findings of all cases revealed fibromuscular obliteration of the lamina propria which was characteristic of this syndrome. But, all cases were diagnosed as rectal cancer in other hospitals. We reported three cases, as this entity has not been popularly recognized either clinically or endoscopically in Japan.View full abstractDownload PDF (7469K) -
[in Japanese]1987 Volume 29 Issue 7 Pages 1522-1626
Published: July 20, 1987
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSDownload PDF (16872K)
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