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Volume 29, Issue 9
Displaying 1-21 of 21 articles from this issue
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Masaru OKUHIRA1987 Volume 29 Issue 9 Pages 1941-1955
Published: September 20, 1987
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSGastric mucosal blood flow rate (GMBFR) was assayed by an endoscopical hydrogen gas clearance method in dog gastric cancers and human early gastric cancers and its correlation to morphological features of gastric cancer was investigated. In dogs, GMBFR decreased gradually till gastric cancers appeared 15th month after the beginning of N-ethyl -N'-nitro-N-nitrosoguanidine administration. However after gastric cancers were induced GMBFR at these lesions increased significantly till experimental month 32. Among gastric cancers with redness, erosion, ulcer and elevation which were observed endoscopically, GMBFR was highest in cancers with elevation. In cancers with redness, which are regarded as the morphology at the beginning of carcinogenesis, GMBFR was higher in the lesions at initial stage than those at late stage. In human early gastric cancers, GMBFR was increased compared with than in intact mucosa. GMBFR was high in IIb-type cancers and low in moderately differentiated cancers. Cancers less than 1 cm2 showed higher GMBFR than those more than 1 cm2. Thus in both dogs and humans, GMBFR was generally, higher in cancers at early stage.View full abstractDownload PDF (8695K) -
Makoto TAKAHASHI1987 Volume 29 Issue 9 Pages 1956-1971
Published: September 20, 1987
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSIn order to improve diagnostic ability and to inquire into the growth of gastric cancer, a retrospective analysis was made using endoscopic films of patients with gastric cancer (47 cases) whose course we have had the chance to observe for more than 6 months before the final detection of the disease. The results were as follows : 1) To diagnose at an early stage, it is necessary to make attention to endoscopic features such as homogenous slight redness, slight irregular white coating with partial redness and bleeding with regarding the difference in the histological type. 2) In the depressed lesion, there are different types of invasion such as the type to invade at an early stage of the course, and the type in which cancer invasion stays in the mucosa for a long time. Therefore, it is speculated that the mucosal muscle layer act as the barrier against cancer invasion. 3) In 17 cases in whom the square of lesion are possible to measure retrospectively, the area of the lesion was tend to expand slowly having expansion rate of 103 mm2 for a year. 4) Concerning of the growing curve of the lesion, it was almost fit into the formula of S=0.1t2 in early cancer (14 cases) and of S=0.3t2 in advanced cancer (3 cases) which was proposed by Nakamura (1978).View full abstractDownload PDF (3519K) -
Tadashi TOKUTOMI, Ken HARUMA, Koji SUMII, Masaharu YOSHIHARA, Hiroaki ...1987 Volume 29 Issue 9 Pages 1973-1979_1
Published: September 20, 1987
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSNineteen cases of superficial esophageal cancer including 16 of early cancer were studied to clarify the problems on the early diagnosis of esophageal cancer. As for the depth of invasion, 4 cases were limited to the mucosal layer (so called "mm cancer") and 15 cases were limited to the submucosal layer (so called "sm cancer"). Of 15 cases of sm cancer, 12 cases (80.0%) had mild symptoms related to the cancerous lesion, and 13 cases (86.7%) could be visualized by X-ray examination. On the contrary, 4 cases of mm cancer had no symptoms and only half of them could be visualized by X-ray examination These findings suggest that sm cancer can be picked up by symptoms or X-ray examination, but mm cancer or ep cancer is difficult to be picked up by them. In order to detect mm cancer or ep cancer, the most effective method is careful endoscopic observation of the esophagus combined with the Lugol staining method.View full abstractDownload PDF (6469K) -
-REEVALUATION OF THE ENDOSCOPIC METHYLENE BLUE STAINING METHOD-Masahiro TADA, Mikio KARITA, Kazuko HIROTA, Hirofumi KAWANO, Masaki SI ...1987 Volume 29 Issue 9 Pages 1980-1988_1
Published: September 20, 1987
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSThe adequate relationship between the endoscopic finding and the histology is necessary to confirm the diagnosis of chronic gastritis. But, the bite biopsy specimens are too small to clarify. In surgical specimens the endoscopic finding such as vascular marking and redness are deminished. To relate the endoscopic finding to histology, we have applied jumbo biopsy technique called strip biopsy. In strip biopsy specimens, the color of the specimens is held as in the endoscopic picture. We have evaluated the limitation and the usefullness of the methylene blue staining method by using strip biopsy. By cryostat section, it has become clear, that methylene blue is absorped on the apical portion of intestinal metaplasia. By strip biopsy specimens of methylene blue stained area and nonstained area, the dissecting microscopic findings and the histology and the endoscopic findings are related as followings. The intestinal metaplasia which has brush border on the apical portion are stained by methylene blue. On the other hand, the intestinal metaplasia which dose not have brush border on the apical portion are not stained by methylene blue. M. B. (-)-I. M, are rare on the atrophic border and are frequent on the antrum, namely about 20%. But, there are no method to clarify the M. B. (-)-I. M. without hostology.View full abstractDownload PDF (13932K) -
-FOR THE PURPOSE OF ESTABLISHING A NEW CLASSIFICATION OF THE HEALING PROCESS OF GASTRIC ULCER-Saburo NAKAZAWA, Tsuneya NAKAMURA, Junji YOSHINO, Toshihiro YAMANAKA, ...1987 Volume 29 Issue 9 Pages 1991-1998
Published: September 20, 1987
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSWe studied about the possibility of judgement of the healing of gastric ulcer and prediction of the recurrence from a standpoint of the EUS appearance. At first, we defined "White fur echo" as a thick and clear high echo layer of the superficial part of the ulcer base and "Ulcer echo" as a low echo area of the ulcer base. In ulcers of Ul-II, Ul-III and Ul-IV, "White fur echo" was not seen in S1 and S2 stage of endoscopic classification. In ulcers of Ul-II, Ul-III and Ul-IV, "Ulcer echo" was seen in Al to H2 stage of the endoscopic classification. In ulcers of Ul-II and Ul-III, "Ulcer echo" was seen in S1 stage. In some ulcers of Ul-IV, "Ulcer echo" was seen in Sl stage. Only in Ul-IV ulcers, "Ulcer echo" was not seen in S2 stage. The Ul-IV ulcer scar with "Ulcer echo" in S1 stage had the possibility of recurrence. The Ul-IV ulcer scar without "Ulcer echo" in S1 stage and S2 stage was not recurrent. Therefore, the healing of ulcer can be judged when "Ulcer echo" disappeared. From these findings, it is suggested that the new endoscopic stage classification including EUS classification is useful for the treatment, judgement of healing and study of recurrence of peptic ulcer.View full abstractDownload PDF (8289K) -
Nobuhiro SAKAKI, Mitsuru SAITO, Kouji NOMURA, Yoshito OSHITA, Yukinori ...1987 Volume 29 Issue 9 Pages 1999-2004_1
Published: September 20, 1987
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSEndoscopic and clinical features of minute gastric erosions accompanying chronic gastritis were studied. By using magnifying endoscopes, minute erosion was demonstrated as the depressed area without fine gastric mucosal pattern, and its regenerated mucosa was observed as the area where showed granular regenerative mucosal pattern. The minute erosions were observed in about 70% of patients with chronic gastritis by magnifying endoscopes and conventional panendoscopes. The clinical course of erosions were divided into 4 stages ; stage of bleeding, depression, red regenerated mucosa and white regenerated mucosa. Main complaints were epigastralgia in the stage of bleeding and epigastric discomfort in the stage of depression respectively. After a medical treatment, endoscopic findings were improved and subjective complaints were subsided.View full abstractDownload PDF (4275K) -
Masahiko TAKAMASU, Tadashi KODAMA, Toru OISHI, Shin-ichi FURUYA, Shoji ...1987 Volume 29 Issue 9 Pages 2005-2009_1
Published: September 20, 1987
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSWe investigated 682 cases of total or partial gastrectomized patients and 62 cases (9.1 %) of postoperative reflux esophagitis were detected. They were evaluated in comparison with 248 cases of nonoperative reflux esophagitis diagnosed during the same period. These reflux esophagitis were classified into discoloring (type A), erosive-ulcerative (type B) and uneven (type C) according to their endoscopic findings. Type A postoperative reflux esophagitis was 16.1%, type B was 80.7%, and type C was 3.2%. In cases of distal gastrectomy, the frequency of postoperative reflux esophagitis was almost the same in both cases reconstructed with Billroth-I and Billroth-II (Billroth-I ; 7.4% and Billroth-II ; 7.6%). Type B was further divided into grade Bi, Bii and Biii according to the amount of white coat. Bi was not covered with white coat, Bii with thin and Biii with thick white coat. With this classification, 46.8% of postoperative reflux esophagitis were grade Bi, 14.5% were Bii and 19.4% were Biii. In the postoperative, we found more cases of the low grade than those in the nonoperative, while less cases of high grade were detected. Endoscopic improvement was noted in less cases and more cases were unchanged. These differences were considered to be due to the different causes of each reflux esophagitis.View full abstractDownload PDF (4107K) -
CLINICAL EVALUATION OF ENDOSCOPIC INJECTION SCLEROTHERAPY FOR BLEEDING VARICES OF THE GASTRIC CARDIAHitoshi OKANO, Tadashi KODAMA, Hideharu TSUJI, Masahiko TAKAMASU, Shoj ...1987 Volume 29 Issue 9 Pages 2010-2015
Published: September 20, 1987
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSEndoscopic injection sclerotherapy was performed in 14 patients with hemorrhage from gastric varices, and the acute bleeding could be stopped in all of them. One of the patients underwent surgery later with the patient's request. In 7 patients, varices almost disappeared with additional sclerotherapy, and all of them are alive without episodes of recurrent bleeding. The remaining 6 died from causes such as hepatic failure, but recurrent bleeding did not occur during the clinical course in 5 of them. Sclerotherapy for esophageal varices could be safely performed and was effective in controlling hemorrhage. Moreover, gastric varices disappeared in some patients with additional sclerotherapy.View full abstractDownload PDF (6350K) -
Hiroaki OHMORI, Hiroshi ASAHI, Tadashi ABE, Masatoshi WATANABE, Muneki ...1987 Volume 29 Issue 9 Pages 2016-2021
Published: September 20, 1987
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSThe effect of famotidine on gastric mucosal blood flow (GMBF), transmucosal potential difference (GMPD) and mucosal pH (GMpH) were studied by endoscopy in five healthy subjects. And the effects on serum gastrin and secretin were also investigated. Before administration of 20 mg/hr of famotidine, GMBF of the antrum, angle and body was 53.9 ± 8.5 (M ± SE), 57.7 ± 10.9 and 64.2 ± 12.1 ml/min/ 100 g respectively. After the administration, the GM BF was 95.1±10.5, 108.1±11.2 and 80.4±11.7 ml/min/100g respectively. After the administration of famotidine GMBF was significantly increased in the three regions. GMPD was also significantly increased especially in the body. But there were no significant changes on serum gastrin and secretin levels. From these results, it was suggested that famotidine enhanced the gastric mucosal resistance in addition to the inhibition of acid secretion.View full abstractDownload PDF (625K) -
-A TRIAL OF THE NEW THERAPY FOR CHOLEDOCHOLITHIASIS-Yoshihiko NAKAZAWA, Kazuichi OKAZAKI, Yasutake YAMAMOTO1987 Volume 29 Issue 9 Pages 2022-2030
Published: September 20, 1987
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSEndoscopic coagulation using microwave system was recently employed in Japan for the treatment of polypoid lesions, cancers and bleedings in alimentary tract. We have attenpted to apply a new therapy for biliary obstruction caused by choledocholithiasis. First, the most effective and safe conditions with microwave system was determined to be 20 watt for 10 to 20 seconds in alimentary tract of dogs. Secondaly, the fistulization from the duodenum to the common bile duct was successfully achieved in a Japanese monkey. There were no remarkable side effects including acute pancreatitis or acute cholangitis during and after this procedure. Clinically, six patients (mean 72.5 yrs.) with choledocholithiasis were treated with EDCF. In four patients, stones were removed through the fistulae. Acute cholangitis was observed only in one case. The diameter of the common bile duct reduced from 14.6 to 11.1 mm within a week regardless of stone removal after EDCF (p<0.05, n=6). Significant decreases in ALP and γ-GTP were observed in 7 days after EDCF (p< 0.01, p < 0.05, n=10). We concluded that EDCF was applicable as an effective non-surgical therapy for common bile duct stones, especially in patients considers to be high risk for surgery.View full abstractDownload PDF (8335K) -
Katsuro SAGARA, Shigetoshi FUJIYAMA, Osamu HASHIGU, Masatoshi SAKAI, S ...1987 Volume 29 Issue 9 Pages 2031-2036
Published: September 20, 1987
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSThe incidence and characteristic features of extraintestinal complications were studied in 25 patients with ulcerative colitis in the last 8 years. The incidence was 20%, all the patients having total colitis and the patients with relapsing-remission type were more frequently associated than other types of clinical cource. The incidence was not related to the duration of colitis. A 26-year-old-female had aseptic necrosis of the femoral head 5 years after the onset of colitis. A 43-year-old-male accompanied intermittent claudication 4 and a half years after the onset of colitis and he underwent by-pass operation due to arterial thrombosis of the right lower extremitiy. To our knowledge, these complications were extremely rare. Case 3 was a 33-year-old-female who died of multiple organ failure due to DIC. In case 4, a 65-year-old-female, ulcerative colitis developed with diabetes mellitus and brain thrombosis, and case 5 was a 36-year-old-male with asymptomatic colitis complicated with liver cirrhosis (non-B type). The physician should be kept in mind that the serious complications occur in the recovery stage from severe total colitis.View full abstractDownload PDF (3193K) -
Yasutaka KAMIYA, Norishige OZEKI, Akitaka TANAKA, Yoshisuke TAKADA, Hi ...1987 Volume 29 Issue 9 Pages 2037-2043_1
Published: September 20, 1987
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSCase 1. A 57-year-old male patient visited our clinic for sore throat and fever. He had been drinking 360540ml/day of Japanese Sake for 35 years and had hepatic dysfunction. Upper GI series revealed long, low, narrow, elevated lesions with smooth surfaces and a serrated mucosal appearance in the upper to middle esophagus. Endoscopic examination of the esophagus showed three streaks of laceration and transverse folds which were probably the inner circular muscle layer. For two months he was treated with fasting and intravenous hyperalimentation, and was then discharged with cure. Case 2. A 53-year-old male patient visited our clinic for abdominal pain. He had been drinking 540720m1/day of Japanese Sake for 30 years. Upper GI series revealed similar findings to case 1. Endoscopic examination of the esophagus showed circular peeled esophageal mucosa and transverse folds. His condition did not improve with fasting and intravenous hyperalimentation, and he was then treated with protein assimilation hormone and prostaglandin. After that his condition improved and he was discharged. To our knowledge, 17 cases of esophageal submucosal dissection have been reported in Japan. Only 2 of them resembled ours. It is suggested that esophageal submucosal dissection in our patients seemed related to a long history of heavy alcohol drinking and hepatic dysfunction.View full abstractDownload PDF (9346K) -
A CASE OF GASTRIC ABERRANT PANCREATIC TISSUE DETECTED FINE PANCREATOGRAM BY ENDOSCOPICAL CANNULATIONManabu YONESHIMA, Nobuyuki HIRAI, Yoshiyasu OIKO, Takeshi URABE, Nobuy ...1987 Volume 29 Issue 9 Pages 2044-2051
Published: September 20, 1987
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 38-year-old man without subjective complaints had an x-ray examination for a gastric mass survy, which pointed out a filling defect on the lesser curvature of the upper body. A close x-ray examination and a fiberscopy of the stomach disclosed a submucosal tumor with a central umbilication on the upper body. EUS findings showed that the tumor was located in the submucosal layer with thicken-ing of the surrounding proper muscle layer and its echo pattern was solid with some small cystic or ductulous low areas. The findings suggested that the tumor was aberrant pancreatic tissue. On the second gastrofiberscopy, we extracted PPJ and got pancreatic tissue from the tumor. And we succeeded in pancreatography by endoscopical cannulation into the outlet of the duct of the tumor. Thus, this case is a rare case of gastric aberrant pancreatic tissue for which EUS, collection of PPJ and pancreatography were useful for the diagnosis.View full abstractDownload PDF (14328K) -
Hiroyuki OHSIRO, Yasuhisa YOKOYAMA, Isao YOKOYAMA, Ken KONDOU, Manabu ...1987 Volume 29 Issue 9 Pages 2052-2055_1
Published: September 20, 1987
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 37-year-old unmarried man complained epigastralgia, vomiting and anorexia. X-ray examination showed narrowing of the antrum with granular appearance of the anglus mucosa. Gastroscopic examination showed multiple shallow small ulcers of the antrum and anglus, which were surrounded with easily bled and thickened mucosa. Although the upper gastrointestinal study initially raised a suspicion of gastric lymphoma, gastric biopsy showed intense mononuclear infiltration with no evidence of malignancy. Based on positive result of serologic test for syphilis and characteristic X-ray and endoscopic findings, gastric syphilis was strongly suspected. After 4 weeks of anti-leuetic therapy with peros erythromicin 1200 mg/day and anti-ulcer agents with a H2-blocker, epigastric pain was relieved and the lesion healed completely. Biopsy of the stomach after the treatment revealed no cellular infiltration.View full abstractDownload PDF (9681K) -
Masaki KAWANO, Yasuaki ITOH, Masami OHRUI, Takashi OHE, Misao MAEHARA, ...1987 Volume 29 Issue 9 Pages 2056-2060_1
Published: September 20, 1987
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSLaparoscopic findings on congenital dilatation of intrahepatic bile duct were described. A 65-year-old woman was admitted to our hospital because of suspected gall stones and cancer. Ultrasonographic examination, computerized tomography and celiac angiography revealed no definite evidences of malignancy in the gall bladder. On laparoscopy gall bladder was seemed to have normal appearance, but whitish small elevated lesions were observed locally on the surface near the edge of the right lobe of the liver. These elevated lesions had irregular surface and meadering appearance without central umbilication. Atypical cells were present on the biopsy specimen from the elevated lesions. The patient underwent surgical intervention. Operative cholangiography showed dilatation of the intrahepatic bile duct which corresponded to the lesions on laparoscopy. The elevated lesions were easily resected, and cut surface of the resected specimen showed several number of bile ducts, further after cutting the specimen fluid like bile juice was shedding. Clinical features and histology of the resected specimen strongly supported that the lesions were congenital origin. Reports on the laparoscopic findings of congenital dilatation of intrahepatic bile duct were few in number, therefore, the laparoscopic findings of our case was considered to be suggestive.View full abstractDownload PDF (11383K) -
-PERITENEOSCOPIC FINDINGS AFTER INTRAVENOUSADMINISTRATION OF INDOCYANINE GREEN-Takeo IMANISHI, Yumiko YAMADA, Katsuhisa OMAGARI, Sintaro KURIHARA, Sy ...1987 Volume 29 Issue 9 Pages 2061-2066_1
Published: September 20, 1987
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSPeritoneoscopic examination was performed in two cases of Wilson's disease after intravenous administration of indocyanine green (ICG). Case 1: a 19-year-old male with clinical stage JIB (Deiss) showed a smooth liver surface but several prenodular patches (Kalk's Bunteflecke) in a part of the left lobe. These prenodular patches were stained dark green after injection of ICG 2.5 mg/kg body weight. Biopsy specimens of the liver revealed chronic active hepatitis. Case 2 : a 21-year-old female with clinical stage IV (Deiss) showed light blue macronodules, which seemed to be specific to Wilson's disease. These nodules were stained dark green and the nodular surface became clearer by the colour contrast enhancement between dark green nodules and white stroma after ICG injetion. Biopsy specimens of the liver revealed post necrotic lever cirrhosis. These findings after ICG injection seem to be similar to other common liver diseases, and not specific to Wilson's disease.View full abstractDownload PDF (4704K) -
Yih-Fong LIN, [in Japanese], Nozomu ITO1987 Volume 29 Issue 9 Pages 2069-2074_1
Published: September 20, 1987
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 64-year-old male suffering from epigastric discomfort for about 10 months was admitted to our hospital because of duodenal ulcer. One month after admission, the duodenal ulcer improved and epigastralgia subsided. But dyspepsia with dull pain from epigastrium to right hypochondrium appeared again 3 months after admission. A soft elevated mass with irregular shape, uneven surface and whitish discoloration in the duodenal second portion was found by endoscopic examination. In histological examination of the bioptic specimens obtained from the lesion, RLH was highly suspected but malignant lymphoma could not be ruled out. One month later, endoscopy and biopsy were performed again. The lesion extended close to the papilla Vater and the irregular edge and uneven surface with erosions became prominent. Under the histological diagnosis of malignant lymphoma, pancreaticoduodenectomy was performed. No invasion or metas-tasis was found at the time of operation. Pathohistological examination of the resected duodenum showed primary follicle-like structure lacking germinal center formation with prominent proliferation of small lymphocyte in the proper mucosal layer. Therefore, this lesion was diagnosed to be RLH of the duodenum (second portion), finally. RLH of the duodenum is very rare, and primary RLH of the duodenum in the second portion was not reported literary as far as we know. Differentiation of RLH from malignant lymphoma is usually very difficult, especially only from bioptic specimens.View full abstractDownload PDF (9612K) -
Koh KODAMA, Kiyoshi IGARASHI, Mitsuroh CHIBA, Hiromichi ARAKAWA, Osamu ...1987 Volume 29 Issue 9 Pages 2075-2080_1
Published: September 20, 1987
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 55-year-old woman was referred to our Department for further evaluation of a mass in the sigmoid colon detected by a local doctor. She had an episode of bloody stool with sudden onset, not associated with abdominal pain 28 days prior to the admission. Barium enema disclosed a circumscribed protruded lesion, 22 mm in diameter, with uneven attachment of barium on the surface, in the sigmoid colon, Endoscopic examination revealed a dark-red purple colored, semipedunculated mass which easily bled and looked like a blood clot. Cavernous hemangioma was strongly suspected from the angiographic finding of inferior mesenteric artery demonstrating a pooling in the late venous phase at the same area where the mass was detected by barium enema examination. Massive bleeding with sudden onset occurred and necessitated emergency operation. A dark-red colored, semipedunculated, soft mass measuring 18 × 13 mm was found in the sigmoid colon. A diagnosis of cavernous hemangioma was made from the histological finding demonstrating dilated vessels filled with intravascular thrombi or blood clots.View full abstractDownload PDF (6627K) -
Shigeki HOTTA, Yoshiaki ITO, Akira MATSUURA, Yuri YOSHII, Seibi KOBAYA ...1987 Volume 29 Issue 9 Pages 2081-2084_1
Published: September 20, 1987
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSThree patients of pseudomembranous colitis in whom colonoscopic aspiration of colonic contents for Clostridium difficile toxin was very useful in making early diagnosis of this disease were reported. The patients complained of watery diarrhea and pyrexia during postsurgical antibiotic therapy were colonoscoped at earlier stage after the onset. Colonoscopy revealed mucosal edema and multiple small white plaques in case 1, mucosal edema and pseudomembrane in case 2 and marked mucosal nodularity and pseudomem-brane in case 3. During the colonoscopic examination, colonic contents were aspirated and delivered for detecting Clostridium difficile toxin which was reported to be positive within 30 minutes. Clostridium difficile was demonstrated by culture of colonic contents aspirated by colonoscopy afterwards. On the basis of our experience of these three cases, we emphasized usefulness of earlier colonoscopy with aspiration of colonic contents for Clostridium difficile toxin in cases suspected pseudomembranous colitis.View full abstractDownload PDF (3823K) -
Shozo OKAMURA, Toshio ASAI, Hatsuhiro YAMAGUCHI, Masahiro MITAKE, Taka ...1987 Volume 29 Issue 9 Pages 2087-2093
Published: September 20, 1987
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 55-year-old man was referred to our hospital for exact diagnosis and its treatment of the polypoid lesion of the ascending colon. He had not any gastrointestinal trouble. Laboratory examination revealed no abnormality without positive reaction for stool occult blood. Radiological and colonoscopic examination showed a small sessile mass with central shallow depression at the ascending colon. The depressed area was discolored and the mucosa surrounding the depressed area showed normal color, so that the lesion looked like a submucosal tumor (Figure 1-a, b, and Figure 2-a, b). Endoscopic polypectomy was performed on October 11, 1985. The mass measured 10 × 9 × 8 mm, macroscopically. Histological diagnosis was well differentiated tubular adenocarcinoma (Figure 3-c). Cancer cells invaded the mucosa locally at the top of the mass, and invaded the submucosa massively (Figure 3-a, b). Adenoma was not detected in the removed specimen. Radical operation was performed on November 6, 1985. But, cancerous infiltration was found neither in the colonic wall nor in the removed lymph nodes. This case is considered to be valuable for the investigation of the evolution and the growing process of the colonic cancer.View full abstractDownload PDF (8291K) -
Hiroshi SUGIYAMA, Takashi TSUJI, Masahiko KATOH, Takashi KUMAHARA, Hir ...1987 Volume 29 Issue 9 Pages 2094-2099_1
Published: September 20, 1987
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSThe authors experienced a case of minute mucosal defect of colon found by colono-scopy at emergency operation due to massive hemorrhage developing during treatment of chronic rheumatoid arthritis and sepsis The patient was a 63-year-old male. Since August 13, 1986, when developed hematoch-ezia, he had been treated with blood and fluid transfusion. As the volume of hemorrhage amounted to 3, 200 ml emergency operation was performed on August 14. At lapalotomy, retention of blood was found at the hepatic and splenic flexures of the colon. However, neither tumor nor ischemic lesion was noted. Colonoscopy done during operation, a pulsating hemorrhage was noted from the end of a blood vessel projecting from the mucosa corresponding to the tenia libera at the right third of the transverse colon. Therefore, partial resection of the colon as large as 2 × 2 cm was performed. Histpathologically, there was a solitary mucosal defect (Ul-1), wherefrom a blood vessel of 1 mm in diameter and 3 mm in length bulged. Although no abnormal blood vessels like large and tortuous running was noted in the submucosa, this lesion was considered similar to Dieulaf oy's ulcer.View full abstractDownload PDF (3319K)
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