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Volume 30, Issue 4
Displaying 1-26 of 26 articles from this issue
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Hiroshi TORIYA, Kensei MAESHIRO, Shigeaki YOSHIMURA, Sumitaka ARIMA, H ...1988 Volume 30 Issue 4 Pages 667-677
Published: April 20, 1988
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSThe clinical efficacies of endoscopic injection sclerotherapy (EIS) and trans-ileocecal obliteration (TIO) for esophago-cardiac varices (ECV) were studied on 50 patients who had had hepato-cellular carcinoma (HCC). The mean survival time (M±SD) after the confirmed diagnosis of HCC was 6.8±4.2 months in non-hemorrhagic cases, 3.1±1.3 months in hemorrhagic cases after preventional or elective EIS, 3.7±1.2 months in emergency hemorrhagic cases and 1.3±0.8 months in re-hemorrhagic cases after emergency treatment. According to these results, some cases without hemorrhage in their clinical courses had longer survival time than hemorrhagic cases and aggressive, preventional treatment to avoid the variceal hemorrhage should be necessary to improve the prognosis of HCC. However, for the reason of existence of portal hypertension due to tumor thrombi in the main branch of portal vein, it is difficult to treat the varices by EIS only. On the incidence of emergency cases and of variceal hemorrhagic cases after preventional or elective EIS, significant differences depended on the existence of tumor thrombi were observed in 29% to 62% (p<0.05). The incidence of re-hemorrhage after emergency EIS on both cases with or without tumor thrombi is 38% and 0%, respectively, and emergency hemostatic rate on the cases with tumor thrombi is no more than 50% by EIS. From these rerults, we conclude that a combination therapy with EIS and TIO must be performed to the patients who has tumor thrombi in the main branch of portal vein, and when we are going to treat patients who have severe EGV with good prognostic HCC, further additional treatment such as Hassab's operation must be recommended.View full abstractDownload PDF (1229K) -
Choichi SUGAWA, Yoichi KON, Charles E. LUCAS, Anna M. LEDGERWOOD1988 Volume 30 Issue 4 Pages 678-682
Published: April 20, 1988
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSSuccessful antibiotic therapy for pancreatic infection requires tissue penetration. The penetrance of several antimicrobial agents into the pancreatic juice was assessed by comparing antimicrobial concentrations between pure pancreatic juice at the time of endoscopic retrograde pancreatography and serum. The estimated antimicrobial agents were Ampicillin, Mezocillin, Cephamandol, Gentamicin, Amikacin, Clindamycin, Chloram-phenicol, Metronidazole and Trimethoprim-sulfamethoxadole. Good penetrance into the pancreatic juice was recognized only in Chloramphenicol, Metronidazole and Trimetho-prim. The intrapancreatic ductal levels of Ampicillin, Mezocillin, Cephamandol, Gentamycin, Amikacin and Clindamycin were very low, and we conclude the penetrance of these antimicrobials to the pancreas is very poor.View full abstractDownload PDF (620K) -
-ENDOSCOPIC FINDINGS BEFORE AND JUST AFTER EMBOLIZATION THERAPY-Kenji IKEDA, Hiromitsu KUMADA, Yasuji ARASE, Kazuaki CHAYAMA, Toshiaki ...1988 Volume 30 Issue 4 Pages 683-690_1
Published: April 20, 1988
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSGastroduodenal complications of transcatheter arterial embolization (TAE) were studied in 86 patients with hepatocellular carcinoma. Upper gastrointestinal tract endoscopy was done in each cases before and just after TAE therapy. Newly appeared gastric lesions were divided into two types endoscopically:19 "is-chemic" localized gastric lesions and 3 "non-specific" acute gastric .mucosal lesions. The former were morphologically classified as localized irregular-shaped mucosal reddenings in 5, erosions in 10, ulcers in 4. Newly appeared duodenal lesions were erosion in one and ulcers in 2, and all of them were thought to be due to ischemic origin. Incidence of gastroduodenal lesions were significantly higher in cases with apparent backflow of emboli into gastric and/or duodenal arteries at the time of TAE (11 out of 15, 73.3%). Therefore, almost all of gastroduodenal lesions after TAE were thought to be caused by thrombotic ischemia of the alimentary tract. Both gastric and duodenal lesions did not develop to bleeding nor perforation. But ulcers were resistant to ordinary treatment with antacids and histamine H2 antagonist, and 3 to 4 months were required for healing.View full abstractDownload PDF (4523K) -
Masahiro IGARASHI, Tomoe KATUMATA, Kenichi SEGAWA, Toyoji OKADA, Yoshi ...1988 Volume 30 Issue 4 Pages 693-699_1
Published: April 20, 1988
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSWe performed the colonoscopic examination to study the exacerbation pattern in two types of ulcerative colitis ; total colitis and left-sided colitis type. A total of 51 examinations were made in 23 patients with total colitis and a total of 44 examinations were made in 25 patients with left-sided colitis. The results were as follows: 1) The recurrence of ulcerative colitis was classified into four groups ; the recurrence in the lower segment (62%), the recurrence in the same site (18%), the segmental recurrence (12%) and the spreading recurrence (8%). 2) The segmental recurrence occurred only in patients with total colitis and the most frequent site was in descending to transverse colon. Only 2 patients showed recurrence in the ascending colon. 3) In patients with total colitis the repetition of the similar recurrence pattern occurred only in 30%, which made it difficult to predict the recurrence pattern. 4) When the recurrence of ulcerative colitis was divided into two types endoscopically, the erosive type and the ulcerative type, the ulcerative type was severer and was seen more often in the segmental or the spreading recurrence types. The segmental recurrence in the upper portion of the colon occurred in about 10% of active recurrences, which may be overlooked if only the sigmoidscopic examination was performed. It is critically important to make a complete observation of total colon in the follow-up examination of the recurrent ulcerative colitis.View full abstractDownload PDF (3868K) -
Hideo YAMAZAKI, Nobuo HIWATASHI, Yuji KUMAGAI, Masaaki MIURA, Kiyoshi ...1988 Volume 30 Issue 4 Pages 700-704
Published: April 20, 1988
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSIn an attempt to evaluate the maintenance treatment and to investigate factors which predispose to relapse in patients with ulcerative colitis, we have carried out a retrospective study of 161 maintenance-treatments in 45 patients with ulcerative colitis of relapsing-remitting type. The extent of disease, severity of each attack, age and years after onset had respectively little influence on the length of the period of remission. No significant difference in the mean and median values of the duration of remission was observed between patients receiving oral sulfasalazine alone and those receiving no treatment. In 161 relapse cases, 67 were considered to be induced by some factors, which were upper respiratory infection (28 times), excessive fatigue (11 times), change of medication (9 times), emotional tension (7 times), analgesic ingestion (4 times), pregnancy and delivery (3 times) and the others.View full abstractDownload PDF (625K) -
Kazuhide KUMAGAI, Akira YASUI, Yoshiaki NISHIDA, [in Japanese], Tsuguh ...1988 Volume 30 Issue 4 Pages 705-711_1
Published: April 20, 1988
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSThe criteria at evaluation of anticancer agent for gastric carcinoma is shown as grade of tumor regression. The purpose of this study is to evaluate effects of antitumor chemotherapy using 14 cases of depressed type of early gastric carcinoma with shortterm treatment by oral administration as preoperative adjuvant chemotherapy. Histological examination of the resected stomach and the comparative study of the endoscopic findings between pre and post-treatment were performed. The results were as follows; 1. According to the criteria of the histopathological effect by The General Rules for the Gastric Cancer Study, evaluation of depressed type early carcinoma was shown as the extent of cancer free area in the mucosal layer. There was 3 cases of Grade 0, 6 cases of Grade la, 2 cases of Grade lb, 2 cases of Grade 2 and 1 cases of Grade 3. 2. There were some cancer free areas on the IIc floor of the depressed type of early carcinoma without chemotherapy. 3. Changes of the macroscopical finding with preoperative chemotherapy were seen in the majority cases. There was some discrepancy between the histological effect and the change of the macroscopical findings. Consequently, we have some problems for the evaluation of anti-cancer chemotherapy as the natural history of the depressed type of early gastric carcinoma.View full abstractDownload PDF (5152K) -
Katsuhide SHIMAKURA, Takashi SHIGENO, Kotaro YAMAGUCHI, Osamu HASEBE, ...1988 Volume 30 Issue 4 Pages 712-719
Published: April 20, 1988
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSEndoscopic retrograde cholangiopancreatography (ERCP) has been considered difficult in patients with Billroth II gastrectmised stomach. We have tried ERCP on 83 patients with Billroth II gastrectmised stomach during the last 10 years. Results improved with experience ; ERP and ERC were successfully performed in 72.3% and 70.2%, respectively, of 47 patients with Billroth II gastrectomy between May, 1984 and September, 1987. Therapeutic procedures, such as endoscopic papillotomy (EPT), endoscopic nasobiliary drainage (ENBD) and endoscopic retrograde biliary drainage (ERBD) were successfully done in 8 of the patients. In 2 patients with a common bile duct stone, we were able to extract the stone with a basket catheter after EPT. The EPT in these cases was performed as follows ; at first, ENBD with a pigtail catheter was done with a sideviewing duodenoscope JF-1 T 10, then the duodenoscope was reintroduced into the duodenal second portion through an afferent loop, and an incision of the papilla Vater was made with a diathermic needle knife in the proximal direction with the assistance of the ENBD catheter. We think the tecinique of EPT described above is safe and easy to perform and, when indicated, it is a useful method for patients with Billroth II gastrectmised stomach.View full abstractDownload PDF (5585K) -
Kazuya NAKAMOTO, Touru MITSUSIMA, Hiroyuki OOSHIRO, Osamu TSURUTA, Kei ...1988 Volume 30 Issue 4 Pages 720-724_1
Published: April 20, 1988
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSThe accuracy of a single guaiac fecal occult blood testing (OBT) in the screening of colorectal cancer was evaluated by total colonoscopy. The evaluated cases were 3, 704 patients who received physical check-up at our hospital. As there was no selection bias regarding colorectal cancer and as the whole colon was examined on all cases, the material was considered appropriate in discussing the accuracy of OBT. We found 17 cases (0.46%) of colorectal cancer in which the positive rate of OBT was 47.1%. That is, less than half of the cancer cases were proved to be positive. Compared with the positive rate of OBT in those without cancer, this is not a significant statistical difference. We found 283 cases (7.6%) of adenoma in which the positive rate of OBT was also as low as 39.6%. Guaiac OBT was found to be an inappropriate method of screening of colorectal cancer, at least in a single examination.View full abstractDownload PDF (2779K) -
Nobuo YOSHIKAWA, Junji KASANUKI, Haruya WATANABE, Mikio KISHI, Terue I ...1988 Volume 30 Issue 4 Pages 725-729
Published: April 20, 1988
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSIn order to evaluate clinical course and effects of treetment for ulcerative colitis, we have developed ulcerative colitis activity index (UCAI) from clinical symptoms, laboratory data, and complications. UCAI correlated to endoscopic and histological findings very well. These correlations were found in all cases and there were no dif ferenses according to the duration of bloody stool, location of lesions, and steroid tratment. When UCAI was less than 20, it would be possible to say that ulcerative colitis might be inactive.View full abstractDownload PDF (452K) -
Teruo KIYAMA, Koji SASAJIMA, Hisataka HAYASHI, Jun TEI, Kiyohiko YAMAS ...1988 Volume 30 Issue 4 Pages 730-733_1
Published: April 20, 1988
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA case of idiopathic rupture of the esophagus complicated with Mallory-Weirs syndrome was reported. Fifty nine year-old male who had repeated vomiting after drinking bevarages for several days, refered to our hospital with complaints of hematemesis, tarry stool and severe back pain. Emergency endoscopy on admission revealed an ulcerated lesion with white coating in the lower esophagus and Mallory-Weirs tears in the esophago-gastric junction of the rest stomach. On 3 rd admission day, sharp, spindle-shaped and deep tear about 1.5 cm in length was found in the left side of the lower esophagus, endoscopically. Esophagogram showed leakage of radiopaque from the esophagus. He was treated conservatively with intravenous hyperalimentation and antibiotics. On 22 nd day, endoscopy showed only scar of the esophagus. He discharged in good condition on 30 th day.View full abstractDownload PDF (4030K) -
FOLLOW UP STUDY OF ENDOSCOPIC INJECTION SCLEROTHERAPY WITH PREOPERATIVE PARTIAL SPLENIC EMBOLIZATIONSei-ichiro SHIBUYA, Hiromichi IMAI, Ryoji MANABE, Kazuo HAMATSU, Kouhe ...1988 Volume 30 Issue 4 Pages 734-741_1
Published: April 20, 1988
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSTwo patients of liver cirrhosis with hypersplenism, large splenomegaly and esophageal varices were successfully treated by endoscopic injection sclerotherapy (EIS) with preoper-ative partial splenic embolization (PSE) The platelet mean count rose significantly soon after the PSE, however, it was back to normal level within about four weeks, and was remaining at this range, when the EIS was carried out. The patients were followed for eighteen months after the PSE showing a fairly good response on peripheral blood count, bleeding tendency and blood chemistry of liver func-tion. According to selective arteriogram, the pre-PSE dilated splenic artery narrowed after PSE, and in contrast the hepatic artery became dilated. The abdominal computed tomo-graphy revealed the enlarged spleen became peripheraly infarcted and contracted to significant degree. These findings led us to surmise that the distribution of splanchnic blood flow was altered markedly by the PSE. The bluish esophageal varices with positive red colour sign changed to withish ones with negative red colour sign after PSE, and there was no severe esophageal bleeding thereafter We believe the PSE was performed preoperatively not only to decrease esophageal bleeding during the EIS but to ameliorate the hypersplenism and the liver function.View full abstractDownload PDF (5874K) -
Masahiro SAKAI, Masaru HAGIWARA, Yasuharu SATO, Hajime KURIHARA, Jiro ...1988 Volume 30 Issue 4 Pages 742-746_1
Published: April 20, 1988
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 64-year-old man with cirrhosis was performed endoscopic injection sclerotherapy (EIS) by using Paoscle (5% phenol, almond oil). About 1.5 ml of Paoscle was injected into the varices accidentaly during the EIS (The 5th, session). A few seconds later he com-plained right cervical pain, and in about 4 hours he had convulsion, resulting in a loss of consciousness. About 24 hours later cranial CT revealed a low density area in the right parietal lobe (Figure 1). The patient was discharged without any neurological disorders. He died of hepatic insufficiency 4 years and 6 months after the occasion. In the autopy finding, there was a cystic infarct in the right parietal lobe (Figure 2). There was no cardiac anomalies. Histological finding showed an old cystic infarct in the cerebral cortex of the right parietal lobe (Figure 3, 4). It was concluded that Paoscle injected into the esophageal varices went into the systemic circulation through porto-pulmonary anastmosis, causing the cerebral embolism. This is a rare case of cerebral embolism due to EIS using Paoscle.View full abstractDownload PDF (5103K) -
Hiroshi FUJISHIMA, Tadashi MISAWA, Akira MARUOKA, Takatoshi TOYOTA, Na ...1988 Volume 30 Issue 4 Pages 749-752_1
Published: April 20, 1988
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 74-year-old man was admitted to our hospital with complaint of the abdominal tumor. A diagnosis of malignant lymphoma of the stomach was made by barium meal, endoscopic examination and direct-vision brushing cytology of the lesion. EUS findings showed that the five-layer structure of the gastric wall was destructed by hypoecohic homogeneous tumor. This findings suggested that the lymhoma invated into the serosa. After chemotherapy the 3rd and 4th layer of the gastric wall were re-visualized by means of EUS, therefore the invasion of lymphoma was thought to become limited to the mucosa. It is rare that the reduction of intramural infiltration of gastric lymphoma was observed by EUS.View full abstractDownload PDF (5460K) -
Mitsuya HARIGANE, Yoichi SHIBAZAKI, Osamu KAWAMURA, Hiroyasu OHARA, Hi ...1988 Volume 30 Issue 4 Pages 755-759_1
Published: April 20, 1988
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA case of eosinophilic gastroenteritis with involvement of the esophagus and rectum was experienced. A 60-year-old man, who had been suffered from bronchial asthma and chronic urticaria, was admitted to our hospital with intractable watery diarrhea. Marked eosino-philia (31%) was present in the peripheral blood, and serum IgE level was also elevated. Endoscopic examination revealed mild mucosal edema, multiple small ulcers, and patchy erosions in the stomach and duodenum (Figure 2). Biopsied specimens showed diffuse or focal eosinophilic infiltration in the lamina propria (Figure 3, 4). Though X-ray and endoscopic examinations revealed no abnormalities in the esophagus and rectum, marked eosinophilic infiltration was also observed in the mucosa of the biopsied specimens (Figure 5, 6). From this, it suggested that eosinophils were infiltrated through out the gastrointesti-nal tract Oral predonisolon relieved diarrhea and eosinophilia, but these symptoms recurred a month after it was discontinued. He has been given low dose predonisolon (7.5-10 mg/ day) without recurrence for six years, although H2-receptor antagonist-resistant ulcer was complicated.View full abstractDownload PDF (3802K) -
Tetsuji AKIYAMA, Tadasu FUJI, Satoshi KONDOH, Kayoko ADACHI, Shinya TA ...1988 Volume 30 Issue 4 Pages 760-765_1
Published: April 20, 1988
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSWe experienced two cases of drug-induced pancreatitis. The first case caused by methyldopa was proved by challenge test, and the second case by mephenamic acid was proved by lymphocyte stimulating test. The former developed epigastric pain associated with hyperamylasemia, and the latter presented with frequent vomiting after meal. These symptoms were similar to those of alcoholic pancreatitis. Nine cases of methyldopainduced pancreatitis have already been reported in the world. On the other hand, mephenamic acid has not been previously reported as a cause of pancreatitis.View full abstractDownload PDF (5149K) -
Nobuyoshi OKUMURA, Naoharu TAKEYAMA, Osamu KAMMA, Tetsuo HAYAKAWA, Yuz ...1988 Volume 30 Issue 4 Pages 766-770
Published: April 20, 1988
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 57-year-old male visited our hospital for further examination of periodic health check-up. Abnormalities checked were abnormal folds on upper GI series, liver damage, hypertriglyceridemia and abnormal O-GTT. UGI series showed calculi in the duodenal loop. High density areas were subsequently confirmed in the pancreatic uncinate on CT. ERP demonstrated smooth stenosis of the duct of Santorini and dilatation and filling defects in a branch. It is suggested that pancreatic calculi might be formed by stasis of pancreatic flow in the branch associated with congenital or acquired stenosis of the duct of Santorini.View full abstractDownload PDF (3783K) -
Hiroya TAKIUCHI, Kiyoshi ASHIDA, Masahiro SHIKAKI, Hirofumi MIYOSHI, S ...1988 Volume 30 Issue 4 Pages 771-776_1
Published: April 20, 1988
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSThis is a case report of carcinoid tumor at the duodenal bulb. A 54-year-old male with upper abdominal pain was referred to our hospital because of further evaluation of the polypoid lesion at the duodenal bulb which was detected at the other hospital. On upper GI series and endoscopy, semi-pedunculated polypoid lesion with the central depression about 15 mm in diameter at the anterior wall of the duodenal cap. The biopsies were endoscopically performed from the central depression. This polipoid lesion was carcinoid tumor histologically. Endorcopic polypectomy was performed because he refused the operation. This tumor was successfully removed and the resected polyp was 12 x 9 x 6 mm in size. Histologically, this tumor was mainly localized in the submucosa and partially invaded to the mucous layer. Furthermore, this tumor was encapsulated with the connective tissue and did not remain in the resected end. Therefore, it would be thought that this carcinoid tumor was completely resected by endoscopic polypectomy. However, careful observation should be needed as the metastasis of the tumor could not be completely ruled out.View full abstractDownload PDF (3600K) -
Kazunori HOSHIKA, Kimihiko OTANI, Ryuichi KAMOI, Tomohiro KATO, Eizo K ...1988 Volume 30 Issue 4 Pages 777-782_1
Published: April 20, 1988
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 62-year-old women was admitted to our hospital complaining with anal bleeding. On digital examination a nodular protruded lesion was palpated. On barium enema, a nodular protruded lesion was recognized in the rectum. On endoscopical examination, a semipedunculated reddish protruded lesion was observed in the rectum. The surface of the lesion was nodular and eroded at the top of the lesion. On histological examination of the biopsied specimen obtained from the lesion endoscopically, lymphoid infiltrate with lymphoid f ollicules containing germinal center was observed under the colonic epithelium. So the lesion was diagnosed as benign lymphoid polyp endoscopically. Surgical polypectomy was performed. The specimen was 3.2×2.7×1.2 cm in size. On histological examination, the lesion was composed of lymphoid infiltrate with numerous lymphoid follicules containing germinal centers under the colonic epithelium and defect of the epithelium was observed at the top of the lesion. Only 11 cases of benign lymphoid polyp of the colon, including our case, have been reported so far in Japan.View full abstractDownload PDF (5604K) -
Masahiko TAKAMASU, Katsuhisa KAWAMOTO, Yoshihide TATSUMI, Kazuhiko TOK ...1988 Volume 30 Issue 4 Pages 785-787_1
Published: April 20, 1988
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSTotal twenty lesions of gastric polypectomies in thirteen cases were performed under electronic endoscopy (Toshiba-Machida Co. Ltd. EES-50 A, TGS-50 D, TGI-50 D). Six lesions were macroscopically Yamada type II, eight were type III and six were type IV. Histologically two lesions were adenocarcinoma, three were adenoma and fifteen were hyperplastic polyp. During polypectomy under electronic endoscopy, serrated graph pattern was appeared on the picture, which was not an obstacle to our work. This method was safe and could perform smoothly. The results were as follows, 1) a large and clear picture of the TV-monitor made the co-operated procedures more smoothly, 2) polypectomized specimens were distinctly photographed by electronic endoscope, 3) begin-ners were able to learn the technique for polypectomy without interrupting the procedures.View full abstractDownload PDF (2008K) -
1988 Volume 30 Issue 4 Pages 788
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1988 Volume 30 Issue 4 Pages 789-802
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1988 Volume 30 Issue 4 Pages 802-816
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1988 Volume 30 Issue 4 Pages 816-827
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1988 Volume 30 Issue 4 Pages 827-840
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1988 Volume 30 Issue 4 Pages 840-849
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1988 Volume 30 Issue 4 Pages 849-861
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