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Volume 31, Issue 10
Displaying 1-37 of 37 articles from this issue
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Ryuichi SAKITA, Takehisa NAGAYAMA1989 Volume 31 Issue 10 Pages 2573-2585
Published: October 20, 1989
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSThe distribution and location of carcinoembryonic antigen (CEA), carbohydrate antigenl9-9 (CA19-9), epithelial membrane antigen (EMA) and carbohydrate antigen 125 (CA125) were studied investigated by immunoperoxidase technique (procedures) in 30 lesions from 30 patients with colorectal carcinoma and 30 lesions from 30 patients with adenomatous polyp of cob-rectum and 10 lesions from 10 patients with carcinoma in adenoma. The results were as follows; 1 Comparrison of each tumor marker staining among the three groups (normal mucosa, adenoma and cancer) (1) Percentage of positive CEA staining were high in all groups (100% in normal mucosa, 100% in adenoma, 93.3% in cancer), but the intensity of staining was highest in cancer and lowest in normal mucosa. (2) Percentage of positive CA19-9 staining was high in cancer (86.6%) and in adenoma (83.3%), while not so high in normal mucosa (46.6%). (3) Percentage of positive EMA staining showed the remarkable difference among the groups-0% in normal mucosa, 13.3% in adenoma and 70% in cancer. (4) CA125 staining was not observed in all cases. 2 In carcinoma in adenoma, there was a difference of positive staining by each tumor marker between in carcinoma portion (CEA :100%, CA19-9 : 90%, EMA : 80%) and that in adenoma portion (CEA :100%, CA19-9 : 70%, EMA : 50%). In conclusion, the present study suggests the existence of adenoma-carcinoma sequence and the prominent specificity of EMA to the colorectal tumor and that combined use of three tumor markers-CEA, CA19-9 and EMA- may be useful for the diagnosis of color-ectal tumor.View full abstractDownload PDF (4053K) -
Yasuna SUZUKI, Kazuhiko MASUDA, Masanori HIRAO, Kazumichi HARADA, Kiyo ...1989 Volume 31 Issue 10 Pages 2587-2593
Published: October 20, 1989
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSWe developed infrared (IR) electronic endoscope. An infrared cut off filter was removed from an electronic endoscope (Toshiba, TGI-50 D), and a infrared passing filter (IR-76 and IR-80, Hoya) was taken into the xenon lamp. We examined 80 cases with benign and malignant diseases of stomach. In 66 cases submucosal blood vessels could be seen and in 14 cases many dots in the fundic gland mucosa seemed to be collecting venule were observed. Since adenoma and well differentiated adenocarcinoma were dark, we could see both tumor and vessels. Thus, IR-electronic endoscope was useful for making sure of the endoscopic resection of the tumor. However, the power of our infrared lighting system was not enough to get still images and we needed auto-light control.View full abstractDownload PDF (3910K) -
Toru MIYAHARA, Shigeaki NAGAO, Toshimitsu DOI, Masahiro KANAZAWA, Keiz ...1989 Volume 31 Issue 10 Pages 2595-2604_1
Published: October 20, 1989
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSIn order to study the difference in capability among spectral bands of visible rays to represent a lesion of the upper gastrointestinal tract, pictrial-image output part of videoendoscope system is devised to enable to select one analog signal among R. G. and B components and conventional pictorial image signals at random. The subjects for this study; 18 cases of gastric ulcer, 16 cases of duodenal ulcer, 8 cases of gastric cancer, 17 cases of gastric polyp, 26 cases of various gastritis, and 10 other cases. By comparing each pictorial image on real time from each of 3 components with conventional ones, the following results were obtained. The pictorial image by only G component is superior to representing the fine mucosal structure because of the following reasons. 1) It has more information about the structure. 2) It changes its luminance a lot. 3) A minimun difference threshold of G component exists in the same spectrum. 4) It fits well enough to the spectral luminous efficacy of our eyes. It is difficult for the pictorial image by only B component to represent the fine mucosal structure because of the following reasons. 1) The pictorial image of B component does not have enough signal volume. 2) Adding to 1) biasis of brightness makes the pictorial images dark and unclear. The pictorial images of only R component is not able to represent the fine mucosal structures because of penetrability through tissue of R component is higher than those of G and B components. But it is suggested that the pictorial image of R component produces a line to that of infra-red rays.View full abstractDownload PDF (9667K) -
Hdieo YOSHIMOTO, Seiyo IKEDA, Yuji KURODA, Kensei MAESHIRO, Masanobu T ...1989 Volume 31 Issue 10 Pages 2605-2615
Published: October 20, 1989
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSCholedochoscopic lithotomy was performed in 16 patients with cholecystolithiasis. Fourteen patients had one or more reasons which rendered nonsurgical removal of the stones preferable (Table 1). In 12 patients, the stones were attempted to disintegrate with electrohydraulic lithotripsy because the size of the stones was larger than the diameter of the sinus tract. The largest stone was 40×35mm in diameter. An access route for the choledochoscopy was as follows ; percutaneous transhepatic gallbladder drainage in 12 patients, percutaneous transhepatic bile ductt drainage in 2, and external cholecystostomy in 2 (Table 3). The stones were disintegrated in all but one patient in whom choledochoscopic access to a gallstone was difficult due to deformity of the gallbladder. Complete removal of the stones was achieved in 13 patients (81.3%). There were no serious complication. Minor complications occurred, including bleeding from the gallbladder mucosa in two patients and postprocedure chills and fever in two (Table 4). Choledochoscopic lithotomy for the gallbladder stones has still several problems such as the duration of the treatment, the complexity of the procedure, and possible reformation of the stones. A good indication at present is the management of patients with a confluence stone. In addition, it might be useful to remove the stones in some patients with surgical risks.View full abstractDownload PDF (6241K) -
Osamu TSURUTA, Nobuyuki ARIMA, Akira IRIE, Hideo IKEDA, Kazuhiro OHMAG ...1989 Volume 31 Issue 10 Pages 2616-2626
Published: October 20, 1989
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSColonoscopic and histopathological studies were undertaken in 538 elevated lesions which were found in 764 consecutive colonofiberscopied patients with 92.6% success rate of total colorectal examination. These lesions included 361 of adenoma (67.1%).153 of nonadenoma (28.4%) and 24 of early carcinoma (4.5%). In the cases with total colonofiberscopy, nonadenoma was frequent and adenoma was less in the rectum. although early carcinoma was detected in 77.3% in the sigmoid colon and in the rectum. From the view point of size, majority of both adenoma and nonadenoma were less than 5 mm in the size, however, nonadenoma was smaller in size than adenoma. Both in adenoma and in nonadenoma had trend to show pedunculation with reddish tone as by increase of size, and particularly early pedunculation was noted in adenoma. Early carcinoma was consisted in 11 flat elevations, 2 subpedunculation and 11 pedunculation in shape. Flat elevation was revealed to be total cancer or to be more than 50% of lesion made up of cancer, while pedunculated lesions had prominent adenoma component in more than 50% of lesion. It is consequently suggested that there is a difference between flat elevations and polypoid lesions in development and advancing manner of cancer. Therefore it is more impotant to detect not only polyps but also flat elevations for early detection of colorectal cancer.View full abstractDownload PDF (1393K) -
-WITH SPECIAL REFERENCE TO THEIR LOCATION-Shinichi HINO, Motohide TAKASHI, Masahiko IGARASHI1989 Volume 31 Issue 10 Pages 2627-2632_1
Published: October 20, 1989
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSEndoscopic observations of gastric varices were carried out in 214 patients with portal hypertension and in 50 normal controls from June 1981 to December 1987. We defined the "Lc varices" as any vein located in the cardia and/or lesser curvature of the body close to cardia (Lc). We also defined the "Lf varices" as veins over 3 mm in diameter located in the f undus (Lf). Of our 214 patients, 108 (50.5%) had gastric varices, 86 (40.2%) had Lc varices and 55 (25.7%) had Lf varices. Lc varices were seen only in patients with esophageal varices. Lc varices with "Risky signs (redness, white coat, bleeding and/or blood clot)" were frequently observed in patients with esophageal varices accompanied by R-C signs. Endoscopic injection sclerotherapy (EIS) was carried out for esophageal varices in 30 patients with both esophageal and gastric varices from January 1985 to December 1987. Improvements of Lc varices by EIS were frequently observed in patients who had a dramatic effect on esophageal varices. In contrast, Lf varices bore no definite relation to esophageal varices neither from the point of their frequency, sign related with bleeding nor change by EIS.View full abstractDownload PDF (2566K) -
-COMPARISON BETWEEN EARLY AND LATE ONSET CASES-Masahide ATSUMI, Masahiko TAKAMASU, Satoshi EBISUI, Kazushi ISETANI, T ...1989 Volume 31 Issue 10 Pages 2633-2638_1
Published: October 20, 1989
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSApproximately 49, 200 endoscopic examinations have been perfomed for last 5 years. After these endoscopic examinations, 15 cases (0.03%) with acute gastric mucosal lesion (AGML) or acute gastroduodenal mucosal lesion (AGDML) were detected without any other causes. Age of the cases ranged from 30 to 61 with an average of 49.7. A male to female ratio was 11 to 4. The lesions were almost seen in the antrum. Most lesions occurred after the first endoscopic examination. The endoscopic examination prior to the onset often revealed erosive gastitis. The period from the day of the initial endoscopic examination to the onset of symptom ranged from 1 to 8 days with an average of 5.0 days. Two of 15 cases developed within 24 hours and had mild symptoms. In these cases, the lesions were found in the body to the f ornix of the stomach. On the other hand, other 11 cases occurred after 3 to 8 days with severe epigastric pain and vomiting and endoscopically lesions developed mainly in the antrum and the duodenal bulb. From the results, it is suggested that there could be two different clinical features among AG (D) ML after endoscopic examination.View full abstractDownload PDF (2488K) -
-A COMPARATIVE STUDY-Hiroshi ASHIDA, Yoshinao KOTOURA, Ikuji AOKI, Kazumitu TAKAGI, Masahar ...1989 Volume 31 Issue 10 Pages 2641-2646_1
Published: October 20, 1989
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSWe evaluated the clinical results of 10 patients with gastric varices in this study. For the control of acute gastric variceal bleeding in 4 patients, we tried performed several methods of therapy ; 2 cases had endoscopic sclerotherapy, 1 had percutaneaous transhepatic obliteration and 1 had partial splenic embolization. Acute bleeding was controllable in only 1 patient undergoing endoscopic sclerotherapy and subsequent elective Hassab's operation, and urgent operations were performed in other two cases. However, they died of hepatic failure several months later. In 4 of the remaining 6 patients, selective operations were performed, elective endoscopic sclerotherapy underwent in 1 and 1(nonbleeder) had no therapy. Rebleeding was recognized in 2 patients who had had operation and endoscopic sclerotherapy, respectively. Four of these 10 patients were survived. Angiographic evaluation revealed that endoscopic sclerotherapy may be effective only in cases who have no gastrorenal shunt. In conclusion, it is thought that surgical operation. (H assab's method) is the most suitable therapy for gastric varices at present.View full abstractDownload PDF (5701K) -
Osamu HASEBE, Katsuhide SHIMAKURA, Yoshiaki MATSUDA, Takashi SHIGENO, ...1989 Volume 31 Issue 10 Pages 2647-2655
Published: October 20, 1989
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSENBD was performed in 171 patients with pancreatic and biliary diseases between May, 1983 and March, 1988. ENBD was effective in 40 of 41 patients (97.5%) with benign obstructive jaundice, and 38 of 54 patients (70.3%) with malignant obstructive jaundice. ENBD was done with good results in all cases for biliary lavage in 51 patients who developed clogging of endoprosthesis or cholangitis, and for the prophylaxis of stone impaction after ERCP or EPT in 25 patients. Daily mean bile flow volume through ENBD catheter was 389±250ml. In biliary lavage and benign biliary drainage groups, the bile volume was greater than that in the other groups. No significant correlation between the size of ENBD catheter and bile volume was obseved Only two cases developed complications such as bleeding after EPT and clogging due to hemobilia. Above results indicate that ENBD is a safe and effective method for biliary drainage in benign obstructive jaundice, but for malignant obstruction at hepatic hilar portion, the drainage is much less effective and PTBD is better indicated.View full abstractDownload PDF (3255K) -
Toshiaki YOSHIDA, Akihito KASHIWAGI, Akihiko TAKAHASHI, Masatoshi YAMA ...1989 Volume 31 Issue 10 Pages 2656-2662_1
Published: October 20, 1989
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSThe first subject was a 46-year-old male diagnosed as grade II spindle type esophageal achalasia. Direct endoscopic dilatation was performed using a Rigiflex TTS balloon dilator (Microvasive) for strictures of the upper digestive tract, and reduction of the esophageal maximum transverse diameter was confirmed by esophagogram. The second subject was a 51-year-old female diagnosed as grade II sigmoid type esophageal achalasia, and treated by endoscopic dilatation. Following treatment, maximum transverse diameter had been decreased, and food intake became possible. Direct endoscopic balloon dilatation is thought to be an extremely safe method which allows direct visual manipulation and observation of the mucus membrane.View full abstractDownload PDF (6023K) -
Hitoshi ITO, Sumio MATAMA, Yasuharu FUJII, Yorio MATSUMOTO, Tomoya KAN ...1989 Volume 31 Issue 10 Pages 2665-2669_1
Published: October 20, 1989
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSTwo cases of gastric syphilis were successfully diagnosed by demonstrating Treponema pallidum from biopsy specimens by immunofluorescent complement and enzyme assay ABC method, respectively. Both cases are 32 male patients with and 26 years of age. They were admitted because of epigastric discomfort and vomiting. The TPHA tests were strongly positive and the diagnosis of secondary syphilis were made based on dermatological findings. On UGI examination, the irregular shaped shallow ulcerations were seen from the angulus to the antrum. Making the diagnosis of gastric syphilis is difficult in terms of image examination. The detection of Treponema pallidum as shown in this paper, using immunological technique from gastric tissue was essential of making diagnosis of gastric syphilis.View full abstractDownload PDF (3939K) -
Hirofumi SAKAMOTO, Yasuo OE, Toru OCHIAI, Takashi TAKEI, Takashi SUZUK ...1989 Volume 31 Issue 10 Pages 2670-2676_1
Published: October 20, 1989
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA case of primary malignant melanoma of the esophagus, which is relatively rare, is reported. A 71 yr.-old male was admitted at our hospital with an approximately 3-week history of dysphagia, loss of body weight and anorexia. A barium meal and endoscopic examinations revealed a blackish tumor with an uneven surface located in the Im and Ei. A biopsy study showed a proliferation of tumor cells with dark brown pigment. Since no abnormal pigmentation was domonstrated in other mucosa of the gastrointestinal tract and skin, subtotal esophagectomy was done. The resected material revealed a large and blackish tumor, 7.5×4.5×1.5 cm in size, with partially brown-colored and uneven nodular surface in the Im and Ei. Histological examination showed junctional activity. In addition, melanosomes of various stages were demonstrated in the cytoplasm of the tumor cells electron microscopically. Thus, a diagnosis of primary malignant melanoma of the esophagus was confirmed. A review of the literature on primary malignant melanoma of the esophagus revealed that 62 cases had been reported from 1960 to 1987 in Japan. An early diagnostic consideration including recent concepts on precancerous manifestation was also discussed.View full abstractDownload PDF (5356K) -
Hideto TANIGUCHI, Kouichi KOIZUMI, Hitoshi YAMAMOTO, Yukihiro NAKAJIMA ...1989 Volume 31 Issue 10 Pages 2677-2680_1
Published: October 20, 1989
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 54-year-old man was admitted to our hospital with complants of hematomesis and melena. Emergency endoscopy revealed an exposed vessel without definite ulcers at the fornix of the stomach. Endoscopic hemostasis was successfully made by local injection of hypertonic saline epinephrine solution (HS-E method) at that time. However massive rebleeding occured becoming shock on the 4th day of admission. Emergency endoscopic findings showed no bleeding from the previous lesion at the fornix, but oozing of fresh blood from an exposed vessel at the angle was visualized. Endoscopic hemostasis was successfully done by HS-E method again. On the following day endoscopic findings revealed no definite ulcer at the angle. Therefore our diagnosis in this case was double lesions of Dieulafoy's ulcer of the stomach. Dieulafoy's ulcer is known as a relatively rare disease. Moreover a case of double Dieulafoy's ulcer is extremely rare. We considered endoscopic local injection of HS-E in an effective therapeutic method for patients with Dieulaf oy's ulcer.View full abstractDownload PDF (2384K) -
-REPORT OF A CASE-Eiji UMEGAKI, Hogen TEI, Katuyoshi HAYASHI, Kiyoshi ASHIDA, Ichiro HIR ...1989 Volume 31 Issue 10 Pages 2683-2687_1
Published: October 20, 1989
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 65-year-old man, being pointed out multiple gastric polyps 12 years ago, came to our hospital with chief complaint of epigastric discomfort. Upper gastrointestinal examinations revealed the multiple polyps of various sizes on the intermediate zone of the stomach, which were suggestive of Nakamura typeII, and the shallow depression with converging folds among the polyps. Moreover, the polyp near its depression was pale and flattened. Biopsy specimens taken from the shallow depression showed well differentiated adenocarcinoma. Macroscopic view of the resected stomach showed about 70 polypoid lesions of various sizes (3-20mm in diameter), some of which had irregular central depression, and the shallow depression with converging folds on the lesser curvature of the lower body. Histopathologically, early gastric cancer of type IIc+IIa, 25×17 mm in size, was found on the lesser curvature aspect of lower body. IIa part of the lesions showed the polyp cancer. In the antrum, the minute mucosal cancer, 2 mm in size, was found. We reported the case of gastric polyps with multiple early gastric cancers. This case suggests that the stomach with multiple proliferating polyps has the malignant potential.View full abstractDownload PDF (6124K) -
Manabu YONESHIMA, Takeshi URABE, Yoshiyasu OIKO, Yutaka INAGAKI, Hisas ...1989 Volume 31 Issue 10 Pages 2688-2693_1
Published: October 20, 1989
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 27-year-old man with epigastralgia and hyperamylasemia was pointed out a submucosal tumor of stomach by gastrof iberscopy. The first examination of EUS revealed the mass was a aberrant pancreas with low echoic area. Because the size of the mass was slightly increased, EUS was done again. The EUS findings showed that low echoic cystic area occupied most of the aberrant pancreatic tissue. The fluid from the cyst was obtained by endoscopical puncture of the mass. Analysis of the fluid revealed high levels of the pancreatic enzymes suggesting the pancreatic juice. On the third EUS examination, we recognised that the size of the cyst was not so decreased after the puncture of the cyst. The mucosa upon the cyst was cut by endoscopic LASER therapy. After LASER cutting, the cyst became undetectable by the fourth EUS examination. Thus, this case is a first case of gastric aberrant pancreas in which the formation of cyst was detected by repeated EUS examinations.View full abstractDownload PDF (7366K) -
Fiji FUJIMAKI, Ryoichi KAMIYA, Atsushi KANO, Sadahide ONO, Masahiko MU ...1989 Volume 31 Issue 10 Pages 2694-2703
Published: October 20, 1989
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 76-year-old male with a chief complaint of epigastralgia was referred to our hospital for further examination of pancreatic mass on March 16, 1987. A huge mass was recognized at the pancreatic body and tail on the pictures of US (Figure 1), CT (Figure 2) and angiography (Figure 3). But ERCP through major papilla showed only a short pancreatic duct without irregularity and a normal biliary tract (Figure 4-a, 4-b). Therefore, non-fusion of pancreatic ducts was strongly suspected. Pancreatography through accessory papilla was performed, and a irregularly interrupted image at pancreatic body was observed (Figure 4-c). From these findings, this case was diagnosed as dorsal pancreatic cancer associated with non-fused pancreatic ducts. Because of the multiple lung metastasis. he was treated conservatively. Unfortunately, he died on June 15, 1987. Autopsy revealed a huge pancreatic tumor 8×6×4cm in size, and the histological finding was moderately differentiated tubular adenocarcinoma (Figure 7). Until now only 17 cases of pancreatic cancer with non-fused pancreatic ducts were reported in Japan including this case (Table 2), and the cancer developed on the dorsal pancreas in all the cases except one. This fact could suggest the connection between dorsal pancreatitis and cancer, but there is a controversy over this issue. It may be considered that a positive examination of dorsal pancreatography through accessory papilla is necessary to elucidate this issue, if non-fusion of pancreatic ducts is suspected.View full abstractDownload PDF (8355K) -
Yoshiyasu OIKO, Kouichi NISHIMURA, Takashi MURATA, Manabu YONESHIMA1989 Volume 31 Issue 10 Pages 2704-2708_1
Published: October 20, 1989
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 71-year-old-man was admitted to our hospital for complaining of nausea and anorexia. Two years before admission, he had been pointed out duodenal adenoma, but he had recieved no teatment. Upper GI series showed a polypoid lesion about 1.5 cm in diameter in the second portion of the duodenum. Endoscopic examination revealed the pedunculated polypoid lesion with slightly nodular and partial reddish surface. The biopsy study showed well differenciated tubular adenocarcinoma. Endoscopic polypectomy was performed. The size of resected tumor was 12×12×7mm in size. Histological findings showed tubular adenocarcinoma with invasion in the mucyysal layer but no adenoma was in the resected specimen.View full abstractDownload PDF (6641K) -
Shingo MORIISHI, Toshio NAKANISHI, Goro KAJIYAMA, Michio YAMANOUE, Tar ...1989 Volume 31 Issue 10 Pages 2709-2713_1
Published: October 20, 1989
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSReports concerning findings of laparoscopies and liver biopsies performed in cases of macroglobulinemia are very rare. We have encountered a case of WMG in which cancer cells had infiltrated into the liver. The patient was a 57-year-old male hospitalized for liver dysfunction. He was diagnosed as suffering from WMG after detailed clinical studies. Laparoscopy revealed that the liver surface was relatively smooth and dark brown, and that there was marked distension of the lymphatics. Liver biopsy revealed that while the basic tissue structure was retained, there was marked infiltration of the Glisson's capsule by lymphoid cells. Immunohistochemical staining of the biopsy tissue was performed and these lymphoid cells were found to stain positively with anti-IgM and anti-K antibody. Moreover, serum protein electrophoresis performed during hospitalization showed an obvious M-bow and Bence-Jones proteinuria was positive. Hematological studies were performed as well, and as the results the patient was diagnosed as suffering from WMG. Infiltration of the liver by cancer cells in this disease has been studied in a relative detail at autopsy etc., but there have been very few reports regarding the findings of laparoscopy or liver biopsy, and we, therefore, presented this report with review of the literatures.View full abstractDownload PDF (4312K) -
Waichi SATO, Yih-Fong LIN, Kanji KOMATSU1989 Volume 31 Issue 10 Pages 2714-2718_1
Published: October 20, 1989
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSIt is still difficult to make early diagnosis of acute hemorrhagic pancreatitis. The most utilized therapy for acute hemorrhagic pancreatitis has been surgical treatment interven-tion. The authors applied emergency laparoscopy for early diagnosis of acute hemorrhagic pancreatitis. Under laparoscopy, two drains were inserted into the peritoneal cavity of the patient through which the cavity was washed with saline containing naf amostat mesilate. After such peritoneal lavage for ten hours, the patient was treated with a large intravenous dose of nafamostat mesilate, a large amount of fluid and protein replacement, as well as prevention of secondary infection. The authors obtained good results in some cases by the above treatment.View full abstractDownload PDF (3837K) -
Takashi MORI, Junko SOBAJIMA, Tadao MOCHI, Munehisa OKUDA, Tetsurou KA ...1989 Volume 31 Issue 10 Pages 2721-2727_1
Published: October 20, 1989
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 26-years-old man had a mass in his bladder, and suffered pneumouria, fecauria, and ileus symptoms during close examination. An emergency colonofiberscopy showed colonic stenosis and cobblestone appearance, and he was diagnosed as Crohn's disease. Radiographic examination after an emergency operation revealed a vesico-ileum-sigmoid colonic fistula. Secondary operation was performed after the elemental diet combined with Salazopyrine therapy. Histologicaly, the specimen of the ileum showed the non-caseating granuloma with multinucleated giant cells.View full abstractDownload PDF (7366K) -
Akihiro SHIGEMATSU, Mitsuo IIDA, Masaya TOMINAGA, Tadahiko FUCHIGAMI, ...1989 Volume 31 Issue 10 Pages 2728-2733_1
Published: October 20, 1989
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 65-year-old Japanese woman, admitted to our hospital on January 1980, had passed tarry stool in August 1976 and had experienced four similar episodes over a 4-year period. On admission, her physical examination and laboratory data were normal except for a moderate anemia. Upper gastrointestinal series and barium enema failed to show a bleeding source. Small bowel X-ray showed multiple diverticula in the duodenum and jejunum (Figure 1-a). The jejunal loop revealed a focal narrowing of the lumen and focal rigidity of the wall, which suggested an ulceration, just at the orifice of the two of multiple jejunal diverticula (Figure 1-b and 1-c). Intraoperative endoscopy revealed open ulcers at the orifice of the two diverticula (Figure 2). Accordingly, these two jejunal diverticula associated with ulcer were thought to be a source of bleeding. The 75 cm segment of the jejunum containing sixteen diverticula, all of which sited on a mesenteric border, was resected (Figure 3). Pathological examination revealed pseudodiverticula and also showed open ulcers (Ul-II) just around the orifice of the two jejunal diverticula (Figure 4). The postoperative course was uneventful and no further gastrointestinal bleeding occurred. This is a unique case in which the diagnosis of ulceration at the orifice of jejunal diverticula was made by radiography and endoscopy.View full abstractDownload PDF (6524K) -
-REPORT OF A CASE-Takashi INAGAKI, Kimitomo MORISE, Akio IIZUKA, Mituru SHIMADA, Masayuk ...1989 Volume 31 Issue 10 Pages 2734-2740_1
Published: October 20, 1989
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 67-year-old female, complaining of fever and weight loss, was admitted to our hospital. Double contrast X-ray examination of the small intestine showed a stenosis with irregular-shaped ulcers at the terminal ileum. Colonofiberscopy revealed nodulopolypoid lesions and ulcerations at the terminal ileum. A diagnosis of B-cell type malignant lymphoma was made by immunohistochemical study of biopsy specimen using monoclonal antibodies. Tumor cells also expressed IL-2 R (interleukin-2 receptor) antigen on the cytoplasmic membrane. There was no evidence of distant metastasis but regional lymphnodes by means of Ga-scintigraphy, US, CT-scan and chest X-P, and this case was diagnosed as stage II by Naqvi's classification. Relatively curative operation and post-operative chemotherapy were done. However, reccurence occured in two months and the patient died three months after operation. We suggest that the expression of IL-2R antigen in B-cell type lymphoma may be crucial for poor prognosis like ATL (adult T-cell leukemia/lymphoma). We conclude that immunohistochemical study of biopsy specimen on lymphocyte subsets and IL-2R antigen is important for the diagnosis and estimation of prognosis in primary malignant lymphoma of GI-tract.View full abstractDownload PDF (8308K) -
Hiroyuki OHSIRO, Yasuhisa YOKOYAMA, Isao YOKOYAMA, Manabu KIKUCHI, Mas ...1989 Volume 31 Issue 10 Pages 2741-2744_1
Published: October 20, 1989
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSThe patient was a 42-year-old man with chief complaints of anal bleeding and dyschesia of three months' duration. Barium enema revealed a marked stricture at 5 to 10 cm from the anus. Endoscopically, the tumor was easily bled. By biopsy, it was confirmed to be adenocarcinoma. Examination of the resected specimen showed a protruding tumor with central excavacation of 4.5×3.5 cm in size situating at 4cm from the anus. Within the lesion surrounded by the tumor, a cobblestone like lesion was seen. Histologically, the tumor was diagnosed as tubular adenocarcinoma with the depth of pm invasion and the cobblestone-like lesion adjacent to the tumor showed characteristic changes of Crohn's disease.View full abstractDownload PDF (5931K) -
P. G. Perakos, T. F. Scheer1989 Volume 31 Issue 10 Pages 2747-2753
Published: October 20, 1989
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSLocal treatment of squamous cell carcinoma of the esophagus is only modestly successful. To increase local control, we have developed a procedure to inject a boost dose of radiation into the tumor bed after completion of external beam radiotherapy. The boost dose is given with 32P, a readily available radiocolloid. 32P is a pure emitter and poses no significant radiation hazards. It can penetrate 10-15 mm into the tumor mass and has a half-life of 14.3 days. After determination of the volume to be treated, the colloid is injected with endoscopic guidance using the same technique as used in injection sclerotherapy of esophageal varices. We use the Pentax FG 34 JA operating gastroscope and a Bard disposable 0.5 cm 25 Ga retractable injection sclerotherapy needle. We deliver 150-200 microCurie of 32P colloid diluted to 20 ml with normal saline at 10 to 20 injection sites. This boosts the radiotherapy dose of 5, 500-6, 000 cGy to the range of 7, 500-8, 000 cGy. We have treated five patients so far, with length of follow-up ranging from 8-28 months. Local control and survival results have been excellent and no complications have been associated with the procedure. A combination of external beam radiotherapy and interstitial boost treatment with colloidal 32P appears to be a safe and effective method of managing squamous cell carcinoma of the esophagus.View full abstractDownload PDF (4383K) -
[in Japanese]1989 Volume 31 Issue 10 Pages 2754
Published: October 20, 1989
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSDownload PDF (140K) -
1989 Volume 31 Issue 10 Pages 2755
Published: October 20, 1989
Released on J-STAGE: May 09, 2011
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[in Japanese]1989 Volume 31 Issue 10 Pages 2756-2757
Published: October 20, 1989
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSDownload PDF (275K) -
[in Japanese]1989 Volume 31 Issue 10 Pages 2758-2761
Published: October 20, 1989
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[in Japanese]1989 Volume 31 Issue 10 Pages 2762-2768
Published: October 20, 1989
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1989 Volume 31 Issue 10 Pages 2769-2789
Published: October 20, 1989
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1989 Volume 31 Issue 10 Pages 2790-2811
Published: October 20, 1989
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1989 Volume 31 Issue 10 Pages 2812-2828
Published: October 20, 1989
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1989 Volume 31 Issue 10 Pages 2829-2840
Published: October 20, 1989
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1989 Volume 31 Issue 10 Pages 2841-2859
Published: October 20, 1989
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1989 Volume 31 Issue 10 Pages 2860-2876
Published: October 20, 1989
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1989 Volume 31 Issue 10 Pages 2877-2891
Published: October 20, 1989
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1989 Volume 31 Issue 10 Pages 2892-2908
Published: October 20, 1989
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