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Volume 32, Issue 11
Displaying 1-19 of 19 articles from this issue
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[in Japanese]1990 Volume 32 Issue 11 Pages 2539-2540
Published: November 20, 1990
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSDownload PDF (205K) -
Isei JYO, Hideaki TSUKADA, Syunji UEDA, Minoru OHKUMA, Masahiko SAKAI, ...1990 Volume 32 Issue 11 Pages 2541-2548
Published: November 20, 1990
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSTo establish one of endoscopic diagnostic procedures for gastrointestinal cancers, we developed a new laser instrument and evaluated it in detail. YAG laser was produced by laser system (Surgical Laser Technologies, Inc., Malvern, P. A.) and the wavelength of YAG laser was changed from 1, 064 nm (infrared) to 532nm (green) with KTP crystal and irradiated into pheophorbide solution and the fluorescence from pheophorbide was subject-ed to spectroanalysis with the high sensitvity spectrophotometer and the intensity of the each wavelength was measured with the photomultiplier. (Hamamatsu Photonics, Inc.) The fluorescence was seen in the range from 660nm to 800nm and showed the peak at 680nm. Studies of the relationships between the intensity of fluorescence and the holding voltage, density of pheophorbide, laser power, laser frequency, The distance between the fiber tip and the pheoporbide solution has revealed that the instrument can detect the very weak fluorescence and might be useful for the endoscopjc diagnosis of gastrointestinal cancers.View full abstractDownload PDF (2269K) -
Seiji SHIMIZU, Hirotomo OOTSUKA, Tadaaki ISO, Masako OKAMURA, Yoshimi ...1990 Volume 32 Issue 11 Pages 2549-2554
Published: November 20, 1990
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSUtility of Miniature Ultrasonic Probe (MUSP) in preoperative evaluation of colorectal cancer was assessed in comparison with the ultrasonic colonoscope, CF-UM 3. Fourteen lesions in 13 subjects were included in this study ; ultrasonic observation with both of the instruments was conducted in all cases. Visualization of the lesions was successful in 11 lesions (78.6%) with MUSP, and in 8 lesions (57.1%) with CF-UM 3. A lower rate of successful visualization by the latter instrument was explained by the fact that narrowing of the lumen precluded appropriate observation ; with MUSP, however, visualization was difficult when a lesion located in crooked portion. With MUSP, a correct diagnosis of the depth of cancer invasion was possible in 9 (81.8%) of 11 lesions with which visualization was successful ; with CF-UM 3, it was possible in 7 (87.5%) of 8 lesions Evaluation of the depth of cancer invasion was difficult in lesions of protrude type, especially with MUSP, due to the attenuation of ultrasound. With CF-UM3, visualization of paraintestinal lymph node enlargement was possible in all of th three cases in which lymph node metastasis was revealed by postoperative evaluation ; with MUSP, however, it was possible in only one of four cases. By the development of MUSP, visualization of lesions with marked luminal narrowing has become possible. At present, however, the quality of the ultrasonic image of MUSP was significantly inferior to that of CF-UM3, and improvement of the quality of image is an urgent problem with MUSP for the purpose of evaluation of minute changes and lymph node metastasis.View full abstractDownload PDF (3463K) -
Masahiro IGARASHI, Tomoe KATSUMATA, Yoshimasa YAMAMOTO, Kiyonori KOBAY ...1990 Volume 32 Issue 11 Pages 2555-2561
Published: November 20, 1990
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSWe evaluated the significance of follow-up study in the patients after endoscopic polypectomy. The incidence of adenomas which were detected again during follow-up period was 25.8% for them with single adenoma and 52% of the patient with multiple adenoma at the initial examination. Adenomas which were found by initial examination were commonly distributed in the rectum and sigmoid colon, on the other hand newly detected adenoma were frequently located in the right side colon including the transverse colon. Two of 209 patients (0.9%) were early colonic cancer after endoscopic polypectomy. Eighty three percent of newly detected adenomas were found within first two years after initial polypectomy. The data suggested that there were high incidence of newly developed adenomas including missing ones in patients with adenomas. In addition, if we defined the redetected adenoma as missing cases within one year, its incidence was 6.9%. We recommended follow-up intervals as follows : Patients with early colonic cancer should be examined 6 months after the initial polypectomy, and then every year. Patients with multiple colonic adenomas at the initial colonoscopy should be followed-up annually, while those initially presenting with a single adenoma should be followed-up every two years. After "clean colon" was confirmed, we recommended the follow-up interval to be every 2 or 3 years in all patients. It is concluded that the follow-up colonoscopy for patients with the previous polypectomy is valuable for the early detection and prevention of colon cancer.View full abstractDownload PDF (785K) -
Hiroshi HASHIMOTO, Atsushi MITSUNAGA, Kyoko NAKAO, Motoko CHIBA, Akira ...1990 Volume 32 Issue 11 Pages 2562-2569
Published: November 20, 1990
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSWe studied to differentiate leiomyosarcoma from leiomyoma, under 5.0 cm in diame-ter, by estimating the irregularity of marginal echo (IRM), the irregularity of internal echo (IRI), low echo area (LEA) and lobulation (LOB) on EUS findings. These four findings were characteristic of myogenic tumor, over 5.0 cm in diameter. And in three cases of leiomyosarcoma, under 5.0 cm in diameter, appearance of these four findings was as followed : IRM showed in 3 cases, IRI, 2 cases, LEA, 1 case and lobulation, 2 cases. On the other hand, in five cases of leiomyoma, each of these four findings appeared in only 1 case. On the basis of comparative study between EUS and pathological findings, the irregularity of marginal echo showed the external margin of lobuli in 4 cases, and low echo area showed the necrotic tissues in all cases. As a result, these four findings appeared to be more popular in cases of leiomyosarcoma than in cases of leiomyoma. On EUS examination, it was important to evaluate these four findings.View full abstractDownload PDF (5391K) -
Hiroshi AKAKI, Chiemi MICHINAKA, Kazushi ISETANI, Hiroshi UEHIRA, Hide ...1990 Volume 32 Issue 11 Pages 2570-2576_1
Published: November 20, 1990
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSEleven patients with gastrointestinal malignancies coexisting with skin diseases, such as dermatomyositis, acanthosis nigricans, anular erythema, bullous pemphigoid, subcorneal pustular dermatosis in our clinic for the last ten years were reported. We have encountered 4 cases of dermatomyositis accompanied with gastric cancer, 1 case of acanthosis nigricans accompanied with esophagus cancer, 2 cases of acanthosis nigricans with colon cancer, 1 case of acanthosis nigricans accompanied with double cancer of the stomach and colon, 1 case of anular erythema with gastric cancer, 1 case of bullous pemphigoid with gastric cancer and 1 case of subcorneal pustular dermatosis with gastric cancer. In all cases, the skin lesions appeared before the onset of gastrointestinal symptoms. Among them, 2 cases of early cancer were noticed. These cases were found before the onset of gastrointestinal symptoms by screening. If these skin diseases are noticed, exact examination for the internal organs especially stomach and colon should be necessary.View full abstractDownload PDF (2842K) -
Teruyuki KISHIDA, Sadamu MINAMI, Susumu YAMAKADO, Yasuhito TAMAGAWA, F ...1990 Volume 32 Issue 11 Pages 2577-2584
Published: November 20, 1990
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSThe detection rate of colorectal polyps was compared between f iberscopy and elec-tronic endoscopy. One thousand one hundred, eighty-two patients underwent total colono-scopy using fiberscope (FCSL50, Machida), and 193 of 1, 182 (16.3%) were found colorectal polyps (FCS group). On the other hand, 730 patients underwent total colonoscopy using electronic endoscope (TCE50L, Toshiba), and 199 of 730 (27.3%) were found colorectal polyps (TCE group). There was a significant difference in the detection rate of colorectal polyps between two groups (P <0.005). Three hundred twenty-four polyps in FCS group and 532 in TCE group were respectively detected. One more polyp was found per patient in TCE group than in FCS group on average. TCE group had a lower incidence of polyp at the sigmoid colon (35.5% vs. 45.7%) compared with FCS group, on the other hand, it was higher at the descending colon (13.2% vs. 10.2%) and transverse colon (18.0% vs. 10.2%). As to the number of polyps, the results showed a similar trend. The incidence of polyp concerning about size which was less than 10mm, especially 5mm in size (54.5% vs. 46.9%) was higher in TCE group. The number of polyps was much greater in TCE group. The incidence of polyp according to size at locations was apparently higher at rectum under 5mm in size in TCE group (73.5% vs. 58.7%), but there was no difference in other colon The number of polyp, under 10mm was greater at any location in TCE group. It was concluded that electronic endoscopy was more useful than fiberscopy on the detection of colorectal polyps.View full abstractDownload PDF (820K) -
Kenichi IDO, Hiroyuki SHIBUSAWA, Shinichi SATO, Norio ISODA, Masahiko ...1990 Volume 32 Issue 11 Pages 2585-2590
Published: November 20, 1990
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSWe have carried out a series of experimental laparoscopic cholecystectomy in dogs (n=5). In our animal experiments, laparoscopic removal of the gallbladder was performed by Nd-YAG laser, ligating the cystic artery and cystic duct with the clips used for vascular ligation. The irradiation of Nd-YAG laser for the ablation of the gallbladder using the non-contact type of quartz was done under 15 watts of output with 4, 000-5, 000 J in total energy. This procedure requires a comprehensive technical integration, such as the preparations of optimum instruments, excellent skills and the cooperation with surgeons. From the experience of these experiments, it will be concluded that this poocedure could be clinically applied in human patients.View full abstractDownload PDF (3348K) -
Hirokazu KIYOZAKI, Masaaki TERANAKA, Jinichi NEI1990 Volume 32 Issue 11 Pages 2591-2597_1
Published: November 20, 1990
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSEndoscopic and histological findings of the stomach and bile acids composition of intra-gastric bile were examined in 18 patients with bile reflex gastritis after the distal gastrectomy by the Billroth I procedure (B-I) in 10 cases and by the Billroth II (B-II) in 8 cases. Six of these patients were treated with ursodeoxycholic acid (UDCA) for at least 4 weeks, and the effects of UDCA on bile reflux gastritis were also analyzed. The endoscopic and histological findings of gastritis were more severe in patients of the B-II group than in those of the B-I group. The percentage of chenodeoxycholic acid (CDCA) in the intra-gastric bile was significantly higher in the B-II group than in the B-I group. By the treatment with UDCA, 4 out of 6 patients showed improvement of the clinical symptoms and endoscopic findings improved in all cases. With the UDCA treatment, the percentage of UDCA in intra-gastric bile increased and that of CDCA decreased significantly. These results suggest that UDCA is useful for the treatment of bile reflux gastritis after gastrectomy.View full abstractDownload PDF (2589K) -
-A REVIEW OF JAPANESE LITERATURES IN 42 REPORTED CASES-Makoto SANO, Atsushi SUGIOKA, Keiichi SAOTOME, Tetsushi ESAKI, Kouichi ...1990 Volume 32 Issue 11 Pages 2598-2609
Published: November 20, 1990
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSWe encountered a patient with an esophageal ulcer due to rupture of an abscess arising from spinal caries, and followed up the changes of endoscopic findings. The patient was a 61-year-old man. An ulcer was observed on the right anterior wall of the middle part of the esophagus and superficial esophageal carcinoma was suspected, but malignancy was not proved histopathologically, The ulcer spontaneously improved one month later, and a fistula developed. Subsequent examination showed spinal caries affecting the second and third thoracic vertebrae in association with gravitation abscess. Thus, a diagnosis was made as ulceration due to rupture of the esophagus by a tuberculous abscess, and antituberculous therapy was started. The fistula was completely closed after treatment. Removal of the infectious focus and anterior fixation were performed for the spinal caries. At presest, the patient remains in a good condition at 14 months after operation. Only two cases of esophageal ulcer due to spinal caries have been reported so far in Japan. In the present case, the esophageal ulcer was similar to a depressed esophageal carcinoma. This is the first case which was been able to follow up the course of reduction in ulcer size, fistula and scar formation.View full abstractDownload PDF (9384K) -
-A CASE REPORT AND REVIEW OF THE JAPANESE LITERATURE-Hiroya NAKATA, Atsushi OKU, Kikukazu SAKATSUJI, Misaki YOSHIOKA, Misak ...1990 Volume 32 Issue 11 Pages 2611-2617_1
Published: November 20, 1990
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 59-year-old man was performed subtotal esophagectomy and esophagogastrostomy in the thoracic cavity for esophageal cancer in March, 1983 and pathological diagnosis was squamous cell carcinoma, sm in depth, without lymphnode metastasis. In July 1988, the patient suffered from hematemesis and dysphagia and admitted to our hospital on August 11, 1988. X-ray and endoscopic examinations of upper gastrointestinal series revealed advanced gastric carcinoma in the reconstructed stomach tube. Biopsied specimen showed papillary adenocarcinoma histopathologically. An abdominal computed tomogram revealed multiple liver metastasis. The therapy during hospitalization consisted of total parenteral nutrition and insertion of an esophageal prosthesis. The patient was getting worse gradually and died on November 29, 1988. Since similar cases are anticipated to increase in the future, endoscopic follow-up after operation for esophageal carcinoma will be an essential regimen.View full abstractDownload PDF (6135K) -
-REPORT OF A CASE-Tatsuya KUBO, Hirokazu DATE, Shun-ichi INOSHITA, Tokihiko FUKUYAMA, Ma ...1990 Volume 32 Issue 11 Pages 2618-2625
Published: November 20, 1990
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 72 year-old man was admitted to our hospital because of melena. Double contrast X-ray examination of the small intestine showed a stenosis at the jejunum, 60 cm anal from Treitz Ligament, 3.5 cm in length. The Kerckring's folds of the stenotic lesion were wide with small ulceration. The border of lesion was smooth and enlargement of the oral side was not appeared. These roentgenological findings strongly suggested malignant lymphoma. In addition, US and CT-scan revealed mass in the same region. The tumor and regional lymph-nodes were resected. Intraoperative endoscopy revealed coarse mucosa with ulcer scar and the border of lesion was not clear. The resected tumor showed enlarged Kerckring's fold with irregular ulceration. Histological examination revealed diffuse type of malignant lymphoma, small cell type and the lymphoma cells possessed the IgG, x type surface membrane immunoglobulin, which suggests a monoclonal B cell origin.View full abstractDownload PDF (5712K) -
Kazunobu YAMAZAKI, Mataichirou SEKIYA, Hiromi KAMOSHITA, Kazuhito KUGA ...1990 Volume 32 Issue 11 Pages 2627-2631_1
Published: November 20, 1990
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 25-year-old man who was pointed out esophageal varix without impaired hepatic function, was admitted to our hospital for further examination for portal hypertension. Gastrointestinal endoscopy showed a smooth protruded lesion with normal mucosal cover-ing in the duodenal bulb, and ultrasonography revealed enlarged, tortuous vessels near the hepatic hilum, so this tumor was highly suspected as varix of the duodenal bulb. Celiac arterioportography revealed extrahepatic portal obstruction and dilated collateral vein was running tortuously from the portion of obstruction to the hepatic hilum via the duodenal bulb. Most of the causes for varix of the duodenal bulb are hepatopetal collaterals, and these vessels are developed especially by extrahepatic portal obstruction. Varix of the duodenal bulb is one of the differential diagnosis for duodenal tumor. So this condition is suspected, it is important to examine portal system by angiography.View full abstractDownload PDF (5148K) -
Soichi HOTTA, Hiromasa KASHIMURA, Yoko SAITO, Tsuguo EBIHARA, Akira NA ...1990 Volume 32 Issue 11 Pages 2632-2639
Published: November 20, 1990
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSWe experienced 49-year-old man suffered from Cronkhite-Canada syndrome associated with multiple adenomas and 1 early cancer of the colon. Upper gastrointestinal series and endoscopy revealed nearly total replacement of gastric mucosa by numerous polyps of various sizes which were under 1 cm in diameter. Biopsy specimens of these polyps showed hyperplastic glands without atypia and edematous stroma with inflammatory cell infiltra-tion. These polyps resembled "juvenile polyps". Barium enema study revealed two pedunculated and six semi-pedunculated polyps about 1 cm in diameter in addition to numerous, irregular-shaped sessile polyps. Colonoscopic polypectomy was performed for these polyps. We could withdraw six of them. Histological findings showed that two of them were hyperplastic polyps with dilatated cystiform glands and edematous stroma, three were tubular adenomas with moderate to severe atypia and another one was tubular adenocarcinoma with mucosal invasion. There were no adenomatous or carcinomatous foci in non-neoplastic polyps in our case, indicating that all adenomas and carcinoma were supposed to be accidentaly associated with Cronkhite-Canada syndrome. Twenty-five cases of Cronkhite-Canada syndrome associated with gastrointestinal cancer have already been reported in the world according to our research. Only three of them were cases of early cancer. Accordingly, our case can be classified as a rare case.View full abstractDownload PDF (4470K) -
Takeshi TOKUYAMA, Ryuichi HIGASHIGUCHI, Masayuki TSUJIMOTO, Takayo YAM ...1990 Volume 32 Issue 11 Pages 2640-2645_1
Published: November 20, 1990
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA patient was a 67-year-old man with the complaint of repeated water mucus diarrhea. Laboratory data on admisson showed marked hypokalemia (K 1.7 mEq/1), and increase of myogenetic enzyme associated with hypokalemia. Barium enema examination and colonoscopic examination revealed tumor with velvety mucosa in the rectum and revealed a Yamada type 4 polyp and Borrmann type 3 advanced cancer. Biopsy specimen revealed respectively villous adenoma, tubular adenoma and well differentiated adenocar-cinoma. Resection of the tumors was performed. Resected specimen revealed a large, wide-spread tumor measuring 12 × 10 cm in the rectum. Histological findings showed villous adenoma with cancer cells which invased to the subumucosal layer partially. And it revealed in the sigmoid colon a polyp consisted of tubular adenoma, 1 cm in size and an advanced cancer consisting of well differentiated adenocarcinoma, 3.5 × 4.0 cm in size. A patient had no symptoms after operation, until he had died of a reccurence of sigmoid cancer, 18 months later. Villous tumor with electrolyte depletion syndrome is rare in Japan and only 20 cases have been reported including this case.View full abstractDownload PDF (4010K) -
Isao WAKIYA, Hiroshi YAMAMOTO, Isao DOI, Naoki HINO, Shigeki SENZAKI, ...1990 Volume 32 Issue 11 Pages 2646-2655
Published: November 20, 1990
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSThe first case was a 58-year-old male suffering from total colitis for 18 years. A IIa+ IIc type lesion was disclosed in the rectum by a barium enema study when diarrhea worsened. Based on a diagnosis of early rectal cancer, peranal transection of the tumor was performed. Only 4 months later, 4 lesions of cancer inclusive of Borrmann I type tumor infiltrating to the serosa were found around the rectal incision. The second case was a 72-year-old female with a history of left-sided colitis for 11 years. Colonoscopy was performed annually for 8 years, and a red flat elavated lesion was revealed in the rectum. Left side colectomy was performed under a diagnosis of early rectal cancer. Histologically these flat elevated lesions were well differentiated adenocarcinoma and mucosal carcinoma surrounded with dysplasia. Therefore, these lesions were thought to be developed from ulcerative colitis. Patients with a history of more than 10 years of ulcerative colitis should undergo surveillance colonoscopy annually. Careful observation focusing on elevated lesions in the rectum and biopsies should be performed at each examination.View full abstractDownload PDF (7414K) -
Ryuichi HIGASHIGUCHI, Takeshi TOKUYAMA, Masaoki SUNAGAWA, Rumiko NISHI ...1990 Volume 32 Issue 11 Pages 2657-2662_1
Published: November 20, 1990
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSRecently, we performed endoscopic sclerotherapy for 3 cases of fundic varices without esophageal varices two cases with bleeding and one expecfed case. Fundic varices were punctured endoscopically and injected with 50% glucose solution, then with iopamillon-added ethanolamine oleate under transillumination. Sclerothrapy performed at a week interval until varices disappear. The side effect noted was only hemoglobinuria in one case, which was not serious. Sclerothrapy could be applied safely to cases of fundic varices in the same manner as esophageal varices, leading to disppearance of varices.View full abstractDownload PDF (5447K) -
First Bulletin (part II)-1988-[in Japanese]1990 Volume 32 Issue 11 Pages 2663-2679
Published: November 20, 1990
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSDownload PDF (1315K) -
[in Japanese]1990 Volume 32 Issue 11 Pages 2680-2791
Published: November 20, 1990
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSDownload PDF (20543K)
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