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Volume 32, Issue 12
Displaying 1-19 of 19 articles from this issue
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Haruhiro INOUE, Hiroshi NAKAMURA, Katsuo SHIMOJYU, Naoya MURASE, Tatsu ...1990 Volume 32 Issue 12 Pages 2813-2819
Published: December 20, 1990
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSChanges of collateral circulation of the esophageal varices have been evaluated by endoscopic ultrasonography before and after sclerotherapy using intravariceal injection technique. According to our results, intramural vessels (varices) at the esophagus and upper body of the stomach were completely thrombosed after sclerotherapy. The extramural vessels showed various changing patterns at the paraesophegeal region. The paragastric vessels deminished markedly in every cases. It was concluded that sclerotherapy using intravariceal injection technique was a therapy mainly for the intercep-tion of intramural varices at the esophagus and upper gastric region.View full abstractDownload PDF (1159K) -
Masahiro KANAZAWA, Junjiro SANO, Atsushi KAWAGUCHI, Masashi IWATA, Mas ...1990 Volume 32 Issue 12 Pages 2820-2825
Published: December 20, 1990
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSThe duodenal ulcer scars are often observed endoscopically at the anterior wall, especially just beyond the pyroric ring. The authors studied whether these endoscopical "scars" were compatibie to pathological scars with the resected specimen or not. At the area diagnosed as endoscopical "scar", tear and irregularity of muscuralis mucosae, thinning of Brunner's gland in submucosal layer, fibrosis in both submucosal and propria muscular layer were microscopically observed and they were diagnosed pathologically as scar. To study the frequency of this type of endoscopical "scar", 154 cases were selected at random from endoscopical gastric mass survey cases. After other doctors diagnosed them as "normal" bulbi, the authors paid special attention to this area, namely, just beyond the pyloric ring. The "scars" existed in 75% of them. It was revealed that scars at this area were existed more frequently than previously thought.View full abstractDownload PDF (2759K) -
Masaki MIYAMOTO, Shinsuke MORIMOTO, Hiroyuki YAMADA, Takatoshi NAKASHI ...1990 Volume 32 Issue 12 Pages 2826-2837
Published: December 20, 1990
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSWe designed a system with an RGB (Red, Green, Blue) colour subtraction unit. RGB-subtraction image processing was used before or/and after scattering methylene blue dye for various gastric lesions. As for a preliminary experiment, we measured the refractory characteristic curve of normal gastric mucosa after scattering the methylene blue and obtained the mean refractory peak wave length. We studied the image gained by using the RGB-subtraction processing unit and investigated the subtraction rate and gain number as parameters. From the preliminary experiment, the mean peak value of the reflectory rate was 452 nm and in the blue colour zone. The R-G image (ie, that produced by subtracting red and green) was similar to the R -B image as the G-R image did the B-R image and the G-B image the B-G image after RGB-subtracting for the original image. RGB-subtraction image processing showed us the border between diseased and normal mucosa and mucosal changes clearly after methylene blue dye scattering. The border between normal and lesioned mucosa on these images corresponded to those prepared histologically. This image processing enables us to detect the lesions more clearly and the lesional area on gastric mucosa accurately. TV-endoscopy using RGB-subtraction image processing may permit endoscopic surgery.View full abstractDownload PDF (3383K) -
Satoshi EBISUI, Katsuhisa KAWAMOTO, Naoki TERAMAE, Shinji FUKUMITSU, C ...1990 Volume 32 Issue 12 Pages 2839-2845_1
Published: December 20, 1990
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSWe have studied 51 cases of ischemic colitis (IC). Forty one cases of them were transient form, 6 of the stricturing form, 2 of the gangrenous form and 2 of the unknown. The average age was 62.5 years, ranging between 27 and 87 years and more frequent in women (64.7%), especially in less than 40 years (75.0%). IC developed with presenting symptoms such as abdominal pain (78.4%), melena or hematochezia (84.3%) and diarrhea (31.4%). The associated diseases were hypertension (25.5%), heart disease (15.7%), apoplexy (7.8%). However, constipation or enema were seen in 5 women (9.8%) and 8 cases (15.7%) were after laparotomy of the abdomen. The results suggested that not only vascular disease but also increased intraluminal pressure and peristalsis are triggers of ischemic colitis. In our study, the duration of subjective symptoms was significantly longer and WBC measured within 5 days after the onset of the disease was significantly increased in the stricturing form than in the transient form. It seemed that these were helpful to distinguish the stricturing form from the transient form.View full abstractDownload PDF (3033K) -
WITH SPECIAL REFERENCE TO ADENOMA AND CARCINOMAHeiji OKAMOTO1990 Volume 32 Issue 12 Pages 2846-2855_1
Published: December 20, 1990
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSThirty nine colonic diminutive early carcinomas (38 carcinomas in situ & 1 invasive carcinoma) out of 6, 390 colonic polyps were identified and removed endoscopically during the past eight years. Thease diminutive carcinomas were studied endoscopically and histopathologically. The results were as follows; 1) The diminutive carcinomas were not so rare among all early ones (10.1%), but not so common in all diminutive polyps (1.1%). 2) Most of them were classified into the protruded type excluding a few lesions showing the flat or depressed type. 3) One third of them could be diagnosed endoscopically by the irregular shape, depression and solid impression suggesting of malignancy. The rest of the lesions were shown later to have carcinomas by the histological examination. 4) 24 cases (63.2%) were accompanied by other neoplastic lesions including focal carcinomas in 10 cases. 5) Histopathology revealed well differentiated adenocarcinoma in all lesions ; "de novo" carcinomas in 15 lesions (38.5%) and carcinomas accompanied with a small amount of adenoma in the rest lesions. In conclusion, both carcinomas accompanied by adenoma and "de novo" carcinomas were proved to exist even in cases of diminutive carcinomas (5 mm or less in diameter). The ratio among them is regarded as 6 : 4.View full abstractDownload PDF (4616K) -
Akitada ISO, Hirotomo Ootsuka, Seiji SHIMIZU, Yoshihiro AOKI, Masako O ...1990 Volume 32 Issue 12 Pages 2856-2863
Published: December 20, 1990
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSMagnifying observation was performed for colorectal elevated lesions with magnifying electronic colonoscope, CF-V 10 ZI (Olympus). Nine cases were included in this study : one case with metaplastic polyp (2 lesions), three with tubular adenoma (6 lesions), one with early cancer (2 lesions) and 4 with advanced cancer (4 lesions). Binary images were obtained from the original images of the surface structures, and image analysis was conducted using parameters concerning "width", "area", "elongation", "irregularity" and "dilatation". The results showed the possibility that the differentiation of the histological types can be made by parameters of "area", "irregularity", or "elongation". Our method is considered to introduce a quantitative approach to endoscopic diagnosis, and the possibility of automatic diagnosis was suggested.View full abstractDownload PDF (3691K) -
Tatsuoki SHIRAHAMA, Kazuo TAKEI, Tsutomu MOMURA, Kazuo HURUKAWA, Masas ...1990 Volume 32 Issue 12 Pages 2865-2875
Published: December 20, 1990
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSDuring 12 years (1978-1989), we endoscopically observed 47 cases of acute gastric ulcers (7.9%) due to ranger training among 593 trainees. Six cases of these acute ulcers examined by endoscope over one year were discussed. 1. In two of 6 cases the ulcer scars were found on endoscopic examination before training, but in 4 of these any endoscopic findings ware observed before training. So, these four were the cases of recurrence of primary acute ulcers. 2. The factors of the recurrence were thought to be due to severe training in all the cases, and the locations of the recurrent ulcers were the same as those of the primary ones. 3. It was suggested that an acute stress ulcer tended to recur because of severe persistent or repeated stress such as hard training.View full abstractDownload PDF (3625K) -
Nobuhide OSHITANI, Atsuo KITANO, Akihiro TABATA, Makoto OBAYASHI, Kazu ...1990 Volume 32 Issue 12 Pages 2877-2882_1
Published: December 20, 1990
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSSteroid pulse therapy was used in 5 male patients with ulcerative colitis ; one with total colitis and 4 with left-sided colitis. Four patients had relapsing type and one became to have chronic continuous type. Hydrocortisone sodium succinate was administrated as drip infusion 500-1, 000 mg/day for 3 days, usually 3 pulses were employed. Clinical symptoms rapidly improved in 4 patients and their bowel movements decreased the day after the first administration. Endoscopic improvement was obtained in 3 patients. The side effect was not noted in these patients. The advantages of this treatment are to make the judgement of efficacy of medical treatment faster and unnecessary tapering of steroid dose.View full abstractDownload PDF (2662K) -
Yasushi SAKATA, Kotaro YAMAOKA, Tatsuro KISU, Yasufumi UCHIDA, Hisao M ...1990 Volume 32 Issue 12 Pages 2883-2887_1
Published: December 20, 1990
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSWe present a case of gastric tuberculosis without involving any other organs, which is of the ulcerative type, confirmed by proof of mycobacteria in a culture of an endoscopic biopsy specimen. A 74-year-old-male was admitted to the department of orthopedics for the treatment of spinal canal stenosis in our hospital. An endoscopic examination was performed because of his complaint of nausea, vomiting and epigastric pain. Multiple irregularly-shaped ulcers were found in the lower part of the gastric body and at the angulus. Histologic findings of biopsy specimen could not reveal epithelioid cell granuloma, caseation necrosis or mycobacteria, but we could identify mycobacteria in a culture of endoscopic biopsy specimen. Administration of antituberculous agents (isoni-azide, rifampicin, ethambutol) resulted in a good response. Six weeks later, an endoscopic examination showed that the ulcerations were diminished markedly in size. As tuberculo-sis of the stomach is rare, there have been only 17 cases reported which have been diagnosed by endoscopic biopsy, Only one case report of gastric tuberculosis with identified mycobacteria which was diagnosed by endoscopic biopsy . To our knowledge, this is the first case of gastric tuberculosis in which diagnosis was confirmed by a culture of biopsy.View full abstractDownload PDF (2643K) -
Kazuhiko INOUE, Kenji TOKUMO, Takehiko SUZUKI, Hitoshi TESHIMA, Masaha ...1990 Volume 32 Issue 12 Pages 2888-2895
Published: December 20, 1990
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 69-year-old woman was admitted to our hospital because of mild dysphagia. An upper gastrointestinal series showed dilatation of the lower esophagus and smooth swelling of folds like varices. Esophagoscopy showed soft and smooth protruding lesions longitudi-nally. There were no ulcers or erosions on the esophageal mucosa. Biopsy specimens showed a diffuse small-cell lymphoma. A computed tomographic scan showed marked thickening of the wall of the entire esophagus. Magnetic resonance imaging showed high density in the area of the esophageal lesion. Chemotherapy was administered with VEPA (vincristine, cyclophosphamide, pred-nisolone, adriamycin). A follow-up barium study showed that the tumor had disappeared, and a follow-up computed tomographic scan showed that the thickness of the esophageal wall had decreased from 28mm to 5mm. We reported a case of malignant lymphoma of the esophagus with complete remission following chemotherapy.View full abstractDownload PDF (2807K) -
Yoshinari FURUKAWA, Kunihiko DAITOKU, Yasuhiko HIRATA, Yoshifumi YAMAO ...1990 Volume 32 Issue 12 Pages 2896-2902_1
Published: December 20, 1990
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSThe case is a 44-year-old man, in whom a protuberant lesion was pointed out by an occasional check-up examination in the descending part of duodenum. Fiberscopic examination of the duodenum revealed a tumor with bridging fold, and the biopsy of its superficial erosion confirmed a carcinoid tumor. Endoscopic retrograde cholangiopancreatography revealed an opening of accessory pancreatic duct in the central part of the tumor, thus leading to the preoperative diagnosis as carcinoid of an accessory papilla of the duodenum. Serum serotonin level was within normal limits. Pancreatoduodenectomy was carried out. The tumor extirpated was 1.8 cm sized, but presented infiltration of the pancreas and metastases to the regional lymph nodes. Pathologically, the solid islands of tumor cells and glandular structures with central lumina were present. The lumina of the glandular structures contained psammoma bodies that are characteristic of the histologic pattern. Immunohistologically, somatostatin antibodypositive cells were noted. In any case of submucosal tumor found in the descending part of duodenum, it was thought necessary to make examination in consideration of possible carcinoid of the accessory papilla as well and also to carry out pancreatoduodenectomy for the treatment of the above carcinoid.View full abstractDownload PDF (3697K) -
Hidenaga UESUGI, Tomoe KATUMATA, Yoshimasa YAMAMOTO, Hiroyuki MITOMI, ...1990 Volume 32 Issue 12 Pages 2903-2911
Published: December 20, 1990
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSWe report three adult cases of malignant lymphoma with intussusception diagnosed before the surgery. All cases care to our unit complaining of intermitted abdominal pain. Barium enema studies showed characteristically the large tumor, crabclaw-like findings and coiled-spring sign. They were diagnosed as intussusception resulting from the advanced portion of tumor. Colonoscopic findings demonstrated a ball-like tumor with rough, lustrous and lack of hemorrhagic surface, which occupied a lumen. These findings differed from usual epithelial tumor, especially a malignant lymphoma, was strongly suspected. Malignant lymphoma was diagnosed from biopsy specimens. The sites of original tumors, which were confirmed histopathologically, were the terminal ileum, ileocecal valve and cecum. These cases of intussusception occurring at the anal side of Bauhin's valve were very rare and the endoscopic findings were very specific.View full abstractDownload PDF (3531K) -
Shigeru MORICHIKA, Fumitoshi KISHI, Takatoshi YAMADA, Kenji KOJO, Ken ...1990 Volume 32 Issue 12 Pages 2913-2916_1
Published: December 20, 1990
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSThree resected cases of primary malignant lymphoma of the rectum were reported. The first case was a 57-year-old female with constipation and had two nodular rectal lesions ; one lesion showed smooth surface resembled a submucosal tumor and another showed lobulated surface with a central depression (Figure 1, 2-a, 2-b, 3). The second case was a 54-year-old female with fresh bloody feces and had one nodular rectal lesion with a minor ulceration on the surface (Figure 4, 5). These patients are now alive for 40 and 60 months without recurrence, respectively. The third case was a 74-year old female with fresh bloody feces and showed a large ulcerative lesion in the rectum (Figure 6). This patients died of apoplexy four months after operation. ALL these patients had only rectal lesions which limited within the rectal wall, and were diagnosed to have "primary malignant lymphoma (B cell type) of the rectum" by histological examinations.View full abstractDownload PDF (2311K) -
A CASE OF CROHN'S DISEASE INITIALLY PRESENTED EXCLUSIVELY WITH MULTIPLE APHTHOID ULCERS IN THE COLONHidehito MIYAHARA, Taiji AKAMATU, Osamu OOWA, Eiji TUGANE, Noriaki MAT ...1990 Volume 32 Issue 12 Pages 2917-2922_1
Published: December 20, 1990
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 14-year-old male visited our hospital with complaints of diarrhea, abdominal pain and body weight loss. He was found to have slight fever (37.3°C) and upper abdominal tenderness. Laboratory findings revealed mild inflammatory signs (ESR 22 mm/1 hr, CRP 0.9 mg/dl). Barium enema examination and colonoscopic examination showed multiple aphthoid ulcers in the total colon, but neither longitudinal ulcer nor cobble stone appearance. Microscopic examination of the biopsied specimen from the aphthoid ulcer disclosed noncaseating granulomas, suggesting Crohn's disease. The patient was treated with elemental diet alimentation and salazosulfapyridine and his symptoms and laboratory findings were improved. Three months later, the second colonoscopic examination newly revealed longitudinal ulcer in the terminal ileum, and also perianal fistulas developed. From these findings, the definite diagnosis of Crohn's disease was made. The evolutional pattern of Crohn's disease was unusual in this case, and 4 similar cases have been reported so far in Japan which were briefly reviewed.View full abstractDownload PDF (3211K) -
Shinichi KISO, Takeshi KASHIHARA, Toshio ITOH, Kouji HASHIMOTO, Eijiro ...1990 Volume 32 Issue 12 Pages 2923-2931
Published: December 20, 1990
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSWe report the laparoscopic findings and liver biopsies of two cases of Infectious Mononucleosis-like syndrome. Case 1. A 20-year-old male. He complained of fever and sore throat. Swelling of lymph nodes of his whole body and hepatomeagly were noted. His laboratory data showed that atypical lymphocytosis, positive Paul-Bunnell test, GOT 105 IU/L, GPT 114 IU/L, and LDH 1, 024 IU/L. Case 2. A 32-year-old male. He complained of fever and swelling of cervical lymph nodes. His laboratory data showed atypical lymphocytosis, GOT 103 IU/L, GPT 129 IU/ L and LDH 1, 101 IU/L. Laparoscopic findings of both cases revealed the following. The spleen was enlarged prominently. The liver was slightly enlarged and its surface was smooth. A close-up view showed that white markings were increasing. These are thought to be compatible with the whitish marking of portal areas after ICG infusion. In Case 1, it was possible to observe swelling of mesenteric lymph nodes at laparoscopy. Liver biopsies of both cases revealed moderate small round cell infiltration in the portal areas and along the sinusoids. Cellular infiltration of the Glisson's sheath was severe. Round cell infiltration of the sinusoids was striking. There was almost no fibrosis.View full abstractDownload PDF (3234K) -
Osamu YAMAKAWA, Yasuhiro KATO, Manabu YONESHIMA1990 Volume 32 Issue 12 Pages 2932-2937
Published: December 20, 1990
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 30-year-old male was admitted to our hospital because of severe left hypochondric pain after excessive drinking. Computed tomography showed diffuse pancreatic enlargement and retroperitoneal edema, and serum amylase was elevated. ERCP demonstrated unfused pancreatic duct systems, but no abnormalities were observed in both dorsal and ventral pancreatic ducts. After discharge from hospital, the attacks repeated 5 times until his second admission to our hospital during 9 months after the first attack. ERCP at the second admission showed moderate dorsal pancreatitis. This is the first report of endoscopic pancreatograms of a case with pancreas divisum before and after repeated pancreatitis, showing unique development of dorsal pancreatitis in pancreas divisum.View full abstractDownload PDF (943K) -
Masahiro ISHIGOOKA, Masanori HIRAO, Ryohei TAKAKUWA, [in Japanese], Ta ...1990 Volume 32 Issue 12 Pages 2938-2945
Published: December 20, 1990
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSAn endoscopic resection method, which we developed for resection of early gastric cancer with local injection of hypertonic saline-epinephrine (HSE) solution, was applied to 7 cases of esophageal tumor. The way of endoscopic resection with local injection of HSE solution (ERHSE) is summarized as follows. 1. Marking on mucous menbrane to incise by scalpel (needle type). 2. Local injection of HSE solution by needle for endoscopy. 3. Incision of marked mucous menbrane by scalpel. 4. Somewhat mobilization of the lesion with forceps. 5. Squeeze and resection with high frequency current snare. In this way, all of 7 cases were completely resected and diagnosed pathologically. None of these showed severe complications, neither bleeding nor perforation. And all of them took good courses. In conclusion, endoscopic resection by this method we developed seems to be excellent in treating esophageal protuberant tumors, furthermore, to be able to treat esophageal flat or depressed lesions, for instance, ep type carcinomas and dysplasias. Hence, we consider that this method is widely applicable to endoscopic resection and patho-histological diagnosis of esophageal tumors.View full abstractDownload PDF (2786K) -
First Bulletin-1988- (Part III)[in Japanese]1990 Volume 32 Issue 12 Pages 2947-2957
Published: December 20, 1990
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSDownload PDF (607K) -
[in Japanese]1990 Volume 32 Issue 12 Pages 2958-3112
Published: December 20, 1990
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSDownload PDF (24429K)
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