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Volume 32, Issue 6
Displaying 1-20 of 20 articles from this issue
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Iruru MAETANI1990 Volume 32 Issue 6 Pages 1321-1331
Published: June 20, 1990
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSEndoscopic injection sclerotherapy (EIS) using 1% Polidocanol was performed in 105 patients with esophageal varices from Jul. 1983 to Sep. 1989. Of them, 24 had paravariceal injection (PVI) in the earlier series and 81 had para- and intravariceal injection (PVI +IVI) in the later series. In this study, prognosis and complications of EIS were evaluated. Concerning the bleeding rate from varices after complete EIS, PVI + IVI(2.6%) was significantly excellent compared with PVI (26%) (p<0.01). Major complications occured in 7 cases (7%), and minor ones in 64 cases (61%). Two patients with hepatocellular carcinoma (HCC) associated with late stage of liver cirrhosis died due to major complications. In prognosis after EIS, there was no difference on long-term survival rate in emergent, elective, or prophylactic conditions. The difference between survival rates of A and B according to the Child's classification was noted statistically significant (p<0.01), and the difference between A and C (p <0 .001). The difference between B and C was also statistically noted (p< 0.01) only at 2 years and 9 months after EIS. In addition, the difference between liver cirrhosis with and without HCC was statistically significant. When cases of HCC was excluded, the difference between survival rates of B and C was not significant. In conclusion, EIS, especially by PVI + IVI, was very useful to treat esophageal varices in any condition including liver cirrhosis at a rather late stage according to Child's classification except cases of HCC.View full abstractDownload PDF (1273K) -
Shinya TANAKA1990 Volume 32 Issue 6 Pages 1332-1340
Published: June 20, 1990
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSThe successful rates in endoscopic biliary drainage (EBD) of non-surgical procedure was inferior to percutaneous transhepatic cholangio drainage (PTCD). Using Shimizu's bilirubin decreasing rate "b", EBD was effective in 83% of our cases (Table 2). Survival rate in unpresectable biliary and pancreatic cancer was evaluated by Kaplan-Meier's curve and EBD showed significantly better and longer survival period (p <0.05) compared to PTCD (Figure 1, 2). On the other EBD cases who were kept intubation for a long time needed to devise a prevent plan for a complication of clogging. We concluded that it was possible to prevent the clogging by use of biliary stent with more smooth internal surface. Thus, the necessity of improving the stent to prevent such a complication was pointed out.View full abstractDownload PDF (1118K) -
Toru TAKAHASHI, Takehiko ABE, Masahiko AKIYA, Takafumi SAITO, Shinji Y ...1990 Volume 32 Issue 6 Pages 1341-1353
Published: June 20, 1990
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSPeritoneoscopic findings in 119 cases of alcoholic liver injury were assessed with special referrence to histological changes. These are as follows : the incidence and severity of swelling of left liver lobe, thickening and blunting of liver edge, unevenness of liver surface, lymphatic cysts and development of collateral vessels increased in parallel with the histological grade of fibrosis. The characteristic peritoneoscopic finding in hepatic fibrosis of chronic alcoholics, which is considered to be a key lesion for the evolution to liver cirrhosis, was blurred whitish markings. This finding was observed in 44% of the cases and was thought to be in accordance with a histological changes called wiremesh fibrosis. Protrusion and/or ditch-like depression was encountered in alcoholic hepatitis with a relatively high incidence and closely correlated with the histological extent and severity of necrosis, collapse and/or regeneration of hepatic parenchyma. Peritoneoscopy failed to demonstrate any recognizable nodule on liver surface in three cases with his-tologically proven sublobular cirrhosis, which was considered to be very early stage of alcoholic cirrhosis. Red patch and/or reddish markings, which are frequently observed in viral liver diseases, were scarcely found in alcoholic liver injury and thought to be useful for differential diagnosis.View full abstractDownload PDF (1721K) -
Katsunori SAIGENJI1990 Volume 32 Issue 6 Pages 1354-1360_1
Published: June 20, 1990
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSThe aim of this study was to evaluate the factors influencig healing rate of gastric ulcer with H2-receptor antagonist. Background factors of tractable and intractable gastric ulcers were compared stastically with chi-squre and quanitif ication theory type I. Trac-table ulcer was defined as healed within 4 or 8 weeks, and intractable ulcer was as unhealed at 8 or 12 weeks. As background factors 22 items were employed. They were as follows : age, sex, chief complaint, ulcer history, duration of symptoms, concomitant disease, concurrent duodenal ulcer, MAO, smoking, alcohol consumption, patient's category and regimen. Endoscopic findings of gastric ulcers were also used for items, such as location, shape, type, diameter of ulcer and so on. The subjects were 247 cases of gastric ulcers, in which endoscopy were performed at 4, 8 and 12 weeks. 1) Endoscopic findings of gastric ulcers in acute and healing stages were stastically significant factors for intractable ulcers. 2) The most important factors influencing the healing rate were type I ulcer (deep, excavated), marked elevation around ulcer and converging mucosal folds. 3) On the other hand, sex, age, smoking habit and patient's category were not intractable factors under treatment with H2-receptor antagonist.View full abstractDownload PDF (1095K) -
Hiroshi HASHIMOTO, Keiiti SAITO, Eiitiro KUBOTA, Kyouko NAKAO, Motoko ...1990 Volume 32 Issue 6 Pages 1363-1368_1
Published: June 20, 1990
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSWe presumed that the analysis of resional image texture on endoscopicultrasonogra-phy (EUS) would be an useful method to differential diagnosis for gastrointestinal lesions. In order to prove this hypothesis, we determined the quantitative texture in the regional and spatial distribution of echo amplitudes in a case with gastric ulcer and three cases with gastric cancers (IIc Borrmann-2, Borrmann-1). Pathological findings in these cases were that the gastric ulcer was ul-IV, IIc cancer was poorly differentiated adenocarcinoma with fibrosis, Borrmann-2 cancer was poorly differentiated adenocarcinoma with fibrosis and cancer cells infiltration, and the Borrmann-1 cancer was moderately differentiated adenocarcinoma without fibrosis. We used gray level run length statistics (4 parameter : SRE, LRE, GLU, RLU) to analyze the texture and these four parameters were calculated. This method was quantatively possible to differentiate these cases. As it was possible to differentiate between the IIc case with fibrosis and the Borrmann-2 case with cell infiltra-tion in fibrosis, it would be useful to estimate for depth invasion of gastric cancer. We concluded that the automatic diagnosis for EUS would be possible by improvement of this method.View full abstractDownload PDF (809K) -
Naoki HINO, Hiroshi YAMAMOTO, Isao WAKIYA, Shigeki SENZAKI, Isao DOI, ...1990 Volume 32 Issue 6 Pages 1369-1376_1
Published: June 20, 1990
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSWe reviewed 89 gastric adenomas found in 83 patients over the past 10 years. Of these, 38 lesions in 36 patients were followed up endoscopically and histopathologically for periods ranging from 6 months to 10 years. Gastric adenomas were found more frequently in elderly male patients, and most of lesions were located in the A region. Most of lesions were of an elevated type with ha-like elevation, and were less than 2cm in diameter. Coexistence with carcinoma was seen in 70% of the adenomas more than 2cm in diameter. Adenoma coexisting with carcinoma within the same lesion was found in 6 cases. Focal cancer in adenoma, which was thought to be the result of malignant change, was found in 3 cases. During the follow up period, changes in the endoscopic appearance were observed in 10 lesions. 3 lesions increased in size and 2 of them coexisted with gastric cancer, 3 lesions decreased in size, and 4 lesions disappeared. Gastric cancer was associated in 25% of 83 cases. Adenomas, which show a gradual increase in size and are more than 2cm in diameter, are recommended strip biopsy. Even if adenomas are less than 2cm in diameter, endoscopical follow-up should be undertaken, because of the possible association with gastric cancer.View full abstractDownload PDF (1053K) -
METOCLOPR, AMIDE IN PREPARATION FOR COLONOSCOPYKiyotaka OKAWA, Atsuo KITANO, Hiromu OKABE, Ryuji HUKUSHIMA, Kazutoshi ...1990 Volume 32 Issue 6 Pages 1377-1385
Published: June 20, 1990
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSWe reported that 2, 000 ml of PEG with sennoside and metoclopramide taken for 120 minitues (120 minute-combination method) was superior to PEG only regarding patient acceptance and residual fluid. It is, however, unclear whether 120 minutes are optimal time for the ingestion or not. Therefore, in this report we tried to determine the optimal time for the ingestion. Seventeen patients received a 70 minute-combination method and 120 minute-combination method for colonoscopy at an interval of one week. Seventeen patients received a 90 minute-combination method and 120 minute-combination method. Seventeen patients received a 180 minute-combination method and 120 minute-combination method. In colon cleansing, all methods were almost equally well. In residual fluid, the 120 minute-combination method was the best and the 70 minute-combination method was the worst. In patient acceptance, the 180 minute-combination method and 120 minute-combination method were good. This study suggests that the 120 minute-combination method is the most useful one in colonic preparation for colonoscopy.View full abstractDownload PDF (1010K) -
Kenichi NISHIDA, Yoshihiko OKA, Hiroshi MURAYAMA, Tsuneyoshi YAO1990 Volume 32 Issue 6 Pages 1386-1393
Published: June 20, 1990
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 36-year-old woman with epigastricpain is presented. On roentgenologic and endos-copic examination of the stomach, she was suspected to have early gastric cancer (type TIC) at the angulus. Biopsy specimen from the depressed lesion showed marked inflammatory cellular infiltration, and most of the inflammatory cells are plasmacytes. Becanse of positive serological tests for syphilis Gastric syphilis was strongly suspected. Then, the biopsied specimens obtained in the endoscopy series were stained by Ohtani's method; a kind of silver stains for Treponema pallidum. Many of Treponema pallidum were seen in the specimens taken by the first endoscopy after hospitalization. Therefore, a diagnosis of gastric syphilis was made and antiluetic therapy led to complete cure. Literatures on gastric syphilis for the past 21 years were rewieued.View full abstractDownload PDF (3478K) -
Satoshi KAMIYAMA, Hiroshi NAGATA, Tatsunobu KARASAWA, Shojiroh MORINAG ...1990 Volume 32 Issue 6 Pages 1394-1398_1
Published: June 20, 1990
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 31-year-old male complained of epigastralgia and nausea. Endoscopic examination showed shallow ulcers with irregular margins the gastric angulus extending to the pre-pyloric region, which was easily bled. There was histopathologically infiltration of inflam-matory cells and no malignant findings was seen in the biopsy specimens. On the basis of a positive result of serologic test for syphilis and charastaric endoscopic findings, gastric syphilis was highly suspected. The biopsy specimens were stained by immunoperoxydase staining method, As Treponema Pallidum was found in the specimens, this case was diagnosed as gastric syphilis. His complaints and the endoscopic findings were improved after antiluetic therapy.View full abstractDownload PDF (888K) -
Yumiko MORI, Toshio OKUNO, Yuji MATSUBAYASIHI, Tohru KOTERA, Akiko ITO ...1990 Volume 32 Issue 6 Pages 1399-1407
Published: June 20, 1990
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 46-year-old man complained of anorexia and weight loss. Repeated endoscopic examination showed multiple shallow irregularly-shaped hemorrhagic erosions in the antrum (Figure 1-a, 1-b, and 1-c). Microscopic examination of endoscopic biopsy specimen revealed cellular infiltration, although plasma cells were not prominent (Figure 2). Under the diagnosis of Acute Gastric Mucosal Lesion (AGML), anti-ulcer agents containing H2-receptor antagonist were administered for 4 weeks, but failed to improve the lesions. Since the serologic test for syphilis was positive, Gastric syphilis was suspected. After the treatment with anti-luetic drug for only 8 days, most of the lesions seen in endoscopic examination disappeared (Figure 1-d). Numerous Treponema pallidum were demonstrated in formalin fixed gastric biopsy specimens by immuno-peroxidase technique (PAP method) (Figure 4).View full abstractDownload PDF (5154K) -
-IMMUNOHISTOCHEMICAL STUDY OF ITS ETIOLOGY-Daisuke HIRAYAMA, Takahiro FUJIMORI, Kazuhiro SATONAKA, Souhei KITAZAW ...1990 Volume 32 Issue 6 Pages 1408-1414_1
Published: June 20, 1990
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSFour cases of inflammatory fibroid polyp(IFP) of the stomach were reported. All of them were from gastric antrum. Their size ranged from 4.0 to 9.0 mm on maximum cross section. The mucosal surface in these cases was smooth and appeared to be almost normal color. The features of them were those of Yamada's type II, III, IV. The histological findings of the polypectomized tissues were the proliferation of the connective tissue with massive infiltration of eosinophilic leucocytes. Moreover, surround-ing the small vessels, the whorl-like proliferation of the connective tissue were recognized. The immunohistochemical staining of S-100 protein, NSE, Myoglobin, Desmin, F VIIIRA were all negative in the proliferating cells of four cases. Our conclusion is that IFP of the stomach represents a reactive lesion of myofibroblas-tic nature.View full abstractDownload PDF (1161K) -
Kyoichi ADACHI, Masyuki MIKAMI, Koji UNO, Hiroo KOBAYASHI, Shuzou HATT ...1990 Volume 32 Issue 6 Pages 1415-1418_1
Published: June 20, 1990
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 90-year-old woman was admitted to our hospital with fever, appetite loss and anemia of one month's duration. Upper gastrointestinal endoscopy revealed many red worms, 1 cm in length, in the duodenum. The worms were removed by biopsy forces, and dignosed as Necator amer-icanus. Fever and loss of appetite disappeared, and anemia improved after Pyrantel pamoate and ferrum therapy. In Japan, our case is the third case dignosed as Necator on upper gastrointestinal endoscopic examination.View full abstractDownload PDF (813K) -
Kiyoto SAKAMOTO, Toshihiro SAKURAI, Tsukane NAKAHARA, Kuniyoshi OODA, ...1990 Volume 32 Issue 6 Pages 1419-1426_1
Published: June 20, 1990
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 49 years old male was admitted emergently with acute right hypochodralgia. Based on a large defect demonstrated on barium enema study, a probable diagnosis of carcinoma of the asending colon was made and a laparotomy was performed. Marked adhesion was found between the right colon, post-bulbar portion and gall-bladder. Because of the difficulty in separation of the adhesion, an ileotransversostomy was performed. No malignant findings were obtained from the specimen of this region. Post-operatively, the findings in the ascending colon noted on barium enema study were not visible. Duodenofiveroscopy, performed immediately after operation revealed an ulcerative lesion at the post-bulbar portion. Biopsy under direct vision revealed well differentiated adenocarcinoma. The endoscopic picture suggested carcinomatous invasion secondary to the other tumor. A second laparotomy was performed to identify the primary lesion. Separation of the adhesion revealed a small carcinoma at the tip of the appendix which was deviated to a cranial direction. This carcinoma had infiltrated the duodenum and a portion of the colon. Initially, this carcinoma probably perforated, causing the acute symptoms. Subsequently, inflammation around the lesion caused ulceration of the asending colon and the severe adhesive changes.View full abstractDownload PDF (1338K) -
Naoya KATOH, Kiyoshi YOKOCHI, Hiroshi KOHNO, MAKOTO ITOH, Susumu ISHIK ...1990 Volume 32 Issue 6 Pages 1429-1434_1
Published: June 20, 1990
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 69-year-old man was admitted to our hospital requesting a further examination of the biliary tract because of an elevation of biliary tract enzymes noted at another hospital. On ultrasonography, a marked dilatation of both intra- and extra-hepatic bile ducts and the gall bladder was recognized. A X-ray film taken by endoscopic retrograde cholangiogra-phy (ERC) showed a filling defect with irregular margin in the lateral site of the lower common bile duct. The lesion was observed as a non-ulcerated polypoid lesion with reddish and nodular surface by percutaneous transhepatic cholangioscopy (PTCS). Biopsy speci-mens obtained at the PTCS revealed that the lesion was histologically adenocarcinoma. The tumor was 12 × 10 mm in size in the specimen resected by pancreaticoduodenectomy ; histologically poorly differentiated type of tubular adenocarcinoma invading partly to the pancreas without metastasis to adjacent lymphonodi. No recurrence has not been con-firmed yet for fast 22 months after surgery. Since the lumen of the lower common bile duct ordinarily surrounded by pancreatic tissues is narrow and limited to dilate, a tumor developing in this region easily leads to obstructive jaundice. A case of carcinoma in this region diagnosed in an early stage before appearance of jaundice as presented herein is very rare.View full abstractDownload PDF (974K) -
Shuji TAKAHASHI, Toshikazu YOSHIKAWA, Tomoko ISHIDA, Hiroshi ICHIKAWA, ...1990 Volume 32 Issue 6 Pages 1435-1441_1
Published: June 20, 1990
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSThis case report describes a patient with ileocolic intussusception caused by malignant lymphoma. A 59-year-old female was admitted to our hospital with chief complaints of intermit-tent lower abdominal pain and diarrhea. Barium enema showed a spheroid tumor in the ileocecal region. Abdominal sonography and CT revealed intussusception caused by the tumor. Barium meal study showed that the terminal ileum with preceding a tumor was invaginated into the ascending colon. On a superior mesenteric arteriogram, there was dilatation and upward displacement of the ileal arteries and the ileal branches of the ileocolic artery, which showed a hairpin curve sign. Some features of malignancy were noted at the top of the intussuscepted arteries. Colonofiberscopy revealed a large tumor with redness and erosion, and invaginated mucosa of the terminal ileum. Microscopic examination of biopsied specimens from the tumor revealed malignant lvmuhoma. From these findings, we diagnosed this case as ileocolic intussusception caused by malignant lymphoma of the terminal ileum. And the operation was performed. The resected specimen showed a tumor measuring 5 × 4 × 4cm in the terminal ileum and histological examination of the tumor revealed diffuse type of malignant lymphoma. We reviewed the utility of sonographic, radiographic and endoscopic examinations in the diagnosis of intussusception in the adults.View full abstractDownload PDF (1228K) -
Masuho HARAGUCHI, Hiroyuki SAKAI, Hidetoshi ODA, Koji NAKAMUTA, Hajime ...1990 Volume 32 Issue 6 Pages 1442-1446_1
Published: June 20, 1990
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 60-year-old man was admitted to our hospital because of general fatigue and diarrhea. Chest X-ray film revealed diffuse interstitial infiltrates with calcification in both upper lung fields, and bacteriological examination of the sputum showed acid fast bacilli. Those laboratory findings suggested active pulmonary tuberculosis. Barium enema showed circular strictures with irregular wall in the descending and transverse colons. Colonoscopy revealed shallow ulcers with edematous hemorrhagic border and circular strictures in the descending colon, which suggested active colonic tuberculosis. Colono-scopic biopsy was performed and acidfast bacilli were found in the biopsied specimen by Ziehl-Neelsen stain. Making the definite diagnosis of colon tuberculosis by colonoscopic biopsy is not easy and the confirmation of Mycobacterium tuberculosis has been rarely successful. This is the 6th reported Japanese case in which Mycobacterium tuberculosis was verified by colono-scopic biopsy.View full abstractDownload PDF (841K) -
Kazunori HOSHIKA, Mie MURAKAMI, Masayo HOSOBE, Keisuke HONDA, Tsuyoshi ...1990 Volume 32 Issue 6 Pages 1447-1452_1
Published: June 20, 1990
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSThis case report describes a patient with pedunculated leiomyoma of the descending colon removed by endoscopic polypectomy. A 59-year-old man was admitted to the division of Cardiology in our hospital on July 10th, 1989 for follow-up study of angina. Barium enema was performed because he was complaining of leadpencil-like stools. Barium enema showed a pedunculated protruded lesion in the descending colon. He was referred to our division for endoscopic removal of the lesion. Colonof iberscopic examination showed a pedunculated lesion covered with normal mucosa in the descending colon. Endoscopic diagnosis was a pedunculated sub-mucosal tumor of the colon. The lesion was removed by endoscopic polypectomy. The collected specimen was 6 × 4 × 5 mm in size. The cut surface of the specimen showed a white round firm tumor covered with normal epithelium of the colon. Histological finding of the specimen disclosed leiomyoma. Only 22 cases of leiomyoma of the colon and rectum treated by endoscopic polypectomy and 6 cases of pedunculated leiomyoma of the colon and rectum were reported so far in Japan.View full abstractDownload PDF (1076K) -
Hiroshi SERIZAWA, Haruhiko OGATA, Shin TANAKA, Noriaki WATANABE, Yasus ...1990 Volume 32 Issue 6 Pages 1455-1460_1
Published: June 20, 1990
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSWe presented 2 patients with amoebic colitis, whose endoscopic findings were similar to those of ulcerative colitis. They came to the hospital for bloody diarrhea. Barium enema showed slight mucosal granularity and irregularity of bowel margins with erosions. On endoscopic examination, there were so-called varioform and aphthoid lesions with the redness and edema in intervening mucosa in both patients. These findings suggested amoebic colitis, but ulcerative colitis and the other infectious colitis could not be ruled out. The initial fecal and pahological tests for amoeba were negative. However, both of the patients showed positive serological tests for amoeba. One showed positive in gel diffusion precipitin test (GDP) and enzyme-linked immunosorbent assay (ELISA), and the other in GDP, counterimmunoelectrophoresis (CIE), immunofluorescent antibody test (IFA), and indirect hemagglutination test (IHA). Fecal and pathological tests were repeated and then trophozoites of amoeba were demonstrated in the specimens. We concluded that ser-ological tests for amoeba were simple and useful for the differential diagnosis and early treatment.View full abstractDownload PDF (1014K) -
Toshio SEKIOKA, Takahiko KOSUGA, Kiyoshi ENDOU, Osamu IIZUKA, Misao OM ...1990 Volume 32 Issue 6 Pages 1461-1468_1
Published: June 20, 1990
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSWe developed a new insertion technique of the colonoscopy. By this method water is poured via a channel instead of air until the colonoscope reaches the cecum. This method was designated as the submarine method because it is similar to a submarine under water. The cases were divided into two groups: group A ; 432 cases before use of the subma-rine method and group B ; 432 cases after use of the submarine method. In comparison between group A and group B, two merits and two demerits of the submarine method were recognized. The one merit is that the submarine method makes the colonoscope insertion through the sigmoid-decending junction (SD) much easier. The other merit is that the pain of patients is very little. These merits come from the fact that there is no overinflation of the colon by the submarine method. On the other hand, the one demerit of the submarine method is that the colonic lumen can not be observed during the insertion of the colonoscope to the cecum. Therefore, the observation can be done only when the colonoscope is withdrawn. The other demerit is that it takes more time to reach the cecum by using the submarine method. These demeritis come from the fact that the colonoscope is inserted while pouring water into the colon using the submarine method. Despite these demerits, the submarine method has two big merits : smooth insertion through SD and little pain for the patients. Using the submarine method the colonoscope can be inserted step by step, namely, haustra by haustra. It is considered that the submarine method can become a new insertion technique of the colonoscopy.View full abstractDownload PDF (1159K) -
1990 Volume 32 Issue 6 Pages 1469-1598
Published: June 20, 1990
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSDownload PDF (17729K)
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