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Volume 33, Issue 7
Displaying 1-13 of 13 articles from this issue
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Mitsuru KAISE, Noritsugu UMEDA, Kei MATSUEDA, Ryousuke SHODA, Hizuru K ...1991 Volume 33 Issue 7 Pages 1349-1356
Published: July 20, 1991
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSEndoscopic Activity Index of Crohn's Disease (EAICD) was diviced for the purpose of more accurate assessment of Crohn's disease activity. Its validity and feasibility of clinical application were studied. Fourteen patients of Crohn's colitis were examined 43 times in total by colonoscopy. And its activity index was caluculated on each examination under the criteria of EAICD (Table 1). EAICD was significantly correlated to other activdty indeces (AIs) including Crohn's disease activity index (CDAI). Internal Organisation of Inflammatory Bowel Disease assessing (IOIBD) and simple CDAI. EICDA correlated significantly with WBC count, but not with other inflammatory reactions (IRs) including CRP and ESR. Dissociation was noted between EAICG and, AIs and/or IRs, especialy in cases of relatively lower disease activity. More than half cases in remission under the criteria of AIs and/or IRs had active ulcers on endoscopic examinations, and were assessed to be active on EAICD. It was suggested that AIs and IRs tended to underestimate Crohn's disease activity compared to EAICD, whereas EAICD was simple, valid and sensitive index to assess the disease activity. In conclusion, endoscopic index, such as EICDA, was proved to be feasible for clinical application in Crohn's disease.View full abstractDownload PDF (1669K) -
Hitoshi NAKAJIMA, Akihiro MUNAKATA, Yutaka YOSHIDA, Tika KODATE, Hidek ...1991 Volume 33 Issue 7 Pages 1357-1362_1
Published: July 20, 1991
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSWe studied the clinical significance of the inlet patch in 60 cases of the inlet patch of heterotopic gastric mucosa in the upper esophagus. By endoscopic observation, it was revealed that the incidence of ectopic gastric mucosa in the upper esophagus is 4.0% in male, 2.6% in female and 3.3% totally. Endoscopic examination revealed each patch mostly existing with the size of less than 3mm, at a distance of 15-23cm from the incisor teeth. Electronmicroscopical examination of the biopsy specimens demonstrated parietal cells. Nineteen (31.7%) of 60 patients complained of various symptoms. Histamine H2-antagonist was administered to 2 patients. Their symptoms were completely disappeared after the treatment. Clinical significance of the inlet patch has been overlooked. But our experience of 60 cases of the inlet patch suggests that endoscopic observation of the inlet patch is important because it can be a genesis of various symptoms in pharyngeal or upper esophageal region and esophageal cancer can occur at the same time.View full abstractDownload PDF (4942K) -
Sunao KAWANO, Shingo TSUJI, Nobuhiko HAYASHI, Masahiko TSUJII, Eiji MA ...1991 Volume 33 Issue 7 Pages 1363-1368_1
Published: July 20, 1991
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSThe gastric mucosal hemodynamic changes in ulcer healing were analyzed by elec-tronic endoscope and image analyzing system. The green image which covers the main absorption peaks of hemoglobin was used as a sample image and the red image which has little absorption of hemoglobin was used as a reference. Using a special algorythm (32×log Vg/Vr, Vg : intensity of green image, Vr : intensity of red image), the intensity at each pixel was calculated automatically by personal computer. This parameter had a good correlation with the mucosal hemoglobin content measured with reflectance spectro-photometry. The ratio of ulcer area to the increased area of mucosal hemoglobin content around ulcer was used as an index of ulcer healing. When this index was plotted against the period after gastric ulceration, this index decreased exponentially with time after ulceration. Therefore, when it was plotted in semilogarythmic paper, the regression line was obtained as y=-0.218 X+0.988, r=0.72, (p<0.0002). The calculated t1/2 was 1 week. In conclusion, using electronic endoscope and image analyzing system, the speed of ulcer healing was estimated quantitatively. This method makes us possible to predict ulcer healing in human.View full abstractDownload PDF (2391K) -
Matsuhei TANAKA, Kenji OHMURA, Eiji KANEHIRA, Yoshinori MUNEMOTO, Iwao ...1991 Volume 33 Issue 7 Pages 1371-1384_1
Published: July 20, 1991
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSWe have developed a TV-endoscopic measurement system producing three dimen-sional (3D) images of gastro-intestinal abnormalities since 1987. The method is based on the principle of trianguration (3D). The pattern projection method with grid pattern is to calculate the objected grid pattern, and to make a computer graphics of the object. We already reported that we had organized TV-endoscopic measurement system by projection of grid pattern in the last paper. This time we introduced the way of minimizing the errors caused by the aberration of lens system and by missing some edges in dead angle or mistaking a shadow for edges in this paper. We obtained a formula for correcting the aberration of lens system by using a simplified model and we could confirm its vality by calculating a plane with the formula. Then, we invented a color slit pattern to decrease the errors in detecting edges of slit pattern. The color grid patterns whose color was red and blue in turm, were projected on the object surface and we took two pictures : one projected with the beam through red filter and the other through blue filter. We could recognize two kinds of silhouettes whose interval was 90 out of phase. Furthermore, we designed a computer program that automatically corrected the wrong edges. Although we couldn't insert the pattern film and lens system in the tip of TV-endo-scope by ourselves, it should not be so difficult for makers. We have finished fundamental experiments and we believe this method is very useful to detect the structure of gastric wall.View full abstractDownload PDF (6018K) -
Masahiko KOBAYASHI, Hisao TAJIRI, Yoshitaka FUKUSHIMA, Astushi KAWAGUC ...1991 Volume 33 Issue 7 Pages 1385-1390_1
Published: July 20, 1991
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSWe connected the special video converter on the head of ultra-thin (0.8 mm in diameter) pancreatoscoge, and could get the pancreatic duct images on TV monitor as the sequential electric endoscope images. By this method the pictures of the main pancreatic duct images could be easily visualized taken on TV monitor at any time. Furthermore, we improved the pancreatoscoge in the durability and the handiness. This new system has been clinically used for the observation of main pancreatic duct in 18 cases. In 13 out of 18 cases (72%), this scope could be inserted to the target points of the pancreatic ducts and the lumens were observed successfully. We studied the brightness, color and quality of the images on 35mm films and VTR. As a results, it has been clear that the images by this system are much better than those by the usual method. However, we think that further improvement about resolution and ability for angulation of the scope will be needed.View full abstractDownload PDF (3819K) -
Takuji TAGO, Shigeaki YOSHIMURA, Zentaro SHIRAI, Hiroshi TORIYA, Kense ...1991 Volume 33 Issue 7 Pages 1391-1395
Published: July 20, 1991
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSThe risk of variceal bleeding associated with endoscopic findings of esophagogastric varices (EGV) were studied in 234 patients suffered from EGV, including 174 patients received prophylactic treatment and 60 patients with emergency treatment. The endo-scopic findings of EGV were classified into 5 types as follows ; I-E (esophageal type): only esophageal varices (EV), I-J (junctional type): esophageal varices originated from esophago-gastric junction (EGJ), II-C (cardiac type) : esophageal varices existing continuously from cardiac varices of the lesser curvature of the stomach, II-S (surrounding type) : esophageal varices with cardiac varices which surrounds EGJ, III (fundic type) : gastric varices of the fornix of the stomach with or without EV. The incidence of bleeding cases were 16%, 19%, 33%, 43%, and 41% in type I-E, I-J, II-C, II-S, and III, respectively. The bleeding point was observed below EGJ in 45%, 57%, 66%, and 75% on type I-J, II-C, II-S, and III, respectively. These results indicate that the existence of fundic varices, themselves, tends to have high risk of variceal bleeding. We therefore emphasize that the prophylactic treatment should be recommended in order to prevent bleeding from fundic varices.View full abstractDownload PDF (633K) -
Ryo MIYAZAKI, Seiyo IKEDA, Hideo YOSHIMOTO, Kensei MAESHIRO, Yuji KURO ...1991 Volume 33 Issue 7 Pages 1396-1401
Published: July 20, 1991
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSDuodenoscopic electrohydraulic lithotripsy was attempted in four patients with giant stones in the common duct. In order to protect the bile duct wall from discharge sparks, a lithotripsy probe was designed to tip a balloon. The stones were fragmented in all patients without serious complications. Complete removal of the stones was achieved in 3 of 4 patients. Duodenoscopic electrohydraulic lithotripsy with the balloon-tipped probe is efficient and useful to disintegrate the stones which are difficult to grasp in the basket.View full abstractDownload PDF (3488K) -
Akihiko MURAKAMI, Atsushi KANO, Hiroki KAMATA, Yoshihiro TAKIKAWA, Chi ...1991 Volume 33 Issue 7 Pages 1402-1406_1
Published: July 20, 1991
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 80-year-old woman was admitted to Iwate prefectural MIYAKO hospital complain-ing of right hypochondric pain. In July 1986, EST was performed for common bile duct stones. After EST, stone extraction was completed with basket catheter. On that occasion, normal papilla was observed at the diverticulum of the duodenum on endoscopy. No biopsy specimen was obtained at that time. In January 1988, she was operated for cystadenoma originating in the Vermiform appendix. However, in January 1989, 2 years and 7 months after EST, she was admitted to our hospital again with complaints of fever and right hypochondric pain. Laboratory findings on admission were as follows : T. Bil 1.8 mg/dl, Alp 51.2 KA, GOT 65 IU/L, GPT 46 IU/L, r-GTP 502 IU/L, serum Amylase 200 IU/L, urine Amylase 904 IU/L, WBC 5800/mm3, Hb 9.3 g/dl, CEA 3.1 ng/ml, and CA 19-9 130 U/ml. Endoscopy demonstrated a tumor with bleeding at the papilla of Vater. A 7.2 Fr both pigtailed catheter was inserted into the bile duct for drainage. Another catheter was inserted later for effective drainage. In view of the patient's old age, diabetes mellitus, cerebral infarction and fracture of the left neck of femur, operation was not performed, and ERBD was instituted. She died 8 months later after the procedure.View full abstractDownload PDF (4952K) -
Takeshi SAEKI, Tsugiyo FUKUDA, Shuichi INOUE, Shinei KUDOH1991 Volume 33 Issue 7 Pages 1409-1416_1
Published: July 20, 1991
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSLymphangioma of the large intestine is a rare disease. In Japan, 128 cases including our cases have been reported and 40 of them were resected by endoscopic polypectomy. Two cases of Lymphangioma of the ascending colon are described. Case 1 was a 77 -year-old male admitted to our hospital because of a feeling of residual defecation and case 2 was a 59-year-old male visited our hospital with the complaint of lower abdominal pain. Bariun enema study showed well-defined, smooth, radiolucent, and oval filling defects in the ascending colon which varied in form associated with changing positions. Endoscopic examination showed cystic tumors covered with normal colonic mucosa in case 1 and with grayish white in case 2. Palpation with biopsy forceps produced a cushion sign. Endoscopic polypectomy was done uneventfully. Pathology revealed cystic lymphan-gioma in the submucosa with intact overlying mucosa.View full abstractDownload PDF (5420K) -
Yujiro TAKAO, Hisashi MATSUMOTO, Osamu SAITOH, Chikao SHIMAMOTO, Katsu ...1991 Volume 33 Issue 7 Pages 1417-1423
Published: July 20, 1991
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 30-year-old male with a history of ulcerative colitis of 2 year's duration was admitted to our hospital because of multiple small white pustules of the oral mucosa and scalp. He also had diarrhea, with blood and mucus seven or eigh times a day. Colonoscopic examination revealed findings of ulcerative colitis. Histological examination of the scalp revealed microabscesses, containing numerous neutrophils and eosinophils in the epith-elium. Intercellular epidermal deposits of IgG were recognized in the skin close to the lesion by immunofluorescent technique. On the basis of these findings, pemphigus vegetans of Hallopeau was diagnosed. After treatment with prednisolone, the lesions of the skin and oral cavity healed, and the bloody stool disappeared. The activity of the skin lesions paralleled that of the bowel disease. The clinical course of this patient is very instructive, since both diseases are considered to be caused by immunological processes.View full abstractDownload PDF (4272K) -
Kyoya SAKIMURA, Yuuichi HANDA, Kazuo MIYOSHI, Tadatoshi SATOH, Kou KAN ...1991 Volume 33 Issue 7 Pages 1424-1434_1
Published: July 20, 1991
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 46-year-old female consulted with us for the follow up of her ulcerative colitis. Three years earlier, she had first episode of diarrhea and bloody stool. She was diagnosed as ulcerative colitis and had been well for three years under salazosulfapyridine and predonisolone therapy. On consulting to our hospital, barium enema study and colono-scopic examination were performed and we got typcal findings of active ulcerative colitis and a sessile type polypoid lesion at hepatic flexure. Histological examination of the biopsy specimens revealed carcinoma. Total colectomy was carried out. Typical findings of ulcerative colitis, two elevated and one depressed lesions in the resected ascending colon were observed macroscopically. Histological examination showed two polypoid lesions which consisted of carcinoma in adenoma and a IIc type depressed lesion in the ascending colon. The latter was diagnosed as poorly differentiated adenocarcinoma resembling gastric cancer, histologically. Three small and one moderate sized IIb type cancers were observed aroud the polypoid cancers. In the oral side of the ascending colon, there was a IIb like cancer surrounded by dysplastic lesion. All cancers invaded at most to the submucosal layer of the colon. Retrospectively the IIc type lesion was detected by colonoscopy and a IIb type lesion was detected by barium enema study.View full abstractDownload PDF (14494K) -
Yoshifumi FUJIMORI, Taiji AKAMATSU, Hidehito MIYAHARA, Yoshiaki MATSUD ...1991 Volume 33 Issue 7 Pages 1435-1441_1
Published: July 20, 1991
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 59-year-old man was admitted to our hospital with the complaints of general fatigue, anorexia, body weight loss, and deformity of finger nails. Diarrhea and pigmenta-tion of skin were not observed. X-ray and endoscopic examination showed multiple polyposis and hypertrophic change in the stomach. However, polyposis was not seen in the colon, only a few small polyps were recognized. Biopsy of gastric polyps revealed hyperplasia of foveola epithelium, cystic dilatation of glands, edema, and inflammatory cell infiltration in lamina propria. Based on these findings, this case was diagnosed as the "incomplete type" of Cronkhite-Canada syndrome. Although prednisolone was administer-ed at 30mg per day for one month and there was no effective change in endoscopic findings and hypoproteinemia. Then antiplasmin agent (T-AMCHA, 750 mg per day) and H2 blocker (voxatidine acetate hydrocloride, 150mg per day) were given, and clinical and laboratory abnormalities improved gradually. It has been considered that steroid is an effective therapeutic agent for Cronkhite-Canada syndrome, but ineffective case have been reported so far in the literature except our case. Therefore it would be necessary to reevaluate the effectivity of steroid in Cronkhite-Canada syndrome and to find more potent therapeutic approach for this disease.View full abstractDownload PDF (5902K) -
[in Japanese]1991 Volume 33 Issue 7 Pages 1442-1615
Published: July 20, 1991
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSDownload PDF (27848K)
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