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Volume 34, Issue 1
Displaying 1-27 of 27 articles from this issue
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[in Japanese]1992 Volume 34 Issue 1 Pages 1
Published: January 20, 1992
Released on J-STAGE: May 09, 2011
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[in Japanese]1992 Volume 34 Issue 1 Pages 2
Published: January 20, 1992
Released on J-STAGE: May 09, 2011
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Takuji TAGO1992 Volume 34 Issue 1 Pages 3-19
Published: January 20, 1992
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSThirty-four patients with gastro-esophageal varices were evaluated from the findings of endoscopic ultrasonography (EUS). The demonstrability of gastric varices on the fornix (fundic varices ; FV) in EUS was superior than that of abdominal angiography or abdominal CT. However the demonstrability of esophageal varices was lower using EUS. Fundic varices (FV) were endoscopically observed in 27 out of the 34 patients. These patients were classified into 3 groups endoscopically ; 9 patients with flat elevated FV, 10 with nodular FV, and 8 with tumorous FV. All the FV were revealed by EUS. The mean diameters of the intramural blood vessels were 3.1 mm, 5.0 mm and 9.1 mm respectively (p < 0.01, x2-test). The perforated blood vessel in tumorous FV cases also significantly larger than as flat elevated or nodular FV cases. These findings suggest that tumorous FV have a richer blood flow. The gastric wall covering the intramural blood vessel was demonstrated as a three-layered structure. The mean thickness from the surface of the first layer to the bottom of the third layer was measured as 2.1 mm. This was tinner than that of the upper three layers in the normal gastric mucosa which measured 3.6 mm (p < 0.01, x2-test). These findings indicate that gastric erosion on the FV may provoke bleeding from the FV. Behind the FV, the normal structure of the gastric wall could not be seen in most of the tumorous FV. Consequently, when an ulcer or necrosis associated with endoscopic injection sclerotherapy is located on the gastric mucosa, perforation or penetration of the gastric wall might be caused. These results clearly demonstrate the usefulness of EUS in making an accurate diagnosis of FV.View full abstractDownload PDF (11975K) -
Toshitsugu KOBATAKE, Yoshihiro SHIMADA1992 Volume 34 Issue 1 Pages 20-29
Published: January 20, 1992
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSIn order to elucidade the morphorogical features of type C chronic hepatitis, we have studied the backgrounds, peritoneoscopic findings, and histological findings of 134 cases of non-A non-B chronic hepatitis and 115 cases of type B chronic hepatitis which were diagnosed at the 2nd Department of Internal Medicine, Shimane Medical Univ.. They were classified into 4 groups, type B (95 cases), type C (110 cases), B+C (20 cases), and non-B non -C (24 cases), by evaluating the titer of HCV-Ab in all cases. The mean age in type C and non-B non-C groups were older than those in type B and B+C. In type C group, the frequency of reddish markings (RM) with regular distribution over the liver surface was lower than those in type B, and the frequency of localized and larger RM (irregular RM) which were distributed irregularly was higher. Further detailed observation revealed that the irregular RM were localized mostly along the Cantlie line, or the boundary between the right and the left hepatic vessels. Those findings suggested the poor blood flow of the area. Histological findings revealed that these irregular RM pattern appeared in about 50% of CAH-2B cases. In conclusion, it was shown that the irregular pattern of RM on the liver surface was one of the characteristics of the peritoneoscopic findings of type C hepatitis.View full abstractDownload PDF (2315K) -
SERUM LEVELS OF PEPSINOGEN I AND GASTRIN, AND GASTRIC ACID SECRETION IN PATIENTS WITH GASTRIC CANCERChiyuki WATANABE, Ken HARUMA, Koji SUMII, Akihiko MORIKAWA, Siro OKAMO ...1992 Volume 34 Issue 1 Pages 31-38
Published: January 20, 1992
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSSerum levels of pepsinogen I (PGI) and gastrin, and gastric acid secretion were investigated in 116 patients with gastric cancer (78 early gastric cancers and 38 advanced gastric cancers) and 128 endoscopically confirmed control subjects. Both serum levels of PGI and maximal acid output (MAO) were significantly lower in patients with gastric cancer than in control subjects. Serum levels of PGI were significantly lower in advanced stage than in early stage of gastric cancer. Considering the macroscopic and histological type, both serum levels of PGI and MAO were significantly lower in patients with the protruded type, depressed type without ulceration or differentiated type than in other types of gastric cancer. No significant differences in the serum levels of gastrin between patients with gastric cancer and control subjects were found, although high levels of serum gastrin were found in those with advanced gastric cancer. Our results indicate that gastric cancer, macro-scopically of the protruded type, depressed type without ulceration or histologically differentiated type, might develop in atrophic gastric mucosa and that the serum PGI is a useful diagnostic marker for these types of gastric cancer.View full abstractDownload PDF (900K) -
Yoko SAITOH, Kiyoshi SAITOH, Akira NAKAHARA, Hisayuki FUKUTOMI1992 Volume 34 Issue 1 Pages 39-47_1
Published: January 20, 1992
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSIn order to clarify the histological characteristics of endoscopic reddening, 298 biopsied gatric mucosae were examined. One hundred fourty seven mucosae were diagnosed as patchy reddening, 33 as "Kammrotung", and 45 as spotty reddening endoscopically. Fourty non-reddening mucosae with giant fold or irregular surface, and 33 non-reddening mucosa with smooth surface were used for the control. Histlogical criteria for acute inflammation were congestion, edema, neutrophil infiltration and erosion, and those for chronic infiltra-tion were lympho-plasma cell infiltration, atrophy of foveolar epithelium, atrophy of pyloric or fundic glands and intestinal metaplasia. Most of the gastric mucosae with reddening (193/225, 86%) showed acute inflamma-tory changes and the incidence was significantly higher than non-reddening mucosae with smooth surface (18/33, 55%). The mucosae surrounding the reddening showed varied degree of chronic inflammatory changes, and atrophy of foveolar epithelium and pyloric or fundic glands were similarly observed in both the reddening and non-reddening mucosae. Therefore, endoscopic reddening of the gastric mucosa were related to acute inflammation and it might be independent of superficial gastritis as the initial stage of chronic gastritis.View full abstractDownload PDF (5415K) -
Kiyotaka OKAWA, Tetsuya AOKI, Yuko IKEDA, Yasuko MORIYOSHI, Kenjiro OT ...1992 Volume 34 Issue 1 Pages 48-56_1
Published: January 20, 1992
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSTotal colonoscopy was performed in 50 patients with liver cirrhosis during a period of two years. Clinical features and background factors for vascular ectasia of the colon were investigated prospectively in these patients and the following results were obtained: 1. Vascular ectasia was noted in 22 (44%) of 50 patients. Colonoscopy revealed the frequent presence of a vascular spider-like symptom. 2. This symptom was observed in all regions of the colon, especially with a high incidence in the area ranging from the sigmoid colon to the transverse colon. The onset of this symptom was very frequent, with the size of less than 1 cm in most cases. 3. This symptom was frequently seen in the cases of uncompensated cirrhosis and the incidence was significantly higher in those cases with poor hepatic reserve. There was no significant correlation between this symptom and portal hypertension. 4. This symptom was found to have no significant correlation with vascular spider of the body surface and blood estradiol levels. 5. This symptom may be a cause of lower gastrointestinal bleeding, particularly in the cases of uncompensated cirrhosis, and would warrant further investigations.View full abstractDownload PDF (3376K) -
Masayasu YAMAGUCHI, Kunio NAGATA, Kaoru KAWAHARA, Teturou YOSIDA, Rint ...1992 Volume 34 Issue 1 Pages 59-65_1
Published: January 20, 1992
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSAttention has been paid in recent years to large intestinal flat and concave lesions as colonic early cancer or precancerous lesions. The dye spraying method and dye solution infusion method have been tried to improve endoscopic detection rate of these small lesions, and the usefulness of these methods has already been reported. However, these methods are not yet popularized generalized and their shortcoming are also pointed out. In the present study, colonoscopy was performed to evaluate the efficacy for detection of colonic small polyp for screening purpose by packing 0.3g indigo-carmine powder in capsules with Golytely as preparation. Two hundred and one cases that underwent total colonoscopy for detailed examination of abdominal complaints were divided into dye capsule taking group (Group A, 98 cases) and non-taking group (Group B, 103 cases), and their results were compared. The detection rate of polyp was significantly higher in Group A (41.8%) than in Group B (22.3%). The detection rate of histologically tumorous polyp also showed a significant difference between Group A (36.7%) and Group B (18.4%). Significantly more flat and sessile polyps were found in Group A. Among 165 non-symptom cases, detection rate of adenoma was also significantly higher in Group A (17.3%) than in Group B (7.8%). This method was considered to be very convenient and useful in the improvement of detection of colonic small lesion compared with conventional dye method, and it may be sufficiently applicable to routine colonoscopy.View full abstractDownload PDF (3291K) -
Shinji FUKUMITSU, Hiroya FUJINO, Hideharu TSUJI, Hitoshi AKAKI, Hitosh ...1992 Volume 34 Issue 1 Pages 66-73
Published: January 20, 1992
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSClinical problems and benifits of esophageal ulcer after endoscopic injection scleroth-erapy (EIS) using 1% Aethoxysklerol were evaluated. We attempted to classify the esophageal ulcer by the pattern of horizontal distribution. We found that the larger ulcer, which formed the fibrosing of esophageal wall, was more useful for the long effectiveness. Clinical problems were dysphagia, chest pain and fever after EIS. In them, dysphagia was related to the classification of ulcer after EIS. We experienced the esophageal stricture in 5 cases and the bleeding from ulcer in 2 cases after severe ulcer formation. All of them were improved by the conservative treatment. The esophageal ulcer after EIS was useful to prevent the re-appearance of RC sign for long time, and it did not induce severe clinical problems.View full abstractDownload PDF (3197K) -
Natsuya KATADA, Hisashi SHINOHARA, Hajime YONEKAWA, Hiroaki KURIHARA, ...1992 Volume 34 Issue 1 Pages 74-80_1
Published: January 20, 1992
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSIt is often said that primary malignant lymphoma of the rectum is a rare disease. We have done a clinicopathological study including the prognostic factor, in 4 cases we recently experienced and 53 cases which were reported in Japan. Clinical symptoms often were anal bleeding and bloody feces. The findings of image examination and macroscopic findings often showed submucosal tumor-like lesions or ulcerative lesions with marginal walls. It is sometimes difficult to diagnose by means of biopsy before surgery, because the lesion is located in the submucosal layer. Pathological findings often showed diffuse lymphoma which resulted from B-cell type. It is to be desired that chemotherapy is made an addition to resection of the lesion surgically. It is often said that the general prognosis is extremely poor. In this report, we thought that the Working-Formulation which was used for international classification of pathological findings and its grades were one of the impor-tant prognostic factors.View full abstractDownload PDF (5984K) -
Hanzo KUROSAKO, Takahito AOKI, Tatsuo HIROOKA, Yoshihisa SADANAGA, Sho ...1992 Volume 34 Issue 1 Pages 81-88
Published: January 20, 1992
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSDetermination of gastric mucosal pH was performed at various spots in the stomach in 286 Japanese healthy subject from 3rd decade to 8th decade. The 14 spots in the stomach were measured by I. S. F. E. T sensor through endoscope. Results were as follows ; 1. Gastric mucosal pH increased with aging significantly at every spot of lesser, greater curvature and anterior wall. 2. From the view point of alternation of the gastric mucosal pH in the same decade, the gastric mucosal pH significantly decreased antrum to upper body of lesser curvature and anterior wall, it demonstrated significant reduction at greater curvature from lower body to upper, but there was no significant change in another age.View full abstractDownload PDF (745K) -
Hiroaki OMORI, Choichi SUGAWA1992 Volume 34 Issue 1 Pages 89-93
Published: January 20, 1992
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSContinuous monitoring of arterial oxygen saturation (SaO2) using the pulse oximeter was performed in 112 patients undergoing colonoscopy. Automated blood pressure was also investigated in the latter 66 patients. Sixteen patients (14 percent) showed decrease in SaO2, lower than 90 percent during the procedure. Hypertension and hypotension (systolic blood pressure>200mm Hg, <90mm Hg) were found in 10 patients (15 percent) and only three patients (five percent) respectively, during or just after the procedure. In patients who had a history of cardiopulmonary disease, the incidence of desaturation was significantly higher. Intervention was required in five patients with desaturation, two with hypertension and one with hypotension after the procedure. However, all of those patients recovered to the levels of the preprocedure period within 15 minutes. Pulse oximeter monitoring and blood pressure measurement are valuable during colonoscopy in patients who have underlying disease (especially cardiopulmonary disease) in order to predict and prevent complications.View full abstractDownload PDF (636K) -
Masaya MUKAI, Hiroyasu MAKUUCHI, Takao MACHIMURA, Takashi SUGIHARA, Ta ...1992 Volume 34 Issue 1 Pages 94-101_1
Published: January 20, 1992
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA case of esophageal cyst was presented. The lesion grew rapidly and was cystic tumor with solid component suggesting malignancy on preoperative examination. The resected specimen revealed the submucosal cyst with internal bleeding. The wall of cyst was lined by ciliated columnar epitherium and it was diagnosed as a intraluminal bron-chogenic cyst. The internal bleeding led the preoperative diagnosis of malignancy. One hundred thirty-six cases of esophageal cyst collected from Japanese literature were also discussed.View full abstractDownload PDF (5886K) -
Masaki KUROSAWA, Ryouichi ISHIHATA, Kyouji SUZUKI, Yoshinobu IIZUKA1992 Volume 34 Issue 1 Pages 102-108_1
Published: January 20, 1992
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 79-year-old female was diagnosed as having pure red cell aplasia with hypogammaglobulinemia. Although anemia was improved by administration of glucocorticoid, white cell count decreased markedly to 700/mm3 with marked granulocytopenia. She complained of fever and epigastric pain. The first endoscopic examination revealed 3 ulcers in the stomach and multiple white plaques in the esophagus. Culture of the white plaque was positive for candida. Leukocytopenia improved gradually after stopping all drugs administered. Potassium chloride was given for hypokalemia induced by glucocorticoid. Two months later, she complained of dysphagia and the second endoscopic exami-nation showed a stricture with erosion in the middle of the esophagus. Intranuclear inclusion bodies were seen in the biopsied specimen from the erosion at the esophageal stricture. Although candida, potassium chloride and cytomegalovirus were suspected as causes of the stricture, potassium chloride was considered as the most probable agent, since it produces an esophageal ulcer followed by a stricture similar to that found in this patient.View full abstractDownload PDF (4212K) -
Taro SHINDO, Masato HARA, Takeo OHTA, Kunihiko KOJIMA1992 Volume 34 Issue 1 Pages 111-116_1
Published: January 20, 1992
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 5-month-old male infant was admitted to Kitasato University Hospital for the evaluation of tarry stool lasting for three weeks. Plain abdominal X-ray films demonstrated no abnormalities. Upper gastrointestinal endoscopy revealed a protruding lesion covered with whitish mucosa with vascular proliferation at the upper portion of the gastric body. Biopsy specimen taken from this lesion showed hyperplastic squamous epithelium. Upper gastrointestinal series showed a protruding lesion with irregular mucosal surface at the gastric body. At operation the tumor developed at the upper posterior wall of the gastric body, measuring 8.5 × 6.8 × 5.5 cm in size. Histologic study revealed structures consisted of tridermal components in varying proportions containing immature neural elements. The final diagnosis was gastric immature teratoma. Gastric teratoma is extremely rare and only 34 cases have been far reported in the Japanese literature.View full abstractDownload PDF (5998K) -
Atushi IDOGAWA, Atuki NAGASHIMA, Takeo ARAKAWA, Sayuri YAMAGATA, Masat ...1992 Volume 34 Issue 1 Pages 117-122_1
Published: January 20, 1992
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSWe reported a case of gastric arteriovenous malformation which was able to observe by endoscopy for a long time before and after bleeding. During the treatment of the cholangiocarcinoma, gastrointestinal bleeding occurred suddenly. Emergency endoscopy was done. A Dieulafoy's ulcer was found and endoscopic hemostasis was successful. However, the patient was die becase of peritonitis carcinomatosa. The final diagnosis obtained by autopsy revealed a gastric arteriovenous malformation. Seven years before the bleeding, we observed reddish three polypoid lesions. Eighteen days before the bleeding, two erosive lesions were observed at the same portion. The mechanism of bleeding was suspected that a local circulatory disturbance in the submucosa and autodigestion by gastric juice might develop a erosion of the gastric mucosa and lead to rupture the vessles finally.View full abstractDownload PDF (5788K) -
Masahiko YAMADA, Satoshi NAKANO, Isao TAKEDA, Takashi KUMADA, Keiichi ...1992 Volume 34 Issue 1 Pages 123-129_1
Published: January 20, 1992
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSWe reported two cases of Cronkhite-Canada syndrome improved markedly with steroid therapy. The first case was 43-year old male and the second was 58-year old male. In both cases, diarrhea, generalized gastrointestinal polyposis, alopecia, onychotrophia, skin pigmentation and hypoproteinemia were found. Histological examination of biopsy specimens from polyps revealed cystic dilatation of the glands, edema of the lamina propria and inflammatory cellular infiltration. No especial changes of clinical manifestations were seen with conventional treatment such as elemental diet and albumin transfusion, but ectodermal abnomalities and polyposis improved remarkably with steroid therapy in both cases.View full abstractDownload PDF (5063K) -
Kenichirou INOUE, Takashi NISHIYAMA, Takafumi SAWA, Hiroki MUTA, Tetsu ...1992 Volume 34 Issue 1 Pages 130-134_1
Published: January 20, 1992
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSWe reported the first case of colonic neurofibroma in Japan. A 52-year-old man visited our hospital for routine check up and diagnosed to have caecal submucosal tumor. X-ray and endoscopic studies showed a subpedunculated polyp with smooth surface. Endoscopic polypectomy was successfully performed. The tumor was 10×10×7.5 mm in diameter and consisted of yellowish solid tissue. Microscopically, the tumor had no capsule and consisted of fusiform cells. The tumor cells showed immunoreactivity to S-100 protein and diagnosed as neurofibroma.View full abstractDownload PDF (5179K) -
Shiro TAKAMI, Munehisa OKUDA, Junko SOBAJIMA, Yasutaka ISHI, Hiroshi N ...1992 Volume 34 Issue 1 Pages 137-143_1
Published: January 20, 1992
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 34- year-old man visited our hospital with conplaints of fever, diarrhea, sore throat and oral aphtoid ulcer in March 1985. Laboratory findings revealed inflammatory sign and mild anemia. Barium enema and colonoscopy showed multiple aphtoid ulcers throughout the colon. Microscopic examination of the biopsied specimens from the aphtoid ulcers disclosed non-specific inflammation. The patient was treated with elental diet, intravenous hyper alimentation and salazosulfapyridine. But the aphtoid ulcers did not disappear. In February 1988, barium enema and colonoscopy showed enlarged aphtoid ulcers, and UGI endoscopy showed a pharyngeal ulcer. Therefore, he was treated with predonisolone and later cyclophosphamide. In April 1989, barium enema and colonoscopy showed disappearance of the aphtoid ulcers, but showed an irregular ulcer in the cecum at that time. After continuation of the same therapy, barium enema in July 1990 showed disappearance of the cecal ulcer. From appearance of oral aphtoid ulcer, cecal ulcer and positive HLA B-51 test, the most suspicious diagnosis of this case is intestinal Behcet's disease.View full abstractDownload PDF (6862K) -
Tetsuro YAMASHINA, Shinichiro AKIYAMA, Hidekazu TAKEUCHI, Jyoji KAWANI ...1992 Volume 34 Issue 1 Pages 144-150_1
Published: January 20, 1992
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA-78-year old woman was admitted to our hospital complaining of epigastric pain. Ultrasonographic examination showed a cystic lesion in the left hepatic lobe with thick wall, a septum and a solid node, we therefore suspected this case of cystadenoma or cystadenocarcinoma. The exudate aspirated from the cyst was mucinous and it showed a high level of CA19-9 but the cytological diagnosis was Class II. After percutaneous transhepatic drainage, PTCS was performed. On endoscopic examination, the cyst was found to have smooth lining, and the histopathological findings of biopsy specimens revealed columnar ephithelium and no malignancy. On the basis of these findings, this case was diagnosed as cystadenoma. PTCS was cosidered to be a useful method for the differential diagnosis of cystic lesion in the liver.View full abstractDownload PDF (6765K) -
Dairuke SHIBUYA, Shigeru ASAKI, Takashi TAMURA, Norio YAMAGUCHI, Hitos ...1992 Volume 34 Issue 1 Pages 151-154_1
Published: January 20, 1992
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 58-year-old male patient with von-Willebrand disease was admitted to our hospital. He had esophageal varices due to liver cirrhosis, who had no anemia, icterus and ascites. Serum transaminases were slightly elevated. Platelet count was 32, 000/mm3. Blood coagulation test showed decrease of platlet aggregation rate. Endoscopic injection scler-otherapy (EIS) was done for six times to prevent from hemorrhage. Large esophageal hematoma was formed twice after EIS in spite of receiving substitutional therapy for von Willebrand disease. The reason for forming large hematoma by EIS is due to decrease of platelet aggregation rate and, furthermore, to the damaged esophageal mucosa by EIS. A large hematoma should be prevented by injection of pure ethanol and spraying of thrombin to the ruptured hematoma, even if hemorrhagic diathesis were accompanied with von Willebrand disease.View full abstractDownload PDF (3887K) -
[in Japanese]1992 Volume 34 Issue 1 Pages 157-168
Published: January 20, 1992
Released on J-STAGE: May 09, 2011
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[in Japanese]1992 Volume 34 Issue 1 Pages 168-179
Published: January 20, 1992
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[in Japanese]1992 Volume 34 Issue 1 Pages 179-188
Published: January 20, 1992
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[in Japanese]1992 Volume 34 Issue 1 Pages 189-199
Published: January 20, 1992
Released on J-STAGE: May 09, 2011
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[in Japanese]1992 Volume 34 Issue 1 Pages 199-215
Published: January 20, 1992
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[in Japanese]1992 Volume 34 Issue 1 Pages 215-275
Published: January 20, 1992
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