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Volume 34, Issue 12
Displaying 1-20 of 20 articles from this issue
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Tadanori SHIMIZU1992 Volume 34 Issue 12 Pages 2817-2826
Published: December 20, 1992
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSEndoscopic retrograde cholangiopancreatography (ERCP) is one of the methods for diagnosis of pancreatic diseases, and the techniques and instruments have been improved year by year. However, the contrast radiographic findings obtained by ERCP alone are occasionally insufficient for differential diagnosis of a lesion in regard to benignancy and malignancy. Even if combined with other image diagnoses, it is often difficult to make a correct diagnosis of tumor-forming pancreatitis or small pancreatic cancer confined to the pancreatic duct. It is important for such cases to perform a cytological study obtaining cells directly from the pancreatic duct. So, the method of collecting the cells that can be carried out following ERCP is improved. This paper is to report a comparison of the various methods of cytological study of the pancreas, with special reference to the technique of the guide wire method which is the latest and most efficient. The methods were divided into 4 groups depending on the sessions in which each technique was used : Group A ; washing and aspiration by canulation into the major papilla, Group B ; 'A' plus brushing of the pancreatic duct, Group C ; 'B' plus endoscopic sphincter-otomy, and Group D ; 'B' plus a guide wire method. The correct diagnostic rates were 55.3%, 76.2%, 84.8%, and 92.0% in each groups, respectively. With the use of a guide wire, insertion of the brushing catheter into the pancreatic duct has become easier, and a sufficient amount of cells could be obtained from the aimed lesion.View full abstractDownload PDF (10024K) -
Hiroo OHTAKE1992 Volume 34 Issue 12 Pages 2827-2841
Published: December 20, 1992
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSAimed biopsy under laparoscopic control were done in the liver with whitish markings and similar findings of the liver surface (periportal yellowish-white spots) and were studied histopathologically. All 8 lesions with whitish markings were histologically characterized by old fibrosis, staining positive for Victoria blue, which adjoined the capsule in the immediate subcapsular region. The appearance of whitish markings in chronic hepatitis was thought to represent local improvement of liver disturbances. On the other hand, the examination of 10 lesions with periportal yellowish-white spots obtained from the patients with lymphoid follicles in tissue taken by needle biopsy consis-tently revealed associated lymphocyte infiltration. Annual follow-up examinations in patients with chronic hepatitis type C indicated that the yellowish tone of whitish markings faded in association with decreased lymphocyte infiltration and with progression of fi-brosis, leading to the formation of whitish markings on the liver surface. The development of whitish markings in chronic hepatitis was thus demonstrated to involve changes in periportal yellowish-white spots in addition to reddish markings.View full abstractDownload PDF (22542K) -
Yoshihisa URITA, Masue MUTOH, Shuuichi YAMADA, Naoto NAKATANI, Eisaku ...1992 Volume 34 Issue 12 Pages 2843-2851
Published: December 20, 1992
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSThe clinical significance of esophageal ulcer after combined injection sclerotherapy (EIS) using 1%Aethoxysklerol (AS) has not been clarified. We did not always find esophageal ulcer one week after the first EIS. Esophageal ulcer after the first EIS did not always depend on the total volume of sclerosant and hepatic function classified by Pugh's score. In 14 of 38 cases treated by EIS esophageal ulcers were demonstrated, and oral paravariceal injection was performed in 11 of 14 cases in the ulcer group. Esophageal ulcers were not demonstrated in 20 of 23 cases treated by the other EIS method without oral paravariceal injection. Total volume of 1%AS and frequency of EIS needed for complete disappearance of esophageal varices in the ulcer group were less than those in the non-ulcer group. The cumulative non-reccurence rate in the ulcer group was higher than that in the non-ulcer group. Esophageal ulcers were classified into three types with the size. In the ulcer case such as type III with disappearance of esophageal varices, in which EIS was most effective, complete eradication of varices were achieved with less total volume of AS and fewer procedures of EIS. This type of ulcer was demonstrated in cases treated by the method of both oral and anal paravariceal injection. This study clearly shows that oral paravariceal injection is very important for more efficient EIS.View full abstractDownload PDF (4875K) -
Akitaka SHIBUYA, Keiji SHIRASAKI, Masanao SUGIMOTO, Masato MURAKAMI, M ...1992 Volume 34 Issue 12 Pages 2852-2855_1
Published: December 20, 1992
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSSuperficial hepatic lymphatic capillaries (HLC) were observed with a magnifying laparoscope in various liver diseases. HLC were recognized as lucent fine mesh-like network on the hepatic lobules. HLC were successfully observed in non-cirrhotic stage of primary biliary cirrhosis, fatty liver, alcoholic fibrosis, and cholestatic drug-induced liver disease. However, HLC were hardly visualized on the protruded capsular surface of the pseudolobules of liver cirrhosis. These observations suggest overproduction of hepatic lymph in cholestasis and outflow block of hepatic lymph in inflammation. Discussions were also made on disappearance of HLC under the pressure of the protruded surface of psedolobules.View full abstractDownload PDF (4695K) -
Osamu WAKABAYASHI, Junichi SUZUKI, Atsuhiko MIURA, Akiko KANAYA, Tomoa ...1992 Volume 34 Issue 12 Pages 2856-2862
Published: December 20, 1992
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSThe purpose of this study was to determine the characteristics of the gastroduodenal lesions in patients with chronic pulmonary emphysema by using the gastrointestinal endoscopy. Subjects consisted of 49 patients of chronic pulmonary emphysema (em-physema group) and 72 cases of aged-much healthy volunteers (control group). After observation of the surface of the gastric mucosa, the extent of gastric mucosal atrophy were examined by the endoscopic Congo red test. Serum pepsinogen levels detected by the radioimmunoassay method has been studied in the subjects. This study demonstrated that the incidence of peptic ulcer was significantly higher in emphysema group (40.8%) than in control group (23.6%). Emphysema group had heavy smoking habit, lower %VC, FEV1.0% and PaO2. There was no significant correlation between the extent of gastric mucosal atrophy in emphysematous group and control group. But emphysema group tended to have higher serum pepsinogen I/pepsinogen II than control group. These results suggested the possible gastric hypersecretion in patients with chronic pulmonary emphysema.View full abstractDownload PDF (897K) -
ESTABLISHMENT OF CONDITIONS FOR AUTOMATIC DIAGNOSISHiroshi HASHIMOTO, Keiichi SAITO, Michiaki MATSUMURA, Shiniti NAKAMURA ...1992 Volume 34 Issue 12 Pages 2863-2869
Published: December 20, 1992
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSWe tried to study automatic diagnosis of gastric tumors using the calculated texture analysis. The diagnostic results of discriminate analysis in our 3rd reports were 60-70% insufficiently. And then we made experiments with f antoms and resected specimens under water, establishing good conditions for texture analysis on endoscopic ultrasongraphies. As a result, two conditions were established: at first the adjustable distance between EUS probe and leisions was 2.5-3.0 cm, and the adjustable angle of inclination between the center axis of EUS probe and mucosal surface was less than 15 degrees. Only 35% of cases (18/57) were performed on EUS under these two conditions. On these cases, we performed discriminate analysis for differentiating stroma (medullary, intermediate) from the view point of fibrosis. Discriminate analysis rate was 88.9% and many of these cases were located in lower part of gastric body. On these cases, automatical diagnosis of histological structures could make possible by texture analysis quantitatively.View full abstractDownload PDF (4296K) -
Arata SAKATANI, Koichi KOIZUMI, Shunkichi KAI, Masakazu MARUYAMA, Taka ...1992 Volume 34 Issue 12 Pages 2870-2877
Published: December 20, 1992
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSCertain areas of the colon have been difficult to observe and manipulate during biopsy and polypectomy with conventional forward viewing colonoscopes. In order to overcome these problems we developed a forward-oblique viewing colonoscope (provisional name, Olympus CF-XK20: forward-oblique angle, 45°c) and compared its utility with that of a conventional forward viewing colonoscope (Olynpus CF-1T10I) in 216 patients. The new fiber scope was used in 52 patients and the conventional one in 164 patients. The former provided a wider frontal visual field and was found to be more useful in making observa-tion and manipulation. The cecal insertion rate and time and acceptability by patients of the forward-oblique viewing colonoscope and the conventional one were also compared. There were no statistically significant differences between the two fiberscopes with respect to any of these parameters. CF-XK20 was useful as an ecdoscope for the large intestine, especially for precise examination and treatment.View full abstractDownload PDF (7048K) -
Tsutomu NOMURA, Tatuya FUJII, Kazuo TAKEI, Masasi KATOU, Yukiya HAKOZA ...1992 Volume 34 Issue 12 Pages 2879-2884_1
Published: December 20, 1992
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSWe experienced 3 cases of gastric syphilis appearing ulcerative lesions in the corpus of the stomach. All of cases were not affective by administration of H2-blocker and showed strongly positive result of serologic test for syphilis. On the endoscopic examination, multiple ulcers with irregular shape were seen at the corpus and antrum in 3 cases. Immunofluorescent staining of the biopsy specimens in 2 cases was positive for Treponema pallidum in the gastric mucosa. Irregular ulcers of gastric syphilis develop due to ischemic change of gastric mucosa. They often develop at the antrum which shows the weak point of vascular structure and serious 3 cases extend to the corpus of the stomach.View full abstractDownload PDF (7449K) -
Toshihide AWATANI, Yukio YORIMITSU, Takashi YAMASAKI, Motohiro TAKASAK ...1992 Volume 34 Issue 12 Pages 2885-2890_1
Published: December 20, 1992
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA rare case of angiodysplasia of the stomach in a Japanese female, lcm in diameter confirmed by magnifying endoscopy and selective angiography was reported. A 53-year-old female was hospitalized with hematemesis. Fibergastroscopy revealed a bright-red lesion, measuring about 7mm in diameter, on the posterior wall of the upper gastric body. Magnifying endoscopy confirmed that the lesion was composed of dilated blood vessels radiating from its center. Selective angiography revealed a dense stain suggestive of a hypervascular lesion, measuring about lcm in diameter, opacif ied by way of the left gastric artery. The features by the magnifying endoscopy and the angiography supported a diagnosis of angiodysplasia of the stomach with abundant blood supply in the lesion. Partial resection including the lesion was performed. During a follow-up period of more than 12 months, there was no sign of re-bleeding.View full abstractDownload PDF (7876K) -
Michiaki YOSHIDA, Hiroshi UEHIRA, Katsuhisa KAWAMOTO, Yoshiaki IWASAKI ...1992 Volume 34 Issue 12 Pages 2893-2898_1
Published: December 20, 1992
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 52-year-old woman was admitted to our hospital complaining of epigastralgia. The X-ray and endoscopic examination revealed ulcerative lesions surrounded with mucosal elevation on the anterior and posterior wall of the greater curvature of the lower gastric body. The lesion on the anterior wall side had a shallow and almost round ulceration. The lesion on the posterior wall side had a deep and irregular ulceration and its oral side of the elevation was partially unclear. Both of them showed the interruption of the third layer of gastric wall on endoscopic ultrasonography. From these roentogennographic and endoscopic feature, the diagnosis of malignant lymphoma were made for these lesions, which were not confirmed by histological diagnosis of the biopsy specimen. A subtotal gastrectomy was performed on the 31st hospital day. The gross appearance of the resected stomach showed an ulceration surrounded with elevation on the anterior wall of the lower body near the greater curvature, which was diagnosed histologically as non-Hodgkin, diffuse lymphoma, medium-sized cell type. The depth of invasion was limited within submucosal layer and regional lymph nodes were free from invasion. On the posterior wall side, the lesion became a small erosion and contained no lymphoma cell in the specimen. The lesion of the posterior wall side suggests the possibility of desquamation of the tumor cells in the early gastric lymphoma.View full abstractDownload PDF (9267K) -
Tsukasa TOSHIMORI, Kinichiro SUWAKI, Hirohumi KUMASHIRO, Shouji HIRASA ...1992 Volume 34 Issue 12 Pages 2899-2905
Published: December 20, 1992
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSGranular cell tumor (GCT) occures rarely in the large bowel. A 50-year-old man with abdominal discomfort was examined. Colonoscopic examination showed the submucosal tumor, 5mm in diameter, in the transverse colon. The submucosal tumor was removed by endoscopic polypectomy. Histologic examination of the specimen showed the neoplastic lesion located in the submucosal area. Periodic acid-Schiff (PAS) showed acidphilic granules of the cytoplasma. A detailed immunohistochemical analysis revealed positivity for S-100 protein and neuron specific enolase (NSE). Reported 9 cases of granular cell tumor (GCT) of the large bowel in Japan were discussed being compared with our case.View full abstractDownload PDF (10065K) -
-THE CLINICAL USEFULNESS OF INTRADUCTAL ULTRASONOGRAPHY OF THE PANCREAS-Tsuyoshi FURUKAWA, Yoshihisa TSUKAMOTO, Yasuo NAITOH, Masahiro MITAKE, ...1992 Volume 34 Issue 12 Pages 2906-2911_1
Published: December 20, 1992
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 44-year-old man was admitted to our hospital for further examinations of epigas-tralgia with increased serum amylase. Conventional ultrasonography showed dilatation of the main pancreatic duct (MPD) from the body to the tail of the pancreas. Endoscopic ultrasonography revealed severe localized stenosis of the MPD without tumor. Endoscopic retrograde pancreatography showed severe localized stenosis and dilation of the distal portion of the duct. Peroral pancreatoscopy of the stenosing part of the MPD showed normal mucosa. The diagnosis of benign stenosis of the MPD was made. Partial resection of the body of the pancreas was done due to the history of recurrece of the attack of the pancreatitis. Pathohistological findings revealed chronic pancreatitis. Intraductal sonography of the pancreas (IDUS) (30MHz at frequency) in the postoperative specimen showed hypoe-choic band all around the MPD corresponding with periductal fibrosis in the histological sectons. We suggest the usefulness of the IDUS in the diagnosis of the segmental stenosis of the MPD.View full abstractDownload PDF (11261K) -
Hiroyuki OSAWA, Shinji MATSUMOTO, Ikuo SUMIDA, Motosuke HANADA1992 Volume 34 Issue 12 Pages 2912-2917
Published: December 20, 1992
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 32-year-old man was admitted to our hospital. He was diagnosed as chronic pancreatitis from the finding of ERP, which showed the stenosis with smooth wall of the main pancreatic duct in the pancreatic tail. After 3 years, the level of tumor markers elevated and the CT scan showed a diffuse swelling of the pancreas with calcified spots and low density areas. The ERP at the second admission revealed the obstruction of the pancreatic main duct in the body. It was suspected that on the previous examination stenosis of the pancreatic tail duct resulted in invasion of cancer and pancreatic tail cancer developed from the tail to the head and body. But, the abdominal angiography showed no abnormal signs. The balloon catheter ERPcs for more detail study showed only a smooth narrowing of the main duct, but not any obstruction. Pancreatic cancer was ruled out. On the following examination, the level of tumor markers and pancreatic function improved. He was diagnosed and followed as chronic pancreatitis. The balloon catheter ERPcs is an useful method for differential diagnosis among pancreatic diseases.View full abstractDownload PDF (8116K) -
Naohiko KOIDE, Wataru ADACHI, Shouichirou KOIKE, Futoshi IIDA, Hidehar ...1992 Volume 34 Issue 12 Pages 2918-2923_1
Published: December 20, 1992
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 54 year-old man, visited to our department with the complaint of passage of stool mixed with blood and mucus which had lasted from February in 1991. On phisical examination he did not have hepatomegaly, splenomegaly and swelling of superficial lymphnodes. Colonoscopic and gastroscopic examination were done. Colonoscopic examination revealed the innumerable diffuse small polypoid lesions with redness from terminal ileum to rectum. And endoscopic examination of upper GI tract also revealed the multiple small polypoid lesions in the esophagus, stomach and duodenum. In the stomach we also found small polypoid lesions as submucosal tumor. Barium f ollowthrough examination of the small intestine revealed innumerable small polypoid lesions in the duodenum, jejunum and ileum. Histologically biopsy specimens revealed diffuse infiltration of small monophilic lymphocytes mainly in the submucosa. Finally we diagnosed the case as "Multiple Lymphomatous Polyposis of the Gastro-intestinal Tract". Then tweice modified VEPA chemotherapy were done. On subsequent endoscopic examination as these lesions of GI tract were improved, patient discharged from the hospital under the condition of continuing of chemotherapy.View full abstractDownload PDF (10434K) -
Naoto KANEMAKI, Saburo NAKAZAWA, Kenji YAMAO, Junji YOSHINO, Kazuo INU ...1992 Volume 34 Issue 12 Pages 2924-2930_1
Published: December 20, 1992
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 42 Year-old male visited our hospital for a detailed examination of the gallbladder. Abdominal ultrasonography (US) revealed the wall thickening with high echo spots in the inner layer of the gallbladder, and no dilatation of the common bile duct. Endoscopic ultrasonography (EUS) showed papillomatous cholesterosis in the gallbladder, and the abnormal connection of the common bile duct and main pancreatic duct located well within the pancreatic parenchyma. From these results, we were able to diagnose anomalous arrangement of the pancreaticobiliary duct without dilatation of the bile duct along with papillomatous cholesterosis of the gallbladder. Cholecystectomy and resection of the common bile duct were performed. It is suggested that EUS should be (inevitably) applied in case of papillomatous gallbladder with wall thickening for the early detection of anomalous arrangements of the pancreaticobiliary duct.View full abstractDownload PDF (11784K) -
Hiroshi YAMAMOTO, Isao WAKIYA, Kazuhiro MATSUEDA, Masanori ARIYOSHI, H ...1992 Volume 34 Issue 12 Pages 2933-2938_1
Published: December 20, 1992
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSCase 1 was a 56-year-old male who had previously undergone transabdominal eso-phageal transection and splenectomy for esophageal and gastric varices associated with alcoholic cirrhosis of the liver. This time he was hospitalized for gastric variceal hemor-rhage accompanying recurrence of esophageal and gastric varices. Endoscopic findings of the varicose reputured region on the lessor curvature in the upper body of the stomach were as follows: 1. a flat red spot without erosions, 2. adheison of red plug, and 3. spurting bleeding. Case 2 was hospitalized for gastric variceal hemorrhage associated with non-A, non-B cirrhosis of the liver. The ruptured region of the nodular varices at the posterior wall of the cardia showed as follows: 1. a flat red spot without erosions, 2. adhesions of blood clots. Since minor findings such as a flat red spot without erosions may be observed after the rupture of gastric varices, this is considered to be important in diagnosing the site of bleeding.View full abstractDownload PDF (4488K) -
[in Japanese]1992 Volume 34 Issue 12 Pages 2939-3008
Published: December 20, 1992
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSDownload PDF (11104K) -
[in Japanese]1992 Volume 34 Issue 12 Pages 3009-3093
Published: December 20, 1992
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSDownload PDF (13593K) -
[in Japanese]1992 Volume 34 Issue 12 Pages 3094
Published: December 20, 1992
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSDownload PDF (101K) -
[in Japanese], [in Japanese], [in Japanese], [in Japanese]1992 Volume 34 Issue 12 Pages 3095-3099
Published: December 20, 1992
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSDownload PDF (724K)
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