GASTROENTEROLOGICAL ENDOSCOPY
Online ISSN : 1884-5738
Print ISSN : 0387-1207
ISSN-L : 0387-1207
Volume 34, Issue 7
Displaying 1-15 of 15 articles from this issue
  • Shuichi SATO
    1992 Volume 34 Issue 7 Pages 1541-1547
    Published: July 20, 1992
    Released on J-STAGE: May 09, 2011
    JOURNAL FREE ACCESS
    The location and shape of colorectal tumors were investigated in order to determine whether any correlations could be made between them, using 1706 adenomas and 98 m cancers. The peduncular rate (i. e. the ratio of pedunculated polyps in all tumors) of adenomas ; (1) increased with size at all locations, (2) was not affected by location in adenomas of 5mm or smaller, (3) was higher in the left colon than the right in adenomas of 6mm or larger, and (4) was higher in the right colon than in the rectum in adenomas of 6mm or larger. The peduncular rate of m cancers increased with size at all locations although it was less obvious than in adenomas. However, it showed no significant difference at all locations.In another way, 1) The peduncular rate of colorectal tumors increased with size, both in adenoma and m cancer. 2) Increase in peduncular rate in adenomas tended to be affected by the location of them ; the lowest rate was in the rectum, the highest rate was in the left colon. 3) In m cancers, the peduncular rate increased with size ; it was not affected by location, even in large tumors. Therefore, it is concluded that the shape of colorectal tumors is affected by the location in adenomas, and not in m cancers.
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  • Tsuneya NAKAMURA, Yoshihisa TSUKAMOTO, Toshihiro YAMANAKA, Shigekazu H ...
    1992 Volume 34 Issue 7 Pages 1548-1555
    Published: July 20, 1992
    Released on J-STAGE: May 09, 2011
    JOURNAL FREE ACCESS
    Endoscopic findings of 52 cases with peptic ulcer treated with proton-pump inhibitor (PPI) were studied with special reference to whitish protrusion in ulcer base. Subjects were 40 cases with gastric ulcer, 11 cases with duodenal ulcer, and one case with stomal ulcer. In 7 cases with gastric ulcer, whitish protrusions appeared after 4.6 weeks of treatment on the average and in a case of stomal ulcer, whitish protrusions appeared after 2 weeks. In cases with duodenal ulcer, no whitish protrusions appeared. In 3 cases with gastric ulcer, whitish protrusions disappeared eight weeks later and in a case, whitish protrusion developed and transformed to reddish protrusion. In the remaining 3 cases with gastric ulcer, whitish protrusions developed but still remained. The gastric ulcers with whitish protrusion were reccurent in 6 cases and located in the middle body of the stomach in 5 cases. The histological findings of biopsy specimens taken from the whitish protrusions showed granulation tissue with marked infiltration of neutrophils and lymphocytes. The whitish protrusions developed and transformed to reddish protrusions or disappeared after administration of PPI.
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  • Yoshihisa URITA, Manabu ISHIHARA, Motonobu OZAKI, Akihiko HACHIYA, Shu ...
    1992 Volume 34 Issue 7 Pages 1557-1563
    Published: July 20, 1992
    Released on J-STAGE: May 09, 2011
    JOURNAL FREE ACCESS
    The purpose of this study is to clarify the distribution of sclerosant injected into the paravariceal esophageal wall. CT scan of the chest was performed 30 minutes after combined injection sclerotherapy (EIS) using 1% Polidocanol (Aethoxysklerol ; AS) in 23 patients with esophageal varices. CT findings included (1) ring-enhanced esophageal wall (2) ring-enhanced paraesophageal wall (3) locally enhanced esophageal wall (4) beltlike-enhanced parietal pleura. Types (1) (2) (4) were obtained in the 1st or the 2nd EIS, and type (3) was obtained in the 3rd EIS or more. These CT findings did not correlate with total volume of injected sclerosant. Seven of 8 patients with CT finding of Type (3) had esophageal ulcer. (We consider that esophageal ulcer is necessary to fibrosis of the lower eshophageal wall). When CT finding of type (3) was obtained, we put off the next procedure of EIS. Pleural effusion occured after 2 of 18 procedures with CT finding of type (1), 2 of 9 with type (2), 0 of 8 with type (3), and 1 of 14 with type (4). We speculated that most of patients with type (4) would have pleural effusion. But CT findings did not correlate with pleural effusion. Chest pain occured after 1 of 18 procedures with CT finding of type (1), 1 of 9 with type (2), 2 of 8 with type (3), and 1 of 14 with type (4). Fever occured after 0 of 18 procedures with CT findings of type (1), 0 of 9 with type (2), 2 of 8 with type (3), 0 of 14 with type (4). These results suggest that 1%AS injected into paravariceal esophageal wall have no reference to the minor complications. The sclerosants injected into the paravarices was thought to diffuse rapidly, but it is unlikely that this distribution of 1%AS is the main factor of pleural effusion, chest pain, and fever after EIS.
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  • Eizo KANEKO, Go ITO, Kazunori HANAJIMA, Kazumasa MIKI, Akihiro SHIMIZU ...
    1992 Volume 34 Issue 7 Pages 1564-1568
    Published: July 20, 1992
    Released on J-STAGE: May 09, 2011
    JOURNAL FREE ACCESS
    390 cases with duodenal ulcer (DU) detected by gastric mass survey over 40 years of age were followed up for 2 years with endoscopy every 6 months and without any anti-ulcer drugs. In the same group, 300 cases without DU were selected as the healthy controls. Serum pepsinogen (PG) I and II were measured at the end of the follow-up period in the DU cases. Serum PG I were 69.7± 1.4 ng/ml in the DU cases and 57.7± 1.6 ng/ml in the controls (p<0.0001). Regarding the relation between ulcer activity during the follow-up period and PG I, PG I in DU which remained in the scar stage was significantly less than PG I in active DU. Also PG I in linear and multiple DU was significantly higher than PG I in single DU. These data suggest that cases with high serum PG I are not only in high risk of DU, but anticipated to take active course.
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  • Osamu HASEBE, Kendo KIYOSAWA, Yoshiaki MATSUDA, Katsuhide SHIMAKURA, K ...
    1992 Volume 34 Issue 7 Pages 1569-1579
    Published: July 20, 1992
    Released on J-STAGE: May 09, 2011
    JOURNAL FREE ACCESS
    We performed ERC in 10 patients with hepatocellular carcinoma after intraarterial infusion chemotherapy and transcatheter arterial embolization. Extensive and severe bile duct necrosis was recognized in 3 patients. Cholangiographic characteristic was irregular stenosis of the bile duct in hepatic portion to peripheral bile duct and it resembles primary sclerosing cholangitis. These 3 cases complicated gallbladder necrosis and hepatic infarction. In one case bile duct necrosis occurred only after CDDP infusion, and thrombosis of intralobular artery was seen in pathological study. These results indicated that ischemia due to anticancer drug-induced intravasucular thrombosis cause bile duct necrosis.
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  • COMPARISON OF THOSE WITH AND WITHOUT CONGENITAL CHOLEDOCHAL CYST
    Shinji MATSUMOTO, Masao TANAKA, Seiyo IKEDA, Hideo YOSHIMOTO
    1992 Volume 34 Issue 7 Pages 1580-1583
    Published: July 20, 1992
    Released on J-STAGE: May 09, 2011
    JOURNAL FREE ACCESS
    Sphincter of Oddi motor activity was investigated in ten patients with malfusion of the pancreaticobiliary ducts (MPBD) and in six controls by endoscopic manometry under fluoroscopy. Five of the ten patients had a congenital choledochal cyst (CCC group) and the others had a normal caliber bile duct (non-CCC group). Characteristic phasic wave activity was observed in the sphincter segment in all subjects. Although those with MPBD had a longer common channel (16.5±3.1 mm in CCC group, 24.6±2.0 mm in non-CCC group), the length of the sphincter segment with phasic wave activity was not different among the three groups. Phasic wave activity was not seen at the junction of the pancreatic and bile ducts in the disease groups except for one patient. Amplitude of the phasic contractions was significantly higher in the CCC group than in controls (p<0.005). Bile obtained from within the bile duct in the disease gruops showed very high concentra-tion of amylase. Morphine given to cause spasm of the sphincter increased basal pressure and frequency of the phasic waves in all controls and in two patients with MPBD studied. Manometry with morphine stimulation was complicated by acute pancreatitis only in one patient with MPBD. These findings suggest that contractions of the sphincter of Oddi in patients with MPBD may contribute to influx of bile and pancreatic juice into the pancreatic and bile ducts respectively, leading to various pathologic conditions associated with this anomaly.
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  • Hiroshi KOYAMA, Atsuhiro IWAI, Etsurou IWASHITA, Tetsuji TOKUNAGA, Jun ...
    1992 Volume 34 Issue 7 Pages 1584-1593
    Published: July 20, 1992
    Released on J-STAGE: May 09, 2011
    JOURNAL FREE ACCESS
    We made acute colitis model with 5 %DSS and chronic colitis model with 2 % DSSEndoscopic, pathological and fecal bacteriologic findings of these models were studied.The results were as follows ;I. Acute colitis model1 On the endoscopic study of the 7th day, ulcers and blood were seen in the rectum of rats.2 On the pathological study, strong inflammation in the rectum of rats and weaker inflammation in the colon than the rectum were seen.3 On the concentrations of SOD activity and leukotriens in the tissues of the colon, the concentrations in the colon of colitis rats tended to be higher than those of normal rats, but therwas no significant difference between them.II. Chronic colitis modelOn the endoscopic and pathological studies, the grades of inflammation on the chronic colitis models were lower than those of the acute colitis models.
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  • Masaki SUZUKI, Toru MATSUDA, Hirotaka TODA, Ryuichi NAGASHIMA, Yoshimi ...
    1992 Volume 34 Issue 7 Pages 1594-1600_1
    Published: July 20, 1992
    Released on J-STAGE: May 09, 2011
    JOURNAL FREE ACCESS
    Endoscopic findings and histological characteristics of 44 minute (<5mm) and 125 small gastric cancers (<10mm) were investigated in our hospital from 1981 to 1990. The results were as follows.(1) Poorly differentiated adenocarcinoma or signet ring cell carcinoma tended to have peptic ulceration in comparison with differentiated adenocarcinoma.(2) The rate of invasion to the submucosal layer in poorly differentiated adenocarcinoma or signet ring cell carcinoma was higher than that in differentiated adenocarcinoma. Poorly differentiated adenocarcinoma had more tendency of deep invasion than the other types.(3) Cancer cells in differentiated and poorly differentiated adenocarcinoma were distributed through the mucosa, but in signet ring cell carcinoma were located in the middle of the mucosa.(4) Endoscpically, irregular redness was characteristic in differentiated and poorly differentiated adenocarcinoma, while the presence of redness in discolored lesions was characteristic in signet ring cell carcinoma.(5) In analyzing small gastric cancer, poorly differentiated adenocarcinoma and signet ring cell carcinoma had completely different endoscopical and histological features.
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  • Takeo YAMANAKA
    1992 Volume 34 Issue 7 Pages 1601-1610
    Published: July 20, 1992
    Released on J-STAGE: May 09, 2011
    JOURNAL FREE ACCESS
    An intra-corporal scanning ultrasonic micro-probe used through a forceps channel of conventional endoscope was applied for evaluation of biliary diseases. This newly developed radial scanning ultrasonic micro-probe is 2.4 mm in diameter and equipped with 15MHz transducer. As a fundamental study, the gastric wall of mouse was scanned at the intra-stomach using the ultrasonic micro-probe. As the result, the gastric wall, approximately 0.5 mm thick, visualized into 3 to 5 layers. On the clinical study, the ultrasonic micro probe was inserted into biliary tract under surgical operation for 5 patients with diseases of biliary tract (1 cholecystolithiasis, 2 choledocholithiasis, 1 choledochal cancer, 1 choledochal obstruction due to invasion by colon cancer). By scanning intra-biliary tract using the ultrasonic micro-probe, the sphincter of Oddi was clearly demonstrated as a hypoechoic layer at the papilla of Vater and the wall of bile duct was imaged as three layered structure. Simultaneously, the surrounding organs such as portal vein, hepatic artery and pancreatic duct were also clearly demonstrated. In patient with chronic cholangitis accompanied by choledocholithiasis, the wall of bile duct was visualized as a regular thick wall, and separated into multiple layers. In the meantime choledochal cancer was demonstrated as an irregular and low echoic thick wall. The ultrasonic micro-probe was superior to conventional ultrasonic endoscopes in evaluating diseases of biliary tract, particularly in determining the extent of the tumorous lesions and differentiating between chronic cholangitis and bile duct cancer.
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  • Masao WATANABE, Nobuo MASAUJI, Atsushi MATSUURA, Junji TANAKA, Yoshio ...
    1992 Volume 34 Issue 7 Pages 1611-1616_1
    Published: July 20, 1992
    Released on J-STAGE: May 09, 2011
    JOURNAL FREE ACCESS
    We reported an 81-year-old male patient with giant early gastric cancer showing I + IIa type. His chief complaints were appetite loss and discomfort in epigastric region, and upper G-i series barium meal and gastro-duodenal fiberscopy were performed. They revealed giant protruded lesion appearing papillary and granular-surfaced growth at lower corpus to antrum of stomach. Histological findings of biopsied specimen suspected adenocarcinoma and then subtotal gastrectomy was performed. The size of resected specimen revealed 12.8×9.2 cm, and it showed histologically well differentiated adenocar-cinoma associated with both cellular and structural atypia, but tumor cells invaded only to the superficial mucosal epithelium showing more adenomatous and less atypical feature histologically on the basis of mucosa.
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  • Hideya NOGUCHI, Kenji HIRAI, Hideo TATEISHI, Naofumi ONO, Kenji SAKATA ...
    1992 Volume 34 Issue 7 Pages 1618-1625_1
    Published: July 20, 1992
    Released on J-STAGE: February 13, 2012
    JOURNAL FREE ACCESS
    A case of a 44-year-old woman complaining of jaundice, ascites, and severe liver dysfunction was reported. Laparoscopy performed 7 months after onset revealed marked deformity and atrophy of the liver. Magnetic resonance imaging (MRI) and computed tomography (CT) were performed serially on the 1, 2, 3 and 22 months after admission. Spotty low density areas which appeared on the plain CT were enhanced after injection of cotrast material. Moreover, they were shown as low or iso signal intense areas on T1-weighted and high signal intense areas on T2-weighted images. These areas were gradu-ally diminished, therefore the necrosis and scar of the liver were suggested. MRI is a safe and effective diagnostic modality for the evaluation of histological changes in patients with severe liver injury.
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  • Hideya NOGUCHI, Kenji HIRAI, Hideo TATEISHI, Naofumi ONO, Kenji SAKATA ...
    1992 Volume 34 Issue 7 Pages 1619-1625_1
    Published: July 20, 1992
    Released on J-STAGE: May 19, 2011
    JOURNAL FREE ACCESS
    A case of a 44-year-old woman complaining of jaundice, ascites, and severe liver dysfunction was reported. Laparoscopy performed 7 months after onset revealed marked deformity and atrophy of the liver. Magnetic resonance imaging (MRI) and computed tomography (CT) were performed serially on the 1, 2, 3 and 22 months after admission. Spotty low density areas which appeared on the plain CT were enhanced after injection of cotrast material. Moreover, they were shown as low or iso signal intense areas on T1-weighted and high signal intense areas on T2-weighted images. These areas were gradu-ally diminished, therefore the necrosis and scar of the liver were suggested. MRI is a safe and effective diagnostic modality for the evaluation of histological changes in patients with severe liver injury.
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  • Kazuo NAKANO, Toshio ICHIBA, Toshikazu KATOH, Keiji OHKUBO, Kojiro MIC ...
    1992 Volume 34 Issue 7 Pages 1626-1630_1
    Published: July 20, 1992
    Released on J-STAGE: May 09, 2011
    JOURNAL FREE ACCESS
    A 71-year-old female was admitted to our hospital for further examination of upper abdominal mass. Laboratory tests revealed no abnormalities except slight elevation of s-GOT. Abdominal computed tomography and sonography showed the findings of hyper-trophic left lobe and missing the right lobe of the liver. The abdominal angiography revealed the absence of the right branch of the hepatic artery. The abdominal mass proved to be a hypertrophic left lobe of the liver at laparoscopy. No right lobe of the liver was observed. White capsular thickening and block formation were observed on the surface of the left lobe. Biopsy of the left lobe showed nonspecific inflammatory change and relatively normal architecture. We herein reported a rare case of agenesis of the right lobe of the liver.
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  • Masahiro TAKATANI, Masahiro WATANABE, Jiro TAKEBAYASHI, Takashi HAKU, ...
    1992 Volume 34 Issue 7 Pages 1631-1637
    Published: July 20, 1992
    Released on J-STAGE: May 09, 2011
    JOURNAL FREE ACCESS
    Peritoneoscopy was performed for a rare case of a 46-year-old male with systemic amyloidosis manifested portal hypertension. Peritoneoscopic findings showed numerous small and large depressions on the liver surface with splenomegaly and ascites. Magnifying peritoneoscopic examination revealed the whitish mesh-like depressions surrounding the slightly protruded areas and abnormal small vessels on the liver surface. The histological findings of the liver showed parenchymal cell necroses consistent with depressions on the liver surface. The portal tracts were enlarged, including many dilated portal veins and arteries. Deposits stained by Congo-red were observed only in the wall of the subcapslar arteries of the liver surface. The deposits were revealed as amyloid A protein (AA) by the immunohistochemical method. The pattern of deposition was different from that of the cases reported previously, so the authors discucussed the possible mechanism of portal hypertension in this case.
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  • [in Japanese]
    1992 Volume 34 Issue 7 Pages 1638-1779
    Published: July 20, 1992
    Released on J-STAGE: May 09, 2011
    JOURNAL FREE ACCESS
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