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Volume 35, Issue 12
Displaying 1-21 of 21 articles from this issue
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Kousuke KASHIWABARA, Hiroyuki NAKAMURA, Masanori SHITAYA, Hiroshi NISH ...1993 Volume 35 Issue 12 Pages 2865-2872
Published: December 20, 1993
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSWe reviewed 37 cases (0.48%) of postendoscopic acute gastric mucosal lesion (PE-AGML) among 7, 574 cases of panendoscopy for the upper GI tract. The interval of the onset of PE-AGML was 7.3±1.5 days after endoscopy. The predirection site of the lesion was the antrum of the stomach (92%). There were no significant corelations between the PE-AGML and the following factors: age of the patient, endoscopic experiences for the patients, the month of examination, career and technique of the endoscopist. Furthermore, prophylactic therapy of diazepam injection and/or H2-blocker for PE-AGML did not show a significant difference opposed controls. On the other hand, incidence of PE-AGML was significantly higher in cases undergoing endoscopy later as a result of frequent use of the same endoscopy in a day. This study suggests that strict sterilization of the endoscopy would be more effective for PE-AGML than prophylactic therapy of diazepam injection and/or H2-blocker.View full abstractDownload PDF (1092K) -
WITH SPECIAL REFERENCE TO STUDY ON CASES OF INSUFFICIENT EFFECTS AND RECURRENCESMasahito TOBA, Nobuhiko TANIAI, Hideki NISHIKUBO, Hironori MAMADA, Hir ...1993 Volume 35 Issue 12 Pages 2873-2882_1
Published: December 20, 1993
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSWe have experienced 66 cases of endoscopic injection sclerotherapy (EIS) for severe esophagogastric varices. And we evaluated the effectiveness of EIS combined method with vascular embolization with special reference to study on cases of insufficient effects and recurrences after EIS. A compared study between 34 patients receiving EIS alone (EIS group) and 32 patients treated by combined EIS and vascular embolization (combined Emb group) revealed more preventive rates of cumulative recurrence (P<0.05) in the combined Emb group. Interval duration from initial to supplemental treatment in the combined Emb group was approximantely twice as long as in the EIS group. Favorable results were especially obtained from the combined Emb group in cases of Child C. Recurrencies were frequent in the EIS gruop among Child C cases with markedly effective and effective treatment, and recurrences or bleeding occurred within 1 year. Insufficient effects were obtained from 83.3% in Child C cases also corresponding to more than 2 items of Child's classification and the majority, approximately 67%, included in patients treated with the EIS alone. Regarding the importance of reliable and permanent effects for the treatment of esophagogastric varices, this study suggested that combined endoscopic sclerotherapy and vascular embolization were extremely useful for the treatment in patients with severe hepatic functional impairment.View full abstractDownload PDF (5360K) -
Kuniyasu SODA, Takeo YAMANAKA, Yukio YOSHIDA, Kazuhisa SHITOU, Michio ...1993 Volume 35 Issue 12 Pages 2883-2891
Published: December 20, 1993
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSThe usefulness of our original model of a fine fiberscope (2.09 mm in external diameter) for peroral transpapillary cholangioscopy is presented. The scope can be applied using the same techniques employed in endoscopic nasobiliary drainage, without a need for papillotomy. Seven cases that were suspected of having lesions in the bile duct were examined. The patients' ages ranged from 35 to 79 years, and the male-to-female ratio was 4:3. Insertion of the scope through an untreated papilla was easy and successful in all cases. The scope could be introduced into a fine-bore choledochus, and even into intrahepatic ducts. A clear visual field could be promptly obtained by rinsing the bile duct through the working channel of the scope. The fine structure and color of the mucosal surface of a protruding lesion in the bile duct could be observed clearly. It was easy to ascertain the existence of tiny stones that could not be detected by ERCP. And the diagnosis of the type of choledochal stones was also possible. The authors think it is very important especially for young people, to preserve the function of the papilla, because long-term exposure to refluxing intestinal juice after papillotomy may cause disagreeable pathological changes on bile duct mucosa. Preoperative or detailed cholangioscopy, using this type of fine scope, is a very useful diagnostic procedure to prevent unnecessary surgical maneuvers, such as endoscopic papillotomy.View full abstractDownload PDF (8659K) -
Naoto KANEMAKI, Saburo NAKAZAWA, Kenji YAMAO, Junji YOSHINO, Kazuo INU ...1993 Volume 35 Issue 12 Pages 2892-2898_1
Published: December 20, 1993
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSWe previously described an SMA (shaped memorizing alloy) catheter for peroral cholangio-pancreaticoscopy using an ultrathin fiberscope in 1992. However, this catheter had poor manipulation characteristics for inserting into the major papilla, because of its insufficiently thin diameter. A Newly developed thinner SMA catheter was found to have improved manipulation despite only unidirectional bending. Ten cases of pancreatico-biliary disease, including seven normal major papilla, were examined using this catheter. In two biliary and nine pancreatic cases we tried for insertion into the common bile duct or main pancreatic duct, and succeeded in insertion for all cases. Cholangio-pancreatoscopy using an ultrathin scope was performed for one biliary case and nine pancreatic cases and eight cases could be observed clearly through this catheter. We conclude that the new SMA catheter is an useful instrument for peroral cholangio-pancreatoscopy in combination with ultrathin scopes.View full abstractDownload PDF (8876K) -
Toshio HOASHI, Keiji TANAKA, Koji OH, Hajime OHKURA, Soichiro MAEKAWA, ...1993 Volume 35 Issue 12 Pages 2899-2903_1
Published: December 20, 1993
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 62-year-old man was admitted to our hospital with complaints of dysphagia and 8 kg weight loss for the past four months. X-ray examination of the esophagus showed a giant nodular elevated lesion located in the lower two third of the esophagus. Endoscopic examination of the esophagus disclosed a reddish tumor covered with food residues and necrotized substances. As this tumor was suspected of carcinosarcoma of the esophagus by endoscopic biopsy, sub total esophagectomy was carried out. Histological and immunohitochemical studies of the surgical specimen revealed so-called carcinosarcoma of the esophagus. The tumor was measured 21.7×7.0 cm in size, which was the biggest one reported in Japan. The patient expired two months after the operation, because of multiple metastasis to the lung.View full abstractDownload PDF (4286K) -
Nobuo ASHIZAWA, Kazuya HIRAKAWA, Noriyuki ARIMA, Kyoichi ADACHI, Sator ...1993 Volume 35 Issue 12 Pages 2904-2909
Published: December 20, 1993
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 53-year-old man with alcoholic liver cirrhosis was admitted to our hospital because of esophageal varices and iron deficiency anemia. A clot of blood was found in the duodenal bulb on the first panendoscopy of upper GI series. Next day's endoscopy revealed vascular ectasia (VE) on the same place, and could not detect another lesion as a bleeding source. Pure ethanol was endoscopically injected into the lesion. Eight months after the endoscopic therapy, follow-up endoscopy was done but could not find any lesion in the duodenal bulb and his anemia was already improved. During upper GI panendoscopy, we occasionally encounter the VE, but few VE may bleed intermittently. When we find himorrhagic VE, we should fix or coagulate the lesion endoscopically as deep as submucosa because of the presence of submucosal thin-walled dilated vein, and follow up carefully about anemia and stool occult blood, because painless and intermittent bleeding may occur.View full abstractDownload PDF (3032K) -
Shunichi YASUDA, Takaharu MASUNAGA, Yasuo TAKEDA, Ryouyu TAKEDA, Takas ...1993 Volume 35 Issue 12 Pages 2910-2915_1
Published: December 20, 1993
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSThe patient was a 36-year-old man with a chief complaint of nausea. Upper Gl endoscopy revealed a lesion showing marked convexity and concavity with irregular redness and discoloration on the posterior wall from the lower part of the gastric body to the antrum. On histological examination of biopsy specimen obtained from the area, the lesion was considered to be a MALT lymphoma which arose by formation of lymphoepithelial lesion through infiltration of the glandular epithelium. Endoscopic examination one month later revealed that the lesion presented a shallow irregular ulcer. This case was considered to be a MALT lymphoma at its early stage.View full abstractDownload PDF (6062K) -
Hitomi TSUJIGUCHI, Takashi AMATSU, Hidehiro MASAKI, Mitsuo ANDO, Toru ...1993 Volume 35 Issue 12 Pages 2916-2921
Published: December 20, 1993
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSThe patient was a 47-year-old woman who was referred to our hospital with epigastric discomfort. The upper gastrointestinal endoscopy revealed flat elevation with central erosion at the lesser curvature of the supra angular region. In the 6 months follow-up of the lesion, it rapidly enlarged and formed nodular protrusion with redness. Pathological diagnosis of the biopsy specimen taken from the lesion was pyogenic granuloma. The endoscopic ultrasonography revealed that the lesion was localized in the mucosal layer. Therefore, the endoscopic resection was performed. Pyogenic granuloma is polypoid lesion consisting of capllary hemangioma, which occur preferentially in the skin and mucosa. It is a painless and is tended to hemorrhage. As to the gastrointestinal tract, it occurs relatively often in the oral mucosa and tongue. The occurence in the gastric mucosa has not yet been reported. Our case is supposed to be the first.View full abstractDownload PDF (4616K) -
Shigeru ITAKURA, Nobuyuki ASADA, Hirokazu GOISHI, Kazuhiko INOUE, Kazu ...1993 Volume 35 Issue 12 Pages 2922-2926_1
Published: December 20, 1993
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 79-year-old woman was admitted to our hospital with a complaint of abdominal pain on April 29, 1992. She had past histories of cerebral infarction at the age of 64 and right hemicolectomy due to colonic cancer at the age of 78. Colonoscopic examination on May 7 showed circumferential erosion, edematous mucosa and stenosis from the intestinal anastomosis to the oral side. Barium enema study on May 8 showed tubular stenosis and disappearance of Kerkring folds from the intestinal anastomosis to the oral side for about 40 cm long. Operation was performed on June 3 because of the colonoscopic examination on May 25 showed circumferential ulcer and severe stenosis. We diagnosed ischemic enteritis by the macroscopic characteristics and the microscopic appearance of the resected specimen.View full abstractDownload PDF (6546K) -
Kenji WATANABE, Kiyotaka OKAWA, Tetsuya AOKI, Yasuhiko SAKAI, Yasuko M ...1993 Volume 35 Issue 12 Pages 2927-2933_1
Published: December 20, 1993
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSCase 1 was initially medicated with oral vancomycin (VCM), which was followed by a combination of oral administration of metronidazole and endoscopic VCM scattering therapy. Although there is no study referring to endoscopic VCM scattering to pseudomembranous colitis (PMC), it is an effective diagnostic and therapeutic means. Case 2 was a rare case of PMC complicated with toxic megacolon. Both cases, who had been medicated with antibiotics of the Cephems, were complicated with renal failure, which was considered to be an important pathogenesis.View full abstractDownload PDF (5788K) -
Masahide KAJI, Kouji KONISHI, Yoshinobu YOKOYAMA, Masuo NAKAI, Naotaka ...1993 Volume 35 Issue 12 Pages 2934-2938_1
Published: December 20, 1993
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 68-year-old man was admitted to our hospital, complaining of general malaise with severe anemia. No bleeding site could not be detected by barium enema X-ray examination and upper GI endoscopy. A flat protrusion with redness was observed in the ascending colon by colonoscopy. Spurting bleeding occurred from this lesion just after biopsy specimens were taken. Selective angiography revealed proliferation of capillaries and early venous return. Therefore, arteriovenous malformation of the ascending colon was diagnosed. Recently, reports of arteriovenous malformation of the ascending colon increase. Therefore, it is suggested that flat protrusion seen in the ascending colon could be arteriovenous malformation.View full abstractDownload PDF (6071K) -
Takuya UEOKA, Shintaro KITAUCHI, Akira SAKAGUCHI, Shohei NISHI, Rumi K ...1993 Volume 35 Issue 12 Pages 2939-2945
Published: December 20, 1993
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 72-year-old woman, who had been continued to receive conservative treatment for transient form of ischemic colitis since 1990, was admitted to our hospital with melena in June, 1992. Ischemic change was suspected in the same part of the descending colon as at the first attack. Inferior mesenteric arterial angiography showed slenderness of the end of left colic artery. It was suggested that vascular factors and intestinal factors such as constipation were related to the development of ischemic colitis. It has been commonly said that recurrence of ischemic colitis is rare, but cases with mild symptom is tend to be overlooked, and careful observations are necessary for the patients of ischemic colitis.View full abstractDownload PDF (3501K) -
Hirofumi FUKE, Naoki FUJITA, Iccho WAKI, Seisuke TSUTSUMI, Hirotaka HI ...1993 Volume 35 Issue 12 Pages 2946-2951_1
Published: December 20, 1993
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSWe report a case of early colonic cancer complicated by colonic adenomatous polyposis which was detected 4 years after surgery for colonic mucinous adenocarcinoma. The stage of disease and pattern of spread was determined to be IIa+IIc. The patient was a 32-year-old male. He was operated upon at the age of 28 for cancer of the ascending colon. The histological diagnosis was mucinous adenocarcinoma. The stage of disease was Borrman III. A surgical specimen revealed 2 intra-adenomatous cancer as well as more than 10 adenomatous polyps. A diagnosis of colonic adenomatous polyposis was made 6 months after operation. After the diagnosis, the colon was examined both endoscopically and radiographically every 6 months. During the follow-up period, by endoscopic polypectomy 3 adenomatous polyps were removed. An early colonic cancer (Type IIa+IIc) demonstrating penepration of the submucoosal layer was detecated at the hepatic flexure of the transverse colon at age 32. Partial resection of the transverce colon was performed. Histologically, the ha portion of the lesion was adenocarcinoma, with moderately to well differentiation; the IIc portion was consisted of signet ring cells. We first repoted the case of signet ring cell adenocarcinoma complicated by colonic adenomatous polyposis in Japan. This case is interesting, considering the process in which adenomatous polyps become malignant.View full abstractDownload PDF (8850K) -
Takamasa IWASHITA, Hogen TEI, Kazuo MAJIMA, Saburo OHSHIBA1993 Volume 35 Issue 12 Pages 2952-2959
Published: December 20, 1993
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 42-year-old female visited Ohno memorial hospital with a complaint of lower abdominal pain. The barium enema and the colonoscopic examination revealed a type 2 advanced cancer in the ascending colon. It was diagnosed as moderately differentiated squamous cell carcinoma with minor component of undifferentiated carcinoma-like histology on light microscopic examination using H. E. staining. Therefore, we performed immuno-histochemical study using two distinct anti-keratin antibodies, one of which specifically reacts with keratin in squamous epithelium, the other reacts with keratin in both glandular epithelium and squamous epithelium. The immuno-histochemical study suggested undifferentiated carcinoma-like cells expressed adenocarcinoma-like differentiation. Thus we diagnosed the present case as adenosquamous cell carcinoma. We discussed briefly on clinical and histopathological features of adenosquamous cell carcinoma of the colon.View full abstractDownload PDF (8777K) -
Masaki AMENOMORI, Shinichi FURUYA, Tadashi KODAMA1993 Volume 35 Issue 12 Pages 2961-2965_1
Published: December 20, 1993
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 67-year-old man visited our clinic with complaints of melena and epigastric pain. The first endoscopic examination showed a large gastric ulcer with blood clots on the lesser curvature of the prepyloric region. The second endoscopic examination which was performed two months later revealed a healed gastric ulcer and an accessory opening on the lesser curvature of the pylorus. Fifty three months later endoscopic examination revealed a large single pylorus and two elevated lesions which were formerly composed of the septum between the pylorus and accessory opening. Seventy one months later the elevated lesions were flattened.View full abstractDownload PDF (2852K) -
Yasunaga SUZUKI, Tatsushi SHIMAZU, Yoshitsugu KAMISHIRADO, Naoyuki UEN ...1993 Volume 35 Issue 12 Pages 2966-2971
Published: December 20, 1993
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 70-year-old female visited to our hospital with prolonged symptoms of slight diarrhea for the past six years. A diagnosis of sigmoid-appendiceal fistula was made with, barium enema and colonoscopic examinations ; however, the causes of fistula were not identified. The patient did not undergo surgical treatment. However, symptoms improved with administration of Lactobacillus bif idus. Enteric-appendiceal fistula has been reported to be rare, and only 12 cases have been documented in Japan. In enteric-appendiceal fistula, sigmoid-appendiceal fistula with less symptoms is considered to be extremely rare. We hereby report a case of long standing sigmoid-appendiceal fistula with less symptoms for the past six years.View full abstractDownload PDF (5858K) -
Hideo MORIMOTO, Toshihiko OKABE, Hideaki OONO, Tokio WAKABAYASHI, Kuni ...1993 Volume 35 Issue 12 Pages 2973-2978_1
Published: December 20, 1993
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSWe report an interesting case of unclassifiable multiple rectal ulcers with variegated endoscopic findings. A 65-year-old man with liver cirrhosis and diabetes mellitus was admitted to our hospital complaining of anal bleeding. Physical examination revealed severe edema of the scrotum and perianal area. Endoscopic examination of the rectum on admission revealed severe edema and multiple circumferential bleeding ulcerations with variegated endoscopic findings at 3 to 15 cm from the anal ring. Ten days later, those ulcerations severely extended and mucosal bridge formation was found in some portions. These lesions were improved quite slowly by conservative therapy, whereas there remained some shallow depressions covered with regenerative tissue and mucosal bridge. During the course, rectal biopsy specimens taken at 7 times of endoscopic examination (total 39 spots), did not show any specific inflammatory change. This case obviously differes from the other established diseases and seems to be very interesting.View full abstractDownload PDF (6456K) -
Takeshi KAMIYA, Toshihiro NAGAO, Takashi ANDO, Naoko MIKI, Yuka KOBAYA ...1993 Volume 35 Issue 12 Pages 2979-2987_1
Published: December 20, 1993
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSTwo cases with primary sclerosing cholangitis (PSC) in adolescence were reported. Case 1(a 19-year-old male) and Case 2 (a 16-year-old male) were admitted to our hospital because of liver dysfunction. In both cases, serum transaminases and alkaline phosphatase were moderately elevated. Endoscopic retrograde cholangiography of the first case showed sclerotic wall and local narrowing of the common bile duct. That of the second case showed dilatation of the common bile duct and pruned tree appearance of the right branch as well as beaded appearance of the left branch of the intrahepatic ducts. PSC is a rare disease in the adolescence and only 18 cases (including our cases) have been reported in patients younger than 20 years old in Japan. We reviewed these cases and contrasted clinical features of the adolescence and adult of PSC. Characteristics of PSC in adolescence were (1) less common in association with jaundice, (2) mainly with the intrahepatic type, and (3) more frequently associated with ulcerative colitis than PSC in adulthood.View full abstractDownload PDF (9807K) -
1993 Volume 35 Issue 12 Pages 2988-3054
Published: December 20, 1993
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSDownload PDF (11130K) -
1993 Volume 35 Issue 12 Pages 3055-3116
Published: December 20, 1993
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSDownload PDF (10379K) -
[in Japanese], [in Japanese]1993 Volume 35 Issue 12 Pages 3117-3119
Published: December 20, 1993
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSDownload PDF (459K)
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