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Volume 35, Issue 5
Displaying 1-27 of 27 articles from this issue
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Tooru HONDA1993 Volume 35 Issue 5 Pages 967-977
Published: May 15, 1993
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSMagnifying electronic endoscopic examination was done to assess the gastric elevated lesions such as hyperplastic polyp, small polyp, gastric adenoma, ha, I and I+IIa type early gastric cancers. We also used band enhancement to visualize the original image of mucosal pattern more clearly. These magnifying endoscopic images were compared with the dissecting microscopic view of the rescted specimens and pathological examination was performed. The results obtained were as follows. 1) Hyperplastic foveolar polyp showed reddish and coarse pattern on the magnifying endoscopy which reflected enlargement of Leistenspitz due to congestion and edema of the interstitium. 2) Gastric adenoma showed whitely, minute and regular mucosal pattern on the magnifying endoscopy which reflected the flat surface structure composed of compact and regular pits and Leistanspitz. 3) Well differentiated tubular adenocarcinoma showed irregular mucosal pattern on the magnifying endoscopy and irregular pit pattern on the dissecting microscopy. 4) Papillary carcinoma showed relatively coarse and irregular mucosal pattern on the magnifying endoscopy and irregular projection pattern on the dissecting microscopy. These results indicated close relationship among the magnifying endoscopic findings, the mucosal microstructures on the dissecting microscopy and pathological features. So, mucosal observation with magnifying electronic endoscopy and band enhancement leads to more accurate diagnosis of the gastric elevated lesions.View full abstractDownload PDF (10792K) -
Yukimitsu KAWAURA, Kazuyuki KAWAKAMI, Kenji DOHDEN, Yumiko OHTAKE, Shi ...1993 Volume 35 Issue 5 Pages 979-989
Published: May 15, 1993
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSFor the purpose of developing Barrett's epithelium, cardia resection and creation of the esophageal hiatal hernia were performed with mongrel dogs. The dogs were divided into three groups. Group A : Cardia resection and creation of hiatal hernia alone (n=18). Group B : Cardia resection, creation of hiatal hernia, and N-amyl-N-methylnitrosamine (AMN) administration (n=17). Group C : AMN administration alone (n=9). All samples were taken by endoscopy. In group B, adenocarcinoma developed at Barrett's epithelium and/or adjacent to the site of Barrett's epithelium, while at the distant site from Barrett's epithelium has obser-ved, cancers have developed within two years. In comparison with group B and C, cancers developed in early stage in group B. Based on DNA histograms, a diploid pattern was recognized in the cases of Barrett's epithelium alone, while aneuploid pattern was detected in the cases of cancers or the cases, having the Barrett's epithelium for long time. We concluded that the Barrett's epithelium played on role of neoplastic potential.View full abstractDownload PDF (2659K) -
Yoshihisa URITA, Masue MUTOH, Eisaku KONDOH, Shuuichi YAMADA, Akihiko ...1993 Volume 35 Issue 5 Pages 990-995_1
Published: May 15, 1993
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSFalling factors of 91 clipping apparatus (Olympus Optical Co Ltd. ; HX-3L) used for endoscopic variceal ligation (EVL-c) were studied by multivariate analysis in 19 cirrhotic patients with esophageal varices admitted in our hospital between July, 1991 and August, 1992. The cummulative non-falling probabilities were 87.7%, 80.2%, 69.0%, and 36.3% at 2, 4, 6, and 8 weeks, respectively. Multivariate analysis of non-falling factors using Cox's regression proportional hazard model showed that previous endoscopic injection sclerother-apy (EIS) was statistically significant non-falling factor (p = 0.00147), while the other 8 factors (age, sex, indication of EVL-c, Child's classification, combination with EIS, var-iceal form and location, and diet after therapy) were not significant. The univariate analysis using generalized wilcoxon test revealed that this factor was also significant (p= 0.0150). Although food comes into contact with clipping apparatus in the esophagus directly, the diet factor was not significant. It was suggested that a clipping apparatus was easy to be fallen if esophageal ulcer was made up just on the clipping site, but the factor of combination with EIS was not significant. We conclude that previous EIS is the most significant non-falling factor of clipping apparatus used for EVL-c and one must be careful for early falling of them when treating patients of recurrent varices with EVL-c.View full abstractDownload PDF (2468K) -
Kazuo INUI, Saburo NAKAZAWA, Junji YOHSINO, Kenji YAMAO, Hitoshi YAMAC ...1993 Volume 35 Issue 5 Pages 996-1002
Published: May 15, 1993
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSWe reported MR endoscopy developed as a new modality for precise diagnosis of digestive diseases. MR endoscopes consisted of a non-magnetic scope and an antena-probe incorporated with a small RF coil, 10×47 mm in size, at the tip of the endoscope. We obtained MR images of the stomach, rectum, liver, gallbladder, and pancreas resected from pigs and humans. MR images disclosed the stomach wall of human being as four layers : the first layer, high signal intensity ; the second, lower signal intensity, the third, slight higher signal intensity, and the fourth, higher signal intensity. Histological examination revealed the first layer to be compatible with the mucosa layer, the second, the submucosa layer and a part of the proper muscle layer, the third, the proper muscle layer, and the fourth, a part of the proper muscle layer, subserosa, and serosa. Invasion of gastric and rectal cancers was shpown as destruction of the layers. MR images showed clear and charastaristic findings of the liver, gallbladder, and pancreas. MR images revealed metastatic liver cancer as an area with round, higher signal intensity. MR endoscopy is expected as a new modality of a precise dignosis of gastric cancer, rectal cancer, and hepato-pancreato-biliary diseases.View full abstractDownload PDF (7550K) -
Tadanori SAITO, Shigeuki IKEDA, Tomonori ANPHO, Noriyoshi BAN, Hisato ...1993 Volume 35 Issue 5 Pages 1003-1007_1
Published: May 15, 1993
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 57-year-old man was visited to our department for close examination for gastric submucosal tumor on August 7, and was admitted on October 4, 1991. X-ray and endo-scopic examination revealed a submucosal tumor of approximately 2cm in diameter. The surface of the tumor was smooth and was associated with bridging folds. Endoscopic ultrasonography showed small spotty low echoic lesions in the thickened submucosal layer. Endoscopic polypectomy was performed. The specimen excised was 12×11×5mm in size, and the tumor was diagnosed as lymphangioma.View full abstractDownload PDF (4762K) -
Shuji MIZUMACHI, Hirofumi KAWANO, Akira KATOH, Takahiro YAMASAKI, Shin ...1993 Volume 35 Issue 5 Pages 1008-1014_1
Published: May 15, 1993
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 51-year-old male with a benign submucosal tumor who had been followed for 2 years and 4 months was readmitted because of hunger pain in the epigastric region. Upper GI endoscopy confirmed a gastric submucosal tumor which was suspected to be leiomyosar-coma. It was localized in the antral posterior wall. The endoscopic findings were characterized by superficial smooth mucosa with so-called bridging folds, central ulcera-tion and slightly irregular mucosa on the oral side of the ulcer. It was extremely difficult to make a diagnosis of cancer by endoscopic findings in this case. A definitive diagnosis of gastric carcinoma was made by endoscopic forceps biopsy. Histological traits of the cancer tissue consisted of eosinophilic infiltration and growth of fibroblasts in addition to scirrhous cancer.View full abstractDownload PDF (6670K) -
Shigenari HOUZAWA, Tsuyoshi KUROKAWA, Nagamu INOUE, Eiichi SEKIZUKA, S ...1993 Volume 35 Issue 5 Pages 1015-1020_1
Published: May 15, 1993
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA case of eosinophilic enteritis was reported. A 25-year-old female came to the hospital because of epigastric pain and diarrhea after delivery. There was a history of allergic rhinitis. Laboratory data revealed increased eosinophil count (34%) in peripheral blood and a elevated serum IgE level (430 IU/ml). Malignant cells were not found in bone marrow. Ascites or splenomegaly was not found by CT scan. Endoscopy revealed erosive gastritis in antrum and minimal edematous mucosal changes in duodenum and rectosig-moidal colon. Barium enema did not show any abnormal findings. Biopsies obtained from the rectosigmoidal colon revealed edema in the lamina propria and mild infiltration of the mucosa with eosinophils. The submucosa appeared to be spared from the eosinophilic infiltration. On the other hand, the duodenal biopsies suggested non-specific inflammation of mucosa with infiltrations of inflammatory cells including neutrophils and eosinophils. The esophageal and gastric biopsies revealed no mucosal infiltration of eosinophils, either. Neither eggs nor parasites were found in feces and biopsy specimens. Although differential diagnosis was difficult because eosinophilic infiltrations were seen only slightly, electron microscopical findings showed inflammatory changes around eosinophils which suggest that eosinophils were responsible to mucosal injury. From these findings, the diagnosis is determined to be "predominant mucosal layer disease" of eosinophilic enteritis according to Klein's classification. Electron microscopy was useful to distinguish the disease from other inflammatory bowel diseases and collagen diseases which clinical and pathological manifestation may mimic those of eosinophilic enteritis at the initial stage.View full abstractDownload PDF (5780K) -
Miwako SAKURAMOTO, Naoto EGAWA, Kumiko MONMA, Junichi ISHIWATA, Tsuyos ...1993 Volume 35 Issue 5 Pages 1023-1030_1
Published: May 15, 1993
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSSarcoidosis is a systemic disease that commonly affects the lung and lymphnodes. Gastrointestinal involvement, especially involvement of small intestine and colon, is very rare in this disease. We report a case of sarcoidosis with involvement of the terminal ileum. The colonoscopic examination revealed polyposis-like changes and ulceration in the terminal ileum. Histologocal examination showned non-caseating granulomas. The same changes were found also in the lung and lingual tonsils. Previous reports of intestinal sarcoidosis are reviewed and a further discussion of the relationship of this disease to Crohn's disease is described.View full abstractDownload PDF (7470K) -
Hiroshi KAWAMURA, Takeshi OCHI, Masanori HAMADA, Kunihiko KOHMOTO, Eij ...1993 Volume 35 Issue 5 Pages 1033-1037_1
Published: May 15, 1993
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 24-year-old man suffered from Cowden's disease. X-ray and endoscopic examination revealed multiple sessile esophageal polyps, numerous Yamada I-III typed gastric polyps, a few number of duodenal and lower colonic polyps. Histological examination of the polypectomized gastric polyps was typical hyperplastic polyp which showed an unusual finding in the gastrointestinal polyposis. Of the 25 cases of Cowden's disease which have been reported in Japan, gastrointestinal polyposis have been observed in 96% (24/25), especially including 19 of twenty-five (76%) esophageal sessile polyposis. Gastrointestinal polyposis in association with sessile polyposis in esophagus were supposed to be a characteristic feature of Cowden's disease.View full abstractDownload PDF (3436K) -
Shigeru ITAKURA, Nobuyuki ASADA, Hirokazu GOISHI, Kazufumi SAKANOUE, H ...1993 Volume 35 Issue 5 Pages 1038-1047
Published: May 15, 1993
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSWe reported a case of Cowden's disease accompanied by gastrointestinal polyposis. A 34-year-old male visited our hospital for the examination of the gastrointestinal tract. The endoscopic examination of the gastrointestinal tract revealed polyposis of esophagus, stomach, duodenum and rectum. The pathologic diagnosis was non-neoplastic polyposis ; i. e. hamartomatous and hyperplastic. Small facial papules, palmoplantar keratoses, oral mucosal papillomatosis and adenomatous goiter were also observed.View full abstractDownload PDF (9122K) -
Yutaka OZEKI, Toshio SAIGA, Mikio YASUMURA, Tomihiko KIMURA, Hideki IS ...1993 Volume 35 Issue 5 Pages 1048-1057_1
Published: May 15, 1993
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 59-year-old man was admitted to our hospital because of fluctuating jaundice. Ultrasonography and computed tomography showed a mass in the right intrahepatic bile duct extending to the commom hepatic duct. Percutaneous transhepatic cholangiography revealed a shadow defect in the common hepatic duct. Angiography showed no tumor stains. Percutaneous transhepatic cholangioscopy (PTCS) revealed a papillary tumor in the left hepatic duct covered with thick coat. Hepatocellular carcinoma was proven by biopsy under PTCS. A diagnosis of hepatocellular carcinoma in the bile duct was made and operation was performed. A tumor in the right intrahepatic bile duct extending to the commom hepatic duct was shown in the resected specimen but no tumor was demonstrated in the liver parenchyma by histologic examination.View full abstractDownload PDF (12301K) -
Terumi KAMISAWA, Tomoaki ISAWA, Naoto EGAWA, Yuyang TU, Shunichi SAEKI ...1993 Volume 35 Issue 5 Pages 1058-1065
Published: May 15, 1993
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 30-year-old female was admitted to our hospital asymptomatically for the evalua-tion of liver dysfunction. Ultrasonography showed thickening of gall bladder wall and gall bladder polyp. ERCP demonstrated anomalous arrangement of the pancreaticobiliary ductal system without dilatation of the common bile duct and fuzzy irregularity of the gall bladder wall. Cholecystectomy was performed. Histologically hyperplasia of mucosa and hyperplastic polyps were detected in the gall bladder wall. ERCP should be performed to detect the non-biliary dilated anomalous arrangement of the pancreaticobiliary system for patients with thickening of the gall bladder wall by US.View full abstractDownload PDF (8150K) -
Yukiko SATOH, Haruhide SHINZAWA, Katsuaki UKAI, Hitoshi TOGASHI, Hirot ...1993 Volume 35 Issue 5 Pages 1066-1070_1
Published: May 15, 1993
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSCongenital hepatic fibrosis (CHF), with chief symptoms of portal hypertension and hepatomegaly, is a rare condition usually detected in infancy. We recently encountered a case of this condition, which had been asymptomatic before detection by abdominal ultrasonography. The patient was a 57-year-old man who was referred to our department after detection of a liver abnormality by abdominal ultrasonography during routine health check up. Repeat abdominal ultrasonography disclosed small scattered cystic lesions (about 1-5 mm in size) in both lobes of the liver. Abdominal CT revealed diffusely distributed small, low-density areas in the liver, which were not enhanced by contrast material. Laparoscopy disclosed numerous small black-green cysts (1-2 mm in diameter) on the liver surface. In addition, whitish markings were distinct in the portal region of the liver. Magnified Laparoscopy revealed branched whitish markings with a clear margin surrounding the hepatic lobules. This finding is specific for CHF. Therefore, laparoscopy was shown to be useful for diagnosis of CHF.View full abstractDownload PDF (5571K) -
Masakyo ASAHARA, Masamichi NASU, Yuka IDEI, Syomei SYA, Shinichi SHIMI ...1993 Volume 35 Issue 5 Pages 1071-1079_1
Published: May 15, 1993
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 51-year-old housewife with a past history of melena was admitted to our hospital because of painful abdominal tumor. The labolatory findings on admission pointed out mild anemia and normal count and morphology of white-cell. Endoscopic examinations (panendoscopy and colonoscopy) showed no localized lesions in the esophagus, stomach, and colon. But, small intestinal X-ray study demonstrated a tumor-like lesion in the duodenal third portion. The enteroscopy showed the nodular protruding lesion without ulceration of which surface was whitish and lustrous. The specimen taken from this lesion revealed marked infiltration of atypical lymphocytes, suspected non-Hodgkin's lymphoma (diffuse medium-sized cell type), and immunohistological study revealed tumor cells were B-cell origin. Chest X-ray, abdominal ultrasonography, whole body computed tomogra-phy, and Ga-scintigram pointed out no metastatic lesions. Thus, this case was diagnosed as malignant lymphoma localized in the duodenal third portion. Chemotherapy (VEPA) was not effective. Autopsy proved us no other lesions except for the duodenal third portion. Primary malignant lymphoma diagnosed by enteroscopy in the duodenal third portion is extremely rare in Japan. Only 3 cases were reported in the past literatures.View full abstractDownload PDF (10047K) -
Ken NISHIKURA, Shigenori WATANABE, Katsumasa TSUNASHIMA, Haruo SHIMIZU ...1993 Volume 35 Issue 5 Pages 1080-1084_1
Published: May 15, 1993
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 64-year-old man was admitted to our hospital suf f erring from vomiting, abdominal pain and diarrhea after accidental ingestion of a poisonous mushroom Lampteromyces Japonicus. Endoscopic examination was performed to reveal reddish and severely edematous mucosa with multiple erosions in the stomach and duodenum. Histological examination of endoscopic biopsy specimens showed acute ischemic changes in the duodenum. In addition, the liver function tests showed moderate liver damage. The mechanism of intoxication of Lampteromyces Japonicus is not well known. Liver injury due to this toxication is very rare, and no case of acute ischemic enteritis caused by this toxication has been so far reported.View full abstractDownload PDF (2436K) -
Etsuko IKEDA, Masatsugu NAKAJIMA, Kenjiro YASUDA, Eisai CHO, Hidekazu ...1993 Volume 35 Issue 5 Pages 1087-1092_1
Published: May 15, 1993
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSEndoscopic sphincterotomy (EST) using a newly developed bipolar sphincterotome (Everest Medical Co) was performed in 14 patients with various bile duct diseases for diagnosis and treatment of these diseases. The bipolar sphincterotome is designed as consisting of two electrodes : a cutting wire and the return coil electrode encircling the catheter. Two types of electrosurgical generator (Olympus UES and Evelest Medical K2 -8700) were used in this study. Sphincterotomy was performed successfully in 13 of 14 cases. One failure was due to a weak power of incision at the setting of an electrosurgical generator. In 13 cases with successful sphincterotomy, endoscopic transpapillary treat-ment and/or diagnosis were all completed by these procedures. In these series, minimum bleeding was seen in 2 cases and perforation for which no surgical therapy was required, was encountered in 1 case. Bipolar EST is performed by passing radio frequency (RF) current flows from the cutting wire through the tissue to the return electrode. The localized RF current reduces systemic complications especially for the patient with a pacemaker and eliminates the need for a distant return electrode (grounding pad). Therefore, the bipolar sphincterotome can be used easily and safely. At present, however, this bipolar sphincterotome is inferior to the monopolar sphincterotome in the manipulation and the durability. Further refinements of the instruments are recommended for better and wider use of the technique.View full abstractDownload PDF (5512K) -
[in Japanese]1993 Volume 35 Issue 5 Pages 1093
Published: May 15, 1993
Released on J-STAGE: May 09, 2011
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Tsuyoshi TAJIMA1993 Volume 35 Issue 5 Pages 1094-1096
Published: May 15, 1993
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[in Japanese]1993 Volume 35 Issue 5 Pages 1097-1099
Published: May 15, 1993
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1993 Volume 35 Issue 5 Pages 1101-1124
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1993 Volume 35 Issue 5 Pages 1125-1129
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1993 Volume 35 Issue 5 Pages 1142-1168
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1993 Volume 35 Issue 5 Pages 1169-1192
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1993 Volume 35 Issue 5 Pages 1193-1215
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1993 Volume 35 Issue 5 Pages 1216-1236
Published: May 15, 1993
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[in Japanese], [in Japanese], [in Japanese], [in Japanese]1993 Volume 35 Issue 5 Pages 1237-1240
Published: May 15, 1993
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[in Japanese], [in Japanese], [in Japanese]1993 Volume 35 Issue 5 Pages 1241-1244
Published: May 15, 1993
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