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Volume 35, Issue 7
Displaying 1-13 of 13 articles from this issue
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Takeshi SHIMAKAWA1993 Volume 35 Issue 7 Pages 1531-1543
Published: July 20, 1993
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSIn our institute, endoscopic injection sclerotherapy with 5% ethanolamine oleate has been successfully performed in the treatment of about 300 cases with esophagogastric varices, and ensuing therapeutic results have been good. However, it has been difficult to stop bleeding in some cases, and there are great expectation for the hemostasic effect of Histoacryl, a new sclerosing agent that is a tissue adhesive of the cyanoacrylate family. Unfortunately, side effects have not yet clarified, and there are some problems of safety. Therefore, we conducted basic and clinical studies on the effect and safety of Histoacryl. The basic study proved that Histoacryl was different from the conventional sclerosing agents and it could form polymers with blood which resulted in excellent hemostasis as an embolus. When Histoacryl was used at 70% or 80% concentration in a mixture with Lipiodol, it seemed to be safety result in favorable local retention of polymers and X-ray contrast. In the clinical evaluation, this therapy could accomplish complete hemostasis and reduction of varix size in all 11 cases. There were no such side effects as liver dysfunction, blood coagulation abnormalities and embolism in other organs. Based on these results, sclerotherapy with Histoacryl is supposed to be a safe, effective method for treating esophagogastric varices.View full abstractDownload PDF (7036K) -
Shuji OTAKI1993 Volume 35 Issue 7 Pages 1545-1553
Published: July 20, 1993
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSNimustine, which was produced by removing Hydrochloride from Nimustine Hydrochloride, was suspended in lipiodol (5mg/ml). The resulting suspension (Nimustine-Lipiodol suspension) was experimentally injected to find out the anti-tumor effects to the primary carcinoma and metastatic lymph nodes.
[Material and Method]
(1) Nimustine-Lipiodol suspension was injected into the tumor (Lewis lung cancer) which was implanted onto the shoulders of mice (C57 black/6 mice) for the purpose of finding out the anti-tumor effects on primary lesions compared to the anti-tumor effects of injection of Mitomycin-lipiodol suspension (0.4 mg/ml), Adriamycin-Lipiodol suspension (2mg/ml) and Oil bleo (15mg/ml).
(2) Using the same material and method, DNA histograms were daily analyzed by flow cytometry before injection to 6 days after injection.
(3) Nimustine-Lipiodol suspension was injected into the tumor (Sarcoma 180) which was implanted to the legs of mice (ICR mice) for the purpose of finding out the anti-tumor effect on metastatic lymph nodes.
[Result]
(1) Nimustine-Lipiodol suspension was the most effective local injection drug for the tumor.
(2) The change of the DNA histogram after injection was that tha percentage of GO-1 stage had decreased and the percentage of S stage and G2-M stage had increased. This tendency continued till 6 days after injection.
(3) Nimustine-Lipiodol suspension had an anti-tumor effect on metastatic lymph nodes.
[Conclusion] The results obtained in this study may suggest that local injection of Nimustine-Lipiodol suspension can be used as an endoscopic treatment for early gastric carcinoma.View full abstractDownload PDF (3679K) -
Shuji OTAKI1993 Volume 35 Issue 7 Pages 1554-1567
Published: July 20, 1993
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSNimustine, which was produced by removing Hydrochloride from Nimustine Hydrochloride, was suspended in lipiodol (5mg/ml). The resulting suspension (Nimustine-Lipiodol suspension) was clinically injected to find out the anti-tumor effects on primary carcinoma and metastatic lymph nodes.
[Material and Method]
Nimustine-lipiodol suspension, which has proved to be effective for malignant tumors experimentally, was injected in 22 cases of gastric carcinoma using an endoscope. The movement of the suspension and its effects on primary lesions and metastatic lymph nodes were investigated.
[Result] 1) Movement of injected Nimustine-Lipiodol suspension was investigated by roentgenogram.
(1) Nimustine-Lipiodol suspension, which was injected into the AM area of the stomach, was mainly drained into the lymph nodes around the left gastric artery and right gastroepiploic artery 2 days after injection.
(2) It may be possible to examine the depth of the carcinoma by Nimustine-Lipiodol suspension injected into the circumference of the tumor.
2) Histological examination
(1) In the cases with early gastric carcinoma, Nimustine-Lipiodol suspension was drained into 76.1 ± 18.0% of lymph nodes (N2).
(2) Nimustine-Lipiodol suspension, which was injected into the tumor, was proved to be effective for primary gastric carcinoma in 3 out of 10 cases.
(3) Nimustine-Lipiodol suspension proved to be effective for the metastatic lymph nodes in one case.
[Conclusion] The results obtained in this study may suggest that local injection of Nimustine-Lipiodol suspension can be used as an endoscopic treatment for early gastric carcinoma.View full abstractDownload PDF (10565K) -
Katsuhiko MATSUMOTO, Hiroyasu MAKUUCHI, Takao MACHIMURA, Yoshio SOH, T ...1993 Volume 35 Issue 7 Pages 1568-1573_1
Published: July 20, 1993
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSWe studied local complications in the esophagus and the symptoms associated with sclerotherapy by questionnaire in 122 patients with esophageal varices who underwent endoscopic sclerotherapy. The most frequent local complication was ulceration (31%), which was seen in many of the patients with giant hematoma or stenosis of the esophagus. The questionnaire revealed that the most frequent posttherapeutical symptoms were dysphagia (68.4%) and followed by heartburn(12.5%). Many of the patients who received frequent injections, especially extravasal injections, presented with lacal complications in the esophagus, and tended to have a prolonged symptomatic period. We believe that sclerotherapy should be applied in a manner that would reduce the incidence of complications.View full abstractDownload PDF (2201K) -
Masaki MIYAMOTO, Ken HARUMA, Takehiro SHIMAMOTO, Masaharu YOSIHARA, Ji ...1993 Volume 35 Issue 7 Pages 1574-1578_1
Published: July 20, 1993
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSSix cases of gastric inflammatory fibroid polyp removed by endoscopic polypectomy or strip biopsy were reported. Five cases were located in the gastric antrum and one case was located in the greater curvature of the gastric angle. Histological examination showed that all lesions were located in the bottom of the mucosa or the submucosa. We performed endoscopic ultrasonography in a case of an inflammatory fibroid polyp and we confirmed that the lesion arised from the bottom of the mucosal layer. Therefore, we could remove the lesion by strip biopsy safely. We performed examination of gastric juice in four cases of inflammatory fibroid polyp. All of them showed hypochlorhydria. The examinations of gastric juice for inflammatory fibroid polyp of the stomach have not been so far reported. The result indicates that there is a possibility of relationship between inflammatory fibroid polyp and gastric atrophy.View full abstractDownload PDF (5148K) -
Mototsugu KATOH, Masahiro ASAKA, Hidetoshi KAGAYA, Yasuo SATOH, Mineo ...1993 Volume 35 Issue 7 Pages 1581-1587_1
Published: July 20, 1993
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSWe investigated the process of gastric mucosal lesions induced by ethanol in rats using an electronic endoscopy system. Immediately after ingestion of ethanol, venous congestion, edema and spotty hemorrhages on the gastric mucosa were observed endoscopically. A few minutes after ethanol ingestion, endoscopic observation revealed reticular pattern of whitish necrosing surface epithelium following disappearence of transient mucosal edema. If mucosal damage with ethanol was more severe, reddish erosions were observed under necrosing surface epithelium and such erosions tended to be observed longitudinally along the mucosal folds of the greater curvature. The mucosal lesions became most severe in 10 minutes after ethanol ingestion. The longitudinal erosions had been gradually healed about 10 days after ethanol ingestion. Minute gastric mucosal changes induced with 20% ethanol were clearly detected by electronic endoscopy, although it was rarely detected by macroscopic observation. These results suggest that electronic endoscopy would be quite useful for observing experimental gastric lesions in rats.View full abstractDownload PDF (4482K) -
Shigeki SUGIYAMA, Kou NAGASAKO, Chiharu KAWANAMI, Yoshiki TANAKA, Rika ...1993 Volume 35 Issue 7 Pages 1588-1592_1
Published: July 20, 1993
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSMarphological gap between early pedunculated and adovanced ulcerrated cancer is tremendous. But there is no doubt that pedunculated lesions evaluate to ulcerated ones so long as the former are cancer. Morphological change of pedunculated sm cancers was studied according to the volume of cancer in the submucosal layer. Thirty-eight pedunculated sm cancers polypectomied were used for the study. The shape of the head was defined at the widest slice of the polyp; round, concave and semicircle with horizontal head (SHH). The following items were studied; (1) the ratio of size of cancer and of head, (2) the ratio of width of neck and head, (3) the depth of invasion, and (4) supposed percentage of the size of remaining head compared to the initial round head. It was concluded that as the volume of cancer increases in the submucosal layer the width of the stalk gets broader and the round head collapses like full moon waves. Finally the head of there remains the broad stalk alone.View full abstractDownload PDF (5035K) -
Shukoh ITO, Hiroyuki WATANABE, Toshio NAGANUMA, Tomonori ISHIOKA, Osam ...1993 Volume 35 Issue 7 Pages 1595-1601
Published: July 20, 1993
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA rare case of AFP producing early gastric cancer without liver metastasis is reported. A patient was 78-year-old woman admitted to our hospital because of tarry stool. Hb fell to 10.6 g/dl and the serum AFP level was elevated to 10, 715 ng/ml. Abdominal computed tomography revealed no liver metastasis, although multiple liver cysts were demonstrated. X-ray and endoscopic examination showed a protruded lesion on the greater curvature of the gastric antrum. Poorly differentiated adenocarcinoma was confirmed by biopsy. Subtotal gastrectomy was performed. The resected specimen showed a protruded lesion, 4×3cm, locating on the greater curvature. Histopathological examination disclosed poorly differentiated adenocarcinoma of medullary type involving the submucosal layer. AFP with PAP method was immunohistochemically demonstrated in the cytoplasm of cancer cells. No recurrence was observed 12 months after operation.View full abstractDownload PDF (4196K) -
Hiroshi TOMITA, Takeo IWAMA, Keigo YOSHINAGA, Sayuri OKA, Shigeo KAWAI ...1993 Volume 35 Issue 7 Pages 1602-1607_1
Published: July 20, 1993
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSWe report a 46-year-old female case of ampullary carcinoma with familial adenomatous polyposis (FAP). She underwent subtotal colectomy and ascending colostomy at 27 year-old. Endoscopic examination of the upper gastrointestinal tract revealed ampullary adenoma with moderate atypia. Total colectomy and local excision of the ampulla of Vater were performed because malignant polyps were found on the colostomy region. Histological examination of the resected ampulla showed a well-differentiated adenocarcinoma localizing only in the mucosal layer. Twenty two cases of ampullary carcinoma with FAP have been reported in Japan, and 61% of them were at advanced stage. When severe atypia is found histologically in the biopsy specimens of periampullary area, local excision of the ampulla of Vater should be indicated for early diagnosis and treatment of ampullary carcinoma.View full abstractDownload PDF (3799K) -
Yasuhiko SAITOH, Satoshi SHINOHARA, Yutaka HANDA, Shigehumi MORITA, Hi ...1993 Volume 35 Issue 7 Pages 1608-1615
Published: July 20, 1993
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA case of early depressed cancer in the 2nd portion of the duodenum is reported. A 42-year-old man recieved periodic upper GI series, which revealed an abnormal shadow in the stomach. Endoscopic examination revealed an irregular depressed lesion in the 2nd portion of the duodenum, which was proved to be well differentiated tublar adenocarcinoma by endoscopic biopsy. Endoscopic resection was performed. The resected specimen showed a depression, 6 × 4mm in size. Histological examination revealed a well differentiated tubular adenocarcinoma with depth of invasion into the mucosal layer, and the resected margins were tumor-free. This case was the 11th case of early depressed cancer of the duodenum, and the first reported case resected endoscopically in Japan.View full abstractDownload PDF (5553K) -
Sakumi SAEGUSA, Hitoshi SUGAYA, Tazuko KOBAYASHI, Nobuyoshi YANAGISAWA ...1993 Volume 35 Issue 7 Pages 1616-1622_1
Published: July 20, 1993
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSWe report laparoscopical findings of two cases with late onset hyper-citrullinemia. Case 1 was 29 year old male with abnormal behavior and consciousness disturbance and case 2 was 59 year old female with consciousness disturbance. Blood ammonia value of two cases was high and analysis of plasma amino acid showed 10 to 20 folds increase in citrulline concentration in both cases. There were no portal-systemic shunting on abdominal angiograms. Laparoscopical findings common to both cases included enlargement of the liver and yellowish liver surface. The liver surface of case 1 appeared reddish insular areas in yellowish liver parenchyma and that of case 2 appeared diffusely yellowish colored. Histological findings of the liver correspond with laparoscopical findings of liver surface in each cases, that is, local fatty change in the liver parenchyma in case 1 and diffuse fatty change in case 2. Analysis of argininosuccinate synthetase (ASS) activity in biopsied liver tissue showed decrease in ASS activity in both cases. Reports on hyper-citrullinemia are small in number and laparoscopical findings are reported only seven cases. We presented that laparoscopical findings of this disease shows basically fatty liver, and the degree of yellowish tone on the liver surface is considered to be varied with its degree and distribution of fatty deposition.View full abstractDownload PDF (2792K) -
1993 Volume 35 Issue 7 Pages 1623-1700
Published: July 20, 1993
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSDownload PDF (12367K) -
1993 Volume 35 Issue 7 Pages 1701-1740
Published: July 20, 1993
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSDownload PDF (6194K)
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