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Volume 36, Issue 11
Displaying 1-27 of 27 articles from this issue
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Toshihiko KOBAYASHI1994 Volume 36 Issue 11 Pages 2127-2135
Published: November 20, 1994
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSThe mucosal surface of 223 resected stomachs was observed through a video micro-scope. At a magnification of 50×, 294 minute lesions showing characteristic features on their surface were detected and micro-dissected. The mean diameter of these lesions was 1.5 mm. Histopathologically, these lesions included 17 minute neoplasms (8 minute gastric cancers, 4 minute adenomas, one minute carcinoid and 4 intragastric metastatic lesions). The other lesions corresponded mainly to intestinal metaplasias, minute erosions and foveolar hyperplasias. All minute neoplastic lesions, especially differentiated cancers and adenomas, showed the characteristic pit pattern. However, the mucosal surface of some intestinal metaplastic lesions also presented a similar pattern. Generally, most minute gastric cancers of less than 5 mm in diameter are incidentally found in serial sections of resected tissues. As reported here, the video microscope enabled us to detect minute lesions of less than 3 mm in diameter more efficiently than serial histopathological examination. But several lesions were undetected by video microscopy because the gastric mucosa showed rough surface or severe artifacts. This method is, however, simple and can be applied as a routine examination after the ordinary usual dissection for surgically resected stomachs.View full abstractDownload PDF (8651K) -
Yuji INOUE, Yoko MURATA, Mamoru SUZUKI, Kazuyoshi WATANABE, Katutoshi ...1994 Volume 36 Issue 11 Pages 2136-2145
Published: November 20, 1994
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESS[Introduction] Using color doppler endoscopic ultrasonography (CDEUS), blood flow of 30 patients with rectal cancer was visualized and measured from May 1992 to January 1994. The patients were classified into the group with distant metastasis (metastasis group n=8) and the group without distant metastasis (control group n=22) . Association of maximum blood flow velocity, the number of observed blood flow and the density of observed blood flow of patients with distant metastasis and venous invasion were studied. [Results] (1) Number and density of blood flow in metastasis group were more than those in control group (p < 0.01, p < 0.05), and maximum blood flow velocity of metastasis group was faster than that of control group (p lt; 0.01). (2) More number of blood flow and faster maximum blood flow velocity were observed in patients with higher venous invasion. (3) In cases of the marked venous invasion (v2, v3), the number of blood flow of metastasis group was higher than that of control group (p < 0.05), and the maximum blood flow velocity of metastasis group was faster than that of control group (p < 0.01) . [Conclusion] Color doppler endoscopic ultrasonography for rectal cancer is useful to estimate the risk of distant metastasis.View full abstractDownload PDF (2954K) -
Hiroshi NAKASE, Noriaki SAKATANI, Kazumi NASUNO, Yoshihiro YAMAMOTO, K ...1994 Volume 36 Issue 11 Pages 2147-2155
Published: November 20, 1994
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSIt has not yet been reported that EVL has little effect on the whole body compared with EIS in terms of liver, renal and pulmonary function the short period after therapy. In this study, to estimate the systemic effect of endoscopic variceal ligation (EVL) compared to those of endoscopic injection sclerotherapy (EIS), we observed changes of liver, renal and pulmonary functions in 39 patients with liver cirrhosis treated by EIS or EVL. Liver and renal functions were observed before, 24hrs, 3days, and 7days after therapy, and arterial oxygen saturation (Sa02) was monitored during therapy. Significant elevations of serum TBi1 and DBil levels from the basal levels were observed at each time course only in EIS group (especially in Child C group) but not in EVL group. No significant elevations of serum GOT and GPT levels from the basal levels were observed at each time course but in Child C group of patients treated by EIS, serum GOT and GPT tended to be peak levels at 3days after therapy. No significant changes of BUN, Cr, PT and HPT were observed at each time course. No significant differences of Sa02 between two groups were noted. However, significant decrease of SaO2 level from the basal was observed during the procedure in both groups. These results suggested that EVL has little systemic effect compared to those of EIS in terms of changes of liver function duting the short period after therapy. Therefore, EVL might be a first choice of therapy for eradicating esophageal varices in patients with poor hepatic function.View full abstractDownload PDF (992K) -
-COMPARISON WITH ENDOSCOPIC AND HISTOPATHOLOGICAL EFFECTS BY EUS-Akira KUSUYAMA, Hideo TASHIRO, Norio MITSUMORI, Mani WAKABAYASHI, Jun ...1994 Volume 36 Issue 11 Pages 2156-2163
Published: November 20, 1994
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSIn our institution, preoperative intra-arterial chemotherapy was started for advanced gastric carcinoma from January 1988. We have performed pre- and post-chemotherapeutic endosonographic examination in 38 cases for 3 years and 3 months since January 1990. We evaluated the effectiveness of chemotherapy with endoscopic ultrasonography (EUS) in comparison between pre- and post-chemotherapeutic effects with cross-section of lesions, and compared its results with the study of endoscopic findings and histopathological examination of the resected stomach. In our result, tumor reduction was observed in 8 of 38 cases from EUS images, but endoscopic and histopathological findings were not always so effective. Consequently, it is believed that EUS provides one of the objective indices of cancer chemotherapeutic effects by visualizing the cross-section of tumor. However, we have some problems for the evaluation and cancer chemotherapeutic effects on each case should be judged on the basis of multilateral findings.View full abstractDownload PDF (6427K) -
Yoshihisa URITA, Eisaku KONDO, Masue MUTO, Yutaka HOJO, Hisashi ARIKI, ...1994 Volume 36 Issue 11 Pages 2164-2170_1
Published: November 20, 1994
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSThe combined method of endoscopic variceal ligation using clipping apparatus (EVL-c) and endoscopic injection sclerotherapy (EIS) was performed in 51 patients with esophageal varices in our department. Twelve of them were observed for over one year after the initial therapy at regular intervals. Non-recurrence period after EVL-c+EIS method were ranged from 2.5 to 13 months, with an average of 5.8 months. Additional therapies for recurrent varices were performed from 2 to 9 times, and the average interval of additional therapies was 4.2 months. There was no statistically significance among total volume of 1% Aethoxysklerol (AS) used in each additional therapy. Although there was no relationship between the length of non-recurrence period and total volume of 1 %AS used in the initial therapy, the more total volume of 1%AS was used in the first additional therapy, the longer non-recurrence period became statistically. The polypoid lesion made after clipping apparatus was fallen, was found in 18.3% and more frequently as more volume of 1%AS was injected in the initial therapy. Telangiectagia could not grow up across the polypoid lesion. Complications with EVL-c+EIS method decreased significantly. In order to maintain the therapeutic effect for a long time while keeping this merit, the additional therapy was thought to be very important.View full abstractDownload PDF (2898K) -
Yasuhiko UCHIDA, Tsuneyoshi YAO, Toshiyuki MATSUI, Toshihiro SAKURAI, ...1994 Volume 36 Issue 11 Pages 2171-2181
Published: November 20, 1994
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSIn order to cure early gastric cancer and gastric adenoma, Endoscopic Mucosal Resection (E. M. R.) was performed, and the indication of E. M. R to them was examined. In thirty-five out of sixty-nine lesions (50.7%), negative focal residuum was observed, and in thirty out of thirty-five lesions there have no remnants and recurrence observed up to the present. The progress of these lesions is still now being observed. It is significant that the rate of negative focal residuum in antrum and prepylorus was much higher than that in other portions of the stomach. In every portion of the stomach which is more than 10mm in size, a lot of remnant lesions were observed. E. M. R. for early gastric cancer is best indicated for the lesion which is located in the antrum including prepylorus, well-differentiated in histological type, localized in the mucosal layer, no ulcer formining, and size less than 10mm.View full abstractDownload PDF (4742K) -
Shun SUGAI, Shigetoshi KANAZAWA, Seishi ORII, Eiji FUJIMAKI, Yoshiaki ...1994 Volume 36 Issue 11 Pages 2182-2189_1
Published: November 20, 1994
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSDuring 24 months between January 1992 and December 1993, 83 superficial colonic neoplasms were endoscopically diagnosed in 47 out of 531 patients (8.9%) by total colonoscopy at our clinic. Forty-four of the 83 lesions (44.6%) were located in the transverese colon. Endoscopic appearance of the superficial neoplasms was classified into : ha; 57.9%, IIa+IIc ; 22.9%, IIb ;1.2%, IIc+IIa ; 9.6%, and IIc ; 8.4%. The superficial neoplastic lesions were histologically categorized into : carcinoma (3.6%), lesion with mild atypia (43.4%), moderate atypia (44.6%), severe atypia (8.4%). Among 41 patients with superficial colonic neoplasms, 21(44.7%) showed multiplicity and 26 (55.3%) had co-existing colonic adenoma of elevated type. Thirty-six patients with superficial tumors by second endoscopic examination for and, in 12 patients, 8 (66.7%) had multiple tumors and 9 (75.0%) had co-existing adenoma. The "over looked" tumors were frequently located in the ascending colon. These results suggest that careful observation is crucial for early detection of superficial colonic tumor.View full abstractDownload PDF (2893K) -
Norihiro HAMAMOTO, Yujiro TAKAO, Yutaro EGASHIRA, Chikao SHIMAMOTO, Ki ...1994 Volume 36 Issue 11 Pages 2190-2194_1
Published: November 20, 1994
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 36-year-old female was admitted to our hospital because of epigastric pain. Upper GI series and gastric endoscopic examination revealed multiple small polyposd lesions in the fundic gland area and a big semi-pedunculated polyp which was 60mm in diameter in the fornix. Histological findings of the biopsy specimens from the big polyp was suspicious of gastric adenoma. Total gastrectomy was performed. Histological findings of these small polyps and the big polyp revealed juvenile polyposis of the stomach. We also found a well differentiated adenocarcinoma invading the top of the big juvenile polyp. This case is the 6th of juvenile polyposis localized in the stomach in Japan.View full abstractDownload PDF (4706K) -
Nobuyuki YANAGAWA, Yusuke SAITOH, Masaki TARUISHI, Tokiyoshi AYABE, Sh ...1994 Volume 36 Issue 11 Pages 2195-2201_1
Published: November 20, 1994
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 58-year-old male with ulcerative colitis who manifested pneumatosis cystoides intestinalis during the treatment of ulcerative colitis is presented. He had intermittent episodes of bloody stools and showed positive reaction for fecal occult blood test. Barium enema and colonoscopy in November 1991 disclosed left-sided ulcerative colitis. He was given salazosulf apyridine, 3g per day. On a follow-up colonoscopy in August 1992, multiple submucosal tumor-like lesions were found in the ascending colon. Endoscopic ultrasonography with a miniature probe scanner showed high echoic areas with acoustic reflection and deep attenuation suggesting the presence of gas in the submucosal layer. An abdominal plain X-ray picture taken immediately after the colonoscopic examination revealed multiple cystic gas shadows along the ascending colon, resulting in the definitive diagnosis of pneumatosis cystoides intestinalis. The use of a miniature probe scanner is very useful in the differential diagnosis of submucosal tumors seen on colonoscopic examination.View full abstractDownload PDF (8623K) -
Tazuko OOISHI, Hiroshi SERIZAWA, Yoshiki HAMADA, Noriaki WATANABE, Nao ...1994 Volume 36 Issue 11 Pages 2202-2209
Published: November 20, 1994
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSThis report describes a 64-year-old male with bacterial liver abscess complicated with multiple colonic ulcers. He had been febrile for 2weeks before visiting the hospital. Laboratory examination showed leukocytosis and high concentration of serum enzymes of the biliary tract. Liver abscess was diagnosed by abdominal CT scan and US. Colonoscopic study revealed multiple round ulcers with intact intervening mucosa in the transverse colon, and multiple diverticula in the ascending colon. Biopsy specimens showed nonspecific chronic inflammation. Bacteriological examination showed Enterobacteriaceaes in the venous blood and the pus drainaiged from the abscess. Percutaneous drainage and systemic infusion of antibiotics were effective, and 2weeks later, both of liver abscess and colonic ulcers disappeared. There has been no report of such cases with liver abscess and multiple colonic ulcers. This is the first report of liver abscess complicated with multiple colonic ulcers, suggesting the relationship between liver abscess and colonic ulcers.View full abstractDownload PDF (8491K) -
Hiro-o YAMANO, Takao ENDO, Hideto ITO, Yukinari YOSHIDA, Eiji HATA, Ko ...1994 Volume 36 Issue 11 Pages 2210-2214_1
Published: November 20, 1994
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSWe experienced a rare case that massive gastrointestinal hemorrhage was caused suddenly by a ruptured submucosal aneurysm in the jejunum. A 38-years-old male was admitted to our hospital for massive bloody stool with severe shock status. Initialy we tried to perform upper and lower gastrointestinal endoscopic examinations, but we were unable to find an obvious hemorrhagic sourse. Angiographic study was done, but we had negative findings for gastrointestinal hemorrhage. Since his shock status and bleeding persisted in spite of a large quantity of continous fresh blood transfusion, we tried to perform an endoscopic examination in exploratory laparotomy. We found a submucosal tumor with intermittently bleeding from the top in the jejunum, and segmental resection was done. Pathological study showed a ruptured submucosal aneurysm of small intestine (cirsoid aneurysm). We reported this case and reviewed clinicopathological characteristics on 19 cases of cirsoid aneurysm reported in Japan.View full abstractDownload PDF (4532K) -
Hideaki SAKABE, Miya FUKANO, Shigeki KOYAMA, Takehiko SHIOMI, Yoshihid ...1994 Volume 36 Issue 11 Pages 2215-2220_1
Published: November 20, 1994
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSThis case report describes a primary diffuse malignant lymphoma located at the submucosa of the entire large intestine. The patient was a 78-year-old female who hospitalized with hypoproteinemia and dyspnea. Examination of the gastro-intestinal tract was performed because of severe anemia and a bloody stool. Colonoscopy revealed diffuse verrucif orm -like erosions on the entire large intestine accompanied by a prominent ileo-cecal valve and an erosive polypoid lesion of the ascending colon. Biopsy specimens showed marked lymphoid proliferation of the submucosa of the large intestine, which revealed a malignant lymphoma of the diffuse, small cell type. Generally, primary intestinal lymphoma shows various endoscopic findings. The endoscopic findings of this case should be kept in mind in order to differentiate cases like it from inflammatory bowel diseases and infectious colitises.View full abstractDownload PDF (7688K) -
Hideya MERA, Mariko MATSUI, Makoto UTSUMI, Katsumi SHIROTA, Miho OKAMO ...1994 Volume 36 Issue 11 Pages 2223-2229_1
Published: November 20, 1994
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 59-year-old female visited our hospital because of persistent epigastric pain. As US study of the gallbladder showed thickening of the wall and multiple polypoid lesions, she was admitted for further evaluation. ERCP revealed narrowing of the lumen of the gallbladder from the body to fundus, serrated changes of the margin of the fundus, and multiple polypoid lesions in the gallbladder. Moreover, abnormal connection of the common bile duct and main pancreatic duct of non-dilatation type was noted. From these findings, a diagnosis of adenomyomatosis and cholesterolosis of the gallbladder associated with anomalous arrangement of the pancreaticobiliary duct was made. This case is of particular interest in investigating the etiology of adenomyomatosis and cholesterolosis of the gallbladder.View full abstractDownload PDF (8122K) -
Satoru TAKAISHI, Masahiko OZAKI, Takamitsu ARIGA, Ikuya OHSHIMA, Takas ...1994 Volume 36 Issue 11 Pages 2230-2234_1
Published: November 20, 1994
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 42-year-old man with sudden onset of right epigastric pain was admitted to our hospital. Preoperative ultrasonography, ERCP and enhanced computed tomography showed some interesting findings as follows : the tail of the gallbladder was situated on the left side of the round ligament, the neck of it curved and cystic duct met left side of the common bile duct. Echogenic shadowing lesiones were detected and the fundus were thick. No abnormal formation of the portal vein was seen on ultrasonography. Under general anaesthesia, umbilical skin incision was made by closed laparoscopic method and four trocars (three 10mm and one 5mm) were inserted as usual manner. Another trocar was inserted from left side to tug the gallbladder to the left side. The neck of the gallbladder closely adhered to the common bile duct and cystic artery was a branch of the left hepatic artery. Left sided gallbladder without situs inversus totalis is a rare condition. We concluded that laparoscopic cholecystectomy could be applied to this case and the trocar inserted from left side was necessary for this operation.View full abstractDownload PDF (6116K) -
Katsumi KIMURA, Naotaka FUJITA, Yutaka NODA, Go KOBAYASHI, Akio YAGO, ...1994 Volume 36 Issue 11 Pages 2235-2238_1
Published: November 20, 1994
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSWe report a case of acute pancreatitis after endoscopic biliary drainage (EBD) without endoscopic sphincterotomy (EST). The patient, a 26-year-old woman, was admitted to our institution a complaint of epigastralgia and was diagnosed as cholecystolithiasis. Laparos-copic cholecystectomy was performed, but bile leakage occurred due to cystic duct injury during operation. ERC showed leakage of the contrast medium into the abdominal cavity from the remnant cystic duct. An endoprosthesis, 7.2 Fr, in diameter was inserted into the bile duct without EST. Two hours later, the patient began to complain of severe epigastral-gia, and so a narcotics was administered to relieve the pain. The serum amylase level at 3 hours, 6 hours and 24 hours after EBD was 3887 ml/dl, 7749 ml/dl and 9732 ml/dl, respectively. She was diagnosed as acute pancreatitis due to occlusion of the orfice of the pancreatic duct by the endoprosthesis. Immediately after the removal of the endo-prosthesis on the next day, the pain subsided. EBD was performed again via the choledo-choduodenal fistula, and she is free of bile leakage 3 months after discharge. There is a possibility of obstruction of the common channel following insertion of an endoprosthesis. It is concluded that in case in which the papilla of Vater is unusually small, EBD without EST should be prudently performed and the patient's condition and serum amylase level should be carefully monitored.View full abstractDownload PDF (4798K) -
Hiromitsu WATANABE, Naotaka FUJITA, Yutaka NODA, Go KOBAYASHI, Katsumi ...1994 Volume 36 Issue 11 Pages 2241-2244_1
Published: November 20, 1994
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSWe developed a new pancreatoscope, XPF-22, with an outer diameter of 2.2 mm to perform peroral pancreatoscopy (POPS) in cases with normal papilla of Vater. To improve the maneuverability of the scope, the tip is equipped with a two-directional tip-bending system. POPS and peroral cholangioscopy with this scope were performed in 16 cases of pancreatic diseases and 14 cases of bliary disorders by the mother-baby scope method. Insertion of this scope into the target duct and up to the area of interest through the normal papilla of Vater was achieved in 80% of the cases. The endoscopic view was kept satisfactory with the use of the tip-bending function during the examination. Durability of the scope was sufficient for clinical use.View full abstractDownload PDF (5621K) -
[in Japanese]1994 Volume 36 Issue 11 Pages 2247-2254
Published: November 20, 1994
Released on J-STAGE: May 09, 2011
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[in Japanese]1994 Volume 36 Issue 11 Pages 2255-2259
Published: November 20, 1994
Released on J-STAGE: May 09, 2011
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Yoshiharu SATAKE1994 Volume 36 Issue 11 Pages 2260-2261
Published: November 20, 1994
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESS422 cases of early colorectal cancers were analyzed clinicopathologically, and Japanese problems on this disease were discussed. We encountered a total of 104 cases of depressed type neoplastic lesions including 27 cases of early cancer and 77 cases of adenoma. According to our cases excised on endoscopy, depressed neoplastic lesion includes more adenoma than cancer. It is necessary for us to know that there are a lot of cancers in depressed neoplastic lesions and that there exist several times more adenomas in the large intestine. Cases of protruded type (Ip, Isp, Is) early cancer occupied 83.4% of all early cancers (352/422). When we think of the size of early colorectal cancer, the diameter of 6mm is regarded as a figure of prime importance. As for protruded type early cancers of 6 to 10mm in diameter, 25.9% of this lesion is sm cancer. Furthermore 35% of this sm cancer shows sm massive invasion. In view of our results, we think that a neoplastic lesion of 6 mm and over in diameter should be endoscopically resected irrespective of the types of lesions, protruded or depressed.View full abstractDownload PDF (233K) -
1994 Volume 36 Issue 11 Pages 2262-2271
Published: November 20, 1994
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1994 Volume 36 Issue 11 Pages 2272-2286
Published: November 20, 1994
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1994 Volume 36 Issue 11 Pages 2287-2296
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1994 Volume 36 Issue 11 Pages 2297-2317
Published: November 20, 1994
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1994 Volume 36 Issue 11 Pages 2318-2329
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1994 Volume 36 Issue 11 Pages 2330-2340
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1994 Volume 36 Issue 11 Pages 2341-2353
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1994 Volume 36 Issue 11 Pages 2354-2365
Published: November 20, 1994
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