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Volume 36, Issue 6
Displaying 1-17 of 17 articles from this issue
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Tamotsu ANZAI1994 Volume 36 Issue 6 Pages 1175-1185
Published: June 20, 1994
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSThe usefulness of endoscopic naso-biliary drainage (ENBD) after endoscopic sphincter-otomy (EST) and endoscopic lithotripsy (EL) was assessed by comparing the outcome in patients undergoing ENBD with those not undergoing this procedure. Meterials and methods : EST was performed in 170 patients with common bile duct stone (CBDS) from Octobar 1985 to July 1993. Among these patients, 84 were excluded : 44 due to hyperamylasemia (>500IU) appearing 2 hours after EST, 32 because they had previously undergone percutaneous drainage, and 8 undergoing EST a second time to treat recurrence. The subjects for this study, therefore, consisted of 86 patients. These patients were divided into two groups depending on whether ENBD was performed (NBD group, 59 patients) or not (non-NBD group, 27 patients). The groups were compared in regard to the improvement in body temperature (BT), WBC, CRP, T-Bil, AIP, and LAP, two days after EST and EL. Results : Although there were no distinct intergroup differences in BT and WBC, in the NBD group and in the non-NBD group. Significant differences between the NBD group and the non-NBD group were noted in CRP, T-Bil, AlP and LAP. In the NBD group, these variables clearly improved after EST and EL compared with before therapy (p <0.005, p < 0.001, p <0.001, p <0.001, respectively) ; no improvement was evident in the non-NBD group. Conclusion : ENBD after EST and EL was evaluated to be a useful procedure for preventing early complications from occurring after these procedures and for improving inflammation and bile congestion.View full abstractDownload PDF (1327K) -
Yoshiro SAIKAWA, Koichiro KUMAI, Shinjiro WILSON MATSUZAKI, Shinji OGA ...1994 Volume 36 Issue 6 Pages 1186-1190
Published: June 20, 1994
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSIn the present study, the usefulness of endoscopic treatment for senile gastric cancer patients who were more than 80 years old was estimated from the view points of QOL and prognosis after treatment. Fifty-eight senile patients who were diagnosed histopathologically as gastric cancer in our department between Jan. 1988 and Jun. 1992 were evaluated. The patient's characteristics were 45 males and 13 females, 85.7 years old in average, and 35 cases of advanced gastric cancer and 23 cases of early gastric cancer. Endoscopic treatment (21 cases), open surgery (21 cases) and course observation (16 cases) was undergone in the study. As active controls of post-therapeutic prognosis, 327 advanced cases and 172 early cases of gastric cancer patients, who were treated by standard surgery in the same period of our department, were utilized. High incidence of postoperative complications (6/21 cases, 28.6%) was observed in open surgery group of senile patients. In post-therapeutic prognosis, good prognosis was obtained in endoscopic treatment group for early gastric cancer. According to advanced gastric cancer, open surgery group of senile patients showed slightly better prognosis than endoscopic treatment or course observation group.View full abstractDownload PDF (644K) -
Kazuo KAWAGUCHI, Jiroh OKUWAKI, Sigeto TAKAMI1994 Volume 36 Issue 6 Pages 1191-1198
Published: June 20, 1994
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSRecently, intramucosal cancers (m cancers) of the colorectum treated by endoscopic mucosal resection have been increasing in number. Fifty three of 71 lesions in 47 cases of intramucosal colorectal cancers resected endoscopically were smaller than 10 mm in diameter and were classified macroscopically as follows: 17, superficial elevated type (IIa) ; 2, superficial depressed type (IIc) ;19, pedunculated type (Ip) ;11, subpedunculated type (Isp) and 4, sessile type (Is). The age distribution in cases of intramucosal colorectal cancer resected endoscopically shifted to younger age in comparison with that in surgically resected cases. Moreover, multiple cancers were found in 8 of 53 cases of colorectal cancers resected surgically, while 13 of 47 cases of intramucosal colorectal cancers resected endoscopically were multiple cancers. Synchronous multiple intramucosal cancers consisting of superficial type (IIa, IIc) alone were 3 cases and consisting of protruded type (Ip, Isp, Is) alone were 6 cases found in the transverse colon to the rectum. In contrast, synchronous multiple intramucosal cancer lesions consisting of superficial type alone or of both superficial and protruded types were found anywhere from the cecum to the sigmoid colon.View full abstractDownload PDF (1006K) -
Akira ZENIYA, Hiroyuki WATANABE, Toshiyuki KUWABARA, Setsuya OTANI, To ...1994 Volume 36 Issue 6 Pages 1199-1203_1
Published: June 20, 1994
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSTwo cases of spontaneous submucosal hematoma of the esophagus were reported. Case 1; A 41-year-old male was admitted to Ogachi Central Hospital with a chief complaint of hematemesis. Endoscopic examination revealed hematoma in the upper portion of the esophagus and a diagnosis of submucosal hematoma was made. Anti-acid drugs were administered and hematoma was absorbed one week after treatment. Case 2 ; A 45-year-old male was admitted to Ogachi Central Hospital because of hematemesis. Endoscopic examination revealed a large dark red-colored swelling extending from the upper esophagus to the cardia of the stomach and a diagnosis of submucosal hematoma was made. Treatment with H2-blocker in addition to anti-acid drugs was begun. In the 2nd endoscopic examination done one week later, the hematoma disappeared and a shallow ulcer due to the dissection of mucosa was formed at the area of the hematoma. The ulce was healed four weeks after treatment.View full abstractDownload PDF (3885K) -
Toshihiro SAKAKIBARA, Akira YAMADA, Naoki NOMURA, Yoshito KUROKI, Koic ...1994 Volume 36 Issue 6 Pages 1204-1208_1
Published: June 20, 1994
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSWe reported a case in which an ulcer developed in the gastric tube after esophageal reconstruction for esophageal ulcer with hemorrhage. The patient was a 44-year-old man, who had undergone an esophagectomy, and a whole gastric tube replacement through the anterior portion of the sternum 3 years and 7 months ago. He complained of anterior chest pain. Endoscopic examination revealed an active ulcer in the angulus of the gastric tube. He was treated with an H2-blocker. Endoscopic study showed the ulcer scar 2 months later. This ulcer was located away from the border between pyloric and fundic gland, and specific type of intestinal metaplasia was recognized surrounding the ulcer. We consider that gastric stasis after eating caused by antethoracic replacement and alcohol overdrink-ing might play a part in the pathogenesis of ulcer formation.View full abstractDownload PDF (4094K) -
Hiroyuki NARAHARA, Takashi NAKANISHI, Tatsuya KIYOHARA, Yasuhisa SAKAM ...1994 Volume 36 Issue 6 Pages 1211-1216_1
Published: June 20, 1994
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSWe report a patient with Behcet's disease complicated by a huge esophageal ulcer in whom the process of progression and healing of the ulcer was observed by endoscopy. A 19-year-old male was diagnosed as having Behcet's disease in 1986, because he had oral ulceration and typical uveitis. He developed retrosternal pain and dysphagia in May 1990. Endoscopy showed multiple flat erosions in the middle and lower esophagus. The erosions developed into a kissing ulcer in June, and progressed to a nearly circumferential ulcer in July. Along with progression of the ulcer, laboratory studies showed evidence of systemic inflammation, and involvement of the terminal ileum was detected at the same time. The ulcer was refractory to steroid and antacid therapy, but the inflammation subsided soon after the commencement of total parenteral nutrition. The esophageal ulcer then gradually decreased in size and healed with scarring. Parenteral nutrition appeared to be beneficial in this patient. Most previously reported esophageal ulcers associated with Behcet's disease were circular and shallow. In this patient, serial endoscopy demonstrated various changes of the esophageal ulcer and it eventually progressed to nearly a circumf erential lesion. Huge ulcers of the esophagus complicating Behcet's disease tend to be refractory and appear to only occur in patients with severe Behcet's disease. The present patient showed a good response to total parenteral nutrition.View full abstractDownload PDF (2047K) -
Hiroshi SATOH, Tetsuo ARAKAWA, Atsushi NAKAMURA, Kohichiro NAKAGAWA, T ...1994 Volume 36 Issue 6 Pages 1219-1223_1
Published: June 20, 1994
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSWe experienced 3 cases with localized gastric or duodenal telangiectasias in whom a heater probe was effective for hemostasis of the lesions. They had had an attack of hematoemesis and/or melena. Endoscopy showed a spot of fresh red and flat telangiectasia in their stomach or duodenal bulb, and no other hemorrhagic lesion was found. The lesions were treated with a heater probe and disappeared thereafter. No upper gastrointestinal bleeding has occured after the treatment. The heater probe is widely used for hemostasis of hemorrhagic ulcers with exposed vessels. This treatment may be useful not only for the ulcers but also for telangiectasias in gastrointestinal tract.View full abstractDownload PDF (2037K) -
Teruyuki KANE, Tokio YAMAZAKI, Kenji IDE, Shigeki KOYAMA, Tadao BAMBA, ...1994 Volume 36 Issue 6 Pages 1224-1228_1
Published: June 20, 1994
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSThe patient was a 19-year old female. She visited our hospital with a chief complaint of vomiting. Upper gastrointestinal barium examination and endoscopic examination revealed circumferential stenosis in the descending portion of the duodenum. Congenital duodenal diaphragm in an adult female was diagnosed by these findings, in addition to abdominal echography and abdominal CT. She refused to under go surgical operation due to cosmetic reasons. Although it was still considered that surgical treatment was indicated in this case, endoscopic incision of congenital duodenal diaphragm was performed. After the procedure, there were no complications, and her symptoms disappeared. The incised portion still remains opened and, she is well now.View full abstractDownload PDF (4820K) -
Katsuyoshi HAYASHI, Hisashi MATSUMOTO, Motomi KASHIWAGI, Kouzou IGUCHI ...1994 Volume 36 Issue 6 Pages 1229-1234_1
Published: June 20, 1994
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 67-year-old male visited to our hospital with complaints of lower abdominal discomfort. Barium enema showed a giant pedunculated polyp which developed from the caecum, with a head size of 70 × 58 mm and stalk size of 18 mm. Colonoscopy revealed that the polyp was a submucosal tumor with a positive cushion sign. A CT scan obtained after Gastrografin® enema disclosed a tumor with a radiographic density similar to adipose tissue. The tumor was located in the ascending colon, well demarcated, and had a homogenous internal structure. MRI demonstrated T1 and T2 weighted images and the intensity of the tumor was similar to that of adipose tissue. On the basis of these findings, a diagnosis of colonic lipoma was made. The polyp was successfully ligated and polypectomized under endoscopic guidance by repeated applying clips to its stalk. Histological examination of the excised specimen (50 × 35 × 35mm) showed that the tumor was a lipoma. We can conclude that the procedure of repeated application of clips for the stalk of polyp before polypectomy is supposed to be safty method for a giant polyp.View full abstractDownload PDF (7321K) -
Chika IWABE, Hitoshi SHINDOU, Naoaki HAYASHI, Yoshihiko KAZAMA, Tatuji ...1994 Volume 36 Issue 6 Pages 1237-1243
Published: June 20, 1994
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA thirty-nine year-old Japanese man with Cowden's disease is presented. He had facial papules, aacal keratosis, gingival papillomatosis, and multiple follicular cyst on his breast and abdomen. He also had adenomatous goiter, multiple gastrointestinal polyps and pelvic arteriovenous malformations. A diagnosis of Cowden's disease with arteriovenous malformations is rare, he is the first case of Cowden's disease in Japan complicated with pelvic arterioven ous malformations. The dysfunction of the immune systems has been pointed out in Cowden's disease. Our H LA typing research revealed that, five of four patients had A2 antigen.View full abstractDownload PDF (4079K) -
Takahiko NAKAMURA, Yoshimichi IMAMURA, Takahiro IKEMURA, Kazuhiro FUJI ...1994 Volume 36 Issue 6 Pages 1245-1249_1
Published: June 20, 1994
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 21-year-old male was admitted to our hospital because of epigastric pain and bloody stools. Six years earlier, he was diagnosed to have ulcerative colitis and had since been well with salazosulf apyridine. Laboratory data on admission showed anemia and leucocytosis with remarkable eosinophilia. Colonoscopic examination revealed typical findings of active ulcerative colitis. Gastroendoscopy revealed multiple mass-like protru-sions in the lower body and angular region. Biopsy specimen from the stomach revealed diffuse infiltration of eosinophils in the mucosal and submucosal layers. The diagnosis was made as eosinophilic gastroenteritis associated with ulcerative colitis. His clinical symp-toms and eosinophilia were improved significantly with corticosteroid therapy.View full abstractDownload PDF (6289K) -
Kazuhiro NAGAO, Seiichi HIMENO, Kazuo KIRIYAMA, Yutaka NAGASAWA, Hiroy ...1994 Volume 36 Issue 6 Pages 1250-1254_1
Published: June 20, 1994
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 64-year-old female was admitted for the investigation of constipation. Conoloscopy and CT scan revealed an advanced cancer of the ascending colon and an egg-sized cyst which was located close to the cancer. Operation and pathological findings revealed that ascending colon cancer of stage IV (well differenciated adenocarcinoma) and a monolocular cyst, 7 × 6 × 6cm in size, were present and that the cancer penetrated into a part of the cyst wall. Immunohistochemical study showed that lining cells of the cyst were positive for keratin and vimentin, and negative for CEA and factor VIII. These results indicated that the cyst was of mesothelial origin. This is the first case report of colon cancer coexisting with mesothelial cyst.View full abstractDownload PDF (6739K) -
Yoshito KAWASE, Arata MOTOYAMA, Toshiya TAKEMURA, Naoya IGAKI, Tomio Y ...1994 Volume 36 Issue 6 Pages 1255-1260_1
Published: June 20, 1994
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSWe successfully implanted the Z stents covered with polyurethane membrane inmalignant biliary strictures. Polyurethane membrane was prepared with solid polyureth-ane and tetrahydrofulan. The covered stents were implanted percutaneously in 3 cases (two pancreatic cancers and a cancer of gallbladder) and endoscopicaly in a case of cancer of gallbladder. None of obstruction was confirmed for 5-7 months of follow-up period. In a case of pancreatic cancer patency of the stents was confirmed by percutaneus cholangioscopy and peroral duodenoscopy. None of obstruction of the stents with tumor ingrowth and sludge was confirmed despite no endothelialization of the stents. Polyurethane is a useful material because of low encrustation rate with bile and its flexibility. The covered stents with polyurethane would be widely applied for the implantation of the bile duct.View full abstractDownload PDF (7588K) -
[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...1994 Volume 36 Issue 6 Pages 1263-1273
Published: June 20, 1994
Released on J-STAGE: May 09, 2011
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1994 Volume 36 Issue 6 Pages 1274-1283
Published: June 20, 1994
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSDownload PDF (1726K) -
1994 Volume 36 Issue 6 Pages 1283-1297
Published: June 20, 1994
Released on J-STAGE: May 09, 2011
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1994 Volume 36 Issue 6 Pages 1297-1324
Published: June 20, 1994
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSDownload PDF (4814K)
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