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Volume 38, Issue 11
Displaying 1-15 of 15 articles from this issue
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Haruhike OKAMOTO, Yasuo SAKAI, Tatsuo TANI, Toshiyuki YAMAZAKI, Takayu ...1996 Volume 38 Issue 11 Pages 2577-2582_1
Published: November 20, 1996
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSIn 57 colorectal submucosal invasive cancers (sm cancers), endoscopic findings such as stiffness, irregular form, scale like surface pattern and visible vessels in submucosal layer were investigated to clarify the characteriss of sm cancers. The findings such as stiffness and irregular form are a little subjective, but scale like surface pattern and visible vessels are objective findings. Sm cancers were divided into two groups according to the shape of tumor. Ip and Isp type tumors were in (semi-) pedunculated group, and Is, IIa and IIa+IIc type tumors were in sessile group. Depth of invasion was classified into three groups (sml, sm2 and sm3) according to Kudo's classification. In the lesions of sm2 or sm3 (so called massively invasive cancers), those findings were frequently recognized. In (semi-) pedunculated group, stiffness was observed in 85.7% of lesions, irregular form 85.7%, and in sessile group stiffness 91.7%, scale like surface pattern 45.8% and visible vessels 41.7%. Concerning the shape of tumor, 70.6% of the Is type tumors were massively invasive cancers, and in the IIa+IIc type tumors we could diagnose sml invasion precisely by definite depression. We concluded that scale like surface pattern and visible vessels are most objective and distinctive endoscopic findings and that Is and IIa + IIc type is the most distinctive shape of colorectal sm cancers.View full abstractDownload PDF (6122K) -
Yoshio SAKAI, Yasuhiro TAKEMORI, Yatsugi NODA1996 Volume 38 Issue 11 Pages 2583-2590_1
Published: November 20, 1996
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSIn 2 cases who revealed AGML after an upper gastrointestinal endoscopic examination, we discussed about the diagnosis of H. pylori infection and the character of H. pylori in respecst of gene. To detect H. pylori infection, H. pylori quantative culture, rapid urease test (CLO test), urea breath test, H, pylori PCR (Polymerase Chain Reaction) and light microscopic examination by both Gram's stain and immunostaining were performed using biopsy specimens taken from the greater curvature of the antrum as well as the corpus on each case. Besides PCR method of cag A and vac A gene, RFLP (Restrictive Fragment Length Polymorphism) method of ure B and ure C gene were performed with regard to the gene of H. pylori. The following results were obtained. (1) In two cases, H. pylori culture were positive, though the number of bacilli was small. Immunostaining were positive at the corpus, whereas Gram's stain, CLO test and urea breath test were negative. (2) RFLP of ure B and ure C gene proved that two strains cultured from each case were different. (3) Each strain had both cag A and vac A gene. These findings indicate that it is difficult to diagnose the H. pylori infection in AGML caused after an endoscopic examination and that different strains of H, pylori which may cause AGML possess cag A gene and vac A gene.View full abstractDownload PDF (6295K) -
Hironao MIYOSHI, Kazuo INUI, Saburo NAKAZAWA, Junji YOSHINO, Kenji YAM ...1996 Volume 38 Issue 11 Pages 2593-2602
Published: November 20, 1996
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSUltrasound imaging of benign stenosis of the Vaterian bile duct was examined with a thin ultrasonic probe for intraductal scanning. Nine cases were diagnosed as benign stenosis of the Vaterian bile duct and they were compared cholangiographically with 12 normal papilla cases. A four layered structure was imaged in normal papilla cases, when the probe was in close contact with the inner luminal wall of the papilla. When there was no close contact, the first low echoic layer from the probe side demonstrated separation into two layers, one with a high echo, termed la, and the other with a low echo, termed lb, so that a total of 5 layers were imaged. This was the case for imaging of 5 of the 9 (55.6%) cases of benign stenosis of the Vaterian bile duct and 3 of the 12 normal cases. Ultrasonic images of benign stenosis of the Vaterian bile duct showed first layer thickening, or la and/or lb thickening. Comparing with the results of cholangiography, la thickening mainly corresponded to types I or II, while visualization of lb thickening coincided with type III.View full abstractDownload PDF (7790K) -
RELATIONSHIP BETWEEN PORTAL PRESSURE AND ENDOSCOPIC FINDINGSHidenori KANAZAWA, Norihiko TADA, Satoshi MATSUSAK, Yuuji OSADA, Nobuh ...1996 Volume 38 Issue 11 Pages 2603-2609
Published: November 20, 1996
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSTo clarify the effects of decrease in portal pressure achieved by transjugular intrahepatic portosystemic shunt (TIPS) on esophageal varices, post-TIPS portal pressure and endoscopic findings of esophageal varices after TIPS were compared in 30 patients with liver cirrhosis. TIPS lowered the mean portal pressure from 23±4mmHg to 12±3 mmHg, with 48% decrease. Esophageal varices improved in all cases from before TIPS (F2: 13cases, F3: 17cases/RC+7cases, RC++: 9cases, RC+++:14cases) to after TIPS (F0: 8cases, F1: 12cases, F2 : 9cases, F3: lcase/RC- : 24cases, RC+: 5cases, RC++: lcase). Nineteen out of 30 patients improved to F0 or F1RC- a month after the procedure. The mean post-TIPS portal pressure in FO, Fl and F2 groups after TIPS differed significantly each other and the smaller F-group showed lower post-TIPS portal pressure. In addition, the mean post-TIPS portal pressure of the patients in which RC signs disappeared after TIPS was significantly lower than that of patients in which RC signs remained after TIPS. These results suggest that the improvement of esophageal varices after TIPS is influenced by post-TIPS portal pressure and the lower post-TIPS portal pressure induce the greater improvement of esophageal varices.View full abstractDownload PDF (969K) -
Atsushi MINAMI, Toshiaki NAKATSU, Uchida NAOHITO, Tohru EZAKI, Hiroki ...1996 Volume 38 Issue 11 Pages 2610-2614
Published: November 20, 1996
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSEndoscopic Papillary Dilation (EPD) and Endoscopic sphincterotomy (EST) were attempted in 30 patients with bile duct stones All of the stones were less than 1.2 cm in diameter. Extraction of stones was performed successfully in both groups. No serious intraoperative complications were observed. Laboratory tests before and after treatments included white blood cell (WBC) counts, serum C-reactive protein (CRP) levels, serum amylase, and serum total bilirubin. No significant difference in blood chemistry analysis were found between EPD and EST before or after treatment, except for serum total bilirubin levels which elevated in EST patients (p < 0.001) . Complications of mild pancreatitis were observed in three patients (10%) in EPD group and two patients (7%) in EST group. In one day of conservative management, they showed complete recovery. No patient experienced post-treatment bleeding. We conclude that therapeutic effectiveness of removal of bile duct stones is almost same between EST and EPD.View full abstractDownload PDF (2074K) -
Katsuya NAKANO, Akiko HARADA, Rie MANABE, Masamichi TANINO, Tsuguhiro ...1996 Volume 38 Issue 11 Pages 2615-2619_1
Published: November 20, 1996
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSWe reported herein a case of Barrett's esophagus in which the process of development was endoscopically observed. A 61-year-old male was admitted to our hospital due to malignant lymphoma of the stomach. Total gastrectomy with splenorectomy and adjuvant chemotherapy were performed. He then developed retorosternal discomfort and hearburn after the operation. Endoscopic examination 3 months after the operation showed severe reflux esophagitis due to duodenal contents. A velvety pink mucosa appeared on the lower esophagus up to 2 cm above the anastomosis 6 months after the operation and sperad up gradually and finally 6 cm above the anastomosis 18 months after the operation. Biopsy specimen taken from the velvety pink mucosa of the esophagus showed columnar epithelium with many goblet cells and Paneth cells resembling intestinal mucosa. Also pyloric gland-like glands were found at the bottom of the mucosa. Barrett's esophagus may develop in a short period after total gastrectomy and the periodical endoscopic follow-up is recommended.View full abstractDownload PDF (5093K) -
Ichizo TSUJINO, Hideyuki SEKI, Syuuichi KITAHAMA, Hirohide HAMAMOTO, T ...1996 Volume 38 Issue 11 Pages 2620-2624_1
Published: November 20, 1996
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 34-year-old man came to our hospital with a complaint of epigastric discomfort. Upper gastrointestinal endoscopy revealed a sessile polyp of about 1.5 cm in diameter just proximal to esophagogastric mucosal junction. Polypectomy was performed and histological examination showed granulation tissue with irregular epithelial hyperplasia and inflammatory cell invasion. Inflammatory esophagogastric polyp is rare among benign tumors of esophagus, but it must be noted as one of the important diseases in differential diagnosis of elevated lesion of esophagus.View full abstractDownload PDF (3431K) -
Kenichi SUMIYOSHI, Shigeki KOYAMA, Hitoshi SAKUMOT, Akira ANDOH, Yoshi ...1996 Volume 38 Issue 11 Pages 2627-2633_1
Published: November 20, 1996
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSWe reported a case of early gastric cancer coexisting on submucosal tumors of the stomach. A 62-year old female visited our hospital with epigastric pain on May 10, 1994. Upper GI series revealed a protruding lesion in the cardia. Endoscopic examination revealed the lesion with erosion and redness on the surface. Biopsy specimens obtained from the lesion were interpreted as well differentiated adenocarcinoma. Endoscopic ultrasonography revealed two low echoic masses in the fourth layer under the tumor. Under a diagnosis of early gastric cancer on two leiomyomas at the cardia, proximal distal gastrectomy was performed. On histlogical examination, the protruding lesion was an early gastric cancer invading the submucosal layer on the leiomyomas locating in the muscularis propria. Gastric cancer coexisting on submucosal tumor has been rarely reported in Japan. This case was the 3rd one in the last 15 years.View full abstractDownload PDF (9030K) -
Hirofumi FUKE, Hyoe SATO, Hirotaka HIGASHIYAMA, Iccho WAKI, Akira KAME ...1996 Volume 38 Issue 11 Pages 2634-2639_1
Published: November 20, 1996
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 36-year-old female was admitted to our hospital because of massive gastrointestinal bleeding on August, 30th, 1994. Emergent endoscopy revealed a type IIc+III early gastric cancer with an exposed vessel on the anterior wall of the middle body of the stomach, in which hemoclips and a gelform injection were succesfully performed. Endoscopic ultrasonogram demonstrated an abnormal vessel like a string in the submucosal layer. Resected specimen showed a type IIc+III lesion mesuring 2.5 cm in diameter. Histological finding showed a signet ring cell carcinoma partially invading the submucosal layer. Enlarged musclar vessels were shown in it. We diagnosed this case as a type IIc +III early gastric cancer presenting as Dieulaf oy's ulcer on the basis of the endoscopical and pathological findings.View full abstractDownload PDF (7810K) -
Haruko SHIRAISHI, Shinzo KATOH, Hiroshi SERIZAWA, Shigeru KOYAMA, Hiro ...1996 Volume 38 Issue 11 Pages 2640-2649
Published: November 20, 1996
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 21-years old female patient with Crohn's colitis in whom abnormal findings were colonic aphthoid lesions alone, was presented. She came to the hospital on May 1993 because of iron deficiency anemia, and the fecal occult blood was positive. Barium enema study revealed a polypoid lesion about 3 cm in diameter in the sigmoid colon. The polyp was resected endoscopically and was diagnosed as juvenile polyp histologically. Although colonic mucosa except polypoid lesion seemed to be normal, non-caseous granuloma was demonstrated in the submucosa of polypectomied specimen retrospectively. Six months later, 2nd colonoscopy was performed because of abdominal pain and bloody stool. It showed multiple aphthoid erosions of 1-3 mm in diameter surrounded with red halo through entire colon and they were arranged longitudinal in the terminal ileum. Biopsy specimen revealed non-caseous granuloma with cellular infiltration. Crohn's disease was diagnosed and symptoms was improved after administration of sulfasarazopyridine (3g/day). On October 14th 1994, colonofiberscopy showed no aphthoid erosions in the rectum but multiple tiny elevated lesions which showed lymphoid follicular formation histologically. But aphthoid lesions in the terminal ileum remained unchanged. This is the first report of Crohn's colitis which demonstrates non-caseous granuloma before the appearance of the aphthoid lesions.View full abstractDownload PDF (9925K) -
Koji SANO, Kiyotaka OKAWA, Kenji WATANABE, Naoko HAMASAKI, Hiroyasu MO ...1996 Volume 38 Issue 11 Pages 2651-2655_1
Published: November 20, 1996
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSThe patient was a 37-year-old female with a chief complaint of diarrhea. Endoscopic examination revealed one minute-carcinoid in the rectum. On endoscopic resection, another minute-carcinoid was detected in its vicinity, and both lesions were resected completely under endoscopy. Multiple rectal carcinoids are a rare disease, with only 10 cases having been reported in Japan including the present case. The lesions could be resected by endoscopic operation in only 2 cases including ours. Multiple rectal carcinoids are often complicated with malignant tumors (50%), and careful follow-up is considered to be needed.View full abstractDownload PDF (4589K) -
Hirokazu INOUE, Kazuhito ICHIKAWA, Takeo UKITA, Akihiro TAMURA, Hiroak ...1996 Volume 38 Issue 11 Pages 2656-2661_1
Published: November 20, 1996
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 84-year-old female was suspected gallbladder carcinoma by conventional urtrasono-graphy. For definite diagnosis, she received percntaneous transhepatic cholecystscopy (PTCCS) and intraluminal ultrasonography by ultrasonic probe under the PTCCS and diagnosed of IIb + I type gallbladder carcinoma was made. Intraluminal ultrasonography revealed that The wall of the gallbladder had 3 layers; 1 hypo and 2 hyperechoic layers. The elevated lesion could be detected but the depth of the flat lesion could not be evaluated.View full abstractDownload PDF (7269K) -
Tadayuki OHSHIMA, Yasutaka KAMIYA, Makoto HOSHINO, Tomihiro HAYAKAWA, ...1996 Volume 38 Issue 11 Pages 2662-2669
Published: November 20, 1996
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSWe managed a case of gallbladder and bile duct stones with a hiliobiliary fistula, using duodenoscopic pulsed dye laser lithotripsy. A 56-year-old man visited a local physician with complaints of abdominal fullness and dark urine. He was diagnosed as having obstractive jaundice with bile duct stones. He was transferred to our hospital for removal of the stones after endoscopic naso-biliary drainage. Lithotomy was performed four times using duodenoscopic pulsed dye laser methods because of alcoholic liver cirrhosis. The impacted stones in the common hepatic duct were fragmented without serious complica-tions and were completely removed from the bile duct. However, the gallstones continued to come out one after another from the bile duct through the biliobiliary fistula. Then, laser lithotomy was performed an additional four times and the stones in the bile duct were completely removed except for one large gallstone. The patient remains free of bile duct stones at two years and two months after discharge.View full abstractDownload PDF (7742K) -
Jun ISHIGURO, Hirokazu INOUE, Tadayoshi KAKEMURA, Tamotsu ANZAI, Satos ...1996 Volume 38 Issue 11 Pages 2670-2676_1
Published: November 20, 1996
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 47-year-old male was admitted in our hospital because he was detected the pancre-atic tumor by ultrasonography (US) in another hospital. It was diagnosed as a mucin producing pancreatic tumor (MPT) by US, endoscopic ultrasonography (EUS) and endo-scopic retrograde cholangiopancreatography (ERCP). Intra pancreatic ductal ultrasonography (IDUS) showed cleary the low echoic area at the site of tumor invasion. The distal margin of the elevated lesion showed as a border between localized low echoic area and the smooth pancreatic duct. Pancreatoduodenectomy was perf ormedand histological diagnosis of the tumor was intraductal adenocarcinoma. And the IDUS in the resected specimen showed the same image as preoperative one. IDUS is useful to determine the suitable site for the surgical resection.View full abstractDownload PDF (9239K) -
Osamu MUROBAYASHI, Yoshitake SATOMURA, Hiroshi YONEJIMA, Hiderou OGINO ...1996 Volume 38 Issue 11 Pages 2677-2681
Published: November 20, 1996
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSWe investigated endoscopic retrograde cholangiopancreatography (ERCP) findings for 2 cases of pancreatitis with hyper-parathyroidism (HPT). Case 1: A 44-year-old man admitted to the hospital because of nausea, vomiting and upper abdominal pain in Septem-ber 16, 1994. He was diagnosed as acute pancreatitis and discharged after treatments. However he sometime had complained the same symptoms. He readmitted to the hospital because of severe abdominal pain. Laboratory data on admission showed elevated serum levels of pancreatic enzymes and calcium (Ca). Cervical ultrasonography was performed and parathyroid adenoma was detected. He was diagnosed as pancreatitis with HPT and parathyroidectomy was performed. After the operation, he has had no symptom and laboratory data have been within normal range. Case 2 : A 75-year-old man visited our hospital because of vomiting and upper abdominal pain in July 5, 1995. Elevated serum amylase and serum Ca level were found. Cervical ultrasonography revealed parathyroid adenoma. He was diagnosed acute pancreatitis with HPT and parathyroidectomy was performed. After parathyroidectomy, he has complained no symptoms and laboratory data have returned to normal range. We performed ERCP for both cases. In ERCP findings of case 1, pancreatic duct was almost normal, and case 2 revealed mild irregularity in main pancreatic duct and slightly dilated branches. Both cases showed the almost normal pancreatgrams and it was suggested that acute relapsing pancreatitis was developed by hypercalcemia due to HPT.View full abstractDownload PDF (3512K)
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