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Volume 38, Issue 4
Displaying 1-12 of 12 articles from this issue
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Masumi KOSHIYAMA1996 Volume 38 Issue 4 Pages 1001-1010
Published: April 20, 1996
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSThe relationship between ABO blood group and mucosal infiltration pattern of H, pylori (HP) was examined. One hundred and thirty-six patients who had undergone upper-gastroduodenoscopy were enrolled. The mucosal infiltration pattern of HP was assessed according to a five-degree classification (range 0-4) using histological sections. Fasting blood samples were taken to examine the ABO blood group and serological diagnosis of HP infection. The serological prevalence of HP infection was 73.8% in blood type A, 47.5% in type B, 30.0% in type AB and 72.7% in type 0 (type A vs B : p< 0.025, type A vs AB : p < 0.01, and type 0 vs B or AB : p < 0.025) . The histological density score and the infiltration score of HP were highest in blood type 0 in both antrum and corpus, and these scores were significantly higher in both type 0 and A compared with type B and AB groups in antrum (type 0 vs B : p < 0.002, type 0 vs AB : p < 0.01, and type A vs B or AB : p <0.05) . The titers of serum anti-HP IgG antibody in blood type A and 0 were significantly higher than those in blood type B and AB, similarly. A close correlation was observed between the titer of serum anti-HP IgG antibody and the density score of HP or the infiltration score of HP. In conclusion, we suggest that the ABO blood antigen was implicated as a co-f actor in the attachment of HP on gastric mucosa and that titer of serum anti-HP IgG antibody reflected the grade of HP density and bacterial mucosal infiltration.View full abstractDownload PDF (1452K) -
Manabu MUTO, Yasutoshi SAITO, Tomoyuki KOIKE, Katsunori IIJIMA, Takano ...1996 Volume 38 Issue 4 Pages 1011-1019
Published: April 20, 1996
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSTo clarify the clinical management of histological margin positive cases after endoscopic mucosal resection (EMR) for early gastric cancer, we analyzed the therapeutic effect of additional treatment and the frequency of residue or recurrence after EMR in histologically incomplete resection cases. EMR was done for 91 cases in our hospital. 66 cases could be follow up and estimated for this study. As additional treatments for histologically incomplete resection cases, surgical resection was performed in 6 cases, laser irradiation was done in 9 cases, and electrocautery was done in 13 cases. Histologically, cancer remnant were not seen in any surgical resected specimens. Among 22 cases who received endoscopic additional treatment because of histological positive margin, residue of the cancer was demonstrated in two cases (9.1%). However, in 38 cases who showed histological negative margin, no cases was found to have residue or recurrnce. We conclude that immediate endoscopic additional treatment was effective for reducing the rate of residue and recurrence in the cases of histological positive margin after EMR.View full abstractDownload PDF (3170K) -
Mikihiro FUJIYA, Hisanobu TOMIMATU, Norio MITUNAGA, Hirosi SENOKUCHI, ...1996 Volume 38 Issue 4 Pages 1020-1028_1
Published: April 20, 1996
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSSmall red spots that are often found in the stomach on endoscopic study can be benign or malignant lesions of various types, but their differentiation is not so easy. Considering their characterization to be of clinical value, 460 red spots were studied endoscopically. Of the 460 lesions, 415 were found by histopathological examination to be non-tumorous and 45 tumorous (24 minute cancers, 19 small cancers, 2 atypical epithelial lesions). The non-tumorous lesions were classified into a group of active erosions, a group of erosion being repaired, and a group of gastritis-like lesions. Endoscopic appeances were compared with those of tumorous lesions. There was a significant difference between the active erosions and the erosion being repaired with respect to only the marginal elevation of lesions, but their differentiation needed with the aid of biopsy. The group of erosions being repaired was difficult to differentiate from the group of gastritis-like lesions. Compared to the benign small red spots, the minute cancers were characterized by the granular marginal elevations with irregular depressed border, and spinous protrusions. The frequencies of lesions hard to differentiate from minute cancers were, erosions being repaired (26.1%), active erosions (9.3%), and gastritis-like lesions (6.9%), in a decreasing order.View full abstractDownload PDF (5813K) -
Toshihiro MORITA, Hisao FUJII, Katsuhiko YAMAMOTO, Hirohumi ISHIKAWA, ...1996 Volume 38 Issue 4 Pages 1029-1037
Published: April 20, 1996
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSThe aim of this paper is to study the clinical characteristics of gangrenous ischemic colitis (GIC). We reported our 6 cases of GIC and, for comparsion, presented our 71 cases of transient ischemic colitis (TIC) during 12 years between 1982 and 1993. 1) In TIC some of patients were young or without associated diseases, but in GIC, almost patients were aged or had some associated diseases. 2) TIC was mainly caused by the intestinal factor such as increased intraluminal pressure, whereas GIC by the vessel factor such as arteriosclerosis, and it was suggested intervention of blood factor such as thrombocyte. 3) Favorite sites of GIC were in left side colon, and so flexible sigmoidoscopy was useful examination for a diagnosis of GIC. 4) As treatment of GIC, it was important to resect the necrotic colon extensively. 5) For postoperative care, attention must be paied for the associated diseases and complication, especially, blood coagulopathy.View full abstractDownload PDF (3831K) -
Tadanori SAIT, Shigeyuki IKEDA, Toshihiro TAKAZAWA, Hiroaki MIURA, Tos ...1996 Volume 38 Issue 4 Pages 1038-1046_1
Published: April 20, 1996
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSEndoscopic Ultrasonography (EUS) was performed in 12 patients having one of the following 7 relatively rare rectal disorders to assess its value : submucosally localized recurrent rectal cancer (2 patients) ; carcinoid tumors, (3) ; leiomyoma, (2) ; leiomyosarcoma, (1) ; mucosal prolapse syndrome (polypoid), (1) ; heterotopic endometriosis, (2) and fibroma, (1). Regionally recurrent rectal carcinomas were located in the area from the rectal wall exterior to the submucosa, and appeared as hypoechoic regions with slightly irregular margins and a spotty hyperechoic interior. Carcinoid tumors were well-defined and almost homogeneous, and were displayed as slightly hyperechoic when compared to the fourth layer. Leiomyomas showed less irregularity in their margins and interiors, and no internal unechoic regions were present. On the other hand, the leiomyosarcoma showed an irregular margin and interior, and hypoechoic as well as hyperechoic regions were intermingled internally. Mucosal prolapse syndrome (polypoid) was depicted as relatively hyperechoic, mainly in the submucosal layer, with a sporadic hypoechoic interior. In heterotopic endometriosis, the fourth and fifth layers became a lump and it appeared as a thick, ill-defined hypoechoic region. The fibroma appeared to be relatively homogeneous and hypoechoic. These findings indicated that EUS was useful for differentiating these diseases.View full abstractDownload PDF (10990K) -
Naoto KANEMAKI, Saburo NAKAZAWA, Kenji YAMAO, Junji YOSHINO, Kazuo INU ...1996 Volume 38 Issue 4 Pages 1047-1056
Published: April 20, 1996
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSBetween December 1993 and September 1994, endoscopic transpapillary gallbladder drainage (ETGBD) was performed on 13 patients with cholecystitis caused by cystic duct obstruction by impacted gallstones, 11 acute and 2 chronic cases. In 10 of the 13 cases (76.9%) a catheter could be cannulated into the cystic duct. In 7 of the 13 cases (53.8 %) a drainage tube was placed in the gallbladder by removal of impacted stones and ETGBD was successful. Moreover, in 3 of 7 ETGBD successful cases gallstones could be treated by external shock wave lithotripsy (ESWL) utilizing drainage tubes. Suitable conditions for ETGBD application for cystic duct obstruction by impacted stones were as follows. 1) acute cholecystitis, 2) under 15 mm impacted stone size, 3) no gallbladder swelling and no severe wall thickening on ultrasonography, 4) over 4 mm cystic duct diameter. We conclude that ETGBD is a useful method for treatment of acute cholecystitis caused by cystic duct obstruction by impacted stones.View full abstractDownload PDF (5728K) -
Nobuo SUEOKA, Hitoshi NISHIGAKI, Katsuhiko IWAKIRI, Tsukasa TAKEUCHI, ...1996 Volume 38 Issue 4 Pages 1057-1062_1
Published: April 20, 1996
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 68-year-old female was admitted to our hospital in March 1995 with the history of anemia and abdominal fullness. The endoscopic examination showed Barrett's esophagus (BE) with esophageal hiatal hernia. The squamo-columnar mucosal junction was clearly demonstrated determined defined in the middle esophagus. And we could observe the micro-pattern of the BE mucosa. The length of BE was 7cm. Biopsy specimens obtained from the lesion demonstrated regenerating columnar epithelium with goblet cell meta-plasia. Endoscopy was initially first performed in Novembeer, 1990 at another hospital. It revealed esophageal ulcer above the lower esophageal sphincter (LES), and the creeping type of columnar epithelium was observed (2 cm from LES). Then, she had been medicated with ranitidine 300mg/day and sucralfate 4g/day. Two endoscopic examination were performed after the first endoscopy, the diagnoses were also ref lux esophagitis. Retrospec-tively, in this case, we presumed suspect that BE developed 5cm for 4.4 years. And this case was considerd an aquired disorder associated with gastro-esophageal reflux.View full abstractDownload PDF (5923K) -
Kyoko YUHARA, Tsugio EBIHARA, Yoshimi TAKANO, Jyun-ichi SATOH, Hisayuk ...1996 Volume 38 Issue 4 Pages 1063-1067_1
Published: April 20, 1996
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSThis report described a case of successful endoscopic sphincterotomy via gastrostomy for common bile duct stone removal. A 70-year-old man with advanced esophageal cancer treated by radio-and chemotherapy developped cholangitis due to two common bile duct stones. He required gastrostomy because of nutrition and severe esophageal stenosis. Ten days after surgical gastrostomy, an endoscope was inserted into the duodenum via gastros-tomy, and endscopic sphincterotomy was performed. Common bile duct stones were removed by endoscopic mechanical lithotripsy.View full abstractDownload PDF (4233K) -
Naoya MIURA, Tetsurou HAMAMOTO, Katsuo OKADA, Naoya NOGUCHI, Akeri MIT ...1996 Volume 38 Issue 4 Pages 1068-1072_1
Published: April 20, 1996
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 73-year-old woman had been followed up for three years with a diagnosis of RLH. The tenth biopsy report suggested possible malignant lymphoma, and she was admitted to our department for further examination. Southern blot analysis by JH prove using EMR samples revealed rearranged band. We adviced her to receive operation with the diagnosis of MALT lymphoma, but she refused surgical treatment. Helicobacter pylori was detected by both culture and urease test using biopsy samples, and so we tried antibiotic therapy. After treatment, endoscopic and histological findings became almost normal. There is no report like this case in Japan and it is interested that anti-HP treatment should be beneficial for MALT lymphoma.View full abstractDownload PDF (3043K) -
Hideo TEZUKA, Hideki MATSUYAMA, Yuji SUGIYAMA, Takehiro OHTA, Yuji INO ...1996 Volume 38 Issue 4 Pages 1075-1081_1
Published: April 20, 1996
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSWe reported a case of gastrocolic fistula due to gastric ulcer without previous abdominal surgery. A 42-year-old female was admitted to our hospital because of nausea, vomiting, epigastric pain and body weight loss of 15kg in 6 months. Endoscopic and X-ray examination showed a gastrocolic fistula due to gastric ulcer. We could observed a mucosal elevation of the transeverse colon and inflow of feces on the bottom of the gastric ulcer through endoscopy. She underwent a distal gastrectomy and partial resection of the transverse colon. Microscopically, Gastric and intestinal mucosa were seen on the margins of the gastric ulcer and there was no evidence of malignancy in this lesion. We thought that the cause of this disease was based on adhesion due to chronic inflammation of gastric ulcer. This disease extremely rare and only 15 cases have been reported in the Japanese literature.View full abstractDownload PDF (7817K) -
Yuka ENDO, Hirofusa SATO, Kiyoaki HANZAWA, Hiroaki KAWARADA, Masanori ...1996 Volume 38 Issue 4 Pages 1082-1085_1
Published: April 20, 1996
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSWe reported one case of acute pancreatitis caused by obstruction of papilla Vater with vegetable matter. A 44-year-old female visited our hospital because of severe epigastric pain. Her laboratory tests showed hyperamylasemia of 675 IU/l and leukocytosis of 11, 200/mm3. She was treated as acute pancreatitis, and her clinical condition improved rapidly. On the examination of the endoscopic retrograde cholangio-pancreatography, a yellowish firm string, protruding 0.5 cm from the papilla, was found. This string was confirmed to be vegetable material of unknown species, and was considered to induce pancreatitis through the obstruction of papilla Vater.View full abstractDownload PDF (4525K) -
Yasuhide OCHI, Kenji MUKAWA, Shinya MAEJIMA, Naoyuki FURUYA, Akira HOR ...1996 Volume 38 Issue 4 Pages 1086-1090_1
Published: April 20, 1996
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 46-year-old man was introduced to Shinshu university hospital in May 1995 with a complain of recurring hypochondralgia due to cholelithiasis. He had received Billroth II gastrectomy at 31 years old. Endoscopic retrograde chorangiopancreatography showed a bile duct stone of 8 mm in diameter, and we performed endoscopic removal of bile duct stone with balloon dilation of the sphincter of Oddi. After diagnostic cholangiography, a balloon-tipped biliary catheter was positioned across the papilla and inflated for dilating the sphincter of Oddi. The papilla was sufficiently dilated to extract the stone easily with a retrieval balloon catheter. After the procedure, the serum amylase level was elevated (369U/l), but pancreatitis did not occur. There was no other associated complications. This technique was useful to remove the stone safely and easily in this case.View full abstractDownload PDF (5304K)
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