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Volume 39, Issue 1
Displaying 1-17 of 17 articles from this issue
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[in Japanese]1997 Volume 39 Issue 1 Pages 1
Published: January 20, 1997
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSDownload PDF (109K) -
[in Japanese]1997 Volume 39 Issue 1 Pages 2
Published: January 20, 1997
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSDownload PDF (121K) -
-AN EXPERIMENTAL STUDY-Norichika NARIMIYA, Tsutomu TAKEUCHI, Izumi SUGIMOTO, Hiroko HAMADA, T ...1997 Volume 39 Issue 1 Pages 3-9
Published: January 20, 1997
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSSubmucosal blood vessels of the stomach can be visualized by means of an inflared ray electronic endoscope. In the present experimental study the effect of endoscopic mucosal resection (EMR) on submucosal blood vessels of the stomach was explored by performing the surgical procedure under infrared ray electronic endoscopic vision. Ten adult dogs were used for the study. On infrared ray electronic endoscopy those submucosal blood vessels which were injured at the time of EMR and hence became the sources of hemor-rhage caused by EMR were visualized as an arborescent appearance of vessels, at around 2 mm in diameter, in C area. On microangiogram of the area where blood vessels were visualized by infrared ray electronic endoscopy, venules running transversely in the sub-mucosa before their portal of entry into the muscularis externa and an arteriole ac-companying them was found. When EMR was performed on the same mucosal area as described above and its injurious effect on the above-specified submucosal vessels was examined by microangiography, it became obvious that while a vascular injury caused by EMR involving a mucosal area <10 mm in longer diameter was slight, as high a vascular injury rate as 85.7% was noted for EMR involving a mucosal area >15 mm in longer diameter. Most of vascular injuries caused by EMR were accounted for by rupture of vessels running transversely in the submucosa at margins of the mucosal area undergoing EMR, although rupture of submucosal vessels in close proximity to their portal of entry into the muscularis externa was occasionally seen.View full abstractDownload PDF (7738K) -
Takanori KOYAMA, Chika MATSUNAGA, Shin-ichi OGATA, Takahiro NODA, Yosh ...1997 Volume 39 Issue 1 Pages 10-18
Published: January 20, 1997
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSWe performed this study in order to determine the benefits and limitations of endoscopic hemostasis for bleeding peptic ulcer and analyzed the accumulated data on patients who underwent emergent endoscopy at our hospital during a 14-year-period. Most of 12 cases with bleeding gastric ulcer requiring emergent surgery were severe (Nagao's Classifi-cation) cases with spurting lesions located on the lesser curvature to posterior wall of the angulus or body of the stomach. The pathological findings showed that the ulcer bases of these surgical cases were characteristic of causative vessels. Seven patients with gastric ulcer and 6 patients with duodenal ulcer expired within 30 days from the onset. Most of these mortal patients were severely ill cases and had other severe underlying diseases. In the mortal cases with duodenal ulcer, the endoscopic findings were characteristic, of the features of acute ulcers located in the postbulbar portion. In the retrospective analysis of bleeding duodenal bulbar ulcers, rebleeding rates of the cases with nonbleeding visible vessels or adherent clots on the ulcer base, which cases underwent endoscopic treatment by spraying only thrombin and epinephrine, were 5.6% and 15.4%, respectively. These rates were significantly lower than those of the cases with gastric ulcers. These results indicate that the exposed vessels, location of the ulcers and underlying diseases are important factors that determine the prognosis of patients with bleeding ulcer.View full abstractDownload PDF (3027K) -
Yoshiki MIZUNO, Masamiki MORI, Kazunori KUMADA, Katsuo HAYASHI, Tadash ...1997 Volume 39 Issue 1 Pages 19-25
Published: January 20, 1997
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSDuring the period from 1982 to December 1994, 36 patients with amoebiasis were treated at our hospital. Twenty-one of them underwent a total of colonoscopic examina-tions. All of the patients were male, ranging in age from 28 to 84 years (median: 48.4 years). Twenty patients had amoebic colitis and nine had amoebic liver abscess. The most common sites of amoebiasis were the rectum and cecum. Diverse lesions were found at endoscopy, ranging from typical skip-like variolif orm elevated lesions, erosions, and erythema, to atypical cases of irregular fused ulcers. Ulcers and erosions were rapidly eliminated by treatment, but erythema persisted for a relatively long time. The endoscopic features of the nine patients with liver abscesses ranged from severe ulceration to no findings at all. A diagnosis of Entamoeba histolytica was verified in 16 patients (76.2%). It is necessary to use feces, lavage fluid, and biopsy concomitantly to improve detection.View full abstractDownload PDF (5959K) -
Ken-ichi SUMIYOSHI, Shigeki KOYAMA, Hitoshi SAKUMOTO, Akira ANDOH, His ...1997 Volume 39 Issue 1 Pages 26-32
Published: January 20, 1997
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSGastric adenoma was found 213 lesions in 190 cases among 14, 000 endoscopic studies during the period between Oct. 1978 and Apr. 1995. We studied the cases of gastric carcinoma with gastric adenoma which were classified into four groups based on same or different area and same time or follow-up periods. The frequency of gastric adenoma was 1.3% (mean age: 62.4). Male to female ratio was 1.9:1 in overall. The frequency of gastric carcinoma with gastric adenoma was 19.0% (36/190 cases). The cases of gastric carcinoma in adenoma were 14 cases (6.6%). These adenomas showed a reddish, large and/or depressed component. The cases of gastric carcinoma with adenoma in different area were 16 cases (7.5%). In all cases, gastric carcinoma were located at the same area or oral side of gastric adenomas. The cases of gastric carcinoma in adenoma found during the follow-up period were 5 cases and the case of gastric carcinoma with adenoma at different area found during the follow-up period was only one case. These observations indicated evidently that gastric mucosa with adenoma has the malignant potential as compared to normal mucosa without adenoma, suggesting that it may be possible to pick up high risk patients for malignancy based on endoscopic findings. When a patient has gastric adenoma, it is necessary to bear in mind that gastric carcinoma may develope in the same or different areas and at same time or during the follow-up period. Careful endoscopic observation of the same and oral side area of gastric adenoma is needed.View full abstractDownload PDF (792K) -
Iwao SASAKI, Koichiro OKAZAKI, Yoshimitsu INOMATA, Hiroaki SUZUKI1997 Volume 39 Issue 1 Pages 33-41
Published: January 20, 1997
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSTo achieve painless and safe total colonoscopy (TCS), 48 patients who underwent diagnostic and therapeutic procedures by TCS were generally controlled by conscious sedation and monitoring. Flunitrazepam (mean 12μg/kg) was administered intravenously for sedation before TCS and was added adequately according to the degrees of pain. Flumazenil, a specific antagonist of benzodiazepine, (mean 8μg/kg) was administered intravenously to reverse patients soon after TCS. All patients were monitored to detect early signs of distress before compromised vital function occured. This included changes in pulse rates, blood pressure, ventilatory status, cardiac electrical activity, and clinical and neurologic status. Pulse rates decreased slightly after sedation but the change was not statistically significant. Blood pressure decreased significantly (systolic blood pressure; p<0.01, diastolic blood pressure ; p< 0.05) after sedation and the decrease remained unchanged after the injection of the antagonist. The value of oxygen saturation decreased significant-ly (p<0.01) after sedation and rapidly returned to the former value after its reversal. Electrocardiographic rhythm showed no significaant change by sedation and its reversal. Pain scores of the sedation group (N=48) were significantly (p<0.01) low, compared with those of non-sedation group (N=8). In the sedation group, pain scores of previous lapar-otomy group (N=25) were significantly (p<0.05) high, compared with the scores of previous non-laparotomy group (N=23). In conclusion, the method of conscious sedation and monitoring is useful for the decrease of the pain and increase of the safety in TCS.View full abstractDownload PDF (2095K) -
Yuta NAKAMURA, Saburo NAKAZAWA, Kenji YAMAO, Junji YOSHINO, Kazuo INUI ...1997 Volume 39 Issue 1 Pages 42-51
Published: January 20, 1997
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSIntraductal ultrasonography of the pancreas was performed in 20 cases of Intraductal papillary tumor (IDT). Findings included multilocular cysts, increased wall thickness, mural nodules, mucus echos and mass with a mixed pattern of high and low echo. Mural nodules were observed only in cases of adenoma and adenocarcinoma. On the basis of the ultrasonographic findings and histopathological findings, the images of IDT were classified into four types : Type I lacked any nodule or wall thickening; Type II had a nodule or wall thickness under 3 mm ; Type III had a nodule or wall thickness over 4 mm, or a cyst including tumor ; Type IV had a mass with a mixed pattern, or interruption of the pancreatic duct wall. Type I or II tumors were confirmed to be hyperplasia or adenoma. Taking types III and IV as index of malignant findings, sensitivity was 100%, specificity was 82% and the accuracy rate was 89%. IDUS was usefull for differential diagnosis of benign and malignant IDT.View full abstractDownload PDF (8302K) -
Masayoshi YASUMURA, Kenshi NISHIMOTO, Toshikazu SHIOTANI, Motoi SHIMA, ...1997 Volume 39 Issue 1 Pages 52-55
Published: January 20, 1997
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 43-year-old male visited to our hospital with epigastralgia and nausea. Endoscopic examination was performed on January 16, 1993 and it revealed two reddish ulcerative lesions situated longitudinally at 32cm from the incisors in the posterior wall of the esophagus. Histopathological study of the biopsied specimens revealed cardiac gland tissue in connection with the normal esophageal squamous epithelium and diagnosed as ectopic gastric mucosa in the esophagus. Endoscopic examination performed on March 12, 1994 showed marked decrease in size of the distal legion. These findings were considered as a result of the defect of the esophageal mucosa which was replaced with columnar epith-elium, and this evidence might be in a process of being gradually replaced with squamous epithelium again. Thus, this case was considered to be an important one in the healing process of the esophageal mucosal injury.View full abstractDownload PDF (4121K) -
Masako MURAI, Toshiyuki KATO, Yukifumi SAITO, Nobuhiro AKIYAMA, Jiro T ...1997 Volume 39 Issue 1 Pages 56-61
Published: January 20, 1997
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 70-year-old female who had been followed-up at Niigata Cancer Center Hospital with gastric adenoma. Endoscopic examination revealed iodine-unstained esophageal lesion and elevated lesion on the middle body of the stomach. These lesions were diagnosed as 0-IIb esophageal carcinoma and gastric adenoma. Endoscopic mucosal resection (EMR) were applied for these lesions respectively. Histopathological findings of resected specimens showed squamous cell carcinoma of the esophagus (0-IIb, ml) and carcinoma (OIIa, m, tubl) of the stomach. Survilance study for these carcinoma showed no reccurence for 3 and half years after EMR.View full abstractDownload PDF (5264K) -
Jun NISHIKAWA, Hideo YANAI, Yusuke MATSUMOTO, Hiroshi TOKIYAMA, Kouki ...1997 Volume 39 Issue 1 Pages 62-67
Published: January 20, 1997
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA case of Epstein-Barr virus (EBV)-associated early gastric carcinoma is reported. The patient was a 60-year-old male with upper abdominal discomfort. Endoscopic and endosonographic examination revealed a protruded type of gastric carcinoma invading into the submucosal layer, therefore, surgical resection was performed. Histologically, the tumor was a mixed carcinoma showing features of both diffuse type and intestinal type. Poorly differentiated adenocarcinoma with lymphoid stroma was found in the submucosal invasive area and well-differentiated component coexisted in the mucosa. EBV was detected in the nuclei of almost all carcinoma cells by in situ hybridization for EBV-encoded small RNA 1. The high association of EBV with gastric carcinoma with lymphoid stroma has already been reported, but EBV-associated well-differentiated carcinoma is rare. This case suggests the process of neoplastic development from intestinal type to diffuse type in EBV-associated gastric carcinoma.View full abstractDownload PDF (6286K) -
Hajime ISOMOTO, Keiichiro MATSUNAGA, Saburo SHIKUWA, Megumi OFUKUJI, Y ...1997 Volume 39 Issue 1 Pages 68-72
Published: January 20, 1997
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 59-year-old man had presented with epigastric pain and nausea. Endoscopic examination showed erythema, erosions, and enlarged folds on the greater curvature of the corpus. Biopsy specimens from the corpus region revealed moderate chronic gastritis with mild neutrophil infiltration. Helicobacter pylori were negative but Gastrospirillum hominis (G. hominis) were detected in the gram smear of a corpus specimen. Follow-up endoscopic examination with biopsy 12 months later showed essentially normal gastric mucosa without the spiral organisim. We report a rare case of G, hominis-associated corpus gastritis.View full abstractDownload PDF (5339K) -
Takaaki YAMAMOTO, Takashi SHIROBE, Toshio MORI, Hidenori TOKUHARA, Mas ...1997 Volume 39 Issue 1 Pages 73-78
Published: January 20, 1997
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 79-years-old male with epigastralgia was admitted. Endoscopic and ultrasonogra-phic examination revealed four gastric carcinomas and thickness of the gastric wall. Macroscopic and histological examination of the resected specimen confirmed synchronous five early gastric carcinomas combined with wall thickness due to diffuse submucosal cysts. Stomach including diffuse submucosal cysts is known to co-exist often with mutiple gastric carcinomas. However, we are sure that this case of five synchronous early gastric carcinomas co-existing with diffuse submucosal cysts is extremely rare.View full abstractDownload PDF (5913K) -
Kazuo ENDOH, Masahiko YAMAZAKI, Tatsuya KUZUSHIMA, Shunichi FUKAO, Hir ...1997 Volume 39 Issue 1 Pages 79-83
Published: January 20, 1997
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA very rare case of early cancer of ileum is reported. A subpedunculated tumor of the terminal ileum, about 10 cm from the ileocecal valve, was disclosed in a 70-year-old male during colonoscopy. Although biopsy revealed tubular adenoma, the lesion was diagnosed as an early cancer of the ileum from the roentogenologic and endoscopic findings. Partial resection of the ileum was undertaken. The resected specuimen showed a mulberry-shaped tumor, 4.5 X 2.8 X 2.2 cm in size. Histological examination showed well differentiated adenocarcinoma whose invasion was limited only to the mucosa. Early cancer of the ileum has been rarely reported. Observation of the terminal ileum during colonoscopy or barium enema is highly recommended to detect early ileal cancers, as ileal cancers frequently develop in the terminal ileum within 20 to 30 cm from the ileocecal valve.View full abstractDownload PDF (4285K) -
Tetsuya AOKI, Kiyotaka OKAWA, Kouji SANG, Hiroko OHBA, Yasuko MORIYOSH ...1997 Volume 39 Issue 1 Pages 84-88
Published: January 20, 1997
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSThe patient was a 35-year-old man who visited our department with a chief complaint of abdominal fullness. The patient had been suffering from symptoms of irritable bowel syndrome for the last 10 years ; in addition, he had habitual straining for more than 10 minutes at the time of defecation. Endoscopy of the lower GI tract demonstrated circum-ferential zonal redding in the rectum about 5 cm from the anal edge. Biopsy revealed fibromuscular obliteration. The diagnosis of recal mucosal prolapse syndrome was estab-lished. Ultrasonic endoscopy demonstrated hyperplasia of the third layer with a micro-scopic lesion within the third layer.View full abstractDownload PDF (3806K) -
Akiko FUJIWARA, Hiroshi INOUE, Masako FUKAZAWA, Naoaki KUWAHARA, Hirom ...1997 Volume 39 Issue 1 Pages 89-94
Published: January 20, 1997
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSIn Japan, only 7 cases of intestinal endometriosis diagnosed by colonoscopic biopsy have been reported. We here report a case of rectal endometriosis diagnosed by biopsy. The case was 36-year-old female who was admitted to our hospital complaining of hematochezia and lower abdominal pain during menstrual period. Colonoscopy revealed a submucosal tumor with multiple reddish granules in the rectum. Biopsy specimens from the reddish granules revealed endometrial tissue in the mucosa. We treated the patient with danazol 400 mg per day for 3 months, and confirmed the reduction of the submucosal tumor by colonoscopy.View full abstractDownload PDF (4672K) -
Kazuya TAKEDA, Yasushi SHINOHARA, Kazuo TAKEI, Takao ITOI, Toshiya HOR ...1997 Volume 39 Issue 1 Pages 95-101
Published: January 20, 1997
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 76-year-old woman with hepatic dysfunction was admitted and demonstrated intrahepatic bile duct dilatation and a hepatic cyst on abdominal US and CT, which measured 7 cm in diameter and occupied most of the segment of stenosis of S5. Because ERC showed the proximal bile duct, the possibility of bile duct cancer could not be ruled out and PTCD and percutaneous transhepatic cholangioscopy (PTCS) were performed. On PTCS, the bile duct in the stenotic site was slit-like in shape, and its wall was blue and swollen. On intraductal ultrasonography performed under PTCS, an echo-free space was observed in contact with the outer wall of the stenotic bile duct. From these findings, we diagnosed biliary stenosis due to compression by the hepatic cyst, and treated this case with percutaneous intracystic ethanol injection.View full abstractDownload PDF (7832K)
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