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Volume 39, Issue 4
Displaying 1-16 of 16 articles from this issue
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Tsutomu TAKEUCHI, Norichika NARIMIYA, Tatsusi MARUYAMA, Hiroto MIYAZIM ...1997 Volume 39 Issue 4 Pages 771-778
Published: April 20, 1997
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSIn an attempt to obtain overall infrared ray electoronic endoscopic views of the vasculature of the stomach and large intestine an experimental study was conducted on 8 adult dogs. Microangiograms of the vasuculature were taken with two contrast agents of different colors, one injected into an artery and the other into a vein, and compared with corresponding infrared ray electoronic endoscopic views. Blood vessels that were visualized by infrared ray electoronic endoscopy were found to represent those segments of submucosal venules, above 200 μm in diameter, which were intermediate between their portal of entry into the muscularis propria and that into the muscularis mucosae, the image faithfully representing the actual course and configuration of the vessels. The mucosa, muscularis mucosae and propria, and serosa were not visualized. There was an arteriole accompanying the submucosal venules delineated by infrared ray electoronic endoscopy and, in the stomach, this arteriole was estimated to account for approximately 19% of the total diameter of the infrared ray image of vessels. Likewise, in the large intestine, blood vessels visualized by infrared ray electoronic endoscopy turned out to be submucosal venules, in the proximity of which an accompany-ing arteriole was noted to run. The study clearly defined the anatomical portion of veins in the gastrointestinal walls that can be visualized by infrared ray electoronic endoscopy and also confirmed that this endoscopic technique can afford information on the course and size of the submucosal arteriole.View full abstractDownload PDF (7840K) -
Motoko OTSUKA, Kou NAGASAKO, Yasushi SANO, Takahiro FUJIMORI, Naoaki H ...1997 Volume 39 Issue 4 Pages 779-785
Published: April 20, 1997
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSWe investigated the growth and progression of colorectal carcinomas by histological findings, K-ras point mutation and immunohistochemical studies of P53 in advanced colorectal carcinomas of less than 20mm in diameter. Thirty-one cases of advanced colorectal carcinomas of less than 20mm were obtained from surgically resected specimens. P53 was examined by immunohistochemical staining using microwave and LSAB method. We used antibody NCL-P53-CM1. DNA was extracted from formalin-fixed and paraffin-embedded sections. A mutation of colon 12 of K-ras gene was detected by polymerase chain reaction (PCR) and dot blot hybridization. They were classified into three groups ; polypoid growth (PG), non-polypoid growth (NPG) and intermediate growth by intramucosal growth type. The average age was 60. The locations were ascending colon: 1, transverse colon : 4, descending colon: 7, sigmoid colon : 15, rectum : 4. All samples were well differentiated adenocarcinoma, except two with poorly differentiated type. Histological depth was mp :19, and deeper: 12. K-yas mutation was found in PG carcinoma : 55%, NPG carcinoma : 0%, intermediate type : 36% by 15 to 20mm in diameter. However we found no mutation of K-ras genes in PG and NPG of less than 15mm in diameter. In contrast, there was no difference in immunohistochemical staining of P53 between PG or NPG. Based on these results, it is concluded that early carcinomas positive for P53 and negative for K-yas mutation will grow into advanced carcinoma of less than 20mm in diameter, and its tendency is clearer in most of smaller colorectal carcinomas.View full abstractDownload PDF (2345K) -
-REAMER'S METHOD AND ITS TATTOO DYE-Masanori HIRAO, Sayuki YAMASAKI, Setsuji TAKANASHI, Masahiro ISHIGOOKA ...1997 Volume 39 Issue 4 Pages 786-790
Published: April 20, 1997
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSIn the surgical gastrectomy and endoscopic mucosal resection, the tattoo marking is useful to decide the surgical margin. In order to make clear and non-blotted tattoo-marking, we studied the endoscopic reamer as a tattooing device to improve the weak point of the needl's method. The tattoo dye is composed of 20% carbon black, 2 % poly vinylpyrrolidone and the pure ethanol as the solvent. The tattoo dye is autoclaved and attached to the reamer. The reamer is then stabbed 2 mm into the gastric mucosa. In 33 regions of 20 cases of gastric cancer, the clear tattoo-marking was maed in 30 regions (90.9%). The reamer's method is excellent for the endoscopic tattoo marking in the gastric mucosa.View full abstractDownload PDF (3925K) -
-THE HEMOSTATIC EFFECT AND ANALYSIS OF RISK FACTORS FOR REBLEEDING-Shintaro KITAUCHI, Hiroshi OHATA, Rumi KURODA, Motoyo KAWAGUCHI, Takuy ...1997 Volume 39 Issue 4 Pages 791-796
Published: April 20, 1997
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSFrom April 1988 to September 1994, endoscopic hemostatic therapies by microwave tissue coagulation were performed in 44 patients with bleeding gastric ulcers. The patients were observed again by endoscopic examinations within 24 hours after the first therapy to evaluate the endoscopic stigmata of recent hemorrhage. Initial hemostasis was obtained in all patients. Rebleeding occurred in eight patients. In six of the eight patients, second hemostasis succeeded by microwave coagulation. Permanent hemostasis was obtained in 42 patients. In all of four patients with spurting bleeding, hemostasis was achieved without rebleeding. Microwave therapy had good hemostatic effect in patients with underlying diseases. We studied the risk factors of rebleeding after microwave hemostasis. In patients without underlying disease, rebleeding was significantly associated with endo-scopic stigmata of recent hemorrhage. However, in patients with underlying diseases, rebleeding was significantly associated with prolongation of prothrombin time. It is important to evaluate these risk factors precisely to prevent rebleeding after endoscopic therapy.View full abstractDownload PDF (648K) -
Fumitoshi WATANABE, Satoshi HONDA, Tetsurou OIKAWA, Hiroyuki KUBOTA, S ...1997 Volume 39 Issue 4 Pages 797-801
Published: April 20, 1997
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSAfferent loop obstruction is a rare complication after gastrectomy. If diagnosis is delayed or conservative treatment is adopted, the outcome is often fatal. A 65 year-old man who had a history of Billoth II gastrectomy for duodenal ulcer was admitted because of abdominal pain, vomiting and icterus. Ultrasonography and CT showed dilated afferent loop and dilated intrahepatic bile duct. We diagnosed it as afferent loop obstruction. We tried to treat the patient by endoscopy. Endoscopy could pass the stricture of the afferent loop by attaching a transparent cap to the tip. We could drain a large amount of biliary fluid through endoscopic channel, and indwell a 6.0 Fr drainage catheter. These treatments were successful and the patient is doing well without recurrence.View full abstractDownload PDF (3857K) -
Tomoki MATSUDA, Junichi SUZUKI, Akiyoshi NOMURA, Manabu MASUTANI, Kuni ...1997 Volume 39 Issue 4 Pages 802-807
Published: April 20, 1997
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 39-year-old man presented complaining of diahrrea and bloody stool. Colonoscopy and barium enema showed continuous tiny ulcerations in the whole rectum and sigmoid colon. Endoscopic biopsy specimen showed infiltration of inflammatory cells and crypt abscess in the mucosa of rectum. We diagnosed the patient as left side ulcerative colitis. By the colonoscopy and barium studies, the oral side from sigmoid colon appeared to be normal except for the appendix in which the orifice elevated like a whirlpool. After a treatment with SASP (salazosulfapyridine), the left side of the colon improved, but the orifice of the appendix became more erosive and edematous. The appendix could not be visualized by barium enema. Malignant tumor in the appendix could not be ruled out. The resected appendix showed severe erosion but no malignancy. The diagnosis of this case was appendicitis associated with ulcerative colitis, coincident so-called 'ulcerative appendicitis'. This is the second operated case in Japan.View full abstractDownload PDF (5378K) -
Tetsuya KUROSAKI, Tetsuya KOBAYASHI, Toru FUJIKAWA, Kenji IKEUCHI, Sad ...1997 Volume 39 Issue 4 Pages 808-812
Published: April 20, 1997
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 46-year-old mal was admitted to our hospital for farther examination of positive fecal occult blood in stool. Colonoscopy revealed a rectal cancer like a+c lesion. Endoscopic ultrasonography showed that the cancerous lesion seemed to be limited to the mucosal layer, but a well-difined, round and low echoic lesion was detected in the submucosal layer. This low echoic lesion was diagnosed as lymph follicle by EUS and then, this lesion was diagnosed as mucosal cancer and resected endoscopically. Histopathology of the resected specimen revealed a mucosal cancer with lymph follicles in the submucosal layer. Generally it is difficult to distinguish lymph follicles in submucosal layer from submucosal invasion of cancer by EUS. However, the differentiation was possible in this case.View full abstractDownload PDF (5061K) -
Reiko HOBARA, Kazuya TAKAHAMA, Makoto WATANABE, Atsushi TOKUDA, Chisa ...1997 Volume 39 Issue 4 Pages 813-817
Published: April 20, 1997
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 20-year-old woman with diarrhea, abdominal colic pain, fever, and bloody stool was admitted in our clinic four days after onset of symptoms. In the feces culture, Enterohemorragic E. coli : O157 was revealed. Severe edema, hemorrhagic mucosa with ulcer and erosin was observed in the sigmoid colon to the cecum on colonoscopic examination. Severe edematous mucosa showing thumb-printing sign was demonstrated in the barium enema. Those findings were similar to the antibiotics-associated hemorrhagic colitis. The findings of this colitis showed much severe ulceration and erosion than in the associated hemorragic colitis.View full abstractDownload PDF (5554K) -
Okuhide FUJII, Kohji OH, Mitsuo OKADA, Mitsuru SEO, Makoto OKUMURA, Hi ...1997 Volume 39 Issue 4 Pages 818-824
Published: April 20, 1997
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 40-year old male was admitted to our hospital with a sudden onset of bloody stool after obstinate constipation. An emergency colonoscopy revealed a exfoliation of the mucosa, and an irregularly shaped ulceration with sharp demarcation of the margins in the sigmoid colon. A biopsy taken from the lesion revealed foreign materials that appeared to be fecal origin in the mucosa. Thus, the patient was diagnosed as having stercoral ulcer. Treatment with normalization of the bowel habit, and intravenous hyperalimentation resulted in healing of the ulcer in three weeks. Stercoral ulcer is a rare disease and have reported only thirty-eight cases, including the present case in Japan.View full abstractDownload PDF (4110K) -
Tatsuya TOYOKAWA, Nobumasa IKEDA, Motowo MIZUNO, Humitoshi KISHI, Hiro ...1997 Volume 39 Issue 4 Pages 825-830
Published: April 20, 1997
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSThe patient was an 85-year-old man, who had visited our department due to jaundice 5 years previouly and had been diagnosed as having obstructive jaundice resulting from mucus retention in the biliary tract. He was conservatively managed on an outpatient basis. At the present admission, percutaneus transhepatic cholangioscopy revealed tumorous lesions in the intrahepatic biliary tract and he was diagnosed as having a mucus producing biliary carcinoma on biopsy. Because the growth of the mucus producing biliary carcinoma appeared to be slow, the patient received laser treatment and satisfactory results were obtained. He has remained well with no significant problems for these two years five months after treatment. Laser treatmeat is thus considered to be useful for high risk patient with mucus producing biliary carcinama.View full abstractDownload PDF (6659K) -
Tetsuya INOUE, Kouji KONISHI, Mitsuharu EARASHI, Hironobu KIMURA, Kiic ...1997 Volume 39 Issue 4 Pages 831-835
Published: April 20, 1997
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSWe present a case of refractory biliary leakage after surgery successfully managed by ENBD stenting. A 46-year-old male was operated on for malignant lymphoma in the hilus hepatis. Cholecystectomy and lymphnode dissection were done. On the first postoperative day (POD), substantial biliary leakage from the abdominal drain occurred and was not reduced. Then endoscopic retrograde cholangiography (ERC) was performed on the 13 POD, and extravasation of the contrast from the right posterior branch of the bile duct was seen. Immediately, endoscopic naso-biliary drainage (ENBD) was done and a 7.2 Fr. drainage tube was placed bridging the extravasation.View full abstractDownload PDF (3963K) -
Kenji YAMAO, Saburo NAKAZAWA, Jyunji TOSHINO, Hitoshi YAMACHIKA, Naoto ...1997 Volume 39 Issue 4 Pages 836-844
Published: April 20, 1997
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSMetal stents were used to treat pancreatic ductal stenosis in 3 symptomatic patients with chronic pancreatitis. Insertion and placement of Strecker metal stents was followed by sustained clinical improvement in 2 patients during a follow-up periods of 6 and 14 months, respectively. In the remaining case, abdominal pain recurred due to stent obstruction 5 months after the insertion. However, the symptoms rapidly disappeared after reexpansion of the stent. Metal stent for the placement in the treatment of pancreatic ductal stenosis in cases of chronic pancreatitis can thus be considered as an alternative to plastic stent for obtaining more long-term pain relief.View full abstractDownload PDF (7733K) -
Sumitaka HISA, Kazuhiro YOKOGI, Masayuki ITO, Hideo SHISHIDO, Hiroyuki ...1997 Volume 39 Issue 4 Pages 845-852
Published: April 20, 1997
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA case of a pure PP-oma of the pancreas was reported. The patient was 56 years old woman. She visited a near physician's office because of epigastralgia and back pain. There were no endocrine symptoms. Since abdominal ultrasonography showed a hypoechoic tumor in the head of the pancreas, she was admitted to our hospital for further examination. There was no abnormality in laboratory data on admission. CT revealed a sharply marginated hypodense lesion at plain scan and concentric interf low pattern at contrast-enhanced scan in the head of the pancreas. ERCP revealed stricture in both the pancreatic duct and the common bile duct. Angiography reveled a hypervascular lesion with early venous return in the head of the pancreas. MRI revealed a lesion of low intensity in Ti weighted, high intensity in T2 weighted in the head of the pancreas. EUS revealed a hypoechoic lesion in which the margin was distinctly observed with halo, lateral shadow and posterior enhancement, and the contour was smooth and the internal echo pattern was hetrogeneous. EUS was most useful in preoperative diagnosis of islet cell tumor of the pancreas. Pancreatoduodenectomy was performed. Histopathological examinations of the resected specimen revealed a tumor (30mm) of the head of the pancreas. Immunohistological examination revealed positive results in PP, and negative results in insulin, glucagon, gastrin, somatostatin, and VIP. Final diagnosis was pure PP-oma of the pancreas.View full abstractDownload PDF (8113K) -
Hideki TADA, Katunori TODA, Yoshifumi ARISAKA, Nobusuke FUKUMOTO, Haru ...1997 Volume 39 Issue 4 Pages 853-858
Published: April 20, 1997
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSEndoscopic transpapillary treatment such as EST and implantation of stents is presumed to be difficult, when placement of an endoscopic nasal biliary drainage (ENBD) tube is attained after much effort. Therefore, we tried to approach the biliary tract, using the ENBD tube which has been already placed as a guide. Thirty two patients with obstructive jaundice, in whom the placement of an ENBD tube was difficult and also endoscopic transpapillary treatment after palliation of jaundice was needed, were chosen for this trial. Firstly, a ENBD tube was inserted into to the oral cavity through the nose. Secondly, the ENBD tube was inserted into a channel from the tip of fiberscope. Subsequently, the fiberscope was manipulated along the ENBD tube with similar technique as an ordinary ERCP procedure. When performing this method, the following aspects should be given special attention ; constantly watch the tip of the fiberscope from the patient's throat to the duodenal papilla in order to straighten the ENBD tube under X-ray control. This method was successfully performed in 30 of 32 patients. Furthermore, it took less than 5 minuts in all cases to approach the biliary tract. It is concluded that this method of approaching the biliary tract using the ENBD tube which has been already placed as a guide is extremely useful, when the endoscopic transpapillary treatment is thought to be difficult.View full abstractDownload PDF (4561K) -
1997 Volume 39 Issue 4 Pages 859-860
Published: April 20, 1997
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSDownload PDF (342K) -
1997 Volume 39 Issue 4 Pages 861-879
Published: April 20, 1997
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSDownload PDF (2013K)
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