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Volume 39, Issue 6
Displaying 1-15 of 15 articles from this issue
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-EUS IMAGING OF ULCERS DURING ULCER HEALING AND EFFECT OF HELICOBACTER PYLORI ERADICATION-Shigetaka TOUNOU, Shigeaki AONO, Shigeaki NAGAO, Atsushi KAWAGUCHI, Sh ...1997 Volume 39 Issue 6 Pages 1043-1053
Published: June 20, 1997
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSEndoscopic ultrasonography (EUS) was performed on 231 duodenal ulcers using the 20MHz EUS probe system. Very good correlation was observed between healing of duodenal ulcers as determined by endoscopy and by EUS imaging, and the depth of ulcers could be assessed by EUS imaging. In the case of immature ulcer healing, biphasic ulcer echo was observed, and it was thought to reflect the presence of loose fibrous tissue at the base of the ulcer floor. High echoic region beyond the duodenal wall (SR : serosa echo) was characteristic of deep duodenal ulcer (Ul-IV) and was thought to reflect thickened serosa and subserosal tissue. Most single ulcers were shallow in depth (Ul-II-III), but most linear ulcers were deep in depth (UL-IV) with muscle layer deformity and strong serosa echo. Rapid and satisfactory ulcer healing was observed whith EUS imaging in Helicobacter pylori (H. P.) eradicated cases, whereas immature ulcer healing was observed in non eradicated cases. EUS imaging was useful in evaluating ulcer depth, ulcer healing, and prognosis of duodenal ulcers. Eradication of H. P. can improve the quality of ulcer healing in duodenal ulcer and lead to good prognosis of duodenal ulcers.View full abstractDownload PDF (10900K) -
Osamu CHINO, Hiroyasu MAKUUCHI, Kouji KANNO, Hideo SHIMADA, Kyouichi M ...1997 Volume 39 Issue 6 Pages 1054-1061
Published: June 20, 1997
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSAchalasia of the esophagus is a benign disease caused by dyskinesia of lower esophagus and cardia, and is considered to cause esophageal carcinoma frequently. A total of 50 patients with achalasia of esophagus were treated at the Second Department of Surgery of Tokai University until 1996, and 6 cases (12.0%) of them were complicated with esophageal carcinoma. Those data were as follows : the range of age; 48 to 70 years old, the sex ratio (male : female); 4 cases : 2 cases, the type of esophageal dilatation ; 2 cases of flask type and 4 cases of sigmoid type on X-ray classification by esophagography, and the grade of esophageal dilatation; 3 cases of grade II and 3 cases of III on X-ray classification by esophagography. There were past history of operation for achalasia in 4 cases. The range of period until generation of esophageal carcinoma after operation for achalasia ranged 13 and 30 years. Endoscopic findings showed advanced type in 2 cases and 4 cases of superficial type. Treatment for esophageal carcinoma included 5 cases of surgical resection and 1 case of endoscopic mucosal resection. Sixty-two cases of esophageal carcinoma concomitant with achalasia ever reported in Japan were investigated clinicopathorogically. Problems of biopsy and endoscopic diagnosis due to residual meal to detect esophageal carcinoma with achalasia were reported. It is important to carry out careful long term follow-up for patients with achalasia.View full abstractDownload PDF (6662K) -
Yuji NOMIYAMA, Tadahiko FUCHIGAMI, Tsuneyoshi YAO, Mitsuru SEOAND, Aki ...1997 Volume 39 Issue 6 Pages 1062-1071
Published: June 20, 1997
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSTo evaluate the factors affecting the overlooking of the accesary lesion in the multiple gastric cancer, we reviewed 141 cases with 3021esions detectable grossly in the resected specimen. In univariate analysis, such cancers as having the following factors were revealed to be overlooked in significantly higher incidence:the lesion limited to mucosa, less than 5mm in diameter, the lesions located in the antrum, or along the lesser curvature. Multiple logistic regression analysis applied in all lesions showed that the lesions limited to mucosa, less than 5mm in diameter and the lesion located in the antrum were significantly overlooked. The relative risk of the former three factors were 2.420, 9.591, and 4.786 repectively. Furthermore, when regression analysis was applied in accessary lesions only, the relative risks were 5.456 in lesions less.than 5mm, and 3.268 in lesions located in the antrum, respectively. To avoid overlooking of the accessary lesions, careful observation using a dye spraying method, especially of the antrum, was suggested to be necessary.View full abstractDownload PDF (1183K) -
-APPLICATION TO TWO CASES OF A SWALLOWED DENTURETakeaki KOBAYASHI, Miyoka TOHYAMA, Takashi TAKEI, Yoshikazu AKAHONAI, ...1997 Volume 39 Issue 6 Pages 1072-1077
Published: June 20, 1997
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSHooded endoscopy is a technique for removing foreign bodies in the upper gastrointesfinal tract using a fiberscope attached with a cone-shaped hood on the tip. We applied hooded endoscopy to 2 cases of swallowed artificial denture where extraction with ordinary endoscopic removal technique had failed. In this technique, the swallowed denture was pulled into the hood by a grasping forceps and easily extracted with the fiberscope through the cardia and pharyngo-esophageal junction without mucosal injuries. The hood used in this study covered the irregular surface and sharp edges of the denture. In addition, it could cover a denture larger than the diameter of the fiberscope in size. Hooded endoscopy was considered to be an applicable technique to endoscopic removal of a swallowed denture.View full abstractDownload PDF (5156K) -
Naoko UTSUNOMIYA, Taisei NAKAO, Shinya OHAGI, Tokio SANKE, Kishio NANJ ...1997 Volume 39 Issue 6 Pages 1078-1082
Published: June 20, 1997
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 43-year-old Peruvian man encountered the Hanshin-Awaji eartyhquake on January 170f 1995. He suffered from"crush syndrome"and acute renal failure progressed rapidly. He was referred to our hospital on January 20 and was treated with hemodialysis. His physical condition recovered gradually, and he started drinking water after four days of hospitalization. On the next day, however, he complained of anterior chest pain and showed melena. Endoscopic examination revealed multiple hemorrhagic erosions and small hematocytic spots in the middle esophagus. With fasting and combined treatment of proton pomp inhibitor and cytoprotective agents, his chest pain and melena were improved. White coat with granular surface in the same lesion was identified by endoscopic examination performed one month later. The lesion was not stained with iodine. Pathological examination revealed a defect of the mucosa and infiltration of neutrophiles and macro phages. Thus, we diagnosed this lesion as an ulcer of middle esophagus accompanied with intermural hematomas. This is theught to be a rare case of ulcer of the middle esophagus in the course of the"crush syndrome".View full abstractDownload PDF (2228K) -
A CASE OF PEDUNCULATED HAMARTOMATOUS INVERTED POLYP OF THE STOMACH TREATED BY ENDOSCOPIC POLYPECTOMYKyoichi ADACHI, Hiroshi SUETSUGU, Norihisa ISHIMURA, Tomoko KATSUBE, T ...1997 Volume 39 Issue 6 Pages 1083-1088
Published: June 20, 1997
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSWe report a case of hamartomatous inverted polyp which grew with a peduncula in the cardiac portion of the stomach. A 75-year-old woman was admitted for further examina tion and treatment of an elevated lesion of the stomach. For the purpose of total biopsy, endoscopic polypectomy was performed after snaring the base of the stalk with detachable snare. Histological examination of the polypectomized specimen showed gastric gland with cystic dilatation in the submucosal layer. This was a rare case that a group of ectopic gastric glands was pedunculated and polypectomized endoscopically.View full abstractDownload PDF (5127K) -
Haruhiko HAGINO, Takashi FUJISAWA, Masanori SAKASHITA, Yoshinobu TOMOF ...1997 Volume 39 Issue 6 Pages 1089-1093
Published: June 20, 1997
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 48-year-old man had been followed up in our hospital because of duodenal ulcer. Follow-up endoscopy and hypotonic duodenography showed depressed type tumor with redness and marginal elevation, measuring 7X7mm in size, at the third portion of the duodenum. The histological examination of the biopsy specimens highly suggested well differentiated adenocarcinoma, and endoscopic mucosal resection was performed. But perforation was encountered and a pancreatico-duodenectomy was performed. The resected specimen showed type IIc+IIa early duodenal cancer. Histological examination showed well differentiated adenocarcinoma with low-grade atypia restricted to the mucosa. The authors reviewed 16 cases of depressed type early duodenal cancer in Japanese literature.View full abstractDownload PDF (2442K) -
Shigeru AOKI, Junichi YAMADA, Toshihisa FUJIOKA, Fumihiro IWATA, Junsy ...1997 Volume 39 Issue 6 Pages 1094-1098
Published: June 20, 1997
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 77-year-old woman was admitted to our hospital because of pneumobilia in a gastric cancer mass survey. Plain X-ray, abdominal US and CT taken after admission revealed pneumobilia. A fistulous communication between the lower common bile duct and the duodenal diverticulum just above the papilla was confirmed by ERCP and on hypotonic duodenography. Fistula formation between the biliary tree and the duodenal diverticulum is uncommon, and, to our knowledge, only 5 cases have been reported on the Japanese literature. This case may help elucidate the occurrence of biliary fistula to duodenal diverticulum.View full abstractDownload PDF (4688K) -
Masahiro YABE, Kentaro IGARASHI, Kojiro HATA, Neechau HO, Satoshi TSUK ...1997 Volume 39 Issue 6 Pages 1099-1104
Published: June 20, 1997
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 47-year-old Japanese female was referred to our hospital with complaints of chronic diarrhea, bloody stool and lower abdominal pain. Colonoscopic findings of the patient include (1) edematous, friable mucosal appearance and indistinct vascular patterns in the colorectum, (2) patchy erythemas in the ascending colon and (3) mucosal hypertrophy and apthoid ulcers surrounded by small exacavations from the sigmoid colon to rectum. A histologic examination of biopsied colorectal mucosa showed thick collagen band in the limited upper i. e. subepithelial area and chronic inflammatory cell infiltrates in the lamina propria. A diagnosis of collagenous colitis was made by these findings. She has been treated with salazosulf apyridine 1500mg/day per os for five years from her first visit to our hospital. However, her complaints have not been improved and the frequent (6 times) endoscopic examination does not demonstrate any improvement. Although it has been reported that the majority of patients with collagenous colitis have an almost normal colonoscopic appearance, our case showed a unique endoscopic appearance which is worth reporting.View full abstractDownload PDF (4228K) -
Hiromi HAMAMOTO, Hiroshi YAMAMOTO, Mituko KIMURA, Takahiro SUZUKI, Shu ...1997 Volume 39 Issue 6 Pages 1105-1112
Published: June 20, 1997
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSCase I was a 64-year-old man who visited to our hospital for close examination because he was notified for positive fecal occult blood. A colorectal cancer about 1cm in size which resembled a submucosal tumor was found in the sigmoid colon. Resection revealed a moderately differentiated adenocarcinoma with sm invasion. Case II was a 76-year-old woman who presented with a sensation of incomplete defecation. A cancer resembling a submucosal tumor 3.5 cm in size was found in the rectum. Resection revealed a mucinous carcinoma with a1 invasion. Case reports of colorectal cancer with a submucosal tumor like morphology were rare. The development and progression of such tumors was discussed.View full abstractDownload PDF (8904K) -
Kenji WATANABE, Takayuki MATSUMOTO, Shirou NAKAMURA, Kyouko TOJI, Mich ...1997 Volume 39 Issue 6 Pages 1113-1118
Published: June 20, 1997
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSWe reported colonoscopic findings for 2 adult cases of Enterohemorrhagic E, coli (EHEC) induced colitis. Case 1 was 60-year-old female. Colonoscopic findings showed longitudinal ulceration in the descending colon. Case 2 was 18-year-old female. Colonoscopic findings showed multiple ulceration and stenosis due to edema mainly in the ileocecal portion.
When Colonoscopy is carried out for exact diagnosis of bloody diarrhea patients, which are important in differential diagnosis against ischemic colitis or other infectious colitis, endoscopic findings may be modified by clinical period, severity, or examination area. Therefore, it is important that fecal examination often provides more information than colonoscopic findings in diagnosing infectious colitis.View full abstractDownload PDF (5647K) -
REPORT OF 3 CASESTakashi SHIGENO, Masahiro MATSUZAWA, Taimei KANEKO, Satoshi SHIMIZU, H ...1997 Volume 39 Issue 6 Pages 1119-1124
Published: June 20, 1997
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSThree cases of hemorrhagic colitis due to E. coli O157: H7 infection were reported. The endoscopic features are as follows : (1) Marked mucosal edema, erythema, disappearance of vascular pattern, hemorrhage, erosion and shallow ulcer are the main findings, and these findings are more severe than those of other types of infectious colitis. (2) The distribution of the lesion extends from the sigmoid colon to the cecum and the severity of the findings tends to increase on the proximal side of the colon. There are almost no abnormal finding in the rectum and terminal ileum. (3) Longitudinal ulcers are often seen.View full abstractDownload PDF (5192K) -
Kazuhiko NEMOTO, Yukihito YAMADA, Atushi TAKAHASHI, Takayuki KATOH, Sa ...1997 Volume 39 Issue 6 Pages 1125-1131
Published: June 20, 1997
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSWe present a case of hemorrhagic colitis due to Verotoxin-producing Escherichia coli (VTEC).
A 18-year-old male was admitted with symptoms of abdominal pain and bloody watery diarrhea. Coonoscopy revealed marked mucosal edema with dark-red blood and the presence of necrotic masses. The abnormal findings were seen mainly from the ascending colon to the cecum, continuing decreasingly down to the sigmoid colon, and were patchy erythematous changes only in the rectum. Serum test of Verotoxin was positive, but VTEC (O-157) was not found by stool cultures. We made a diagnosis of this hemorrhagic colitis due to VTEC (O-157) by the clinical findings and the result of serum test.View full abstractDownload PDF (4647K) -
Hiroshi NISHIO, Saburo NAKAZAWA, Junji YOSHINO, Kazuo INUI, Hitoshi YA ...1997 Volume 39 Issue 6 Pages 1132-1137
Published: June 20, 1997
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSWe studied stomach lesions by a ultrasonic probe (OLYMPUS, ULTRASONIC PROBE XUM-4R), which was able to insert through the biopsy channel (2.2 mm in diameter) of a ultrasonographic endoscope. The method of the ultrasonic probe combined with the ultrasonographic endoscope (so-called, miniature probe in EUS) improved clinical diagnosis of tiny or minute lesions, because we can easily observe both ultrasonograms taken by the ultrasonic probe and the endoscopic ultrasonograph simultaneously. By this method, some cases of the lesions which were difficult to scan by the ultrasonographic endoscope, were easily observed by the ultrasonic probe. But, in general, the ultrasonograms with the ultrasonographic endoscope were better than those with the ultrasonic probe. Clear images were not obtained for deeper portions of the stomach with an ultrasonic probe because the frequency of ultrasonic waves was high. For these reasons, it was thought that the ultrasonic probe together with the ultrasonographic endoscope was one of the useful methods to examine gastric lesions.View full abstractDownload PDF (5187K) -
-EXPERIMENTAL STUDY AND CLINICAL USE-Osamu MOTOHASHI, Hideya SANO, Seiichi TAKAGI, Atsushi KIYOHASHI, Katsu ...1997 Volume 39 Issue 6 Pages 1138-1143
Published: June 20, 1997
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSWe experimented using 5 mongrel dogs and confirmed a safe and reliable technique for endoscopic mucosal resection for the middle or lower rectum using a ligating device (EMRL). And then, we resected two lower rectal carcinoid less than 10mm in diameter by this procedure. It is concluded that EMRL is an easy and valuable procedure to resect correctly and enough submucosal tissue between tumor and resected surface. So EMRL would have a benefit to give a correct decision to need more therapy or not.View full abstractDownload PDF (3864K)
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