GASTROENTEROLOGICAL ENDOSCOPY
Online ISSN : 1884-5738
Print ISSN : 0387-1207
ISSN-L : 0387-1207
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Volume 39, Issue 7
Displaying 1-19 of 19 articles from this issue
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  • LAPALOSCOPIC FINDINGS IN PATIENTS WITH AUTOIMMUNE CHOLANGIOPATHY
    Toshikazu MASUMOTO, Tuneyuki NINOMIYA, Yuusuke YAMAUCHI, Masanori ABE, ...
    1997 Volume 39 Issue 7 Pages 1183-1188
    Published: July 20, 1997
    Released on J-STAGE: May 09, 2011
    DOIhttps://doi.org/10.11280/gee1973b.39.1183
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    We analysed laparoscopic findings of the liver in 7 patients with autoimmune cholangiopathy (AIC) and compared those with the findings in 40 patients with PBC (not AIC). At least one of the characterestic laparoscopic findings for PBC, such as gentle undulation, reddish patch, or leopard-skin like lesion was observed in all patients with AIC. In regard to non-specific findings, incidence of reddish markings was significantly increased in patients with AIC, compared with patients with PBC (P<0.05). These laparoscopic findings in patients with AIC suggest that AIC is one of the entities of PBC morphologically and represents hepatitis superimposed on cholangitis.
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  • COMBINED LIGATION AND PARAVARICEAL INJECTION SCLEROTHERAPY FOR ESOPHAGEAL VARICES: OUTCOME OVER 3 YEARS
    Masaharu TAKEUCHI, Yoshiyuki NAKAI, Seigo SHA, Chiaki YASUI, Kiyoaki N ...
    1997 Volume 39 Issue 7 Pages 1189-1195
    Published: July 20, 1997
    Released on J-STAGE: May 09, 2011
    DOIhttps://doi.org/10.11280/gee1973b.39.1189
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    Endoscopic variceal ligation (EVL) performed without sclerotherapy has shown a high recurrence rate in early postoperative period compared to endoscopic injection sclerotherapy alone. The recurrence is thought to be related to the persistence of small vessels adjacent to the normal esophageal mucosa and the ligated varices. In an attempt to reduce this high recurrence rate, we employed a combined therapy using ligation and endoscopic paravariceal injection sclerotherapy (EIS) in 40 patients. Sixteen patients (40%) with circumferential ulcer of the lower esophagus treated with combined therapy had no evidence of recurrent varices over the 3-year follow-up period. This suggests that prolonged eradication of esophageal varices was achieved with the use of combined therapy in patients with circumferential ulcer. Unfortunately, 11 of these 16 patients (68.9%) developed an esophageal stricture which had to be dilated postoperatively. The postoperative cumulative 3-year recurrence rate for patients without circumferential ulcer was 55.0 % in F0RC (-) patients, and 92.8% in F1RC (-) patients after initial treatment. The recurrence rate was within one-year in F1RC (-) patients and approximately two years in F0RC (-) patients. We conclude, therefore, the initial objective of the Combined therapy should be the eradication of esophageal varices with circumferential ulcer. Recurrences may be predicted by incomplete ulcer formation and residual persistence of small vessels. Prophylactic endoscopic injection sclerotherapy should be added to the treatment regimen in patients with these high risk endoscopic findings.
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  • ERADICATIVE LIGATION THERAPY FOR ESOPHAGEAL VARICES AND RESULTING CHANGES OF OUTFLOW OF THE BLOOD STREAMS
    Hiroshi MATSUZAKI, Eisaku KONDOU, Toshio KURITA, Takashi YONEYA, Shige ...
    1997 Volume 39 Issue 7 Pages 1196-1202
    Published: July 20, 1997
    Released on J-STAGE: May 09, 2011
    DOIhttps://doi.org/10.11280/gee1973b.39.1196
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    Eradicative ligation therapy, which involves an average of applying 40 0-rings, rather than sclerotherapy, has been used at our institution for the treatment of esophageal varices. To investigate the effectiveness of eradicative ligation therapy, we studied changes in endoscopic findings, in terms of the F factor and RC factor, changes in percutaneous transhepatic portographic (PTP) appearances of the left gastric vein (LGV), posterior gastric vein (PGV), cardiac plexus, Sudare like vein, esophageal varices or paraesophagral veins, as well as changes in the endoscopic ultrasonographic (EUS) appearances of the esophageal varices and paraesophageal veins in 15 previously untreated patients with esophageal varices who had undergone eradicative ligation therapy. Changes in endoscopic appearances before and after the therapy as evaluated by the F factor and RC factor, were statistically significant (p<0.01). Changes in the PTP apperances of the LGV were significant (P<0.01), while those of the PGV were not significant. Chanes in the PTP appearances of the cardiac plexus (P<0.01), Sudare like veins, esophageal varices and of the paraesophageal veins were also significant. Changes in the EUS appearances of the esophageal varices were statistically significant, while those of the paraesophageal veins were not significant. It was noted that eradicative ligation therapy decreased the inflow of the blood into the esophageal varices through the cardiac plexus, Sudare like vein and LGV, although the procedure did not influence the inflow through the PGV or the outflow of blood through the paraesophageal veins.
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  • PROFILE MEASUREMENT BY AN ELECTRONIC ENDOSCOPE WITH LASER SLIT BEAM PROJECTION AND ITS CLINICAL APPLICATION
    Masahito OIDA, Satoshi SUGANO, Sayuri YAMAGATA, Katsunori SAIGENJI, Hi ...
    1997 Volume 39 Issue 7 Pages 1203-1209
    Published: July 20, 1997
    Released on J-STAGE: May 09, 2011
    DOIhttps://doi.org/10.11280/gee1973b.39.1203
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    An electronic endoscopic sytem with slit beam projection has been developed to measure a profile of the surface of the object. This system is consisted of VIDEO System (CV 200, 01ympus), electronic endoscopy(GIF type Q200, 01ympus), and EVIP 230 for image processing. Slit beam from an angio fiberscope was projected onto an object surface. The distance from an endoscope to the surface of the object can be calculated from the intensity distribution of slit image coordinates since the relation between coordi-Hates of the image and the distance is related in advance by polynominal equation. Two types of test objects with convex and concave surfaces were measured from two directions; perpendicular(90°)and oblique (-70°to 110°), and the measuring precision was analyzed. The mean error for the concave surface by measurement from the perpendicular direction was less than 2%, however, mean errors for the measurement of the height and diameter in the convex surface were 3.1%and 20.4%respectively. On the other hand, in the oblique direction, the mean error was approximately the same as the perpendicular direction. We also measured a surface profile of human gastric ulcer.
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  • ASTUDY OF VOLUME MEASUREMENT FOR DIGESTIVE TRACT TUMORS BY THREE-DIMENSIONAL ULTRASOUND SYSTEM
    Kou HARADA, Saburo NAKAZAWA, Junji YOSHINO, Kazuo INUI, Hitoshi YAMACH ...
    1997 Volume 39 Issue 7 Pages 1210-1218
    Published: July 20, 1997
    Released on J-STAGE: May 09, 2011
    DOIhttps://doi.org/10.11280/gee1973b.39.1210
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    We studied the volume measurement by the three-dimensional ultrasound system using ultrasonic probe. The ultrasonic frequency of probe was 12MHz and 20MHz. The scanning method was the mechanical spiral one. This system could obtain 40 radial scaned images and 8mm, 20mm and 40mm images of linear scanning. The volume was measured in a water tank for 180bjects of resected spleen of an already-known volume. The mean measured volume was 115.4% (108.8-121.2%) of real one. It was difficult to measure the volume accurately for objects with irregular form. Objects with small volume were able to be measured more accurately by reducing the width of the slice. As for the measurements by frequency 20MHz, errors were fewer than the measurements by 12MHz. To improve the accuracy of the volume measurement, it was suggested to be necessary to shorten the scanning time and to decrease the slice width.
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  • TWO CASES OF DUODENAL BRUNNER'S GLAND TUMOR DISSIMILAR IN ENDOSCOPIC AND HISTOLOGICAL CHARACTER
    Toshihiro SAKAKIBARA, Syunyou OTAGIRI, Kunisuke UTSUMI, Noboru TANAKA, ...
    1997 Volume 39 Issue 7 Pages 1219-1224
    Published: July 20, 1997
    Released on J-STAGE: May 09, 2011
    DOIhttps://doi.org/10.11280/gee1973b.39.1219
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    We experienced two cases of duodenal Brunner's gland tumor dissimilar in endoscopic and histological character. Case 1: tumor was elastic soft, histologically showed a simple hyperplasia of Brunner's gland. Case 2 : tumor was a pale elastic hard submucosal tumor with depression at the top, histologically showed a nodular proliferation, connective tissue with smooth muscle fiber. The duct-like structures formed by glandular epithelium probably open out the depressed lesion in the surface of tumor. This case would best be classified as a hamartoma of Brunner's gland.
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  • A CASE OF GASTRIC ANTRAL VASCULAR ECTASIA ASSOCIATED WITH BASEDOW'S DISEASE WHICH WAS SUCCESSFULLY TREATED BY HEAT PROBE THERAPY
    Chifumi YAMAMOTO, Yasuyuki KUWANO, Kunihiko AOYAGI, Kouichi EGUCHI, Ta ...
    1997 Volume 39 Issue 7 Pages 1225-1229
    Published: July 20, 1997
    Released on J-STAGE: May 09, 2011
    DOIhttps://doi.org/10.11280/gee1973b.39.1225
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    We report a 59-year-old female with gastric antral vascular ectasia complicated with Basedow's disease. She was diagnosed as Basedow's disease at age 53 and iron deficiency anemia at age 54. Upper gastrointestinal endoscopic examination for iron deficiency anemia revealed multiple red spots in the antrum. She was referred to our hospital for treatment of the gastric lesions in August 1995. Barium meal study disclosed thickening of the folds in the antrum. Upper endoscopic examination showed linear vascular ectasia radiating from the pylorus. Biopsy specimens obtained from these lesions demonstrated capillary dilation and fibrin thrombus, consistent with gastric antral vascular ectasia (GAVE). She was diagnosed as GAVE and treated by heat probe therapy. After several treatments, vascular ectasia disappeared almost completely and anemia improved. Heat probe therapy is considered to be effective for GAVE.
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  • A CASE OF DIFFUSE ANTRAL VASCULAR ECTASIA WORSENED ACCORDING TO HEALING PROCESS OF GASTRIC ULCERLATION
    Yasuhiro NISHIZAKI, Norihito WATANABE, Atsushi NAKANO, Mitsuru WASADA, ...
    1997 Volume 39 Issue 7 Pages 1230-1238
    Published: July 20, 1997
    Released on J-STAGE: May 09, 2011
    DOIhttps://doi.org/10.11280/gee1973b.39.1230
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    A 53-years old male was admitted complaining of hematoemesis with severe anemia. Emergency endoscopic examination revealed that a hemorrhagic gastric ulcerlation of A1 stage in angle on minor curveture and diffuse antral vascular ectasia (DAVE) in upper body to antrum respectively. When the ulcerlation healed to A2-Hl stage in 10-17 days after his admission, DAVE was enlarged individually and extended to all over the gastric mucosa. DAVE reduced both in size and in occupation on S1-S2 stage. Histologically, the numbers of cells positirely reacted by Grimerius method and by myeloperoxidase staining were significantly increased at the part of DAVE compered to the normal gastric mucosa. There are some reports concerned about the relation between anemia and DAVE, but it has not been reported about the DAVE which changed the size and the occupacy in association with the healing process of the gastric ulcerlation. This case is interesting, in terms of the pathophysiology of the DAVE.
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  • A CASE OF GASTRIC MUCOSAL BRIDGE WITH AGML
    Ken SUGIMOTO, Hirohiko IWASAKI, Ryota HIGUCHI, Shigeto YOSHII, Hiroyuk ...
    1997 Volume 39 Issue 7 Pages 1239-1243
    Published: July 20, 1997
    Released on J-STAGE: May 09, 2011
    DOIhttps://doi.org/10.11280/gee1973b.39.1239
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    A case of 70-year-old male patient visiting our hospital with chief complaint of tarry stools revealed extensive bleeding erosion from lower body to upper body of stomach and mucosal bridge at the lesser curvature of upper body of stomach on the upper gastrointestinal endoscopy. The mucosal bridge associated with AGML has not been reported in Japan. Therefore, this complicated lesion would be extremely rare in our country. We present here our experience with the consideration of relevant literatures.
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  • A CASE OF INTERMITTENT AND REPEATED HEMORRAGE FROM DUODENAL DIVERTICULUM
    Jun UNNO, Tomoe YOSHIMURA, Eriko FUJII, Kengo SHIMIZU, Kie YOKOYAMA, S ...
    1997 Volume 39 Issue 7 Pages 1244-1248
    Published: July 20, 1997
    Released on J-STAGE: May 09, 2011
    DOIhttps://doi.org/10.11280/gee1973b.39.1244
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    A 77 year-old female having hypertension was admitted to our hospital because of hematemesis and tarry stool. Although she experienced the same bleeding episodes at least 4 times for over the last 7 years, a bleeding source could not be detected. After admission panendoscopic exermination was done repeatedly and finally it revealed an active bleeding from the eroded vessel at the duodenal diverticulum. Since ethanol injection therapy was failed to control the bleeding, ligation of the eroded vessel under laparotomy was performed and no hemorrhage took place thereafter. There are 44 reported cases of hemorrhage from duodenal diverticulum in Japan. Four cases of them had the similar clinical course of ours, i.e. intermittent and repeated hemorrhage more than two times in the past. All these 5 cases were female and had diverticulum at a distal portion of duodenum which was not cheched by routine panendoscopic exerminations. But the diverticula of 4 cases, located at the transverse portion, were eventually detected by repeated panendoscopic exermination for distal part of the duodenum. Therefore, in a case of repeated upper gastrointestinal bleeding from unknown origin, the endoscopic exermination should be performed down to the distal portion of the duodenum to rule out the diverticular hemorrhage.
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  • A CASE OF AORTODUODENAL FISTULA DIAGNOSED BY ENDOSCOPIC EXAMINATION
    Akira ZENIYA, Keiko MINASHI, Masaru ODAJIMA, Hiromi TAKAHASHI, Syunji ...
    1997 Volume 39 Issue 7 Pages 1249-1253
    Published: July 20, 1997
    Released on J-STAGE: May 09, 2011
    DOIhttps://doi.org/10.11280/gee1973b.39.1249
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    A 75-year-old man was admitted with a complaint of melena 14 months after aortic graft insertion. Upper GI endoscopy showed an ulcer with surrounding elevation at the 3rd portion of the duodenum and clipping was performed at the oral side of the ulcer. The clip was demonstrated to be in contact with the anterior wall of the graft by abdominal CT and aortogram performed after endoscopic clipping. A final diagnosis of secondary aortoduodenal fistula was established from these examinations, and an operation with procedure of bilateral axillofemoral bypass was performed. This case was the 5th reported case of aortoduodenal fistula diagnosed by endoscopic examination in Japan.
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  • GASTROINTESTINAL BLEEDING DUE TO JEJUNAL METASTASIS OF PULMONARY CARCINOSARCOMA
    Hajime ISOMOTO, Keiichiro MATSUNAGA, Isao SHIMOKAWA, Fuminao TAKESHIMA ...
    1997 Volume 39 Issue 7 Pages 1254-1259
    Published: July 20, 1997
    Released on J-STAGE: May 09, 2011
    DOIhttps://doi.org/10.11280/gee1973b.39.1254
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    A 73-year-old man who had received right upper lobectomy for pulmonary carcinosarcoma consisting of adenocarcinomatous and fibrosarcomatous components 9 months ago, developed melena. As enterography of the jejunum showed a protruding tumor with thin barium pool, laparotomy was performed. Enteroscopy of the jejunum revealed bleeding from the protruding tumor, and partial jejunal resection was performed. Histological examination revealed that the jejunal tumor had similar features to the carcinomatous component of the pulmonary tumor. He died of cereberal bleeding 66 days after laparotomy. Only 5 patients with pulmonary carcinosarcoma complicated with small intestinal metastasis have been reported.
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  • A CASE OF AMOEBIASIS WITH CONTINUATION OF EXCRETING CYSTS
    Yukiko TONOE, Katsuhiko HIGASHI, Hiroshi YAMANE, Kazuhisa OKADA, Yoshi ...
    1997 Volume 39 Issue 7 Pages 1260-1264
    Published: July 20, 1997
    Released on J-STAGE: May 09, 2011
    DOIhttps://doi.org/10.11280/gee1973b.39.1260
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    A 61-year-old male was admitted to our hospital in December, 1993, because of mucohemorrhagic diarrhea and fever of two week's duration after travel. Inflammatory test was strongly positive on laboratory data and total colonoscopy showed elevated lesions with thick white fur, ameboma, in the rectum and sigmoid colon. Amoebiasis was diagnosed by detection of Entamoeba histolytica from the mucosal specimens. Ulcerative lesions were cured with metronidazole and the cysts of amoeba also disappeared in the stool with diloxanide furoate.
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  • A CASE OF MUCOSA ASSOCIATED LYMPHOID TISSUE LYMPHOMA IN THE COLON
    Katsumi AZUMA, Takahiro NAKAGAWA, Yasuyuki NAKAMUR, Nobuaki SARAI, Mas ...
    1997 Volume 39 Issue 7 Pages 1265-1269
    Published: July 20, 1997
    Released on J-STAGE: May 09, 2011
    DOIhttps://doi.org/10.11280/gee1973b.39.1265
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    We report a case of mucosa-associated lymphoid tissue (MALT) lymphoma which was difficult to differentiate from early colon-cancer. The patient was a 72-year-old man who complained of abdominal pain, diarrhea and body weight loss (6kg in three years). Colonoscopy revealed a flat elevated lesion in the sigmoid-colon. The lesion was 10 x 10mm in diameter and had a shallow depression and bleeding. It's margin was unclear and had no bridging fold. The histological study of the biopsy specimens revealed a simple chronic colitis. However, from the colonoscopic findings, we highly suspected early colon cancer. Endoscopic mucosal resection was performed for diagnostic purposes. The histological study of resected specimen revealed formation of lymph follicles and infiltration of small or medium sized lymphocytes with cleaved nuclei in the lamina propria and submucosa. Invasion of abnormal lymphocytes into epithelium, so called lymphoepitherial lesion, were observed and abnormal lymphocytes different from plasma cells were present in the lamina propria. The abnormal lymphocytes were positive for L-26 and negative for UCHL-1 in immunological study. The patient was diagnosed as MALT lymphoma and the depth of invasion was deep submucosal layer (sm3). Because abdominal ultrasonic examination and Ga scintigram showed no abnormality, the patient underwent a recto-sigmoidectomy for curative therapy. A similar lesion with invasion in the deep submucosal layer was found in another part of sigmoid colon. This is a rare case showing the early stage of colon MALT lymphoma. Endoscopy should be performed carefully to differentiate early stage of malignant lymphoma from early colon cancer.
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  • ENDOSCOPIC ULTRASOUND GUIDED FINE NEEDLE ASPIRATION CYTOLOGY FOR THE DIAGNOSIS OF DIGESTIVE DISEASES (2ND REPORT) IN SPECIAL REFERENCE TO THE DIAGNOSIS AND TREATMENT OF SUBMUCOSAL TUMORS OF THE UPPER GASTROINTESTINAL TRACT
    Sayoko TERAMOTO, Kenji YAMAO, Saburo NAKAZAWA, Jyunji YOSHINO, Kazuo I ...
    1997 Volume 39 Issue 7 Pages 1270-1279
    Published: July 20, 1997
    Released on J-STAGE: May 09, 2011
    DOIhttps://doi.org/10.11280/gee1973b.39.1270
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    Endoscopic ultrasonography (EUS) is an indispensable means for the diagnosis of submucosal tumors of the upper gastrointestinal tract. However, in remains difficult to defferentiate between malignant and benign lesions. Therefore, the EUS-guided fine needle aspiration (FNA) cytology is a ratinal method for the diagnosis of submucosal tumors of the upper G. I. tract. EUS guided FNA cytology using the Olympus Prototype XGF-UC4 was performed in 14 patients with submucosal tumor of the upper gastrointestinal tract (7 were operated upon and the other 7 were not). The obtained rate of specimens by FNA was 86%, and the adoption of the new puncture system greatly contributed to the improvement of the rate. The diagnostic value of EUS guided FNA cytology for malignancies in our series was as follows. Sensitivity was 83%, Specificity 100%, the ture positive value 100%, the ture negative value 83% and the overall accuracy rate 91%. No complications were encountered. Taking into account previously reported pathological analyses, the treatment of choice whether operation or follow-up for myogenic tumors should be selected by tumor size, internal echo and FNA cytology. In conclusion, EUS guided FNA cytology has the potential of becoming a very advantageous approach for therapeutic purpose as well as diagnostic purpose in submucosal tumors.
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  • [title in Japanese]
    1997 Volume 39 Issue 7 Pages 1280-1288
    Published: July 20, 1997
    Released on J-STAGE: May 09, 2011
    DOIhttps://doi.org/10.11280/gee1973b.39.1280
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  • [title in Japanese]
    1997 Volume 39 Issue 7 Pages 1289-1295
    Published: July 20, 1997
    Released on J-STAGE: May 09, 2011
    DOIhttps://doi.org/10.11280/gee1973b.39.1289
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  • [title in Japanese]
    [in Japanese], [in Japanese]
    1997 Volume 39 Issue 7 Pages 1296-1298
    Published: July 20, 1997
    Released on J-STAGE: May 09, 2011
    DOIhttps://doi.org/10.11280/gee1973b.39.1296
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  • [title in Japanese]
    [in Japanese], [in Japanese], [in Japanese]
    1997 Volume 39 Issue 7 Pages 1299-1303
    Published: July 20, 1997
    Released on J-STAGE: May 09, 2011
    DOIhttps://doi.org/10.11280/gee1973b.39.1299
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