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Volume 39, Issue 9
Displaying 1-17 of 17 articles from this issue
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Motohiro TAKASAKI1997 Volume 39 Issue 9 Pages 1545-1556
Published: September 20, 1997
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSThe purpose of the present study was to determine the relationship between IA values as described by brilliant blue chromo-endoscopy and serum pepsinogens, and thereby determine chromo-endoscopically the atrophic extent of gastric mucosa. During the period from September 1991 to July 1992, 728 consecutive subjects (342 males and 386 females with an average age of 56.7 years), including 101 patients with gastric carcinoma (n=40 advanced and 61 early), were examined by brilliant blue chromo-endoscopy. Serum pepsinogen I and pepsinogen II were concomitantly assayed by RIA (Dynabot) . IA refers to the sum of I and A (ranging from 0 to 6) ;Iis defined as the grading ofintestinal metaplasia (ranging from 0 to 3) ;Ais defined as the grading of rnucosal atrophy (ranging from 0 to 3) . The subjects were divided into 2 subgroups, IA=0 (n=221) and IA≥1 (n=507), and into 5 age groups of under 40, 40-49, 50-59, 60-69 and over 69 years old. The fallowing conclusions were obtained: (1) IA values correlated with the extent of the atrophic border (0.8926) classified by Kimura and Takemoto, and with the serum PGI/PGII ratios (-0.6794) ; (2) The number of subjects in the subgroup IA=0decreased while those subjects with higher IA values (in the subgroup IA≥1) increased in increasing order of age groups; (3) The serum PGI/PGII ratios were comparable in each age group in the subgroup IA=0, and decreased in increas-ing order of the age groups in the subgroup IA≥1. The serum PGI/PGII ratios in the subgroup IA=0 were significantly lower (P<0.0001) than in the subgroup IA≥1 in each age group. In conclusion, clinical application of IA values described by brilliant blue chromo-endoscopy can contribute to obtain an accurate noninvasive diagnosis of gastric mucosalatrophy.View full abstractDownload PDF (5257K) -
Hideaki ARIMA, Miwako ARIMA, Teruo KOUZU, Etsuo HISHIKAWA, Eiichirou S ...1997 Volume 39 Issue 9 Pages 1557-1565
Published: September 20, 1997
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSMagnified observation esophageal mucosa on resected specimens of esophageal cancerware studied to compare with the histological findings. Fifty-five non-staining lesions lessthan 3cm in diameter of 2Z resected cases were studied and these lesions were classified to3types. Type A is a lesion that has a clear papilla-pattern of regularly arranged whitespots. In type B, the papilla pattern has a tendency to be fused bu.t still has a distinguish-able outline. In type C, the surface is amorphous, irregular and not stained at all. Elevenout of twelve lesions of type A, 13/211esions of type B have no atypic, and 19/21esionsof type C were squamous cell carcinoma. In vivo, 114 un-staining lesions were studiedthrough a magnifying endoscope(GIF200Z). Forty-five out of fifty-four lesions of type A, 16/251esions of type B had no atypia, and 21/351esions of type C Were squamous cellcarcinoma. Magnified observation of the lesion with special reference to the papilla-pattern and its classification is useful to make a diagnosis for atypia of esophageal mucosa.we also made our own tulip hood to perform endoscopic examination for screening andmagnified observation at the same time.View full abstractDownload PDF (6789K) -
Takatoshi NAKASHIMA, Koichi YASUTAKE, Hogara NISHISAKI, Hiroshi HASEGA ...1997 Volume 39 Issue 9 Pages 1566-1572
Published: September 20, 1997
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSTo clarify the growth process of nodule-aggregating lesions of the colorectum, weanalyzed the endoscopic findings and clinicopathological features in 561esions. Accordingto the size, these tumors were classified into 3 groups as fallows;group A which was largerthan 20mm in diameter(n=23), group B whose diameter was 10-20mm(n=20), and Initialgroup less than 10mm(n=13). Nodule-aggregating tumors were predominantly found in the rectum, sigmoid colon, ascending colon and caecum in every group. Hoveever, the tumors at the rectum merelarger than those at other lesions. Almost all the tumors in the initial group were flatsurfaced tumors with homogeneous nodules and without reddness endoscopically. On theother hand, almost all the tumors in graup A were irregular-surfaced tumors withmutifarmed nodule and reddness. Moreover, the endoscopic feature of the tumors in groupBwere intermediate type between the two groups. As the size of tumors increased, villouscomponents in adenoma grew and the tumors contained more cancerous foci histologically. The growth process of the colorectal nodule-aggregating lesions was supposed asfollows;as small flat-surfaced tumors with homogeneous nodules and without reddnesschange to irregular-surfaced tumors with heterogeneous nodule and reddness endoscopical-1y, villaus components in adenoma grow and the tumors contain more cancerous focihistologicaliy. In the late stage, these tumors developed to invasive cancer with verticalgrowth.View full abstractDownload PDF (3317K) -
Hirokazu GOISHI, Shinji TANAKA, Ken HARUMA, Norimichi KOIKE, Toshihisa ...1997 Volume 39 Issue 9 Pages 1573-1581
Published: September 20, 1997
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSAbsolute indication of endoscopic treatment for early gastric cancer is considered tohe histologically differentiated, less than 20 mm in diameter, intramucosal, and non-ulcerative carcinoma. In this study we evaluated the prognosis of 69 cases (701esions)ofearly gastric cancer, treated endoscopically, in which the indzcation of endoscopzc treat-ment was not absolute. These cases were not indicated for surgical operation because ofcomplications and advanced age. Furthermore, we analyzed 68 cases (75lesions)of earlygastric cancer operated on surgically in order to compare the prognosis of both groups. Twenty three (48.9%)of 471esions followed up for more than one year after endo-scopic treatment showed a complete cure locally. Cases with surgical operation and withendoscopic treatment showed 78.1%, and 37.8%of 5-year survival rate, respectively, sothe latter cases had a significantly poorer prognosis than the former. Considering onlydeath caused by gastric cancer, cases with surgical operation and with endoscopic treatmeat shoved 98.5%, and 79.9%of 5-year survival rate, respectively, and there is nosignificant difference between them. Furthermore, comparing between the prognosis ofcases with absolute indication and cases without absolute indication regarding the depth, histologic type, and size separately, submucosal cancer showed a significantly(P<0.05)poorer prognosis than intramucosal one. These results indicated that endoscopic treatment is effective for cases of early gastriccancer without absolute indication.View full abstractDownload PDF (2487K) -
Norimichi KOIKE, Shinji TANAKA, Ken HARUMA, Hirokazu GOISHI, Yuko HIRA ...1997 Volume 39 Issue 9 Pages 1582-1590
Published: September 20, 1997
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSWe examined the relationship between clinieopathologic findings and lymph nodemetastasis on 118 cases with u.ndifferentiated type early gastric cancer (m : 70lesions, sm :481esions) resected surgically. Six lesions (5%) had lymph node metastasis. The depth ofinvasion in these six mucosal lesions were one mucosal cancer and five submucosalinvasive cancers. only ane aut of 7a lesians (1.4%) had lymph node metastasis. Themucosal lesion with lymph node metastasis was 35mm in diameter with ulceration.Su.bmucosal invasive lesions with lymph node metastasis were one sm21esion and four sm31esions. All lesions with lymph node metastasis were accompanied by ulceration. This datasuggest that if the legion can be resected in ane try, undifferentiated type mucosal cancerwithout ulceration may be treated curatively by EMR.View full abstractDownload PDF (5523K) -
Yukihiko FUKUSHI, Shinichirou HONGOU, Keiji OOMURA, Toshihiko FUKUCHI, ...1997 Volume 39 Issue 9 Pages 1591-1596
Published: September 20, 1997
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 63-year-old man was admitted to the hospital in May 199 because of waterydiarrhea and lower abdominal pain. On physical examination, several cervical lymph nodes were palpable but hepatos-plenomegaly was not observed. Peripheral blood picture was normal. The serum totalprotein value was moderately decreased and immunoglobulin M was slightly elevated.Examination of the gastrointestinal tract with X-ray and endoscopy revealed multiplepolypoid lesions in the small and large intestine and hypertrophy of mucosal folds on theupper body of the stomach. Histological examination of biopsied specimen from the stomach, duodenum, terminalileum, large intestine and cervical lymphnode disclosed non-Hodgkin's, diffuse, mediumsized, B-cell type malignant lymphoma. And centrocyte-like cells which resembled thecentrocytes of the follicular centers proliferated diffusely but did not infiltrate the epith-elial glands. After chemotherapy with VEPA, X-ray and endoscopic findings of the gastrointestinaltrust improved markedly, and diarrhea and abdominal pain also disappeared. We reported a case of malignant lymphoma of the gastrointestinal truct of which X-ray and endoscopic appearances were polypid lesions in the intestine and hypertrophy ofmucosal folds in the stomach.View full abstractDownload PDF (4579K) -
Kouji TANAKA, Hiroshi NISHIWAKI, Ippei FUJINO, Tetsuya IKEDA, Tetsuya ...1997 Volume 39 Issue 9 Pages 1597-1601
Published: September 20, 1997
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 44-year-old woman had appetite loss, a abdominal fullness for four years. She wasadmitted to our hospital far abdominal pain, vomiting, and abdominal fullness in April 7, 1996.The double contrast examination showed bird's beak sign in the transverse colon andno abnormality of sigmoid colon. VLre successfully performed reduction of volvulus of thetransverse colon by means of colonoscopy. The partial resection of the transverse coonwas perfarmed palliativelly after colonic preparation. There have been only 4 cases forwhich reduction of volvulus of the transverse colon by means of colonoscopy have beenattempted in Japan, but no successful colonoscopy have been reported in Japanese litera-ture.View full abstractDownload PDF (2904K) -
Yasuhiro FUTAGAMI, Shinji TANAKA, Ken HARUMA, Jiro HATA, Hirokazu GOIS ...1997 Volume 39 Issue 9 Pages 1602-1607
Published: September 20, 1997
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 51-year-old female was admitted to a hospital, because of general tiredness, hypogeusia, diarrhea, anorexia, alopecia, and onychadystrophy in September 1994. Thelaboratory data showed anemia and hypoproteinemia. Endoscopic and fluoroscopic examinations of the gastrointestinal tract showed multiple hyperplastic polyposis in the stomachand small and Iarge bowe1. Administration of predonisolone, (30mg/day)for 2 months, vvasnot effective. In May 1995, she was introduced to our hospital. On admission, colonicinvagination from the ascending colon to the right transverse colon was detected initiallyby ultrasonography. Histologie examination of biopsy specimens from polyp in the caecumrevealed hyperplastic changes of intestinal epithelium, edema and inflammatory cell infiltration, such as lymphocyte and eosinocyte, in the interstitiurn. On the basis of thesefindings, she was diagnosed as Cronkhite-Canada syndrome complicated with colonicinvagination. After treatment by steroid pulse therapy, subjective symptom, alopecia, onychodestrophy, hypoproteinemia and invagination improved gradually. The multiplepolyposis of gastrointestinal tract diminished and almost disappeared. Until now, she isimproving weld and has no recurrence.View full abstractDownload PDF (5674K) -
Yoshihiro ISHIGURO, Hidemi GOTO, Yoshiki HIROOKA, Akihiro ITOH, Tomoyu ...1997 Volume 39 Issue 9 Pages 1608-1613
Published: September 20, 1997
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSThe patient, 6S years old, vvas admitted to our hospital complaining of epigastric painand icterus. Percutaneous transhepatic cholangzoscopy(PTCS)showed papillary tumor illthe bile duct. Biopsy specimen through PTCS revealed adenocarcinoma. Intraductalultrasonography(IDUS)and endoscopic ultrasonography(EUS)demonstrated a tumor inthe cystic duct protruding into the common bide duct. In addition, IDUS showed that thetumor did not invade into the common bile duct, whereas EU5 could only demonstrate mainpart of the tumor existing in the cystic duct and other part in the common bile duct withno evidence of invasion. IDUS was useful in the diagnosis of carcinoma occuring in the cystic duct.View full abstractDownload PDF (4233K) -
Nobuyuki YANAGAWA, Hiroyuki MAGUCHI, Tatsuya NAGAKAWA, Hiroyuki MIYAKA ...1997 Volume 39 Issue 9 Pages 1614-1621
Published: September 20, 1997
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 63-year-old female was admitted for the treatment of cholangitis. She had beenseen under the elsewhere diagnosis of Mirizzi syndrome where insertion of an endoscapicbiliary stent could not prevent obstruction of the previous stmt and caused her cholangitisrecurrence. We performed percutaneous transhepatic biliary drainage approaching B30fthe liver and fractured a stone 30 mm diameter in the bile duct using an electrohydrauliclithotriptor under cholangioscopy. We then found a biliobiliary fistula connecting thecommon hepatic duct and the cystic duct. We also performed endoscopic resection of asmall polyp with a stalk 2 mm in diameter locating in the orifice of the fistula near theopening of the common hepatic duct. The polyp was histologically diagnosed as aninflammatory polyp.View full abstractDownload PDF (7068K) -
Kiyoshi ASHIDA, Kyoichi TOGO, Masumi FUKAI, Manabu KANO1997 Volume 39 Issue 9 Pages 1622-1629
Published: September 20, 1997
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 68-year-old male had occasional complaint of epigastralgia during recent nine yearsand had been diagnosed as acute pancreatitis. ERP showed a marked dilatation of a mainpancreatic duct (MPD) and a cystic dilatation of inferior branches of pancreatic head. Wediagnosed as mucin producing tumor of the pancreas. Three-dirnensiona1-CT pancreatography (3D-CTP) was performed.3D-CTP cou.ld hot figure out obvious tumor growthconfined to the pancreatic duct in the patient. However, 3D-ATP showed followingfeatures; 1) Adistinct picture and a cross-sectional view of MPD could be obtained. 2) A deformity of MPD could be examined from an optional direction. 3) Acubic constructionand an optional cross-section picture of pancreatic parenchyma could be obtained. Inconclusion, it is possible that 3D-CTP may be included in multidissiplinary diagnosticimage of the pancreas disease and contributes to improve diagnostic abilities.View full abstractDownload PDF (5644K) -
Masamichi HIRAI, Daishu TOYA, Yoshiya TACHIBANA, Ken-ichi FUKUOKA, Nob ...1997 Volume 39 Issue 9 Pages 1630-1633
Published: September 20, 1997
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSHelicobacter pylori (HP) eradication therapy was performed in 117 patients with gastric and/or duodenal ulcer using 20 mg of omeprazol (or 30mg of lannsopurazol), two antibiotics (400 mg of clarithromycin/500 mg of metronidazole or clarithromycin/1g of amoxicilin) and 2g of ecabet sodium (or 150 mg of palaprezinc) . After cure of HP infection and gastric/duodenal ulcer, three patients developed an endoscopically proven reflux esaphagitis gyrate 2.6% . Two were duodenal ulcer patients and the other a gastric ulcer patient, who have been treated previously with H2 receptor antagonist. Thus, it is necessary to pay attention to development of reflux esophagitis after cure of HP infection.View full abstractDownload PDF (2129K) -
Tsuyoshi IWASE, Kazuhiko TOKITA, Hiroki ISHIKAWA, Shoji MITSUFUJI, Tad ...1997 Volume 39 Issue 9 Pages 1634-1638
Published: September 20, 1997
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSWe devised a new method of the ileogram using a colonoscope. A 24 year-old man was admitted to our hospital because of intestinal obstruction. We introduced a colonoscope with cuff at the end into the terminal ileum and instilled a water-soluble contrast medium and air through the colonoscope. Retrograde ileogram revealed narrowing of the ileum suggesting Crohn's disease. Resection of the small intestine was performed and a pathological diagnosis of Crohn's disease was made.View full abstractDownload PDF (3512K) -
Naohito UCHIDA, Toru EZAKI, Shuko HIRABAYASHI, Atsushi MINAMI, Hiroki ...1997 Volume 39 Issue 9 Pages 1639-1643
Published: September 20, 1997
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSWe evaluated the efficacy of a new metal tip ERCP cannula for patients with biliary diseases in whom cholangiography was failed. The cannula had a metal ball tip(2 mm indiarneter)with a side hole(0.6mm in diameter)deflected at 60 degree upper angulation. Of 143 patients undergoing ERCP by using a conventional cannula, cholangiography was failed in 10 cases. Employing the metal tip cannula, cholangiography was achieved in 8 of 10 failed cases(80%: new cannula versus 0%: conventional cannula: p<0.0004, Fisher's exact test). A success rate of cholangiogram was increased from 93.0% to 98.6% No complications were observed during and after the procedure. The new metal tip cannula is safe and effective for cholangiography.View full abstractDownload PDF (2085K) -
[in Japanese], [in Japanese], [in Japanese], [in Japanese], [in Japane ...1997 Volume 39 Issue 9 Pages 1644-1649
Published: September 20, 1997
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSDownload PDF (804K) -
1997 Volume 39 Issue 9 Pages 1650-1654
Published: September 20, 1997
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSDownload PDF (509K) -
1997 Volume 39 Issue 9 Pages 1655-1669
Published: September 20, 1997
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSDownload PDF (1600K)
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