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Volume 40, Issue 1
Displaying 1-15 of 15 articles from this issue
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[in Japanese]1998 Volume 40 Issue 1 Pages 1
Published: December 10, 1998
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSDownload PDF (132K) -
[in Japanese]1998 Volume 40 Issue 1 Pages 2
Published: December 10, 1998
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSDownload PDF (106K) -
Fumio ARIMURA1998 Volume 40 Issue 1 Pages 3-11
Published: December 10, 1998
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSFor the differential diagnosis of gallbladder (GB) diseases with thickened wall, 39 cases including 17 chronic cholecystitis, 11 adenomyomatosis and 11 carcinoma were subjected to the study of endoscopic ultrasonography (EUS) prior to surgery and their pathology was studied on the resected specimens. On EUS images chronic cholecystitis showed 3-layered structure or high echoic wall. Adenomyomatosis showed moderately to highly thickened low echoic wall with cystic regions, and carcinoma had highly thickened heterogeneous low echoic wall with irregular surface. From these findings, six features of GB wall including: 1. thickness, 2. presence of 3-layered structure, 3. echo level, 4. internal echo, 5. presence of irregular surface and 6. presence of cystic regions, were chosen as factors for the quantification theory type 2 of the multivariate analysis. Correlation ratios obtained by the method were 0.854 and 0.713 for the axis 1 and 2 respectively. They were well differentiated each other and the total correct diagnosis rate was 92%. Five factors on GB wall except for factor 4 were determined to be important by the evaluation of ranges of standardized category scores obtained by the analysis. In conclusion, the quantification theory type 2 was useful for differentiation of EUS images of GB diseases with thickened wall. Thickness, presence of 3-layered structure, echo level, presence of irregular surface, and presence of cystic regions of the GB wall were important for differential diagnosis of these diseases.View full abstractDownload PDF (3937K) -
Shoichi SAITO, Masahiro IKEGAMI, Masashi ONO, Yasuhiro SATO, Makiko IC ...1998 Volume 40 Issue 1 Pages 12-21
Published: December 10, 1998
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSThe term "Serrated adenoma (SA)" was proposed by Longacre et al in 1990 to emphasize its neoplastic character and to distinguish from MHAP. We studied histological and endoscopical macroscopic features of SA which is fit for the pathological diagnotic criteria of Longacre et al. Ninty-three SAs excised from 90 patients and 11 MHAPs excised from 11 patients by colonoscopy during the period between 1977 and 95, were studied. As control, 170 hyperplastic polyps (HPs) excised from 151 patients in the same period were used. The sizes of tumors in SA (average; 10.3 mm) and MHAP (average ; 8.2 mm) were larger than those of HP (average ; 5.4 mm). Endoscopically, HP tended to show smooth surface with whitish mucosa and SA tended to show lobular and/or granular surface and reddish mucosa. Histologically, SA could be classified into two types of growth pattern, mono-existing type purely composed of adenoma, and co-existing type composed of admixed HP. Proliferating cells in SA frequently moved from the base of the crypt to the upper portion by Ki-67 (MIB-1) stain. The index of MIB-1 was relatively high on the base of the crypt with mild or moderate atypia. On the other hand, the labeling index of MIB-1 was equal between the upper portion and lower portion of the crypt in SA with high grade atypia. This was also seen in traditional tubular adenoma. The results obtained in this study suggest that SA has a neoplastic character similar to tubular adenoma, and should be treated in the same way as tubular adenoma.View full abstractDownload PDF (5250K) -
Kei SATOH, Ikuo MURATA, Masafumi TAGUCHI, Nobuaki WATANABE, Shigekazu ...1998 Volume 40 Issue 1 Pages 22-26
Published: December 10, 1998
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 59-year-old man had a 11-year history of increasing dysphagia. In October 1995, he was admitted to our hospital and treated with endoscopic pneumatic dilation of the esophagocardial junction. The treatment resulted in marked improvement of the symptoms without complications. In this case, it was possible to follow, retrospectively, the development of diverticula and achalasia on the serial esophagograms. The esophagogram in 1984, when his symptom first appeared, showed only a tiny indentation of the wall in the mid-esophagus. Since then, the diverticula had gradually increased in size while dilatation of the esophageal wall was not seen until 1994 when features of achalasia became apparent. These observations indicate that enlargement of the diverticula interfered progression of achalasia due to increased intraesophageal pressure.View full abstractDownload PDF (4901K) -
Akira FURUDOI, Yoshihiko TAKEHARA, Tomoki HIRAMOTO, Tosiki KAMIYASU, K ...1998 Volume 40 Issue 1 Pages 27-32
Published: December 10, 1998
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSWe reported a rare case of primary malignant lymphoma of the esophagus without extraesophageal involvement. A 75-year-old woman was admitted to our hospital because of dysphagia. An upper gastrointestinal series showed irregularity of the wall from the middle intrathoracic esophagus (Im) to the lower intrathoracic esophagus (Ei). Esophagoscopy showed multiple granules with ulcers. Biopsy specimens showed a diffuse medium-sized cell lymphoma. Chemotherapy was performed with modified CHOP (cyclophosphamide, vindesine, pirarubicin, prednisolone). A follow-up barium study and endoscopy showed that the lesion had disappeared. Thus this case of malignant lymphoma of the esophagus achieved complete remission. She has been well for 2 years and 6 months since the chemotherapy.View full abstractDownload PDF (3687K) -
Shinichi KATAOKA, Hiroaki OHCHI, Takashi TOYONAGA, Toshio DOZAIKU, Shi ...1998 Volume 40 Issue 1 Pages 33-39
Published: December 10, 1998
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 71-year-old man was admitted to our hospital with hematemesis. He was in shock state on arrival and endoscopy was carried out immediately after stabilization of vital signs with transfusion. Spouting bleeding from an exposed vessel of gastric ulcer on the angulus was seen and endoscopic injection therapy with hypertonic saline .epinephrine solution (HS-E) around the vessel and pure ethanol aside the vessel was carried out. On the next day, endoscopic study revealed a large ulcer developed on anterior wall of the stomach united with the ulcer on the angulus. Diffuse peritonitis appeared on the day 6th and a distal gastrectomy was carried out on the day 7th. The injection induced ulcer with perforation was located on the anterior wall of the stomach but the ulcer of angulus was not perforated. Pathologically, the injection induced ulcer had been developed along one of the anterior parietal branch of the left gastric artery. The arterial wall of the parietal branch was severely degenerated transmurally and thrombi were seen intraluminally. The proper muscle of the stomach along the parietal branch was also severly degenerated which was similar to the muscular change with myocardial infarction. These findings suggest that the perforation of the stomach was caused by ischemia with thrombosis that was the result of injection therapy.View full abstractDownload PDF (5518K) -
Wataru SANO, Shigeya HIROHATA, Kouichi YASUTAKE, Kazuya IWAMOTO, Mikio ...1998 Volume 40 Issue 1 Pages 40-45
Published: December 10, 1998
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSEnterobiasis is the most prevalent parasitic disease in Japan. We report three cases with enterobiasis unexpectedly detected by colonoscopic examination. Case 1 is a 65-year-old man, who visited us with a positive fecal occult blood test. Colonoscopic examination revealed numerous Enterobius vermicularis in the cecum to the ascending colon. Case 2 is a 70-year-old man, who was admitted for the resection of colorectal polyps. One Enterobius vermicularis was found in the cecum under colonoscopic examination. Case 3 is a 40-year-old woman, who visited due to constipation. One Enterobius vermicularis was found in the transverse colon under colonoscopic examination. There was no colorectal mucosal injury in any of these cases.Pyrantel pamoate, 10 mg/kg, was given to each case. Enterobiasis is rare in adults but is thought to be the disease that we should still carefully bear in mind because of occasionally causing appendicitis, perforation or penetration of the intestine.View full abstractDownload PDF (5044K) -
Daiki HABU, Tatsuhide OGA, Masayuki MIZUNO, Akihiko WATANABE, Hitoshi ...1998 Volume 40 Issue 1 Pages 46-51
Published: December 10, 1998
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSHereditary ceruroplasumin deficiency with systemic hemosiderosis attracts attention as a new metabolic disease. A 55-year-old man had normal liver function and both laparoscopic and histological findings of his liver were compatible to middling advanced primary hemochromatosis. Liver damge was both clinicaly and histologicaly slight inspite of large amount of iron deposition togather with basal ganglia on organ imaging studies such as MRI compared with other organs.View full abstractDownload PDF (4495K) -
Koki HIRASAWA, Mutsuo KITAGAWA, Yasunori TAKEHIRA, Katsutoshi TAMAKOSH ...1998 Volume 40 Issue 1 Pages 52-57
Published: December 10, 1998
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSWe experienced a rare case of anomalous arrangement of the unexpanded pan-creaticobiliary duct system with gallbladder cancer and inflammatory pseudotumor in the spleen. A 62-year-old woman was admitted to our hospital because of right hypochondral-gia. Endoscopic retrograde cholangiopancreatography revealed anomalous arrangement of the pancreaticobiliary duct system with unexpanded common bile duct and gallbladder tumor. Abdominal ultrasonography showed low echoic lesions in the liver and heter-ogenous mass in the spleen. Cholecystectomy, splenectomy and partial liver resection was performed. Histological findings revealed gallbladder cancer (well differentiated adenocar-cinoma papillare), peripheral cholangitis, iuf lammatory pseudotumor of the spleen.View full abstractDownload PDF (5211K) -
Satoshi OGAWA, Hideyuki KISHI, Shigeki OHASHI, Iruru MAETANI, Sumio FU ...1998 Volume 40 Issue 1 Pages 58-63
Published: December 10, 1998
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 56-year-old male with past history of liver cirrhosis, hepatoma, and esophageal varices. He admitted to Kousei Chuou hospital due to jaundice. As abdominal echography and CT revealed bilateral intrahepatic bile ducts dilatation, percutaneous transhepatic cholangiography (PTC) was carried out. The filling defect was noted in the right hepatic bile duct to common hepatic duct. PTCS revealed yellowish and friable tumor and biopsy specimen showed hepatoma. Ethanol was injected to the tumor, and it changed color white. The 12days later, the tumtr color changed dark brown, and biopsy specimen showed almost necrotic features. Totally 24ml of ethanol was injected but no complication was seen.View full abstractDownload PDF (5199K) -
Toshio URAOKA, Jun TOMODA, Tamiya MORIKAWA, Yuko ASATANI, Hirosuke YAM ...1998 Volume 40 Issue 1 Pages 64-69
Published: December 10, 1998
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 32-year-old man presented with hematoemesis and melena. He had suffered from hematoemesis in 1992 and 1993, but the cause remained unknown. Upper gastrointestinal endoscopy revealed bleeding in the fundus of stomach close to the posterior wall of the greater curvature, suggesting the Dieulafoy's ulcer. Local injection of ethanol and clipping achieved hematostasis. As his prior history of bleeding suggested the presence of a vascular anormaly, he underwent abdominal angiography. The angiogram revealed narrowing of the splenic artery at its origin from the celiac artery, many expanding and serpiginous branches from the left gastric artery, and an aneurysm in the fundus of the stomach. To avoid rebleeding, he underwent fundusectomy and splenectomy. In this patient, Dieulaf oy's ulcer was probably caused by collateral vessels that developed due to splenic artery aplasia. Young patients with a history of bleeding of unknown etiology must be checked for vascular anormaly.View full abstractDownload PDF (4112K) -
Norikazu ARAKURA, Hideharu MIYABAYASHI, Tomio OCHI, Hisa ISHIBASHI, Sh ...1998 Volume 40 Issue 1 Pages 70-75
Published: December 10, 1998
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 71-year-old old man was underwent a endoscopic examination in healthy screening and found a submucosal tumor of duodenal bulb with central depression. Conventional forceps biopsy specimens showed no diagnostic findings. So we underwent endscopic needle aspiration (ENA) with hood after endoscopic ultrasound and obtained a enough material for histological diagnosis. A Papanicolaou's stain of the aspirated material revealed a cluster of monomorphic tumor cells with round nuclei and moderately abundant, ill-defined granular cytoplasm which indicated carcinoid tumor.View full abstractDownload PDF (6833K) -
1998 Volume 40 Issue 1 Pages 76-83
Published: December 10, 1998
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSDownload PDF (830K) -
1998 Volume 40 Issue 1 Pages 84-94
Published: December 10, 1998
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSDownload PDF (1173K)
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