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Volume 42, Issue 1
Displaying 1-14 of 14 articles from this issue
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[in Japanese]2000 Volume 42 Issue 1 Pages 1
Published: January 20, 2000
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSDownload PDF (127K) -
[in Japanese]2000 Volume 42 Issue 1 Pages 2
Published: January 20, 2000
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSDownload PDF (104K) -
Shin-ei KUDO, Keiko ISHIKAWA, Hiro-o YAMANO, Yoshiro TAMEGAI, Yasushi ...2000 Volume 42 Issue 1 Pages 3-7
Published: January 20, 2000
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESS“Polypoid”(type Is)is the most frequent form of early colorectal cancers. It has long beenbelieved that these polypoid cancers always evolve from polyps; i. e. polyp-cancer sequence.Recently, however, there are enough evidence to believe that some “polypoid” cancers evolvefrom depressed carcinomas(type IIc). Such lesion has the demarcated depression whose outlineis irregular like type IIc. Therefore, we classify these polyp-mimicking cancers with depressioninto type Is+IIc. They look like simple polypoid lesions at first sight, but after the sprayingof dye the depression emerges. The depression in type Is+IIc is composed of submucosallyinvasive carcinomatous tissue which always shows type VN pit pattern with a zoom colonoscope. The rim itself is always covered urith normal colonic musosa which shows normal typeI pigs, as well as th:e type IIc lesion. Some IIc lesions get elevated as a result of massive cancer proliferatio in the submucosa, and become type Is+IIc. These lesions are significantly smallerr(12.6 mm in diameter on average)than another Is submucosally invasive cancer withoutdernarcated depression(19.0mm in diameter on average).Even in our country, most colonos-copists classify both types of “polypoid” lesions into type Is. It is, however, very important todistinguish type IS+IIc from another Is lesions which evolve from polyps, using dye-sprayingand zooming, because their biological behavior is quite different.View full abstractDownload PDF (4878K) -
-EVALUATION BY ENDOSCOPIC ULITRASONOGRAPHY-Takahiro SATO, Katsu YAMAZAKI, Jouji TOYOTA, Yoshiyasu KARINO, Takumi ...2000 Volume 42 Issue 1 Pages 8-13
Published: January 20, 2000
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSThis study was designed to evalute blood flow of the gastric wall after therapies of gastricvarices, and the prognosis of gastric varices using endoscopic color Doppler ultrasonography (ECDUS)in 39 patients observed over six months. The therapy techniques used in this study included endoscopic injection sclerotherapy (EIS) using 70% Histoacryl in 34 cases, EIS using 5% ethanolamine oleate (EO) in three, and balloon-occuluded retrograde transvenous obliteration (B-RTO) in two. The blood flow in gastric wall was delineated in 25 of 39 (64.1%) patients using ECDUS after therapies of gastric varices. The pulsatile wave in gastric wall was delineated in 18 patients, the maximum velocity of 15.3±5.1cm/s, and the minimum velocity of 4.6±1.6cm/s. Continu.ous wave in gastric wall was delineated in seven patients, the velocity of 8.0±3.7cm/s. Next, we investigated the recurrence of gastric varices. Recurrence rates of gastric varices were 0/14(0%)in cases without color flow images, 1/18(5.6%) in cases with pulsatile wave, and 6/7(85.7%)in cases with continuous wave, respectively. ECDUS is a useful modality in evaluating therapeutic effects and the prognosis after therapies of gastric varices.View full abstractDownload PDF (4132K) -
Toshihiko OKUYAMA, Kyoichi ADACHI, Kazunori UEKI, Yoshikazu KINOSHITA2000 Volume 42 Issue 1 Pages 14-19
Published: January 20, 2000
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSAn 88-year-old woman was referred to our hospital for the evaluation of the esophagealtumor, which was found by her family physician. Endoscopy demonstrated a round protrusionwith approximately about l cm in diameter on the thoracic segment of the esophagus.Histological diagnosis of the biopsy specimen was squamous cell carcinoma. The depth of thetumor invasion was found to be as deep as submucosa lay endoscopic ultrasonography. Sincethe patient and her families refused the treatment by surgical resection, endoscopic mucosalresection was perfarmed. The resected specimen was found to be an esophageal carcinoma of O-I pl. (plateau) type with the histblogy of mucoepidermoid carcinoma, a subtype ofadenosquamous carcinoma. The clinical course of the patient is uneventful and she shows nolocal recurrence and distant metastasis for more than five years after the endoscopic treatment. We report this rare case since endoscopic resection was useful for the treatmgnt ofesophageal mucoepidermoid carcinoma found in elderly case.View full abstractDownload PDF (6681K) -
Tatsuhiro TSUJIMOTO, Shigeki KURIYAMA, Masahide YOSHIKAWA, Noriko NIWA ...2000 Volume 42 Issue 1 Pages 20-26
Published: January 20, 2000
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA case of a 46-year-old man who had pemphigus vulgaris of the esophagus was reported. The patient got blisters on his skin 2 years before and was histologically diagnosed as pemphigus vulgaris. After treatment with predonisolone for three months, his skin lesions improved markedly and he stopped receiving the treatment by his own judgement. Five days before admission, he had a sore throat and hoarseness. He suddenly vornitted approximately 40cm esophageal rnucosa with fresh blood after a meal. An emergent endoscopic examination on admission revealed detachment of almost entire esophageal mucosa. A biopsy specimen of the esophagus disclosed aeantholysis of suprabasilar epithelial sells. A direst immunofluorescent (DIF) study revealed intraepidermal deposits of IgG, and an indirect immunofluorescent (IIF) study revealed a titer of 1 : 160 of anti-pemphigus vulgaris antibodies. With the diagnosis of pemphigus vulgaris involving the esophagus, the patient was treated with 20mg of predonisolonedaily. Eight weeks later, the esophageal lesions completely disappeared endoscopically, and DIF and IIF examinations were shown to be negative. Pemphigus vulgaris is a rare chronic autoirnmUne bullous disease mediated by IgG deposits at the intracellular space of the epithelium of the skin and mucosa. Although esophageal pemphigus vulgaris is considered to be rare, its incidence has been increasing with the spread of endoscopes. Therefore, it is important in the follow-up of patients with pemphgus vulgaris to take esophageal lesions into consideration. Furthermore, we suggest that careful attention to esophageal symptorns and endoscopic examination in selected cases of pemphigus vulgaris may reveal a higher incidence of this entity.View full abstractDownload PDF (6250K) -
Ryota HIGUCHI, Fumitoshi WATANABE, Yoshiaki HORIO, Masanobu KAGEOKA, H ...2000 Volume 42 Issue 1 Pages 27-31
Published: January 20, 2000
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 75-year-old woman was admitted to our hospital because of epigastric pain. Upper endascopic examination revealed smooth submucosal tumor in the upper body of the stomach, which was 60mm in size and had bridging fcld by an upper gastrointestinal barium series. EUS revealed a low echoic mass with some microcystic areas, derived from the forth layer of the gastric walL We suspected of leiomyosarcoma of the stomach and laparotomy wasperformed. The tumor was diagnosed gastrointestinal stromal tumor (GIST) of the stomach and a few mitoses (3/25HPF) were observed on histological examination. Tumor cells were positive for CD34 and c-kit, but negative for actin and s-100 by histochemical examination. Recently it has been said that the c-kit recepter is an useful marker for stromal turnors that have a wide differential diagnosis in view of variable histological apperances. We report the case of GIST which was positive for c-kit and discuss the concept and the hisagenesis of GIST.View full abstractDownload PDF (4398K) -
Hidcyuki AJISAKA, Takashi FUJIMURA, Sachio FUSHIDA, Yutaka YONEMURA, K ...2000 Volume 42 Issue 1 Pages 32-35
Published: January 20, 2000
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 61-year-old woman was admitted to our hospital for Borrmann type 4 gastric cancer with complete obstruction of the body. She could not receive operation but chemotherapy because of multiple liver metastases, lymphnode metastases including paraaortic lymphnodes and peritoneal dissemination. As a result of 5times chemotherapy, multiple liver metastases and lymphnode metastases were partially remitted and obstruction of gastric body slightly improved, therefore an expandable metallic stent (EMS) was indwelt. She turned out to eat orally enough to be discharged from the hospital without complication related to the indwelt EMS. It is very important for the quality of life to indwell EMS actively even against gastric body stenosis.View full abstractDownload PDF (2416K) -
Takeshi HARA, Akira SAKAGUCHI, Shigeyuki TAKENAKA, Aki HORIMOTO, Toshi ...2000 Volume 42 Issue 1 Pages 36-40
Published: January 20, 2000
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 52-year-old woman underwent investigation for epigastric discomfort and vomiting. Endoscopic examination showed multiple gastric polyps of various sizes. Histologically, polyps were identified as hyperplastic polyps composed of elongation and hyperplasia of the foveolae. Three large polyps were removed endoscopically and multiple polyps that remained in the stomach, less than 10mm in diameter, were evaluated carefully by annual endoscopy. Fou. ryears later, the polyps were unchanged and Helicobacter pylori (H. pylri) was found with the CLO test. The patient was treated with a 1-week course of lansoprazole, clarithromycin and tinidazole. About l year later, almost all gastric polyps had disappeared with eradication of H. pylori. Anti-H. pylori treatment may be useful as the treatment of choice for hyperplastic gastric polyps.View full abstractDownload PDF (4472K) -
Yasuhiro OSHIMO, Naoya OTSU, Masahiro OTA, Michio IMAMURA, Sunjin KIM, ...2000 Volume 42 Issue 1 Pages 41-45
Published: January 20, 2000
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA case of appendiceal mucocele with elevated SEAI evel in the cystic fluid detected by colonoscopic examination is presented. A 70-year-old woman was admitted to our hospital because of apositive fecal occult test. Colonoscopy revealed a semispherical, smooth-surfaced, soft elevated lesion at the end of the cecum with a wide circumferential zonal fold, and the orifice of the appendix was undetected, which was strongly suggestive of appendiceal mucocele. Barium enema showed an elevated lesion similar to a submucosal tumor at the lower end of the cecum and a shape of the tumor varied according to pesition and compression, and the appendix was not visualized. Abdominal ultrasonography and CT examination showed a bi-lobular cystic lesion at the ileo-cecal region. Under a diagnosis of appendiceal mococele, operation was performed. Pathological examination showed mutinous cystadenoma, and immunohistochemical staining with antibody to CEA showed positive in part of the cystic wall. CEA level in the cystic fluid was elvated, and after aperatian the serum SEA has smoothly fallen to normal leve1, so CEA was thought to beproduced at the appendiceal mucosa and to be entered into venous system. Number of eases of asyrnptomatie appendieeal mueoeele is thought to increase as number of colonoscopic examination increase. Therfore we should keep appendiceal mucocele in mind when an elevated lesion at the cecum with a wide circumferential zonal fold is found at the end of the cecum.View full abstractDownload PDF (4947K) -
Kiyomi KIMURA, Hiroyuki KATO, Shungo ENDO, Kazuhiko YOSHIMATSU, Shunsu ...2000 Volume 42 Issue 1 Pages 46-49
Published: January 20, 2000
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSThis paper reports a case of Inverted Appendiceal Stump(IAS)treated by endoscopic polypectamy. A 59-year-old female patient with a history of appendectomy fir appendicitis, was performed contrast barium enema because of bloody stoat, and revealed a protrudedpolypoid lesion of the bottom of cecum. Colonoscopy revealed a worm-like polyp at the cecum.The mucasa of the polyp showed a normal pit pattern. This polyp was resected endoscopicallyusing an indwelling snare. Histopathological examination revealed a reversed structure of thenormal appendix with mild hyperplasia. Therefore, the lesion was evaluated as BAS.View full abstractDownload PDF (5215K) -
Taru SHIZUMA, Kiyoshi HASEGAWA, Etsuko HASHIMOTO, Makiko TANIAI, Eii K ...2000 Volume 42 Issue 1 Pages 50-55
Published: January 20, 2000
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSSiblings (21-year-old female and 26-year-old male) were hospitalized for examination ofsuspected portal hypertension. Both had esophageal and gastric varicosis, and CT demonstrat-ed liver fibrosis. Laparoscopy revealed diffuse whitish marking on thelIiver surface and was auseful procedure for making the diagnosis of congenital hepatic fibrosis. Although congenitalhepatic fibrosis is a genetic disease, siblings cases are rare. we reviewed some literatures andreported two cases.View full abstractDownload PDF (4763K) -
Yoshitake SHINJI, Meiko NISHIUCHI, Yoshio KAMEDA, Koichi SEKI2000 Volume 42 Issue 1 Pages 56-60
Published: January 20, 2000
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSFrom October 1974 to December 1998, we performed 3467 medical laparoscopies in 2807 patients. The ages of the patients ranging from one year and 5 months to 87 years with arl average of 49 years. The records included 44 pediatric laparoscopies of the children under 15 years. The laparoscopy was repeated twice to 9 times in each of 493 patients(17.6%)and brought very valuable informations for the follow-up of their clinical courses. Among the techniques of laparoscopy, biopsy of the liver was most frequently performed and done in 3234 examinations. The indications for these 3467 laparoscopies at the Hyogo Prefectural Nishinomiya Hospital were compared with those of 3500 experiellces at the Osaka University Hospital from 1959 to 1973. The rnost common indication was the assesment of liver diseases and its proportion increased from 67%in Osaka to 91%in Nishinomiya. Differential diagnosis of obstructive janudice and bile tract diseases was significantly decreased ill Nishinomiya. New indications such as evaluation of the liver status before and/or after renal transplantation and emergency laparoscopy have emerged in Nishinomiya. Major cornplications occurred in 23 cases with one death from intraabdominal hemorrhage following concomitant liver biopsy. despite the alteration of the indications laparoscopy is still useful in medical practice.View full abstractDownload PDF (3169K) -
En YONEDA, Yukio OSAKI, Toru KIMURA, Kentaro TSUJI, Tornoo KOMIBUCHI, ...2000 Volume 42 Issue 1 Pages 61-67
Published: January 20, 2000
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSEndoscopic mucosal resection(EMR)was performed safely in 2 cases after transcatheter arterial embolization(TAE). Case l was a 67-year-01d male. Early gastric cancer, of the protruded type(type I), was detected at the antrum by gastrointestinal X-ray and endoscopic examinations. EMR was performed after TAE. Histopathological assessment demonstrated a well differentiated adenocarcinoma. Case 2 was a 66-year-old male. Subm .ucosal tumor was detected at the posterior wall of the duodenum by gastrointestinal X-ray and endoscopic examinations. EMR was performed after TAE. Histapathologicai findings revealed hamartoma of the Brunner's gland. No bleeding complications were recognized in either case.View full abstractDownload PDF (7040K)
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