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Volume 42, Issue 4
Displaying 1-15 of 15 articles from this issue
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Kazuhiro WATANABE, Satoshi HOSHIYA, Kengo TOKUNAGA, Akifumi TANAKA, Ki ...2000 Volume 42 Issue 4 Pages 807-815
Published: April 20, 2000
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSIt was not clear why the new upper GI mucosal lesions bad appeared occasionally after cure of Helicobacter pylori (Hp) infection. The aim of this study was to evaluate the relationship among the mucosal lesions after Hp eradication, symptoms and the serological examinations. The subjects consisted of 27 patients with gastric ulcer, 31 patients with duodenal ulcer, 12 patients with gastro-duodenal ulcer and 7 patients with chronic gastritis. All of the 77 patients were diagnosed by endoscopically examination and treated with the triple regimen, namely, one week treatment using a standard or twice dose of proton pump inhibitor, arnoxycillin (1500mg) and clarithromycin (600mg or 800mg) in daily doses for Hp eradication. Two-year follow-up study was done in Hp negative patients. Our finding that showed reflux esophagitis occured in 5.2% and gastric erosion in 16.9% and duodenal erosion in 10.4% within two-years. However, 81.0% of these lesions were appeared within 10 weeks. But, in a few cases mucosal lesions persisted for two-years. No correlations were found among these mucosal lesions, the symp-toms and the serological tests (gastrin, pepsinogen I& II, secretin). These mucosal lesions were unaffected by administration of H2-receptor antagonist (H2RA). In conclusion, from these results, It was suggested that most of these mucosal lesions were not of clinical importance. The endoscopic examination should be followed serially in cases of the appearance of these mucosal lesions after Hp eradication.View full abstractDownload PDF (9604K) -
A CASE OF SPONTANEOUS SUBMUCOSAL HEMATOMA OF THE ESOPHAGUS WITH MUCOSAL BRIDGES AT THE HEALING STAGEKazuhiro HANDA, Shosei ISIGURO, Shigehumi ITAGAKI2000 Volume 42 Issue 4 Pages 816-821
Published: April 20, 2000
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSBoth mucosal bridge and spontaneous submucosal hematoma of the esophagus are rare diseases. We herein describe a case of spontaneous submucosal hematoma of the esophagus with mucosal bridge at the healing stage. A-73-year old female with anterior chest pain and nausea visited the Yawata Municipal Hospital. During examination she suddenly vomited approximately 300 ml of blood on a single occasion. Emergent endoscopic examination revealed a giant hematoma on the wall of the entire esophagus. Fasting and intravenous hyperalimentation were begun and follow up studies were conducted using the CT scan. In the second endoscopic examination done two weeks later, the hematoma had disappeared and a shallow ulcer and mucosal bridges had formed at the area of the hematoma. The esophageal mucosal bridges remained for more than two years and we cut them down because the patient had occasional dysphagia. After treatment, her symptoms had completely disappeared. From the evaluation of 23 cases of spontaneous submucosal hematoma in Japan, it was thought that the prognosis of this disease was excellent under conservative therapy.View full abstractDownload PDF (8532K) -
Yoshiya TACHIBANA, Kaheita KAKINOKI, Hiroshi YONEJIMA, Hidero OGINO, Y ...2000 Volume 42 Issue 4 Pages 822-828
Published: April 20, 2000
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 43-year-old man consulted our hospital complaining leg edema. Laboratory data showed hypoproteinemia. Upper gastrointestial endoscopic examination revealed enlarged gastric folds and multiple nodular lesions with an erosion at the top in the body and f ornix of the stomach, consisted with diffuse varioliform gastritis. Histological study of the specimen of endscopic biopsy revealed massive f oveolar hyperplasia with minimal inflammatory changes. Helicobacter pylori was observed in the body and the antral mucosa. We diagnosed diffuse varioliform gastritis associated with protein-losing gastropathy for the presence of H pylori. After eradication of H pylori, serum total protein was normalized and abnormal findings of endoscopic and histological examination of the stomach was improved.View full abstractDownload PDF (10006K) -
Masayuki TSUJISAKI, Seiya NAKAHARA, Mitsuru YOSHIMOTO, Jun ITOH, Shige ...2000 Volume 42 Issue 4 Pages 829-833
Published: April 20, 2000
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSWe report an interesting case of gastric malignant lymphoma that was able to be followed up without treatment by the endoscopic findings. A 81-year-old woman was admitted to our hospital because of a further examination of gastric ulcer lesion. Histopathological and immunohistochemical examination of biopsy specimens showed a gastric malignant lymphoma (diffuse large B cell type). She and her family refused specific treatments (chemotherapy or surgical resection), that made us observe the natural course of gastric lymphoma by upper gastrointestinal endoscopy. Serial endoscopic findings for about one year revealed that the morphology of lymphoma lesion changed remarkably with time. It changed from submucosal lesion, mucosal elevated lesion, ulcerations with thicking and extensive ulcer with invasion to surroundings, to repaired ulcer scar with discoloration. This finding of lymphoma process suggests that various appearances of lymphoma lesion may depend upon multiple phases of lymphoma progression.View full abstractDownload PDF (7115K) -
Mitsugi YASUDA, Masako KAJI, Rika AOKI, Jiro NAKAMOTO, Osamu SAKASHITA ...2000 Volume 42 Issue 4 Pages 834-839
Published: April 20, 2000
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 59-year-old-woman was admitted to our hospital for the further examination of the stomach. Endoscopic findings showed a IIc typed early gastric cancer in the gastric pylorus. Microscopic findings of the resected specimen showed a intramucosal signet-ring cell carcinoma with 1. 1 cm invasion in length into the duodenal mucosa and no lymph node metastasis. Generally, the frequency of duodenal extension by the stomach cancer is rare. In our case, it was speculated that the destruction of the mucosal structure of the duodenum by pyloric ulcer allowed stomach cancer to invade the doudenum.View full abstractDownload PDF (9609K) -
A CASE OF EARLY GASTRIC CANCER TREATED BY ARGON PLASMA COAGULATION-HISTOLOGICAL FINDINGS AT AUTOPSY-Shinichi NAKAMURA, Atsushi MITSUNAGA, Yoko FUKASAWA, Maiko KISHINO, Hi ...2000 Volume 42 Issue 4 Pages 840-845
Published: April 20, 2000
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 76-year-old man was diagnosed as having antral gastric cancer (type OI). His cancer was treated by argon plasma coagulation (APC). The patient died of an arrythmia 3 days after APC, and autopy was carried out. Histological examination showed that the mucosa and muscularis mucosae were obliterated by APC. The thermal effect also spread in the superficial layer of the submucosa. No thermal effect of APC reached as far as the muscle layer. Slight degenera-tion, fibrosis, edema, and infiltration of inflammatory cells were observed in the submucosa. There were moderately differentiated adenocarcinoma cells scattered in the submucosal layer as well. Though several experimental studies of the thermal effect of APC have been reported, human data remain scarce. In this case, the histological effect of APC could be evaluated in a human. This case may provide useful information for determining the technique and indications for APC in cancer patients.View full abstractDownload PDF (10423K) -
Ryuta TAKENAKA, Jun TOMODA, Chiho MAKIDONO, Takako MURAKAMI, Junichi K ...2000 Volume 42 Issue 4 Pages 846-851
Published: April 20, 2000
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 60-year-old man visited our hospital for the purpose of further examination of the anemia. Physical examination showed no abnormalities except that his palpebral conjunctiva was slightly anemic. Laboratory data were as follws ; RBC 432×104/mm3, Hb 11.5 g/dl, Ht 38.4%, Fe 22 μg/dl, Ferritin 25.4 ng/dl, CA19-9 134.4 ng/ml, and CEA 0.6 U/ml. Double contrast radiography of the small bowel revealed annular stenosis in the jejunum. Digital endoscopic examination showed an ulcerated, circumscribed tumor with clearly defined sharp margins and coated with dirty whitish exudate, like type 2 carcinoma in Borrmann's gross classification. We made a diagnosis of primary jejunal cancer. On microscopic study, the removed specimens showed sheet arrangement of small cells and tubular glands lined by columnal cells. Some small cells were positive for argylophil reaction (Grimelius stain), leading to a diagnosis of neuroendocrine cell carcinoma of the jejunum. No relapse was detected 11 months after the operation.View full abstractDownload PDF (8704K) -
Shino KAMACHI, Toshihiro SAKURAI, Taku NISHIMURA, Shigeru SATO, Toshiy ...2000 Volume 42 Issue 4 Pages 852-858
Published: April 20, 2000
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 41-year-old man was admitted to our hospital for evaluation of iron deficiency anemia. Small intestinal radiography showed a finger-like long pedunculated polypoid legion 70cm distal to the Bauhin's valve. Radiographically, it looked sac-shaped and the shape was easily changed during the compression study. An ulceration was suspected on the tip of the polypoid legion. Because of the peculiar shape, history of bleeding, and location, an inverted Meckel's diverticulum was suggested. Local resection of the small intestine was performed. Histologically, ectopic gastric pyloric-type mucosa with an open ulcer (Ul-III) was seen in the tip, however, most of the diverticulum was covered with small intestinal mucosa. This legion was diagnosed as an inverted Meckel's diverticulum.View full abstractDownload PDF (10985K) -
Kiyotaka OKAWA, Hisami HOSHINO, Hiroko KUROOKA, Hideto OIYA, Koji SANO ...2000 Volume 42 Issue 4 Pages 859-863
Published: April 20, 2000
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 24 year-old woman underwent surgery for a large ulcer in the ileo-cecal lesion. She was diagnosed to have a simple ulcer. Postsurgically, she developed fever of unknown origin. Genital ulcers involving the vagina and uterine cervix were discovered when examinations were performed for the origin of fever and Behcet's syndrome was diagnosed. The vaginal and uterine ulcers were healed by local antibiotic therapy. If a patient is suspected to have Behcet's syndrome, the vagina and uterus must be examined except the labia. If a patient with Behcet's syndrome develops fever of unknown origin, the possibility of infection of vaginal ulcer must be considered.View full abstractDownload PDF (7465K) -
Junichi SHIMURA, Satoshi SUGANO, Takaaki TAMAYAMA, Mituhiro TAMURA, Ta ...2000 Volume 42 Issue 4 Pages 864-869
Published: April 20, 2000
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 55-year-old man with a history of chronic alcoholic pancreatitis was admitted to our hospital with severe back pain. Serum amylase was 275 IU/L, but CRP was 34.2 mg/dl. Abdominal CT scan showed a pancreatic pseudocyst and effusions around the pancreatic tail and the left kidney. The patient was treated by the conservative therapy. The case improved biochemically. But after fifteen days, his conditions were deteriorated with elevated CRP, and CT scanning indicated the presence of pseudocyst communicated with main pancreatic duct suggesting the abscess formation. Perirenal abscess was collapsed by the percutenous drainage of purulent exsudate. But the pseudocyst of the pancreatic tail was increased in the size after drainage and the biochemical data was getting worse. Endoscopic transpapillary pancreatic duct stenting was placed into the main pancreatic duct. The abscess became collapsed and the biochmical data was improved. In conclusion, endoscopic transpapillary stenting is effective for the pancreatic abscess connected with the main pancreatic duct.View full abstractDownload PDF (9087K) -
Yoshiharu UNO, Ying HAN, Ayako ISHIGURO, Tatuya MIKAM, Yoshihiro SASAK ...2000 Volume 42 Issue 4 Pages 870-873
Published: April 20, 2000
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSXCF240AI (Olympus) is new colonoscope which is stiffness-adjustable in the flexible shaft. In order to evaluate its practical usefulness, 54 cases were examined consecutively with either X240AI (XCF240AI group) of CF240I (CF240I group), and prospective study was carried out. No significant difference was noticed between two groups in terms of insertion time to the cecum, but abdominal pain during insertion was significantly decreased in XCF240AI group. The adjustment of stiffness (from soft to stiff) of the shaft was performed in thirteen cases (48%), which succeeded in arriving the cecum. In conclusion, compared with CF240I, XCF240AI is easier to be performed with less pain.View full abstractDownload PDF (5431K) -
2000 Volume 42 Issue 4 Pages 874
Published: 2000
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSDownload PDF (49K) -
[in Japanese]2000 Volume 42 Issue 4 Pages 879-885
Published: April 20, 2000
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSDownload PDF (824K) -
[in Japanese]2000 Volume 42 Issue 4 Pages 886-899
Published: April 20, 2000
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSDownload PDF (1757K) -
[in Japanese]2000 Volume 42 Issue 4 Pages 900-905
Published: April 20, 2000
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSDownload PDF (663K)
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