GASTROENTEROLOGICAL ENDOSCOPY
Online ISSN : 1884-5738
Print ISSN : 0387-1207
ISSN-L : 0387-1207
Volume 43, Issue 10
Displaying 1-10 of 10 articles from this issue
  • Kei KASHIMA
    2001 Volume 43 Issue 10 Pages 1983-1996
    Published: October 20, 2001
    Released on J-STAGE: May 09, 2011
    JOURNAL FREE ACCESS
    Major technological advances have recently occurred in the measurement of motility in every area of the tubular gut. In addition, the expansion of motility techniques to include biofeedback has transformed motility recordings from simply a diagnostic tool into an instrument for treatment of gastrointestinal disorders. In the present article the results of our motility studies in the esophagus, the sphincter of Oddi, and the colon are shown, and the clinical importance of the measurement of gastrointestinal motility is disscussed.
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  • Toshiyuki KAGAWA, Kazuya MATSUDA, Yoshihito UCHIDA, Minako ITOH, Hideh ...
    2001 Volume 43 Issue 10 Pages 1997-2004
    Published: October 20, 2001
    Released on J-STAGE: May 09, 2011
    JOURNAL FREE ACCESS
    BACKGROUND & AIM: Intestinal metaplasia in Barrett's epithelium has been shown to be associated with adenocarcinoma. It is, however, difficult to endoscopically detect intestinal metaplasia in Barrett's epithelium. The aim of this study was to evaluate the usefulness of methylene blue staining for detecting intestinal metaplasia in Barrett's epithelium. METHODS: We performed upper endoscopy with methylene blue-directed biopsy and obtained 83 biopsy specimens (57 stained and 26 unstained) from 24 Japanese patients with Barrett's epithelium, 1 cm or more in length. All specimens were examined histologically. RESULTS: The sensitivity and specificity of methylene blue staining for detecting intestinal metaplasia were 98.2% and 92.6%, respectively. Patients with short or limited length of Barrett's epithelium have a focal distribution of intestinal metaplasia. CONCLUSIONS: Methylene blue staining is a useful method for detecting intestinal metaplasia in Barrett's epithelium and may aid the endoscopist in selective biopsies from Barrett's epithelium.
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  • Ryousuke MISHIMA, Takafumi SAWA, Hiroshi OHARA, Keigo KUBO, Hiroshi SA ...
    2001 Volume 43 Issue 10 Pages 2005-2011
    Published: October 20, 2001
    Released on J-STAGE: May 09, 2011
    JOURNAL FREE ACCESS
    A 54-year-old woman was admitted to our hospital due to epigastric pain. Upper gastrointestinal endoscopy and X-ray examination revealed a giant gastric ulcer at the gastric angle and a gold floating bezoar measuring 11×6cm in size. We treated the bezoar endoscopically with mechanical bascket lithotripter. Because the bezoar was huge and hard, first challenge for crushing the bezoar transformed mechanical bascket lithotripter and it was failed. However, heating and extending transformed mechanical bascket lithotripter enabled us to crush the bezoar successfully. Even if a bezoar is big, our method of crushing the bezoar was simpler and cheaper than others in past reports.
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  • Teruyuki USUBA, Yutaka SUZUKI, Yoshio ISHIBASHI, Akira KURAMOCHI, Hiro ...
    2001 Volume 43 Issue 10 Pages 2012-2016
    Published: October 20, 2001
    Released on J-STAGE: May 09, 2011
    JOURNAL FREE ACCESS
    A 43-year-old male was admitted to our hospital for disorder of consciousness and emaciation, we diagnosed him as AIDS and immediately administerd anti-virus medicines through a nasal tube. However his condition gradually deteriorated. So we placed PEG to keep the route for nutrition and medication. After that, his condition got better and kept stable. It is thought that PEG is effective for AIDS patients.
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  • Satoshi ITANO, Sadayuki HORIKI, Norihiko TERADA, Akira ENDO, Masahiro ...
    2001 Volume 43 Issue 10 Pages 2017-2025
    Published: October 20, 2001
    Released on J-STAGE: May 09, 2011
    JOURNAL FREE ACCESS
    Case 1:A 51-year-old female visited our hospital because of fecal occult blood. Pedunculated polypoid early cancer (m) with adenoma was found in the terminal ileum. Case 2: A 68-year-old male VISIted our hospital because of repeating abdominal pain. Protruded earlycarlcer(sm2)without adenomatous component was found in the ileurn, 15cm from the ileocecaIvalve. Both cases were able to be diagnosed definitively with colonoscopy before operationbecause of being the intussusception. Thirty-one operated cases of cancer of ileum werereported in Japan and twenty cases were diagnosed with colonoscopy. but of these 31 cases, thenumber of early stage cancer of the ileum was only six.
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  • Shuji SUZUKI, Yuko MIYAZONO, Masato KIMURA, Hiroshi KATO, Hideki NOZAW ...
    2001 Volume 43 Issue 10 Pages 2026-2030
    Published: October 20, 2001
    Released on J-STAGE: May 09, 2011
    JOURNAL FREE ACCESS
    A Case of colonic muco-submucosal elongated polyp (CMSEP) is reported. A 59 year old woman visited our hospital because of a positive occult blood test. Double contrast study showed a long pedunculated polyp in the transverse colon. Colonoscopic polypectomy was performed. The size of the resected specimen was 48×18mm. Histopathological examination showed normal mucosa and edematous submucosal layer with dilated vessels and lymphatics. These findings confirmed the diagnosis of CMSEP.
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  • Akihiko TACHIBANA, Naoto FUKUDA, Junzo NAGAYAMA, Tatsuo YAMAKAWA, Shig ...
    2001 Volume 43 Issue 10 Pages 2031-2035
    Published: October 20, 2001
    Released on J-STAGE: May 09, 2011
    JOURNAL FREE ACCESS
    A 51-year-old man was admitted to our hospital with a complaint of difficulty in swallowing and cough. He had previous surgeries for gastric ulcer and pancreatic cancer. After admission, endoscopic examination revealed a severe stenosis in the jejunum 45cm from incisional teeth 5cm distal to the esophago-jejunal anastomotic site, and multiple fistulae were seen near the lesion. We diagnosed it as a malignant stricture due to recurrent pancreatic cancer complicated with jejunobroncial and jejunocutaneous fistulae which was considered to be inoperable. A covered self-expandable metallic stent was inplaced at the site of the stricture and fistulae. Bndoscopically the stricture was remitted and the fistulae were sealed, and the patient's oral intake was much improved soon. This experience suggested that the use of covered self-expandable metallic stent for jejunobronchial and jejunocutaneous fistulae with malignant stenosis is an alternative for the patients in a grave condition.
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  • Gen TOHDA, Kenichi SUMIYOSHI, Hitoshi SAKUMOTO, Shotaro KOSAKA, Chikak ...
    2001 Volume 43 Issue 10 Pages 2036-2043
    Published: October 20, 2001
    Released on J-STAGE: May 09, 2011
    JOURNAL FREE ACCESS
    A 75-year-old man complaining of right hypochondralgia was admitted to our hospital because of mild jaundice. Duodenal endoscopic findings revealed the yellowish mucin outflow from Vater's papilla. Endoscopic retrograde cholangiography (ERC) revealed the filling defect in the hepatic hilar region and the dilatation extending from the intrahepatic bile ducts into the common bile duct. Obstructive jaundice resulting from mucin-like material retention in the biliary duct was suggested. Percutaneous transhepatic cholangioscopy (PTCS) revealed white tumors associated with yellowish mucin in the left intrahepatic bile duct. The histopathological diagnosis of PTCS biopsy specimens revealed mucin-producing cholangiocarcinoma. He underwent a left lobectomy, and the operative curability was evaluated histologically. Although the mucin-producing cholangiocarcinoma is rare entity, a relatively good prognosis can be promised if it had been accurately diagnosed preoperatively and adequate operation was performed. Conventional cholangiographies such as percutaneous transhepatic cholangiography (PTC) or ERC can not offer precise information of bile ducts because of mucin products. PTCS is indispensable for accurate preoperative diagnosis of mucin-producing cholangiocarcinomaa including the evaluation of superficial spread of cancer, which may improved the prognosis of patients with this disease.
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  • Takeshi SAWADA, Osamu KAWAMURA, Haruto SANADA, Takefumi HARA, Tatsuki ...
    2001 Volume 43 Issue 10 Pages 2044-2049
    Published: October 20, 2001
    Released on J-STAGE: May 09, 2011
    JOURNAL FREE ACCESS
    A 53-year-old woman was admitted to our hospital with sudden epigastralgia, back pain, and nausea. Upper gastrointestinal endoscopy showed an Ascaris lumbricoides worm in the duodenal bulb, which was removed with biopsy forceps. The patient's abdominal symptom was reduced, but she once again complained of fever, epigastralgia, and nausea. Laboratory data was suggestive of liver injury, and magnetic nesonance cholangiopancreatography (MRCP) revealed a linear low-signal-intensity area, which is surrounded by the high-signal-intensity bile in the common bile duct. Thus, the diagnosis of biliary ascariasis was confirmed. Longitudinal ultrasonographic scanning of the common bile duct revealed the worm body as a thick echoic strip containing a central aechoic tube ("inner tube" sign). The worm was identified by way of endoscopic retrograde cholangiography and extracted using basket forceps after endoscopic papillary balloon dilatation. In Japan, this is the first report of biliary ascariasis diagnosed by MRCP, which is considered to be an useful and non-invasive method for the diagnosis and follow up of biliary ascariasis. It is suggested that symptomatic treatment, the oral administration of pyrantel pamoate, and the use of various endoscopic interventional procedures may be necessary in patients with biliary ascariasis depending on the patient's general condition and complications.
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  • 2001 Volume 43 Issue 10 Pages 2053-2055
    Published: October 20, 2001
    Released on J-STAGE: May 09, 2011
    JOURNAL FREE ACCESS
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