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Volume 44, Issue 9
Displaying 1-9 of 9 articles from this issue
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Akira HORIUCHI, Yoshiko NAKAYAMA, Hironobu MAEYAMA, Takahiro YAMAURA, ...2002 Volume 44 Issue 9 Pages 1663-1672
Published: September 20, 2002
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSThe development of a new device and techniques for its use have made it possible to endoscopically decompress acute, malignant colorectal obstruction in 17 patients (5 with rectal carcinoma, 4 with carcinoma of the sigmoid colon, 3 with carcinoma of the descending colon, 2 with carcinoma of the transverse colon, 2 with carcinoma of the ascending colon, and 1 with carcinoma of the cecum). Following adequate cleansing of the colon, a definitive surgery was carried out in all patients. We describe here the techniques based upon the above experiences. 1) When abdominal CT suggests acute, malignant colorectal obstruction, colonoscopy should be carried out using a colonoscope equipped with an auxiliary water inlet under fluoroscopy. 2) Following the advance of a colonoscope to the site of the tumor, a hydrophilic guide wire is then introduced through the tumor beyond the point of obstruction using a water-soluble contrast medium and a biliary guide catheter. 3) A drainage tube whose tip is tapered is placed transanally with the aid of a dilator or a sliding tube. When difficulty is encountered in inserting the tube beyond the obstruction, the tube should be introduced into the stenotic segment holding the tube by grasping forceps.View full abstractDownload PDF (16356K) -
Youichi MIYAOKA, Syunji ISHIHARA, Mika YUKI, Akira KAWAMURA, Hiroshi S ...2002 Volume 44 Issue 9 Pages 1673-1680
Published: September 20, 2002
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 54-year-old woman was admitted to our hospital because of epigastralgia. Upper endoscopic examination showed a large elevated lesion with a wide irregular ulceration at surface and normal gastric mucosa at lateral side in the upper gastric body. The tumor size was more than 5cm and intratumor necrosis was suspected on abdominal CT. Clinical diagnosis was thought malignant submucosal tumor, malignant lymphoma and gastric carcinoma etc. Histopathologically, its diagnosis was GIST. Immunohistological examination revealed Smooth muscle type (positive for c-kit, CD34, SMA, M-actin and Vimentin, negative for desmin and S-100). Then we performed operation. The diagnosis was GIST (smooth muscle type) and borderline malignancy tumor. None c-kit germline mutation in exon 11 was detected. Recently it has been reported that the germline mutation in the c-kit gene of GIST is associated with aggressive features and poor prognosis, and malignant GISTs frequently have mutations in that site. Our case has been no reccurence for 1-years after operation therapy. We expected the molecular biological method is useful for the diagnosis of malignant state and prognosis.View full abstractDownload PDF (12615K) -
Hirofumi HIRANA, Masahide ATSUMI, Rie MANABE, Naoki SAWAI, Hiroshi UEH ...2002 Volume 44 Issue 9 Pages 1681-1686
Published: September 20, 2002
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA report is presented on a case of gastric abscess after endoscopic hemostasis in a 91-year-old female with Dieulafoy's ulcer, who was admitted to the hospital because of speech and gait disterbance. Although general condition had tended to be improved, tarry stool was seen and urgent endoscopy revealed local bleeding from Dieulafoy's ulcer, which was treated by endoscopic injection of absolute ethanol and HS-E fluid. Rebleeding had not been seen, but a hemispherical elevated lesion like a submucosal tumor was found by follow-up endoscopic study. EUS revealed a cystic lesion in the third layer of the gastric wall, which suggested a submucosal gastric abscess. Endoscopic drainage was performed for the lesion, and α-Streptococcus and Neisseria were detected by the culture of the aspirated content. An elevated lesion was disappeared 7 days after endoscopic drainage.View full abstractDownload PDF (10158K) -
Yasuharu YAMAGUCHI, Taro YAMATO, Naoya KATSUMI, Yasuyuki IMAO, Kei AOK ...2002 Volume 44 Issue 9 Pages 1687-1691
Published: September 20, 2002
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSArgon plasma coagulation (APC) has been reported as a diathermy-based non-contact therapeutic endoscopic modality that may have a lower risk of complication. However, we report two cases of bleeding gastric ulcers after APC based on our experience. Case 1 : A 66-year-old man with concomitant liver cirrhosis and chronic renal failure was treated by APC for bleeding from diffuse antral vascular ectasia. Initially, no complications were observed. However, 12 days later, he developed melena. Emergency endoscopy revealed APC induced multiple bleeding gastric ulcers. Endoscopic hemoclipping for hemostasis was applied and resulted in prompt resolution of bleeding. Case 2 : A 77-year-old man with chronic renal failure was treated by APC for bleeding from vescular ectasia localized on the lesser curvature of the gastric cardia. Seven days after, he had an episode of hematemesis. Emergency endoscopy likewise disclosed a bleeding gastric ulcer induced by APC at the aforementioned site. Subsequently, bleeding was controlled using endoscopic hemoclipping. APC, previously thought as a low risk therapeutic modality, can cause mucosal damage resulting in bleeding gastric ulcers. Based on our observation, patients undergoing APC should therefore be carefully monitored for possible complications such as bleeding gastric ulcers.View full abstractDownload PDF (6809K) -
Takashi FUJISAWA, Norikazu SAKAMOTO, Kazuhiko SAKAGUCHI, Shoji KURODA, ...2002 Volume 44 Issue 9 Pages 1692-1698
Published: September 20, 2002
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA retrospectively observed differentiated type gastric cancer was reported. First endoscopy showed a depressed lesion in the prepyloric region and was diagnosed as no malignancy by biopsy. Two years later, endoscopy showed ha +IIc-resembling advanced cancer with granular surface on the same site. Therefore, pyloric subtotal gastrectomy was performed. Histological examination showed well differentiated adenocarcinoma with invasion of the serosa and villous growth of tumor cells mimicking gastric f oveolar epithelium in the intramucosal layer. Mucin histochemistry revealed gastric foveolar phenotypic expression of adenocarcinoma.View full abstractDownload PDF (13166K) -
Takuya INOUE, Yasumasa HATADA, Kohsuke KANAZAWA, Masanori TANAKA2002 Volume 44 Issue 9 Pages 1699-1704
Published: September 20, 2002
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 79-year-old man, who had been visiting our department as out patient after colorectal polypectomy, rapidly developed typical Cronkhite-Canada syndrome (CCS), complaining diarrhea as initial symptom from late December 1999. Intravenous hyperalimentation and oral steroid were given for the treatment. Since poorly differentiated adenocarcinoma had been found at the time of endoscopic mucosal resection in November, 1999, he underwent subtotal colectomy and ileosigmoidostomy. His postoperative course was satisfactory, and both gastric and residual rectal polyposis had disappeared. Interestingly, polyposis had not been found in the stomach and colorectum two months before the disease onset, while edematous and reddish colorectal mucosa was demonstrated one month before the disease onset, and rapidly followed by typical endoscopic findings of CCS. These findings suggest that gastrointestinal lesions of CCS may emerge within a very short period.View full abstractDownload PDF (9548K) -
Yoshiaki EBUCHI, Keiji TAKAHASHI, Shigeru NAKANO, Naoki OKANO, Yoshiko ...2002 Volume 44 Issue 9 Pages 1705-1709
Published: September 20, 2002
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 57-year-old man was diagnosed to have ulcerative colitis (UC) and had since been well with no relapse for 16 years. He was admitted to our hospital because of pain of the left knee joint and numbness of the leg. Colonoscopy revealed multiple pseudopolyps and erosion on the surface of colonic mucosa. Bone scintigram showed accumulation of isotope around the left knee and ankle joints. Nerve conduction velocity was a slow at peroneal nerve. He was treated mesalazine and prednisolone, this treatment improved his subjective symptom. We have reported a rare case of UC associated with arthritis and mononeuritis.View full abstractDownload PDF (8203K) -
Masamoto NAKAMURA, Hiroki NAKASONE, Akira HOKAMA, Kiyoshi MAEDA, Jun F ...2002 Volume 44 Issue 9 Pages 1710-1714
Published: September 20, 2002
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 49-year-old man presented with jaundice and appetite loss. He had a history of removal of his right eye with choroidal malignant melanoma a year earlier. Abdominal US and CT showed dilated biliary tree and liver metastasis. Endoscopy revealed gastroduodenal metastatic malignant melanoma. ERCP showed the stenosis of the terminal portion of the common bile duct. We placed a self-expandable metallic stent into the common bile duct, which improved his quality of life. Five months later, the patient died of carcinomatosis.View full abstractDownload PDF (8046K) -
[in Japanese]2002 Volume 44 Issue 9 Pages 1718-1719
Published: September 20, 2002
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSDownload PDF (329K)
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