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Volume 46, Issue 3
Displaying 1-9 of 9 articles from this issue
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-INDICATION, CHOICE OF METHOD AND OUTCOME-Shinji TANAKA, Shiro OKA, Kazuaki CHAYAMA2004 Volume 46 Issue 3 Pages 243-252
Published: March 20, 2004
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSWe assessed endoscopic mucosal resection (EMR) for superficial type early colorectal carcinoma (CRC), especially regarding its indication, choice of resection methods, and outcome. It was indicated that CRC even with submucosal massive invasion can be cured by complete EMR on conditions that the depth of sm invasion is within 1, 500, um and histologic grade at the deepest invasive portion is W or Mw, if there are no vessel involvement. However, cases with Mp or Por grade can never be curative by EMR, even if they showed a sm scanty invasion.
Limit of size in en block EMR using snare with one-channel colonoscope was considered 20 mm in average diameter. However, intentional piecemeal EMR for large colorectal intramucosal tumor, such as laterally spreading tumor (LST) is useful for curative EMR. Recently submucosal dissection EMR method using Hook knife, IT knife or Flex knife has enabled to perform endoscopic en block resection for large colorectal tumor as well as gastric carcinoma. However, it is needed to improve present procedure/device to easier one and standardize this technique to every general colonoscopist.View full abstractDownload PDF (18082K) -
Takaya SHIMURA, Masami INUKAI, Nobuo YOSHIOKA, Yasuhiko SAIDA, Tomonor ...2004 Volume 46 Issue 3 Pages 253-258
Published: March 20, 2004
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 62-year-old man presented with dysphagia and chest discomfort. Esophagogram and upper digestive tract endoscopy revealed a polypoid mass, 8.0-cm in size, in the lower intrathracic and abdominal esophagus. We diagnosed pseudosarcomatous squamous cell carcinoma on histology and treated with a subtotal esophagectomy. Histologically, most of the tumor was composed of spindle cells with mitosis. And squamous cell carcinoma presented focally at the base of the polypoid tumor. Immunohistochemically, spindle cells were stained with vimentin and partially stained with cytokeratin. Squamous cell carcinoma was stained with cytokeratin. These findings indicated that the tumor should be designated as so-called carcinosarcoma, according to the classification of carcinosarcoma recommended by the Japanese Society for Esophageal Disease. And rhab-domyosarcomatous cells were found in the sarcomatous portion of cardiac lymph nodes metastasis.View full abstractDownload PDF (9668K) -
Hideaki KATO, Yuji NISHI, Makoto OHYAMA, Takashi TOHYAMA, Makoto NAKAM ...2004 Volume 46 Issue 3 Pages 259-264
Published: March 20, 2004
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSEsophageal intramural hematoma is a rare complication of endoscopic injection sclerotherapy (EIS). Here we present a patient with liver cirrhosis and developed esophageal intramural hematoma after EIS. A 55-year-old male was admitted to Toyokawa City Hospital with a complaint of melena. He was diagnosed to have a rupture of esophageal varices and elective EIS was performed twice. After the second EIS, he presented nausea, dysphagia and substernalpain. Esophagogastroduodenoscopy (EGD) and computed tomography scan revealed complete obstruction of the esophageal lumen due to dissecting intramural hematoma . He was treated conservatively and his symptoms subsided after 6 days . The resolution of intramural hematoma was demonstrated on EGD 65 days after the onset.View full abstractDownload PDF (9147K) -
Junko OMORI, Nozomi KAZUKA, Mikinori KATAOKA, Kunio HARUYAMA, Akiko YA ...2004 Volume 46 Issue 3 Pages 265-271
Published: March 20, 2004
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 72-year-old man was operated for advanced esophageal cancer in 1999. The patient was diagnosed as the O-IIc type early cancer on the greater curvature of the lower gastric tube by the endoscopic examination 3 years after the operation, and admitted to our hospital. The gastric cancer of this case was about 2cm in size and suggested sm invasion on endoscopy. Therefore, the therapeutic choice should direct to gastrectomy. However, due to the patient's refusal disagreement to undergo the operation, we decided to treat by EMR and APC. The 7 months later after EMR and APC treatment, no recurrence has been recognized. We concluded that the combined treatment in EMR addition to APC is one of a effective treatment in a early cancer of gastric tube.View full abstractDownload PDF (10072K) -
Hiroshi KAYAMA, Hiroki HASUI, Koutarou NISHIMURA, Akira IZUMORI, Shinj ...2004 Volume 46 Issue 3 Pages 272-277
Published: March 20, 2004
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSWe report a rare case of intra-mucosal gastric carcinoma with a Krukenberg's tumor. Only 7 cases have been reported in Japanese medical literature. The case is of a 35-year-old woman who received a right oophorectomy and a left enucleation of ovarian tumor in Jan. 1998. The tumor was histopathologically classified as a singet ring cell carcinoma, which was suspected to have been a metastatic ovarian tumor. But postoperative studies revealed no primary carcinoma in the gastrointestinal tract, the lungs, the breasts nor the thyroid glands. After 3 years and 4 months from the first operation, we found an early gastric carcinoma of the IIc-type on the lesser curvature of the upper potion of the gastric body. The biopsy specimens were diagnosed as a signet ring cell carcinoma, and a proximal gastrectomy was performed. There was some metastasis in the regional lymph nodes (n1). Because there were no ascites nor peritoneal disseminations, the lymphatic spread of the cancer cells to the ovaries was considered as the most possible pathway of metastasis.View full abstractDownload PDF (9080K) -
Masako ASAYAMA, Shigeru YAMATO, Akira MURAOKA, Junichi AKIYAMA, Naohik ...2004 Volume 46 Issue 3 Pages 278-284
Published: March 20, 2004
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA case of mucosal prolapse syndrome improved by conservative treatment is reported. The patient was a 32-year-old male, complaining of rectal bleeding at defecation. Colonoscopy revealed 3 polypoid lesions at the anterior wall of the lower rectum. The final diagnosis was made on the histological findings of the endoscopically resected specimen. Defecography revealed rectal intussusception and puborectalis contraction during straining. He was recommended to abstain from excessive straining at defecation and to control bowel movement with dietary fiber, dairy products and laxatives. With these conservative treatment, he became almost asymptomatic, and polypoid lesions of the rectum disappeared.View full abstractDownload PDF (9270K) -
Yoshiharu UNO2004 Volume 46 Issue 3 Pages 285-290
Published: March 20, 2004
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 84-year-old man with a history of spinal cord injury and paraplegia was admitted for bowel control. The patient has been suffering from severe constipation and fecal incontinence. His usual bowel care time lasted four hours. Percutaneous endoscopic cecostomy was performed for antegrade continence enema without the need for laparotomy and can be accomplished using a local anesthesia. After antegrade continence enema of 120 ml of 50 percent glycerin through the cecostomy, his bowel care time was decreased 4 hours to one hour, and his constipation was improved.View full abstractDownload PDF (10314K) -
Motoi TAKEUCHI, Yoshinori FUJITSUKA, Akihiko HACHIYA, Kazumasa MIKI, S ...2004 Volume 46 Issue 3 Pages 291-302
Published: March 20, 2004
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSAlthough APC has been utilized as one procedure of the endoscopic treatments for early gastric cancer, there are still few reports on histological effect of APC. It seems important to evaluate the histological effect of APC on early gastric cancer. This study was conducted on 6 patients of early gastric cancer with informed consents. We carried out APC for the lesions in all patients, and for the boundary area between early gastric cancer and normal mucosa in 3 of 6 patients before operation. We examined 9 coagulated areas histologically from resected stomach. The average time of APC was 11.5 seconds for gastric cancer and was 9 seconds for the boundary area. APC lesions were observed as simply heat coagulation of gastric mucosa endoscopically. Histological observation revealed various depth of the damage from mucosal muscle layer to proper muscular layer. (mm: 1, superficial sm : 3, deep sm : 4, pm :1) One session of APC therapy may be efficient for mucosal or super ficial submucosal cancer, however, it is possible that perilous that one session of therapy could unexpectedly infuluence proper muscular layer.View full abstractDownload PDF (21380K) -
2004 Volume 46 Issue 3 Pages 306-311
Published: March 20, 2004
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSDownload PDF (1948K)
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