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Volume 48, Issue 7
Displaying 1-12 of 12 articles from this issue
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Satoru TAMURA, Tomoko ONISHI, Saburo ONISHI2006 Volume 48 Issue 7 Pages 1415-1424
Published: July 20, 2006
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSThe Authors examined 5620 colorectal tumorous lesions via magnifying endoscopy, stereomicroscopy and histopathology. Lesions with type I or II pit pattern are nontumors, whereas lesions with types IIIs, IIIL, IV and/or V pit pattern are tumors. Their magnifying endoscopic pit patterns images were fundamentally similar to the stereomicroscopic images. The accuracy of endoscopic diagnosis, or magnifying endoscopic diagnosis consistent with histological diagnosis, was 95.2% (5351/5620 lesions). Lesions exhibiting type VN or VI-s pit pattern with bounded surface are cancers invading the submucosal layer. If this pit pattern ranges extensively, sm-massive is strongly suspected. Polypectomy or endoscopic mucosal resection is not indicated for these lesions in view of invasive character.View full abstractDownload PDF (15173K) -
Minoru AYADA, Tatsunori NAKANO, Naoki HOTTA, Harumichi NAKAE, Shin KUN ...2006 Volume 48 Issue 7 Pages 1425-1430
Published: July 20, 2006
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSWe performed percutaneous endoscopic gastrostomy (PEG) by transnasal endoscopy using a small-caliber endoscope for the purpose of relieving the pain and stress of gastrointestinal endoscopy and PEG without conscious cedation. The usefulness and safety were compared between cases performed PEG by transnasal endoscopy and those by transoral endoscopy. Cases with dysphagia by neurological diseases were divided into two groups randomly. The pull technique was used for both groups. We observed vital signs etc to compare pain and stress in transnasal insertion group and transoral insertion group. An increase in blood pressure and pulse rate was significantly small during PEG in the transnasal insertion group compared to the transoral group. There was no major complication in the transnasal insertion group as well as the transoral group. Our experience suggested that PEG by transnasal endoscopy using a smallcaliber endoscope is more useful than PEG by transoral endoscopy to relieve the pain and stress, and PEG by transnasal endoscopy is a safe method as well as PEG by transoral endoscopy.View full abstractDownload PDF (8493K) -
Akira SASAKAWA, Taizo HIJIOKA, Keiko NAKAMURA, Minoru SIGEKAWA, Osamu ...2006 Volume 48 Issue 7 Pages 1431-1436
Published: July 20, 2006
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 71-year-old woman was admitted to our hospital with epigastric pain. Serological test revealed slight inflammation. X rays of the breast and abdomen did not revealed abnormal findings such as free air in the peritoneal cavity. Urgent upper gastrointestinal endoscopy showed a toothpick sticking in the gastric wall of the lesser curvature of the pylorus. Abdominal ultrasonography and computed tomography revealed the gastric perforation with the toothpick and regional peritonitis, but there was no visceral injury around the stomach. The toothpick was removed successfully and safely via an endoscope with polypectomy snare. She was treated conservatively by nasogastric intubation and administration of antibiotics.View full abstractDownload PDF (10952K) -
Mitsuhiro MORIKAWA, Hiroyuki HAYASHI, Osamu HOSOKA, Taiji KAIZAKI, Ken ...2006 Volume 48 Issue 7 Pages 1437-1441
Published: July 20, 2006
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 75-year-old female previously diagnosed as von Recklinghausen's disease (VRD) was underwent follow-up abdominal CT after operation for rectal carcinoid, thyroid cancer and intrahepatic cholangiocarcinoma. Endoscopic examination of the duodenum showed a submucosal tumor in the papilla of Vater. Because of the diagnosis as adenocarcinoma by biopsy specimen, pancreatoduodenectomy was performed. Histological examination showed collision tumor with adenocarcinoma and carcinoid in the papilla of Vater. We reported this case because collision tumor of the papilla with VRD is the first case in Japan, quintuple cancer is very rare and only 8 cases including our case have been reported in Japan.View full abstractDownload PDF (7886K) -
Takahiko NAKAJIMA, Satoshi HIRAI, Hitoshi KUNITANI, Satoru NAKAMURA, T ...2006 Volume 48 Issue 7 Pages 1442-1446
Published: July 20, 2006
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 41-year-old man was admitted to our hospital because of high fever and diarrhea. CT scan and MRI showed a monolocular mass in the retrorectal space. Sigmoidoscopy revealed a smooth hemispherical elevated lesion coverd with smooth mucosa in the rectosigmoid. Endoscopic ultrasonography showed a hypoechoic mass with hyperechoic parts, which was located in the outer submucosal layer. He was diagnosed as having a submucosal abscess of the rectosigmoid and transmucosal endoscopic drainage was chosen in terms of the location and the depth of the mass, and white pus was drained into the rectal lumen. His symptoms had disappeared after the drainage. Torulopsis glabrata was detected from the pus. A case of perirectal abscess, which was treated by endoscopic intraluminal drainage was presented.View full abstractDownload PDF (11289K) -
Takashi MOURI, Takenori HADA, Hideharu YASUE, Takeshi GOCHO, Tomotaro ...2006 Volume 48 Issue 7 Pages 1447-1451
Published: July 20, 2006
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSAn eighty-year-old woman visited a local hospital for right lower abdominal pain. She was first referred to the gynecology service of our hospital. Since abdominal CT demonstrated a cystic lesion in contact with the bladder in the lower right abdomen, the patient was refurred to us. Endoscopic examination revealed mucin production through the orifice of the vermiform appendix. Cystoscopy demonstrated an edematous mucosa with ulceration. Ileocecal resection and partial resection of the bladder were performed for suspected appendiceal mucinous cystadenocarcinoma. In the resected specimens, the appendiceal wall was thickened and the lumen of the appendix was filled with jelly-like mucus. Although appendiceal mucinous cystadenocarcinoma may simulate submucosal tumor on endoscopy, visualization of mucin accumulation at the appendiceal orifice is a rare feature.View full abstractDownload PDF (9359K) -
Toshihiro OSHIMA, Takao ITOI, Atsushi SOFUNI, Toshio KURIHARA, Takayos ...2006 Volume 48 Issue 7 Pages 1452-1459
Published: July 20, 2006
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 67-year-old female was admitted to our hospital for jaundice. Gallbladder cancer with bile duct infiltration was diagnosed by imaging modalities and PTBD was performed. After jaundice was ameliorated, two partially covered self-expandable metallic stents (C-SEMS) were inserted to both lobes of the liver for biliary drainage. Six months later, she was admitted again for jaundice. Patency of the stents was excellent. However, a new papillary elevated lesion was found at the distal end of the lower common bile duct. Under choledochoscopic guidance, YAG laser ablation was performed on the lesion for recanalization and she was discharged. Six months later, she was re-admitted to our hospital for anemia. Massive genital hemorrhage occurred after admission. Treatment to stop the bleeding was in vain and she died. Autopsy revealed synchronous triple cancer consisted of gallbladder cancer, lower biliary duct cancer, and uterine cervical cancer.View full abstractDownload PDF (17556K) -
Masaya WADA, Yoshihiro OKABE, Shuji YAMAMOTO, Naoya KIMOTO, Akihiko OK ...2006 Volume 48 Issue 7 Pages 1460-1467
Published: July 20, 2006
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 66-year-old man was admitted to our hospital because of body weight loss and jaundice. Abdominal CT showed a solid tumor in the head of the pancreas, measuring 8 cm. Endoscopic retrograde pancreatography (ERP) revealed pancreatic duct blockage due to the bulging tumor into the main pancreatic duct. Endoscopic biopsy from the surface of the exposed mass at the site of the papilla of Vater obtained only necrotic tissue. Endoscopic ultrasound-guided fine needle aspiration biopsy (EUS-FNAB) revealed acinar cell carcinoma (ACC). Pyrolus-preserving pancreaticoduodenectomy was performed. Histological findings showed a bulging tumor occupying the main and accessory pancreatic ducts. This from of spreading of ACC is very rare, and only two cases have been reported previously. In this case, EUS-FNA was very useful for the preoperative diagonosis.View full abstractDownload PDF (20203K) -
[in Japanese], [in Japanese], [in Japanese]2006 Volume 48 Issue 7 Pages 1468-1469
Published: July 20, 2006
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSDownload PDF (2636K) -
Junko FUJISAKI, Mituo SAITO, Yorimasa YAMAMOTO, Makoto Tatewaki, Akiyo ...2006 Volume 48 Issue 7 Pages 1470-1479
Published: July 20, 2006
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSThe narrow-band imaging (NBI) is a newly developed device which brings about an information of the microvascular structure of GI mucosa. An aim of this study is to investigate the usefulness of the magnified NBI for more accurate endoscopic diagnosis of the early gastric cancer. The appearances of the magnified NBI were classified as follows ; fine-network, oval, spiral, and irregular patterns. Well-differentiated adenocarcinomas typically showed fine-network pattern. Moderately differentiated adenocarcinomas typically showed oval or spiral pattern. Poorly differentiated adenocarcinomas typically showed irregular pattern. Using these vascular pattern, we will be able to diagnose minute cancer without biopsy. The magnified NBI observation was useful for the pretreatment histological evaluation of the early gastric cancer.View full abstractDownload PDF (22453K) -
Kazuo INUI, Junji YOSHINO, Hironao MIYOSHI, Takao WAKABAYASHI, Kazumu ...2006 Volume 48 Issue 7 Pages 1480-1484
Published: July 20, 2006
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSBackground : We used percutaneous transhepatic cholangioscopy for detailed assessment of biliary tumors. Among the most important endoscopic findings is greater mucosal vascularity in malignant than in benign biliary strictures. Development of digital image processing now permits measurement of mucosal hemoglobin volume as a hemoglobin index. We studied the clinical usefulness of this hemoglobin index for differentiating malignant from benign bilialy strictures. Methods : From 2000 to 2002 we determined the hemoglobin index in 22 patients with biliary stricture (8 with bile duct carcinoma ; 1 with carcinoma of the duodenum ; 5 with pancreatic carcinoma and 8 with benign stricture). Eight patients with malignant stricture were diagnosed by the histological examinations of resected specimens ; six with malignant stricture and eight with benign stricture were diagnosed by examination of biopsy specimens. The ratio of hemoglobin indices in a given patient of lesional and uninvolved mucosa was determined from cholangioscopic imaging data. Results : The mean hemoglobin index ratio for bile duct carcinoma was 1.83 ; for carcinoma of the duodenum 1.98 ; and for pancreatic carcinoma, 1.35. For benign strictures, the ratio was only 1.09. The mean hemoglobin index ratio in patients with bile duct or pancreatic carcinoma was significantly higher than in patients with benign stricture (P< 0.05, paired t-test). Conclusions : An image-derived hemoglobin index is useful for diagnostic assessment of biliary stricture.View full abstractDownload PDF (8607K) -
[in Japanese], [in Japanese]2006 Volume 48 Issue 7 Pages 1485-1488
Published: 2006
Released on J-STAGE: January 29, 2024
JOURNAL FREE ACCESSDownload PDF (336K)
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