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Volume 49, Issue 1
Displaying 1-13 of 13 articles from this issue
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[in Japanese]2007 Volume 49 Issue 1 Pages 1
Published: January 20, 2007
Released on J-STAGE: May 09, 2011
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[in Japanese]2007 Volume 49 Issue 1 Pages 2
Published: January 20, 2007
Released on J-STAGE: May 09, 2011
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Naomi UEMURA, Jyunichi AKIYAMA, Yoshiya KUMAGAI2007 Volume 49 Issue 1 Pages 3-11
Published: January 20, 2007
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSSince the discovery of Helicobacter pylori, the concept of diagnosis and treatment of upper gastrointestinal diseases has changed greatly from conventional beliefs. It has been recognized that H. pylori infection affects endoscopy images of gastric mucosa at the same time. It has become clear that eradication of H. pylori markedly improved histological gastritis induced by H. pylori infection. Because the histological change concerning H. pylori infection is reflected for the endoscope images, they also change greatly. The most remarkable histological change by eradication is improvement of infiltration of inflammatory cells and epithelial hyperplasia, characteristics of endoscopic change are improvement of edema and disappearance of spotty and macular redness of gastric mucosa. In addition, swelling and tortuosity of gastric fold are improved and adhesion mucin disappears in the greater curvature of gastric body after eradication. Moreover, nodular gastritis in the antrum improved by eradication. On the other hand, redness and/with erosion newly appear in the antrum and duodenal bulb. As disorders, gastric MALT lymphoma and hyperplastic polyp are improved by eradication. It is important that changes of endoscopic image after eradications are known well in common practice.View full abstractDownload PDF (10519K) -
Kyosuke TANAKA, Shigenori KADOWAKI, Yasuhiko HAMADA, Ryo KOSAKA, Toshi ...2007 Volume 49 Issue 1 Pages 12-20
Published: January 20, 2007
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSBackground : A detail demarcation line diagnosis of esophago-gastric tumor has become important by inventing Endoscopic Submucosal Dissection (ESD). On the other hand, the mucosal surface structure can be observed in detail by enhanced-magnification endoscopy using acetic acid.Aim : The aim of this study was to evaluate usefulness of enhanced-magnification endoscopy for ESD.Subjects and Method : Subjects were 53 lesions. There were one superficial Barrett's esophageal adenocarcinoma lesion, 34 early gastric cancer lesions, and 18 gastric adenoma lesions. Usefulness of demarcation line diagnosis of tumor by enhanced-magnification endoscopy for ESD was investigated.Result : In depressed type tumors, demarcation lines diagnosis of tumors by enhanced-magnification endoscopy were useful in all lesions. In elevated-type lesions, it was useful in only 24% lesions. In the cases with clear demarcation line of tumors by enhanced-magnification endoscopy, the diagnosis of tumor demarcation lines was corresponding to the pathological diagnosis by the resected specimens. There were two lesions which were able to avoid positive lateral margin by enhanced-magnification endoscopy for ESD.Conclusion : Enhanced-magnification endoscopy for ESD was able to observe the demarcation lines of early cancers and adenomas in detail, especially in tumors of the depressed type, and may be useful to avoid positive lateral margin.View full abstractDownload PDF (12696K) -
Rika MIYOSHI, Yuichi YASUNAGA, Takashi KIZU, Takuya INOUE, Chie WATANA ...2007 Volume 49 Issue 1 Pages 21-29
Published: January 20, 2007
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 21-year-old man was admitted to the hospital because of epigastric pain and slight fever. Physical examination showed epigastric tenderness, rebound tenderness and muscular defence. Blood tests showed increases in the white blood cell counts, erythrocyte sedimentation rate and C-reactive protein value. Endoscopic examination and barium study revealed the lesser curvature of the stomach pushed from the outside. Ultrasonography and computed tomography showed inflammatory and mass-like changes in the fat tissue between the liver and stomach, that is, the lesser omentum. Laparoscopical examination revealed strong adhesion between the liver and stomach. Under the diagnosis of panniculitis of the lesser omentum, the symptoms disappeared and laboratory data were normalized by a conservative treatment. This is the first case report of panniculitis of the lesser omentum and its characteristic images.View full abstractDownload PDF (14003K) -
Azuma MURAMATSU, Shinya KOBAYASHI, Chihiro HASEGAWA, Tomihiro HAYAKAWA2007 Volume 49 Issue 1 Pages 30-38
Published: January 20, 2007
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSBall valve syndrome is defined as clinical phenomenon in which the sudden obstruction of the lumen of the pylorus by a gastric tumor intussusception. We report a rare case of Ball valve syndrome in which one lesion of multiple gastric cancer prolapsed into the duodenal bulb. A 76-year-old bedridden man with cerebral infarction was referred because of abdominal fullness and vomiting. Gastrointestinal endoscopy showed the irregular, double-headed polyp with the long, wide stalk on the greater curvature of the pyloric antrum. Another two protruding lesions on the posterior wall of the upper corpus and the anterior wall of the ventricular angle were also shown. UGI series demonstrated prolapse of a large pedunculated polyp which consisted of 2 parts, through the pylorus into the duodenal bulb. Biopsy specimens taken from these lesion were diagnosed as gastric cancer. Resection of the tumors was performed. After treatment, his symptoms were resolved. Because of elderly patients who have complicated disease with deteriorated Activities of Daily Living, local resection seemed to be one of the treatment for this case.View full abstractDownload PDF (15280K) -
Kenjiro TAMORI, Yukinori NAKAE, Mitsutaka KUMAMOTO, Toshiaki HAMAZAKI, ...2007 Volume 49 Issue 1 Pages 39-44
Published: January 20, 2007
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSThere have been many reports on the major papilla in the duodenal diverticulum. However, we rarely encountered reports on the minor papilla in the duodenal diverticulum. A 88-year-old woman was admitted to our hospital to the further evaluation of the common bile duct dilatation with abdominal ultrasonography. MRCP reveals dilatation of the common bile duct, short ventral duct and long dorsal duct. ERCP disclosed that a large diverticulum was in the cranial side of the major papilla, and a minor papilla lie in the floor of the diverticulum. Endoscopic pancreatogram via the major papilla showed a short ventral duct with harmonious terminal arborization. Dorsal catheteriza-tion was attempted via the minor papilla and no communication was seen between the ventral and dorsal duct. This patient was diagnosed as pancreas divisum. This case may suggest the involvement of congenital factor, including abnormalities in the development of f oregut in the embryonal stage, and local fragility of duodenal wall. This paper discussed the significance and development of duodenal intradiverticular minor papilla.View full abstractDownload PDF (7669K) -
Hidenori TOKUHARA, Yoshihiko SAKURAI, Yohei YAMADA, Shinobu UMEMURA2007 Volume 49 Issue 1 Pages 45-50
Published: January 20, 2007
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 37-year-old woman was referred to our hospital for fecal blood. Colonoscopic examination revealed a laterally spreading tumor, 15mm in diameter, at the rectum. Prior to the endoscopic polypectomy, submucosal injection of hypertonic saline-epinephrine was performed. However, because it was judged that the total specimen was unable to be excised by EMR at one time, we decided to try the transanal resection. But we failed it, and colonoscopy was performed again for the purpose of piecemeal EMR 11 days after submucosal injection. The lesion was ulcerlized and no adenoma component was recognized histopathologically. We report this rare case, that the disappearing process was endoscopically able to be observed after submucosal injection to a flat colonic lesion.View full abstractDownload PDF (12144K) -
Takuji IWASHITA, Ichiro YASUDA, Youhei SHIRAKAMI, Yoshihiko TSUKADA, H ...2007 Volume 49 Issue 1 Pages 51-57
Published: January 20, 2007
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 56-year-old man was admitted to our department because of increased levels of serum hepato-biliary enzymes and dilatation of intrahepatic bile ducts on abdominal CT image. ERCP showed stricture of the main pancreatic duct and dilatation of its branches in the head of the pancreas. Lower common bile duct was also narrow and multiple strictures of intrahepatic bile ducts were seen. Serum IgG and IgG4 levels were high and histological examination of pancreatic biopsy specimen obtained by EUS-FNA showed infiltration of lymphocytes and plasma cells, and interlobular fibrosis. Therefore, we diagnosed autoimmune pancreatitis, but the cholangiogram was difficult to discriminate from primary sclerosing cholangitis. Oral steroid therapy was commenced after the diagnosis of autoimmune pancreatitis. Increased levels of hepatobiliary enzymes and IgG4 went down after starting steroid therapy, and cholangiogram was also improved markedly.View full abstractDownload PDF (8731K) -
[in Japanese]2007 Volume 49 Issue 1 Pages 58-59
Published: January 20, 2007
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSDownload PDF (1961K) -
Iruru MAETANI, Takeo UKITA, Tomoko TADA, Masaki IKEDA, Masahiro SEIKE, ...2007 Volume 49 Issue 1 Pages 60-69
Published: January 20, 2007
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSKnacks for doing PTCS safely and adequately were outlined. As for lithotomy, it was used in patients with hepatolithiasis and those with CBD stones which is difficult to be removed by transpapillary procedures. In terms of treatment for hepatolithiasis, choice of appropriate route for lithotomy and optimal management of stenosis offers a high success rate. On the other hand, PTCS was also performed to determine mucosal spreading of the bile duct cancer (especially papillary type or protruded type) and to do ablative treatment for unresectable bile duct cancer. Laser or microwave is used for ablative therapy. It is very important to avoid over cauterization in order to reduce the risk of major complication such as perforation or bleeding.View full abstractDownload PDF (16839K) -
[in Japanese]2007 Volume 49 Issue 1 Pages 70-73
Published: 2007
Released on J-STAGE: January 29, 2024
JOURNAL FREE ACCESSDownload PDF (679K) -
2007 Volume 49 Issue 1 Pages 75
Published: January 20, 2007
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSDownload PDF (193K)
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