-
Kohzoh IMAI, Fumio ITOH
1995 Volume 92 Issue 9 Pages
1227-1232
Published: September 05, 1995
Released on J-STAGE: February 26, 2008
JOURNAL
FREE ACCESS
-
Matsuomi UMEHARA, Masahiko ONDA, Takashi TAJIRI, Masahito TOBA, Kiyohi ...
1995 Volume 92 Issue 9 Pages
1233-1240
Published: September 05, 1995
Released on J-STAGE: February 26, 2008
JOURNAL
FREE ACCESS
Endoscopic variceal ligation using an intensive ligation method, or intensive EVL, as we call it, was performed in 17 cases of esophageal varices, from August 1993 to November 1994. Intensive EVL involves making as many ligations as possible from just above the esophago-gastric junction at every session for the complete eradication of varices (F0 and negative Red color sign). Our success rate for the complete eradication of varices was 82.4% (14 out of 17 cases) with the mean number of sessions at 2.2 ± 0.5 times. The total number of rubber bands used was 20.2 ± 8.4, with 14.1 ± 6.0 being used in the initial session alone. The rate of recurrence in complete eradicated cases was 50% (7 out of 14 cases) and the period to recurrence was 6.3 ± 0.7 months. Although EVL using the intensive ligation method is useful for complete eradication of varices, a high incidence of recurrence in the short term is a concern. We conclude therefore that it is difficult to achieve long term complete eradication of varices with EVL alone, and that additional therapy is needed for long term control.
View full abstract
-
Masumi WATANABE, Saburo NAKAZAWA, Junji YOSHINO, Kenji YAMAO, Kazuo IN ...
1995 Volume 92 Issue 9 Pages
1241-1249
Published: September 05, 1995
Released on J-STAGE: February 26, 2008
JOURNAL
FREE ACCESS
We studied the correlation of the gastric acid secretion and the depth of sleep at night with no medication in 32 cases (19 gastric ulcer, 6 duodenal ulcer patients and 7 healthy controls). Using Memory PH Monitor intragastric pH values were consecutively measured without antiulcer drugs. The depth of sleep were monitored continuously by recording without any sleeping drugs. In healthy controls, the pH values of awake phase was significantly lower than that of sleep stage 1, 4 and rapid eye movement (REM) phases. The pH values of REM phases were significantly high rather than that of sleep stage 1 and 2 phases. In patients with gastric ulcer, the pH values of awake phases were significantly lower than that of sleep stage 1 and REM phases. The pH values of REM phases were significantly high rather than that of the other sleep stages. On the other hand, in patients with duodenal ulcer, the obvious changes of the pH values were not seen with sleep stages. The pH values of healthy controls and gastric patients were changed with sleep stages. But the pH of duodenal ulcer patients were not changed obviously. Therefore, it is suggested that the dysfunction of autonomous nervous system was influenced the nocturnal intragastric pH in the patients with duodenal ulcer and played one of the important role in the occurrence of duodenal ulcer.
View full abstract
-
Jiro WATARI, Yutaka ORII, Yusuke SAITOH, Masanori MURAKAMI, Yusuke MIZ ...
1995 Volume 92 Issue 9 Pages
1250-1257
Published: September 05, 1995
Released on J-STAGE: February 26, 2008
JOURNAL
FREE ACCESS
To clarify the clinicopathological features of tumors with submucosal invasion, especially superficial elevated and sessile ones, histological architectures of 32 cases of submucosal invasive cancers were analyzed. They were classified into 3 types based on cross-section view : PG and NPG of Shimoda's classification and PG'. Histological architectures were drawn in accordance with these findings. In 7 PG-Ca which consisted of PG only, no apparent correlation was found between the tumor sizes and invasion depth of submucosal layer. However, 12 NPG-Ca which consisted of NPG only and 12 Mixed-Ca which include various cross-section views both showed massive invasion into the submucosa with 1 cm or more in tumor size. Therefore these two types were similar in biological behavior in terms of invasion depth. And degree of submucosal invasion tended to increase in the order of PG-Ca, Mixed-Ca and NPG-Ca. Examinating histological architectures of the Mixed-Ca tumors in details, all of these cancers were consisted of both PG and PG'. Of the 12 Mixed-Ca, 91.7% were proved to be PG dominant type. Macroscopically, Is and IIa contained 88.9% and 40.0% of Mixed-Ca, respectively. In conclusion, these results suggest that PG' is a subtype of PG, and PG-Ca have a correlation between tumor invasion and alternation from PG to PG' in histological architectures among submucosal cancers. It is important to clarify morphological features of PG' in margin of Is and IIa tumors in diagnosing the depth of early colorectal cancers.
View full abstract
-
Takashi KUMADA, Satoshi NAKANO, Isao TAKEDA, Keiichi SUGIYAMA, Toshima ...
1995 Volume 92 Issue 9 Pages
1258-1265
Published: September 05, 1995
Released on J-STAGE: February 26, 2008
JOURNAL
FREE ACCESS
A total of 96 patients with small hepatocellular carcinoma (HCC) with a maximal diameter of below 2 cm were analyzed according to recurrent factors and recurrent modes after the first treatment. In this study, recurrences were divided into two groups based on the style of recurrences provisionally : intrahepatic metastases (IM, 35 cases) and multicentric recurrences (MC, 22 cases).
In patients with IM, the majority of recurrences were observed within 2 years after the first treatment and the primary HCC lesions had strong relation to the degrees of malignancy.
On the other hands, there were no association with recurrent intervals and the degrees of malignancy, although the recurrent rate was high in patients with anti-HCV in MC group.
The prognosis after the second treatment in MC group was superior to that in IM group (p<0.05).
These results indicate MC group have a good prognosis if early detection and the second accurate treatment are performed.
View full abstract
-
Hitoshi SAITO, Hidenori KANAZAWA, Masafumi KOBAYASHI, Tatsuo KUMAZAKI
1995 Volume 92 Issue 9 Pages
1266-1274
Published: September 05, 1995
Released on J-STAGE: February 26, 2008
JOURNAL
FREE ACCESS
We performed transjugular intrahepatic portosystemic shunt (TIPS) in 25 patients with liver cirrhosis who developed upper gastrointestinal bleeding due to portal hypertension. The procedure was successful in 23 patients, in whom portal pressure decreased by 51%. Bleeding was stopped in all 5 emergency for whom other treatments, including sclerotherapy, had failed. During the follow-up period (mean : 367 days), shunt dysfunction due to stenosis was observed in 75% of the patients. However, by percutaneous transluminal angioplasty, the patency could be maintained in 85% of the cases after 1 year and 73% of the cases after 2 years. Re-bleeding was observed in 13% of the cases after both 1 and 2 years. Color Doppler ultrasonography was useful for detecting shunt dysfunction. TIPS seems to be an effective treatment of upper gastrointestinal bleeding due to portal hypertension.
View full abstract
-
Motohiro TAKASAKI, Sojiro MORITA, Tadashi HORIMI, Masahiro TAKAMATSU, ...
1995 Volume 92 Issue 9 Pages
1275-1284
Published: September 05, 1995
Released on J-STAGE: February 26, 2008
JOURNAL
FREE ACCESS
From December 1993 to December 1994, we inserted 14 biliary endoprostheses (Wallstent) endoscopically in 12 consecutive patients (5 men and 7 women ; 55-91 years [mean 69.8 years] of age) with malignant biliary stenosis. Successful placement of Wallstent was achieved in all 12 patients. Procedure related death was encountered in one patient (8.3%) who was complicated with emphysematous cholecystitis, combined with a slipping migration of the stent. In 11 of the 12 patients, serum bilirubin levels reduced to less than 2.0 mg/dl. Acute obstruction, which was defined as the obstruction of the stent within 24 hours after the stent placement, occurred in 2 patients (16.7%). Endoscopic nasal bile drainage (ENBD) following stent placement was performed in 4 patients and acute obstruction was not developed in these cases. After endoprosthesis 8 patients were discharged with 6-47 hospital days and the average hospitalized period excluding a case with cerebral infarction was 12.7 days. Excluding one procedure related death, 6 patients died of primary malignancy 39-189 days (average 90.7 days) after endoprosthesis and in 2 cases recurrence of jaundice was observed. The other 4 patients have been alive for 60-174 days (average 102.5 days) without jaundice. The survival rate of the all patients was 64% for 3 months and 32% for 6 months, respectively.
In conclusion, we suggested that the endoscopic Wallstent placement would contribute to the improvement of the quality of life for patients with malignant biliary stenosis. However, acute obstruction may be developed in some cases. For the purpose of managing acute obstruction, we recommend ENBD for a few days following the placement of a Wallstent.
View full abstract
-
Kazuharu SUNAMI, Hideto TANIGUCHI, Tomoaki MORIYAMA, Hajime MIKAMI, Ry ...
1995 Volume 92 Issue 9 Pages
1285-1288
Published: September 05, 1995
Released on J-STAGE: February 26, 2008
JOURNAL
FREE ACCESS
-
Shinetsu HOSHI
1995 Volume 92 Issue 9 Pages
1289-1292
Published: September 05, 1995
Released on J-STAGE: February 26, 2008
JOURNAL
FREE ACCESS
-
Yoshihiro YAMAMOTO, Noriaki SAKATANI, Shouzou YANO, Kibon KOU, Shin OC ...
1995 Volume 92 Issue 9 Pages
1293-1296
Published: September 05, 1995
Released on J-STAGE: February 26, 2008
JOURNAL
FREE ACCESS
-
Osam MIYANAGA, Takuya SAWABE, Ikuo KIKUCHI, Kenroh MIHARA, Hiromi ISHI ...
1995 Volume 92 Issue 9 Pages
1297-1303
Published: September 05, 1995
Released on J-STAGE: February 26, 2008
JOURNAL
FREE ACCESS
-
Tsunenori SAKURAI, Yutaka SAJI, Keizou KAZUI, Shoji YAMAGA, Kunihiro H ...
1995 Volume 92 Issue 9 Pages
1304-1308
Published: September 05, 1995
Released on J-STAGE: February 26, 2008
JOURNAL
FREE ACCESS
-
Takashi FUJISAWA, Yoshinobu TOMOFUJI, Nobutoshi KURODA, Haruhiko HAGIN ...
1995 Volume 92 Issue 9 Pages
1309-1314
Published: September 05, 1995
Released on J-STAGE: February 26, 2008
JOURNAL
FREE ACCESS
-
Tetsuro YAMASHINA, Hiroshi MARUYAMA, Masaya KIDA, Hiroyuki FUJITA, Mas ...
1995 Volume 92 Issue 9 Pages
1315-1319
Published: September 05, 1995
Released on J-STAGE: February 26, 2008
JOURNAL
FREE ACCESS
-
Atsushi UCHIDA, Kazuho SHIMURA, Maki TAKENAKA, Kazue NAKAMURA, Toshiyu ...
1995 Volume 92 Issue 9 Pages
1320-1326
Published: September 05, 1995
Released on J-STAGE: February 26, 2008
JOURNAL
FREE ACCESS
-
Shuichi ARAO, Haruo IGUCHI, Kokichi SUGANO, Hisanao OHKURA, Hidehisa K ...
1995 Volume 92 Issue 9 Pages
1327-1330
Published: September 05, 1995
Released on J-STAGE: February 26, 2008
JOURNAL
FREE ACCESS