Juntendo Medical Journal
Online ISSN : 2188-2134
Print ISSN : 0022-6769
ISSN-L : 0022-6769
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Volume 33, Issue 4
Displaying 1-18 of 18 articles from this issue
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Contents
  • Clinical and Radiological Studies on Gastric Ulcer of the Posterior Wall of the Body
    TOSHIHIDE MARUYAMA
    1987 Volume 33 Issue 4 Pages 517-527
    Published: December 10, 1987
    Released on J-STAGE: November 20, 2014
    DOIhttps://doi.org/10.14789/pjmj.33.517
    JOURNAL FREE ACCESS
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    Two hundred fifteen cases with 310 gastric ulcers of the posterior wall of the body, the en face view of which could be clearly visualized by the double contrast technique, were clinically and radiologically analyzed to define the features of those that were difficult to heal and those that tended to recur. The following results were obtained : 1. The features of gastric ulcer in the aged were occasionally noted in ulcers on the posterior wall of the body in patients in their 50s. 2. Healing was confirmed within 8 weeks in ulcers less than 1.0 cm in size or in shallow spindle-shaped ulcers, but healing was obviously delayed in ulcers with (1) irregular ulcer margin, (2) a further deep part in the ulcer bottom, (3) surronding elevative or non-elevative stiffness and (4) a few mucosal folds not converging toward the center of the ulcer and interrupted near the ulcer margin. 3. The manner of ulcer reduction was radiologically divided into concentric type and eccentric type. Eccentric reduction is the sign of delayed healing. 4. Recurrence was often encountered in ulcers more than 3.0cm in size, in those at the upper part of the body and in those with a further deep part in the ulcer bottom or surronding elevative or non-elevative stiffness. These abnormalities in the ulcer bottom or around the ulcer crater were also occasionally seen at recurrence. 5. Radiological analysis suggested that healing of ulcers of the posterior wall of the body is delayed in about 10% of cases and is possibly delayed in about 25%. Approximately 14-35% of ulcers detected at routine X-ray examination were considered to be recurrent.
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  • Radiological Studies for the Early Diagnosis of 'Linitis plastica' Gastric Cancer
    TOZO HOSOI
    1987 Volume 33 Issue 4 Pages 528-536
    Published: December 10, 1987
    Released on J-STAGE: November 20, 2014
    DOIhttps://doi.org/10.14789/pjmj.33.528
    JOURNAL FREE ACCESS
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    Forty cases with the 'Linitis plastica' type of gastric cancer were rediologically and pathologically analyzed in an attempt to enhance early diagnosis. The following results were obtained : 1. Pathological analysis suggested (1) that the primary focus of linitis plastica gastric cancer occurring at the fundic gland area was a II c-like carcinoma of the poorly differentiated type less than 25mm at it's largest diameter without mucosal fold convergence and a depth of ulceration in the focus deeper than U1-II degree, and (2) that the primary focus of linitis plastica gastric cancer occurring at the intermediate zone was also II c-like carcinoma of poorly differentiated type without mucosal fold convergence but with a focus of more than 50mm in the largest diameter often accompanied with depression of U1-I degree. Early diagnosis of linitis plastica gastric cancer could well be made by the detection of these cancer lesions. 2. The radiological findings of the previous examination were retrospectively analyzed to determine the possible primary focus, and it was found that in about 70% of cases with linitis plastica gastric cancer, the focus could have been detected 2 to 3 years earlier if the findings had been more carefully interpreted. The results suggest that the primary focus of linitis plastica gastric cancer can be detected and the depth of invasion at the time of possible detection was estimated to be limited to the proper muscle or subserosal layer. Thus, radiological manifestations of cancerous lesions involving the proper muscle layer in the growth of linitis plastica gastric cancer can be defined by pathological and radiological analysis, and early diagnosis of linitis plastica gastric cancer can be made by detecting these radiological manifestations.
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  • Inhibitory Role of the Septum and Facilitory Role of the Preoptic Area in Regulating Ovarian Compensatory Hypertrophy in Rats
    YUMIKO NAKANO
    1987 Volume 33 Issue 4 Pages 537-542
    Published: December 10, 1987
    Released on J-STAGE: November 20, 2014
    DOIhttps://doi.org/10.14789/pjmj.33.537
    JOURNAL FREE ACCESS
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    Effects of septal or preoptic lesions on the development of ovarian compensatory hypertropohy (OCH) were investigated. Radiofrequency lesions were made in the medial septum (MSL), lateral septum (LSL), dorsal septum (DSL) or dorsal preoptic area (DPOAL) in female rats. At the time of brain surgery, the left ovary was removed and weight. Two weeks after surgery, the wet weight of the remaining ovary was recorded in each rat. The OCH% in DPOAL females was significantry lower than that in the hemicastrated controls. On the other hand, MSL facilitated the development of OCH, the mean OCH% being significantly higher than that of controls. The OCH% in the LSL and DSL groups was comparable to that in controls. These results suggest that the medial septum plays an inhibitory role and, conversely, that the dorsal preoptic area plays a facilitory role in regurating ovarian compensatory hypertrophy. The brains in a number of animals with or without brain surgery were subjected to LH-RH immunohistochemical examinations to clarify the effects of the lesions on LH-RH neurons which send fibers to the median eminence. LH-RH immunoreactive terminals in the median eminence were not significantly different among the groups examined, indicating that the elevation or reduction of OCH% in MSL or DPOAL rats may not be the result of direct damage to LH-RH neurons in the septal area and POA. Rather, the lesions were thought to affect the neural substrate controlling the activity of LH-RH neurons during the development of OCH.
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  • Radiological Study on the Prognosis of Ulcerative Colitis
    MASATSUGU HARAIKAWA
    1987 Volume 33 Issue 4 Pages 543-552
    Published: December 10, 1987
    Released on J-STAGE: November 20, 2014
    DOIhttps://doi.org/10.14789/pjmj.33.543
    JOURNAL FREE ACCESS
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    Between 1970 and 1983, we studied 60 cases of ulcerative colitis by regular X-ray examination, using the double-contrast barium enema method. Our aim was to trace the natural history of ulcerative colitis. The results were as follows : 1. Based on the size of the ulcer, its form, and whether or not it is undermined, three types may be identified : large ulceration with longitudinal extension, middle-sized ulceration and small ulceration. There were 14 cases of longitudinal extnsion with undermining, 9 of middle sized ulceration with multiple ulcerations of irregular form and size (3-4mm), and 37 of small ulceration with very small ulcers (1-3mm). 2. Some time after the fifth year, many cases of the first type were found to shift from relapsing/remitting to chronic continuous. In this first group, operation was indicated in 8 of 13 cases. In the second and third groups, the cases that shifted from relapsing/remitting to chronic continuous were relatively few. Operation was indicated in only 1 case of 8 in the second group and 2 of 33 in the third group. Clearly, the prognosis of ulcerative colitis is closely connected with the classification by type. The prognosis of the first group was not good, whereas that for the second and third groups was.
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  • Clinical and Radiological Study of Gastric Linear Ulcers, with Emphasis on Those in the Gastric Body and Cardiac Portion
    TADASHI YARITA
    1987 Volume 33 Issue 4 Pages 553-562
    Published: December 10, 1987
    Released on J-STAGE: November 20, 2014
    DOIhttps://doi.org/10.14789/pjmj.33.553
    JOURNAL FREE ACCESS
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    This paper presents the results of our study of 74 lesions in 71 cases of gastric linear ulcers. In all cases patients complaints were recorded and strict examinations were made, both preoperatively and postoperatively. Thirty-two lesions were discovered in the gastric body and cardiac portion among the 30 cases included in the 71 cases studied. Cases of linear ulcer were found in patients who were older on average than those who had resected non-linear ulcers. The main cause of resection of gastric linear ulcers was recurrence, the rate of which was 75.5%. The rate of resection of non-linear ulcers for the same reason was 59.6%. Thirteen of the 55 cases proved to have had recurrence of ulcers did not show any evidence of aggravation of symptoms, indicating that examinations should be repeated every 4 months. In both the cardiac and body cases, the liner niches were identified at a rate of 75% on the first X-ray examination and of 100% on detailed examination. This was coufirmed by review work done after resection. Actually, however, the rate of correct diagnosis was 93.8% when the preoperative X-ray diagnoses were supported by interpretation of the gastric deformities found. Through interpretation of deformities at both the lesser and greater curvatures and in the whole area of the stomach, the diagnostic accuracy was increased by 12.5%. This rate of improvement in achieving correct diagnosis is as high as that of endoscopic examinations. Interpreting gastric deformities can be an effective device in finding linear ulcers in the cardia and body of the stomach.
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