bluuebunny/crossref_metadata_2025 huggingface dataset:
Crohn's Disease Consisting Solely of Aphthoid Ulcers at the Time of First Visit
Authors: HIWATASHI Nobuo , YAMAZAKI Hideo , KINOUCHI Yoshitaka , ITO Kaoru , KIMURA Mitsuo , KOBAYASHI Masayoshi , MITA Masanori , TOYOTA Takayoshi
Published: August 2007

Abstract: It is generally considered that early lesions detected macroscopically in Crohn's disease are aphthoid ulcers. The lesions are usually found close to more advanced lesions and sometimes observed in the distal colon. However, there are a few patients who have almost only aphthoid ulcers without any typical major lesions through the alimentary tract. We studied 5 such cases (4 men and 1 woman, 15–31 years old) out of 107 patients who had not undergone any surgery at the time of their first visit. Four patients had aphthoid ulcers in both the small and large intestine as well as some lesions (ulcer, erosion and redness) in the gastroduodenal region. The remaining case had some lesions only in the large intestine. Non‐caseating epitheloid cell granulomas were detected in the biopsy specimens obtained from the aphthoid ulcers of the colon in 4 cases. These cases with granulomas were considered to suffer from Crohn's disease and were treated with an elemental diet. Aphthoid ulcers showed a remarkable improvement but relapse followed the beginning of an oral diet. In 3 cases, the lesions in the small intestine developed into longitudinal ulcers 18, 27 and 37 months after the first visit, respectively. Although a female patient in whom granulomas could not be proven was not diagnosed as having Crohn's disease, she had bloody stool again 17 months later, and a barium enema revealed a cobblestone appearance in the colon so that she was diagnosed as having Crohn's disease.

Consequently, aphthoid ulcers developed into longitudinal ulcers or cobblestoning, with repeated disappearance and reappearance during the follow‐up period in 4 of the 5 cases. Almost only aphthoid ulcers with granulomas in non‐operated cases are considered to be in the earliest stage of what can be diagnosed as being Crohn's disease.
An Application of Endoscopic Color Doppler Ultrasonography (ECDUS) in the Diagnosis of Hemodynamics of Gastric Varices, and the Therapeutic Effect of Endoscopic Therapy
Authors: SATO Takahiro , HIGASHINO Kiyoshi , MURASHIMA Yoshio , SUGA Toshihiro , YAOSAKA Toru , IMAMURA Akimichi , FUJINAGA Akira , KOITO Kazumitsu , MIYAKAWA Hiroyuki , TOCHIHARA Masahiro , NATSUI Kiyoto , ANBO Tomonori , NAGAKAWA Tatsuya , SATO Shinsuke , KATO Shigeharu , GOTO Manabu
Published: August 2007

Abstract: We studied 14 patients using endoscopic color Doppler ultrasonography (ECDUS) to evaluate the hemodynamics of gastric varices, and evaluated the endoscopic therapeutic effects on gastric varices in 8 patients. Three patients had F3 type gastric varices and eleven had F2. The ECDUS was performed with a PENTAX FG‐32UA (7.5MHz, convex type) and a HITACHI EUB 565 was used as a display machine. The intramural blood flow in the gastric varices and inflows from the extra‐gastric wall were clearly observed with the ECDUS in all 14 patients. The extramural blood flow (gastro or spleno‐renal shunts) was detected in 9 of 14 patients. The velocity of the intramural flow in tumorous type varices (F3) was higher than in the nodular or flat elevated type (Fa). Next, we evaluated the therapeutic effects on gastric varices of the ECDUS. The successful disappearance of intramural blood flow was observed in 6 of 8 patients who had this endoscopic therapy. In two of the 8 patients, there was not enough therapeutic effect on the intramural blood flow. The extramural blood flow, however, did not change before or after endoscopic therapy with the ECDUS.

Therefore, we concluded that ECDUS is a very useful modality for the diagnosis of hemodynamics and to evaluate the therapeutic effects on gastric varices.
Endoscopic Ultrasonography of the Lower Esophageal Sphincter in Reflux Esophagitis and Achalasia
Authors: KUNUGI Shori , KOMATSU Munehiro , SEKIGUCHI Toshikazu , KAWAMURA Osamu , HORIKOSHI Tsutomu , TOKI Munetoshi , OWADA Tsuneo
Published: August 2007

Abstract: The endoscopic ultrasonography findings at the lower esophageal sphincter (LES) were compared in patients with reflux esophagitis and esophageal achalasia to clarify the differences in wall structure between these diseases. In reflux esophagitis, the esophageal wall was hypertrophied at the LES and featured both irregularity and interruption of the submucosa, muscularis propria, and adventitia. In achalasia, there was generalized hypertrophy of the esophageal wall at the LES including the mucosa, submucosa, muscularis propria and adventitia but for each layer the normal 5‐layer structure was visualized well.

Thus achalasia and reflux esophagitis both featured hypertrophy at the LES, but the detailed findings were quite different. This difference was thought to arise from the presence of inflammation in reflux esophagitis and no inflammation in achalasia.
A Patient with a Left Accessory Hepatic Duct with Gallstones
Authors: SAWABE Jun , ISHIDA Hideaki , NIIZAWA Makoto , NAGANUMA Hiroko , UNO Atsushi , MASAMUNE Osamu
Published: August 2007

Abstract: Accessory hepatic ducts, especially the left ducts, are relatively rare anomalies of the biliary tract. We present here a patient with this anomaly complicated by the presence of multiple stones. Endoscopic retrograde cholangiography (ERC) and ultrasound (US) were very useful in establishing the diagnosis preoperatively and in determining our surgical strategy. ERC demonstrated the left accessory hepatic duct with multiple radiolucent stones at the level of the cystic duct on the opposite side of the gallbladder. US demonstrated a hyperechoic mass measuring 15×10 mm with an acoustic shadow at the hepatic hilus. It also showed the internal “honey‐comb” structure of the mass which contained numerous stones measuring 5–6 mm in diameter and a fine tubular structure between the accessory hepatic duct and the caudate lobe. Intraoperatively the sac‐like, dilated (35×10 mm), left accessory hepatic duct was filled with numerous bilirubin stones originating at the cystic duct from its contralateral side. A few fine bile ducts communicated with the accessory hepatic duct and the caudate lobe.
Intracorporeal Shock Wave Lithotripsy (ISWL) in Bile Ducts under Peroral Endoscopy: Progress and Current Status
Authors: SAISHO Hiromitsu
Published: August 2007

Attempting to use ISWL (intracorporeal shock wave lithotripsy) for treating large and difficult biliary stones was started in the mid 1970s, approximately 10 years before the introduction of ESWL (extracorporeal shock wave lithotripsy). However, in contrast to ESWL, ISWL did not quickly become popular in practise. The main reason for this delayed recognition, undoubtedly, lay in the technical difficulties of the peroral applications until the mid 1980s, when the development of an improved cholangios‐cope system and a thin, flexible probe allowed the use of EHL (electrohydraulic lithotripsy) under direct vision during peroral cholangioscopy. Thanks to recent advances in technology, a powerful pulsed laser has begun to be used for ISWL through a 0.2 mm sized quartz fiber. A laser version of ISWL with such a thin probe is expected to facilitate its use by minimizing the endoscope system. The automatic stone‐tissue recognition system which interrupts the laser discharge in case of wall contact is another useful advance in technology which increases the safety and therapeutic efficacy. Whereas laser techniques are still in development, ISWL with a laser will be the first choice technique for treating difficult bile duct stones after failure of mechanical lithotripsy and it also promises to improve its therapeutic efficacy for intrahepatic stones in combination with ESWL.

In this article, the recent progresses and results of ISWL treatment were reviewed with a respect to the success of ESWL.
Successful Endoscopic Treatment of Diffuse Antral Vascular Ectasia and Early Gastric Carcinoma in an Aged Patient
Authors: IKEDA Masahiro , INOKI Ken , HAYASHI Nobuhiko , YAMAMOTO Keiji , MASUZAWA Manabu , TAKEDA Masashi
Published: August 2007

Diffuse antral vascular ectasia and a lla type early gastric cancer were detected in an 83‐year‐old male patient through an endoscopy during treatment for iron deficiency anemia. Monopolar electrocoagulation was effective for eradication of red spots which represented ectatic vessels. Five sessions of the therapy resulted in the ablation of almost all of the vascular lesions, negative fecal occult blood tests and improvement of his anemia. The lla lesion was endoscopically resected from the posterior wall of the upper body. Histologic examination demonstrated well differentiated adenocarcinoma confined to the mucosal layer. Both the vascular ectasia and carcinoma did not show any sign of recurrence after a year and a half.
The Value of a Transparent Hood for Biopsy of Minute Lesions of the Esophagus
Authors: OZAKI Motonobu , OTSUKA Sachio
Published: August 2007

Minute lesions of the esophagus were biopsied using a transparent hood designed by the authors to fit on the tip of a forward viewing endoscope. The quality of the bite biopsies performed using the hood and their accuracy, as well as technical difficulty, were investigated. Minute lesions of less than 5 mm in diameter located at 1, 2 or 3 o'clock were chosen for investigation since these are usually difficult areas from which to obtain a biopsy. Twenty subjects were biopsied using the hood and 20 were biopsied without it, in the conventional way, over the 15 month period from November 1993 to January 1995. A comparison of first biopsy success rates, with and without the hood, was made. The rate of success was very high (19/20; 95%) when the hood was used, but low (11/20; 55%) when the hood was not used (p<0.01). A comparison of the time taken for the first biopsy showed that when the hood was used, the time taken was shorter, averaging 21.9 seconds, in contrast to the rather slow average of 118.2 seconds taken when the hood was not used (p<0.01).

The transparent hood is used by positioning it gently on the oral side of a tangential lesion, and then angulating the tip of the endoscope with this point as a fulcrum to position the tip so as to be virtually perpendicular to the esophageal wall, facilitating attainment of a frontal view of the lesion. The lesion thus brought forward can then be fixed, enabling the operator to obtain a biopsy with great ease and accuracy.
A Catheter Devised for Intraoperative Cholangiography during Laparoscopic Cholecystectomy
Authors: YUNOTANI Seiji , HAMAMOTO Takahiro , SAMEJEMA Ryuichiro , HISATSUGU Takeharu
Published: August 2007

A catheter devised to facilitate intraoperative cholangiography (IC) during laparoscopic cholecystectomy (lapcholy) is herein introduced. It is a polyethylene tube connected to a 10 mm stainless‐steel tube with an adjustable, pliable guiding sheath. The catheter allowed for accurate and easy cannulation of the cystic duct, as well as tight clipping of the cystic duct. Removal of the guiding sheath after clipping decreased the tension on the polyethylene tube, thereby giving natural biliary tract findings. We describe, herein, our experience with this instrument.

The mean duration of IC during lapcholy, including developing time, was only about 10 minutes. This catheter made the intraoperative administration of IC more rapid and reliable, thus markedly reducing the duration of surgery. As a result, preoperative application of ERCP (endoscopic retrograde cholangiopancreatography), which used to be applied to all patients undergoing lapcholy, is now limited to selected cases.
A Case of Familial Adenomatous Polyposis Associated with Colon Cancer, Ureteral Cancer and Two Early Gastric Cancers
Authors: KATAOKA Hiromi , KATSUMI Kohei , KUTSUNA Takeo , SUZUMURA Hiroshi , KOJMA Shoji , TAKESHIMA Akihiko , BAN Yoshimitsu , ITOH Tatsuo , KISHIMOTO Akihiko , KATO Minoru , IWATA Fumihiro , ITOH Makoto , TAKEUCHI Toshihiko , OGAWA Kumiko , SHIRAI Tomoyuki
Published: August 2007

A rare case of Familial Adenomatous Polyposis (FAP), associated with colon cancer, ureteral cancer and two early gastric cancers, is reported. A 42‐year‐old male was admitted to our hospital for evaluation of bloody stools and macrohematuria. There were six FAP patients in his family line, spanning four generations, and five had developed colon cancers. A barium enema revealed diffuse and scattered polyposis throughout the colon and an apple core sign in the descending colon. Abdominal CT disclosed right hydronephrosis with a markedly dilated ureter. Surgery was undertaken and included total colectomy, mucosal proctectomy, ileoanal anastomosis and right nephrectomy with ureteral resection, under a diagnosis of colon cancer and complete right ureteral stenosis. The resected specimens revealed a colon cancer in the descending colon, 50×32×15 mm in size and a ureteral cancer in the lower part of the right ureter, 30×16×16 mm in size.

Four years later, he visited our hospital for detailed gastric examination, because gastric abnormalities had been pointed out in a health screening examination. Upper Gl X‐ray and endoscopic studies disclosed two cancerous lesions in the gastric antrum, one being a lie lesion in the anterior wall and the other a Ha + lie lesion in the posterior wall. Subtotal gastrectomy was performed and histological study revealed that invasiveness was limited to the submucosa in both lesions. No case of FAP associated with ureteral cancer has previously been reported and only 28 cases with associated gastric cancer have appeared in the Japanese literature.
Usefulness of Real‐Time Band Enhancement in Differential Diagnosis of Colorectal Tumors
Authors: ISO Akitada , SHIMIZU Seiji , TADA Masahiro , KAWAI Keiichi
Published: August 2007

Abstract: Various forms of image processing have been attempted since the development of the electronic endoscope; band enhancement is an image processing technique designed to accentuate minute surface structures. We observed 161 colorectal tumors with an electronic colonoscope and compared the pit pattern identification rate among ordinary, edge‐enhanced and bandenhanced images. We found that the pit pattern identification rate was significantly higher with band‐enhanced than with other image types. Furthermore, band enhancement was especially useful in the differential diagnosis of small lesions. Accordingly, this technique was considered to be useful for determining endoscopic treatment indications for colorectal tumors.
Gastrointestinal Complications Following Transcatheter Arterial Embolization through Subsegmental Catheterization for Hepatic Malignancies
Authors: TSUCHIGAME Tadatoshi , URATA Joji , MATSUKAWA Tetsuya , ARAKAWA Akihiko , SAITO Ryuichi , NAKASHIMA Kouki , MIYAO Masayuki , YAMASHITA Yasuyuki , TAKAHASHI Mutsumasa
Published: August 2007

Abstract: We assessed gastrointestinal complications after transcatheter arterial embolization (TAE) performed over the three‐year period from 1991–1994. Gastric erosion, gastroduodenal ulcer and hemorrhagic gastritis were investigated in a series of 273 cases (408 TAEs) with hepatic malignancies. Gastric erosions were found in 60 cases (7.6%), gastroduodenal ulcer in 24 cases (5.9%) and hemorrhagic gastritis in six cases (1.5%). Gastroduodenal complications occurred in a total of 60 cases (61 instances) (15.0%). Neither the formerly occurring geographic ulcers in the gastric antrum nor fatal hemorrhagic gastritis/ ulcers were encountered in the present study. This relative mildness of complications is probably attributable to superselective catheterization into the proximal hepatic artery. Such complications are due not only to ischemic changes resulting from backflow of embolic materials into the gastroduodenal artery, but also to transient liver damage caused by TAE.

The incidence of complications in those taking anti‐ulcer medications was 24.7% for Ha‐blockers (p<0.01), 14.3% for combination therapy and 16.5% for no medication, as compared to 9.8% for PGE1 and 9.6% for Teprenone. Therefore PGE1 or Teprenone, which increase gastric mucosal blood flow, should be used to reduce the occurrence of these complications after TAE.
Endoscopic Detection Rate of Minute Neoplasms in Autopsied Colons
Authors: IWASAKI Masafumi , KAGAMI Akihiko , NIKAIDO Takashi , TAKEUCHI Yukihiro , OHTA Yuko , KOBAYASHI Michiko , USUI Toshirou , MOCHIZUKI Keiko , TANAMURA Akira , KINOSHITA Tomoko , NISHIDE Ryouichi , KAWASHIMA Osamu , MOCHIZUKI Seibu , SUZUKI Hiroaki
Published: August 2007

Abstract: This study was designed to determine the actual incidence, distribution and morphology of minute neoplastic polyps, under 5 mm in diameter, in the so‐called normal colon obtained at autopsy. In order to increase the sensitivity of detection of minute lesions, this study was done with the aid of electronic endoscopy using the dye spraying method. The case‐occurrence of minute neoplastic polyps among the 49 autopsy cases was almost 50% and the ratio of cases without adenomas or cancers of the colon was no more than 50%. The ratio of minute neoplastic polyps among the total number of neoplastic polyps, based on electronic endoscopy, was much higher than that of minute polyps of autopsy cases reported previously with macroscopic observation. Regarding the grade of atypia of the minute neoplastic polyps, only one polyp (5 mm in diameter) among 85 lesions was a carcinoma. The results of this study indicate the possibility of considerable numbers of minute neoplastic polyps which are likely to go undetected by endoscopy, probably due to technical difficulties in endoscopic control and the lack of sufficient examination time for each patient.
An On‐line Endoscopic Image Filing System
Authors: KASHIMURA Hiromasa , NAKAHARA Akira , MUTOH Hiroshi , FUKUTOMI Hisayuki
Published: August 2007

Abstract: The introduction of the electronic endoscope has opened the way to tremendous possibilities in handling endoscopic images in terms of filing, storage and retrieval. Although there have been many approaches to retaining endoscopic data, no system has been found to be applicable to all endoscopy units. An integrated filing system that allows storage and recall of endoscopic data in a rapid and convenient manner is essential for a busy endoscopy unit. A hybrid filing system developed by combining analog and digital devices is currently in use in many endoscopy units and fulfills this purpose to some extent. We have developed an on‐line system of endoscopic image filing together with a local area network by connecting the hospital host computer, different endoscopy units and terminals located in distant places within the hospital. This system assured filing of digitalized endoscopic and endoscopic ultrasound images together with simultaneous rapid and reliable access to the filed data. Future improvements will include simultaneous recording of endoscopic reports and application of image analyzing software.
Total Colonoscopy in Patients with Polyps in the Proctosigmoid Region
Authors: SHIEH Ming‐Jium , WANG Cheng‐Yi , WONG Jau‐Min , HUANG Chium‐Sheng , HUANG Shinh‐Horng
Published: August 2007

Abstract: We conducted a prospective study of the general population in Taiwan to determine how many patients with polyps in the proctosigmoid region would have synchronous polyps in the proximal colon. The pathology and the number of proctosigmoid polyps as well as the benefits of subsequent colonoscopy were taken into account. Proctosigmoid polyps were identified in 261 of 2746 asymptomatic patients by 60 cm sigmoidoscopy, yeilding a 9.5% (male: 11.0%; female: 5.0%) prevalence rate. Subsequent total colonoscopy combined with polypectomy was completed in 205 patients (152 males; 53 females) eligible for analysis. In all, 353 polyps were removed for pathological verification at colonoscopy. The mean size of adenomatous polyps was 6.2 mm and that of hyperplastic polyps 3.2mm (p<0.05). Five mucosal cancers as well as one submucosal cancer were identified, and one of the mucosal cancers was beyond the range of the prior 60 cm sigmoidoscopy. Of these 205 patients, 63 (31%) were found to have at least one proximal polyp. The prevalences of synchronous proximal colon polyps were 23%, 42% and 77% for the 1‐polyp, 2‐polyp and β2‐polyp groups in the proctosigmoid region, respectively. When the pathology of the proctosigmoid polyps was taken into account, it was found that 42% of patients with adenomatous polyps in the proctosigmoid region had proximal polyps, compared with 10% of those with distal hyperplastic polyps and 8% of those with other findings (p<0.05). The present study suggests that all polyps, of all sizes, found at sigmoidoscopy merit pathological verification. Furthermore, colonoscopy should be reserved for patients proved to have adenomatous or multiple polyps in the proctosigmoid region.
Is the Histogenesis of 6‐10 mm Early Colorectal Cancer Different from that of Larger Cancers?
Authors: MACHIDA Makiyo , SATAKE Yoshiharu , KATAKURA Shigehiro , TSUBOMIZU Yoshio , MASUMITSU Hiroshi , KAMINAGA Norihiro , ENDO Yutaka , FUJITA Rikiya
Published: August 2007

Abstract: Out of a total of 466 cases of early colorectal cancer, we analyzed 139 cases with submucosal invasion (sm cancer) according to tumor size, gross appearance, depth and degree of invasion, and the presence of adenoma components. Early colorectal cancers 11 ‐20 mm in diameter were the most common lesion in this group, and the percentage with sm cancer increased with tumor size. More than 70% of relatively small sm cancers, 6‐10 mm in diameter, had moderate or massive submucosal invasion similar to that found in large sm cancers. Only 35% of 6‐10 mm cancers had an adenoma component; the majority (65%) had no adenoma component. In marked contrast, 63% of sm cancers 11 ‐20 mm in diameter had an adenoma component and in sm cancer the percentage of tumors composed solely of cancerous tissue without an adenoma component was low. Similar results were obtained when only protruding type sm cancers, which accounted for the majority of sm cancer cases, were included in the analysis. Therefore, we believe that the protruding type sm cancer 6‐10 mm in diameter is at a stage close to advanced cancer. It is possible that many 6‐10 mm sm cancers have a histogenesis different from that of large sm cancers.
A Study of the Rate of Superficial Cancer Progressing to Advanced Cancer of the Colon and Rectum
Authors: SAITO Kenichi , OGAWA Akira , OHKI Ichiro
Published: August 2007

Abstract: In order to clarify the rate of superficial cancer developing into colorectal cancer histologically, we examined horizontal growth type cancer in the residual mucosa of 68 samples with submucosal (sm) cancer, 91 with cancer with invasion of the muscularis propria (mp) and 311 with invasion deeper than the subserosa (ss). Among 68 samples of sm cancer, residual mucosa persisted in 65 (95.6%) and horizontal growth type cancer was found in 17 (26.2%). There was no significant difference in size between the horizontal and non‐horizontal growth type cancers. Among 91 samples of mp cancer, residual mucosa persisted in 15 (15.5%), horizontal growth type cancer was found in five (33.3%), and the latter were significantly smaller than non‐horizontal growth type cancers (p< 0.05). Among 311 samples of ss cancer, residual mucosa persisted in 12 (3.9%) and horizontal growth was found in six (50.0%). In cancer with invasion deeper than the ss layer, malignant tissue is generally lost from the mucosa, such that the rates may not reflect the actual incidence. The rates of progression from superficial to sm cancer (26.2%) and mp cancer (33.3%) may be close to the present rate of superficial cancer developing into colorectal cancer. We conclude that the rate of superficial cancer developing into invasive cancer is at least 26.2%, and that superficial type cancers have a strong tendency to invade the mp even when smaller than protruded type cancers. It may be useful to focus on horizontal growth type cancers to elucidate the growth and development of colorectal cancer.
A Case of Cronkhite‐Canada Syndrome with Spontaneous Kemission
Authors: YAMAGUCHI Takeo , KUSUGAMI Kazuo , YAMAMOTO Hitoshi , INA Kenji , ANDO Takafumi , SHIMIZU Tatsuji , ISHIHARA Akira
Published: August 2007

Abstract: A 64‐year old woman visited our hospital with a chief complaint of diarrhea of nearly one year's duration. One month before seeking medical treatment at our hospital, she noticed dysgeusia, hyperpigmentation of the skin, and nail shrinkage and loss without hypoalbuminemia. Endoscopic examination demonstrated numerous sessile and semipedunculated polyps in the stomach and colon. Histological examination of biopsy specimens showed epithelial hyperplasia with cystic dilation, interstitial edema and infiltration of inflammatory cells. Based on these characteristic clinical and pathological features, a diagnosis of Cronkhite‐Canada syndrome was made. As her symptoms gradually improved, she was placed under observation without specific treatment. The initial magnifying colonoscopy revealed enlargement of epithelial glands and cryptal dilation in both the protruding lesions and the intervening mucosa. On follow‐up magnifying colonoscopic examination, small islets of abnormal glandular tissue persisted for 1.5 years but did eventually disappear. Magnifying colonoscopy may be useful for observation of the healing process in patients with Cronkhite‐Canada syndrome.
A Case Report of Crohn's Disease Confined to the Appendix
Authors: SHIKUWA Saburo , SENJYU Masahiro , HARAGUTI Masuho , ITSUNO Minora , IWASAKI Keisuke , MURASE Kunihiko , OMAGARI Katsuhisa , MIZUTA Yohei , MAKIYAMA Kazuya , KOHNO Shigeru , ITO Masahiro , SEKINE Ichiro
Published: August 2007

Abstract: A 36‐year‐old man was admitted to our hospital with complaints of right lower abdominal pain and fever. Radiological and endoscopic examination revealed a polypoid lesion composed of several nodules in the orifice of the appendix in addition to irregular ulcers among the nodules. Macroscopic examination of the ileocolectomized specimen also revealed a polypoid lesion in the orifice of the appendix and a thickened appendiceal wall. The resected appendix and the polypoid lesion in the cecum exhibited Crohn's disease as characterized by transmural inflammation with non‐caseating epithelioid granulomas and fissuring ulcers. This patient was diagnosed as a rare case of Crohn's disease confined to the appendix manifesting as a polypoid lesion in the orifice of the appendix.
A Case of Acute Organoaxial Gastric Volvulus Treated by Endoscopic Reduction and Fixation with the Use of Percutaneous Endoscopic Gastrostomy Device
Authors: HISATSUNE Hiroshi , YOSHIDA Shunichi , MIZUNO Shigeto , OKI Teruki , MUKAI Masako , MARUI Kiyotaka , HIRAYAMA Tetsuya , ITOH Tadashi , KIMOTO Kunihiko
Published: August 2007

Abstract: Acute organoaxial gastric volvulus with paraesophageal hernia was detected by upper gastrointestinal endoscopy in a 75‐year‐old female patient. Endoscopic reduction of gastric volvulus was initially performed and a nasogastric tube was inserted into the jejunum. The introduction of oral intake resulted in vomiting and a barium meal study suggested recurrence of gastric volvulus. Endoscopic reduction was then performed, and a percutaneous endoscopic gastrostomy tube was inserted to anchor the stomach to the anterior abdominal wall. The tube was removed 15 weeks later, and the patient has remained asymptomatic to date.
Endoscopically Resected Granular Cell Tumor of the Stomach
Authors: WAKASUGI Satoshi , TAKAHASHI Hiroshi , OTSUKA Tatsuhiko , SUZUKI Satoshi , FUJITA Rikiya , KIDOKORO Tsutomu
Published: August 2007

Abstract: We report a rare case of granular cell tumor of the stomach resected endoscopically. The patient was a 53‐year‐old man who visited our clinic because of a protruding lesion incidentally found by X‐ray examination of the stomach at a mass screening. Endoscopic examination revealed an apparent submucosal tumor at the anterior wall of the upper body of the stomach. An endoscopic ultrasonographic (EUS) study showed that the tumor was a hypoechoic lesion localized in the third layer (submucosal layer). On resection, a lesion measuring 6X5X3 mm was found to be localized in the submucosa. It was histologically diagnosed as granular cell tumor, which is quite uncommon in the stomach with only 44 cases having been reported to date.
God Is Watching You
Authors: Shariff Azim F. , Norenzayan Ara
Published: August 2007

We present two studies aimed at resolving experimentally whether religion increases prosocial behavior in the anonymous dictator game. Subjects allocated more money to anonymous strangers when God concepts were implicitly activated than when neutral or no concepts were activated. This effect was at least as large as that obtained when concepts associated with secular moral institutions were primed. A trait measure of self-reported religiosity did not seem to be associated with prosocial behavior. We discuss different possible mechanisms that may underlie this effect, focusing on the hypotheses that the religious prime had an ideomotor effect on generosity or that it activated a felt presence of supernatural watchers. We then discuss implications for theories positing religion as a facilitator of the emergence of early large-scale societies of cooperators.
The Soft Embodiment of Culture
Authors: K.-y. Leung Angela , Cohen Dov
Published: August 2007

Cultural assumptions about one's relation to others and one's place in the world can be literally embodied in the way one cognitively maps out one's position and motion in time and space. In three experiments, we examined the psychological perspective that Asian American and Euro-American participants embodied as they both comprehended and produced narratives and mapped out metaphors of time and space. In social situations, Euro-American participants were more likely to embody their own perspective and a sense of their own motion (rather than those of a friend), whereas Asian American participants were more likely to embody a friend's perspective and sense of motion (rather than their own). We discuss how these psychological perspectives represent the soft embodiment of culture by implicitly instantiating cultural injunctions (a) to think about how you look to others and to harmonize with them or (b) to know yourself, trust yourself, and act with confidence.
Development of an instrument to test the middle‐range theory for the self‐care of home‐dwelling elderly
Authors: Räsänen Päivi , Backman Kaisa , Kyngäs Helvi
Published: August 2007

Purpose: This paper describes the process of developing an instrument to test the middle‐range nursing theory for the self‐care of home‐dwelling elderly.

Background: Instrument development is a multiphase process, during which the researcher tests the reliability and validity of the instrument with various data and modifies it based on the test results. The aim of the study was to develop an instrument to test a theory, but also to be able to use it later in clinical settings to evaluate the self‐care of home‐dwelling elderly and factors associated with it.

Methods: The instrument development was done in four phases. At the first phase, the initial version was created on the basis of the theory. At the second phase, two home‐dwelling elders were pilot‐interviewed, and 20 elders completed the structured questionnaire and commented upon its ease of use. The results were used to develop the second version of the instrument. At the third phase, the second version of the instrument was used to collect data from home‐dwelling elders aged 75 or more from different parts of Finland (n = 200). Face validity, exploratory factor analyses, correlation coefficients and Cronbach's alpha were used to test and further develop the instrument. At the fourth phase, the content validity of the third version was assessed by three home‐dwelling elders.

Results: The agreement between the elders and the researchers about the contents of the instrument was acceptable, and exploratory factor analyses verified quite well the structure of the theory. Based on the Cronbach's alpha values (0.49–0.90), the internal consistency of the instrument was fairly good.

Conclusion: The results provide sufficient evidence of the validity and reliability of the final version of the instrument, which has nine background questions and 82 items to measure the self‐care of home‐dwelling elderly and factors associated with it.
Demand‐oriented and demand‐driven health care: the development of a typology*
Authors: Rijckmans Madeleine , Garretsen Henk , Van De Goor Ien , Bongers Inge
Published: August 2007

In most European countries, there is an increasing demand for demand‐oriented and demand‐driven approaches in the development of health care policy and the organization of health care services. Both approaches, in which the main focus is on ‘the demand’, are seen as counterparts of the supply‐oriented approach, that has ‘the supply’ as point of departure. However, there is much confusion about the definition of the concepts. To identify the different views, and to examine to what extent there is consensus in the Netherlands about the concepts of demand‐orientation and demand‐driven care, a Delphi study was done among 26 experts; scientists, health care insurance companies, health care suppliers, the government, independent advisory bodies and client interest groups. The study resulted in a typology. The similarities and differences between the two concepts were demonstrated in five dimensions; responsibility, control, need‐determination, formal embedment of vision in organization and choice. Furthermore, the typology was used to identify existing types of services as being either demand‐oriented or demand‐driven services. The typology provides an understanding of the similarities and differences between the two concepts, and appears to be a useful tool in identifying services to the extent that they are demand oriented or demand driven.
THE ANALYSIS OF GOLD COINS—A COMPARISON OF RESULTS OBTAINED BY NON‐DESTRUCTIVE METHODS
Authors: ODDY W. A.
Published: August 2007

ABSTRACTS

This paper discusses a systematic difference between the results found when one series of Dark‐Age gold coins were analysed both by neutron activation and by specific gravity analysis and when a second series of similar coins was analysed by the Oxford Milliprobe and by specific gravity. No reason is given for this systematic difference, although there is evidence that all three methods are slightly in error, two of them giving results for gold which are too high and the specific gravity method giving results which are too low.
THERMOLUMINESCENT DATING OF COLOMBIAN POTTERY IN THE YOTOCO STYLE
Authors: SAMPSON E. H. , FLEMING S. J. , BRAY W.
Published: August 2007

ABSTRACTS

Two contexts from the Colombian sites, Yotoco Ferry and Moralba, had been linked by archaeological similarities in pottery style, and dated by association with ware from other sites at circaa.d. 1000. However, radiocarbon dating of those contexts set Moralba at circa 800 b.c., some 2000 yr older than Yotoco Ferry. Thermoluminescent dating of pottery from Yotoco Ferry dated it at circaa.d. 900, and pottery from Moralba was dated at circaa.d. 870.

In addition a metal‐smelting pottery crucible, thought to be prehispanic, was studied by thermoluminescence and dated, on the contrary, at less than 120 yr old.
COPPER AND COPPER ALLOYS IN ANCIENT IRAQ, SYRIA AND PALESTINE: SOME NEW ANALYSES
Authors: MOOREY P. R. S. , SCHWEIZER F.
Published: August 2007

ABSTRACTS

In a pilot‐programme to increase evidence for the history of copper‐alloying in ancient Iraq, Syria and Palestine 128 objects in the Ashmolean Museum, Oxford, were tested with a point‐source linear X‐ray spectrometer for tin, arsenic and antimony. These analyses showed the gradual introduction of tin‐copper alloys into Iraq after ca. 2750 b.c. (Early Dynastic IIIA), into Syria a little later and into Palestine by the end of the third millennium b.c., though numerous artefacts continue to be of copper or arsenical‐copper until well into the second millennium b.c. at least. With the appearance of tin‐copper alloys the percentage of arsenic in the copper objects noticeably declines indicating that the earlier arsenical‐coppers were deliberately produced under controlled conditions.
DISPERSION DIAGRAMS: A NEW APPROACH TO THE DISPLAY OF CARBON‐14 DATES
Authors: OTTAWAY B.
Published: August 2007

ABSTRACTS

A statistical approach to the display of sets of 14C dates is suggested. All available dates of any particular culture are used to calculate the two quartiles and the median dates for it. The ‘dispersion’of the dates is then displayed as a bar showing the extreme dates, the quartiles and the median; thus neither individual dates nor their standard deviations are shown. This ‘dispersion diagram’saves much space when the dates of several cultures are to be displayed.

The argument is developed that the inter‐quartile range, which does not change very much when new dates become available and are added to the set, is a good index of the time span during which a culture flourished, and this range should normally be quoted rather than the mean, median or extreme dates of the culture. With samples of nine or more it can be shown by the Hypergeometric Distribution that there is a 97% chance of two cultures being different if their inter‐quartile ranges just fail to overlap, so that this method of display is useful in assessing the overlap of cultures. The fact that the dispersion diagram contains within it a measure of the statistical uncertainties of the individual estimates and therefore can replace the standard deviation of each individual 14C date is discussed.
THE PRE‐DOSE TECHNIQUE: A NEW THERMO‐LUMINESCENT DATING METHOD
Authors: FLEMING S. J.
Published: August 2007

ABSTRACTS

A thermoluminescent (TL) glow‐curve peak occurs around 110°C for the mineral quartz. Its sensitivity may be changed by application of a radiation dose (termed the pre‐dose) followed by a heating of the quartz to 500°C: heating alone causes no sensitivity change. The enhancement observed (measured relative to the sensitivity of the peak prior to heating) is a measure of the magnitude of the pre‐dose.

For quartz extracted from pottery the sensitivity enhancement induced by laboratory heating records a natural pre‐dose, i.e. the accumulated dose experienced during archaeological burial. The latter quantity is used in TL age‐determination and a test programme is reported on the application of the pre‐dose dating method to sites covering the Roman era in Britain forward to modern times.
OXYGEN ISOTOPE ANALYSIS AS A MEANS OF DETERMINING SEASON OF OCCUPATION OF PREHISTORIC MIDDEN SITES
Authors: SHACKLETON N. J.
Published: August 2007

ABSTRACTS

By making oxygen isotope palaeotemperature determination of successive growth increments in molluscan food‐refuse shells it is possible to determine the sea temperature, and hence the season, at time of death of the shells. Although this is a method which involves the use of sophisticated and expensive equipment, it may under favourable circumstances give extremely reliable results. Shells of the limpet species Patella tabularis in the midden deposits at Nelson Bay Cave, Robberg, Cape Province, South Africa, prove to represent almost ideal material, and are used to demonstrate, contrary to what guesswork might lead one to suppose, that the site was occupied during the winter months.
URANIUM VARIATIONS IN A DATED FOSSIL BONE SERIES FROM OLDUVAI GORGE, TANZANIA
Authors: SEITZ M. G. , TAYLOR R. E.
Published: August 2007

ABSTRACTS

Of twelve elements analyzed in a series of bovid teeth from the Olduvai Gorge, uranium is the only element which varies appreciably with the ages of the samples. Uranium concentrations increase at first, then decrease with increasing age, and therefore cannot be used by themselves to obtain absolute or even relative ages of the samples. A model accounting for the behaviour of uranium is proposed in which uranium is absorbed in the samples during the decay of organic material and is lost after this decay ceases. If one accounts for uranium losses, the concentrations of uranium and its decay products may be used to accurately date skeletal material from the Olduvai gorge.
HELLENISTIC GLAZED WARES FROM ATHENS AND SOUTHERN ITALY: ANALYTICAL TECHNIQUES AND IMPLICATIONS
Authors: PRAG A. J. N. W. , SCHWEIZER F. , WILLIAMS J.Ll. W. , SCHUBIGER P. A.
Published: August 2007

ABSTRACTS

The original intention of the project, conceived in the context of the British School at Rome's excavation and survey programme in the Bradano basin (based on Gravina) was to establish the composition patterns of Hellenistic glazed wares from sites in southern Apulia, and then to use these to trace the trading patterns of the area, against a control group of sherds from the Athenian Agora. It proved possible to distinguish Attic from Apulian sherds by their nickel and chromium content, and average‐link‐cluster‐analysis by computer showed that Gnathian ware from Taranto could be distinguished from seven other south Italian groups, suggesting that speciality wares were made of clays from special beds. Because of the geological homogeneity of the area no further distinctions could be made, but some sherds were also analysed petrologically and by heavy mineral analysis, for a methodological comparison. The very homogeneous geology, coupled with the fineness of the wares showed these methods to be at the limits of their usefulness. Only very generalized conclusions could be drawn concerning the origin of the pottery from the petrological evidence; the micro‐mineralogical data showed that interesting differences existed between pottery from the main Apulian sites, but these could equally have reflected natural variations occurring within fairly homogeneous clay deposits.
AN ANALYSIS OF SOME THIRD‐CENTURY ROMAN COINS FOR SURFACE SILVERING AND SILVER PERCENTAGE OF THEIR ALLOY CONTENT
Authors: KING C. E. , HEDGES R. E. M.
Published: August 2007

ABSTRACTS

The silver content within the body and at the surface of 22 Roman ‘bronze’coins dating to a.d. 274–305 was determined by X‐ray fluorescence to discover whether these coins were silver dipped and/or issued with a deliberately added amount of silver in their alloy.

Results of this analysis indicate that antoniniani and fractional coins of the period 274–294 were probably both silver dipped and minted in an argentiferous alloy. Radiate and laureate fractions issued after 295 do not seem to have had an argentiferous alloy, nor does this analysis provide any evidence that they were silverdipped.
KIRKHEAD CAVE: BIOSTRATIGRAPHY AND MAGNETOSTRATIGRAPHY
Authors: GALE S. J. , HUNT C. O. , SOUTHGATE G. A.
Published: August 2007

Existing hypotheses concerning the speed and timing of the recolonisation of Britain by man after the last glaciation have largely been developed in the absence of securely‐dated Later Upper Palaeolithic (LUP) sites in the marginal areas of colonisation. In Kirkhead Cave, the most important LUP site in northern England, palynological, molluscan and palaeomagnetic evidence indicate that LUP occupation did not commence until mid‐pollen zone III of the Late‐glacial. This suggests later and slower colonisation of marginal areas than indicated by previous hypotheses.
ON THE SOURCE OF CLAY USED FOR COLOGNE ROMAN POTTERY
Authors: HANCOCK R. G. V.
Published: August 2007

Chemical analyses have been made of Roman wares found in Cologne and of bearded man jugs found both in Cologne and Frechen. The question of the influence of the approximately 1600 year difference in time between the manufacture of the two major groups of wares is addressed. It is concluded that the Roman wares were very probably made of Frechen clay.
CHARACTERISTIC ELEMENTS OF LONGQUAN GREENWARE
Authors: HOU LI HU
Published: August 2007

Some examples of Longquan greenware have been analysed by neutron activation analysis. Most sherds are from kiln excavations in Zhejiang province, and date from the Song, Yuan and Ming dynasties. The elements Ce, Yb, Hf and Ta are shown to be consistently high and suggest that a common clay was used over a long period. The iron content of the glaze is shown to decrease from the Song to the Ming dynasty, implying an improvement in the refiring of the glaze raw materials.
SCIENTIFIC INVESTIGATIONS OF THE SOPRON‐KRAUT ACKER IRON AGE POTTERY WORKSHOP
Authors: KARDOS J. , ZIMMER K. , KRISTON L. , MOROZOVA O. , TRÄGER T. , JEREM E.
Published: August 2007

Excavations at the Celtic settlement of Sopron‐Krautacker (W. Hungary) make it possible to form an overall view on the local practice of pottery manufacture. Study of the soil conditions has established that the source of raw material is the nearly calcium carbonate‐free upper layer of the local soil resulting from a leaching process. By the various analytical methods used (XRD, XRF spectroscopy, and thermal analysis) composition of the pottery has been determined, and it has been shown that the vessels were fired at 600–700 °C.
NEUTRON ACTIVATION ANALYSIS OF CERAMICS: PROBLEMS WITH TITANIUM AND CALCIUM
Authors: HANCOCK R. G. V.
Published: August 2007

Titanium and calcium in ceramic materials can be analysed by neutron activation using a number of radioisotopes. Historical usage of scandium‐47 for the analysis of both elements is reviewed. Measurements were made of the production and decay of 47Sc sources prepared by SLOWPOKE reactor irradiations of pure titanium and calcium salts. Relative interferences were established and their effects calculated for a range of ceramic types. This study indicates that published values of the concentrations of titanium and calcium, using 47Sc, must be seriously reassessed.
ARCHAEOMAGNETIC RESULTS FROM SOME PREHISTORIC SITES IN BULGARIA
Authors: KOVACHEVA M. , ZAGNIY G.
Published: August 2007

Six newly discovered prehistoric sites in Bulgaria have been studied archaeomagnetically in a joint work between the Geophysical Institutes in Sofia and Kiev. Two sites (Samovodene and Podgoritza) belong to the neolithic age, Slatino and Omurtag belong to the aeneolithic period, and the last two (Yunatzite and Plovdiv‐Nebet tepe) are from the bronze and iron ages.
DISCRIMINATION BETWEEN ETRUSCAN POTTERY AND RECENT IMITATIONS BY MEANS OF THERMAL ANALYSES
Authors: FLAMINI A. , FLAMINI P. DE LORENZO
Published: August 2007

Black bucchero and red pottery of Etruscan production (Cerveteri, seventh‐fifth century B.C.), made from the local Pliocene clay, acquire the property of quickly adsorbing and releasing water after heating up to 300°C. Thermal analysis thus allows easy discrimination between ancient artefacts and recent imitations found to be impervious to water.
GAS LIQUID CHROMATOGRAPHIC ANALYSIS OF FATTY ACIDS IN FOOD RESIDUES FROM CERAMICS FOUND IN THE SOUTHWESTERN CAPE, SOUTH AFRICA
Authors: PATRICK M. , de KONING A. J. , SMITH A. B.
Published: August 2007

Gas liquid chromatography was used to analyse residues adhering to the inside of excavated potsherds from dated South African sites. The results suggested marine animal fat, possibly seal, had been cooked in the vessels. Fat of modern seals was baked and also analysed as a control sample. This gave similar results. The importance of seals in the prehistoric diet of the Southwestern Cape is supported by a large number of seal bones in the associated faunal material.
CARBON ISOTOPE RATIOS IN PALAEODIET: LACK OF AGE OR SEX EFFECT
Authors: LOVELL N. C. , NELSON D. E. , SCHWARCZ H. P.
Published: August 2007

Palaeodiet of humans can be determined using stable carbon isotope ratios of bone collagen. Differences in δ13C‐values between individuals in a population may be due to real differences in diet, or alternatively, they could be due to age‐ or sex‐dependent differences in the physiologically controlled fractionation of carbon isotopes between food and collagen. The dependence of this fractionation on age and sex was tested in a study of 50 individuals of differing ages from a prehistoric population of bison hunters. The total variation in δ13C for bone collagen was found to be ± 0.3‰, indicating that variations larger than this, observed in other populations, are due to real dietary differences between individuals.