bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Case of Pancreatic Somatostatinoma Found Endoscopically with Metastasis to the Duodenal Periampulla
Authors: MATSUNAGA Takashi , IWAOKA Hideaki , TSUBURA Yukimasa , SATOH Shin‐ichi , HACHISU Tadashi 
Published: August 2007

Abstract:A case of pancreatic somatostatinoma with duodenal metastasis is reported. The presenting feature was severe right hypochondrial pain with cholecystolithiasis and mild diabetes mellitus. Duodenogastroscopy revealed a small polypoid lesion at the duodenal peri‐ampulla of the major papilla. A biopsy specimen demonstrated a neuroendocrine tumor. Selective gastroduodenal arteriography disclosed a spherical hypervascular lesion in the pancreaticoduodenal arcade. Pancreatoduodenectomy was performed and pathological examination demonstrated pancreatic islet cell tumor and metastasis to the duodenal peri‐ampulla. Immunocytochemical examinations demonstrated intra‐cytoplasmic somatostatin and calcitonin in both tumors. The patient's basal plasma somatostatin level was 4 times higher than the normal range, however her plasma calcitonin level was within the normal range. After the operation, plasma somatostatin levels were within the normal range and her clinical course was good. In this case endoscopy was very useful in detecting the early stage duodenal metastasis of pancreatic somatostatinoma.
Early Gastric Lymphoma Coexisting with Reactive Lymphoreticular Hyperplasia (RLH) ‐A Case Report‐
Authors: TAKECHI Keishi , FURUHASHI Kazutoshi , USUI Toshio , MAEKAWA Hiroyuki , KIZAWA Akira , TANABE Hiroshi , IKEDA Youko , SHIMOKAWA Kuniyasu 
Published: August 2007

Abstract:A 34‐year‐old female visited our hospital because of epigastralgia. We performed an upper gastrointestinal x‐ray examination, and both conventional endoscopy and dye‐spraying endoscopy (indigo‐carmine contrast method). We diagnosed early gastric lymphoma which simulated Borrmann 3 type gastric cancer with IIb type early gastric cancer on the middle body and reactive lymphoreticular hyperplasia (RLH) of cobble stone‐like granular pattern by endoscopic appearance on the lower body. Although dye‐spraying endoscopy showed the details of the mucosa, it was very difficult to diagnose the lesions correctly by gross appearance alone. Because gastric lymphoma arises from the mucosal or submucosal layer and spreads in the mucosa diffusely, ultrasonic visualization by echo‐endoscopy might be useful in the diagnostic procedure. We report a case of early gastric lymphoma coexisting with RLH; both lesions showed uncommon endoscopic features.
Evaluation of Cancer‐Associated Carbohydrate Antigen (NCC‐ST‐439) Measurement in Pure Pancreatic Juice Collected by Endoscopic Aspiration
Authors: TAKEMORI Yasuhiro , SAWABU Norio , OHTA Hideki , SATOMURA Yoshitake , WATANABE Hiroyuki , YAMAKAWA Osamu , KAWAKAMI Hiroyasu , KIDANI Hisashi , TAKAHASHI Hirokazu , WAKABAYASHI Tokio 
Published: August 2007

Abstract: This study was undertaken to elucidate the diagnostic significance of the measurement of a cancer‐associated carbohydrate antigen, NCC‐ST‐439 (ST‐439), in pure pancreatic juice collected by endoscopic cannulation, chiefly from patients with pancreatic diseases.The mean concentrations of ST‐439 in each of the 4 fractions collected were significantly higher in patients with pancreatic cancer than in controls, but patients with chronic pancreatitis or cholecystolithiasis did not have higher levels. Similarly, a significant increase in the mean output of ST‐439 was observed only in patients with pancreatic cancer. When the cut‐of value was set at the mean concentration+ 2 X the standard deviations of the controls, significant concentrations of ST‐439 were found, in the first fraction (washout phase) in 56% of the pancreatic cancer cases, 31% of the chronic pancreatitis cases and 0% of the cholecystolithiasis cases; in the third fraction (secretory phase) results were 50%, 7% and 0%, respectively. Furthermore, when the cut‐of value was set at the highest concentration found among patients with chronic pancreatitis (to enhance the specificity for pancreatic cancer), the prevalence of significant ST‐339 levels among Pancreatic cancer patients was 50% in the first fraction and 44% in the third fraction.These results indicate that the measurement of ST‐439 in pancreatic juice is useful as a specific marker for pancreatic cancer, although its sensitivity is less than was initially hoped,
ENDOSCOPIC AND CLINICAL STUDY ON HEMORRHAGIC GASTRITIS IN PATIENTS WITH LIVER CIRRHOSIS
Authors: IWAO Tadashi , TOYONAGA Atsushi , TANAKA Johji , YAMASHITA Fumihiko , IRIE Akira , HARADA Hiroshi , MITSUYAMA Keiichi , SUMINO Michihiro , TAKAGI Kohsuke , SASAKI Ei , TANIKAWA Kyuichi , SHIMOTSUURA Yasuhiro , IDE Kohichi 
Published: August 2007

Abstract: During a 5‐year period from 1984 through 1988, an emergency endoscopy was performed for an upper digestive tract hemorrhage in 283 consecutive patients with 290 lesions. Of these, 54 patients were diagnosed as having hemorrhagic gastritis on the basis of the endoscopic findings and were employed as the subjects of the present study. They were classified on the basis of the presence/absence of liver cirrhosis into two groups, i. e. the cirrhosis group (C‐group) and non‐cirrhosis group (NC‐group), and the two groups were comparatively studied.The incidence of hemorrhagic gastritis in hemorrhagic sources of the upper digestive tract was higher in the C‐group than in the NC‐group, and it was seen in the gastric body most frequently. In addition, no clear causes for hemorrhagic gastritis could be identified in many of the cases in the C‐group. These clinical findings were thought to indicate that, in patients with liver cirrhosis, the gastric mucosa itself, especially of the gastric body, is in an impending state of mucosal hemorrhage. A hemorrhage was the major cause of death in the C‐group.In patients with liver cirrhosis, the incidence of hemorrhagic gastritis had no correlation with the grade of esophageal varices, but was high in patients with severe liver cirrhosis. Thus, patients with severe liver cirrhosis were considered to be a high risk group of hemorrhagic gastritis.
Quantitative Evaluation of Mucosal Regeneration in Gastric Ulcers by Electronic Endoscopy —Comparison between Tractable and Intractable Ulcers—
Authors: OSAKA Naofumi 
Published: August 2007

Abstract: The electronic endoscope named TGS‐50B (TOSHIBA) provides a fine resolvable image (Fig. 6) and flat white balance covering a wide range (Fig. 7). Using this electronic endoscope, the regenerative mucosal patterns in 15 cases with intractable and 30 cases with tractable gastric ulcers (Table 1) were observed at 2‐week intervals until the healed stage or until 12 weeks after the start of H2‐blocker administration.To clarify the difference between intractable and tractable gastric ulcers, the electronic endoscopic images were fed into an image analyzer; SPICCA (AVIONICS). The regenerative mucosal pattern was converted into 20 binary digited particles by the image analyzer (Fig. 4, Color) and quantified by the oval specification (OSF) value (Fig. 5).The OSF value of the tractable ulcers significantly increased in the healing stage I (H1) and healing stage 2 (H2), in comparison with those of intractable ulcers (Fig. 8). Moreover, the OSF value of the tractable ulcer significantly increased at 4 weeks after the start of an H2‐blocker, comparing with that at 2 weeks. Consequently, the OSF values of the tractable ulcers were significantly high in comparison with those of the intractable ulcers, at 4, 6 and 8 weeks after the start of administration of H2‐blockers (Fig. 9).By histological study of the biopsy specimen, an increase in the OSF value suggested an extension of the regenerative mucosa by a well progressed annular contraction of the gastric wall.In conclusion, it is thought that intractability of gastric ulcers may be objectively predictable in its early healing stages by determination of the OSF value using the electronic endoscope and the image analyzer.
Selective Endoscopic Retrograde Pancreatography (Selective ERP) Using a Radifocus Gllidewire–A New Technique for a Diagnostic Pancreatogram
Authors: MAGUCHI Hiroyuki , OBARA Takeshi , OKAMURA Kiyoshi , ARISATO Satoshi , ITOH Akinori , SAITOH Yusuke , SOHMA Mitsuhiro , KITAMORI Shigeru , SHIBATA Yoshimi , NAMIKI Masayoshi , ORII Yutaka , MINEMOTO Hiromasa 
Published: August 2007

Abstract: We have developed a new method called the “Selective Endoscopic Retrograde Pancreatograpy (Selective ERP)” which uses a Radifocus guidewire to obtain a more precise pancreatogram than a standard ERP. The deep cannulation of a catheter guided by a Radifocus guidewire following standard ERP was easily and rapidly accomplished and precise pancreatograms were successfully obtained. The Selective ERP was very useful not only for obtaining detailed pancreatograms beyond severe stenosis of the main pancreatic duct in ductal cell carcinoma of the pancreas but also in revealing whether mucinous cystadenoma/cystadenocarcinoma communicated with the pancreatic duct or not. In the case of a mucin producing pancreatic tumor, Selective ERP successfully enabled us to obtain a whole pancreatogram and the location and extent of a tumor that standard ERP often fails to reveal because of an abundant accumulation of mucin in the duct.A Selective ERP is a simple and useful method for diagnosing pancreatic tumors and can provide precise and whole pancreatograms. We recommend Selective ERP as it enables us to obtain more complete diagnostic pancreatograms following standard ERP.
Clinicopathological and Endoscopic Studies on Gastric Cancer Located; the Cardia
Authors: MURAMATSU Hirohito , SAITO Daizo , YOSHIDA Shigeaki , WATANABE Shichiroku , BOKU Narukazu , FUJII Takahiro , YOSHINO Mitsuya , TAJIRI Hisao , YAMAGUCHI Hajime , YOSHIMORI Masayoshi , OGURO Yanao , SASAKO Mitsuru , KINOSHITA Taira , MARUYAMA Keiichi , ITABASHI Masayuki , HIROTA Teruyuki 
Published: August 2007

Abstract: In this study the definition of cardiac cancer (histologically adenocarcinoma) was taken to be a cancerous lesion, the size of which is less than 4 cm and the center of which is located within 2 cm from the esophagocardiac junction. 42 patients (0.8%) fit the above definition of cardiac cancer out of 4,958 patients with solitary gastric cancer operated on at the National Cancer Center Hospital daring the period between 1962 and 1988. The clinicopathological and endoscopic findings of these 42 patients were compared with those of 132 patients with gastric cancer located in the upper third of the stomach other than in the cardia (cancer in the other C‐area). In the group with cardiac cancer, the male patients (M/F ratio: 3.7), the elderly patients (mean age: 61.3 years), a differentiated type of adenocarcinoma (90%), lesions located at the lesser curvature (62%) and the elevated type of lesion were found to predominate. The incidence of early cancer (60%) and the incidence of small lesions less than 2 cm (32%) in diameter were lower than in the patients with cancers in the other C‐area. In the group with cardiac cancer, however, the incidence of such types of early cancer as the depressed lesion, a small lesion less than 2 cm in diameter and lesions difficult to diagnose endoscopically, have been increasing. In recent years, cardicac cancers have been found not only on the lesser curvature, but also in different areas of the cardia.These results suggest an improvement in endoscopic diagnosis for cardiac cancer. To make early detection more precise, it will be indispensable not to overlook even faint or indistinct mucosal abnormalities at the area adjacent to the esophagocardiac junction.
α‐Fetoprotein Producing Early Gastric Cancer
Authors: TAKAGI Hitoshi , SAKURAI Seiji , ABE Takehiko , IKEYA Toshirou , YAMADA Shoji , KOBAYASHI Setsuo , AOYAGI Yutaka 
Published: August 2007

Abstract: A 53‐year‐old male suspected of having a testicular tumor associated with a moderately high titer of α‐Fetoprotein (AFP), was shown to have a IIa + IIc type early gastric cancer in the cardia. The urological diagnoses made from the operated specimen were orchitis and epididimitis. Because of the moderately high titer of AFP (30–80 ng/ml), it was suspected that he had a hepatocellular carcinoma (HCC). A routine upper gastrointestinal endoscopy performed prior to the celiac angiography to assess for a liver tumor revealed gastric cancer. HCC was ruled out using celiac angiography and a total gastrectomy was performed. The operative findings of: P0 H0 N4 S0 corresponded with stage IV gastric cancer. Subsequently his AFP decreased to an undetectable level and the patient is in a good postoperative condition.The resected tumor was a well differentiated tubular adenocarcinoma and stained positive for AFP.A differential diagnosis with the subtype of AFP excluded the possibility of a yolk sac tumor but did not permit differentiation of the HCC from gastric cancer. A diagnosis of AFP producing gastric cancer must be carefully considered when HCC has been excluded in patients with high AFP titers.
The Rigiflex TTS: A New Method to Dilate Benign Esophageal Stenosis
Authors: SPADA F. LA , CASABLANCA G. , BARONE M. , BONARDELLI P. 
Published: August 2007

Abstract: This paper dicusses the use of esophageal dilatation with a Rigiflex TTS balloon. This method was used 45 times on 11 patients affected by anastomotic or a severe grade peptic esophageal stenosis. Fluoroscopic guidance was used in 36 procedures (80%) without effecting the mean duration of the treatment (12 minutes). The results were considered satisfactory when these goals had been achieved: a) dilatation of the stenosis over 15 mm; b) a dysphagia free‐time of more than 6 months. A satisfactory result was achieved in 10 patients (90.9%), without deaths and major complications. 5 patients received 1 dilatation and the other 5 needed, 3‐3‐4‐7–11 procedures respectively to obtain a satisfactory result. On these basis we consider that its great efficacy, security and tolerability depend on the following characteristics of the Rigiflex TTS balloon: 1) “radial” dilatation; 2) the possibility of introducing the balloon through the operative channel of the fiberscope; 3) direct visualization of the stenosis during dilatation.The following disadvantages with this method are: the absence of a tactile sensation of dilatation and the elevated cost of the instrument. We conclude that the Rigiflex TTS balloon is an important alternative to guide‐wire techniques, especially for the treatment of severe esophageal strictures.
Effects of Sclerosing Agents on the Local Blood Flow of the Mesenteric Vein in Rabbits
Authors: NISHIWAKI Hideki , ASM Takeshi , SOWA Michio , UMEYAMA Kaoru 
Published: August 2007

Abstract: To investigate the pathophysiology of scleroembolization as a treatment for esophageal varices, studies were made of the effects of the intravenous administration of Aethoxysklerol (AS), Ethanolamine Oleate (EO), ethanol and thrombin on the local blood flow of the mesenteric vein, the systemic hemodynamics and thrombus formation in blood vessels in rabbits.The dosages and concentrations of Aethoxysklerol used were from 0.5 to 2 ml and from 0.5% to 2%, respectively. This was done to ascertain the possible relationships of these variances of Aethoxysklerol on the local blood flow in vessels with a low‐flow and a high‐flow.99% ethanol, 50 U thrombin and 5% Ethanolamine Oleate were also administered into low‐flow and high‐flow vessels in doses of 0.5 ml and 1 ml, respectively.The increase in AS concentration from 0.5% to 2% caused no remarkable changes in the degree of blood flow inhibition in vessels with either a low‐or a high‐flow, but the time required for inhibition was 45–50 min in vessels with a high flow, which was longer than the 25 min necessary in vessels with a low‐flow. The increase in AS dosage from 0.5 to 2 ml was negligible for enhancing the inhibitory effect of the drug upon the blood flow, but the blood flow inhibition was significantly increased in the low‐flow vessels compared with the high‐flow vessels even when the AS was administered in the same volume and concentrations.The AS‐induced changes on the systemic blood pressure were minimal even with high dosages and high concentrations.99% ethanol and thrombin were less effective in blood flow inhibition in both the low‐and the high‐flow vessels. 5% Ethanolamine Oleate when administered in a volume of either 0.5 ml or 1 ml significantly inhibited the flow in the low‐flow vessels as compared to the flow in the high‐flow vessles.On the other hand, when AS was administered with thrombin, the inhibitory effects were accelerated to 88±26% in the low flow vessels and 44±16% in the high‐flow vessels as compared with administration of AS alone in both the low‐flow and the high‐flow vessels, respectively.We concluded that the embolizing effect of AS alone is rather weak, although it is a relatively safe drug. We consider it wise to combine it with thrombin.
Multiple Early Gastric Carcinoma in Cases Treated Endoscopically
Authors: SUGIURA Junsaku , IDA Kazunori , FUJII Takaaki , FUKUSHIMA Tatsuki , KANETAKE Yasufumi , YAGI Nobuaki , KAWASE Kouhachirou , KOJIMA Takao , KATOH Takahiro , OKUDA Junichi 
Published: August 2007

Abstract:Multiple gastric carcinoma was endoscopically diagnosed in 14 patients (13.6%) with 33 lesions (27.3%), out of 103 cases of early gastric carcinoma treated by endoscopic surgery. The sex ratio of these patients was 11 males to 3 females, and their mean age was 61.7 years old. In 79% of the patients the macroscopic type of the lesions was the same. Twelve of 33 lesions were metachronous lesions diagnosed by endoscopy using the dye contrast method. All of the metachronous lesions were evaluated as invading only as far as the mucosa. Almost all of the metachronous lesions were located at a height similar to that of the initial lesion or in a more oral direction. Eleven of 12 metachronous lesions were less than 2 cm in diameter, including 5 minute cancer lesions which were less than 5 mm in size. All these lesions were treated again endoscopically without gastrectomy. These results suggest that an annual endoscopy using the dye contrast method permits early detection of gastric carcinoma at a stage at which it can be treated endoscopically.
A Case of Spontaneous Regression of Primary Malignant Lymphoma of the Stomach
Authors: HAYAKAWA Kazuo , FUKUCHI Sohtaro , YOSHIDA Yukiya , HASHIMOTO Mitsuyo , HOSHIHARA Yoshio , MIYAKOSHI Shigesaburo , NANAUMI Kyoo , UNAKAMI Masamitsu 
Published: August 2007

Abstract:A 62‐year‐old female who complained of discomfort in her upper abdominal region and a poor appetite had an endoscopically documented polypoid lesion with a shallow irregular central depression at the lesser curvature of the angulus. A diagnosis of malignant lymphoma was made following a gastric biopsy. A gastric endoscopy performed about 20 days later revealed a marked increase in size with an ulcerated surface the margin of which had an auricle‐like shape. These findings were compatible with a diagnosis of malignant lymphoma of the stomach. No medical therapy, such as antineoplastic agents, was given during the follow‐up period. A gastric resection was performed 1.5 months after the initial endoscopy. A detailed histopathological examination of the resected gastric specimen revealed a U1‐II type ulcer scar but no malignant lymphoma cells. Very few cases of a complete spontaneous regression of a malignant lymphoma of the stomach have been reported either within or outside of Japan though it is well known that lymphomas show rapid morphological changes in some patients who are followed‐up without any specific therapy. These rare case reports in the literature are reviewed and discussed together with our present case.
Peptic Ulceration in Patients with Chronic Obstructive Pulmonary Disease
Authors: FUKUMURA Motonori , MACHIDA Makiyo , KOIDE Kouhei , YOSHIIKE Yasuhiro , MIZUNO Tadaoki , SHINDO Kunihiko 
Published: August 2007

Abstract:Chronic obstructive pulmonary disease (COPD) is frequently accompanied by peptic ulceration. Recent studies strongly suggest that the major cause is hypersecretion of gastric juice induced by hypoxemia or hypercapnia. To determine the incidence of peptic ulcers in COPD, we surveyed 267 patients with COPD seen at our hospital as inpatients or outpatients between 1984 and 1988. There were 90 patients with pulmonary emphysema, 93 with chronic bronchitis, and 84 with bronchiectasis. The prevalence of gastric ulcer in the patients with COPD was 23 out of the 267 patients (8.6%) surveyed. These included 13 patients with pulmonary emphysema, 6 with chronic bronchitis, and 4 with bronchiectasis. One‐half of the patients with pulmonary emphysema had hypoxemia and hypercapnia: These observations suggest it is necessary to improve the abnormal blood gas concentration in patients with COPD in order to promote the healing of the peptic ulcer.
Colonic Lipoma Removed by Endoscopic Polypectomy:—A Report of Three Cases—
Authors: NAKAGOE Tohru , FUKUDA Yutaka , NAKAZAKI Takayuki , ISHIKAWA Hiroshi , SHIMIZU Teruhisa , KUSANO Hiroyuki , AYABE Hiroyoshi , TOMITA Masao 
Published: August 2007

Abstract:We report on three cases of colonic lipoma removed by endoscopic polypectomy. Patient 1 was a 46‐year‐old female, Patient 2 a 63‐year‐old male and Patient 3 a 76‐year‐old female, with their afflicted regions being the; ascending colon, ascending colon and transverse colon, respectively. All the three lipomas were pedunculated and smooth on the surface, with the subrnucosal figure presenting yellowish or reddish in color. In Patient 1 and Patient 2, both tumors were totally removed, and in Patient 3, a “half resection” of the polyp was performed by endoscopic polypectomy. The resected specimens were 1.5 cm, 2.6 cm and 1.0 cm, respectively, in size at their maximum diameter and soft tumors with uniformly yellow cut‐surfaces. All were histopathologically diagnosed as being “lipoma”. Because the colonic lipoma is benign, an endoscopic polypectomy should be tried as the treatment of choice in selected patients.
Chemotherapy of Gastric Cancer with Complete Endoscopic Remission: Report of a Case
Authors: YANG Hong‐Jen , WANG Jin‐Town , UEN Wu‐Ching , LIN Jaw‐Town , WANG Teh‐Hong 
Published: August 2007

Abstract:We report on a case of a 31‐year‐old male patient who had advanced gastric cancer with distant lymph node and liver metastasis. A panendoscopy revealed a huge Borrmann's type III advanced gastric cancer involving the esophago‐cardiac junction, cardia, fundus, body, angle and part of the antrum. After 2 courses of VP‐16, adriamycin, cisplatin (EAP), a 4 cm diameter benign looking ulcer was noted at the lesser curvature side of the high to mid‐body. After 4 courses of EAP, a long linear scar was noted at the cardia to low body, while the biopsy revealed only chronic inflammation. A follow‐up abdominal echo and CT scans indicated a complete disappearance of liver metastasis and lymphadenopathy. Although recurrence was noted 2 months later, the new chemotherapy protocol provides a promising treatment for unresectable gastric cancer.