bluuebunny/crossref_metadata_2025_split huggingface dataset:
Laparoscopic Follow‐up of Asymptomatic Primary Biliary Cirrhosis with Negative Anti‐mitochondrial Antibody
Authors: WATANABE Makoto , UCHIDA Yasushi , ADACHI Kyoichi , KOHGE Naruaki , ONO Naomi , FUKUMOTO Shiro 
Published: August 2007

Abstract: The case of a 59 year‐old female with asymptomatic primary biliary cirrhosis with negative anti‐mitochondrial antibody is presented. According to the results of the first laparoscopy and liver biopsy, reddish patch was observed but chronic non‐suppurative destructive cholangitis could not histologically be confirmed. A follow‐up laparoscopy with liver biopsy conducted 39 months after the first laparoscopy revealed progress in the laparoscopic findings, i. e. a focal appearance of mesh‐like white marking and undulation, when chronic non‐suppurative destructive cholangitis was histologically demonstrated. Following the diagnosis of primary biliary cirrhosis, ursodeoxycholic acid treatment was begun, and the patient's serum levels of transaminases and biliary tract enzymes showed a rapid improvement.The importance of a laparoscopy with liver biopsy for the diagnosis of asymptomatic primary biliary cirrhosis in a case with negative anti‐mitochondrial antibody is emphasized, and the follow‐up of such a case discussed.
Endoscopic Characteristics of Gastric Polyps and Their Background Mucosa on the Gastric Body
Authors: TAKECHI Keishi , ENDO Junko , FURUHASHI Kazutoshi , SAITO Yoshio , YAMADA Tetsuya , MORIWAKI Hisataka , MUTO Yasutoshi 
Published: August 2007

Abstract: We investigated the endoscopic and histopathological characteristics of 112 gastric polyps on the gastric body. According to the histopathological findings of the glands in the biopsy specimens, we classified the polyps into 6 categories; dense fundic gland type (group A), sparse fundic gland type (B), mixed fundic and pyloric gland type (C), pyloric gland type (D), complete atrophic gland type (E) and others (F). The grade of atrophic gastritis was defined by the fundic‐pyloric border type of the stomach, and was found to change from mild to severe respectively in groups A to E. The gastric area type of background fundic gland mucosa also changed from F0 to F3 in parallel with the order of the groups A to E. Thirty‐five of the 36 polyps in group A, all 19 in group B, 2 out of 3 in group C, 1 of 4 in group D, and the 1 in group E were located on the dye‐endoscopically defined fundic gland mucosal area. The gland type of biopsy specimens which were obtained from the mucosa adjacent to the polyps changed from fundic to fundic‐pyloric and to pyloric type in groups A to E respectively. In conclusion, the histopathological findings of polyps on the gastric body reflect the background mucosa, and in particular the extent of the atrophic change of the stomach. The majority of polyps, either fundic gland polyps (groups A and B) or hyperplastic polyps (groups C, D and E), on the gastric body were found to be the same gland type as their respective background mucosa. They thus seem to fall into the same category as hyperplastic polyps of background mucosal origin but are not the same as a hamartomatous polyp.
The Colon Mucus Test in Comparison with the Fecal Occult Blood Test in the Detection of Gastrointestinal Disease
Authors: WATANABE Hiroyuki , MOURI Ikurou , YAMAGUCHI Yasushi , YAMAKAWA Osamu , KAWAKAMI Hiroyasu , SATOMURA Yoshitake , Ohta Hideki , MOTOO Yoshiharu , OKAI Takashi , FUKUI Masanori , SAWABU Norio 
Published: August 2007

Abstract: This study was undertaken to assess the diagnostic significance of the colon mucus test (CMT) by which the cancer‐associated carbohydrate antigen, β‐D‐Gal (1 ‐ 3)‐D‐GalNAc (T antigen) is measured in rectal mucus, chiefly in patients with various alimentary tract diseases. The incidence of a positive CMT was relatively high in colorectal cancer (69%) and gastric cancer (40%), and was similarly high in some benign colorectal diseases such as colonic diverticulum (42%) and colonic polyps (39%), and in gastric polyps (75%). On the other hand, the incidence of a positive CMT in other benign diseases or in healthy controls was less than 10%. A positive CMT was significantly more common in colorectal disease and in gastric tumors (cancer and polyps) than in the other diseases (p < 0.001). Of 28 colonic polyp patients, 20 (71%) had negative fecal occult blood test results (FOBT), and nine of them (45%) had positive CMT results. These results suggest that the CMT may be a useful screening test for alimentary tract disease, particularly colorectal disease and gastric tumors, although its specificity for colorectal cancer is only moderate. Furthermore, a combination assay using FOBT plus CMT may help to improve the diagnostic rate.
A Case of Terminal Ileum Lipoma Treated by Endoscopic Polypectomy
Authors: KAGAMI Akihiko , ARINO Toru , USUI Toshirou , SEKI Shingo , TSUCHIYA Masahito , OKUMURA Mitsuru , TANAKA Fumio , IWAI Takaaki , HIROTA Yoshiyuki , KOMORI Akihiko , SAKATO Hideyoshi , TAKAHASHI Kaoru , MOCHIZUKI Seibu , NAGANO Makoto , SUZUKI Hiroaki 
Published: August 2007

Abstract: This study reports on the case of a 71‐year‐old man who complained of repeated episodes of right lower abdominal pain. A barium enema and colonoscopy revealed a 20 times 20 times 15 mm smooth‐surfaced polypoid tumor (Yamada type III) located in the terminal ileum. An endoscopy showed that the lesion had a slightly yellowish surface and the cushion sign was observed, so the tumor was considered to be an intestinal lipoma. During colonoscopy, prolapse of the tumor occurred through the orifice of Bauhin's valve and the patient simultaneously complained of right lower abdominal pain. The tumor was removed endoscopically. After a colonoscopic polypectomy, the patient's right lower abdominal pain disappeared. A pathological examination of the specimen revealed a lipoma of the terminal ileum. In general, the correct preoperative diagnosis of intestinal lipoma is difficult. Furthermore, 80% of lipomas situated at the terminal ileum are complicated by acute intussusception. We suggest that a colonoscopic polypectomy is a useful procedure for confirming the diagnosis of intestinal lipoma and for the prophylaxis of intussusception when the tumor is located in the terminal ileum.
New Endoscopic Approach to Diagnosing Pancreatic Diseases Using an Intraductal Ultrasound System
Authors: FURUKAWA Tsuyoshi , TSUKAMOTO Yoshihisa , NAITOH Yasuo , MITAKE Masahiro , ISHIHARA Akira , HIROOKA Yoshiki , KATOH Tadashi , OHSHIMA Youichi , KANAMORI Shinichi , KUROIWA Masanori 
Published: August 2007

Abstract: We found that pancreatic diseases can be accurately visualized and diagnosed from the main pancreatic duct via the major papilla using an intraductal ultrasound (IDUS) catheter at a frequency of 30 MHz to create a 360 real‐time image. Herein we present the problems and potential future development of the IDUS system in visualizing pancreatic diseases. The clinical application of the IDUS was evaluated in 16 patients with pancreatic diseases (3 with pancreatic cancer, 6 with a mucin‐producing tumor and 7 with chronic pancreatitis). Insertion was successful in all 4 patients (100%) with a wide‐open orifice and in 9 out of 12 patients (75%) with a normal orifice.We encountered four primary difficulties using this modality : 1) As the IDUS catheter is only 135 cm long, it could not be inserted all the way to the pancreatic tail in some patients. Therefore, we had to resort to an unmanageable gastroscope instead of the preferred duodenoscope for scanning. 2) The tip of the catheter is fragile and can be easily damaged during endoscopic examination. 3) Anatomical problems from n reversed Z configuration at the head of the main pancreatic duct prevented insertion all the way to the pancreatic tail in a few patients. 4) The scanning area around the main pancreatic duct was limited to a radius of about 10 mm due to the frequency setting of the IDUS catheter.Further developments of the clinical applications of IDUS in the pancreas may eventually result in more accurate diagnoses, particularly in differential diagnoses between focal chronic pancreatitis and pancreatic carcinoma. The IDUS may also provide valuable details regarding invasion into the pancreatic Parenchyma in patients with mucin‐producing tumors. The IDUS may also be useful in determining the extent of excision necessary in patients with pancreatic diseases.
Experience with Laparoscopic Appendectomy —The Technique and Our Views of its Indications—
Authors: KANO Nobuyasu , YAMAKAWA Tatsuo , ISHIKAWA Yasuro , SAKAI Shigeru , HONDA Hiraku , KASUGAI Hisashi , OHTAKI Shuji 
Published: August 2007

Abstract: Since June, 1991 a laparoscopic appendectomy (LA) was performed on eleven patients with suspected appendicitis which could not be confirmed by the conventional diagnostic methods. The patients included 7 males and 4 females, with a mean age of 27, 9, ranging from 16 to 46 years. No postoperative complications were encountered. The laparoscopic diagnoses included gangrenous appendicitis in 2, suppurative appendicitis in 2, catarrhal appendicitis in 4, salpingitis in 2 and an appendiceal mass in one patient (Case 7). Histopathological diagnoses were phlegmonous appendicitis in 3, mucinous cystadenoma in one and catarrhal appendicitis in 7 patients. Two cases of salpingitis and a case with ovarian bleeding were treated conservatively after incidental laparoscopic removal of the appendix. Case 7 was histopathologically diagnosed as having mucinous cystadenoma. The patients’postoperative hospital stay was from 5 to 8 days, with an average of 6.9 days. All patients had been given the permission to be discharged by the third POD but they stayed longer because of benefits given by the health insurance system very specific to Japan.LA in our clinic has so far been limited to selected patients in whom the diagnosis of appendicitis could not been confirmed and laparoscopic examination was indicated, mainly due to manpower problems involving surgeons, anesthetists and operating room nurses. However, LA provides not only benefits for patients but also several merits for surgeons including better exposure of the operating field in most cases when compared with an open appendectomy. We feel, therefore, that the indications for LA might be extended more widely, probably to most cases of appendicitis.
A Case of a Patient with a Rectal Ulcer Who Had an Unusual Defecation Habit
Authors: HOSHIKA Kazunori , MIZUNO Mitsuru , KIHARA Tsuyoshi 
Published: August 2007

Abstract: This case report describes a patient with a rectal ulcer who had an unusual defecation habit. Complete healing was recognized colonoscopically after the patient was instructed to break this habit.A polyp of the ascending colon was detected by a barium enema in a 37‐year‐old man complaining of anal bleeding. He was admitted to our division to undergo a polypectomy. At the time of the polypectomy, a round ulcer, measuring 1 cm in diameter, was detected on the right wall of the rectum 3 cm from the anal verge. A diagnosis of mucosal prolapse syndrome of the rectum could not be made because the patient did not exhibit the characteristic habit of excessive “straining” mentioned by patients with this syndrome, and no characteristic finding of fibromuscular obliteration was found on histological examination of biopsied specimens taken endoscopically from the lesion. Repeated history taking, however, revealed that the patient had the unusual habit of inserting his finger into his rectum after defecation. He broke this habit following instruction to do so. As a result, on colonoscopic examination 15 month later, the ulcer was found to have become a scar:
Gastric Pit Density and Depth of Foveolae of the Gastric Body Mucosa Assessed by Dye Endoscopy
Authors: TAKECHI Keishi , OHASHI Miyoji , KODA Koji , SHIMOJO Hirofumi , MORIWAKI Hisataka , MUTO Yasutoshi , YAMADA Tetsuya 
Published: August 2007

Abstract: We examined the histological characteristics of the foveolar zone of the gastric body mucosa, using dye endoscopy and endoscopic biopsy. In 63 patients, the gastric area type of the gastric body was placed in one of the following categories; fundic gland type 0 (F0), where small and fine areas are arranged closely to one another; F1, where the areas are largest in size, round and high; F2, where the areas are intemediate in size but not so high; F3, where small and flat areas are loosely arranged; pseudo‐pyloric gland type 1 (Pb1), where the areas are regular in size and arrangement; and the completely atrophic gland type (Pb2) with areas irregular in size and arrangement. The histological characteristics of the foveolar zone were emmined on printed microphotographs of the biopsy specimens of the gastric body. The density of the gastric pit was defined as the number of pits in a 1 mm width of the mucosal surface and depth of the foveolae was measured as the distance between the top and bottom (or the isthmus) of the foveolae as seen on vertical sections. The gastric pit density and depth of the foveolae were dense and shallow, respectively, in FO and sparse and deep, in Pbl and Pb2 respectively. The degree of these factors showed independency in area types F0, F1 and Pb2 and there were correlations of P<0.033 and P<0.001 between F2 and Pb1, F3 and Pb1, respectively.Our observations may be useful to define atrophic gastritis in the gastric body mucosa, in terms of the gastric area types.
A Case of Gallbladder Perforation in Which the Developmental Pattern was Demonstrated by Laparoscopy
Authors: MATSURA Tatsuya , WATANABE Makoto , FUKUMOTO Shiro , NAGAOKA Saburo , GOBARU Yoshiyuki 
Published: August 2007

Abstract: A 58‐year‐old man with diabetes mellitus was referred to our clinic because of epigastric colicky pain of sudden onset with fever. An ultrasonography (US) and endoscopic ultrasonography (EUS) demonstrated marked thickening of the gallbladder wall and a pericholecystic echo‐free space. A laparoscopy showed tight adhesion between the greater omenturn and the parietal peritoneum, and pooling of bile on the liver surface, the greater omenturn, and in the perisplenic area. The gallbladder itself could not be seen. A surgical laparotomy revealed perforation of the gallbladder with a pericholecystic abscess. No laparoscopic observation of free bile has been reported in cases of gallbladder perforation.In the present case, US, EUS and laparoscopy were useful for early diagnosis of gallbladder perforation. In addition, laparoscopy played an important role in determining the type of gallbladder perforation.
Gastric Ulcer Relapse
Authors: OGOSHI Kazuei 
Published: August 2007

Abstract: In this review we found that the rate of gastric ulcer relapse reached near! 70% over a 13 year period and was nearly 10% after one year from when they reache the white scar stage. A H2‐RA or proton pump inhibiter had a high relapse rate the reason being the fragile re‐epithelization of the scar3)4). Factors involved in gastric ulcer relapse are considered to be the fragile re‐epithelization of the ulcer, disturbance c blood flow due to fibrosis underneath the ulcer scar, and etiological factors such a smoking and so on. Endoscopic findings of the ulcer scar can statistically suggest th gastric ulcer relapse rate. The main cause of peptic ulcers, especially duodenal ulce relapse, is strongly related to Helicobacter pylori infection. The causes of gastric ulcer relapse are very complicated and variegated. H. pylori infection contributes to les gastric ulcer relapse than duodenal ulcer relapse.To prevent gastric ulcer relapse, therefore, one should consider the eradication c H. pylori, the endoscopic features of the ulcer scar and etiological factors.
An Unusual Form of Aphthoid Proctocolitis
Authors: CHIBA Mitsuro , SUZUKI Toshio , HORIE Yasuo , MASAMUNE Osamu 
Published: August 2007

Abstract: An unusual form of aphthoid colitis is presented. A 21 ‐year‐old man complained of hematochezia for about 2 years. Examinations revealed crowded polypoid lesions in the lower rectum: the closer to the anus the site was, the bigger the size of the polypoid lesions. Polypoid lesions were also observed in the terminal ileum and on the ileocecal valve. Biopsy specimens revealed that these polypoid lesions were lymph follicles. Lymphoid hyperplasia was observed in the upper rectum and proximal colon but not in the transverse colon. The patient was given a salicylazosulfapyridine suppository followed by a rapid ceasing of hematochezia on the following day and disappearance of most lymph noduli in the rectum by the second week. About two years later hematochezia recurred. The findings of the lower rectum and the response to the suppository were the same as in the first episode. Known diseases associated with aphthoid colitis were ruled out.The present case is unusual in several respects compared to typical apthoid colitis: the clinical course is not acute self‐limited but chronic protracted; the lesions are distributed not evenly in the large bowel or its segment(s) but in the lower rectum, in addition, the lesions become more pronounced toward the anus; skipped lymph noduli are observed in the ileocecal valve and the terminal ileum. The other characteristics of this case include a marked response to salicylazosulfapyridine, recurrence, no precedence of flu‐like syndromes, no symptoms except for hematochezia, and normal laboratory data.
Significance of Follow‐up Total Colonoscopy after Resection for Colorectal Cancer
Authors: NAKAGOE Tohru , FUKUDA Yutaka , ISHIKAWA Hiroshi , NAKAZAKI Takayuki , SAWAI Terumitsu , IKENAGA Hidetsune , KUSANO Hiroyuki , AYABE Hiroyoshi , TOMITA Masao 
Published: August 2007

Abstract: This is a retrospective study of the results of total colonofiberscopy performed on 180 postoperative patients with colorectal cancer. We divided the patients into two groups: “Group A” that had no concurrent polyp and/or synchronous multiple carcinoma besides the main lesion at the time of surgery and “Group B” that had a concurrent polyp and/or synchronous multiple carcinoma besides the main lesion at the time of surgery, and compared them. Colorectal polyps were found in 77 patients (42.8%), recurrent cancers in 9 patients (5.0%). and metachronous cancers in 6 patients (3.3%). respectively. In Group A, no abnormality was found in 65.7% (69/ 105), which was significantly higher compared with 33.3% (25/75) of Group B (p< 0.0001). The detection ratio of polyps in Group B was significantly higher than that of Group A (61.3% versus 29.5%. p<0.0001). The number of detected polyps in Group B was also large. As for the time required to detect the polyps, no difference was found between the two groups. There was no certain tendency for the location in which the polyp developed, and polyps were found in any portion of the residual colon and rectum. The development of metachronous cancer was found in 3 patients (2.8%) in Group A and 3 patients (4.0%) in Group B, which indicated a higher ratio for Group B, but statistically no significant difference was confirmed. In the metachronous cancer group, more than half were in the early stage, and even with the advanced cancers, the diameter of the tumor was small. In all of them, a curative resection were performed, and they were found to be Dukes’A and B in which no spreading was found to the lymphnodes.From the above, we can conclude that a follow‐up using total colonoscopy is useful, and that a postoperative follow‐up total colonofiberscopy should be performed on postoperative patients with colorectal cancer within 6 months after surgery regardless of the presence of a concurrent polyp and/or synchronous multiple carcinoma besides the main lesion at the time of surgery. Also a follow‐up schedule must be conducted once a year after the first follow‐up using the endoscopic method. (Dig Endosc 1994; 6: 7–16)
Morphological Study of Pancreas Divisum in Niigata Using ERCP
Authors: NARISAWA Rintarou , ASAKURA Hitoshi , NIWA Masayuki , OGOSHI Kazuei 
Published: August 2007

Abstract: The morphological characteristics and incidence of pancreas divisum (PD) in Niigata were investigated by studying 16,646 cases diagnosed by ERCP. These cases had been patients in 16 hospitals located in Niigata prefecture.PD was found in 114 (63 cases confirmed, 51 cases unconfirmed) of these 16,646 cases (0.68%). An unconfirmed case was defined as being a patient in whom only the short ventral pancreatic duct was visible through the main papilla, and the confirmed cases were classified into the 3 types according to the ductal systems of the dorsal and ventral pancreas. The classification of these 3 types was as follows.Type 1: Nonfusion between the ventral (VPD) and dorsal pancreatic ducts (DPD), which was visualized through the main papilla (MP) and the accessory papilla (AP), separately.Type 2: Only DPD was visualized through the AP. In spite of the cannulation of the MP, the VPD was not demonstrated.Type 3: Miscellaneous cases.The frequency of Type 1, Type 2, and Type 3 was 58.7% (37 cases), 28.6% (18 cases), and 12.7% (8 cases), respectively. Type 3 consisted of two subtypes. One (7 cases) was regarded as being when the patient had a very fine communicating branch between VPD and DPD, whether an obvious communicating branch could be detected or not by ERCP. The other subtype (only one case) showed very strange findings in which through the AP a short pancreatic duct distributed to the head of the pancreas and to the uncinate process was visualized and in which through the MP a long pancreatic duct to the tail was demonstrated, separately.
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.