bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reasons for False Negatives in the Endoscopic Screening for Cancer in the Upper Gastrointestinal Tract
Authors: O'CALLAGHAN Elena , TAKAHASHI Hiroshi , FUJITA Rikiya 
Published: August 2007

Abstract: The following paper is a study of 119 gastric cancer lesions that were not diagnosed as malignant in the first gastroscopic examination. These cases were classified according to their endoscopic appearance, and the frequency with which they appeared was compared with the frequency of that type of lesion in the population that receives endoscopy.Gastric ulceration, adenomas, polyps, submucosal tumors, acute gastric mucosal lesions, and gastric redness appeared more frequently in the false negative group than in the population that receives endoscopy.Atrophic gastritis, duodenal ulceration, gastric ulcer scar and gastric erosion appeared less frequently in this group titan in the population that receives endoscopy.To evaluate whether malignancy should really have been suspected in the lesions, the gastroscopic pictures were reviewed by an expert endoscopist. In only 15% of the lesions was cancer not suspected by the expert endoscopist.Chromoscopy as an auxiliary method for the endoscopist was used in only about half of the cases. Depending on the experience of the endoscopist, some endoscopic findings appeared more often than others:i‐ INTERMEDIATE and BEGINNING endoscopists mainly mistook cancer for gastric ulceration.ii‐EXPERT endoscopists confused many more adenomas and polips.We conclude that some gastric lesions are more easily confused in regard to malignancy than others, and that the experience level of the endoscopist stakes hint or her more prone to confusing certain kinds of lesions.
Peptic Ulcer in Infants: Three Case Reports and a Review of the Japanese Literature
Authors: HAYAKAWA Makoto , MORISE Kimitomo , SUGITO Tetsuaki , UMEDA Takashi , UCHIDA Kiyoshi , OKA Youji , KUROKAWA Susumu , KUSAKABE Atsuhiko , TACHINO Fumio , ANDO Takahumi , SAKAI Toru , HATTORI Tatsuo , KANAYAMA Kazuhiro , KUSUGAMI Kazuo , CHIN Kenshou , ITO Shingo , KONAGAYA Toshihiro , KOJIMA Kunihiko , HIKI Yoishiki 
Published: August 2007

Abstract: Three cases of peptic ulcer in children under two years of age are reported, and 33 cases of infants with peptic ulcer reported in Japan between 1955 and March, 1989 are reviewed.Case 1 was an 8‐month‐old male complaining of melena, and endoscopic examination showed a gastric ulcer on the lesser curvature of the antrum. Cases 2 and 3 were a 15‐month‐old mule and an 18‐month‐old male, respectively, with complaints of melena and hematemesis. Endoscopic examination revealed an active duodenal ulcer in both cases. All 3 infants were successfully treated with H2 blocker and/or antacid. In these 3 cases, infection or drugs were speculated to be predisposing factors, and the fathers of these three infants all had histories of duodenal ulcer.Among 33 cases of infants under 2 years old with peptic ulcer in Japan, 9 had a gastric ulcer and 24 had a duodenal ulcer. Seventeen were treated with conservative therapy and 16 were operated on because of perforation or bleeding.We should always keep in mind that peptic ulcer does occur in infancy, and that endoscopic examination should be promptly performed when peptic ulcer is suspected.
Jejunojejunal Intussusception in a Patient with von Recklinghausen's Disease
Authors: SATO Tadashi , FUJINO Masayuki A. , IKEDA Masahiro , TAKEKAWA Masazumi , NAKAMURA Toshiya , TACHIKAWA Hirokuni , KINOSE Tadashi , AINOTA Takao , MIYAZAKI Yoshiki , YAMAMOTO Yasuyuki , AKAHANE Yoshihiro , SUZUKI Hiroshi , SUGAHARA Katsuhiko , KAWAOI Akira 
Published: August 2007

Abstract: A 63‐year‐old female with von Recklinghausen's disease was referred to us because of intermittent periumbilical pain and vomiting. Abdominal ultrasonography showed a segment of the bowel with intussusception in the left ripper quadrant. After intestinal decompression, small‐intestinal endoscopy was performed. Endoscopy revealed multiple protruding lesions in the esophagus, stomach, and jejunum, the largest one markedly stenosing the proximal jejunum. We were able to identify a tumor as the lead point preoperatively. Segmental jejunectomy was performed for the resection of the tumor. Pathological studies revealed that the tumor was leiomyosarcoma.Gastrointestinal involvement is well documented in von Recklinghausen 's disease. Thus attention should be paid to gastrointestinal involvement in the management of these patients. The present case had intussusception, a rare complication of von Recklinghausen 's disease. Svnall‐intestinal Endoscopy played an essential vole in the diagnosis of gastrointestinal involvement in our patient.
Elevation of the Ulcer Base in Cases Treated with an H2‐Blocker —Difference between an Elevated Type of Gastric Ulcer Scar and a White Elevated Lesion—
Authors: ITO Susumu , TAKAOKA Tsukasa , KAJIMOTO Yoshifumi , WADA Satoru , SYUNDOU Jyoji , SHIMIZU Ichiro , KISHI Seiichiro , SANO Toshiaki , II Kunio 
Published: August 2007

Abstract: A white elevated lesion (WEL) was noted in 7 out of 227 ulcer patients treated with an H2‐blocker. These were compared with eight patients with an elevated type of gastric ulcer scarsThe elevated type of gastric ulcer scar (ES) is an elevated lesion covered with regenerating epithelium, showing no whitish exudate, and is foveolar hyperplasia in the histological picture of biopsy. The period prior to the formation of an elevated lesion was as short as 4 weeks on average, and the formed elevated lesion retained the elevated from for as long as several months to several years.The WEL is an elevated lesion covered with whitish exudate, and shows granulation in the histological picture of biopsy. The period prior to the formation of an elevated lesion was as short as 3 weeks on average, and the formed elevated lesion became flattened in a relatively short period of several weeks to several months.From the above results the ES and the WEL are different in the clinical course, morphology and the histological picture, and considered to be of a different quality.
Clinical Evaluation of Brushing Cytology and Biopsy of the Pancreatic Duct in Patients with Mucin Producing Tumor of the Pancreas
Authors: TADA Hideki , TAKEDA Yoshinobu , SHINDO Hiroaki , NISHIHARA Tokufumi , HASHIMURA Naotaka , TAKASHIMA Tetuya , NAKAJIMA Shuzo , HIGASHINO Takeshi , HONGO Yasushi , ADACHI Gakuji , OSHIBA Saburo , KUROKAWA Akio 
Published: August 2007

Abstract: A cytological study of pure pancreatic juice obtained endoscopically after brushing the lesion of the pancreatic duct urns performed in 10 patients with mucin producing tumors of the pancreas. In 6 of these 10 patients, biopsies from the lesion in the pancreatic duct were also carried out endoscopically.The brushing cytology in all 6 patients with mucin producing carcinoma of the pancreas, except for the sidebranch type, showed cellular atypism and the cytological diagnoses were Class IV or Class V. The results of the brushing cytology in the patients assumed clinically benign were Class I ˜ Class III.Biopsy results in 4 patients with mucin producing carcinoma of the pancreas indicated that one of them had adenocarcinoma, and the other 3 had atypical hyperplasia which suggests the existence of malignancy. In the patient with adenoma, diagnosis of the biopsy specimen revealed hyperplasia only.It was concluded that cytology and biopsy of lesions in the pancreatic duct are a valuable way of assessing mucin producing tumors of the pancreas before surgery.
Evaluation of Laparoscopic Findings in Chronic Hepatitis C
Authors: HINO Keisuke , KONISHI Tomomi , OKUDA Michiari , FURUKAWA Tetsuya , YAMASHITA Satoyoshi , SHIRASAWA Hiroyuki , ANDO Masaya , YASUNAGA Mitsuru , FUKUMOTO Yohei , OKITA Kiwamu 
Published: August 2007

Abstract: To elucidate the differences in the progression of liver cirrhosis of chronic hepatitis B and C, the laparoscopic appearance of the liver surface and the histological findings were carefully assessed in 65 patients with chronic hepatitis B and 58 patients with chronic hepatitis C.There was a difference noted in the distribution of periportal reddish markings between the two types of chronic hepatitis. Localized and irregular markings were found to be common in hepatitis C. While the markings were seen to be diffusely distributed over the liver surface in hepatitis B. In addition, localized and longitudinal depressions on the liver surface were observbed more frequently in the hepatitis C patients than in those with hepatitis B. Biopsy specimens obtained from the hepatitis C patients with the above‐mentioned laparoscopic findings showed more advanced histological activity. These laparoscopic changes developed in accordance with the progression of histological activity in chronic hepatitis C. Lymphoid follicles or aggregates within the portal areas were observed more frequently in the patients with chronic hepatitis C than in the chronic hepatitis B patients.Although it is not yet clear how the laparoscopic and histological differences between these two types of chronic hepatitis come about, it appears that the progression of hepatocellular necrosis in chronic hepatitis C is different from that of chronic hepatitis B.
The Endoscopy‐Guided Plan of Radiotherapy for Detecting Esophageal Cancer Using Lugol Staining
Authors: KOBAYASHI Hisataka , ITOH Tsuyoshi , MURATA Rumi , NAOKI Masao , MAEKAWA Takama , SATAKE Hiroshi , KAJITANI Yukio , TANABE Masaya , KOGAWA Kochu 
Published: August 2007

Abstract: The Lugol staining method has recently come to play an important role in the detection of superficial esophageal cancers which are extremely difficult to detect using only a barium double‐contrasted esophagogram and/or a conventional esophagoscopy. We have therefore tested the endoscopy‐guided treatment by radiotherapy using Lugol stainings as a technique for detecting 8 lesions of esophageal cancers in 5 patients.This method was found to be useful for the detection of small intraepithelial lesions, such as intramural metastasis or multiple origin cancers. It is also useful in projecting the lesions accurately on the surface of the body of the patient and planning the radiotherapeutic treatment of the lesions. Additionally, it has been found useful in determining the definite shape of superficial malignant lesions in the evaluation of biopsy specimens taken from the border of the non‐stained regions.
Characteristic Laparoscopic Findings of Chronic Hepatitis C: A Comparison with Hepatitis B.
Authors: KAJINO Kazunori , OGAWA Yasushi , MICHITAKA Kojiro , NADANO Seijin , ONJI Morikazu , HORIIKE Norio , KIKUCHI Takashi , NONAKA Takashi , KANDA Kimitoshi , MASUMOTO Toshikazu , NAKANISHI Kimio , MATSUURA Bunzou , DOI Kazuaki , OHTA Yasuyuki 
Published: August 2007

Abstract: We performed laparoscopy on 72 patients with chronic hepatitis C (CH‐C) to elucidate its morphological features and characteristics relating to its progressive clinical course. We then compared these findings with those of 188 patients with chronic hepatitis B (CH‐B).The frequency of reddish hepatic markings was almost the same in the patients with CH‐B (21%) and the patients with CH‐C (24%). In the patients with CH‐B, reddish markings were present more frequently in the subjects with sublobular hepatic necrosis (34%) than in those without it (5%, p<0.01), but in CH‐C the difference was not significant. Reddish markings were more even in the patients with CH‐B with respect to form, size and distribution, whereas those in the patients with CH‐C were more uneven. Prenodular patchy markings were present more frequently in the patients with CH‐B (14%) than in the patients with CH‐C (6%, p<0. 05).These findings suggested that the progression of hepatic necrosis was more variable in different parts of the liver, and that the regeneration of hepatocytes was less active in the patients with CH‐C, compared with the patients with CH‐B.
Upper GI Bleeding in an Emergency Hospital: Etiology, Prognosis and Improved Survival by Endoscopic Hemostasis
Authors: THOMAS Gregory A. , SUGAWA Choichi , JOSEPH Anthony L. , NAKAMURA Ryuji , SAIHARA Tetsushi , INOUE Yoshihiro 
Published: August 2007

Abstract:Acute upper gastrointestinal bleeding (UGIB) is a frequent diagnosis prompting hospital admission or complicating another preexisting condition. This report examines the experience of an urban medical center in the utilization of endoscopy and endoscopic hemostasis in the diagnosis and management of UGIB over a four‐year period.The first portion of this study examines 562 admissions to a single institution with UGIB. The most common causes of bleeding were acute gastric mucosal lesions (AGML), 24%; esophageal varices (EV), 22%; gastric ulcers, 19%; duodenal ulcers, 14%; Mallory‐Weiss tears, 11%; and esophagitis, 3%. Nonoperative treatment was sufficient in the majority of patients (89.5%). Endoscopic therapy was utilized in 144 patients (26%), of whom 12 required a subsequent operation. Fifty‐eight patients (10.5%) underwent surgery; however, emergent operations were required in only 2.5% of the patients. Factors correlating with mortality included shock at the time of admission (SBP < 80), transfusion requirements of > 5 U PRBC, and presence of EV (each p < 0.001).The second part of this study examines the effect of thrombogenic sclerotherapy on both short and long‐term survival in 101 patients referred with bleeding esophageal varices. Alcoholic cirrhosis was responsible for the majority (88%) of EV, and most patient were Child's C classification (84%). In long‐term follow‐up, rebleeding was significantly reduced (p = 0.03) in patients compliant with follow‐up sclerotherapy. A trend toward decreased mortality was noted in patients compliant with sclerotherapy and in those who avoided further alcohol usage.
Endoscopic Intravariceal Injection Sclerotherapy with 5% Ethanolamine in 187 Acute Oesophageal Variceal Bleeding Patients
Authors: WILAIRATANA Sommai , WILAIRATANA Polrat 
Published: August 2007

Abstract:One hundred and eighty seven patients (161 males and 26 females) with endoscopically proven active variceal bleeding underwent endoscopic sclerotherapy by the intravariceal method (EST). All of the patients were cirrhotic and 37.4 percent (70/187) had associated underlying diseases. The patients' status before EST, according to Child‐Turcotte's classification, were class A % 6.4%, class B = 49. 7%, and class C = 43% respectively.An intravariceal injection with 4 ml of ethanolamine oleate per varix through an Olympus fiberoptic scope was performed. Then sclerotherapy sessions required for each patients was different. Seventy four percent (138/187) required only one session. Neither a compression balloon nor sliding tube after injection were used. Bleeding was arrested in all cases after this method.The results revealed that recurrent bleeding developed in 17.6 percent of the patients (33/187) and occurred between one day (one case) to two years afer EST. Hemorrhagic gastritis (22/187) was the major cause of post sclerotherapy bleeding. Complications related with EST in this report occurred in two patients (1.06 percent). The first case had a low grade fever after treatment which spontaneously subsided on day three after EST without any specific medication. The other one had oesophageal perforation and died with severe post operative sepsis.
Laparoscopic Trial of Fundoplication (Nissen) and Cardiac Myotomy (Heller) in Animals
Authors: INOUE Haruhiro , YOSHINO Kunihide , TAKESHITA Kimiya , NAGAHAMA Yuji , MURAOKA Yukihiko , YONESHIMA Hideo , Endo Mitsuo 
Published: August 2007

Abstract:We studied two kinds of laparoscopic upper gastrointestinal surgery: fundoplication for reflux esophagitis and myotomy for achalasia of the esophagus. Two basic and common procedures which are required for the successful completion of these two operations are: 1) retraction of the left liver lobe to obtain a clear visual field of the esophageal hiatus, and 2) taping of the abdominal esophagus to sufficiently pull the esophagus down into the operative visual field. The operations were successfully performed on pigs using five animals and no major complications such as uncontrollable bleeding were incurred. In only one subject a laceration of the mucosa occurred after myotomy due to careless overinflation of the endoscopic balloon situated in the lumen of the esophagus, but this could easily be avoided in future operations. We believe that these laparoscopic procedures will soon be ready for clinical application.
Laparoscopy in a Case of Primary Sclerosing Cholangitis with an Ultrasonographically Detected Portal Thrombus
Authors: WATANABE Makoto , UCHIDA Yasushi , KOHGE Naruaki , AKAGI Shuji , ASHIZAWA Nobuo , ADACHI Kyoichi , KISHIDA Keiko , ONO Naomi , FUKUMOTO Shiro , ONO Masakazu 
Published: August 2007

Abstract:A case of sclerosing cholangitis is presented. The patient was a 65 year‐old male and visited a hospital because symptoms of a biliary tract infection suddenly appeared. These symptoms improved in the short term with antibiotic therapy. As a high level of serum CA19–9 was found and the double wall structure of the intrahepatic bile duct and a portal thrombus were observed during an abdominal ultrasonography, the patient was transferred to our clinic for further examination of his hepatobiliary system. A malignant lesion was suspected from an endoscopic retrograde cholangiography and celiac angiography, although the patient's serum CA19–9 level rapidly decreased after admission. A liver with a smooth surface, some focal wide depressions, and an increase of white markings was observed laparoscopically. An adenomyomatosis‐like lesion was observed in the gallbladder. Bile duct destruction with periductar fibrosis was histologically proven. This is a case of histologically diagnosed sclerosing cholangitis but without the typical findings usually found during an endoscopic retrograde cholangiography.
Repeated Laparoscopy of 27 Patients with Chronic Non‐A, Non‐B Hepatitis Showing a Complete Response to IFN Therapy
Authors: ITO Toshio , UKIDA Minoru , YAMAMOTO Kazuhide , TANIMIZU Masahito , MIZUTAMARI Koukichi , KAKIO Takeshi , KOBASHI Haruhiko , SAKAI Nobuyuki , MATSUO Ryuichi , MORIMOTO Youichi , MIYAMOTO Rieko , OMOTO Masaki , NAKANISHI Sousuke , MIKAMI Masayuki , OMORI Nobuhiko , TERAOKA Tadashi , TSUJI Takao 
Published: August 2007

Abstract:The laparoscopies and liver histology results of 27 patients with chronic non‐A, non‐B hepatitis who had a complete response to the longterm administration of IFN‐alpha were studied. When comparing the liver surface before IFN therapy, code number 1 using Shimada's classification, i. e., whitish markings, increased from 14.0% to 57.9%, code number 2, i. e., dilated vessels, decreased from 34.9% to 10.6%, code number 4, i. e., reddish markings, decreased from 11.6% to 2.6%, and code number 7, i. e., patchy markings, decreased from 16.3% to 2.6%. Improvement of the liver edge dullness and a decrease of the liver consistency after the IFN therapy were also observed in 40. 7%, and 14. 8% of the patients, respectively. Liver histology after the therapy showed normal liver or liver fibrosis in chronic hepatitis patients, and liver cirrhosis with active hepatitis developed into liver cirrhosis without activity. The hepatitis activity index score decreased significantly after the therapy. The present report seems to be the first which describes detailed changes of the liver surface before and after IFN therapy in patients with chronic non‐A, non‐B hepatitis who had a complete response to the therapy
The Diagnosis of the Anomalous Connection of Pancreaticobiliary Ducts Without Biliary Dilatation—The Usefulness of US/EUS Serial Examination—
Authors: YAMAO Kenji , NAKAZAWA Saburo , YOSHINO Junji , INUI Kazuo , YAMACHIKA Hitoshi , KANEMAKI Naoto , FUJIMOTO Masao , WAKABAYASHI Takao , MATSUMOTO Sumio , SEGAWA Kose , SUZUKI Takashi , MITAKE Masahiro 
Published: August 2007

Abstract:The anomalous connection of the pancreaticobiliary duct (ACPBD) without accompanying dilatation of the bile duct (non‐dilated type of ACPBD) has recently been found to be associated with gallbladder cancer at a rather high rate. We analyzed the diagnostic process of 5 patients with non‐dilated type of ACPBD including 3 asymptomatic cases and reviewed the literature. Symptoms and laboratory data were not useful in detecting this type of lesion. All our patients were checked by ultrasonography for gallbladder lesions which are suggested by: wall thickening, multiple polyps, intramural gall stones, cholecystolithiaisis, and debris. ACT revealed only wall thickening of the gallbladder. An EUS revealed a high rate of ACPBD in addition to the ultrasonographic findings of gallbladder lesions obtained by US. An ERCP was effective in clearly demonstrating ACPBD, but was not so useful for the diagnosis of concomitant gallbladder lesions. Therefore, an US is considered to be a useful means for screening this disease, and EUS is useful as a procedure to follow in order to select patients with or without ACPBD, because EUS can be conducted on an outpatient basis and is highly sensitive in detecting ductal anomalies in ACPBD. Therefore, the US/EUS serial examination is thought to be an effective means for diagnosing this disease.
A Basic Study on the Eye Fixation Points in Endoscopic Observation with Special Reference to the Difference Between the Beginners and Experts
Authors: KUROSAKA Hanzo , AOKI Takahito , HIROOKA Tatsuo , SADANAGA Yoshihisa , SUZUKI Hiroo , KANEKO Shohnosuke , KOZASA Kiyoshi , ISHIKAWA Masazumi , IWAI Chikara , TAJIRI Inaho , AONO Giichi , UKAWA Shiro , JYOHJIMA Yoshiaki , KAMINISHI Michio , OOHARA Takeshi 
Published: August 2007

Abstract:Accurate image analysis is essential for correct diagnosis in gastrointestinal endoscopy. In the past, the process of diagnosis has varied based merely on the personal experience of the examiner, and yet there has been no basic study concerning its improvement. We conducted a basic study on endoscopic image analysis particularly with regard to eye fixation points, and noticed that there was a significant difference between beginners and experts. The beginners tended to fix their eyes on the area showing a larger color tone difference, whereas the experts tended to have their fixation points on areas with less of a color tone difference
A Case of Endometriosis of the Appendix
Authors: FUKE Hirofumi , SATO Hyoe , HIGASHIYAMA Hirotaka 
Published: August 2007

Abstract:A 51‐year‐old woman visited our clinic her chief complaint being right hypogastric discomfort. An abdominal ultrasonography revealed a circular, cystic mass in the right hypogastric region. A colorectal radiography disclosed a semi‐globular shadow defect at the end of the cecum and did not visualize the appendix. A colorectal endoscopy revealed a submucosal tumor accompanied by a central dimple which seemed to represent the ostium appendicis vermiformis. Based on a preoperative diagnosis of submucosal tumor, the patient underwent a partial resection of the cecum. A histopathological examination of tissue removed led to a diagnosis of endometriosis of the appendix.In Japan, 7 cases of endometriosis of the appendix have been reported to date. In those cases, endometriosis of the appendix was detected as a lesion accompanying endometriosis of some other site or during laparotomy was based on a diagnosis of acute appendicitis. Unlike these cases, the patient presented here had been diagnosed by a preoperative colorectal radiography and endoscopy as having a submucosal tumor of the appendix.