bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical Evaluation of Endoscopic Ultrasonogrphy in Diagnosis of Submucosal Tumor of the Upper Alimentray Tract
Authors: MATSUMOTO Jun , NAKASHIO Kazuaki , YOSIKAWA Junichi , TANAKA Keizo , SHIBUE Tadashi 
Published: August 2007

Abstract: The usefulness and the problems of endoscopic ultrasonograpy (EUS) in the diagnosis of submucosal tumors (SMT) of the upper alimentary tract were evaluated in this study. EUS was carried out in 86 cases with SMT of the stomach. Tumors of 13 cases was confirmed histologically (leiomyoma in 7 cases, leiomyosarcoma in one, lipoma in 2, gastric cyst in one, aberrant pancreas in one and Schwannoma in one case). In only one out of 22 cases with SMT of the esophagus, the tumor was surgically resected and a pathological examination revealed leiomyoma EUS was useful in estimating the histological origin of SMT by observation of the relationship between the location of the tumor and each layer in the gastric or esophageal wall. However, it was imposible to differentiate leiomyoma from leiomyosarcoma in myogenic tumors through the echoic pattern of the tumor by EUS alone at the present time. EUS was also useful in distinguishing the cause of extragastric compression showing similar findings with SMT, which could not be clarified by X‐ray or endoscopic examination. In fact, organs compressing the stomach were easily clarified by EUS. It was decided that EUS should be performed in all cases whenever there is any doubt of SMT existing after an X‐ray or endoscopic examination.
Ascending Colon Stenosis:A Rare Presentation of Perforated Appendicitis
Authors: KAKEI Nobuyuki , MIKI Kazumasa , KIMURA Masayoshi , ICHINOSE Masao , HOSHINO Etsuo , SANO Junjiro , KAWAMURA Norio , TASHIRO Takao , MATSUSHIMA Masashi , KUROKAWA Kiyoshi , HASHIMOTO Daijo , IDEZUKI Yasuo 
Published: August 2007

Abstract: Described is a 49‐year‐old Japanese male who developed an ascending colon stenosis secondary to perforated appendicitis. The patient was examined at our hospital because of an abdominal pain and the presence of a firm mass in the right flank. A barium enema and colonoscopic examination revealed an ascending colon stenosis with multiple nodular elevations. On laparotomy, an inflammatory mass, originating from a ruptured appendix, was found adhered to the cecum and the ascending colon. Thus, a right hemicolectomy was performed. Microscopic examination revealed a periappendiceal abscess with marked submucosal fibrosis and lymphoid hyperplasia of the ascending colon and cecum. Large intestinal stenosis is a rare complication of appendicitis, and there have been only a few reported cases involving the ascending and sigmoid colon, and the rectum. In these cases, however, the polypoid lesions as seen in our case have never been described. In reviewing the literature, we found only two other cases in which a coarse or a polypoid lesion, similar to our case, was noted in the cecum, though the mucosal change was localized and luminal stenosis did not occur. Thus, when a patient with an ascending colon stenosis is encountered, a possibility of periappendiceal abscess must be kept in mind.
Gastric Cancer Developing in a Patient with Chronic Lymphocytic Leukemia with Massive Gastrointestinal Involvement
Authors: MATSUHASHI Nobuyuki , URABE Akio , OHNISHI Shin , OHNISHI Mayumi , KONDO Yukio , SUGANO Kentaro , TAKAKU Fumimaro 
Published: August 2007

Abstract:Massive infiltration of neoplastic lymphocytes caused a variety of gross gastrointestinal manifestations in a 71‐year‐old patient with chronic lymphocytic leukemia (CLL). These included plaque‐like elevations in the esophagus, convoluted gyrus‐like folds in the stomach, and many polypoid lesions in the stomach and duodenum. No gross lesions were noted in the large intestine. Four years later, systemic chemotherapy reduced the gastrointestinal involvement, but a papillary elevation grew at the gastric angle, which was shown to be an early cancer on histological examination. Gastrointestinal involvement in CLL and second cancers associated with CLL are reviewed, with special reference to the possible relationship between CLL and gastric cancer.
Endoscopic Retrospective Study on Gastric Malignant Lymphoma—with Special Reference to the Appearance of the Initial Lesion—
Authors: AMANO Yuji , ISHIHARA Shunji , TAKATORI Yoshimasa , IMAOKA Tomonori , WATANABE Makoto , FUKUMOTO Shiro 
Published: August 2007

Abstract:An endoscopic retrospective study was performed on five lesions in four patients with gastric malignant lymphoma, in order to elucidate the characteristics of the initial lesion and the growth process of these lymphomas.In case 1 (protruding type of malignant lymphoma), an area of small macular redness and a shallow ulcer, which had neither a surrounding elevation due to edema nor the circumscribed redness caused by regenerative epithelium, were observed 23 and 11 months before, respectively, when a cobblestone appearance, indicative of early lymphoma of the stomach, was found. A shallow ulcer was also recognized in the initial stage of the disease in case 2 (giant rugal type). Discolored and lustrous granules were observed as a first endoscopic finding in cases 3 and 4 (ulcerative type). These endoscopic findings were thought to be key findings indicative of gastric malignant lymphoma in the initial stage. For the early diagnosis of gastric malignant lymphoma, a careful follow‐up with a skillfully performed biopsy, i. e. an exactly aimed biopsy using large, sharp‐edged forceps, should be carried out if the findings described above are once observed.
Benign Strictures of the Intrahepatic Bile Ducts Managed with Percutaneous Transhepatic Cholangioscopy: A Case Report
Authors: KUBOTA Yoshitsugu , SEKI Toshihito , YAMAGUCHI Takashi , KUNIEDA Kouji , TANI Kazuhiro , KIN Hideyuki , MIZUNO Takako , SAMESHIMA Yoshiko 
Published: August 2007

Abstract:Benign strictures of the intrahepatic bile ducts were detected, by percutaneous transhepatic cholangioscopy combined with forceps biopsies, in a patient who presented symptoms suggesting cholangitis. The patient was successfully treated by non‐operative stricture dilation techniques, with the aid of cholangioscopy. In this paper, the usefulness of percutaneous transhepatic cholangioscopy for the management of benign biliary strictures is discussed.
Gallbladder Cancer Laparoscopy
Authors: WATANABE Makoto , TAKESHITA Masahiro , TAKATORI Yoshimasa , UEKI Kazunori , UMEKAWA Yasuhiro , HIRAKAWA Hiroyasu , FUKUMOTO Shiro , SHIMADA Yoshihiro 
Published: August 2007

Abstract:The role of laparoscopy in the diagnosis of gallbladder cancer was evaluated. Fifteen patients who were suspected of having gallbladder cancer, following physical examination, laboratory tests, and imaging techniques, received laparoscopy at our clinic, and the laparoscopic findings and histologies were analyzed. Five patients in whom the gallbladder was observed were laparoscopically confirmed as having gallbladder cancer, and in 2 of these cases metastases to the liver were observed. Among the 10 patients in whom the gallbladder could not be observed, metastases to the liver and the peritoneum were observed in 6 and 4 cases, respectively. In 3 cases neither the gallbladder nor metastases to other visceral organs could be observed. Thus, the qualitative rate of laparoscopic diagnosis was 80% (12/15 cases). Five cases (42%) among the 12 cases in which laparoscopy suggested gallbladder cancer, were histologically confirmed after biopsy specimens were obtained. Only one of these cases was diagnosed by direct forceps biopsy of the gallbladder wall.
A Clinicopathological Study of IIa +IIc Type Early Colorectal Cancer with Massive Submucosal Invasion
Authors: OKAMURA Shozo , ASAI Toshio , YAMAGUCHI Hatsuhiro , HAMAJIMA Eiji , KATOH Tadashi , SHIMODAIRA Masaya , ITOH Hisayoshi 
Published: August 2007

Abstract: The authors investigated clinical data and pathological findings of eight cases of IIa+IIc type early colorectal cancer which showed minimal invasion in the mucosal laver, but massive invasion in the submucosal layer (deep invasion type). The average age of these 8 patients was 57.8 years (6 out of 8 cases were between 55 and 61‐years‐old). 6 patients were males; 2 were females. Five patients were asymptomatic with a positive reaction for fecal occult blood; the other 2 had anal bleeding. All but 1 patient were diagnosed as having the IIa+IIc type of cancerous lesion, by barium enema examination and colonoscopy. Five patients had lesions in the sigmoid colon, 2 had lesions in the rectum, and 1 had a lesion in the ascending colon. The maximum lesion diameters ranged from 5 to 25 mm, averaging 15.9 mm. Six lesions were less than 20 mm in maximum diameter; 3 of these were less than 10 mm. Pathologically, 5 cases were moderately differentiated adenocarcinoma, 2 were well differentiated adenocarcinoma, and one was poorly differentiated adenocarcinoma. None of the lesions had a coexisting adenomatous component. The incidence of lymph node metastasis was considerably higher than expected (2 out of 8 cases) for early invasive colorectal cancer.Our results suggest that the deep invasion type of early colorectal cancers (which probably arise de novo) are, though small as a rule, considered to have great potential to be malignant.
Evaluation of Endoscopic Naso‐biliary Drainage Established without Endoscopic Sphincterotomy for Malignant Obstructive Jaundice
Authors: NAKATSU Toshiaki , HIRABAYASHI Shuko , NISHIOKA Mikio 
Published: August 2007

Abstract: Endoscopic naso‐biliary drainage (ENBD) without endoscopic sphincterotoyny (ES) was carried out using 7.2 Fr naso‐biliary tubes in 36 patients with malignant obstructive jaundice. The success rate of this method was SO .4% (37/16 cases). The effectiveness of ENBD without ES in terms of lowering total bilirubin values was good or excellent in 24 out of 29 cases (82.8%). Complications were observed in 1 out of 37 cases (10.8%);fortunately, none were as severe as perforation or bleeding. After ENBD established without ES serum amylase levels increased makcdly in 7 cases (17.9%), but these increases were transient and decveased vapidly.Endoscopic internal bilio‐duodenal drainage established without ES was also successfully performed, using 10 or 12 Fr endoprosthetic tirbes, in 6 cases of malignant obstructive jaundice. Amylase levels after this procedure did not show any significant elevation. This fact suggests that compression of the pancreatic orifice by the naso‐biliary tube dose not cause hyperamylaseynia.Endoscopic biliary drainage established without ES is an effective, safe, and simple method which can be applied to patients with malignant obstructive jaundice.
A Case of Extensive Gastrointestinal Involvement of Malignant Lymphoma Associated with Early Gastric Carcinoma
Authors: KAKEI Nobuyuki , MIKI Kazumasa , KIMURA Masayoshi , SANO Junjiro , ICHINOSE Masao , HOSHINO Etsuo , KAWAMURA Norio , TASHIRO Takao , MATSUSHIMA Masashi , KUROKAWA Kiyoshi 
Published: August 2007

Abstract: Described is a 59 year old Japanese man With malignant lymphoma involving the stomach, duodenum, terminal ileum, colon and rectum, who developed early gastric carcinoma. Repeated gastroduodenoscopy revealed various appearances of the gastrointestinal involvement in malignant lymphoma, such as giant folds, polypoid lesions, and ulcerations, in addition to a depressed lesion of early gastric carcinoma. Colonoscopy also showed multiple polypoid lesions throughout the large bowel. Though the gastrointestinal involvement in malignant lymphoma is not rare, diffuse multiple polypoid lesions in the entire large bowel as seen in our case have rarely been endoscopically described.The coexistance of malignant lymphoma and gastric carcinoma in our case might be only a coincidence, though some reports of an increasing incidence of second tumors in patients with malignant lymphoma have been published. Further consideration will be needed as to the relationship between malignant lymphoma and the occurence of a second malignancy.
The Specificity of the Penetrating and the Superficial Spreading Types of Early Gastric Cancer—Classification of Early Gastric Cancer Using the Interactive Image Analysis System—
Authors: HIRAYAMA Daisuke , FUJIMORI Takahiro , SATONAKA Kazuhiro , NAKAMURA Tetsuya , GOTOH Akinobu , TOKUDA Yoshio , TERAMOTO Tadahisa , KITAZAWA Souhei , HORIO Mitsuzou , MAEDA Sakan , ARAO Mototsugu , NAGASAKO Kou 
Published: August 2007

Abstract: Specific types of early gastric cancer were investigated in accordance with the cancer surface area and the degree of penetration by means of quantitative measurements of the surface area of early gastric cancer using the interactive image analysis system.The results indicated a significant correlation between the surface area and the penetration depth in ordinary early gastric cancer. However these correlations were not observed in both well and poorly differentiated adenocarcinoma cases of the so‐called PEN and SUPER types, which showed a significant specificity when compared with ordinary early gastric cancer. The PEN and SUPER types of early gastric cancer also exhibited various clinicopathological characteristics, and it was suggested that the poorly differentiated PEN type might be the initial lesion of a linitis plastica type gastric cancer.Examination of the conditions of the mucosa surrounding the cancer revealed a difference between the PEN and the SUPER types, and this suggested that the environment at the site of a cancer growth influences the type of growth and the spread of early gastric cancer.
Inflammatory Fibroid Polyp of the Ileum Which Could be Endoscopically Diagnosed —A Case Report and Review of the Literature—
Authors: NOMURA Masafumi , TAKAHASHI Atsushi , TAKANO Hideya , HIRAI Katsuyuki , UGAJIN Wakato , FURUSHO Yasushi , SUGA Masaru , SUZUKI Tomokatsu , UEHARA Akira , OKAMURA Kiyoshi , NAMIKI Masayoshi 
Published: August 2007

Abstract: Inflammatory fibroid polyp (IFP) of the small intestine is a very rare disease. Our review of the literature revealed only 40 cases of small intestinal IFP were reported from July 1975 through August 1989 in Japan. It is extremely difficult to make a definite diagnosis of IFP prior to surgery; none of the cases reported were diagnosed preoperatively. We describe here the first case of small intestinal IFP in Japan whose diagnosis was strongly suspected from an endoscopic examination prior to surgery.A 62‐year‐old woman was admitted to our hospital with diarrhea, abdominal pain, nausea and vomiting. A plain abdominal x‐ray revealed the presence of an ileus. The subsequent contrast x‐ray performed via a long intestinal decompression tube and colonoscopic observation found an ileo‐ileal intussusception caused by a spherical mass (about 30 mm in diameter) in the ileum. When pushed with forceps, the tumor demonstrated a rubber‐like hardness, suggesting the presence of an IFP. Surgery was performed to treat the intestinal obstruction, and the ileo‐ileal intussusception was confirmed at a site 30 cm proximal to the ileocecal valve. At the leading point of the intussusception there was a semipedunculated tumor of 30X30X25 mm in size. The intestinal tumor was histopathologically diagnosed as IFP.
Endoscopic Retrograde Pancreatography and Brushing Cytology Using a Guidewire with Special Reference to the Recanalization Method in Patients with Main Pancreatic Duct Obstruction
Authors: TADA Hideki , TAKEDA Yoshinobu , SHINDO Hiroaki , NISHIHARA Tokufumi , HASHIMURA Naotaka , TAKASHIMA Tetuya , NAKAJIMA Shuzo , HIGASHINO Takeshi , HONGO Yasushi , ADACHI Gakuji , YONEHARA Toru , NOMURA Toshiyuki , FUKUMOTO Nobusuke , MATUMOTO Taizo , AZUMI Haruhiko , SHIOZAKI Michiaki , OSHIBA Saburo 
Published: August 2007

Abstract: We attempted endoscopic retrograde cholangiopancreatography (ERCP) using guidewires on 32 patients: 16 with main pancreatic duct (MPD) stricture and 16 with MPD obstruction which had been detected by ordinary ERCP. We also performed brushing cytology for pancreatic ductal lesions in 24 of these patients. In 15 of the 16 patients with a MPD stricture, an ERCP catheter was inserted up to the stricture and then the catheter was passed into the proximal MPD through the stricture using a guidewire (recanalization method). In 14 of the 16 patients with a MPD obstruction, the lesion was reached using guidewires. In addition, the recanalization method was possible in 12 of these 14 patients and the pancreatic ductal system proximal to the obstruction was visualized.ERCP using guidewires, especially using the recanalization method, allowed us to obtain detailed information, not only about the lesion itself but also on the pancreatic ductal system proximal to the lesion. Employing these methods, we obtained pancreatograms cliaracteristic of chronic pancreatitis or pancreatic cancer with a high detection rate and could evaluate whether the lesion was benign or malignant even in cases difficult to diagnose using ordinary ERCP. Furthermore, an assessment of the lesion expansion was possible to some degree with the recanalization method. The diagnostic accuracy of brushing cytology of the ductal lesion using guidewires was 79%. Although one subject experienced acute pancreatitis after these procedures, she recovered following conservative treatment. No other serious complications were observed.
A Basic Study on the Chromatic Responses of the Liver Surface by the Infrared Ray TV Camera After ICG Injection
Authors: TODA Hirotaka , SHINZAWA Haruhide , WAKABAYASHI Hiroto , TAKAHASHI Tsuneo , ISHIKAWA Makoto 
Published: August 2007

Abstract: In basic studies, infrared ray television pictures of rats' livers were made with the aim of: (1) assessing, continuously and correctly, changes over time in liver surface coloration following an intravenous injection of Indocyanine green (ICG) and (2) quantifying the degree of ICG coloration of areas of the liver surface of interest by changing the image obtained into electrical signals and thereby obtaining an objective measure of coloration status. An Olympus CLE‐F10 (Olympus, Tokyo) was used as a light source for infrared ray TV imaging, while a monochromic CCD camera (Toshiba, Tokyo) was used as a television camera, with a visible light cut filter attached to the eyepiece of the scope. By means of a video mean densitometric apparatus (Hoei, Tokyo) the degree of ICG coloration was determined as a luminosity, which was recorded after being changed into electrical signals. Infrared ray television imaging made it possible to distinguish areas of shades of coloration even after an intravenous injection of ICG in as small dose as 0.5 mg/kg. It made a continuous clear record of changes over time in the coloration of ICG‐stained liver surface areas. The changes in the degree of coloration of the liver surface recorded as luminosity consisted of an early, steep component (vascular phase) and a subsequent slow component (parenchymal phase).The vascular component was influenced by the dosage of ICG while the parenchymal phase was influenced by the severity of hepatic injury.
Evaluation of Endoscopic Resection of Gastric Tumors Following Local Injections of HSE (Hypertonic Saline‐Epinephrine Solution)
Authors: NAKAMURA Masaki , ISHIBASHI Tomoko , TANIGUCHI Hideto , YAMAMOTO Hitoshi , NAKAJIMA Yukihiro , UMEZU Hitoshi , CHIBA Kanenobu , HOSHINO Kiyoshi , KIMURA Kanae , ISHII Keiichi , NAKAMURA Youichi , UMETANI Kaoru 
Published: August 2007

Abstract: The Endoscopic resection of gastric tumors following local injections of hypertonic saline‐epinephrine solution (ERHSE) was performed on 72 lesions (69 patients) of gastric tumors at Yoyogi Hospital etc. from March, 1983, to December, 1989. These included 40 cases of adenoma, 31 cases of carcinoma, and one carcinoid tumor.The average length of the major axis of the endoscopically resected tumors was 12 ± 9 mm. The curative rate at the first attempt was 94% (64 of 68 lesions). The curative rate of the final procedure was 99% (67 of 68 lesions). This excluded 4 lesions in 3 patients in whom a follow‐up examination was not possible.There was no relationship found between the final cure rate and the form and location of the lesions.Fifty four lesions were resected with one session of snare cautery; the average length of their major axis was 9 ± 6mm. The resection of 18 lesions was done piecemeal, and the average length of their major axis was 20 ± 10mm. A statistical significance was noted between the size of the lesions which could be resected with one session of snare cautery and those treated by the piecemeal method, but no difference was noted in the location of lesions for the two groups.The indication for ERHSE was assessed in accordance with the cases that resulted in piecemeal resection, those in which the first ERHSE left residual tumor tissues, and those with perforation. ERHSE could be performed with difficulty on lesions which were (1) on the sharply bending gasric wall, (2) observed only tangentially, (3) inadequately observed.These lesions were situated on the gastric fornix, cardia, and their vicinities, the gastric angulus, posterior wall and greater curvature of the gastric body, and anterior wall and lesser curvature of the middle to the upper gastric body.
A New Technique for Endoscopic Esophageal Mucosectomy Using a Transparent Overtube with Intraluminal Negative Pressure (np‐EEM)
Authors: KAWANO Tatsuyuki , MIYAKE Satoshi , YASUNO Masamichi , TAKAMATSU Susumu , KATOH Shoichi , NAKAMURA Hiroshi , SUGIHARA Kunio , HATANO Makoto , YOSHINO Kunihide , TAKESHITA Kimiya , INOUE Haruhiro , YAMAGIWA Akinaga , ENDO Mitsuo 
Published: August 2007

Abstract: We devised a new technique for endoscopic esophageal mucosectomy using a transparent overtube (OT) with intraluminal negative pressure (np‐EEM) (Figs. 1,2). Basic studies were performed on six dogs. The following two methods were utilized in the np‐EEM technique in line with standard approaches used for mucosal resection: (1) A “snare” method was used in which the esophageal mucosa protruded, similar to a polyp, through the slit of the OT and was resected by an electro‐snare passing through the endoscope biopsy channel or the injection channel of the OT. A high‐frequency current was used for the resection (Figs. 2‐a 2‐b, Fig. 3, Color). (2) A “cutter” method was used in which the mucosal protrusion was resected by a recently developed electro‐cutter (Figs. 2‐a, 2‐c, 2‐d, Fig. 3, Color).A mucosal protrusion, similar to a polyp, can be caused by intraluminal negative pressure at any point in the esophageal area. Mucosa up to 1.5 cm in diameter can be resected by both methods (Tables 1, 2; Figs. 5, 6, 7). The cutter method showed many advantages in terms of the ease of procedure, predictablility, and the ability to control the width and depth of the resection.Therefore, np‐EEM, especially using the cutter method, has significant advantages for application with esophageal mucosal lesions for both diagnosis and treatment.