摘要:

Abstract:Reports of endoscope‐mediated infectious diseases have been increasing. In order to investigate the usefulness of acid electrolyzed water for endoscope disinfection, a test endoscope was disinfected with acid electrolyzed water, and bacteria were examined before and after disinfection. The rates of detection of general bacteria on the surface of the endoscope were 100% (33/33 cases) immediately after its removal, 73% (24/33 cases) after washing the endoscope, and 0% (0/33 cases) after disinfection with acid electrolyzed water. The rates of detection for the forceps channel were 100% (33/33 cases) immediately after endoscope removal, 100% (33/33 cases) after washing, and 0% (0/33 cases) after disinfection with acid electrolyzed water.Helicobacter pylori (H. pylori)was detected at the tip of the endoscope in 3 of the 33 cases immediately after the endoscope was removed. The bacteria were observed in 3 cases after washing as well, but disappeared after disinfection with acid electrolyzed water. The bactericidal effect of acid electrolyzed water onH. pyloriwas also investigated by culturing a condensed solution of a standard strain ofH. pyloriwith acid electrolyzed water. Growth was inhibited within 30 seconds after the addition of acid electrolyzed water. Endoscope disinfection with acid electrolyzed water should be considered usefu

ISSN:0915-5635    

DOI:10.1111/j.1443-1661.1995.tb00130.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

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

ISSN:0915-5635    

DOI:10.1111/j.1443-1661.1995.tb00131.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Abstract:A‐59‐year old woman was admitted with lumbago and back pain. An abdominal ultrasonography and abdominal computed tomography demonstrated a tumor of the body of the pancreas and multiple space occupying lesions in the liver. Endoscopic retrograde chorangiopancreatography revealed a 11 mm cystic dilatation of the terminal portion of the common bile duct protruding into the duodenal lumen and an obstruction of the pancreatic duct in the body portion. Celiac artery angiography showed an irregularity in the wall of the splenic artery. In line with these findings, the patient was diagnosed as suffering from choledochocele associated with carcinoma of the pancreas. As she already had multiple metastatic liver tumors, her treatment was limited to amelioration of her symptoms. Increasing stenosis of the common bile duct, however, required endoscopic sphinctomy and endoscopic retrograde biliary drainage. Type 3 Choledochocele of Alonso‐Lej's classification is very rare, and only a few cases have been reported in association with malignant bile duct tumors. We believe this case to be the first one in our country linked with carcinoma of the pan

ISSN:0915-5635    

DOI:10.1111/j.1443-1661.1995.tb00132.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Abstract:Pancreatic pseudocyst after pancreatic surgery is a relatively rare condition and conservative therapy is the common treatment of choice. When symptoms persist or complications follow, however, surgical treatment is considered. There have been reports on endoscopic cystoenterostomy since the early 1980s. We herein describe a case of postsurgical pancreatic pseudocyst treated successfully by endoscopic cystogastrostomy. A nineteen‐year‐old female showing left hypochondralgia and back pain with elevation of her serum amylase level, who had undergone enucleation of a solid cystic tumor in the body of the pancreas, was referred to our department. She was diagnosed as having a pseudocyst of the pancreas 5.8×4.5 cm in size at the site of enucleation by US and CT. Endoscopic retrograde pancreatography and endoscopic ultrasonography performed simultaneously revealed obstruction of the main pancreatic duct and a cystic change in the body‐tail of the pancreas just behind the gastric wall of the upper body. An extrinsic compression was seen in the posterior wall of the upper body of the stomach endoscopically. An incision was made using a sphincterotome. A pigtail stent, 7.2 Fr in size, was placed to keep the patency of the fistula, which was removed one and a half months later. Her symptoms showed great improvement immediately after the procedure. Follow‐up CT demonstrated no recurrence of the ps

ISSN:0915-5635    

DOI:10.1111/j.1443-1661.1995.tb00133.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

AbstractA 39‐year‐old male with general malaise visited our clinic with high levels of aminotransferases (AST 776 IU/1, ALT 1,069 IU/I) and a prolonged prothrombin time. Serum‐fetoprotein (AFP) level was markedly elevated (2,214 ng/ml) and human hepatocyte growth factor (hHGF)was also high (0.81 ng/ml). Hepatocellular carcinoma was found to be negative from imaging techniques. AFP bands separated by lectin affinity electrophoresis had a benign pattern. Laparoscopic diagnosis was scarred liver and histologically massive hepatic necrosis with a strongly positive AFP stain. Levels of hHGF and AFP fell into a normal range after treatments with glucagon‐insulin and prostaglandin Ei. At second laparoscopy, regenerated nodules were confirmed by improved staining with Indocyanine Green. Hepatocyte regeneration was also histologically proven with a weakly positive AFP stain. The proliferating cell nuclear antigen (PCNA) was stained, and hepatocytes with PCNA positive nuclei were not seen at the time of the first laparoscopy, whereas hepatocytes with PCNA positive nuclei were found to be many at the time of the second laparoscopy. Seroconversion from HBe Ag to HBe Ab was observed 4 months after the maximum rise of AFP (6,341 ng/ml), when levels of ALT and DNA polymerase were within normal ranges.This is a patient with a marked rise in his serum level of AFP in association with seroconversion from HBe Ag to HBe Ab, and the elevation of AFP in the present case was thought to reflect severe liver injury with concomitant regenerative activities of injured hepatocytes rather than simple hepatocyte regeneration after hepatic necrosis was r

ISSN:0915-5635    

DOI:10.1111/j.1443-1661.1995.tb00134.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Abstract:A 77‐year‐old male was admitted to the department of Oto‐rhino‐laryngology of our hospital in 1989 with hoarseness due to laryngeal cancer. It was well treated with X‐ray irradiation and could not be detected by computed tomography (CT) and Gallium (87Ga) scintigraphy at the time of his discharge from hospital, and his hoarseness also subsided.In November 1992, he noticed the hoarseness again with a gradual worsening. On admission to the same department, multiple space occupying lesions were detected in right lobe of the liver by abdominal ultrasonography (US) and CT. When he was transferred to our department, a US‐guided aspiration biopsy showed a pathohistology mimicking hepatocellular‐carcinoma with a multiple restiformation. Laparoscopy revealed multiple yellowish white flat lesions with an irregular margin, and aimed biopsy was performed to one of these lesions. Histology mimicked hepatocellular carcinoma with a few keratinocytes and a coiled structure and these were consistent with a diagnosis of metastatic epidermoid carcinoma.This is the first case report regarding laparoscopic observation of metastatic epidermoid carcinoma originating

ISSN:0915-5635    

DOI:10.1111/j.1443-1661.1995.tb00135.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Abstract:We report on a case of an 80‐year‐old male with autopsy‐confirmed biliary cystadenocarcinoma. The tumor's growth was followed up for five years. CT findings on first admission revealed that the cyst walls of the tumor were smooth. However, a CT taken four years later showed large cysts with irregular walls which were growing invasively and expanding beyond the liver. The patient died of liver dysfunction caused by obstructive jaundice due to the liver tumor, and an autopsy was performed. Histologic examination of the autopsy material revealed a multilocular tumor that was identified as being a biliary cystadenocarcinoma and microscopic lung metastases were seen. The character of the multilocular cyst with septations covered by papillary proliferation of atypical columnar epithelium and many remaining portions with low grade dysplasia led us to suspect the tumor was derived from a cystad

ISSN:0915-5635    

DOI:10.1111/j.1443-1661.1995.tb00136.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Abstract:Percutaneous Endoscopic Gastrostomy (PEG) which can be accomplished with local anesthesia and without the necessity for laparotomy is now gaining popularity as a clinical treatment for patients who have difficulties in swallowing and require long term nutritional support but have an intact gut. A total of 40 patients underwent percutaneous endoscopic placement of a feeding tube in our clinic. They included 37 patients who had had PEG, 1 Percutaneous Endoscopic Duodenostomy (PED) and 2 Percutaneous Endoscopic Jejunostomy (PEJ). Of these patients, 3 had previously had a partial gastrectomy and 1 had had an esophagectomy with esophago‐jejunostomy. Three patients who had undergone a previous partial gastrectomy received different procedures; 1 PEG, 1 PED and 1 PEJ, which were considered to be most appropriate for each patient. One patient with a previous esophagectomy had a PEJ. PEG, PED and PEJ for the patients who had previously undergone a gastrectomy were successfully done with great care. Our experience suggests that PEG, PED or PEJ are rapid, safe and useful procedures for patients who are a poor anesthetic or poor operative risk and can be used even for patients who have undergone previous surger

ISSN:0915-5635    

DOI:10.1111/j.1443-1661.1995.tb00137.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Abstract:Endoscopic variceal ligation with an elastic O band has been performed in the treatment of esophageal varices. Generally, after ligating the varix during the treatment the endoscope is removed and the O band is changed each time until the desired result is achieved. However, it is thought that a shorter time to change the O band would make endoscopic variceal ligation more convenient. Therefore, we designed continuous endoscopic variceal ligation with three elastic O bands. To release three bands continuously, a self recoiling spring is attached at the endoscopic side between the inner and outer cylinders. After releasing one band by pulling the wire, the inner cylinder is returned to its original position by recoiling the spring and the next O band is automatically set up. Continuous endoscopic variceal ligation was performed for one case of esophageal varices due to hepatocellular carcinoma with liver cirrhosis. This technique enabled the ligation of three varices concomitantly, thus eliminating the necessity of repeated extraction and insertion of the endoscope every time the varix was ligated. The operation time was considerably shortened. The case reported did not develop any complications. Hence, it was thought that our technique of a three‐shooter is easier to perform and more convenient for the patien

ISSN:0915-5635    

DOI:10.1111/j.1443-1661.1995.tb00138.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

ISSN:0915-5635    

DOI:10.1111/j.1443-1661.1995.tb00139.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY