摘要:

Abstract:A quantitative study of parietal cell populations was done using the cell isolation method designed by the authors in order to investigate the cause of the phenomenon of locational variation in the speed of discoloration during the endoscopic Congo red test. The endoscopic Congo red test was performed in three mongrel dogs and five patients with peptic ulcers. In each case, at the time when spotty discoloration was observed, three biopsy specimens were obtained from both the quickly discolored portion (Q) and the slowly discolored portion (S) of the greater curvature of the middle body. After determination of wet weight, the biopsy specimens, having been separated into two groups (the Q‐group and the S‐group), were digested simultaneously with collagenase and dispose in the same way in each case. The number of parietal cells per microlitre in the obtained cell suspensions were counted using Neubauer's hemocytometer, staining with tetranitroblue tetrazolium. The number of parietal cells per milligram tissue wet weight was calculated for each sample from both groups. The number of parietal cells per milligram wet weight of the quickly discolored portion was 2.0 times (on average) as large as that of the slowly discolored portion in the case of the dogs. In the case of patients, the former was 1.7 times (on average) as large as the latter, with a statistically significant difference. We concluded that the locational variation of the speed of discoloration during the endoscopic Congo red test may be mainly due to the unequal distribution of parietal ce

ISSN:0915-5635    

DOI:10.1111/j.1443-1661.1990.tb00065.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Abstract:Duodenal lipomas are rarely reported. We reported two asymptomatic pedunculated duodenal lipomas successfully resected by endoscopic polypectomy. Case 1 was a 48‐year‐old Chinese female who came for a physical check‐up. Upper gastrointestinal series and endoscopic examination revealed a 2.0 × 1.0 cm pedunculated polyp in the posterior wall of the bulb. Case 2 was a 67‐year‐old female. A 1.7 times 1.0 cm olive‐shaped pedunculated polyp was found by endoscopic examination during a health check‐up. Both tumors were polypectomised by endoscopy and proven to be duodenal lipomas pathologically. The diagnosis of duodenal lipoma has largely been made by surgery and autopsy in the past. It may be made nowadays with abdominal computed tomography and repeated deep biopsies. Duodenal lipomas may be treated by endoscopic polypectomy if the tumor is small and

ISSN:0915-5635    

DOI:10.1111/j.1443-1661.1990.tb00066.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Abstract:We present two cases of squamous cell papilloma of the esophagus (SPE) diagnosed by panendoscopy and confirmed by histology. In one case the SPE was removed by endoscopy, and in the other, the SPE detached during severe vomiting. Our patients both had a previous history of heartburn and repeated vomiting. An immunological study for human papilloma virus (HPV) was conducted in both cases, with negative results.

ISSN:0915-5635    

DOI:10.1111/j.1443-1661.1990.tb00067.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

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 endo

ISSN:0915-5635    

DOI:10.1111/j.1443-1661.1990.tb00068.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

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

ISSN:0915-5635    

DOI:10.1111/j.1443-1661.1990.tb00069.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

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 obser

ISSN:0915-5635    

DOI:10.1111/j.1443-1661.1990.tb00070.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

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 discusse

ISSN:0915-5635    

DOI:10.1111/j.1443-1661.1990.tb00071.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Abstract:Survival period, causes of death and variceal rebleeding in 20 patients with esophageal varices associated with hepatocellular carcinoma and liver cirrhosis were analyzed to evaluate the effectiveness of injection sclerotherapy. The first injection sclerotherapy successfully stopped active variceal bleeding in all seven emergency cases. These were followed up as elective cases later on. The remaining 13 patients, who had a history of variceal bleeding, were treated as elective cases from the beginning. Endoscopic evaluation of the varices was performed at intervals of six months to one year, after the first sclerotherapy, and recurrence was treated by elective sclerotherapy. 85% of the patients died within one year. Three out of 20 cases were still alive until this study was performed. But, whereas 17 patients died mainly due to hepatic failure and hepatocellular carcinoma, only one patient died due to variceal rebleeding. No deaths were observed to have been directly due to sclerotherapy or its complications. Hence we think that injection sclerotherapy should be considered one of the treatments for esophageal varices in patients with hepatocellular carcinoma and liver cirrhosis.

ISSN:0915-5635    

DOI:10.1111/j.1443-1661.1990.tb00072.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Abstract:Esophago‐gastric varices of 22 patients were studied using a newly developed method of endoscopic ultrasonography (EUS). During the observation, the esophagus was filled with de‐aerated water, and reflux of the water was prevented using a balloon placed 7 cm proximal to the tip of the endoscope. Thirteen of 22 patients received endoscopic sclerotherapy (EIS) for their esophago‐gastric varices, and sequential changes of the varices were observed mith EUS.The EUS method demonstrated esophago‐gastric varices as singular, or a bundle of low‐echoic luminal structures, and extramural collateral vessels were also observed. Therefore, it was possible to evaluate the residual blood flow after EIS by the EUS findings. Sequential changes of the treated varices were observed as follows: (1) formation of a thrombus in the varices, (2) thickening of variceal wall, and (3) disappearance of luminal structures. Small luminal structures in the extramural space of the lower esophagus, dilated paraesophageal veins, were detected in 6 of 13 patients with EIS. The recurrence rate was smaller and the remission period was longer in these 6 patients than those in patients without these luminal structures. Our new EUS method has been shown to be useful not only for the morphological evaluation of varices, but also for the assessment of the effe

ISSN:0915-5635    

DOI:10.1111/j.1443-1661.1990.tb00073.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

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.

ISSN:0915-5635    

DOI:10.1111/j.1443-1661.1990.tb00074.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY