摘要:

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 toHelicobacter pyloriinfection. The causes of gastric ulcer relapse are very complicated and variegated.H. pyloriinfection contributes to les gastric ulcer relapse than duodenal ulcer relapse.To prevent gastric ulcer relapse, therefore, one should consider the eradication cH. pylori, the endoscopic features of the ulcer scar and etiological fa

ISSN:0915-5635    

DOI:10.1111/j.1443-1661.1994.tb00369.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Abstract:〈Objective〉 The aim of this study was to assess the accuracy and limitations of endoscopic ultrasonography (US) and dynamic computed tomography (CT) in the preoperative evaluation of esophageal carcinoma.〈Methods〉 Endoscopic US and dynamic CT were performed preoperatively in 96 patients with an esophageal squamous cell carcinoma. The results were correlated with the histology of specimens resected from patients who had undergone subtotal esophagectomy with lymph node dissection.〈Results〉 According to the TN staging classification, endoscopic US was superior to dynamic CT for evaluating the depth of tumor infiltration (overall accuracy: EUS 75%, CT 35%) and in assessing regional lymph node metastases (overall accuracy: EUS 77%, CT 67%). However, the T4 stage was not accurately evaluated using endoscopic US in this study. Its specificity was high (97%) but its sensitivity was low (45%).〈Conclusions〉 We believe endoscopic US is the most accurate method for local tumor staging in esophageal carcinoma. A limitation to endoscopic US staging performed with current instruments was severe stenosis, as it would not permit passage of the instrument (25% of all cases

ISSN:0915-5635    

DOI:10.1111/j.1443-1661.1994.tb00370.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Abstract:The early stage of colorectal cancer is divided into two morphological types polypoid and superficial. What percentage of advanced cancer is derived from the polypoid or superficial type is a matter of concern. The ratio of superficial variety among of ulcerated cancers was studied using those 2 cm or less in diameter, which often retain mucosal cancer. The existence of horizontal growing mucosal cancer at the marginal area of ulcerated cancer is a hallmark showing the lesion being of superficial origin. Eight (57 %) out of the 14 cases of ulcerated cancer, 2 cm or less, had this finding. This suggests that more than half of smaller colorectal cancers are of superficial origin. A zig‐zag pattern (ZZP) was evident in 3 cases of superficial origin. No cases in the nonsuperficial group had the ZZP. The existence of circumferential ZZP during colonoscopic observation indicates that the cancer is of superficial origi

ISSN:0915-5635    

DOI:10.1111/j.1443-1661.1994.tb00371.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Abstract:Endoscopic administration of 25 mg NaCl powder to target sites on the gastric mucosa of five dogs, using a compressed air delivery system developed by the author, was followed by observation of changes in the gastric mucosa. After 30 seconds, 1 minute, 2 minutes, 5 minutes and 10 minutes, the sprayed NaCl was washed away by endoscopic water spray, and the presence of submucosal bleeding was observed at the target sites. After 24 hours, ulcers in the gastric mucosa were recognized at sites at which the NaCl had been in contact for 2 minutes or more before being washed away. With one minute or less contact time between NaCl and the mucosa, erosion and redness were observed at the target sites. In a control study, however, no mucosal lesions occurred following identical spray of 25 mg lactose powder which was left in contact for 30 seconds, 1 minute, 2 minutes, 5 minutes and 10 minutes, and also 24 hours.Experimental gastric ulcers can be induced by endoscopic administration of a small amount of NaCl powder. The time of contact of NaCl on the gastric mucosa affected the induction of gastric mucosal damage. This method will be useful in the investigation of the direct effects of various drugs on the gastric mucosa.

ISSN:0915-5635    

DOI:10.1111/j.1443-1661.1994.tb00372.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Abstract:A comparative evaluation was made between the efficacy of endoscopic treatment in 116 cases with that of surgical treatment in 59 cases. Both groups were treated at Yamagata Prefectural Central Hospital during a period from July 1978 up until December 1989. All of the patients had single mucosal adenocarcinoma of a well differentiated type which were not accompanied by ulcer or ulcerative scar with their maximum diameter of foci being less than 20mm. A curve of the survival rate of both groups as of June 30, 1990 was prepared using the Kaplan‐Meier method, and significance in the statistic difference between the two groups was examined using the logrank test. There was no significant difference noted in the results of both groups. This demonstrated that endoscopic treatment can bring about a long‐term prognosis which is comparable to that of surgical treatm

ISSN:0915-5635    

DOI:10.1111/j.1443-1661.1994.tb00373.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Abstract:This is a report of a case of hepatocellular carcinoma (HCC) with gastric metastasis and a review of 20 cases of gastric metastasis of HCC in Japan. A 67‐year‐old man was diagnosed as having HCC in May 1991, and underwent transcatheter arterial embolization in June 1991 and February 1992. He came to us with hematemesis in November 1992. An endoscopic examination revealed a semipedun‐culated polypoid lesion with bleeding spots at the fornix of the stomach. The polypoid lesion was resected by endoscopic snare polypectomy to prevent rebleeding and in order to make a definitive diagnosis. Histological examination of the resected specimen, 15X10X6 mm in size, revealed well‐differentiated HCC with bile pro

ISSN:0915-5635    

DOI:10.1111/j.1443-1661.1994.tb00374.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Abstract:A 64‐year‐old female was admitted to our hospital with enlarged solitary gastric varices. Cardiofornical varices were seen using an endoscopy. We performed balloon‐occluded retrograde transvenous obliteration (B‐RTO) for gastric varices using 5% ethanolamine oleate. We observed the gastric varices before and after B‐RTO using endoscopic color Doppler ultrasonography (ECDUS). Prior to B‐RTO, the intramural and extramural blood flow coming from gastric varices were detected. The intramural blood flow produced a to and fro color image on ECDUS. The blood flow velocity was 31.2 cm/sec. The amount of blood flow was 2.40 liter/min. Seven days after the B‐RTO, high echo lesions were observed in the gastric varices which indicated that the thrombosis and color flow image had also decreased. Twenty one days after B‐RTO, the color flow image of the gastric varices had nearly disappeared and had completely disappeared after 3 months. In this case, ECDUS was an extremely useful modality for viewing the therapeutic e

ISSN:0915-5635    

DOI:10.1111/j.1443-1661.1994.tb00375.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

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 laborato

ISSN:0915-5635    

DOI:10.1111/j.1443-1661.1994.tb00376.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Abstract:The case of a 54‐year‐old man with hemochromatosis who developed cirrhosis of the liver and hepatocellular tumor is discussed. Before laparoscopy, the possibility of hepatocellular carcinoma was not ruled out by imaging tests only. Laparoscopy revealed a tumor, 60 mm in diameter, protruding from the lower portion of the left lobe of the liver. The tumor was biopsied during laparoscopy, and tentatively identified as a regeneration nodule. Laparoscopy is useful for the definite diagnosis of hepatocellular tum

ISSN:0915-5635    

DOI:10.1111/j.1443-1661.1994.tb00377.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Abstract:Gastric cancer manifesting as a submucosal tumor (SMT) is not common. A gastric barium meal and endoscopic studies performed on a 49‐year‐old male with epigastric pain, revealed an elevated lesion with bridging folds and central depression on the posterior wall of the lower body. An endoscopic ultrasonography (EUS) revealed a hypoechoic mass lesion within the submucosal layer. Due to an increase in the size of the tumor and its central depression during the subsequent year and a half, the patient was admitted for closer examination. Endoscopic biopsy material from the deeper layer, obtained by mucosal resection, revealed a poorly differentiated adenocarcinoma. Microscopic examination of the resected stomach showed a poorly differentiated adenocarcinoma within the submucosal layer, with considerable lymphocyte infiltration. Immunohistological examination disclosed marked T cell infiltration adjacent to the cancer cells. We suggest that considerable lymphocyte infiltration, particularly T cells, may have some role in the protective reaction against cancer cells. Our case was diagnosed as being cancer 18 months after the first endoscopic study. The biopsy material taken from the depression at the time of the first examination showed benign findings and a EUS revealed typical SMT. In the case of SMT shown by EUS to be a hypoechoic mass lesion in the submucosal layer, it is recommended that biopsy material be obtained from the deeper layer using methods available such as artificial ulcer format

ISSN:0915-5635    

DOI:10.1111/j.1443-1661.1994.tb00378.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY