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PubMed2002

Ureteral stenting via an ileal conduit using a gastroscope.

PURPOSE: We describe a technique that facilitates retrograde ureteral cannulation and stenting in patients with an ileal conduit. MATERIALS AND METHODS: A standard flexible gastroscope is inserted into the ileal conduit. Guide wires are passed into the ureters under direct vision. Stents are inserted over the guide wires with the aid of the image intensifier. RESULTS: The technique was used repeatedly in 1 patient with a complex history who had ureteral strictures. The procedure is technically easy and it was successful on each occasion. CONCLUSIONS: A fiber optic gastroscope may have advantages over conventional urological instrumentation for inserting ureteral stents in patients with an ileal conduit. This novel, simple technique is less invasive than percutaneous stenting and easier than fluoroscopic cannulation of the ureters. It is readily repeated.

Gastroscopes↗
PubMed1988

Gastroscopic screening for gastric carcinoids and carcinoma in pernicious anemia.

Among 196 patients examined in 1972-1985 because of pernicious anemia (PA), 105 patients under the age of 76 years were invited for gastroscopic screening, and 71 patients (68%) participated. Gastroscopy revealed carcinoid tumor(s) in 5 patients (7%) but no case of carcinoma. In addition, one patient with gastric carcinoid, 5 patients with adenocarcinomas and one with a concomitant carcinoid and carcinoma had already been diagnosed earlier in the overall PA group on the basis of clinical symptoms. Thus, within a follow-up of 0-20 years (mean 7 years) the total frequency of gastric carcinoid tumors was 4% and that of carcinoma 3%. Patients with carcinoid tumors had a long duration of PA and young age of onset; these cases were not necessarily those with the highest serum gastrin levels. Even though most gastric carcinoids are small subclinical tumors of uncertain clinical significance, their unexpectedly high frequency, combined within the risk of carcinoma in PA, might indicate the need for gastroscopic follow-up, at least in cases of juvenile onset PA.

Adult↗
PubMed2002

Gastroscopic-assisted laparoscopic cystogastrostomy in the management of pseudocysts of the pancreas.

Once pancreatic pseudocysts become persistent, unresolving, and symptomatic, surgical drainage is mandatory. Between January 1998 and December 2001, we performed five laparoscopic cystogastrostomies for such pseudocysts with the simultaneous use of the gastroendoscope. The mean cyst diameter was 20 cm (range, 18.5-24). In the first four cases, the anterior wall of the stomach was entered through two 10-mm balloon cannulae under gastroscopic guidance. By introducing the laparoscope through one port and a harmonic scalpel through the other, a wide cystogastrostomy was performed. In the fifth case, a modification of the above technique was carried out. A single 10-mm cannula was used to enter the stomach and, with the use of a side-viewing gastroduodenoscope as the camera source, the harmonic scalpel was used to create the cystogastrostomy. The punctures in the wall of the stomach were repaired with endosutures. The gallbladder was removed in all cases. The mean operating time was 110 minutes (range, 92-128) for the combined procedure. There were no postoperative complications, and the mean hospital stay was 4 days. Postoperative follow-up with ultrasonography over a period of 1 year in each case revealed complete resolution of the cyst. Laparoscopic cystogastrostomy using harmonic scalpel under gastroscopic control is an effective and rapid method of surgically managing such lesions.

Adult↗
PubMedDate not supplied

Food hypersensitivity reactions in Soft Coated Wheaten Terriers with protein-losing enteropathy or protein-losing nephropathy or both: gastroscopic food sensitivity testing, dietary provocation, and fecal immunoglobulin E.

The purpose of this study was to evaluate Soft Coated Wheaten Terriers (SCWTs) affected with protein-losing enteropathy (PLE) or protein-losing nephropathy (PLN) or both for allergy to food. We performed gastroscopic food-sensitivity testing, a provocative dietary trial, and measurement of fecal immunoglobulin E (IgE) in 6 SCWTs affected with PLE or PLN or both. Positive gastroscopic food-sensitivity test reactions were noted in 5 of 6 dogs. Positive reactions were found to milk in 4 dogs, to lamb in 2 dogs, and to wheat and chicken each in 1 dog. Adverse reactions to food (diarrhea, vomiting, or pruritus) were detected in all 6 dogs during the provocative dietary trial. Adverse reactions were found to corn in 5 dogs, to tofu in 3 dogs, to cottage cheese in 2 dogs, to milk in 2 dogs, to farina cream of wheat in 2 dogs, and to lamb in 2 dogs. Serum albumin concentrations significantly decreased and fecal alpha1-protease inhibitor concentration significantly increased 4 days after the provocative trial when compared with baseline values. Antigen-specific fecal IgE varied throughout the provocative trial, with peak levels following ingestion of test meals. We conclude that food hypersensitivities are present in SCWTs affected with the syndrome of PLE/PLN. Mild inflammatory bowel disease was already established in the 6 SCWTs of this report at the time of study, making it impossible to determine if food allergies were the cause or result of the enteric disease.

Animals↗
PubMed1987

Simple and quick gastric cancer screening method using the "Bi-Digital O-Ring Test" and its critical evaluation by standard X-ray, gastroscopic and pathological microscopic examination.

The simple, quick and non-invasive application of the "Bi-Digital O-Ring Test Cancer Screening Method" for adenocarcinoma of the stomach originally described by Y. Omura, indicated 21 out of 196 randomly selected patients who visited our hospital (114 male and 82 female with an average age of 57.2 years) to have a cancer positive response regardless of their original chief complaint. In all these 21 patients we did imaging of the outline of the stomach and localized adenocarcinoma positive area with the "Bi-Digital O-Ring Test Imaging Method." 5 out of 21 patients were confirmed to have adenocarcinoma of the stomach by microscopic examination of biopsied stomach tissue following X-ray and gastroscopic examination. Of these 5 patients with the cancer, 3 had no chief complaint indicative of stomach problems. This study indicated that simple, quick and non-invasive cancer screening method using "Bi-Digital O-Ring Test" with microscopic slide of adenocarcinoma of stomach as reference control substance, can detect stomach cancer with much greater accuracy, without giving any physical discomfort to the patient and with minimum time and expense, compared with well established standard x-ray and gastroscopic examination methods. The effectiveness and relative accuracy of mass screening of patients for gastric cancers using "Bi-Digital O-Ring Test" was well established by this study.

Adenocarcinoma↗
PubMed2003

Clinicopathologic study of mucosa-associated lymphoid tissue lymphoma in gastroscopic biopsy.

AIM: To explore and discuss the clinicopathologic characteristics of mucosa-associated lymphoid tissue (MALT) lymphoma in gastroscopic biopsy specimen. METHODS: A retrospective study of 26 cases of lymphoma diagnosed by gastroscopic biopsy during 1999 to 2001 from gastroscopy files of Xijing Hospital was made. The diagnostic criteria were adopted according to the new classification of non-Hodgkin's lymphoma. RESULTS: Twenty-six cases of primary gastric lymphoma consisting of 15 men and 11 women, aged between 23 to 76 years were recruited from 6 225 cases who received gastroscopy. All of them were diagnosed by both endoscopic findings and histological examinations. Histologically, 23 cases were MALToma (low grade) and 3 cases lymphoblastic lymphoma (high grade). Immunohistochemically, all cases were CD20 positive, while CK and EMA were negative. CONCLUSION: The majority of the cases of primary low-grade gastric lymphoma have morphologic and clinical features that justify their inclusion in the category of low-grade lymphoma of mucosa associated lymphoid tissue.

Adult↗
PubMed1991

[Comparative gastroscopic and pathologic study on "one point carcinoma" in gastric cancer--analysis of 25 cases. "One Point Carcinoma" National Cooperative Group].

Twenty-five cases of "one point carcinoma" of the stomach, collected from 14 institutes in China, diagnosed by gastroscopic biopsy and proved by regional serial sectioning of the resected specimen as having no more cancerous lesion are presented and studied. The concept, terminology and significance of "one point carcinoma" on the gastric mucosa are put forward by comparative study of the local gross findings and the histopathologic features. The gastroscopic findings showed: mucosal discoloration 3 cases; nodule-like elevation 8 cases; superficial erosion 6 cases; and superficial ulceration 8 cases. Pathologic diagnosis of mucosal biopsy material was: well and moderately differentiated adenocarcinoma 11 cases; poorly differentiated adenocarcinoma 4 cases; signet-ring cell carcinoma 1 case; cancerous change 4 cases; and carcinoma unclassifiable 3 cases. The pathologic changes in the gastric mucosa of the resected specimen were: chronic atrophic gastritis, intestinal metaplasia with superficial erosion and dysplasia 14 cases; superficial gastritis (including partial gastritis verrucosa), intestinal metaplasia with superficial erosion, superficial ulceration and dysplasia 11 cases. The concept of "one point carcinoma", its gross characteristics, biopsy technique and observations as well as other relevant problems discussed are important in the detection of micro-cancerous lesion of gastric carcinoma.

Adenocarcinoma↗
PubMed1989

Gastroscopic screening of the post-gastrectomy stomach. Relationship of dysplasia to remnant cancer.

In July 1980, an aggressive screening program for benign disease of the stomach in 163 patients at risk for carcinomatous change of the gastric remnant was instituted. All patients were at least ten years post-gastrectomy. Three gastric remnant cancers were identified during esophago-gastroduodenostomy (EGD) on 45 patients undergoing only one screening endoscopic examination during the study. One hundred and eighteen additional patients underwent two or more screening gastroscopic studies between July 1980 and July 1985. Of this group, seven patients (5.8%) had gastric biopsies showing mild to moderate dysplasia in the gastric remnant. During the period July 1985 to July 1987, these seven patients underwent two to four additional gastroscopic examinations that revealed carcinoma of the gastric remnant in two patients (28%) with progression of the dysplastic changes in three of these seven patients (42%). The post-gastrectomy interval in these seven patients ranged from 10 to 27 years with a mean of 21.5 years. This study supports the concept of neoplastic change in the gastric remnant as a function of time from initial gastric resection. EGD and biopsy are important in identifying dysplastic changes which may be harbingers of invasive carcinoma of the gastric remnant. Aggressive endoscopic screening is recommended for patients with dysplasia in order to identify gastric remnant cancer while potentially curable.

Adenocarcinoma↗
PubMed1978

Gastroscopic reduction of afferent loop intragastric intussusception.

A case is presented of afferent loop intragastric intussusception diagnosed by gastroscopy 18 years after partial gastrectomy with retrocolic gastrojejunostomy. The intussusception was successfully reduced by means of the gastroscope. The symptoms were instantly relieved, with a symptom-free follow-up of 1/2 year. Provided that the intussuscepted segment appears viable it seems justified to aim initially to reduce jejuno-gastric intussusception with the aid of the gastroscope.

Aged↗
PubMed1981

Treatment of achalasia with a pneumatic dilator attached to a gastroscope.

A pneumatic dilator for the treatment of achalasia of the esophagus is described. An inflatable polyurethane balloon assembly is attached to a small-caliber forward-viewing fiber-optic gastroscope. The balloon is introduced and dilatation carried out under endoscopic visual control. The described method greatly increases the safety and accuracy of the dilatation procedure, even in patients with an extreme degree of megaesophagus. 39 patients have been successfully treated with the dilator with no complications.

Dilatation↗
PubMed1984

Sonographic examination of the mediastinum and upper abdomen by fiberoptic gastroscope.

A prototype fiberoptic gastroscope with a 9 MHz transducer 7 cm from its tip was used to evaluate intrinsic and extrinsic abnormalities of the upper abdomen and mediastinum. Small hepatic and pancreatic tumors were identified, often with more clarity than when other imaging modalities were used. The instrument clearly defined intrinsic bowel wall lesions including focal and diffuse disease. Bowel wall thickness was identified, and exact wall dimensions were measured. In addition, unsuspected pericardial, mitral, and aortic valvular disease was detected. These preliminary results suggest a new complementary imaging modality.

Adult↗
PubMed1987

Early detection of gastric remnant carcinoma. The role of gastroscopic screening.

Partial gastrectomy for benign ulcer disease has been associated with carcinoma in the gastric remnant. To detect formation of this cancer in patients having undergone this operation, we initiated a screening protocol using barium contrast studies, flexible gastroscopy, and biopsy. Patients were selected from a group of 233 patients who had undergone partial gastrectomy for benign disease between 1960 and 1975. In this group, operations for duodenal ulcer had been performed in 156 patients (83 Billroth I and 73 Billroth II reconstructions) and subtotal gastrectomy in 77 patients with gastric ulcer (17 Billroth I and 60 Billroth II reconstructions). From July 1980 to July 1985, 163 patients underwent gastroscopy and biopsy with a median postoperative interval of 14.6 years. Through screening, three resectable remnant carcinomas were found. We conclude that routine gastroscopy leads to earlier detection and a higher rate of resectability if gastric remnant carcinoma is found; yearly screening should be performed after a ten-year postresection interval; and gastroscopic biopsy is more accurate than upper gastrointestinal tract barium contrast studies and should be used preferentially to identify gastric remnant carcinoma.

Duodenal Ulcer↗
PubMed1981

Gastroscopic evaluation of the effect of aspirin and oxaprozin on the gastric mucosa.

Oxaprozin, a new long-acting, antiinflammatory agent, and aspirin were compared utilizing gastroscopic evaluation and photography of the gastric mucosa in a double-blind, crossover study in normal volunteers. Submucosal hemorrhages or mucosal bleeding was observed in seven of eight subjects on aspirin and in only two of eight on oxaprozin (P = 0.061). Adverse effects were experienced by seven of eight subjects after the aspirin treatment period--tinnitus in five and gastrointestinal symptoms in four. Only one patient had mild diarrhea on oxaprozin. The incidence of adverse effects was found significantly higher with aspirin therapy (P less than 0.001). No laboratory abnormalities of clinical significance were attributed to either drug administration. Results after ten days of treatment show that oxaprozin in therapeutic dose levels (1200 mg once a day) produces significantly fewer changes in the gastric mucosa than aspirin (975 mg administered four times a day, total daily dose 3.9 Gm) in the same subjects, who received both drugs in this double-blind, crossover experiment with a four-week washout period between treatments.

Anti-Inflammatory Agents↗
PubMed1981

Gastroscopic observations following aspirin and naproxen sodium administration.

A double-blind crossover study was conducted to compare the effects of aspirin (3.25 Gm/day) and a new nonsteroidal antiinflammatory drug, naproxen sodium (1.1 Gm/day), on the gastric mucosa of 12 healthy volunteers. Subjects were gastroscoped after one week on each drug, intragastric photographs were obtained, and gastric contents were examined for blood. Ten subjects exhibited some degree of gastric pathology following aspirin administration, compared with one subject with gastric pathology following naproxen sodium. Naproxen sodium also induced less gastrointestinal bleeding and caused fewer side effects than aspirin.

Adult↗
PubMed1982

Gastroscopic and pharmacokinetic evaluation of a new pivmecillinam tablet.

Three different pivmecillinam preparations, a conventional 200 mg tablet (P tablet) and two new formulations containing respectively pivmecillinam 200 mg and 400 mg plus Avicel (microcrystalline cellulose) as a disintegrator (PA tablet), were compared in vitro and in a gastroscopic study in 8 healthy volunteers. Disintegration of the PA tablet was significantly more rapid both in vitro and in the stomach. Following disintegration, the content of the PA tablet was spread over a larger area of the gastric mucosa (1088 mm2) than was observed with the P tablets (408 mm2). Three of the 8 volunteers taking the P tablet developed hyperaemia, interstitial bleeding or erosions of the mucosa of the stomach. No such reactions were seen with the PA tablets. Serum concentrations of mecillinam following ingestion of pivmecillinam tablets were determined in three groups of subjects; fasting volunteers, both supine and ambulant, and in ambulant subjects who took the preparation with a light meal. There was a tendency for the new PA tablets to produce a higher peak serum level as well as greater bioavailability of mecillinam. Administration of the PA tablets with a meal significantly increased the peak serum level and total bioavailability of the drug. On the basis of our observations we recommend adoption of the new PA tablet, because of its quick passage through the oesophagus and its more rapid and complete disintegration in the stomach.

Amdinocillin Pivoxil↗
PubMed1982

Gastroscopic biopsy of the stomach for the diagnosis of amyloidosis.

1. Amyloid deposition was investigated in the biopsied specimens obtained from the stomachs of suspected cases of amyloidosis. The subjects were seven cases of suggestive amyloidosis with clinical symptoms of muscle rigidity, masked face, macroglossia and B-J proteinuria. The stomach of an autopsied amyloidosis patient was also investigated. 2. Mucosal tissue was obtained from fundus, corpus and antrum of the stomach using gastrofiberscope, Olympus GFB2. And amyloid in the tissue was detected by H & E Congo red staining and polarization microscopy. Rectal biopsy was also done in the majority of the cases to compare with stomach biopsy. 3. Positive results were obtained with gastric biopsy in all seven cases and five of the 5 cases by rectal biopsy. Thus, gastric and rectal biopsy yielded the same results so far as detection of amyloid deposition was concerned. 4. Biopsy specimens from several sites of the stomach gave similar results in regard to the amyloid deposition. Tissue deposition of amyloid in the stomach wall showed a somewhat high incidence in the walls of intramucosal capillaries and in the walls of blood vessels of lamina muscularies mucosa. Gastroscopic biopsy of the stomach proved to be useful as a routine technique for the definite diagnosis of the disease.

Aged↗
PubMed1987

Gastric cancer in San Marinese and their first degree relatives in San Marino and the United States. Gastroscopic biopsy as an epidemiological tool.

The Republic of San Marino, a small, 23-square mile, independent country near the Adriatic Coast within Italy, has been noted to have a high incidence of gastric cancer in its 22,000 population (9% of all deaths from 1969-1983 with 33% of all cancer deaths attributed to gastric cancer). Gastroscopic biopsy studies on 284 first degree relatives of San Marinese gastric cancer patients in the Republic of San Marino and in Detroit, where 2,000-2,500 San Marinese reside, have allowed detection of six gastric malignancies. Intestinal metaplasia of gastric mucosa was found in 16 (52%) of 31 Detroit first degree relatives and 51 (36%) of 143 San Marino first degree relatives. Gastroscopy provides an important tool not only for the early detection of gastric cancer in populations of high risk (such as that of San Marino), but also for providing clues to the genetic and environmental factors in gastric neoplasia.

Aged↗