Submucosal fibrosis and basic-fibroblast growth factor-positive neutrophils correlate with colonic stenosis in cases of ulcerative colitis.

Background And Aims: The frequency of benign stenosis in ulcerative colitis (UC) is low, reported as being 3.2-11.2%, with fibrosis in the submucosa or deeper pointed out as one of the causes.

Rectal granular-cell tumor difficult to distinguish from carcinoid tumor.

A 60-year-old man had a positive fecal occult-blood test on a medical check-up. Colonoscopy revealed a yellowish-white submucosal tumor 8 mm in diameter in the rectum. Endoscopic ultrasonography showed a well-demarcated mass with a homogeneous, low-level, internal echo in the second to third layers of the rectal wall.

[Single-balloon enteroscopy].

Double-balloon enteroscope (DBE) requires a long preparation time and scope insertion is often confused because balloons have to be attached to both the endoscope and the overtube. Single-balloon enteroscope (SBE) is a new model endoscope produced by Olympus Medical Systems, and SBE does not require a balloon to be attached to the scope and has only sliding tube. Therefore, examination, preparations and scope insertion are easier than with DBE.

Clinicopathologic features of Crohn's disease with free intestinal perforation.

Background/aims: Free perforation is the most serious intestinal complication of Crohn's disease, and early diagnosis is an important determinant of survival. The aim of this study was to evaluate the clinical and histopathologic characteristics of free perforation associated with Crohn's disease.

Methodology: Twelve free perforations in 10 patients with Crohn's disease were studied.

Clinical usefulness of EUS for active ulcerative colitis.

Background: Ulcerative colitis (UC) is a chronic inflammatory bowel disease with repeated flare-ups. It is difficult to predict the response to medical treatment and the necessity for surgery.

Objective: We undertook this study to determine whether EUS is useful for evaluating the depth of intestinal inflammation, predicting the response to medical treatment, and determining the necessity for surgery in active UC.

Comparative histologic assessment of proctocolectomy specimens from Japanese and American patients with ulcerative colitis with or without dysplasia.

There have been no reports of histologic differences in ulcerative colitis (UC) between Japanese and American patients. We therefore compared histology in proctocolectomy resection specimens between Japanese patients with UC (19 cases with and 21 without dysplasia) at the Kitasato University East Hospital and American patients with UC (21 cases with and 24 without dysplasia) at the University of Washington Medical Center. In cases of UC with, but not without dysplasia, cryptitis (p = 0.

Clinicopathologic differences among subtypes of serrated adenomas of the colorectum.

Background/aims: Serrated adenomas (SAs) of the colorectum can be broadly divided into two subtypes: type I more closely mimicking hyperplastic polyps, and type II unequivocal traditional adenomas. The aim of this study was to clarify their differential clinicopathologic and colonoscopic features.

Methodology: A total of 127 SAs (53 type I, 52 type II and 22 admixed type I+II) were investigated and colonoscopic surface patterns were divided into three categories: speckled, granular and cerebriform.

Indications of endoscopic polypectomy for rectal carcinoid tumors and clinical usefulness of endoscopic ultrasonography.

Purpose: This study was designed to define the indications of endoscopic polypectomy for rectal carcinoid tumors and evaluate the diagnostic value of endoscopic ultrasonography.

Methods: A total of 66 rectal carcinoid tumors treated at our hospital were analyzed histopathologically to clarify risk factors for metastasis. The depth of invasion was determined for 52 lesions examined by endoscopic ultrasonography, and the value of endoscopic ultrasonography for deciding whether a lesion is indicated for endoscopic polypectomy was assessed.

Dye spraying and magnifying endoscopy for dysplasia and cancer surveillance in ulcerative colitis.

Purpose: The aim of this study was to investigate detection of dysplasia or colitic cancer with ulcerative colitis by use of magnifying endoscopic observation.

Methods: From 1986 through 2000, ulcerative colitis was diagnosed and treated in 886 patients at Kitasato University East Hospital. Of the total, we studied 25 patients in depth: 14 who had dysplasia alone, 5 in whom cancer was diagnosed during follow-up after the detection of dysplasia, and 6 who had colitic cancer.