大腸粘膜の拡大観察―とくに潰瘍性大腸炎の寛解像について

Observations of the Mucous Membrane of the Colon by an Inproved Magnifying Fiber-colonoscope: With special reference to the remission features of ulcerative colitis

　新しい検査法ができ，それが実際に用いられるようになっても，はじめから臨床的に有用なものばかりとは限らない．

　新しい知見として得られるということと，それが臨床上にどれ位応用できるかということとは別の問題である．

　The high-precision fiber-colonoscope equipped with an efficiency of one to thirty magnification allowing more detailed study of the colonic mucous membrane, developed by our research team and built to our specifications by Machida Manufacturing Co., has proven an invaluable clinical tool.

　Clinical indications for the use of the magnifying colonoscope for colon infirmity are as follows:

　1) judgment of the healing stage of ulcerative colitis

　2) discrimination between early colon carcinoma and colon polyp (adenoma)

　3) discrimination between colon polyp (adenoma) and hyperplastic colon polypv

　The following conclusion were reached by observing the course of ulcerative colitis by the magnifying fiber-colonoscope:

　1) Features which may be judged as normal by conventional radiology or endoscopology are frequently revealed as abnormal by the magnification method.

　2) Observation by magnification of normal mucous membrane of the colon reveals a well-ordered pattern of round-like pits of a similar size known as a “honeycomb pattern”. Progression of disease leads to a subsequent decrease in the number of pits.

　3) During the healing stage of ulcerative colitis clinical signs and symptoms first disappear; secondly; radiographic and endoscopic findings are normalized ; lastly, the magnified image and histologic findings of biopsy specimens are normalized.

　In summary, it may be said that observation by the magnification process is a reliable substitute for biopsy, and further, that it provides for more precise judgment on the remission stage of ulcerative colitis.