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위질환 특히 위궤양 및 위암진단을 위한 X선학적 연구

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 (A) new roentgenological studies in diagnosis of the tumours and the ulceration in the stomach 
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The Balloon Insufflation Method was employed in the present study to make early

and differntial diagnosis of certain gastric disorders, particularly carcinoma and

ulceration in the stomach and much more accurate diagnosis was obtained comparing

to gastric examination methods customarily employed.

1. Difference in appearance of ulcer margin between benign and malignant ulcers

was so markedly obvious that differential diagnosis of some benign and malignant

ulcers which thus far could not be made was easily reached.

In benign ulcers, a clear and sharp demarcation was observed, while in malignant

ulcers, the ulcer margin showed irregular and hazy.

In case when the ulcer size was same, the size of ulcer crater in the malignant

from became reduced or disappeared as insufflation of ballon increased.

2. A curved lihear shadow along the tumour edge was observed in gastric

carcinoma, and it was named "edge-line" by the author temporarily in this study.

The edge-line is produced by the difference in height between tumour and normal

mucosa levels, or that of tumours themselves, and its inner margin was sharply

demarcated by tumour mass, while the outer margin showed an impression of gradual

fade-out. In some cases where more than two edge-lines appeared, the outer most

edge-line coincided with the tumour border.

3. The gastric wall with carcinoma infiltration or benign organic contraction

becomes less elastic and does not expand easily as in normal gastric wall.

Therefore, the stronger the insufflation force. the greater the ratio of length

between the greater and lesser curvature. When the lesser curvature was mainly

involved, the concavity of the lesser curvature became increased as stronger

insufflation was applied.

4. Tumour mass protruding into the gastric cavity was clearly demonstrated by the

tightly surroundinf balloon.

5. In patient with obstructive or stenotic symptom, the stenotic portion was

clearly by this method.

6. The Ballon Insufflation Method enables a simultaneous examination of gastric

juice. The gastric juice studies by the caffeine meal test and histamine test were

also made.

7. The radiation hazard could be reduced by this method because of lesser

exposure to both radiologist and patients by reducing the numbers of X-ray pictures.
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