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<title>はるま先生の見るから診るへの内視鏡診断学 | 株式会社文光堂</title>


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<meta name="description" content="本書は上部消化管内視鏡診断の本です．癌や炎症など様々な病変があります．まず画像INDEXを見て下さい！ 1つでも「？」と思った先生は即購入して最後まで読み進めて下さい．内視鏡画像から病変の発生病態を考えることは，疾患リスクを絞り効率よく拾い上げ診断できることにつながります．そして何より診療が楽しくワクワクします．全部を読み終わったら，先生の内視鏡をみる目は「見る」から「診る」へと変わっていることで">

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		<h1 class="catchCopy">疾患の背景と病態を考えよう！あなたの内視鏡をみる目は「見る」から「診る」へ変わります！</h1>
		

		<h1 class="copy">病態を考える！</h1>
		<h1 class="title">はるま先生の見るから診るへの内視鏡診断学<span class="version"></span></h1>
		<h2 class="subTitle">診療が楽しくなる上部消化管内視鏡テキスト</h2>

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					編集：春間　賢（川崎医科大学名誉教授／淳風会医療診療セクター長）
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				<ul class="property"><li class="disc">B5判・160頁・4色刷</li><li class="disc">ISBN&nbsp;978-4-8306-2118-5</li><li class="disc">2024年5月14日発行</li></ul>

				
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		<div class="headers"><h3 class="current content">内容</h3><h3 class="preface">序文</h3><h3 class="indexes">主要目次</h3></div><section class="current content">本書は上部消化管内視鏡診断の本です．癌や炎症など様々な病変があります．まず画像INDEXを見て下さい！ 1つでも「？」と思った先生は即購入して最後まで読み進めて下さい．内視鏡画像から病変の発生病態を考えることは，疾患リスクを絞り効率よく拾い上げ診断できることにつながります．そして何より診療が楽しくワクワクします．全部を読み終わったら，先生の内視鏡をみる目は「見る」から「診る」へと変わっていることでしょう．</section><section class="preface">序　文<br><br>　私はポリープ博士である．私の医学博士論文は「胃ポリープにおける萎縮性胃炎の特徴に関する臨床的研究：広島大学医学雑誌30：399-418，1982」であるので，間違いなくポリープ博士である．胃ポリープはかつては胃潰瘍，慢性胃炎と並び，胃がんの前がん病変の三大病変の一つであった．その後，胃過形成性ポリープについての多くの研究が行われ，さらに内視鏡的ポリペクトミーの普及で多くのポリープが切除され病理学的検討が行われた結果，2cm以上の大きなものを除き，前がん病変としての地位から脱落した．そのような状況下で私の胃ポリープの臨床研究は行われたが，研究指導をしてくださった末永健二先生，隅井浩治先生は胃の病気そのものよりも，病気の出来る背景に拘りを持ち，研究をされていた．胃液検査と血中ガストリンの測定，私が病理学を学んでいたことから胃生検組織で炎症と萎縮を評価する．胃過形成性ポリープの背景胃粘膜は無酸と高ガストリン血症，そして胃体部優位の胃炎，A型胃炎に類似した病態であると結論し，その結果が学位論文となった．この研究が切っ掛けとなり，病変，特に上部消化管の病変を見ると，診断するだけでなく，病変が出来る背景を考えるようになった．<br>　現在，消化管，特に上部消化管においては胃がんや食道がん，十二指腸がんの内視鏡診断と治療が中心となっているが，消化管には正常構造とそれに対応した分泌や収縮機能があり，その異常が疾患の発生に強く関与している．従って，疾患には必ず発生する背景がある．疾患を診断するだけでなく，その発生病態を考えることは疾患リスクを絞り効率よく拾い上げ診断できることと，ひいては疾患の発生予防に繋がり，何よりも，診療が楽しく，ワクワクする．また，がんといえども悪性度（発育速度）にはかなりの違いがあり，この悪性度を考えることは，超高齢社会における上部消化管の診療を行う上で極めて重要である．このようなコンセプトから『はるま先生の見るから診るへの内視鏡診断学』を発刊することになった．そこで本テキストは，まず，病変の内視鏡写真を提示し，その画像から考えられる疾患（これは比較的易しい），さらにその背景にある発生病態を考える過程となっている．症例の中にはびっくりするような経過を取り，また，びっくりするような背景の病変も多く含まれている．上部消化管には多くの病変が存在し，これからも多くの新しい病変が出現する．そのような病変に出会ったとき，本テキストで培った病態解析のプロセスに従えば診療上の問題を解決できると確信している．派手さのないテキストである．売れるのか，売れ残るのか皆目分からない．このような危険な状況のもと，テキストの作成の企画に耳を傾け，さらに発刊させて頂いた文光堂編集企画部　黒添勢津子さんに感謝である．<br><br>　2024年4月<br>　川崎医科大学名誉教授/淳風会医療診療セクター長<br>　春間　　賢</section><section class="indexes">　画像INDEX<br>1．好酸球性食道炎<br>　A　典型的な内視鏡像<br>　B　画像強調観察を含めて<br>2．食道の機能異常（アカラシア，食道痙攣症など）<br>3．食道扁平上皮癌<br>4．Barrett腺癌<br>5．胃癌―こんなに違う悪性度<br>　A　悪性度の異なるさまざまな胃癌<br>　B　ラズベリー様腺窩上皮型胃腫瘍<br>　C　<i>H. pylori</i> 陰性胃癌，未感染胃癌<br>6．<i>H. pylori</i> 胃炎とNHPH感染<br>7．胃ポリープ<br>　A　過形成性ポリープ<br>　B　胃底腺ポリープ3<br>　C　白色扁平隆起（春間・川口病変）<br>　D　黒点<br>　E　白点<br>　F　GAP（gastropathy-associated with PPI）の病理組織像からみた病態機能―胃粘膜上皮の変化・病態<br>8．自己免疫性胃炎<br>　A　ペプシノゲン検診から<br>　B　泥沼除菌<br>　C　実地医家の立場から<br>　D　早期像<br>9．消化性潰瘍と特発性潰瘍（idiopathic peptic ulcer）<br>10．急性胃粘膜病変<br>11．P–CAB関連胃症<br>12．壁細胞機能不全症<br>13．GAVE（gastric antral vascular ectasia）<br>14．黄色腫（xanthoma）<br>15．胃の症状があるのに所見がない―好酸球性消化管疾患の胃内視鏡像<br>16．十二指腸潰瘍<br>17．非乳頭部十二指腸上皮性腫瘍<br>　索　引</section></article>
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