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Volume 52, Issue 7
Displaying 1-13 of 13 articles from this issue
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Takuto HIKICHI, Atsushi IRISAWA, Tadayuki TAKAGI, Hiromasa OHIRA, Kats ...2010 Volume 52 Issue 7 Pages 1655-1665
Published: 2010
Released on J-STAGE: September 06, 2010
JOURNAL FREE ACCESSIn 1992 Vilmann et al, reported endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) of pancreatic tumors and Grimm et al. reported EUS-guided transmural drainage of pancreatic pseudocysts. Since then, EUS-guided aspiration has been applied in a number of diagnostic and therapeutic methods that have come to be collectively called “Interventional EUS”. Because of its high utility and safety, interventional EUS is widespread mainly in America and Europe. Since the beginning of the New Millennium, Interventional EUS has also been gradually performed in Japan, chiefly in institutions specializing in treating pancreatobiliary diseases, and its utility and safety are being recognized. For pancreatic lesions, Interventional EUS is used in sample collection (e.g., fine-needle aspiration biopsy), injection (e.g., celiac plexus neurolysis), and drainage (e.g., pancreatic pseudocyst drainage and biliary drainage). Interventional EUS has unlimited possibilities. It is especially hoped that further improvements and innovations in this therapy will provide a breakthrough in the treatment of refractory pancreatic cancer.View full abstractDownload PDF (423K)
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Michio INUKAI, Fuminori GODA, Toshio NOGUCHI, Hiroyuki OKUYAMA, Takash ...2010 Volume 52 Issue 7 Pages 1666-1670
Published: 2010
Released on J-STAGE: September 06, 2010
JOURNAL FREE ACCESSBackground and purpose : In order to help to determine the prognosis of gastrostomy patients, the outcomes of gastrostomy patients were compared to their Onodera prognostic nutritional index (PNI) results.
Method : The subjects included 121 patients who had undergone a PEG procedure from January 2006 to March 2008. Onodera's PNI was calculated at pre-gastrostomy and at discharge from hospital. The relationship of Onodera's PNI results to the gastrostomy patients outcome was determined. The prognosis was confirmed by information of the final hospital visit and telephone communication.
Result : 119 patients were followed for an average of 285.8 ± 210.0 days. The survival rate after gastrostomy was 95% at 30 days, 89% at 90 days, and 50% at 665 days. The survival of the group with a pre-gastrostomy Onodera's PNI of 35 or higher was significantly longer compared to the group with PNI of less than 35. However, even in patients with a pre-gastrostomy Onodera's PNI of less than 35, survival improved if their Onodera's PNI increased to 35 or higher by the time of discharge.
Conclusion : In gastrostomy patients, Onodera's PNI can not be used as an inclusion or exclusion criterion for PEG. However, it is useful for predicting the prognosis.View full abstractDownload PDF (344K)
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Naoyuki TOMINAGA, Ryuichi IWAKIRI, Nanae TSURUOKA, Koutaro MANNEN, Yas ...2010 Volume 52 Issue 7 Pages 1671-1676
Published: 2010
Released on J-STAGE: September 06, 2010
JOURNAL FREE ACCESSWe herein discuss two cases, a 78 year-old woman and 43 year-old woman. They had chronic iron deficiency anemia and had gradually developed dysphagia. Esophageal webs were revealed on upper gastrointestinal endoscopy and a barium esophagogram. These webs were diagnosed as Plummer-Vinson syndrome. We performed endoscopic balloon dilatation, and the patients' symptoms quickly improved. Endoscopic balloon dilatation is easy and safe to perform, and is therefore proposed as a good primary approach in cases of dysphagia with an esophageal web.View full abstractDownload PDF (739K) -
Yugo IWAYA, Takashi MURAKI, Shigenori YAMADA, Shuichi YOKOSAWA, Norika ...2010 Volume 52 Issue 7 Pages 1677-1683
Published: 2010
Released on J-STAGE: September 06, 2010
JOURNAL FREE ACCESSA male in his late 50's visited our hospital with dysphagia which had started 3 months previously. The physical examination showed no abnormal findings except for limited extension of the neck. Upper gastrointestinal endoscopy revealed an extramural compression at the posterior wall of the laryngopharynx. X-ray examination of the cervical spine showed osteophytes at the anterior of the vertebral bodies, and the patient was diagnosed as having ossification of the anterior longitudinal ligament (OALL). MRI and barium meal examination revealed compression of the laryngopharyngeal wall by the osteophytes. The osteophytes (ossified ligament) from C4 to C6 were resected surgically whereafter the symptoms disappeared immediately. Endoscopic and radiographic findings confirmed a marked improvement. The present case clearly showed that OALL can be a cause of dysphagia. Thus, we should not overlook findings of extramural compression at the posterior wall of the laryngopharynx during endoscopic examination of patients who complain of dysphagia.View full abstractDownload PDF (951K) -
Takashi YOKOTA, Ryu NISHIYAMA, Akifumi OGIHARA, Akiko NOZAWA, Hisako A ...2010 Volume 52 Issue 7 Pages 1684-1690
Published: 2010
Released on J-STAGE: September 06, 2010
JOURNAL FREE ACCESSA 33-year-old man was admitted to our hospital with hematemesis. Upper gastrointestinal endoscopy on admission revealed a circumferentially black esophageal mucosa and erosions from just below the pharyngoesophagea1 constriction to the esophagogastric junction. A diagnostic biopsy following an upper gastrointestinal endoscopy revealed that the patient had acute esophageal necrosis. Diabetic acidosis is one of the risk factor of acute esophageal necrosis. We report on a case in which high esophageal internal pressure with vomiting caused severe dehydration with the diabetic acidosis and acid reflux.View full abstractDownload PDF (861K) -
Shinji KASAMAKI, Tsuyoshi OKADA, Shunji OKADA2010 Volume 52 Issue 7 Pages 1691-1697
Published: 2010
Released on J-STAGE: September 06, 2010
JOURNAL FREE ACCESSWe experienced nine cases of gastric mucosal injury due to Mallory-Weiss syndrome during percutaneous endoscopic gastrostomy (PEG). Six cases (66.7%) were over 80 years of age and the locations of the mucosal injury were the lesser curvature in from the body to the cardia. Seven cases (77.8%) had atrophic gastric mucosa. Vomiting did not occur during the PEG procedure in any of the patients. Although gastric expansion by maximum air insufflation with endoscopy is necessary for successful PEG, it may cause gastric mucosal injury.View full abstractDownload PDF (875K) -
Tetsuya ITO, Suguru YONEDA, Momoko SUDO, Tadanobu NAGAYA, Kazuhiro TAK ...2010 Volume 52 Issue 7 Pages 1698-1705
Published: 2010
Released on J-STAGE: September 06, 2010
JOURNAL FREE ACCESSA 23-year old man was referred to our department in May 2008 with high fever and vomiting. He had been treated in the Neurosurgery Department of our hospital for a brain tumor from 4 months previously. Because he had been suffering from unconsciousness due to the brain tumor, he was under intubation feeding. A proton pump inhibitor and a steroid hormone were administered every day to prevent peptic ulcer formation and secondary adrenal insufficiency. Enhanced CT examination showed remarkable thickness of the gastric wall and existence of gas in the portal vein. Esophagogastroendoscopy showed swelling of the gastric fold, multiple erosions, mucosal redness, and edema in the upper and the middle portion of the stomach. Endoscopic ultrasonography revealed the disappearance of normal laminated structure and some small hypoechoic lesions in the thick gastric wall. Enterobacter aerogenes and Enterococcus faecalis were cultured in the gastric juice and biopsy specimens taken from the stomach, but no pathogenic bacteria was cultured from his blood sample. Based on those findings, the patient was diagnosed as having acute phlegmonous gastritis with hepatic portal venous gas (HPVG). His clinical symptoms improved and the abnormal endoscopic and CT examination findings were normalized following the administration of antibiotics. Fifty cases of phlegmonous gastritis with and without HPVG have been reported in Japan since 1996 and their clinical features are reviewed.View full abstractDownload PDF (2843K) -
Mitsutaka KUMAMOTO, Yukinori NAKAE, Kenjiro TAMORI, Kenji MATSUYAMA, K ...2010 Volume 52 Issue 7 Pages 1706-1713
Published: 2010
Released on J-STAGE: September 06, 2010
JOURNAL FREE ACCESSA 65-year-old man was treated for gastric MALT lymphoma and concomitant duodenal diffuse large B-cell lymphoma in 2001. He had undergone 2 courses of CHOP therapy, after which the ascending part of the duodenum had developed complete stenosis, necessitating resection in January 2002. The serum IL-2 receptor antibody level gradually started to elevate in 2006. The patient underwent upper gastrointestinal endoscopy, which showed recurrence of MALT lymphoma in the duodenal bulbus, and he was admitted to our institution for treatment.
Colonoscopy identified diffuse reddish markings, which were similar to those often observed on the liver surface in laparoscopic examination, from the terminal ileum and cecum to the descending colon. Biopsy confirmed MALT lymphoma. The tumor cells were positive for CD20, and the patient underwent 5 courses of R-CHOP, which attained improvement in both the endoscopic and histological findings. Colonic MALT lymphoma commonly presents as a nodular lesion, and the reddish markings as observed in this case represent a rare endoscopic feature, suggesting diffuse infiltration. This finding is sometimes associated with multiple organ invasion of lymphoma, for which systemic examination is mandatory.View full abstractDownload PDF (3728K) -
Kimio KAWASAKI, Kouzou IKUTA, Takahiro KOYAMA, Maho KITAMI, Shoko ISHI ...2010 Volume 52 Issue 7 Pages 1714-1719
Published: 2010
Released on J-STAGE: September 06, 2010
JOURNAL FREE ACCESSA 64-year-old woman with dull pain in the right hypochondriac region was diagnosed as having a progressive simple liver cyst, 13 cm in diameter. After percutaneous transhepatic cyst drainage, the liver cyst was found to communicate with the intrahepatic bile duct. More than 400 ml/day bile was continuously removed via a percutaneous drain, and injection of minocycline hydrochloride (200 mg/day×7days) into the cyst was ineffective. ENBD (endoscopic naso-biliary drainage) was performed to decrease the inflow of bile from the bile duct into cyst, and minocycline was injected in the same method as before. Approximately 1 week after the injection, the percutaneous drain and ENBD tube were removed. Ten months after the therapy, CT scan revealed that the size of the liver cyst remained reduced. This is the first report of a simple liver cyst with biliary communication successfully treated with ENBD.View full abstractDownload PDF (501K)
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[in Japanese], [in Japanese], [in Japanese]2010 Volume 52 Issue 7 Pages 1720-1721
Published: 2010
Released on J-STAGE: September 06, 2010
JOURNAL FREE ACCESSDownload PDF (428K)
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Ichiro YASUDA2010 Volume 52 Issue 7 Pages 1722-1732
Published: 2010
Released on J-STAGE: September 06, 2010
JOURNAL FREE ACCESSEndoscopic ultrasound-guided fine needle aspiration (EUS-FNA) has been developed mainly in Western countries since the mid 1990's, and it has recently also become popular in Japan. This technique is the safest and easiest way of obtaining pathological samples of the pancreas. Of the many doctors who have evaluated the usefulness of this technique, some did not find it satisfactory because they obtained insufficient results for the diagnosis. In order to improve the diagnostic ability, it is important to adequately understand the procedure well and modify the technique depending on each case and institution.View full abstractDownload PDF (1206K)
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[in Japanese]2010 Volume 52 Issue 7 Pages 1733-1736
Published: 2010
Released on J-STAGE: September 06, 2010
JOURNAL FREE ACCESSDownload PDF (325K)
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[in Japanese]2010 Volume 52 Issue 7 Pages 1737
Published: 2010
Released on J-STAGE: September 06, 2010
JOURNAL FREE ACCESSDownload PDF (147K)
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