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Volume 45, Issue 12
Displaying 1-8 of 8 articles from this issue
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Kazuo INUI2003 Volume 45 Issue 12 Pages 2301-2305
Published: December 20, 2003
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSIreviewed the recent papers on conscious sedation for gastrointestinal endoscopy, espe-dally the present state in Japan increasing in this decade. In 2000, the working group of JapanGastroenterological Endoscopy Society(JGES)reported that the incidence of adverse reactionof conscious sedation for gastrointestinal endoscopy was O.0006%(73/12, 043, 781)and 2 patientswere died caused by sedation between 1993 alld 1997. Compared with the report of the workinggroup in 1995, the incidence was decreased. One of the reasons why the incidence decreased wasconsidered that the guidelines and issues for conscious sedation from JGES enlightened theendoscopists. The drugs most often used in Japan were diazepam and midazolam(benzodiaze-pine), and the others were pethidine hydrochloricde (narcotic) and flunitrazepam(benzodiaze-pine). Recently, propofol, which has many merits besides quicker recovery time than mid-azolam, becomes popular in Western countries, and it will be popular in Japan in the nearfuture. To perform endoscopy in safety and painless, endoscopist should have correct knowl-edge for sedation and perform adequate monitoring during endoscopic procedures.View full abstractDownload PDF (2996K) -
Masahiro SOGABE, Masahiko NAKASONO, Hiroshi HUKUNO, Kouji TSUJIGAMI, Y ...2003 Volume 45 Issue 12 Pages 2306-2313
Published: December 20, 2003
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSThe use of metallic stems in gastreintestinal malignant strictures has been frequentlyreported. But the report of double stems in the esophageal and tracheal stenosis is very rareand the report of autopsy for double stents is none. we experienced the case with double stemsin the esophageal and tracheal stenosis caused by lung cancer. A 65-year-old man who wastreated with chemotherapy and radiotherapy for the lung cancer at 64-year-old had dysphasiais difficult for eating, because of the esophageal stenosis due to swelling lymphonode of the lungcancer. Another tracheal stem was placed after one month of placement of an esophageal stmt, because of tracheal stenosis due to swelling lymphonode of the lung cancer anLd compression ofesophageal stmt. After placement of double stems, the patient could have meals easily withoutdyspnea. It is suggested that placement of double scents in the esophageal and tracheal stenosiscaused by cancer would be safe and effective.View full abstractDownload PDF (7221K) -
Satoshi HIBI, Shingo ITOH, Hitoshi YAMAMOTO, Ken NAGATA, Kazuya OHNO2003 Volume 45 Issue 12 Pages 2314-2320
Published: December 20, 2003
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 25-year old man was admitted to our hospital with right lower abdominal pain. Abdominal ultrasonography painted out the ileal tumor, and colonoscopy revealed the sub-mucosal tumor about 20rnm in diarneter of the terminal ileum.17 days later rc-colonoscopyrevealed that the tumor was growing semipedunculated, and the top of the tumor was erosiveand the mucasa around the tumor was reddish, and the part of the tumor was resected byendoscopic polypectomy. Histopathological examination showed that the tumor consisted ofblood vessels, loose fibrous stroma and in.filtration of inflammatory cells mainly composod ofeosinophiles, and so the diagnosis was inflammatory fibroid polyp. The tumor was growing, andthe invagination occurred. So meal resection about 4cm in length with the tumor was perfor-med. Inflammatory fihroid polyp of the small intestine is rare and extremely difficult in thepreoperative diagnosis. We reported a case of the inflamrnatory fibroid polyp of the smallintestine with preoperative histopathological diagnosis.View full abstractDownload PDF (7067K) -
Yoshiharu UNO2003 Volume 45 Issue 12 Pages 2321-2326
Published: December 20, 2003
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 75-year-ald female patient was admitted for abdominal pain and hypoprotenemia. Forseveral years the patient had been suffering from abdominal distention and constipation. Plainabdominal X-ray films showed rnarked dilatation with massive gas of the left side colon. Thesigmoid colon was 15cm in diameter, however, the right side colon was not dilated with few gas.Percutaneous endoscopic sigmoidostomy (PES) was perfarmed without laparoscopic controlbecause of refuse for sigmoidectomy and laparotomy. After decompression of gas in thesigmoid colon, antegrade continence enema was performed every day through the sigmoidos-tomy. Lead to this way, her megaton was improved, and defecation was controlled. To myknowledge, there has bees no report of this procedu.re in Japan.View full abstractDownload PDF (5226K) -
Hiroaki IGARASHI, Sachiko SHINOZAKI, Takeo MUKADA2003 Volume 45 Issue 12 Pages 2327-2332
Published: December 20, 2003
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 21-year-old woman with a past history of blunt abdominal trauma due to traffic accident was admztted because of increasing jaundice. US and CT scan revealed obstructive jaundice with a stricture of the common bile duct inthe middle portion. MRI showed a soft tissue mass surrounding a narrowed site of the common bile duct and distorted portal vein in the suprapancreatic portion. ERC revealed a smooth stricture of the comrnon bile duct, 1cm in length, in the middle portio:n. A 7Fr ENBD tube wassuccessfully introduced as the initial treatment. Under the diagnosis of benign traumatic bile duct stricture, ENBD tube was replaced by an 8Fr erldoprosthese(plastic stent). Twenty-six days later an 8Fr stent was exchanged for a 10Fr stent after sphincterotorny and additional balloon dilation of the stricture site. Final exchange for a 12Fr stent vvas done 2 months later. After 3 months'application, this was removed and the following cholangiogram demonstrated resolution of the stricture. On the next day of stent removal serum total bilirubin level slightly elevated because possibly of mucosal edema of the common bile duct caused by final scent extraetlon. Both bzochemically and anatomically, the hepatobiliary system seemed to be well preserved for at least following 6 months. Endoscopic stentmg and dilation method, which is safe and effective, should be considered for the treatment of traumatic biliary strictures.View full abstractDownload PDF (5024K) -
Toshio TAKESHIMA, Tokuyuki YOKOHATA, Ryoji FUKUSHIMA, Fujio OGAWA, Tak ...2003 Volume 45 Issue 12 Pages 2333-2337
Published: December 20, 2003
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSThe dilatation method using a balloon dilator was a simple, safe, and useful treatment forpostoperative anastomotic stricture. one of problems of this method is difficulty in locating thedilator to the exact place of stenosis. We developed a modified type of a balloon dilator thatwas attached With two pieces of thin and soft film containing a radiopaque mesh between them.We performed dilatation using this rnodified balloon dilator on ll patients with postoperativeesophageal anastomotic stricture from April 1996 to March 2001. We were able to locate thedilator exactly to the stenosis, to treat successfully all the patients, and to measure the lengthand diameter of stenosis without barium study.View full abstractDownload PDF (4497K) -
Norichika NARIMIYA, Hiroshi NIMURA, Junko FLTJISAKI, Hiroshi ARAKAWA, ...2003 Volume 45 Issue 12 Pages 2338-2345
Published: December 20, 2003
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSSentinel lymph node are the first lymph nodes to flow into cancerous lesion. The dyeindocyanine green(ICG)is used as a tracer for sentinel lymph nodes diagnosis in gastric cancer.we injected ICS into tumor tissue and examined ICS in the Iymph flow using infrared light. Experimentally, the lymph du.cts were visualized as dark blu.e lines following local injectionof ICS. Clinically, ICG could also be clearly seen flowing from the lymph ducts into the sentinellymph nodes following local injection of ICG into the tumor tissue. On examination for 20 minutes during surgery, the stained sentinel lyrnph nodes basin wereone-directional in 53.5% of the patients, two-directional in 42.8%of the patients, and three-directional in 3.7%of the patients. A mean of 3.3 sentinel lymph nodes were visualized perpatient. After surgery, 26.4%of the resected lymph nodes were ICG-positive on normalendoscopic examination and 43.2%were ICG-positive on examination with infrared light. Theinfrared images became, therefore, clearer than on the normal endoscopic ones. Lymph flowand sentinel lymph nodes that were not visible with normal endoscopic image were clearlyvisualized on the infrared images, indicating that examination using infrared light is a usefulnew technique in the sentinel lymph nodes diagnosis.View full abstractDownload PDF (6587K) -
[in Japanese], [in Japanese], [in Japanese], [in Japanese]2003 Volume 45 Issue 12 Pages 2346
Published: December 20, 2003
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSDownload PDF (1853K)
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