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Volume 48, Issue 6
Displaying 1-13 of 13 articles from this issue
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Koichi FURUKAWA, Kazuyosi TAKIZAWA, Haruo IKEDA, Yasuhiko IWAMOTO, Tun ...2006 Volume 48 Issue 6 Pages 1199-1209
Published: June 20, 2006
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSPreventive consolidation therapy for esophageal varices is performed with endoscopic injection sclerotherapy (EIS) and endoscopic variceal ligation (EVL). EVL in particular has proliferated rapidly because of the safety and simplicity of the procedure, essentially making the treatment of esophageal varices no longer a specialized therapy. In contrast, various prevention consolidation therapies have been attempted. Argon plasma coagulation (APC) is used in this department. APC is considered to be one of the combinations in which coagulation characteristics are said to be optimal for prevention of the recurrence of RC following EVL. On the other hand, EVL, which is repeated based on the supposition of recurrence, also ultimately brings about similar changes as the esophagus in combination with preventive consolidation therapy. When considering the significance of preventive consolidation therapy, it is necessary to reexamine the conventional treatment of RC as related to preventive consolidation therapy along with safety, QOL, cost and other factors that are in line with the current health care environment. There is also considerable need for personalization of effective treatment methods based on hemodynamic studies, prevention consolidation therapy for esophageal varices that focuses on EVL, and standardization of preventive consolidation therapy for esophageal varices that incorporates pharmacotherapy.View full abstractDownload PDF (13768K) -
Takatomi OKU, Yuko WADA, Eriko WAGA, Miri FUJITA, Yasuhiro NAGAMACHI, ...2006 Volume 48 Issue 6 Pages 1210-1214
Published: June 20, 2006
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 59-year-old woman was introduced to our hospital with suspicious of bleeding from upper GI and for evaluation of liver dysfunction. The initial endoscopic examination showed a gastric ulcer with visible vessels on the lesser curvature of antrum. We performed hemostasis with local injection of hypertonic saline epinephrine solution (HSE). The second endoscopic examination performed two weeks later revealed that the center of this ulcer had penetrated into the duodenal bulb forming double pylorus. Although the lesser curvature of antrum is common site of double pylorus, short transition from ulcer to fistula in our case indicates that local injection of HES contributed to the double pylorus formation. There is no report of double pylorus caused by HSE.View full abstractDownload PDF (8796K) -
Kenichirou TSUKADA, Chiharu MIYABAYASHI, Koichi FURUKAWA, Yumiko TERAO ...2006 Volume 48 Issue 6 Pages 1215-1220
Published: June 20, 2006
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSWe report 3 cases of transient global amnesia (TGA) after the endoscopic examination. All of them were female and had both retrograde amnesia and anterograde amnesia. They didn't have the disturbance of consciousness and had a long-term memories. However, they could not understand their current situation. Their families had difficulties in understanding the situation and had doubts on the doctors. The operators were also perplexed by the outcomes of their operation. Stresses caused by uneasiness and strain to receive endoscopic examination were nominated as the reasons. It seems that it is extremely rare to meet TGA after the endoscopic examination, however, we believe that this is the important complication we should be aknow-ledged.View full abstractDownload PDF (6810K) -
Yasushi TAMURA, Kenichi TAKAKU, Shiro WATANABE, Takahiro MARUYAMA, Iku ...2006 Volume 48 Issue 6 Pages 1221-1227
Published: June 20, 2006
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 37-year-old man was admitted to our hospital for the further examination and therapy of the duodenal tumor. Gastrointestinal endoscopy revealed a large polypoid lesion which had a rough, nodular surface in the duodenal bulb. And at the side of tumor edge, there were elevated lesions like a submucosal tumor. Endoscopic ultrasonography showed a slight hypere-choic mass derived from second to third layers of the duodenal wall. Cystic areas were contained within the tumor. Fine-needle aspiration biopsy was performed. The biopsy speci-men showed epithelial and Brunner's gland cells hyperplasia. Surgical resection was performed in consideration of the tumor size, and duodenal polypoid lesion measured 50× 43× 28mm in size. The tumor was diagnosed histologically as Peutz Jeghers (P-J) polyp with pseudoinvasion in the submucosa to subserosa. Additionally, another hamartomatous polyps were observed in the jejunum and ileum. Neither family history of intestinal polyposis nor muco-cutaneous pigmentation was observed, the case was diagnosed as incomplete Peutz-Jeghers Syndrome.View full abstractDownload PDF (13687K) -
Kenji YAMAZAKI, Hiroshi ARAKI, Yasuhiro OSHIMA, Makoto SHIRAKI, Hideki ...2006 Volume 48 Issue 6 Pages 1228-1232
Published: June 20, 2006
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSDepressed-type duodenal adenoma is rare. We report a case of 51 year-old man with this disease. An upper gastrointestinal endoscopy examination for health screening revealed a depressed lesion, 3 mm in diameter, in the second portion of the duodenum. We suspected the lesion was adenoma or carcinoma limited in the mucosal layer by endoscopic findings. We removed this lesion by endoscopic mucosal resection (EMR). Pathological findings of the resected specimen showed a depressed lesion, 3 mm in diameter, and the histology of the depressed lesion was tubular adenoma with moderate atypia. EMR can be applied for the diagnosis and treatment of duodenal neoplasms under cautious performance.View full abstractDownload PDF (9032K) -
Hiroyuki NAGAYAMA, Youji ITOH, Masahiro HAYASHI, Kouji TAKENAKA, Mitsu ...2006 Volume 48 Issue 6 Pages 1233-1238
Published: June 20, 2006
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 59 year-old male was referred to our hospital because of positive fecal occult blood, testing colonoscopy revealed a hemispherical polyp covered with normal mucosa, measuring 20mm in the sigmoid colon. Submucosal tumor was made, and sigmoidectomy was performed for the lesion. Histologically, the polyp was composed mainly may of normal submucosal tissues and edematous submucosa with dilated vessels and lymphangiectasia under the normal surface mucosa. The shape of this polyp was hemispherical and the diagnosis was made as a mucosal polyp of the colon.View full abstractDownload PDF (9146K) -
Wataru UEDA, Tomomi YUKAWA, Kenji MATUMOTO, Satoshi TAKATUKA, Teruyuki ...2006 Volume 48 Issue 6 Pages 1239-1245
Published: June 20, 2006
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSWe report a case of cytomegalovirus (CMV) colitis as acute refractory colitis in a patient with a 3-year history of ulcerative colitis (UC) who had never previously been treated with corticosteroids or immunosuppressants. A 74-year-old man with UC was being maintaining in remission with only aminosalicylic acid (5-ASA). Fever and bloody stool suddenly appeared. Initial colonoscopy revealed reddish, friable mucosa with deep ulcer, longitudinal ulcer, and geographic ulcer. A biopsy specimen revealed intranuclear inclusion bodies, so we diagnosed that this case was UC associated with CMV infection. CMV infection often occurs in im-munocompromised hosts. Corticosteroids are frequently used in the treatment of UC, and use of them is a well-documented risk factor for CMV infection. CMV colitis should be recognized as an exacerbating factor in UC patients. Treatment in this case was not initially effective, but administration of ganciclovir reduced the ulcers and improved symptoms. This case demon-strates that CMV infection can be a complication of UC even in the absence of corticosteroids. CMV should be considered a possible complication especially in individuals with UC who do not respond to traditional treatment and exhibit atypical colonoscopic finding.View full abstractDownload PDF (9621K) -
Naoya MIURA, Tetsuro HAMAMOTO, Michiko NOGUCHI, Masayuki INOUE, Hirosh ...2006 Volume 48 Issue 6 Pages 1246-1249
Published: June 20, 2006
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 84-year-old female was admitted to our hospital because of pneumonia. On the second hospital day, she complained of abdominal fullness and right side lower abdominal pain. An abdominal X-ray examination showed dilatated intestine at right lower quadrant, suggesting cecal volvulus. Emergency colonoscopy was done and diagnosed cecal volvulus by appearance of torsion at ascending colon. Cecum was too dilatated, and detorsion was done by endoscopic suction of intestinal gas. Colonoscopic examination and detorsion could be beneficial for early state of cecal volvulus.View full abstractDownload PDF (6046K) -
[in Japanese], [in Japanese], [in Japanese]2006 Volume 48 Issue 6 Pages 1250-1251
Published: June 20, 2006
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSDownload PDF (1740K) -
Kiyonori KOBAYASHI, Taishi OGAWA, Tomoe KATSUMATA, Katsunori SAIGENJI2006 Volume 48 Issue 6 Pages 1252-1258
Published: June 20, 2006
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSEndoscopic balloon dilation (EBD) is a relatively easy and useful treatment method for benign colorectal strictures. The main indications of EBD are anastomotic strictures after operation of colorectal cancer and inflammatory bowel disease. Most of EBD treatment is carried out using the TTS (though the scope) balloon which can be inserted from the forceps channel of a colonoscope, and the dilated balloon is advanced though the stricture under direct vision. Before EBD treatment for colorectal strictures, it is important to choose adaptation of EBD strictly. If the stricture of the large intestine separates from adaptation of EBD, other treatments such as surgical operation are taken into consideration. When performing EBD treatment, it is important to avoid forcible dilatation and pay attention for the grade of a patient's abdominal pain. Usually, under one EBD treatment, it limits to the dilation of stricture about 3 times, and one or two treatment per week is repeated. Since recurrent strictures after EBD are frequently occurred, it is necessary to perform progress observation with colonoscopy or radiography.View full abstractDownload PDF (12980K) -
Shoji MITSUFUJI, Mariko NAGOSHI, Yoichi TATSUMI, Miki SAKAI, Satoshi S ...2006 Volume 48 Issue 6 Pages 1259-1266
Published: June 20, 2006
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSBackground : Argon plasma coagulation (APC) has proved to be safe in vitro, and has been widely introduced to therapeutic endoscopy. We evaluated the thermal effects on esophageal or gastric wall in vivo, and effectiveness as an adjunct to incomplete resection of early esophageal and gastric cancer after endoscopic mucosal resection (EMR).Methods : Thermal injuries were made using endoscopic APC irradiation in porcine esophagus and stomach under various conditions during general anesthesia, and depth of tissue damage was determined histopathologically. Patients with early gastric cancer (n=24) and early esophageal cancer (n=5) were treated with additional APC following microscopically incom-plete EMR. APC was applied to coagulate the entire edge of EMR-induced ulcer 1 week after resection at power/gas settings of 50 W and 1.5 L/min in the stomach, and 40 W and 1.5 L/min in the esophagus for less than 5 s at each point.Results : Depth of tissue damage was related to pulse duration and power output. At power/gas settings of 60 W and 2.0 L/min, thermal damage extended across the submucosal layer with 5-s pulse duration in the stomach. Thermal damage with 5-s pulse duration at power/gas settings of 40 W and 2.0 L/min extended to the muscularis propria in the esophagus. In the clinical study of additional APC therapy, recurrence rate was 6.9 % (2 of 29 cases).Conclusion : To avoid perforation, we recommend an APC power setting of 40-60 W for less than 5 s in the stomach and a lower power setting with shorter duration in the esophagus. APC seems to reduce recurrence of esophageal or gastric cancer after incomplete EMR.View full abstractDownload PDF (14751K) -
[in Japanese]2006 Volume 48 Issue 6 Pages 1267-1270
Published: 2006
Released on J-STAGE: January 29, 2024
JOURNAL FREE ACCESSDownload PDF (660K) -
2006 Volume 48 Issue 6 Pages 1274-1277
Published: June 20, 2006
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSDownload PDF (1991K)
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