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Volume 49, Issue 8
Displaying 1-15 of 15 articles from this issue
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Nobuto HIRATA, So NAKAJI, Takayuki SONOYAMA, Yona KUSHIDA2007 Volume 49 Issue 8 Pages 1785-1797
Published: August 20, 2007
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSThirty-two years have passed since endoscopic sphincterotomy (ES) was developed. Complications, such as pancreatitis, hemorrhage and perforation are still problems after the procedure is performed, and they were reviewed in this paper using PubMed research. Pancreatitis developed in the cases of hyperamylasemia at a rate five times the normal upper limit four hours after ES. The complication rate for pancreatitis was 0.7 to 5.4 percent. Multivariet analysis showed multiple cannulation into the pancreatic duct, difficult cannulation, low volume experience (less than 40 case per year), sphincter of Oddi dysfunction, small bile duct (<5mm), gender (female) and precutting as significant. Pancreatic stenting after the procedure is useful for preventing pancreatitis in difficult cases. The rate of hemorrhage was 0.45 to 2.5 percent and was mostly recognized 2 to 3 days following ES. Factors contributing to hemorrhage were prolonged prothrombin time, bleeding during the procedure, low volume (less than 200 cases a year) and precutting. Hypersaline-epinephrin was mostly applied for hemostasis. Whenever heat coagulation or hemoclip is used, the pancreatic orifice should be protected to ensure it remains open. The perforation rate was 0.3 to 1.2 percent. The factors associated with perforation were precutting and Billroth II. Pneumoretroperitoneum was recognized in 29 percent after ES. Treatment is not required when asymptomatic. It is possible to treat peripapillary microperforation coservatively using naso-biliary drainage. Surgery is required whenever the free duodenal wall is perforated.View full abstractDownload PDF (19052K) -
With the Trend of Medical InformaticsHideto YOKOI, Masayuki A. FUJINO2007 Volume 49 Issue 8 Pages 1798-1805
Published: August 20, 2007
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSThe medical informatics scene in Japan is in a phase of spreading Electronic Medical Record. The field of digestive endoscopy has also seen significant advances in picture archiving and electronic reporting systems. However, the interconnectivity and reusability of the information are not in a satisfactory stage, because of their insufficient progression. There were many epoch-making endeavors in standardization. In this article, we will review the standardization activities in Japanese digestive endoscopy, and will make a prediction on the direction of those activities in the near future.View full abstractDownload PDF (11740K) -
Naohisa YOSHIDA, Naoki WAKABAYASHI, Daisuke HASEGAWA, Takashi OKUDA, K ...2007 Volume 49 Issue 8 Pages 1806-1814
Published: August 20, 2007
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSBackground : It is difficult to make the objective estimate of V, pit pattern in colorectal tumors. In the current study, we define the shapes of irregular pits and perform the scoring of irregular pits, and analyzed the correlation between pit scores and the histological diagnosis. Methods : One hundred thirty cases (adenoma, 73 cases ; cancer with the depth at m to sm <1000μm, 35cases ; cancer with the depth sm≥1000μm, 22cases), which had been diagnosed histologically as colorectal tumors from January, 2002 to September, 2005 at Kyoto Prefectural University of Medicine and had observed pits with a magnifying endoscope, were analyzed in the current study. We classified 5 magnifying endoscopic findings of irregular pit as follows : 1. irregularity of pit shape, 2. existence of borderless small round pit, 3. heterogeneous area between pits, 4. existence of unclear pit about beginning and ending, 5. more than 2 branched pits. The scores of irregular pits were calculated with each tumor. A statistical analysis was performed which findings were mostly related to cancer. We calculated pit score with significant findings of irregular pits in each tumor and analyzed the correlation between pit scores and the depth of cancer. Results : Four irregular pit findings were significantly related to cancer . The odds ratio showed that the existence of the irregularity of pit shape was mostly related to cancer. Pit scores significantly increased more in cancers with the depth sm ≥1000, am than in cancers with the depth of m to sm < 1000μm. Conclusions : The scoring of irregular pit detected by magnifying endoscopy in colorectal tumors is a promising method to diagnose the existence of cancer and the depth of cancer.View full abstractDownload PDF (15675K) -
Masaki SAHARA, Katsutoshi TANIGUCHI, Takeshi TSUJI, Minoru OCHIAI, Hir ...2007 Volume 49 Issue 8 Pages 1815-1820
Published: August 20, 2007
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSAn 82-year-old man was urgently admitted to our hospital due to severe chest pain of unknown etiology. On chest computed tomography (CT), the characteristic findings of extraesophageal emphysema and pleural effusion were found bilaterally . Therefore, a diagnosis of spontaneous rupture of the esophagus was made. And 16 hours after onset the patient was surgically treated via the trans-abdominal approach. As well, intraoperative upper gastrointestinal endoscopy was done to close the esophageal perforation using metallic clips. The patient recovered well and was discharged 74 day postsurgey. In aging society, one can continue to expect an increased number of high risk patients who can develop various complications postsurgey. Therefore spontaneous esophageal rupture should be treated with conservative or minimally invasive endoscopic approaches.View full abstractDownload PDF (9040K) -
Hisaharu SHIKATA, Masahiko KANEKO, Hiroki TERAOKA, Mikio ICHIKAWA, Mam ...2007 Volume 49 Issue 8 Pages 1821-1826
Published: August 20, 2007
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSWe encountered four cases of gastric Diffuse large B-cell primary lymphoma treated with rituximab in addition to chemotherapy. All cases had no grave complications such as bleeding, perforation and maintained CR. Reports that non-surgical therapy can obtain the same treatment outcome as surgery for gastric primary DLBCL increase . Rituximab in addition to chemotherapy may also become one of treatment for Diffuse large B-cell primary gastric lymphoma.View full abstractDownload PDF (9471K) -
Hiroshi NIMURA, Sumio TAKAYAMA, Jun TSUTSUMI, Teruaki AOKI, Masahiro I ...2007 Volume 49 Issue 8 Pages 1827-1831
Published: August 20, 2007
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSAlthough gastric small cell carcinoma has a poor prognosis, the natural course of this disease has not been reported. We herein report a patient with gastric small cell carcinoma that grew repidly and caused liver metastasis and peritonitis carcinomatosa. The patient was a 77 -year-old male with type 2 gastric cancer simulating a submucosal tumor . He was admitted for hematemesis. Biopsy under endoscopy revealed small cell carcinoma of the stomach. Since the operation was refused, his natural course was observed. At seven weeks after the diagnosis, the tumor increased in size, caused marginal disintegration and became a type 1+3 huge gastric cancer. Liver metastasis and peritonitis carcinomatosa were also documented by abdominal CT and an ultrasonography, and he died of a respiratory failure with lymphangitis carcinomatosa.View full abstractDownload PDF (10567K) -
Teruo NAKAYA, Shigetaka TOUNOU, Shigeaki AONO, Tetsuji TOKUNAGA, Shini ...2007 Volume 49 Issue 8 Pages 1832-1838
Published: August 20, 2007
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 44-year-old man admitted with dysphagia was diagnosed with cervical and upper thoracic esophageal cancer (T3N4M0 Stage IVa). He received a chemo-radiotherapy (CRT). Abdominal follow-up CT after CRT showed the tumor in the abdominal cavity. Symptoms due to obstructed bowel developed one month later. After a conservative treatment, an operation was conducted for ileus. The histopathological examination revealed the jejunal metastasis from the esophageal cancer. Metastasis to the small bowel from the esophageal cancer is very rare. We describe a case of squamous cell carcinoma of the esophagus with a metastasis to the small bowel causing small bowel obstruction.View full abstractDownload PDF (10943K) -
Kenji FUKUMOTO, Hiroyuki MIYATANI, Yukio YOSIDA, Sinya USIMARU, Yasuta ...2007 Volume 49 Issue 8 Pages 1839-1843
Published: August 20, 2007
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA case of 64-years-old woman suffer from repeated cholangitis with intrahepatic calculus after living donor liver transplantation. Since ERCP was technically difficult to perform in this case, cholangiography was performed using a double balloon enteroscopy which could reach the site of anastomotic structure of choledochojejunostomy. After ENBD (endoscopic nasobiliary drainage), ESWL (extracorporeal shock wave lithotripsy) and EBD (endoscopic biliary drainage) were performed, cholangitis did not occur in this patient. Recently, the number of cases of the living donor liver transplantation has increased. Double balloon enteroscopy was expected to contribute to the diagnosis and treatment in a similar case.View full abstractDownload PDF (7257K) -
Hiroki SAKAMOTO, Masayuki KITANO, Yoichiro SUETOMI, Mikio SHIOMI, Taka ...2007 Volume 49 Issue 8 Pages 1844-1847
Published: August 20, 2007
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 64-year-old female with recurrent breast cancer and abdominal lymph node metastasis was hospitalized with obstructive jaundice. Endoscopic biliary drainage could not done, since it was not possible to reach the papilla due to severe stenosis of the second portion. Therefore, endoscopic ultrasound-guided biliary drainage (EUS-CD) was done. The transducer was placed in the first portion of the duodenum. After transduodenal puncture of the extrahepatic bile duct, contrast was injected and cholangiography was done. Then, a stent was placed in the bile duct. On the day after EUS-CD, laboratory tests confirmed that the serum bilirubin level had decreased, 1 week later the patient no longer had jaundice disappeared.View full abstractDownload PDF (8091K) -
Akihiro MORI, Noritsugu OHASHI, Takayuki ASANO, Takako MARUYAMA, Nobut ...2007 Volume 49 Issue 8 Pages 1848-1853
Published: August 20, 2007
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESS[Aim] We have developed a new technique (‘Cathelin needle method’) for the fixation of the stomach to the abdominal wall in performing percutaneous endoscopic gastrostomy (PEG). We have also compared the new method to the conventional Funada's technique. [Methods] We have performed the fixation using two Cathelin needles under endoscopic observation in 50 patients. The procedure time, complications and costs were compared between the Cathelin needle method (n39) and Funada's technique (n=28).[Results]No significant complication was experienced in performing the new method. The median procedure time was significantly longer in the Cathelin needle method than in Funada's technique (360 and 247 sec, respectively). However, the median time did not differ between the two methods when compared among the beginners for the PEG technique. The costs of Cathelin and Funada's method were 40 and 12, 000 yen, respectively. [Conclusion] We have developed the Cathelin needle method, a new technique for the fixation of the stomach in performing PEG. The new method is likely superior in the costbenefit balance to the conventional technique. Moreover, the new fixation method may be advantageous in performing percutaneous endoscopic jejunostomy because of its easiness in inserting needles in the narrow jejunal lumen.View full abstractDownload PDF (11136K) -
[in Japanese], [in Japanese], [in Japanese]2007 Volume 49 Issue 8 Pages 1854-1855
Published: August 20, 2007
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSDownload PDF (1703K) -
[in Japanese], [in Japanese]2007 Volume 49 Issue 8 Pages 1856-1857
Published: August 20, 2007
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSDownload PDF (4688K) -
Namiki IZUMI2007 Volume 49 Issue 8 Pages 1858-1865
Published: August 20, 2007
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSThe development of hepatocellular carcinoma (HCC) has been observed mostly in patients with hepatitis B or C infection. Therefore intrahepatic distant recurrence is detected in more than 20% per year after curative resection was carried out. Radiofrequency ablation has been chosen as a first line treatment for early stage hepatocellular carcinoma smaller than 3cm in diameter. Percutaneous puncture is sometimes difficult when the HCC nodule is located near the surface of the liver or beside gall bladder or gastrointestinal tract. For such HCC nodule, laparoscopic RFA provide safe and accurate ablation. Laparoscopic ultrasound is essential for the safe treatment of HCC nodule near the surface of the liver. To use mesh type port provide less complication to abdominal wall vessels. Adverse events are rare when the indication isaccurately chosen. Five year survival reached as high as 69 % in our hospital.View full abstractDownload PDF (13043K) -
[in Japanese]2007 Volume 49 Issue 8 Pages 1866-1868
Published: 2007
Released on J-STAGE: January 29, 2024
JOURNAL FREE ACCESSDownload PDF (580K) -
[in Japanese]2007 Volume 49 Issue 8 Pages 1869-1872
Published: August 20, 2007
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSDownload PDF (4204K)
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