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Volume 51, Issue 10
Displaying 1-15 of 15 articles from this issue
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Akimichi IMAMURA2009 Volume 51 Issue 10 Pages 2675-2689
Published: 2009
Released on J-STAGE: October 19, 2012
JOURNAL FREE ACCESSRecent colorectal cancer (CRC) mortality ranks fourth in men and first in women with increasing risk factors such as westernization food intake, lifestyle and aging in community in Japan.
Organized screening program in order to reduce mortality from CRC using immunochemical fecal occult blood test (IFOBT) in public health policy has been running since 1992 in Japan. Recommended screening program involves offering annual IFOBT for 2 days to average-risk individuals over 40 years old. Colonoscopy investigation is primarily recommended for positive IFOBT patient. The present CRC screening program using IFOBT has is likely effective against CRC death. However, there remains some problems, such as low uptake rate (18.8% of eligible people), low follow-up colonoscopy investigation rate (under 60%) even though load to outpatient colonoscopy capacity or colonoscopic treatment with increasing in number of colonoscopy investigation, lack of coverage of colonoscopy investigation (71%), and rather false negative IFOBT rate. Improvement of above problems is needed for better IFOBT screening. Japan gastroenterological endoscopy society has to play an important role in training excellent colonoscopist because of maintenance of colonosopy investigation for early CCR detection and subsequent colonoscopic treatment for prevention against CCR death.
The current status of screening activities in several foreign countries was compared and the emerging screening was also described. Finally, the successful findings of RCT using CS in Akita prefecture will be awaited in the future.View full abstractDownload PDF (728K)
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Koichi ACHIWA, Naoyuki ARAKAWA, Kota AOKI, Tsuyoki YAMA, Minoru KUBOTA ...2009 Volume 51 Issue 10 Pages 2690-2698
Published: 2009
Released on J-STAGE: October 19, 2012
JOURNAL FREE ACCESSAn 84-year-old woman developed epigastralgia and hematemesis. She was diagnosed as having peritonitis due to a duodenal ulcer perforation. After surgery, she developed cytomegalovirus (CMV) esophagitis, which resulted in severe stricture. On immunohistochemistry, the cells were positive for CMV, inclusion bodies were also noted. Since the esophageal stricture did not resolve after ganciclovir (GCV) trament, the patient was given dilatation therapy using a balloon catheter. Although CMV esophagitis is rare in patients without HIV infection, in immunocompromized patients it should be considered in the differential diagnosis of esophagitis.View full abstractDownload PDF (1081K) -
Yuichi SHIMODATE, Shuhei WATANABE, Hitoshi NISHIOKA, Takeshi HAGIWARA, ...2009 Volume 51 Issue 10 Pages 2699-2703
Published: 2009
Released on J-STAGE: October 19, 2012
JOURNAL FREE ACCESSTwenty one-year-old man was admitted to our hospital, complaining of anal pain and odynophagia. He was diagnosed with Crohn's disease involving in the small and large intestine and anus as well as the esophagus, in which endoscopy revealed longitudinally arranged aphthaes. Mesalazine powder 250mg/day and rabeprazole 10mg/day were administrated for esophageal lesions, which relieved the symptoms a few days later. Esophago-gastroendoscopy at 1 month after the administration of mesalazine powder and rabeprazole comfirmed that the therapy improved the esophageal aphthaes. We reported a case of Crohn's disease with esophageal longitudinal aphthaes.View full abstractDownload PDF (520K) -
Takashi FUJISAWA, Akio ISHIHARA, Shigemitsu UEYAMA, Tetsuya TERANISHI, ...2009 Volume 51 Issue 10 Pages 2704-2711
Published: 2009
Released on J-STAGE: October 19, 2012
JOURNAL FREE ACCESSA 70-year-old female with liver cirrhosis had a follow-up endoscopy, and an area of a white depressed mucosa, approximately 4 cm in size, which was connected to the esophagogastric junction, was seen in the lesser curvature of the upper body. The lesion was flat, and the submucosal vessels were transparent, suggesting squamous epithelium. A diagnosis of gastric squamous metaplasia was made. The endoscopic findings were observed with narrow-band imaging (NBI) to differentiate squamous epithelium from gastric mucosa, and continuicity between the esophageal mucosa and the lesion was noted. Magnifying NBI endoscopic findings showed an intraepithelial papillary capillary loop (IPCL) in the white depressed mucosa. The lesion turned brown on iodine staining. On pathology, the biospied specimen showed esophageal epithelium with no atypia. This lesion has been observed for 5 years and has not changed during this period. Gastric squamous metaplasia with no atypia extending to the gastric body was extremely rare. This is the eleventh case report in the literature and the first case showing the usefulness of NBI.View full abstractDownload PDF (1384K) -
Hideki HORIE, Takahiro KATO, Takao KOJIMA, Hideyuki MATSUDA, Hiroaki H ...2009 Volume 51 Issue 10 Pages 2712-2716
Published: 2009
Released on J-STAGE: October 19, 2012
JOURNAL FREE ACCESS91-year-old woman who had been complaining of epigastric vague discomfort for lmonth. She underwent a endoscopic examination, and was found to have three bezoars. Seven days after hospitalization, before endoscopically treatment, one of the three bezoars dropped into the 3rd portion of the duodenum and caused ileus.
Therefore, using the colonoscopy (PCF-Q260AI), we forcepsed the bezoar shaved, dropping in the jejunum. On the next day, two bezoars in the stomach were broken into small pieces snairing with clear hood, followed with excretion into the stool for 6 days.View full abstractDownload PDF (799K) -
Tetsuro HAMAMOTO, Michiko NOGUCHI, Yuuji TAKANO, Tatsuaki HORI, Ichiro ...2009 Volume 51 Issue 10 Pages 2717-2722
Published: 2009
Released on J-STAGE: October 19, 2012
JOURNAL FREE ACCESSA 51-year-old man visited our hospital because of bloody diarrhea and tenesmus. Colonoscopy revealed multiple shallow punched out ulcers without white exudates, in the caecum and whole colon. In the rectum, ulcers with white exudates, which were surrounded by reddish and edematous mucosa, were seen. Biopsy specimen taken from the rectal ulcer disclosed Entamoeba histolytica trophozites. Based on these findings, this patient was diagnosed amoebic colitis. After treatment with metronidazole 750mg/day, his symptom and colonoscopic findings were improved.
Although colonoscopic findings of amoebic colitis typically include multiple edematous ulcers with white exudates or aphtoid erosions, our patient had multiple shallow punched out ulcers without white exudates. This case shows that when encountering such lesions, the possibility of amoebic colitis must be considered.View full abstractDownload PDF (1088K) -
Toru TAKAHASHI, Tomofumi MIURA, Junichiro NAKAMURA, Satoshi YAMADA, Ma ...2009 Volume 51 Issue 10 Pages 2723-2727
Published: 2009
Released on J-STAGE: October 19, 2012
JOURNAL FREE ACCESSA 20-year-old man was admitted to our division for the close examination of jaundice. Jaundice was direct-predominant and not obstructive in nature. Hepatosplenomegaly with almost smooth and diffusely icteric liver surface was characteristic in laparoscopy. Liver biopsy specimen histologically showed lace-like fibrosis, intrahepatic cholestasis and necroinflammatory reactions in centrilobular areas without any change in bile ducts. Ursodeoxycholic acid was strikingly effective in the resolution of his jaundice. Therefore, we clinically and morphologically diagnosed this case as benign recurrent intrahepatic cholestasis type 1 although the genetic background remained to be analysed.View full abstractDownload PDF (820K) -
Takahiro SHIMIZU, Yukitaka YAMASHITA, Takahisa KAYAHARA, Yoshito UENOY ...2009 Volume 51 Issue 10 Pages 2728-2734
Published: 2009
Released on J-STAGE: October 19, 2012
JOURNAL FREE ACCESSA 84-year-old woman had been hospitalized with acute cholangitis and undergone endoscopic sphincterotomy about 1 year previously. She presented to the hospital with fever and vomiting and was initially diagnosed with recurrence of CBD stones causing abnormalities in liver function test. ERCP revealed double common bile ducts that opened into the papilla of Vater separately and both had stones and we did endoscopic treatments. A double common bile duct is a rare congenital anomaly and we describe a case of recurrence of stones in each of double common bile ducts.View full abstractDownload PDF (576K)
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Atsushi MATSUNAGA, Yoshito ARISAWA, Takashi NAKAMURA, Masaharu KAWAGUC ...2009 Volume 51 Issue 10 Pages 2735-2738
Published: 2009
Released on J-STAGE: October 19, 2012
JOURNAL FREE ACCESSWe employed a glass type visual monitoring system to provide patients the live screen view of the endoscopic examination as well as treatment as means of communication tool between the patients and the doctors on site. We assessed the patient's satisfaction with this monitoring system by the question and answer after the endoscopic procedures. From January to December in 2007, 155 patients accepted to have this monitor during the endoscopy and answered the questionnaire (141 colonoscopies and 54 upper gastrointestinal (GI) endoscopies). Patients were allowed to wear the monitor after the insertion up to the cecum in colonoscopy, or duodenum in upper GI endoscopy to avoid showing the unexpected serious pathological lesions. The most patients were well satisfied with the view size (89%), the color (75%), and the view sharpness (79%). Eighty five percent of the patients felt no eye fatigue, 82 percent had better understanding for the examination results and the procedures, and 83 percent had less fear. Ninety percent of the patients wanted to wear this monitor in the next endoscopy, and 91 percent well satisfied in general.View full abstractDownload PDF (390K) -
Hiroshi TAKAHASHI, Kunio UKAWA, Kaoru KATO, Yuko HAYASHI, Kazuhito YOS ...2009 Volume 51 Issue 10 Pages 2739-2745
Published: 2009
Released on J-STAGE: October 19, 2012
JOURNAL FREE ACCESSAbstract
We studied efficacy and safety of a low-dose sedative in eshophagogastroduodenoscopy.
Subjects and methods
We intravenously administered midazolam as a sedative. We measured SpO2, blood pressure and pulse rate and also observed subjective symptoms during the procedure. Doses of the agent per body surface area were divided into four groups : group A, less than 1.5 mg/m2 ; B, 1.5 to less than 2.0 ; C, 2.0 or more ; and D, no agent.
Results
There were no significant difference in SpO2 reduction and changes in blood pressure and pulse rate. An increment in Rate Pressure Product (RPP), an index of myocardial oxygen consumption, did not differ significantly among patients in terms of the above parameters. (t-test) Vomiting reflexes at the time of endoscope insertion or during the examination were significantly suppressed by the agent depending on its dose (x2 test p<.01). Significantly more patients answered “the examination was easy” in the agent users than in the non-users (x2 test p<.001).
Conclusion
Conscious sedation using a small dose of the sedative made the endoscopic examination safe and easy.View full abstractDownload PDF (412K)
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[in Japanese], [in Japanese], [in Japanese]2009 Volume 51 Issue 10 Pages 2746-2747
Published: 2009
Released on J-STAGE: October 19, 2012
JOURNAL FREE ACCESSDownload PDF (410K)
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Naotaka MARUOKA, Yutaka ENDO, Yusuke HASHIMOTO, Jun TAKEKOSHI, Toshihi ...2009 Volume 51 Issue 10 Pages 2748-2755
Published: 2009
Released on J-STAGE: October 19, 2012
JOURNAL FREE ACCESSThe endoscopic retrograde cholangiography (ERCP) after gastric resection is challenging and required excellent skill for the scope insertion difficulty. Recently developed double balloon endoscopy (DBE) improved of the results of ERCP after gastrectomy. In our experience, the success rate of scope insertion to the Vater's papilla and cannulation was 100% and 73% (Roux-en-Y 11, Billroth-II 1). However, the DBE insertion and forward view scope canulation is the different techniques from the duodenoscope examination and therapy. This paper describes the actual procedure and tips for ERCP after gastric resection by DBE.View full abstractDownload PDF (1163K)
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Osamu TAKASAWA, Naotaka FUJITA, Yutaka NODA, Go KOBAYASHI, Kei ITO, Ju ...2009 Volume 51 Issue 10 Pages 2756-2762
Published: 2009
Released on J-STAGE: October 19, 2012
JOURNAL FREE ACCESSEndosonography-guided biliary drainage (ESBD) is gaining acceptance as an effective treatment for obstructive jaundice. Only a few reports on the application of this technique to the gallbladder (endosonography-guided gallbladder drainage [ESGBD]) have been published in the literature. In order to relieve acute cholecystitis which developed in a patient with unresectable malignant biliary obstruction after deployment of a covered metal stent (CMS), we applied this technique. ESGBD was carried out by using an electronic curved linear array echoendoscope. After visualization of the gallbladder and determination of the puncture route, a needle knife papillotome was advanced with electrocautery to pierce the gastric and gallbladder walls. Under the guidance of a guidewire inserted through the needle sheath into the gallbladder, a 7.2 Fr, 30 cm-long, single pigtail plastic tube was placed to bridge the gallbladder and the stomach. No complications relevant to the procedure were encountered. ESGBD was quite effective in ameliorating the patient's acute cholecystitis and the drainage tube was removed after 10 days without sequelae. Acute cholecystitis following CMS deployment is considered to be a good indication for ESGBD.View full abstractDownload PDF (604K)
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[in Japanese]2009 Volume 51 Issue 10 Pages 2763-2765
Published: 2009
Released on J-STAGE: October 19, 2012
JOURNAL FREE ACCESSDownload PDF (197K)
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[in Japanese]2009 Volume 51 Issue 10 Pages 2766
Published: 2009
Released on J-STAGE: October 19, 2012
JOURNAL FREE ACCESSDownload PDF (127K)
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