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Volume 51, Issue 6
Displaying 1-12 of 12 articles from this issue
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Kazuichi OKAZAKI, Kazushige UCHIDA, Masanori KOYABU, Takeo KUSUDA, Mak ...2009 Volume 51 Issue 6 Pages 1403-1415
Published: 2009
Released on J-STAGE: July 17, 2012
JOURNAL OPEN ACCESSRecent advances support the concept of autoimmune pancreatitis as a unique systemic disease, because occasional extrapancreatic lesions such as sclerosing cholangitis, sclerosing sialoadenitis, retroperitoneal fibrosis show similar pathological features with firosis and abundant infiltration of IgG4 positive plasma cells, and steroid responsive. Based on these findings, several diagnostic criteria have been proposed. In this review, we discussed the dignosis, pathophysiology and treatment.View full abstractDownload PDF (1146K)
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Koichi SUGIURA, Hikaru TAMURA, Masao KOJIMA2009 Volume 51 Issue 6 Pages 1416-1422
Published: 2009
Released on J-STAGE: July 17, 2012
JOURNAL OPEN ACCESSA case of synchronous triple cancers of the esophagus, stomach, and duodenum is reported. The patient was a 73 years old man. Gastrointestinal endoscopy and computed tomography revealed triple advanced cancers : an esophageal cancer involving left main bronchus, a gastric cancer and a duodenal cancer. The esophageal cancer was thought to be unresectable, and we planned to perform chemotherapy. We thought the most fatal cancer was the escophageal cancer and performed chemotherapy using the protocol at first selected for unresectable esophageal cancer : CDDP 80mg/m2+5FU 800mg/m2 once a month. At the second course of chemotherapy, CDDP was reduced to 40mg/m2 because of renal dysfunction. After the third course of chemotherapy, the esophageal cancer was partially remitted and the gastric cancer was completely remitted, but the duodenal cancer was stable. Two months after the third course of chemotherapy, esophago-mediastinal fistula occurred and esophageal metallic covered stent was placed into the esophagus. The esophago-mediastinal fistula was covered by the stent, and the stent relieved the patient not only from fever and chest pain but from dysphagia. He seemed to have been comfortable until he died from progression of the cancer five months after the third course of chemotherapy.View full abstractDownload PDF (2592K) -
Shinya TSURUTA, Tomonori YANO, Manabu MUTO, Keiko MINASHI, Makoto TAHA ...2009 Volume 51 Issue 6 Pages 1423-1430
Published: 2009
Released on J-STAGE: July 17, 2012
JOURNAL OPEN ACCESSNutritional disorders due to severe oral mucositis are a major problem during chemoradiotherapy (CRT) in patients with head and neck cancers. Prophylactic percutaneous endoscopic gastrostomy (PEG) insertion before CRT is advocated to maintain good nutritional status during CRT. From September 2002, we introduced prophylactic PEG before CRT for patients with head and neck cancer in our institution, and now have experience of 101 cases of prophylactic PEG insertion. Here, we present two cases with locally advanced hypopharyngeal cancer who developed gastrostomy site metastasis after prophylactic PEG insertion before definitive CRT. They underwent prophylactic PEG insertion using the pull technique and were subsequently treated with definitive chemoradiotherapy. They achieved a complete response with CRT ; however, they developed recurrence, including gastrostomy site metastasis, and died with cancer progression 7 and 14 months later, respectively. Gastrostomy site metastasis of head and neck cancer should be considered the implantation metastasis after PEG insertion using the “pull” method, as the PEG tube passes through the cancerous region. Gastrostomy site metastasis of head and neck cancer is fatal and its clinical course is miserable, because of the difficulties of salvage treatment. Therefore, it is very important to prevent implantation metastasis during PEG placement. The use of alternative techniques such as the “Introducer method” or the “Direct method” is recommended to minimize the risk of implantation metastasis in this group of patients.View full abstractDownload PDF (757K) -
Hyonji KIM, Kampei SAIJO, Mitsuru SEO, Takashi MATSUURA, Hitoshi ICHIM ...2009 Volume 51 Issue 6 Pages 1431-1436
Published: 2009
Released on J-STAGE: July 17, 2012
JOURNAL OPEN ACCESSA 50-year-old male complainted of tarry stools, palpitations, and dizziness. He did not have past or family history of mucocutaneous pigmentation or gastrointestinal polyps. On upper gastrointestinal endoscopy, a solitary, sessile polyp was located in the second portion of the duodenum. During the examination blood was seen spurting from a vessel located at the top of the lesion. Local injection of absolute ethanol successfully stopped the bleeding. On hypotonic duodenography, a sessile polyp was noted beside Vater's papilla. Given the risk of rebleeding and the fact that the lesion was 20 mm large, the polyp was resected. The resected specimen was 20×8 mm in size. On histology, the lesion consisted of branching bundles of smooth muscle fibers covered with hyperplastic epithelium. The patient was diagnosed as having a solitary, Peutz-Jeghers (PJ) duodenal polyp. In the present case the PJ duodenal polyp had a sessile configuration, whereas it usually has a pedunculated or semi-pedunculated configuration.View full abstractDownload PDF (666K) -
Naoyuki HOMMA, Shigemi HACHINOHE, Akihiro ENDO, Hidekazu HORIUCHI, Tom ...2009 Volume 51 Issue 6 Pages 1437-1442
Published: 2009
Released on J-STAGE: July 17, 2012
JOURNAL OPEN ACCESSA 70-year old man was admitted to our hospital for further evaluation of a tumor in the papilla of Vater that was incidentally founded by upper gastrointestinal endoscopy. Upper gastrointestinal contrast radiograpy and side-view endoscopy during endoscopic retrograde cholangiopancreatography (ERCP) revealed a submucosal tumor 16mm in size with a partially reddish depressed area in the papilla of Vater. Biopsy specimen from the tumor revealed carcinoid tumor and pylorus-preserving pancreaticoduodenectomy (PpPD) was performed. At present, 10months after operation, patient is alive and well without recurrence.View full abstractDownload PDF (1027K) -
Sakae MIKAMI, Takehiro NAKAMURA, Eiji IKEDA, Yasuhiko SUMITOMO, Yukima ...2009 Volume 51 Issue 6 Pages 1443-1449
Published: 2009
Released on J-STAGE: July 17, 2012
JOURNAL OPEN ACCESSWe firstly observed the endoscopic appearance of the enterocolitis due to type X larva of the suborder spirurina migrans which appeared after the patient had eaten raw firefly squids.
A 56-year-old male was hospitalized on April 11th, complaining of abdominal pain that started in the night of April 10th and gradually worsened. Abdominal X-ray and computed tomography showed intestinal obstruction with the wall thickening of ileum. The abdominal symptom disappeared in a few days during which he was conservatively treated. We performed single balloon enteroscopy and the endoscopic finding demonstrated the severe edema with redness at the ileum. Pathological finding of the biopsy specimen showed an infiltration of eosinophils in the mucosal and submucosal layer. We diagnosed type X larva of the suborder spirurina migrans by the immunoenzymatic method.View full abstractDownload PDF (1912K) -
Shin KASHIMA, Ryu SATO, Shigeaki MAEDA, Jiro WATARI2009 Volume 51 Issue 6 Pages 1450-1453
Published: 2009
Released on J-STAGE: July 17, 2012
JOURNAL OPEN ACCESSA 70-year-old male was admitted to our hospital with severe hematochezia. An emergency colonoscopy revealed multiple diverticula and flesh blood in the proximal colon. After cleaning the colon with the use of an endoscope equipped with water-jet, the diverticulum with adherent clots was detected in the right transverse colon. Although bleeding point was obscure on the conventional view, small erosion was detected clearly in the deverticulum on Narrow Band Imaging (NBI), which is suspected of bleeding. Successfully hemostasis was carried out using hemoclips. NBI colonoscopy, equipped with automatic water conveyance function, is useful modality for the detection of bleeding lesion in case with lower gastrointestinal hemorrhage.View full abstractDownload PDF (499K)
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Masayu ITO, Ichiro TAKEMASA2009 Volume 51 Issue 6 Pages 1454-1459
Published: 2009
Released on J-STAGE: July 17, 2012
JOURNAL OPEN ACCESS[Background and purpose] We experienced a novel anesthetic method using 2.8% lidocaine solution for infusion through the nasal cavity (hereafter “infusion anesthesia”), and studied its clinical utility.
[Subjects and method] From January to June 2008, 281 patients underwent transnasal endoscopy with infusion anesthesia and were evaluated according to four items of subject tolerance using a questionnaire conducted after the examination.
[Results] The percentage of cases who felt discomfort in the overall examination was 3.7% ; 8.2% felt nasal discomfort at insertion ; 9.3% felt pharyngeal discomfort at insertion and 6.7% felt discomfort by anesthesia itself.
[Conclusion] The subject tolerance with the infusion anesthesia was good, and it enabled a simple procedure with low incidence pain for the patients.View full abstractDownload PDF (592K)
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[in Japanese]2009 Volume 51 Issue 6 Pages 1460-1461
Published: 2009
Released on J-STAGE: July 17, 2012
JOURNAL OPEN ACCESSDownload PDF (300K)
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Masaki SANAKA, Hajime ANJIKI, Naoto EGAWA, Kumiko MONMA2009 Volume 51 Issue 6 Pages 1462-1472
Published: 2009
Released on J-STAGE: July 17, 2012
JOURNAL OPEN ACCESSIt has well been established that endoscopy is the first-line diagnostic and therapeutic intervention for patients presenting with hematoemesis or melena. However, the role of endoscopy has to be considered in the context of the entire management of upper gastrointestinal bleeding, which involves initial resuscitation to stabilize a shocked patient and subsequent treatment to arrest hemorrhage using endoscopy, interventional radiology, or surgery. The present review addresses not only the basic skill of endoscopic procedure but also the importance of periprocedual management . The following issues are especially stressed : 1)prompt and effective intravascular volume repletion by infusing crystalloid and blood products is the mainstay for therapeutic success, 2)the most optimal stategy for hemostatic intervention should be determined based on patient's hemodynamic status, 3)if indicated, endoscopy should be performed gently and carefully to achieve accurate diagnosis and successful endoscopic therapy, and 4)the appropriate timing of converting endoscopic treatment to interventional radiology or surgery should always be considered.View full abstractDownload PDF (1117K)
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[in Japanese]2009 Volume 51 Issue 6 Pages 1473-1475
Published: 2009
Released on J-STAGE: July 17, 2012
JOURNAL OPEN ACCESSDownload PDF (247K)
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[in Japanese], [in Japanese]2009 Volume 51 Issue 6 Pages 1476
Published: 2009
Released on J-STAGE: July 17, 2012
JOURNAL OPEN ACCESSDownload PDF (164K)
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