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Volume 55, Issue 3
Displaying 1-14 of 14 articles from this issue
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Koichi NAGATA, Hisao TAJIRI, Toru MITSUSHIMA, Kenichi UTANO, Ken TAKAB ...2013 Volume 55 Issue 3 Pages 435-444
Published: 2013
Released on J-STAGE: May 21, 2013
JOURNAL FREE ACCESSObjective : CT colonography (CTC) is an accurate examination for evaluating the colorectal length. The purpose of this study was to compare possible differences in colorectal length between Japanese and American asymptomatic adults with CTC. Methods : CTC studies in 1300 adults (650 Japanese and 650 American adults over 50 years of age) with technically adequate distension were analyzed using a colon imaging workstation. The total colorectal length and rectosigmoid length measurements were recorded for all patients. Results : Although the total colorectal length was significantly shorter (p-value = 0.003) in the Japanese group (average = 154.7 cm) compared to the American group (average = 158.2 cm), the effect size (0.17) was very small. There was no significant difference (p-value = 0.23, effect size = 0.07) in rectosigmoid length comparing the Japanese group (average = 62.5 cm) to the American group (average = 63.3 cm). The total colorectal lengths of the Japanese and American groups in the 50-59 years age group were 153.2 cm and 155.6 cm respectively, in the 60-69 years age group they were 155.2 cm and 159.3 cm respectively, and 161.8 cm and 165.2 cm, respectively, in the over-70 group. The total colorectal length significantly increased with age. Conclusion : In conclusion, we found that there was no overall difference in the total colorectal length or rectosigmoid length between Japanese and American adults. The total colorectal length increased with age in both the Japanese and American groups.View full abstractDownload PDF (896K)
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Kunihiro TSUJI, Hisashi DOYAMA, Hiroyoshi NAKANISHI, Youhei WASEDA, Na ...2013 Volume 55 Issue 3 Pages 445-449
Published: 2013
Released on J-STAGE: May 21, 2013
JOURNAL FREE ACCESSA 67-year-old male was referred to our hospital for further evolution of a gastric cancer. Gastrointestinal endoscopy revealed a small depressed lesion at the gastric antrum measuring around 15 mm. This lesion was diagnosed based on the presence of a demarcation line and an irregular microvascular pattern which could be seen using narrow band imaging with magnifying endoscopy but which was difficult to diagnose with white light imaging. Endoscopic mucosal dissection was performed. Histopathological examination of the resected specimen confirmed a diagnosis of early gastric cancer with gastric xanthoma.View full abstractDownload PDF (1093K) -
Mika TAKASUMI, Ryoichi ISHIHATA, Naoki KONNO, Kenya WATANABE, Makoto T ...2013 Volume 55 Issue 3 Pages 450-458
Published: 2013
Released on J-STAGE: May 21, 2013
JOURNAL FREE ACCESSA 69-year-old man was referred to our department with a gastric tumor which was detected during a medical checkup. Upper gastrointestinal endoscopy showed a gastric tumor with epithelial change in the greater curvature. Endoscopic submucosal dissection (ESD) was performed because early gastric cancer was suspected. Histopathological examination of the resected specimen confirmed the diagnosis of composite gastric carcinoid and early gastric cancer with endocrine cell micronests for a background. In addition, type A gastritis was confirmed on the basis of blood chemical analysis and endoscopic findings. We present herein on this case treated with ESD, considering its possible rarity.View full abstractDownload PDF (1470K) -
Masaaki YAMADA, Keizo KATOU, Rei KASHIMA, Makoto FUJIMOTO, Shinya KAJI ...2013 Volume 55 Issue 3 Pages 459-466
Published: 2013
Released on J-STAGE: May 21, 2013
JOURNAL FREE ACCESSA 71-year old man was admitted to our hospital in an unconscious state with hematemesis. Upper gastrointestinal endoscopy showed an ulcer in the duodenal bulb with an exposed vessel. On treatment with endoscopic clipping for hemostasis, the vessel strated to spurt large quantities of blood, and eventually we lost sight of it. The patient was in a state of life-threatening hemorrhagic shock. Therefore, we decided to insert an intra-aortic balloon occlusion (IABO) catheter to counteract the bleeding and treat the shock. The IABO helped to maintain the blood pressure in the upper half of the patient's body, and reduced the ulcer bleeding. It also enabled us to relocate the vessels and complete endoscopic hemostasis with clipping. A few days later, the ulcer was diagnosed as duodenal invasion from a pancreatic carcinoma. In the present case, endoscopic hemostasis with IABO was effective for treatment of duodenal bleedings with life-threatening hemorrhagic shock.View full abstractDownload PDF (1229K) -
Nobuhiro TAKEUCHI, Tetsuo MAEDA, Hidetoshi TADA, Yu NISHIDA, Yusuke NO ...2013 Volume 55 Issue 3 Pages 467-475
Published: 2013
Released on J-STAGE: May 21, 2013
JOURNAL FREE ACCESSAn 83-year-old man with melena was transferred to our hospital, and multiple ileal ulcers were revealed by colonoscopy. Low-dose aspirin was suspected as the cause of the ileal ulcers, so aspirin was stopped. During hospitalization, the patient developed a high grade fever and several sets of laboratory studies showed severe leukocytosis and increased C-reactive protein. Colonoscopy showed that the ileal ulcers had almost healed. Fifty-three days after admission, celecoxib 200 mg per day was initiated for relief of severe low back pain due to lumbar spinal stenosis. Seventy-eight days after admission, severe abdominal pain occurred and abdominal computed tomography showed the presence of free air, so the diagnosis of a gastrointestinal perforation was made. An operation was performed and 10 punched-out perforations were found in the terminal ileum. Pathological findings showed non-specific inflammation in the ileum, so the association between celecoxib and multiple ileal ulcers was suspected. We report herein on a case of NSAIDs-induced multiple ileal ulcers complicated by multiple perforation.View full abstractDownload PDF (1195K) -
Kimitoshi KUBO, Takuto MIYAGISHIMA, Hisashi ODA, Junji YAMAMOTO, Yoshi ...2013 Volume 55 Issue 3 Pages 476-484
Published: 2013
Released on J-STAGE: May 21, 2013
JOURNAL FREE ACCESSWe report herein on a 75-year-old male who presented with melena. Initial upper GI endoscopy, colonoscopy and computed tomography failed to find the bleeder. Capsule endoscopy revealed a polypoid lesion with net-like white line in the ileum, followed by double-balloon endoscopy which revealed a club like polypoid lesion located at the distal ileum. A Barium meal examination revealed a bulbous polypoid filling defect in the ileum. We therefore diagnosed that the lesion was an inverted Meckel's diverticulum. Surgical resection was performed. Pathologic examination indicated inverted Meckel's diverticulum. We propose that capsule endoscopy and double-balloon endoscopy are promising techniques to diagnose an inverted Meckel's diverticulum.View full abstractDownload PDF (1940K)
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Yukiya YOSHIDA, Chieko IWANAGA, Jinghua YIN, Susumu NAKAMATA, Nobuo MI ...2013 Volume 55 Issue 3 Pages 485-489
Published: 2013
Released on J-STAGE: May 21, 2013
JOURNAL FREE ACCESSThe J-through, new disposable biopsy forceps for transnasal endoscopy could be relatively readily passed through the curved portion of the scope even when it was in the maximum up-angle state. In addition, when the forceps were withdrawn, the resistance value during their passage through the curved portion was low. The J-through is characterized by marked flexibility of the 25-mm portion from its tip, particularly the cup-wire connection area, and its favorable passage may have been due to this structure. In addition, the amount of tissue that could be collected using this instrument was adequate for histological diagnosis. These results suggest that J-through is an appropriate disposable biopsy forceps for transnasal endoscopy that shows excellent passage through the forceps channel, and reduces the load on the forceps channel caused by forceps withdrawal and insertion. The clinical application of this instrument can be expected.View full abstractDownload PDF (848K)
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[in Japanese], [in Japanese], [in Japanese]2013 Volume 55 Issue 3 Pages 490-491
Published: 2013
Released on J-STAGE: May 21, 2013
JOURNAL FREE ACCESSDownload PDF (680K) -
[in Japanese], [in Japanese], [in Japanese]2013 Volume 55 Issue 3 Pages 492-493
Published: 2013
Released on J-STAGE: May 21, 2013
JOURNAL FREE ACCESSDownload PDF (740K)
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Tsuyoshi KANEKO, Hirofumi MATSUI, Kanho RAI, Takashi MAMIYA, Yuji MIZO ...2013 Volume 55 Issue 3 Pages 494-501
Published: 2013
Released on J-STAGE: May 21, 2013
JOURNAL FREE ACCESSPhotodynamic therapy (PDT) is a clinically approved, minimally invasive therapeutic procedure that can exert a selective cytotoxic activity toward malignant cells. In Japan PDT has indications for early staged gastrointestinal cancer, lung cancer and uterocervical cancer. PDT involves two key components : a photosensitizer and a light source. After administration of a photosensitizer, irradiation at a wavelength corresponding to an absorbance band of the sensitizer produces reactive oxygen species within cells in the cancerous area and leads to direct tumor cell death, damage to the microvasculature, and induction of a local inflammatory reaction. PDT can prolong survival in patients with inoperable cancers and significantly improve their quality of life. PDT has little normal tissue toxicity, negligible systemic effects and greatly reduced long-term morbidity. We herein introduce the PDT procedure and methodology for medical staff.View full abstractDownload PDF (1439K)
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Hirotoshi IWANO, Shomei RYOZAWA, Noriko ISHIGAKI, Kumiko TABA, Manabu ...2013 Volume 55 Issue 3 Pages 502-509
Published: 2013
Released on J-STAGE: May 21, 2013
JOURNAL FREE ACCESSAim : There is no consensus on the choice of either unilateral or bilateral drainage in stent placement for patients with unresectable hilar biliary obstruction. The aim of this study was to clarify which drainage method is superior.
Patients and methods : We retrospectively reviewed 82 patients with hilar biliary obstruction who underwent metallic stenting. These patients were divided into a unilateral drainage group (Uni group) and a bilateral drainage group (Bi group).
Results : There was no significant difference between the groups in median survival time, median stent patency period, and median complication-free survival time. The most frequent complication was stent obstruction followed by cholangitis. Liver abscess was found at a higher frequency in the Bi group (17.6%) than in the Uni group (1.5%) (P = 0.0266). There was no significant difference between the groups in the occurrence of two or more complications (P = 0.247), life-threatening severe complications (P = 0.0577), and stent obstruction by sludge (P = 0.0912).
Conclusions : When compared with bilateral biliary drainage, unilateral biliary drainage is associated with a lower incidence of liver abscess as well as a comparable outcome of stent patency time and complication-free survival. We therefore propose that hilar biliary obstruction can be treated first by unilateral drainage with a metallic stent and by bilateral drainage only in patients who develop cholangitis in the contralateral biliary tree.View full abstractDownload PDF (742K)
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[in Japanese], [in Japanese]2013 Volume 55 Issue 3 Pages 510-512
Published: 2013
Released on J-STAGE: May 21, 2013
JOURNAL FREE ACCESSDownload PDF (630K) -
[in Japanese]2013 Volume 55 Issue 3 Pages 513-515
Published: 2013
Released on J-STAGE: May 21, 2013
JOURNAL FREE ACCESSDownload PDF (567K)
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[in Japanese]2013 Volume 55 Issue 3 Pages 516
Published: 2013
Released on J-STAGE: May 21, 2013
JOURNAL FREE ACCESSDownload PDF (513K)
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