All issues
Volume 62 (2020)
- Issue 12 Pages 3029-
- Issue 11 Pages 2929-
- Issue 10 Pages 2255-
- Issue 9 Pages 1575-
- Issue 8 Pages 1455-
- Issue 7 Pages 751-
- Issue 6 Pages 647-
- Issue 5 Pages 527-
- Issue 4 Pages 439-
- Issue 3 Pages 309-
- Issue 2 Pages 135-
- Issue 1 Pages 1-
- Issue Supplement3 Pag･･･
- Issue Supplement2 Pag･･･
- Issue Supplement1 Pag･･･
Volume 50 (2008)
- Issue 12 Pages 2987-
- Issue 11 Pages 2805-
- Issue 10 Pages 2665-
- Issue 9 Pages 2443-
- Issue 8 Pages 1699-
- Issue 7 Pages 1557-
- Issue 6 Pages 1427-
- Issue 5 Pages 1289-
- Issue 4 Pages 1079-
- Issue 3 Pages 323-
- Issue 2 Pages 189-
- Issue 1 Pages 1-
- Issue Supplement3 Pag･･･
- Issue Supplement2 Pag･･･
- Issue Supplement1 Pag･･･
Volume 56, Issue 3
Displaying 1-15 of 15 articles from this issue
- |<
- <
- 1
- >
- >|
-
Itaru NAITOH, Hirotaka OHARA, Takahiro NAKAZAWA, Kazuki HAYASHI, Takas ...2014 Volume 56 Issue 3 Pages 433-442
Published: 2014
Released on J-STAGE: April 02, 2014
JOURNAL FREE ACCESSIgG4-related sclerosing cholangitis (IgG4-SC) is a sclerosing cholangitis characterized by increased levels of serum IgG4, dense infiltration of IgG4-positive plasma cells in the bile duct wall, and a good response to steroid therapy. The concept of IgG4-SC recently has been recognized as that of IgG4-related diseases, and the Clinical Diagnostic Criteria of IgG4-SC 2012 was established in Japan. The diagnosis of IgG4-SC is based on the combination of the following 4 criteria : (1) characteristic biliary imaging findings, (2) elevation of serum IgG4 concentrations, (3) coexistence of IgG4-related diseases except for those of the biliary tract, and (4) characteristic histopathological features. Primary sclerosing cholangitis, cholangiocarcinoma and pancreatic cancer are very important diseases to consider in the differential diagnosis of IgG4-SC. Endoscopic retrograde cholangiopancreatography, biliary intraductal ultrasonography, endoscopic ultrasonography and colonoscopy are useful modalities for the acquisition of images. Endoscopic bile duct biopsy and endoscopic ultrasonography-guided fine-needle aspiration are useful modalities for endoscopic biopsy procedures. We review endoscopic procedures in the diagnosis of IgG4-SC on the basis of Clinical Diagnostic Criteria of IgG4-SC 2012.View full abstractDownload PDF (1478K)
-
Masashi NOZAKI, Akihiro MORI, Astuo YOSHIDA, Shintaro HAYASHI, Nobutos ...2014 Volume 56 Issue 3 Pages 443-450
Published: 2014
Released on J-STAGE: April 02, 2014
JOURNAL FREE ACCESSBackground : Percutaneous endoscopic gastrostomy (PEG) with transnasal endoscopy has been reported to be a safe method. However, limited information is available on which PEG method is the most suitable. Our aim was to compare safety between the modified introducer (I) method and the pull (P) method in PEG with transnasal endoscopy.
Patients and methods : Patients with indications for PEG were prospectively randomly assigned into two groups : I method and P method. Patients in both groups underwent PEG with a button-type catheter of the same diameter (24 Fr) by transnasal endoscopy. We evaluated hemodynamic changes (blood pressure, heart rate, peripheral blood oxygen saturation) and complications (pneumoperitoneum, intraoperative and postoperative hemorrhage and peristomal infection). The primary outcome was to evaluate the frequency of complications.
Results : Ninety-nine patients were enrolled (I method : 49 patients, P method : 50 patients). Procedures were successful in all patients. There were no significant differences between the two groups in patients' background and hemodynamic changes. However, the frequency of pneumoperitoneum was significantly higher in the I method group than in the P method group (p<0.05). Furthermore, one death occurred in the I method group, which may have been caused by massive pneumoperitoneum.
Conclusion : The frequency of pneumoperitoneum was higher in the I method group. Therefore, attention should be paid when selecting the PEG method for patients at risk for hemodynamic changes and pulmonary problems caused by pneumoperitoneum.View full abstractDownload PDF (1082K)
-
Kazutoshi YAMADA, Kazuya KITAMURA, Kouki NIO, Tetsuro SHIMAGAMI, Kunia ...2014 Volume 56 Issue 3 Pages 451-456
Published: 2014
Released on J-STAGE: April 02, 2014
JOURNAL FREE ACCESSWe report a 57-year-old male with esophageal varices who had difficulty in hemostasis after endoscopic injection sclerotherapy (EIS). Laboratory data revealed a decrease in blood clotting, a dissociation in prothrombin activity with the hepaplastin test results, and a significant reduction in factor V (FV) activity. Therefore, we made the diagnosis of an acquired FV inhibitor. Since the patient had no unusual bleeding at the time of diagnosis, we provided careful observation with no particular treatment. Subsequently we confirmed that there was an improvement in blood clotting and a decrease in the FV inhibitor titer. We report a case of acquired FV deficiency caused by EIS, which is extremely rare.View full abstractDownload PDF (1138K) -
Hirokazu TSUJI, Masashi KUMAGAI, Yuuki INADA, Masako KOBAYASHI, Takehi ...2014 Volume 56 Issue 3 Pages 457-464
Published: 2014
Released on J-STAGE: April 02, 2014
JOURNAL FREE ACCESSHere we describe the case of a 78-year-old man taking iron supplements for iron deficiency anemia who presented with dizziness and shock following gastrointestinal hemorrhage. The source of bleeding could not be identified by upper and lower endoscopy or computed tomography. Because ileal small ulcers were detected by video capsule endoscopy (CE) at another hospital, CE was reperformed. CE revealed an annular ulcer in the upper jejunum and double-balloon endoscopy (DBE) revealed a large diverticulum in the upper part of the jejunum with an ulcer in the diverticular ostia. Large jejunal diverticulosis was diagnosed, and the diverticulum was resected. The lesion was pathologically diagnosed as a jejunal duplication cyst. The postoperative course was uneventful, and the patient had no further episodes of bleeding or anemia. Detection of intestinal diverticulum, including jejunal duplication cysts, is difficult prior to surgery ; however, the combination of CE and DBE is a useful examination, thus enabling precise preoperative diagnosis of a jejunal diverticulum.View full abstractDownload PDF (3042K) -
Hiroshi SUITO, Yuji YAMAMOTO, Hajime TANAKA, Shinichiro SHIMIZU2014 Volume 56 Issue 3 Pages 465-470
Published: 2014
Released on J-STAGE: April 02, 2014
JOURNAL FREE ACCESSWe herein describe a case of schwannoma of the ascending colon in a 44-year-old male. After bleeding from a colon diverticulum, the patient underwent colonoscopy. He was found to have a 20-mm flat type tumor in the ascending colon classified as Group 1 according to examination of a biopsy specimen. On follow-up endoscopy, the shape of the tumor had changed from a flat lesion into a clearly elevated lesion with a hollow area and raised perimeter. We were therefore unable to exclude a diagnosis of malignancy. Laparoscopic right colectomy was performed. The histopathological diagnosis was a schwannoma of the ascending colon. Schwannomas of the colon are rare, and there have been no reports of cases involving such changes in form as observed in our case although there have been reports of cyst formation.View full abstractDownload PDF (2241K) -
Masaki YAMADA, Masahiko SATOU, Suguru WATABE, Naoki NEGAMI, Tetsuya SA ...2014 Volume 56 Issue 3 Pages 471-476
Published: 2014
Released on J-STAGE: April 02, 2014
JOURNAL FREE ACCESSA 73-year-old male underwent FDG-PET to investigate his chief complaint of discomfort in the left lower abdominal quadrant. Enhanced uptake of FDG was evident in the descending colon. After colonoscopy was performed, a diagnosis of a submucosal tumor was made. Since the possibility of malignant disease could not be refuted, partial laparoscopic resection of the colon was performed based on results of diagnostic imaging. Histopathologic examination showed that the tumor consisted of increased spindle-shaped cells in disarray. Immunohistochemically, the cells exhibited positivity for S-100 protein, α-SMA and c-kit in the absence of CD34. The tumor was diagnosed as a primary descending colon schwannoma, and there were no malignant findings. Herein, we report our experience of a case of descending colon schwannoma in which FDG-PET showed enhanced uptake.View full abstractDownload PDF (4228K) -
Kei YANE, Hiroyuki MAGUCHI, Manabu OSANAI, Kuniyuki TAKAHASHI, Akio KA ...2014 Volume 56 Issue 3 Pages 477-483
Published: 2014
Released on J-STAGE: April 02, 2014
JOURNAL FREE ACCESSA 53-year-old woman had undergone pancreaticoduodenectomy (SSPPD-IIA) for an intraductal papillary mucinous neoplasm (IPMN) in November 2009. Nineteen months after the surgery, abdominal CT showed a dilated remnant main pancreatic duct and a small soft tissue density mass. Findings suggested a pancreaticojejunal anastomosis stricture or a recurrent IPMN. Subsequently, the patient was admitted to our hospital with acute pancreatitis. We tried to observe the pancreaticojejunal anastomosis using a prototype short single-balloon enteroscope (Short SBE). However, the first attempt at ERCP was unsuccessful due to difficulty in finding the anastomotic site. In a second attempt 25 months after the surgery it was possible to find the anastomosis using a Short SBE with a transparent hood. We performed balloon dilatation of the anastomotic stricture and removed white protein plugs. The filling defects in the main pancreatic duct disappeared following pancreatography, and it was decided that there was no apparent tumor recurrence. During the following 14 months, no recurrence of the IPMN or pancreatitis has occurred. ERCP using Short SBE is a useful option for the management of a pancreaticojejunal anastomosis stricture.View full abstractDownload PDF (1617K)
-
Takuji GOTODA, Chika KUSANO, Nobuo YAMADA, Masaharu HASHIMOTO, Fuminor ...2014 Volume 56 Issue 3 Pages 484-489
Published: 2014
Released on J-STAGE: April 02, 2014
JOURNAL FREE ACCESSA variety of diseases often lead to impaired swallowing abilities in the elderly. Indications for selecting individuals for percutaneous endoscopic gastrostomy (PEG) remain unclear. The aim of this study was to investigate the validity of PEG placement in elderly patients performed at a local community hospital in Japan. The medical records of 481 consecutive patients aged 65 and older who underwent PEG were retrospectively reviewed. Cerebrovascular diseases were found to be the most common among the underlying diseases (48.2%). The majority of patients were unable to consent on their own to PEG placement. Among 220 individuals who died after PEG placement (median 7 months), the 1-year survival rate was 60.1%. PEG placement in elderly patients with dementia in an end-of-life care setting who cannot consent to PEG might be decided without actual benefit to such patients. A debate over indications for and issues of human dignity related to this procedure needs to be immediately initiated throughout the entire nation. There are several limitations to this study. This was a single center and case-series study. However, it is difficult to conduct a randomized controlled study in this field. Despite these limitations, we have to initiate an argument in order to arrive at a reasonable agreement regarding this issue.View full abstractDownload PDF (722K)
-
[in Japanese], [in Japanese], [in Japanese]2014 Volume 56 Issue 3 Pages 490-491
Published: 2014
Released on J-STAGE: April 02, 2014
JOURNAL FREE ACCESSDownload PDF (1042K)
-
[in Japanese], [in Japanese], [in Japanese]2014 Volume 56 Issue 3 Pages 492-493
Published: 2014
Released on J-STAGE: April 02, 2014
JOURNAL FREE ACCESSDownload PDF (1421K)
-
Kiyotaka OKAWA, Tetsuya AOKI, Wataru UEDA, Hiroko OHBA, Koji SANO, Hir ...2014 Volume 56 Issue 3 Pages 494-503
Published: 2014
Released on J-STAGE: April 02, 2014
JOURNAL FREE ACCESSMucosal prolapse syndrome (MPS) is a group of diseases caused by occult and obvious mucosal prolapse with fibromuscular obliteration determined histologically. The endoscopic appearance of MPS varies (polypoid type, ulcerative type and flat type), and a differential diagnosis for cancer and other inflammatory bowel diseases is necessary. Almost all large polypoid types of MPS have an irregular surface, erosions and sloughs mimicking rectal cancer. If the rectal lesion is diagnosed as MPS endoscopically or clinically without fibromuscular obliteration determined from a biopsy specimen, a large specimen obtained by polypectomy, endoscopic mucosal resection or transanal local resection is necessary to demonstrate fibromuscular obliteration histologically. If MPS is misdiagnosed as rectal cancer, there is a possibility that an unnecessary operation will be performed. The flat type of MPS is classified according macular redness just above the anus and circular redness on the Houston valve. If these findings are not recognized, a differential diagnosis is necessary for other inflammatory bowel diseases.View full abstractDownload PDF (10336K) -
Kazumichi KAWAKUBO, Hiroshi KAWAKAMI, Hiroyuki ISAYAMA, Naoya SAKAMOTO2014 Volume 56 Issue 3 Pages 504-514
Published: 2014
Released on J-STAGE: April 02, 2014
JOURNAL FREE ACCESSThe endoscopic ultrasound (EUS)-guided rendezvous technique was reported to be a useful salvage method for patients with failed cannulation. In such patients, after bile duct puncture under EUS guidance, cholangiography was obtained. Then the guidewire was inserted through the needle into the bile duct and further antegradely advanced through the papilla into the duodenum. The echoendoscope was removed leaving the guidewire in place, followed by duodenoscope insertion. Finally, the bile duct was cannulated alongside of the guidewire or over the guidewire. The EUS-guided rendezvous technique is a complicated procedure and not yet standardized due to the absence of dedicated devices. However, the EUS-guided rendezvous technique allows reliable bile duct cannulation because of bile duct access under ultrasonographic guidance compared to conventional retrograde bile duct cannulation using the ERCP technique. However, the possibility of serious complications, such as bile leak or peritonitis, should be of concern due to bile duct access through the peritoneum or retroperitoneum. To gain familiarity with various approach routes in the EUS-guided rendezvous technique is essential for a successful procedure.View full abstractDownload PDF (5888K)
-
Takeshi YAMASHINA, Ryu ISHIHARA, Noriya UEDO, Kengo NAGAI, Fumi MATSUI ...2014 Volume 56 Issue 3 Pages 515-521
Published: 2014
Released on J-STAGE: April 02, 2014
JOURNAL FREE ACCESSBackground and Aim : Limited data are available regarding the use of endoscopic submucosal dissection (ESD) for superficial esophageal cancers ≥50 mm in diameter. The aim of the present study was to investigate the safety and success of ESD for superficial esophageal cancers ≥50 mm.
Methods : A total of 39 patients with superficial esophageal squamous cell carcinoma ≥50 mm were treated with ESD at Osaka Medical Center for Cancer and Cardiovascular Diseases between January 2004 and April 2011, and were analyzed in a retrospective study.
Results : En bloc resection was achieved in all patients. One mediastinal emphysema without perforation occurred during the procedure. Stricture developed in 11 of 39 patients, requiring a median of five endoscopic balloon dilatation procedures. Thirty-three clinical epithelial or lamina propria mucosal cancers were treated by ESD with curative intent, of which invasion into the muscularis mucosa or deeper was detected in seven and lymphovascular involvement in three. The en bloc resection rate was 100% with a tumor-free margin achieved in 92% of lesions. The curative resection and complication rates during ESD were 70% and 2.5%, respectively.
Conclusion : ESD achieved a high en bloc resection rate of 92% with a tumor-free margin. Curative resection rate of ESD in patients with clinical epithelial or lamina propria mucosal cancers was not low at 70%. However, the risk of stricture must be taken into account when considering the use of ESD in lesions ≥50 mm.View full abstractDownload PDF (2171K)
-
[in Japanese]2014 Volume 56 Issue 3 Pages 522-524
Published: 2014
Released on J-STAGE: April 02, 2014
JOURNAL FREE ACCESSDownload PDF (608K)
-
[in Japanese]2014 Volume 56 Issue 3 Pages 525
Published: 2014
Released on J-STAGE: April 02, 2014
JOURNAL FREE ACCESSDownload PDF (500K)
- |<
- <
- 1
- >
- >|