Obstruction and perforation of the intestine are uncommon but serious accidents after barium-X-ray examination, and rapid excretion of barium after the examination is very important to prevent such accidents. In order to certify the administration of purgative medicine after radiographic mass screening for gastric cancer, Miyagi Cancer Society used 130 cc of 200% high-concentration and low-viscosity barium combined with 1.0 cc, 0.5 cc or 0 cc of 0.75% picosulfate solution, respectively (in the case of 0 cc, 2 tablets of 12 mg Sennoside were prescribed for substitution). In addition, 4 other tablets of sennoside were prescribed to all participants as reserve medicines and the telephone consultations from the barium X-ray examinees concerning barium excretion, abdominal symptoms etc. were responded to by the doctors and nurses of our institute 24 hours a day. In 2013, 349 out of 186,887 examinees consulted our institue by telephone regarding the slow excretion and administration of reserve purgative medicines, and in 2014 the number of consultations decreased to 188 out of 182,147 examiness. There were no serious accidents caused by problematic barium excretion in 2013 and 2014. Strict management of barium excretion is desirable in radiographic mass screening with many senior participants.

View full abstract

We performed this study to clarify the current status of diagnosis and eradication therapy for Helicobacter pylori (H. pylori) infection in subjects who underwent mass screening for gastric cancer. Study subjects were a total of 20444 cases (males 12274, females 8170; mean age 56.7 years) who underwent X-ray gastric cancer mass screening by Shimane Environment and Health Public Corporation from April to September 2015. A past history of H. pylori diagnosis and its result were examined for all subjects. In addition, a past history of H. pylori eradication therapy and its result were investigated in cases with a positive result of H. pylori diagnosis. A total of 3886 cases (19.0%) had a past history of H. pylori diagnosis and its result showed that a positive rate of H. pylori infection was 63.7%. A positive rate in cases under 50 years was 60.2%, although higher positive rates were observed in study subjects in their 50s∼70s. Eradication therapy was performed in 89.6% of cases with a positive result of H. pylori infection, and a total of 10.5% of study subjects were in a post-eradicated condition. A strategy for patients who are diagnosed as having H. pylori positive gastritis by X-ray findings and who have not undergone an examination for H. pylori infection should be determined.

View full abstract

Objective: We assessed the amount of residual fluid and fecal residue, the effect of fecal tagging, and the diagnostic accuracy and acceptability of computed tomography colonography (CTC) after bowel preparation with polyethylene glycol electrolyte lavage solution with ascorbic acid (PEG+Asc), which is a novel bowel agent in Japan.
Material and Methods: This study was performed in 60 asymptomatic patients scheduled to undergo optical colonoscopy (OC) and CTC on the same day. Bowel preparations were 1300 ml of PEG+Asc and 60 ml of iodinated oral contrast on the day of the procedure. The residual fluid was evaluated according to its proportion to the maximal anteroposterior diameter of the colon segment. The residual feces were divided into two categories (<6 mm and 6 mm≤). The efficacy of tagging was evaluated by the attenuation value of the tagged fluid. The diagnostic accuracy of CTC for lesions ≥ 6 mm was compared with OC findings. The acceptability of bowel preparation was investigated with questionnaires using a visual analogue scale (VAS).
Results: The average of the residual fluid was under 50%, and 308 colon segments (85.6%) were clean of feces. The median density of fluid was more than 200HU in all segments. For lesions ≥ 6 mm, the per-patient sensitivity was 94.7%, and specificity was 90.2%. Patient acceptance was good.
Conclusion: We conclude that the PEG+Asc-based bowel preparation for CTC provides a high-quality preparation, diagnostic accuracy and good patient acceptance.

View full abstract