Purpose: We aimed to test if the increase in viscosity of semisolid contrast agent to 10,000 mPa・s reduce the frequency of gastroesophageal reflux with or without hiatal hernia.

Methods: The severity of hiatal hernia was classified into none, mild and severe at the time of percutaneous endoscopic gastrostomy (PEG) construction in 67 patients. Every 200 mL of a mixture of a contrast agent (Gastrografin^®, Bayer) and a gel-forming additive (Easygel^®, EN Otsuka) was bolus-infused into the stomach of these patients within 2 days of PEG construction. We observed the gastroesophageal reflux of contrast agent from the beginning of infusion to one minute after the end of the infusion. We compared with the results of the previous report1).

Results: The over all frequency of gastroesophageal reflux of contrast agent with 10,000 mPa・s (9/67) was significantly lower than that using contrast agent with 6,000 mPa・s (18/66). The frequency of gastroesophageal reflux in patients without hiatal hernia (3/37) or with moderate hiatal hernia (2/21) was significantly lower than that in patients with severe hiatal hernia (4/9).

Conclusion: The increase in viscosity of semisolid contrast agent to 10,000 mPa・s reduced the frequency of gastroesophageal reflux, however not enough in patients with severe hiatal hernia.

Objectives: To investigate the potential factors associated with improvement in oral intake function after PEG(percutaneous endoscopic gastrostomy).

Subject/Method: Sixteen patients were enrolled in this study and their swallowing function was assessed based on videofluoroscopic examination of swallowing(VF) appearances. The preoperative clinical parameters were analyzed by Student's t test and Chi square test.

Result: This analysis revealed that the swallowing function before PEG pharyngeal residue on epiglottis evaluated by VF was a significant independent determinant of improvement in oral intake function after PEG. P<0.049)

Conclusion: This study may lead to the suggestion that pharyngeal clearance is a clinical predictor for the improvement.

Objective: The purpose of this study was to clarify the clinical utility of fecal microbiota transplantation (FMT) to children with severe refractory UC.

Patients and methods: A single-center, descriptive study was undertaken between August 2015 and July 2017 at Okinawa Chubu Hospital. FMT was performed in four patients with refractory UC (2–14 years old) who had not responded to infliximab, cyclosporin, tacrolimus, or leukocytapheresis. Three of the patients were administered the FMT via elemental diet tubes, whereas the fourth received the FMT via colonoscopy. The following variables were evaluated using the patients' medical records: age, medication history, route of FMT administration, clinical course, PUCAI (Pediatric Ulcerative Colitis Activity Index) scores and FMT's complications.

Results: One patient experienced clinical remission for 24 months, and two patients experienced clinical remission for a few weeks. No severe complications occurred.

Conclusion: FMT appears to be safe for children with severe refractory UC. FMT may have utility as a temporizing induction therapy for severe refractory UC prior to the ultimately necessary step of surgery.