Nippon Shokakibyo Gakkai Zasshi
Online ISSN : 1349-7693
Print ISSN : 0446-6586
Volume 104, Issue 8
Displaying 1-12 of 12 articles from this issue
Review article
Monthly report; Pathophysiology and natural history of inflammatory bowel disease
Original article
  • Katsunobu OYAMA, Takashi FUJIMURA, Itasu NINOMIYA, Tomoharu MIYASHITA, ...
    2007 Volume 104 Issue 8 Pages 1183-1191
    Published: 2007
    Released on J-STAGE: August 06, 2007
    JOURNAL FREE ACCESS
    The aim of this study is to investigate the cyclooxygenase (COX)-2 expression in esophageal epithelium of rat duodenoesophageal reflux model and the effect of a selective COX-2 inhibitor on esophageal adenocarcinogenesis in rats. A series of rats underwent a duodenoesophageal reflux procedure and were divided into 2 groups. One group was given commercial chow (control group), and the other group was given experimental chow containing nimesulide, a selective COX-2 inhibitor (nimesulide group). The animals were sacrificed sequentially after surgery and esophageal examinations were performed. In the control group, esophagitis, Barrett's esophagus (BE) and adenocarcinoma (EAC) were observed, and the frequency of these conditions increased with time. COX-2 expression, PGE2 level and proliferative activity were up-regulated, predominantly in the inflamed esophageal epithelia, from the 10th week. In the nimesulide group, the esophagitis was mild and the frequency of BE was significantly lower than the control group, while EAC was not observed throughout the experiment. PGE2 level and proliferative activity were lower in the nimesulide group than in the control group. COX-2 may play an important role in esophageal carcinogenesis through the activation of the inflammation-metaplasia-adenocarcinoma sequence. Nimesulide is effective in preventing BE and EAC by suppressing COX-2 activity.
    Download PDF (837K)
  • Akinari TABARU, Hidehiko MATSUOKA, Satoru MAEKAWA, Misa SHIMADA, Ryoic ...
    2007 Volume 104 Issue 8 Pages 1192-1203
    Published: 2007
    Released on J-STAGE: August 06, 2007
    JOURNAL FREE ACCESS
    Although many workers suffer from chronic hepatitis, the influence of labor on its clinical course is not clear. We prospectively followed 89 workers with chronic hepatitis for 3 years, and examined the relationship between job-related factors, such as job class, job type, working hours and work effort, and the liver function test. There were no job-related factors that had any influence on the activity of hepatitis. Moreover, no significant relationship was found between job-related factors, including tiredness, and the acute exacerbation of hepatitis. No significant changes of aminotransferase levels and of platelet counts divided by each job-related factor were found during the observation period, but the platelet counts decreased in workers with acute exacerbation, but without clinical significance. These results suggest that job-related factors have little influence on the clinical course of chronic hepatitis during a relatively short observation period.
    Download PDF (792K)
Case Report
  • Toshihiro GOTO, Hirotsugu WATABE, Takayuki KAWAKAMI, Masashi WATANABE, ...
    2007 Volume 104 Issue 8 Pages 1204-1211
    Published: 2007
    Released on J-STAGE: August 06, 2007
    JOURNAL FREE ACCESS
    A 63-year-old man visited our hospital with complaints of the chest pain and loss of appetite. A computed tomography of chest showed wall thickening in the lower portion of the esophagus and carinal and para-aorta lymph node swelling. Upper gastrointestinal endoscopy revealed an irregular ulcerated lesion in the middle portion of the esophagus, which was pathologically diagnosed as small cell carcinoma. A computed tomography of the abdomen showed multiple liver metastases and para-aortic, cardiac, and common hepatic arterial lymph node swelling. One course of combined chemotherapy with CPT-11 and CDDP, then 3 courses of chemotherapy with CPT-11 showed clinical complete remission.
    Download PDF (822K)
  • Daisuke NISHIYA, Tatsuya MIKAMI, Shinsaku FUKUDA, Norihiro HANABATA, S ...
    2007 Volume 104 Issue 8 Pages 1212-1217
    Published: 2007
    Released on J-STAGE: August 06, 2007
    JOURNAL FREE ACCESS
    A 79-year-old man was admitted our hospital because of severe abdominal fullness. An abdominal ultrasonography showed a large amount of ascites, and diagnostic puncture detected chylous ascites. An abdominal computed tomography revealed a large amount of ascites and a multinodular mass with calcification in the mesentery of the small intestine. An infectious disease, such as tuberculosis, or malignant tumor was suspected to be the causative disease, but there was no diagnostic evidence in further examinations. Based on clinical features, imaging data and chylous ascites, we searched for case reports and found two similar cases of mesenteric panniculitis. Mesenteric panniculitis was highly suspected in this case, however, histopathological examination was rejected by patient. Therefore, we treated with steroid therapy, which had been reported as effective therapy, and the ascites decreased without recurrence.
    Download PDF (550K)
  • Yasuhisa FUJINO, Yoshihiro INOUE, Makoto ONODERA, Nobuhiro SATO, Shige ...
    2007 Volume 104 Issue 8 Pages 1218-1224
    Published: 2007
    Released on J-STAGE: August 06, 2007
    JOURNAL FREE ACCESS
    A 67-year-old woman underwent distal gastrectomy (Billroth type II reconstruction) for gastric ulcer perforation in March, 2001. In October of the same year, she was admitted to our hospital with a diagnosis of acute afferent loop syndrome with severe acute pancreatitis. The patient was successfully treated by endoscopic decompression of the afferent loop, followed by continuous drainage. Combined use of decompression and percutaneous abscess drainage was effective for the management of the retroperitoneal abscess. The most common treatment strategy employed for acute afferent loop syndrome is surgical therapy, however, the experience in this patient suggests that endoscopic drainage, which is less invasive, may also be considered.
    Download PDF (669K)
  • Kazuta FUKUMORI, Yoichi YANO, Koutaro KUWAKI, Shuji SUMIE, Eiji ANDO, ...
    2007 Volume 104 Issue 8 Pages 1225-1230
    Published: 2007
    Released on J-STAGE: August 06, 2007
    JOURNAL FREE ACCESS
    A 64-year-old man was admitted for further examinations of a liver tumor. The patient was diagnosed as chronic hepatitis C complicated with advanced hepatocelluar carcinoma (HCC) with left portal vein tumor thrombosis. As he refused surgical treatment, hepatic arterial infusion chemotherapy (HAIC) using cisplatin and 5-fluorouracil was performed initially. Administration of ursodesoxycholic acid (UDCA) was also started. Following HAIC, microwave coagulation therapy for residual tumor was added. Consequently, viable lesions of HCC disappeared completely. At present, after more than 8 years, neither signs of tumor recurrence, nor elevation of hepatic enzymes has been observed. Although the precise reason for long survival of this patient is not known, we speculate that suppression of levels of hepatic enzymes, as well as HAIC for subclinical intrahepatic metastasis, contributed to the good outcome. Therapeutic strategy for hepatic inflammation seems to be important for long-term prevention of hepatocarcinogenesis.
    Download PDF (597K)
  • Eriko INOMATA, Tetsuro SOHDA, Hidetoshi NAKANE, Daisuke MORIHARA, Osam ...
    2007 Volume 104 Issue 8 Pages 1231-1235
    Published: 2007
    Released on J-STAGE: August 06, 2007
    JOURNAL FREE ACCESS
    A 57 year-old woman was admitted to our hospital because of large hepatocellular carcinoma (HCC). Laboratory data showed hypercholesterolemia, thrombocytosis and hypoglycemia. Based on several examinations and the clinical course, we diagnosed HCC with paraneoplastic syndrome. It is rare that 3 paraneoplastic phenomena occur in a patient with HCC. In particular, paraneoplastic thrombocytosis is very rare in paraneoplastic syndrome associated with HCC.
    Download PDF (360K)
  • Sho TAKAHASHI, Hisato HOMMA, Takehide AKIYAMA, Shinichi MESAWA, Kenich ...
    2007 Volume 104 Issue 8 Pages 1236-1244
    Published: 2007
    Released on J-STAGE: August 06, 2007
    JOURNAL FREE ACCESS
    A 75-year-old man had been admitted to another hospital because of left abdominal pain, and was given a diagnosis of left hydronephrosis and acute pancreatitis. After a JJ stent insertion and medication, he was transferred to our hospital for further examinations. US and EUS revealed a chronic pancreatitis-like pattern and multicystic lesion in the pancreas head and body. At that time enhanced CT findings showed an extrapancreatic low density area to be inflammatory change, extending from the pancreas body to the left crus of the diaphragm and posteriorly the spreading from the left crus of the diaphragm via the left urinary duct into the left iliopsoas muscle, in which MRI revealed partial high intensity. ERCP and MRCP showed focal irregular narrowing of the pancreatic duct of unknown cause, and we decided that an internal pancreatic fistula due to pancreatitis had induced left ureteral obstruction, caused by a protein plug or alcohol. Follow-up 6 months later showed that extrapancreatic spreading of the low density area had markedly regressed without any change in the ureteral obstruction.
    Download PDF (746K)
TTT(Train the Trainers)
feedback
Top