Nippon Shokakibyo Gakkai Zasshi
Online ISSN : 1349-7693
Print ISSN : 0446-6586
Volume 106, Issue 10
Displaying 1-13 of 13 articles from this issue
Review article
Monthly report; Progress in treatments for metastatic liver tumor
Round-table discussion; Progress in treatments for metastatic liver tumor
Original article
  • Masayo UEMURA, Noriyuki HORIKI, Shoko SUZUKI, Naoki ISHII, Yusuke IIZU ...
    2009 Volume 106 Issue 10 Pages 1466-1477
    Published: 2009
    Released on J-STAGE: October 15, 2009
    JOURNAL FREE ACCESS
    Background: Severe stenosis of gastrointestinal (GI) tract anastomosis often requires frequent treatment for restenosis. It can cause long-term poor quality of life.
    Aim: To investigate the effectiveness of the endoscopic incision method with an Insulation-Tipped (IT)-knife for cases of severe GI stenosis in which the condition of the area distal to the stricture is unknown.
    Methods: Endoscopic incisions with an IT-knife were performed in 6 cases of postoperative stenosis who underwent gastrojejunostomy (n=3), esophagogastrostomy (n=2), and ileocolestomy (n=1). The incisions were made in three or four directions.
    Result: In all cases, the incisions were successful, with no perforation. There was no severe complication excluding slight bleeding in one case. Because of sufficient incision, there was no restenosis for 20-40weeks after treatment.
    Conclusion: Endoscopic incision with an IT-knife is useful for severe postoperative stenosis.
    Download PDF (2185K)
  • Kenji FURUTA, Shunji ISHIHARA, Shuichi SATO, Tatsuya MIYAKE, Norihisa ...
    2009 Volume 106 Issue 10 Pages 1478-1487
    Published: 2009
    Released on J-STAGE: October 15, 2009
    JOURNAL FREE ACCESS
    The Izumo Scale is a new questionnaire for the assessment of quality of life of the patients with gastrointestinal symptoms comprehensively. The validity and reliability of the scale were verified in 170 patients with gastrointestinal symptoms. Spearman's rank correlation coefficient between the Izumo Scale and visual analog scale (VAS) showed a positive correlation of 0.581-0.753. Internal consistency was also good with Cronbach's coefficient alpha of 0.616-0.805. The reproducibility was good with an intra-class correlation coefficient of 0.755-0.887. The results suggest that the Izumo Scale may be useful as a disease-specific quality of life assessment scale for patients with gastrointestinal symptoms.
    Download PDF (1305K)
Case report
  • Satoru KAKIZAKI, Hideyuki SUZUKI, Takeshi ICHIKAWA, Ken SATO, Hitoshi ...
    2009 Volume 106 Issue 10 Pages 1488-1493
    Published: 2009
    Released on J-STAGE: October 15, 2009
    JOURNAL FREE ACCESS
    We recently encountered a case of autoimmune hepatitis whose symptoms worsened after switching from a brand name to a generic version of prednisolone. The patient was a 46-year-old woman. She was admitted because of elevation of alanine aminotransferase (ALT) levels during follow-up sessions. We diagnosed worsening of autoimmune hepatitis and increased the medication dose of prednisolone, which resulted in a quick normalization of serum ALT levels. When the prednisolone medication was switched from a brand name to a generic version, the serum ALT levels again increased. We concluded that switching from a brand name to generic version of the drug was one of reasons for the elevation in the serum ALT levels. Although most generic drugs are considered to be useful, it is important to carefully observe patients to confirm that an equivalent effect is obtained after switching from a brand name to a generic drug.
    Download PDF (729K)
  • Katsutoshi NAKANO, Shinya YAMASHITA, Itsuro SOMA, Nobuyasu HAYASHI, Na ...
    2009 Volume 106 Issue 10 Pages 1494-1499
    Published: 2009
    Released on J-STAGE: October 15, 2009
    JOURNAL FREE ACCESS
    A 52-year-old man was admitted for detailed examination of a mass with extensive calcification in the tail of the pancreas by fluoro-deoxy glucose-positron emission tomography/computed tomography (FDG-PET/CT). Abdominal CT and magnetic resonance imaging (MRI) findings showed a calcified tumor 5 cm in diameter with a smooth surface. The tumor mainly showed calcification at it center and a partially solid element around it margin which was enhanced in the early phase.
    With no definiture preoperative diagnossi, we performed distal pancreatectomy and splenectomy. Pathological and immunohistochemical studies revealed a nonfunctioning islet cell tumor with calcification.
    A nonfunctioning islet cell tumor with central calcification formation as it grew to a maximum diameter of 7 cm is rare. When diagnosing pancreatic tumors it must be kept in mind that some nonfunctioning islet cell tumors of the pancreas can show nontypical features such as calcification formation.
    Download PDF (1144K)
  • Tomofumi MIURA, Satoshi YAMADA, Gen MARUYAMA, Junichiro NAKAMURA, Tsut ...
    2009 Volume 106 Issue 10 Pages 1500-1507
    Published: 2009
    Released on J-STAGE: October 15, 2009
    JOURNAL FREE ACCESS
    A 28-year-old pregnant woman at 26 weeks and 2 days gestation visited a local outpatient clinic complaining of a tender abdominal mass. Examinations revealed an advanced gastric cancer with multiple liver, bone, lymph node metastasis and mesenteric dissemination, thus she was transferred to our division at 27 weeks and 1day-gestation. With her consent we decided to maintain her pregnancy until 28 weeks when the delivered fetus could be kept alive an incubator, avoiding the adverse effect on the fetus by anti-cancer chemotherapy to mother. Rapid fetus delivery by cesarean section was carried out at 28 weeks and 1day gestation, yielding a 958-gram baby. The mother complained of respiratory distress and suffered from lymphangitis carcinomatosa on the 3 postoperative day. We began combination chemotherapy with S-1 and paclitaxel (S-1 100 mg/day, 3 weeks on, 2 weeks off and paclitaxel 70 mg/day on 1, 8 and 15) was started on the 4th postoperative day. Although temporary regression of lymphangitis carcinomatosa was seen with a relief of symptoms, her condition deteriorated on the 24th days. The second course chemotherapy was started on the 28th days without any relief of symptoms. Her general status deteriorated and she died on the 33rd postoperative day.
    The association of pregnancy and gastric cancer is rare but such cases are often in an advanced clinical stage, with bad prognosis. It is necessary to determine the treatment strategy on the basis of comprehensive consideration of the status of both the mother and fetus. Upper gastrointestinal endoscopy when gastric cancer is suspected is recommended in any pregnant woman with long-term morning sickness.
    Download PDF (1055K)
  • Yuichi YASUNGA, Kengo NAGAI, Noriko MATSUURA, Takuo YAMAI, Minori IKEZ ...
    2009 Volume 106 Issue 10 Pages 1508-1515
    Published: 2009
    Released on J-STAGE: October 15, 2009
    JOURNAL FREE ACCESS
    A 48-year-old woman with iron deficiency anemia (Hb 8.1 g/dl) and Helicobacter pylori (H. pylori)-associated enlarged fold gastritis underwent successful H. pylori eradication. Hemoglobin, serum iron concentrations, and other indices of iron deficiency anemia reached almost normal levels 10 to 16 months after the first eradication treatment. Iron absorption tests and measurements of basal acid output were performed before and after eradication therapy. Iron absorption almost doubled within 3.5 months, whereas basal acid output was nothing but it increased after 15 months. Therefore, it was suggested that the increase in iron absorption was possibly involved in improvement of iron deficiency anemia after H. pylori eradication therapy. Furthermore, it was also suggested that mechanisms other than increase in acid secretion might be involved in increase in iron absorption.
    Download PDF (669K)
  • Teiichiro HONDA, Naohiko MAKINO, Nakao SHIRAHATA, Tomohiro TOZAWA, Yus ...
    2009 Volume 106 Issue 10 Pages 1516-1523
    Published: 2009
    Released on J-STAGE: October 15, 2009
    JOURNAL FREE ACCESS
    A 67-year-old woman presented with a chief complaint of malaise. CT showed a pancreatic head tumor 5 cm in diameter with calcification. It also showed multiple liver metastases and bile duct dilatation. Esophagogastroduodenoscopy showed deformation and stenosis on the superior and inferior side of the duodenal angle due to a papillary tumor. Thus, retrograde insertion of an endoscope was difficult, and a diagnosis of a carcinoid tumor was obtained by biopsy. After disclosing the diagnosis to the patient, we explained the necessity of treatment. However, the patient refused all proposed treatments, and therefore, we merely provided treatment of her symptom. The patient died of liver failure approximately 3 months later. At autopsy, multiple neurofibromas and café-au-lait spots were observed on the body surface. The tumor was a carcinoid tumor with distant metastases which originated from the duodenal papillary area. On histopathological examination, there were psammoma bodies in neoplastic cells and production of somatostatin. There were also stromal amyloid deposits. We report here a valuable case of carcinoid tumor with type 1 neurofibromatosis accompanied with amyloid deposits.
    Download PDF (1570K)
  • Hiroki TAKAHASHI, Nobuyuki CHIDA, Kenji KIMURA, Yoko YAMAO, Kaori SHIO ...
    2009 Volume 106 Issue 10 Pages 1524-1530
    Published: 2009
    Released on J-STAGE: October 15, 2009
    JOURNAL FREE ACCESS
    In this report, we present a rare case of Ewing's sarcoma with a peripheral primitive neuroectodermal tumor (ES/pPNET) arising from the abdominal cavity in a 20-year-old woman. The patient complained of upper abdominal pain. Radiological imaging showed a 15-cm mass penetrating to the proxymal jejunum in the upper abdominal cavity and peritoneal disseminations. Immunohistochemical studies revealed that the tumor was ES/pPNET. Although the patient underwent radiation therapy, she died of the disease two months after diagnosis. ES/pPNET in the abdominal cavity is extremely rare and our case showed aggressive behavior and an unfortunate outcome.
    Download PDF (1051K)
feedback
Top