Nippon Shokakibyo Gakkai Zasshi
Online ISSN : 1349-7693
Print ISSN : 0446-6586
Volume 107, Issue 2
Displaying 1-12 of 12 articles from this issue
Review article
Monthly report; Clinical feature of gastroenterology in community-based medicine
Case report
  • Takaharu ICHI, Hiroshi SHIROMA, Kyoko ARAKAKI, Tsutomu ISA
    2010 Volume 107 Issue 2 Pages 227-232
    Published: 2010
    Released on J-STAGE: February 05, 2010
    JOURNAL FREE ACCESS
    A 60-year-old man was admitted to our hospital with a tumor in the thoracic esophagus, and squamous cell carcinoma was detected by endoscopic biopsy. On computed tomography, the tumor was suspected of having invaded adjacent organs by so the patient was given neoadjuvant chemotherapy consisting of low-dose CDDP and 5-FU. After 2 courses of chemotherapy, a subtotal esophagectomy was performed. The resected specimen showed no residual squamous cell carcinoma but another tumor was found in the submucosal layer which had a cribiform pattern in a solid nest. The tumor cells were positive for S-100 protein and an Alcian-blue-positive substance in the gland, so the tumor was diagnosed as an adenoid-cystic carcinoma.
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  • Ken-ichi TAKAHASHI, Yuji FUNAYAMA, Hiromi TOKUMURA, Shigeru TANDA, Hir ...
    2010 Volume 107 Issue 2 Pages 233-240
    Published: 2010
    Released on J-STAGE: February 05, 2010
    JOURNAL FREE ACCESS
    The patient was a 75-year-old woman who had undergone resection of a transverse colon cancer two years before. She had anemia and intestinal obstruction, and a diagnosis of multiple metastases to the small intestine was made by double balloon enteroscopy. Eleven metastatic foci were resected by partial resection of the jejunum and ileum. Adjuvant FOLFOX chemotherapy was given, achieving a 26-month disease-free survival. The double balloon enteroscopy was useful in the definitive diagnosis of this case, and aggressive resection with adjuvant chemotherapy contributed to the good outcome.
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  • Fukiko KAWAI, Satoshi OTANI, Tomohiko SANO, Misa MIZUMORI, Hitoshi KUR ...
    2010 Volume 107 Issue 2 Pages 241-247
    Published: 2010
    Released on J-STAGE: February 05, 2010
    JOURNAL FREE ACCESS
    A 52-year-old man underwent abdominoperineal resection of the rectum, a partial hepatectomy, and intrahepatic arterial infusion chemotherapy for rectal cancer and liver metastases in 2001. Due to recurrent liver metastases, additional hepatectomies were performed in 2003 and 2005. He then underwent radiofrequency ablation therapy and systemic chemotherapies with mFOLFOX6 and FOLFORI. In July 2007, positron emission tomography (PET) and computed tomography (CT) revealed a high level of 18F-fluorodeoxyglucose (FDG) accumulation in the liver. After 6 cycles of chemotherapy with bevacizumab plus mFOLFOX6, the FDG accumulation disappeared. The multidisciplinary therapy was effective, yielding long term survival of over 8 years.
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  • Tateki YAMANE, Sunao AKIYAMA, Takayuki ISHII, Toru FURUYA, Kan UCHIYAM ...
    2010 Volume 107 Issue 2 Pages 248-256
    Published: 2010
    Released on J-STAGE: February 05, 2010
    JOURNAL FREE ACCESS
    A 47-year-old man presented with an abnormality of the duodenum detected on a health check endoscopy. Further endoscopy revealed swelling of the papilla of Vater with a whitish exudate and surrounding small nodules, which biopsy revealed to be non-caseating granulomas. Colonoscopy showed typical tubercular lesions in the colon on the right side, so we speculated that the lesions of the papilla of Vater were tubercular. After the administration of anti-tubercular drugs, both the duodenal lesion and the colonic lesions improved. Therefore, the papilla of Vater lesion was diagnosed as tubercular, although such cases are extremely rare.
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  • Jo UNOTORO, Eishin NONAKA, Naohito TAKITA, Yoshimasa SUZUKI
    2010 Volume 107 Issue 2 Pages 257-262
    Published: 2010
    Released on J-STAGE: February 05, 2010
    JOURNAL FREE ACCESS
    Recently, the antipruritic activity of the selective serotonin reuptake inhibitor paroxetine has been reported. We report 3 patients with severe cholestatic pruritus due to gastrointestinal malignancy. All of them were successfully treated with 10 mg oral paroxetine. The onset of the antipruritic action of paroxetine was observed at from several hours-two days. Paroxetine seems to be an effective, well-tolerated treatment for cholestatic pruritus due to gastrointestinal malignancy.
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  • Koichi SHINOTO, Masahiko OZAKI, Seiji YOSHIMURA, Takamitsu ARIGA
    2010 Volume 107 Issue 2 Pages 263-269
    Published: 2010
    Released on J-STAGE: February 05, 2010
    JOURNAL FREE ACCESS
    Primary hepatic actinomycosis is relatively rare, but it should be remembered in the differential diagnosis of liver masses. A 66-year-old woman with right hypochondralgia was admitted and for detailed examination and treatment of a liver tumor. Abdominal ultrasonography revealed a hypoechoic lesion 55 mm in diameter in the anterior segment. Enhanced CT showed a deep-stained tumor in the early phase and a low density area in the late phase. The feeding arteries were the right hepatic artery and right inferior phrenic artery on abdominal angiography. The patient was given a diagnosis of hepatocellular carcinoma with invasion of the inferior lobe of the right lung. We performed a central bisegmentectomy of the liver and partial resection of the inferior lobe of the right lung. Microscopic findings of the resected specimen revealed sulfur granules and the tumor was diagnosed as primary hepatic actinomycosis.
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  • Kazuo KIRIYAMA, Takeo USUI, Tadaharu TAKEMURA, Koichiro IKEDA, Hiroshi ...
    2010 Volume 107 Issue 2 Pages 270-277
    Published: 2010
    Released on J-STAGE: February 05, 2010
    JOURNAL FREE ACCESS
    A 54-year-old woman suffered acute hepatitis after she acquired cystitis. Laboratory results on admission showed: AST 925, ALT 1171, ALP 623, γ-GTP127 IU/l, T-Bil 5.0 mg/dl, antinuclear antibodies negative, smooth muscle antibodies 80, antimitochondrial antibodies (AMA) 80, antimitochondrial M2 antibody (AMA-M2) 117 index, IgG 2210 mg/dl. She also had HLA-DR4 and HLA-DR8. Histological study of a liver biopsy specimen suggested that she had autoimmune hepatitis rather than primary biliary cirrhosis. When prednisolone was administered, her liver function immediately improved and AMA and AMA-M2 levels fell to 20 and 52 respectively. However when cystitis recurred 4 months later, her liver function worsened. Laboratory findings showed AST 174, ALT 183 IU/l. Upon increasing the dosage of prednisolone, her liver function improved again. After the recurrence of hepatitis, AMA and AMA-M2 levels increased to 320 and 149 respectively. We speculate that the urinary tract infection triggered an autoimmune response and her genetic predisposition also played a crucial role in the process.
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  • Kyoko KUMAGAI, Masaya TAMANO, Kazuo KOJIMA, Chizu MAEDA, Keiichi TOMIN ...
    2010 Volume 107 Issue 2 Pages 278-284
    Published: 2010
    Released on J-STAGE: February 05, 2010
    JOURNAL FREE ACCESS
    A 16-year-old girl had been given a diagnosis of systemic lupus erythematosus (SLE) at age 4, and a diagnosis of nephrotic syndrome caused by lupus nephritis at age 9. Medical treatment began with steroids from age 4. She developed acute pancreatitis in May 2007. Abdominal computed tomography showed cystic lesions in the abdominal cavity, and surgical drainage was performed for intracystic bleeding, infection and alimentary canal perforation.
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