Nippon Shokakibyo Gakkai Zasshi
Online ISSN : 1349-7693
Print ISSN : 0446-6586
Volume 108 , Issue 8
Showing 1-12 articles out of 12 articles from the selected issue
Review article
Monthly report; Progress in research on molecular mechanisms of gastrointestinal and liver cancer
Original article
  • Tadashi SHIWA, Yoshiya KAWANAMI, Tomoko YOKOYAMA, Akihiko MORITANI, Ma ...
    2011 Volume 108 Issue 8 Pages 1383-1392
    Published: 2011
    Released: August 05, 2011
    JOURNALS FREE ACCESS
    The usefulness of ezetimibe was examined in 297 patients with dyslipidemia who did not achieve LDL-C target levels set in JAS 2007 Guidelines by lifestyle modification. The mean period of administration was 178.2±295.4 days. Ezetimibe significantly improved serum lipid levels in the patients with and without non-alcoholic fatty liver disease (NAFLD) (p<0.01). Significant improvement of AST, ALT and γ GTP levels were also observed in the patients with NAFLD (p<0.01, p<0.05, and p<0.01, respectively). Seventy of the patients with NAFLD who underwent abdominal ultrasound before and after administration of ezetimibe were followed. Of those, 38.6% of the patients showed disappearance of steatosis, indicating that administration of ezetimibe is useful in patients with NAFLD.
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Case report
  • So NISHIMURA, Naoyoshi NAGATA, Masao KOBAYAKAWA, Akahito SAKO, Ryo NAK ...
    2011 Volume 108 Issue 8 Pages 1393-1398
    Published: 2011
    Released: August 05, 2011
    JOURNALS FREE ACCESS
    While Candida infection is a common opportunistic infection, Candida-associated gastric lesions are far less frequent. We report a case of gastric ulcers due to candidal infection. A 73-year-old woman had ulcers refractory to treatment with a proton pump inhibitor (PPI) and Helicobacter pylori eradication. Endoscopic findings showed that this case involved 2 gastric ulcers with thick exudate mainly located in the fornix. Biopsy specimens from gastric ulcers revealed numerous Candida forms. The patient was treated with antifungal drugs and the ulcers healed completely on endoscopy. We should draw attention to our observation in elderly patients with gastric ulcers, and if we find gastric ulcers with such characteristic endoscopic findings, candidal infection of gastric ulcers should be considered.
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  • Ryo YUGE, Akira FUKUMOTO, Shintaro SAGAMI, Tomohiro IIBOSHI, Seiji ONO ...
    2011 Volume 108 Issue 8 Pages 1399-1404
    Published: 2011
    Released: August 05, 2011
    JOURNALS FREE ACCESS
    A 75-year-old woman was referred to our hospital for further examination of gastric antral abnormal endoscopic findings. Endoscopic study of the stomach revealed a depressed lesion in the gastric antrum. Atrophic findings were not recognized in the background gastric mucosa, and Helicobacter pylori infection was not detected by histology, an urea breath test, a rapid urease test and serological test. A diagnosis of adenoma was given histopathologically from the resected specimens. As a result of immunohistological study, the phenotype of the tumor was not classified as either gastric type or intestinal type. CDX2 was positive in part of the tumor.
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  • Sho TAKAHASHI, Yasushi SATO, Tamotsu SAGAWA, Shingo TANAKA, Kazuyuki M ...
    2011 Volume 108 Issue 8 Pages 1405-1412
    Published: 2011
    Released: August 05, 2011
    JOURNALS FREE ACCESS
    A 64-year-old man had been admitted to a previous hospital because of melena and a diagnosis of ulcerative colitis (UC, pancolitis type) had been made. He had received prednisolone and 5-ASA but steroid-induced hyperamylasemia had developed. Prednisolone had been tapered and halted, but it had resulted in UC relapse and thrombocytopenia. Then, he was referred to our hospital due to severe melena with hypovolemic shock. However, he was also positive for CMV antigen. Thus, we attempted to treat him with ganciclovir for CMV and intravenous cyclosporine (CsA) for UC. According to his clinical course, a reduction of CsA blood concentration induced leukocytopenia. Myelodysplastic syndrome (MDS, RAEB-1) was then revealed after bone marrow biopsy. A high blood CsA concentration may cause the improvement of UC and MDS conditions.
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  • Norifumi TAKAHASHI, Kazuhisa ARAKAWA, Yutaka SUNOSE, Osamu TOTSUKA, Hi ...
    2011 Volume 108 Issue 8 Pages 1413-1419
    Published: 2011
    Released: August 05, 2011
    JOURNALS FREE ACCESS
    A 26-year-old man was admitted to our hospital because of a high-grade fever and abdominal pain. A blood test showed marked inflammation. Enhanced computed tomography (CT) showed an 8.0×6.0cm cystic lesion in the left hepatic lobe. Esophagogastroduodenoscopy showed a huge egg-yolk-like mass in the gastric submucosa in the lesser curvature of the gastric body from the gastric angle. There were 3 ulcers on the mass, out of which milky pus flowed. Trophozoites of Entamoeba histolytica were detected from cultures of the liver abscess and a biopsy of the gastric ulcers. The amoebic dysentery antibody titer was increased 1600 times. An amoebic liver abscess complicated by a gastric fistula was diagnosed. As therapy, oral metronidazole was administered for 2 weeks without percutaneous drainage. The systemic inflammatory findings improved immediately and the abscess decreased markedly in size.
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  • Hideyasu NAGAMATSU, Ken TAKAHASHI, Tetsuya UEO, Ryouichi NARITA, Tamot ...
    2011 Volume 108 Issue 8 Pages 1420-1427
    Published: 2011
    Released: August 05, 2011
    JOURNALS FREE ACCESS
    A 46-year-old man was admitted to our hospital for further evaluation of a hypoechogenic mass in the pancreatic body. He had no history of hypertension, pancreatitis, abdominal trauma, or portal hypertension. He had no abdominal symptoms. A contrast-enhanced CT scan demonstrated a hypodense, round shaped mass. EUS and MRI also showed it to be a pancreatic mass. Because of the tumor size of more than 30mm and the possibility of malignancy, distal pancreatectomy was performed. Microscopic findings showed the mass was the dissection of the proximal splenic artery. The true lumen of the dissecting aneurysm was occluded and the false lumen developed fusiform dilatation. Moreover, microscopic findings revealed the rupture of the false lumen complicated by pseudoaneurysm. We finally diagnosed the lesion simulating a pancreatic tumor as the pseudoaneurysm of the splenic artery.
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  • Koichi KAGAWA, Yoshinari FURUKAWA, Soichiro YAMASAKI, Mutsumi HANANOKI ...
    2011 Volume 108 Issue 8 Pages 1428-1436
    Published: 2011
    Released: August 05, 2011
    JOURNALS FREE ACCESS
    We present a case of spindle cell type anaplastic carcinoma of the pancreas in a 63-year-old woman. A pancreatic mass was incidentally detected by routine abdominal ultrasonography examination for her hepatitis B infection, and she was admitted to our hospital for further examination. Computed tomography revealed a hypo-vascular mass measuring 25mm in maximal dimension at the pancreas body. Endoscopic ultrasonography showed a hypoechoic mass as the pancreas body and a swollen lymph node near the tumor. Endoscopic retrograde pancreatography revealed disruption of the main pancreatic duct, and carcinoma cells were detected in pancreatic juice obtained via an endoscopic nasopancreatic drainage tube. We diagnosed this case as an invasive ductal adenocarcinoma of the pancreas body, therefore the distal pancreatectomy with splenectomy (D1+α) was performed. The histopathological diagnosis for this case was a "spindle cell type anaplastic carcinoma of the pancreas". The patient has remained well with no evidence of recurrence for 9 months since her operation.
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