Nippon Shokakibyo Gakkai Zasshi
Online ISSN : 1349-7693
Print ISSN : 0446-6586
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Volume 109, Issue 6
Displaying 1-13 of 13 articles from this issue
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Review article
Monthly report; Current status in diagnosis and treatment of autoimmune pancreatitis
Original article
  • CT enterography with polyethylene glycol electrolyte solution for diagnosis of Crohn's disease
    Masaya OHANA, Atsushi MIMA, Hiroki SONOYAMA, Shino KIKUCHI, Makoto OKA ...
    2012 Volume 109 Issue 6 Pages 910-920
    Published: 2012
    Released on J-STAGE: June 05, 2012
    DOIhttps://doi.org/10.11405/nisshoshi.109.910
    JOURNAL FREE ACCESS
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    This study aimed to assess the diagnostic usefulness of CT enterography (CTE) in Crohn's disease in Japanese patients. A total of 32 cases with bowel symptoms underwent CT enterography with polyethylene glycol electrolyte solution as oral contrast medium, among which 18 were clinically diagnosed as Crohn's disease and 14 were not: ulcerative colitis 1, Beçhet disease 1, simple ulcer 1, inflammatory bowel disease without definite diagnosis 5 and bowel symptoms of unknown origin 6. The incidence of bowel wall thickening, mural hyperenhancement, "the comb sign", mesenteric lymph nodes swelling, and stenosis were significantly higher in Crohn's disease than in other disease. Moreover, uneven bowel wall thickening and unilateral mural hyperenhancement on CTE were characteristic features of Crohn's disease, which our original quantitative evaluation with imaging analysis could support. Consequently, CTE is useful in Japanese patients with Crohn's disease.
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Case report
  • Four cases of esophageal metastasis from breast cancer
    Yasuhiro SATO, Hiroto HORIGUCHI, Makoto YOSHIDA, Tokiko NAKAMURA, Tamo ...
    2012 Volume 109 Issue 6 Pages 921-928
    Published: 2012
    Released on J-STAGE: June 05, 2012
    DOIhttps://doi.org/10.11405/nisshoshi.109.921
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    The 4 patients with esophageal metastasis from breast cancer were women aged 55 to 68, who had multiple metastases and long term survival (9 to 13 years) from diagnosis of primary breast cancer. All of them presented with progressive dysphagia. Computed tomography revealed a circumferential wall thickening of the upper to middle esophagus without enlarged mediastinal lymph nodes or other lesions that would cause esophageal obstruction through external compression. Endoscopic examination revealed circumferential stricture without mucosal abnormality. In 3 cases, biopsy or EMR specimens revealed adenocarcinoma, which suggested metastasis of breast cancer resected previously. In the other case, biopsy failed to detect any malignancy. Metastatic cancer to the esophagus is a rare occurrence. We report these rare cases with references to the literature.
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  • Russell body gastritis
    Susumu MIURA, Kentarou SHIRAHAMA, Masahiro SAKAGUCHI, Miyuki TAKAO, To ...
    2012 Volume 109 Issue 6 Pages 929-935
    Published: 2012
    Released on J-STAGE: June 05, 2012
    DOIhttps://doi.org/10.11405/nisshoshi.109.929
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    A 63-year-old woman who presented with chest and back pain underwent an upper gastrointestinal endoscopy which revealed elevated legion in the antrum mucosa. Histologic examinations of gastric biopsies were showing monoclonal proliferation plasma cells containing Russell bodies. Differential diagnosis from B-cell lymphoma and plasmacytoma is difficult, because of monoclonality. Molecular analyses of immunoglobulin heavy chain (IgH) gene demonstrated that gene rearrangement was negative. Thus, diagnosis of Russell body gastritis was made. The Giemsa stains were also showing infection of Helicobacter pylori(H.pylori). After eradication therapy for H.pylori, follow-up upper gastrointestinal endoscopy was performed. She then recovered.
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  • Successful treatment of a case of advanced sigmoid colon cancer with occlusion of the common celiacomesenteric trunk
    Hiroki TAKAHASHI, Ryouichi TAKAHASHI, Katsuaki UKAI, Kaori SUGAWARA, Y ...
    2012 Volume 109 Issue 6 Pages 936-943
    Published: 2012
    Released on J-STAGE: June 05, 2012
    DOIhttps://doi.org/10.11405/nisshoshi.109.936
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    A 74-year-old man was admitted to our hospital with abdominal pain and bloody stool. The patients' history showed that he had had occlusion of the proximal common trunk of the celiac artery (CA) and the superior mesenteric artery (SMA). The inferior mesenteric artery (IMA), and the marginal artery of the colon had developed well. It was assumed that almost the entire visceral blood might be supplied by the IMA to the CA and the SMA. Our investigation revealed that the patient had advanced cancer of the sigmoid colon, which had caused intestinal obstruction. Sigmoidectomy was performed with care to avoid injuring the IMA and the marginal arcade artery. Normal hemodynamics were successfully established followed by sigmoidectomy, and cure was obtained in this patient.
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  • A case of pulmonary embolism due to heparin-induced thrombocytopenia after the placement of hepatic arterial infusion catheter
    Yoki FURUTA, Koichi KUDOH, Shuji TADA, Kazuaki SUGIHARA, Kazuhiro IZUM ...
    2012 Volume 109 Issue 6 Pages 944-951
    Published: 2012
    Released on J-STAGE: June 05, 2012
    DOIhttps://doi.org/10.11405/nisshoshi.109.944
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    A 68-year-old woman developed acute pulmonary embolism after hepatic arterial infusion therapy for advanced hepatocellular carcinoma. Because the platelet count was significantly reduced, heparin-induced thrombocytopenia (HIT) due to heparin usage in hepatic arterial infusion therapy was clinically suspected. Subsequently, the patient tested positively for HIT antibodies, and a definitive diagnosis was obtained. Antithrombotic therapy with heparin was discontinued and treatment with argatroban was started. After the heparinized hydrophilic catheter was removed, the platelet count improved immediately. HIT should be considered when a decrease in platelet count and thrombosis are involved with the usage of heparin.
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  • A case of hepatocellular carcinoma showed the usefulness of endoscopic ultrasound-guided fine needle aspiration cytology using the cell block technique for differential diagnosis of gastric submucosal tumor
    Akihiko KIDA, Koichiro MATSUDA, Satoshi HIRAI, Akiyoshi SHIMATANI, You ...
    2012 Volume 109 Issue 6 Pages 952-960
    Published: 2012
    Released on J-STAGE: June 05, 2012
    DOIhttps://doi.org/10.11405/nisshoshi.109.952
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    A mass lesion presenting difficulty in differential diagnosis between a tumor in the lateral segment of the liver and a gastric submucosal tumor (SMT) was found in a 59-year-old man with chronic hepatitis B. For differential diagnosis between the 2 lesions, endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) was performed. EUS showed a tumor exhibiting a mosaic pattern with a halo derived from the lateral segment of the hepatic left lobe in contact with the stomach. FNA using the cell block technique revealed findings consistent with HCC. No examination-associated complications developed. In patients with HCC that is in contact with the stomach and shows extrahepatically protruding growth, which is difficult to differentiate from gastric SMT, EUS-FNA is a method worthy of trying.
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  • A case of autoimmune pancreatitis associated with ulcerative colitis
    Masao KISHIMOTO, Toshiki TAKAYA, Tadashi OHSHIMA, Dai SAKAMOTO, Nobuak ...
    2012 Volume 109 Issue 6 Pages 961-968
    Published: 2012
    Released on J-STAGE: June 05, 2012
    DOIhttps://doi.org/10.11405/nisshoshi.109.961
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    A 31-year-old man was admitted to our hospital because of upper abdominal pain. He had been diagnosed with ulcerative colitis (UC) at age 28, but the disease has been in remission since then. On admission, he had slight fever, abdominal pain, and bloody stools six times a day, and the serum levels of pancreatic enzyme and IgG4 were elevated. Diffuse enlargement of the pancreas was detected by abdominal computed tomography; furthermore, narrowing of the main pancreatic duct was revealed using endoscopic retrograde cholangiopancreatography. Based on these findings, he was given a diagnosis of autoimmune pancreatitis (AIP) associated with UC. Both diseases improved without using steroids. After discharge, he has not had any recurrence of AIP or UC despite not being on steroid treatment, although the serum IgG4 level has shown a slight tendency to elevate.
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  • Large accessory spleen torsion with a distorted fascicular structure; a case report
    Toshihiro MORITA, Masataka KIKUYAMA, Takafumi KUROKAMI, Chisako NAGAKU ...
    2012 Volume 109 Issue 6 Pages 969-974
    Published: 2012
    Released on J-STAGE: June 05, 2012
    DOIhttps://doi.org/10.11405/nisshoshi.109.969
    JOURNAL FREE ACCESS
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    A 37-year-old woman was admitted with left upper quadrant pain. Imaging examinations revealed a cystic mass with a diameter of 70mm near the tail of the pancreas. The mass had a distorted fascicular structure adjacent to the hilum of the spleen. On operation the distorted fascicular structure was revealed to be connective tissue including vessels. On histopathological examination, the mass was strongly suspected to be an accessory spleen because spleen-like stroma was recognized, in spite of degeneration due to infarction.
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Letter to the Editor
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