Nippon Shokakibyo Gakkai Zasshi
Online ISSN : 1349-7693
Print ISSN : 0446-6586
Volume 110, Issue 10
Displaying 1-13 of 13 articles from this issue
Review article
Monthly report; Diagnosis and treatment for patients with superficial esophageal carcinoma
Round-table discussion
Original article
  • Yasushi YAMASAKI, Ryuta TAKENAKA, Noriko OKAZAKI, Yuki BABA, Kenta HAM ...
    2013 Volume 110 Issue 10 Pages 1774-1782
    Published: 2013
    Released on J-STAGE: October 07, 2013
    JOURNAL FREE ACCESS
    We monitored the management of acute cholecystitis in a rural area of Japan to determine the effectiveness of new guidelines for the management of acute cholecystitis and cholangitis. Between January 2000 and September 2011, 366 patients were treated for acute cholecystitis. Of these, 59 had common bile duct stones (CBDS) and 307 did not. Patients in both groups were further subdivided into two groups: a before guidelines group (BGG; n=153) and an after guideline group (AGG; n=154). Among the patients without CBDS, early cholecystectomy was more common in the AGG group (n=53) than in the BGG group. Furthermore, the length of hospital stay was four days shorter in the AGG group than in the BGG group (n=23). Among the patients with CBDS, the timing of cholecystectomy after endoscopic retrograde cholangiography was seven days earlier in the AGG group than in the BGG group. Even in a rural area of Japan, early cholecystectomy appears safe and can decrease the length of hospital stay.
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Case report
  • Toshihiro TADANO, Hiroki TAKAHASHI, Kaori SUGAWARA, Mikako SUGIMURA, M ...
    2013 Volume 110 Issue 10 Pages 1783-1789
    Published: 2013
    Released on J-STAGE: October 07, 2013
    JOURNAL FREE ACCESS
    A 23-year-old woman was admitted with a relapse of ulcerative colitis. Tacrolimus therapy was initiated following inadequate response to corticosteroid therapy. Although the symptoms partially improved, she suddenly developed severe pain localized to the lower limbs on day 16 of tacrolimus therapy. By day 17, she was unable to move. Magnetic resonance imaging revealed born marrow edema in the lower limbs. We suspected calcineurin-inhibitor induced pain syndrome (CIPS) due to tacrolimus therapy. The pain improved within approximately four weeks of tacrolimus cessation. CIPS that is not associated with organ transplantation is a rare occurrence. Here we report a rare case of CIPS that was caused by tacrolimus therapy in a patient with ulcerative colitis.
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  • Yoshikazu YAMAMOTO, Shinsuke KUMEI, Takeshi OGURA, Yutaka ONISHI, Mits ...
    2013 Volume 110 Issue 10 Pages 1790-1796
    Published: 2013
    Released on J-STAGE: October 07, 2013
    JOURNAL FREE ACCESS
    An 87-year-old man presented with appetite loss and abdominal distension. Routine blood tests revealed hypoproteinemia. Abdominal computed tomography revealed ascites, which was subsequently drained. Biochemical analysis of the ascitic fluid detected chyle. Esophagogastroduodenoscopy revealed nodular swelling of the mucosa, swelling folds, and widespread erosions in the stomach. Stage I diffuse large B-cell gastric malignant lymphoma was diagnosed on the basis of the Lugano International Conference classification system. Six courses of R-CHOP [rituximab, cyclophosphamide, hydroxydaunorubicin (doxorubicin), vincristine (Oncovin®), and prednisolone] therapy were administered, following which complete remission was achieved and the chylous ascites mostly disappeared.
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  • Tomohiro SHIMODA, Takeshi MATSUTANI, Hiroshi YOSHIDA, Masaru HOSONE, E ...
    2013 Volume 110 Issue 10 Pages 1797-1803
    Published: 2013
    Released on J-STAGE: October 07, 2013
    JOURNAL FREE ACCESS
    A 72-year-old man with a complaint of lower limb edema was admitted to our hospital. Investigations revealed anemia, a decreased serum albumin level (1.7g/dl), and an increased urinary protein volume (7.4g/day), leading to a diagnosis of nephrotic syndrome. He also tested positive for anti-nuclear antibody and anti-DNA antibody, fulfilling the criteria for systemic lupus erythematosus (SLE). Endoscopy revealed type 2 advanced gastric cancer at the greater curvature of the antrum of the stomach. We performed distal gastrectomy and an open right renal biopsy without preoperative treatment. Histopathological examination of the resected stomach specimens revealed adenocarcinoma. Immunohistochemistry of the kidney specimen suggested membranous lupus nephritis. After surgery, his urinary protein volume gradually decreased and lower limb edema improved in the absence of any specific treatment for nephrotic syndrome or SLE.
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  • Akihiko OKA, Yuji AMANO, Yasushi UCHIDA, Kouji KAGAWA, Kento TAKATORI, ...
    2013 Volume 110 Issue 10 Pages 1804-1813
    Published: 2013
    Released on J-STAGE: October 07, 2013
    JOURNAL FREE ACCESS
    Here we report the cases of eight patients who developed small bowel obstruction and/or gastric ulcers after ingesting rice cake, the traditional Asian food, and were managed conservatively. This report adds to the existing literature on gastrointestinal disorders induced by rice cake ingestion, which are characterized by gastrointestinal obstruction, perforation, and ulceration and are occasionally accompanied by peritonism. These conditions tend to occur in 50-60-year-old males who wear dentures or eat rapidly. Therapeutically, hard rice cake remnants in the upper gastrointestinal tract can be broken up by endoscopic snaring and can be detected by computed tomography as homogeneous high-density material at approximately 145 (range:120-206) Hounsfield units.
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  • Tatsunori HANAI, Takafumi NAIKI, Manabu TAKAMATSU, Kenji IMAI, Junichi ...
    2013 Volume 110 Issue 10 Pages 1814-1822
    Published: 2013
    Released on J-STAGE: October 07, 2013
    JOURNAL FREE ACCESS
    A 61-year-old female was admitted to our hospital with severe jaundice and anemia. She was diagnosed with severe acute hepatitis secondary to autoimmune hepatitis (AIH) on the basis of positive anti-nuclear antibody titers, high serum IgG levels, and liver biopsy. Autoimmune hemolytic anemia (AIHA) was diagnosed because of the presence of reticulocytosis, decreased haptoglobin, positive direct Coombs test, and erythroid hyperplasia in the bone marrow. Although AIH occurs in association with various immunological disorders, an association with AIHA is rarely reported. We report a rare case of severe AIH associated with AIHA.
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  • Kazuyuki MATSUMOTO, Hironari KATO, Takeshi TOMODA, Ichiro SAKAKIHARA, ...
    2013 Volume 110 Issue 10 Pages 1823-1830
    Published: 2013
    Released on J-STAGE: October 07, 2013
    JOURNAL FREE ACCESS
    We report our experience with two cases of lymphoepithelial cysts (LECs) of the pancreas. Both patients were in their sixties. Contrast-enhanced computed tomography revealed masses in the pancreas with multilocular cystic lesions. Endoscopic ultrasound (EUS) findings presented highly echo-dense structures in the cystic masses; however, contrast-enhanced EUS revealed only the septum inside each mass without enhancing the dense structures. Contrast-enhanced EUS was useful for defining the contents in the cystic lesions; therefore, it may be useful for the diagnosis of LEC.
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  • Hideo KIDOGAWA, Kohji OKAMOTO, Takatomo YAMAYOSHI, Junya NOGUCHI
    2013 Volume 110 Issue 10 Pages 1831-1837
    Published: 2013
    Released on J-STAGE: October 07, 2013
    JOURNAL FREE ACCESS
    A 45-year-old female presented at our hospital with a one-day history of upper abdominal pain. Abdominal computed tomography (CT) revealed that the root of the celiac artery was obstructed and that a large hematoma was present in the retroperitoneum. The patient was diagnosed with retroperitoneal hemorrhage associated with the rupture of an inferior pancreaticoduodenal artery aneurysm, which was caused by increased blood flow in the pancreaticoduodenal arterial arcade. Because the patient's general condition was stable, she was managed conservatively and discharged on achieving remission after a month. Follow-up CT revealed spontaneous resolution of the celiac artery obstruction and aneurysm. The celiac artery obstruction in this case was assumed to be caused by segmental arterial mediolysis.
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