Nippon Shokakibyo Gakkai Zasshi
Online ISSN : 1349-7693
Print ISSN : 0446-6586
Volume 112 , Issue 8
Showing 1-11 articles out of 11 articles from the selected issue
Review article
Monthly report; Risk factor of pancreatic cancer
Original article
  • Kazuya YOSHIZAWA, Harufumi OIZUMI, Yu SASAKI, Yasuhiko ABE, Nana KANNO ...
    2015 Volume 112 Issue 8 Pages 1492-1502
    Published: August 05, 2015
    Released: August 05, 2015
    JOURNALS FREE ACCESS
    In the ABC classification for gastric cancer risk screening, group A (Helicobacter pylori infection-negative, pepsinogen [PG]-negative) patients are assumed to be at low risk, but some patients do have atrophic gastritis and H. pylori infection. This study aimed to identify the characteristics of group A patients. Healthy adults in Yamagata City who underwent barium radiography and ABC classification participated in the survey. Patient radiographs were randomly interspersed and reviewed by two gastroenterologists who were blinded to the H. pylori and PG statuses. Group A patients (n=1462) was subclassified as follows: atrophic gastritis group, 21.5%; intermediate group, 15.7%; and no atrophic gastritis group, 62.8%. Elderly subjects and those with H. pylori antibody titers of 3.0-9.9U/ml should be carefully evaluated while interpreting the results of the ABC classification for gastric cancer risk screening.
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Case report
  • Masami YAMAUCHI, Katsunori SHINOZAKI, Masaaki SUMIOKA, Takashi NISHISA ...
    2015 Volume 112 Issue 8 Pages 1503-1509
    Published: August 05, 2015
    Released: August 05, 2015
    JOURNALS FREE ACCESS
    A 72-year-old man visited our hospital because of dysphagia and weight loss. He was diagnosed by endoscopy with advanced (stage IV) basaloid squamous carcinoma of the thoracic esophagus. CT and CT-guided tumor biopsy revealed two lung metastases in the right upper and lower lobes, with diameters of 8 and 5 mm, respectively. The primary lesion disappeared after concurrent chemoradiotherapy consisting of 5-FU, cisplatin, and 60-Gy irradiation, which was administered for palliation of obstructive and hemorrhagic symptoms. Subsequently, eight cycles of chemotherapy were administered, resulting in a reduction in size of the metastases. However, multiple cycles of chemotherapy caused prolonged toxicity, and the metastases slightly enlarged during chemotherapy-free periods. Since the number of metastases did not change, stereotactic body radiotherapy was performed, which resulted in disappearance of the lung metastases. Five years following initial diagnosis, the patient has been doing well, with no signs of disease recurrence.
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  • Masahide AWAZU, Tomoyuki WAKAHARA, Hiroshi ASHITANI, Shinobu TSUCHIDA, ...
    2015 Volume 112 Issue 8 Pages 1510-1516
    Published: August 05, 2015
    Released: August 05, 2015
    JOURNALS FREE ACCESS
    A 69-year-old man with a malignant tumor of the stomach underwent distal gastrectomy with partial resection of the abdominal wall, transverse colon, and lateral segment of the liver. Based on a detailed pathological examination of the resected specimen, a diagnosis of undifferentiated gastric cancer was established. Six months after the operation, during postoperative adjuvant chemotherapy with S-1, diagnostic imaging, including CT and positron emission tomography (PET), revealed a portal vein tumor thrombus and diffusely spreading metastases in the posterior segment of the liver. Despite chemotherapy with S-1/CDDP, the metastatic tumors continued to grow rapidly. The patient died 10 months after the operation. On autopsy, the portal vein tumor thrombus was observed to be composed of undifferentiated cancer cells invading into the liver parenchyma through hepatic sinusoids, with the metastatic tumors replacing 60% or more of the entire liver.
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  • Yoshiaki ISONO, Shimpei MATSUSAKI, Youichirou BABA, Hiroki TANAKA, Tom ...
    2015 Volume 112 Issue 8 Pages 1517-1524
    Published: August 05, 2015
    Released: August 05, 2015
    JOURNALS FREE ACCESS
    A 70-year-old woman with jaundice was referred to our hospital. Obstructive jaundice caused by common bile duct (CBD) stones was diagnosed based on the results of blood tests, abdominal computed tomography, and endoscopic retrograde cholangiopancreatography. We attempted to remove the CBD stones endoscopically. After endoscopic sphincterotomy, a polypoid lesion was exposed at the ampulla of Vater. Histological examination of a biopsy specimen from the ampullary lesion revealed a tubular adenoma, and the patient underwent pylorus-preserving pancreatoduodenectomy. Pathological examination of the resected specimen revealed a polyp-type ampullary carcinoma-in-adenoma arising from the ampullary channel. Herein, we report a rare case of polyp-type ampullary carcinoma-in-adenoma displaying an intraductal growth pattern.
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  • Hideyuki IWASHITA, Noriaki MATSUI, Shinji TSUKAMOTO, Sadahiro FUNAKOSH ...
    2015 Volume 112 Issue 8 Pages 1525-1532
    Published: August 05, 2015
    Released: August 05, 2015
    JOURNALS FREE ACCESS
    A 74-year-old man was referred to our hospital because of a high fever. He had undergone a dental extraction about 1 month prior to admission because of apical periodontitis. Imaging study revealed liver abscess lesions. Infection with Streptococcus anginosus was confirmed using both stab and blood culture. An adequate selection of antibiotics was administered, and a good outcome was obtained. There have been no case reports of liver abscess caused by intraoral commensal flora related to dental extraction in healthy adults. This case shows that liver abscesses can occur secondary to dental extractions, even in healthy adults.
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  • Masahiko NAKAMURA, Kazunori KUSUMOTO, Toshimasa OCHIAI, Tomio KAWAGOE, ...
    2015 Volume 112 Issue 8 Pages 1533-1541
    Published: August 05, 2015
    Released: August 05, 2015
    JOURNALS FREE ACCESS
    We experienced two cases of acute hepatitis E in Miyazaki Prefecture in the same period. The patients were unknown to each other and did not have any clear causes or common risk factors of hepatitis E virus (HEV) infection. Nucleotide sequences of the HEV isolates revealed that the two isolates were closely related but with different HEV genotype 3 strains. The two cases appeared to be infected from unknown and different sources. Molecular phylogenetic analysis indicated that the strains were probably descendants of the strains which had been isolated from swine herd in Miyazaki Prefecture 12 years previously. This result indicates that the strains persisted in pig farms, in wild life, or in the natural environment in this region. The source should be identified, and efforts should be made to prevent of the spread of the infection. One of the cases had acute facial paralysis, which might be an extra-hepatic manifestation of HEV infection.
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