JaLCDOI | 10.18926/AMO/52900 |
---|---|
FullText URL | 68_5_307.pdf |
Author | Muro, Shinichiro| Nasu, Junichiro| Harada, Ryo| Matsubara, Minoru| Nakarai, Asuka| Kanzaki, Hiromitsu| Tsutsumi, Kouichiro| Kato, Hironari| Tanaka, Takehiro| Fujiwara, Hiroyasu| Uno, Masatoshi| Okada, Hiroyuki| Yamamoto, Kazuhide| |
Abstract | A 45-year-old female who presented with loss of consciousness and a cold sweat was found to have a pancreatic tumor and multiple liver metastases. Laboratory studies showed marked hypoglycemia and inappropriately elevated serum insulin, C-peptide, and serum tumor markers. Fine needle aspiration revealed Grade 3 small-cell type primary pancreatic neuroendocrine carcinoma. Consequently, the diagnosis of malignant insulinoma was made. Transarterial embolization (TAE) for hepatic metastases resulted in the reduction of tumor volume and prompt resolution of hypoglycemic attacks, whereas diazoxide and systemic chemotherapy had been ineffective for controlling blood glucose levels, and octreotide was unavailable due to the allergic effect. This case report highlights the potential usefulness of TAE for malignant insulinomas in the management of hypoglycemia. |
Keywords | malignant insulinoma hypoglycemia liver metastases transarterial embolization neuroendocrinetumor |
Amo Type | Case Report |
Publication Title | Acta Medica Okayama |
Published Date | 2014-10 |
Volume | volume68 |
Issue | issue5 |
Publisher | Okayama University Medical School |
Start Page | 307 |
End Page | 311 |
ISSN | 0386-300X |
NCID | AA00508441 |
Content Type | Journal Article |
language | English |
Copyright Holders | CopyrightⒸ 2014 by Okayama University Medical School |
File Version | publisher |
Refereed | True |
PubMed ID | 25338488 |
Web of Science KeyUT | 000343269300008 |
JaLCDOI | 10.18926/AMO/53026 |
---|---|
FullText URL | 68_6_369.pdf |
Author | Iwamuro, Masaya| Miyashima, Yuichi| Yoshioka, Takahiro| Murata, Toshihiro| Miyabe, Yoshio| Kawai, Yoshinari| Urata, Haruo| Shiraha, Hidenori| Okada, Hiroyuki| Yamamoto, Kazuhide| |
Abstract | A 67-year-old Japanese man underwent enterotomy because of enterolith ileus. Component analysis by infrared spectroscopy revealed that the enterolith was composed of a high concentration of deoxycholic acid. We further analyzed and compared the ultrastructure of the enterolith and a commercially available powdered form of deoxycholic acid by means of scanning electron microscopy and energy dispersive X-ray spectroscopy. Energy dispersive X-ray spectroscopy analysis revealed that the ratios of carbon and oxygen in the enterolith were equal to those in the deoxycholic acid powder. Scanning electron microscopy analysis showed rectangular prism-shaped particles on the surface of the enterolith. This structure was similar to that of the deoxycholic acid powder. The surgically removed enterolith had a twisted and coiled appearance. Possible mechanisms underlying the formation of this unique form are discussed. |
Keywords | enterolith deoxycholic acid scanning electron microscopy infrared spectroscopy energy dispersive X-ray spectroscopy |
Amo Type | Case Report |
Publication Title | Acta Medica Okayama |
Published Date | 2014-12 |
Volume | volume68 |
Issue | issue6 |
Publisher | Okayama University Medical School |
Start Page | 369 |
End Page | 374 |
ISSN | 0386-300X |
NCID | AA00508441 |
Content Type | Journal Article |
language | English |
Copyright Holders | CopyrightⒸ 2014 by Okayama University Medical School |
File Version | publisher |
Refereed | True |
PubMed ID | 25519031 |
Web of Science KeyUT | 000346882200007 |
JaLCDOI | 10.18926/AMO/53120 |
---|---|
FullText URL | 69_1_37.pdf |
Author | Iwamuro, Masaya| Okada, Hiroyuki| Takata, Katsuyoshi| Kawai, Yoshinari| Kawano, Seiji| Nasu, Junichiro| Kawahara, Yoshiro| Tanaka, Takehiro| Yoshino, Tadashi| Yamamoto, Kazuhide| |
Abstract | The sensitivity and specificity of magnified endoscopic features for differentiating follicular lymphoma from other diseases with duodenal whitish lesions have never been investigated. Here we compared the magnified endoscopic features of duodenal follicular lymphoma with those of other whitish lesions. We retrospectively reviewed the cases of patients with follicular lymphoma (n=9), lymphangiectasia (n=7), adenoma (n=10), duodenitis (n=4), erosion (n=1), lymphangioma (n=1), and hyperplastic polyp (n=1). The magnified features of the nine follicular lymphomas included enlarged villi (n=8), dilated microvessels (n=5), and opaque white spots of various sizes (n=9). The lymphangiectasias showed enlarged villi, dilated microvessels, and white spots, but the sizes of the white spots were relatively homogeneous and their margin was clear. Observation of the adenoma and duodenitis revealed only whitish villi. Although the lymphangioma was indistinguishable from the follicular lymphomas by magnified features, it was easily diagnosed based on the macroscopic morphology. In conclusion, magnified endoscopic features, in combination with macroscopic features, are useful for differentiating follicular lymphomas from other duodenal diseases presenting whitish lesions. |
Keywords | duodenal neoplasm follicular lymphoma gastrointestinal lymphoma magnifying endoscopy |
Amo Type | Original Article |
Publication Title | Acta Medica Okayama |
Published Date | 2015-02 |
Volume | volume69 |
Issue | issue1 |
Publisher | Okayama University Medical School |
Start Page | 37 |
End Page | 44 |
ISSN | 0386-300X |
NCID | AA00508441 |
Content Type | Journal Article |
language | English |
Copyright Holders | CopyrightⒸ 2015 by Okayama University Medical School |
File Version | publisher |
Refereed | True |
PubMed ID | 25703169 |
Web of Science KeyUT | 000349740300004 |
JaLCDOI | 10.18926/AMO/53676 |
---|---|
FullText URL | 69_5_301.pdf |
Author | Seki, Anna| Iwamuro, Masaya| Yoshioka, Masao| Fujii, Nobuharu| Okada, Hiroyuki| Nose, Soichiro| Takata, Katsuyoshi| Yoshino, Tadashi| Yamamoto, Kazuhide| |
Abstract | A 41-year-old woman was diagnosed with duodenal follicular lymphoma. She had no other lesions and was assigned to a "watch and wait" policy. Swelling of the inguinal lymph nodes appeared 45 months later, and rituximab monotherapy resulted in complete remission. However, follicular lymphoma recurred in the stomach, rectum and mesenteric and external iliac lymph nodes 81 months after the therapy. The patient received rituximab monotherapy again and has remained in complete remission in the fifteenth year after the initial diagnosis. This case suggests the usefulness of rituximab monotherapy in the long-term management of intestinal follicular lymphoma. |
Keywords | follicular lymphoma duodenum rituximab |
Amo Type | Case Report |
Publication Title | Acta Medica Okayama |
Published Date | 2015-10 |
Volume | volume69 |
Issue | issue5 |
Publisher | Okayama University Medical School |
Start Page | 301 |
End Page | 306 |
ISSN | 0386-300X |
NCID | AA00508441 |
Content Type | Journal Article |
language | English |
Copyright Holders | CopyrightⒸ 2015 by Okayama University Medical School |
File Version | publisher |
Refereed | True |
PubMed ID | 26490027 |
Web of Science KeyUT | 000365519600006 |
JaLCDOI | 10.18926/AMO/53912 |
---|---|
FullText URL | 69_6_365.pdf |
Author | Kawano, Seiji| Hiraoka, Sakiko| Okada, Hiroyuki| Akita, Mitsuhiro| Iwamuro, Masaya| Yamamoto, Kazuhide| |
Abstract | Several studies have identified a relationship between myelodysplastic syndrome and Behçetʼs disease (BD), especially intestinal BD, and trisomy 8 appears to play an important role in these disorders. Despite this, only few case reports or series have been reported in gastroenterology, meaning that endoscopic findings and characteristics of intestinal BD have not been clarified yet. In this report, we describe three cases of intestinal BD associated with myelodysplastic syndrome and trisomy 8, and discuss the clinical features and problems of these disorders from a gastroenterology perspective. |
Keywords | Behçetʼs disease trisomy 8 myelodysplastic syndrome |
Amo Type | Case Reports |
Publication Title | Acta Medica Okayama |
Published Date | 2015-12 |
Volume | volume69 |
Issue | issue6 |
Publisher | Okayama University Medical School |
Start Page | 365 |
End Page | 369 |
ISSN | 0386-300X |
NCID | AA00508441 |
Content Type | Journal Article |
language | English |
Copyright Holders | CopyrightⒸ 2015 by Okayama University Medical School |
File Version | publisher |
Refereed | True |
PubMed ID | 26690248 |
Web of Science KeyUT | 000368434500007 |
Title Alternative | Current state of and views regarding clinical approarches to Helicobacter pylori infection |
---|---|
FullText URL | 128_13.pdf |
Author | Okada, Hiroyuki| |
Keywords | Helicobacter pylori 除菌療法 胃癌 胃炎 MALT リンパ腫 |
Publication Title | 岡山医学会雑誌 |
Published Date | 2016-04-01 |
Volume | volume128 |
Issue | issue1 |
Start Page | 13 |
End Page | 19 |
ISSN | 0030-1558 |
Related Url | isVersionOf https://doi.org/10.4044/joma.128.13 |
language | Japanese |
Copyright Holders | Copyright (c) 2016 岡山医学会 |
File Version | publisher |
DOI | 10.4044/joma.128.13 |
NAID | 130005149601 |
JaLCDOI | 10.18926/AMO/54513 |
---|---|
FullText URL | 70_4_323.pdf |
Author | Yamamoto, Naoki| Kato, Hironari| Mizukawa, Sho| Muro, Shinichiro| Akimoto, Yutaka| Uchida, Daisuke| Tomoda, Takeshi| Matsumoto, Kazuyuki| Horiguchi, Shigeru| Tsutsumi, Koichiro| Okada, Hiroyuki| |
Abstract | Contrast-enhanced harmonic endoscopic ultrasonography (CH-EUS) with contrast agent enabled us to assess the hemodynamics closely, despite limited data in pancreatic tumors. We have initiated a prospective, single arm, and non-randomized study to clarify the accuracy and safety of CH-EUS with Sonazoid and time-intensity curve (TIC) analysis for diagnosing benign or malignant pancreatic tumors. A total of 200 patients will undergo CH-EUS and TIC analysis. Receiver operating characteristic (ROC) analysis will be used to determine the optimal parameter cutoff values for TIC analysis. This will clarify whether CH-EUS and TIC can further improve the diagnosis of pancreatic tumors over conventional EUS. |
Keywords | CH-EUS pancreatic tumor TIC |
Amo Type | Clinical Study Protocols |
Publication Title | Acta Medica Okayama |
Published Date | 2016-08 |
Volume | volume70 |
Issue | issue4 |
Publisher | Okayama University Medical School |
Start Page | 323 |
End Page | 325 |
ISSN | 0386-300X |
NCID | AA00508441 |
Content Type | Journal Article |
language | English |
Copyright Holders | CopyrightⒸ 2016 by Okayama University Medical School |
File Version | publisher |
Refereed | True |
PubMed ID | 27549682 |
Web of Science KeyUT | 000384748600017 |
JaLCDOI | 10.18926/AMO/54511 |
---|---|
FullText URL | 70_4_313.pdf |
Author | Matsumoto, Kazuyuki| Kato, Hironari| Tsutsumi, Koichiro| Mizukawa, Sho| Yabe, Syuntaro| Seki, Hiroyuki| Akimoto, Yutaka| Uchida, Daisuke| Tomoda, Takeshi| Yamamoto, Naoki| Horiguchi, Shigeru| Okada, Hiroyuki| |
Abstract | Recently, endoscopic ultrasonography (EUS)-guided ethanol ablation for small pancreatic neuroendocrine tumors (p-NETs) has been reported. However, the efficacy and safety of the technique remain unclear. We have launched a prospective pilot study of EUS-guided ethanol ablation for p-NETs. The major eligibility criteria are the presence of a pathologically diagnosed grade (G) 1 or G2 p-NET, a tumor size of 2cm, and being a poor candidate for surgery. A total of 5 patients will be treated. The primary endpoint will be the complete ablation rate at 1 month after treatment. |
Keywords | pancreatic neuroendocrine tumor ethanol ablation EUS-guided |
Amo Type | Clinical Study Protocols |
Publication Title | Acta Medica Okayama |
Published Date | 2016-08 |
Volume | volume70 |
Issue | issue4 |
Publisher | Okayama University Medical School |
Start Page | 313 |
End Page | 316 |
ISSN | 0386-300X |
NCID | AA00508441 |
Content Type | Journal Article |
language | English |
Copyright Holders | CopyrightⒸ 2016 by Okayama University Medical School |
File Version | publisher |
Refereed | True |
PubMed ID | 27549680 |
Web of Science KeyUT | 000384748600015 |
Title Alternative | Magnified observation of spontaneous morphological changes of duodenal follicular lymphoma |
---|---|
FullText URL | 128_111.pdf |
Author | Iwamuro, Masaya| Takata, Katsuyoshi| Kawano, Seiji| Kawahara, Yoshiro| Yoshino, Tadashi| Okada, Hiroyuki| |
Abstract | A 63-year-old Japanese woman was diagnosed with duodenal follicular lymphoma. The initial esophagogastroduodenoscopic examination with magnifying observation revealed opaque white spots and enlarged whitish villi. Nine months later, esophagogastroduodenoscopy showed that the size of the lymphoma lesion decreased, and only opaque white spots were visible. The histological analysis of biopsy samples obtained during the initial endoscopy examination showed both neoplastic follicles and an inter-follicular infiltration of lymphoma cells, whereas the biopsy samples obtained at the endoscopy performed 9 months later showed only neoplastic follicle formation. These results suggest that the magnifying endoscopic features may reflect the underlying pathological mechanisms : enlarged whitish villi are probably due to lymphoma cell infiltration in the inter-follicular area, and opaque white spots are probably caused by neoplastic follicle formation. |
Keywords | 消化管原発濾胞性リンパ腫(primary gastrointestinal follicular lymphoma) 悪性リンパ腫(malignant lymphoma) 拡大内視鏡検査(magnifying endoscopy) |
Publication Title | Journal of Okayama Medical Association |
Published Date | 2016-08-01 |
Volume | volume128 |
Issue | issue2 |
Start Page | 111 |
End Page | 116 |
ISSN | 0030-1558 |
Related Url | isVersionOf https://doi.org/10.4044/joma.128.111 |
language | Japanese |
Copyright Holders | Copyright (c) 2016 岡山医学会 |
File Version | publisher |
DOI | 10.4044/joma.128.111 |
NAID | 130005262531 |
JaLCDOI | 10.18926/AMO/54605 |
---|---|
FullText URL | 70_5_417.pdf |
Author | Mizukawa, Sho| Kato, Hironari| Muro, Shinichiro| Akimoto, Yutaka| Uchida, Daisuke| Tomoda, Takeshi| Matsumoto, Kazuyuki| Yamamoto, Naoki| Horiguchi, Shigeru| Tsutsumi, Koichiro| Okada, Hiroyuki| Inoue, Hirofumi| Tanaka, Noriyuki| |
Abstract | Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) is a standard procedure for precise histological diagnosis of pancreas tumors, but it is sometimes difficult to obtain adequate specimens. EUS Sonopsy CY® is a newly designed needle with original features. This randomized study will compare the tissue collection rate of EUS Sonopsy CY® to that of a conventional needle in EUS-FNA. The major eligibility criteria are as follows: Patients with a pancreatic mass referred for EUSFNA; age ≥20 years, and performance status<4. The primary outcome is the tissue collection rate. This study will elucidate the efficacy of EUS Sonopsy CY®. |
Keywords | endoscopic ultrasound-guided fine needle aspiration pancreatic cancer Menghini type needle tip |
Amo Type | Clinical Study Protocols |
Publication Title | Acta Medica Okayama |
Published Date | 2016-10 |
Volume | volume70 |
Issue | issue5 |
Publisher | Okayama University Medical School |
Start Page | 417 |
End Page | 420 |
ISSN | 0386-300X |
NCID | AA00508441 |
Content Type | Journal Article |
language | English |
Copyright Holders | CopyrightⒸ 2016 by Okayama University Medical School |
File Version | publisher |
Refereed | True |
PubMed ID | 27777439 |
Web of Science KeyUT | 000388098700016 |
JaLCDOI | 10.18926/AMO/54602 |
---|---|
FullText URL | 70_5_405.pdf |
Author | Tomoda, Takeshi| Kato, Hironari| Mizukawa, Sho| Muro, Shinichiro| Akimoto, Yutaka| Uchida, Daisuke| Matsumoto, Kazuyuki| Yamamoto, Naoki| Horiguchi, Shigeru| Tsutsumi, Koichiro| Okada, Hiroyuki| |
Abstract | Acute pancreatitis is the major complication of endoscopic retrograde cholangiopancreatography (ERCP). A preliminary research suggested that the administration of nonsteroidal anti-inflammatory drugs (NSAIDs) with nitroglycerin might reduce the incidence of post-ERCP pancreatitis (PEP) more effectively than NSAIDs alone. We conduct a two-arm, multicenter, prospective, randomized, superiority trial to evaluate the additional effect of nitroglycerin for prevention of PEP. A total of 900 patients randomly receive 50 mg diclofenac suppository either alone or with 5 mg isosorbide dinitrate sublingual tablet. The primary endpoint is the occurrence of PEP. This study will clarify whether NSAIDs plus nitroglycerin can prevent PEP. |
Keywords | post-ERCP pancreatitis NSAIDs nitroglycerin |
Amo Type | Clinical Study Protocols |
Note | the word “nitroglycerin” should be corrected to “nitrate” throughout the manuscript.| |
Publication Title | Acta Medica Okayama |
Published Date | 2016-10 |
Volume | volume70 |
Issue | issue5 |
Publisher | Okayama University Medical School |
Start Page | 405 |
End Page | 408 |
ISSN | 0386-300X |
NCID | AA00508441 |
Content Type | Journal Article |
language | English |
Copyright Holders | CopyrightⒸ 2016 by Okayama University Medical School |
File Version | publisher |
Refereed | True |
PubMed ID | 27777436 |
Web of Science KeyUT | 000388098700013 |
Related Url | isReplacedBy http://doi.org/10.18926/AMO/55314 |
JaLCDOI | 10.18926/AMO/54810 |
---|---|
FullText URL | 70_6_469.pdf |
Author | Yamasaki, Yasushi| Takenaka, Ryuta| Hori, Keisuke| Takemoto, Koji| Kawano, Seiji| Kawahara, Yoshiro| Fujiki, Shigeatsu| Okada , Hiroyuki| |
Abstract | The usefulness of endoscopy in marginal ulcer bleeding has rarely been studied, and the optimal method for preventing rebleeding is unclear. Here we assessed the efficacy of endoscopy in marginal ulcer bleeding and examined the efficacy of proton pump inhibitors (PPIs) in the prevention of rebleeding. A total of 28 patients with marginal ulcer bleeding (21 men, 7 women; median age 58.5 years) were treated by endoscopy. We analyzed the clinical characteristics, results of endoscopic therapy, characteristics of rebleeding patients, and relation between the use of PPIs and the duration of rebleeding. Sixteen patients had active bleeding. Initial hemostasis was achieved in all patients. There were no procedure-related adverse events. Rebleeding occurred in one patient within the first month and in 7 patients thereafter. There was a significant difference in the rebleeding rate between the patients who received a PPI and those who did not. In a multivariate analysis, the non-use of PPIs was a risk factor for rebleeding (hazard ratio, 6.22). Therapeutic endoscopy is effective in achieving hemostasis from marginal ulcer bleeding. PPIs may prevent rebleeding from marginal ulcers. |
Keywords | marginal ulcer upper gastrointestinal bleeding endoscopic hemostasis proton-pump inhibitor |
Amo Type | Original Article |
Publication Title | Acta Medica Okayama |
Published Date | 2016-12 |
Volume | volume70 |
Issue | issue6 |
Publisher | Okayama University Medical School |
Start Page | 469 |
End Page | 475 |
ISSN | 0386-300X |
NCID | AA00508441 |
Content Type | Journal Article |
language | English |
Copyright Holders | CopyrightⒸ 2016 by Okayama University Medical School |
File Version | publisher |
Refereed | True |
PubMed ID | 28003672 |
Author | Iwamuro, Masaya| Okada, Hiroyuki| Harada, Keita| Kanzaki, Hiromitsu| Hori, Keisuke| Kita, Masahide| Kawano, Seiji| Kawahara, Yoshiro| Tanaka, Takehiro| Yamamoto, Kazuhide| |
---|---|
Published Date | 2016-12-01 |
Publication Title | Journal of Okayama Medical Association |
Volume | volume128 |
Issue | issue3 |
Content Type | Journal Article |
Author | Gotoda, Tatsuhiro| Kawano, Seiji| Kono, Yoshiyasu| Miura, Kou| Kanzaki, Hiromitsu| Iwamuro, Masaya| Kawahara, Yoshiro| Tanaka, Takehiro| Yoshino, Tadashi| Shirakawad, Yasuhiro| Tabata, Masahiro| Tanimoto, Mitsune| Okada, Hiroyuki| |
---|---|
Published Date | 2016-12-01 |
Publication Title | Journal of Okayama Medical Association |
Volume | volume128 |
Issue | issue3 |
Content Type | Journal Article |
Author | Iwamuro, Masaya| Urata, Haruo| Tanaka, Takehiro| Ando, Akemi| Nada, Takahiro| Kimura, Kosuke| Yamauchi, Kenji| Kusumoto, Chiaki| Otsuka, Fumio| Okada, Hiroyuki| |
---|---|
Published Date | 2017-02 |
Publication Title | Acta Medica Okayama |
Volume | volume71 |
Issue | issue1 |
Content Type | Journal Article |
JaLCDOI | 10.18926/AMO/54828 |
JaLCDOI | 10.18926/AMO/54977 |
---|---|
FullText URL | 71_2_97.pdf |
Author | Iwamuro, Masaya| Kondo, Eisei| Tanaka, Takehiro| Hagiya, Hideharu| Kawano, Seiji| Kawahara, Yoshiro| Otsuka, Fumio| Okada, Hiroyuki| |
Abstract | We retrospectively analyzed the cases of 14 patients (9 women, 5 men, mean age: 51.6 years) with cytomegalovirus (CMV) involvement in the esophagus, stomach, and/or duodenum diagnosed at a single center, to determine their endoscopic features and clinical backgrounds. Thirteen patients (92.9%) had hematologic disease; the other had rheumatoid arthritis. Of the former, 12 patients underwent allogeneic hematopoietic stem cell transplantation, and 9 of these patients had graft-versus-host disease (GVHD) before undergoing esophagogastroduodenoscopy (EGD). All 14 patients had been taking one or more immunosuppressive agents including cyclosporine (n=10), corticosteroids (n=9), mycophenolic acid (n=6), tacrolimus (n=3), and methotrexate (n=1). Tests for CMV antigenemia were positive in 11 patients (78.6%). EGD examinations revealed esophageal (n=3), gastric (n=9), and duodenal involvement (n=6). Macroscopically, esophageal lesions by CMV infection presented as redness (n=1), erosions (n=1), and ulcers (n=1). Gastric lesions manifested as redness (n=7), erosions (n=3), exfoliated mucosa (n=2), and verrucous erosions (n=1). Mucosal appearances in the duodenum varied: redness (n=2), ulcers (n=2), multiple erosions (n=2), single erosion (n=1), edema (n=1). CMV was detected even in the intact duodenal mucosa (n=1). In conclusion, physicians must recall the relevance of CMV infection when any mucosal alterations exist in the upper gastrointestinal tract of immunosuppressed patients. |
Keywords | cytomegalovirus duodenum esophagogastroduodenoscopy esophagus stomach |
Amo Type | Original Article |
Publication Title | Acta Medica Okayama |
Published Date | 2017-04 |
Volume | volume71 |
Issue | issue2 |
Publisher | Okayama University Medical School |
Start Page | 97 |
End Page | 104 |
ISSN | 0386-300X |
NCID | AA00508441 |
Content Type | Journal Article |
language | English |
Copyright Holders | CopyrightⒸ 2017 by Okayama University Medical School |
File Version | publisher |
Refereed | True |
PubMed ID | 28420890 |
Title Alternative | Changes of colonic mucosa caused by long-term use and discontinuation of anthraquinone |
---|---|
FullText URL | 129_23.pdf |
Author | Iwano, Eiji| Iwamuro, Masaya| 岡田 裕之| |
Abstract | Anthraquinone, an anthracene derivatives, is widely used as a purgative medicine. The long-term use of anthraquinone is known to cause melanosis coli and elevated lesions in the colon. However, the clinical course of patients who take anthraquinone over a long term and those who discontinue the drug has not been fully investigated. Here we investigated 22 patients who had colonic mucosal changes ( i.e., melanosis coli and elevated lesions) who had been taking anthraquinone for at least one year and discontinued it. We classified the elevated lesions into two subtypes:the small-lesion, which included multiple small nodules that were < 2 mm in dia., and the large-lesion, which included a single or multiple nodules of ≥ 2-mm dia. We used colonoscopy to investigate the changes of colonic lesions between before and after the discontinuation of anthraquinone. The results indicated that the nodules of the small-lesion group were lymphoid follicle hyperplasia. In the large-lesion group, adenoma was most frequently observed ( n=118) , followed by hyperplastic polyp ( n=52) and inflammatory changes with edema ( n=22) . Melanosis coli and elevated lesions were decreased or invisible after the discontinuation of anthraquinone. Our findings thus suggest that the long-term use of anthraquinone may cause some type of elevated lesions due to chronic inflammation. It is recommended that the use of anthraquinone be limited to a short term. |
Keywords | アントラセン誘導体(anthracene derivatives) アントラキノン(anthraquinone) 大腸黒皮症(melanosis coli) 大腸メラノーシス(pseudomelanosis coli) リンパ濾胞過形成(lymphoid follicle hyperplasia) |
Publication Title | Journal of Okayama Medical Association |
Published Date | 2017-04-03 |
Volume | volume129 |
Issue | issue1 |
Start Page | 23 |
End Page | 30 |
ISSN | 0030-1558 |
language | Japanese |
Copyright Holders | Copyright (c) 2017 岡山医学会 |
File Version | publisher |
DOI | 10.4044/joma.129.23 |
NAID | 130005632078 |
JaLCDOI | 10.18926/AMO/55207 |
---|---|
FullText URL | 71_3_241.pdf |
Author | Iwamuro, Masaya| Tanaka, Shouichi| Moritou, Yuki| Inaba, Tomoki| Higashi, Reiji| Kusumoto, Chiaki| Yunoki, Naoko| Ishikawa, Shin| Okamoto, Yuko| Kawai, Yoshinari| Kitada, Ken-ichi| Takenaka, Ryuta| Toyokawa, Tatsuya| Okada, Hiroyuki| |
Abstract | Most gastric bezoars can be treated with endoscopic fragmentation combined with or without cola dissolution, whereas laparotomy or laparoscopic surgery is generally inevitable for small intestinal bezoars because they cause small bowel obstruction. Therefore, early diagnosis and management of gastric bezoars are necessary to prevent bezoar-induced ileus. To investigate the incidence of overlooked gastric bezoars during the initial esophagogastroduodenoscopy, we retrospectively reviewed the cases of 27 patients diagnosed with gastrointestinal bezoars. The bezoars were diagnosed using esophagogastroduodenoscopy (n=25), abdominal ultrasonography (n=1), and barium follow-through examination (n=1). Bezoars were overlooked in 9/25 patients (36.0%) during the initial endoscopy examination because the bezoars were covered with debris in the stomach. Of the 9 patients, 8 had concomitant gastric ulcers, and the other patient had gastric lymphoma. Although a computed tomography (CT) scan was performed before the second-look endoscopy in 8 of the 9 patients, the bezoars were mistaken as food debris on CT findings and were overlooked in these patients. In conclusion, gastric bezoars may not be discovered during the initial esophagogastroduodenoscopy and CT scan. In cases with debris in the stomach, second-look endoscopy is essential to detect bezoars. |
Keywords | bezoar gastric ulcer foreign bodies phytobezoar |
Amo Type | Original Article |
Publication Title | Acta Medica Okayama |
Published Date | 2017-06 |
Volume | volume71 |
Issue | issue3 |
Publisher | Okayama University Medical School |
Start Page | 241 |
End Page | 247 |
ISSN | 0386-300X |
NCID | AA00508441 |
Content Type | Journal Article |
language | English |
Copyright Holders | CopyrightⒸ 2017 by Okayama University Medical School |
File Version | publisher |
Refereed | True |
PubMed ID | 28655944 |
JaLCDOI | 10.18926/AMO/55314 |
---|---|
FullText URL | 71_4_357.pdf |
Author | Tomoda, Takeshi| Kato, Hironari| Mizukawa, Sho| Muro, Shinichiro| Akimoto, Yutaka| Uchida, Daisuke| Matsumoto, Kazuyuki| Yamamoto, Naoki| Horiguchi, Shigeru| Tsutsumi, Koichiro| Okada, Hiroyuki| |
Abstract | In the article by Tomoda T et al. entitled “A Multicenter, Prospective, Randomized Controlled Trial Evaluating the Efficacy of Rectal Diclofenac and Sublingual Nitroglycerin as a Combined Prophylactic Treatment for Post-ERCP Pancreatitis”, which appeared in the October 2016 issue, Vol. 70, No. 5, pp405-408, the word “nitroglycerin” should be corrected to “nitrate” throughout the manuscript. |
Keywords | post-ERCP pancreatitis NSAIDs nitrate |
Amo Type | Corrected and Republished Article |
Publication Title | Acta Medica Okayama |
Published Date | 2017-08 |
Volume | volume71 |
Issue | issue4 |
Publisher | Okayama University Medical School |
Start Page | 357 |
End Page | 362 |
ISSN | 0386-300X |
NCID | AA00508441 |
Content Type | Journal Article |
language | English |
Copyright Holders | CopyrightⒸ 2017 by Okayama University Medical School |
File Version | publisher |
Refereed | True |
PubMed ID | 28824193 |
Related Url | replaces http://doi.org/10.18926/AMO/54602 |
Title Alternative | Achalasia treated with per-oral endoscopic myotomy (POEM) |
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FullText URL | 129_115.pdf |
Author | Sugihara, Yuusaku| Harada, Keita| Kato, Ryo| Yamauchi, Kenji| Takashima, Shiho| Takei, Daisuke| Inokuchia, Toshihiro| Takahara, Masahiro| Kawano, Seiji| Hiraoka, Sakiko| Tanabe, Shunsuke| Noma, Kazuhiro| Shirakawa, Yasuhiro| Manabe, Noriaki| Inoue, Haruhiro| Okada, Hiroyuki| |
Abstract | Esophageal achalasia is a disorder of the lower esophageal sphincter muscle. Patients present with dysphagia, chest pain, vomiting, and aspiration. Esophageal achalasia had traditionally been treated with esophageal achalasia balloon dilatation and the Heller-Dor method, but in recent years, the use of per-oral endoscopic myotomy (POEM) has increased. Our patient, a 39-yr-old male, began experiencing dysphagia 4 years prior to his referral to our hospital. Based on the results of esophagogastroduodenoscopy, esophageal radiography and high-resolution manometry, we made the diagnosis of esophageal achalasia (Chicago classification type I) . After informed consent from the patient and his family and approval from our hospital's ethics committee were obtained, we performed a POEM. The patient was discharged on the 4th day post-surgery. At the 1-year post-operative examination, no worsening of symptoms and no relapse were observed. POEM is an excellent treatment method for esophageal achalasia from the perspective of therapeutic effect and prevention of invasion. We recommend that it be considered as the first-choice treatment for achalasia. However, accessibility to the procedure itself is limited due to the few adequately trained operators worldwide. POEM should thus be performed by an expert operator at a high-volume center. |
Keywords | POEM 食道アカラシア (esophageal achalasia) |
Publication Title | Journal of Okayama Medical Association |
Published Date | 2017-08-01 |
Volume | volume129 |
Issue | issue2 |
Start Page | 115 |
End Page | 121 |
ISSN | 0030-1558 |
Related Url | https://doi.org/10.4044/joma.129.115 |
language | Japanese |
Copyright Holders | Copyright (c) 2017 岡山医学会 |
File Version | publisher |
DOI | 10.4044/joma.129.115 |
NAID | 130006039377 |