bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Case of Pancreatolithiasis Treated by a Combination of Endoscopic Extraction and Extracorporeal Shock Wave Lithotripsy
Authors: OKUSHIMA Kazumu , NAKAZAWA Saburo , YAMAO Kenji , YOSHINO Junji , INUI Kazuo , YAMACHIKA Hitoshi , KANEMAKI Naoto , IWASE Teruhiko , KISHI Katsuhiko , FUJIMOTO Masao , WATANABE Masumi , HIRANO Ken , HARADA Kou , MIYOSHI Hironao , NIMURA Yuji 
Published: August 2007

Abstract:We report on the case of a 50‐year‐old woman with idiopathic chronic calcifying pancreatitis and diabetes. An endoscopic retrograde pancreatography showed a stone with a diameter of 23 mm and multiple small stones in the head of the pancreas. An endoscopic pancreatic sphincterotomy was performed. However, the stone could not be removed endoscopically. So we performed an extracorporeal shock wave lithotripsy (ESWL) using a Tripter X1. The stone was located in the shock wave focus by fluoroscopy. Under intravenous sedation, the patient received 5 ESWL sessions (a total of 11700 shock waves with an energy of 18kv). ESWL permitted stone disintegration and successful endoscopic extraction of the fragments. Complete clearance in the main pancreatic duct was achieved. No severe complications were observed. After treatment, an improvement in the PFD test was seen. ESWL is an effective method for treatment of endoscopically unextractable pancreatic ductal stones.
Low‐Power Contact Nd: YAG Laser Endoscopy
Authors: MIWA Takeshi , SUZUKI Sohtaro 
Published: August 2007

Abstract: Laser application in gastrointestinal endoscopy started with the development of flexible optical fibers in about 1970. Originally, non‐contact irradiation with high power Nd: YAG lasers of 100 watts (W) was used for gastrointestinal hemostasis. It was difficult to achieve safe and reliable irradiation with this method, the quarts fiber tips were susceptible to coagulation damage, and the cost was high. As a result local injections were recognized as an inexpensive and excellent method of producing hemostasis, and became the treatment of first choice. Therefore, the endoscopic use of lasers shifted from hemostasis to the topical treatment of tumors. In 1984 low‐power Nd: YAG laser irradiation at 1 to 30W became possible using a ceramic contact probe co‐developed by the authors and the Surgical Laser Technology Japan Co. This made photocoagulation, vaporization, cutting and local hyperthermia (Laserthermia) feasible. Improvements in laser irradiation efficiency led to the development of inexpensive equipment, costing less than one‐third of the price of conventional equipment. The application of low‐power contact lasers significantly improved the clinical efficacy of the treatment of minute cancers, but the technique has the same limitations as other endoscopic methods. Furthermore, because laserthermia is still being developed, the best technique has not yet been fully defined. In the future, treatments that can be used effectively in association with low‐power contact laser therapy need to be identified. Low‐power contact laserthermia, local hyperthermia with microwaves, and photodynamic therapy with excimer dye lasers all need to be studied further. This will contribute to the development of a minimum invasive therapy for gastrointestinal lesions.
Endoscopic and Histopathological Study about 25 Cases of Minute Superficial Depressed Neoplastic Lesions in the Large Intestine
Authors: KATAKURA Shigehiro , SATAKE Yoshiharu , AKSOZ Kadir , SUGIMOTO Hiroyuki , KAMINAGA Norihiro , TUBOMIZU Yoshio , FUJITA Rikiya , SUGATA Fumio 
Published: August 2007

Abstract: We studied 25 cases of minute (less than 5 mm in a diameter) superficial depressed neoplastic lesions during the period of March 1990 to September 1991. These depressed neoplastic lesions were recognized by colonoscopy as asteroid redness with surrounding elevation. The thickness and height of the surrounding elevations were modified by air volume. Occasionally, they seemed according to the air volume to be elevated lesions, though their fundamental form was confirmed as being superficial depressed lesions from observations of histopathological sections and using a dissecting microscope. The endoscopic figures were emphasized by sprinkling them with Methylene Blue.All of the minute depressed neoplastic lesions were histopathologically diagnosed as being tubular adenoma. For the purpose of confirming the histopathological character of the depressed neoplastic lesions (n = 25) and distinguishing them from conventional elevated adenomas (n = 71) of the same diameter, we compared the incidences of glandular crowding, nuclear stratification, nuclear pleomorphism and loss of nuclear polarity in two groups. Glandular crowding and nuclear pleomorphism were recognized significantly more often in the depressed neoplastic lesions than in the elevated adenomas.Although most of the minute depressed neoplastic lesions were fundamentally adenomas, because of their unique histopathologic character, they could give new insight into the development of colon cancer.
Duodenoscopic Management in Biliary Ascariasis
Authors: KAMIYA Toshiaki , MORISHITA Tetsuo , REREDO Remberto , MARANCENBAUM Carlos , MONTAÑO Carlos 
Published: August 2007

Abstract: Ascaris lumbricoides is spreading throughout the entire world. In its adult form it usually lives in the human intestine, but biliary or pancreatic complications due to the worn's infestation are not uncommon in endemic areas like Bolivia and have become a significant problem. Many authors recommended surgical treatment for the removal of the worn.In this paper we present our experiences with the endoscopic management of bilialy ascariasis.From June 1985 to August 1991, 38 patients were diagnosed as having biliary ascuriasis by means of an endoscopic retrograde cholungiography. In the duodenoscopic treatment, all of the procedures were performed under fluoroscopic control.These Ascaris lumbricoides were located in the choledocus and common hepatic ducts in 33 patients (86.8%), 3. patients had them in the gallbladder (7.9%) and 2 patients had them (5.3%) in the intrahepatic ducts.Endoscopic extractions were successful in 17 out of 20 (85.0%) non‐jaundice patients, in the other 3 cases the woms were removed surgically. In the jaundice cases, 3 of the 6 patients with woms (50.0%) were successfully treated by endoscopic extractions with simultaneous stones prior to an endoscopic sphincterotomy and the rest were treated surgically.Since no significant complications were observed after this endoscopic treatment method we recommend endoscopic extractions of biliary ascariasis.
Chronic Pancreatitis as a Complication of Ulcerative Colitis —Report of 2 Cases—
Authors: SAITOH Osamu , NAKAGAWA Ken , HIRATA Ichiro , TOKIOKA Satoshi , OHSHIBA Saburo 
Published: August 2007

Abstract: We report on two patients with chronic pancreatitis associated with ulcerative colitis. Both patients had ulcerative colitis involving the entire colon and rectum. The diagnosis of chronic pancreatitis was based on the typical findings of endoscopic retrograde cholangiopancreatography (ERCP) and episodes of hyperamylasemia. The changes in the levels of serum pancreatic enzymes are considered to have paralleled the activity of the colitis. None of the classical etiologies for pancreatitis was found in either case. The time sequence and exclusion of known causes of pancreatitis suggest an association between these two conditions.These two cases, together with other reported cases, provide some evidence for the hypothesis that chronic pancreatitis may be one of the extraintestinal complications of ulcerative colitis. The symptoms of ulcerative cblitis, such as diarrhea and abdominal pain, may mimic the symptoms of chronic pancreatitis. Pancreatitis and ulcerative colitis are probably mutually exacerbating factors. Therefore, the recognition of this phenomenon contributes substantially to the management of ulcerative colitis. (Dig Endosc 1994; 6 : 59–65)
Pancreatogram of Unfused Pancreatic Duct Systems
Authors: TOKI Fumitake , KOZU Tadahiko , YOSHIDA Kenji , NISHINO Takayoshi , TADOKORO Hiroyuki 
Published: August 2007

Abstract: The aim of this study was to indirectly evaluate functional aspects of the accessory papilla, by measuring the diameter of the dorsal duct in non‐fusion (pancreas divisum). In 56 patients with definite non‐fusion, the diameter of the duct on ERCP was measured with a caliper rule, in the ventral duct (V1, V2), in the head of the dorsal duct (Dh1, Dh2), the body (Dbl, Db2), and the tail (Dt1, Dt2). The controls were 61 consecutive patients with a normally fused pancreatic duct system. The mean value ± SD were V1:2.0±1.1, V2:1.7±0.8, Dh1:2.5±0.6, Dh2:2.6±0.8, Dbl:2.7±0.8, Db2: 2.1 ±0.5, Dt1: 1.7±0.5, Dt2: 0.9±0.2 in the non‐fusion group. The values in the control group were 3.4±0.9, 3.0±0.8, 1.0±0.3, 1.3±0.4, 2.6±0.6, 2.3±0.6, 1.6 ± 0.3, 0.9 ± 0.2, respectively. Results showed that the diameter of the pancreatic duct was significantly related to the age of the patient in the body and tail of the non‐fusion group but not in the controls (p<0.05). The diameter of the ventral duct in the control group was related to the age but not in the non‐fusion group (p<0.0001).In non‐fusion group, mean values of V1 and V2 was smaller (p<0.02), and Dh1 and Dh2 were larger (p<0.05) than those in the controls. While there were no significant differences in the mean values of Db1, Db2, Dt1, and Dt2 in both groups.These results may indicate a more prominent influences of age to the caliber changes of pancretic duct when non‐fusion existed.
Evaluation of Small‐caliber Transnasal Panendoscopes for Upper G‐I Screening Examination
Authors: NOZAKI Ryoichi , FUJIYOSHP Tateshi , TAMURA Masaki , TSUCHIYA Akira , TAKAGI Koichi , TAKANO Masahiro 
Published: August 2007

Abstract:We evaluated two models of small‐caliber panendoscopes for the upper G‐I tract, for their applicability to gastric cancer mass screening or upper G‐I screening; one type is a fiberscope (GIF‐N30; Olympus Optical Co.) with an outer tip diameter of 5.3mm (start date. May, 1993) originally designed for newborns and infants, while the other is a newer electronic videoscope (XGIF‐N200; Olympus) with a tip diameter of 6mm (start date, February, 1994) recently developed to allow transnasal insertion. Both scopes are suitable for transnasal insertion. Of the 658 subjects examined, 403 were randomly selected to undergo transnasal insertion. Conversation between the operator and subject was possible during the procedure. Among those subjects who had previously been examined by means of panendoscopy, 90.3% (224/248) replied that the transnasal insertion was more comfortable than the ordinary peroral insertion, and 89.9% (223/248) stated that they would not mind undergoing transnasal endoscopic examination in the future. The examiners reported no difficulties with manipulation, visual acuity, or obtaining biopsy specimens. The mean examination time with the small‐caliber endoscopes was about five minutes, which is shorter than with previously reported examinations. Transnasal insertion of the small‐caliber panendoscopes is recommended particularly for screening purposes, such as the gastric cancer mass survey. However, the long‐term durability of the instrument must be assessed before widespread application becomes possible.
Endoscopic Biliary Drainage without Endoscopic Sphincterotomy
Authors: KIMURA Katsumi , FUJITA Naotaka , NODA Yutaka , KOBAYASHI Go , YAGO Akio , CHONAN Akimichi , MATSUNAGA Atsuo , ANDO Masao , YUKI Toyohiko , TOMINAGA Gen , NOMURA Mikiko , ISHIDA Kazuhiko , INOUE Shigeru , CHIBA Masaki , KISARA Norihiro , MOCHIZUKI Fukuji 
Published: August 2007

Abstract:Endoscopic biliary drainage (EBD) is usually performed after endoscopic sphincterotomy (EST). In some patients, however, EBD without EST, so‐called nonEST‐EBD, is also effective.Thirty‐four patients treated from 1983 to the present, were investigated to estimate the usefulness, safety, and drawbacks of nonEST‐EBD.First, the reasons for adopting nonEST‐EBD were reviewed in each patient. The most common reason was to reduce jaundice so as to preserve the function of the papilla of Vater in patients with choledocholithiasis who were to undergo surgery. However, such patients were treated in the early period of the investigation, and most would have undergone EST just after endoscopic retrograde cholangiography (ERC), had they been treated more recently. The most important reason, at present, was, thus, to avoid bleeding in patients with general or local hemorrhagic diathesis, who accounted for 20.6% (7/34 of our subjects).Next, the effect of drainage was examined. Drainage in seven patients was judged to be excellent, while that in 15 patients was determined to be effective. In 10 patients without jaundice, nonEST‐EBD was performed to prevent jaundice. Therefore, in 91.7% of patients (22/24), nonEST‐EBD was considered to be useful.Changes in the serum amylase level were investigated to estimate the safety of nonEST‐EBD. Twenty‐seven patients with nonEST‐EBD, in whom the serum amylase level was within normal limits before treatment, and 57 patients with EBD after EST were evaluated. No statistically significant difference was recognized between these two groups in the degree of serum amylase elevation after drainage.NonEST‐EBD is concluded to be an effective and safe method of reducing jaundice, if appropriate patients are selected.
A Case of Giant Gastric Folds with Hypoalbuminemia Healed by Helicobacter pylori Eradication
Authors: SHIMOYAMA Tadashi , FUKUDA Shinsaku , MIKAMI Tatsuya , MUNAKATA Akihiro , YOSHIDA Yutaka , KAMATA Yoshimasa 
Published: August 2007

Abstract:A 66‐year‐old man with hypoalbuminemia was found to have diffuse giant mucosal folds in the body of the stomach. Helicobacter pylori (H pylori) status was evaluated by several examinations, all of which showed positive results. To eradicate H pylori, he was treated with clarithromycin (200mg b. i. d.), lansoprazole (30mg q. d.) and plaunotol (80mg t. i. d.). By two weeks, the serum albumin concentration had risen to 3.4g per dl. Four weeks after finishing clarithromycin therapy, endoscopy was repeated and H pylori status was evaluated as before. All examinations showed negative results and the giant mucosal folds had improved markedly. Before treatment, histological specimens showed irregular elongation of pits with inflammatory infiltrates. After treatment, the architecture of pits returned to its normal form with decreased inflammatory infiltrates. In this case, giant gastric folds and hypoalbuminemia were improved by H pylori eradication, suggesting that H pylori infection may play a role in the giant gastric folds associated with hypoalbuminemia.
Risk Factors For Duodenal Ulcer Recurrence: Three‐year Follow‐up during Famotidine Maintenance Therapy
Authors: SAIGENJI Katsunori , HARASAWA Shigeru , IWASAKI Ariyoshi , ASAKA Masahiro , ASAKI Shigeru , FUKUTOMI Hisayuki , KANEKO Eizo , TSUKAMOTO Yoshihisa , INOUE Masaki , MIWA Takeshi , MATSUO Yutaka , OKABE Haruya , MIYOSHI Akima 
Published: August 2007

Abstract:The recurrence‐free rate and factors related to recurrence after healing were investigated in duodenal ulcer patients on H2‐blocker maintenance therapy with famotidine. Famotidine maintenance therapy (20 or 40 mg once a day before bedtime) was performed in 488 evaluable patients after endoscopically‐proven healing of ulcers (S1 or S2). The cumulative recurrence‐free rates were 81.1%, 65.1% and 58.2%, respectively, after one, two and three years of maintenance therapy. Among various background factors, those which have been suggested to be closely associated with ulcer recurrence were compared on the basis of their relation to the recurrence‐free rate. These factors included a past history of duodenal ulcer, smoking, alcohol use, bulbar deformation, the endoscopic stage of ulcer healing, concomitant drugs and compliance with famotidine therapy. Recurrence correlated most significantly with a past history of duodenal ulcer and with compliance. Compliance was categorized as excellent, good, fair or poor. The recurrence‐free rate was significantly lower in patients with excellent compliance than in any other compliance group. A famotidine dose of 40 mg/day (the standard dose), versus the half dose of 20 mg/day, produced no significant difference in the cumulative recurrence‐free rate and it was therefore suggested that 20 mg/day of famotidine is comparable to 40 mg/day in its preventive effect on duodenal ulcer recurrence.In addition, because recurrence was more common in patients who had previously experienced recurrence, a past history of ulcer was suggested to be a significant risk factor for ulcer recurrence.
Correlation Between Peritoneoscopic Findings and Response to Interferon in Patients with Chronic Hepatitis C
Authors: KASAHARA Akinori , HAYASHI Norio , OSHITA Masahide , HLJIOKA Taizou , KATAYAMA Kazuhiro , MITA Eiji , KATO Michio , MASUZAWA Manabu , YOSHIHARA Harumasa , TATSUMI Tomohide , MUKUDA Tomoyuki , ITOH Akihiko , KASHIWAGI Toru , FUSAMOTO Hideyuki , KAMADA Takenobu 
Published: August 2007

Abstract:This study was designed to investigate the correlation between peritoneoscopic liver surface findings and the alanine aminotransferase (ALT) response to interferon, and to identify peritoneoscopic findings potentially useful as predictors of interferon responsiveness, in chronic hepatitis C. In all, 119 patients with hepatitis C viremia and histological evidence of chronic hepatitis received interferon alpha, in total doses of 258 to 660 million units (MU). A sustained response was seen in 29 cases (24%), a transient response with ALT relapse after therapy completion in 41 (35%) and no response in 49 (41%). Among 64 type 1 b cases, 8 (13%) showed sustained, 27 (42%) transient and 29 (45%) no response. The sustained response rate was higher with Shimada's code 200 than with code 300 or 400, even for type 1b. Interferon therapy was ineffective in more than 50% with code 300 or 400, especially in type 1b, suggesting that interferon efficacy decreases with disease progression. The sustained response rate was significantly higher, and that of no response significantly lower, in patients without reddish liver surface markings than in those with such markings (p<0.05), even in type lb. About 50% of those with reddish markings showed no response, indicating that absence of reddish markings may be a useful predictor of sustained response. The liver fibrosis score was significantly higher in the no response than in the transient and sustained response groups (p<0.02).In summary, patients with reddish liver surface markings and/or advanced fibrosis do not show a good response to interferon.
Diagnostic Accuracy of Laparoscopic Liver Biopsy in Chronic Liver Diseases, Comparison of Laparoscopic and US‐Guided Liver Biopsy Results
Authors: ITO Toshio , UKIDA Minora , YAMAMOTO Kazuhide , KOBASHI Haruhiko , MORIMOTO Youichi , MIKAMI Masayuki , OMOTO Masaki , NAKANISHI Sousuke , SHINMEN Kanji , NAGANO Takuya , MATSUMOTO Seiji , NAKAMURA Masaki , OKAMOTO Ryoichi , FUJIOKA Shin‐ichi , OMORI Nobuhiko , UJIKE Kozo , SHIRAHA Hidenori , TSUJI Takao 
Published: August 2007

Abstract:Liver biopsies were carried out using three different needles, a Vim‐Silverman needle 2.5 mm in outer caliber, an 18‐Gauge (18G) Majima needle, and a 17‐Gauge (17G) Majima needle. The biopsies were obtained from nearby locations on the liver surface under laparoscopic observation, to ascertain differences in histological diagnosis according to the size of the biopsy specimen. The biopsy specimens obtained with the Vim‐Silverman needle were wider than those obtained with the other two needles. The agreement in histological diagnoses of the liver, obtained with the Vim‐Silverman needle versus the 18G Majima needle, was 26.0%, while that between the Vim‐Silverman needle and the 17G Majima needle was 40.0%. Histological diagnosis tended to be underestimated in small biopsy specimens in advanced chronic liver diseases. A questionnaire survey, conducted in 92 hospitals affiliated with Okayama University Medical School, revealed US‐guided liver biopsy to be the practice of choice in 57 of 92 (62.0%) hospitals, and 18G needles were used in US‐guided liver biopsy in 35 of 78 (45.2%) hospitals.
A New Peroral Cholecystoscopy Method Utilizing a Shape Memory Alloy Bending Catheter‐Report of Two Cases
Authors: YAMAO Kenji , NAKAZAWA Saburo , YOSHINO Jyunji , EVUI Kazuo , YAMACHIKA Hitoshi , KANEMAKI Naoto , FUJDIOTO Masao , MIYOSHI Hironao , IWASE Teruhiko , TAKI Norihito 
Published: August 2007

Abstract:For the purpose of improving the ease and reliability of catheter insertion into the cystic duct and gallbladder, we developed a new combination method utilizing an ultrathin fiberscope (miniscope, 0.8 mm), a guidewire (0.25 inches) and a shape memory alloy, bendable, catheter (SMA catheter, 2.6 mm). The main feature of the SMA catheter, which incorporates a micro‐actuator, is that its tip can be bent by remote control as desired. The SMA catheter could be inserted successfully into the cystic duct using a guide‐wire under direct miniscope vision in two patients with gallbladder lesions.Moreover, after the miniscope had been inserted through the SMA catheter into the gallbladder, its maneuverability enhanced observation of the mucosa. This combination method should afford new diagnostic and therapeutic approaches to gallbladder disease.
Exploring Sexuality Education and the Burdened Teacher: A Participatory Approach in a Rural Primary School in Kenya
Authors: KIRAGU SUSAN WANJIRU 
Published: August 2007

Twenty‐five years since the onset of HIV/AIDS, young people aged 15–24 now make up half of new HIV infections. This paper advocates for comprehensive sexuality education as an effective panacea to reverse this, with teachers stepping up and embracing their role as sexuality educators. The exploration of this challenge is informed by a small‐scale participatory study of teacher responses in a rural primary school in Nakuru district, Kenya. Dialogue was held with 18 teachers (11 females, seven males) on the challenges they faced in teaching sexuality education and teachers emerged as disorientated and embarrassed in conversations about sexuality issues with the pupils. Because sexuality education lacks a curriculum, teachers have found it challenging to integrate it into regular subjects; they also observed that parents seem resistant to addressing this at home, and thus this task falls to them.In the study, a process of self‐awareness of the need for them to step up and teach sexuality education emerges among the participants. A key finding is that participatory and dialectical interventions that can prepare teachers and develop their confidence in teaching sexuality education are required.