bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Case of Biliary Cystadenocarcinoma Followed up for Five Years
Authors: AJIKI Tetsuo , FUJIMORI Takahiro , NAKAMURA Tetsuya , MAEDA Sakan , SAITO Yoichi , SUEHIRO Itsuo , MIYAZAKI Junko , NAGASAKO Kou 
Published: August 2007

Abstract:We report on a case of an 80‐year‐old male with autopsy‐confirmed biliary cystadenocarcinoma. The tumor's growth was followed up for five years. CT findings on first admission revealed that the cyst walls of the tumor were smooth. However, a CT taken four years later showed large cysts with irregular walls which were growing invasively and expanding beyond the liver. The patient died of liver dysfunction caused by obstructive jaundice due to the liver tumor, and an autopsy was performed. Histologic examination of the autopsy material revealed a multilocular tumor that was identified as being a biliary cystadenocarcinoma and microscopic lung metastases were seen. The character of the multilocular cyst with septations covered by papillary proliferation of atypical columnar epithelium and many remaining portions with low grade dysplasia led us to suspect the tumor was derived from a cystadenoma.
An Attempt to Analyze Color Wavelengths with an Electronic Endoscope
Authors: KATSU Ken‐ichi 
Published: August 2007

Abstract:We attempted to measure the dominant wavelengths of gastric mucosal lesions and to extract and present color differences of the lesions in image form, by converting spectroscopic visual signals (composed of red, green and blue components) obtained from an electronic endoscope into digital color files. The dominant wavelength, as measured from signals input without gamma correction, was significantly shorter in gastric mucosa affected by atrophic gastritis and type lie early gastric cancer than in normal mucosa. This analysis revealed a significant difference in dominant wavelengths between the endoscopically normal mucosa of the stomach and that found to have been affected by early gastric carcinoma and atrophic gastritis. Color difference extraction allowed us to make a morphological characterization of the surface of type lie early gastric cancer, although this was possible in only one case. The results of this study suggest the diagnostic value of digital representation of the mucosal surface features provided by endoscopy. It is suggested that, in the future, analog endoscopic diagnosis will be replaced by digital endoscopic diagnosis and computerized endoscopic diagnosis.
Modified Endoscopic Variceal Ligation
Authors: MASUMORI Koji , ONDA Masahiko , TAJIRI Takashi , KIM Deug Young , TOBA Masahito , UMEHARA Matsuomi , YOSHIDA Hiroshi , MAMADA Yasuhiro , NISHIKUBO Hideki , TANIAI Nobuhiko , KOJIMA Takayuki , MATSUZAKI Sakae , YAMASHITA Kiyohiko 
Published: August 2007

Abstract:Endoscopic variceal ligation (EVL) has been widely adopted because it is technically easy to perform. However, it is not always possible to eradicate varices by the standard ligation method. Therefore, we examined the effectiveness of the intensive ligation method as an alternative for the eradication of varices. In applying this method, rubber bands are used to make ligations much closer to each other, than with the standard method, just above the esophago‐gastric junction (EG‐junction). We also compared the effectiveness of EVL in nine cases undergoing the standard ligation method with that in nine cases treated by the new intensive ligation method. With the standard ligation method, the average number of sessions was 2.2 per week, while the average number of rubber bands used was 9.6 per patient. Varices disappeared in three of nine cases. With the intensive ligation method, the number of sessions was two per week in all cases, while the average number of rubber bands was 19.9 per patient. Varices disappeared in all nine cases. Chest discomfort, as a complication, was experienced by three of nine cases in both groups. It is concluded that the intensive ligation method is a very effective means of achieving early, safe eradication of varices.
Heat‐Probe Coagulation Treatment of Recurrent Intramucosal Venous Dilatation of the Esophagus and Endoscopic Color Doppler Ultrasonographic Follow‐up
Authors: SATO Takahiro , HIGASHINO Kiyoshi , TOYOTA Jouji , KARINO Yoshiyasu , FURUKAWA Tomoyuki , MURASHIMA Yoshio , SUGA Toshihiro , YAOSAKA Tom , IMAMURA Akimichi , FUJINAGA Akira , KOITO Kazumitsu , MTYAKAWA Hiroyuki , TOCHIHARA Masahiro , NATSUI Kiyoto , ANBO Tomonori , NAGAKAWA Tatsuya , SODA Mitsuhiko , KATO Shigeharu , ASO Kazunobu 
Published: August 2007

Abstract:We treated 14 patients with high risk intramucosal venous dilatation (high risk IMVD) of esophageal varices using heat‐probe coagulation. Two of the 14 patients experienced bleeding from the high risk IMVD. We used an Olympus heat‐probe unit CD‐20Z to stop or prevent variceal bleeding. The 14 patients were treated one to four times (mean: 1.9 times) using a total of 450–2100 joules (mean: 1459 joules). The high risk IMVD disappeared with healing of the heat‐probe‐induced ulcers. No severe side effects were recorded. Two patients with bleeding from high risk IMVD were successfully treated by the heat‐probe technique. In addition, we studied the effects of endoscopic heat‐probe coagulation for esophageal varices via endoscopic color Doppler ultrasonography (ECDUS) in six patients. Our ECDUS study was conducted with a PENTAX FG‐32UA, 7.5MHz convex type, and a HITACHI EUB 565 display monitor. Following heat‐probe treatment, the esophageal walls thickened from 5.1 to 8 mm (mean: 6.3 mm) and a low echoic pattern was visualized by ECDUS. Esophageal intramural blood flow was not observed in any of the six patients. Paraesophageal veins and passageways remained patent in all six patients.
Endoscopic Urease Sensor System for Detecting Helicobacter pylori on Gastric Wall Using a pH‐sensitive Field Effect Transistor
Authors: KOHLI Yoshihiro , KATO Takiyi , ITO Shigeji , MIYAJI Hideki , AZUMA Takeshi , TSURUTA Hitoshi , MATSUI Satomi , OKA Keiko , NAKAMURA Michihiro 
Published: August 2007

Abstract:An endoscopic tube‐tip type urease sensor was developed for the purpose of on‐site detection of Helicobacter pylori (H. pylori) using a pH‐sensitive field effect transistor (pH‐FET). The sensor is composed of an endoscopic‐tube connected to a feed pump with a urea solution and a pH‐FET attached to a sensor holder at the open end of the tube. The urease activity on the gastric wall can be measured by bringing the sensor into contact with the gastric wall just after replacing gastric juice with the urea solution. The presence of H. pylori causes a pH change in the urea solution inside the sensor holder in 20 seconds due to the strong urease activity of this bacterial species. After measurement, the sensor is detached from the wall, and washed with urea solution by turning on the urea pump. A measurement at one site is completed within 30 seconds. Repetition of the procedure makes multi‐site measurements possible. In preliminary evaluations, it was found that clinical sensitivity and specificity were 89% and 86%, respectively, using standard bacteriological testing results as a reference.
Colonic Mucosal Blood Flow in Ischemic Colitis
Authors: YAMAKADO Susumu , TATSUGUCHI Atsushi , SATO Jun , FUJIMORI Shunji , MEVAMI Sadamu , TAGUCHI Fumihiko , TAMAGAWA Yasuhito , KISHIDA Teruyuki , YOSHIDA Yutaka , KOBAYASHI Masafumi 
Published: August 2007

Abstract:Altered colonic mucosal blood flow (CMBF) is thought to be involved in the onset mechanism of ischemic colitis (IC). This study was designed to clarify the features of CMBF in six patients with IC (average age, 61 yr) and 10 control subjects (44.6yr). In the IC patients, CMBF was measured at both the affected site (ulcer margin and surrounding mucosa) and at a normal appearing site, during the active, healing, or recovery phase, by the laser doppler method. In the control group, CMBF was measured in various segments of the colon. The CMBF around the ulcer site during the active phase was significantly lower than that at the homologous segment in normal controls, while CMBF at normal sites in IC patients did not differ markedly from that of normal controls. CMBF in reddened portions of the ulcer margin in IC patients was significantly higher than that of the surrounding mucosa. A significant increase in CMBF was also observed during PGEi administration as compared to that before administration. This evidence clearly indicates that decreased CMBF is involved in the pathogenic mechanism of IC. The CMBF at sites of active mucosal restoration was somewhat increased. Continuous intravenous administration of PGEi was found to increase CMBF in IC patients.
Electronic‐endoscopic Observation of ET‐1 Induced Mucosal Ischemia and Preventive Effect of ETA Recepter Selective Antagonist, FR139317, in Rat Distal Colon
Authors: HOSOKAWA Masaya , TOMINAGA Masayuki , UEDA Syunji , TANIGUCHI Takao , NAKAMURA Hiroshi , TSUKADA Hideaki , OKUMA Mimoru , SAKAI Masahiko 
Published: August 2007

Abstract:For investigation of the effects of Endothelin‐1 (ET‐1) on colonic mucosa, ET‐1 (10–160 nmol/kg) was sprinkled on rat colonic mucosa under observation with a new electronic endoscopic system (TOSHIBA TRE‐3000, Japan). A high dose of ET‐1 induced complete obstruction of submucosal arterioles, but not venules, without affecting arterial blood pressure. The ET‐1 ‐induced contraction of both vessel types was maintained for 50 min and was followed by intramucosal dot hemorrhages. In this experimental model, the effects of ET‐1 on the mucosal microcirculation were further analyzed with a laser doppler blood flowmeter (LDF) during endoscopic observation. The maximum decrease in mucosal blood flow was to 20 % of the control value and this decrease was maintained for 20 min at a dose of 80 nmol/kg. An ETA receptor selective antagonist, FR139317 (800 nmol/kg), inhibited ET‐1 ‐induced changes in endoscopic findings and LDF, shifting the concentration‐response curve of LDF to the right. FR139317 is a potentially useful new therapy for inflammatory bowel diseases, conditions which have been reported to be associated with high local concentrations of ET‐1. Our electronic‐endoscopic system was demonstrated to be a useful basic research tool for studying gastrointestinal pathophysiology.
Efficacy of Endoscopic Prosthesis in T4 Cancer of the Intrathoracic Esophagus
Authors: YAMADA Akira , KUROKI Yoshito , SAKAMOTO Takashi , YAMASHITA Iwao , NOMURA Naoki , SAITO Mitsukazu , SHIMIZU Tetsuro , TAZAWA Kenji , FUJIMAKI Masao 
Published: August 2007

Abstract:No remarkable improvement has yet been achieved in the survival of patients with advanced intrathoracic esophageal cancer. In particular, patients with complications such as esophago‐bronchial fistula or invasion into the mediastinum have an especially miserable prognosis, even with surgical treatment. To improve the quality of life (QOL) of such patients, extensive palliative therapy should be provided. Thus, we have introduced an endoscopic esophageal intubation technique for the treatment of stenosis or perforation in patients with T4 esophageal cancer.Nine patients with unresectable intrathoracic esophageal cancer, complicated by stenosis or perforation, were treated with an endoscopic esophageal prosthesis. Four cases had an esophago‐bronchial fistula, and in three the tumor had perforated the mediastinum. The prosthesis was successfully placed under endoscopic guidance in all nine cases. Six patients (66.7%) subsequently resumed oral intake without discomfort, while two had reasonably good outcomes in this regard (efficacy rate; 88.9%). Complications were seen in three patients: mainly chest discomfort, reflux esophagitis and migration of the prosthesis in one patient each. Six patients required prolonged administration of chemotherapeutic agents following prosthesis placement. Mean survival was 123.4±77.0 days. Four of the nine patients died in the hospital. Palliative endoscopic esophageal prosthesis was considered to be useful for patients with advanced esophageal cancer. With this technique, an improvement in QOL was achieved, as sufficient oral intake was facilitated and pulmonary and mediastinal complications due to perforation were diminished.
Spontaneous Resolution of Chronic Hepatitis C – A Case Report
Authors: SAKAI Shino , WATANABE Makoto , SATO Shuichi , KOHGE Naruaki , AKAGI Shuji , FUKUMOTO Shiro 
Published: August 2007

Abstract:We experienced a case of chronic hepatitis C showing spontaneous resolution. The patient was diagnosed as having chronic hepatitis with moderate activity, non‐A non‐B type, after laparoscopy with liver histology in 1982, and was followed up thereafter at our out‐patient clinic. His aspartate aminotransferase (AST)and alanine aminotransferase (ALT) levels fluctuated but had stabilized by 1990.A second laparoscopy with liver histology, conducted in 1993, revealed non‐specific reactive hepatitis. Serum hepatitis C virus RNA (HCV‐RNA) had been strongly positive in 1982 but was negative in 1990. Interferon therapy may not be indicated in such cases.
Combination of Preoperative EST, Laparoscopic Cholecystectomy with Choledochotomy, and Postoperative Cholangioscopy in the Treatment of Common Bile Duct Stones
Authors: KANO Nobuyasu , KASUGAI Hisashi , HONDA Hiraku , YAMAKAWA Tatsuo 
Published: August 2007

Abstract:A case of common duct stones, successfully managed with a combination of preoperative EST, laparoscopic choledochotomy and postoperative choledochoscopic stone extraction, is reported. A 32‐year‐old man was admitted to our hospital because of jaundice and right hypochon‐dralgia of several‐days' duration. CT, US and ERCP revealed stones in the gallbladder and common bile duct. EST was performed to remove the stones in the common bile duct prior to laparoscopic cholecystectomy. However, the patient developed pancreatitis as a complication of EST, which was successfully managed by conservative therapy. Though some stones remained in the common duct following the first trial of EST, the patient rejected a second round of EST. Laparoscopic cholecystectomy and choledochotomy were performed to remove the gallbladder and the stones remaining in the common bile duct. A T tube was placed in the incised common bile duct for management of possible retained stones. Twenty days after the surgery, successful postoperative cholangioscopy was performed, and the stones remaining in the common duct were removed. Hyperamylasemia and pancreatitis are relatively common complications of EST occurring in about 7% of cases, but only 3% of these patients experience severe pancreatitis, requiring hospitalization. Conservative therapy is always the treatment of choice. In our particular patient, pancreatitis caused by EST was successfully managed by decompression with ENBD and administration of ulinastatin. Residual stones in the CBD were completely removed by laparoscopic common bile duct exploration following EST and postoperative cholangioscopy through the T tube fistula.
A Case of CholangioDuodenal Fistula Formation After Metallic Stenting for Malignant Biliary Stricture
Authors: RYOZAWA Shomei , AKIYAMA Tetsiyi , IKEDA Miyuki , FURUI Toshifumi , YABUSHTTA Yoshiko , KONDO Satoshi , NOGUCHI Takayoshi , NOJIMA Shinji , OKITA Kiwamu 
Published: August 2007

Abstract:A 68‐year‐old man presented with melena in June 1993, and was diagnosed as having adenocarcinoma of the rectum with liver metastasis. He underwent anterior resection of the rectum and was given weekly chemotherapy. In October 1993, he developed jaundice due to severe stricture of the middle to lower common bile duct caused by metastatic spread to the lymph nodes around the pancreatic head. A 10mm wide, 51mm long WallstentTM (Schneider) was inserted into the lower end of the bile duct through the papilla, resulting in rapid normalization of the serum bilirubin level. Three months later, the Wallstent eroded through the duodenal wall, causing massive fatal hemorrhage. We, therefore, emphasize the necessity of being alert to the potential for such complications in cases involving placement of a self‐expanding metallic stent for malignant biliary stricture.
A New Instrument for Measurement of Gastrointestinal Mucosal Color
Authors: TANAKA Michio , KIDOH Yasuaki , KAMEI Masayuki , TERASAKI Teiichi , WATANABE Akiharu , SAKAMOTO Takashi , FUJIMAKI Masao 
Published: August 2007

Abstract: We designed and produced a new instrument that measures the color of the gastrointestinal mucosa during conventional endoscopic examination. The instrument consists fundamentally of an optical fiber sensor and a light source. One end of the optical fiber sensor is connected to the light source and a commercially available spectrophotometric colorimeter, while the other end is passed through the biopsy channel of a commercially available endoscope and placed in contact with the gastrointestinal mucosa. The color of the mucosa is then measured. To evaluate the accuracy of color measurement, the instrument was used to measure the color of 108 color chips belonging to the color range of the gastrointestinal mucosa or surrounding regions, selected from the Munsell Book of Color. The instrument correctly determined the relative hue, chroma and value of all 108 color chips tested. It also had the advantages of consistently measuring the color chips under standardized conditions and of promptly displaying the color readings during endoscopic examination.This instrument was also used to measure the color of the mucosa at different sites of the upper gastrointestinal tract in 20 patients. There were no noteworthy problems in using the instrument clinically. Mucosal color (hue, value and chroma) of the upper gastrointestinal tract was demonstrated to have specific characteristics according to the region measured.The instrument provided highly accurate, objective information that facilitated the distinction of slight differences in mucosal color, an important factor in the endoscopic diagnosis of gastrointestinal diseases.
SRE and Young People in Further Education: A Review of Provision and Practice in England
Authors: EMMERSON LUCY 
Published: August 2007

Many initiatives relating to young people's sexual health have focused on under 16s. Yet, most young people become sexually active between the ages of 16 and 19 and 80 per cent of under‐18 conceptions are to 16‐ and 17‐year‐olds. The shift from school to further education marks a time of transition in young people's lives. It is a time when information and support with sexual health issues is particularly relevant.Reforms to the further education sector invite a fresh look at how every young person's health and well‐being can best be supported. This is in the context of the government teenage pregnancy strategy, which aims to reduce under‐18 conceptions. This paper reports on research conducted by the Sex Education Forum with young people and staff in further education settings across England. This research was used to write guidance on the provision of sexual health services for young people in further education settings, which was published by the Department for Education and Skills and with support from the Department of Health and ministerial backing in June 2007.
RGS9‐2 is a negative modulator of μ‐opioid receptor function
Authors: Psifogeorgou Kassi , Papakosta Paraskevi , Russo Scott J. , Neve Rachael L. , Kardassis Dimitris , Gold Stephen J. , Zachariou Venetia 
Published: August 2007

AbstractRegulators of G‐protein signaling (RGS) 9‐2 is a striatal enriched protein that controls G protein coupled receptor signaling duration by accelerating Gα subunit guanosine triphosphate hydrolysis. We have previously demonstrated that mice lacking the RGS9 gene show enhanced morphine analgesia and delayed development of tolerance. Here we extend these studies to understand the mechanism via which RGS9‐2 modulates opiate actions. Our data suggest that RGS9‐2 prevents several events triggered by mu‐opioid receptor (MOR) activation. In transiently transfected PC12 cells, RGS9‐2 delays agonist induced internalization of epitope HA‐tagged μ‐opioid receptor. This action of RGS9‐2 requires localization of the protein near the cell membrane. Co‐immunoprecipitation studies reveal that RGS9‐2 interacts with HA‐tagged μ‐opioid receptor, and that this interaction is enhanced by morphine treatment. In addition, morphine promotes the association of RGS9‐2 with another essential component of MOR desensitization, β‐arrestin‐2. We also show that over‐expression of RGS9‐2 prevents opiate‐induced extracellular signal‐regulated kinase phosphorylation. Our data indicate that RGS9‐2 plays an essential role in opiate actions, by negatively modulating MOR downstream signaling as well as the rate of MOR endocytosis.
Admiral nursing and the family care of a parent with dementia: using autobiographical narrative as grounding for negotiated clinical practice and decision‐making
Authors: Keady John , Ashcroft‐Simpson Susan , Halligan Kath , Williams Sion 
Published: August 2007

Background: Providing family care at home for a person with a long‐established diagnosis of dementia has been recognized for some time as a multifaceted and complex phenomenon where care roles alter during the course of the condition. Presently, the nursing response to meeting such need is currently poorly defined and documented in the literature and depends more upon descriptive illustrations of practice efficacy rather than any evaluated system of knowledge and skills transfer or framework utilization.Aim: The aim of the study was to capture an autobiographical account of a family carer's (Kath, co‐author) journey through the experience of her mother's dementia and the reflexive dialogue and shared care planning that ensued with the Admiral Nurse*(Susan, co‐author).Design: Kath's narrative was captured using practitioner‐research principles and 10 interview contacts; the autobiography was then used as the basis for therapeutic and clinical work, as reported and jointly negotiated between Kath and Susan.Results: The findings demonstrate the importance of constructing care from an autobiographical perspective and integrating lay knowledge within an overall professional response to family/carer need in dementia caregiving situations. The negotiated clinical response to Kath's grief process (the death of Kath's father, the main carer support to her mother with dementia) and Kath's subsequent adaptation process is illustrated through a shared sessional plan and agreed measures of effective care.Conclusion: Integrating narrative approaches into care practice demonstrates important new ways of working alongside families of people with dementia to help develop negotiated, transparent and shared systems of care.