bluuebunny/crossref_metadata_2025_split huggingface dataset:
ORAL MITEMCINAL (GM‐611), AN ERYTHROMYCIN‐DERIVED PROKINETIC, ACCELERATES NORMAL AND EXPERIMENTALLY DELAYED GASTRIC EMPTYING IN CONSCIOUS DOGS
Authors: Onoma Mitsu , Yogo Kenji , Ozaki Ken‐ichi , Kamei Kenshi , Akima Michitaka , Koga Hiroshi , Itoh Zen , Ōmura Satoshi , Takanashi Hisanori 
Published: August 2007

SUMMARYWe examined effects of orally administered mitemcinal, an erythromycin‐derived motilin agonist, on gastric emptying and antroduodenal motility in conscious normal dogs and conscious dogs with experimentally delayed gastric emptying. For comparison, we also examined the effects of orally administered cisapride.Gastric emptying was assessed by adding paracetamol to the test meal and determining three of its pharmacokinetic parameters as indices of gastric emptying. Antroduodenal motility was assessed from the output of force transducers chronically implanted in the gastric antrum and duodenum.In normal dogs, mitemcinal (0.25, 0.5 and 1 mg/kg) dose‐dependently accelerated gastric emptying, significantly increasing all three indices at doses of 0.5 and 1 mg/kg; cisapride (1, 3 and 10 mg/kg) had no significant effect. Mitemcinal also dose‐dependently stimulated antroduodenal motility in the interdigestive and digestive states. Cisapride, at 100‐fold the dose, produced similar effects in the interdigestive state, but mixed results in the digestive state.In dogs with delayed gastric emptying induced by subcutaneous clonidine (0.03 mg/kg), mitemcinal (0.25, 0.5 and 1 mg/kg) dose‐dependently improved delayed gastric emptying, significantly increasing two of three indices at a dose of 1 mg/kg. Cisapride (1, 3 and 10 mg/kg) caused non‐significant increases in the indices of gastric emptying, with roughly bell‐shaped dose–response curves. The highest dose of mitemcinal (1 mg/kg) also stimulated antroduodenal motility.In dogs with delayed gastric emptying induced by vagotomy, mitemcinal (0.125, 0.25 and 0.5 mg/kg) dose‐dependently improved delayed gastric emptying, significantly increasing all three indices at doses of 0.25 and 0.5 mg/kg. Cisapride (3 mg/kg) restored the indices to roughly prevagotomy levels, but none of the increases was significant. Mitemcinal, at a dose of 0.25 mg/kg, also stimulated antroduodenal motility.Because delayed gastric emptying is the basic characteristic of gastroparesis, the fact that mitemcinal accelerated gastric emptying in dogs with normal and delayed gastric emptying much more robustly than cisapride adds to the evidence that mitemcinal is likely to be useful for the treatment of patients with gastroparesis.
The Transduodenal Endoscopic Treatment of Acute Cholangitis
Authors: AKASHI Ryukichi , YAMABE Hiroshi , KIYOZUMI Takeaki , HOKAMURA Masanori , SAGARA Katsuro , WAKI Sumi , ARITA Tetsumasa , INAYOSHI Atsushi , HAYASHIDA Nobuo , YAGI Yasushi , IKEDA Tsunekazu , HATTORI Masahiro 
Published: August 2007

Abstract:Mortality due to acute cholangitis (AC) has been tremendously reduced by the advent of endoscopic sphincterotomy (EST). This study investigates whether EST is really a curative procedure for the treatment of AC, or not. Diagnosis of AC, in 159 out of 1,061 cases in which EST was performed, had been made by infected bile which was recognized as green or pyobile collected during ERCP. Emergency drainage by EST was performed immediately after AC was diagnosed. The causes of AC were attributable to benign diseases in 128 cases (80.5%) and malignant diseases in the remaining 31 cases. Clinical symptoms included abdominal pain, fever, and obstructive jaundice, but Charcot's triad was noticed in 66 cases (43.3%) and Reynolds pentad in only 7 cases (4.6%). As to the relation between clinical symptoms and properties of bile, pyobile was more likely to be recognized in patients with severe symptoms.Four patients treated at our hospital died of AC (2.5%). All were over 80 years old, and their conditions were already complicated by disseminating intravascular coagulation (DIC) syndrome. Compared with the results obtained in patients treated with percutaneous transhepatic biliary drainage (PTBD), the resulting mortality rate was less. Therefore, we feel the best approach for treating AC, which progresses to acute obstructive suppurative cholangitis (AOSC) in the final stage of the disease, is to diagnose early, by ERCP, and to promptly obtain decompression by subsequent EST, or to perform radical surgery.
Clinical Experience with Prototype Pancreatoscopes
Authors: AKIYAMA Tetsuji , FUJI Tadasu , TANAKA Shinya , HARIMA Kenzo , SASAKI Toshiyuki , NAKAMURA Masaaki , PUA Shirley C. , OKITA Kiwamu , TAKEMOTO Tadayoshi 
Published: August 2007

Abstract: Peroral pancreatoscopy (PPS) was introduced at our institute in 1982, with the aim of improving diagnostic accuracy in patients with pancveatic diseases, and as a preliminary, procedure for therapeutic interventions to the pancreas. However, limitations in instrumentation permitted us to observe only the main pancreatic duct. This is a report of our experience with 2 types of peroral Pancreatoscopes and our findings in patients with chronic pancreatitis and pancreatic cancer.We subjected 30 patients suspected to have pancreatic diseuse to PPS, using either the CPF‐29X, which has an external diameter of 2.9 mm (Olympus: Japan), or the PA‐08, which has an external diameter of 0.8 mm (a modification of the angioscope, Fujinon: Japan).PPS with the CPF‐29h was attempted in 18 cases (pancreatic cancer, 11; chronic pancreatitis, 7), and was successfully introduced into the main pancreatic duct in I 6 cases. This allowed good visualization of the main pancreatic duct and a more definitive diagnosis in 11 cases. On the other hand, PPS with the PA‐08 was successfully introduced in all 12 of the cases in which it was attempted (pancreatic cancer, 7; chronic pancreatitis, 5) and permitted satisfactory endoscopic observation and accurate diagnosis in 9 cases.Puncreatic cancer appeared as an irregular elevation of the pancveatic duct mucosa, while chronic pancreatitis presented as a smooth stenosis, without significant mucosal changes.Thus, PPS is a valuable alternative or supplementary procedure to present‐day diagnostic imaging methods of arriving at a more definitive diagnosis in difficult cases. For the biopsy of lesions under direct vision and the possibility of therapeutic interventions to the pancreas, however, we propose the development of a pancreatoscope equipped with a forceps channel and which has an external diameter of less than 1 mm.
A Case of Boerhaave's Syndrome —Evaluation of Diagnostic Value of Endoscopy—
Authors: Matsumoto Fumiko , Matsumoto Toshihiko , Takasu Masashi , Ka Kunihiko , Murase Toshihiko , Iida Miyako , Mizuno Takako , Kawaguchi Mitsugu , Nishino Hiroji 
Published: August 2007

Abstract: We experienced a case of Boerhaave's syndrome. The patient, a 47‐year‐old male, vomited after drinking a large quantity of alcohol and thereafter, complained of epigastralgia, back pain, and dyspnea. Leukocytosis, positive CRP, fever, tenderness of the upper abdomen and muscular defense were noted on admission. Endoscopy revealed an ulcer at the lower esophagus. Since a chest X‐P and CT showed thoracic effusion and subcutaneous and mediastinal emphysema, rupture of the esophageal ulcer was suspected. The diagnosis of Boerhaave's syndrome was established by esophagography. A rupture along the longitudinal axis of about 3cm was found at the left posterior wall 3cm above the E‐G junction, and was surgically sutured.Of many cases of Boerhaave's syndrome reported in the literature in Japan, endoscopy was performed in 70 cases. Recently, endoscopy has been adopted as the first choice for the diagnosis of this syndrome as well as for emergency examination of the esophagus and the diagnosis is established by endoscopy alone in many cases. Actually endoscopy was useful for the diagnosis of this disease in 88.2% of the above cases. These results as well as our case indicate diagnostic value of endoscopy, if performed carefully.Boerhaave's syndrome,Endoscopy
Small Cell Carcinoma of the Esophagus Concurring with Early Stomach Carcinoma (IIa); A Case Report
Authors: IMAMURA Akimichi , BETSUYAKU Takashi , KADONO Yutaka , AKASAKA Yoshinobu , SASAKI Michiro , YAMASHIRO Katsushige , MIYAKAWA Akira 
Published: August 2007

Abstract: The most common histologic type of carcinoma of the esophagus is squamous cell carcinoma. Small cell or oat cell carcinoma is rare. Only 95 cases have been reported as far as we have investigated in both the English and Japanese Literature since the first description by Mckeown1) in 1952.A case of small cell carcinoma of the esophagus concurring with early stomach carcinoma (IIa) in a 71‐year‐old male is reported.Gross, radiological and endoscopic features in sufficient photographs obtained from literature on the 95 cases and in the present case, were analyzed. A major morphological feature of the lesion is well‐defined ulceration with marginal swelling similar to that in a submucosal tumor.From the viewpoint of double cancer, no case of small cell or oat cell carcinoma of the esophagus concurring with early stomach carcinoma is found in the 95 cases reported. Therefore, the present case is thought to be the first reported case of small cell carcinoma of the esophagus concurring with early stomach carcinoma (IIa).
Colorectal Carcinomas Following Ulcerative Colitis in Japanese Patients
Authors: KAWAGUCHI Atsushi , NIWA Hirohumi 
Published: August 2007

Abstract: Colorectal carcinomas occuring following ulcerative colitis in Japanese patients discussed in the literature were analyzed in order to review their characteristics.1) Of the 74 cases reported from 1962 to November 1989, 29 were males and 45 were females. The sex differences in Japanese ulcerative colitis were almost 1: 1, so females with colorectal carcinomas occured more often than males.2) Male patients had a bimodal peak in their 30's and 40's, while female patients had the peak in their 40's and 50's. More colorectal carcinomas were found among younger people than in the general population.3) Universal colitis was the most common type of colorectal cancer occuring following ulcerative colitis. 57 patients out of 74 were classified into this type.4) The duration of the disease prior to the diagnosis of colorectal cancer was generally 10 years or longer.5) The rectum was the commonest site of cancer, and was seen in 44 cases out of 74. Rectosigmoid colon carcinomas occurred in 61 of 74 cases.6) Histologically, colonic malignancy associated with ulcerative colitis was an adenocarcinoma, displaying a wide spectrum of differentiation. Poorly differentiated (4 males and 6 females) and signet ring cell carcinoma (3 males and 5 females) were also reported.7) The so‐called type 4 tumor occurred in 3 males and 6 females out of a total of 74 cases. This type of tumor is usually rare in colorectal cancer.8) Most of the patients with early carcinomas had suffered from ulcerative colitis for more than 15 years and the characteristics of their macroscopic appearance were protruded lesions.9) Foci of dysplasia accompanied carcinoma in as many as 80% of the Japanese cases reported. (56 out of 74 cases)Based on these, we should take consideration that:1) Patients with pancolitis lasting more than 10 years whose forms are chronically active or intermittently active should be recognized as a high‐risk group. 2) Full colonoscopy every one or two years may be sufficient to find dysplasia as well as carcinoma even if the condition of disease is stable. 3) Protruded lesions should be biopsied to detect early cancer as well as dysplasia on colonoscopy. 4) A change in the disease condition, i. e. rectal bleeding, weight loss and a change of bowel habits should not be mistaken for an exacerbation of colitis and should be investigated without fail.
Role of Endoscopy in the Diagnosis of Papillary Dysfunction
Authors: KOBAYASHI Kenzo , OZAKI Shoichi , TAKAISHI Osamu 
Published: August 2007

Abstract:The role of endoscopy in the papillary region was analyzed in order to review the functional disturbances of the papillary region and the mechanism of excretion of bile into the duodenum. There are several procedures for the diagnosis of reversible or irreversible papillitis. Many investigators try to clarify the pathogenesis of papillary dysfunction by using the endoscopic method. Endoscopic manometry fills an important role in evaluating papillary dysfunction. Nevertheless, physiological and pathophysiological investigation of the mechanism of excretion of bile are not satisfactory, and the significance of the effects on the papillary region of gastrointestinal hormones such as cholecystokinin (CCK) is not clear. More studies using the endoscopic method are necessary to elucidate the function of the papillary region.
Study on the Phenomenon of Locational Variation in the Speed of Discoloration During the Endoscopic Congo Red Test The Second Report: Ultrastructural Studies on Parietal Cell Populations
Authors: KIMURA Norio , TANI Norio , KARASAWA Hiroyuki , MIYAZAWA Masayuki , MUTOH Nobuyoshi , MIWA Takeshi 
Published: August 2007

Abstract:Both quantitative and morphological studies of parietal cells were done in order to investigate the cause of the phenomenon of locational variation in the speed of discoloration during the endoscopic Congo red test. The endoscopic Congo red test was performed in twelve patients with a peptic ulcer and/ or chronic gastritis. In each case, at the times when spotty discoloration was observed, five biopsy specimens were obtained from both the quickly discolored portion (already discolored portion) –Q and the slowly discolored portion (not yet discolored portion) –S of the greater curvature of the middle body at the same time and were separated into two groups (the Q‐group and the S–group). Quantitative studies of the parietal cells were performed using the cell isolation method described in our first report. A morphological study was performed with an electron microscope. Two specimens were fixed in glutaraldehyde and osmium tetroxide, and finally embedded in Epon resin. Ultra‐thin secretions contrasted with uranyl acetate and lead citrate were viewed with a JEOL‐1200EX electron microscope. Each parietal cell was classified according to the classification of ultrastructual stages put forward by Black et al. The number of parietal cells per milligram wet weight of the quickly discolored portion was significantly larger than that of the slowly discolored portion similar to the results of our first report. However the ultrastructural aspects of the parietal cells were not found to be different between the Q–group and S–group portion. It is concluded that the locational variation of the speed of discoloration during the endoscopic Congo red test may be due to the unequal distribution of parietal cells and that the sensitivity and responsiveness of parietal cells to the stimulation may be almost the same in all of the acid secreting area.
Cellular and Structural Atypia of the Early Colorectal Cancers
Authors: SATAKE Yoshiharu , FUJITA Rikiya , KAMINAGA Norihiro , KATAKURA Shigehiro , TSUBOMIZU Yoshio , TAKAHASHI Hiroshi , SUGATA Fumio , MITSUYA Toshiyuki , SAGAWA Fumiaki 
Published: August 2007

Abstract:Cellular and structural gland atypia in lesions of early colorectal cancer removed by endoscopic polypectomy in 101 patients were histopathologically studied. The following results were observed. Cellular atypia was frequently found in lesions with a high rate of nuclear polarity loss and multiple nuclear mitoses (99. 0%). The most frequent findings in the glands with structural atypia was intraglandular glands and crowding of neoplastic glands (85. 1%). Most of the appearances of the cellular and structural atypias showed no marked relationship with the sizes of the lesions, depth of invasion and association of adenoma components. Early cancer had both cellular and structural atypia in 95% of the patients and could be diagnosed by conventional histopathological criteria. However five patients with early cancer showed no structural atypia and were diagnosed as having cellular atypia. These cancers were early intramucosal cancer and four lesions were associated with adenoma components 20 mm or less in size. The loss of nuclear polarity and nuclear pleomorphism may be considered more important than nuclear stratification and mitoses in the diagnosis of early cancer.
Expandable Metallic Stents: in the Benign Strictures of Intrahepatic Ducts in Patients with Primary Intrahepatic Stones
Authors: KIM Myung Hwan , LEE Sung Koo , MIN Young II , SUNG Kyu Bo , LEE Sung Gyu , MIN Pyung Chul 
Published: August 2007

Abstract: In Korea there is a prevalence for primary intrahepatic stones. Patients with primary intrahepatic stones and oriental cholangiohepatitis ofen have accompanying intrahepatic strictures. Despite complete removal of the intrahepatic stones, sustained intrahepatic strictures will evoke bile stasis and impairment of liver function. So the correction of intrahepatic strictures in addition to the removal of the stones is important in the management of primary intrahepatic stones.We inserted self‐expandable metallic stents in 16 patients with primary intrahepatic stones for the correction of intrahepatic strictures after complete removal of their intrahepatic stones. All of the patients had a previous history of abdominal surgery for the removal of intrahepatic stones. The criteria for insertion of expandable metallic stents was recurrent stenosis after successful balloon dilatation. The metallic stents inserted were Gianturco‐Rosch stents (24F) and the stents were inserted via a T‐tube or percutaneous transhepatic biliary drainage (PTBD) track. In the follow‐up period of an average of 12 months (9–15 months), 14 (88%) out of 16 patients experienced relief of pruritus and improved liver function. But two patients (12%) with secondary biliary cirrhosis showed no improvement of their clinical symptoms and signs.In conclusion, these findings suggest that expandable metallic stents will be useful in the management of intrahepatic strictures, which recurred after successful balloon dilatation, in patients with primary intrahepatic stones.
A Case of Lymphangioma Coexistent with Tubular Adenoma in the Descending Colon and a Review of the Literature
Authors: MATSUMOTO Toshihiko , MATSUMOTO Fumiko , HASHIMOTO Norihiro , HIROTA Toshiya , IIDA Miyako , MIZUNO Takako , HOSOKAWA Kouichi , MAEKURA Syunji 
Published: August 2007

Abstract: We recently encountered a case of lymphangioma of the colon which coexisted with a tubular adenoma. The patient was a 71‐year‐old male who was admitted for physical therapy for lumbago caused by osteoarthritis. He had no evident abdominal symptoms and no weight loss. Although mild anemia and hypoproteinenia were observed, his stool occult blood test was negative and tumor markers revealed no significant changes. A barium enema revealed two elevated lesions in the descending colon. The proximal lesion appeared to be semipedunculated and its form changed following postural changes. The distal lesion was pedunculated. When the patient changed his posture, the head and stalk of the lesion were identified, Both lesions were removed by endoscopic polypectomy. The proximal lesion was histologically diagnosed as being a cavernous lymphangioma, while the distal one was found to be a tubular adenoma.Lymphangioma of the colon is considered to be rare. In Japan, 102 cases including the present case have been reported to date. The coexistence of this disease with neoplasmic lesions of the colon has been reported in 20 cases, including 7 cancer cases and 16 adenoma cases; some cases had overlapping coexistence. The frequency of coexistence of a lymphangioma with cancer or adenoma seems to be rather high. The relationship between lymphangioma and these lesions is unknown. The coexistence of neoplasmic lesions may be accidental. The patients with this coexistence had no characteristic features, except for a high incidence of gastrointestinal bleeding. At least 43% of the coexisting cancers were found in the cecum, the vermiform appendix and the hepatic flexure, indicating the necessity of a detailed examination of the entire colon in cases where a lymphangioma is detected.
Continuous Endoscopic Variceal Ligation with a Three‐shooter
Authors: SHIBUYA Susumu , TAKASE Yasuhiro , CHIKAMORI Fumio , NAKAHARA Akira , FUKUTOMI Hisayuki 
Published: August 2007

Abstract:Endoscopic variceal ligation with an elastic O band has been performed in the treatment of esophageal varices. Generally, after ligating the varix during the treatment the endoscope is removed and the O band is changed each time until the desired result is achieved. However, it is thought that a shorter time to change the O band would make endoscopic variceal ligation more convenient. Therefore, we designed continuous endoscopic variceal ligation with three elastic O bands. To release three bands continuously, a self recoiling spring is attached at the endoscopic side between the inner and outer cylinders. After releasing one band by pulling the wire, the inner cylinder is returned to its original position by recoiling the spring and the next O band is automatically set up. Continuous endoscopic variceal ligation was performed for one case of esophageal varices due to hepatocellular carcinoma with liver cirrhosis. This technique enabled the ligation of three varices concomitantly, thus eliminating the necessity of repeated extraction and insertion of the endoscope every time the varix was ligated. The operation time was considerably shortened. The case reported did not develop any complications. Hence, it was thought that our technique of a three‐shooter is easier to perform and more convenient for the patient.
Study on Numerical Expression of Gastric Mucosal Color with a Videoendoscope and an Image Processor
Authors: TAKAHASHI Yoshinobu , NAKAZAWA Yoshihiko , OKAZAKI Kazuich , YAMAMOTO Yasutake 
Published: August 2007

Abstract:This study was conducted to determine the numerical expression of gastric mucosal color using the L*a*b* color system to analyze an image obtained by videoen‐doscopy (GIF‐V10, Olympus, Tokyo). These data were then quantitated using an image processor (LA‐500, PI AS, Osaka), and the results were compared with the gastric mucosal blood flow determined by laser Doppler flowmetry to determine if a correlation exists between gastric mucosal blood flow and color.The ΛHue and the ΛChroma were defined as the difference between the reference region and a white disk on the gastric mucosa, respectively. The ΛHue represents the degree of redness relative to the white disk. The ΛChroma represents the vividness of the red color. Both were calculated in patients with flat erythema, erosion, gastric ulcer, and early gastric cancer type lie.In the early stages of gastric cancer, the ΛHue of poorly differentiated adenocarcinoma was more reddish than that of well differentiated adenocarcinoma. However, we should pay attention to the ΛHue difference between the cancer and the background, with that of well differentiated adenocarcinomas being higher than that of poorly differentiated lesions. This is due to the Color Contrast Effect. Endoscopically, lesions of well differentiated adenocarcinoma are more reddish than those of poorly differentiated adenocarcinoma. Furthermore, we demonstrated a correlation between AHue and gastric mucosal blood flow in normal gastric mucosa.We conclude that color analysis of analog imaging using a videoendoscope and image processor is a potentially important clinical aid in endoscopic diagnosis.