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Present Status of Endoscopic Submucosal Dissection for Non-Ampullary Duodenal Epithelial Tumors
Naomi Kakushima,Masao Yoshida,Yohei Yabuuchi,Noboru Kawata,Kohei Takizawa,Yoshihiro Kishida,Sayo Ito,Kenichiro Imai,Kinichi Hotta,Hirotoshi Ishiwatari,Hiroyuki Matsubayashi,Hiroyuki Ono 대한소화기내시경학회 2020 Clinical Endoscopy Vol.53 No.6
Prediction of histology by endoscopic examination is important in the clinical management of non-ampullary duodenal epithelial tumors (NADETs), including adenoma and adenocarcinoma. The use of a simple scoring system based on the findings of white-light endoscopy or magnified endoscopy with narrow-band imaging is useful to differentiate between Vienna category 3 (C3) and C4/5 lesions. Less invasive endoscopic resection procedures, such as cold snare polypectomy, are quick to perform and convenient for small (<10 mm) C3 lesions. Neoplasms with higher grade histology, such as C4/5 lesions, should be treated by endoscopic mucosal resection (EMR), endoscopic submucosal dissection (ESD), or surgery. Although EMR often requires piecemeal resection, the complication rate is acceptable. Excellent complete resection rates could be achieved by ESD; however, it remains a challenging method considering the high risk of complications. Shielding or closure of the ulcer after ESD is effective at decreasing the risk of delayed bleeding and perforation. Laparoscopic endoscopic cooperative surgery is an ideal treatment with a high rate of en bloc resection and a low rate of complications, although it is limited to high-volume centers. Patients with NADETs could benefit from a multidisciplinary approach to stratify the optimal treatment based on endoscopic diagnoses.
Satomi Seki,Naoko Kato,Naomi Ito,Koichiro Kinugawa,Minoru Ono,Noboru Motomura,Atsushi Yao,Masafumi Watanabe,Yasushi Imai,Norihiko Takeda,Masashi Inoue,Masaru Hatano,Keiko Kazuma 한국간호과학회 2010 Asian Nursing Research Vol.4 No.2
Purpose The aim of this study was to evaluate the validity and reliability of the Seattle Angina Questionnaire, Japanese version (SAQ-J) as a disease-specific health outcome scale in patients with coronary artery disease. Methods Patients with coronary artery disease were recruited from a university hospital in Tokyo. The patients completed self-administered questionnaires, and medical information was obtained from the subjects’medical records. Face validity, concurrent validity evaluated using Short Form 36 (SF-36), known group differences, internal consistency, and test-retest reliability were statistically analyzed. Results A total of 354 patients gave informed consent, and 331 of them responded (93.5%). The concurrent validity was mostly supported by the pattern of association between SAQ-J and SF-36. The patients without chest symptoms showed significantly higher SAQ-J scores than did the patients with chest symptoms in 4 domains. Cronbach’s alpha ranged from .51 to .96, meaning that internal consistency was confirmed to a certain extent. The intraclass correlation coefficient of most domains was higher than the recommended value of 0.70. The weighted kappa ranged from .24 to .57, and it was greater than .4 for 14 of the 19 items. Conclusions The SAQ-J could be a valid and reliable disease-specific scale in some part for measuring health outcomes in patients with coronary artery disease, and requires cautious use. [Asian Nursing Research 2010;4(2):57–63]
Natural History of Early Gastric Cancer: a Case Report and Literature Review
Iwai, Tomohiro,Yoshida, Masao,Ono, Hiroyuki,Kakushima, Naomi,Takizawa, Kohei,Tanaka, Masaki,Kawata, Noboru,Ito, Sayo,Imai, Kenichiro,Hotta, Kinichi,Ishiwatari, Hirotoshi,Matsubayashi, Hiroyuki The Korean Gastric Cancer Association 2017 Journal of gastric cancer Vol.17 No.1
Early detection and treatment decrease the mortality rate associated with gastric cancer (GC). However, the natural history of GC remains unclear. An 85-year-old woman was referred to our hospital for evaluation of a gastric tumor. Esophagogastroduodenoscopy identified a 6 mm, flat-elevated lesion at the lesser curvature of the antrum. A biopsy specimen showed a well-differentiated tubular adenocarcinoma. The depth of the lesion was estimated to be intramucosal. Although the lesion met the indications for endoscopic resection, periodic endoscopic follow-up was performed due to the patient's advanced age and comorbidities. The mucosal GC invaded into the submucosa 3 years later, and finally progressed to advanced cancer 5 years after the initial examination. The patient died of tumor hemorrhage 6.4 years after the initial examination. In this case, mucosal GC progressed to advanced GC, eventually leading to the patient's death from GC. Early and appropriate treatment is required to prevent GC-related death.
( Mariko Mochizuki ),( Yukari Osada ),( Nami Shimaoka ),( Mayumi Ito ),( Naomi Sannda ),( Junko Fujita ),( Hiroyuki Matumoto ),( Tadashi Matushita ) 대한임상병리사협회 2015 임상미생물검사학회 발표자료집 Vol.2015 No.-
Case The patient was a 45-year-old man. He was diagnosed as having malignant melanoma ten years ago, and received chemotherapy including alkylating agents. After nine years, he developed treatment-related myelodysplastic syndrome / myeloproliferative neoplasm (MDS / MPN), and he received hematopoietic stem cell transplantation. He had recurrence as MDS and re-transplanted. The blood culture after re-transplantation were repeatedly positive for Enterococci and yeast-like fungi of black-colored colony. Micafungin (MCFG) and Fluconazole were added to the treatment with liposomal-amphoterisin B. Hematopoetic stem cell transplantation was performed again due to bone marrow graft failure, however, his condition got worsened and died. Microbiological findings A yeast-like form with budding was found under microscopy, and black-colored colonies were grown on a CHROMagarTM Candida plate (Becton Dickinson). Species identification was not possible using VITEK and ApiC AUX (bioMerieux). Further culture revealed brown filamentous form on the melted chocolate-like colonies, which was strongly suggestive of dimorphic fungi. This fungus was identified as Exophiala dermatitidis by sequence analysis of ITS region of rRNA gene. Susceptibility test using the ASTY (KYOKUTO PHARMACEUTICAL INDUSTRIAL Co., Ltd) showed that, after 72hr growth, a high MIC values of > =16㎍/ml in MCFG and relatively good susceptibility to other antifungal drugs. Discussion Exophiala dermatitidis is a type of pathogenic dematiaceous fungi which was widely found in residential environment. It mainly causes infections of cutaneous and subcutaneous tissue in immunocompromised patients, but sometimes fatal infections such as bloodstream infection. In clinical settings, it is important to speculate this species from morphological features, which will lead to the early diagnosis and treatment especially in immunocompromised cases. Acknowledge Takashi Yaguchi, Aki Hirabayashi, Daizo Kato, Mitsutaka Iguchi, Satoshi Morioka, Tetsuya Yagi
Natural History of Early Gastric Cancer: a Case Report and Literature Review
Tomohiro Iwai,Masao Yoshida,Hiroyuki Ono,Naomi Kakushima,Kohei Takizawa,Masaki Tanaka,Noboru Kawata,Sayo Ito,Kenichiro Imai,Kinichi Hotta,Hirotoshi Ishiwatari,Hiroyuki Matsubayashi 대한위암학회 2017 Journal of gastric cancer Vol.17 No.1
Early detection and treatment decrease the mortality rate associated with gastric cancer (GC). However, the natural history of GC remains unclear. An 85-year-old woman was referred to our hospital for evaluation of a gastric tumor. Esophagogastroduodenoscopy identified a 6 mm, flat-elevated lesion at the lesser curvature of the antrum. A biopsy specimen showed a well-differentiated tubular adenocarcinoma.
( Shinya Fujie ),( Hirotoshi Ishiwatari ),( Keiko Sasaki Junya Sato ),( Hiroyuki Matsubayashi ),( Masao Yoshida ),( Sayo Ito ),( Noboru Kawata ),( Kenichiro Imai ),( Naomi Kakushima ),( Kohei Takizawa 대한간학회 2019 Gut and Liver Vol.13 No.3
Background/Aims: To compare the diagnostic yield of 20-gauge forward-bevel core biopsy needle (CBN) and 22-gauge needle for endoscopic ultrasound (EUS)-guided fine needle aspiration (FNA) of solid pancreatic masses. Methods: The use of 20-gauge CBN was prospectively evaluated for 50 patients who underwent EUS-FNA from June 2016 to December 2016. Data were compared with those obtained by a retrospective study of 50 consecutive patients who underwent EUS-FNA using standard 22-gauge needles between December 2016 and April 2017. At least two punctures were performed for each patient; the sample from the first pass was used for cytology with or without histology and that from the second pass was used for histology. Sample quantity was evaluated using the sample obtained from the second pass. Results: There was no significant difference in the diagnostic accuracy rate between the first and second passes (20-gauge CBN: 96% [48/50]; standard 22-gauge needle: 88% [44/50]). Samples >10× power fields in length were obtained from 90% (43/48) and 60% (30/50) of patients using the 20-gauge CBN and standard 22-gauge needle, respectively (p=0.01). Technical failure occurred for two patients with the 20-gauge CBN. Conclusions: Diagnostic accuracy of the 20-gauge CBN was comparable to that of the 22-gauge needle. However, two passes with the 20-gauge CBN yielded a correct diagnosis for 100% of patients when technically feasible. Moreover, the 20-gauge CBN yielded core tissue for 90% patients, which was a performance superior to that of the 22-gauge needle. (Gut Liver 2019;13:349-355)
개에 있어서 중증(重症)의 판막상성(瓣上性) 및 판막성폐동맥협착증(瓣性肺動脈狹窄症)에 대한 심박동정지하 (心停止下) 심장막패치법에 의한 1 치험례(治驗例)
백영기(번역자),長屋好昭(Yoshiaki NAGAYA),金本 勇(Isamu KANEMOTO),千村?一(Syuichi CHIMURA),益本友成(Tomonari MASUMOTO),小原公成(Kiminari OHARA),伊藤裕二(Yuji ITO),猪股直美(Naomi INOMATA),竹島昌俊(Masatoshi TAKESHIMA),田中郁江(Ikue TANAKA) 로얄에이알씨 주식회사 2004 로얄동물임상의학 Vol.2 No.4
4개월령 때의 예방접종을 위한 진찰에서 수축기잡음이 청취되었던 1세령의 암컷, 체중 3㎏의 치와와가 각종의 검사에서 중증의 판막상성(瓣上性)-판막성(瓣性)폐동맥협착증으로 진단되었다. 이 증례에 대하여 표면냉각단순저체온마취(表面冷却單純低體溫麻醉)에의한 심장박동 정지하(停止下)에서의 심장막 패치법(Patch method)으로 외과수술을 실시하여 교정에 성공하였다. 수술 후에는 X선 검사에 의하여 심흉격비율(心胸隔比)의 축소와 우심실압(右心室壓)의 저하가 인정되었다. In a one-year-old female Chihuahua, weighing 3㎏, which had shown a systolic murmur at the examination of vaccination at 4 months of age, we diagnosed several supravalvular and valvular pulmonic stenoses using various examinations. Our surgical treatment with the pericardial path-method under cardiac arrest succeeded using simple surface hypothermia. The treatment induced a reduction of the cardiothoracic ratio in radiographic examination and decline of right ventricle pressure after operation.