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Mitsuhiko Takahashi,Ryosuke Sato,Kenji Kondo,Koichi Sairyo 대한초음파의학회 2018 ULTRASONOGRAPHY Vol.37 No.2
Purpose: The aim of this study was to elucidate whether intrasynovial corticosteroid injections for trigger digit reduced the volume of the tendon and pulley on high-resolution ultrasonography. Methods: Twenty-three digits of 20 patients with trigger digit were included. Each affected finger was graded clinically according to the following classification: grade I for pre-triggering, grade II for active triggering, grade III for passive triggering, and grade IV for presence of contracture. Axial ultrasound examinations were performed before an intrasynovial corticosteroid injection and at an average of 31 days after the injection. The transverse diameter, thickness, and crosssectional area of the tendon and the thickness of the pulley were measured by two independent, blinded researchers. Results: At least 1 grade of improvement was achieved in this study group by the time of the second examination. The transverse diameter and cross-sectional area of the tendon and the thickness of the pulley significantly decreased (P<0.05). Conclusion: The injection of a single dose of betamethasone improved clinical symptoms by reducing the volume of both the tendon and pulley, which may be related to the fact that tendon and pulley ruptures are delayed by corticosteroid injections.
Hiroshi Nakagawara,Kenji Yamao,Takuji Gotoda,Daiichiro Kikuta,Akinori Takei,Kunio Iwatsuka,Toshimi Takahashi,Masahiro Ogawa,Akihiro Henmi,Makio Kobayashi,Mitsuhiko Moriyama 소화기인터벤션의학회 2019 International journal of gastrointestinal interven Vol.8 No.2
Background: Endoscopic-guided placement of metal stents for unresectable malignant hilar biliary obstruction (UMHBO) is performed using partial stent-in-stent or side-by-side (SBS) techniques. The latter involves placing sequential stents within the bile duct. Excessive dilation of the bile duct during stent placement can have serious effects on the surrounding organs.Methods: This study details seven cases of SBS placement of 8.0 mm metal stents for UMHBO. Histopathological examinations were performed to identify the effects on the bile duct and surrounding tissues.Results: The mean post-placement diameter of the bile ducts was 13.86 mm, and no compression necrosis or thrombi were observed in surrounding tissues. Cholangitis occurred in five cases, and death occurred as a result of cholecystitis in one case. Conclusion: The use of 8.0-mm stents for SBS is unlikely to have major negative effects on peribiliary tissues and blood vessels. However, post-placement cholecystitis can result in increased mortality; thus, gallbladder drainage should be considered.
Hiroshi Nakagawara,Kenji Yamao,Takuji Gotoda,Daiichiro Kikuta,Akinori Takei,Kunio Iwatsuka,Toshimi Takahashi,Masahiro Ogawa,Akihiro Henmi,Makio Kobayashi,Mitsuhiko Moriyama 소화기인터벤션의학회 2019 Gastrointestinal Intervention Vol.8 No.2
Background: Endoscopic-guided placement of metal stents for unresectable malignant hilar biliary obstruction (UMHBO) is performed using partial stent-in-stent or side-by-side (SBS) techniques. The latter involves placing sequential stents within the bile duct. Excessive dilation of the bile duct during stent placement can have serious effects on the surrounding organs.Methods: This study details seven cases of SBS placement of 8.0 mm metal stents for UMHBO. Histopathological examinations were performed to identify the effects on the bile duct and surrounding tissues.Results: The mean post-placement diameter of the bile ducts was 13.86 mm, and no compression necrosis or thrombi were observed in surrounding tissues. Cholangitis occurred in five cases, and death occurred as a result of cholecystitis in one case. Conclusion: The use of 8.0-mm stents for SBS is unlikely to have major negative effects on peribiliary tissues and blood vessels. However, post-placement cholecystitis can result in increased mortality; thus, gallbladder drainage should be considered.