A Nodule-aggregating Lesion of the Rectum Associated with Gastric Adenoma —A Case Report—

Abstract: A 81-year-old female was admitted to our hospital to undergo endoscopical treatment for a gastric adenoma and received YAG-laser therapy. The gastric adenoma was completely removed by laser therapy. However, following treatment, she complained of having mucous feces. Although she had undergone a colonoscopy twice during the previous six month, we examined her large intestine using colonoscopy and barium enema. A colonoscopy revealed a large-flat elevated lesion of the same color as the surrounding mucosa and no transmucosal vascularity of the rectum. A well demarcated flat lesion 4 cm in size with conglomerated nodules on its surface was confirmed using the dye-spraying contrast method with 0.2% indigo carmine solution. A lower anterior resection of the rectal lesion was performed and the patient is now living and well 16 month following surgery. We believe that, if we encounter gastric adenomas, more careful observation and use of the dye-spraying contrast method are necessary for the detection of adenomas or cancers in the colon.     

Reduction in blood glucose values following indomethacin therapy for patent ductus arteriosus

PURPOSE: To evaluate the effects of indomethacin on blood glucose values in premature infants with patent ductus arteriosus (PDA). METHODS: Twenty-five very low birthweight infants with PDA were given 0.2 mg/kg, i.v., indomethacin for up to three doses. We examined the relationship between blood glucose values and glucose infusion rate before and after indomethacin therapy. RESULTS: There was a significant reduction in blood glucose values between 12 and 96 h following i.v. indomethacin therapy. Eleven of 25 infants (44%) had blood glucose values below 40 mg/dL between 12 and 60 h (mean 32.7 h) after the initial dose. Although the glucose infusion rate during the first 12 h was constant (3.56 +/- 0.98 mg/kg per min), the blood glucose values decreased from 96 +/- 32 mg/dL at the starting point to 75 +/- 29 mg/dL at 12 h (P < 0.05). The maximum blood glucose reduction was 51.6 +/- 34.7 mg/dL and the maximum blood glucose reduction rate was 50.4 +/- 20.2%. CONCLUSIONS: The results suggest that blood glucose values should be measured at least every 6 h for 72 h until they stabilize in order to prevent unexpected hypoglycemia.