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991.
992.
Kazuhiko Uchiyama Takeshi Ishikawa Naoyuki Sakamoto Hirokazu Kajikawa Tomohisa Takagi Osamu Handa Yoshihide Tatsumi Nobuaki Yagi Yuji Naito Yoshito Itoh Shuhei Takemura 《Journal canadien de gastroenterologie》2014,28(1):31-34
BACKGROUND:
Transnasal esophagogastroduodenoscopy (EGD) without sedation has been reported to be safe and tolerable. It has recently been used widely in Japan for the detection of upper gastrointestinal disease. Alternatively, transoral examination using a thin endoscope has also been reported to be highly tolerable.OBJECTIVE:
To examine the cardiocirculatory effects of transoral versus transnasal EGD in an attempt to determine the most suitable endoscopic methods for patients ≥75 years of age.METHODS:
Subjects who underwent monitoring of respiratory and circulatory dynamics without sedation during endoscopic screening examinations were enrolled at the New Ooe Hospital (Kyoto, Japan) between April 2008 and March 2009. A total of 165 patients (age ≥75 years) provided written informed consent and were investigated in the present study. Patients were randomly divided into three subgroups: UO group – thin endoscope; SO group – standard endoscope; and UT group – transnasal EGD. Percutaneous arterial blood oxygen saturation, heart rate and blood pressure were evaluated just before EGD and at five time points during EGD. After transnasal EGD, patients who had previously been examined using transoral EGD with a standard endoscope were asked about preferences for their next examination.RESULTS:
There were no statistical differences in the characteristics among the groups. Percutaneous oxygen saturation in the UT group showed a transient drop compared with the SO and UO groups at the beginning of the endoscopic procedure. Heart rate showed no significant differences among the SO, UO and UT groups; Systolic blood pressure in the UO group was lower immediately after insertion compared with the SO and UT groups. The rate pressure product in the UO group was comparable with that in the UT group during endoscopy, and the SO group showed a continuously higher level than the UO and UT groups. More than one-half (54.4%) of patients were ‘willing to choose transnasal EGD for next examination’.CONCLUSIONS:
For elderly patients, unsedated transnasal EGD failed to show an advantage over unsedated standard endoscopy. Transoral thin EGD was estimated to be safe and tolerable. 相似文献993.
994.
Hiroshi Moritake Sachiyo Kamimura Hiroyuki Nunoi Hideki Nakayama Aiko Suminoe Hiroko Inada Jiro Inagaki Fumio Yanai Yasuhiro Okamoto Yuichi Shinkoda Maiko Shimomura Nobuyoshi Itonaga Noriko Hotta Yasufumi Hidaka Osamu Ohara Masakatsu Yanagimachi Noriko Nakajima Jun Okamura Yoshifumi Kawano 《International journal of hematology》2014,100(1):70-78
This present study sought to analyze acute lymphoblastic leukemia (ALL) patients with hemophagocytic lymphohistiocytosis (HLH) registered in Kyushu–Yamaguchi Children’s Cancer Study Group studies conducted between 1996 and 2007. Four of 357 patients, including two of 318 patients with B cell precursor acute lymphoblastic leukemia (BCP-ALL) and two of 39 of those with T cell acute lymphoblastic leukemia (T-ALL), were identified. HLH was observed more frequently in the T-ALL patients than in the BCP-ALL patients (P = 0.061). The mean age of 13.0 years at the diagnosis of leukemia in the HLH + ALL group was significantly higher than the 6.05 years observed in the remaining ALL groups (P = 0.001). A female predisposition was noted, as all four patients were female (P = 0.043). In two of four patients, the leukemic cells exhibited deletions on the long arm of chromosome 6 (P = 0.003). Three patients suffered from HLH during maintenance therapy. Parvovirus B19 infection and cytomegalovirus reactivation were identified as causes of HLH in one and two patients, respectively. All four patients are currently in complete remission, although one developed relapse of leukemia after receiving maintenance therapy. Based on the genetic analyses, non-synonymous single nucleotide polymorphisms (SNPs) in UNC13D, syntaxin 11, and STXBP2 were identified in all patients. Clinicians should therefore be aware of the risk of HLH during maintenance therapy, especially in older T-ALL patients with SNPs in familial HLH causative genes. 相似文献
995.
Shintaro Akiyama Koji Izutsu Yasunori Ota Tsunao Imamura Osamu Ogawa Atsushi Wake Kazuo Takeuchi 《Medicine》2014,93(26)
A 46-year-old woman underwent upper endoscopy for evaluation of anemia, which revealed whitish granules at the duodenal papilla, diagnosed as duodenal follicular lymphoma (DFL) by biopsy. Computed tomography and abdominal ultrasonography revealed that follicular lymphoma was confined to the duodenum. Seven years after the diagnosis, fluorine-18 fluorodeoxyglucose positron emission tomography scanning revealed multiple lesions including in bone marrow and lymph nodes. Bone marrow biopsy of the right iliac bone revealed diffuse large B-cell lymphoma, indicating systemic dissemination and histologic transformation of the DFL. The patient responded to chemotherapy and has been progression-free for 2.5 years. Although DFL is usually indolent even without any treatment, systemic dissemination with histologic transformation can occur. This case suggests that the life-time follow-up that is usually done for patients with nodal follicular lymphoma should be provided to patients with DFL. 相似文献
996.
997.
Kobayashi Kentaro Manabe Osamu Hirata Kenji Yamaguchi Shigeru Kobayashi Hiroyuki Terasaka Shunsuke Toyonaga Takuya Furuya Sho Magota Keiichi Kuge Yuji Kudo Kohsuke Shiga Tohru Tamaki Nagara 《European journal of nuclear medicine and molecular imaging》2020,47(8):1833-1842
European Journal of Nuclear Medicine and Molecular Imaging - 18F-fluoromisonidazole (18F-FMISO) is the most widely used positron emission tomography (PET) tracer for imaging tumor hypoxia. Previous... 相似文献
998.
Shinji Tanaka Hiroshi Kashida Yutaka Saito Naohisa Yahagi Hiroo Yamano Shoichi Saito Takashi Hisabe Takashi Yao Masahiko Watanabe Masahiro Yoshida Yusuke Saitoh Osamu Tsuruta Ken-ichi Sugihara Masahiro Igarashi Takashi Toyonaga Yoichi Ajioka Masato Kusunoki Kazuhiko Koike Kazuma Fujimoto Hisao Tajiri 《Digestive endoscopy》2020,32(2):219-239
Suitable lesions for endoscopic treatment include not only early colorectal carcinomas but also several types of precarcinomatous adenomas. It is important to establish practical guidelines wherein preoperative diagnosis of colorectal neoplasia and selection of endoscopic treatment procedures are appropriately outlined and to ensure that actual endoscopic treatment is useful and safe in general hospitals when carried out in accordance with guidelines. In cooperation with the Japanese Society for Cancer of the Colon and Rectum, the Japanese Society of Coloproctology, and the Japanese Society of Gastroenterology, the Japan Gastroenterological Endoscopy Society compiled colorectal endoscopic submucosal dissection/endoscopic mucosal resection guidelines by using evidence-based methods in 2014. The first edition of these guidelines was published 5 years ago. Accordingly, we have published the second edition of these guidelines based on recent new knowledge and evidence. 相似文献
999.
Mitsuru Kaise Naoyoshi Nagata Naoki Ishii Jun Omori Osamu Goto Katsuhiko Iwakiri 《Digestive endoscopy》2020,32(2):240-250
There is the East-West paradox in prevalence and phenotype of colonic diverticula, but colonic diverticular bleeding (CDB) is the most common cause of acute lower gastrointestinal bleeding worldwide. Death from CDB can occur in elderly patients with multiple comorbidities, thus the management of CDB is clinically pivotal amid the aging populations in the East and West. Colonoscopy is the key modality for managing the condition appropriately; however, conventional endoscopic hemostasis by thermal coagulation and clipping cannot achieve the expected results of preventing early rebleeding and conversion to intensive intervention by surgery or transcatheter arterial embolization. Ligation therapy by endoscopic band ligation or endoscopic detachable snare ligation has emerged recently to enable more effective hemostasis for CDB, with an early rebleeding rate of approximately 10% and very rare conversion to intensive intervention. Ligation therapy might in turn reduce long-term rebleeding rates by eliminating the target diverticulum itself. Adverse events have been reported with ligation therapy including diverticulitis of the ascending colon in less than 1% of cases and perforation of the sigmoid colon in a few cases, thus more data are necessary to verify the safety of ligation therapy. Endoscopic hemostasis is indicated only for diverticulum with stigmata of recent hemorrhage (SRH), but the detection rates of SRH are relatively low. Therefore, efforts to increase detection are also key for improving CDB management. Urgent colonoscopy and triage by early contrast-enhanced computed tomography may be candidates to increase detection but further data are necessary in order to make a conclusion. 相似文献
1000.
Tomonori Aoki Atsuo Yamada Kazuharu Aoyama Hiroaki Saito Gota Fujisawa Nariaki Odawara Ryo Kondo Akiyoshi Tsuboi Rei Ishibashi Ayako Nakada Ryota Niikura Mitsuhiro Fujishiro Shiro Oka Soichiro Ishihara Tomoki Matsuda Masato Nakahori Shinji Tanaka Kazuhiko Koike Tomohiro Tada 《Digestive endoscopy》2020,32(4):585-591