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胃癌预防亚太地区共识指南

胃肠病学 2008年第4期13卷 231-240页

作者： Kwong Ming Fock Nick Talley Paul Moayyedi Richard Hunt takeshi azuma Kentaro Sugano Shu Dong Xiao Shiu Kum Lam Khean Lee Goh Tsutomu Chiba Naomi Uemura Jae G Kim Nayoung Kim Tiing Leong Ang Varocha Mahachai Hazel Mitchell Abdul Aziz Rani Jyh Ming Liou Ratha-korn Vilaichone Jose Sollanor 钱本余 Changi General Hospital Singapore Mayo Clinic College of Medicine Rochester USA McMaster University Medical Center Ontario Canada University of Fukui Fukui Jichi Medical University Tochigi Shanghai Institrte of Digestive Disease Shanghai University of Hong Kong Hong Kong University of Malaya Kuala Lumpur Malaysia Kyoto University Kyoto Kure Kyousai General Hospital Kure Japan Chung Ang University College of Medicine Seoul National University College of Medicine Seoul Korea Chulalongkorn University Hospital Bangkok University of New South Wales Sydney New South Wales Australia University of Indonesia Jakarta Indonesia National Taiwan University Hospital Taipei China Thammasat University Hospital Pathumthani Thailand University of Santo Tomas Manila Philippines

背景与目的:胃癌是亚太地区的主要健康负担之一,但对其预防策略尚缺乏共识。本共识会议旨在评价预防胃癌的策略。方法:多学科专家组应用德尔菲(Delphi)法制订共识条文,提呈相关数据,对证据等级、推荐强度以及共识水平予以分级。结果:幽... 详细信息

背景与目的:胃癌是亚太地区的主要健康负担之一,但对其预防策略尚缺乏共识。本共识会议旨在评价预防胃癌的策略。方法:多学科专家组应用德尔菲(Delphi)法制订共识条文,提呈相关数据,对证据等级、推荐强度以及共识水平予以分级。结果:幽门螺杆菌(H.pylori)感染是非贲门胃腺癌必要但非充分的致病因子。盐的高摄入与胃癌强烈相关。新鲜果蔬对胃癌具有预防作用,但维生素和其他饮食补充并不能预防胃癌。H.pylori感染中的宿主-细菌相互作用导致不同类型的胃炎和胃酸分泌,从而决定疾病结局。胃癌阳性家族史是一个重要的危险因素。低血清胃蛋白酶原反映胃萎缩程度,可作为检出胃癌高危人群的标志物。H.pylori筛查和治疗被推荐作为减少高危人群胃癌危险性的一种策略,该策略在萎缩性胃炎发生前实施最为有效,但并不排除对胃癌高危人群的内镜监测。对胃癌低危人群不推荐行H.pylori筛查。H.pylori感染的一线治疗应遵循国家治疗指南。结论:高危人群中H.pylori筛查和根除策略可能会减少胃癌的发生率,本共识根据现有证据予以推荐。

关键词：癌指南幽门螺杆菌预防

Ileus caused by cholesterol crystal embolization: A case report

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World Journal of Gastroenterology 2016年第12期22卷 3502-3505页

作者： Shunjiro azuma Maiko Ikenouchi Takuji Akamatsu takeshi Seta Shunji Urai Yoshito Uenoyama Yukitaka Yamashita Department of Gastroenterology Japan Red Cross Society Wakayama Medical Center

Cholesterol crystal embolization(CCE) is a rare systemic embolism caused by formation of cholesterol crystals from atherosclerotic plaques. CCE usually occurs during vascular manipulation, such as vascular surgery or endovascular catheter manipulation, or due to anticoagulation or thrombolytic therapy. We report a rare case of intestinal obstruction caused by spontaneous CCE. An 81-year-old man with a history of hypertension was admitted for complaints of abdominal pain, bloating, and anorexia persisting for 4 mo. An abdominal computed tomography revealed intestinal ileus. His symptoms were immediately relieved by an ileus tube insertion, and he was discharged 6 d later. However, these symptoms immediately reappeared and persisted, and partial resection of the small intestine was performed. A histopathological examination indicated that small intestine obstruction was caused by CCE. At the 12-mo follow-up, the patient showed no evidence of CCE recurrence. Thus, in cases of intestinal obstruction, CCE should also be considered.

关键词： Cholesterol crystal embolization Ileus Intestinal obstruction Vascular manipulation Catheter manipul

Pulmonary embolism after arterial chemoembolization for hepatocellular carcinoma: An autopsy case report

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World Journal of Gastroenterology 2015年第4期21卷 1344-1348页

作者： Keiichi Hatamaru Shunjiro azuma Takuji Akamatsu takeshi Seta Shunji Urai Yoshito Uenoyama Yukitaka Yamashita Kazuo Ono Department of Gastroenterology and Hepatology Japan Red Cross Society Wakayama Medical CenterWakayama 640-8558Japan Department of Pathology Japan Red Cross Society Wakayama Medical CenterWakayama 640-8558Japan

We report an extremely rare case of pulmonary lipiodol embolism with acute respiratory distress syndrome(ARDS) after transcatheter arterial chemoembolization(TACE) for hepatocellular carcinoma(HCC). A 77-yearold man who was diagnosed with a huge HCC wasadmitted for TACE. Immediately after the procedure, this patient experienced severe dyspnea. We suspected that his symptoms were associated with a pulmonary lipiodol embolism after TACE, and we began intensive treatment. However, his condition did not improve, and he died on the following day. A subsequent autopsy revealed that the cause of death was ARDS due to pulmonary lipiodol embolism. No cases have been previously reported for which an autopsy was performed to explain the most probable mechanism of pulmonary lipiodol embolism; thus, ours is the first report for such a rare case.

关键词： Hepatocellular carcinoma Transcatheter arterial ch

Mucocele of the appendix due to endometriosis:A rare case report

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World Journal of Gastroenterology 2013年第30期19卷 5021-5024页

作者： Motoyuki Tsuda Yukitaka Yamashita Shunjiro azuma Takuji Akamatsu takeshi Seta Shunji Urai Yoshito Uenoyama Yasunori Deguchi Kazuo Ono Tsutomu Chiba Department of Gastroenterology Japanese Red Cross Wakayama Medical Center Department of Surgery Japanese Red Cross Wakayama Medical Center Department of Pathology Japanese Red Cross Wakayama Medical Center Department of Gastroenterology and Hepatology Kyoto University Graduate School of Medicine

Mucocele of the appendix due to endometriosis is extremely rare,and there are only 10 previously reported cases in the English literature.We report a case of mucocele of the appendix due to endometriosis and provide the first review of the literature.A 43-year-old woman was admitted to the hospital because of recurrent right lower abdominal pain during her menstrual periods.Colonoscopy revealed submucosal tumorlike elevations of the appendiceal orifice.Computed tomography and magnetic resonance imaging of the abdomen suggested cystic lesions near the appendix.Consequently,mucocele of the appendix was suspected preoperatively.An open ileocecal resection was performed.Multiple cystic lesions were observed around the appendix.The cystic lesions contained mucus.Histopathological examination was consistent with a mucocele of the appendix due to endometriosis.The postoperative course was uneventful.We present the first review of the literature to clarify the clinical features.

关键词： Mucocele Appendix Endometriosis