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Impact of changing our cannulation method on the incidenceof post-endoscopic retrograde cholangiopancreatography pancreatitis after pancreatic guidewire placement

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World Journal of Gastroenterology 2011年第48期17卷 5289-5294页

作者： Takeshi Hisa Ryusuke Matsumoto Masato Takamatsu Masayuki Furutake Department of Internal Medicine Saku Central Hospital

AIM： To clarify whether the incidence of post-endoscopic retrograde cholangiopancreatography （ERCP） pancreatitis （PEP） after pancreatic guidewire placement （PGW） can be reduced by using a different cannulation method. METHODS： BebNeen April 2001 and October 2009, PGW was performed in 142 patients with native papilla to overcome difficult biliary cannulation. Our cannulation method for ERCP was changed from contrast injection （CI） using a single-lumen catheter （April 2001-May 2008） to wire-guided cannulation （WGC） using a double-lumen catheter （June 2008-October 2009）. The CI protocol was also changed during the study period： in the first period it was used for routine pancreatography for detecting small pancreatic cancer （April 2001-November 2002）, whereas in the second period it was not （December 2002-May 2008）. In PGW with CI using a single- lumen catheter, the contrast medium in the catheter lumen was injected into the pancreatic duct. The success rate of biliary cannulation, the incidence of PEP according to the cannulation method, and the impact of CI using a single-lumen catheter on PEP in comparison with WGC using a double-lumen catheter were ***： CI with routine pancreatography, CI without routine pancreatography, and WGC were performed in 27 patients, 77 patients and 38 patients, respectively. Routine pancreatography did not contribute to the early diagnosis of pancreatic cancer in our study period. In CI without routine pancreatography and WGC, diagnostic pancreatography was performed in 17 patients and no patients, respectively. The success rate of biliary cannulation by PGW alone was 69%, and the final success rate was increased to 80.3% by the addition of consecutive maneuvers or a second ERCP. PEP occurred in 22 patients （15.5%）, and the severity was mild in all cases. When analyzed according to cannulation method, the incidence of PEP was 37.0% （10/27） in the patients who underwent CI with routine pancreatography, 14.3% （11/77） in tho

关键词： Pancreatic guidewire placement Wire-guidedcannulation Contrast injection Difficult biliary cannulation Post-endoscopic retrograde cholangiopancreatography pan-creatitis

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Growth process of small pancreatic carcinoma: A case report with imaging observation for 22 months

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World Journal of Gastroenterology 2008年第12期14卷 1958-1960页

作者： Takeshi Hisa Hiroki Ohkubo Satoshi Shiozawa Hiroki Ishigame Masato Takamatsu Masayuki Furutake Bunsei Nobukawa Koichi Suda Department of Internal Medicine Saku Central Hospital Nagano 384-0301 Japan Department of Surgery Saku Central Hospital Nagano 384-0301 Japan Department of Clinical Pathology Saku Central Hospital Nagano 384-0301 Japan Department of Human Pathology Juntendo University School of Medicine Tokyo Japan Department of Pathology Tokyo-West Tokusyukai Hospital Tokyo Japan

This report describes serial observations of the growth process of a small invasive ductal carcinoma (IDC) of the pancreas from imaging studies. Histopathological studies showed IDC with macroscopic retention cysts proximal to an intraductal papillary-mucinous adenoma with mild atypia of the branch duct type in the pancreatic body, with no relation between the two lesions. IDC was demonstrated as an extremely low-echoic mass resembling a cyst with an unclear margin on the initial endoscopic ultrasonography. We misinterpreted the low-echoic mass as a benign intraductal mucinous-papillary neoplasm (IPMN) based on findings of other imaging studies, and the patient was followed-up. The mass increased from 7 mm to 13 mm in diameter over 22 mo, and remained smaller than 10 mm in diameter for about 420 d. The tumor volume doubling time was 252 d. The Ki67 labeling index was 15.9%, similar to that described in previous reports. Hence, IDC may grow slowly while remaining small.

关键词： Invasive ductal carcinoma Pancreas Intraductal papillary-mucinous neoplasm Endoscopicultrasonography Tumor volume doubling time

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SECONDARY BONE GRAFTING FOR REPAIR OF RESIDUAL CLEFT DEFECTS IN THE ALVEOLAR PROCESS—SURGICAL PROCEDURE

SECONDARY BONE GRAFTING FOR REPAIR OF RESIDUAL CLEFT DEFECTS...

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第二届中国国际暨第五届全国口腔颌面外科学术会议

作者： M．IINO K．SETO K.KITAGAWARA K.MURAKAMI T.HORIUCHI K.NIITSU H．ISHII DEPT.OF DENTISTRY AND ORAL SURGERY saku central hospital NAGANO JAPAN 1ST DEPT.OF OMFS TSURUMI UNIVERSITY YOKOHAMA JAPAN DEPT.OF DENTISTRY AND ORAL SURGERY saku central hospital NAGANO JAPAN DEPT.OF DENTISTRY AND ORAL SURGERY saku central hospital NAGANO JAPAN DEPT.OF DENTISTRY AND ORAL SURGERY saku central hospital NAGANO JAPAN DEPT.OF DENTISTRY AND ORAL SURGERY saku central hospital NAGANO JAPAN 1ST DEPT.OF OMFS TSURUMI UNIVERSITY YOKOHAMA JAPAN

Secondary bone grafting for repair of alveolar clefts has become a well-accepted procedure used in the occlusal rehabilitation of the cleft lip/palate *** of secondary alveolar bone grafting are 1)improving of bone su... 详细信息

关键词： SECONDARY BONE GRAFTING FOR REPAIR OF RESIDUAL CLEFT DEFECTS IN THE ALVEOLAR PROCESS SURGICAL PROCEDURE

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How to establish endoscopic submucosal dissection in Western countries

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World Journal of Gastroenterology 2015年第40期21卷 11209-11220页

作者： Tsuneo Oyama Naohisa Yahagi Thierry Ponchon Tobias Kiesslich Frieder Berr Department of Endoscopy Saku Central Hospital Advanced Care Center Cancer Center Keio University School of Medicine35 ShinanomachiShinjuku-kuTokyo 160-8582Japan H?pital Edouard Herriot Specialités DigestivesPavillon HPlaced’Arsonval69437 LyonFrance Department of Medicine I University Hospital Salzburg and Institute of Physiology and PathophysiologyParacelsus Medical University

Endoscopic submucosal dissection(ESD) has been invented in Japan to provide resection for cure of early cancer in the gastrointestinal tract. Professional level of ESD requires excellent staging of early neoplasias with image enhanced endoscopy(IEE) to make correct indications for ESD,and high skills in endoscopic electrosurgical dissection. In Japan,endodiagnostic and endosurgical excellence spread through personal tutoring of skilled endoscopists by the inventors and experts in IEE and ESD. To translocate this expertise to other continents must overcome two fundamental obstacles:(1) inadequate expectations as to the complexity of IEE and ESD; and(2) lack of suitable lesions and master-mentors for ESD trainees. Leading endoscopic mucosal resection-proficient endoscopists must pioneer themselves through the long learning curve to proficient ESD experts. Major referral centers for ESD must arise in Western countries on comparable professional level as in Japan. In the second stage,the upcoming Western experts must commit themselves to teach skilled endoscopists from other referral centers,in order to spread ESD in Western countries. Respect for patients with early gastrointestinal cancer asks for best efforts to learn endoscopic categorization of early neoplasias and skills for ESD based on sustained cooperation with the masters in Japan. The strategy is discussed here.

关键词： Endoscopic submucosal dissection Early cancer Endo

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Defecation disorders are crucial sequelae that impairs the quality of life of patients after conventional gastrectomy

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World Journal of Gastrointestinal Surgery 2021年第11期13卷 1484-1496页

作者： Koji Nakada Masami Ikeda Masazumi Takahashi Shinichi Kinami Masashi Yoshida Yoshikazu Uenosono Masanori Terashima Atsushi Oshio Yasuhiro Kodera University School of Medicine Tokyo 105-8461Japan Department of Surgery Asama General HospitalSaku 385-0022Japan Division of Gastroenterological Surgery Yokohama Municipal Citizen’s HospitalYokohama 240-8555Japan Department of Surgical Oncology Kanazawa Medical SchoolKanazawa 920-0293Japan Department of Surgery International University of Health and Welfare HospitalTochigi 329-2763Japan Department of Digestive Surgery Imamura General HospitalKagoshima 890-0064Japan Division of Gastric Surgery Shizuoka Cancer CenterShizuoka 411-8777Japan Faculty of Letters Arts and SciencesWaseda UniversityTokyo 169-8050Japan Department of Gastroenterological Surgery Nagoya University Graduate School of MedicineNagoya 466-8550Japan

BACKGROUND Defecation disorders are obscure sequelae that occurs after gastrectomy,and its implication on daily lives of patients have not been sufficiently *** To examine the features of defecation disorders after gastrectomy and to explore its implication on daily lives of patients in a large cohort using the Postgast rectomy Syndrome Assessment Scale(PGSAS)-*** We conducted a nationwide multi-institutional study using PGSAS-45 to examine the prevalence of postgastrectomy syndrome and its impact on daily lives of patients after various types of *** were obtained from 2368 eligible patients at 52 institutions in *** these,1777 patients who underwent total gastrectomy(TG;n=393)or distal gastrectomy(DG;n=1384)were *** severity of defecation disorder symptoms,such as diarrhea and constipation,and their correlation with other postgastrectomy symptoms were *** importance of defecation disorder symptoms on the living states and quality of life(QOL)of postgastrectomy patients,and those clinical factors that affect the severity of defecation disorder symptoms were evaluated using multiple regression *** Among seven symptom subscales of PGSAS-45,the ranking of diarrhea was 4th in TG and 2nd in *** ranking of constipation was 5th in TG and 1st in *** symptoms that correlated well with diarrhea were dumping and indigestion in both TG and DG;while those with constipation were abdominal pain and mealrelated distress in TG,and were meal-related distress and indigestion in *** five main outcome measures(MOMs)of living status domain,constipation significantly impaired four MOMs,while diarrhea had no effect in *** diarrhea and constipation impaired most of five MOMs in *** six MOMs of QOL domain,diarrhea impaired one MOM,whereas constipation impaired all six MOMs in *** diarrhea and constipation equally impaired all MOMs in *** sex,younger age,division of the celiac branch of vagus nerv

关键词： Postgastrectomy syndrome Defecation disorders Quality of life Patientreported outcome measures Gastrectomy

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Development of otology specific outcome measure:Ear Outcome Survey-16 (EOS-16)

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Journal of Otology 2021年第3期16卷 150-157页

作者： Juha T.Laakso Juha Silvola Timo Hirvonen Samuli Suutarla Ilkka Kivekas Riitta Saarinen Lotta Haavisto Jaakko Laitakari Antti A.Aarnisalo Aarno Dietz Jussi Jero Maija Hytonen saku T.Sink Department of Otorhinolaryngology-Head and Neck Surgery Head and Neck CenterHelsinki University Hospital and University of HelsinkiHelsinkiFinland Department of Ear Noseand Throat-Division of SurgeryAkershus University HospitalLørenskogNorway Department of Otorhinolaryngology Kymenlaakso Central HospitalKotkaFinland Department of Otorhinolaryngology-Head and Neck Surgery Tampere University Hospital and Tampere UniversityTampereFinland Department of Otorhinolaryngology-Head and Neck Surgery Turku University Hospital and University of TurkuTurkuFinland Department of Otorhinolaryngology-Head and Neck Surgery Oulu University Hospital and PEDEGO Research UnitUniversity of Oulu and Medical Research Center OuluFinland Department of Otorhinolaryngology-Head and Neck Surgery Kuopio University Hospital and University of KuopioKuopioFinland

Purpose An important outcome measure of patient care is the impact on the patient’s health-related quality of life(HRQoL).Current ear-specific HRQoL instruments are designed for one diagnosis and emphasize different subdivisions such as symptoms,hearing problems,psychosocial impact,and the need for *** optimal length of the recall period has not been *** these reasons,a new survey is needed that would cover most chronic ear *** A preliminary 24-item survey(EOS-24)was *** adult patients(included n=186)with one of seven different chronic otologic conditions from all university hospitals in Finland were recruited to respond to EOS-24 and the 15D general HRQoL *** recruiting otologists evaluated the severity of the disease and the disability caused by it.A control group was *** on the patients’responses in different diagnosis groups,the items were reduced according to pre-defined *** resulting survey was validated using a thorough statistical *** The relevance and necessity of the original 24 items were thoroughly investigated,leading to the exclusion of 8 items and the modification of *** remaining 16 items were well-balanced between subdivisions and were useful in all seven diagnosis groups,thus constituting the final instrument,*** most suitable recall period was three *** EOS-16 has been created according to the HRQoL survey guidelines with a versatile nationwide patient *** survey has been validated and can be used for a wide range of chronic ear diseases as a HRQoL instrument.

关键词： Otology Chronic ear diseases HRQoL Health-related quality of life PROM

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Factors affecting the quality of life of patients after gastrectomy as assessed using the newly developed PGSAS-45 scale: A nationwide multi-institutional study

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World Journal of Gastroenterology 2016年第40期22卷 8978-8990页

作者： Koji Nakada Masazumi Takahashi Masami Ikeda Shinichi Kinami Masashi Yoshida Yoshikazu Uenosono Yoshiyuki Kawashima Sayumi Nakao Atsushi Oshio Yoshimi Suzukamo Masanori Terashima Yasuhiro Kodera Department of Laboratory Medicine Daisan Hospital Jikei University School of MedicineTokyo 201-8601Japan Division of Gastroenterological Surgery Yokohama Municipal Citizen’s HospitalYokohama 240-8555Japan Department of Surgery Asama General HospitalSaku 085-0022Japan Department of Surgical Oncology Kanazawa Medical SchoolKanazawa 920-0293Japan Department of Surgery International University of Health and Welfare HospitalTochigi 329-2763Japan Department of Digestive Surgery Breast and Thyroid SurgeryKagoshima University Graduate School of MedicineKagoshima 890-8620Japan Division of Gastroenterological Surgery Saitama Cancer CenterSaitanna 362-0806Japan Department of Surgery 2 Tokyo Women’s Medical UniversityTokyo 162-8666Japan Faculty of Letters Arts and SciencesWaseda UniversityTokyo 169-8050Japan Department of Physical Medicine and Rehabilitation Tohoku University Graduate School of MedicineSendai 980-8575Japan Division of Gastric Surgery Shizuoka Cancer CenterShizuoka 411-8777Japan Department of Gastroenterological Surgery Nagoya University Graduate School of MedicineNagaya 466-8550Japan

AIM To identify certain clinical factors other than the type of gastrectomy which affect the postoperative quality of life(QOL) of patients after *** The postgastrectomy syndrome assessment scale(PGSAS)-45 was designed to assess the severity of symptoms, the living status and the QOL of gastrectomized patients. It consists of 45 items, of which 22 are original items while 23 were retrieved from the SF-8 and Gastrointestinal Symptoms Rating Scale questionnaires with permission. A nationwide surveillance study to validate PGSAS was conducted and 2368 gastric cancer patients who underwent various types of gastrectomy at 52 medical institutions were enrolled. Of these, 1777 patients who underwent total gastrectomy(TG) reconstructed with Roux-Y(n = 393), distal gastrectomy(DG) reconstructed with Billroth-I(n = 909), or DG reconstructed with Roux-Y(n = 475) were evaluated in the current study. The influence of the type of gastrectomy and other clinical factors such as age, sex, duration after surgery, the symptom severity, the degree of weight loss, dietary intake, and the ability for working on the postoperative QOL(i.e., dissatisfaction for daily life subscale, physical component summary and mental component summary of the SF-8) were examined by multiple regression analysis(MRA). In addition, importance of various symptoms such as esophageal reflux, abdominal pain, meal-related distress, indigestion, diarrhea, constipation and dumping on the postoperative living status and QOL were also appraised by *** The postoperative QOL were significantly deteriorated in patients who underwent TG compared to those after DG. However, the extent of gastrectomy was not an influential factor on patients' QOL when adjusted by the MRA. Among various clinical factors, the symptom severity, ability for working, and necessity for additional meals were the most influential factorsto the postoperative QOL. As for the individual symptoms, meal-related distress, dumping,

关键词： Postgastrectomy syndrome Quality of life Patient-reported outcome Effect size Gastrectomy

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Evaluation of pure-tone audiometric protocols in vestibular schwannoma screening

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Journal of Otology 2021年第3期16卷 138-143页

作者： Matej Vnencak Elina Huttunen Antti A.Aarnisalo Jussi Jero Katja Liukkonen saku T.Sinkkonen Department of Otorhinolaryngology-Head and Neck Surgery Turku University HospitalTurkuFinland Head and Neck Center Otorhinolaryngology-Head and Neck SurgeryHelsinki University HospitalAnd University of HelsinkiHelsinkiFinland

The objective was to evaluate the pure-tone audiogram-based screening protocols in VS *** retrospectively analyzed presenting symptoms,pure tone audiometry and MRI finding from 246 VS patients and 442 controls were collected to test screening protocols(AAO-HNS,AMCLASS-A/B,Charing Cross,Cueva,DOH,Nashville,Oxford,Rule3000,Schlauch,Seattle,Sunderland)for sensitivity and *** were pooled with data from five other studies,and analysis of sensitivity,specificity and positive likelihood ratio(LR+)for each protocol was *** results show that protocols with significantly higher sensitivity(AMCLASS-A/B,Nashville)show also significantly lowest specificity,and tend to have low association(positive likelihood ratio,LR+)to the *** highest LR+was found for protocols AAO-HNS,Rule3000 and *** conclusions,knowing their properties,screening protocols are simple decision-making tools in VS *** use the advantage of the highest sensitivity,protocols AMCLASS-A+B or Nashville can be of *** more reasonable approach,applying the protocols with high LR+(AAO-HNS,Rule3000,Seattle)may reduce the overall number of MRI scans at expense of only few primarily undiagnosed VS.

关键词： Vestibular schwannoma Asymmetric sensorineural hearing loss Screening protocol

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Diagnostic evaluation of acute pancreatitis in two patients with hypertriglyceridemia

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World Journal of Gastroenterology 2004年第24期10卷 3691-3695页

作者： Yoshifumi Okura KozoHayashi TetsujiShingu GoroKajiyama Yoshiyuki Nakashima Keijiro saku Division of Internal Medicine Fukuoka Dental College HospitalFukuokaJapan First Department of Internal Medicine Hiroshima University School of MedicineHiroshimaJapan Division of Cardiology Fukuoka University School of MedicineFukuokaJapan

We present two diagnostically challenging cases of acute pancreatitis with hypertriglyceridemia accompanied with chylomicronemia caused with a deficiency of lipoprotein lipase and with the presence of type Ⅴ hyperlipidemia. Both cases suffered from acute abdomen following the ingestion of fatty food and revealed the increase in parameters of inflammation without significant elevation of serum amylase *** imaging examination of ultrasonography could not detect significant findings of acute pancreatitis and a computer tomography scan eventually confirmed the findings of acute *** cases responded to a low fat diet and administration of a cholecystokinin receptor antagonist,exhibiting a relief of abdominal *** in the present cases with acute abdomen following the ingestion of fatty food,the identification of serum hypertriglyceridemia and an abdominal computer tomography scan might be useful in establishing the diagnosis of acute pancreatitis and in developing the therapeutic regimen,when hypertriglyceridemia interferes with the evaluation of pancreatic enzyme activities and ultrasound examination provides poor pancreatic visualization.

关键词： Acute Disease Adult Female Humans Hypertriglyceridemia Male Middle Aged Pancreatitis Triglycerides

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The status of Eustachian tube balloon dilations in Nordic countries

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World Journal of Otorhinolaryngology-Head and Neck Surgery 2019年第3期5卷 148-151页

作者： Juha T.Silvola saku T.Sinkkonen Jens Wanscher Eva Westman Niels H.Holm Therese Ovesen Akershus University hospital ENT Dept.and Campus AhusUniversity of OsloNorway Department of Otorhinolaryngology-Head and Neck Surgery Head and Neck CenterHelsinki University HospitalUniversity of HelsinkiHelsinkiFinland Odense University hospital ENT Dept.OdenseDenmark University of Ume(a) Dept.of Clinical ScienceENTSite SundsvallUme(a)Sweden Region hospital West Jutland ENT DepartmentHolstebro Denmark University of Aarhus Dept.of Clinical MedicineAarhusDenmark

There is no unanimous consensus for indications of eustachian tube balloon dilation(ETBD).Nordic countries have relatively similar hospital organizations and treatment ***,it was logical to organize a consensus meeting of *** symposium:Nordic Experiences on Eustachian Tube Balloon Dilation,in Copenhagen,30-31 March,*** panellists from Denmark,Finland,Norway and Sweden and the attendees of the meeting agreed a consensus on the following issues:Candidates,Definition of Eustachian Tube Dysfunction,Diagnostic Work up,Differential Diagnosis,Contraindications,ETBD Procedure,Complications,Follow-up,and *** article also presents the status for ETBD in each of these *** the consensus statement has been discussed in the national societies and meetings for ear surgeons in each of these *** can be assumed that surgeons in the hospitals of these Nordic countries generally follow the recommendations from the consensus meeting.

关键词： Eustachian tube Eustachian tube dysfunction Balloon dilation Nordic consensus

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