Search

Background and study aims: Only a few large cohort studies have evaluated the efficacy and safety of endoscopic necrosectomy for infected walled- off pancreatic necrosis (WOPN). Therefore, a multicenter, large cohort study was conducted to evaluate the efficacy and safety of endoscopic necrosectomy and to examine the procedural details and follow-up after successful endoscopic necrosectomy. Patients and methods: A retrospective review was conducted in 16 leading Japanese institutions for patients who underwent endoscopic necrosectomy for infected WOPN between August 2005 and July 2011.The follow-up data were also reviewed to determine the long-term outcomes of the procedures. Results: Of 57 patients, 43 (75 %) experienced successful resolution after a median of 5 sessions of endoscopic necrosectomy and 21 days of treatment. Complications occurred in 19 patients (33 %) during the treatment period. Six patients died (11 %): two due to multiple organ failure and one patient each from air embolism, splenic aneurysm, hemorrhage from a Mallory-Weiss tear, and an unknown cause. Of 43 patients with successful endoscopic necrosectomy, recurrent cavity formation was observed in three patients during a median follow-up period of 27 months. Conclusions: Endoscopic necrosectomy can be an effective technique for infected WOPN and requires a relatively short treatment period. However, serious complications can arise, including death. Therefore, patients should be carefully selected, and knowledgeable, skilled, and experienced operators should perform the procedure. Further research into safer technologies is required in order to reduce the associated morbidity and mortality. [ABSTRACT FROM AUTHOR]

Background and study aims: No prospective comparison of endoscopic ultrasonography-guided direct celiac ganglia neurolysis (EUS-CGN) vs. EUS-guided celiac plexus neurolysis (EUS-CPN) has been reported. The aim of the current study was to compare the effectiveness of EUS-CGN and EUS-CPN in providing pain relief from upper abdominal cancer pain in a multicenter randomized controlled trial. Patients and methods: Patients with upper abdominal cancer pain were randomly assigned to treatment using either EUS-CGN or EUS-CPN. Evaluationwas performed at Day 7 postoperatively using a pain scale of 0 to 10.Patients for whom pain decreased to⩽3 were considered to have a positive response, and those experiencing a decrease in pain to⩽1 were considered to be completely responsive. Comparison between the two groups was performed using intention-to-treat analysis. The primary endpoint was the difference in treatment response rates between EUS-CGN and EUS-CPN at postoperative Day 7.Secondary endpoints included differences in complete response rates, pain scores, duration of pain relief, and incidence of adverse effects. Results: A total of 34 patients were assigned to each group. Visualization of ganglia was possible in 30 cases (88 %) in the EUS-CGN group.The positive response ratewas significantly higher in the EUS-CGN group (73.5 %) than in the EUS-CPN group (45.5 %; P=0.026). The complete response rate was also significantly higher in the EUS- CGN group (50.0 %) than in the EUS-CPN group (18.2 %; P=0.010). There was no difference in adverse events or duration of pain relief between the two groups. Conclusions: EUS-CGN is significantly superior to conventional EUS-CPN in cancer pain relief. [ABSTRACT FROM AUTHOR]

To assess oxidative stress (OS) induced by endurance exercise, concentrations of serum reactive oxygen species (ROS) were determined in 70 Japanese male amateur runners completing a two-day ultra-marathon race. Serum ROS levels were analyzed at three time points: before the race (baseline), after the 1st day race (mid-race), and after the 2nd day race (goal) (post-race). The means (SE) of ROS were 151.4(3.7) (U. CARR.), 168.7(4.4), and 156.8(4.4), respectively. Significant positive trends were noted between age and serum ROS concentrations at the three race points (p<0.05 for all). After adjusting for age, BMI and average monthly running distance, the baseline serum ROS concentrations were positively associated with completion times of the first-day race, in particular (p<0.05), suggesting that the concentrations may predict physical performance. The ROS production increased at mid-race (p<0.05), but the levels returned to baseline levels at post-race, indicating that an antioxidant defense system may develop post-race to reduce OS. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 45-year-old man who was diagnosed with acute monocytic leukemia. The patient developed hemorrhagic cystitis following intensive chemotherapy and after undergoing allergenic stem cell transplant. He had also underwent gastrointestinal endoscopy which revealed irregular-shaped ulcers in the lesser curvature and anterior wall. It adds that the patient was treated with omeprazole for eight weeks.

The article reports on the use of ultrathin endoscopes in several cases of recanalization of disrupted fistulous tracts.

The article discusses a study which investigated the placement of direct percutaneous endoscopic jejunostomy (DPEJ) tubes using a transgastrostomic endoscope in patients who previously undewent endoscopic gastrostomy.

The article describes the case of a diagnosis of admixture type of hyperplastic polyp of the esophagogastric junction (EGJ) in a 67-year-old man with a history of reflux esophagitis and was presented to the hospital complaining of heartburn.

The article presents a case study of a patient with rectal mucosal prolapse syndrome and mentions topics including the results of colonoscopy, the symptoms of the patient and treatment through bowel retraining.