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3. Endoscopic treatment of severe esophageal strictures in children by combined proximal and distal approaches

Author

Katsuyoshi Nose, Akiyoshi Shu, Yousuke Yoden, Tatsuo Okasora, Yasuji Seki, Akihiro Toyosaka, and Eizo Okamoto

Subjects
medicine.medical_specialty, medicine.diagnostic_test, business.industry, macromolecular substances, General Medicine, medicine.disease, Surgery, Endoscopy, Stenosis, medicine.anatomical_structure, Congenital Esophageal Atresia, Pediatrics, Perinatology and Child Health, Esophageal stricture, Pediatric surgery, medicine, Esophagus, Reflux esophagitis, business, Endoscopic treatment
Abstract

One patient with complete reobstruction following repair of congenital esophageal atresia and another with a severe esophageal stricture due to reflux esophagitis were treated successfully with endoscopic electroincision from both the proximal and distal ends combined with dilation by Tucker's endless bougie. There have been no previous reports of this technique being used for severe esophageal stenosis in children. This method can be applied safely to children with severe esophageal strictures in which no guidewire or other bougie can be passed, a clinical situation previously requiring open surgery.

Published
1994
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5. MANOMETRIC ASYMMETRY OF THE LOWER ESOPHAGEAL SPHINCTER

Author

Akio Kyo, Shuichi Ohashi, Akiyoshi Shu, Akihiro Toyosaka, Ichiro Sugawara, Keiji Kuwata, Eizo Okamoto, Eitaro Suzuki, and Tadayuki Hida

Subjects
Physiology, business.industry, Achalasia, Traumatic diaphragmatic hernia, medicine.disease, Hiatal hernia, medicine.anatomical_structure, High pressure, otorhinolaryngologic diseases, medicine, Esophageal sphincter, Upper gastrointestinal, Esophagus, Abnormality, Nuclear medicine, business
Abstract

Manometric pressure profile of the lower esophageal sphincter (LES) was studied at 3 different points at the same level in 10 adult candidates from 18 to 25 years of age and 6 children from 3 months to 5 years of age who clinically have no abnormality in the upper gastrointestinal tract. This esophageal tube used for adult is Esophageal Motility Tube produced by Sherwood Company which has 3 side holes circularly located at every 120 degree at 5 cm proximal to the tip.For children was used our original tube which is a smaller 3-lumen tube with 3 side holes circulerly located at every 120 degree at 3 cm proximal to the tip.These 3 holes were always kept to face to the anterior (O o'clock), right posterolateral (4 O'clock) and left posterolateral (8 o'clock) in the esophagus, respectively. And pressure profile of LES was measured by a rapid pull through technique.In the normal adults, high pressure zone (HPZ) which is a manometric representation of LES was observed to have 25.1cm H2O at 0°, 16.1cm H2O at 4° and 28.4cm H2O at 8° in average in tone, and 34.5 mm at 0°, 40.4mm at 4° and 27.7mm at 8° in average in length. In normal children an average tone of HPZ was 13.9cm H2O at 0°, 8.4cm H2O at 4° and 17.4cm H2O at 8°, and length of HPZ was 16.1mm at 0°, 20.3mm at 4° and 11.6mm at 8°. These findings indicate that there is an asymmetry in manometric profile of normal LES both in adults and children, with the highest tone at 8° and the lowest at 4°, and the longest length at 4° and the shortest at 8°.In contrast with manometric profile of normal LES, pathological LES was assessed by the same technique in a patient with achalasia of the esophagus, a patient with systemic sclerodema, two patients with hiatal hernia, a patient with traumatic diaphragmatic hernia and a patient with Barrett esophagus. In any one of the above pathological conditions of LES, asymmetry in pressure profile was not observed.The effect of gastrin on LES was further investigated in the same 10 adult candidates by the same technique. Only a slight increase in the tone was observed in 3 directions about 2 minutes after intravenous administration of tetragastrin (0.5 γ/kg).This paper summarized our study on a manometric asymmetry of normal LES in contrast with manometric changes in various diseases that have pathological LES. Further study on these manometric charactaristics and their combinations might us a great advance in clarification of anti-reflux mechanism of LES.

Published
1979
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6. THE EFFECTS OF SPHINCTEROPLASTY ON MANOMETRIC PROFILE OF COMMON BILE DUCT AND THE DUODENUM

Author

Eizo Okamoto, Shuichi Ohashi, Toshihiro Muraji, Akiyoshi Shu, Ichiro Sugawara, Tadayuki Hida, Akio Kyo, Eitaro Suzuki, and Keiji Kuwata

Subjects
Morphine sulfate, medicine.medical_specialty, Common bile duct, Physiology, business.industry, digestive, oral, and skin physiology, Ampulla of Vater, digestive system, Gastroenterology, digestive system diseases, surgical procedures, operative, medicine.anatomical_structure, Bolus (medicine), Internal medicine, Sphincter of Oddi, Duodenum, medicine, Sphincter, In patient, business
Abstract

A simultaneous manometric monitoring of the common bile duct (CBD) and the duodenum were performed 2 weeks after choledocholithotomy on 15 patients whose common bile ducts were explored without sphincteroplasty and 30 patients with sphincteroplasty. These manometric studies were carried out by open-tip catheters intubated into the CBD and duodenum through the T-tube at the operation. In patients without sphincteroplasty, no effects of the duodenal pressure on a CBD pressure profile were recognized, while a synchronized pressure profile of the CBD and the duodenum was obtained in patients with sphincteroplasty. By stimulation with morphine (Morphine sulfate; 0.17 mg/Kg iv bolus), waxing and waning of the pressured in the CBD without sphincteroplasty were observed with 20 cmH2O in maximum at about 13 minutes after injection. However, in the CBD with sphincteroplasty, scale-over increase of the pressure curve was seen immediately after duodenal contraction caused by morphine stimulation. A direct infusion of 5 ml of 0.1 N hydrochloride to the duodenum causes hyperperistalsis of the duodenum, which made a synchronized pressure profile in the CBD with sphincteroplasty but made no remarkable change in a pressure profile of the CBD without sphincteroplasty. These findings conclude that the sphincter of Oddi plays an important role as a "pressure barrier" between the CBD and the duodenum, and that with the destruction of this sphincter by sphincteroplasty, a pressure profile of the CBD becomes close to that of the duodenum. This simultaneous manometric study of the CBD and the duodenum might be one of most valuable methods for evaluation of completeness of the sphincteroplasty.

Published
1979
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7. INDICATION OF LEFT HEPATIC LOBECTOMY IN INTRAHEPATIC CHOLELITIASIS

Author

Ichiro Sugahara, Akio Kyo, Eizo Okamoto, Masao Mitsunobu, Tatsuo Okasora, Akiyoshi Shu, Mitsuyoshi Kashitani, Yosuke Yoden, Eitaro Suzuki, Akihiro Toyosaka, Keiji Kuwata, and Santaro Ryu

Subjects
Left hepatic lobectomy, medicine.medical_specialty, business.industry, Gastroenterology, medicine, Surgery, business
Published
1978
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8. Proceedings Of The 66Th Annual Meeting From March 30 to April 1, 1980—Tokyo, Japan

Author

Takashi Nakamura, Masami Yamakawa, Shigeru Harasawa, Masaharu Tatsuta, Shigeru Okuda, Saburo Nakazawa, Yoshihisa Tsukamoto, Kazuo Shirakawa, Mamoru Nishizawa, Kazuo Nomoto, Terukazu Muto, Seigo Narai, Yoichi Matsubara, Hisashi Matsuki, Mitsugu Sugiyama, Shuuji Tsuchiya, Teruaki Aoki, Fusahiro Nagao, Yozo Watanabe, Hisao Oguchi, Tatsuji Homma, Yoshiro Niitsu, Ichiro Urushizaki, Seiki Matsuno, Masao Kobari, Toshio Sato, Hirofumi Gonda, Yasuo Hayashida, Eii Karasawa, Hiromitsu Saisho, Takashi Suzuki, Tadao Manabe, Yasuji Nakanuma, Goroku Ohta, Eisei Sasaki, Yoichi Kasai, Yoshio Kuniyasu, Tatsuo Yamakawa, Masao Ohto, Yukihito Tsuchiya, Keiichi Ono, Matsuro Shimane, Kyotaro Kanazawa, Kaoru Shimada, Takeo Iwama, Joji Utsunomiya, Takeshi Oohara, Akihiro Ogino, Akihiro Munakata, Fukunori Kinjo, Masahiro Tada, Yuzo Akasaka, Yoshifumi Yokoyama, Takatoshi Sasaki, Chihiro Koizumi, Masayuki Hayashi, Mineo Tomizawa, Keizo Ohnuki, Takesada Mori, Yoshito Ohashi, Teisuke Kamata, Shunji Futagawa, Keizo Sugimachi, Kiyoshi Inokuchi, Michio Kobayashi, Keisuke Yoshida, Yukio Takano, Yoshio Ishikawa, Nobuyoshi Itoh, Toru Sagayama, Hiroshi Ashida, Mitsuhisa Miyai, Eizo Okamoto, Akio Kyo, Akiyoshi Shu, Morio Nakao, and Kozaburo Sugiki

Subjects
medicine.medical_specialty, Surgical oncology, business.industry, Internal medicine, General surgery, Gastroenterology, medicine, Hepatology, business, Colorectal surgery, Abdominal surgery
Published
1980
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9. Proceedings of the 26th annual meeting Chiba, Japan, October 18–20, 1984

Author

Shunsaku Higashi, Yoshio Yamazaki, Junji Tanaka, Kazue Ozawa, Munemasa Ryu, Michio Odaka, Kuniaki Kojima, Takashi Hanzawa, Mitsuo Sugiura, Toru Kanno, Sukeo Yamamoto, Keijiro Ando, Yuji Kado, Morio Sato, Ryusaku Yamada, Masaru Miyazaki, Katsuji Okui, Shingi Imaoka, Yo Sasaki, Yoshiyuki Shimamura, Hisakazu Shimizu, Kiyotaka Tezuka, Ichiya Tsuji, Shoji Kajikawa, Masanori Ishii, Akira Takahashi, Toshinori Kodama, Tomomi Kitatani, Tomoharu Matsuyama, Hiroshi Hasegawa, Hiroaki Kawashima, Katsuyoshi Tabuse, Masaharu Katsumi, Kenji Jinno, Katsuyuki Tokuyama, Yasuo Majima, Yasuhiko Kubo, Atsushi Toyonaga, Satoshi Eguchi, Kenji Hirai, Masahide Abe, Haruki Nakatsuka, Sumio Takashima, Yoshihiro Fukuda, Masahiro Hiraoka, Takatoshi Sasaki, Masakazu Maruyama, Mamoru Nishizawa, Kyoichi Nakamura, N. Saitoh, H. Sarashina, Shinei Kudo, Takeyasu Suda, Shu Kuramoto, Takeshi Oohara, Tomio Narisawa, Makoto Niwa, Nobuaki Kaibara, Shigemasa Koga, S. Takashima, T. Kosaka, Kohi Miura, Norio Nakao, Kunio Ido, Kyoichi Hiramatsu, S. Matsutani, K. Kimura, Akira Sano, Yasumasa Kuroda, Kiyohiro Kawahara, Tomoharu Yoshida, Shuzi Mizumachi, Ken Takeuchi, Yukio Kobayashi, Yasuhiro Takase, Tadasu Fuji, Hideo Amano, Akiyoshi Shu, Eizo Okamoto, Hirokazu Kawata, Tomomitsu Kikuchi, Noburu Sakakibara, Morio Masaki, Reiji Kasukawa, Fumiaki Ikegami, Sachio Takasu, Yoshihisa Tsukada, Fumihiro Ichida, Hiroaki Suzuki, Yoshinori Inagaki, Hideki Yasuda, Tadahiro Takada, Toshikazu Suwa, Yutaka Atomi, Yasuhiko Morioka, Tokuyuki Yokohata, Hisaaki Shimazu, Sadamu Takano, Katsunori Yukimura, S. Shimaguchi, J. Ariyama, Satoshi Sawada, Yoshikuni Okamura, Tomohiko Yoshida, Toshihiko Saito, Okitsugu Nishimura, Haruaki Ogawa, Masahiko Morita, Hiromitsu Saisho, Katsuhide Shimakura, Kazuya Ueno, Susumu Miyata, Tadashi Shibue, Atzumasa Yamaguchi, Seiji Tsunoka, Katsuji Hayashi, Yoshihiko Komatsu, Masakatsu Matsukawa, Yasuso Soejima, Y. Nimura, Toshikazu Ohnuma, Kazuo Inui, Takashi Matsushiro, Hideyuki Nagashima, Hideo Ise, Toshio Sato, Y. Akita, S. Shichino, H. Suzuki, T. Sato, K. Ono, Hideki Fujii, Masayuki Yamamoto, Yoshiro Matsumoto, Katsuhiko Sugahara, Tetsuo Ota, Kohji Konishi, Mikiko Ono, Satoru Sohma, Junji Yoshino, Hirosato Ohta, Hiroshi Obata, Tetsuya Ageta, Sumiaki Tsuru, Yutaka Sasagawa, Koichi Yoshida, Toshiaki Jo, Tsuneo Sasaki, Junichi Ishiwata, Jiro Fujimoto, Takesada Mori, Noboru Azuma, Toshiki Kamano, Akeo Hagiwara, Toshio Takahashi, Y. Sasaki, J. Sasaki, Yasuaki Arai, Choichiro Kido, Kyoichiro Suyama, Masatsugu Kitamura, Yasuyuki Awane, Mishio Maeta, Yuzuru Sugiyama, Hiroki Sohma, Toshiaki Nakashima, Yoshihiro Nakagawa, Kazuo Chijiiwa, Masahiro Yamamoto, Yoichi Saitoh, Itaru Horiuchi, Susumu Fujita, Teruo Nakamura, Isao Marino, Yasushi Matsuzaki, Toshiaki Osuga, Yasutoshi Konno, Nobuo Hiwatashi, Noriaki Tamura, Chisato Hirayama, Naoki Ishiguro, M. Tsuchiya, Masahide Ikeguchi, Susumu Tateno, Toshiaki Setoguchi, Yutaka Shimizu, Masahito Tanaka, Kiyoaki Ouchi, Kenji Koyama, Masayuki Saito, Kunihiko Ohnishi, Fuminori Moriyasu, Motohide Takashi, Shinichi Hino, Toru Kashiwagi, Takeo Koizumi, Kazuo Nagayama, Masaharu Horiguchi, Norio Ueno, Takeo Yamanaka, Akitake Hasumi, Haruo Aoki, Hiroaki Takenaka, Kazuyasu Nakao, Osamu Yamazaki, Hiroaki Kinoshita, H. Komatsu, M. Oda, N. Tsukada, K. Kaneko, Y. Shigeta, K. Funatsu, Akiharu Watanabe, Kazuo Tobe, Akira Matsuo, Yukio Kusumoto, Yukihiko Adachi, Toshio Yamamoto, Chikara Oshio, Hiromasa Ishii, Shigeki Matsuki, Hisao Shibata, Tatsuhiko Kodama, Fumimaro Takaku, Yasuji Miyata, Shigeru Sakamoto, Nobutake Matsuo, Yutaka Tsuchiya, Haruki Nakamura, Toshihiro Maruyama, Tomofumi Morita, Tadasu Tsujii, Masayoshi Kage, Masahiro Arakawa, Nobuyuki Sugiura, Masaaki Ebara, Takashi Kumada, Satoshi Nakano, Hideo Yamazaki, and Sachiko Tanaka

Subjects
Gastroenterology
Published
1985
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10. Disseminated intravascular coagulation in endoscopic injection therapy with thrombin

Author

Morimasa Nasu, Eizo Okamoto, Isao Itoh, Akira Suehiro, Akiyoshi Shu, Yasuharu Nishida, Eizo Kakishita, Kiyoyasu Nagai, and Koyama T

Subjects
Disseminated intravascular coagulation, medicine.medical_specialty, Endoscopic injection, business.industry, medicine.medical_treatment, General Medicine, medicine.disease, Surgery, Thrombin, Esophageal varices, hemic and lymphatic diseases, Shock (circulatory), Anesthesia, medicine, Embolization, medicine.symptom, business, circulatory and respiratory physiology, medicine.drug
Abstract

We attempted to elucidate the cause of the shock during the treatment of the patients with esophageal varices by thrombin using endoscopic embolization. Shock was occured a few minutes after infusion of thrombin, but general condition was immediately recovered without any complication.On the other hand the initial sign of disseminated intravascular coagulation (DIC) was observed 30min. later. Then DIC reached to maximum 180min. later, improved without any treatment on the next day and recovered completely on 7th day. In the relationship between shock and DIC, the shock was recognized at the earliest stage of DIC.

Published
1984
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