Jun Aoki

Experimental Study And Clinical Application Of New Ceramic Endoprobe With Nd-YAG Laser; Endoscopic Hemostasis, Pyloroplasty And Cutting Biopsy

We have been studying endoscopic Nd-YAG laser therapies since 1979. In consequence, advantages of the contact method by using ceramic endoprobes were revealed123. Various endoprobes were developed by our studies, and the experimental studies and clinical applications of ceramic frosted probe and chisel probe with Nd-YAG laser were studied. Frosted probe was able to thrombose in the artery of the canine gastric submucosal layer by Nd-YAG laser irra-diation, and was applied to endoscopic hemostasis. Chisel probe was able to cut canine gastric mucosa at the power of 20watts and duration of 2.Osec. with Nd-YAG laser, and was applied to endoscopic pyloroplasty and cutting complete biopsy of submucosal tumor.

Yogurt Containing Lactobacillus gasseri Mitigates Aspirin-Induced Small Bowel Injuries: A Prospective, Randomized, Double-Blind, Placebo-Controlled Trial

Background: Although there is evidence about the beneficial effects of probiotics, their effects on aspirin-induced small bowel injuries have not been well examined. We evaluated the effects of the probiotic Lactobacillus gasseri OLL2716 (LG) on aspirin-induced small intestinal lesions, such as ulcers, erosions, reddened lesions, and bleeding. Summary: This study enrolled 64 patients who received aspirin for more than 1 month and provided written informed consent to be part of the study. The patients received 112 ml of yogurt containing LG or placebo twice daily for 6 weeks. Small bowel injuries were evaluated by capsule endoscopy before and after consuming the yogurt. The effect of LG on patient symptoms was also assessed using the Frequency Scale for the Symptoms of Gastroesophageal Reflux Disease (FSSG) and Gastrointestinal Symptom Rating Scale (GSRS) questionnaires before and after 6 weeks of treatment. There was no significant difference in any baseline characteristics and the number of small bowel mucosal breaks between the 2 groups. In contrast with the placebo group, the LG group had significantly fewer small bowel mucosal breaks and reddened lesions after 6 weeks (p < 0.01). The FSSG and GSRS scores were also significantly improved in the LG group but not in the placebo group. Key Messages: This double-blind, placebo-controlled study found that LG may be useful in reducing aspirin-induced small bowel injuries and in mitigating gastrointestinal symptoms.

Acute portal vein thrombosis due to chronic relapsing pancreatitis: a fistula between a pancreatic pseudocyst and the splenic vein

Abstract Portal vein thrombosis (PVT) is a relatively common complication in patients with liver cirrhosis, but several other causes might play an important role in PVT pathogenesis. We present a case of alcoholic chronic pancreatitis complicated by acute extensive PVT. The patient was managed conservatively with danaparoid sodium at first, but the thrombosis gradually extended. We then tried radiological intervention using the direct transhepatic and transjugular intrahepatic postsystemic shunt approaches. Although we were able to successfully catheterize the percutaneous transhepatic portal vein (PTP), we could not achieve recanalization of the portal vein. Therefore, PTP catheterization and systemic intravenous infusion of urokinase and heparin was performed to prevent further progression of the thrombosis and cavernous transformation was finally achieved. Computed tomography (CT) and magnetic resonance cholangiopancreatography revealed a pancreatic stone which had possibly induced dilatation of the tail duct and formation of a pancreatic pseudocyst and caused intractable pancreatitis. We performed endoscopic retrograde cholangiopancreatography and placed a stent in the pancreatic duct, which completely cured the pancreatitis. Retrospectively, the previous CT with curved multi-planar reconstruction was reviewed and a fistula was detected between the pancreatic pseudocyst and splenic vein. We concluded that the etiology of the PVT was not only inflammatory extension from pancreatitis but also a fistula between the pancreatic duct and the splenic vein.

Experimental Studies Of Endoscopic Local Hyperthermia With Contact Nd-YAG Laser

We have been studying experimentally and clinically to evaluate the histological effects and safety of the therapeutic Nd-YAG laser endoscopy by the contact method with new ceramic endoprobes comparing wit Li those by the non-contact method with single quartz fiber. In this paper, we would like to discuss possibilities of clinical application of endoscopic local hyperthermia using Nd-YAG laser (Laserthermia) with computer control system. Newly developed computer controlled Laserthermia may possible to apply for the treatment of the malignant tumor in the gastrointestinal (GI) tract.

A Case Report of Borrmann 2 Type Gastric Cancer Complicated with Lung Cancer and Treated with Laserthermia

Abstract: A 52 year‐old female was admitted to our hospital for lung cancer. We performed upper gastrointestinal endoscopy for her complaint of epigastralgia, and diagnosed Borrmann 2 type gastric cancer on the posterior wall of the angle.

Endoscopic Combination Therapy Of Nd:YAG Laser In Conjunction With Conventional Treatments

In this paper, we discuss the possibilities of the clinical application of the contact method with various endoprobes, either alone or combination with other conventional treat ment such as endoscopic polypectomy, local injection therapy, intubation of prosthesis, radiation therapy and general chemotherapy. According to the type of lesions and the severity of the complicated diseases, endoscopic techniques were chosen and combined. It was generally recognized that all of the endoscopic treatments were not curative therapies but applied as local therapeutics. Therefore, during the management of high risk patients with GI cancer within the mucosa, contact endoscopic Nd:YAG laser therapy should be preferred to general surgery.

Development of hybrid laserthermia probe for single-channel G1 endoscope

The computer controlled Laserthermia system by the method of using double channel endoscope with the contact frosted probe and a thermocouple was reported previously.25 In this paper, the single channel method with the new single laser delivery system was studied experimentally. Especially hyperthermal effect by the newly developed Hybrid Laserthermia feedback probe(Hybrid probe) was discussed comparatively with the effects by the interstitial contact probe. The Hybrid probe could be possible to treat clinically more accurate Laserthermia in the near future.