Kenji Yamao

Endoscopic ultrasonography in diagnosis of the extent of gallbladder carcinoma.

Endoscopic ultrasonography (EUS) was performed preoperatively in 39 patients with gallbladder carcinoma. Diagnosis of the anatomical extent of gallbladder carcinoma was compared with histologic analysis, and staging accuracy was evaluated according to the TNM classification. Carcinoma considered to be at an early stage with no lymph node metastasis was correctly diagnosed in 87.5%. Differential diagnosis between early and advanced staged tumors was possible in 79.5%. Overall accuracy for depth of tumor invasion (T) was 76.9%. Limitations were due to many stones in the gallbladder and microinfiltration of carcinoma. Assessment of regional lymph node metastasis (N) was at a sensitivity of 81.8% and specificity of 92.9%, for an overall accuracy of 89.7%. We believe endoscopic ultrasonography is useful in the clinical staging of gallbladder carcinoma.

Effect of omeprazole on gastric acid secretion in rat: Evaluation of dose, duration of effect, and route of administration

SummaryThe effect of omeprazole on gastric acid output was studied in rats before and during stimulation by continuous administration of tetragastrin at 50 Μg/kghour. From 5 to 20 mg/kg of omeprazole was given to animals intraperitoneally, perorally and intravenously from 2 to 24 hours before the gastric secretory study was started, and the respective effects on acid secretion were compared. In each administration group, 20 mg/kg of omeprazole was the most potent among the groups receiving 5, 10 or 20 mg/kg, when the drug was given 2 hours before the study. There were statistically significant differences between the control group given tetragastrin only and each of the groups given 20 mg/kg of omeprazole perorally, intraperitoneally and intravenously. There was no significant difference among the groups given 20 mg/kg of omeprazole intraperitoneally, intravenously and perorally. The effect of 20 mg/kg of omeprazole continued at least 24 hours after the agent was administered perorally.

Transpapillary biopsy in gallbladder disease.

Background: Endoscopic biopsy is routine in gastrointestinal disease; similarly, histopathologic diagnosis is desirable in gallbladder disease. In this study we examined the clinical usefulness and the problems associated with transpapillary gallbladder biopsy. Methods: Transpapillary gallbladder biopsy was attempted in 9 patients with gallbladder disease. After inserting a catheter sheath into the gallbladder using a guidewire via the transpapillary route without sphincterotomy, we inserted a biopsy forceps into the lumen of the sheath up to the gallbladder lumen and obtained specimens. Results: We could obtain sufficient specimens for histopathologic diagnosis in 8 of 9 cases (88.9%). Of the 8 successful cases, targeted specimens were obtained in 7 (87.5%). Diagnostic accuracy with respect to malignant versus benign disease was 100% (2 of 2) and 83.3% (5 of 6), respectively. There were no complications. Conclusion: Transpapillary gallbladder biopsy is a clinically useful technique because it facilitates histopathologic diagnosis and therefore guides the choice of therapy.

Early Diagnosis of Pancreatic Cancer Using Endoscopic Ultrasound

Despite a low incidence, the mortality rate of pancreatic cancer (PC) is high. Early detection and optimal treatment based on the findings of various imaging modalities are essential to improve the survival rate of patients with PC. Multi-detector (MD) row computed tomography (CT) is currently the standard imaging modality for evaluating PC worldwide. However, 10% of PC tumors can be iso-attenuated on CT and thus invisible, especially when ≤2 cm. Endoscopic ultrasonography (EUS) can detect tumors that are <10 cm at a higher rate than CT and might be useful for diagnosing high-grade pancreatic intraepithelial neoplasia (PanIN3) as well as magnetic resonance cholangiopancreatography, as they can both detect local irregular stenosis of the pancreatic duct.

A Role of PET/CT in the Diagnosis of Autoimmune Pancreatitis

Autoimmune pancreatitis (AIP) is a special entity of chronic pancreatitis of presumed autoimmune etiology that is associated with characteristic clinical, histological, and morphological findings [1, 2]. Over the last decade, significant progress has been made in understanding this disease, including identification of two distinct histological subtypes with different clinical phenotypes (termed type 1 and type 2 AIP), incorporation of seemingly unrelated diseases within the spectrum of IgG4-related disease [2–4]. Despite advances, many questions remain unanswered. Among the remaining questions, distinguishing AIP from pancreatic cancer is still challenging. AIP mimics pancreatic cancer in terms of clinical features, such as advanced age, painless jaundice, weight loss, new-onset diabetes mellitus, and the presence of a mass lesion of the pancreas [1, 5].

Abstracts of selected papers presented at the 30th Annual meeting of the Japanese Society of Gastroenterology

S OF SELECTED PAPERS PRESENTED AT THE 30TH ANNUAL MEETING OF THE JAPANESE SOCIETY OF GASTROENTEROLOGY October 20-22, 1988 -Kagoshima, Japan Chairman: Shuji HASHIMOTO, M.D.

Abstracts of selected papers presented at the 73rd general meeting of The Japanese Society of Gastroenterology

S OF SELECTED PAPERS PRESENTED AT THE 73RD GENERAL MEETING OF THE JAPANESE SOCIETY OF GASTROENTEROLOGY Tokyo, Japan, April 7-9, 1987 Chairman : Shinroku ASHIZAWA, M. D.

Abstracts of selected papers presented at the 29th annual meeting of the japanese society of gastroenterology

S OF SELECTED PAPERS PRESENTED AT THE 29TH A N N U A L MEETING OF THE JAPANESE SOCIETY OF GASTROENTEROLOGY K0fu, Japan, November 5--7, 1987 Chairman: Katsuhiko SUGAHARA, M.D.