Shoko Fujiwara

Conflicting clinical environment about the management of antithrombotic agents during the periendoscopic period in Japan

Background and Aims:  Although there are guidelines for the management of antithrombotic agents during the periendoscopic period, gaps between various guidelines create a confusing situation in daily clinical practice. The purpose of this study was to examine the current management of antithrombotic agents during the periendoscopic period in Japan.

CLINICOPATHOLOGICAL CHARACTERISTICS OF ABNORMAL MICRO‐LESIONS AT THE ORO‐HYPOPHARYNX DETECTED BY A MAGNIFYING NARROW BAND IMAGING SYSTEM

Background:  Narrow band imaging (NBI) with magnifying endoscopy (NBI‐ME) allows the detection of abnormal micro‐lesions smaller than 5 mm in diameter in the oro‐hypopharynx that could not be visualized previously. The purpose of the present study was to clarify the clinicopathological characteristics of abnormal micro‐lesions of the oro‐hypopharynx detected by NBI‐ME

A case of small early gastric cancer that was successfully detected by narrow band imaging magnifying endoscopy.

Endoscopic diagnosis of gastric cancer is very often made by conventional white light endoscopy and/or by indigo carmine chromoendoscopy. However, with this method it is difficult to detect and demarcate a small lesion affected by inflammation or a biopsy procedure. We considered it is useful for diagnosis of such small cancers to observe a lesion with a magnifying endoscope combined with a narrow band imaging system.

Endoluminal MR imaging of porcine gastric structure in vivo

Background and aimsRecently, several new endoscopic instruments have been developed. However, even with the full use of current modalities, the safety of endoscopic surgery is not guaranteed. Information regarding factors such as fibrosis and the blood vessels under the mucosa is very important for avoiding procedure-related complications. The aim of this study was to define the detailed anatomy of the gastric wall structure in vivo using original endoluminal radiofrequency coils for safer endoscopic therapy.MethodsSwine were used as the subjects and controlled with general anesthesia. Anatomical images were obtained with T1-weighted fast spin echo (T1FSE) and T2-weighted fast spin echo (T2FSE). Dynamic magnetic resonance (MR) angiography was also obtained with three-dimensional T1-weighted fast spoiled gradient recalled acquisition in the steady state (3D-DMRA) following the injection of hyaluronic acid sodium into the submucosal layer.ResultsPorcine gastric wall structure was visualized, and four layers were discriminated in the T1FSE and T2FSE images. The vascular structure was clearly recognized in the submucosa on 3D-DMRA.ConclusionEndoluminal MR imaging was able to visualize the porcine stomach with similar quality to endoscopic ultrasonography imaging. Additionally, it was possible to visualize the vascular structures in the submucosal layer. This is the first report to show that blood vessels under the gastric mucosa can be depicted in vivo.