The role of juxtapapillary duodenal diverticulum in the formation of gallbladder stones.

Background/aims: Juxtapapillary diverticula (JPD) are considered to be associated with choledocholithiasis but not with cholecystolithiasis. However, there have been few comparative studies on the relationship between JPD and cholecystolithiasis under strict matching for sex and age.

Methodology: Among 4542 consecutive ERCPs at Tokyo Metropolitan Komagome Hospital, 549 patients who were 63 years of age or older were enrolled in this study and were matched for sex and age.

New Classification for the Accessory Pancreatic Duct by ERP.

The head of the pancreas is formed embryologically from two anlage. The pancreatic duct system in the head is a complex structure. We devised a new classification for the accessory pancreatic duct (APD) based on the junctional point of the APD and the main pancreatic duct (MPD) in addition to the shape of the APD, which was found to be applicable to most cases.

Characteristics of pancreatic carcinoma in the elderly.

Conclusion: Lymphogenous as well as hematogenous metastases were significantly less frequent in the elderly group of patients, although local invasion was comparable. Survival was comparable between both groups although palliative therapy alone was significantly more frequent in the elderly.

Background: The relative and absolute numbers of elderly patients continue to increase, as does the incidence of pancreatic carcinoma.

[Function of the accessory pancreatic duct in the pancreaticobiliary maljunction].

We examined the function of the accessory pancreatic duct (APD) in 56 cases of the pancreaticobiliary maljunction. APD existed in 11 of 26 cases of the congenital choledochal cyst. The maximal diameter of APD was over 2 mm in 5 cases.

Relationship between progression of gastric mucosal atrophy and Helicobacter pylori infection: retrospective long-term endoscopic follow-up study.

A retrospective long-term endoscopic follow-up study was designed to examine atrophic changes in the gastric mucosa over time in Helicobacter pylori-positive patients. Over a period of 8-17 years (mean, 13.4 years) 22 subjects (5 men, 17 women, mean age, 55 years) without localized gastroduodenal lesions underwent serial endoscopic examinations and serological and microbiological assessments of H.

Preliminary clinical study on gastric ulcer scars and ulcer relapses after Helicobacter pylori eradication therapy.

To determine the effect of Helicobacter pylori eradication on the healing of gastric ulcers, endoscopic examinations of gastric ulcer scars and ulcer relapse after eradication therapies or antisecretory therapy were carried out in 24 H. pylori-positive patients with recurrent gastric ulcers located in the gastric angle. Sixteen patients were initially treated with 2-week triple eradication therapy.

Differentiation of pancreatic carcinoma induced by retinoic acid or sodium butyrate: a morphological and molecular analysis of four cell lines.

The antiproliferative and differentiation-inducing effects of all-trans retinoic acid (RA) and sodium butyrate (SB) were investigated in four pancreatic ductal adenocarcinoma cell lines, two poorly differentiated ones (PT45 and PaTu-II), one moderately to poorly differentiated one (Panc-1) and one highly differentiated one (A818-1). Treatment with 20 microM RA resulted in moderate inhibition of cell growth in all cell lines, but clear evidence of cytodifferentiation (including elongated cell processes, increased rough endoplasmic reticulum, intensified immunostaining for the mucin marker (M1) was found only in PT45 and Panc-1. These phenotypic changes were paralleled by upregulation of RAR (retinoic acid receptor)-alpha and -gamma mRNA.

The influence of Helicobacter pylori infection on the progression of gastric mucosal atrophy and occurrence of gastric cancer.

Aim: To study the effects of Helicobacter pylori infection on the progression of gastric mucosal atrophy and the development of gastric cancer.

Patients And Methods: We investigated the extension of the atrophic area as assessed on the basis of the Kimura-Takemoto atrophic patterns and the development of gastric cancer in a selected sample of 64 patients who were endoscopically followed up for more than 3 years, and who showed H. pylori infection by culture at the start of the investigation and at some stages during the follow-up.

An endoscopic study on relationship between Helicobacter pylori infection and endoscopic gastric ulcer scars.

A two-year endoscopic follow-up study of 45 gastric ulcer patients was conducted in order to ascertain the relationship between Helicobacter pylori infection, the transformation of ulcer scar patterns, and ulcer relapse during maintenance therapy. Endoscopic findings of gastric ulcer scar patterns, which established the quality of ulcer scars, were classified as follows: Sa, with a central depression, Sb, with a coarse regenerating mucosal pattern up to the center, and Sc, with a fine pattern. The proportion of ulcer relapses was 62% among 29 H.

Relapsing oral and colonic ulcers with monoclonal T-cell infiltration. A low grade mucosal T-lymphoproliferative disease of the digestive tract.

Background: Some cutaneous T-cell lymphoproliferative diseases (LPD), such as lymphomatoid papulosis and pityriasis lichenoides et varioliformis acuta, are characterized by an indolent or waning and waxing clinical course. However, such T-cell LPD are rarely documented in other organs.

Methods: A patient with T-cell LPD of the digestive tract characterized by repetitive episodes of self-healing ulcers in the oral and intestinal mucosa over the course of 17 years is reported.

Serous oligocystic and ill-demarcated adenoma of the pancreas: a variant of serous cystic adenoma.

Serous cystic tumours of the pancreas are uncommon and are usually classified as microcystic adenomas (MCA). As new types of serous cystic tumours of this organ have been reported we reviewed a series of 14 lesions and from macroscopic findings two groups were distinguished: ten tumours revealed the features of MCA, while four were clearly distinct from MCA. Grossly, the latter tumours showed only few cysts which were irregularly assembled in fibrous stroma.

Carcinoma of the ampulla of Vater: expression of cancer-associated antigens inversely correlated with prognosis.

To obtain some useful pathologic indicators for predicting the prognosis in carcinomas of the ampulla of Vater, we analyzed 24 surgically resected ampullary carcinomas pathologically with immunohistochemistry of cancer-associated antigens. Pancreatic invasion, lymph node metastasis, and histology of the tumor were significantly correlated with poor prognosis (p less than 0.01), but the size or ulceration of the tumor did not significantly affect the prognosis (p less than 0.

[A case of non-jaundice ampullary carcinoma with prominent lymphatic infiltration].

A case of a non-jaundiced ampullary carcinoma with a unique tumor spread is reported. A 3.2 X 1.

[Considerations on intraoperative radiation therapy and therapeutic ratio].

In conjunction with the clinical development of intraoperative radiation therapy (IORT), the ability to demonstrate an improvement in therapeutic ratio is critical and an evaluation of treatment complications is essential. The tolerance dose of the normal tissue in IORT is discussed, and if small field is applied, the greater part of tissues or organs tolerate intraoperative irradiations up to 25 Gy. The optimal dose has been estimated on each organs with malignant tumors.