Implantation cyst appearing more than 30 years after gastrectomy.

Implantation cyst is often reported to be a delayed complication after colorectal surgery. This report presents a 70-year-old man undergoing gastrectomy 33 years earlier for an acute gastric ulcer. His endoscopic finding showed a submucosal tumor about 20 mm in diameter at the gastro-jejunal anastomosis.

Invasive Group G Streptococcal Infection Complicated by Posterior Reversible Encephalopathy Syndrome: A Case Report.

BACKGROUND Group G streptococcus (GGS) infection is reported to have invasive pathogenicity similar to that of group A streptococcus (GAS) infection, causing a strong systemic inflammatory response with bacteremia and various complications. Herein, we report a case of posterior reversible encephalopathy syndrome (PRES) as a rare complication of a GGS infection. CASE REPORT An 89-year-old Japanese man presented to our hospital with gastrointestinal bleeding and shoulder pain.

Improvement of Rectal Prolapse Using an Over-the-scope Clip System.

Rectal prolapse is typically treated surgically, and internal therapy has not been reported. We encountered a case of rectal prolapse that improved with an over-the-scope clip (OTSC) system. An 81-year-old woman complaining of anorectal pain underwent colonoscopy, and rectal prolapse was observed prior to colonoscopy.

Balloon-occlusion Retrograde Transvenous Obliteration Using Gadoteridol As an Alternative Contrast Agent in a Patient with Iodine Allergy.

A 70-year-old woman with liver cirrhosis presented with gastric varices and recurrent hepatic encephalopathy. Magnetic resonance imaging (MRI) showed a splenorenal shunt, and balloon-occluded retrograde transvenous obliteration (B-RTO) was indicated but could not be performed due to iodine allergy. We then performed B-RTO using gadoteridol, an MRI contrast medium, instead of iodine contrast and successfully occluded the shunt vessel.

Drainage of Afferent Limb Obstruction via the Trans-gastric-bile Duct Formed after Endoscopic Ultrasound-guided Hepaticogastrostomy in a Patient with Pancreatic Cancer.

A 63-year-old man with advanced pancreatic cancer and pyloric obstruction underwent surgical gastrojejunostomy. Malignant biliary obstruction appeared eight months after surgery and was managed with endoscopic ultrasound (EUS)-guided hepaticogastrostomy (HGS). Subsequently, afferent limb obstruction caused by cancer invasion occurred.

3D-Printed Micro-Tweezers with a Compliant Mechanism Designed Using Topology Optimization.

The development of handling technology for microscopic biological samples such as cells and spheroids has been required for the advancement of regenerative medicine and tissue engineering. In this study, we developed micro-tweezers with a compliant mechanism to manipulate organoids. The proposed method combines high-resolution microstereolithography that uses a blue laser and topology optimization for shape optimization of micro-tweezers.

Inhibitory effects of carbon dioxide insufflation on pneumoperitoneum and bowel distension after percutaneous endoscopic gastrostomy.

Aim: To evaluate the inhibitory effects of carbon dioxide (CO(2)) insufflation on pneumoperitoneum and bowel distension after percutaneous endoscopic gastrostomy (PEG).

Methods: A total of 73 consecutive patients who were undergoing PEG were enrolled in our study. After eliminating 13 patients who fitted our exclusion criteria, 60 patients were randomly assigned to either CO(2) (30 patients) or air insufflation (30 patients) groups.

The Effects of Percutaneous Endoscopic Gastrostomy on Quality of Life in Patients With Dementia.

Background: To examine the effects of percutaneous endoscopic gastrostomy (PEG) on quality of life (QOL) in patients with dementia.

Methods: We retrospectively included 53 Japanese community and tertiary hospitals to investigate the relationship between the newly developed PEG and consecutive dementia patients with swallowing difficulty between Jan 1st 2006 and Dec 31st 2008. We set improvements in 1) the level of independent living, 2) pneumonia, 3) peroral intake as outcome measures of QOL and explored the factors associated with these improvements.

Retrospective analyses of complications associated with transcutaneous replacement of percutaneous gastrostomy and jejunostomy feeding devices.

Background: Feeding device replacement is often required for long-term maintenance after initial percutaneous endoscopic gastrostomy or jejunostomy placement. Although there are several case reports on serious complications of gastrostomy device replacement, there are few reports of an overall analysis of the complications associated with feeding device replacement.

Objective: To evaluate the frequency and variety of complications of transcutaneous replacement of feeding devices.

Predominant copper deficiency during prolonged enteral nutrition through a jejunostomy tube compared to that through a gastrostomy tube.

Background & Aims: Trace element deficiencies are known to occur during long-term enteral nutrition feeding. We compared the serum concentrations of trace elements between patients treated with gastrostomy and those treated with jejunostomy.

Methods: Our subjects were 36 patients who underwent percutaneous endoscopic gastrostomy (PEG group) and 23 patients who underwent percutaneous endoscopic jejunostomy (PEJ group) and were maintained with enteral tube feeding for more than one year.

Survival of geriatric patients after percutaneous endoscopic gastrostomy in Japan.

Aim: To examine the long term survival of geriatric patients treated with percutaneous endoscopic gastrostomy (PEG) in Japan.

Methods: We retrospectively included 46 Japanese community and tertiary hospitals to investigate 931 consecutive geriatric patients (≥ 65 years old) with swallowing difficulty and newly performed PEG between Jan 1st 2005 and Dec 31st 2008. We set death as an outcome and explored the associations among patient's characteristics at PEG using log-rank tests and Cox proportional hazard models.

[Three cases of lung cancer detected after smoking cessation].

COPD is an independent risk factor for lung cancer. There is emerging evidence that chronic inflammation may play a significant role in the pathogenesis of lung cancer as a tumor promoter. Cigarette smoke exponentially up-regulates the production of cytokines.

[A bleeding ileal ulcer associated with Sweet's syndrome].

A 76-year-old woman was admitted to our institution because of high fever and erythema in the upper body with right back pain, and was given a diagnosis of Sweet's syndrome. She also had abdominal pain and developed hematochezia from the fourth hospitalization day. Double balloon enteroscopy detected multiple ulcers with a punched-out appearance at the terminal ileum.

[A case of cardiac sarcoidosis occurring during combination therapy by IFN alpha and ribavirin for chronic hepatitis C].

A 72-year-old woman received combination therapy with peginterferon alpha and ribavirin for treatment of chronic hepatitis C. Approximately 40 weeks after starting treatment, she developed an eruption in the left inner canthus and sarcoidosis was diagnosed after biopsy of the eruption. Combination therapy was discontinued, and further detailed examinations revealed bilateral hilar lymphadenopathy, uveitis, and complete atrioventricular block.

Clinical investigation of upper gastrointestinal hemorrhage after percutaneous endoscopic gastrostomy.

Background: Upper gastrointestinal (GI) hemorrhage after percutaneous endoscopic gastrostomy (PEG) is sometimes reported as one of the serious complications. Our purpose was to clarify the cause of upper GI hemorrhage after PEG.

Patients And Methods: We retrospectively investigated the causes of upper GI hemorrhage among a total of 416 patients out of 426 consecutive patients who underwent PEG in our institution, excluding 10 patients who showed upper GI tumors on PEG placement.

The sky blue method as a screening test to detect misplacement of percutaneous endoscopic gastrostomy tube at exchange.

Background: During tube exchange for percutaneous endoscopic gastrostomy (PEG), a misplaced tube can cause peritonitis and death. Thus, endoscopic or radiologic observation is required at tube exchange to make sure the tube is placed correctly. However, these procedures cost extensive time and money to perform in all patients at the time of tube exchange.

Inhibition of gastroesophageal reflux by semi-solid nutrients in patients with percutaneous endoscopic gastrostomy.

Background: Aspiration is one of the major complications after percutaneous endoscopic gastrostomy (PEG). The administration of semi-solid nutrients by means of gastrostomy tube has recently been reported to be effective in preventing aspiration pneumonia. The effects of semi-solid nutrients on gastroesophageal reflux, intragastric distribution, and gastric emptying were evaluated.

A case of acute gastroduodenitis with cytomegalovirus infection in a healthy adult.

A 33-year-old man with epigastralgia was admitted. Upper gastrointestinal endoscopy revealed gastric fold hypertrophy, mucosal hemorrhage, and widespread erosion in the stomach and aphthoid erosion in the duodenum. The presence of intranuclear inclusion bodies positively stained with anti-cytomegalovirus antibody from the biopsy specimens indicated that the gastroduodenitis was related to cytomegalovirus (CMV) infection.

Clinical analysis of gastroesophageal reflux after PEG.

Background: It is difficult to predict whether or not gastroesophageal reflux (GER), such as aspiration or vomiting, will occur after PEG.

Objective: To identify factors that would support the prediction of aspiration after PEG.

Design: Case-control study.