The intra-conduit release method is useful for avoiding migration of metallic stents during EUS-guided hepaticogastrostomy (with video).

Purpose: Although EUS-guided hepaticogastrostomy (EUS-HGS) with a covered self-expandable metal stent (SEMS) is a useful procedure, it is associated with severe adverse events, including stent migration. We, therefore, developed an intra-conduit release method, and investigated whether the technique yields a safer and more stable procedure.

Methods: The intra-conduit release method is a procedure to release the SEMS in the working channel conduit of the scope for anchoring between the liver and stomach to avoid stent migration.

Bleeding Risk Related to Upper Gastrointestinal Endoscopic Biopsy in Patients Receiving Antithrombotic Therapy: A Multicenter Prospective Observational Study.

Background: Although antithrombotic agents are widely used for cardiac and cerebrovascular disease prevention, they increase the risk of gastrointestinal (GI) bleeding.

Objective: To examine GI bleeding risk in association with an esophagogastroduodenoscopy (EGD) biopsy performed in patients without cessation of antithrombotic therapy.

Methods: This study was prospectively conducted at 14 centers.

[Breast Cancer Patient with Bone Metastases Who Was Able to Return Home without Using Opioids after Administration of Strontium-89 Chloride].

A 46-year-old woman underwent mastectomy for right inflammatory breast cancer.Three years later, she was diagnosed with multiple bone metastases and was treated with systemic chemotherapy and zoledronic acid.Six years after the mastectomy, she complained of severe sacral pain, and 40 Gy external radiotherapy was applied to the sacral metastases.

[A Case of Drug-Induced Lung Injury Associated with Paclitaxel plus Bevacizumab Therapy].

A 61-year old woman with recurrent breast cancer received combined treatment with paclitaxel (PTX) and bevacizumab (BV) as the third-line chemotherapy. During the administration of PTX in the 3 courses of chemotherapy, she suddenly developed respiratory failure, and both chest X-ray and CT revealed bilateral pulmonary infiltrates. Symptoms and radiographic findings responded dramatically to steroid pulse therapy.

Uncommon gastrointestinal bleeding during targeted therapy for advanced renal cell carcinoma: A report of four cases.

Clinically available targeted agents to treat advanced renal cell carcinoma (RCC) include sunitinib, sorafenib and temsirolimus. Sorafenib and sunitinib have been associated with bleeding in selected trials, but clinical and endoscopic characteristics of gastrointestinal bleeding are not well described. Herein, we report four cases of advanced RCC in which endoscopic hemostasis effectively resolved high-grade, life-threatening gastrointestinal bleeding that occurred during targeted therapy.

Effects of antiviral therapy for hepatitis C following treatment of hepatocellular carcinoma: survey findings of the Japanese Red Cross Liver Study Group.

Aim: To investigate, in a large number of cases at multiple institutions, the effects and limitations of antiviral therapy for hepatitis C following treatment of hepatocellular carcinoma (HCC) in clinical practice.

Methods: Retrospective analysis was performed of 112 patients who had received interferon (IFN) for treating hepatitis C following treatment of HCC and were registered with the Japanese Red Cross Liver Study Group. Factors that may influence recurrence and survival rates were investigated.

Early predictors of status epilepticus-associated mortality and morbidity in children.

Background: Early predictors of status epilepticus (SE)-associated mortality and morbidity have not been systematically studied in children, considerably impeding the identification of patients at risk.

Objectives: To determine reliable early predictors of SE-associated mortality and morbidity and identify the etiology of SE-associated sequelae in Japanese children.

Methods: We conducted a prospective multicenter study of clinical findings and initial laboratory data acquired at SE onset, and assessed outcomes at the last follow-up examination.

[A case report of recurrent small bowel adenocarcinoma successfully treated with monoclonal antibody against EGFR and S-1].

A man in 30s was admitted to our hospital with a complaint of abdominal and back pain. Abdominal CT scan showed a large mass and double balloon endoscopy detected a tumor of the jejunum. The pathological diagnosis of biopsy samples was poorly differentiated adenocarcinoma.

[A case of inoperable advanced bile duct cancer treated effectively with combined chemotherapy of gemcitabine and S-1].

The patient was a 63-year-old male. He was admitted to our department due to obstructive jaundice and acute renal failure, and was diagnosed with a lower bile duct cancer. As a result of a stent placement into the bile duct and hemodialysis, jaundice and renal failure improved.

[Efficacy and safety of low-dose matrix-type transdermal fentanyl applied for opioid initiation].

Minimum-size matrix-type transdermal fentanyl(TDF)(Durotep®MTPatch 2.1mg), with a dose equivalent to half of a minimum-size conventional-type TDF(Durotep Patch 2.5mg), was newly produced.

Severe rotational deformity, quadriparesis and respiratory embarrassment due to osteomyelitis at the occipito-atlantoaxial junction.

We present the case of an 83-year-old man who developed quadriparesis and respiratory embarrassment following osteomyelitis at the occipito-atlantoaxial junction. He had developed an abscess at this site after an earlier urinary infection with methicillin-resistant staphylococcus aureus. Stabilisation of the neck and antibiotic therapy led to an almost complete neurological recovery without recourse to anterior surgery.

[Role of palliative chemotherapy and shift from anticancer therapy to palliative care in patients with advanced or recurrent breast cancer].

We examined the role of palliative chemotherapy and the shift from anticancer therapy to palliative care in 30 patients who had died of advanced or recurrent breast cancer. Patients who received more than four chemotherapy regimens had a longer survival and started analgesics later than those who received less than three regimens. In addition, median survival time was prolonged in patients treated with both anthracycline- and taxane-containing regimens.

[A case of recurrent endocrine cell carcinoma of the common bile duct successfully treated by hepatic artery infusion with CPT-11 and CDDP].

A 77-year-old woman underwent pancreatoduodenectomy with the diagnosis of biliary tract cancer. Postoperative immunohistochemical study showed endocrine cell carcinoma originating in the common bile duct. Systemic infusion of gemcitabine was started as adjuvant chemotherapy, however, 6 months after the operation, multiple liver and lymph node metastases were revealed by computed tomography.

Molecular tracing of Japan-indigenous hepatitis E viruses.

The ancestor(s) of apparently Japan-indigenous strains of Hepatitis E virus (HEV) was probably of foreign origin, but it remains unclear when and from where it made inroads. In this study, 24 genotype 3 and 24 genotype 4 HEV strains recovered in Japan each showed a significant cluster, clearly distinct from those of foreign strains, in the phylogenetic tree constructed from an 821 nt RNA polymerase gene fragment. The evolutionary rate, approximately 0.

Pseudo-Meigs' syndrome caused by retroperitoneal tumor in a patient with Ebstein anomaly.

We report an extremely rare case of pseudo-Meigs' syndrome caused by a retroperitoneal tumor in a patient with Ebstein anomaly. A 60-year-old woman was admitted because of marked hydrothorax and ascites. She also had pleural effusion.

Laparoscopy-assisted and open distal gastrectomies for early gastric cancer at a general hospital in Japan.

Background/aims: At general hospitals in Japan, laparoscopic surgery for early gastric cancer is not yet popular. The benefits and feasibility of this procedure remain to be established. The aim of this study was to evaluate the surgical outcome of laparoscopy-assisted distal gastrectomy (LADG) in comparison with open distal gastrectomy (ODG) in a general hospital.

[A case of advanced gastric cancer with peritoneal metastases responding to bi-weekly paclitaxel therapy].

A 68-year-old man underwent bypass operation for gastric cancer, because the tumor was judged to be unresectable due to peritoneal dissemination. After the operation, the patient was treated with daily oral administration of 100 mg TS-1 for two weeks followed by one week rest as one cycle. However, symptoms such as anemia, ascites and edema became worse and the TS-1 resulted in progressive disease.

[A case of idiopathic interstitial pneumonia with marked increase of CA19-9 in serum and BALF].

A 84-year-old man was admitted with dyspnea. Chest X-ray and CT showed honeycombing in the dorso-basal segments of the lung bilaterally. Idiopathic interstitial pneumonia (IIP: chronic, typical type) was diagnosed in accordance with the clinical criteria proposed by the Japanese Ministry of Health and Welfare.

[Transcatheter arterial embolization with SMANCS and epiADM for hepatocellular carcinoma].

We have attempted transcatheter arterial embolization (TAE) with SMANCS and epiADM for 40 patients with hepatocellular carcinoma and evaluated its therapeutic effects and side effects. There were 7 cases of stage I disease, 10 cases of stage II disease, 10 cases of stage III disease and 13 cases of stage IV disease. Patients underwent TAE superselectively following infusion of w/o emulsion of epiADM and SMANCS-lipiodol.

[A case of crush syndrome resulting from continuous compression of the upper arm by automatically cycled blood pressure cuff].

We report a case of crush syndrome (rhabdomyolysis) resulting from the prolonged compression of the inadvertently inflated blood pressure cuff around her upper arm. A 61-yr-old woman had undergone total gastrectomy, splenectomy and cholecystectomy for gastric cancer. At the end of the surgery lasting for 5 hrs 40 mins, we found the right upper arm extremely swollen with cyanotic petechiae beyond the inflated cuff.

[Dissection of the extracranial vertebral artery: a case report].

Spontaneous dissection of the vertebral artery is not a frequent occurrence in the vertebrobasilar system. The authors show a case with spontaneous dissection of the extracranial vertebral artery, which produced recurrent artery-to-artery embolism. The angiography revealed characteristic intimal flap.