PubMed Health⌕ Search

Biomedical subjects

Ichiro Yoshikawa

Publications and source records attributed to Ichiro Yoshikawa.

24 records · Page 2Linked to original sources
PubMed2002

Ischemic colitis caused by strict dieting in an 18-year-old female: report of a case.

Ischemic colitis is typically limited to elderly patients who have concomitant disorders such as cardiovascular disease and chronic renal failure, but rarely affects a young person. The patient was an 18-year-old Japanese female who started dieting to obtain a slim figure three months before admission and presented with a two-month history of constipation and a sudden onset of lower abdominal pain and bloody diarrhea. She underwent colonoscopy, which revealed edema, hemorrhages, and several longitudinal shallow ulcers in the descending colon. Stool and blood culture results were negative for pathogens. She improved rapidly within five days without any specific therapies except intravenous hydration and anticholinergic agents, under the diagnosis of ischemic colitis. In this case constipation and dehydration associated with dieting seemed to be responsible for the development of ischemic colitis. We recommend that ischemic colitis should be included in the differential diagnosis of colitis with bleeding, even in patients younger than age 20 who do not have any predisposing factors.

Adolescent↗
PubMed2002

Biliary obstruction caused by intrabiliary transplantation from hepatocellular carcinoma.

A rare autopsy case of hepatocellular carcinoma (HCC) presenting as extrahepatic bile duct obstruction is reported. A 54-year-old man who had been treated at another hospital for obstructive jaundice was referred to our hospital and admitted on March 1, 1998, because of progressive jaundice. On hospital day 94, he died of bleeding esophageal varices. At autopsy, a bile duct tumor, measuring 3.0 x 3.5 cm and adhering to the wall of the left hepatic duct, occluded the common hepatic duct at the hilus. A tumor measuring 2.0 x 2.0 cm was found in the parenchyma of the left liver lobe. The parenchymal tumor was not continuous with the extrahepatic bile duct tumor. Histologically, the bile duct tumor and the parenchymal tumor of the left lobe were diagnosed as HCC. The bile duct tumor was attached to the mucosa of the bile duct with a thin stalk. No invasive growth into the submucosa was observed. The tumor may have been an intrabiliary transplantation from the HCC in the left lobe via the bile duct.

Bile Duct Neoplasms↗
PubMed2002

Variable stiffness colonoscopes are associated with less pain during colonoscopy in unsedated patients.

OBJECTIVES: Application of a new variable stiffness colonoscope (VSC) is expected to control loop formation and to lessen patient discomfort. The aim of this prospective study was to compare the efficacy of VSC with a conventional colonoscope (CC) in unsedated colonoscopy, based on the experience of examiners. METHODS: Four-hundred sixty-seven patients were randomly assigned to undergo colonoscopy with either VSC or CC by an endoscopist, including experienced and less-experienced examiners. The percentages of completed procedure and time to cecal intubation were recorded. Patients were asked to rate pain on a 5-point pain score. RESULTS: The percentages of completed procedure with VSC and CC were 98% and 95%, respectively, by less-experienced hands, and 99% and 98%, respectively, by experienced hands. Time for cecal intubation with VSC and CC was 15.7 and 18.5 min, respectively, by less-experienced hands, and 9.8 and 10.6 min, respectively, by experienced hands. A significantly lower mean pain score was noted in VSC patients compared with CC patients, irrespective of experience of the examiner. The percent of patients rating the procedure as moderately or severely painful was significantly lower with VSC than with CC, both in less-experienced (19% vs 40%; p < 0.01) and experienced hands (15% vs 26%; p < 0.05). CONCLUSIONS: Our results indicated that VSC allows favorable examination compared with CC regarding completeness, time to cecal intubation, and comfort of patients undergoing unsedated colonoscopy, irrespective of the examiner's experience. These features suggest VSC as the preferred colonoscope for patients undergoing unsedated colonoscopy.

Aged↗
PubMedDate not supplied

Endoscopic piecemeal mucosal resection of large colorectal tumors.

BACKGROUND/AIMS: Since endoscopic en bloc resection of large and sessile tumors is technically difficult, endoscopic en bloc piecemeal mucosal resection (EPMR) is usually chosen for resection of such tumors. Tumors resected by EPMR are, however, difficult to evaluate histologically. The aim of this study was to evaluate the safety and effectiveness of EPMR. METHODOLOGY: We removed 30 large colorectal tumors in 30 patients by EPMR between 1992-2000. Endoscopic examination was repeated at 3, 6 and 12 months and later on after initial endoscopic resection. Patients in whom no residual tumor was found by both endoscopic and histologic examination were considered to be "cured". RESULTS: Histological examination of the resected tumor tissues revealed malignancy in 43.3% (13/30). Three patients had invasive malignant tumors and underwent surgery. Following complete endoscopic resection, recurrences were observed in 2 patients with benign tumors, which were resected by additional endoscopic resection. All patients including the two with non-invasive malignant tumors remain free from recurrence during a mean follow-up period of 45.2 months (range, 3-104 months). Bleeding was the only complication and was seen in one patient (3.3%; 1/30), which was treated by endoscopic clipping. CONCLUSIONS: EPMR of benign or non-invasive large malignant tumors is a safe and effective procedure. Complete excision of large, sessile and non-invasive tumors is possible, although complete removal by EPMR cannot be verified histologically.

Adenoma↗