Backgroud/Aims: Endoscopic stent placement is widely used to treat an unresectable malignant gastric outlet obstruction. The covered stent has the disadvantage of an increased risk of migration, and the uncovered stent has an increased risk of ingrowth. This study examined the technical and clinical efficiency of stent placement of a double-layered combination pyloric stent that was newly designed to reduce tumor ingrowth and stent migration. METHODS: Fifteen patients with a gastric outlet obstruction caused by unresectable stomach cancer were treated with the endoscopic placement of a double-layered combination pyloric stent (an outer uncovered stent to reduce migration and an inner PTEF-covered stent to prevent tumor ingrowth). The technical success, clinical success, and complication especially tumor ingrowth and stent migration were analyzed. RESULTS: Technical success was achieved in 15 out of 15 (100%) patients. Among the 15 patients in whom endoscopic stenting was placed successfully, the clinical success rate was 93.3%, the incidence of tumor ingrowth was 0%, the rate of migration was 6.7%, and tumor overgrowth was observed in 13.3%. The median stent patency period was 105 days. CONCLUSIONS: The placement of a double- layered pyloric combination stent appears to be effective in overcoming the disadvantage of the increased migration observed for a covered stent and the increased ingrowth observed for the uncovered stent.
Gastric Outlet Obstruction* ; Humans ; Incidence ; Stents* ; Stomach Neoplasms* ; Stomach*

Following irradiation with 2.45GHz microwave, pituitary hormonal changes in rabbits were observed. A 30 rabbits (New Zealand, White, Male) were used for the experiments, 10 for each experiment immediately following one two and four weeks after irradiation with amount of 2.4 Joule/cm2, 4.8 Joule/cm2 and 7.2 Joule/cm2 respectively. The following are the results of the study as a conclusion. The secretion of cortisol hormone increased immediately after the exposure and then decrease to below that of the control group until two weeks afterwards, followed by recovery phase with secretion level approaching that of the central group in 4 weeks. Lutenizing hormone showed a tendency of increase from the first week of exposure, rather than immediately after, lasting up to over four weeks, In the irradiation group for 30 min, however, the increase began immediately after the exposure. The secretion of of growth hormone showed an insignificant, increase after the second and fourth weeks over the control group. The duration of exposure did not have much effect on the hormonal secretion. Thyroid stimulating hormone showed a different pattern changes: increase of immediately after exposure, decreased in two weeks, and then approaching the level of the control group after four weeks.
Growth Hormone* ; Hydrocortisone ; Microwaves* ; Pituitary Hormones ; Rabbits* ; Thyroid Gland* ; Thyrotropin

BACKGROUND/AIMS: The use of self-expandable metal stents (SEMS) is a safe and efficacious method for palliating malignant gastric outlet obstruction. However, few reports have assessed clinical outcome after the insertion of SEMS for malignant gastric outlet obstruction caused by stomach cancer. The aim of this study was to assess the usefulness of uncovered SEMS in patients with malignant gastric outlet obstruction caused by stomach cancer. METHODS: We evaluated 62 patients with gastric outlet obstruction caused by stomach cancer treated by the implantation of uncovered SEMS. A total of 62 patients (43 males, 19 females) were treated between August 2000 and March 2007. A scoring system was used to grade the ability to eat. RESULTS: Stent implantation was successful in 61 (98.4%) patients. Relief of obstructive symptoms was achieved in 49 (80.3%) patients. The mean survival duration was 143 days. The mean stent patency time was 103.5 days. An improvement in the ability to eat using the scoring system was statistically significant (p<0.05). CONCLUSIONS: Endoscopic placement of uncovered SEMS is a safe and effective treatment for the palliation of patients with inoperable malignant gastric outlet obstruction caused by stomach cancer.
Gastric Outlet Obstruction ; Humans ; Male ; Stents ; Stomach ; Stomach Neoplasms

BACKGROUND/AIMS: The catheter probe endoscopic ultrasonography (EUS) system is widely used to evaluate upper gastrointestinal tract lesions. The depiction of the esophageal wall by probe EUS remains problematic due to the difficulty of the filling of water in the esophageal lumen. In addition, filling the esophagus with water can be associated with an increased risk of aspiration. To resolve such problems, we recently applied the use of probe EUS with the jelly-filled method for the evaluation of subepithelial lesions. The procedure is characterized by filling the esophageal lumen with jelly. In this study, we evaluated the efficacy of probe EUS by using the jelly-filled method for esophageal subepithelial lesions. METHODS: We analyzed the records of the patients with suspected subepithelial lesions at the time of endoscopy that was performed from November 2005 to June 2007. Esophageal subepithelial lesions with both EUS findings and pathological reports were retrospectively compared. RESULTS: The study included 181 patients (96 males, 85 females), with an average age of 55.5 years (age range, 29~78 years). Sixty-eight patients had lesions in the upper esophagus, 60 patients had lesions in the middle esophagus and 53 patients had lesions in the lower esophagus. Secondary layers of esophageal lesions were predominant (91/181) in the cases. Pathological findings were available for 34 patients. Compared with the pathological findings, the diagnostic accuracy of EUS was 91.1%. CONCLUSIONS: Probe EUS by using the jelly-filled method is convenient and safe to perform and provides clear and full-circumferential imaging of a lesion. It is an alternative method to use in place of previously used probe-EUS procedures for the assessment of esophageal subepithelial lesions.
Catheters ; Endoscopy ; Endosonography ; Esophagus ; Humans ; Hypogonadism ; Male ; Mitochondrial Diseases ; Ophthalmoplegia ; Retrospective Studies ; Upper Gastrointestinal Tract