1.Two Successful Cases of Adult Right-sided Infective Endocarditis with Ventricular Septal Defect.
Hiroshi Ito ; Haruhiko Okada ; Kazuhiro Suzuki ; Kazuya Nishida ; Kimikazu Hamano ; Akihiko Furunaga ; Yoshihiko Fujimura ; Hidetoshi Tsuboi ; Kensuke Esato
Japanese Journal of Cardiovascular Surgery 1995;24(2):117-120
Case 1 was a 42-year-old woman who was admitted because of infective endocarditis. Pulmonary embolism occurred during medical treatment for infective endocarditis. Despite the acute infectious phase, surgical treatment was successfully performed. Case 2 was a 50-year-old man who was admitted because of infective endocarditis. Cardiac catheterization showed ventricular septal defect and atrial septal defect. Surgical treatment was performed successfuly. In both cases, and the postoperative courses were unventful.
2.Comparison of Bilateral and Trisegment Drainage in Patients with High-Grade Hilar Malignant Biliary Obstruction: A Multicenter Retrospective Study
Kazuyuki MATSUMOTO ; Hironari KATO ; Kosaku MORIMOTO ; Kazuya MIYAMOTO ; Yosuke SARAGAI ; Hirofumi KAWAMOTO ; Hiroyuki OKADA
Gut and Liver 2023;17(1):170-178
Background/Aims:
Bilateral endoscopic drainage with self-expanding metallic stent (SEMS) can be used to effectively manage hilar malignant biliary obstruction. However, the benefits of using a trisegment drainage method remain unknown.
Methods:
This study retrospectively reviewed the data of 125 patients with Bismuth type IIIa or IV unresectable malignant strictures who underwent bilateral endoscopic drainage using SEMSs at four tertiary centers. The patients were divided into the bilateral and trisegment drainage groups for comparison. The primary endpoint was stent patency and the secondary endpoints were technical success, technical and clinical success of reintervention, and overall survival.
Results:
The technical success rates of the bilateral and trisegment drainage groups were 95% (34/36) and 90% (80/89) (p=0.41), respectively, with median stent patency durations of 226 and 170 days (p=0.26), respectively. Although the technical success of reintervention was not significantly different between the two groups (p=0.51), the clinical success rate of reintrvention was significantly higher in the trisegment drainage group (73% [11/15] vs 96% [47/49], p=0.009). The median survival times were 324 and 323 days in the bilateral and trisegment drainage groups, respectively (p=0.72). Multivariate Cox hazards model revealed no stent patency-associated factor; however, chemotherapy was associated with longer survival.
Conclusions
Although no significant difference was noted with respect to stent patency, significantly higher clinical success rates were achieved with reintervention using the trisegment drainage method than using the bilateral drainage method alone.
3.Malignant biliary obstruction treated with preoperative endoscopic ultrasound-guided hepaticogastrostomy: A case report
Taira KURODA ; Hideki MIYATA ; Yuka KIMURA ; Ayaka NAKAMURA ; Takuya MATSUDA ; Kana MATSUOKA ; Mai FUKUMOTO ; Kazuya MURAKAWA ; Taisei MURAKAMI ; Hirofumi IZUMOTO ; Kei ONISHI ; Shogo KITAHATA ; Kozue KANEMITSU-OKADA ; Tomoe KAWAMURA ; Fujimasa TADA ; Eiji TSUBOUCHI ; Jun HANAOKA ; Atsushi HIRAOKA ; Tomoyuki NINOMIYA
International Journal of Gastrointestinal Intervention 2025;14(1):20-23
We present the case of a 76-year-old man who underwent preoperative endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) for obstructive jaundice caused by pancreatic head cancer. The patient had obstructive jaundice and cholangitis during neoadjuvant chemotherapy. Transpapillary biliary drainage using endoscopic retrograde cholangiopancreatography was attempted; however, it was unsuccessful because of duodenal tumor invasion. Therefore, EUS-HGS was performed. Jaundice and cholangitis improved promptly after EUS-HGS, and stent obstruction and migration were not observed before surgery. The stent was safely removed during surgery, and no postoperative complications occurred. Most studies of EUS-HGS for preoperative biliary drainage have been small and retrospective, and few have examined the safety of intraoperative stent removal. The fistula in our patient was promptly identified and the stent was safely removed despite the relatively limited field of view during robot-assisted laparoscopy.The promising findings of our case report can be used to inform EUS-based surgical strategies for biliary drainage with obstructive jaundice.
4.Malignant biliary obstruction treated with preoperative endoscopic ultrasound-guided hepaticogastrostomy: A case report
Taira KURODA ; Hideki MIYATA ; Yuka KIMURA ; Ayaka NAKAMURA ; Takuya MATSUDA ; Kana MATSUOKA ; Mai FUKUMOTO ; Kazuya MURAKAWA ; Taisei MURAKAMI ; Hirofumi IZUMOTO ; Kei ONISHI ; Shogo KITAHATA ; Kozue KANEMITSU-OKADA ; Tomoe KAWAMURA ; Fujimasa TADA ; Eiji TSUBOUCHI ; Jun HANAOKA ; Atsushi HIRAOKA ; Tomoyuki NINOMIYA
International Journal of Gastrointestinal Intervention 2025;14(1):20-23
We present the case of a 76-year-old man who underwent preoperative endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) for obstructive jaundice caused by pancreatic head cancer. The patient had obstructive jaundice and cholangitis during neoadjuvant chemotherapy. Transpapillary biliary drainage using endoscopic retrograde cholangiopancreatography was attempted; however, it was unsuccessful because of duodenal tumor invasion. Therefore, EUS-HGS was performed. Jaundice and cholangitis improved promptly after EUS-HGS, and stent obstruction and migration were not observed before surgery. The stent was safely removed during surgery, and no postoperative complications occurred. Most studies of EUS-HGS for preoperative biliary drainage have been small and retrospective, and few have examined the safety of intraoperative stent removal. The fistula in our patient was promptly identified and the stent was safely removed despite the relatively limited field of view during robot-assisted laparoscopy.The promising findings of our case report can be used to inform EUS-based surgical strategies for biliary drainage with obstructive jaundice.
5.Malignant biliary obstruction treated with preoperative endoscopic ultrasound-guided hepaticogastrostomy: A case report
Taira KURODA ; Hideki MIYATA ; Yuka KIMURA ; Ayaka NAKAMURA ; Takuya MATSUDA ; Kana MATSUOKA ; Mai FUKUMOTO ; Kazuya MURAKAWA ; Taisei MURAKAMI ; Hirofumi IZUMOTO ; Kei ONISHI ; Shogo KITAHATA ; Kozue KANEMITSU-OKADA ; Tomoe KAWAMURA ; Fujimasa TADA ; Eiji TSUBOUCHI ; Jun HANAOKA ; Atsushi HIRAOKA ; Tomoyuki NINOMIYA
International Journal of Gastrointestinal Intervention 2025;14(1):20-23
We present the case of a 76-year-old man who underwent preoperative endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) for obstructive jaundice caused by pancreatic head cancer. The patient had obstructive jaundice and cholangitis during neoadjuvant chemotherapy. Transpapillary biliary drainage using endoscopic retrograde cholangiopancreatography was attempted; however, it was unsuccessful because of duodenal tumor invasion. Therefore, EUS-HGS was performed. Jaundice and cholangitis improved promptly after EUS-HGS, and stent obstruction and migration were not observed before surgery. The stent was safely removed during surgery, and no postoperative complications occurred. Most studies of EUS-HGS for preoperative biliary drainage have been small and retrospective, and few have examined the safety of intraoperative stent removal. The fistula in our patient was promptly identified and the stent was safely removed despite the relatively limited field of view during robot-assisted laparoscopy.The promising findings of our case report can be used to inform EUS-based surgical strategies for biliary drainage with obstructive jaundice.
6.Influence of the stage of emergency declaration due to the coronavirus disease 2019 outbreak on plasma glucose control of patients with diabetes mellitus in the Saku region of Japan
Takuya WATANABE ; Yuichi TEMMA ; Junichi OKADA ; Eijiro YAMADA ; Tsugumichi SAITO ; Kazuya OKADA ; Yasuyo NAKAJIMA ; Atsushi OZAWA ; Tetsuya TAKAMIZAWA ; Mitsuaki HORIGOME ; Shuichi OKADA ; Masanobu YAMADA
Journal of Rural Medicine 2021;16(2):98-101
Objective: Because patients with diabetes mellitus (DM) were forced to stay indoors during the state of emergency, resulting in stress and a lack of physical activity, concerns about their glycemic control were raised.Patients and Methods: The 165 patients’ glycated hemoglobin (HbA1c) levels were compared during the following periods: the 4 months that were selected as a representative condition 1 year before the COVID-19 pandemic (May 2018, March 2019, June 2019, and July 2019) and the latter 3 months as a 1-year follow-up during the COVID-19 pandemic (May 2019, March 2020, June 2020, and July 2020).Results: The patients’ HbA1c levels were 7.32 ± 1.23, 7.44 ± 1.20, 7.16 ± 1.06, 7.01 ± 1.05, 7.23 ± 1.06, 7.45 ± 1.18, 7.15 ± 10.7, and 7.11 ± 1.17 in May 2018, March 2019, June 2019, July 2019, May 2019, March 2020, June 2020, and July 2020, respectively (expressed as mean ± standard deviation).Conclusion: The analysis showed that HbA1c levels did not worsen during the self-restraint period.