Introduction: A post-marketing surveillance (PMS) study was conducted to confirm the longterm risk-benefit profile of sitagliptin administered to Japanese patients with type 2 diabetes mellitus (T2DM) under real-world conditions. Methods: This prospective, multicentre, openlabel PMS collected data from 3326 patients receiving sitagliptin according to the approved indication during the case registration period (
We evaluated two models of small‐caliber panendoscopes for the upper G‐I tract, for their applicability to gastric cancer mass screening or upper G‐I screening; one type is a fiberscope (GIF‐N30; Olympus Optical Co.) with an outer tip diameter of 5.3mm (start date. May, 1993) originally designed for newborns and infants, while the other is a newer electronic videoscope (XGIF‐N200; Olympus) with a tip diameter of 6mm (start date, February, 1994) recently developed to allow transnasal insertion. Both scopes are suitable for transnasal insertion. Of the 658 subjects examined, 403 were randomly selected to undergo transnasal insertion. Conversation between the operator and subject was possible during the procedure. Among those subjects who had previously been examined by means of panendoscopy, 90.3% (224/248) replied that the transnasal insertion was more comfortable than the ordinary peroral insertion, and 89.9% (223/248) stated that they would not mind undergoing transnasal endoscopic examination in the future. The examiners reported no difficulties with manipulation, visual acuity, or obtaining biopsy specimens. The mean examination time with the small‐caliber endoscopes was about five minutes, which is shorter than with previously reported examinations. Transnasal insertion of the small‐caliber panendoscopes is recommended particularly for screening purposes, such as the gastric cancer mass survey. However, the long‐term durability of the instrument must be assessed before widespread application becomes possible.
A 49-year-old female was admitted with chief complaint of fecaluria on March 4th 1993. A radiation therapy had been performed for uterocervical cancer 18 years ago. The small intestine and bladder was detected by DIP- and cystogram simultaneously. It was diagnosed as an ileovesical fistula. A segmental resection of the ileum with partial cystectomy was performed on March 23rd. Histopathologically, the ileum showed a radiation enteritis. Eventually, we diagnosed that this ileovesical fistula was caused by radiation. After operation, an incompletion of suture occurred. So we made an ileostomy secondarily and performed hyperbaric oxygen therapy. The patient was getting well temporarily but died of gastric hemorrhage on May 1st.
Hemorrhagic cystitis resulting from radiation to pelvic visceral malignant lesions often might be incurable and there have been established no definitive treatment. We experienced 2 cases with radiation-induced severe hemorrhagic cystitis refractory to conventional therapy. The treatment with hyperbaric oxygen to control hematuria was performed and obtained successful results. Gross hematuria was disappeared and cystoscopic figure was remarkably improved. No remarkable side-effect was observed in both patient. This experience suggested that hyperbaric oxygen could be considered the primary treatment for patient with radiation-induced hemorrhagic cystitis instead of usual treatment.
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