Inserting a guide wire into the pancreatic duct to facilitate deep selective bile duct cannulation is better than persisting with a conventional catheter. Further studies will be needed to confirm these results and to compare this method with other sophisticated techniques for obtaining selective access to the bile duct.

The death rate from gastric cancer decreased when endoscopic screening was used. Endoscopy is recommended as a population-based screening method for gastric cancer in regions or countries where mortality from this disease is high.

Background and Methods. Various factors, including thymidylate synthase, thymidine kinase, 5‐fluorouracil phosphorylation and degradation pathways, folate concentrations, and the stability of ternary complex, which influence thymidylate synthase inhibition rate of fluoropyrimdines, were studied in 87 human adenocarcinoma tissues. Results. The activity of the 5‐fluorouracil degradation pathway was not significantly lower than the activity of the 5‐fluorouracil phosphorylation pathway. The activity of the catabolism pathway of 5‐fluorouracil should be considered in human adenocarcinoma tissue during chemotherapy. On the other hand, the means plus or minus standard deviations (means ± SD) of the concentration of 5,10‐methylenetetrahydrofolate and tetrahydrofolate were 0.69 ± 0.54 and 1.25 ± 0.69 nM, respectively, for the adenocarcinoma tissues without previous chemotherapy. Conclusions. Because the half‐life of tritium‐labeled ternary complex and folate concentration in cytosol were correlated well, the differences in folate concentration among tumors must influence the dynamic equilibrium of ternary complex formation. Moreover, these results show that the ratio of 5,10‐methylenetetrahydrofolate concentration to thymidylate synthase concentration influences the thymidylate synthase inhibition rate in tumor, and that the new synthesis of 5,10‐methylenetetrahydrofolate and tetrahydrofolate from other endogenous reduced folates is also important in tumors with high thymidylate synthase concentrations.

Our findings in this case suggest that rectal lymphoma of mucosa-associated lymphoid tissue may be related to unknown microorganisms other than Helicobacter pylori. Levofloxacin may be effective for treatment of rectal lymphoma of mucosa-associated lymphoid tissue regardless of Helicobacter pylori infection.

The primary modalities for management of liver abscesses are usually antibiotics and percutaneous drainage. However, in patients with ascites or bleeding tendency, the percutaneous puncture of liver abscesses may be unsuitable. We applied a new approach, nasobiliary tube drainage, for a giant pyogenic liver abscess following diagnostic endoscopic retrograde cholangiopancreatography. Pyogenic liver abscess is often biliary in origin, and this new approach includes assessment of biliary abnormality for the management of the abscess, enabling treatment of parients in whom puncture of the abscess is considered dangerous because of massive ascites around the liver. We propose that this procedure is useful in the management of a subgroup of patients with pyogenic liver abscess. To our knowledge, no previous reports of endoscopic transpapillary abscess drainage in pyogenic liver abscess are available.