SUMMARYBackground: It has been reported that inhibitors of gastric acid secretion prevent bleeding after endoscopic mucosal resection for mucosal gastric neoplasm. However, uncertain whether an histamine 2 -receptor antagonist or proton-pump inhibitor is more effective. Aim: To evaluate prospectively the effectiveness of famotidine or omeprazole for ulcer management after endoscopic mucosal resection. Methods: From July 2003 to October 2004, 57 patients were randomly assigned to famotidine or omeprazole for the management of endoscopic mucosal resection. Both drugs were given intravenously for the first 2 days, thereafter by mouth. The bleeding rates after endoscopic mucosal resection, the effects on the healing of endoscopic mucosal resection-induced ulceration, and cost-benefits were compared.
We herein report two cases of portal venous gas (PVG) following alpha-glucosidase inhibitor (α-GI) therapy for diabetes mellitus. Anti-diabetic treatment with voglibose was commenced in the first case, while the second case was treated with miglitol. Both patients recovered without intensive treatment after discontinuing the α-GI therapy. α-GI medications may increase internal intestinal tract pressure by releasing carbon dioxide and hydrogen gas, potentially causing pneumatosis cystoides intestinalis (PCI) or PVG. Our experience suggests that α-GI therapy is an important potential cause of portal venous gas that can be treated conservatively.
Background : The natural history of short-segment Barrett's esophagus (SSBE) is not fully understood. We, thereby, conducted a retrospective cohort study to provide further information about chronological change of SSBE. Materials and methods : A total of 174 cases undergoing upper gastrointestinal endoscopy from April 1980 to October 2002 were diagnosed to have SSBE based on the definition of Barrett's esophagus proposed by the Japanese Society for Esophageal Diseases. A cohort of 100 patients with SSBE less than 3 cm was enrolled in the present study. The mean follow-up period was 76.2 ± 59.9 months and 4.27 ± 2.66 endoscopic examinations were performed on each patient. The cumulative probability of elongation of SSBE to 3 cm or longer was estimated by the Kaplan-Meier method. Then, independent contributing factors to its elongation were determined using Cox's proportional hazard model. Results : Elongation of SSBE to 3 cm or longer occurred in 30 patients (30%) during the follow-up period. The cumulative 5-year probability of elongation of SSBE to 3 cm or longer was 18.4%. Hiatal hernia, severe reflux esophagitis and SSBE 1 cm or longer at initial diagnosis were proven to be independent contributing factors to its elongation.Conclusions : The present study demonstrated that SSBE has a tendency to increase its length over time especially when it is accompanied by hiatal hernia or by severe reflux esophagitis.
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