The triple therapy including lafutidine is equivalent to triple therapy including lansoprazole in terms of H pylori eradication rates and improvement in gastroesophageal reflux and abdominal symptoms. These results are attributed to the fact that lafutidine has strong, continuous antisecretory activity, unaffected by CYP2C19 polymorphisms.
We studied 14 patients using endoscopic color Doppler ultrasonography (ECDUS) to evaluate the hemodynamics of gastric varices, and evaluated the endoscopic therapeutic effects on gastric varices in 8 patients. Three patients had F3 type gastric varices and eleven had F2. The ECDUS was performed with a PENTAX FG‐32UA (7.5MHz, convex type) and a HITACHI EUB 565 was used as a display machine. The intramural blood flow in the gastric varices and inflows from the extra‐gastric wall were clearly observed with the ECDUS in all 14 patients. The extramural blood flow (gastro or spleno‐renal shunts) was detected in 9 of 14 patients. The velocity of the intramural flow in tumorous type varices (F3) was higher than in the nodular or flat elevated type (Fa). Next, we evaluated the therapeutic effects on gastric varices of the ECDUS. The successful disappearance of intramural blood flow was observed in 6 of 8 patients who had this endoscopic therapy. In two of the 8 patients, there was not enough therapeutic effect on the intramural blood flow. The extramural blood flow, however, did not change before or after endoscopic therapy with the ECDUS.
Therefore, we concluded that ECDUS is a very useful modality for the diagnosis of hemodynamics and to evaluate the therapeutic effects on gastric varices.
We treated 14 patients with high risk intramucosal venous dilatation (high risk IMVD) of esophageal varices using heat‐probe coagulation. Two of the 14 patients experienced bleeding from the high risk IMVD. We used an Olympus heat‐probe unit CD‐20Z to stop or prevent variceal bleeding. The 14 patients were treated one to four times (mean: 1.9 times) using a total of 450–2100 joules (mean: 1459 joules). The high risk IMVD disappeared with healing of the heat‐probe‐induced ulcers. No severe side effects were recorded. Two patients with bleeding from high risk IMVD were successfully treated by the heat‐probe technique. In addition, we studied the effects of endoscopic heat‐probe coagulation for esophageal varices via endoscopic color Doppler ultrasonography (ECDUS) in six patients. Our ECDUS study was conducted with a PENTAX FG‐32UA, 7.5MHz convex type, and a HITACHI EUB 565 display monitor. Following heat‐probe treatment, the esophageal walls thickened from 5.1 to 8 mm (mean: 6.3 mm) and a low echoic pattern was visualized by ECDUS. Esophageal intramural blood flow was not observed in any of the six patients. Paraesophageal veins and passageways remained patent in all six patients.
Between 1972 and 1992, 18, 128 ERCPs were performed. Pancreas divisum (PD) was diagnosed in 184 of these patients (1.02%). The clinical features of 108 cases were investigated (M53, F55, average age 54) who were encountered during the last 8 years.
In a morphological study, we examined changes in both the ventral and dorsal ducts. An ERP of the dorsal pancreas demonstrated severe changes (SE) in 2 of 73 patients (3%), moderate changes (MO) in 4 (5%) and minimal changes (MI) in 17 (23%). When the ventral pancreas was examined, SE and MO occurred in one each of the 89 patients (1%), and MI in 5 (6%). The rate of ductal abnormalities in the dorsal pancreas (32%) was significantly higher than the rate in the ventral pancreas (8%). However, the dorsal duct changes did not correlate with alcoholism.
The exocrine or endocrine function in the majority of the patients with PD was normal or slightly disturbed.
An investigation of abdominal pain revealed that patients who complained of pancreatic‐type pain were 33%, and this rate was higher than the rate in the control group without PD (12.8%).
In conclusion, it was suggested that PD was related to mild dorsal pancreatitis. (Dig Endosc 1994; 6: 80–86)
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