Background: Endoscopic mucosal resection with a cap-fitted panendoscope (EMRC) such as a soft prelooped hood is a useful, effective, and safe technique. One problem with this method is that the lesion cannot always be...Background: Endoscopic mucosal resection with a cap-fitted panendoscope (EMRC) such as a soft prelooped hood is a useful, effective, and safe technique. One problem with this method is that the lesion cannot always be maintained in the center of the cap because the procedure is performed blindly after aspiration. Objective: We developed a 2-channel prelooped hood that facilitates EMRC while simultaneously allowing both grip of the center in the lesion and irrigation of the aspiration site and evaluated the usefulness of this end hood for early gastric cancer. Design: Retrospective study. Setting: Between August 2003 and October 2004, patients underwent our novel EMR. Patients: Twelve cases of early gastric cancer. Interventions: Two side holes were fabricated by drilling in the cap portion of a conventional soft prelooped hood, and then the irrigation tube and the accessory channel tube were glued to the exterior surface of the holes. We placed the fabricated transparent hood at the tip of the endoscope and performed grasping forceps-assisted endoscopic aspiration mucosectomy. Main Outcome Measurements: Accurate aspiration and the rate of en bloc resection. Results: We obtained a satisfactory field of view and accurate aspiration in the center of the tumor in all lesions. The rate of en bloc resection was 91.7%(11/12). Limitations: Gastric intramucosal cancer. Conclusion: Grasping forceps-assisted endoscopic mucosal resection with a novel 2-channel prelooped hood is safe and useful for mucosal resection of intramucosal cancers less than 20 mm and may help center the lesion in the cap before resection.展开更多
Background/Aims Diabetes mellitus (DM) is frequently observed in patients with chronic hepatitis caused by hepatitis C virus infection (CHC). The present study was designed to determine the pathogenic factors responsi...Background/Aims Diabetes mellitus (DM) is frequently observed in patients with chronic hepatitis caused by hepatitis C virus infection (CHC). The present study was designed to determine the pathogenic factors responsible for glucose intolerance in CHC patients. Methods A total of 131 patients with CHC were enrolled in this study. Insulin resistance and β-cell function were determined after 75 g oral glucose tolerance tests. Results Glucose intolerance was detected in 27.5% (36/131) of CHC patients; 10 had DM and 26 impaired glucose tolerance. HOMA-R insulin 0× glucose 0/22.5 was greater in patients with both impaired glucose tolerance and DM than in those with normal glucose tolerance (P< 0.01). Matsuda index 104/√ (mean insulin× mean glucose× glucose0× insulin 0) was lower in diabetic patients than in those with normal glucose tolerance (P< 0.05). The insulinogenic indexΔ insulin 30-0/Δ glucose 30-0 and Δ C-peptide 30 Δ C-peptide30-0/Δ glucose 30-0 were significantly lower even in patients with impaired glucose tolerance than in patients with normal glucose tolerance (P< 0.01). Conclusions Both insulin resistance and β-cell dysfunction contribute to glucose intolerance in CHC patients.展开更多
文摘Background: Endoscopic mucosal resection with a cap-fitted panendoscope (EMRC) such as a soft prelooped hood is a useful, effective, and safe technique. One problem with this method is that the lesion cannot always be maintained in the center of the cap because the procedure is performed blindly after aspiration. Objective: We developed a 2-channel prelooped hood that facilitates EMRC while simultaneously allowing both grip of the center in the lesion and irrigation of the aspiration site and evaluated the usefulness of this end hood for early gastric cancer. Design: Retrospective study. Setting: Between August 2003 and October 2004, patients underwent our novel EMR. Patients: Twelve cases of early gastric cancer. Interventions: Two side holes were fabricated by drilling in the cap portion of a conventional soft prelooped hood, and then the irrigation tube and the accessory channel tube were glued to the exterior surface of the holes. We placed the fabricated transparent hood at the tip of the endoscope and performed grasping forceps-assisted endoscopic aspiration mucosectomy. Main Outcome Measurements: Accurate aspiration and the rate of en bloc resection. Results: We obtained a satisfactory field of view and accurate aspiration in the center of the tumor in all lesions. The rate of en bloc resection was 91.7%(11/12). Limitations: Gastric intramucosal cancer. Conclusion: Grasping forceps-assisted endoscopic mucosal resection with a novel 2-channel prelooped hood is safe and useful for mucosal resection of intramucosal cancers less than 20 mm and may help center the lesion in the cap before resection.
文摘Background/Aims Diabetes mellitus (DM) is frequently observed in patients with chronic hepatitis caused by hepatitis C virus infection (CHC). The present study was designed to determine the pathogenic factors responsible for glucose intolerance in CHC patients. Methods A total of 131 patients with CHC were enrolled in this study. Insulin resistance and β-cell function were determined after 75 g oral glucose tolerance tests. Results Glucose intolerance was detected in 27.5% (36/131) of CHC patients; 10 had DM and 26 impaired glucose tolerance. HOMA-R insulin 0× glucose 0/22.5 was greater in patients with both impaired glucose tolerance and DM than in those with normal glucose tolerance (P< 0.01). Matsuda index 104/√ (mean insulin× mean glucose× glucose0× insulin 0) was lower in diabetic patients than in those with normal glucose tolerance (P< 0.05). The insulinogenic indexΔ insulin 30-0/Δ glucose 30-0 and Δ C-peptide 30 Δ C-peptide30-0/Δ glucose 30-0 were significantly lower even in patients with impaired glucose tolerance than in patients with normal glucose tolerance (P< 0.01). Conclusions Both insulin resistance and β-cell dysfunction contribute to glucose intolerance in CHC patients.
