Background: Endoscopic submucosal dissection (ESD) is accepted as a minimally invasive treatment for early gastric cancer, but it is not widely used to treat the colorectum because of its degree of technical difficult...Background: Endoscopic submucosal dissection (ESD) is accepted as a minimally invasive treatment for early gastric cancer, but it is not widely used to treat the colorectum because of its degree of technical difficulty. Thus, a noninvasive tool that facilitates the direct visualization of the submucosal layer is needed. Methods: Traction-assisted dissection was performed on 4 superficial lesions. The system consisted of a metallic clip attached by a nylon line to a sinker 6 × 4 × 4 mm in size and weighing 1 g. After partially dissecting the submucosa, the clip was attached to the edge of the exfoliated mucosa and the weight of the sinker pulled down the partly resected lesion. Observations: In all 4 cases, the sinker allowed direct visualization of the cutting line, and en bloc resection was successfully accomplished. Conclusions: These preliminary results suggest that sinker-assisted ESD is effective for the complete removal of selected superficial early colorectal cancer.展开更多
Background: EMR traditionally is performed by using normal saline solution (NS) as the submucosal fluid cushion. It is thought, however, that NS does not maintain the proper mucosal elevation for EMR of large, flat le...Background: EMR traditionally is performed by using normal saline solution (NS) as the submucosal fluid cushion. It is thought, however, that NS does not maintain the proper mucosal elevation for EMR of large, flat lesions. We investigated the efficacy of glycerol as the submucosal injection solution. Methods: A total of 110 colorectal laterally spreading tumors (LST)were treated by EMR with glycerol. For comparison, 113 LSTs treated by using NS were studied. The en bloc resection, complete resection, and associated complications rates were evaluated retrospectively. Observations: The en bloc resection rate in the glycerol group was 63.6%(70/110) compared with 48.9%(55/113) in the NS group (p < 0.05). The complete resection rate in the glycerol groupwas 45.5%(50/110) compared with 24.6%(28/113) in the NS group (p< 0.01). The associated complications rate was similar in both groups. Conclusions: It technically was easier and as safe to perform EMR of colorectal LST swhen using glycerol as the submucosal injection solution.展开更多
Purpose: To evaluate the ocular circulation in diabetic patients with coronary artery disease (CAD). Methods: Thirty diabetic patients with diabetic retinopathy of grade 20 or 35, as evaluated by the Early Treatment D...Purpose: To evaluate the ocular circulation in diabetic patients with coronary artery disease (CAD). Methods: Thirty diabetic patients with diabetic retinopathy of grade 20 or 35, as evaluated by the Early Treatment Diabetic Retinopathy Study, were studied. They were divided into those without CAD (15 cases) and those with CAD (over 75% stenosis of carotid artery; 15 cases). All underwent standard ophthalmic examinations and orbital color Doppler imaging. Fifteen healthy controls underwent the same examinations. Results: The peak systolic velocity in the central retinal artery was significantly lower in the two diabetic groups. The end-diastolic velocity in the central retinal artery was significantly lower only in the diabetic patients with CAD. There were no significant intergroup differences in blood flow velocities in the ophthalmic artery, short posterior ciliary artery, and central retinal vein. The blood flow waves were flattened in the diastolic phase for all orbital arteries in significantly more eyes in the diabetic patients with CAD. Echocardiography, performed only in the diabetic patients with CAD, showed that 10 cases (67% ) had reduced systolic functions and/or diastolic functions and/or asynergy of the left ventricle. Conclusions: A decrease in blood flow velocities in the diastolic phase was found in diabetic patients with CAD. The findings indicate that this is probably related to the decrease in cardiac output.展开更多
文摘Background: Endoscopic submucosal dissection (ESD) is accepted as a minimally invasive treatment for early gastric cancer, but it is not widely used to treat the colorectum because of its degree of technical difficulty. Thus, a noninvasive tool that facilitates the direct visualization of the submucosal layer is needed. Methods: Traction-assisted dissection was performed on 4 superficial lesions. The system consisted of a metallic clip attached by a nylon line to a sinker 6 × 4 × 4 mm in size and weighing 1 g. After partially dissecting the submucosa, the clip was attached to the edge of the exfoliated mucosa and the weight of the sinker pulled down the partly resected lesion. Observations: In all 4 cases, the sinker allowed direct visualization of the cutting line, and en bloc resection was successfully accomplished. Conclusions: These preliminary results suggest that sinker-assisted ESD is effective for the complete removal of selected superficial early colorectal cancer.
文摘Background: EMR traditionally is performed by using normal saline solution (NS) as the submucosal fluid cushion. It is thought, however, that NS does not maintain the proper mucosal elevation for EMR of large, flat lesions. We investigated the efficacy of glycerol as the submucosal injection solution. Methods: A total of 110 colorectal laterally spreading tumors (LST)were treated by EMR with glycerol. For comparison, 113 LSTs treated by using NS were studied. The en bloc resection, complete resection, and associated complications rates were evaluated retrospectively. Observations: The en bloc resection rate in the glycerol group was 63.6%(70/110) compared with 48.9%(55/113) in the NS group (p < 0.05). The complete resection rate in the glycerol groupwas 45.5%(50/110) compared with 24.6%(28/113) in the NS group (p< 0.01). The associated complications rate was similar in both groups. Conclusions: It technically was easier and as safe to perform EMR of colorectal LST swhen using glycerol as the submucosal injection solution.
文摘Purpose: To evaluate the ocular circulation in diabetic patients with coronary artery disease (CAD). Methods: Thirty diabetic patients with diabetic retinopathy of grade 20 or 35, as evaluated by the Early Treatment Diabetic Retinopathy Study, were studied. They were divided into those without CAD (15 cases) and those with CAD (over 75% stenosis of carotid artery; 15 cases). All underwent standard ophthalmic examinations and orbital color Doppler imaging. Fifteen healthy controls underwent the same examinations. Results: The peak systolic velocity in the central retinal artery was significantly lower in the two diabetic groups. The end-diastolic velocity in the central retinal artery was significantly lower only in the diabetic patients with CAD. There were no significant intergroup differences in blood flow velocities in the ophthalmic artery, short posterior ciliary artery, and central retinal vein. The blood flow waves were flattened in the diastolic phase for all orbital arteries in significantly more eyes in the diabetic patients with CAD. Echocardiography, performed only in the diabetic patients with CAD, showed that 10 cases (67% ) had reduced systolic functions and/or diastolic functions and/or asynergy of the left ventricle. Conclusions: A decrease in blood flow velocities in the diastolic phase was found in diabetic patients with CAD. The findings indicate that this is probably related to the decrease in cardiac output.
