AIM:To determine the utility of endoscopic ultrasoundguided biliary drainage(EUS-BD)with a fully covered self-expandable metal stent for managing malignant biliary stricture. METHODS:We collected data from 13 patients...AIM:To determine the utility of endoscopic ultrasoundguided biliary drainage(EUS-BD)with a fully covered self-expandable metal stent for managing malignant biliary stricture. METHODS:We collected data from 13 patients who presented with malignant biliary obstruction and underwent EUS-BD with a nitinol fully covered selfexpandable metal stent when endoscopic retrograde cholangiopancreatography(ERCP)fails.EUS-guided choledochoduodenostomy(EUS-CD)and EUS-guided hepaticogastrostomy(EUS-HG)was performed in 9 patients and 4 patients,respectively. RESULTS:The technical and functional success rate was 92.3%(12/13)and 91.7%(11/12),respectively. Using an intrahepatic approach(EUS-HG,n=4),there was mild peritonitis(n=1)and migration of the metal stent to the stomach(n=1).With an extrahepatic approach(EUS-CD,n=10),there was pneumoperitoneum(n=2),migration(n=2),and mild peritonitis (n=1).All patients were managed conservatively with antibiotics.During follow-up(range,1-12 mo),there was re-intervention(4/13 cases,30.7%)necessitated by stent migration(n=2)and stent occlusion(n=2). CONCLUSION:EUS-BD with a nitinol fully covered self-expandable metal stent may be a feasible and effective treatment option in patients with malignant biliary obstruction when ERCP fails.展开更多
AIM： To evaluate the effect of ranitidine on gastric mucosal changes and on GI bleeding in long distance runhers. METHODS： Twenty-four long distance runners （M： 16, F： 8, age： 18.2＋ 1.5 years） participated in ...AIM： To evaluate the effect of ranitidine on gastric mucosal changes and on GI bleeding in long distance runhers. METHODS： Twenty-four long distance runners （M： 16, F： 8, age： 18.2＋ 1.5 years） participated in this study. A symptom questionnaire, stool hemoccult test, and upper gastrointestinal （GI） endoscopy were performed on the subjects prior to the study. The subjects took oral ranitidine （150 mg, b.i.d.） for two weeks. The upper GI endoscopy and stool Hemoccult tests were repeated after the treatment. RESULTS： Twenty-two of the 24 runners had at least one upper G1 mucosal lesion before the medication. The Endoscopic improvements were seen in eleven of the 14 cases of erosive gastritis and four of the 5 cases of esophagitis. Six subjects were Heine occult positive prior to the study, but only one was positive after the medication. CONCLUSION： Gastric mucosal lesions and GI bleeding in long distance runners seem to be associated to acidrelated factors mediated by the high level of regular running. Ranitidine seems to be and effective prophylaxis to prevent gastric mucosal lesions and GI bleeding.展开更多
基金Supported by Institute of Wonkwang Medical Science in 2011
文摘AIM:To determine the utility of endoscopic ultrasoundguided biliary drainage(EUS-BD)with a fully covered self-expandable metal stent for managing malignant biliary stricture. METHODS:We collected data from 13 patients who presented with malignant biliary obstruction and underwent EUS-BD with a nitinol fully covered selfexpandable metal stent when endoscopic retrograde cholangiopancreatography(ERCP)fails.EUS-guided choledochoduodenostomy(EUS-CD)and EUS-guided hepaticogastrostomy(EUS-HG)was performed in 9 patients and 4 patients,respectively. RESULTS:The technical and functional success rate was 92.3%(12/13)and 91.7%(11/12),respectively. Using an intrahepatic approach(EUS-HG,n=4),there was mild peritonitis(n=1)and migration of the metal stent to the stomach(n=1).With an extrahepatic approach(EUS-CD,n=10),there was pneumoperitoneum(n=2),migration(n=2),and mild peritonitis (n=1).All patients were managed conservatively with antibiotics.During follow-up(range,1-12 mo),there was re-intervention(4/13 cases,30.7%)necessitated by stent migration(n=2)and stent occlusion(n=2). CONCLUSION:EUS-BD with a nitinol fully covered self-expandable metal stent may be a feasible and effective treatment option in patients with malignant biliary obstruction when ERCP fails.
基金Supported by the 2005 research fund of Wonkwang University
文摘AIM： To evaluate the effect of ranitidine on gastric mucosal changes and on GI bleeding in long distance runhers. METHODS： Twenty-four long distance runners （M： 16, F： 8, age： 18.2＋ 1.5 years） participated in this study. A symptom questionnaire, stool hemoccult test, and upper gastrointestinal （GI） endoscopy were performed on the subjects prior to the study. The subjects took oral ranitidine （150 mg, b.i.d.） for two weeks. The upper GI endoscopy and stool Hemoccult tests were repeated after the treatment. RESULTS： Twenty-two of the 24 runners had at least one upper G1 mucosal lesion before the medication. The Endoscopic improvements were seen in eleven of the 14 cases of erosive gastritis and four of the 5 cases of esophagitis. Six subjects were Heine occult positive prior to the study, but only one was positive after the medication. CONCLUSION： Gastric mucosal lesions and GI bleeding in long distance runners seem to be associated to acidrelated factors mediated by the high level of regular running. Ranitidine seems to be and effective prophylaxis to prevent gastric mucosal lesions and GI bleeding.
