AIM： To search for the optimal surgery for gastrinoma and duodenopancreatic neuroendocrine tumors in patients with multiple endocrine neoplasia type 1. METHODS： Sixteen patients with genetically confirmed multiple e...AIM： To search for the optimal surgery for gastrinoma and duodenopancreatic neuroendocrine tumors in patients with multiple endocrine neoplasia type 1. METHODS： Sixteen patients with genetically confirmed multiple endocrine neoplasia type 1 （MEN 1） and Zollinger-Ellison syndrome （ZES） underwent resection of both gastrinomas and duodenopancreatic neuroendocrine tumors （NETs） between 1991 and 2009. For localization of gastrinoma, selective arterial secretagogue injection test （SASI test） with secretin or calcium solution was performed as well as somatostatin receptor scintigraphy （SRS） and other imaging methods such as computed tomography （CT） or magnetic resonance imaging （MRI）. The modus of surgery for gastrinoma has been changed over time, searching for the optimal surgery： pancreaticoduodenectomy （PD） was first performed guided by localization with the SAST test, then local resection of duodenal gastrinomas with dissection of regional lymph nodes （LR）, and recently pancreas-preserving total duodenectomy （PPTD） has been performed for multiple duodenal gastrinomas. RESULTS： Among various types of preoperative localizing methods for gastrinoma, the SASI test was the most useful method. Imaging methods such as SRS or CT made it essentially impossible to differentiate functioning gastrinoma among various kinds of NETs. However, recent imaging methods including SRS or CT were useful for detecting both distant metastases and ectopic NETs; therefore they are indispensable for staging of NETs. Biochemical cure of gastrinoma was achieved in 14 of 16 patients （87.5%）; that is, 100% in 3 patients who underwent PD, 100% in 6 patients who underwent LR （although in 2 patients （33.3%） second LR was performed for recurrence of duodenal gastri- noma）, and 71.4% in 7 patients who underwent PPTD. Pancreatic NETs more than 1 cm in diameter were resected either by distal pancreatectomy or enucleations, and no hepatic metastases have developed postoperatively. Pathological s展开更多
BACKGROUND The coexistence of esophageal variceal bleeding and superficial esophageal cancer(SEC)is relatively rare in clinical practice.Moreover,there have been few reports of SEC overlying esophageal varices(EVs).He...BACKGROUND The coexistence of esophageal variceal bleeding and superficial esophageal cancer(SEC)is relatively rare in clinical practice.Moreover,there have been few reports of SEC overlying esophageal varices(EVs).Herein,we report our successful use of endoscopic submucosal dissection(ESD),esophageal solitary venous dilatation(ESVD),and endoscopic injection sclerotherapy(EIS)to treat a 75-year-old man who was diagnosed with SEC coexisting with esophageal variceal bleeding.CASE SUMMARY A 75-year-old man was admitted to the hospital due to black stool for 4 days.The patient had a history of liver cancer,cirrhosis,and portal hypertension.Endosco-pic examination revealed esophageal and gastric varicose veins,as well as esoph-ageal carcinoma in situ.We first treated esophageal variceal bleeding by ESVD and EIS.One week later,ESD treatment was done,and the complete rese-ction of early esophageal cancer was successfully completed via endoscopy.There were no postoperative complications,such as bleeding,infection,or perforation.CONCLUSION The sequential treatment of ESVD,EIS,and ESD is an effective method for trea-ting EVs with early esophageal cancer.展开更多
Sulfur dioxide has been found to decrease the chemiluminescence of luminol-iodine system.A new determination method for sulfur dioxide in atmosphere is developed by applying this reaction to a flow injection gas diffu...Sulfur dioxide has been found to decrease the chemiluminescence of luminol-iodine system.A new determination method for sulfur dioxide in atmosphere is developed by applying this reaction to a flow injection gas diffusion separation system.This permits the determination of sulfur dioxide selectively and rapidly.展开更多
基金Supported by a Health and Labor Sciences Research Grant from the Ministry of Health, Labor and Welfare, Government of Japan (Grant No. H21-Nanchi-Ippan-037)
文摘AIM： To search for the optimal surgery for gastrinoma and duodenopancreatic neuroendocrine tumors in patients with multiple endocrine neoplasia type 1. METHODS： Sixteen patients with genetically confirmed multiple endocrine neoplasia type 1 （MEN 1） and Zollinger-Ellison syndrome （ZES） underwent resection of both gastrinomas and duodenopancreatic neuroendocrine tumors （NETs） between 1991 and 2009. For localization of gastrinoma, selective arterial secretagogue injection test （SASI test） with secretin or calcium solution was performed as well as somatostatin receptor scintigraphy （SRS） and other imaging methods such as computed tomography （CT） or magnetic resonance imaging （MRI）. The modus of surgery for gastrinoma has been changed over time, searching for the optimal surgery： pancreaticoduodenectomy （PD） was first performed guided by localization with the SAST test, then local resection of duodenal gastrinomas with dissection of regional lymph nodes （LR）, and recently pancreas-preserving total duodenectomy （PPTD） has been performed for multiple duodenal gastrinomas. RESULTS： Among various types of preoperative localizing methods for gastrinoma, the SASI test was the most useful method. Imaging methods such as SRS or CT made it essentially impossible to differentiate functioning gastrinoma among various kinds of NETs. However, recent imaging methods including SRS or CT were useful for detecting both distant metastases and ectopic NETs; therefore they are indispensable for staging of NETs. Biochemical cure of gastrinoma was achieved in 14 of 16 patients （87.5%）; that is, 100% in 3 patients who underwent PD, 100% in 6 patients who underwent LR （although in 2 patients （33.3%） second LR was performed for recurrence of duodenal gastri- noma）, and 71.4% in 7 patients who underwent PPTD. Pancreatic NETs more than 1 cm in diameter were resected either by distal pancreatectomy or enucleations, and no hepatic metastases have developed postoperatively. Pathological s
基金the Zhejiang Medicine and Health Science and Technology Project,No.2022RC217.
文摘BACKGROUND The coexistence of esophageal variceal bleeding and superficial esophageal cancer(SEC)is relatively rare in clinical practice.Moreover,there have been few reports of SEC overlying esophageal varices(EVs).Herein,we report our successful use of endoscopic submucosal dissection(ESD),esophageal solitary venous dilatation(ESVD),and endoscopic injection sclerotherapy(EIS)to treat a 75-year-old man who was diagnosed with SEC coexisting with esophageal variceal bleeding.CASE SUMMARY A 75-year-old man was admitted to the hospital due to black stool for 4 days.The patient had a history of liver cancer,cirrhosis,and portal hypertension.Endosco-pic examination revealed esophageal and gastric varicose veins,as well as esoph-ageal carcinoma in situ.We first treated esophageal variceal bleeding by ESVD and EIS.One week later,ESD treatment was done,and the complete rese-ction of early esophageal cancer was successfully completed via endoscopy.There were no postoperative complications,such as bleeding,infection,or perforation.CONCLUSION The sequential treatment of ESVD,EIS,and ESD is an effective method for trea-ting EVs with early esophageal cancer.
文摘Sulfur dioxide has been found to decrease the chemiluminescence of luminol-iodine system.A new determination method for sulfur dioxide in atmosphere is developed by applying this reaction to a flow injection gas diffusion separation system.This permits the determination of sulfur dioxide selectively and rapidly.
