Yasushi Asakura

Publications (2)2.7 Total impact

• Article: Efficacy of Argon Plasma Coagulation for Bleeding Gastroduodenal Ulcers

  Yasushi Asakura, Yukinori Imai, Shin Arai, Manabu Kinoshita, Toru Kakinuma, Kotaro Kakoi, Fumie Rai, Yuichiro Eguchi, Kenji Fujiwara, Shinichi Ota
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  ABSTRACT: Background: Argon plasma coagulation (APC) can achieve an effective coagulation of large areas with a relatively shallow but well-controlled and uniform coagulation depth. There are only a few reports of APC therapy applied to bleeding peptic ulcers, especially ulcers with exposed vessels.Methods: The aim of this study is to evaluate the usefulness of APC as a means of achieving endoscopic hemostasis for bleeding gastroduodenal ulcers. Thirty-nine patients having these ulcers were treated with APC.Results: The success rates for initial hemostasis and complete hemostasis with APC are 87% and 97.4%, respectively. These results are almost equal to those of injection therapy and hemoclip. Six cases that re-bled after other hemostatic procedures obtained complete hemostasis finally with APC. In one ineffective case of APC, complete endoscopic hemostasis was achieved with hemoclip.Conclusion: Argon plasma coagulation therapy is an effective therapeutic alternative in endoscopic hemostasis for bleeding peptic ulcers.
  Digestive Endoscopy 09/2008; 14(3):99 - 102. · 1.19 Impact Factor
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  Available from: jsnm.org

  Article: Usefulness of gastroesophageal reflux scintigraphy using the knee-chest position for the diagnosis of gastroesophageal reflux disease.

  Yasushi Asakura, Yukinori Imai, Shinichi Ota, Kenji Fujiwara, Tatsuya Miyamae
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  ABSTRACT: The aim of this study is to evaluate the usefulness of gastroesophageal reflux (GER) scintigraphy using the knee-chest (KC) position for the diagnosis of gastroesophageal reflux disease (GERD). The study subjects were 37 patients with GERD and 8 healthy volunteers (control group). Endoscopically observed esophageal mucosal breaks were evaluated with the Los Angeles classification. For GER scintigraphy, the subjects ingested liquid yogurt labeled with 99mTc-diethylene triamine pentaacetic acid (99mTc-DTPA) and water. Imaging was performed in the supine and KC position, and GER was graded as 1-4 according to the extent of GER assessed by scintigraphy. GER scintigraphy revealed no reflux in the control group (specificity: 100%). In the supine position, gastroesophageal reflux was observed in 49% of the patients with GERD, compared to 76% in the KC position. 21 of 23 (91%) patients with erosive esophagitis were shown to have GER with scintigraphy. GER scintigraphy revealed severe reflux (grade 3 or 4) (83%, 10/12) in the patients who had severe mucosal breaks (LA grade C or D). GER scintigraphy detected grade 1 or 2 reflux in 7 of the 14 patients who were endoscopically negative. There was a correlation between the endoscopically determined severity of mucosa and the reflux grade which was determined with GER scintigraphy. GER scintigraphy can detect gastroesophageal reflux with a high sensitivity in the KC position and might be a useful method in the screening and assessment of the severity of this disease. This method would be useful for the diagnosis of GERD in endoscopically negative patients.
  Annals of Nuclear Medicine 07/2005; 19(4):291-6. · 1.50 Impact Factor