Thieme GruppeActa Medica Okayama2364-372212112024Analysis of painful situations during unsedated esophagogastroduodenoscopyE1267E1276ENHiromitsuKanzakiGastroenterology and Hepatology, Okayama University HospitalSakikoKuraokaGastroenterology and Hepatology, Okayama University HospitalTakuyaSatomiGastroenterology and Hepatology, Okayama University HospitalShotaroOkanoueGastroenterology and Hepatology, Okayama University HospitalKentaHamadaPractical Gastrointestinal Endoscopy, Okayama UniversityYoshiyasuKonoGastroenterology and Hepatology, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical SciencesMasayaIwamuroGastroenterology and Hepatology, Okayama University HospitalSeijiKawanoGastroenterology and Hepatology, Okayama University HospitalYoshiroKawaharaPractical Gastrointestinal Endoscopy, Okayama UniversityHiroyukiOkadaGastroenterology and Hepatology, Okayama University HospitalMotoyukiOtsukaGastroenterology and Hepatology, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical SciencesBackground and study aims Although esophagogastroduodenoscopy (EGD) is a widely used technique, the procedure is often associated with discomfort. This study aimed to analyze painful situations, their frequency, and factors associated with patient discomfort during EGD. <br>
Patients and methods This prospective observational study included patients scheduled to undergo EGD. Seven endoscopists recruited patients scheduled for EGD screening or surveillance. Each endoscopist enrolled 20 patients, performing 10 EGD procedures using ultraslim endoscopes and 10 with standard-sized endoscopes. Data regarding painful situations and frequency were collected using specialized buttons pressed by the patients during EGD. A survey about overall discomfort was conducted after the procedure. <br>
Results We analyzed data from 140 patients. Esophageal insertion and duodenal observation were associated with the highest incidence of pressing the pain button, accounting for 59.3% and 40.7% of the cases, respectively. The factor associated with pressing the pain button during esophageal insertion was endoscopist experience (< 10 years). In contrast, younger age and female sex were the factors associated with pressing the pain button during duodenal observation. In the post-procedure survey, 63.6% of patients reported discomfort. Factors associated with patient discomfort included pressing the pain button during esophageal insertion (odds ratio [OR]: 2.84, P = 0.01) and previous painful EGD experience (OR: 2.41, P = 0.03). <br>
Concusions This study provides objective data on painful situations, their frequency, and related factors during EGD. Further research and interventions focusing on pain reduction during endoscopic procedures are warranted. The results of this study will help endoscopists manage painful situations and potentially improve skills.No potential conflict of interest relevant to this article was reported.Thieme GruppeActa Medica Okayama0936-52142020Nickel-Catalyzed Decarbonylative Alkynylation of Acyl Fluorides with Terminal Alkynes under Copper-Free ConditionsENQiangChenGraduate School of Natural Science and Technology, Okayama UniversityLiyanFuGraduate School of Natural Science and Technology, Okayama UniversityJingwenYouGraduate School of Natural Science and Technology, Okayama UniversityYasushiNishiharaResearch Institute for Interdisciplinary Science, Okayama UniversityNickel-catalyzed decarbonylative alkynylation of acyl fluorides with terminal silylethynes under copper-free conditions is described. This newly developed method has a wide substrate scope, affording internal silylethynes in moderate to high yields. The formation of 1,3-diynes as homocoupled products and conjugate enones as carbonyl-retentive products were effectively suppressed.No potential conflict of interest relevant to this article was reported.Thieme GruppeActa Medica Okayama0013-726X5192019Successful removal of impacted large bile duct stones using electrohydraulic lithotripsy with an ultraslim endoscope after Billroth II gastrectomyE265E266ENKazuyukiMatsumoto Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHironariKato Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShigeruHoriguchi Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesDaisukeUchida Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakeshiTomoda Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShinichiroMuro Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHiroyukiOkada Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesThe diagnostic and therapeutic effectiveness of combined double-balloon endoscopy (DBE) using a short endoscope and peroral direct cholangioscopy with an ultraslim endoscope for altered gastrointestinal anatomy has been demonstrated [1][2][3][4][5]. This method offers the following advantages over mother–baby cholangioscopy for bile duct stone treatment: single-operator use, wide working channel, favourable cost performance, and high image resolution. We treated impacted large bile duct stones using electrohydraulic lithotripsy (EHL) and an ultraslim endoscope in a patient who had undergone Billroth II gastrectomy.</br>
A 75-year-old man was referred to our hospital for treatment of bile duct stones. He had undergone Billroth II gastrectomy for gastric cancer. Complete stone removal at the previous hospital was difficult, and a plastic stent had been placed. Abdominal computed tomography showed large stones stuck in the bile duct (largest stone diameter, 25 mm) ([Fig. 1]). We therefore planned to use EHL to crush the stones ([Video 1]).No potential conflict of interest relevant to this article was reported.Thieme GruppeActa Medica Okayama0936-521431192020Integrated Synthesis of Thienyl Thioethers and Thieno[3,2-b]thiophenes via 1-Benzothiophen-3(2H)-ones19471952ENKoichiMitsudoDivision of Applied Chemistry, Graduate School of Natural Science and Technology, Okayama UniversityNanaeHabaraDivision of Applied Chemistry, Graduate School of Natural Science and Technology, Okayama UniversityYoshiakKobashiDivision of Applied Chemistry, Graduate School of Natural Science and Technology, Okayama UniversityYujiKurimotoDivision of Applied Chemistry, Graduate School of Natural Science and Technology, Okayama UniversityHirokiMandai Department of Pharmacy, Faculty of Pharmacy, Gifu University of Medical ScienceSeijiSugaDivision of Applied Chemistry, Graduate School of Natural Science and Technology, Okayama UniversityA one-pot procedure for the synthesis of thienyl thioethers is described. Several thienyl thioethers were synthesized by a TfOH-promoted Friedel–Crafts-type cyclization, a subsequent nucleophilic attack by an arenethiol, and dehydration. This protocol was successfully applied to the synthesis of thienoacene derivatives by using a Pd-catalyzed dehydrogenative cyclization.No potential conflict of interest relevant to this article was reported.