1
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Ota A, Kitamura H, Sugimoto K, Ogawa M, Dohmae N, Okuno H, Takahashi K, Ikeda K, Tomita T, Matsuoka N, Matsuishi K, Inokuma T, Nagano T, Takeo M, Tsuji T. Comparative studies of hair shaft components between healthy and diseased donors. PLoS One 2024; 19:e0301092. [PMID: 38718028 PMCID: PMC11078425 DOI: 10.1371/journal.pone.0301092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 03/09/2024] [Indexed: 05/12/2024] Open
Abstract
Globally, the rapid aging of the population is predicted to become even more severe in the second half of the 21st century. Thus, it is expected to establish a growing expectation for innovative, non-invasive health indicators and diagnostic methods to support disease prevention, care, and health promotion efforts. In this study, we aimed to establish a new health index and disease diagnosis method by analyzing the minerals and free amino acid components contained in hair shaft. We first evaluated the range of these components in healthy humans and then conducted a comparative analysis of these components in subjects with diabetes, hypertension, androgenetic alopecia, major depressive disorder, Alzheimer's disease, and stroke. In the statistical analysis, we first used a student's t test to compare the hair components of healthy people and those of patients with various diseases. However, many minerals and free amino acids showed significant differences in all diseases, because the sample size of the healthy group was very large compared to the sample size of the disease group. Therefore, we attempted a comparative analysis based on effect size, which is not affected by differences in sample size. As a result, we were able to narrow down the minerals and free amino acids for all diseases compared to t test analysis. For diabetes, the t test narrowed down the minerals to 15, whereas the effect size measurement narrowed it down to 3 (Cr, Mn, and Hg). For free amino acids, the t test narrowed it down to 15 minerals. By measuring the effect size, we were able to narrow it down to 7 (Gly, His, Lys, Pro, Ser, Thr, and Val). It is also possible to narrow down the minerals and free amino acids in other diseases, and to identify potential health indicators and disease-related components by using effect size.
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Affiliation(s)
- Atsuko Ota
- Aderans Company Limited, Shinjuku, Tokyo, Japan
| | | | | | - Miho Ogawa
- OrganTech Inc., Chuo-ku, Tokyo, Japan
- Laboratory for Organ Regeneration, RIKEN Center for Biosystems Dynamics Research (BDR), Kobe, Hyogo, Japan
| | - Naoshi Dohmae
- Biomolecular Characterization Unit, RIKEN Center for Sustainable Resource Science, Wako, Saitama, Japan
| | - Hiroki Okuno
- RIKEN, Nishina Center for Accelerator-Based Science, Wako, Saitama, Japan
| | - Kazuya Takahashi
- RIKEN, Nishina Center for Accelerator-Based Science, Wako, Saitama, Japan
| | - Kazutaka Ikeda
- Department of Applied Genomics, Laboratory of Biomolecule Analysis, Kazusa DNA Research Institute, Kisarazu, Chiba, Japan
| | - Tsutomu Tomita
- Biobank, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Naoki Matsuoka
- Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
| | | | - Tetsuro Inokuma
- Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
| | - Tohru Nagano
- Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
| | - Makoto Takeo
- Laboratory for Organ Regeneration, RIKEN Center for Biosystems Dynamics Research (BDR), Kobe, Hyogo, Japan
| | - Takashi Tsuji
- OrganTech Inc., Chuo-ku, Tokyo, Japan
- Laboratory for Organ Regeneration, RIKEN Center for Biosystems Dynamics Research (BDR), Kobe, Hyogo, Japan
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2
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Akiyama S, Wada M, Inokuma T. Peroral Cholangioscopy Using an Ultra-slim Upper Endoscope. Intern Med 2024:3557-24. [PMID: 38569899 DOI: 10.2169/internalmedicine.3557-24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/05/2024] Open
Affiliation(s)
- Shinsuke Akiyama
- Department of Gastroenterology, Kobe City Medical Center General Hospital, Japan
| | - Masaya Wada
- Department of Gastroenterology, Kobe City Medical Center General Hospital, Japan
| | - Tetsuro Inokuma
- Department of Gastroenterology, Kobe City Medical Center General Hospital, Japan
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3
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Akiyama S, Hara S, Inokuma T. Varicella-Zoster Virus Esophagitis Prior to the Onset of Skin Lesions. Intern Med 2024:3235-23. [PMID: 38432988 DOI: 10.2169/internalmedicine.3235-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/05/2024] Open
Affiliation(s)
- Shinsuke Akiyama
- Department of Gastroenterology, Kobe City Medical Center General Hospital, Japan
| | - Shigeo Hara
- Department of Diagnostic Pathology, Kobe City Medical Center General Hospital, Japan
| | - Tetsuro Inokuma
- Department of Gastroenterology, Kobe City Medical Center General Hospital, Japan
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4
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Morihisa Y, Chung H, Towatari S, Yamashita D, Inokuma T. Autoimmune hepatitis and primary sclerosing cholangitis after direct-acting antiviral treatment for hepatitis C virus: A case report. World J Hepatol 2024; 16:286-293. [PMID: 38495284 PMCID: PMC10941733 DOI: 10.4254/wjh.v16.i2.286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 12/22/2023] [Accepted: 01/16/2024] [Indexed: 02/27/2024] Open
Abstract
BACKGROUND Chronic hepatitis C virus (HCV) infection is a major global health concern that leads to liver fibrosis, cirrhosis, and cancer. Regimens containing direct-acting antivirals (DAAs) have become the mainstay of HCV treatment, achieving a high sustained virological response (SVR) with minimal adverse events. CASE SUMMARY A 74-year-old woman with chronic HCV infection was treated with the DAAs ledipasvir, and sofosbuvir for 12 wk and achieved SVR. Twenty-four weeks after treatment completion, the liver enzyme and serum IgG levels increased, and antinuclear antibody became positive without HCV viremia, suggesting the development of autoimmune hepatitis (AIH). After liver biopsy indicated AIH, a definite AIH diagnosis was made and prednisolone was initiated. The treatment was effective, and the liver enzyme and serum IgG levels normalized. However, multiple strictures of the intrahepatic and extrahepatic bile ducts with dilatation of the peripheral bile ducts appeared on magnetic resonance cholangiopancreatography after 3 years of achieving SVR, which were consistent with primary sclerosing cholangitis. CONCLUSION The potential risk of developing autoimmune liver diseases after DAA treatment should be considered.
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Affiliation(s)
- Yoshiki Morihisa
- Department of Gastroenterology and Hepatology, Kobe City Medical Center General Hospital, Kobe 650-0047, Hyogo, Japan
| | - Hobyung Chung
- Department of Gastroenterology and Hepatology, Kobe City Medical Center General Hospital, Kobe 650-0047, Hyogo, Japan.
| | - Shuichiro Towatari
- Department of Gastroenterology and Hepatology, Kobe City Medical Center General Hospital, Kobe 650-0047, Hyogo, Japan
| | - Daisuke Yamashita
- Department of Pathology, Kobe City Medical Center General Hospital, Kobe 650-0047, Hyogo, Japan
| | - Tetsuro Inokuma
- Department of Gastroenterology and Hepatology, Kobe City Medical Center General Hospital, Kobe 650-0047, Hyogo, Japan
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5
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Nagao S, Yabuuchi Y, Tanaka K, Morihisa Y, Kobayashi T, Akiyama S, Tanke G, Wada M, Morita S, Inoue S, Tei H, Yamashita D, Inokuma T. Multiple Gastric Neuroendocrine Tumors Associated with Long-term Use of a Proton Pump Inhibitor and a Potassium-competitive Acid Blocker. Intern Med 2023:2857-23. [PMID: 38008447 DOI: 10.2169/internalmedicine.2857-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2023] Open
Abstract
A 52-year-old man who had been using a proton pump inhibitor (PPI) and a potassium-competitive acid blocker (P-CAB) for 14 years underwent esophagogastroduodenoscopy and was found to have three neuroendocrine tumors (NETs) in the gastric body. Following detailed examinations, parietal cell dysfunction was excluded, and the NETs did not meet the criteria for the Rindi classification types I-III. The lesions were ultimately considered to be associated with the long-term use of the PPI and P-CAB. We performed endoscopic submucosal dissection of the lesions, with no recurrence or new lesions noted after discontinuation of the PPI and P-CAB.
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Affiliation(s)
- Soichiro Nagao
- Department of Gastroenterology, Kobe City Medical Center General Hospital, Japan
| | - Yohei Yabuuchi
- Department of Gastroenterology, Kobe City Medical Center General Hospital, Japan
| | - Kosuke Tanaka
- Department of Gastroenterology, Kobe City Medical Center General Hospital, Japan
| | - Yoshiki Morihisa
- Department of Gastroenterology, Kobe City Medical Center General Hospital, Japan
| | - Takuya Kobayashi
- Department of Gastroenterology, Kobe City Medical Center General Hospital, Japan
| | - Shinsuke Akiyama
- Department of Gastroenterology, Kobe City Medical Center General Hospital, Japan
| | - Gensho Tanke
- Department of Gastroenterology, Kobe City Medical Center General Hospital, Japan
| | - Masaya Wada
- Department of Gastroenterology, Kobe City Medical Center General Hospital, Japan
| | - Shuko Morita
- Department of Gastroenterology, Kobe City Medical Center General Hospital, Japan
| | - Satoko Inoue
- Department of Gastroenterology, Kobe City Medical Center General Hospital, Japan
| | - Hiroshi Tei
- Department of Gastroenterology, Kobe City Medical Center General Hospital, Japan
| | - Daisuke Yamashita
- Department of Pathology, Kobe City Medical Center General Hospital, Japan
| | - Tetsuro Inokuma
- Department of Gastroenterology, Kobe City Medical Center General Hospital, Japan
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Tanaka K, Yabuuchi Y, Yamashita D, Inokuma T. Breast cancer metastasis to the stomach mimicking early gastric cancer. JGH Open 2023; 7:667-668. [PMID: 37744702 PMCID: PMC10517435 DOI: 10.1002/jgh3.12959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 07/20/2023] [Accepted: 08/12/2023] [Indexed: 09/26/2023]
Abstract
A 79-year-old woman with a history of invasive lobular breast cancer presented with a lesion that was endoscopically and histopathologically consistent with poorly differentiated early gastric adenocarcinoma. Endoscopic submucosal dissection was performed, and histopathological examination using additional immunohistochemistry determined that the lesion was metastatic breast cancer. Even if a lesion suspicious of gastric cancer is found on endoscopy in a patient with a history of breast cancer, the possibility of metastasis should be considered and clinicians should inform the pathologists of the possibility.
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Affiliation(s)
- Kosuke Tanaka
- Department of GastroenterologyKobe City Medical Center General HospitalKobeJapan
| | - Yohei Yabuuchi
- Department of GastroenterologyKobe City Medical Center General HospitalKobeJapan
| | - Daisuke Yamashita
- Department of PathologyKobe City Medical Center General HospitalKobeJapan
| | - Tetsuro Inokuma
- Department of GastroenterologyKobe City Medical Center General HospitalKobeJapan
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7
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Aoyama N, Inokuma T, Nakanishi Y, Fukuda A. Pancreatic metastasis from lung adenocarcinoma. J Gen Fam Med 2023; 24:192-193. [PMID: 37261050 PMCID: PMC10227741 DOI: 10.1002/jgf2.612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 01/14/2023] [Accepted: 02/20/2023] [Indexed: 06/02/2023] Open
Abstract
TTF-1 is a highly useful marker to assist in differentiating between pulmonary and nonpulmonary, nonthyroid adenocarcinomas. Our case shows that TTF-1 is highly useful in differentiating between pancreatic metastasis from lung adenocarcinoma and primary pancreatic cancer, especially when the clinical course and imaging findings are not helpful for differentiating them.
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Affiliation(s)
- Naoki Aoyama
- Department of Gastroenterology and HepatologyKyoto University Graduate School of MedicineKyotoJapan
| | - Tetsuro Inokuma
- Department of Gastroenterology and HepatologyKobe City Medical Center General HospitalKobeJapan
| | - Yuki Nakanishi
- Department of Gastroenterology and HepatologyKyoto University Graduate School of MedicineKyotoJapan
| | - Akihisa Fukuda
- Department of Gastroenterology and HepatologyKyoto University Graduate School of MedicineKyotoJapan
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8
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Ueda T, Yabuuchi Y, Inokuma T. Shaggy white lesion with morphological changes in the oesophagus. Gut 2023; 72:623-698. [PMID: 35074906 DOI: 10.1136/gutjnl-2021-326643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 01/11/2022] [Indexed: 12/08/2022]
Affiliation(s)
- Tomoya Ueda
- Department of Gastroenterology, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Yohei Yabuuchi
- Department of Gastroenterology, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Tetsuro Inokuma
- Department of Gastroenterology, Kobe City Medical Center General Hospital, Kobe, Japan
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9
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Affiliation(s)
- Naoki Aoyama
- Department of Gastroenterology and Hepatology, Graduate School of Medicine and Faculty of Medicine Kyoto University, Kyoto, Japan
| | - Tetsuro Inokuma
- Department of Gastroenterology and Hepatology, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
| | - Yuki Nakanishi
- Department of Gastroenterology and Hepatology, Graduate School of Medicine and Faculty of Medicine Kyoto University, Kyoto, Japan
| | - Akihisa Fukuda
- Department of Gastroenterology and Hepatology, Graduate School of Medicine and Faculty of Medicine Kyoto University, Kyoto, Japan
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10
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Aoyama N, Wada M, Taniguchi Y, Inokuma T, Nakanishi Y, Fukuda A, Seno H. A case of neuroendocrine neoplasm of the minor duodenal papilla. Clin J Gastroenterol 2022; 16:171-179. [PMID: 36542298 DOI: 10.1007/s12328-022-01739-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 11/22/2022] [Indexed: 12/24/2022]
Abstract
A 61-year-old woman was referred to our hospital for intraductal papillary mucinous neoplasm with no symptoms. Magnetic resonance imaging (MRI) depicted a 15 mm nodular lesion at the descending portion of duodenum. Upper gastrointestinal endoscopy showed a submucosal tumor-like mass at the minor duodenal papilla. A boring biopsy of the tumor revealed a neuroendocrine neoplasm (NEN). Various blood hormone tests were all within normal limits, and the tumor was considered to be nonfunctional. Contrast-enhanced computed tomography showed no obvious distant metastasis, and subtotal stomach-preserving pancreaticoduodenectomy (SSPPD) was performed. Histopathological examination revealed a dense cluster of spindle-shaped cells forming a sheet-like foci and areas showing glandular lumen formation, and immunohistochemistry showed synaptophysin ( + ), chromogranin ( + ). Mitotic rate was about 11 mitoses per 2 square millimeters, Ki-67 index was about 0.2%. She was pathologically diagnosed with NEN G2 at the minor duodenal papilla with regional lymph node metastasis according to the WHO2010 classification. The patient has been currently under outpatient observation with a good postoperative course. Review of the literature identified 43 cases of NENs of the minor duodenal papilla. NENs of the minor duodenal papilla have a high rate of lymph node metastasis, even if the tumor size is small.
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11
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Hosotani K, Yabuuchi Y, Yamashita D, Inokuma T. Detecting remnant sessile serrated lesion after piecemeal cold snare polypectomy using acetic acid with narrow-band imaging. Endosc Int Open 2022; 10:E1595-E1596. [PMID: 36531675 PMCID: PMC9754860 DOI: 10.1055/a-1959-6346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Affiliation(s)
- Kazuya Hosotani
- Department of Gastroenterology, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Yohei Yabuuchi
- Department of Gastroenterology, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Daisuke Yamashita
- Department of Clinical Pathology, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Tetsuro Inokuma
- Department of Gastroenterology, Kobe City Medical Center General Hospital, Kobe, Japan
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12
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Yabuuchi Y, Hosotani K, Morita S, Kondo M, Inokuma T. A novel technique to improve endoscopic accessibility in laparoscopic endoscopic cooperative surgery for a duodenal lesion. Endosc Int Open 2022; 10:E1597-E1598. [PMID: 36531677 PMCID: PMC9754874 DOI: 10.1055/a-1961-2625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Affiliation(s)
- Yohei Yabuuchi
- Department of Gastroenterology, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Kazuya Hosotani
- Department of Gastroenterology, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Shuko Morita
- Department of Gastroenterology, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Masato Kondo
- Department of Surgery, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Tetsuro Inokuma
- Department of Gastroenterology, Kobe City Medical Center General Hospital, Kobe, Japan
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13
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Ando Y, Tanke G, Inokuma T. Exposition of Artificial Blood Vessel in the Horizontal Portion of the Duodenum. Clin Gastroenterol Hepatol 2022; 20:A24. [PMID: 35811048 DOI: 10.1016/j.cgh.2022.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 06/02/2022] [Accepted: 06/05/2022] [Indexed: 02/07/2023]
Affiliation(s)
- Yoshiaki Ando
- Department of Gastroenterology, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Gensyo Tanke
- Department of Gastroenterology, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Tetsuro Inokuma
- Department of Gastroenterology, Kobe City Medical Center General Hospital, Kobe, Japan
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14
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Hosotani K, Yabuuchi Y, Yamashita D, Hara S, Inokuma T. Endoscopic submucosal dissection for complete removal of a residual colorectal tumor involving a diverticulum. Endoscopy 2022; 54:E908-E909. [PMID: 35777375 PMCID: PMC9735392 DOI: 10.1055/a-1864-9146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Kazuya Hosotani
- Department of Gastroenterology, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Yohei Yabuuchi
- Department of Gastroenterology, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Daisuke Yamashita
- Department of Clinical Pathology, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Shigeo Hara
- Department of Clinical Pathology, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Tetsuro Inokuma
- Department of Gastroenterology, Kobe City Medical Center General Hospital, Kobe, Japan
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15
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Ikesue H, Yamamoto H, Hirabatake M, Hashida T, Chung H, Inokuma T, Muroi N. Risk Factors of Proteinuria in Patients with Hepatocellular Carcinoma Receiving Lenvatinib. Biol Pharm Bull 2022; 45:333-338. [PMID: 35228399 DOI: 10.1248/bpb.b21-00913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Proteinuria is one of the most frequently reported adverse events leading to the discontinuation of lenvatinib treatment in patients with advanced hepatocellular carcinoma (HCC). However, there are no reports regarding the risk factors of proteinuria in patients with HCC or patients receiving lenvatinib. We retrospectively reviewed the medical records of patients with HCC receiving lenvatinib at the Kobe City Medical Center General Hospital between April 2018 and December 2020. The severity of proteinuria was graded based on the Common Terminology Criteria for Adverse Events (CTCAE) version 5.0. A multivariate Cox proportional hazards model was employed to identify the risk factors of developing grade ≥2 proteinuria. Among the 37 patients included, 3 patients had grade-1 proteinuria at baseline and 10 patients had estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2 at baseline. Grades 1, 2, and 3 proteinuria were observed in 15 (40.5%), 10 (27.0%), and 2 (5.4%) patients, respectively, during lenvatinib treatment. The median value of eGFR was significantly lower in patients who developed grade ≥2 proteinuria than those with grade ≤1 proteinuria (59.6 vs. 78.1 mL/min/1.73 m2, p = 0.045). Multivariate analysis revealed that pre-existing proteinuria at baseline (hazard ratio (HR), 9.72; 95% confidence interval (CI), 1.29-52.21; p = 0.030), and eGFR <60 mL/min/1.73 m2 at baseline (HR, 4.49; 95% CI, 1.32-16.07; p = 0.017) were significantly associated with developing grade ≥2 proteinuria. These patients should be monitored carefully, and our preliminary data should be confirmed by further studies.
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Affiliation(s)
- Hiroaki Ikesue
- Department of Pharmacy, Kobe City Medical Center General Hospital
| | - Haruna Yamamoto
- Department of Pharmacy, Kobe City Medical Center General Hospital
| | | | - Tohru Hashida
- Department of Pharmacy, Kobe City Medical Center General Hospital
| | - Hobyung Chung
- Department of Gastroenterology and Hepatology, Kobe City Medical Center General Hospital
| | - Tetsuro Inokuma
- Department of Gastroenterology and Hepatology, Kobe City Medical Center General Hospital
| | - Nobuyuki Muroi
- Department of Pharmacy, Kobe City Medical Center General Hospital
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16
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Hosotani K, Inoue S, Takahashi K, Hara S, Inokuma T. Underwater endoscopic mucosal resection for complete R0 removal of colorectal polyp in a patient with ulcerative colitis. Endoscopy 2022; 54:E3-E4. [PMID: 33592645 DOI: 10.1055/a-1346-8769] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Kazuya Hosotani
- Department of Gastroenterology, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Satoko Inoue
- Department of Gastroenterology, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Kana Takahashi
- Department of Clinical Pathology, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Shigeo Hara
- Department of Clinical Pathology, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Tetsuro Inokuma
- Department of Gastroenterology, Kobe City Medical Center General Hospital, Kobe, Japan
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17
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Okubo Y, Hosotani K, Taniguchi Y, Hara S, Inokuma T. Gastrointestinal: Recurrence of pembrolizumab-induced severe gastritis after tapering steroid therapy. J Gastroenterol Hepatol 2021; 36:586. [PMID: 32945040 DOI: 10.1111/jgh.15248] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 09/03/2020] [Indexed: 12/09/2022]
Affiliation(s)
- Y Okubo
- Department of Gastroenterology, Kobe City Medical Center General Hospital, Kobe, Japan
| | - K Hosotani
- Department of Gastroenterology, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Y Taniguchi
- Department of Gastroenterology, Kobe City Medical Center General Hospital, Kobe, Japan
| | - S Hara
- Department of Clinical Pathology, Kobe City Medical Center General Hospital, Kobe, Japan
| | - T Inokuma
- Department of Gastroenterology, Kobe City Medical Center General Hospital, Kobe, Japan
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18
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Kitamoto H, Inoue S, Yamamoto S, Okamoto K, Inokuma T. Human diphyllobothriasis - Authors' reply. Lancet 2020; 396:755-756. [PMID: 32919508 DOI: 10.1016/s0140-6736(20)31178-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Accepted: 04/30/2020] [Indexed: 10/23/2022]
Affiliation(s)
- Hiroki Kitamoto
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, Kyoto 606-8507, Japan; Department of Gastroenterology and Hepatology, Kobe City Medical Centre General Hospital, Kobe, Japan.
| | - Satoko Inoue
- Department of Gastroenterology and Hepatology, Kobe City Medical Centre General Hospital, Kobe, Japan
| | - Shuji Yamamoto
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, Kyoto 606-8507, Japan
| | | | - Tetsuro Inokuma
- Department of Gastroenterology and Hepatology, Kobe City Medical Centre General Hospital, Kobe, Japan
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Kitamoto H, Fukushima M, Inokuma T. Successful Endoscopic Removal of a Large Pancreatic Stone in a Patient After Pancreaticoduodenectomy. Clin Gastroenterol Hepatol 2020; 18:A30-A31. [PMID: 30710704 DOI: 10.1016/j.cgh.2019.01.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 01/14/2019] [Accepted: 01/20/2019] [Indexed: 02/07/2023]
Affiliation(s)
- Hiroki Kitamoto
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, Kyoto, Japan; Departments of Gastroenterology and Hepatology, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
| | - Masashi Fukushima
- Departments of Gastroenterology and Hepatology, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
| | - Tetsuro Inokuma
- Departments of Gastroenterology and Hepatology, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
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20
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Kitamoto H, Inoue S, Okamoto K, Inokuma T. Scanning early catches the worm: abdominal ultrasound as a possible screening method for intestinal cestodes. Lancet 2019; 394:1264. [PMID: 31591983 DOI: 10.1016/s0140-6736(19)32132-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2019] [Revised: 03/25/2019] [Accepted: 08/20/2019] [Indexed: 11/16/2022]
Affiliation(s)
- Hiroki Kitamoto
- Department of Gastroenterology and Hepatology, Kobe City Medical Centre General Hospital, Kobe, Japan; Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
| | - Satoko Inoue
- Department of Gastroenterology and Hepatology, Kobe City Medical Centre General Hospital, Kobe, Japan
| | | | - Tetsuro Inokuma
- Department of Gastroenterology and Hepatology, Kobe City Medical Centre General Hospital, Kobe, Japan
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21
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Kitamoto H, Fukushima M, Inokuma T. Chronic GI bleeding in a middle-aged woman. Gut 2019; 68:1385-1429. [PMID: 30554158 PMCID: PMC6691927 DOI: 10.1136/gutjnl-2018-317821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 11/28/2018] [Accepted: 11/29/2018] [Indexed: 12/08/2022]
Abstract
CLINICAL PRESENTATION A middle-aged woman without any underlying systemic disease was referred to our hospital due to a 1-month history of recurrent black diarrhoea and anaemia. At presentation, her vital signs were stable and the physical examination was unremarkable except for pale conjunctiva. Laboratory tests showed iron-deficiency anaemia with a haemoglobin concentration of 7.3 g/dL (reference range, 11.1-15.1 g/dL). As she had no severe symptoms of anaemia, we administered oral iron preparations without blood transfusion and her anaemia was gradually corrected. Oesophagogastroduodenoscopy, colonoscopy and contrast-enhanced abdominal CT revealed no cause of bleeding, so obscure GI bleeding was suspected. Capsule enteroscopy revealed black fluid in the proximal small intestine, and subsequent peroral double-balloon enteroscopy detected a 1 cm diameter hemispheric elevated lesion at the upper jejunum (figure 1A, B). The lesion was non-pulsatile and hard in consistency, appearing as a submucosal tumour (SMT). An ulcer was located at the top of the lesion, suggesting the source of bleeding, although no blood clot was present around the site.gutjnl;68/8/1385/F1F1F1Figure 1Endoscopic findings of the jejunum on white light endoscopy (A) and chromoendoscopy with indigo carmine dye (B). QUESTIONS What is your diagnosis? Do you try to obtain biopsy specimens from this lesion?
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Affiliation(s)
- Hiroki Kitamoto
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Masashi Fukushima
- Department of Gastroenterology and Hepatology, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Tetsuro Inokuma
- Department of Gastroenterology and Hepatology, Kobe City Medical Center General Hospital, Kobe, Japan
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22
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Kitamoto H, Yamashita D, Inokuma T. A Rare Tumor Disseminated to the Gastrointestinal Tract After Treatment for HIV-Associated Lymphoproliferative Disease. Gastroenterology 2019; 156:2136-2138. [PMID: 30664878 DOI: 10.1053/j.gastro.2019.01.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Accepted: 01/14/2019] [Indexed: 12/02/2022]
Affiliation(s)
- Hiroki Kitamoto
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, Kyoto, Japan; Departments of Gastroenterology and Hepatology, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
| | - Daisuke Yamashita
- Departments of Pathology, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
| | - Tetsuro Inokuma
- Departments of Gastroenterology and Hepatology, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
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23
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Toyonaga H, Fukushima M, Shimeno N, Inokuma T. Methotrexate-associated lymphoproliferative disorder in the stomach and duodenum: a case report. BMC Gastroenterol 2019; 19:62. [PMID: 31023238 PMCID: PMC6482581 DOI: 10.1186/s12876-019-0982-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Accepted: 04/10/2019] [Indexed: 11/25/2022] Open
Abstract
Background Methotrexate-associated lymphoproliferative disorder (MTX-LPD) can present as a benign lymphoid proliferation or a malignant lymphoma in patients taking MTX. Almost 50% of MTX-LPD cases show spontaneous remission after withdrawal of MTX treatment. Studies have suggested that the hyper-immune state of rheumatoid arthritis, the immunosuppressive state associated with MTX, and the carcinogenicity of the Epstein-Barr virus might contribute to MTX-LPD development. Although most cases of MTX-LPD occur at extranodal sites, few cases of MTX-LPD affecting the stomach and duodenum have been reported. To our knowledge, no other study has reported on the endoscopic observations of dramatic withdrawal and appearance of multiple digestive tract lesions in a short period of time. Herein, we report the clinical course and imaging findings of our case, which may be useful for understanding the pathological condition of MTX-LPD. Case presentation We describe the case of a 70-year-old woman with MTX-LPD of the stomach and duodenum. Disease regression was temporarily achieved after cessation of MTX treatment; however, it subsequently recurred, and complete response was only achieved after six cycles of rituximab, cyclophosphamide, hydroxydaunorubicin, oncovin, and prednisolone (R-CHOP) chemotherapy. Conclusions The first-choice therapy for patients taking MTX who develop suspected MTX-LPD should be the withdrawal of MTX treatment. Even after remission is achieved, patients should be kept under careful observation, and if the disease recurs, chemotherapy should be commenced promptly.
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Affiliation(s)
- Haruka Toyonaga
- Department of Gastroenterology, Kobe City Medical Center General Hospital, 2-1-1 Minatojima-minamimachi, Chuo-ku, Kobe, Hyogo, 650-0047, Japan.
| | - Masashi Fukushima
- Department of Gastroenterology, Kobe City Medical Center General Hospital, 2-1-1 Minatojima-minamimachi, Chuo-ku, Kobe, Hyogo, 650-0047, Japan
| | - Naoto Shimeno
- Department of Gastroenterology, Kobe City Medical Center General Hospital, 2-1-1 Minatojima-minamimachi, Chuo-ku, Kobe, Hyogo, 650-0047, Japan
| | - Tetsuro Inokuma
- Department of Gastroenterology, Kobe City Medical Center General Hospital, 2-1-1 Minatojima-minamimachi, Chuo-ku, Kobe, Hyogo, 650-0047, Japan
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24
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Kotake T, Satake H, Okita Y, Hatachi Y, Hamada M, Omiya M, Yasui H, Hashida T, Kaihara S, Inokuma T, Tsuji A. Prevalence and risk factors of hepatitis B virus reactivation in patients with solid tumors with resolved HBV infection. Asia Pac J Clin Oncol 2019; 15:63-68. [PMID: 29984542 PMCID: PMC7379615 DOI: 10.1111/ajco.13050] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Accepted: 06/18/2018] [Indexed: 12/13/2022]
Abstract
BACKGROUND Reports of hepatitis B virus (HBV) reactivation in solid tumors are very limited, and their frequencies and risk factors were previously unknown. AIM To evaluate the prevalence and risk factors of HBV reactivation in patients with solid tumors with resolved HBV infection. METHODS All 1088 patients with solid tumors were assessed for eligibility; 251 patients had resolved HBV infection (negative for HBs antigen and positive for anti-HBc antibody and/or positive for anti-HBs antibody), and HBV-DNA was assessed for 243 of these patients in whom we analyzed the prevalence of HBV reactivation. Risk factors for HBV reactivation were exploratorily evaluated by analysis of a case-control study. RESULTS The prevalence of HBV-DNA reactivation was 2.1% (95% confidence interval [CI], 0.3-3.9%). We did not observe any exacerbation of HBV-DNA by early intervention. A low anti-HBs antibody titer (<10.0 mIU/mL) and high average daily dexamethasone dose (>1.0 mg/day) were high risk factors, with odds ratios of 5.94 (95% CI, 1.15-30.6, P = 0.03) and 8.69 (95% CI, 1.27-58.8, P = 0.02), respectively. CONCLUSION HBV reactivation in solid tumor patients was relatively rare. Therefore, risk factors that can identify targets for HBV screening must be determined in future studies.
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Affiliation(s)
- Takeshi Kotake
- Department of Medical OncologyKobe City Medical Center General HospitalKobeJapan
| | - Hironaga Satake
- Department of Medical OncologyKobe City Medical Center General HospitalKobeJapan
| | - Yoshihiro Okita
- Department of Clinical OncologyFaculty of MedicineKagawa UniversityKagawaJapan
| | - Yukimasa Hatachi
- Department of Medical OncologyKobe City Medical Center General HospitalKobeJapan
| | - Mamiko Hamada
- Department of NursingKobe City Medical Center General HospitalKobeJapan
| | - Masatomo Omiya
- Clinical & Translational Research CenterKobe University HospitalKobeJapan
| | - Hisateru Yasui
- Department of Medical OncologyKobe City Medical Center General HospitalKobeJapan
| | - Toru Hashida
- Department of PharmacyKobe City Medical Center General HospitalKobeJapan
| | - Satoshi Kaihara
- Department of General and Transplant SurgeryKobe City Medical Center General HospitalKobeJapan
| | - Tetsuro Inokuma
- Department of GastroenterologyKobe City Medical Center General HospitalKobeJapan
| | - Akihito Tsuji
- Department of Clinical OncologyFaculty of MedicineKagawa UniversityKagawaJapan
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25
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Yamamoto H, Ikesue H, Ikemura M, Miura R, Fujita K, Chung H, Suginoshita Y, Inokuma T, Hashida T. Evaluation of pharmaceutical intervention in direct-acting antiviral agents for hepatitis C virus infected patients in an ambulatory setting: a retrospective analysis. J Pharm Health Care Sci 2018; 4:17. [PMID: 30026959 PMCID: PMC6048910 DOI: 10.1186/s40780-018-0113-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2018] [Accepted: 06/06/2018] [Indexed: 01/17/2023] Open
Abstract
Background Direct-acting antivirals (DAAs) are known to improve tolerability and have higher efficacy and shorter treatment durations compared with conventional interferon (IFN)-based treatments for hepatitis C virus (HCV) infection. Management of drug interactions and maintenance of patient adherence are important to achieve adequate therapeutic effects, sustained virological response (SVR). In order to maximize the benefits of oral DAA therapy, we established an ambulatory care pharmacy practice, a model of integrated collaboration between physicians and pharmacists, for patients receiving IFN-free DAA therapy. In this study, we evaluated pharmaceutical intervention for patients visiting the ambulatory care pharmacy practice. Methods HCV-infected outpatients who visited our ambulatory care pharmacy practice between September 2014 and May 2017 were eligible for inclusion in the study. When IFN-free DAAs were first prescribed, the physicians recommended all patients to visit the ambulatory care pharmacy practice after their clinical examination. Subsequently, at the second visit or later, the patients visited the pharmacy service before the physician's examination. The primary endpoint was SVR, defined as HCV RNA below the lower limit of quantification after the completion of treatment. We also evaluated the adherence rate to DAAs, suggestions to the physicians by the pharmacists, and questions from the patients. All data were obtained retrospectively using an electronic medical record system. Results Among the 401 study subjects, 386 patients completed the IFN-free DAA therapy. A total of 365 patients have reached 12 or 24 weeks after completing the treatment. The overall SVR rate was 98.1% (358/365). The proportion of patients with adherence ≥90% was 99.3% (398/401). Two-hundred and sixty-seven (84%) among 318 suggestions of prescription made by the pharmacists mainly to manage the adverse events were accepted by the physicians. The pharmacists received and answered 1072 questions on DAA therapy from the patients. Conclusions This study indicates that the pharmaceutical intervention may contribute to enhanced adherence to DAAs and higher SVR rates in comparison with previous reports. This study also demonstrates that collaboration between physicians and pharmacists in an ambulatory setting provides favorable outcomes for patients receiving IFN-free DAAs.
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Affiliation(s)
- Haruna Yamamoto
- 1Department of Pharmacy, Kobe City Medical Center General Hospital, 2-1-1 Minatojima Minamimachi, Chuo-ku, Kobe, Hyogo 650-0047 Japan
| | - Hiroaki Ikesue
- 1Department of Pharmacy, Kobe City Medical Center General Hospital, 2-1-1 Minatojima Minamimachi, Chuo-ku, Kobe, Hyogo 650-0047 Japan
| | - Mai Ikemura
- 2Department of Clinical Pharmacy, Faculty of Pharmaceutical Sciences, Kobe Gakuin University, 1-1-3 Minatojima, Chuo-ku, Kobe, 650-8586 Japan
| | - Rieko Miura
- 1Department of Pharmacy, Kobe City Medical Center General Hospital, 2-1-1 Minatojima Minamimachi, Chuo-ku, Kobe, Hyogo 650-0047 Japan
| | - Kazumi Fujita
- 1Department of Pharmacy, Kobe City Medical Center General Hospital, 2-1-1 Minatojima Minamimachi, Chuo-ku, Kobe, Hyogo 650-0047 Japan
| | - Hobyung Chung
- 3Department of Gastroenterology and Hepatology, Kobe City Medical Center General Hospital, 2-1-1 Minatojima Minamimachi, Chuo-ku, Kobe, 650-0047 Japan
| | - Yoshiki Suginoshita
- 3Department of Gastroenterology and Hepatology, Kobe City Medical Center General Hospital, 2-1-1 Minatojima Minamimachi, Chuo-ku, Kobe, 650-0047 Japan
| | - Tetsuro Inokuma
- 3Department of Gastroenterology and Hepatology, Kobe City Medical Center General Hospital, 2-1-1 Minatojima Minamimachi, Chuo-ku, Kobe, 650-0047 Japan
| | - Tohru Hashida
- 1Department of Pharmacy, Kobe City Medical Center General Hospital, 2-1-1 Minatojima Minamimachi, Chuo-ku, Kobe, Hyogo 650-0047 Japan
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26
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Seto WK, Asahina Y, Brown TT, Peng CY, Stanciu C, Abdurakhmanov D, Tabak F, Nguyen TT, Chuang WL, Inokuma T, Ikeda F, Santantonio TA, Habersetzer F, Ramji A, Lau AH, Suri V, Flaherty JF, Wang H, Gaggar A, Subramanian GM, Mukewar S, Brunetto MR, Fung S, Chan HLY. Improved Bone Safety of Tenofovir Alafenamide Compared to Tenofovir Disoproxil Fumarate Over 2 Years in Patients With Chronic HBV Infection. Clin Gastroenterol Hepatol 2018:S1542-3565(18)30633-5. [PMID: 29933096 DOI: 10.1016/j.cgh.2018.06.023] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Revised: 04/25/2018] [Accepted: 06/09/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS Long-term use of tenofovir disoproxil fumarate (TDF) reduces bone mineral density (BMD). Tenofovir alafenamide (TAF), a new prodrug of tenofovir, has shown non-inferior efficacy to TDF in patients with chronic hepatitis B virus (HBV) infection, with improved bone effects at 48 weeks. We performed a randomized trial to evaluate the bone safety of TAF compared with TDF over 2 years, assessing baseline risk factors for bone loss, were evaluated after 2 years of treatment. METHODS In a double-blind study, hepatitis B e antigen (HBeAg)-positive patients (n = 873) and HBeAg-negative patients (n = 425) were randomly assigned (2:1) to groups given TAF (25 mg; n = 866) or TDF (300 mg; n = 432) once daily. We assessed bone safety, including hip and spine BMD, using dual-energy X-ray absorptiometry and measured changes in serum markers of bone turnover over 96 weeks. RESULTS At baseline, treatment groups were well matched. At week 96, patients receiving TAF had significantly smaller decreases in hip BMD (mean reduction of 0.33%) than patients receiving TDF (mean reduction of 2.51%) (P < .001) and spine BMD (reduction of 0.75% in patients receiving patients receiving TAF vs reduction of 2.57% in patients receiving TDF) (P < .001). For hip BMD, the magnitude of difference in bone loss between the TAF and TDF groups increased at week 96 compared to week 48 (P < .001). The TAF group had minimal changes in markers of bone turnover by 12 weeks of treatment, but the TDF group had significant changes, compared to baseline. Risk factors for bone loss had fewer effects in patients receiving TAF than TDF at week 96. CONCLUSIONS In double-blind randomized trials, we found that after 2 years of treatment, patients receiving TAF had continued improvements in bone safety compared with patients receiving TDF. Clinicaltrial.gov ID NCT01940471 and NCT01940341.
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Affiliation(s)
- Wai-Kay Seto
- Department of Medicine, The University of Hong Kong, Hong Kong.
| | - Yasuhiro Asahina
- Department of Gastroenterology and Hepatology and Department of Liver Disease Control, Tokyo Medical and Dental University, Tokyo, Japan
| | - Todd T Brown
- Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, Johns Hopkins University, Baltimore, Maryland
| | - Cheng-Yuan Peng
- Division of Hepatogastroenterology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Carol Stanciu
- Institute of Gastroenterology and Hepatology, University of Medicine and Pharmacy "Grigore T. Popa," Iasi, Romania
| | | | - Fehmi Tabak
- Deparment of Infectious Diseases, Istanbul University, Cerrahpasa School of Medicine, Istanbul, Turkey
| | | | - Wan-Long Chuang
- Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Tetsuro Inokuma
- Department of Gastroenterology, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Fusao Ikeda
- Department of Gastroenterology, Okayama University Hospital, Okayama, Japan
| | - Teresa Antonia Santantonio
- Infectious Diseases Unit, Department of Clinical and Experimental Medicine, University of Foggia, Fogia, Italy
| | - François Habersetzer
- Pôle Hépato-digestif, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg, Institut Hospitalo-Universitaire, Inserm U 1110, Institut sur les Maladies Virales et Hépatiques, Université de Strasbourg, Strasbourg, France
| | - Alnoor Ramji
- Gastrointestinal Research Institute, Vancouver, British Columbia, Canada
| | | | | | | | | | | | | | | | - Maurizia R Brunetto
- Clinical and Experimental Medicine Department, University of Pisa, Pisa, Italy
| | - Scott Fung
- Toronto General Hospital, Toronto, Ontario, Canada
| | - Henry Lik-Yuen Chan
- Department of Medicine & Therapeutics, Prince of Wales Hospital, Hong Kong, Hong Kong
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Toyonaga H, Taniguchi Y, Inokuma T, Imai Y. Traumatic bile duct neuroma diagnosed by boring biopsy with cholangioscopy. Gastrointest Endosc 2018; 87:1361-1362. [PMID: 29102735 DOI: 10.1016/j.gie.2017.10.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Accepted: 10/26/2017] [Indexed: 12/11/2022]
Affiliation(s)
- Haruka Toyonaga
- Department of Gastroenterology, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
| | - Yohei Taniguchi
- Department of Gastroenterology, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
| | - Tetsuro Inokuma
- Department of Gastroenterology, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
| | - Yukihiro Imai
- Department of Pathology, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
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28
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Toyonaga H, Fukushima M, Inokuma T, Imai Y. Mantle cell lymphoma involving the esophagus evaluated by magnifying endoscopy with narrow-band imaging. Gastrointest Endosc 2018; 87:305-306. [PMID: 28720472 DOI: 10.1016/j.gie.2017.07.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Accepted: 07/12/2017] [Indexed: 12/11/2022]
Affiliation(s)
- Haruka Toyonaga
- Department of Gastroenterology, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Masashi Fukushima
- Department of Gastroenterology, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Tetsuro Inokuma
- Department of Gastroenterology, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Yukihiro Imai
- Department of Pathology, Kobe City Medical Center General Hospital, Kobe, Japan
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29
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Hatamori H, Wada M, Taniguchi Y, Inokuma T. Pancreatic pseudocyst localized in the gastric wall after EUS-guided FNA of type 1 autoimmune pancreatitis. Gastrointest Endosc 2017; 86:919-921. [PMID: 28583768 DOI: 10.1016/j.gie.2017.05.034] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Accepted: 05/26/2017] [Indexed: 02/08/2023]
Affiliation(s)
- Hiroyuki Hatamori
- Department of Gastroenterology, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Masaya Wada
- Department of Gastroenterology, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Youhei Taniguchi
- Department of Gastroenterology, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Tetsuro Inokuma
- Department of Gastroenterology, Kobe City Medical Center General Hospital, Kobe, Japan
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30
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Tsuji Y, Takahashi N, Isoda H, Koizumi K, Koyasu S, Sekimoto M, Imanaka Y, Yazumi S, Asada M, Nishikawa Y, Yamamoto H, Kikuchi O, Yoshida T, Inokuma T, Katsushima S, Esaka N, Okano A, Kawanami C, Kakiuchi N, Shiokawa M, Kodama Y, Moriyama I, Kajitani T, Kinoshita Y, Chiba T. Erratum to: Early diagnosis of pancreatic necrosis based on perfusion CT to predict the severity of acute pancreatitis. J Gastroenterol 2017; 52:1147-1148. [PMID: 28447174 DOI: 10.1007/s00535-017-1343-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- Yoshihisa Tsuji
- Department of Gastroenterology and Hepatology, Kyoto University Hospital, Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan.
- Department of Gastroenterology and Hepatology, The Japan Baptist Hospital, 47 Kitashirakawa Yamanomotocho, Sakyo-ku, Kyoto, 606-8273, Japan.
- Shiga University of Medical Science, Seta-Tsukinowacho, Otsu, Shiga, 520-2121, Japan.
| | - Naoki Takahashi
- Department of Radiology, Mayo Clinic, 200 1st St SW, Rochester, MN, 55902, USA
| | - Hiroyoshi Isoda
- Department of Radiology, Kyoto University Hospital, Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Koji Koizumi
- Division of Clinical Radiology Service, Kyoto University Hospital, Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Sho Koyasu
- Department of Radiology, Kyoto University Hospital, Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Miho Sekimoto
- Department of Healthcare Economics and Quality Management, Kyoto University Hospital, Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Yuichi Imanaka
- Department of Healthcare Economics and Quality Management, Kyoto University Hospital, Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Shujiro Yazumi
- Digestive Disease Center, Kitano Hospital, The Tazuke Kofukai Medical Research Institute, 2-4-20 Ohgimachi, Kita-ku, Osaka, 530-8480, Japan
| | - Masanori Asada
- Digestive Disease Center, Kitano Hospital, The Tazuke Kofukai Medical Research Institute, 2-4-20 Ohgimachi, Kita-ku, Osaka, 530-8480, Japan
| | - Yoshihiro Nishikawa
- Digestive Disease Center, Kitano Hospital, The Tazuke Kofukai Medical Research Institute, 2-4-20 Ohgimachi, Kita-ku, Osaka, 530-8480, Japan
| | - Hiroshi Yamamoto
- Department of Gastroenterology and Hepatology, 1 Chome-1-1 Miwa, Kurashiki, Okayama, 710-0052, Japan
| | - Osamu Kikuchi
- Department of Gastroenterology and Hepatology, 1 Chome-1-1 Miwa, Kurashiki, Okayama, 710-0052, Japan
| | - Tsukasa Yoshida
- Department of Gastroenterology and Hepatology, 1 Chome-1-1 Miwa, Kurashiki, Okayama, 710-0052, Japan
| | - Tetsuro Inokuma
- Department of Gastroenterology and Hepatology, Kobe City Medical Center General Hospital, 2-2-1 Minatojima-minami-machi, Chuo-ku, Kobe, Hyogo, 650-0047, Japan
| | - Shinji Katsushima
- Department of Gastroenterology and Hepatology, Kyoto Medical Center, 1-1 Fukakusa, Mukaihata-cho, Fushimi-ku, Kyoto, 612-8555, Japan
| | - Naoki Esaka
- Department of Gastroenterology and Hepatology, Kyoto Medical Center, 1-1 Fukakusa, Mukaihata-cho, Fushimi-ku, Kyoto, 612-8555, Japan
| | - Akihiro Okano
- Department of Gastroenterology and Hepatology, Tenri Hospital, 200 Mishima-cho, Tenri, Nara, 632-8552, Japan
| | - Chiharu Kawanami
- Department of Gastroenterology and Hepatology, Japanese Red Cross Otsu Hospital, 1-1-35 Nagara, Otsu, Shiga, 520-8511, Japan
| | - Nobuyuki Kakiuchi
- Department of Gastroenterology and Hepatology, Japanese Red Cross Otsu Hospital, 1-1-35 Nagara, Otsu, Shiga, 520-8511, Japan
| | - Masahiro Shiokawa
- Department of Gastroenterology and Hepatology, Japanese Red Cross Otsu Hospital, 1-1-35 Nagara, Otsu, Shiga, 520-8511, Japan
| | - Yuzo Kodama
- Department of Gastroenterology and Hepatology, Kyoto University Hospital, Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Ichiro Moriyama
- Division of Clinical Study of Oncology, Shimane University School of Medicine, 1060 Nishikawatsucho, Matsue, Shimane, 690-8504, Japan
| | - Takafumi Kajitani
- Department of Radiology, Shimane University School of Medicine, 1060 Nishikawatsucho, Matsue, Shimane, 690-8504, Japan
| | - Yoshikazu Kinoshita
- Department of Gastroenterology and Hepatology, Shimane University School of Medicine, 1060 Nishikawatsucho, Matsue, Shimane, 690-8504, Japan
| | - Tsutomu Chiba
- Department of Gastroenterology and Hepatology, Kyoto University Hospital, Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
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Tsuji Y, Takahashi N, Isoda H, Koizumi K, Koyasu S, Sekimoto M, Imanaka Y, Yazumi S, Asada M, Nishikawa Y, Yamamoto H, Kikuchi O, Yoshida T, Inokuma T, Katsushima S, Esaka N, Okano A, Kawanami C, Kakiuchi N, Shiokawa M, Kodama Y, Moriyama I, Kajitani T, Kinoshita Y, Chiba T. Early diagnosis of pancreatic necrosis based on perfusion CT to predict the severity of acute pancreatitis. J Gastroenterol 2017; 52:1130-1139. [PMID: 28374057 DOI: 10.1007/s00535-017-1330-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Accepted: 03/14/2017] [Indexed: 02/08/2023]
Abstract
BACKGROUND Perfusion CT can diagnose pancreatic necrosis in early stage of severe acute pancreatitis, accurately. However, no study to date has examined whether early diagnosis of pancreatic necrosis is useful in predicting persistent organ failure (POF). METHODS We performed a multi-center prospective observational cohort study to investigate whether perfusion CT can predict the development of POF in the early stage of AP, based on early diagnosis of the development of pancreatic necrosis (PN). From 2009 to 2012, we examined patients showing potential early signs of severe AP (n = 78) on admission. Diagnoses for the development of PN were made prospectively by on-site physicians on the admission based on perfusion CT (diagnosis 1). Blinded retrospective reviews were performed by radiologists A and B, having 8 and 13 years of experience as radiologists (diagnosis 2 and 3), respectively. Positive diagnosis for the development of PN were assumed equivalent to positive predictions for the development of POF. We then calculated the area under the curve (AUC) of the receiver operating characteristic for POF predictions. RESULTS Fourteen (17.9%) and 23 patients (29.5%) developed PN and POF, respectively. For diagnoses 1, 2, and 3, AUCs for POF predictions were 74, 68, and 73, respectively. CONCLUSIONS Perfusion CT diagnoses pancreatic necrosis and on that basis predicts the development of POF; http://www.umin.ac.jp/ctr/index-j.htm,UMIN000001926 .
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Affiliation(s)
- Yoshihisa Tsuji
- Department of Gastroenterology and Hepatology, Kyoto University Hospital, Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan. .,Department of Gastroenterology and Hepatology, The Japan Baptist Hospital, 47 Kitashirakawa Yamanomotocho, Sakyo-ku, Kyoto, 606-8273, Japan. .,Shiga University of Medical Science, Seta-Tsukinowacho, Otsu, Shiga, 520-2121, Japan.
| | - Naoki Takahashi
- Department of Radiology, Mayo Clinic, 200 1st St SW, Rochester, MN, 55902, USA
| | - Hiroyoshi Isoda
- Department of Radiology, Kyoto University Hospital, Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Koji Koizumi
- Division of Clinical Radiology Service, Kyoto University Hospital, Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Sho Koyasu
- Department of Radiology, Kyoto University Hospital, Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Miho Sekimoto
- Department of Healthcare Economics and Quality Management, Kyoto University Hospital, Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Yuichi Imanaka
- Department of Healthcare Economics and Quality Management, Kyoto University Hospital, Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Shujiro Yazumi
- Digestive Disease Center, Kitano Hospital, The Tazuke Kofukai Medical Research Institute, 2-4-20 Ohgimachi, Kita-ku, Osaka, 530-8480, Japan
| | - Masanori Asada
- Digestive Disease Center, Kitano Hospital, The Tazuke Kofukai Medical Research Institute, 2-4-20 Ohgimachi, Kita-ku, Osaka, 530-8480, Japan
| | - Yoshihiro Nishikawa
- Digestive Disease Center, Kitano Hospital, The Tazuke Kofukai Medical Research Institute, 2-4-20 Ohgimachi, Kita-ku, Osaka, 530-8480, Japan
| | - Hiroshi Yamamoto
- Department of Gastroenterology and Hepatology, 1 Chome-1-1 Miwa, Kurashiki, Okayama, 710-0052, Japan
| | - Osamu Kikuchi
- Department of Gastroenterology and Hepatology, 1 Chome-1-1 Miwa, Kurashiki, Okayama, 710-0052, Japan
| | - Tsukasa Yoshida
- Department of Gastroenterology and Hepatology, 1 Chome-1-1 Miwa, Kurashiki, Okayama, 710-0052, Japan
| | - Tetsuro Inokuma
- Department of Gastroenterology and Hepatology, Kobe City Medical Center General Hospital, 2-2-1 Minatojima-minami-machi, Chuo-ku, Kobe, Hyogo, 650-0047, Japan
| | - Shinji Katsushima
- Department of Gastroenterology and Hepatology, Kyoto Medical Center, 1-1 Fukakusa, Mukaihata-cho, Fushimi-ku, Kyoto, 612-8555, Japan
| | - Naoki Esaka
- Department of Gastroenterology and Hepatology, Kyoto Medical Center, 1-1 Fukakusa, Mukaihata-cho, Fushimi-ku, Kyoto, 612-8555, Japan
| | - Akihiro Okano
- Department of Gastroenterology and Hepatology, Tenri Hospital, 200 Mishima-cho, Tenri, Nara, 632-8552, Japan
| | - Chiharu Kawanami
- Department of Gastroenterology and Hepatology, Japanese Red Cross Otsu Hospital, 1-1-35 Nagara, Otsu, Shiga, 520-8511, Japan
| | - Nobuyuki Kakiuchi
- Department of Gastroenterology and Hepatology, Japanese Red Cross Otsu Hospital, 1-1-35 Nagara, Otsu, Shiga, 520-8511, Japan
| | - Masahiro Shiokawa
- Department of Gastroenterology and Hepatology, Japanese Red Cross Otsu Hospital, 1-1-35 Nagara, Otsu, Shiga, 520-8511, Japan
| | - Yuzo Kodama
- Department of Gastroenterology and Hepatology, Kyoto University Hospital, Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Ichiro Moriyama
- Division of Clinical Study of Oncology, Shimane University School of Medicine, 1060 Nishikawatsucho, Matsue, Shimane, 690-8504, Japan
| | - Takafumi Kajitani
- Department of Radiology, Shimane University School of Medicine, 1060 Nishikawatsucho, Matsue, Shimane, 690-8504, Japan
| | - Yoshikazu Kinoshita
- Department of Gastroenterology and Hepatology, Shimane University School of Medicine, 1060 Nishikawatsucho, Matsue, Shimane, 690-8504, Japan
| | - Tsutomu Chiba
- Department of Gastroenterology and Hepatology, Kyoto University Hospital, Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
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Affiliation(s)
- Satoshi Ogawa
- Department of Gastroenterology and Hepatology, Kyoto University Graduate School of Medicine, Kyoto, Japan; Department of Gastroenterology and Hepatology, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Yukihiro Imai
- Department of Pathology, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Tetsuro Inokuma
- Department of Gastroenterology and Hepatology, Kobe City Medical Center General Hospital, Kobe, Japan
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Ito T, Morita S, Shimeno N, Uehara K, Imai Y, Inokuma T. The prospect of endoscopic submucosal dissection for early anal canal squamous cell carcinoma. Clin J Gastroenterol 2016; 9:384-388. [PMID: 27738909 DOI: 10.1007/s12328-016-0690-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Accepted: 10/02/2016] [Indexed: 12/16/2022]
Abstract
Squamous cell carcinoma (SCC) of the anal canal is seldom diagnosed at an early stage. Chemoradiation therapy is a standard in Europe and the United States, though in squamous cell carcinoma there is no evidence-based therapy. In Japan, endoscopic submucosal dissection (ESD) is the standard minimally invasive treatment for early stage cancer of the digestive tract, including the colorectum. Therefore, if the lesion is diagnosed at an early stage, ESD may be selected for anal canal lesions. We experienced two cases of early stage anal canal cancer in which the diagnosis and the extent of the lesions were confirmed using magnifying endoscopy with narrow-band imaging (NBI), as well as performing ESD. Pathological examination showed the resected specimen to be SCC in situ; the horizontal and vertical margins were free of tumor; and in one case there was no lymphovascular invasion. In the other case it showed the tumor was contained within the epithelium; horizontal and vertical margins were free of tumor; The follow-up period is not long enough to assert that ESD for anal canal squamous cell carcinoma may be an option of minimally invasive therapy. However, if there is a possibility of lymphatic invasion as in one of our cases, we need to give serious consideration to ESD for these lesions, and careful follow-up is necessary even if the lesion is in situ.
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Affiliation(s)
- Takahiko Ito
- Department of Gastroenterology, Kobe City Medical Center General Hospital, Minatojimaminami-machi 2-1-1, Chuo-ku, Kobe-Shi, Hyogo, 650-0047, Japan.
| | - Shuko Morita
- Department of Gastroenterology, Kobe City Medical Center General Hospital, Minatojimaminami-machi 2-1-1, Chuo-ku, Kobe-Shi, Hyogo, 650-0047, Japan
| | - Naoto Shimeno
- Department of Gastroenterology, Kobe City Medical Center General Hospital, Minatojimaminami-machi 2-1-1, Chuo-ku, Kobe-Shi, Hyogo, 650-0047, Japan
| | - Keiichiro Uehara
- Department of Clinical Pathology, Kobe City Medical Center General Hospital, Minatojimaminami-machi 2-1-1, Chuo-ku, Kobe-Shi, Hyogo, 650-0047, Japan
| | - Yukihiro Imai
- Department of Clinical Pathology, Kobe City Medical Center General Hospital, Minatojimaminami-machi 2-1-1, Chuo-ku, Kobe-Shi, Hyogo, 650-0047, Japan
| | - Tetsuro Inokuma
- Department of Gastroenterology, Kobe City Medical Center General Hospital, Minatojimaminami-machi 2-1-1, Chuo-ku, Kobe-Shi, Hyogo, 650-0047, Japan
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Ueki K, Takayama K, Iizuka Y, Kimino G, Imagumbai T, Suginoshita Y, Tei H, Kosaka Y, Inokuma T, Kokubo M. Correlation Between Dose-Volumetric Parameters and Late Liver Dysfunction After Dynamic Tumor-Tracking Stereotactic Body Radiation Therapy for Hepatocellular Carcinoma. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Matsumoto T, Imai Y, Inokuma T. Neuroendocrine Carcinoma of the Gallbladder Accompanied by Pancreaticobiliary Maljunction. Clin Gastroenterol Hepatol 2016; 14:e29-30. [PMID: 26247168 DOI: 10.1016/j.cgh.2015.07.034] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Revised: 07/27/2015] [Accepted: 07/28/2015] [Indexed: 01/21/2023]
Affiliation(s)
- Tomonori Matsumoto
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yukihiro Imai
- Department of Pathology, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Tetsuro Inokuma
- Department of Gastroenterology, Kobe City Medical Center General Hospital, Kobe, Japan
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Fukushima M, Kitamoto H, Inokuma T, Imai Y. Severe spruelike enteropathy associated with olmesartan observed by double-balloon enteroscopy. Gastrointest Endosc 2016; 83:269-70. [PMID: 26149710 DOI: 10.1016/j.gie.2015.06.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Accepted: 06/04/2015] [Indexed: 12/11/2022]
Affiliation(s)
- Masashi Fukushima
- Department of Gastroenterology, Kobe City Medical Center General Hospital, Kobe, Hyuogo, Japan
| | - Hiroki Kitamoto
- Department of Gastroenterology, Kobe City Medical Center General Hospital, Kobe, Hyuogo, Japan
| | - Tetsuro Inokuma
- Department of Gastroenterology, Kobe City Medical Center General Hospital, Kobe, Hyuogo, Japan
| | - Yukihiro Imai
- Department of Pathology, Kobe City Medical Center General Hospital, Kobe, Hyuogo, Japan
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Ogawa S, Wada M, Fukushima M, Shimeno N, Inoue S, Chung H, Fujita M, Suginoshita Y, Okada A, Inokuma T, Yagi S, Ito K, Imai Y. Case of primary hepatic gastrinoma: Diagnostic usefulness of the selective arterial calcium injection test. Hepatol Res 2015; 45:823-6. [PMID: 25145887 DOI: 10.1111/hepr.12404] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2014] [Revised: 08/09/2014] [Accepted: 08/14/2014] [Indexed: 02/08/2023]
Abstract
Gastrinomas mainly occur in the duodenum and pancreas. Primary hepatic gastrinoma is rare and difficult to diagnose because the liver is a frequent site of metastatic gastrinomas. Clinical factors were assessed in a 28-year-old man with diarrhea and heartburn who was hospitalized for recurrent duodenal ulcers. Abdominal ultrasound, endoscopic ultrasound and computed tomography (CT) could not detect a tumor in the duodenum or pancreas. His gastrin level was 846 pg/mL and magnetic resonance imaging showed a mass 12 mm in diameter in the right robe of the liver. A selective intra-arterial calcium injection (SACI) test and 68-gallium edotreotide positron emission tomography CT (Ga-DOTATOC PET-CT) were therefore performed. Calcium gluconate injection into the proper hepatic artery resulted in a marked increase in serum gastrin concentration in the right hepatic vein, with Ga-DOTATOC PET-CT showing uptake only by the liver mass. Following a diagnosis of primary hepatic gastrinoma, the tumor was resected. A histopathological examination indicated gastrinoma. Six months postoperatively, he has no symptoms, is not taking proton-pump inhibitors and his gastrin level remains within the normal range. The SACI test and the clinical course of this patient strongly suggest that the tumor was a primary hepatic gastrinoma. The SACI test is helpful in the diagnosis of primary hepatic gastrinoma.
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Affiliation(s)
- Satoshi Ogawa
- Department of Gastroenterology and Hepatology, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Masaya Wada
- Department of Gastroenterology and Hepatology, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Masashi Fukushima
- Department of Gastroenterology and Hepatology, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Naoto Shimeno
- Department of Gastroenterology and Hepatology, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Satoko Inoue
- Department of Gastroenterology and Hepatology, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Hobyung Chung
- Department of Gastroenterology and Hepatology, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Mikio Fujita
- Department of Gastroenterology and Hepatology, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Yoshiki Suginoshita
- Department of Gastroenterology and Hepatology, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Akihiko Okada
- Department of Gastroenterology and Hepatology, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Tetsuro Inokuma
- Department of Gastroenterology and Hepatology, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Shintaro Yagi
- Department of Surgery, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Kyo Ito
- Department of Radiology, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Yukihiro Imai
- Department of Pathology, Kobe City Medical Center General Hospital, Kobe, Japan
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Matsumoto T, Chung H, Suginoshita Y, Ito K, Inokuma T. Outcomes and Prognostic Factors in Patients with Spontaneously Ruptured Hepatocellular Carcinoma. Hepatogastroenterology 2015; 62:942-946. [PMID: 26902033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
BACKGROUND/AIMS Spontaneous rupture is a life-threatening complication of hepatocellular carcinoma (HCC). Although hemostasis can be achieved by transarterial embolization (TAE), the prognosis remains poor. The aims of this study were to evaluate the effectiveness of emergent TAE for ruptured HCC and to clarify the prognostic factors. METHODOLOGY Thirty-six patients with spontaneously ruptured HCC were retrospectively analyzed. Prognostic factors of short-term (57 days) and long-term (>7 days) survival after HCC rupture were investigated by univariate and multivariate analyses. RESULTS Emergent TAE was performed in 22 patients and conservative treatment was applied in 14. The hemostasis rate of TAE was 86.4%, and median survival time in patients with TAE was significantly longer than that in patients with conservative treatment (142 days vs. 5 days, p = 0.0006). In multivariate analysis, high serum creatinine (p = 0.036) was a significant independent predictor of poor 7-day survival, and low serum albumin (p = 0.050) and absence of emergent TAE (p = 0.061) tended to be associated with poor 7-day survival. HCC treatment within the past 12 months (p = 0.048) and, high serum total bilirubin (p = 0.016) were predictors of poor long-term survival. Conclusions: We identified some survival predictors after HCC rupture. Emergent TAE appears to be effective for improving short-term oroLnosis after HCC ruoture.
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Matsumoto T, Inokuma T. [Mucinous adenocarcinoma, signet-ring cell carcinoma]. Nihon Rinsho 2015; 73 Suppl 3:754-757. [PMID: 25857129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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Ogawa S, Fukushima M, Chung H, Fujita M, Suginoshita Y, Okada A, Inokuma T, Satake H, Miki A, Imai Y. [A case of jejunal ectopic pancreatic cancer: the diagnostic usefulness of MRI]. Nihon Shokakibyo Gakkai Zasshi 2015; 112:70-77. [PMID: 25744922 DOI: 10.11405/nisshoshi.112.70] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
A 70-year-old man was referred to our hospital because of elevated CA19-9. Magnetic resonance imaging revealed a jejunal tumor having duct and retention cyst-like structures, which suggested ectopic pancreatic cancer. We resected that part of the jejunum and the lymph nodes around the tumor. Pathological examination revealed an adenocarcinoma originating from a Heinrich type I ectopic pancreas in the jejunum. Adjuvant chemotherapy with gemcitabine was performed for half a year. After 8 months, CA19-9 remained elevated, and liver metastasis occurred. We began treatment with tegafur/gimeracil/oteracil potassium (S-1) and particle beam therapy. After 7 months, CA19-9 was normal, and the patient has remained in partial remission with S-1 treatment. Ectopic pancreas tissues typically occur in the stomach and duodenum and rarely become cancerous. Here, we report the features of a rare and illustrative case of jejunal ectopic pancreatic cancer.
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Affiliation(s)
- Satoshi Ogawa
- Department of Gastroenterology and Hepatology, Kobe City Medical Center General Hospital
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Fukushima M, Kawanami C, Inoue S, Okada A, Imai Y, Inokuma T. A case series of Meckel's diverticulum: usefulness of double-balloon enteroscopy for diagnosis. BMC Gastroenterol 2014; 14:155. [PMID: 25175823 PMCID: PMC4155089 DOI: 10.1186/1471-230x-14-155] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2013] [Accepted: 08/18/2014] [Indexed: 12/14/2022] Open
Abstract
Background Meckel’s diverticulum is a congenital anomaly of the gastrointestinal tract. About 98% of affected patients are asymptomatic. Small intestinal examination has become easier since the development of double-balloon enteroscopy. The present case series describes 10 patients with Meckel’s diverticulum in whom double-balloon enteroscopy was useful for diagnosis. Case presentation Ten patients (8 men, 2 women) with Meckel’s diverticulum underwent double-balloon enteroscopy at Kobe City Medical Center General Hospital from May 2004 through May 2013. Their median age was 31.5 years (range, 14–83 years). Ten retrograde and two anterograde double-balloon enteroscopy procedures were performed. Double-balloon enteroscopy showed Meckel’s diverticulum in nine patients, but an inverted Meckel’s diverticulum was diagnosed as a lipoma in one patient. Meckel’s diverticulum was detected by iodinated contrast medium during anterograde double-balloon enteroscopy in one of the two patients who underwent this procedure. Meckel’s diverticulum was suspected using capsule endoscopy in one of two patients who underwent this procedure. Abdominal computed tomography was performed in all patients and revealed abnormalities in six, but Meckel’s diverticulum was suspected in only two. Technetium-99 m pertechnetate scintigraphy and a small bowel series were carried out in six patients, revealing Meckel’s diverticulum in one and three patients, respectively. Surgery was performed in eight patients, and endoscopic resection was carried out in one; the remaining patient was transferred to another hospital. Ulcer formation was found in or near Meckel’s diverticulum in eight patients. Conclusion Compared with other modalities, double-balloon enteroscopy is excellent for the diagnosis of Meckel’s diverticulum because direct observation of both Meckel’s diverticulum and ulceration is possible. Double-balloon enteroscopy should be used complementarily to other less invasive examinations when needed to confirm or establish the diagnosis.
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Affiliation(s)
- Masashi Fukushima
- Departments of Gastroenterology, Kobe City Medical Center General Hospital, 2-1-1 Minatojimaminamimachi, Chuo-ku, Kobe Hyogo 650-0047, Japan.
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Satake H, Kotake T, Ito Y, Kitamoto H, Takashima K, Ogawa S, Masuo K, Fujita M, Inokuma T, Tsuji A. The Influence of KRAS Mutation Analysis Before Primary Chemotherapy for Unresectable and Recurrent Colorectal Cancer. Ann Oncol 2013. [DOI: 10.1093/annonc/mdt460.131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Matsumoto T, Inokuma T. Clinical course and rebleeding predictors of acute haemorrhagic rectal ulcer: 5-year experience and review of the literature. Colorectal Dis 2013; 15:878-84. [PMID: 23375083 DOI: 10.1111/codi.12162] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2012] [Accepted: 11/11/2012] [Indexed: 02/08/2023]
Abstract
AIM This study was carried out to clarify the clinical features of acute haemorrhagic rectal ulcer (AHRU) and to determine the risks and predictors of AHRU rebleeding. METHOD Forty patients with AHRU were retrospectively analysed. Patient characteristics, endoscopic features and clinical course were investigated and predictors of AHRU rebleeding were analysed. RESULTS All patients were in a bedridden state as a result of various diseases, and many patients had atherosclerosis-related comorbidities such as hypertension (67.4%), diabetes mellitus (40.0%) and chronic kidney disease (42.5%). All patients had hypoalbuminaemia, 75% of patients were using antithrombotic drugs and 25% of patients were using systemic corticosteroids. Based on colonoscopy, all patients developed ulcers in the distal rectum just above the dentate line and 30% of patients developed whole circumferential ulcers. The median interval between the onset of the bedridden state and the first massive haematochezia was 16 days and 50% of all patients developed rebleeding regardless of the presence or absence of haemostatic therapy. The median time from initial haemostasis to rebleeding was 6 days. Univariate analysis and stepwise multivariate analysis revealed that whole circumferential ulcer (P = 0.036) was a significant independent predictor of AHRU rebleeding. CONCLUSION In the present study, we elucidated the clinical features of AHRU in detail and reviewed previous reports of AHRU. Rebleeding of AHRU occurred at a high rate and whole circumferential ulcer was a significant independent predictor of AHRU rebleeding.
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Affiliation(s)
- T Matsumoto
- Department of Gastroenterology and Hepatology, Kobe City Medical Centre General Hospital, Kobe, Japan.
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Matsumoto T, Shimeno N, Imai Y, Inokuma T. Gastric carcinoma with lymphoid stroma resembling a hypoechoic submucosal tumor. Gastrointest Endosc 2013; 78:164-5; discussion 165. [PMID: 23557836 DOI: 10.1016/j.gie.2013.02.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2012] [Accepted: 02/20/2013] [Indexed: 02/08/2023]
Affiliation(s)
- Tomonori Matsumoto
- Department of Gastroenterology, Kobe City Medical Center General Hospital, Kobe, Japan
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Matsumoto T, Inokuma T, Imai Y. Education and imaging. Gastrointestinal: colonic mucosa-associated lymphoid tissue lymphoma regressed by levofloxacin. J Gastroenterol Hepatol 2013; 28:750. [PMID: 23527757 DOI: 10.1111/jgh.12130] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Affiliation(s)
- T Matsumoto
- Department of Gastroenterology, Kobe City Medical Center General Hospital, Kobe, Japan
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Kitada N, Kanamori K, Konishi A, Tanaka S, Suginoshita Y, Inokuma T, Hashida T. [Analysis of factors affecting the duration of treatment with sorafenib in patients with hepatocellular carcinoma]. Gan To Kagaku Ryoho 2013; 40:479-482. [PMID: 23848015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
The current status of treatment with sorafenib, and factors affecting the duration of treatment in patients started on sorafenib for hepatocellular carcinoma from July 2009 until April 2011 in the Department of Gastroenterology at Kobe City Medical Center General Hospital, were examined. Of 21 patients, 12 were able to continue the administration of sorafenib for more than one month, but 9 had to be discontinued within one month due to disease progression, worsening of general condition, and severe adverse reactions. In the group that was discontinued early, the rate of discontinuation due to side effects such as general fatigue, diarrhea, and hepatic encephalopathy was higher than in the long-term treatment group. On the other hand, hand-foot syndrome developed only in one case in both groups. The median value of PIVKA- II at the start of treatment in the long-term and early discontinued treatment groups were 672.5 and 14, 203 mAU/mL, respectively, and the values in the long-term group were significantly lower than those in the early-discontinued group (p < 0.05). From these results, the values of PIVKA-II at the start of sorafenib were considered to be factors affecting the continuation of sorafenib treatment. In addition, the dosing period was considered to be extended to focus on measures to take against the side effects of sorafenib within the early phase. Therefore, it was considered that these factors improved the effect of treatment with sorafenib in patients with hepatocellular carcinoma.
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Affiliation(s)
- Noriaki Kitada
- Dept. of Pharmacy, Kobe City Medical Center General Hospital
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Shiokawa M, Kodama Y, Yoshimura K, Kawanami C, Mimura J, Yamashita Y, Asada M, Kikuyama M, Okabe Y, Inokuma T, Ohana M, Kokuryu H, Takeda K, Tsuji Y, Minami R, Sakuma Y, Kuriyama K, Ota Y, Tanabe W, Maruno T, Kurita A, Sawai Y, Uza N, Watanabe T, Haga H, Chiba T. Risk of cancer in patients with autoimmune pancreatitis. Am J Gastroenterol 2013; 108:610-7. [PMID: 23318486 DOI: 10.1038/ajg.2012.465] [Citation(s) in RCA: 158] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVES Although simultaneous occurrences of autoimmune pancreatitis (AIP) and cancer are occasionally observed, it remains largely unknown whether cancer and AIP occur independently or these disorders are interrelated. The aim of this study was to examine the relationship between AIP and cancer. METHODS We conducted a multicenter, retrospective cohort study. One hundred and eight patients who met the Asian diagnostic criteria for AIP were included in the study. We calculated the proportion, standardized incidence ratio (SIR), relative risk, and time course of cancer development in patients with AIP. We also analyzed the clinicopathological characteristics of AIP patients with cancer in comparison with those without cancer. RESULTS Of the 108 AIP patients, 18 cancers were found in 15 patients (13.9%) during the median follow-up period of 3.3 years. The SIR of cancer was 2.7 (95% confidence interval (CI) 1.4-3.9), which was stratified into the first year (6.1 (95% CI 2.3-9.9)) and subsequent years (1.5 (95% CI 0.3-2.8)) after AIP diagnosis. Relative risk of cancer among AIP patients at the time of AIP diagnosis was 4.9 (95% CI 1.7-14.9). In six of eight patients whose cancer lesions could be assessed before corticosteroid therapy for AIP, abundant IgG4-positive plasma cell infiltration was observed in the cancer stroma. These six patients experienced no AIP relapse after successful cancer treatment. CONCLUSIONS Patients with AIP are at high risk of having various cancers. The highest risk for cancer in the first year after AIP diagnosis and absence of AIP relapse after successful treatment of the coexisting cancers suggest that AIP may develop as a paraneoplastic syndrome in some patients.
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Affiliation(s)
- Masahiro Shiokawa
- Department of Gastroenterology and Hepatology, Kyoto University Graduate School of Medicine, Kyoto, Japan
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Fukushima M, Inoue S, Ono Y, Tamaki Y, Yoshimura H, Imai Y, Inokuma T. Microscopic polyangiitis complicated with ileal involvement detected by double-balloon endoscopy: a case report. BMC Gastroenterol 2013; 13:42. [PMID: 23452722 PMCID: PMC3598977 DOI: 10.1186/1471-230x-13-42] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2012] [Accepted: 02/28/2013] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Microscopic polyangiitis is characterized by pauci-immune, necrotizing small-vessel vasculitis and an anti-neutrophil cytoplasmic antibody-associated vasculitis. Although gastrointestinal involvement in microscopic polyangiitis is not rare, endoscopic observation of it is extremely rare. To the best of our knowledge, this is the first case report of small intestinal involvement in microscopic polyangiitis detected and followed up by double-balloon endoscopy. CASE PRESENTATION A 70-year-old Japanese woman was transferred to our hospital for close examination of suspected small intestinal lymphoma. Retrograde double-balloon endoscopy revealed various forms of ulcers with redness and edema in the ileum. Histological findings suggested ischemic changes. Because mononeuritis multiplex and a fever spike appeared later, vasculitis was suspected. The perinuclear anti-neutrophil cytoplasmic antibody titer was elevated. Nerve biopsy results suggested vasculitis. From these findings, microscopic polyangiitis was diagnosed. It was suggested that microscopic polyangiitis caused the intestinal involvement. Intravenous pulse cyclophosphamide and oral predonisolone were started. After treatment, perinuclear anti-neutrophil cytoplasmic antibodies decreased to the normal range. Retrograde double-balloon endoscopy after treatment showed ulcer scars and no ulcer. CONCLUSION The cause of gastrointestinal involvement in microscopic polyangiitis is ischemia due to vasculitis. It is difficult to diagnose small-vessel vasculitis by endoscopic biopsy. Although histological evidence of microscopic polyangiitis is important, the treatment should not be delayed by repeating the biopsy, because such delay can result in adverse sequela.This case report shows that microscopic polyangiitis should be considered as a differential diagnosis when small intestinal changes like those in the present case are observed by endoscopy.
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Affiliation(s)
- Masashi Fukushima
- Department of Gastroenterology, Kobe City Medical Center General Hospital, 2-1-1 Minatojimaminamimachi, Chuo-ku, Kobe, Hyogo 650-0047, Japan.
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Matsumoto T, Wada M, Imai Y, Inokuma T. A rare cause of gastric outlet obstruction: gastritis cystica profunda accompanied by adenocarcinoma. Endoscopy 2012; 44 Suppl 2 UCTN:E138-9. [PMID: 22619037 DOI: 10.1055/s-0030-1256842] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- T Matsumoto
- Department of Gastroenterology, Kobe City Medical Center General Hospital, Kobe, Japan
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Matsumoto T, Ogawa S, Takashima K, Masuo K, Fukushima M, Wada M, Shimeno N, Inoue S, Tei H, Fujita M, Suginoshita Y, Okada A, Inokuma T. Clinical Analysis of Pericarditis Carcinomatosa in our Hospital. Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)32528-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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