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Propensity score matching analysis for clinical impact of braided-type versus laser-cut-type covered self-expandable metal stents for endoscopic ultrasound-guided hepaticogastrostomy

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Hepatobiliary & Pancreatic Diseases International 2024年第2期23卷 181-185页

作者： Mitsuki Tomita Takeshi ogura Akitoshi Hakoda Saori Ueno atsushi Okuda Nobu Nishioka Yoshitaro Yamamoto Hiroki Nishikawa 2nd Department of Internal Medicine Osaka Medical and Pharmaceutical UniversityOsakaJapan Endoscopy Center Osaka Medical and Pharmaceutical UniversityOsakaJapan

Background:To prevent stent migration during endoscopic ultrasound-guided hepaticogastrostomy(EUS-HGS),intra-scope channel release technique is important,but is unfamiliar to non-expert hands.The self-expandable metal stent(SEMS)is an additional factor to prevent stent migration.However,no compara-tive studies of laser-cut-type and braided-type during EUS-HGS have been reported.The aim of this study was to compare the distance between the intrahepatic bile duct and stomach wall after EUS-HGS among laser-cut-type and braided-type SEMS.Methods:To evaluate stent anchoring function,we measured the distance between the hepatic parenchyma and stomach wall before EUS-HGS,one day after EUS-HGS,and 7 days after EUS-HGS.Also,propensity score matching was performed to create a propensity score for using laser-cut-type group and braided-type group.Results:A total of 142 patients were enrolled in this study.Among them,24 patients underwent EUS-HGS using a laser-cut-type SEMS,and 118 patients underwent EUS-HGS using a braided-type SEMS.EUS-HGS using the laser-cut-type SEMS was mainly performed by non-expert endoscopists(n=21);EUS-HGS using braided-type SEMS was mainly performed by expert endoscopists(n=98).The distance after 1 day was significantly shorter in the laser-cut-type group than that in the braided-type group[2.00(1.70-3.75)vs.6.90(3.72-11.70)mm,P<0.001].In addition,this distance remained significantly shorter in the laser-cut-type group after 7 days.Although these results were similar after propensity score matching analysis,the distance between hepatic parenchyma and stomach after 7 days was increased by 4 mm compared with the distance after 1 day in the braided-type group.On the other hand,in the laser-cut-type group,the distance after 1 day and 7 days was almost the same.Conclusions:EUS-HGS using a laser-cut-type SEMS may be safe to prevent stent migration,even in non-expert hands.

关键词： Endoscopic ultrasound-guided hepaticogastrostomy Endoscopic ultrasound-guided biliary drainage Endoscopic retrograde cholangiopancreatography

Endoscopic hemostasis using self-expandable metal stent combinedwith PuraStat® for patient with high risk of post-endoscopicsphincterotomy bleeding (with video)

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Hepatobiliary & Pancreatic Diseases International 2024年第1期23卷 94-96页

作者： Takeshi ogura Yuki Uba Masahiro Yamamura Nobu Nishioka Hiroki Nishikawa 2nd Department of Internal Medicine Osaka Medical and Pharmaceutical UniversityOsakaJapan

To the Editor:Endoscopic sphincterotomy(EST)is an established technique for removal of bile duct stones and self-expandable metal stent(SEMS)deployment.However,bleeding can be considered an adverse event after EST,particularly for patients with high risk of bleeding such as those on hemodialysis.Among the various techniques reported for obtaining endoscopic hemostasis[1-3].

关键词： bleeding stasis endoscopic

Inverse relationship between platelet Akt activity and hippocampal atrophy:A pilot case-control study in patients with diabetes mellitus

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World Journal of Clinical Cases 2024年第2期12卷 302-313页

作者： Haruhiko Tokuda Takamitsu Hori Daisuke Mizutani Tomoyuki Hioki Kumi Kojima Takashi Onuma Yukiko Enomoto Tomoaki Doi Rie Matsushima-Nishiwaki Shinji ogura Hiroki Iida Toru Iwama Takashi Sakurai Osamu Kozawa Department of Metabolic Research Research InstituteNational Center for Geriatrics and GerontologyObu 474-8511Japan Department of Clinical Laboratory National Center for Geriatrics and GerontologyObu 474-8511Japan Department of Pharmacology Gifu University Graduate School of MedicineGifu 501-1194Japan Department of Neurosurgery Gifu University Graduate School of MedicineGifu 501-1194Japan Department of Dermatology Central Japan International Medical CenterMinokamo 505-8510Japan Department of Anesthesiology and Pain Medicine Gifu University Graduate School of MedicineGifu 501-1194Japan Department of Emergency Medicine Faculty of MedicineUniversity of ToyamaToyama 930-0194Japan Department of Emergency and Disaster Medicine Gifu University Graduate School of MedicineGifu 501-1194Japan Research Institute National Center for Geriatrics and GerontologyObu 474-8511Japan

BACKGROUND Akt plays diverse roles in humans.It is involved in the pathogenesis of type 2 diabetes mellitus(T2DM),which is caused by insulin resistance.Akt also plays a vital role in human platelet activation.Furthermore,the hippocampus is closely associated with memory and learning,and a decrease in hippocampal volume is reportedly associated with an insulin-resistant phenotype in T2DM patients without dementia.AIM To investigate the relationship between Akt phosphorylation in unstimulated platelets and the hippocampal volume in T2DM patients.METHODS Platelet-rich plasma(PRP)was prepared from the venous blood of patients with T2DM or age-matched controls.The pellet lysate of the centrifuged PRP was subjected to western blotting to analyse the phosphorylation of Akt,p38 mitogen-activated protein(MAP)kinase and glyceraldehyde 3-phosphate dehydrogenase(GAPDH).Phosphorylation levels were quantified by densitometric analysis.Hippocampal volume was analysed using a voxel-based specific regional analysis system for Alzheimer’s disease on magnetic resonance imaging,which proposes the Z-score as a parameter that reflects hippocampal volume.RESULTS The levels of phosphorylated Akt corrected with phosphorylated p38 MAP kinase were inversely correlated with the Z-scores in the T2DM subjects,whereas the levels of phosphorylated Akt corrected with GAPDH were not.However,this relationship was not observed in the control patients.CONCLUSION These results suggest that an inverse relationship may exist between platelet Akt activation and hippocampal atrophy in T2DM patients.Our findings provide insight into the molecular mechanisms underlying T2DM hippocampal atrophy.

关键词： Akt Platelet Hippocampal atrophy Magnetic resonance imaging Diabetes mellitus

Hemobilia due to hepatocellular carcinoma： cholangioscopicfindings and novel endoscopic hemostasis

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Hepatobiliary & Pancreatic Diseases International 2018年第3期17卷 275-277页

作者： takeshi ogura atsushi okuda kazuhide higuchi second department of internal medicine osaka medical college2-7 DaigakuchouTakatsukishiOsaka 569-8686Japan

To the Editor：Trauma, inflammation, iatrogenic procedures such as liverbiopsy and percutaneous transhepatic biliary drainage （PTBD）, vascularanomalies, coagulopathy status, and malignancy can causehemobilia [1]. Malignant causes of hemobilia include cholangiocarcinoma,pancreatic cancer, gallbladder tumor, and liver metastasis,but rarely hepatocellular carcinoma （HCC）. Here, we describeachieving endoscopic hemostasis for hemobilia caused by HCC,which was visualized using the single-operator, SPY-DS cholangioscope（Boston Scientific, Tokyo, Japan） under endoscopic retrogradecholangiopancreatography （ERCP） guidance. This scope is a dramaticimprovement over the SpyGlass system in that it is easier to insert into the biliary tract due to a tapered tip, a 120° digitalfield-of-view provides favorable visualization, and new injection and suction functions have been added via a two-port adaptor.

关键词： COVERED METALLIC STENT

Novel re-intervention device for occluded multiple uncovered self-expandable metal stent(with video)

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Hepatobiliary & Pancreatic Diseases International 2023年第4期22卷 434-436页

作者： Takeshi ogura Yuki Uba Mitsuki Tomita Kimi Bessho Hiroki Nishikawa 2nd Department of Internal Medicine Osaka Medical and Pharmaceutical University2-7 DaigakuchouTakatsukishiOsaka 569-8686Japan

To the Editor:Obstructive jaundice due to unresectable malignant hilar obstruction can be treated by deployment of bilateral uncovered self-expandable metal stents(UCSEMSs),which enable longer stent patency to be obtained compared with multiple plastic stents[1-3].However,re-intervention is needed if obstructive jaundice occurs after bilateral UCSEMS deployment.During re-intervention procedures,insertion of the stent delivery system across the mesh of a UCSEMS and into the bile duct can be challenging.A novel drill dilator has recently become available in Japan(Tornus ES;Asahi Intecc,Nagoya,Japan)(Fig.1)[4].The tract is easily dilated using a clockwise rotation.We herein describe a successful re-intervention using this device for a patient with occluded bilateral UCSEMSs.

关键词： stent struction Asahi

Importance of an appropriate number of examined lymph nodes in patients with pancreatic cancer-the more the better?

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Hepatobiliary Surgery and Nutrition 2022年第4期11卷 605-607页

作者： Toshiro ogura Hiroyuki Ishida Amane Takahashi Yoshiyuki Kawashima Department of Gastroenterological Surgery Saitama Cancer CenterSaitamaJapan

Pancreatic cancer is a highly aggressive malignant cancer with a 5-year survival rate of approximately 10%.The outcome of patients diagnosed with resectable pancreatic cancer as per the National Comprehensive Cancer Network(NCCN)classification and those who underwent resection was not satisfactory.Similar to other abdominal malignant tumors,the stages of pancreatic cancer are defined by local extension,lymph node metastasis,and distant metastasis.The presence or absence of lymph node metastasis is diagnosed by pathological examination of the retrieved lymph,the quality of the diagnosis based on lymph node(N)staging depends on the surgical and pathological aspects(1).

关键词： lymph metastasis patients

Relativistic Velocity Addition on a Space-Time Diagram

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World Journal of Mechanics 2022年第4期12卷 51-56页

作者： Akihiro ogura Laboratory of Physics Nihon University Matsudo Japan

We derive the addition of velocities in special relativity from the Minkowski’s space-time diagram. We only need to draw some world lines on the diagram, measure the lengths and divide the two lengths for obtaining the velocity. We also give the theoretical background for this method. This method is so simple that it is worth for undergraduate students to acquire the addition of velocities in special relativity.

关键词： Velocity Addition Special Relativity Space-Time Diagram

Siltation and radiocesium pollution of small lakes in different catchment types far from the Fukushima Daiichi nuclear power plant accident site

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International Soil and Water Conservation Research 2020年第1期8卷 56-65页

作者： Mikhail Komissarov Shin-ichiro ogura Ufa Institute of Biology Russian Academy of SciencesPr.Oktyabrya 69Ufa450054Russia Graduate School of Agricultural Science Tohoku University232-3 YomogitaNaruko-onsenOsaki989-6711Japan

The Fukushima Daiichi nuclear power plant accident caused radioactive pollution in northeastern Honshu Island,Japan.This study examined the influence of snowmelt and rainfall on soil erosion pro-cesses and siltation of small lakes in Miyagi Prefecture(150 km northwest of the power plant).Two sets of slopes and lakes,respectively in pasture and forest catchments,were examined.Snowpack thickness,soil infiltration,surface runoff volume,soil and sediment physicochemical properties,Cs concentration of precipitation,meltwater,and rainwater,and lake siltation rates were determined.The total radioactive Cs content in precipitation was 0.7-7.4 Bq·L^-1 and was below the Japanese standard(10 Bq·L^-1).Total radioactive Cs was at the allowable level in water flowing down the pasture catchment slope(0.1-9.2 Bq·L^-1)during snowmelt and rainfall,as well as in pasture(0.9-8.8 Bq·L^-1)and forest(0.7-5.2 Bq·L^-1)catchment lake water.There was no soil erosion(surface runoff)in the forest catchment.Soil losses in the pasture catchment were 23 due to rainfall and 9 kg ha^-1 yr^-1 following spring snowmelt.After snow-melt,a 0.5 and 0.2 mm thick layer of silt was deposited in pasture and forest catchment lakes,respec-tively,and 1.4 and 0.6 mm were deposited during the rainfall period.Average siltation rates were 1.9 and 0.8 mm·yr^-1 for pasture and forest catchment lakes,respectively.The upper layer of lake bottom sedi-ments is represented mainly by silt fractions(2-50μm),with high organic matter(4.0-5.7%)and radiocesium(1100-1600 kg·ha^-1)contents.

关键词： Fukushima Daiichi Radiocesium Siltation Suspended sediment Waterbodies Water turbidity

Stimulatory effect on the transport mediated by organic anion transporting polypeptide 2B1

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Asian Journal of Pharmaceutical Sciences 2020年第2期15卷 181-191页

作者： Jiro ogura Hiroaki Yamaguchi Nariyasu Mano Tohoku University Hospital Department of Pharmaceutical SciencesMiyagi 980-8574Japan

Drug-drug interaction(DDI)is one of causes of adverse drug events and can result in lifethreatening consequences.Organic anion-transporting polypeptide(OATP)2B1 is a major uptake transporter in the intestine and contributes to transport various clinically used therapeutic agents.The intestine has a high risk of DDI,because it has a special propensity to be exposed to a high concentration of drugs.Thus,understanding drug interaction mediated by OATP2B1 in the absorption process is important for the prevention of adverse drug events,including decrease in the therapeutic effect of co-administered drugs.Acute drug interaction occurs through the direct inhibitory effect on transporters,including OATP2B1.Moreover,some compounds such as clinically used drugs and food components have an acute stimulatory effect on transport of co-administered drugs by OATP2B1.This review summarizes the acute stimulatory effect on the transport mediated by OATP2B1 and discusses the mechanisms of the acute stimulatory effects of compounds.There are two types of acute stimulatory effects,substrate-independent and-dependent interactions on OATP2B1 function.The facilitating translocation of OATP2B1 to the plasma membrane is one of causes for the substrate-independent acute stimulatory effect.On the contrary,the substrate-dependent effect is based on the direct binding to the substrate-binding site or allosteric progesterone-binding site of OATP2B1.

关键词： OATP2B1 Drug interaction Stimulatory effect Membrane translocation Conformational change