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Radiologic-pathologic correlation of three-dimensional shear-wave elastographic findings in assessing the liver ablation volume after radiofrequency ablation

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World Journal of Gastroenterology 2014年第33期20卷 11850-11855页

作者： Katsutoshi Sugimoto Hisashi Oshiro Saori Ogawa Mitsuyoshi Honjo Takeshi Hara fuminori moriyasu Department of Gastroenterology and Hepatology Tokyo Medical University Tokyo 160-0023 Japan Department of Pathology Tokyo Medical University Tokyo 160-0023 Japan Department of Intelligent Image Information Gifu University Graduate School of Medicine Gifu 501-1193 Japan

AIM: To evaluate the usefulness of three-dimensional (3D) shear-wave elastography (SWE) in assessing the liver ablation volume after radiofrequency (RF) ablation.

关键词： Radiofrequency ablation Liver Ultrasound Shear-wave elastography Three-dimensional

Decreased accumulation of ultrasound contrast in the liver of nonalcoholic steatohepatitis rat model

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World Journal of Gastroenterology 2011年第37期17卷 4191-4198页

作者： Yuki Miyata Takeo Miyahara fuminori moriyasu Department of Gastroenterology and Hepatology Tokyo Medical University

AIM:To investigate the diagnosis of nonalcoholic steatohepatitis(NASH) using contrast ultrasonography in the NASH rat ***:The liver in methionine choline-deficient diet(MCDD) rats,a NASH model constructed by feeding an MCDD,was examined by contrast ultrasonography at weeks 2,4,8,12 and 16,with late phase images of contrast ultrasonography(Kupffer imaging) in which contrast enhancement was achieved by incorporation of a contrast agent by Kupffer cells(KCs),and images were compared to those in rats taking a regular ***:Decrease in contrast enhancement was observed first in MCDD rats at week *** were counted based on immunohistochemistry,but their numbers were not reduced and it was assumed that attenuation of contrast enhancement was attributable to reduced phagocytic activity of the ***:It is suggested that clinical application of contrast ultrasonography may be valuable for noninvasive diagnosis of NASH.

关键词： Nonalcoholic steatohepatitis Leptin Kupffer cell Methionine choline-deficient diet Contrast ultrasound

Can endoscopic atrophy predict histological atrophy? Historical study in United Kingdom and Japan

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World Journal of Gastroenterology 2015年第46期21卷 13113-13123页

作者： Shin Kono Takuji Gotoda Shigeaki Yoshida Ichiro Oda Hitoshi Kondo Luigi Gatta Greg Naylor Michael Dixon fuminori moriyasu Anthony Axon Department of Gastroenterology and Hepatology Tokyo Medical University Aomori Prefectural Central Hospital Endoscopy Division National Cancer Center Hospital Center for Digestive Diseases Tonan Hospital Gastroenterology and Digestive Endoscopy Unit Versilia Hospital Chesterfield Royal Hospital Academic Unit of Pathology University of Leeds Centre for Digestive Disease Leeds General Infirmary

AIM: To assess the diagnostic concordance between endoscopic and histological atrophy in the United Kingdom and ***: Using published data,a total of 252 patients,126 in the United Kingdom and 126 in Japan,aged 20 to 80 years,were evaluated. The extent of endoscopic atrophy was classified into five subgroups according to a modified Kimura-Takemoto classification system and was compared with histological findings of atrophy at five biopsy sites according to the updated Sydney ***: The strength of agreement of the extent of atrophy between histology and visual endoscopic inspection showed good reproducibili ty,wi th a weighted kappa value of 0.76(P < 0.001). Multivariate analysis showed that three factors were associated with decreased concordance: Japanese ethnicity [odds ratio(OR) 0.22,95% confidence interval(CI) 0.11-0.43],older age(OR = 0.32,95%CI: 0.16-0.66) and endoscopic atrophy(OR = 0.10,95%CI: 0.03-0.36). The strength of agreement between endoscopic and histological atrophy,assessed by cancer risk-oriented grading,was reproducible,with a kappa value of 0.81(95%CI: 0.75-0.87). Only nine patients(3.6%) were endoscopically underdiagnosed with antral predominant rather than extensive atrophy and were considered false ***: Endoscopic grading can predict histological atrophy with few false negatives,indicating that precancerous conditions can be identified during screening endoscopy,particularly in patients in western countries.

关键词： Gastritis Atrophy Histology Endoscopy Diagnosis

Arterial-phase contrast-enhanced ultrasonography for evaluating anti-angiogenesis treatment: A pilot study

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World Journal of Gastroenterology 2011年第8期17卷 1045-1050页

作者： Keiko Yoshida Tomihiko Hirokawa fuminori moriyasu Masahiko Yamada Yasuharu Imai Department of Gastroenterology and Hepatology Tokyo Medical University

AIM:To verify whether arterial-phase contrast-enhanced ultrasonography(CEUS) of tumor parenchymal tissue is useful for evaluation of anti-angiogenesis ***:Rabbits with liver tumor were subjected to CEUS,and images of the nodular maximal diameter in vascular phase were *** analysis was performed to plot the time intensity curve(TIC) at the tumor parenchyma,which set the diameter of the region of interest of intensity *** TIC was calculated to obtain the time to peak intensity(TPI) and the magnitude of *** were randomly assigned to a treatment group with sorafenib and a control *** weeks later,the same ultrasound examination was repeated followed by pathological testing to assess the effect of sorafenib on the liver ***:In four rabbits in the treatment group,the rate of change of tumor size was decreased comparedwith that of the control(the rate 2.3 vs 7.9,P = 0.02).The TPI of the treatment group elongated significantly(the rate 3.1 vs 1.1,P = 0.07 for SonoVue,2.0 vs 0.88,P = 0.09 for Sonazoid).The magnitude of PI showed no significant *** pathological examination,capillary diameters in the treatment group were significantly smaller than those in the control group(26.4 vs 42.8 μm,P = 0.013).CONCLUSION:Analysis of the TIC in the arterial phase of tumor tissue could evaluate the efficacy of antiangiogenesis drug treatment in liver tumor.

关键词： Liver tumor Ultrasound agent Contrast-enhanced ultrasonography Sorafenib Animal model

Computer-aided diagnosis for contrast-enhanced ultrasound in the liver

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World Journal of Radiology 2010年第6期2卷 215-223页

作者： Katsutoshi Sugimoto Junji Shiraishi fuminori moriyasu Kunio Doi Kurt RossmannLaboratories for Radiologic Imaging Research Department of RadiologyThe University of ChicagoChicagoIL 60637United States Department of Gastroenterology and Hepatology Tokyo Medical UniversityTokyo 160-0023Japan School of Health Sciences Kumamoto UniversityKumamoto 862-0976Japan

Computer-aided diagnosis(CAD) has become one of the major research subjects in medical imaging and diagnostic *** basic concept of CAD is to provide computer output as a second opinion to assist radiologists' image interpretations by improving the accuracy and consistency of radiologic diagnosis and also by reducing the image-reading *** date,research on CAD in ultrasound(US)-based diagnosis has been carried out mostly for breast lesions and has been limited in the fields of gastroenterology and hepatology,with most studies being conducted using B-mode US *** CAD schemes with contrast-enhanced US(CEUS) that are used in classifying focal liver lesions(FLLs) as liver metastasis,hemangioma,or three histologically differentiated types of hepatocellular carcinoma(HCC) are introduced in this article:one is based on physicians' subjective pattern classifications(subjective analysis) and the other is a computerized scheme for classification of FLLs(quantitative analysis).Classification accuracies for FLLs for each CAD scheme were 84.8% and 88.5% for metastasis,93.3% and 93.8% for hemangioma,and 98.6% and 86.9% for all HCCs,*** addition,the classification accuracies for histologic differentiation of HCCs were 65.2% and 79.2% for well-differentiated HCCs,41.7% and 50.0% for moderately differentiated HCCs,and 80.0% and 77.8% for poorly differentiated HCCs,*** are a number of issues concerning the clinical application of CAD for CEUS,however,it is likely that CAD for CEUS of the liver will make great progress in the future.

关键词： Computer-aided diagnosis Focal liver lesion Ultrasonography Contrast agent Micro-flow imaging

Depletion of CD25^+CD4^+T cells (Tregs) enhances the HBV-specific CD8^+ T cell response primed by DNA immunization

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World Journal of Gastroenterology 2005年第24期11卷 3772-3777页

作者： Yoshihiro Furuichi Hirotake Tokuyama Satoshi Ueha Makoto Kurachi fuminori moriyasu Kazuhiro Kakimi Fourth Department of Internal Medicine (Gastroenterology and Hepatology) Department of Molecular and Preventive Medicine Department of Immunotherapeutics (Medinet)

AIM: Persistent hepatitis B virus (HBV) infection is characterized by a weak CD8+ T cell response to HBV. Immunotherapeutic strategies that overcome tolerance and boost these suboptimal responses may facilitate viral clearance in chronically infected individuals. Therefore, we examined whether CD25+CD4+ regulatory T (Treg) cells might be involved in a inhibition of CD8+T cell priming or in the modulation of the magnitude of the 'peak' antiviral CD8+ T cell response primed by DNA immunization. METHODS: B10.D2 mice were immunized once with plasmid pCMV-S. Mice received 500 μg of anti-CD25 mAb injected intraperitoneally 3 d before DNA immunization to deplete CD25+ cells. Induction of HBV-specific CD8+ T cells in peripheral blood mononuclear cells (PBMCs) was measured by S28-39 peptide loaded DimerX staining and their function was analyzed by intracellular IFN-γ staining. RESULTS: DNA immunization induced HBV-specific CD8+ T cells. At the peak T cell response (d 10), 7.1±2.0% of CD8+ T cells were HBV-specific after DNA immunization, whereas 12.7±3.2% of CD8+ T cells were HBV-specific in Treg-depleted mice, suggesting that DNA immunization induced more antigen-specific CD8+ T cells in the absence of CD25+ Treg cells (n = 6, P<0.05). Similarly, fewer HBV specific memory T cells were detected in the presence of these cells (1.3±0.4%) in comparison to Treg-depleted mice (2.6±0.9%) on d 30 after DNA immunization (n - 6, P<0.01). Both IFN-γ production and the avidity of the HBV-specific CD8+ T cell response to antigen were higher in HBV-specific CD8+ T cells induced in the absence of Treg cells. CONCLUSION: CD25+ Treg cells suppress priming and/or expansion of antigen-specific CD8+ T cells during DNA immunization and the peak CD8+ T cell response is enhanced by depleting this cell population. Furthermore, Treg cells appear to be involved in the contraction phase of the CD8+ T cell response and may affect the quality of memory T cell pools. The elimination of Treg cells or the

关键词： Hepatitis B virus Regulatory T cell (Treg) Cytotoxic T lymphocyte DNA immunization Vaccine

Effectiveness of narrow-band imaging magnification for invasion depth in early colorectal cancer

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World Journal of Gastroenterology 2010年第14期16卷 1727-1734页

作者： Masakatsu Fukuzawa Yutaka Saito Takahisa Matsuda Toshio Uraoka Takao Itoi fuminori moriyasu Division of Endoscopy National Cancer Center Hospital Tokyo 1040045 Japan Division of Gastroenterology and Hepatology Tokyo Medical University Tokyo 1600023 Japan Department of Endoscopy Okayama University Hospital Okayama 7008558 Japan Microvasculature

AIM: To evaluate the surface microvascular patterns of early colorectal cancer (ECC) using narrow-band imaging (NBI) with magnification and its effectiveness for invasion depth diagnosis. METHODS: We studied 112 ECC lesions [mucosal/ submucosal superficial (m/sm-s), 69; sm-deep (sm-d), 43] ≥ 10 mm that subsequently underwent endoscopic or surgical treatment at our hospital. We compared microvascular architecture revealed by NBI with magnification to histological findings and then to magnifi- cation colonoscopy pit pattern diagnosis. RESULTS: Univariate analysis indicated vessel density: non-dense (P < 0.0001); vessel regularity: negative (P < 0.0001); caliber regularity: negative (P < 0.0001); vessel length: short (P < 0.0001); and vessel meandering: positive (P = 0.002) occurred significantly more often with sm-d invasion than m/sm-s invasion. Multivariate analysis showed sm-d invasion was independently associated with vessel density: non-dense[odds ratio (OR) = 402.5, 95% confidence interval (CI): 12.4-13 133.1] and vessel regularity: negative (OR = 15.9, 95% CI: 1.2-219.1). Both of these findings when combined were an indicator of sm-d invasion with sensitivity, specificity and accuracy of 81.4%, 100% and 92.9%, respectively. Pit pattern diagnosis sensitivity, specificity and accuracy, meanwhile, were 86.0%, 98.6% and 93.8%, respectively, thus, the NBI with magnification findings of non-dense vessel density and negative vessel regularity when combined together were comparable to pit pattern diagnosis. CONCLUSION: Non-dense vessel density and/or negative vessel regularity observed by NBI with magnification could be indicators of ECC sm-d invasion.

关键词： Colorectal neoplasms Narrow-band imaging Microvasculature

Risk factors for bleeding after endoscopic submucosal dissection of colorectal neoplasms

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World Journal of Gastroenterology 2014年第7期20卷 1839-1845页

作者： Sho Suzuki Akiko Chino Teruhito Kishihara Naoyuki Uragami Yoshiro Tamegai Takanori Suganuma Junko Fujisaki Masaaki Matsuura Takao Itoi Takuji Gotoda Masahiro Igarashi fuminori moriyasu Department of Gastroenterology Cancer Institute HospitalJapanese Foundation for Cancer ResearchTokyo 135-8550Japan fuminori moriyasu Department of Gastroenterology and HepatologyTokyo Medical UniversityTokyo 160-0023Japan Bioinformatics Group Genome Centerand Division of Cancer GenomicsCancer InstituteJapanese Foundation for Cancer ResearchTokyo 135-8550Japan

AIM: To investigate the risk factors for delayed bleeding following endoscopic submucosal dissection (ESD) treatment for colorectal neoplasms.

关键词： Adverse event Bleeding Colorectal neoplasms Endoscopic submucosal dissection Hemorrhage

Endoscopic resection of carcinoid of the minor duodenalpapilla

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World Journal of Gastroenterology 2007年第27期13卷 3763-3764页

作者： Takao Itoi Atsushi Sofuni Fumihide Itokawa Takayoshi Tsuchiya Toshio Kurihara fuminori moriyasu Department of Gastroenterology and Hepatology Tokyo Medical University Tokyo Japan

We encountered a 65-year-old man with a carcinoid tumor of the minor duodenal papilla. Since he had liver cirrhosis and completely refused surgery, we performed an endoscopic snare papillectomy. The papillectomy was performed successfully without procedure-related complication. The specimens revealed a carcinoid tumor showing that the margin of the tumor was positive. One week later, upper GI endoscopy was performed and the biopsy specimens obtained from base of ulcer showed no neoplastic cells. We performed a duodenoscopy and CT 3, 6 and 18 mo later, and there was no macroscopic or microscopic evidence of tumor recurrence after more than 4 years.

关键词： Endoscopic papillectomy Carcinoid tumor Minor duodenal papilla Papilla of Vater tumor Duodenal papilla