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Effectiveness of antibiotic prophylaxis for acute esophageal variceal bleeding in patients with band ligation: A large observational study

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World Journal of Gastroenterology 2024年第3期30卷 238-251页

作者： Chikamasa Ichita Sayuri Shimizu Tadahiro Goto uojima haruki Naoya Itoh Masao Iwagami Akiko Sasaki Gastroenterology Medicine Center Shonan Kamakura General HospitalKamakura 247-8533KanagawaJapan Department of Health Data Science Yokohama City UniversityYokohama 236-0027KanagawaJapan TXP Research TXP Medical Co.Ltd.Chiyoda-ku 101-0042TokyoJapan Department of Clinical Epidemiology and Health Economics School of Public HealthThe University of TokyoBunkyo-ku 113-0033TokyoJapan Department of Genome Medical Sciences Project Research InstituteNational Center for Global Health and MedicineIchikawa 272-8516ChibaJapan Division of Infectious Diseases Aichi Cancer CenterNagoya 464-8681AichiJapan Department of Health Services Research Institute of MedicineUniversity of TsukubaTsukuba 305-8575IbarakiJapan

BACKGROUND Esophageal variceal bleeding is a severe complication associated with liver cirrhosis and typically necessitates endoscopic *** current standard treatment is endoscopic variceal ligation(EVL),and Western guidelines recom-mend antibiotic prophylaxis following ***,given the impro-vements in prognosis for variceal bleeding due to advancements in the management of bleeding and treatments of liver cirrhosis and the global concerns regarding the emergence of multidrug-resistant bacteria,there is a need to reassess the use of routine antibiotic prophylaxis after *** To evaluate the effectiveness of antibiotic prophylaxis in patients treated for *** We conducted a 13-year observational study using the Tokushukai medical database across 46 *** were divided into the prophylaxis group(received antibiotics on admission or the next day)and the non-prophylaxis group(did not receive antibiotics within one day of admission).The primary outcome was composed of 6-wk mortality,4-wk rebleeding,and 4-wk spontaneous bacterial peritonitis(SBP).The secondary outcomes were each individual result and in-hospital mortality.A logistic regression with inverse probability of treatment weighting was used.A subgroup analysis was conducted based on the Child-Pugh classification to determine its influence on the primary outcome measures,while sensitivity analyses for antibiotic type and duration were also *** Among 980 patients,790 were included(prophylaxis:232,non-prophylaxis:558).Most patients were males under the age of 65 years with a median Child-Pugh score of *** composite primary outcomes occurred in 11.2%of patients in the prophylaxis group and 9.5%in the non-prophylaxis *** significant differences in outcomes were observed between the groups(adjusted odds ratio,1.11;95%confidence interval,0.61-1.99;P=0.74).Individual outcomes such as 6-wk mortality,4-wk rebleeding,4-wk onset of SBP,and in-hospital mo

关键词： Esophageal varices Endoscopic hemostasis Antibiotic prophylaxis Liver cirrhosis Inverse probability of treatment weighting

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Hepatocellular carcinoma effective stereotactic body radiotherapy using Gold Anchor and the Synchrony system:Two case reports and review of literature

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World Journal of Clinical Cases 2022年第8期10卷 2591-2603页

作者： Sakue Masuda Toshitaka Tsukiyama Yumiko Minagawa Kazuya Koizumi Makoto Kako Takeshi Kinbara uojima haruki Department of Gastroenterology Shonankamakura General HospitalKanagawa 247-8533Japan Department of Interventional Radiology Center Shonan Kamakura General HospitalKanagawa 247-8533Japan Department of Radiation Oncology Shonan Kamakura General HospitalKanagawa 247-8533Japan

BACKGROUND Radiotherapy for hepatocellular carcinoma(HCC)is considered to have limited efficacy because of treatment intensity considering that the irradiated area includes the liver,which is highly *** this report,we present two cases in which tumor control by surgical resection,radiofrequency ablation,transcatheter arterial chemoembolization(TACE),and lenvatinib administration was difficult,but stereotactic body radiotherapy(SBRT)using the Synchrony system by Radixact?and Gold Anchor?(GA)was *** SUMMARY A 60-year-old man had a single 10-cm HCC in the right *** lesions remained after TACE,and levels of alpha-fetoprotein and protein induced by vitamin K antagonists II(PIVKA-II)decreased and quickly *** performed SBRT with *** weeks after implantation,localized radiotherapy(SBRT;40 Gy/5 fractions)was performed using the Synchrony system by Radixact?.Four weeks later,the viable lesion had disappeared,and the PIVKA-II levels decreased.A 77-year-old man had a single 12-cm HCC in the right *** patient experienced recurrence after *** recurrence occurred after TACE,and we performed SBRT with *** of the proximity of the HCC to the gastrointestinal tract,localized radiotherapy(SBRT;39 Gy/13 fractions)to the HCC was performed 3 wk after implantation using the Synchrony system by Radixact?.Four weeks later,the viable lesion had disappeared on computed tomography,and the PIVKA-Ⅱlevels *** SBRT using the Synchrony system and GA can deliver a large dose accurately and safely,and could have a high therapeutic effect.

关键词： Fiducial marker Hepatocellular carcinoma Gold Anchor■ Radixact■ Stereotactic body radiotherapy Case report

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Efficacy of combination therapy with natriuretic and aquaretic drugs in cirrhotic ascites patients: A randomized study

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World Journal of Gastroenterology 2017年第45期23卷 8062-8072页

作者： haruki uojima Hisashi Hidaka Tsuyoshi Nakayama Ji Hyun Sung Chikamasa Ichita Shinnosuke Tokoro Sakue Masuda Akiko Sasaki Kazuya Koizumi Hideto Egashira Makoto Kako Department of Gastroenterology Shonan Kamakura General Hospital Department of Gastroenterology Internal MedicineKitasato University School of Medicine Department of Gastroenterology Shonan Atsugi Hospital

AIM To assess the effects of a combination therapy with natriuretic and aquaretic drugs in cirrhotic ascites *** A two-center,randomized,open-label,prospective study was conducted. Japanese patients who met the criteria were randomized to trial group and the combination diuretic group(received 7.5 mg of tolvaptan) or the conventional diuretic group(received 40 mg of furosemide) for 7 d in addition to the natriuretic drug which was used prior to enrolment in this study. The primary endpoint was the change in body weight from the baseline. Vital signs,fluid intake,and laboratory and urinary data were assessed to determine the pharmacological effects after administration of aquaretic and natriuretic *** A total of 56 patients were randomized to receive either tolvaptan(n = 28) or furosemide(n = 28). In the combination and conventional diuretic groups,the average decrease in body weight from the baseline was 3.21 ± 3.17 kg(P < 0.0001) and 1.75 ± 2.36 kg(P = 0.0006),respectively,when measured on the final dosing day. Following 1 wk of treatment,a significantly greater reduction in body weight was observed in the combination diuretic group compared to that in the conventional diuretic group(P = 0.0412).CONCLUSION Compared to a conventional diuretic therapy with only a natriuretic drug,a combination diuretic therapy with natriuretic and aquaretic drugs is more effective for patients with cirrhotic ascites.

关键词： Tolvaptan Liver cirrhosis Diuretic effect Ascites Hepatic edema

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Condyloma acuminatum of the anal canal,treated with endoscopic submucosal dissection

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World Journal of Gastroenterology 2016年第8期22卷 2636-2641页

作者： Akiko Sasaki Takeshi Nakajima Hideto Egashira Kotaro Takeda Shinnosuke Tokoro Chikamasa Ichita Sakue Masuda haruki uojima Kazuya Koizumi Takeshi Kinbara Taku Sakamoto Yutaka Saito Makoto Kako Gastroenterology Medicine Center Shonan Kamakura General Hospital 1370-1 Okamoto Kamakura Endoscopy Division National Cancer Center Hospital5-1-1 Tsukiji Chuoku Diagnostic Pathology Shonan Kamakura General Hospital 1370-1 Okamoto Kamakura

Condyloma acuminatum(CA) is a common sexually transmitted disease caused by human papilloma virus infection. Not all individuals develop persistent, progressive disease, but careful follow up is required with moderate-to-severe dysplasia to prevent progression to malignancy. Standard therapies include surgical treatments(trans-anal resection and transanal endoscopic microsurgery) and immunotherapeutic and topical methods(topical imiquimod); however, local recurrence remains a considerable problem. Here, we report a case with superficial CA of the anal canal, treated with endoscopic submucosal dissection(ESD). A 28-year-old man presented with a chief complaint of hematochezia. Digital exam did not detect a tumor. Screening colonoscopy revealed 10-mm long, whitish condyles extending from the anal canal to the lower rectum. The lesion covered almost the whole circumference, and only a small amount of normal mucosa remained. Magnifying endoscopy with narrow band imaging showed brownish hairpin-shaped, coiled capillaries. Although histopathological diagnosis by biopsy revealed CA, accurate histological differentiation between CA, papilloma, and squamous cell carcinoma can be difficult with a small specimen. Therefore, weperformed diagnostic ESD, which provides a complete specimen for precise histopathological evaluation. The pathological diagnosis was CA, with moderate dysplasia(anal intraepithelial neoplasia 2). There was no recurrence at 16 mo after the initial ESD. Compared to surgical treatment, endoscopic diagnosis and resection could be performed simultaneously and the tumor margin observed clearly with a magnifying chromocolonoscopy, resulting in less recurrence. These findings suggest that endoscopic resection may be an alternative method for CA that prevents recurrence.

关键词： Condylomata acuminate Recurrence Endoscopy Dissection Carcinoma in situ

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Comprehensive review on small common bile duct stones

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World Journal of Gastroenterology 2023年第13期29卷 1955-1968页

作者： Sakue Masuda Kazuya Koizumi Kento Shionoya Ryuhei Jinushi Makomo Makazu Takashi Nishino Karen Kimura Chihiro Sumida Jun Kubota Chikamasa Ichita Akiko Sasaki Masahiro Kobayashi Makoto Kako uojima haruki Department of Gastroenterology Shonan Kamakura General HospitalKanagawa 247-8533Japan Department of Gastroenterology Kitasato University School of MedicineKanagawa 252-0375Japan

Common bile duct stones are among the most common conditions encountered by ***,it is well researched;however,some items,such as indications for endoscopic papillary balloon dilatation(EPBD),safety of EPBD and endoscopic sphincterotomy in patients receiving dual antiplatelet therapy or direct oral anticoagulant,selection strategy for retrieval balloons and baskets,lack adequate ***,the guidelines have been updated with new research,while others remain unchanged due to weak *** this review,we comprehensively summarize the standard methods in guidelines and new findings from recent studies on papillary dilation,stone retrieval devices,difficult-to-treat cases,troubleshooting during the procedure,and complicated cases of cholangitis,cholecystolithiasis,or distal biliary stricture.

关键词： Choledocholithotomy Choledocholithiasis Common bile duct stones Endoscopic papillary balloon dilation Endoscopic sphincterotomy Small common bile duct stones

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Comprehensive review on endoscopic ultrasound-guided tissue acquisition techniques for solid pancreatic tumor

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World Journal of Gastroenterology 2023年第12期29卷 1863-1874页

作者： Sakue Masuda Kazuya Koizumi Kento Shionoya Ryuhei Jinushi Makomo Makazu Takashi Nishino Karen Kimura Chihiro Sumida Jun Kubota Chikamasa Ichita Akiko Sasaki Masahiro Kobayashi Makoto Kako uojima haruki Department of Gastroenterology Shonan Kamakura General HospitalKanagawa 247-8533Japan Department of Gastroenterology Internal MedicineKitasato University School of MedicineKanagawa 252-0375Japan

Pancreatic ductal adenocarcinoma is speculated to become the second leading cause of cancer-related mortality by 2030,a high mortality rate considering the number of *** and chemotherapy are the main treatment options,but they are burdensome for patients.A clear histological diagnosis is needed to determine a treatment plan,and endoscopic ultrasound(EUS)-guided tissue acquisition(TA)is a suitable technique that does not worsen the cancer-specific prognosis even for lesions at risk of needle tract *** the development of personalized medicine and precision treatment,there has been an increasing demand to increase cell counts and collect specimens while preserving tissue structure,leading to the development of the fine-needle biopsy(FNB)***-FNB is rapidly replacing EUS-guided fine-needle aspiration(FNA)as the procedure of choice for EUS-TA of pancreatic ***,EUS-FNA is sometimes necessary where the FNB needle cannot penetrate small hard lesions,so it is important clinicians are familiar with *** these recent developments,we present an up-to-date review of the role of EUS-TA in pancreatic ***,technical aspects,such as needle caliber,negative pressure,and puncture methods,for obtaining an adequate specimen in EUS-TA are discussed.

关键词： Endoscopic ultrasound-guided fine needle biopsy Endoscopic ultrasoundguided tissue acquisition Personalized medicine Genomic profiling test Pancreatic cancer Puncture procedure

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Relationship between response to lusutrombopag and splenic volume

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World Journal of Gastroenterology 2018年第46期24卷 5271-5279页

作者： haruki uojima Yoshitaka Arase Norio Itokawa Masanori Atsukawa Takashi Satoh Koji Miyazaki Hisashi Hidaka Ji Hyun Sung Makoto Kako Kota Tsuruya Tatehiro Kagawa Katsuhiko Iwakiri Ryouichi Horie Wasaburo Koizumi Department of Gastroenterology Shonan Kamakura General Hospital Department of Gastroenterology Internal MedicineKitasato University School of Medicine Division of Gastroenterology and Hepatology Department of Internal MedicineTokai University School of Medicine Department of Internal Medicine Division of GastroenterologyNippon Medical School Chiba Hokusoh Hospital Department of Internal Medicine Division of Gastroenterology and HepatologyNippon Medical School Division of Hematology Department of Medical Laboratory SciencesKitasato University School of Allied Health Sciences Division of Molecular Hematology Kitasato University Graduate School of Medical Sciences Department of Transfusion and Cell Transplantation Kitasato University School of Medicine

AIM To assess the correlation between the efficacy of lusutrom-bopag and clinical characteristics in patients with chronic liver *** In this retrospective, multicenter study, which conducted at four locations in Japan, 50 thrombocytopenic patients with chronic liver disease were enrolled. All patients received oral lusutrombopag(3.0 mg/d for 7 d) for chronic liver disease. We assessed the increase in platelet count after the trial drug administration. A treatment response was defined as a platelet count ≥ 5 × 104/μL and an increased platelet count ≥ 2 × 104/μL from baseline after drug administration. We evaluated the response to lusutrombopag compared to baseline clinical characteristics in patients with chronic liver *** The numbers of responders and non-responders were 40(80.0%) and 10(20.0%), respectively. The patients were divided into a responder and non-responder group, and we added factors that may correspond to successful treatment with lusutrombopag. Splenic volume and body weight were lower in the responder group than in the nonresponder group. White blood cell count and hemoglobin level were higher in responders compared with nonresponders. Using a logistic regression model to assess the relationship between response to lusutrombopag and clinical characteristics, multivariate analysis confirmed that splenic volume was an independent factor that predicted the response of platelet counts(P = 0.025; odds ratio = 11.2; 95% confidence interval: 1.354-103.0). Splenic volume negatively correlated to changes in platelet count(r =-0.524, P = 0.001).CONCLUSION Splenic volume influences the change in platelet counts after administration of lusutrombopag in patients with chronic liver disease.

关键词： Lusutrombopag Portal hypertension Splenic volume Thrombocytopenia Thrombopoietin receptor agonist

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Usefulness of autotaxin for the complications of liver cirrhosis

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World Journal of Gastroenterology 2020年第1期26卷 97-108页

作者： Xue Shao haruki uojima Toru Setsu Tomomi Okubo Masanori Atsukawa Yoshihiro Furuichi Yoshitaka Arase Hisashi Hidaka Yoshiaki Tanaka Takahide Nakazawa Makoto Kako Tatehiro Kagawa Katsuhiko Iwakiri Shuji Terai Wasaburo Koizumi Department of Gastroenterology Internal MedicineKitasato University School of MedicineSagamiharaKanagawa 252-0375Japan Department of Hepatopancreatobiliary Medic Department of Gastroenterology Shonan Kamakura General HospitalKamakuraKanagawa 247-8533Japan Division of Gastroenterology and Hepatology Graduate School of Medical and Dental SciencesNiigata UniversityNiigata 951-8510Japan Department of Internal Medicine Division of GastroenterologyNippon Medical School Chiba Hokusoh HospitalChiba 270-1694Japan Department of Internal Medicine Division of Gastroenterology and HepatologyNippon Medical SchoolTokyo 113-8603Japan Department of Gastroenterology and Hepatology Tokyo Medical University HospitalShinjukuTokyo 113-8510Japan Division of Gastroenterology and Hepatology Department of Internal MedicineTokai University School of MedicineKanagawa 259-1193Japan

BACKGROUND Autotaxin(ATX)has been reported as a direct biomarker for estimating the evaluation of liver *** available data on ATX as a useful biomarker for the complications of liver cirrhosis(LC)are *** To assess the clinical usefulness of ATX for assessing the complications of *** This multicenter,retrospective study was conducted at six locations in *** include patients with LC,n=*** ATX level was evaluated separately in men and women because of its high level in female *** assess the clinical usefulness of ATX for the complications of LC,the area under the curve(AUC)of ATX assessing for the severe complications was analyzed in comparison with the model for end-stage liver disease score,albumin-bilirubin(ALBI)score,fibrosis-4 index,and aspartate aminotransferase-to-platelet ratio *** The mean age was 68.4±11.4 years,240 patients(60.0%)were male.A total of 213(53.3%)and 187(46.8%)patients were compensated and decompensated,*** numbers of patients with varix rupture,hepatic ascites,and hepatic encephalopathy were 35(8.8%),131(32.8%),and 103(25.8%),*** AUCs of ATX in men for hepatic encephalopathy,hepatic ascites,and varix ruptures were 0.853,0.816,and 0.706,*** AUCs of ATX in women for hepatic encephalopathy,hepatic ascites,and varix rupture were 0.759,0.717,and 0.697,*** AUCs of ATX in men were higher than those in women,as were all the other biomarkers used to detect encephalopathy and varix ***,for detecting ascites,the AUC of ALBI in men was more effective than using *** ATX in men was more effective than any other biomarkers for detecting hepatic encephalopathy and varix ruptures.

关键词： Autotaxin Hepatic encephalopathy Hepatic ascites Liver fibrosis Biomarker

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Hepatitis B virus: Where do we stand and what is the next step for eradication?

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World Journal of Gastroenterology 2014年第27期20卷 8998-9016页

作者： haruki Komatsu Department of Pediatrics Toho University Sakura Medical Center

Hepatitis B(HB) virus(HBV) infection, which causes liver cirrhosis and hepatocellular carcinoma, is endemic worldwide. Hepatitis B vaccines became commercially available in the 1980 s. The World Health Organization recommended the integration of the HB vaccine into the national immunisation programs in all countries. HBV prevention strategies are classified into three groups:(1) universal vaccination alone;(2) universal vaccination with screening of pregnant women plus HB immune globulin(HBIG) at birth; and(3) selective vaccination with screening of pregnant women plus HBIG at birth. Most low-income countries have adopted universal vaccine programs without screening of pregnant women. However, HB vaccines are not widely used in low-income countries. The Global Alliance for Vaccine and Immunization was launched in 2000, and by 2012, the global coverage of a three-dose HB vaccine had increased to 79%. The next challenges are to further increase the coverage rate, close the gap between recommendations and routine practices, approach highrisk individuals, screen and treat chronically infected individuals, and prevent breakthrough infections. To eradicate HBV infections, strenuous efforts are required to overcome socioeconomic barriers to the HB vaccine; this task is expected to take several decades to complete.

关键词： Cancer Global Alliance for Vaccine and Immunization Hepatitis B immune globulin Hepatitis B virus Hepatocellular carcinoma Selective vaccination Universal vaccination World Health Organization

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Effect of mechanical treatment on the powder properties of zinc phosphate white pigments

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Journal of Advanced Ceramics 2015年第4期4卷 312-317页

作者： Hiroaki ONODA Miho haruki Department of Informatics and Environmental Sciences Kyoto Prefectural University1-5Shimogamo Nakaragi-cyoSakyo-kuKyoto 606-8522Japan

Zinc oxide,which has photocatalytic activity,is used as a white pigment for cosmetics,resulting in a certain amount of sebum on the skin to be decomposed by the ultraviolet radiation in the *** this work,zinc phosphates as novel white pigments for use in cosmetics were prepared from zinc nitrate and sodium dihydrogen phosphate,and then ball-milled under various *** chemical composition,powder properties,photocatalytic activity,color phase,moisture retention,and smoothness of the zinc phosphates were *** zinc phosphate particle size was decreased by mechanical *** particular,the sample treated with sodium lactate solution had much smaller *** milled zinc phosphates exhibited less photocatalytic activity than zinc oxide,and thus should not decompose sebum on the *** milled zinc phosphates showed sufficiently high reflectance within the range of visible light to act as novel white *** sample treated with sodium lactate solution had higher water retention than the sample treated with ***,the slip resistance and roughness of the powder particles decreased as a result of treatment with sodium lactate solution.

关键词： white pigment zinc phosphate mechanical treatment photocatalytic activity water retention

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