检索结果-南通市图书馆

World Journal of Gastroenterology 2014年第10期20卷 2606-2612页

作者： Satoshi Yamagiwa hiroteru kamimura Masaaki Takamura Yutaka Aoyagi Division of Gastroenterology and Hepatology Niigata University Graduate School of Medical and Dental Sciences Niigata 951-8510 Japan

Primary biliary cirrhosis(PBC)is a chronic progressive cholestatic liver disease characterized by immunemediated destruction of the small-and medium-sized intrahepatic bile ducts and the presence of antimitochondrial antibodies(AMA)in the *** are detected in over 90%of patients with PBC,whereas their prevalence in the general population is extremely low,varying from 0.16%to 1%.Previous studies have shown that the unique characteristics of biliary epithelial cells undergoing apoptosis may result in a highly direct and very specific immune response to mitochondrial ***,recent studies have demonstrated that serum from AMA-positive PBC patients is reactive with a number of xenobiotic modified E2 subunits of the pyruvate dehydrogenase complex,which is not observed in the serum of normal *** findings indicate that chemicals originating from the environment may be associated with a breakdown in the tolerance to mitochondrial *** it is currently generally accepted that AMA are the most specific serological markers of PBC,more than 60 au-toantibodies have been investigated in patients with PBC,and some have previously been considered specific to other autoimmune *** review covers the recent progress in research on the pathogenetic and clinical significance of important autoantibodies in *** the pathogenic role of those autoantibodies in PBC remains a priority of basic and clinical research.

关键词： Primary biliary cirrhosis Autoantibodies Anti-mitochondrial antibodies Anticentromere antibodies Anti-gp210 antibodies

Considerations of elderly factors to manage the complication of liver cirrhosis in elderly patients

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastroenterology 2019年第15期25卷 1817-1827页

作者： Kenya kamimura Akira Sakamaki hiroteru kamimura Toru Setsu Takeshi Yokoo Masaaki Takamura Shuji Terai Division of Gastroenterology and Hepatology Graduate School of Medical and Dental Sciences Niigata University

The aging of the organ function causes sensitivity to the disease progression and need careful consideration for the medical treatment. With the increase of aging population, the opportunity to provide medical treatment for people in very old age is rapidly increasing therefore, the understanding of the various physiological changes of cellular function, size and function of organs are essential for the decision of therapeutic options. Among the various chronic conditions seen in elderly people, we have focused on liver cirrhosis, since despite specific therapeutic options for many of liver diseases including direct acting antivirals for hepatitis C virus, nucleoside analogs for hepatitis B, and corticosteroids for autoimmune hepatitis, there is currently no standard therapy to treat liver cirrhosis, which is the final stage of these liver diseases. Therefore,management of the various symptoms of liver cirrhosis is essential, and agingrelated parameters must be considered in the decision making for therapeutic strategies and dosage of the available medicine. In this mini-review, we have summarized the therapeutic options to manage various symptoms of liver cirrhosis, carefully considering the physiological changes of various organs associated with aging.

关键词： Liver cirrhosis Elderly patients Quality of life Aging

Diagnosis and management of fibromuscular dysplasia and segmental arterial mediolysis in gastroenterology field: A mini-review

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastroenterology 2018年第32期24卷 3637-3649页

作者： Masayoshi Ko Kenya kamimura Kohei Ogawa Kentaro Tominaga Akira Sakamaki hiroteru kamimura Satoshi Abe Kenichi Mizuno Shuji Terai Division of Gastroenterology and Hepatology Graduate School of Medical and Dental Sciences Niigata University

The vascular diseases including aneurysm, occlusion, and thromboses in the mesenteric lesions could cause severe symptoms and appropriate diagnosis and treatment are essential for managing patients. With the development and improvement of imaging modalities, diagnostic frequency of these vascular diseases in abdominal lesions is increasing even with the small changes in the vasculatures. Among various vascular diseases, fibromuscular dysplasia(FMD) and segmental arterial mediolysis(SAM) are noninflammatory, nonatherosclerotic arterial diseases which need to be diagnosed urgently because these diseases could affect various organs and be lethal if the appropriate management is not provided. However, because FMD and SAM are rare, the cause, prevalence, clinical characteristics including the symptoms, findings in the imaging studies, pathological findings, management, and prognoses have not been systematically summarized. Therefore, there have been neither standard diagnostic criteria nor therapeutic methodologies established, to date. To systematically summarize the information and to compare these disease entities, we have summarized the characteristics of FMD and SAM in the gastroenterological regions by reviewing the cases reported thus far. The information summarized will be helpful for physicians treating these patients in an emergency care unit and for the differential diagnosis of other diseases showing severe abdominal pain.

关键词： Fibromuscular dysplasia Segmental arterial mediolysis Mesenteric lesion diagnosis Humans

Improved survival for hepatocellular carcinoma with portal vein tumor thrombosis treated by intra-arterial chemotherapy combining etoposide,carboplatin,epirubicin and pharmacokinetic modulating chemotherapy by 5-FU and enteric-coated tegafur/uracil:A pilo

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastroenterology 2007年第41期13卷 5465-5470页

作者： Toru Ishikawa Michitaka Imai hiroteru kamimura Atsunori Tsuchiya Tadayuki Togashi Kouji Watanabe Kei-ichi Seki Hironobu Ohta Toshiaki Yoshida Tomoteru kamimura Department of Gastroenterology and Hepatology Saiseikai Niigata Second HospitalNiigata 950-1104Japan

AIM： To investigate the poor prognosis of HCC with PVTT, we evaluated the efficacy by a new combination chemotherapy for advanced hepatocellular carcinoma （HCC） with portal vein tumor thrombus （PVTT）. METHODS： From 2002 to 2007, a total of 10 consecutive patients with Stage IVA HCC accompanied by PVTT were studied prospectively to examine the efficacy of treatment by intra-arterial infusion of a chemotherapeutic agents consisting of etoposide, carboplatin, epirubicin and pharmacokinetic modulating chemotherapy by 5-FU and enteric-coated tegafur/uracil. RESULTS： The mean course of chemotherapy was 14.4 （range, 9-21） too. One patient showed complete response （CR） with disappearance of HCC and PVI-F after treatment, and the two patients showed partial response （PR）, response rate （CR ＋ PR/All cases 30%）. The median survival time after the therapy was 457.2 d. The one-year survival rate was 70%. Adverse reactions were tolerable.CONCLUSION： Although the prognosis of most patients with Stage IVA HCC by PVTT is poor, our combination chemotherapy may induces long-term survival and is an effective treatment and produced anti-tumor activity with tolerable adverse effects in patients for advanced Stage IVA HCC accompanied by PVTT.

关键词： Hepatocellular carcinoma Portal vein tumor thrombus Intra-arterial regional chemotherapy

Comparison of a new aspiration needle device and the Quick-Core biopsy needle for transjugular liver biopsy

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastroenterology 2006年第39期12卷 6339-6342页

作者： Toru Ishikawa hiroteru kamimura Atsunori Tsuchiya Tadayuki Togashi Kouji Watanabe Kei-ichi Seki Hironobu Ohta Toshiaki Yoshida Noriko Ishihara Tomoteru kamimura Deptartments of Gastroenterology Saiseikai Niigata Second Hospital Niigata Japan Deptartments of Pathology Saiseikai Niigata Second Hospital Niigata Japan

AIM: To evaluate sample adequacy, safety, and needle passes of a new biopsy needle device compared to the Quick-Core biopsy needle for transjugular liver biopsy in patients affected by liver disease. METHODS: Thirty consecutive liver-disease patients who had major coagulation abnormalities and/or relevant ascites underwent transjugular liver biopsy using either a new needle device (18 patients) or the Quick-Core biopsy needle (12 patients). The length of the specimens was measured before fixation. A pathologist reviewed the histological slides for sample adequacy and pathologic diagnoses. The two methods’ specimen adequacy and complication rates were assessed. RESULTS: Liver biopsies were technically successful in all 30 (100%) patients, with diagnostic histological core specimens obtained in 30 of 30 (100%) patients, for an overall success rate of 100%. With the new device, 18 specimens were obtained, with an average of 1.1 passes per patient. Using the Quick-Core biopsy needle, 12 specimens were obtained, with an average of 1.8 passes per patient. Specimen length was significantly longer with the new needle device than with the Quick- Core biopsy needle (P < 0.05). The biopsy tissue was not fragmented in any of the specimens with the new aspiration needle device, but tissue was fragmented in 3 of 12 (25.0%) specimens obtained using the Quick-Core biopsy needle. Complications included cardiac arrhythmia in 3 (10.0%) patients, and transient abdominal pain in 4 (13.3%) patients. There were no cases of subcapsular hematoma, hemoperitoneum, or sepsis, and there was no death secondary to the procedure. In particular, no early or delayed major procedure-related complications were observed in any ***: Transjugular liver biopsy is a safe and effective procedure, and there was significant difference in the adequacy of the specimens obtained using the new needle device compared to the Quick- Core biopsy needle. Using the new biopsy needle device, the specimens

关键词： Liver disease Biopsy-interventional procedures Transjugular biopsy

Successful treatment of multiple lung metastases of hepatocellular carcinoma by combined chemotherapy with docetaxel, cisplatin and tegafur/uracil

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastroenterology 2009年第14期15卷 1779-1781页

作者： Atsunori Tsuchiya Michitaka Imai hiroteru kamimura Tadayuki Togashi Kouji Watanabe Kei-ichi Seki Toru Ishikawa Hironobu Ohta Toshiaki Yoshida Tomoteru kamimura Department of Gastroenterology Saiseikai Niigata Second Hospital NishiKu Teraji 280-7 Niigata 950-1104 Japan Division of Gastroenterology and Hepatology Graduate School of Medical and Dental Science Niigata University 1-757 Asahimachi-dori Chuo-ku Niigata 951-8510 Japan

We report the successful treatment of multiple lung metastases after hepatic resection for hepatocellular carcinoma (HCC) with combined docetaxel, cisplatin (CDDP), and enteric-coated tegafur/uracil (UFT-E). A 68-year-old man was diagnosed with multiple lung metastases of HCC 7 mo after partial hepatectomy for HCC. Oral UFT-E was given daily and docetaxel and CDDP were given intra-arterially (administered just before the bronchial arteries) every 2 wk via a subcutaneous injection port. One month after starting chemotherapy, levels of tumor marker, protein induced by vitamin K absence(PIVKA--), decreased rapidly,and after a further month, chest X-ray and computed tomography revealed the complete disappearance of multiple liver metastases. Two years after the combined chemotherapy, HCC recurred in the liver and was treated but no pulmonary recurrence occurred. In the absence of a standardized highly effective therapy, this combined chemotherapy with docetaxel, CDDP and UFT-E may be an attractive option for multiple lung metastases of HCC.

关键词： Hepatocellular carcinoma Docetaxel Lungmetastasis Cisplatin

Angiotensin-Ⅱ administration is useful for the detection of liver metastasis from pancreatic cancer during pharmacoangiographic computed tomography

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastroenterology 2007年第22期13卷 3080-3083页

作者： Toru Ishikawa Takashi Ushiki hiroteru kamimura Tadayuki Togashi Atsunori Tsuchiya Kouji Watanabe Kei-ichi Seki Hironobu Ohta Toshiaki Yoshida Keiko Takeda Tomoteru kamimura Department of Gastroenterology and Hepatology Saiseikai Niigata Second Hospital Niigata Japan Department of Radiology Saiseikai Niigata Second Hospital Niigata Japan

AIM: To improve the preoperative diagnosis of liver metastasis from pancreatic cancer, we estimated computed tomography during arterial angiography (CTA) with/without administration of angiotensin-Ⅱ (AT-Ⅱ). METHODS: Thirty-fi ve patients with pancreatic cancer were examined in this study. After conventional CTA was performed, pharmacoangiographic CTA was performed with a 1-3 microgram/5 mL solution of angiotensin Ⅱ injected through a catheter into the celiac artery during spiral computed tomography. We prospectively analyzed the relative region of interest (ROI) ratio of tumor to liver with/without AT-Ⅱ. RESULTS: In all patients, the relative ratio of each computed tomography (CT) number in the ROI was larger at pharmacoangiographic CT than at conventional angiographic CT. Administration of angiotensin-Ⅱ enhanced the metastatic liver tumor as compared with normal tissue. Intratumoral blood flow increased in all patients with malignant tumors due to the pressure effect of AT-Ⅱ. Furthermore, the metastatic lesions in the liver of three patients were represented by only pharmacoangiographic CT, not by conventional CT and conventional CT angiography. In even peripheral and central areas of metastatic liver tumor, the lesions were enhanced after administration of AT-Ⅱ. CONCLUSION: These results support that high detection rate of liver metastasis revealed by pharmacoangiographic CT suggests the improvement of diagnosis on preoperative staging. Moreover, chemotherapy under AT-Ⅱ induced hypertension may have a better effect on the treatment of metastatic liver tumors.

关键词： Angiotensin Ⅱ Phamacoangiographic CT Pancreatic cancer

Rational arrangement of measuring shear wave speed in the liver

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastroenterology 2019年第20期25卷 2503-2513页

作者： Takeshi Yokoo Tsutomu Kanefuji Takeshi Suda Itsuo Nagayama Takahiro Hoshi Satoshi Abe Shinichi Morita hiroteru kamimura Kenya kamimura Atsunori Tsuchiya Masaaki Takamura Kazuyoshi Yagi Shuji Terai Department of Preemptive Medicine for Digestive Diseases and Healthy Active Life Niigata University School of MedicineNiigataNiigata 951-8122Japan Division of Gastroenterology and Hepatology Niigata Tokamachi HospitalTokamachiNiigata 948-0065Japan Department of Gastroenterology and Hepatology Uonuma Institute of Community MedicineNiigata University Medical and Dental HospitalMinami UonumaNiigata 949-7302Japan Division of Gastroenterology and Hepatology Graduate School of Medical and Dental SciencesNiigata UniversityNiigata 951-8122Japan

BACKGROUND Shear wave speed has been widely applied to quantify a degree of liver fibrosis. However, there is no standardized procedure, which makes it difficult to utilize the speed universally. AIM To provide procedural standardization of shear wave speed measurement. METHODS Point shear wave elastography (pSWE) was measured in 781 patients, and twodimensional shear wave elastography (2dSWE) was measured on the same day in 18 cases. Regions-of-interest were placed at 12 sites, and the median and robust coefficient-of-variation (CVR) were calculated. A residual sum-of-square (Σdi2) was computed for bootstrap values of 1000 iterations in 18 cases with each assumption of 1 to 12 measurements. The proportion of the Σdi2 (%Σdi2) was calculated as the ratio of Σdi2 to pSWE after converting it based on the correlation between pSWE and 2dSWE. RESULTS The CVR showed a significantly broader distribution in the left lobe (P < 0.0001),and the smallest CVR in the right anterior segment that covered 95% cases was 40.4%. pSWE was significantly higher in the left lobe than in the right lobe (1.63 ± 0.78 m/s vs 1.61 ± 0.78 m/s, P = 0.0004), and the difference between the lobes became further discrete when the subjects were limited to the cases with a CVR less than 40.4% in any segment (1.76 ± 0.80 m/s vs 1.70 ± 0.82 m/s, P < 0.0001). The highest values of the CVR in every 0.1 m/s interval were plotted in convex upward along pSWE and peaked at 1.93 m/s. pSWE and 2dSWE were significantly correlated (P < 0.0001, r = 0.95). In 216000 resamples from 18 cases, the %Σdi2 of 12 sites was 8.0% and gradually increased as the acquisition sites decreased to reach a significant difference with a %Σdi2 of 7 sites (P = 0.027). CONCLUSION These data suggest that shear wave speed should be measured at 8 or more sites of spreading in both lobes.

关键词： Liver stiffness Ultrasound Shear wave elastography Acoustic radiation force impulse Heterogeneity

Advances in understanding and treating liver diseases during pregnancy:A review

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastroenterology 2015年第17期21卷 5183-5190页

作者： Kenya kamimura Hiroyuki Abe Hirokazu Kawai hiroteru kamimura Yuji Kobayashi Minoru Nomoto Yutaka Aoyagi Shuji Terai Division of Gastroenterology and Hepatology Graduate School of Medical and Dental SciencesNiigata UniversityNiigata 951-8510Japan

Liver disease in pregnancy is rare but pregnancyrelated liver diseases may cause threat to fetal and maternal *** includes pre-eclampsia;eclampsia;haemolysis,elevated liver enzymes,and low platelets syndrome;acute fatty liver of pregnancy;hyperemesis gravidarum;and intrahepatic cholestasis of *** basic researches have shown the various etiologies involved in this disease *** these advances,rapid diagnosis is essential for severe cases since the decision of immediate delivery is important for maternal and fetal *** other therapeutic options have also been shown in recent reports based on the clinical trials and cooperation and information sharing between hepatologist and gynecologist is important for timely therapeutic ***,correct understandings of diseases and differential diagnosis from the pre-existing and co-incidental liver diseases during the pregnancy will help to achieve better ***,here we review and summarized recent advances in understanding the etiologies,clinical courses and management of liver disease in *** information will contribute to physicians for diagnosis of disease and optimum management of patients.

关键词： Pregnancy Liver injury Low platelets Haemolysis elevated liver enzymes Acute fatty liverof pregnancy Hyperemesis gravidarum Intrahepaticcholestasis of pregnancy

Factors predicting aggressiveness of non-hypervascular hepatic nodules detected on hepatobiliary phase of gadolinium ethoxybenzyl diethylene-triamine-pentaacetic-acid magnetic resonance imaging

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastroenterology 2015年第15期21卷 4583-4591页

作者： Tsutomu Kanefuji Toru Takano Takeshi Suda Kouhei Akazawa Takeshi Yokoo hiroteru kamimura Kenya kamimura Atsunori Tsuchiya Masaaki Takamura Hirokazu Kawai Satoshi Yamagiwa Hidefumi Aoyama Minoru Nomoto Shuji Terai Deparatment of Gastro-enterology and Hepatology Uonuma Institute of Community Medicine Niigata University Medical and Dental Hospital 4132 Urasa Minami--Uonuma Department of Radiation Oncology Graduate School of Medical and Dental Sciences Niigata University Niigata Department of Medical Informatics Graduate School of Medical and Dental Sciences Niigata University Niigata Department of Gastroenterology and Hepatology Graduate School of Medical and Dental Sciences Niigata University Niigata

AIM: To establish a prognostic formula that distinguishes non-hypervascular hepatic nodules(NHNs) with higher aggressiveness from less hazardous one. METHODS: Seventy-three NHNs were detected in gadolinium ethoxybenzyl diethylene-triamine-pentaaceticacid magnetic resonance imaging(Gd-EOB-DTPA-MRI) study and confirmed to change 2 mm or more in size and/or to gain hypervascularity. All images were interpreted independently by an experienced, board-certified abdominal radiologist and hepatologist; both knew thatthe patients were at risk for hepatocellular carcinoma development but were blinded to the clinical information. A formula predicting NHN destiny was developed using a generalized estimating equation model with thirteen explanatory variables: age, gender, background liver diseases, Child-Pugh class, NHN diameter, T1-weighted imaging/T2-weighted imaging detectability, fat deposition, lower signal intensity in arterial phase, lower signal intensity in equilibrium phase, α-fetoprotein, des-γ-carboxy prothrombin, α-fetoprotein-L3, and coexistence of classical hepatocellular carcinoma. The accuracy of the formula was validated in bootstrap samples that were created by resampling of 1000 iterations. RESULTS: During a median follow-up period of 504 d, 73 NHNs with a median diameter of 9 mm(interquartile range: 8-12 mm) grew or shrank by 68.5%(fifty nodules) or 20.5%(fifteen nodules), respectively, whereas hypervascularity developed in 38.4%(twenty eight nodules). In the fifteen shrank nodules, twelve nodules disappeared, while 11.0%(eight nodules) were stable in size but acquired vascularity. A generalized estimating equation analysis selected five explanatories from the thirteen variables as significant factors to predict NHN progression. The estimated regression coefficients were 0.36 for age, 6.51 for lower signal intensity in arterial phase, 8.70 or 6.03 for positivity of hepatitis B virus or hepatitis C virus, 9.37 for des-γ-carboxy prothrombin, and-4.05 for fat d

关键词： Hepatocellular carcinoma Magnetic resonanceimaging Ethoxybenzyl moiety Non-hypervascular hepaticnodule Fate prediction