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Fatal liver failure caused by reactivation of lamivudine-resistant hepatitis B virus:A case report

World Journal of Gastroenterology 2007年第6期13卷 964-969页

作者： Yuka Suzuki Hiroshi Yotsuyanagi Chiaki Okuse Yoshihiko Nagase Hideaki Takahashi Kyoji Moriya Michihiro Suzuki kazuhiko Koike Shiro Iino Fumio Itoh Division of Gastroenterology and Hepatology Department of Internal Medicine St. Marianna University School of Medicine 2-16-1 Sugao Miyamae-ku Kawasaki 216-8511 Japan Division of Infectious Diseases Department of Internal Medicine University of Tokyo 7-3-1 Hongo Bunkyo-ku Tokyo 113-0033 Japan Center for Liver Diseases Seizankai Kiyokawa Hospital 2-31-12 Asagayaminami Suginami Tokyo 166-0004 Japan

We present a case of fetal liver failure caused by the activation of larnivudine-resistant hepatitis B virus （HBV） nine months after lamivudine treatment. A 57-year old man visited our hospital for the treatment of decornpensated chronic hepatitis B. Lamivudine was started in December 2001. Subsequently, serum HBV was negative for HBV DNA with seroconversion from HBeAg to anti-HBe and improvement of liver function. However, HBV DNA and HBeAg were again detected in September 2002. He was complicated by breakthrough hepatitis and admitted to our hospital in November for severely impaired liver function. Vidarabine treatment was started and serum HBV DNA and alanine aminotransferase （ALT） decreased transiently. However, after the start of m-interferon treatment, HBV DNA level increased and liver function deteriorated. He died 1 mo after admission. An analysis of amino acid sequences in the polymerase region revealed that rtM204I/V with rtLSOI/V occurred at the time of viral breakthrough. After the start of antiviral treatment, rtL180M was detected in addition to rtM204I/V and rtLSOI/V, and became predominant in the terminal stage of the disease. HBV clone with a high replication capacity may be produced by antiviral treatment leading to the worsening of liver function. Antiviral therapy for patients with breakthrough hepatitis in advanced liver disease should be carefully performed.

关键词： Hepatitis B virus Lamivudine Polymerase Interferon Tyrosine-methionine-aspartate-aspartate

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Comparison of the Sampling Efficiency in Spatial Autoregressive Model

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Open Journal of Statistics 2015年第1期5卷 10-20页

作者： Yoshihiro Ohtsuka kazuhiko Kakamu Department of Economics University of Nagasaki Nagasaki Japan Faculty of Law Politics and Economics Chiba University Chiba Japan

A random walk Metropolis-Hastings algorithm has been widely used in sampling the parameter of spatial interaction in spatial autoregressive model from a Bayesian point of view. In addition, as an alternative approach, the griddy Gibbs sampler is proposed by [1] and utilized by [2]. This paper proposes an acceptance-rejection Metropolis-Hastings algorithm as a third approach, and compares these three algorithms through Monte Carlo experiments. The experimental results show that the griddy Gibbs sampler is the most efficient algorithm among the algorithms whether the number of observations is small or not in terms of the computation time and the inefficiency factors. Moreover, it seems to work well when the size of grid is 100.

关键词： Acceptance-Rejection Metropolis-Hastings Algorithm Griddy Gibbs Sampler Markov Chain Monte Carlo (MCMC) Random Walk Metropolis-Hastings Algorithm Spatial Autoregressive Model

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Inflammation and de-differentiation in pancreatic carcinogenesis

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World Journal of Clinical Cases 2018年第15期6卷 882-891页

作者： Takahiro Seimiya Motoyuki Otsuka Takuma Iwata Eri Tanaka Tatsunori Suzuki Kazuma Sekiba Mari Yamagami Rei Ishibashi kazuhiko Koike Department of Gastroenterology Graduate School of Medicine The University of Tokyo

Pancreatic cancer is a malignancy with an extremely poor prognosis. Chronic pancreatitis is a well-known risk factor for pancreatic cancer. Inflammation is thought to influence carcinogenesis through DNA damage and activation of intracellular signaling pathways. Many transcription factors and signaling pathways co-operate to determine and maintain cell identity at each phase of pancreatic organogenesis and cell differentiation. Recent studies have shown that carcinogenesis is promoted through the suppression of transcription factors related to differentiation. Pancreatitis also demonstrates transcriptional changes, suggesting that multifactorial epigenetic changes lead to impaired differentiation. Taken together, these factors may constitute an important framework for pancreatic carcinogenesis. In this review, we discuss the role of inflammation and de-differentiation in the development of pancreatic cancer, as well as the future of novel therapeutic applications.

关键词： Pancreatitis Inflammation Organogenesis Differentiation Transcription factor Pancreatic cancer

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Fibrinogen degradation product levels on arrival for trauma patients requiring a transfusion even without head injury

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World Journal of Emergency Medicine 2017年第2期8卷 106-109页

作者： Youichi Yanagawa Kouhci Ishikawa Kci Jitsuiki Toshihiko Yoshizawa Yasumasa Oodc kazuhiko Omori Hiromichi Ohsaka Department of Acute Critical Care Medicine Shizuoka HospitalJuntendo UniversityNagaoka Izunokuni City ShizuokaJapan

BACKGROUND: There have been few reports on the clinical significance of the fibrinogen degradation product(FDP) level in trauma patients with and without head injury. We retrospectively analyzed trauma patients with or without head injury to investigate the clinical signifi cance of the FDP ***: From April 2013 to June 2015, a medical chart review was retrospectively performed for all patients with trauma. The exclusion criteria included patients who did not receive a transfusion. The patients were divided into two groups: a FDP>100 group, which included patients who had an FDP level on arrival over 100 ng/m L, and a FDP≤100 ***: The ratio of open fractures and the prothrombin ratio in the FDP>100 group were significantly smaller than those observed in the FDP≤100 group. The average age, ratio of blunt injury, Injury Severity Score(ISS), volume of transfusion and mortality ratio in the FDP>100 group were signifi cantly greater than those in the FDP≤100 group. There was a weakly positive correlation between the FDP level and ISS(R=0.35, P=0.002), but it was not associated with the transfusion volume. The results of an analysis excluding patients with head injury showed a similar ***: The FDP levels may be a useful biochemical parameter for the initial evaluation of the severity of trauma and mortality even in blunt traumatized patients without head injury or with stable vital signs.

关键词： Fibrinogen degradation product Injury Severity Score Transfusion Mortality

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Kidney GATA3^(+) regulatory T cells play roles in the convalescence stage after antibody-mediated renal injury

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Cellular & Molecular Immunology 2021年第5期18卷 1249-1261页

作者： Ryota Sakai Minako Ito Kyoko Komai Mana Iizuka-Koga kazuhiko Matsuo Takashi Nakayama Osamu Yoshie Koichi Amano Hiroshi Nishimasu Osamu Nureki Masato Kubo Akihiko Yoshimura Department of Microbiology and Immunology Keio University School of Medicine35 ShinanomachiShinjuku-kuTokyo160-8582Japan Department of Rheumatology and Clinical Immunology Saitama Medical CenterSaitama Medical University1981 KamodaKawagoe350-8550Japan Medical Institute of Bioregulation Kyushu University 3-1-1 MaidashiHigashi-kuFukuoka812-8582Japan Division of Chemotherapy Kindai University Faculty of PharmacyHigashi-Osaka577-8502Japan The Health and Kampo Institute SendaiMiyagi981-3205Japan Department of Biological Science Graduate School of ScienceThe University of Tokyo7-3-1 HongoBunkyo-kuTokyo113-0033Japan Center for Animal Disease Models Research Institute for Biomedical ScienceTokyo University of Science2669 YamazakiNoda-shiChiba278-0022Japan

FoxP3^(+)regulatory T cells(Tregs)play crucial roles in peripheral immune *** addition,Tregs that reside or accumulate in nonlymphoid tissues,called tissue Tregs,exhibit tissue-specific functions and contribute to the maintenance of tissue homeostasis and *** an experimental mouse model of crescentic glomerulonephritis induced by an anti-glomerular basement membrane antibody,Tregs started to accumulate in the kidney on day 10 of disease onset and remained at high levels(~30–35%of CD4^(+)T cells)during the late stage(days 21–90),which correlated with stable disease *** depletion on day 21 resulted in the relapse of renal dysfunction and an increase in Th1 cells,suggesting that Tregs are essential for disease control during the convalescence *** Tregs that accumulated in the kidney showed tissue Treg phenotypes,including high expression of GATA3,ST2(the IL33 receptor subunit),amphiregulin(Areg),and PPARγ.Although T-bet^(+) Tregs and RORγt^(+) Tregs were observed in the kidney,GATA3^(+) Tregs were predominant during the convalescence stage,and a PPARγagonist enhanced the accumulation of GATA3^(+) Tregs in the *** understand the function of specific genes in kidney Tregs,we developed a novel T cell transfer system to T cell-deficient *** experiment demonstrates that ST2,Areg,and CCR4 in Tregs play important roles in the accumulation of GATA3^(+) Tregs in the kidney and in the amelioration of renal *** data suggest that GATA3 is important for the recruitment of Tregs into the kidney,which is necessary for convalescence after renal tissue destruction.

关键词： Tissue Tregs autoantibody GATA3 kidney IL-33

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Neonatal cholestasis can be the first symptom of McCune–Albright syndrome:A case report

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World Journal of Clinical Pediatrics 2021年第2期10卷 7-14页

作者： Yoshinori Satomura kazuhiko Bessho Taichi Kitaoka Shinji Takeyari Yasuhisa Ohata Takuo Kubota KeiichiOzono Department of Pediatrics Osaka University Graduate School of MedicineOsaka 565-0871Japan

BACKGROUND McCune–Albright syndrome(MAS)is caused by postzygotic somatic mutations of the GNAS *** is characterized by the clinical triad of fibrous dysplasia,caféau-lait skin spots,and endocrinological *** complications in MAS,including hepatobiliary manifestations,are also *** SUMMARY This is a case of a 4-year-old boy who presented with MAS with neonatal *** was suspected to have Alagille syndrome due to neonatal cholestasis with intrahepatic bile duct paucity in liver biopsy,peripheral pulmonary artery stenosis,and renal tubular *** the age of 2 years,his cholestatic liver injury gradually improved,but he had repeated left femoral *** did not exhibit endocrinological abnormality or café-au-lait skin ***,MAS was suspected due to fibrous dysplasia at the age of 4 *** mutation was identified in the GNAS gene in the DNA isolated from the peripheral blood,but an activating point mutation(c.601C>T,***201Cys)was observed in the DNA extracted from the affected bone tissue and that extracted from the formalin-fixed paraffin-embedded liver tissue,which was obtained at the age of 1 *** MAS should be considered as a differential diagnosis for transient cholestasis in infancy.

关键词： McCune–Albright syndrome GNAS Neonatal cholestasis Alagille syndrome Bile duct paucity Case report

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Duplication cyst of the small intestine found by double-balloon endoscopy:A case report

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World Journal of Gastroenterology 2008年第24期14卷 3924-3926页

作者： Haruei Ogino Toshiaki Ochiai Norimoto Nakamura Daisuke Yoshimura Teppei Kabemura Tetsuya Kusumoto Hiroshi Matsuura Akihiko Nakashima Kuniomi Honda kazuhiko Nakamura Department of Internal Medicine Saiseikai Fukuoka General Hospital Department of Surgery Saiseikai Fukuoka General Hospital Department of Pathology Saiseikai Fukuoka General Hospital Department of Medicine and Bioregulatory Science Graduate School of Medical SciencesKyushu University

A 35-year-old man was admitted due to bloody stool and anemia. The bleeding source could not be detected by esophagogastroduodenoscopy or colonoscopy. Double balloon endoscopy (DBE) revealed a diverticulum-like hole in which coagula stuck in the ileum at 1 meter on the oral side from the ileocecal valve. The adjacent mucosa just to the oral side of the hole was elevated like a submucosal tumor. The lesion was considered the source of bleeding and removed surgically. It was determined to be a cyst with an ileal structure on the mesenteric aspect accompanying gastric mucosa. The diagnosis was a duplication cyst of the ileum,which is a rare entity that can cause gastrointestinal bleeding. In the present case,DBE was used to fi nd the hemorrhagic duplication cyst in the ileum.

关键词： Duplication cyst Double-balloonendoscopy Small intestine bleeding

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Anchor-wire technique for multiple plastic biliary stents to prevent stent dislocation

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World Journal of Gastroenterology 2011年第28期17卷 3366-3368页

作者： Tsuyoshi Hamada Yousuke Nakai Saburo Matsubara Hiroyuki Isayama Akiko Narita Kazuhiro Watanabe Yukihiro Koike Shigeo Matsukawa Tateo Kawase kazuhiko Koike Department of Gastroenterology Kanto Central Hospital Department of Gastroenterology Graduate School of MedicineThe University of Tokyo

In endoscopic placement of multiple plastic biliary stents (PBSs),we sometimes experience proximal dislocation of the first PBS at the time of subsequent PBS *** describe the case of a 79-year-old male with obstructive jaundice caused by cholangiocarcinoma who needed to receive multiple PBS placements for management of *** proximal dislocation of the first PBS was observed,we prevented the dislocation via our technique of using guidewire inserted from the distal end of the first PBS to the side hole as the *** could complete this technique only by inserting guidewire through the side hole of the first PBS during the process of releasing the first PBS and pulling out the guidewire and the inner *** did not matter whether the anchor-wire went towards the third portion of the duodenum or the duodenal *** we introduce this "anchor-wire technique",which is useful for the prevention of PBS proximal dislocation in placing multiple PBSs.

关键词： Plastic biliary stent Anchor-wire technique Proximal dislocation Prevention Endoscopic retrograde cholangiography

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Clearance of hepatitis C virus after living-donor liver transplantation in spite of residual viremia on end date of interferon therapy before transplantation

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World Journal of Gastroenterology 2007年第30期13卷 4149-4151页

作者： Tatsuki Ichikawa kazuhiko Nakao Keisuke Hamasaki Takuya Honda Hidetaka Shibata Mana Akahoshi Susumu Eguchi Mitsuhisa Takatsuki Takashi Kanematsu Katsumi Eguchi The First Department of Internal Medicine Graduate School of Biomedical Science Nagasaki University Nagasaki 852-8501 Japan Department of Transplantation and Digestive Surgery Graduate School of Biomedical Science Nagasaki University Nagasaki 852-8501 Japan

Interferon （IFN） therapy is the only treatment strategy for hepatitis C virus （HCV） infection after liver transplantation （LT）, but prophylactic and treatable IFN therapy after LT has been shown to be insufficient due to the adverse effects of IFN and rivabirin. In this paper, we describe the disappearance of HCV after LT without IFN therapy in the presence of residual viremia on the day of LT. We herein report our findings since this is considered an important case for the anti-HCV strategy of post LT. A 60-year old woman with LC and HCC was referred to Nagasaki University Hospital in August 2004. After she underwent LT on February 18, 2005, we injected peg- IFN-α-2a the 11th time at 18 wk and HCV-RNA was still positive in the serum at LT. The serum HCV-RNA was negative one month after operation and subsequently dissolved 15 mo after operation without IFN therapy. As a result, we speculate that if HCV-RNA is positive while HCV core antigen is negative before LT, then it may lead to dearance of HCV after LT. Therefore long acting peg-IFN- α-2a is thus considered a potentially effective agent for the treatment of HCV-related cirrhosis before LT.

关键词： Pegylated interferon Liver transplantation Hepatitis C virus

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Lansoprazole ameliorates intestinal mucosal damage induced by ischemia-reperfusion in rats

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World Journal of Gastroenterology 2004年第19期10卷 2814-2817页

作者： Hiroshi Ichikawa Norimasa Yoshida Tomohisa Takagi Naoya Tomatsuri Kazuhiro Katada Yutaka Isozaki kazuhiko Uchiyama Yuji Naito Takeshi Okanoue Toshikazu Yoshikawa Department of Food Sciences and Nutritional Health Faculty of Human EnvironmentKyoto Prefectural University606-8522Japan Department of Molecular Gastroenterology and Hepatology Graduate School of Medical SciencesKyoto Prefectural University of Medicine606-8522Japan Department of Inflammation and Immunology Graduate School of Medical SciencesKyoto Prefectural University of Medicine606-8522Japan

AIM: To investigate the protective effect of lansoprazoleon ischemia and reperfusion (I/R)-induced rat intestinalmucosal injury in ***: Intestinal damage was induced by clampingboth the superior mesenteric artery and the celiac trunkfor 30 rain followed by reperfusion in male Sprague-Dawleyrats. lansoprazole was given to rats intraperitoneally 1 hbefore vascular ***: Both the intraluminal hemoglobin and proteinlevels, as indices of mucosal damage, significantlyincreased in I/R-groups comparion with those of sham-operation groups. These increases in intraluminal hemoglobinand protein levels were significantly inhibited by the treatmentwith lansoprazole at a dose of 1 mg/kg. Small intestineexposed to I/R resulted in mucosal inflammation that wascharacterized by significant increases in thiobarbituric acid-reactive substances (TBARS), tissue-associatedmyeloperoxidase activity (MPO), and mucosal content of ratcytokine-induced neutrophil chemoattractant-1 (CINC-1).These increases in TBARS, MPO activities and CINC-1 contentin the intestinal mucosa after I/R were all inhibited bypretreatment with lansoprazole at a dose of 1 mg/***, the CINC-1 mRNA expression was increasedduring intestinal I/R, and this increase in mRNA expressionwas inhibited by treatment with ***: Lansoprazole inhibits lipid peroxidation andreduces development of intestinal mucosal inflammationinduced by I/R in rats, suggesting that lansoprazole mayhave a therapeutic potential for I/R injury.

关键词： Animals Gastrointestinal Agents Inflammation control Intestinal Mucosa Ischemia Lipid Peroxidation Male Omeprazole derivatives Rats Rats, Sprague-Dawley Reperfusion

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