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Acute renal failure associated with acute non-fulminant hepatitis B

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World Journal of Hepatology 2013年第2期5卷 82-85页

作者： Tomoya Kishi Yuji Ikeda Tsuyoshi Takashima Shuichi Rikitake Motoaki Miyazono Shigehisa Aoki Takanobu Sakemi Toshihiko Mizuta kazuma fujimoto Department of Internal Medicine Saga University Faculty of MedicineSaga 849-8501Japan Department of Pathology and Biodefense Center for ResearchSaga University Faculty of MedicineSaga 849-8501Japan Development in Higher Education Saga University Faculty of MedicineSaga 849-8501Japan

A 38-year-old female presenting with a high fever of 39 ℃ developed severe liver dysfunction and acute renal failure(ARF).In tests for a hepatitis associated virus,an Immunoglobulin M-anti-hepatitis B virus core antibody was the only positive finding.Moreover,the progression of ARF coincided with the pole period of liver damage and all the other assumed causes for the ARF were unlikely.Therefore,this case was diagnosed as ARF caused by acute hepatitis B.ARF associated with non-fulminant hepatitis has been infrequently reported,usually in association with acute hepatitis A.This case is considered to be an extremely rare and interesting case.

关键词： Acute hepatitis B Acute renal failure Nonfulminant hepatitis Acute tubular necrosis Hyperimmune response

A pilot randomized control study to evaluate endoscopic resection using a ligation device for rectal carcinoid tumors

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World Journal of Gastroenterology 2006年第25期12卷 4026-4028页

作者： Hiroyuki Sakata Ryuichi Iwakiri Akifumi Ootani Seiji Tsunada Shinichi Ogata Hibiki Ootani Ryo Shimoda Kanako Yamaguchi Yasuhisa Sakata Sadahiro Amemori Kotaro Mannen Masanobu Mizuguchi kazuma fujimoto Department of Internal Medicine Saga Medical School Saga 849-8501Japan Department of Radiology Saga Medical School Saga 849-8501Japan

瞄准：比 10 公里小的直肠的良性肿瘤肿瘤能是有用内视镜检查法的本地切除的 resected。以便完全移开直肠的良性肿瘤肿瘤，我们在这飞行员控制与一台结扎设备评估了内视镜的粘膜切除术使随机化的学习。方法：十五个病人从 1993 ～ 2002... 详细信息

瞄准：比 10 公里小的直肠的良性肿瘤肿瘤能是有用内视镜检查法的本地切除的 resected。以便完全移开直肠的良性肿瘤肿瘤，我们在这飞行员控制与一台结扎设备评估了内视镜的粘膜切除术使随机化的学习。方法：十五个病人从 1993 ～ 2002 在我们的医院里与直肠的良性肿瘤肿瘤(不到 10 公里) 被诊断。有 9 男性和 6 女性，与吝啬的年龄 61.5 年(范围， 34-77 年) 。病人没有良性肿瘤症候群症状的抱怨。十五个病人随机被划分成 2 个组：7 个良性肿瘤肿瘤被常规内视镜的切除术治疗，并且 8 个良性肿瘤肿瘤被内视镜的切除术用一台结扎设备治疗。结果：所有直肠的良性肿瘤肿瘤在中间被定位到远侧的直肠。从 3 公里改变到 10 公里和病人的背景特征的肿瘤的尺寸不在二个组是不同的。用一台结扎设备的良性肿瘤肿瘤的完全的移动的率(100% ， 8/8 ) 比常规内视镜的切除术的显著地高(57.1% ， 4/7 ) 。三个病人有深边缘，另外的治疗为被执行的肿瘤参与。没有复杂并发症用一台结扎设备发生了在期间或在内视镜的切除术以后。在两个组的所有病人在 3 年的观察时期期间是活着的。结论：用一台结扎设备的内视镜的切除术是为小直肠的良性肿瘤肿瘤的切除术的一个有用、安全的方法。

关键词：内窥镜检查直肠癌病理机制治疗

Risk factors for adverse in-hospital outcomes in acute colonic diverticular hemorrhage

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World Journal of Gastroenterology 2015年第37期21卷 10697-10703页

作者： Naoyoshi Nagata Ryota Niikura Tomonori Aoki Shiori Moriyasu Toshiyuki Sakurai Takuro Shimbo Katsunori Sekine Hidetaka Okubo Kazuhiro Watanabe Chizu Yokoi Junichi Akiyama Mikio Yanase Masashi Mizokami kazuma fujimoto Naomi Uemura Department of Gastroenterology and Hepatology National Center for Global Health and Medicine Department of Clinical Research and Informatics National Center for Global Health and Medicine Department of Gastroenterology and Hepatology National Center for Global Health and Medicine Kohnodai Hospital Kohnodai Department of Internal Medicine and Gastrointestinal Endoscopy Saga Medical School

AIM: To investigate the factors associated with transfusion, further bleeding, and prolonged length of stay.METHODS: In total, 153 patients emergently hospitalized for diverticular bleeding who were examined by colonoscopy were prospectively enrolled. Patients in whom the bleeding source was identified received endoscopic treatment such as clipping or endoscopic ligation. After spontaneous cessation of bleeding withconservative treatment or hemostasis with endoscopic treatment, all patients were started on a liquid food diet and gradually progressed to a solid diet over 3d, and were discharged. At enrollment, we assessed smoking, alcohol, medications [non-steroidal antiinflammatory drugs(NSAIDs)], low-dose aspirin, and other antiplatelets, warfarin, acetaminophen, and oral corticosteroids), and co-morbidities [hypertension,diabetes mellitus, dyslipidemia, cerebro-cardiovascular disease, chronic liver disease, and chronic kidney disease(CKD)]. The in-hospital outcomes were need for transfusion, further bleeding after spontaneous cessation of hemorrhage, and length of hospital stay.The odds ratio(OR) for transfusion need, further bleeding, and prolonged length of stay were estimated by logistic regression analysis.RESULTS: No patients required angiographic embolization or surgery. Stigmata of bleeding occurred in 18% of patients(27/153) and was treated by endoscopic procedures. During hospitalization, 40patients(26%) received a median of 6 units of packed red blood cells. Multivariate analysis revealed that female sex(OR = 2.5, P = 0.02), warfarin use(OR= 9.3, P 70years(OR = 2.1, P = 0.04) and NSAID use(OR = 2.7,P = 0.03) were independent risk factors for prolonged hospital

关键词： In-hospital adverse clinical outcomes Antithrombot

Simple scoring system for predicting cirrhosis in nonalcoholic fatty liver disease

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World Journal of Gastroenterology 2014年第29期20卷 10108-10114页

作者： Takaomi Kessoku Yuji Ogawa Masato Yoneda Kento Imajo Yoshio Sumida Yuichiro Eguchi Hideki Fujii Hideyuki Hyogo Masafumi Ono Yasuaki Suzuki Takumi Kawaguchi Kazuaki Chayama Saiyu Tanaka kazuma fujimoto Keizo Anzai Toshiji Saibara Michio Sata Yoshito Itoh Atsushi Nakajima Takeshi Okanoue Japan Study Group of NAFLD(JSG-NAFLD)[] Department of Gastroenterology Hepatology Yokohama City University Graduate School of MedicineYokohama 236-0004Japan Department of Molecular Gastroenterology Hepatology Kyoto Prefectural University of Medicine Kyoto 602-0841Japan Department of General Medicine Saga Medical School Saga 849-8501Japan Department of Hepatology Osaka City University Osaka 558-8585Japan Department of Medicine Molecular Science Graduate School of Biomedical Sciences Hiroshima University Hiroshima 730-0053 Japan Department of Gastroenterology and Hepatology Kochi Medical School Kochi 783-8505 Japan Department of Gastroenterology Nayoro City General Hospital Hokkaido 096-8511 Japan Department of Gastroenterology Kurume University School of Medicine Kurume 830-0011 Japan Department of Internal Medicine University Hospital Saga 849-8577 Japan Department of Gastroenterology Hepatology Saiseikai Suita Hospital Osaka 565-0862 Japan

AIM:To investigate a simple noninvasive scoring system for predicting liver cirrhosis in nonalcoholic fatty liver disease(NAFLD)patients.METHODS:A total of 1048 patients with liver-biopsyconfirmed NAFLD were enrolled from nine hepatology centers in Japan(stage 0,216;stage 1,334;stage 2,270;stage 3,190;stage 4,38).The weight and height of the patients were measured using a calibrated scale after requesting the patients to remove their shoes and any heavy clothing.Venous blood samples were obtained in the morning after the patients had fasted overnight for 12 h.Laboratory evaluation was performed in all patients.Statistical analysis was conducted using SPSS version 12.0.Continuous variables were expressed as mean±SD.RESULTS:The optimal cutoff value of platelet count,serum albumin,and aminotransferase/alanine aminotransferase ratio(AAR)was set at0.9,respectively,by the receiver operating characteristic curve.These three variables were combined in an unweighted sum(platelet count=1 point,serum albumin=1 point,AAR=1 point)to form an easily calculated composite score for predicting cirrhosis in NAFLD patients,called the PLALA(platelet,albumin,AAR)score.The diagnosis of PLALA≥2 had sufficient accuracy for detecting liver cirrhosis in NAFLD patients.CONCLUSION:The PLALA score may be an ideal scoring system for detecting cirrhosis in NAFLD patients with sufficient accuracy and simplicity to be considered for clinical use.

关键词： Nonalcoholic fatty liver disease Cirrhosis Fibrosi

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莫苯唑酸对牛脂促进的大鼠结肠癌发生的影响

世界华人消化杂志 2010年第17期18卷 1767-1772页

作者：苗鲁杰白石良介藤濑剛弘柿本隆志岩切龙一藤本一真施瑞华李学良南京医科大学第一附属医院消化科江苏省南京市210029 日本国立佐贺大学医学部消化器内科

目的:探讨环氧化酶-1(COX-1)选择性抑制剂莫苯唑酸对牛脂促进的大鼠结肠癌发生的作用.方法:SD♂大鼠共108只.腹腔注射AOM(azoxymethane)后予不同牛脂含量饲料(混合0.12%莫苯唑酸)12wk,通过对结肠总ACF及多隐窝ACF(≥4个异常隐窝/病灶)计... 详细信息

目的:探讨环氧化酶-1(COX-1)选择性抑制剂莫苯唑酸对牛脂促进的大鼠结肠癌发生的作用.方法:SD♂大鼠共108只.腹腔注射AOM(azoxymethane)后予不同牛脂含量饲料(混合0.12%莫苯唑酸)12wk,通过对结肠总ACF及多隐窝ACF(≥4个异常隐窝/病灶)计数,评估莫苯唑酸对结肠肿瘤形成早期的影响;腹腔注射生理盐水或AOM后予以10%牛脂饲料(混合0.12%莫苯唑酸)44wk,观察莫苯唑酸对肿瘤发病率及数量的影响.BrdU评估肿瘤周围外观正常黏膜的增殖状况,Westernblot检测黏膜β-catenin的表达,探讨莫苯唑酸影响肿瘤发生的可能机制.结果:12wk时,莫苯唑酸组ACF尤其是多隐窝ACF显著低于对照组(P<0.05).44wk时莫苯唑酸组肿瘤发病率及平均肿瘤数量分别为66.7%和2.5±2.3,低于对照组(100%、5.3±1.2)(P<0.05);莫苯唑酸组隐窝增殖细胞的数量均显示出下降趋势(5±0.82vs3.25±0.50;7.75±0.96vs4.75±0.50,均P<0.05),且表现出趋向于生理分布的变化.β-catenin表达均低于对照组(P<0.05).结论:莫苯唑酸可有效抑制牛脂促进的大鼠结肠癌发生,这可能与结肠隐窝上皮细胞β-catenin的表达及增殖受到抑制有关.

关键词：异常隐窝灶环氧化酶-1 β-catenin