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Evaluation of prognostic factors and scoring system in colonic perforation

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World Journal of Gastroenterology 2007年第23期13卷 3228-3231页

作者： Atsushi Horiuchi Yuji Watanabe Takashi Doi kouichi Sato Syungo Yukumi Motohira Yoshida Yuji yamamoto Hiroki Sugishita Kanji Kawachi Department of Surgery 2 Ehime University School of Medicine

AIM: To study the significance of scoring systems assessing severity and prognostic factors in patients with colonic perforation. METHODS: A total of 26 patients (9 men, 17 women; mean age 72.7 ± 11.6 years) underwent emergency operation for colorectal perforation in our institution between 1993 and 2005. Several clinical factors were measured preoperatively and 24 h postoperatively. Acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ), Mannheim peritonitis index (MPI) and peritonitis index of Altona (PIA Ⅱ) scores were calculated preoperatively. RESULTS: Overall postoperative mortality rate was 23.1% (6 patients). Compared with survivors, non- survivors displayed low blood pressure, low serum protein and high serum creatinine preoperatively, and low blood pressure, low white blood cell count, low pH, low PaO2/FiO2, and high serum creatinine postoperatively. APACHE Ⅱ score was significantly lower in survivors than in non-survivors (10.4 ± 3.84 vs 19.3 ± 2.87, P = 0.00003). Non-survivors tended to display high MPI score and low PIA Ⅱ score, but no signif icant difference was identif ied. CONCLUSION: Pre- and postoperative blood pressure and serum creatinine level appear related to prognosis of colonic perforation. APACHE Ⅱ score is most associated with prognosis and scores ≥ 20 are associated with signif icantly increased mortality rate.

关键词： Scoring system Colonic perforation Prognostic factor

Subjective symptoms related to depression and suicidal risk in a Japanese community: a cross-sectional study

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Open Journal of Psychiatry 2011年第2期1卷 40-48页

作者： Shigeki Takemura kouichi Yoshimasu Jin Fukumoto Hiroichi yamamoto Kazuhisa Miyashita 不详

BACKGROUND: This cross-sectional study aimed to assess the association between self-reported somatic and mental symptoms and the presence of major depressive disorder (MDD) and suicidal risk among community dwellers in Japan. METHODS: From two locations in Japan, we recruited 734 community dwellers who underwent an annual health screening. Basic symptoms of MDD, dysthymia, and the presence of associated suicidal risk were determined using a brief structured diagnostic psychiatric interview, Mini International Neuropsychiatric Interview (MINI). Information regarding self-reported somatic and mental symptoms was obtained from a self-administered questionnaire used in the annual health check-up. Suicidal risk was evaluated on the basis of six relevant questions asked in MINI. Logistic regression model was used to calculate age- and gender-adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for MDD. Further adjustment for basic symptoms of MDD was performed to calculate ORs and CIs for suicidal risk. RESULTS: A myriad of somatic symptoms, including headache, heavy headedness, eye strain, and shoulder stiffness [adjusted OR (95% CI), 11.4 (1.22 - 107) at location 1;5.17 (1.23 - 21.7) at location 2], were associated with the presence of MDD. Dysmenorrhea [6.07 (1.14 - 32.3) at location 1] and dysesthesia, arthralgia, and swelling in the extremities [2.72 (1.14 - 6.47) at location 2] were significantly associated with an increase in suicidal risk, independent of the presence of basic symptoms of MDD. CONCLUSION: Several somatic symptoms, especially pain-related ones, may serve as possible signs of depression and suicidal risk among community dwellers.

关键词： Epidemiology Somatic Symptoms Depression Suicide Community Dwellers

Huge mucinous borderline ovarian cystadenoma in a premenarchal girl

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Open Journal of Pediatrics 2012年第1期2卷 82-86页

作者： Atsushi Horiuchi Kazuhiro Kameoka kouichi Sato Yuji yamamoto Yuji Watanabe Department of Surgery Division of Gastrointestinal Surgery and Surgical Oncology School of Medicine Ehime University Toon City Japan

Epithelial ovarian tumors are common in adult women, but rare in children. Especially mucinous ovarian cystadenoma is extremely rare, with only 16 cases in premenarchal girls reported to date. We present a case of 12-year-old premenarchal girl with symptoms of lower abdominal distension. CT showed a large multilocular tumor spreading throughout the entire abdominal cavity from the right upper quadrant to the pelvic cavity. The tumor was brought out little by little with aspiration of the fluid contents with a small incision. The tumor was found to originate from the left ovary, and oophorectomy was performed. The tumor measured 26 × 18 cm and weighed 5860 g. Histological diagnosis was mucinous ovarian cystadenoma with borderline malignancy. No evidence of recurrence had been seen as of 2 years postoperatively. In the review of premenarchal mucinous borderline ovarian cystadenoma, all cases were stage I and underwent salpingo-oophorectomy or oophorectomy. Those patients were alive without recurrence. Al-though mucinous borderline ovarian cystadenoma was characterized as malignancy, premenarchal cases showed favorable outcomes and salpingo-oohprectomy or oophorectomy appears appropriate.

关键词： Ovary Mucinous Cystadenoma Borderline Tumor Premenarchal

Utility of FibroScan-based scoring systems to narrow the risk group of nonalcoholic fatty liver disease with comorbidities

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World Journal of Gastrointestinal Pathophysiology 2022年第3期13卷 96-106页

作者： kouichi Miura Hiroshi Maeda Naoki Morimoto Shunji Watanabe Mamiko Tsukui Yoshinari Takaoka Hiroaki Nomoto Rie Goka Kazuhiko Kotani Hironori yamamoto Department of Medicine Division of GastroenterologyJichi Medical University School of Medicine3311-1 YakushijiShimotsuke 329-0498TochigiJapan Division of Community and Family Medicine Center for Community MedicineJichi Medical University3311-1 YakushijiShimotsuke 329-0498Japan

BACKGROUND Vibration-controlled transient elastography(VCTE)is proposed as a second step of examination to assess liver fibrosis in patients with nonalcoholic fatty liver disease(NAFLD)after triaging by the fibrosis-4(FIB-4)***,VCTEbased scoring systems,including FibroScan-AST(FAST),Agile 3+,and Agile 4,emerged to determine the status of ***,the significance of these scoring systems remains unknown in narrowing the high-risk group of NAFLD patients with comorbidities,including hepatocellular carcinoma(HCC)and esophagogastric varices(EGV).AIM To clarify the significance of VCTE-based scoring systems to narrow the high-risk group of NAFLD patients with *** We performed a cross-sectional study to investigate the usefulness of VCTE-based scoring systems and other fibrosis markers to narrow the high-risk group of patients with ***-4 index was used for the first *** groups of FAST,Agile 3+,and Agile 4 were stratified according to the published *** the 191 patients with NAFLD,there were 26(14%)and 25 patients(13%)with HCC and EGV,*** When 1.3 was used as a cutoff value,the FIB-4 index narrowed the risk group to 120 patients,in which all patients with HCC and/or EGV were *** risk group of Agile 3+could subsequently narrow the risk *** prevalence of HCC and EGV at this step were 33%(26/80)and 31%(25/80),*** further narrowing of EGV,Agile 4 aggregated the patients with EGV into 43 patients,of whom 23(53%)had *** failed to narrow the risk group of patients with *** 2.6 was used as a cutoff value of the FIB-4 index,three patients with HCC and two patients with EGV were missed at the first *** Agile 3+and Agile 4 are useful to narrow the NAFLD patient group,in which patients may have HCC and/or EGV.

关键词： Nonalcoholic fatty liver disease Vibration controlled transient elastography Non-invasive test Hepatocellular carcinoma Varix

Alpha-fetoprotein before and after pegylated interferon therapy for predicting hepatocellular carcinoma development

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World Journal of Hepatology 2015年第19期7卷 2220-2228页

作者： Yasuto Takeuchi Fusao Ikeda Toshiya Osawa Yasuyuki Araki kouichi Takaguchi Youichi Morimoto Noriaki Hashimoto Kousaku Sakaguchi Tatsuro Sakata Masaharu Ando Yasuhiro Makino Shuji Matsumura Hiroki Takayama Hiroyuki Seki Shintarou Nanba Yuki Moritou Tetsuya Yasunaka Hideki Ohnishi Akinobu Takaki Kazuhiro Nouso Yoshiaki Iwasaki Kazuhide yamamoto Department of Gastroenterology and Hepatology Okayama University Graduate School of Medicine Dentistry and Pharma- ceutical Sciences Department of Molecular Hepatology Okayama University Graduate School of Medicine Dentistry and Pharma- ceutical Sciences Department of Internal Medicine Okayama Saiseikai General Hospital Department of Internal Medicine Hiroshima City Hospital Department of Internal Medicine Kagawa Prefectural Central Hospital Department of Internal Medicine Kurashiki Central Hospital Department of Internal Medicine Mihara Red Cross hospital Department of Internal Medicine Fukuyama City Hospital Department of Internal Medicine National Hospital Organization Fukuyama Clinical Center Department of Internal Medicine Mitoyo General Hospital Department of Gastroenterology National Hospital Organization Iwakuni Clinical Center Department of Internal Medicine Sumitomo Besshi Hospital Department of Gastroenterology Tsuyama Central Hospital Health Service Center Okayama University

AIM: To investigate factors that accurately predict hepatocellular carcinoma(HCC) development after antiviral therapy in chronic hepatitis C(CHC) patients. METHODS: CHC patients who received pegylated interferon and ribavirin were enrolled in this cohort study that investigated the ability of alpha-fetoprotein(AFP) to predict HCC development after interferon(IFN) therapy. RESULTS: Of 1255 patients enrolled, 665 developed sustained virological response(SVR) during mean follow-up period of 5.4 years. HCC was occurred in 89 patients, and 20 SVR patients were included. Proportional hazard models showed that HCC occurred in SVR patients showing AFP ≥ 5 ng/m L before therapy and in non-SVR patients showing AFP ≥ 5 ng/m L before and 1 year after therapy besides older age, and low platelet counts. SVR patients showing AFP ≥ 5 ng/m L before therapy and no decrease in AFP to < 5 ng/m L 1 year after therapy had significantly higher HCC incidence than non-SVR patients showing AFP ≥ 5 ng/m L before therapy and decreased AFP(P = 0.043). AFP ≥ 5 ng/m L before therapy was significantly associated with low platelet counts and high values of alanine aminotransferase(ALT) in stepwise logistic regression analysis. After age, gender, platelet count, and ALT was matched by propensity score, significantly lower HCC incidence was shown in SVR patients showing AFP < 5 ng/m L before therapy than in those showing AFP ≥ 5 ng/m ***: The criteria of AFP < 5 ng/m L before and 1 year after IFN therapy is a benefical predictor for HCC development in CHC patients.

关键词： Hepatitis C virus Interferon Hepatocellular carcin