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Clinical Characteristics of Vaginal Discharge Associated Streptococcus pyogenes at General Japanese Hospital

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Journal of Biosciences and Medicines 2018年第1期6卷 9-16页

作者： Masaaki Minami Ryoko Sakakibara mika watanabe Hideo Morita Naoto Kanemaki Michio Ohta Department of Bacteriology Graduate School of Medical Sciences Nagoya City University Nagoya Japan Department of Clinical Investigation Daido Hospital Nagoya Japan Department of Gastroenterology Daido Hospital Nagoya Japan School of Nursing Sugiyama Jyogakuen University Nagoya Japan

Streptococcus pyogenes (S. pyogenes) is popular pathogen caused various infectious disease. This study was conducted to find out the recent clinical characteristics of S. pyogenes isolates from vaginal discharge at Japanese hospital. S. pyogenes was identified by standard laboratory procedure. Antimicrobial susceptibility testing was performed by microdilution assay according to CLSI recommendation. Total 61 S. pyogenes were isolated from vaginal discharge. The major age incidence among 0 - 10 years age group was 14 (23%), among 21 - 30 years age group, 7 (11.5%), among 31 - 40 years age group, 13 (21.3%), among 51 - 60 years age group, 8 (13.1%), and among 61 - 70 years age group, 11 (18%). The numbers of ciprofloxacin and clarithromycin no-susceptible S. pyogenes from 0 - 10, 31 - 40, and 61-70 years age group were higher than those from other groups. The numbers of clindamycin and minocycline no susceptible S. pyogenes from 0 - 10, and 21 - 40 years age group were higher than those from other group. Furthermore, our study revealed that clarithromycin was completely ineffective in 21 - 30 years age group (p S. pyogenes because the trend of infectious disease epidemiology is always changing drastically.

关键词： Streptococcus pyogenes Susceptibility Antimicrobial Resistance Vaginal Discharge Clarithromycin

Trend of Respiratory Tract-Associated Streptococcus dysgalactiae Subsp. Equisimilius at General Japanese Hospital from 2013 to 2015

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Journal of Biosciences and Medicines 2016年第12期4卷 11-17页

作者： Masaaki Minami Ryoko Sakakibara Taichi Imura mika watanabe Hideo Morita Naoto Kanemaki Michio Ohta Department of Bacteriology Graduate School of Medical Sciences Nagoya City University Nagoya Japan Department of Clinical Investigation Daido Hospital Nagoya Japan Department of Gastroenterology Daido Hospital Nagoya Japan School of Nursing Sugiyama Jyogakuen University Nagoya Japan

Streptococcus dysgalactiae subsp. equisimilius are pathogenic bacteria which cause various infectious diseases from acute pharyngitis to streptococcal toxic shock syndrome. Although Streptococcus dysgalactiae subsp. equisimilius infection has been increasing recently, the recent characteristic investigation of respiratory tract associated Streptococcus dysgalactiae subsp. equisimilius has not been performed in Japan. In this study, we analyzed the relationship between respiratory tract and norespiratory tract associated Streptococcus dysgalactiae subsp. equisimilius by investigating the recent clinical characteristics and antimicrobial susceptible patterns of 98Streptococcus dysgalactiae subsp. equisimilius isolated during 2013-2015 in Japan. There was significant difference of gender between respiratory tract and no respiratory tract associated Streptococcus dysgalactiae subsp. equisimilius. No Streptococcus dysgalactiae subsp. equisimilius from no respiratory tract were found under 18 years-old patients. The prevalence of clindamycin non susceptible Streptococcus dysgalactiae subsp. equisimilius isolates from respiratory tract was significant greater than those from non-respiratory tract. We also analyzed the relationship between respiratory tract associated Streptococcus dysgalactiae subsp. equisimilius and Streptococcus pyogenes in *** was no significant difference of gender between Streptococcus dysgalactiae subsp. equisimilius and Streptococcus pyogenes. The numbers of Streptococcus pyogenes-infected patients were significantly greater than those of Streptococcus dysgalactiae subsp. equisimilius-infected patients in children from 1 to 18 years old. From antimicrobial resistance, we found that the numbers of clarithromycin resistant Streptococcus pyogenes were greater than those of clarithromycin resistant Streptococcus dysgalactiae subsp. equisimilius among respiratory tract isolation. Our results suggest that the clinical and antimicrobial susceptible

关键词： Streptococcus dysgalactiaesusp. equsimilius Susceptibility Antimicrobial Resistance Epidemiology

Clinical Characteristics of Respiratory Tract-Associated Streptococcus pyogenes at General Japanese Hospital in 2014

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Journal of Biosciences and Medicines 2015年第12期3卷 26-31页

Streptococcus pyogenesis most popularpathogen caused respiratory tract infection disease. This study was conducted to find out the recent clinical characteristics of Streptococcus pyogenes isolates from respiratory tract at Japanese hospital in 2014. Streptococcus pyogenes was identified by standard laboratory procedure. Antimicrobial susceptibility testing was performed by micro dilution assay according to CLSI recommendation. Respiratory tract isolates were defined as isolation from pharynx, nasal discharge, tonsillar, and sputum. Total one hundred sixty-one Streptococcus pyogenes were isolated among which 136 were from respiratory tract and 25 were from non- respiratory tract. Respiratory tract-associated Streptococcus pyogenes was isolated among which 102 were from male and 59 were from female. The age incidence among 0 - 1 years age group was 8, among 1 - 18 years age group, 131 (p < 0.01), among 19 - 64 years age group, 17 (p < 0.01), and in 65-years it was 5. Although we investigated the relationship between season and bacterial isolation, we did not find any significant differences between respiratory tract and no respiratory tract isolation. However, our study revealed that clarithromycin was less antimicrobial effective in respiratory tract disease than in no respiratory tract disease significantly (p < 0.01). Although several antibiotics such as penicillin are still effective against Streptococcus pyogenes, incidence of Streptococcus pyogenes infection is not decreasing worldwide. Our study suggests the need for continuous epidemiological surveillance of Streptococcus pyogenes.

关键词： Streptococcus pyogenes Susceptibility Antimicrobial Resistance Epidemiology Clarithromycin

Assessment of gastroesophageal reflux disease by serodiagnosis of Helicobacter pylori-related chronic gastritis stage

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World Journal of Gastrointestinal Endoscopy 2011年第4期3卷 71-77页

作者： Shotaro Enomoto Masashi Oka Hiroshi Ohata Chizu Mukoubayashi mika watanabe Kosaku Moribata Yosuke Muraki Naoki Shingaki Hisanobu Deguchi Kazuki Ueda Izumi Inoue Takao Maekita Mikitaka Iguchi Kimihiko Yanaoka Hideyuki Tamai Mitsuhiro Fujishiro Osamu Mohara Masao Ichinose Second Department of Internal Medicine Wakayama Medical UniversityWakayama641-0012Japan Wakayama Wellness Foundation Wakayama640-8404Japan Department of Endoscopy and Endoscopic Surgery Faculty of MedicineUniversity of TokyoTokyo113-8655Japan

AIM:To evaluate the association of Helicobacter pylori(***)-related chronic gastritis stage with upper gastro-intestinal symptoms and gastro-eso-phageal reflux disease(GERD).METHODS:Subjects underwent upper gastrointestinal endoscopy,a questionnaire using a frequency scale for symptoms of GERD(FSSG),and measurements of serum ***-antibody and pepsinogen(PG)*** were classified into the following 4 groups in terms of ***-related chronic gastritis stage:Group A(n = 219),***(-)PG(-);Group B(n = 310),***(+)PG(-);Group C(n = 279),***(+)PG(+);and Group D(n = 17),***(-)PG(+).RESULTS:Reflux esophagitis occurred in 30.6% of Group A,14.5% of Group B,6.8% of Group C,and 0% of Group D(P < 0.001).Scores for acid reflux sympto-ms decreased significantly with chro-nic gastritis stage(from Group A to D)(P < 0.05),while scores for dysmotility symptoms did no-t differ *** prevalence of nonerosive reflux disease(NERD)did not differ amo-ng ***,in subjects with GERD,the prevalence of NERD tended to increase with chronic gastritis stage(P = 0.081).CONCLUSION:Acid reflux sympto-ms and the prevalen-ce of reflux esophagitis can be assessed by measuring both serum ***-antibody and PG levels.

关键词： Gastro-eso-phageal reflux disease Helicobacter pylori Pepsinogen Screening and diagnosis

Efficacy of endoscopic ultrasonography-guided fine needle aspiration for pancreatic neuroendocrine tumor grading

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World Journal of Gastroenterology 2015年第26期21卷 8118-8124页

作者： Mitsuru Sugimoto Tadayuki Takagi Takuto Hikichi Rei Suzuki Ko watanabe Jun Nakamura Hitomi Kikuchi Naoki Konno Yuichi Waragai Hiroyuki Asama mika Takasumi Hiroshi watanabe Katsutoshi Obara Hiromasa Ohira Department of Gastroenterology and Rheumatology Fukushima Medical UniversitySchool of Medicine Department of Endoscopy Fukushima Medical University Hospital

AIM: To evaluate the efficacy of endoscopic ultrasonography-guided fine needle aspiration(EUS-FNA) for grading pancreatic neuroendocrine tumors(PNETs).METHODS: A total of 22 patients were diagnosed with PNET by EUS-FNA between October 2001 and December 2013 at Fukushima Medical University *** these cases,we targeted 10 PNET patients who were evaluated according to the World Health Organization(WHO) 2010 *** was performed in eight patients,and chemotherapy was performed in two patients due to multiple liver *** obtained by EUS-FNA were first stained with hematoxylin and eosin and then stained with chromogranin,synaptophysin,CD56,and *** specimens were graded by the Ki-67 index according to the WHO 2010 *** obtained by surgery were graded by the Ki-67 indexand mitotic count(WHO 2010 classification).For the eight specimens obtained by EUS-FNA,the Ki-67 index results were compared with those obtained by *** the two cases treated with chemotherapy,the effects and prognoses were ***: The sampling rate for histological diagnosis by EUS-FNA was 100%.No adverse effects were *** concordance rate between specimens obtained by EUS-FNA and surgery was 87.5%(7/8).Fo r t h e t w o c a s e s t re a t e d w i t h c h e m o t h e ra p y,case 1 received somatostatin analog therapy and transcatheter arterial infusion(TAI) targeting multiple liver *** treatment consisted of *** chemotherapy,the primary tumor remained unconfirmed,although the multiple liver metastases diminished *** 2 was classified as neuroendocrine carcinoma(NEC) according to the Ki-67 index of a specimen obtained by EUS-FNA; therefore,cisplatin and irinotecan therapy was ***,severe adverse effects,including renal failure and diarrhea,were observed,and the therapy regimen was changed to cisplatin and *** targeting multiple liver metastases was perfor

关键词： Pancreatic neuroendocrine tumor Endoscopicultrasonography-guided fine needle aspiration Ki-67index World Health Organization classification 2010 Chemotherapy

Influence of night duty on endoscopic therapy for bile duct stones

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World Journal of Gastroenterology 2016年第42期22卷 9387-9393页

作者： Mitsuru Sugimoto Tadayuki Takagi Rei Suzuki Naoki Konno Hiroyuki Asama Ko watanabe Jun Nakamura Hitomi Kikuchi Yuichi Waragai mika Takasumi Takuto Hikichi Hiromasa Ohira Department of Gastroenterology and Rheumatology Fukushima Medical University School of Medicine Department of Endoscopy Fukushima Medical University Hospital

AIM To examine the influence of night duty(ND) on endoscopic therapy for biliary duct *** The subjects consisted of 133 patients who received initial endoscopic therapy for biliary duct stones performed by eight endoscopists after they had been on(ND group, n = 34 patients) or not [day duty(DD) group, n = 99 patients]. Patient characteristics(age, gender, history of abdominal surgery, transverse diameter of the largest stone, number of stones), years of experience of the endoscopists, endoscopic procedures [sphincterotomy, papillary balloon dilation(EPBD), papillary large balloon dilation(EPLBD)], and outcomes of initial endoscopy(procedure time; rate of stone removal by the first endoscopist; proceduresuccess rate by the first endoscopist: removal of stones or endoscopic retrograde biliary drainage; rate of final stone removal; final procedure success rate; complications; hospitalization after the procedure) were compared retrospectively between the two groups. History of abdominal surgery and treatment outcomes were also compared between the groups for each of the four endoscopists who performed most of the procedures in the ND *** There were no significant differences regarding the number of treatments performed by each endoscopist or the years of experience between the ND and DD groups. The frequency of endoscopic retrograde cholangiopancreatography procedures did not differ significantly between the groups. There were also no significant differences regarding patient characteristics: age, gender, history of abdominal surgery(ND 7: Billroth II 4, R-Y 3; DD 18: double tract reconstruction 1, Billroth I 3, Billroth II 6, R-Y 7, duodenoduodenostomy for annular pancreas 1), transverse diameter of largest stone, and number of stones between the two groups. Among the treatment procedures, the endoscopic s p h i n c t e r o t o m y a n d E P B D r a t e s d i d n o t d i f f e r significantly between the groups. However, EPLBD was performed more fr

关键词： Night duty Endoscopic therap Bile duct stone Removal of stones Procedure time

Predictive factors for the failure of endoscopic stent-instent self-expandable metallic stent placement to treat malignant hilar biliary obstruction

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World Journal of Gastroenterology 2017年第34期23卷 6273-6280页

作者： Mitsuru Sugimoto Tadayuki Takagi Rei Suzuki Naoki Konno Hiroyuki Asama Ko watanabe Jun Nakamura Hitomi Kikuchi Yuichi Waragai mika Takasumi Yuki Sato Takuto Hikichi Hiromasa Ohira Department of Gastroenterology Fukushima Medical UniversitySchool of Medicine Department of Endoscopy Fukushima Medical University Hospital

AIM To investigate the factors predictive of failure when placing a second biliary self-expandable metallic stents(SEMSs). METHODS This study evaluated 65 patients with an unresectable malignant hilar biliary obstruction who were examined in our hospital. Sixty-two of these patients were recruited to the study and divided into two groups: the success group, which consisted of patients in whom a stent-in-stent SEMS had been placed successfully, and the failure group, which consisted of patients in whom the stent-in-stent SEMS had not been placed successfully. We compared the characteristics of the patients, the stricture state of their biliary ducts, and the implemented endoscopic retrograde cholangiopancreatography(ERCP) procedures between the two *** The angle between the target biliary duct stricture and the first implanted SEMS was significantly larger in the failure group than in the success group. There were significantly fewer wire or dilation devices(ERCP catheter, dilator, or balloon catheter) passing the first SEMS cell in the failure group than in the success group. The cut-off value of the angle predicting stent-in-stent SEMS placement failure was 49.7 degrees according to the ROC curve(sensitivity 91.7%, specificity 61.2%). Furthermore, the angle was significantly smaller in patients with wire or dilation devices passing the first SEMS cell than in patients without wire or dilation devices passing the first SEMS cell. CONCLUSION A large angle was identified as a predictive factor for failure of stent-in-stent SEMS placement.

关键词： Endoscopic stent-in-stent self-expandable metallic stent placement Predictive factor Endoscopic retrograde cholangiopancreatography Malignant hilar biliary obstruction Self-expandable metallic stent

Pancreatic stents for the prevention of post-endoscopic retrograde cholangiopancreatography pancreatitis should be inserted up to the pancreatic body or tail

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World Journal of Gastroenterology 2018年第22期24卷 2392-2399页

作者： Mitsuru Sugimoto Tadayuki Takagi Rei Suzuki Naoki Konno Hiroyuki Asama Yuki Sato Hiroki Irie Ko watanabe Jun Nakamura Hitomi Kikuchi Yuichi Waragai mika Takasumi Takuto Hikichi Hiromasa Ohira Department of Gastroenterology School of Medicine Fukushima Medical University Department of Endoscopy Fukushima Medical University Hospital

AIM To investigate the location to which a pancreatic stent should be inserted to prevent post-endoscopic retrograde cholangiopancreatography(ERCP) pancreatitis(PEP).METHODS Over a ten-year period at our hospital, 296 patients underwent their first ERCP procedure and had a pancreatic stent inserted; this study included 147 patients who had ERCP performed primarily for biliary investigation and had a pancreatic stent inserted to prevent PEP. We dividedthese patients into two groups: 131 patients with a stent inserted into the pancreatic head(head group) and 16 patients with a stent inserted up to the pancreatic body or tail(body/tail group). Patient characteristics and ERCP factors were compared between the *** Pancreatic amylase isoenzyme(p-AMY) levels in the head group were significantly higher than those in the body/tail group [138.5(7.0-2086) vs 78.5(5.0-1266.5), P = 0.03] [median(range)]. No cases of PEP were detected in the body/tail group [head group, 12(9.2%)]. Of the risk factors for post-ERCP hyperamylasemia(≥ p-AMY median, 131 IU/L), procedure time ≥ 60 min [odds ratio(OR) 2.65, 95%CI: 1.17-6.02, P = 0.02) and stent insertion into the pancreatic head(OR 3.80, 95%CI: 1.12-12.9, P = 0.03) were identified as independent risk factors by multivariate *** Stent insertion up to the pancreatic body or tail reduces the risk of post-ERCP hyperamylasemia and may reduce the risk of PEP.

关键词： Pancreatic stent Endoscopic retrograde cholangiopancreatography Post-endoscopic retrograde cholangiopancreatography pancreatitis Post-endoscopic retrograde cholangiopancreatography hyperamylasemia Pancreatic body or tail

Can the wet suction technique change the efficacy of endoscopic ultrasound-guided fine-needle aspiration for diagnosing autoimmune pancreatitis type 1? A prospective single-arm study

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World Journal of Clinical Cases 2020年第1期8卷 88-96页

作者： Mitsuru Sugimoto Tadayuki Takagi Rei Suzuki Naoki Konno Hiroyuki Asama Yuki Sato Hiroki Irie Ko watanabe Jun Nakamura Hitomi Kikuchi mika Takasumi Minami Hashimoto Tsunetaka Kato Takuto Hikichi Kenji Notohara Hiromasa Ohira Department of Gastroenterology Fukushima Medical UniversitySchool of MedicineFukushima 960-1295Japan Department of Endoscopy Fukushima Medical University HospitalFukushima 960-1295Japan Department of Anatomic Pathology Kurashiki Central HospitalKurashiki 710-8602Japan

BACKGROUND Other than surgery,endoscopic ultrasound-guided fine-needle aspiration(EUSFNA)is the only procedure for histologically diagnosing autoimmune pancreatitis(AIP).However,adequate specimens are difficult to ***,more adequate specimens were reported to be obtained with EUS-FNA with a wet suction technique(WEST)than with conventional *** To histologically diagnose AIP by EUS-FNA with a *** Eleven patients with possible type 1 AIP between February 2016 and August 2018 underwent EUS-FNA with a WEST(WEST group),with four punctures by 19 or 22 G *** a historical control,23 type 1 AIP patients who underwent no fewer than four punctures with 19 or 22 G needles were enrolled(DRY group).Patient characteristics and histological findings were compared between the two *** Three histopathological factors according to the International Consensus Diagnostic Criteria were significantly greater in the WEST group than the DRY group[lymphoplasmacytic infiltrate without granulocytic infiltration:9(81.8%)vs 6(26.1%),P=0.003,storiform fibrosis:5(45.5%)vs 1(4.3%),P=0.008,abundant(>10 cells/HPF)IgG4-positive cells:7(63.6%)vs 5(21.7%),P=0.026].Level 1 or level 2 histopathological findings were observed more often in the WEST group than in the DRY group[8(72.7%)vs 3(13.0%),P=0.001].CONCLUSION EUS-FNA with a WEST was more successful than standard EUS-FNA in histologically diagnosing AIP.

关键词： Autoimmune pancreatitis Endoscopic ultrasound-guided fine needle aspiration Wet suction technique