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Push vs pull method for endoscopic ultrasound-guided fine needle aspiration of pancreatic head lesions: Propensity score matching analysis

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World Journal of Gastroenterology 2018年第27期24卷 3006-3012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 Minami Hashimoto Yuko Hashimoto Takuto Hikichi Hiromasa Ohira Department of Gastroenterology Fukushima Medical UniversitySchool of Medicine Department of Endoscopy Fukushima Medical University Hospital Department of Diagnostic Pathology Fukushima Medical University

AIM To evaluate the efficacy of endoscopic ultrasoundguided fine needle aspiration(EUS-FNA) of pancreatic head cancer when pushing(push method) or pulling the echoendoscope(pull method).METHODS Overall, 566 pancreatic cancer patients had their first EUS-FNA between February 2001 and December 2017. Among them, 201 who underwent EUS-FNA for pancreatic head lesions were included in this study. EUS-FNA was performed by the push method in 85 patients, the pull method in 101 patients and both the push and pull methods in 15 patients. After propensity score matching(age, sex, tumor diameter, and FNA needle), 85 patients each were stratified into the push and pull groups. Patient characteristics and EUSFNA-related factors were compared between the two *** Patient characteristics were not significantly different between the two groups. The distance to lesion was significantly longer in the push group than in the pull group(13.9 ± 4.9 mm vs 7.0 ± 4.9 mm, P < 0.01). The push method was a significant factor influencing the distance to lesion(≥ median 10 mm)(P < 0.01). Additionally, tumor diameter ≥ 25 mm(OR = 1.91, 95%CI: 1.02-3.58, P = 0.043) and the push method(OR = 1.91, 95%CI: 1.03-3.55, P = 0.04) were significant factors contributing to the histological diagnosis of *** The pull method shortened the distance between the endoscope and the lesion and facilitated EUS-FNA of pancreatic head cancer. The push method contributed to the histological diagnosis of pancreatic head cancer using EUS-FNA specimens.

关键词： Endoscopic ultrasound-guided fine needle aspiration Pancreatic head Pancreatic cancer Push method Pull method

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Dysbiosis of the duodenal microbiota as a diagnostic marker for pancreaticobiliary cancer

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World Journal of Gastrointestinal Oncology 2021年第12期13卷 2088-2100页

作者： Mitsuru Sugimoto Kazumichi Abe Tadayuki Takagi Rei Suzuki Naoki Konno Hiroyuki Asama Yuki Sato Hiroki Irie Ko watanabe Jun Nakamura Hitomi Kikuchi mika Takasumi Minami Hashimoto Tsunetaka Kato Ryoichiro Kobashi Takuto Hikichi Hiromasa Ohira Department of Gastroenterology Fukushima Medical University School of MedicineFukushima 960-1295Japan Department of Endoscopy Fukushima Medical University HospitalFukushima 960-1295Japan

BACKGROUND Pancreaticobiliary cancer(PB Ca)is a lethal disease,and a useful diagnostic marker is urgently needed.A correlation between the human microbiota and malignant gastrointestinal diseases was recently *** To investigate the efficacy of the duodenal microbiota for diagnosing PB *** We recruited 22 patients with benign pancreaticobiliary diseases(benign group)and 12 patients with PB Ca(malignant group).The duodenal microbiota of each patient was analyzed by the 16S rDNA terminal restriction fragment length polymorphism *** characteristics,tumor markers,and relative abundances of the duodenal microbiota were compared between the benign and malignant *** Cancer antigen 19-9(CA19-9),Bifidobacterium,Clostridium cluster XVIII,and Prevotella levels differed significantly between the benign and malignant *** cluster XVIII had the greatest area under the receiver operating characteristic curve(AUC)among the four factors with respect to diagnosing PB Ca(cutoff value:3.038%;sensitivity:58.3%;specificity:95.2%;AUC:0.81).The combination of Clostridium cluster XVIII(cutoff value:3.038%)and CA19-9 Levels(cutoff value:18.8 U/mL)showed 91.7%sensitivity and 71.4%specificity for diagnosing PB *** The duodenal microbiota may be useful for PB Ca screening.

关键词： Pancreaticobiliary cancer Diagnostic marker Duodenal microbiota Clostridium cluster XVIII Cancer antigen 19-9

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Pancreatic neuroendocrine tumor Grade 1 patients followed up without surgery:Case series

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World Journal of Clinical Oncology 2017年第3期8卷 293-299页

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

Among the three grades of neuroendocrine tumors(NETs),the prognosis for Grade 1(G1) with surgery is very ***,we evaluated the prognoses of pancreatic NET(PNET) G1 patients without surgery.A total of 8 patients who were diagnosed with NET G1,with an observation period of more than 6 mo until surgery or without surgery,were *** patients who underwent surgery were ultimately diagnosed using specimens obtained during the surgery,whereas the patients who did not undergo surgery were diagnosed using specimens obtained by endoscopic ultrasonography-guided fine needle ***,we mainly evaluated the observation period and tumor *** observation period for the five cases with surgery ranged from 6-80 mo,and tumor growth was observed in one *** contrast,the observation period for the three cases without surgery ranged from 17-54 mo,and tumor growth was not ***,although the first-choice treatment for NETs is surgery,our experience includes certain NET G1 patients who were followed up without surgery.

关键词： Pancreatic neuroendocrine tumors Metastasis Neuroendocrine tumors Grade 1 Follow-up Surgery

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Endoscopic therapy for esophageal hematoma with blue rubber bleb nevus syndrome

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World Journal of Gastrointestinal Endoscopy 2014年第12期6卷 630-634页

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

A 57-year-old woman previously diagnosed with blue rubber bleb nevus syndrome(BRBNS) reported hematemesis. BRBNS is a rare vascular anomaly syndrome consisting of multifocal hemangiomas of the skin and gastrointestinal(GI) tract but her GI tract had never been examined. An upper gastrointestinal endoscopy revealed a large bleeding esophageal hematoma positioned between the thoracic esophagus and the gastric cardia. An endoscopic injection of polidocanol was used to stop the hematoma from bleeding. The hematoma was incised using the injectionneedle to reduce the pressure within it. Finally, argon plasma coagulation(APC) was applied to the edge of the incision. The esophageal hematoma disappeared seven days later. Two months after the endoscopic the rapy, the eso phage alulcerhealed and the hemangioma did not relapse. This rare case of a large esophageal hematoma originating from a hemangioma with BRBNS was treated using a combination of endoscopic therapy with polidocanol injection, incision, and APC.

关键词： Blue rubber bleb nevus syndrome Endoscopic injection sclerotherapy Incision Esophageal hematoma Esophageal hemangioma

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Renal Cell Carcinoma Associated with Xp11.2 Translocation/TFE3 Gene Fusion: A Case Report with Immunohistochemical and Cytological Features

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Open Journal of Pathology 2016年第1期6卷 19-25页

作者： Takuji Tanaka Kuniaki Hirai Fumimasa Etori Masashi Matsuyama Naoki watanabe Hiromi Kondo Masayoshi Tamaki Tatsuya Yamashita Shiho Yasue mika Noda Kunihiro Shinoda Hisao Komeda Department of Diagnostic Pathology (DDP) & Research Center of Diagnostic Pathology (RC-DiP) Gifu Municipal Hospital Gifu Japan Department of Radiology Ehime University Graduate School of Medicine Ehime Japan Department of Urology Gifu Municipal Hospital Gifu Japan Department of Pediatrics Gifu Municipal Hospital Gifu Japan

Gene fusions involving two of the MiT subfamily factors, such as TFE3, TFEB, TFC and MiTF, have been identified in renal cell carcinoma (RCC). Xp11.2 translocation RCC is a rare pediatric neoplasm that harbors gene fusions involving TFE3, which plays an important role in cell proliferation and survival. We herein present a case of RCC associated with Xp11.2 translocation/TFE3 gene fusion in a 14-year-old Japanese boy presenting gross hematuria and body weight loss. The tumor was characterized by histopathology, cytology and TFE3-immunohistochemistry/immunocytochemistry. Knowledge of distinctive morphological and immunostaining features of this tumor can help to accurately diagnose this rare subset of translocation associated RCC in routine pathological diagnostic procedures.

关键词： Renal Cell Carcinoma Xp11.2 Translocation TFE3 Cytology Immunohistochemistry Immunocytochemistry

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Improvement in Accuracy of Word Segmentation of a Web-Based Japanese-to-Braille Translation Program for Medical Information

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通讯和计算机（中英文版） 2013年第1期10卷 82-89页

作者： Tsuyoshi Oda Aki Sugano Masashi Shimbo Kenji Miura mika Ohta Masako Matsuura Mineko Ikegami Tetsuya watanabe Shinichi Kita Akihiro Ichinose Eiichi Maeda Yuji Matsumoto Yutaka Takaoka Department of Medical Informatics and Bioinformatics Graduate School of Medicine Kobe 650-0017 Japan Department of Medical Informatics and Bioinformatics Kobe University Hospital Kobe 650-0017 Japan Graduate School of lnformation Science Nara Institute of Science and Technology Nara 630-0192 Japan Nursing Department Kobe University Hospital Kobe 650-0017 Japan Department of Bioeybernetics Faculty of Engineering Niigata University Niigata 950-2181 Japan Graduate School of Humanities Kobe University Kobe 657-8501 Japan Department of Plastic Surgery Kobe University Graduate School of Medicine Kobe 650-0017 Japan

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Efficacy and Tolerability of Second-Line Metronidazole Triple Therapy Using Vonoprazan for Helicobacter pylori Eradication in Japan—Comparative Study: Vonoprazan vs. Proton Pump Inhibitors

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Open Journal of Gastroenterology 2018年第1期8卷 27-38页

作者： Masahiko Ohtaka mika Miura Mitsuhiko Hanawa Yuichi Hirose Atsuko Kitahashi Naoki Imamura Ikko watanabe Kazuhiko Takaso Naoki Shimura Yoshioki Yoda Ichiro Takayama Mitsuharu Fukasawa Nobuyuki Enomoto Yamanashi Koseiren Health Care Center Yamanashi Japan First Department of Internal Medicine Graduate School of Medical and Engineering Science University of Yamanashi Yamanashi Japan Health Care Center University of Yamanashi Yamanashi Japan

Aim: To investigate the efficacy and tolerability of second-line metronidazole triple therapy with vonoprazan (VPZ) for Helicobacter pylori (H. pylori). Methods: We retrospectively reviewed medical records of patients who experienced clarithromycin triple therapy failure and were treated with second-line (20 mg VPZ (n = 274)/30 mg lansoprazole (n = 323) or 10 mg rabeprazole (n = 141) twice daily, 750 mg amoxicillin twice daily, 250 mg metronidazole twice daily for 7 days) eradication therapies. Successful eradication rates were compared between two groups: those receiving VPZ and those receiving a proton pump inhibitor (PPI). Adverse events were also investigated. Results: Successful second-line eradication rates according to ITT analysis and PP analysis, respectively, were 79.9% and 92.4% for VPZ therapy and 83.6% and 93.3% for PPI therapy. There were no significant differences between treatment groups. The eradication rates in those who had received first-line VPZ therapy previously according to ITT and PP analysis were 75.2% and 88.1%, respectively;in contrast, values were 82.5% and 95.4%, respectively, for those who had received first-line PPI therapy previously. In second-line therapy, the overall adverse event rate for VPZ therapy was the same as for PPI therapy. Conclusions: The efficacy and tolerability of metronidazole-containing second-line triple therapy with VPZ or a PPI were equivalent.

关键词： Vonoprazan Metronidazole Proton Pump Inhibitor Second-Line Eradication Helicobacter pylori

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Prevention of post-endoscopic retrograde cholangiopancreatography pancreatitis using pancreatic stents: A review of efficacy, diameter and length

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World Journal of Meta-Analysis 2019年第6期7卷 259-268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 Takuto Hikichi Hiromasa Ohira Department of Gastroenterology Fukushima Medical UniversitySchool of Medicine Fukushima 9601247Japan Department of Endoscopy Fukushima Medical University HospitalFukushima 9601295Japan

Although endoscopic retrograde cholangiopancreatography (ERCP) is an important procedure for the diagnosis and treatment of pancreaticobiliary diseases, post-ERCP pancreatitis (PEP) is the most frequent adverse event that can sometimes be fatal. However, prophylactic pancreatic stent (PS) insertion has been performed to prevent PEP in high-risk patients. In some randomized controlled trials (RCTs) and meta-analyses, the efficacy of prophylactic PS insertion has been shown to prevent PEP. In addition, several types of stents have been used to decrease PEP. In this review, we introduce the details of these RCTs and meta-analyses and reveal the specifications for stent placement, for example, the stent diameter and length and the pancreatic region into which the stent should be inserted.

关键词： Endoscopic retrograde cholangiopancreatography Post-endoscopic retrograde cholangiopancreatography pancreatitis Prophylactic pancreatic stent

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Usefulness of Fractional Exhaled Nitric Oxide-Guided Treatment in Patients with Asthma-Chronic Obstructive Pulmonary Disease Overlap

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Open Journal of Respiratory Diseases 2018年第1期8卷 1-12页

作者： Taisuke Akamatsu Toshihiro Shirai Yuko Tanaka Hirofumi watanabe Yoshinari Endo Yukiko Shimoda Takahito Suzuki Rie Noguchi mika Saigusa Akito Yamamoto Yuichiro Shishido Takefumi Akita Satoru Morita Kazuhiro Asada Department of Respiratory Medicine Shizuoka General Hospital Shizuoka Japan

Background: Some patients present clinical features of both asthma and chronic obstructive pulmonary disease (COPD), which has led to the recent proposal of asthma-COPD overlap (ACO) as a diagnosis. Fractional exhaled nitric oxide (FeNO) is a candidate biomarker to diagnose ACO. We assessed the effect of an add-on treatment with budesonide/formoterol (BUD/FM) combination in patients with ACO, which was diagnosed by FeNO. Methods: This was a prospective, single-arm, open-label, before and after comparison study. Subjects included 83 patients with COPD who attended outpatient clinics for routine checkups at Shizuoka General Hospital between June and November 2016. All patients fulfilled the GOLD definition of COPD and were receiving long-acting muscarinic antagonist (LAMA) or LAMA/long-acting β2 agonist (LABA) combinations. After an 8-week run-in period, BUD/FM was added to the patients with FeNO levels of ≥35 ppb, defined as having ACO. For patients receiving LAMA/LABA, BUD/FM was added after the discontinuation of LABA. The modified British Medical Research Council (mMRC) score, COPD assessment test (CAT) score, spirometric indices, forced oscillation parameters, and FeNO were assessed before and after 8 weeks of BUD/ FM add-on treatment. Results: Twenty-four patients (28.9%) had FeNO levels ≥ 35 ppb, and 17 patients completed the study (mean age: 73 years and GOLD I/II/III/IV, 5/10/1/1). The mean CAT scores significantly improved (9.2 to 5.4, p = 0.015) and 10 patients (58.8%) showed ≥2 points improvement, a minimal clinically important difference. The mean FeNO levels significantly decreased from 63.0 to 34.3 ppb (p Conclusions: FeNO-guided treatment with BUD/FM improves symptoms in patients with ACO.

关键词： Asthma-COPD Overlap Budesonide/Formoterol Combination COPD Assessment Test Fractional Exhaled Nitric Oxide

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Effects of Direct Switching Dual Bronchodilators between Dry Powder and Soft Mist Inhalers in COPD Patients

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Open Journal of Respiratory Diseases 2020年第1期10卷 11-19页

作者： Taisuke Akamatsu Toshihiro Shirai Hiromasa Nakayasu Kanami Tamura Toshihiro Masuda Shingo Takahashi Yuko Tanaka Hirofumi watanabe Yutaro Kishimoto Kyohei Oishi mika Saigusa Akito Yamamoto Satoru Morita Kazuhiro Asada Department of Respiratory Medicine Shizuoka General Hospital Shizuoka Japan

Objective: Dual bronchodilation with long-acting muscarinic antagonist and long-acting β2-agonist combinations are available worldwide in COPD patients. However, the choice of agents remains under debate. We hypothesized that switching devices between dry powder and soft mist inhalers without a wash-out period to mimic clinical practice would improve clinical symptoms and lung function. The aim of this study was to examine the effects of switching between once-daily glycopyrronium/indacaterol (GLY/IND) or umeclidinium/vilanterol (UMEC/VI), dry powder inhalers, and tiotropium/olodaterol (TIO/OLO), a soft mist inhaler, in COPD patients. Methods: This was a prospective, open-label, 8-week, observational study with follow-up. Subjects included 57 COPD patients, who attended outpatient clinics at Shizuoka General Hospital for routine check-ups between February and December 2015, receiving GLY/IND (50/110 μg) or UMEC/VI (62.5/25 μg). After an 8-week run-in period, medications were switched to TIO/OLO (5/5 μg). Study outcomes included patient’s global rating (PGR), modified MRC (mMRC), COPD assessment test (CAT), and spirometric and forced oscillatory parameters after 8 weeks. PGR used in this study was a 7-point scale ranging from 1 to 7, with 4 in the middle. Patients who consented to switch from TIO/OLO to GLY/IND or UMEC/VI were followed-up thereafter. Results: In total, 53 patients completed the study (mean age, 75 years;48 males and 5 females;GOLD 1/2/3/4 = 19/27/6/1;mMRC 0/1/2/3/4 = 14/22/12/4/1;UMEC/VI 26, GLY/IND 27). PGR, mMRC, and CAT improved in 20 (38%), 9 (17%), and 15 patients (28%), respectively. Respiratory system resistance at 5 Hz (R5), 20 Hz (R20), and the difference between R5 and R20 (R5 - R20) significantly improved. In a follow-up of 16 patients after switching from TIO/OLO to UMEC/VI (9) or GLY/IND (7), PGR, mMRC, and CAT improved in 5 (31%), 3 (12%), and 4 patients (25%), respectively, and R20 significantly improved (p = 0.011). Conclusions: Switc

关键词： Device Dry Powder Inhaler Dual Bronchodilator Soft Mist Inhaler Switching

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