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Safety trial of high-intensity focused ultrasound therapy for pancreatic cancer

World Journal of Gastroenterology 2014年第28期20卷 9570-9577页

作者： Atsushi Sofuni Fuminori Moriyasu Takatomo Sano Fumihide Itokawa Takayoshi Tsuchiya Toshio Kurihara Kentaro Ishii Syujiro Tsuji Nobuhito Ikeuchi Reina Tanaka Junko Umeda Ryosuke Tonozuka Mitsuyoshi Honjo Shuntaro Mukai mitsuru fujita Takao Itoi Department of Gastroenterology and Hepatology Tokyo Medical University

AIM:To evaluate the safety and clinical application of high-intensity focused ultrasound(HIFU)therapy for unresectable pancreatic cancer(PC).METHODS:Thirty PC patients(16 cases in stage III and 14 cases in stage IV)with visualized pancreatic tumors were admitted for HIFU therapy as an optional local therapy in addition to systemic chemotherapy or *** consent was *** study began at the end of 2008 and was approved by the ethics committee of our hospital[Institutional Review Board(IRB):890].The HIFU device used was the FEP-BY02(Yuande Bio-Medical Engineering,Beijing,China).RESULTS:The mean tumor size after HIFU therapy changed to 30.9±1.7 mm from 31.7±1.7 mm at *** were no significant changes in tumor size,mean number of treatment sessions(2.7±0.1 mm),or mean total treatment time(2.4±0.1 h).The rate of symptom relief effect was 66.7%.The effectiveness of primary lesion treatment was as follows:complete response,0;partial response,4;stable disease,22;progressive disease,*** after HIFU therapy included 2 operations,24 chemotherapy treatments,and 4 best supportive care *** events occurred in 10%of cases,namely pseudocyst formation in 2 cases and mild pancreatitis development in ***,no severe adverse events occurred in this ***:We suggest that HIFU therapy is safe and has the potential to be a new method of combination therapy for PC.

关键词： High-intensity focused ultrasound Pancreatic cancer Safety trial Tumor ablation Ultrasonography

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Evaluation of novel slim biopsy forceps for diagnosis of biliary strictures: Single-institutional study of consecutive 360 cases(with video)

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World Journal of Gastroenterology 2017年第35期23卷 6429-6436页

作者： Kenjiro Yamamoto Takayoshi Tsuchiya Takao Itoi Shujiro Tsuji Reina Tanaka Ryosuke Tonozuka Mitsuyoshi Honjo Shuntaro Mukai Kentaro Kamada mitsuru fujita Yasutsugu Asai Yukitoshi Matsunami Yuichi Nagakawa Hiroshi Yamaguchi Atsushi Sofuni Department of Gastroenterology and Hepatology Tokyo Medical University Third Department of Surgery Tokyo Medical University Department of Pathology Tokyo Medical University

AIM To evaluate the feasibility and reliability of endoscopic transpapillary bile duct biopsy for the diagnosis of biliary *** A total of 360 patients(241 men) who underwent endoscopic retrograde cholangiopancreatography for biliary strictures with biopsy from April 2012 to March 2016 at Tokyo Medical University Hospital were retrospectively reviewed. This study was approved by our Institutional Review Board(No. 3516). Informed consent was obtained from all individual participants included in this study. The biopsy specimens were obtained using a novel slim biopsy forceps(Radial Jaw 4P, Boston Scientific, Boston, MA, United States).RESULTS The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 69.6%, 100%, 100%, 59.1%, and 78.8%, respectively. The sensitivity was 75.6% in bile duct cancer, 64% in pancreatic cancer, 61.1% in gallbladder cancer, and 57.1% in metastasis. In bile duct cancer, a lower sensitivity was observed for perihilar bile duct stricture(68.7%) than for distal bile duct stricture(83.1%). In terms of the stricture lengths of pancreatic cancer, gallbladder cancer, and metastasis, a longer stenosis resulted in a better sensitivity. In particular, there was a significant difference between pancreatic cancer and gallbladder cancer(P < 0.05). One major complication was perforation of the extrahepatic bile duct with bile leakage. CONCLUSION Endoscopic transpapillary biopsy alone using novel slim biopsy forceps is feasible and reliable, but restrictive. Biopsy should be performed in consideration of the stricture level, stricture length, and cancer type.

关键词： Endoscopic transpapillary biopsy Biopsy forceps Biliary stricture Bile duct cancer Endoscopic retrograde cholangiography

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Gastric-and-Intestinal Mixed Intestinal Metaplasia Is Irreversible Point with Eradication of Helicobacter pylori

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Open Journal of Pathology 2016年第2期6卷 93-104页

作者： Yuka Kiriyama Tomomitsu Tahara Tomoyuki Shibata Masaaki Okubo mitsuru Nakagawa Asako Okabe Naoki Ohmiya Makoto Kuroda Atsushi Sugioka Masao Ichinose Masae Tatematsu Tetsuya Tsukamoto Department of Diagnostic Pathology School of Medicine Fujita Health University Toyoake Aichi Japan Department of Gastroenterology School of Medicine Fujita Health University Toyoake Aichi Japan Department of Hepatobiliary and Liver Transplant Surgery School of Medicine Fujita Health University Toyoake Japan Second Department of Internal Medicine Wakayama Medical University Wakayama Japan Japan Bioassay Research Center Hadano Japan

Helicobacter pylori (H. pylori) represents an important factor in the development of atrophic gastritis, intestinal metaplasia (IM), and gastric cancer. Eradication of H. pylori has been reported to prevent gastric cancer only in cases without atrophy or IM. However, histological changes with eradication have yet to be fully clarified. We evaluated 38 H. pylori-positive cases before and after eradication at the gland level;pyloric glands were classified as showing gastric proper (G) and IM gland types, with the latter including gastric-and-intestinal mixed IM (GI-IM) and solely intestinal IM (I-IM), depending on the remaining gastric phenotypes. On eradication, acute and chronic inflammation attenuated rapidly and gradually, respectively, whereas levels of MUC5AC and MUC6 expression were not markedly altered. Gland width, size of nuclei and cytoplasm and their ratio in surface foveolar epithelium, the number of Ki-67-positive cells and the length of the proliferating zone in each gland were significantly decreased in G glands after eradication compared with those in GI-IM and I-IM. The number of mitotic phase cells, positive for phosphorylated histone H3 at serine 28, was increased in both types of IM compared to that in G glands in the H. pylori-infected state, but unexpectedly remained unchanged with eradication. These results suggest that GI-IM, as the beginning of IM, could represent a histological irreversible point with eradication and be considered as a “histological point of no return”.

关键词： Helicobacter pylori Chronic Atrophic Gastritis Intestinal Metaplasia Eradication Stomach

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