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Protective effects of ursodeoxycholic acid on chenodeoxycholic acid-induced liver injury in hamsters

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World Journal of Gastroenterology 2007年第37期13卷 5003-5008页

作者： Tomomichi Iwaki Kaoru Ishizaki shuji Kinoshita Hideki Tanaka Atsushi Fukunari Makoto Tsurufuji Teruaki Imada Research Laboratory Ⅲ (Immunology) Pharmaceuticals Research Division Mitsubishi Pharma Corporation Yokohama Japan Pharmacokinetics Laboratory Pharmaceuticals Research Division Mitsubishi Pharma Corporation Chiba Japan Discovery Technology Laboratory Pharmaceuticals Research Division Mitsubishi Pharma Corporation Yokohama Japan

AIM： TO investigate the effects of ursodeoxycholic acid （UDCA） on chenodeoxycholic acid （CDCA）-induced liver injury in hamsters, and to elucidate a correlation between liver injury and bile acid profiles in the liver.METHODS： Liver injury was induced in hamsters by administration of 0.5% （w/w） CDCA in their feed for 7 d. UDCA （50 mg/kg and 150 mg/kg） was administered for the last 3 d of the experiment.RESULTS： At the end of the experiment, serum alanine aminotransferase （ALl） increased more than 10 times and the presence of liver injury was confirmed histologically. Marked increase in bile acids was observed in the liver. The amount of total bile acids increased approximately three-fold and was accompanied by the increase in hydrophobic bile acids, CDCA and lithocholic acid （LCA）. UDCA （50 mg/kg and 150 mg/kg） improved liver histology, with a significant decrease （679.3 ±77.5 U/L vs 333.6 ± 50.4 U/L and 254.3 ±35.5 U/ L, respectively, P 〈 0.01） in serum ALT level. UDCA decreased the concentrations of the hydrophobic bile acids, and as a result, a decrease in the total bile acid level in the liver was achieved.CONCLUSION： The results show that UDCA improves oral CDCA-induced liver damage in hamsters. The protective effects of UDCA appear to result from a decrease in the concentration of hydrophobic bile acids, CDCA and LCA, which accumulate and show the cytotoxicity in the liver.

关键词： Chenodeoxycholic acid Hamster Liver bileacids Ursodeoxycholic acid

Diversion colitis and pouchitis: A mini-review

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World Journal of Gastroenterology 2018年第16期24卷 1734-1747页

作者： Kentaro Tominaga Kenya Kamimura Kazuya Takahashi Junji Yokoyama Satoshi Yamagiwa shuji Terai Division of Gastroenterology and Hepatology Graduate School of Medical and Dental Sciences Niigata University

Diversion colitis is characterized by inflammation of the mucosa in the defunctioned segment of the colon after colostomy or ileostomy. Similar to diversion colitis, diversion pouchitis is an inflammatory disorder occurring in the ileal pouch, resulting from the exclusion of the fecal stream and a subsequent lack of nutrients from luminal bacteria. Although the vast majority of patients with surgically-diverted gastrointestinal tracts remain asymptomatic, it has been reported that diversion colitis and pouchitis might occur in almost all patients with diversion. Surgical closure of the stoma, with reestablishment of gut continuity, is the only curative intervention available for patients with diversion disease. Pharmacologic treatments using short-chain fatty acids, mesalamine, or corticosteroids are reportedly effective for those who are not candidates for surgical reestablishment; however, there are no established assessment criteria for determining the severity of diversion colitis, and no management strategies to date. Therefore, in this mini-review, we summarize and review various recently-reported treatments for diversion disease. We are hopeful that the information summarized here will assist physicians who treat patients with diversion colitis and pouchitis, leading to better case management.

关键词： Diversion colitis Diversion pouchitis Ileitis Inflammatory bowel disease

Impact of continuous positive airway pressure therapy for nonalcoholic fatty liver disease in patients with obstructive sleep apnea

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World Journal of Clinical Cases 2021年第19期9卷 5112-5125页

作者： Haruka Hirono Kazuhiko Watanabe Katsuhiko Hasegawa Masaki Kohno shuji Terai Shogo Ohkoshi Department of Internal Medicine The Nippon Dental University School of Life Dentistry at NiigataNiigata 951-8580Japan The Center for Dental Sleep Medicine The Nippon Dental University Niigata HospitalNiigata 951-8580Japan Division of Gastroenterology and Hepatology Graduate School of Medical and Dental SciencesNiigata UniversityNiigata 951-8510Japan

BACKGROUND Obstructive sleep apnea(OSA)has been suggested as an independent risk factor for nonalcoholic fatty liver disease(NAFLD),and continuous positive airway pressure(CPAP)is the first-line therapy for *** To clarify the efficacy of effective CPAP therapy on NAFLD of OSA patients by serum markers and transient elastography(TE)using FibroScan®(Echosens,Paris,France).METHODS We prospectively enrolled 123 consecutive patients with OSA who met the indications for *** fibrosis and steatosis were assessed using *** and after 6 mo of CPAP therapy,serum markers and TE were assessed for all *** mean usage rate of CPAP therapy for 6 mo was arbitrarily calculated in each patient and expressed as“mean compliance index”(m-CI).RESULTS In 50 OSA patients with NAFLD,both aspartate aminotransferase(AST)and alanine aminotransferase(ALT)levels were significantly decreased after 6 mo of CPAP *** analysis showed that decreased body weight(BW),decreased body mass index(BMI),decreased AST level,decreased hemoglobin A1c,and high m-CI were significantly related with improved ALT *** multivariate regression model adjusted for quantities of BW change during 6 mo of CPAP therapy,high m-CI tended to improve ALT level(P=0.051).All 17 OSA patients with NAFLD,high m-CI and no BMI changes showed significant improvements in AST and ALT ***,no significant changes in TE data or serum fibrosis markers were *** Some NAFLD could be associated with chronic intermittent hypoxia due to OSA independent of BW *** those cases,adequate reoxygenation from effective CPAP therapy may improve NAFLD.

关键词： Nonalcoholic fatty liver disease Obstructive sleep apnea Continuous positive airway pressure Chronic intermittent hypoxia Transient elastography

Endoscopic submucosal dissection as excisional biopsy for anorectal malignant melanoma:A case report

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World Journal of Clinical Cases 2019年第13期7卷 1652-1659页

作者： Shigeo Manabe Yoshio Boku Michiyo Takeda Fumitaka Usui Ikuhiro Hirata shuji Takahashi Department of Gastroenterology Kouseikai Takeda Hospital Kyoto 600-8558 Japan Fujita Clinic 67 Gokiya-cho Oomiya-dori Shichijo-kudaru Shimogyo-ku Kyoto 600-8267 Japan

BACKGROUND Anorectal malignant melanoma(AMM)is a rare disorder with an extremely poor *** there is currently no consensus on the treatment methods for AMM,surgical procedures have been the most common treatment methods used until *** recently encountered a case of AMM that we diagnosed using endoscopic submucosal dissection(ESD).To our knowledge,this is the first case of ESD for AMM,suggesting that ESD can potentially be a diagnostic and treatment method for *** S UMA/MARY A 77-year-old woman visited our hospital with a chief complaint of anal bleeding and a palpable rectal *** revealed a 20-mm protruded lesion in the lower *** obtaining biopsy specimens from the lesion,although a malignant rectal tumor was suspected,a definitive diagnosis was not *** ultrasonography revealed tumor invasion into the submucosal layer but not the muscular ***,we performed an excisional biopsy using *** examination of the ESD-resected specimen revealed tumor cells positive for Human Melanin Black-45,Melan-A,and ***,the tumor cells lacked melanin pigment;thus,a diagnosis of amelanotic AMM was *** the AMM had massively invaded the submucosal layer and both lymphatic and venous invasion were present,we closely monitored the patient without any additional therapy on the basis of her *** months after ESD,local recurrence was detected,and the patient consented to wide local *** USION It is suggested that ESD is a potential diagnostic and treatment method for AMM.

关键词： Endoscopic submucosal dissection Anorectal malignant melanoma Endoscopic mucosal resection Case report

PROCESSING AND PROPERTIES OF Nb_3Al ALLOYS

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Acta Metallurgica Sinica(English Letters) 1995年第Z1期8卷 477-487页

作者： HANADA shuji TABARU Tatsuo and GNMAMOORTHY Rajappa(Institute for Materials Research, Tohoku University, Sendai 980-77, Japan) Tohoku Univ Soudai Japan

In the development of Nb_3Al alloys as high temperature structural materials, the incorporation of a ductile phase is essential to increase fracture toughness. Various processes for fabricating Nb_3Al matrix in-situ composites consisting of Nb_3Al and a Nb solid solution are briefly mentioned and mechanical properties of the composites are discussed in relation to the characteristic microstructures produced during processing.

关键词： Nb_3Al ductile phase toughening composite,strength fracture behavior

Pyloric-gland metaplasia may be an origin of cancer and intestinal metaplasia with possible CDX2 expression

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Gastroenterology Report 2021年第4期9卷 370-373,I0003页

作者： Kazuyoshi Yagi Atsunori Tsuchiya Satoru Hashimoto Taisuke Kato Osamu Onodera shuji Terai Department of Gastroenterology and Hepatology Uonuma Institute of Community MedicineNiigata University Medical and Dental HospitalNiigataJapan Division of Gastroenterology and Hepatology Graduate School of Medical and Dental SciencesNiigata UniversityNiigataJapan Department of System Pathology for Neurological Disorders Brain Science BranchBrain Research InstituteNiigata UniversityNiigataJapan Department of Neurology Brain Research InstituteNiigata UniversityNiigataJapan

Introduction The majority of cases of gastric cancer are thought to develop due to chronic inflammation from Helicobacter pylori(***)infection leading to intestinal metaplasia,termed the intestinal metaplasia–dysplasia–cancer sequence[1].Chronic inflammation from *** infection causes mucin core protein 6-positive(MUC6t)pyloric-gland metaplasia;however,its origin is *** MUC6t pyloric-gland metaplasia is similar to spasmolytic polypeptide-expressing metaplasia in mouse studies[2–4].

关键词：肠上皮化生幽门腺 Helicobacter CDX2

Oncological problems in pancreatic cancer surgery

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World Journal of Gastroenterology 2006年第28期12卷 4466-4472页

作者： Akimasa Nakao Tsutomu Fujii Hiroyuki Sugimoto Naohito Kanazumi shuji Nomoto Yasuhiro Kodera Soichiro Inoue Shin Takeda Department of Surgery Ⅱ Nagoya University Graduate School of MedicineNagoyaJapan

Despite the development of more sophisticated diagnostic techniques, pancreatic carcinoma has not yet been detected in the early stage. Surgical resection provides the only chance for cure or long-term survival. The resection rate has increased due to recent advances in surgical techniques and the application of extensive surgery. However, the postoperative prognosis has been poor due to commonly occurring liver metastasis, local recurrence and peritoneal dissemination. Recent molecular-biological studies have clarified occult metastasis, micrometastasis and systemic disease in pancreatic cancer. Several oncological problems in pancreatic cancer surgery are discussed in the present review.

关键词： Pancreatic cancer Extended resection Molecular diagnosis Micrometastasis Adjuvant therapy

Considerations of elderly factors to manage the complication of liver cirrhosis in elderly patients

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World Journal of Gastroenterology 2019年第15期25卷 1817-1827页

作者： Kenya Kamimura Akira Sakamaki Hiroteru Kamimura Toru Setsu Takeshi Yokoo Masaaki Takamura shuji Terai Division of Gastroenterology and Hepatology Graduate School of Medical and Dental Sciences Niigata University

The aging of the organ function causes sensitivity to the disease progression and need careful consideration for the medical treatment. With the increase of aging population, the opportunity to provide medical treatment for people in very old age is rapidly increasing therefore, the understanding of the various physiological changes of cellular function, size and function of organs are essential for the decision of therapeutic options. Among the various chronic conditions seen in elderly people, we have focused on liver cirrhosis, since despite specific therapeutic options for many of liver diseases including direct acting antivirals for hepatitis C virus, nucleoside analogs for hepatitis B, and corticosteroids for autoimmune hepatitis, there is currently no standard therapy to treat liver cirrhosis, which is the final stage of these liver diseases. Therefore,management of the various symptoms of liver cirrhosis is essential, and agingrelated parameters must be considered in the decision making for therapeutic strategies and dosage of the available medicine. In this mini-review, we have summarized the therapeutic options to manage various symptoms of liver cirrhosis, carefully considering the physiological changes of various organs associated with aging.

关键词： Liver cirrhosis Elderly patients Quality of life Aging

Successful laparoscopic splenectomy after living-donor liver transplantation for thrombocytopenia caused by antiviral therapy

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World Journal of Gastroenterology 2008年第26期14卷 4245-4248页

作者： Hiroyuki Kato Masanobu Usui Yoshinori Azumi Ichiro Ohsawa Masashi Kishiwada Hiroyuki Sakurai Masami Tabata shuji Isaji Department of Hepatobiliary Pancreatic Surgery Mie University Graduate School of Medicine Tsu Mie 514-8507 Japan

Although interferon (IFN) based therapy for recurrent hepatitis C virus (HCV) infection after liver transplantation has been widely accepted, it induces various adverse effects such as thrombocytopenia, resulting in its interruption. Recently, concomitant splenectomy at the time of living donor liver transplantation (LDLT) has been tried to overcome this problem, but this procedure leads to several complications such as excessive intraoperative bleeding and serious infection. A 60-year-old female received LDLT using a left lobe graft from her second son for liver failure caused by hepatitis C-related cirrhosis. Six months after LDLT, she was diagnosed as recurrent HCV infection by liver biopsy. IFN monotherapy was started from 7 mo after LDLT and her platelet count decreased to less than 50 000/μL, which thus made it necessary to discontinue the treatment. We decided to attempt laparoscopic splenectomy (LS) under general anesthesia. Since intra-abdominal findings did not show any adhesion formations around the spleen, LS could be successfully performed. After LS, since her platelet count immediately increased to 225 000/μL 14 d after operation, IFN therapy was restarted and we could convert the combination therapy of IFN and ribavirin, resulting in no detectable viral marker. Inconclusion, LS can be performed safely even after LDLT, and LS after LDLT is a feasible and less invasive modality for thrombocytopenia caused by antiviral therapy.

关键词： Concomitant splenectomy Portal veinthrombosis Ribavirin