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Severe acute cholestatic hepatitis of unknown etiology successfully treated with the Chinese herbal medicine Inchinko-to (TJ-135)

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World Journal of Gastroenterology 2009年第23期15卷 2927-2929页

作者： susumu ohwada Isao Kobayashi Nobuo Harasawa Kyoichiro Tsuda Yosikatsu Inui Kanetsu Chuo Hospital Kitaharacho 71 Takasaki Gunma 370-3513 Japan Inui Clinic of Internal Medicine Shimokobanamachi Takasaki Gunma 370-0076 Japan

Severe acute hepatitis of unknown etiology is difficult to treat and often progresses to subacute fulminant hepatitis or late-onset hepatic failure. A 45-year-old wellnourished, healthy man had progressive fatigue and his liver function tests showed severe liver dysfunction. The etiology of sever acute cholestatic hepatitis was unknown. The liver function tests normalized gradually, which excluded high persistent total bilirubin after starting on predonine. A liver biopsy showed chronic active hepatitis with mild f ibrosis (A2, F1). Oral Inchinko-to, a Chinese herbal medicine, at 7.5 g daily was prescribed. The treatment was effective with no adverse effects. We present a successfully treated case and discuss hepatoprotective and choleretic effects of Inchinko-to.

关键词： Acute cholestatic hepatitis Etiology Inchinko-to Herbal medicine

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Xanthogranulomatous cholangitis causing obstructive jaundice:A case report

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World Journal of Gastroenterology 2006年第27期12卷 4428-4430页

作者： susumu Kawate susumu ohwada Hayato Ikota Kunihiro Hamada Kenji Kashiwabara Yasuo Morishita Department of Surgery Gunma University Graduate School of MedicineGunma 371-8511Japan Clinical Department of Pathology Gunma University HospitalMaebashiGunma 371-8511Japan

This article reports the case of a 34-year-old woman with xanthogranulomatous cholangitis who developed obstructive jaundice. Microscopically, the bile duct was surrounded and narrowed by a xanthogranulomatous lesion, but no xanthogranulomatous cholecystitis was seen. Although percutaneous cholangiograms done via the transhepatic biliary drainage showed smooth narrowing of the upper to middle bile duct, the cytology of bile was diagnosed as class V adenocarcinoma. Therefore, right extended hepatectomy and extrahepatic bile duct resection were performed. The differentiation of benign and malignant strictures at the hepatic hilum is often difficult. Xanthogranulomatous cholangitis is one possible diagnosis of a bile duct stricture. Precise review of all the preoperative information is required to make a correct diagnosis.

关键词： Xanthogranulomatous cholangitis Obstructive jaundice Bile cytology Bile duct stricture

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Prognostic significance of BMP and activin membrane-bound inhibitor in colorectal cancer

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World Journal of Gastroenterology 2008年第31期14卷 4880-4888页

作者： Nozomi Togo susumu ohwada Shinji Sakurai Hiroyuki Toya Ichiro Sakamoto Tatsuya Yamada Tetsuhiro Nakano Ken Muroya Izumi Takeyoshi Takashi Nakajima Takashi Sekiya Yusuke Yamazumi Tsutomu Nakamura Tetsu Akiyama Departments of Surgery Graduate School of Medicine Gunma University Gunma 371-8511 Japan Departments of Tumor Pathology Graduate School of Medicine Gunma University Gunma 371-8511 Japan Laboratory of Molecular and Genetic Information Institute for Molecular and Cellular Biosciences University of Tokyo Tokyo 113-0032 Japan

AIM： To investigate the clinical significance of BMP and activin membrane-bound inhibitor （BAMBI） which is a pseudoreceptor of transforming growth factorbeta （TGF-β） type 1 receptors and acts as a negative regulator of TGF-β signaling and expression aberrantly elevated in colorectal cancers （CRCs）. We studied BAMBI expression in CRCs. METHODS： We studied BAMBI expression in 183 surgically resected CRCs by immunochemical and immunoblotting analyses using a generated monoclonal anti-BAMBI antibody. Commercially available anti-β- catenin and anti-p53 antibodies were also applied for immunochemical analyses as a comparison ***： Immunohistochemical analysis revealed that BAMBI expression was observed in 148 （80.8%）, and strong BAMBI expression was observed in 46% of the CRCs. Strong BAMBI expression was positively correlated with histological type, depth of invasion, lymph node metastases, and tumor node metastasis （TNM） stage （P 〈 0.05）. Clear associations were found between BAMBI and β-catenin （P = 0.035） and p53 （P =0.049） expression. In curatively resected CRC, 5-year recurrence-free survival was 51.9% （P = 0.037） for strong BAMBI expression compared to 79.8% for weak BAMBI expression. In the Cox＇s multivariate analysis, lymph node metastases （relative risk 6.685; P 〈 0.001） and depth of invasion （RR 14.0; P = 0.013） were significant indicators for recurrence, and strong BAMBI expression （RR 2.26; P = 0.057） tended to be significant. CONCLUSION： BAMBI was linked to a potentially aggressive tumor phenotype and predicted tumor recurrence and cancer-related death in CRC. BAMBI expression might be applicable in the routine clinical setting of CRC.

关键词： BMP and activin membrane-bound inhibitor Colorectal cancer Transforming growth factor-beta signal Prognosis Wnt signal

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