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1.5 Harmonic Imaging Sonography with microbubble contrast agent improves characterization of hepatocellular carcinoma

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World Journal of Gastroenterology 2005年第36期11卷 5607-5613页

作者： Kouji Yamamoto Katsuya Shiraki Shigeo Nakanishi Hiroyuki Fuke takeshi Nakano Akira Hashimoto Atsuya Shimizu Toshinobu Hamataki First Department of Internal Medicine Mie University School of Medicine Tsu Mie 514-8507 Japan Department of Internal Medicine Saiseikai Matsusaka General Hospital Matsusaka Mie 515-8557 Japan Sales Engineering Department Toshiba Medical Systems Corporation Nagoya Aichi 450-0003 Japan

AIM： TO investigate the usefulness of 1.5 Harmonic Imaging Sonography with the use of the contrast agent Levovist for the diagnosis of hepatocellular carcinoma （HCC） and for the evaluation of therapeutic response. METHODS： Phantom experiments were performed to compare the contrast effects of 2^rd harmonic imaging and 1.5 Harmonic Imaging Sonography. 1.5 Harmonic Imaging Sonography was employed to examine 36 patients with HCC （42 nodules） before and after the treatment and to compare against the findings obtained using other diagnostic imaging modaUties. RESULTS： In 1.5 Harmonic Imaging Sonography, the tumor vessels of HCCs were clearly identified during the early phase, and late-phase images clearly demonstrated the differences in contrast enhancement between the tumor and surrounding hepatic parenchyma. Blood flow within the tumor was detected in 36 nodules （85.7%） during the early phase and in all 42 nodules （100%） during the late phase using 1.5 Harmonic Imaging Sonography, in 38 nodules （90.5%） using contrast-enhanced CT, in 34 nodules （81.0%） using digital subtraction angiography （DSA）, and in 42 nodules （100%） using US CO2angiography. Following transcatheter arterial embolization, 1.5 Harmonic Imaging Sonography detected blood flow and contrast enhancement within the tumors that were judged to contain viable tissue in 20 of 42 nodules （47.6%）. However, 6 of these 20 cases were not judged in contrastenhanced CT. 1.5 Harmonic Imaging Sonography was compared with the US CO2 angiography findings as the gold standard, and the sensitivity and specificity of these images for discerning viable and nonviable HCC after transcatheter arterial embolization were 100% and 100%,respectively. CONCLUSION： 1.5 Harmonic Imaging Sonography permits the vascular structures of HCCs to be identified and blood flow within the tumor to be clearly demonstrated. Furthermore, 1.5 Harmonic Imaging Sonography is potentially useful for evaluating the therapeutic effects of transcatheter arte

关键词： 1.5 Harmonic imaging sonography Hepatocellular carcinoma Microbubble

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Propensity score matching analysis for clinical impact of braided-type versus laser-cut-type covered self-expandable metal stents for endoscopic ultrasound-guided hepaticogastrostomy

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Hepatobiliary & Pancreatic Diseases International 2024年第2期23卷 181-185页

作者： Mitsuki Tomita takeshi Ogura Akitoshi Hakoda Saori Ueno Atsushi Okuda Nobu Nishioka Yoshitaro Yamamoto Hiroki Nishikawa 2nd Department of Internal Medicine Osaka Medical and Pharmaceutical UniversityOsakaJapan Endoscopy Center Osaka Medical and Pharmaceutical UniversityOsakaJapan

Background:To prevent stent migration during endoscopic ultrasound-guided hepaticogastrostomy(EUS-HGS),intra-scope channel release technique is important,but is unfamiliar to non-expert *** self-expandable metal stent(SEMS)is an additional factor to prevent stent ***,no compara-tive studies of laser-cut-type and braided-type during EUS-HGS have been *** aim of this study was to compare the distance between the intrahepatic bile duct and stomach wall after EUS-HGS among laser-cut-type and braided-type ***:To evaluate stent anchoring function,we measured the distance between the hepatic parenchyma and stomach wall before EUS-HGS,one day after EUS-HGS,and 7 days after ***,propensity score matching was performed to create a propensity score for using laser-cut-type group and braided-type ***:A total of 142 patients were enrolled in this *** them,24 patients underwent EUS-HGS using a laser-cut-type SEMS,and 118 patients underwent EUS-HGS using a braided-type ***-HGS using the laser-cut-type SEMS was mainly performed by non-expert endoscopists(n=21);EUS-HGS using braided-type SEMS was mainly performed by expert endoscopists(n=98).The distance after 1 day was significantly shorter in the laser-cut-type group than that in the braided-type group[2.00(1.70-3.75)vs.6.90(3.72-11.70)mm,P<0.001].In addition,this distance remained significantly shorter in the laser-cut-type group after 7 *** these results were similar after propensity score matching analysis,the distance between hepatic parenchyma and stomach after 7 days was increased by 4 mm compared with the distance after 1 day in the braided-type *** the other hand,in the laser-cut-type group,the distance after 1 day and 7 days was almost the ***:EUS-HGS using a laser-cut-type SEMS may be safe to prevent stent migration,even in non-expert hands.

关键词： Endoscopic ultrasound-guided hepaticogastrostomy Endoscopic ultrasound-guided biliary drainage Endoscopic retrograde cholangiopancreatography

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HER2 heterogeneity is a poor prognosticator for HER2-positive gastric cancer

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World Journal of Clinical Cases 2019年第15期7卷 1964-1977页

作者： Akio Kaito takeshi Kuwata Masanori Tokunaga Kohei Shitara Reo Sato Tetsuo Akimoto Takahiro Kinoshita Department of Gastric Surgery National Cancer Center Hospital EastKashiwa 277-8577Japan Department of Pathology and Clinical Laboratories National Cancer Center Hospital EastKashiwa 277-8577Japan Department of Gastrointestinal Oncology National Cancer Center Hospital EastKashiwa 277-8577Japan Exploratory Oncology Research&Clinical Trial Center(EPOC) National Cancer Center Hospital EastKashiwa 277-8577Japan Juntendo University Graduate School of Medicine Tokyo 163-8001Japan Department of Radiation Oncology National Cancer Center Hospital EastKashiwa 277-8577Japan

BACKGROUND The clinical significance of intratumoral human epidermal growth factor receptor 2(HER2)heterogeneity is unclear for HER2-positive gastric cancer,although it has been reported to be a significant prognosticator for HER2-positive breast cancer,which has received trastuzumab-based *** To clarify the clinical significance of intratumoral HER2 heterogeneity for HER2-positive gastric cancer,which has received trastuzumab-based *** Patients with HER2-positive unresectable or metastatic gastric cancer who received trastuzumab-based chemotherapy as a first line treatment were *** patients were classified into two groups according to their intratumoral HER2 heterogeneity status examined by immunohistochemistry(IHC)on endoscopic biopsy specimens before treatment,and their clinical response to chemotherapy and survival were *** A total of 88 patients were included in this study,and HER2 heterogeneity was observed in 23(26%)patients(Hetero group).The overall response rate was significantly better in patients without HER2 heterogeneity(Homo group)(Homo vs Hetero:79.5%vs 35.7%,P=0.002).Progression-free survival of trastuzumab-based chemotherapy was significantly better in the Homo group(median,7.9 vs 2.5 mo,HR:1.905,95%CI:1.109-3.268).Overall survival was also significantly better in the Homo group(median survival time,25.7 vs 12.5 mo,HR:2.430,95%CI:1.389-4.273).Multivariate analysis revealed IHC HER2 heterogeneity as one of the independent poor prognostic factors(HR:3.115,95%CI:1.610-6.024).CONCLUSION IHC of HER2 heterogeneity is the pivotal predictor for trastuzumab-based ***,HER2 heterogeneity should be considered during the assessment of HER2 expression.

关键词： Human epidermal growth factor receptor 2 Heterogeneity Trastuzumab Gastric cancer Chemotherapy

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Hepatocellular carcinoma effective stereotactic body radiotherapy using Gold Anchor and the Synchrony system:Two case reports and review of literature

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World Journal of Clinical Cases 2022年第8期10卷 2591-2603页

作者： Sakue Masuda Toshitaka Tsukiyama Yumiko Minagawa Kazuya Koizumi Makoto Kako takeshi Kinbara Uojima Haruki Department of Gastroenterology Shonankamakura General HospitalKanagawa 247-8533Japan Department of Interventional Radiology Center Shonan Kamakura General HospitalKanagawa 247-8533Japan Department of Radiation Oncology Shonan Kamakura General HospitalKanagawa 247-8533Japan

BACKGROUND Radiotherapy for hepatocellular carcinoma(HCC)is considered to have limited efficacy because of treatment intensity considering that the irradiated area includes the liver,which is highly *** this report,we present two cases in which tumor control by surgical resection,radiofrequency ablation,transcatheter arterial chemoembolization(TACE),and lenvatinib administration was difficult,but stereotactic body radiotherapy(SBRT)using the Synchrony system by Radixact?and Gold Anchor?(GA)was *** SUMMARY A 60-year-old man had a single 10-cm HCC in the right *** lesions remained after TACE,and levels of alpha-fetoprotein and protein induced by vitamin K antagonists II(PIVKA-II)decreased and quickly *** performed SBRT with *** weeks after implantation,localized radiotherapy(SBRT;40 Gy/5 fractions)was performed using the Synchrony system by Radixact?.Four weeks later,the viable lesion had disappeared,and the PIVKA-II levels decreased.A 77-year-old man had a single 12-cm HCC in the right *** patient experienced recurrence after *** recurrence occurred after TACE,and we performed SBRT with *** of the proximity of the HCC to the gastrointestinal tract,localized radiotherapy(SBRT;39 Gy/13 fractions)to the HCC was performed 3 wk after implantation using the Synchrony system by Radixact?.Four weeks later,the viable lesion had disappeared on computed tomography,and the PIVKA-Ⅱlevels *** SBRT using the Synchrony system and GA can deliver a large dose accurately and safely,and could have a high therapeutic effect.

关键词： Fiducial marker Hepatocellular carcinoma Gold Anchor■ Radixact■ Stereotactic body radiotherapy Case report

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Isolated arterioportal fistula presenting with variceal hemorrhage

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World Journal of Gastroenterology 2013年第17期19卷 2714-2717页

作者： Anupama Nookala Behnam Saberi Ramon Ter-Oganesyan Gary Kanel Phillip Duong takeshi Saito Division of Gastroenterology and Liver Diseases Department of Medicine University of Southern California Los Angeles Department of Radiology University of Southern California Department of Pathology University of Southern California

We report a case of life-threatening hematemesis due to portal hypertension caused by an isolated arterioportal fistula (APF). Intrahepatic APFs are extremely rare and are a cause of presinusoidal portal hypertension. Etiologies for APFs are comprised of precipitating trauma, malignancy, and hereditary hemorrhagic telangiectasia, but these were not the case in our patient. Idiopathic APFs are usually due to congenital vascular abnormalities and thus usually present in the pediatric setting. This is one of the first cases of adult-onset isolated APF who presented with portal hypertension and was successfully managed through endoscopic hemostasis and subsequent interventional radiological embolization.

关键词： Arterioportal fistula Presinusoidal portal hypertension Hepatic vein pressure gradient Hepatic artery embolization

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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

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Irritable bowel syndrome evaluation using computed tomography colonography

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World Journal of Gastroenterology 2016年第42期22卷 9394-9399页

作者： Hideki Ohgo Hiroyuki Imaeda Minoru Yamaoka Kazuaki Yoneno Naoki Hosoe takeshi Mizukami Hidetomo Nakamoto Department of Gastroenterology Saitama Medical University Department of General Internal Medicine Saitama Medical University Center for Diagnostic and Therapeutic Endoscopy School of Medicine Keio University Endoscopy Center NHO Kurihama Medical and Addiction Center

AIM To evaluate the morphology of the colon in patients with irritable bowel syndrome(IBS) by using computed tomography colonography(CTC).METHODS Twelve patients with diarrhea type IBS(IBS-D), 13 patients with constipation type IBS(IBS-C), 12 patients with functional constipation(FC) and 14 control patients underwent colonoscopy following CTC. The lengths of the rectosigmoid colon, transverse colon and the total colon were measured. The diameters of the rectum, sigmoid colon, descending colon, transverse colon, and ascending colon were *** The mean length of the total colon was 156.5 cm in group C, 158.9 cm in group IBS-D, 172.0 cm in group IBS-C, and 188.8 cm in group FC. The total colon in group FC was significantly longer than that in group C(P < 0.05). The mean length of the rectosigmoid colon was 56.2 cm, 55.9 cm, 63.6cm, and 77.4 cm(NS). The mean length of the transverse colon was 49.9 cm, 43.1 cm, 57.0 cm, and 55.0 cm. The transverse colonin group IBS-D was significantly shorter than that in group IBS-C(P < 0.01) and that in group FC(P = 0.02). The mean diameter of the sigmoid colon was 4.0 cm, 3.3 cm, 4.2 cm, and 4.3 cm(NS). The mean diameter of the descending colon was 3.6 cm, 3.1 cm, 3.8 cm, and 4.3 cm. The descending colon diameter in group IBS-D was significantly less than that in group IBS-C(P = 0.03) and that in group FC(P < 0.001). The descending colon diameter in group FC was significantly greater than that in group C(P = 0.04). The mean diameter of the transverse colon was 4.4 cm, 3.3 cm, 4.2 cm, and 5.0 cm(NS).CONCLUSION CT colonography might contribute the clarification of subtypes of IBS.

关键词： Constipation Irritable bowel syndrome Computed tomography colonography

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Hydrogen promotes the activation of Cu, Zn superoxide dismutase in a rat corneal alkali-burn model

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International Journal of Ophthalmology(English edition) 2020年第8期13卷 1173-1179页

作者： takeshi Arima Tsutomu Igarashi Masaaki Uchiyama Maika Kobayashi Ikuroh Ohsawa Akira Shimizu Hiroshi Takahashi Department of Ophthalmology Nippon Medical SchoolTokyo1138602Japan Department of Analytic Human Pathology Nippon Medical SchoolTokyo1138602Japan Biological Process of Aging Tokyo Metropolitan Institute of GerontologyTokyo173-0015Japan

AIM: To investigate the effects of hydrogen(H2) on Cu, Zn superoxide dismutase(SOD1) activation in a rat model of corneal alkali burn. METHODS: In each rat, one cornea was subjected to alkali exposure. Physiological saline(saline group) or H2-dissolved saline(H2 group) was instilled continuously on the cornea for 5 min before and after alkali exposure. Inflammatory cells, neovascularization, and cytoplasmic SOD1 levels were evaluated immunohistochemically in enucleated eyes from both groups. Three-dimensional ultrastructural tissue changes in the eyes were analyzed using low-vacuum scanning electron ***: The numbers of both inflammatory and vascular endothelial cells were significantly reduced in the corneas of the H2 group(P<0.01). Furthermore, H2 treatment increased both cytoplasmic SOD1 levels(P<0.01) and activity in corneal epithelial cells(P<0.01). Notably, the SOD1 activity level in the H2 group was approximately 2.5-fold greater than that in the saline ***: H2 treatment suppresses inflammation and neovascularization in the injured cornea and indirectly suppresses oxidative insult to the cornea by upregulating the SOD1 enzyme protein level and activity.

关键词： hydrogen alkali burn Cu,Zn superoxide dismutase low-vacuum scanning electron microscopy rats

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Generation of Iroha-Uta Using Frequency Distribution of Kana

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Journal of Shanghai University(English Edition) 2001年第Z1期5卷 152-157页

作者： takeshi Akatsuka

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Advances in refractory ulcerative colitis treatment: A new therapeutic target, Annexin A2

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World Journal of Gastroenterology 2015年第29期21卷 8776-8786页

作者： Satoshi Tanida Tsutomu Mizoshita Keiji Ozeki Takahito Katano Hiromi Kataoka takeshi Kamiya Takashi Joh Department of Gastroenterology and Metabolism Nagoya City University Graduate School of Medical Sciences Nagoya city Aichi prefecture

Medical treatment has progressed significantly over the past decade towards achieving and maintaining clinical remission in patients with refractory ulcerative colitis(UC). Proposed mediators of inflammation in UC include pro-inflammatory cytokines such as tumor necrosis factor-α(TNF-α) and interleukin-2, and the cellsurface adhesive molecule integrin α4β7. Conventional therapeutics for active UC include 5-aminosalicylic acid, corticosteroids and purine analogues(azathioprine and 6-mercaptopurine). Patients who fail to respond to conventional therapy are treated with agents such as the calicineurin inhibitors cyclosporine and tacrolimus, the TNF-α inhibitors infliximab or adalimumab, or a neutralizing antibody(vedolizumab) directed against integrin α4β7. These therapeutic agents are of benefit for patients with refractory UC, but are not universally effective. Our recent research on TNF-α shedding demonstrated that inhibition of annexin(ANX) A2 may be a new therapeutic strategy for the prevention of TNF-α shedding during inflammatory bowel disease(IBD) inflammation. In this review, we provide an overview of therapeutic treatments that are effective and currently available for UC patients, as well as some that are likely to be available in the near future. We also propose the potential of ANX A2 as a new molecular target for IBD treatment.

关键词： Tumor necrosis factor-α Shedding Integrin α4β7 Epidermal growth factors

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