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Hepatobiliary Surgery and Nutrition 2020年第6期9卷 815-816页

作者： Yoshio Sumida takeshi okanoue Atsushi Nakajima Japan Study Group of NAFLD(JSG-NAFLD) Division of Hepatology and Pancreatology Department of Internal MedicineAichi Medical UniversityAichiKarimataJapan Hepatology Center Saiseikai Suita HospitalSuitaOsakaJapan Department of Gastroenterology and Hepatology Yokohama City UniversityKanagawaJapan 不详

We read with great interest the article by Wong and colleagues(1).Hepatic fibrosis is the most important determinant of mortality in patients with NAFLD(2).Although noninvasive tests or imaging modalities such as FibroScan and MR elastography have been developed for evaluation of hepatic fibrosis(3),liver biopsy is now the gold standard.Liver biopsy has several drawbacks including intra-observers’and inter-observers’variability(4-7),because the histology-based fibrosis is depend on the subjective evaluation by the pathologists.In this article,automated quantification of fibrosis-related parameters(q-FPs)using dual-photon microscopy can accurately diagnose fibrosis stage and predict cumulative incidence of liver-related events(1).It is expected that this novel method will replace diagnosis by pathologists.

关键词： diagnosis NAFLD replace

Factors associated with the overall survival of elderly patients with hepatocellular carcinoma

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World Journal of Gastroenterology 2012年第16期18卷 1926-1932页

作者： Hideki Fujii Yoshito Itoh Naoki Ohnishi Masafumi Sakamoto Tohru Ohkawara Yoshihiko Sawa Koichi Nishida Yasuo Ohkawara Kanji Yamaguchi Masahito Minami takeshi okanoue Department of Internal Medicine Aiseikai Yamashina HospitalKyoto 602-8566Japan Molecular Gastroenterology and Hepatology Kyoto Prefectural University of MedicineGraduate School of Medical ScienceKyoto 602-8566Japan Hepatology Center Saiseikai Suita HospitalOsaka 564-0013Japan

AIM:To identify the factors associated with overall survival of elderly patients with hepatocellular carcinoma(HCC).METHODS:A total of 286 patients with HCC(male/female:178/108,age:46-100 years),who were diagnosed and treated by appropriate therapeutic procedures between January 2000 and December 2010,were enrolled in this study.Patients were stratified into two groups on the basis of age:Elderly(≥ 75 years old) and non-elderly(< 75 years old).Baseline clinical characteristics as well as cumulative survival rates were then compared between the two groups.Univariate and multivariate analyses were used to identify the factors associated with prolonged overall survival of patients in each group.Cumulative survival rates in the two groups were calculated separately for each modified Japan Integrated Stage score(mJIS score) category by the Kaplan-Meier method.In addition,we compared the cumulative survival rates of elderly and non-elderly patients with good hepatic reserve capacity(≤ 2 points as per mJIS).RESULTS:In the elderly group,the proportion of female patients,patients with absence of hepatitis B or hepatitis C viral infection,and patients with coexisting extrahepatic comorbid illness was higher(56.8% vs 31.1%,P < 0.001;27.0% vs 16.0%,P = 0.038;33.8% vs 22.2%,P = 0.047;respectively) than that in the nonelderly group.In the non-elderly group,the proportion of hepatitis B virus(HBV)-infected patients was higher than that in the elderly group(9.4% vs 0%,P = 0.006).The cumulative survival rates in the elderly group were 53.7% at 3 years and 32.9% at 5 years,which were equivalent to those in the non-elderly group(55.9% and 39.4%,respectively),as shown by a log-rank test(P = 0.601).In multivariate analysis,prolonged survival was significantly associated with the extent of liver damage and stage(P < 0.001 and P < 0.001,respectively),but was not associated with patient age.However,on individual evaluation of factors in both groups,stage was significantly(P < 0.001) associated with prolonged survival.Regarding mJIS scor

关键词：中老年生存期患者肝癌肝功能损害肝炎病毒治疗程序病毒感染

Multifocal intraportal invasion of breast carcinoma diagnosed by laparoscopy-assisted liver biopsy

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World Journal of Gastroenterology 2005年第15期11卷 2360-2363页

作者： Tomoki Nakajima Satoru Sekoguchi Taichirou Nishikawa Hidetaka Takashima Tadashi Watanabe Masahito Minami Yoshito Itoh Naruhiko Mizuta Hiroo Nakajima takeshi Mazaki Akio Yanagisawa takeshi okanoue Molecular Gastroenterology and Hepatology Endocrine Surgery Surgical Pathology

Hepar lobatum carcinomatosum (HLC) is defined as an acquired hepatic deformity consisting of an irregularly lobulated hepatic contour caused by intravascular infiltration of metastatic carcinoma. To date, only nine cases of HLC have been reported in the literature. We report a case of a 68-year-old woman showing hepatic metastasis of breast carcinoma in radiologically unidentified form. Initially, she received left partial mastectomy for breast cancer but solid hepatic metastases were identified in S2 and S6, 9 mo after surgery. Then, they responded to chemotherapy and radiologically disappeared. After radiological disappearance of the liver tumors, the patient's blood chemistry showed abnormal liver function. A CT scan demonstrated heterogeneous enhancement effect in the liver in the late phase,suggesting uneven hepatic blood supply. Hepatic deformity was not obvious. Laparoscopy revealed a slightly deformed liver surface with multiple indentations and shallow linear depressions. Furthermore, a wide scar was observed on the surface of S2 possibly at the site where the metastatic tumor existed before chemotherapy. Liver biopsy from the wide scar lesion showed intraportal tumor thrombi with desmoplastic change. Because of its similarity to the histology of the original breast cancer, we concluded that the hepatic functional abnormalities and slightly deformed liver surface were derived from the circulatory disturbance caused by microscopic tumor thrombi. Besides, since the wide scar was located at the site of the pre-existing tumor,it is probable that chemotherapy was an important cause of fibrous scarring as a result of tumor regression. These morphologic findings are compatible with those of HLC.Laparoscopy-assisted liver biopsy was useful to make definite diagnosis, even though the hepatic deformity was radiologically undetectable.

关键词：乳腺肿瘤诊断方法腹腔镜检查肝脏组织活组织检查

Successful treatment with rifampin for fulminant antibiotics-associated colitis in a patient with non-Hodgkin's lymphoma

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World Journal of Gastroenterology 2004年第5期10卷 765-766页

作者： Kenichi Nomura Yosuke Matsumoto Naohisa Yoshida Sawako Taji Naoki Wakabayashi Shoji Mitsufuji Shigeo Horiike Masuji Morita takeshi okanoue Masafumi Taniwaki Molecular Hematology and Oncology Kyoto Prefectural University of Medicine Graduate School of Medical ScienceKyotoJapan Molecular Gastroenterology and Hepatology Kyoto Prefectural University of Medicine Graduate School of Medical ScienceKyotoJapan School of Nursing Kyoto Prefectural University of Medicine Graduate School of Medical ScienceKyotoJapan Clinical Molecular Genetics and Laboratory Medicine Kyoto Prefectural University of Medicine Graduate School of Medical ScienceKyotoJapan

A 74-year-old man was admitted to the hospital because of chemotherapy for relapsed non-Hodgkin's lymphoma (NHL).The patient became febrile and experienced diarrhea after chemotherapy. Although ceftazidime and amikacin sulfate were administered as empiric therapy, diarrhea was continued.After several days, stool cytotoxin assay for clostridium difficile (C. difficile) was positive and he was diagnosed as having antibiotics-associated colitis (AAC). Although antibiotics were discontinued and both oral vancomycin and metronidazole were administrated, disease was not improved. To rule out the presence of an additional cause of diarrhea, colon fiberoscopic examination was performed. It revealed multiple deep ulcerative lesions at right side colon, surface erosive and minute erosive lesions in all continuous colon.Pseudomembranes were not seen. These findings are compatible with AAC without pseudomembranes. There are no reports that the rifampin is effective on refractory AAC.However, we administered oral rifampin for the current patient.The reasons are 1) conventional antibiotics were not effective,2) rifampin has excellent in vitro activity against C. difficile,and 3) the efficacy of rifampin on relapsing colitis due to C.difficile is established. After administration of rifampin, fever alleviated and diarrhea was improved. Because AAC may result in significant mortality, patients with refractory or fulminant AAC should be treated with oral rifampin from outset.

关键词：暴发性抗生素相关性大肠炎利福平非何杰金氏淋巴瘤抗药性羧形菌病例报告

Detection of BCL2-IGHrearrangement on paraffin-embedded tissue sections obtained from a small submucosal tumor of the rectum in a patient with recurrent follicular lymphoma

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World Journal of Gastroenterology 2004年第17期10卷 2602-2604页

作者： Naohisa Yoshida Kenichi Nomura Yosuke Matsumoto Kazuhiro Nishida Naoki Wakabayashi Hideyuki Konishi Shoji Mitsufuji Keisho Kataoka takeshi okanoue Masafumi Taniwaki Molecular Gastroenterology and Hepatology Kyoto Prefectural University of Medicine Graduate School of Medical ScienceKyoto 602-8566Japan Molecular Hematology and Oncology Kyoto Prefectural University of Medicine Graduate School of Medical ScienceKyoto 602-8566Japan Clinical Molecular Genetics and Laboratory Medicine Kyoto Prefectural University of Medicine Graduate School of Medical ScienceKyoto 602-8566Japan

A 59-year-old woman was admitted to our hospital because of recurrent follicular lymphorna (FL). Colonoscopic examination revealed a rectal submucosal tumor (SMT) without any erosions and ulcers. In this patient, it was difficult to distinguish non-Hodgkin's lymphoma (NHL) invasion from other disorders of the colon including carcinoid tumor merely based on endoscopic findings. Histopathologic and immunohistochemical studies on biopsy specimens showed an infiltration of atypical lymphocytes that were positive for CD20 and BCL2 but negative for UCHL-1. Fluorescence in situ hybridization on paraffin-embedded tissue sections (T-FISH) identified a translocation of BCL2 with IGHgene.Based on these findings, the tumor was defined as an invasion of FL. T-FISH method is useful for the detection of a monoclonality of atypical lymphocytes in an SMT of the gastrointestinal tract, and particularly for the detection of chromosomal translocations specific to lymphoma subtypes.

关键词： BCL2-IGH 整理作用石蜡植入组织切片粘膜下层瘤周期发作性囊性淋巴瘤肿瘤

Lansoprazole ameliorates intestinal mucosal damage induced by ischemia-reperfusion in rats

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World Journal of Gastroenterology 2004年第19期10卷 2814-2817页

作者： Hiroshi Ichikawa Norimasa Yoshida Tomohisa Takagi Naoya Tomatsuri Kazuhiro Katada Yutaka Isozaki Kazuhiko Uchiyama Yuji Naito takeshi okanoue Toshikazu Yoshikawa Department of Food Sciences and Nutritional Health Faculty of Human EnvironmentKyoto Prefectural University606-8522Japan Department of Molecular Gastroenterology and Hepatology Graduate School of Medical SciencesKyoto Prefectural University of Medicine606-8522Japan Department of Inflammation and Immunology Graduate School of Medical SciencesKyoto Prefectural University of Medicine606-8522Japan

AIM: To investigate the protective effect of lansoprazoleon ischemia and reperfusion (I/R)-induced rat intestinalmucosal injury in vivo.METHODS: Intestinal damage was induced by clampingboth the superior mesenteric artery and the celiac trunkfor 30 rain followed by reperfusion in male Sprague-Dawleyrats. lansoprazole was given to rats intraperitoneally 1 hbefore vascular clamping.RESULTS: Both the intraluminal hemoglobin and proteinlevels, as indices of mucosal damage, significantlyincreased in I/R-groups comparion with those of sham-operation groups. These increases in intraluminal hemoglobinand protein levels were significantly inhibited by the treatmentwith lansoprazole at a dose of 1 mg/kg. Small intestineexposed to I/R resulted in mucosal inflammation that wascharacterized by significant increases in thiobarbituric acid-reactive substances (TBARS), tissue-associatedmyeloperoxidase activity (MPO), and mucosal content of ratcytokine-induced neutrophil chemoattractant-1 (CINC-1).These increases in TBARS, MPO activities and CINC-1 contentin the intestinal mucosa after I/R were all inhibited bypretreatment with lansoprazole at a dose of 1 mg/kg.Furthermore, the CINC-1 mRNA expression was increasedduring intestinal I/R, and this increase in mRNA expressionwas inhibited by treatment with lansoprazole.CONCLUSION: Lansoprazole inhibits lipid peroxidation andreduces development of intestinal mucosal inflammationinduced by I/R in rats, suggesting that lansoprazole mayhave a therapeutic potential for I/R injury.

关键词：羊毛二烯肠道黏膜病多次灌注液老鼠血色素

Lack of evidence for leukocyte maternal microchimerism in primary biliary cirrhosis

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World Journal of Gastroenterology 2004年第16期10卷 2415-2416页

作者： Kenichi Nomura Yoshio Sumida Takaharu Yoh Atsuhiro Morita Yosuke Matsumoto SawakoTaji NaohisaYoshida MasahitoMinami YoshitoItoh ShigeoHoriike Keisho Kataoka Masafumi Taniwaki takeshi okanoue Molecular Hematology and Oncology Kyoto Prefectural University of Medicine Graduate School of Medical ScienceKyoto 602-0841Japan Department of Internal Medicine National Nara HospitalNara 630-8305Japan Department of Internal Medicine Aiseikai Yamashina HospitalKyoto 607-8086Japan Ayabe city Hospital Kyoto 623-0011Japan Molecular Gastroenterology and Hepatology Kyoto Prefectural University of Medicine Graduate School of Medical ScienceKyoto 602-0841Japan Clinical Molecular Genetics and Laboratory Medicine Kyoto Prefectural University of Medicine Graduate School of Medical ScienceKyoto 602-0841Japan

It is reasonable to assume that microchimerism could also be involved in the induction of primary biliary cirrhosis (PBC). However, previous reports investigated only fetus-microchimerism in women patients. Maternal microchimerism has not been investigated until now.The current study aimed to clear either maternal microchimerism was involved in the pathogenesis of PBC or not.METHODS: We used fluorescence in situ hybridization on paraffin-embedded tissue (We called 'Tissue-FiSH'.) to determine whether maternal cells infiltrated in male patients who were diagnosed as having PBC. Tissue-FiSH was performed by using both X and Y specific probes on the biopsy liver sample of 3 male PBC patients.RESULTS: Infiltrating lymphocytes demonstrated both X and Y signals in all 3 male patients.CONCLUSION: Maternal microchimerism dose not play asignificant role in PBC. PBC may not relate to fetus and maternal microchimerism.

关键词：白细胞女性色谱法分析原发性胆汁性肝硬变肝脏疾病

Clear cell adenocarcinoma of the colon:A case report and review of literature

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World Journal of Gastroenterology 2008年第7期14卷 1137-1140页

作者： Koichi Soga Hideyuki Konishi Natsuko Tatsumi Chika Konishi Keimei Nakano Naoki Wakabayashi Shoji Mitsufuji Keisho Kataoka takeshi okanoue Ken-Ichi Mukaisho Takanori Hattori Molecular Gastroenterology and Hepatology Kyoto Prefectural University of Medicine Graduate School of Medical ScienceKyotoJapan Department of Pathology Shiga University of Medical ScienceShigaJapan

A primary clear cell adenocarcinoma of the colon is a rare oncologic entity. We herein report a case of such a tumor of the sigmoid colon in a 71-year-old woman who was successfully treated by an endoscopic polypectomy in our hospital. We also reviewed the published reports regarding cases of primary clear cell tumors in the colon.

关键词：肿瘤程序结肠癌内窥镜技术肿瘤细胞

Hepatitis B virus reactivation in a patient undergoing steroid-free chemotherapy

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World Journal of Gastroenterology 2004年第15期10卷 2301-2302页

作者： Daisuke Shimizu Kenichi Nomura Yosuke Matsumoto Kyoji Ueda Kanji Yamaguchi Masahito Minami Yoshito Itoh Shigeo Horiike Masuji Morita Masafumi Taniwaki takeshi okanoue Molecular Hematology and Oncology Kyoto Prefectural University of Medicine Graduate School of Medical ScienceKyoto 602-0841Japan Molecular Gastroenterology and Hepatology Kyoto Prefectural University of Medicine Graduate School of Medical ScienceKyoto 602-0841Japan School of Nursing Kyoto Prefectural University of Medicine Graduate School of Medical ScienceKyoto 602-0841Japan Molecular Hematology and Oncology Kyoto Prefectural University of Medicine Graduate School of Medical ScienceKyoto 602-0841Japan Clinical Molecular Genetics and Laboratory MedicineKyoto Prefectural University of Medicine Graduate School of Medical ScienceKyoto 602-0841Japan

A 62-year-old Japanese man who was positive for hepatitis B surface antigen (HBsAg) and anti-HBe antibody, underwent chemotherapy for non-Hodgkin's lymphoma (NHL). Mutations were detected in the precore region (nt1896) of HBV. Because steroid-containing regimen may cause reactivation of hepatitis B virus (HBV) and hepatitis may progress to be fulminant afcer its withdrawal, we administered CHO (CPA, DOX and VCR) therapy and the patient obtained complete response. However, he developed acute exacerbation of hepatitis due to HBV reactivation. Recovery was achieved with lamivudine (100 mg/d) and plasma exchange. The present case suggests that acute exacerbation of hepatitis can occur with steroid-free regimen. Because the efficacy of the prophylactic use of lamivudine has been reported and the steroid enhances curability of malignant lymphoma,the steroid containing regimen with prophylaxis of lamivudine should be evaluated further.

关键词：乙型肝炎 HBV 再生作用自由胆固醇化学疗法 CHO

Successful endoscopic hemostasis for gastric arterial bleeding due to invasion of malignant lymphoma

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World Journal of Gastroenterology 2005年第27期11卷 4285-4286页

作者： Kenichi Nomura Shinya Yamada Daisuke Shimizu Takashi Okuda Yuri Kamitsuji Naohisa Yoshida Yosuke Matsumoto Naoki Wakabayashi Kazuya Mikami Shigeo Horiike takeshi okanoue Masafumi Taniwaki Masafumi Taniwaki Molecular Gastroenterology and Hepatology Department of Urology Clinical Molecular Genetics and Laboratory Medicine

A 75-year-old male with malignant lymphoma (ML) accompanied with gastric lesion was treated with combination chemotherapy. The patient produced tarry stool on the 4th d, and emergency gastroscopy showed arterial bleeding from the lesion. Hemostasis was achieved by injecting pure ethanol and using hemostatic clips. There is only one previous report on endoscopic hemostasis being effective for bleeding due to lymphoma. Since gastric bleeding causes significant mortality, endoscopic hemostasis should be considered as first-line treatment for ML patients who were treated with chemotherapy.

关键词：内窥镜止血方法胃动脉淋巴瘤