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Diagnosis and initial management of cholangiocarcinoma with obstructive jaundice

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World Journal of Gastroenterology 2008年第19期14卷 3000-3005页

作者： Takashi Tajiri Hiroshi Yoshida Yasuhiro Mamada NobuhikoTaniai Shigeki Yokomuro yoshiaki mizuguchi Departmentof Surgery Nippon Medical School1-1-5 SendagiBunkyo-ku

Cholangiocarcinoma is the second most common primary hepatic cancer. Despite advances in diagnostic techniques during the past decade, cholangiocarcinoma is usually encountered at an advanced stage. In this review, we... 详细信息

关键词： Cholangiocarcinoma Obstructive jaundice Diagnosis Treatment Initial management

Effect of transforming growth factor-β1 on human intrahepatic cholangiocarcinoma cell growth

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World Journal of Gastroenterology 2006年第39期12卷 6316-6324页

作者： Tetsuya Shimizu Shigeki Yokomuro yoshiaki mizuguchi Yutaka Kawahigashi Yasuo Arima Nobuhiko Taniai Yasuhiro Mamada Hiroshi Yoshida Koho Akimaru Takashi Tajiri Surgery for Organ Function and Biological Regulation Graduate School of Medicine Nippon Medical School Tokyo 113-8603 Japan

AIM： To elucidate the biological effects of transforming growth factor-β1 （TGF-β1） on intrahepatic cholangiocarcinoma （ICC）.METHODS： We investigated the effects of TGF-β1 on human ICC cell lines （HuCCT1, MEC, and HUH-28） by monitoring the influence of TGF-β1 on tumor growth and interleukin-6 （IL-6） expression in ICC cells.RESULTS： All three human ICC cell lines produced TGF-β1 and demonstrated accelerated growth in the presence of TGF-β1 with no apoptotic effect. Studies on HuCCT1 revealed a TGF-β1-induced stimulation of the expression of TGF-β1, as well as a decrease in TGF-β1 mRNA expression induced by neutralizing anti-TGF-β1 antibody. These results indicate that TGF-β1 stimulates the production and function of TGF-β1 in an autocrine fashion. Further, IL-6 secretion was observed in all three cell lines and exhibited an inhibitory response to neutralizing anti-TGF-β1 antibody. Experiments using HuCCT1 revealed a TGF-β1-induced acceleration of IL-6 protein expression and mRNA levels. These findings demonstrate a functional interaction between TGF-β1 and IL-6. All three cell lines proliferated in the presence of IL-6. In contrast, TGF-β1 induced no growth effect in HuCCT1 in the presence of small interfering RNA against a specific cell surface receptor of IL-6 and signal transducer and activator of transcription-3.CONCLUSION： ICC cells produce TGF-β1 and confer a TGF-β1-induced growth effect in an autocrine ***-β1 activates ILo6 production, and the functional interaction between TGF-β1 and IL-6 contributes to ICC cell growth by TGF-β1.

关键词： Transforming growth factor-β1 Interleukin-6 Intrahepatic cholangiocarcinoma

Postoperative bile leakage managed successfully by intrahepatic biliary ablation with ethanol

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World Journal of Gastroenterology 2006年第21期12卷 3450-3452页

作者： Tetsuya Shimizu Hiroshi Yoshida Yasuhiro Mamada Nobuhiko Taniai Satoshi Matsumoto yoshiaki mizuguchi Shigeki Yokomuro Yasuo Arima Koho Akimaru Takashi Tajiri Graduate School of Medicine Surgery for Organ Function and Biology Regulation Nippon Medical SchoolTokyo113-8603Japan

We report a case of postoperative refractory bile leakage managed successfully by intrahepatic biliary ablation with ethanol. A 75-year-old man diagnosed with hepatocellular carcinoma underwent extended posterior segmentectomy including the caudate lobe and a part of the anterior segment. The hepatic tumor attached to the anterior branch of the bile duct was detached carefully and resected. Fluid drained from the liver surface postoperatively contained high concentrations of total bilirubin, at a constant volume of 150 mL per day. On d 32 after surgery, a fistulogram of the drainage tube demonstrated an enhancement of the anterior bile duct. Endoscopic retrograde cholangiography demonstrated complete obstruction of the proximal anterior bile duct and no enhancement of the peripheral anterior bile duct. On d 46 after surgery, a retrograde transhepatic biliary drainage （RTBD） tube was inserted into the anterior bile duct under open surgery. However, a contrast study of RTBD taken 7 mo post-surgery revealed that the fistula remained patent despite prolonged conservative man- agement, so we decided to perform ethanol ablation of the isolated bile duct. Four mL pure ethanol was injected into the isolated anterior bile duct for ten minutes, the procedure being repeated five times a week. Following 23 attempts, the volume of bile juice reached less than 10 mL per day. The RTBD was clamped and removed two days later. After RTBD removal, the patient had no complaints or symptoms. Follow-up magnetic resonance imaging demonstrated atrophy of the ethanol-injected anterior segment without liver abscess formation.

关键词： Postoperative complication Bile leakage Ethanol ablation

Placement of percutaneous transhepatic biliary stent using a silicone drain with channels

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World Journal of Gastroenterology 2009年第33期15卷 4201-4203页

作者： Hiroshi Yoshida Yasuhiro Mamada Nobuhiko Taniai Sho Mineta yoshiaki mizuguchi Yoichi Kawano Junpei Sasaki Yoshiharu Nakamura Takayuki Aimoto Takashi Tajiri Department of Surgery Nippon Medical School

This report describes a method for percutaneous transhepatic biliary stenting with a BLAKE Silicone Drain, and discusses the usefulness of placement of the drain connected to a J-VAC Suction Reservoir for the treatment of stenotic hepaticojejunostomy. Percutaneous transhepatic biliary drainage was performed under ultrasonographic guidance in a patient with stenotic hepaticojejunostomy after hepatectomy for hepatic hilum malignancy. The technique used was as follows. After dilatation of the drainage root, an 11-FF tube with several side holes was passed through the stenosis of the hepaticojejunostomy. A 10-Fr BLAKE Silicone Drain is flexible, which precludes onestep insertion. One week after insertion of the 11-Fr tube, a 0.035-inch guidewire was inserted into the tube. After removal of the 11-Fr tube, the guidewire was put into the channel of a 10-Fr BLAKE Silicone Drain. The drain was inserted into the jejunal limb through the intrahepatic bile duct and was connected to a J-VAC Suction Reservoir. Low-pressure continued suction was applied. Patients can be discharged after insertion of the 10-Fr BLAKE Silicone Drain connected to the J-VAC Suction Reservoir. Placement of a percutaneous transhepaUc biliary stent using a 10-Fr BLAKE Silicone Drain connected to a J-VAC Suction Reservoir is useful for the treatment of stenotic hepaticojejunostomy.

关键词： Biliary tract Drainage Hepaticojejunostomy Stenosis Stents

One-step palliative treatment method for obstructive jaundice caused by unresectable malignancies by percutaneous transhepatic insertion of an expandable metallic stent

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World Journal of Gastroenterology 2006年第15期12卷 2423-2426页

作者： Hiroshi Yoshida Yasuhiro Mamada Nobuhiko Taniai yoshiaki mizuguchi Tetsuya Shimizu Shigeki Yokomuro Takayuki Aimoto Yoshiharu Nakamura Eiji Uchida Yasuo Arima Manabu Watanabe Eiichi Uchida Takashi Tajiri Department of Surgery 1 Nippon Medical School Japan Uchida Hospital Japan

AIM： To describe a simple one-step method involving percutaneous transhepatic insertion of an expandable metal stent （EMS） used in the treatment of obstructive jaundice caused by unresectable malignancies. METHODS： Fourteen patients diagnosed with obstructive jaundice due to unresectable malignancies were included in the study. The malignancies in these patients were a result of very advanced carcinoma or old age. Percutaneous transhepatic cholangiography was performed under ultrasonographic guidance. After a catheter with an inner metallic guide was advanced into the duodenum, an EMS was placed in the common bile duct, between a point 1 cm beyond the papilla of Vater and the entrance to the hepatic hilum. In cases where it was difficult to span the distance using just a single EMS, an additional stent was positioned. A drainage catheter was left in place to act as a hemostat. The catheter was removed after resolution of cholestasis and stent patency was confirmed 2 or 3 d post-procedure. RESULTS： One-step insertion of the EMS was achieved in all patients with a procedure mean time of 24.4 min. Out of the patients who required 2 EMS, 4 needed a procedure time exceeding 30 min. The mean time for removal of the catheter post-procedure was 2.3 d. All patients died of malignancy with a mean follow-up time of 7.8 mo. No stent-related complication or stent obstruction was encountered. CONCLUSIONS： One-step percutaneous transhepaticinsertion of EMS is a simple procedure for resolving biliary obstruction and can effectively improve the patient＇s quality of life.

关键词： Expandable metallic stent Bile duct carcinoma Gall bladder carcinoma Pancreatic carcinoma Gastric carcinoma Obstructive jaundice

A nucleotide substitution at the 5′ splice site of intron 1 of rice HEADING DATE 1(HD1) gene homolog in foxtail millet, broadly found in landraces from Europe and Asia

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The Crop Journal 2015年第6期3卷 481-488页

作者： Kenji Fukunaga Naoko Izuka Takehiro Hachiken Satoshi mizuguchi Hidemi Ito Katsuyuki Ichitani Faculty of Life and Environmental Sciences Prefectural University of Hiroshima Faculty of Agriculture Kagoshima University

We investigated genetic variation of a rice HEADING DATE 1(HD1) homolog in foxtail ***, we searched for a rice HD1 homolog in a foxtail millet genome sequence and designed primers to amplify the entire coding sequence of the gene. We compared full HD1 gene sequences of 11 accessions(including Yugu 1, a Chinese cultivar used for genome sequencing) from various regions in Europe and Asia, found a nucleotide substitution at a putative splice site of intron 1, and designated the accessions with the nucleotide substitution as carrying a splicing variant. We verified by RT-PCR that this single nucleotide substitution causes aberrant splicing of intron 1. We investigated the geographical distribution of the splicing variant in 480 accessions of foxtail millet from various regions of Europe and Asia and part of Africa by d CAPS and found that the splicing variant is broadly distributed in Europe and Asia. Differences of heading times between accessions with wild type allele of the HD1 gene and those with the splicing variant allele were unclear. We also investigated variation in 13 accessions of ssp. viridis, the wild ancestor, and the results suggested that the wild type is predominant in the wild ancestor.

关键词： Foxtail millet Geographical distribution HD1(HEADING DATE 1) homolog Setaria italica Splice site

Engagement of membrane immunoglobulin enhances Id3 promoter activity in WEHI-231 B lymphoma cells

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Acta Pharmacologica Sinica 2005年第4期26卷 486-491页

作者： Kikumi HATA Junichiro mizuguchi Department of Immunology and Intractable Disease Research Center Tokyo Medical University 6-1-1 Shinjuku Shinjuku-ku 160-8402 Tokyo Japan Department of Immunology and Intractable Disease Research Center Tokyo Medical University 6-1-1 Shinjuku Shinjuku-ku 160-8402 Tokyo Japan

Aim:We have recently shown that engagement of membrane immunoglobulin(mIg)induced upregulation of inhibitor of differentiation 3(Id3)mRNA,resultingin growth arrest at G1 phase in WEHI-231 *** the present study,we examinedwhether engagement of mIg will affect promoter activity of the Id3 gene in WEHI-231 ***:DNA fragments corresponding to the 5'-flanking region ofmid3 gene were amplified by polymerase chain reaction(PCR)using genomicDNA as the *** DNA fragments upstream of the transcription startsite(+1)of the mid3 gene were subcloned into the luciferase reporter vector *** recombinant constructs were transiently transfected into WEHI-231 cellsby an electroporation *** incubation for 24 h,WEHI-231 cells werestimulated with 10 mg/L anti-IgM or irradiated CD40L-expressing NIH3T3 cells orcontrol NIH3T3 cells for further 24 h,followed by assay for luciferase ***:The luciferase analysis demonstrated that basal promoter activity of theId3 gene was found in the region between-200 and +*** Id3 promoter activitywas increased 2-fold following stimulation with anti-IgM,but not CD40L,com-pared with medium ***:The mIg-mediated upregulation of Id3expression is controlled,at least in part,through transcriptional regulation,asassessed by luciferase assay.

关键词： B lymphoma cells inhibitor of differentiation CD40L anti-IgM transcriptional control

Prognostic roles of preoperative α-fetoprotein and des-γ-carboxy prothrombin in hepatocellular carcinoma patients

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World Journal of Gastroenterology 2015年第16期21卷 4933-4945页

作者： Makoto Meguro Toru mizuguchi Toshihiko Nishidate Kenji Okita Masayuki Ishii Shigenori Ota Tomomi Ueki Emi Akizuki Koichi Hirata Department of Surgery Surgical Oncology and ScienceSapporo Medical University School of Medicine

AIM:To clarify the utility of using des-γ-carboxy prothrombin(DCP)andα-fetoprotein(AFP)levels to predict the prognosis of hepatocellular carcinoma(HCC)in patients with hepatitis B virus(HBV)and the hepatitis C virus(HCV)***:A total of 205 patients with HCC(105patients with HBV infection 100 patients with HCV infection)who underwent primary hepatectomy between January 2004 and May 2012 were enrolled *** AFP and DCP levels were used to create interactive dot diagrams to predict recurrence within 2 years after hepatectomy,and cutoff levels were *** in the HBV and HCV groups were classified into three groups:a group with low AFP and DCP levels(LL group),a group in which one of the two parameters was high and the other was low(HL group),and a group with high AFP and DCP levels(HH group).Liver function parameters,the postoperative recurrence-free survival rate,and postoperative overall survival were compared between *** survival curves were compared by logrank test using the Kaplan-Meier *** analysis using a Cox forward stepwise logistic regression model was conducted for a ***:The preoperative AFP cutoff levels for recurrence within 2 years after hepatectomy in the HBV and HCV groups were 529.8 ng/m L and 60 m AU/m L,respectively;for preoperative DCP levels,the cutoff levels were 21.0 ng/m L in the HBV group and 67 m AU/m L in the HCV *** HBV group was significantly different from the other groups in terms of vascular invasion,major hepatectomy,volume of intraoperative blood loss,and surgical *** differences were found between the LL group,the HL group,and the HH group in terms of both mean disease-free survival time(MDFST)and mean overall survival time(MOST):64.81±7.47 vs 36.63±7.62 vs 18.98±6.17mo(P=0.001)and 85.30±6.55 vs 59.44±7.87 vs46.57±11.20 mo(P=0.018).In contrast,the HCV group exhibited a significant difference in tumor size,vascular invasion,volu

关键词： Hepatocellular carcinoma Hepatitis B Hepatitis C Des-γ-carboxy prothrombin α-fetoprotein

Propensity score analysis demonstrated the prognostic advantage of anatomical liver resection in hepatocellular carcinoma

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World Journal of Gastroenterology 2014年第12期20卷 3335-3342页

作者： Masayuki Ishii Toru mizuguchi Masaki Kawamoto Makoto Meguro Shigenori Ota Toshihiko Nishidate Kenji Okita Yasutohsi Kimura Thomas T Hui Koichi Hirata Department of Surgery Surgical Oncology and ScienceSapporo Medical University Hospital Sapporo Medical University Department of Surgery Children’s Hospital and Research Center Oakland

AIM: To compare the prognoses of hepatocellular carcinoma (HCC) patients that underwent anatomic liver resection (AR) or non-anatomic liver resection (NAR) using propensity score-matched populations.

关键词： Anatomical liver resection Propensity score analysis Hepatocellular carcinoma