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Push vs pull method for endoscopic ultrasound-guided fine needle aspiration of pancreatic head lesions: Propensity score matching analysis

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World Journal of Gastroenterology 2018年第27期24卷 3006-3012页

作者： Mitsuru Sugimoto Tadayuki Takagi Rei Suzuki Naoki Konno Hiroyuki Asama Yuki Sato Hiroki Irie Ko Watanabe Jun Nakamura Hitomi Kikuchi Yuichi Waragai Mika Takasumi Minami hashimoto yuko hashimoto Takuto Hikichi Hiromasa Ohira Department of Gastroenterology Fukushima Medical UniversitySchool of Medicine Department of Endoscopy Fukushima Medical University Hospital Department of Diagnostic Pathology Fukushima Medical University

AIM To evaluate the efficacy of endoscopic ultrasoundguided fine needle aspiration(EUS-FNA) of pancreatic head cancer when pushing(push method) or pulling the echoendoscope(pull method).METHODS Overall, 566 pancreatic cancer patients had their first EUS-FNA between February 2001 and December 2017. Among them, 201 who underwent EUS-FNA for pancreatic head lesions were included in this study. EUS-FNA was performed by the push method in 85 patients, the pull method in 101 patients and both the push and pull methods in 15 patients. After propensity score matching(age, sex, tumor diameter, and FNA needle), 85 patients each were stratified into the push and pull groups. Patient characteristics and EUSFNA-related factors were compared between the two *** Patient characteristics were not significantly different between the two groups. The distance to lesion was significantly longer in the push group than in the pull group(13.9 ± 4.9 mm vs 7.0 ± 4.9 mm, P < 0.01). The push method was a significant factor influencing the distance to lesion(≥ median 10 mm)(P < 0.01). Additionally, tumor diameter ≥ 25 mm(OR = 1.91, 95%CI: 1.02-3.58, P = 0.043) and the push method(OR = 1.91, 95%CI: 1.03-3.55, P = 0.04) were significant factors contributing to the histological diagnosis of *** The pull method shortened the distance between the endoscope and the lesion and facilitated EUS-FNA of pancreatic head cancer. The push method contributed to the histological diagnosis of pancreatic head cancer using EUS-FNA specimens.

关键词： Endoscopic ultrasound-guided fine needle aspiration Pancreatic head Pancreatic cancer Push method Pull method

Contrast uptake in primary hepatic angiosarcoma on gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid-enhanced magnetic resonance imaging in the hepatobiliary phase

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World Journal of Hepatology 2018年第1期10卷 166-171页

作者： Manabu Hayashi Satoshi Kawana Hirofumi Sekino Kazumichi Abe Naoki Matsuoka Masahito Kashiwagi Ken Okai Yukiko Kanno Atsushi Takahashi Hiroshi Ito yuko hashimoto Hiromasa Ohira Department of Gastroenterology Fukushima Medical University School of Medicine Department of Diagnostic Pathology Fukushima Medical University School of Medicine Department of Radiology Fukushima Medical University School of Medicine

Primary hepatic angiosarcoma is the most common malignant mesenchymal tumor of the liver. It has a poor prognosis and various appearances on magnetic resonance(MR) images. We report a case of hepatic angiosarcoma with a characteristic appearance on gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid(Gd-EOB-DTPA)-enhanced MR imaging in the hepatobiliary phase. A 72-year-old man was admitted with a complaint of abdominal pain. Gd-EOBDTPA-enhanced MR imaging revealed a liver tumor that showed slight hyperintensity in the hepatobiliary phase. These findings suggested Gd-EOB-DTPA uptake in the tumor. An autopsy revealed the solid proliferation and sinusoidal spreading of hepatic angiosarcoma cells. Immunohistochemistry indicated that the tumor was negative for OATP1B3. Gd-EOB-DTPA uptake in the liver tumor in the hepatobiliary phase suggested sinusoidal tumor invasion with residual normal hepatocytes.

关键词： Hepatic angiosarcoma Gadoliniumethoxybenzyl-diethylenetriamine pentaacetic acid Cirrhosis Hepatocellular carcinoma

Pancreatic neuroendocrine tumor Grade 1 patients followed up without surgery:Case series

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World Journal of Clinical Oncology 2017年第3期8卷 293-299页

作者： Mitsuru Sugimoto Tadayuki Takagi Rei Suzuki Naoki Konno Hiroyuki Asama Ko Watanabe Jun Nakamura Hitomi Kikuchi Yuichi Waragai Mika Takasumi Satoshi Kawana yuko hashimoto Takuto Hikichi Hiromasa Ohira Department of Gastroenterology Fukushima Medical UniversitySchool of Medicine Department of Endoscopy Fukushima Medical University Hospital Department of Diagnostic Pathology Fukushima Medical UniversitySchool of Medicine

Among the three grades of neuroendocrine tumors(NETs),the prognosis for Grade 1(G1) with surgery is very ***,we evaluated the prognoses of pancreatic NET(PNET) G1 patients without surgery.A total of 8 patients who were diagnosed with NET G1,with an observation period of more than 6 mo until surgery or without surgery,were *** patients who underwent surgery were ultimately diagnosed using specimens obtained during the surgery,whereas the patients who did not undergo surgery were diagnosed using specimens obtained by endoscopic ultrasonography-guided fine needle ***,we mainly evaluated the observation period and tumor *** observation period for the five cases with surgery ranged from 6-80 mo,and tumor growth was observed in one *** contrast,the observation period for the three cases without surgery ranged from 17-54 mo,and tumor growth was not ***,although the first-choice treatment for NETs is surgery,our experience includes certain NET G1 patients who were followed up without surgery.

关键词： Pancreatic neuroendocrine tumors Metastasis Neuroendocrine tumors Grade 1 Follow-up Surgery

Screening for hilar biliary invasion in ampullary cancer patients

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World Journal of Gastrointestinal Endoscopy 2022年第9期14卷 536-546页

作者： Tadayuki Takagi Mitsuru Sugimoto Rei Suzuki Naoki Konno Hiroyuki Asama Yuki Sato Hiroki Irie Jun Nakamura Mika Takasumi Minami hashimoto Tsunetaka Kato Ryoichiro Kobashi Takumi Yanagita yuko hashimoto Shigeru Marubashi Takuto Hikichi Hiromasa Ohira Department of Gastroenterology Fukushima Medical UniversityFukushima 960-1295Japan Department of Endoscopy Fukushima Medical University HospitalFukushima 960-1295Japan Department of Pathological Diagnosis Fukushima Medical UniversityFukushima 960-1295Japan Department of Hepato-Biliary-Pancreatic and Transplant Surgery Fukushima Medical UniversityFukushima 960-1295Japan

BACKGROUND The treatment for ampullary cancer is pancreatoduodenectomy or local ***,effective methods for the preoperative investigation of hilar biliary invasion in ampullary cancer patients have not yet been *** To determine the necessity of and an appropriate method for investigating hilar biliary invasion of ampullary *** Among 43 ampullary cancer patients,34 underwent endoscopic treatment(n=9)or surgery(n=25).The use of imaging findings(thickening and enhancement of the bile duct wall on contrast-enhanced computed tomography,irregularity on endoscopic retrograde cholangiography,thickening of the entire bile duct wall on intraductal ultrasonography(IDUS),and partial thickening of the bile duct wall on IDUS)and biliary biopsy results for diagnosing hilar biliary invasion of ampullary cancer was *** Hilar invasion was not observed in every *** the patients who did not undergo biliary stent insertion,the combination of partial thickening of the bile duct wall on IDUS and biliary biopsy results showed the highest accuracy(100%)for diagnosing hilar biliary ***,each imaging method and biliary biopsy yielded some false-positive *** Although some false-positive results were obtained with each method,the combination of partial thickening of the bile duct wall on IDUS and biliary biopsy results was useful for diagnosing hilar biliary invasion of ampullary ***,hilar invasion of ampullary cancer is rare;therefore,the investigation of hilar biliary invasion of ampullary cancer might be unnecessary.

关键词： Ampullary cancer Biliary biopsy Contrast-enhanced CT Hilar biliary invasion Intraductal ultrasonography

Electronic Properties of Nanopore Edges of Ferromagnetic Graphene Nanomeshes at High Carrier Densities under Ionic-Liquid Gating

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Materials Sciences and Applications 2014年第1期5卷 1-9页

作者： Taijyu hashimoto Syota Kamikawa yuko Yagi Junji Haruyama Faculty of Science and Engineering Aoyama Gakuin University Sagamihara Japan

Graphene edges with a zigzag-type atomic structure can theoretically produce spontaneous spin polarization despite being a critical-metal-free material. We have demonstrated this in graphene nanomeshes (GNMs) with honeycomb-like arrays of low-defect hexagonal nanopores by observing room-temperature ferromagnetism and spin-based phenomena arising from the zigzag-pore edges. Here, we apply extremely high electric fields to the ferromagnetic (FM) GNMs using an ionic-liquid gate. A large on/off-ratio for hole current is observed for even small applied ionic-liquid gate voltages (Vig). Observations of the magnetoresistance behavior reveal high carrier densities of ~1013 cm-2 at large Vig values. We find a maximum conductance peak in the high -Vig region and its separation into two peaks upon applying a side-gate (in-plane external) voltage (Vex). It is discussed that localized edge-π band with excess-density electrons induced by Vig and its spin splitting for majority and minority of spins by Vex (half-metallicity model) lead to these phenomena. The results must realize critical-element-free novel spintronic devices.

关键词： Graphene Nanomesh Edge Spin Polarization Magnetism Ionic-Liquid Gate High Electric Fields Rare-Metal-Free Spintronics

The Efficacy and Safety of Continuous Popliteal Sciatic Nerve Block for the Relief of Pain Associated with Critical Limb Ischemia: A Retrospective Study

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Open Journal of Anesthesiology 2013年第10期3卷 433-437页

作者： Atsushi hashimoto Hiroshi Ito yuko Sato Yoshihiro Fujiwara Department of Anesthesiology Aichi Medical University Nagakute Japan

Background: Patients with critical limb ischemia (CLI) often suffer from severe pain. A continuous peripheral nerve block has been shown to provide effective analgesia for patients having lower limb surgery. We have been administering continuous sciatic nerve block (CSNB) for patients with CLI whose pain could not be relieved by other analgesic tools. The aim of this retrospective study was to investigate the efficacy and safety of CSNB for patients with CLI. Method: We retrospectively investigated 99 patients who received CSNB for the relief of severe pain in the lower limb associated with CLI. Patient demographics, neurological history, complications, and subjective evaluation of the effectiveness of CSNB were investigated from their clinical records. The distal tips of 108 catheters were cultured. Result: One hundred and seventy-two catheters were placed in 99 patients. More than 90% of the patients enjoyed considerable relief of severe pain. The analgesic effect of CSNB was greater in patients with older age and hemodialysis. Thirty-one catheters had positive bacterial colonization. However, no severe infectious complication was found. There was no relationship between the co-existence of diabetes and positive bacterial colonization. We encountered a patient with ASO and diabetes who suffered from persistent motor weakness and hypesthesia even after 3 months of CSNB placement. Conclusions: CSNB provided good pain control for patients with severe pain caused by CLI. Although catheters were frequently found to be colonized, infection at the catheter site was self-limiting even in patients with diabetes.

关键词： Critical Limb Ischemia Continuous Sciatic Nerve Block Pain Control

A new index for non-invasive assessment of liver fibrosis

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World Journal of Gastroenterology 2010年第38期16卷 4809-4816页

作者： Naohiro Ichino Keisuke Osakabe Toru Nishikawa Hiroko Sugiyama Miho Kato Shiho Kitahara Senju hashimoto Naoto Kawabe Masao Harata Yoshifumi Nitta Michihito Murao Takuji Nakano yuko Arima Hiroaki Shimazaki Koji Suzuki Kentaro Yoshioka Faculty of Medical Technology School of Health SciencesFujita Health UniversityToyoakeAichi 470-1192Japan Department of Clinical Laboratory Fujita Health University Hospital Department of Liver Biliary Tract and Pancreas DiseasesFujita Health University

AIM:To construct and evaluate a new non-invasive fibrosis index for assessment of the stage of liver f ibrosis. METHODS:A new f ibrosis index (Fibro-Stiffness index) was developed in 165 of 285 patients with chronic hepatitis C, and was validated in the other 120 patients where liver biopsy was performed. Its usefulness was compared with liver stiffness (LS) measured by FibroScan, the aminotransferase-to-platelet ratio index, the Forns index and the FibroIndex. RESULTS: The Fibro-Stiffness index consists of LS,platelet count and prothrombin time. The values of the Fibro-Stiffness index differed signif icantly between neighboring f ibrosis stages except F0-F1. The area under the receiver operating characteristics curves of the Fibro-Stiffness index for prediction of F≥2 (0.90), F≥ 3 (0.90) and F= 4(0.92) in the estimation group and those for F≥ 3 (0.93) and F =4 (0.97) in the validation group were the highest among the 5 methods examined. The accuracy of the Fibro-Stiffness index had highest values for F≥2, F≥3 and F=4 in both the estimation and validation groups. The diagnostic performance for F= 4 was improved by a combination of the Fibro-Stiffness index with serum hyaluronic acid level. CONCLUSION: The Fibro-Stiffness index was constructed and validated. It showed superior diagnostic performance to other indices for F ≥ 2,3 and 4.

关键词： Non-invasive fi brosis index Fibro-Stiffness index Chronic hepatitis C Liver stiffness Liver fi brosis

Factors correlating with acoustic radiation force impulse elastography in chronic hepatitis C

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World Journal of Gastroenterology 2014年第5期20卷 1289-1297页

作者： Toru Nishikawa Senju hashimoto Naoto Kawabe Masao Harata Yoshifumi Nitta Michihito Murao Takuji Nakano yuko Mizuno Hiroaki Shimazaki Toshiki Kan Kazunori Nakaoka Yuka Takagawa Masashi Ohki Naohiro Ichino Keisuke Osakabe Kentaro Yoshioka Department of Liver Biliary Tract and Pancreas Diseases Fujita Health University Faculty of Medical Technology School of Health Sciences Fujita Health University

AIM: To investigate the factors other than fibrosis stage correlating with acoustic radiation force impulse (ARFI) elastograpy in chronic hepatitis C.

关键词： Acoustic radiation force impulse Body mass index Chronic hepatitis C Computer-assisted morphometric image analysis Fibrosis stage Hyaluronic acid Liver stiffness measurement Transient elastography Velocity of shear wave

Management of cervical intraepithelial neoplasia in Japanese pregnant women

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Open Journal of Obstetrics and Gynecology 2013年第3期3卷 337-340页

作者： yuko Matsubara Toru Fujioka Hisashi hashimoto Katsuyuki Hamada Keiichi Matsubara Akihiro Nawa Department of Obstetrics and Gynecology School of Medicine Ehime University Toon Japan

Objective: In this study, we evaluated the management of cervical intraepithelial neoplasia (CIN) in pregnant women and evaluated the postpartum prognosis. Methods: Twenty-four pregnant women, who were diagnosed with CIN at Ehime University Hospital between January 2008 and October 2012, were recruited. The mode of delivery and pathophysiological examination results in the postpartum period were evaluated. Results: Four patients were antenatally diagnosed with either CIN1 or CIN2. Of these patients, CIN regressed or remained stable during pregnancy, and there was no disease progression in the postpartum period. Nine patients were diagnosed with severe dysplasia (CIN3) and eleven patients had carcinoma in situ (CIS). Of these patients, 5/9 (55%) and 4/11 (36%), respectively, had disease regression postnatally. No CIN lesion progressed to invasive carcinoma after delivery. Conclusions: We determined that many cases diagnosed antenatally with CIN regressed during the postpartum period, regardless of the grade of CIN. We recommend a conservative management strategy with careful ante- and postpartum examinations for pregnant women with CIN.

关键词： Cervical Intraepithelial Neoplasia Prenancy