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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 hands.The self-expandable metal stent(SEMS)is an additional factor to prevent stent migration.However,no compara-tive studies of laser-cut-type and braided-type during EUS-HGS have been reported.The 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 SEMS.Methods: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 EUS-HGS.Also,propensity score matching was performed to create a propensity score for using laser-cut-type group and braided-type group.Results:A total of 142 patients were enrolled in this study.Among them,24 patients underwent EUS-HGS using a laser-cut-type SEMS,and 118 patients underwent EUS-HGS using a braided-type SEMS.EUS-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 days.Although 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 group.On the other hand,in the laser-cut-type group,the distance after 1 day and 7 days was almost the same.Conclusions: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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Endoscopic hemostasis using self-expandable metal stent combinedwith PuraStat® for patient with high risk of post-endoscopicsphincterotomy bleeding (with video)

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Hepatobiliary & Pancreatic Diseases International 2024年第1期23卷 94-96页

作者： Takeshi Ogura Yuki Uba Masahiro Yamamura Nobu Nishioka hiroki nishikawa 2nd Department of Internal Medicine Osaka Medical and Pharmaceutical UniversityOsakaJapan

To the Editor:Endoscopic sphincterotomy(EST)is an established technique for removal of bile duct stones and self-expandable metal stent(SEMS)deployment.However,bleeding can be considered an adverse event after EST,particularly for patients with high risk of bleeding such as those on hemodialysis.Among the various techniques reported for obtaining endoscopic hemostasis[1-3].

关键词： bleeding stasis endoscopic

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Novel re-intervention device for occluded multiple uncovered self-expandable metal stent(with video)

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Hepatobiliary & Pancreatic Diseases International 2023年第4期22卷 434-436页

作者： Takeshi Ogura Yuki Uba Mitsuki Tomita Kimi Bessho hiroki nishikawa 2nd Department of Internal Medicine Osaka Medical and Pharmaceutical University2-7 DaigakuchouTakatsukishiOsaka 569-8686Japan

To the Editor:Obstructive jaundice due to unresectable malignant hilar obstruction can be treated by deployment of bilateral uncovered self-expandable metal stents(UCSEMSs),which enable longer stent patency to be obtained compared with multiple plastic stents[1-3].However,re-intervention is needed if obstructive jaundice occurs after bilateral UCSEMS deployment.During re-intervention procedures,insertion of the stent delivery system across the mesh of a UCSEMS and into the bile duct can be challenging.A novel drill dilator has recently become available in Japan(Tornus ES;Asahi Intecc,Nagoya,Japan)(Fig.1)[4].The tract is easily dilated using a clockwise rotation.We herein describe a successful re-intervention using this device for a patient with occluded bilateral UCSEMSs.

关键词： stent struction Asahi

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The new era of precision medicine in hepatocellular carcinoma:the urgent need for promising biomarkers

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Hepatobiliary Surgery and Nutrition 2018年第6期7卷 490-491页

作者： Haruhiko Takeda hiroki nishikawa Yukio Osaki Department of Gastroenterology and Hepatology Graduate School of MedicineKyoto UniversityKyotoJapan Department of Gastroenterology and Hepatology Osaka Red Cross HospitalOsakaJapan Department of Gastroenterology and Hepatology Hyogo College of MedicineNishinomiyaJapan Department of Gastroenterology and Hepatology Meiwa HospitalNishinomiyaJapan

Hepatocellular carcinoma(HCC)is the second most lethal malignancy worldwide,and the prognosis of advanced HCC is especially dismal.After the SHARP trial reported in 2007,a number of phase III trials of molecular targeting agents for advanced HCC have been conducted,but most of them have failed to achieve their primary endpoint,and sorafenib has been the only first-line systemic therapy approved for HCC in this decade(1).

关键词： prognosis carcinoma hepatocellular

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Branched-chain amino acid treatment before transcatheter arterial chemoembolization for hepatocellular carcinoma

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World Journal of Gastroenterology 2012年第12期18卷 1379-1384页

作者： hiroki nishikawa Yukio Osaki Tadashi Inuzuka Haruhiko Takeda Jun Nakajima Fumihiro Matsuda Shinichiro Henmi Azusa Sakamoto Tetsuro Ishikawa Sumio Saito Ryuichi Kita Toru Kimura Department of Gastroenterology and Hepatology Osaka Red Cross Hospital

AIM:To examine the significance of branched-chain amino acid (BCAA) treatment before transcatheter arterial chemoembolization (TACE) for hepatocellular carcinoma (HCC).METHODS:This study included 99 patients who underwent TACE therapy for HCC at our hospital and were followed up without treatment for at least 6 mo between January 2004 and January 2010.They were divided into 2 groups:those receiving BCAA granules (n=40) or regular diet (n=59,control).Data obtained were retrospectively analyzed (prior to TACE,and 1 wk,1,3,and 6 mo after TACE) in terms of nutritional condition and clinical laboratory parameters (serum albumin level and Child-Pugh score),both of which are determinants of hepatic functional reserve.RESULTS:The BCAA group comprised 27 males and 13 females with a mean age of 69.9 ± 8.8 years.The patients of the BCAA group were classified as follows:Child-Pugh A/B/C in 22/15/3 patients,and Stage Ⅱ/Ⅲ /ⅣA HCC in 12/23/5 patients,respectively.The controlgroup comprised 32 males and 27 females with a mean age of 73.2 ± 10.1 years.In the control group,9 patients had chronic hepatitis,Child-Pugh A/B/C in 39/10/1 patients,and StageⅠ/Ⅱ/Ⅲ/ⅣA HCC in 1/11/35/12 patients,respectively.Overall,both serum albumin level and Child-Pugh score improved significantly in the BCAA group as compared with the control 3 and 6 mo after TACE (P 3.5 g/dL;and (3) epirubicin dose.A similar trend indicating a significant improvement of all variables in the BCAA group was noted (P < 0.05).CONCLUSION:Treatment with BCAA granules in patients who have undergone TACE for HCC is considered useful to maintain their hepatic functional reserve.

关键词：支链氨基酸肝细胞癌治疗栓塞化疗导管动脉 NOMA

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Development of risky varices in alcoholic cirrhosis with a well-maintained nutritional status

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World Journal of Hepatology 2015年第21期7卷 2358-2362页

作者： Hirayuki Enomoto Yoshiyuki Sakai Yoshinori Iwata Ryo Takata Nobuhiro Aizawa Naoto Ikeda Kunihiro Hasegawa Chikage Nakano Takashi Nishimura Kazunori Yoh Akio Ishii Tomoyuki Takashima hiroki nishikawa Hiroko Iijima Shuhei Nishiguchi Division of Hepatobiliary and Pancreatic Disease Department of Internal Medicine Hyogo College of Medicine

AIM: To compare the nutritional status between alcoholic compensated cirrhotic patients and hepatitis C virus(HCV)-related cirrhotic patients with portal hypertension.METHODS: A total of 21 patients with compensated cirrhosis(14 with HCV-related cirrhosis and seven with alcoholic cirrhosis) who had risky esophageal varices were investigated. In addition to physical variables, including the body mass index, triceps skinfold thickness, and arm-muscle circumference, the nutritional status was also assessed using the levels of pre-albumin(pre-ALB), retinol-binding protein(RBP) and non-protein respiratory quotient(NPRQ) measured with an indirect calorimeter.RESULTS: A general assessment for the nutritional status with physical examinations did not show a significant difference between HCV-related cirrhosis and alcoholic cirrhosis. However, the levels of pre-ALB and RBP in alcoholic compensated cirrhotic patients were significantly higher than those in HCV-related compensated cirrhotic patients. In addition, the frequency of having a normal nutritional status(NPRQ ≥ 0.85 and ALB value > 3.5 g/d L) in alcoholic compensated cirrhotic patients was significantly higher than that in HCV-related compensated cirrhotic patients.CONCLUSION: According to our small scale study, alcoholic compensated cirrhotic patients can develop severe portal hypertension even with a relatively well-maintained liver function and nutritional status compared with HCV-related cirrhosis.

关键词： Alcoholic liver cirrhosis Hepatitis C virus Rapid-

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Stage at diagnosis of colorectal cancer through diagnostic route:Who should be screened?

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World Journal of Gastroenterology 2024年第10期30卷 1368-1376页

作者： Nobukazu Agatsuma Takahiro Utsumi Yoshitaka nishikawa Takahiro Horimatsu Takeshi Seta Yukitaka Yamashita Yukari Tanaka Takahiro Inoue Yuki Nakanishi Takahiro Shimizu Mikako Ohno Akane Fukushima Takeo Nakayama Hiroshi Seno Department of Gastroenterology and Hepatology Kyoto University Graduate School of MedicineKyoto 606-8507Japan Department of Gastroenterology and Hepatology Japanese Red Cross Wakayama Medical CenterWakayama 640-8558Japan Department of Health Informatics Kyoto University School of Public HealthKyoto 606-8501Japan Institute for Advancement of Clinical and Translational Science(iACT) Kyoto University HospitalKyoto 606-8507Japan Medical Support Section Medical Affairs DivisionKyoto University HospitalKyoto 606-8507Japan

BACKGROUND Colorectal cancer(CRC)is a global health concern,with advanced-stage diagnoses contributing to poor prognoses.The efficacy of CRC screening has been well-established;nevertheless,a significant proportion of patients remain unscreened,with>70%of cases diagnosed outside screening.Although identifying specific subgroups for whom CRC screening should be particularly recommended is crucial owing to limited resources,the association between the diagnostic routes and identification of these subgroups has been less appreciated.In the Japanese cancer registry,the diagnostic routes for groups discovered outside of screening are primarily categorized into those with comorbidities found during hospital visits and those with CRC-related symptoms.AIM To clarify the stage at CRC diagnosis based on diagnostic routes.METHODS We conducted a retrospective observational study using a cancer registry of patients with CRC between January 2016 and December 2019 at two hospitals.The diagnostic routes were primarily classified into three groups:Cancer screening,follow-up,and symptomatic.The early-stage was defined as Stages 0 or I.Multivariate and univariate logistic regressions were exploited to determine the odds of early-stage diagnosis in the symptomatic and cancer screening groups,referencing the follow-up group.The adjusted covariates were age,sex,and tumor location.RESULTS Of the 2083 patients,715(34.4%),1064(51.1%),and 304(14.6%)belonged to the follow-up,symptomatic,and cancer screening groups,respectively.Among the 2083 patients,CRCs diagnosed at an early stage were 57.3%(410 of 715),23.9%(254 of 1064),and 59.5%(181 of 304)in the follow-up,symptomatic,and cancer screening groups,respectively.The symptomatic group exhibited a lower likelihood of early-stage diagnosis than the follow-up group[P<0.001,adjusted odds ratio(aOR),0.23;95%confidence interval(95%CI):0.19-0.29].The likelihood of diagnosis at an early stage was similar between the follow-up and cancer screening groups(P=0.493,aOR for early-stage diagnosis in the

关键词： Colorectal neoplasms Cancer registry Diagnostic route Cancer screening Stage at diagnosis

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赛黑桦组织培养技术研究

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湖北林业科技 2018年第4期47卷 6-9页

作者：蒋祥娥西川浩已湖北省林业厅林木种苗管理总站武汉430079 山梨县森林综合研究所日本4000502

以赛黑桦休眠枝萌发的腋芽为外植体,研究了不同种类和不同浓度植物激素对赛黑桦外植体诱导、愈伤组织诱导、不定芽增殖和生根等环节的影响。结果表明:(1)外植体芽的诱导培养以WPM+6-BA0.5 mg·L^(-1)+NAA0.1 mg·L^(-1)为最佳培养基;(2... 详细信息

以赛黑桦休眠枝萌发的腋芽为外植体,研究了不同种类和不同浓度植物激素对赛黑桦外植体诱导、愈伤组织诱导、不定芽增殖和生根等环节的影响。结果表明:(1)外植体芽的诱导培养以WPM+6-BA0.5 mg·L^(-1)+NAA0.1 mg·L^(-1)为最佳培养基;(2)愈伤组织诱导以WPM+6-BA1.0 mg·L^(-1)+NAA0.02 mg·L^(-1)为最佳培养基;(3)在芽增殖培养中以WPM+6-BA0.1 mg·L^(-1)+NAA0.02 mg·L^(-1)增殖效果最好,增殖系数达4.0;(4)生根培养以WPM+NAA0.05 mg·L^(-1)效果最佳,生根率91.7%;(5)生根苗移栽成活率达90%以上。

关键词：组织培养技术黑桦愈伤组织诱导最佳培养基生根培养不定芽增殖生根苗移栽外植体

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利用探针跳跃式扫描离子电导显微镜技术揭示结直肠癌单细胞层面对H2O2良性应激的动态响应（英文）

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Science Bulletin 2024年第12期 1909-1919页

作者：王东 Emily Woodcock 杨羲 Hiromi nishikawa Elena V.Sviderskaya Masanobu Oshima Christopher Edwards 张彦军 Yuri Korchev WPI Nano Life Science Institute (WPI-Nano LSI) Kanazawa University Department of Medicine Imperial College London Cell Biology Research Centre Molecular and Clinical Sciences Research Institute St George's University of London

Colorectal cancer（CRC）, a widespread malignancy, is closely associated with tumor microenvironmental hydrogen peroxide（H2O2） levels. Some clinical trials targeting H2O2for cancer treatment have revealed its paradoxical role as a promoter of cancer progression. Investigating the dynamics of cancer cell H2O2eustress at the single–cell level is crucial. In this study, non–contact hopping probe mode scanning ion conductance microscopy（HPICM） with high-sensitive Pt–functionalized nanoelectrodes was employed to measure dynamic extracellular to intracellular H2O2gradients in individual colorectal cancer Caco–2cells. We explored the relationship between cellular mechanical properties and H2O2gradients.Exposure to 0.1 or 1 mmol/L H2O2eustress increased the extracellular to intracellular H2O2gradient from 0.3 to 1.91 or 3.04, respectively. Notably, cellular F–actin–dependent stiffness increased at 0.1 mmol/L but decreased at 1 mmol/L H2O2eustress. This H2O2–induced stiffness modulated AKT activation positively and glutathione peroxidase 2（GPX2） expression negatively. Our findings unveil the failure of some H2O2-targeted therapies due to their ineffectiveness in generating H2O2, which instead acts eustress to promote cancer cell survival. This research also reveals the complex interplay between physical properties and biochemical signaling in cancer cells' antioxidant defense, illuminating the exploitation of H2O2eustress for survival at the single–cell level. Inhibiting GPX and/or catalase（CAT） enhances the cytotoxic activity of H2O2eustress against CRC cells, which holds significant promise for developing innovative therapies targeting cancer and other H2O2-related inflammatory diseases.

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Mucosal patterns change after Helicobacter pylori eradication:Evaluation using blue laser imaging in patients with atrophic gastritis

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World Journal of Gastroenterology 2023年第17期29卷 2657-2665页

作者： Yoshiyuki nishikawa Yoshio Ikeda Hidehiro Murakami Shin-Ichiro Hori Megumi Yoshimatsu Naoki nishikawa Department of Gastroenterology Nishikawa Gastrointestinal ClinicMatsuyama 790-0878EhimeJapan Endoscopy Center Ehime University HospitalToon 791-0295EhimeJapan Department of Internal Medicine Saiseikai Matsuyama HospitalMatsuyama 791-8026EhimeJapan Department of Gastroenterology Himeji Red Cross HospitalHimeji 670-8540HyogoJapan Department of Gastroenterology National Hospital Organization Shikoku Cancer CenterMatsuyama 791-0280EhimeJapan Department of Gastroenterology Matsuyama Shimin HospitalMatsuyama 790-0067EhimeJapan

BACKGROUND Mucosal patterns(MPs)observed on blue laser imaging in patients with atrophic gastritis can be classified as spotty,cracked,and mottled.Furthermore,we hypothesized that the spotty pattern may change to the cracked pattern after Helicobacter pylori(H.pylori)eradication.AIM To further substantiate and comprehensively investigate MP changes after H.pylori eradication in a larger number of patients.METHODS We included 768 patients who were diagnosed with atrophic gastritis with evaluable MP using upper gastrointestinal endoscopy at the nishikawa Gastrointestinal Clinic,Japan.Among them,325 patients were H.pylori-positive,and of them,101 patients who underwent upper gastrointestinal endoscopy before and after H.pylori eradication were evaluated for post-eradication MP changes.The patients’MPs were interpreted by three experienced endoscopists who were blinded to their clinical features.RESULTS Among 76 patients with the spotty pattern before or after H.pylori eradication,the pattern disappeared or decreased in 67 patients[88.2%,95%confidence interval(CI):79.0%-93.6%),appeared or increased in 8 patients(10.5%,95%CI:5.4%-19.4%),and showed no change in 1 patient(1.3%,95%CI:0.2%-7.1%).In 90 patients with the cracked pattern before or after H.pylori eradication,the pattern disappeared or decreased in 7 patients(7.8%,95%CI:3.8%-15.2%),appeared or increased in 79 patients(87.8%,95%CI:79.4%-93.0%),and showed no change in 4 patients(4.4%,95%CI:1.7%-10.9%).In 70 patients with the mottled pattern before or after H.pylori eradication,the pattern disappeared or decreased in 28 patients(40.0%,95%CI:29.3%-51.7%),appeared or increased in 35 patients(50.0%,95%CI:38.6%-61.4%),and showed no change in 7 patients(10.0%,95%CI:4.9%-19.2%).CONCLUSION After H.pylori eradication,MPs changed from spotty to cracked in most patients,which may help endoscopists easily and precisely evaluate H.pylori-related gastritis status.

关键词： Atrophic gastritis Helicobacter pylori Gastrointestinal endoscopy Image enhancement Classification

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