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Shear wave velocity is a useful marker for managing nonalcoholic steatohepatitis

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World Journal of Gastroenterology 2010年第23期16卷 2918-2925页

作者： Akihiko Osaki Tomoyuki Kubota Takeshi Suda masato Igarashi Keisuke Nagasaki Atsunori Tsuchiya Masahiko Yano Yasushi Tamura Masaaki Takamura Hirokazu Kawai Satoshi Yamagiwa Toru kikuchi Minoru Nomoto Yutaka Aoyagi Department of Gastroenterology and Hepatology Graduate School of Medical and Dental SciencesNiigata University Department of Homeostatic Regulation and Development Graduate School of Medical and Dental SciencesNiigata University Department of Laboratory Medicine Niigata University Medical and Dental Hospital

AIM:To investigate whether a noninvasive measurement of tissue strain has a potential usefulness for management of nonalcoholic steatohepatitis(NASH).METHODS:In total 26 patients,23 NASHs and 3 normal controls were enrolled in this *** was staged based on Brunt *** a region of interest(ROI),a shear wave was evoked by implementing an acoustic radiation force impulse(ARFI),and the propagation velocity was quantif ***:Shear wave velocity(SWV) could be reproducibly quantified at all ROIs in all subjects except for 4 NASH cases,in which a reliable SWV value was not calculated at several *** average SWV of 1.34 ± 0.26 m/s in fibrous stage 0-1 was significantly slower than 2.20 ± 0.74 m/s and 2.90 ± 1.01 m/s in stages 3 and 4,respectively,but was not significantly different from 1.79 ± 0.78 m/s in stage *** a cutoff value was set at 1.47 m/s,receiver operating characteristic analysis showed significance to dissociate stages 3 and 4 from stage 0-1(P=0.0092) with sensitivity,specificity and area under curve of 100%,75% and 94.2%,*** addition,the correlation between SWV and hyaluronic acid was significant(P<0.0001),while a tendency toward negative correlation was observed with serum albumin(P=0.053).CONCLUSION:The clinical implementation of ARFI provides noninvasive repeated evaluations of liver stiffness at an arbitrary position,which has the potential to shed new light on NASH management.

关键词： Nonalcoholic steatohepatitis Ultrasound Liver stiffness measurement Shear wave velocity Acoustic radiation force impulse

Survival of geriatric patients after percutaneous endoscopic gastrostomy in Japan

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World Journal of Gastroenterology 2010年第40期16卷 5084-5091页

作者： Yutaka Suzuki Seryna Tamez Akihiko Murakami Akihiko Taira Akihiro Mizuhara Akira Horiuchi Chie Mihara Eiji Ako Hirohito Muramatsu Hitoshi Okano Hitoshi Suenaga Kazuaki Jomoto Junya Kobayashi Katsunari Takifuji Kazuhiro Akiyama Koh Tahara Koji Onishi Makoto Shimazaki Masami Matsumoto Masashi Ijima masato Murakami masato Nakahori Michiaki Kudo Michio Maruyama Mikako Takahashi Naohiro Washizawa Shigeru Onozawa Satoshi Goshi Satoyoshi Yamashita Shigeki Ono Shin Imazato Shinji Nishiwaki Shuichirou Kitahara Takao Endo Takao Iiri Takeshi Nagahama Takuto Hikichi Tatsuya Mikami Tetsuo Yamamoto Tetsushi Ogawa Tomoko Ogawa Tomoyuki Ohta Toshifumi Matsumoto Toshiroh Kura Tsutomu kikuchi Tsuyoshi Iwase Tsuyotoshi Tsuji Yukio Nishiguchi Mitsuyoshi Urashima Department of Surgery International Universi-ty of Health and Welfare Hospital Department of Molecular Epidemiology Jikei University School of Medicine Endoscopy Unit Iwate prefectural Central Hospital Department of Internal Medicine Tsuyama Chuo Hospital Department of Surgery Higashi Washi-nomiya Hospital Digestive Disease Center Showa Inan General Hospital Department of Neurology Ebina Medical Sup-port Center Department of Surgery Sumitomo Hospital Department of Gastroenterology Kiyota Hospital Department of Gastroenterology Okano Clinic Department of Geriatrics Hitachikoh Hospital Department of Internal Medicine Jomoto Gastroenteric and Internal Medical Clinic Department of Surgery Fujiyoshida Munici-pal Hospital 2nd Department of Surgery Wakayama Medical University Hospital Department of Surgery Tokatsu-clinic Hospital Department of Surgery Kure Kyosai Hospital Department of Internal Medicine Matsue Sei-kyo Genaral Hospital Department of Gastroenterology Hirano General Hospital Department of Internal Medicin Nara Prefectural Gojo Hospital Department of Internal Medicine Isesaki Mu-nicipal Hospital Department of Internal Medicine Muraka-mi Memorial Hospital Digestive Endoscopy Center Sendai Kousei Hospital Department of Surgery Onishi Hospital Department of Surgery Tokyo Metropoli-tan Ohkubo Hospital Department of Internal Medicine Tsuruoka Kyoritsu Hospital Nutritional Therapy Center Toho Uni-versity Omori Medical Center Home Care Department Kameda Medical Hospital Endoscopic Treatment Center Japan Labour Health and Welfare Organization Niigata Rousai Hospital Department of Gastroenterology and Hepatology Social Insurance Shimonoseki Welfare Hospital Department of Gastroenterology Ako City Hospital Percutaneous Endoscopic Gastrostomy Center Oita Kensei Hospital Department of Internal Medicine Nishimino Kosei Hospital Department of Pediatric Surgery Nagano Red Cross Hospital Department of Internal Medicine Sapporo Shirakaba-dai hospital Department of Gastroenterology Tachikawa

AIM: To examine the long term survival of geriatric patients treated with percutaneous endoscopic gastrostomy (PEG) in Japan. METHODS: We retrospectively included 46 Japanese community and tertiary hospitals to investigate 931 consecutive geriatric patients (≥ 65 years old) with swallowing difficulty and newly performed PEG between Jan 1st 2005 and Dec 31st 2008. We set death as an outcome and explored the associations among patient’s characteristics at PEG using log-rank tests and Cox proportional hazard models. RESULTS: Nine hundred and thirty one patients were followed up for a median of 468 d. A total of 502 deaths were observed (mortality 53%). However, 99%, 95%, 88%, 75% and 66% of 931 patients survived more than 7, 30, 60 d, a half year and one year, respectively. In addition, 50% and 25% of the patients survived 753 and 1647 d, respectively. Eight deaths were considered as PEG-related, and were associated with lower serum albumin levels (P = 0.002). On the other hand, among 28 surviving patients (6.5%), PEG was removed. In a multivariate hazard model, older age [hazard ratio (HR), 1.02; 95% confidence interval (CI), 1.00-1.03; P = 0.009], higher C-reactive protein (HR, 1.04; 95% CI: 1.01-1.07; P = 0.005), and higher blood urea nitrogen (HR, 1.01; 95% CI: 1.00-1.02; P = 0.003) were significant poor prognostic factors, whereas higher albumin (HR, 0.67; 95% CI: 0.52-0.85; P = 0.001), female gender (HR, 0.60; 95% CI: 0.48-0.75; P < 0.001) and no previous history of ischemic heart disease (HR, 0.69; 95% CI: 0.54-0.88, P = 0.003) were markedly better prognostic factors. CONCLUSION: These results suggest that more than half of geriatric patients with PEG may survive longer than 2 years. The analysis elucidated prognostic factors.

关键词： Percutaneous endoscopic gastrostomy Enteral nutrition Comorbidity Survival Risk factor

Assessing quality of life using the brief cancer-related worry inventory for gynecological surgery

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World Journal of Obstetrics and Gynecology 2019年第1期8卷 1-7页

作者： Ami kikuchi Ryo Koide Masahiro Iwasaki Mizue Teramoto Seiro Satohisa masato Tamate Masami Horiguchi Nozomi Niwa Tsuyoshi Saito Toru Mizuguchi Department of Nursing and Surgical Science Sapporo Medical University Postgraduate School of Health ScienceSapporo 0608556Japan Department of Obstetrics and Gynecology Sapporo Medical University Postgraduate School of MedicineSapporo 0608556Japan

BACKGROUND The mental status of gynecologic patients has an important influence on their quality of life(QOL).Although high-quality QOL studies into breast cancer patients have been performed internationally,few QOL studies have examined patients with gynecological *** To investigate the brief cancer-related worry inventory(BCWI)could evaluate the mental status of gynecological *** Between July 2018 and December 2018,19 consecutive gynecological cancer patients were prospectively recruited for this *** BCWI is a 15-item selfreported questionnaire that assesses cancer-related worries on a numeric scale(0–100).RESULTS The high BCWI group was significantly younger than the low BCWI *** social status,the absence of a spouse and children was significantly more common in the high BCWI group than in the low BCWI *** operation time was longer in the worsening BCWI group than in the stable BCWI group(305.3±140.5 min vs 171.1±97.2 min;P=0.026).CONCLUSION Being young,having no family,and a long operation time were found to be risk factors for increased ***,gynecological cancer patients should be assessed using the BCWI,and specific perioperative mental care should be considered for highly anxious patients.

关键词： Gynecology Brief cancer-related worry inventory Quality of life Surgery

Hematogenous umbilical metastasis from colon cancer treated by palliative single-incision laparoscopic surgery

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World Journal of Gastrointestinal Surgery 2013年第10期5卷 272-277页

作者： Tomohide Hori Noriyuki Okada Masaya Nakauchi Shuji Hiramoto Ayako kikuchi-Mizota Masahisa Kyogoku Fumitaka Oike Hidemitsu Sugimoto Junya Tanaka Yoshiki Morikami Kaori Shigemoto Toyotsugu Ota Masanobu Kaneko masato Nakatsuji Shunji Okae Takahiro Tanaka Daigo Gunji Akira Yoshioka Department of Surgery Mitsubishi Kyoto Hospital Department of Medical Oncology Mitsubishi Kyoto Hospital Department of Histopathology Mitsubishi Kyoto Hospital Department of Gastroenterology Mitsubishi Kyoto Hospital Department of Radiology Mitsubishi Kyoto Hospital Department of Internal Medicine Mitsubishi Kyoto Hospital

Sister Mary Joseph’s nodule(SMJN)is a rare umbilical nodule that develops secondary to metastatic *** malignancies are located in the abdomen or *** with SMJN have a poor *** 83-year-old woman presented to our hospital with a1-month history of a rapidly enlarging umbilical *** findings revealed advanced transverse colon *** tomography and fluorodeoxyglucose-positron emission tomography revealed tumors of the transverse colon,umbilicus,right inguinal lymph nodes,and left *** feeding arteries and drainage veins for the SMJN were the inferior epigastric *** findings of the left lung tumor allowed for identification of the primary lung cancer,and a diagnosis of advanced transverse colon cancer with SMJN and primary lung cancer was *** patient underwent local resection of the SMNJ and subsequent single-site laparoscopic surgery involving right hemicolectomy and paracolic lymph node ***-abdominal dissemination to the mesocolon was confirmed during ***,the transverse colon cancer was confirmed to be moderately differentiated tubular *** suspect that SMJN may occur via a hematogenous *** chemotherapy for colon cancer and thoracoscopic surgery for the primary lung cancer were scheduled,the patient and her family desired home *** months after surgery,she died of rapidly growing lung cancer.

关键词： Umbilicus Sister Mary Joseph Singleincision laparoscopic surgery Palliative operation Hematogenous metastasis