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Alpha-fetoprotein-producing colon cancer with atypical bulky lymph node metastasis

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World Journal of Gastroenterology 2006年第47期12卷 7715-7716页

作者： Kuangi Fu Akihiro Kobayashi norio Saito Yasushi Sano Shigeharu Kato Hiroaki Ikematsu Takahiro Fujimori Yasushi Kaji Shigeaki Yoshida Department of Radiology Dokkyo University School of Medicine 880 Kitakobaysashi Mibu Shimotuga Tochigi 321-0293 Japan Department of Gastrointestinal Oncology and Digestive Endoscopy National Cancer Center Hospital East Kashiwa Chiba 277-8577 Japan Department of Surgery National Cancer Center Hospital East Kashiwa Chiba 277-8577 Japan Department of Gastrointestinal Oncology and Digestive Endoscopy National Cancer Center Hospital East Kashiwa Chiba 277-8577 Japan Department of Surgical and Molecular Pathology Dokkyo University School of Medicine 880 Kitakobaysashi Mibu Shimotuga Tochigi 321-0293 Japan Department of Radiology Dokkyo University School of Medicine 880 Kitakobaysashi Mibu Shimotuga Tochigi 321-0293 Japan

Alpha-fetoprotein (AFP)-producing colorectal cancer is extremely rarely reported until now. All of the reported cases harboring synchronous hematogenous spread including liver and/or lung metastasis had a poor prognosis and died within 12 mo. We here describe a 71-year old man with AFP-producing colon cancer who presented with an unusual bulky lymph node metastasis instead of hematogenous spread. He underwent adjuvant chemotherapy in addition to curative surgical resection, which prolonged his survival.

关键词： Alpha-fetoprotein Colon cancer Bulky lymph node metastasis Computed tomography Colonoscopy

Comparison between surgical outcomes of colorectal cancer in younger and elderly patients

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World Journal of Gastroenterology 2011年第12期17卷 1642-1648页

作者： Longxue Jin norio Inoue Naoki Sato Susumu Matsumoto Hitoshi Kanno Yuko Hashimoto Kazuhiro Tasaki Kinya Sato Shun Sato Katsutoshi Kaneko Center for Digestive Diseases Northern Fukushima Medical Center Fukushima 960-0502 Japan Department of Pathology Fukushima Medical University Hospital Fukushima 960-1295 Japan Division of Anesthesiology Northern Fukushima Medical Center Fukushima 960-0502 Japan

AIM:To compare the outcome of surgical treatment of colorectal adenocarcinoma in elderly and younger ***:The outcomes of 122 patients with colorectal adenocarcinoma who underwent surgical treatment between January 2004 and June 2009 were *** clinicopathological and blood biochemistry data of the younger group(<75 years) and the elderly group (≥75 years) were ***:There were no significant differences between the two groups in operation time,intraoperative blood loss,hospital stay,time to resumption of oral intake,or *** elderly group had a significantly higher rate of hypertension and cardiovascular *** perioperative serum total protein and albumin levels were significantly lower in the elderly than in the younger *** serum carcinoembryonic antigen level was lower in the elderly than in the younger group,and there was a significant decreasing trend after the operation in the elderly ***:The short-term outcomes of surgical treatment in elderly patients with colorectal adenocarcinoma were *** treatment in elderly patients was considered a selectively effective approach.

关键词： Colorectal tumor Elderly patient Morbidity Carcinoembryonic antigen C-reactive protein

Helicobacter pylori eradication to prevent gastric cancer: underlying molecular and cellular mechanisms

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World Journal of Gastroenterology 2006年第11期12卷 1671-1680页

作者： Shingo Tsuji Masahiko Tsujii Hiroaki Murata Tsutomu Nishida Masato Komori Masakazu Yasumaru Shuji Ishii Yoshiaki Sasayama Sunao Kawano norio Hayashi Department of Gastroenterology and Hepatology Osaka University Graduate School of Medicine (Kl) YamadaokaSuita565-0871 Japan Department of Internal Medicine Kansai Rohsai Hospital Amagasaki660-0064 Japan Department of Internal Medicine Kashiwara Muncipal Hospital Kashiwara582-0002 Japan Department of Clinical Laboratory Science Osaka University Graduate School of Medicine Suita565-0871 Japan

Numerous cellular and molecular events have been described in development of gastric cancer. In this artide, we overviewed roles of Helicobacter pylori （H pylori） infection on some of the important events in gastric carcinogenesis and discussed whether these cellular and molecular events are reversible after cure of the infection. There are several bacterial components affecting gastric epithelial kinetics and promotion of gastric carcinogenesis. The bacterium also increases risks of genetic instability and mutations due to NO and other reactive oxygen species. Epigenetic silencing of tumor suppressor genes such as RUNX3 may alter the frequency of phenotype change of gastric glands to those with intestinal metaplasia. Host factors such as increased expression of growth factors, cytokines and COX-2 have been also reported in non-cancerous tissue in Hpylori-positive subjects. It is noteworthy that most of the above phenomena are reversed after the cure of the infection. However, some of them including overexpression of COX-2 continue to exist and may increase risks for carcinogenesis in metaplastic or dysplastic mucosa even after successful H pylori eradication. Thus, H pylori eradication may not completely abolish the risk for gastric carcinogenesis. Efficiency of the cure of the infection in suppressing gastric cancer depends on the timing and the target population, and warrant further investigation.

关键词： Helicobacter Cancer Gastric acid p53 Inflammation Gastric atrophy Intestinal metaplasia

Usefulness of portal vein pressure for predicting the effects of tolvaptan in cirrhotic patients

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World Journal of Gastroenterology 2016年第21期22卷 5104-5113页

作者： Ai Nakagawa Masanori Atsukawa Akihito Tsubota Chisa Kondo Tomomi Okubo Taeang Arai norio Itokawa Yoshiyuki Narahara Katsuhiko Iwakiri Division of Gastroenterology Department of Internal Medicine Nippon Medical School Chiba Hokusoh Hospital Core Research Facilities for Basic Science Research Center for Medical Sciences Jikei University School of Medicine Division of Gastroenterology Department of Internal Medicine Nippon Medical School

AIM: To elucidate influencing factors of treatment response, then tolvaptan has been approved in Japan for liquid ***: We herein conducted this study to clarify the influencing factors in 40 patients with decompensated liver cirrhosis complicated by liquid retention. Tolvaptan was administered at a dosage of 7.5 mg once a day for patients with conventional diuretic-resistant hepatic edema for 7 d. At the initiation of tolvaptan, the estimated hepatic venous pressure gradient (HVPG) value which was estimated portal vein pressure was measured using hepatic venous catheterization. We analyzed the effects of tolvaptan and influencing factors associated with treatment ***: Subjects comprised patients with a median age of 65 (range, 40-82) years. According to the Child-Pugh classification, class A was 3 patients, class B was 19, and class C was 18. Changes from the baseline in body weight were -1.0 kg (P = 2.04 × 10-6) and -1.3 kg (P = 1.83 × 10-5), respectively. The median HVPG value was 240 (range, 105-580) mmH2O. HVPG was only significant influencing factor of the weight loss effect. When patients with body weight loss of 2 kg or greater from the baseline was defined as responders, receiver operating characteristic curve analysis showed that the optimal HVPG cutoff value was 190 mmH2O in predicting treatment response. The response rate was 87.5% (7/8) in patients with HVPG of 190 mmH2O or less, whereas it was only 12.5% (2/16) in those with HVPG of greater than 190 mmH2O (P = 7.46 × 10-4). We compared each characteristics factors between responders and non-responders. As a result, HVPG (P = 0.045) and serum hyaluronic acid (P = 0.017) were detected as useful ***: The present study suggests that tolvaptan in the treatment of liquid retention could be more effective for patients with lower portal vein pressure.

关键词： Tolvaptan V2 receptor antagonist Portal vein pressure Hepatic venous pressure gradient Decompensated chirrosis

Combination therapy with daclatasvir and asunaprevir for dialysis patients infected with hepatitis C virus

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World Journal of Clinical Cases 2016年第3期4卷 88-93页

作者： Ken Sato Yuichi Yamazaki Tatsuya Ohyama Takeshi Kobayashi norio Horiguchi Satoru Kakizaki Motoyasu Kusano Masanobu Yamada Department of Medicine and Molecular Science Gunma University Graduate School of Medicine Department of Gastroenterology Heisei Hidaka Clinic Department of Endoscopy and Endoscopic Surgery Gunma University Hospital

The standard antiviral therapy for dialysis patients infected with hepatitis C virus(HCV) is(pegylated) interferon monotherapy, but its efficacy is insufficient. Oral direct-acting antiviral agents(DAAs) have recently been developed for chronic hepatitis C patients. However, some DAAs have contraindications for chronic renal failure(CRF). Daclatasvir and asunaprevir are metabolized largely in the liver and are not contraindicated in CRF. Combination therapy with daclatasvir and asunaprevir was used for 4 dialysis patients infected with genotype 1b HCV. One patient had viral breakthrough, and the 3 others had sustained virological response 12. One patient was admitted for heart failure and percutaneous coronary intervention due to concomitant ischemic disease. Heart failure was unlikely to be caused by the combination therapy, as it was probably due to water overload. The patient continued to receive the combination therapy after the remission of the heart failure. The combination therapy was well tolerated in the other patients.

关键词： Hepatitis C Oral drug Daclatasvir Asunaprevir Dialysis

MK-0626,a selective DPP-4 inhibitor,attenuates hepatic steatosis in ob/ob mice

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World Journal of Gastroenterology 2014年第43期20卷 16227-16235页

作者： Tatsuya Ohyama Ken Sato Yuichi Yamazaki Hiroaki Hashizume norio Horiguchi Satoru Kakizaki Masatomo Mori Motoyasu Kusano Masanobu Yamada Department of Medicine and Molecular Science Gunma University Graduate School of MedicineGunma 371-8511Japan Department of Endoscopy and Endoscopic Surgery Gunma University HospitalGunma 371-8511Japan

AIM: To investigate the mechanism and in vivo effects of MK-0626, a dipeptidyl peptidase-4 inhibitor, on hepatic steatosis using ob/ob mice.

关键词： Dipeptidyl peptidase-4 inhibitor Hepatic steatosis ob/ob mice AMP-activated protein kinase Microsomal triglyceride transfer protein Adiponectin

Primary hepatic choriocarcinoma in a 49-year-old man:Report of a case

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World Journal of Gastroenterology 2013年第48期19卷 9485-9489页

作者： Ryosuke Sekine Masanobu Hyodo Masayuki Kojima Yoshiyuki Meguro Akifumi Suzuki Taku Yokoyama Alan T Lefor norio Hirota Department of Emergency Medicine Ibaraki Prefectural Central Hospital Ibaraki 309-1793 Japan Department of Surgery Hitachiomiya Saiseikai Hospital Ibaraki 319-2256 Japan Department of Surgery Jichi Medical University Tochigi 329-0498 Japan Department of Pathology Hirota Institute for Surgical Pathology Tochigi 329-0403 Japan

We report a case of hepatic choriocarcinoma in a man diagnosed at autopsy after a rapid downhill clinical *** patient was a 49-year-old man who presented with acute right-sided abdominal *** were no masses palpable on physical *** findings showed large multi-nodular tumors mainly in the right lobe of the *** emission tomography scan showed uptake only in the liver,and no uptake in the *** initially planned to perform a liver resection for the presumed diagnosis of intra-hepatic ***,the tumors grew rapidly and *** lung metastases rapidly developed resulting in respiratory failure,preventing liver resection or even *** died 60 d after initial presentation with no pathological *** studies included histopathological and immunohistological examinations which diagnosed a primary choriocarcinoma of the *** hepatic choriocarcinoma is very rare but should be considered in the differential diagnosis of a liver tumor in a middle aged *** this diagnosis may enable treatment of the *** biopsy and evaluation of serum human chorionic gonadotropin are recommended in these patients.

关键词： Hepatic choriocarcinoma Male Human chorionic gonadotropin Liver biopsy Fludeoxyglucosepositron emission tomography

Probable case of drug reaction with eosinophilia and systemic symptom syndrome due to combination therapy with daclatasvir and asunaprevir

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World Journal of Clinical Cases 2015年第12期3卷 1005-1010页

作者： Takayoshi Suga Ken Sato Yuichi Yamazaki Tatsuya Ohyama norio Horiguchi Satoru Kakizaki Motoyasu Kusano Masanobu Yamada Department of Medicine and Molecular Science Gunma University Graduate School of Medicine Department of Endoscopy and Endoscopic Surgery Gunma University Hospital

A 66-year-old, interferon-ineligible, treatment-naive man who was diagnosed with chronic hepatitis C due to hepatitis C virus genotype 1b began combination therapy with daclatasvir and asunaprevir. On day 14 of treatment, hepatic reserve and renal function deterioration was observed, while his transaminase levels were normal. Both daclatasvir and asunaprevir were discontinued on day 18 of treatment, because the patient complained of dark urine and a rash on his trunk and four limbs. After discontinuing antiviral therapy, the abnormal laboratory finding and clinical manifestations gradually improved, without recurrence. Our case fulfilled the diagnostic criteria of probable drug reaction with eosinophilia and systemic symptom(DRESS) syndrome. Despite the 18-d treatment, sustained virological response 12 was achieved. Based on the clinical course, we concluded that there was a clear cause-and-effect relationship between the treatment and adverse events. To our knowledge, this patient represents the first case of probable DRESS syndrome that includes concomitant deterioration of hepatic reserve and renal function due to combination therapy with daclatasvir and asunaprevir, regardless of normalization of transaminase levels. Our case suggests that we should pay attention not only to the transaminase levels but also to allergic symptoms associated with organ involvement during combination therapy with daclatasvir and asunaprevir.

关键词： Hepatitis C Daclatasvir Renal dysfunction Asunaprevir Hepatic reserve deterioration

The relationship between tyrosine kinase inhibitor therapy and overall survival in patients with non-small cell lung cancer carrying EGFR mutations

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Chinese Journal of Cancer 2013年第3期32卷 136-140页

作者： Hidekazu Suzuki Tomonori Hirashima norio Okamoto Tadahiro Yamadori Motohiro Tamiya Naoko Morishita Takayuki Shiroyama Tomoyuki Otsuka Kanako Kitai Ichiro Kawase Department of Thoracic Malignancy Osaka Prefectural Medical Center for Respiratory and Allergic Diseases 3-7-1 Habikino Habikino-shiOsaka 583-8588 Japan.

For patients with epidermal growth factor receptor (EGFR) mutation-positive lung cancer, the relationship between the dose or duration of treatment with tyrosine kinase inhibitor (TKI) and overall survival remains unclear. Here, we analyzed clinical data of 39 patients who were diagnosed with EGFR mutation-positive non-small cell lung cancer and treated with TKI, but subsequently died. Several parameters were measured in this study: overall survival; first, second, and overall TKI therapy durations; first TKI intensity (actual dose/normal dose); and TKI rate (overall TKI therapy duration/overall survival). The response rate to TKI therapy was 50% , and the median survival was 553 days. After TKI therapy failed, 38.5% patients were re-challenged with TKI. We observed a moderate relationship [r = 0.534, 95% confidential interval (CI) = 0.263 to 0.727, P < 0.001] between overall TKI therapy duration and overall survival. However, we found no relationship between overall survival and first TKI intensity (r = 0.073, 95% CI = -0.380 to 0.247, P = 0.657) or TKI rate (r = 0.0345, 95% CI = -0.284 to 0.346, P = 0.835). Nonsmall cell lung cancer patients with mutation-positive tumors remained on TKI therapy for, on average, 33% of the overall survival time. These findings suggest that patients with EGFR mutation-positive tumors should not stick to using TKIs.

关键词：酪氨酸激酶抑制剂非小细胞肺癌治疗剂量肿瘤患者 EGFR 生存期突变表皮生长因子受体