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Serum cystatin C can be used as a marker of renal function even in patients with intestinal urinary diversion

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Asian Journal of Urology 2015年第3期2卷 167-169页

作者： Masahiro Matsuki Toshiaki Tanaka Takeshi Maehana Koji Ichihara Masahiro Yanase Masanori Matsukawa Hideki Adachi satoshi takahashi Naoya Masumori Department of Urology Sapporo Medical UniversitySchool of MedicineSapporoJapan Sapporo Kidney Disease Treatment Forum SapporoJapan Department of Urology Sunagawa City Medical CenterSunagawaJapan Department of Urology Takikawa Municipal HospitalTakikawaJapan Department of Urology SaiseikaiOtaru HospitalOtaruJapan

Objective:Recently,serum cystatin C(CysC)has been used as a novel marker of renal function.However,there is a lack of data on CysC levels in patients with intestinal urinary diversion(UD).Here we report CysC levels in such patients.Methods:We prospectively observed 38 patients who were diagnosed with bladder cancer and subsequently treated with radical cystectomy and UD at our institution in 2012 and 2013.Serum creatinine(sCr)and CysC were obtained optionally at the same time at least 1 month after radical cystectomy and UD.Results:The median CysC and sCr concentrations were 1.12 mg/L(range 0.75-2.47 mg/L)and 0.99 mg/dL(range 0.61-2.22 mg/dL),respectively.The median estimated concentrations of glomerular filtration rate(GFR)based on CysC(eGFRcys)and GFR based on creatinine(eGFRcreat)were 61.08 mL/min/1.73 m^2(range 22.64e99.89 mL/min/1.73 m^2)and 58.01 mL/min/1.73 m^2(range 23.48e91.82 mL/min/1.73 m2),respectively.CysC had a significant correlation with sCr(r=0.8607,p<0.0001)and eGFRcreat(r=-0.8993,p<0.0001).eGFRcys also had a significant correlation with eGFRcreat(r=0.8104,p<0.0001).Conclusion:The correlation between CysC and sCr was strong and the correlation coefficient was equivalent to that in patients without UD.The results suggest that CysC is not affected by UD and can be used as a marker of renal function similarly to sCr in patients with UD.

关键词： Renal function Cystatin C Urinary diversion

Efficacy and safety of telaprevir- and simeprevir-based triple therapies for older patients with chronic hepatitis C

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World Journal of Hepatology 2017年第5期9卷 252-262页

作者： satoshi Yamagiwa Toru Ishikawa Nobuo Waguri Soichi Sugitani Hiroto Wakabayashi Shogo Ohkoshi Takashi Tsukishiro Toru takahashi Toshiaki Watanabe Shuji Terai Division of Gastroenterology and Hepatology Niigata University Graduate School of Medical and Dental Sciences Department of Gastroenterology and Hepatology Saiseikai Niigata Daini Hospital Department of Gastroenterology and Hepatology Niigata City General Hospital Department of Gastroenterology and Hepatology Tachikawa General Hospital Department of Gastroenterology and Hepatology Takeda General Hospital Department of Internal Medicine Nippon Dental University Medical Hospital Department of Internal Medicine Itoigawa General Hospital Department of Internal Medicine Uonuma Hospital Watanabe Clinic

AIM To evaluate and compare the efficacy and safety of telaprevir(TVR)-and simeprevir(SMV)-based triple therapies in elderly patients, specifically patients aged 66 years or older.METHODS The present study enrolled 112 and 76 Japanese patients with chronic hepatitis C virus genotype 1b infection who were treated with a 12-wk TVR-based or SMV-based triple therapy, respectively, followed by a dual therapy that included pegylated interferon α and ribavirin(RBV) for 12 wk. The patients were categorized into two groups according to age as follows: A younger group of patients aged ≤ 65 years old and an older group of patients aged > 65 years old. Among the patients treated with TVR-based triple therapy, 34 patients were included in the older group. The median ages were 56 years(range: 28-65 years) in the younger group and 69 years(range: 66-81 years) in the older group. Among the patients treated with SMV-based triple therapy, 39 patients were included in the older group. The median ages were 59 years(range: 36-65 years) in the younger group and 71 years(range: 66-86 years) in the older group. The clinical, biochemical and virological data were analyzed before and during treatment.RESULTS Among the patients treated with the TVR-based triple therapy, no significant difference in the sustained virological response(SVR) was found between the younger(80.8%) and older(88.2%) groups. The SVR rates for patients with the interleukin 28B(IL28B)(rs8099917) TG/GGgenotypes(73.9% and 60.0% in the younger and older groups, respectively) were significantly lower than for patients with the IL28B TT-genotype(86.3% and 92.9%, respectively). The cumulative exposure to RBV for the entire 24-wk treatment period(as a percentage of the target dose) was significantly higher in the younger group than in the older group(91.7% vs 66.7%, respectively, P < 0.01), but the cumulative exposure to TVR was not significantly different between the younger and older groups(91.6% vs 81.9%, respectively). A multivariate analysis identified the TT-genotype o

关键词： Telaprevir 年老的病人丙肝病毒遗传型 1b Interleukin 28B Simeprevir

A Postimplant Cholesteatoma after Modified Radical Mastoidectomy

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International Journal of Otolaryngology and Head & Neck Surgery 2019年第1期8卷 25-31页

作者： Masahiro takahashi satoshi Iwasaki Department of Otolaryngology School of Medicine International University of Health and Welfare Mita Hospital Tokyo Japan

A postimplant cholesteatoma is one of surgical complications of cochlear implantation. Hoffman and Cohen (1995) reported that only one out of 172 (0.58%) patients developed a postimplant cholesteatoma. We experienced a case of postimplant cholesteatoma after the modified radical mastoidectomy. Case: A 61-year-old man underwent left modified radical tympanoplasty with mastoidectomy for middle ear cholesteatoma at another hospital 40 years ago. We performed right open type tympanoplasty for right cholesteatoma, and at that time there was no recurrent cholesteatoma on the left side. He had already lost the sensorineural hearing in both ears. After three-year-observation with no recurrence of cholesteatoma in both ears, the patient underwent a left cochlear implantation with a Nucleus-24 channel device. After 1 year, we found new lesion of cholesteatoma in the left attic, and removed it by transcanal approach. There has been no recurrence of cholesteatoma for 12 years. Conclusion: In long-standing middle ear problems, when we perform cochlear implantation, even though there is good aeration of the middle ear and an intact tympanic membrane, we need to adequately reflect on the area which should be obliterated.

关键词： Cochlear Implant Choleateatoma Modified Radical Mastoidectomy

Cervical Castleman's disease mimicking lymph node metastasis of esophageal carcinoma

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World Journal of Gastrointestinal Oncology 2017年第9期9卷 397-401页

作者： Takumi Yamabuki Masanori Ohara Mototsugu Kato Noriko Kimura Tomohide Shirosaki Kunishige Okamura Aki Fujiwara Ryo takahashi Kazuteru Komuro Nozomu Iwashiro satoshi Hirano Department of Surgery National Hospital Organization Hakodate Hospital Department of Gastroenterology National Hospital Organization Hakodate Hospital Department of Pathology National Hospital Organization Hakodate Hospital Department of Gastroenterological Surgery Ⅱ Hokkaido University Hospital

Castleman's disease(CD) is an uncommon benign lymphoproliferative disorder of unknown etiology. A rare case of cervical CD diagnosed at lymph node dissection for esophageal carcinoma is reported. An esophageal tumor was identified in a 67-year-old man during a follow-up examination after surgery for oral carcinoma. Esophagoscopy revealed a type 1 tumor in the cervical esophagus. Histology of esophagoscopic biopsies indicated squamous cell carcinoma. Contrastenhanced computed tomography revealed swollen lymph nodes of the right cervical region. No distant metastasis was detected. Esophageal carcinoma, T2N2M0, Stage ⅢA was diagnosed. Neoadjuvant chemotherapy was recommended, but the patient rejected the chemotherapy. The patient underwent laparoscopic-assisted transhiatal esophagectomy. The histopathological diagnosis was moderately differentiated squamous cell carcinoma with pT1bN0M0, Stage ⅠA. On histology, the swollen lymph nodes of the right cervical region revealed CD. The patient's postoperative course was relatively good.

关键词： Castleman’s disease Lymph node metastasis Esophageal carcinoma

Risk factors for perforation during endoscopic retrograde cholangiopancreatography in post-reconstruction intestinal tract

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World Journal of Clinical Cases 2019年第1期7卷 10-18页

作者： Shinichi Takano Mitsuharu Fukasawa Hiroko Shindo Ei takahashi Sumio Hirose Yoshimitsu Fukasawa satoshi Kawakami Hiroshi Hayakawa Hiroshi Yokomichi Makoto Kadokura Tadashi Sato Nobuyuki Enomoto First Department of Internal Medicine Faculty of Medicine University of Yamanashi Yamanashi 409-3898 Japan Department of Health Sciences Interdisciplinary Graduate School and Engineering University of Yamanashi Yamanashi 409-3898 Japan

BACKGROUND Endoscopic retrograde cholangiopancreatography(ERCP) in patients with surgically altered anatomy has been a major challenge to gastrointestinal endoscopists with low success rates for reaching the target site as well as high complication rates. The knowledge of ERCP-related risk factors is important for reducing unexpected complications.AIM To identify ERCP-related risk factors for perforation in patients with surgically altered anatomy.METHODS The medical records of 187 patients with surgically altered anatomy who underwent ERCP at our institution between April 2009 and December 2017 were retrospectively reviewed. An analysis of patient data, including age, sex, type of reconstruction, cause of surgery, aim of ERCP, success rate of reaching target site,success rate of procedure, adverse events, type of scope, time to reach the target site, and duration of procedure, was performed. In patients with Billroth-Ⅱ reconstruction, additional potential risk factors were the shape of the inserted scope and whether the anastomosis was antecolic or retrocolic.RESULTS All patients(n = 187) had surgical anatomy, such as Billroth-Ⅰ(n = 22), Billroth-Ⅱ(n = 33), Roux-en-Y(n = 54), Child, or Whipple reconstruction(n = 75). ERCP was performed for biliary drainage in 43 cases(23%), stone removal in 29 cases(16%),and stricture dilation of anastomosis in 59 cases(32%). The scope was unable to reach the target site in 17 cases(9%), and an aimed procedure could not be accomplished in 54 cases(29%). Adverse events were pancreatitis(3%),hyperamylasemia(10%), cholangitis(6%), cholestasis(4%), excessive sedation(1%), perforation(2%), and others(3%). Perforation occurred in three cases, all of which were in patients with Billroth-Ⅱ reconstruction; in these patients, further analysis revealed loop-shaped insertion of the scope to be a significant risk for perforation(P = 0.01).CONCLUSION Risk factors for perforation during ERCP in patients with surgically altered anatomy were Billroth-Ⅱ reconstruction and looping of the scope dur

关键词： Surgically altered anatomy Billroth-Ⅱ Endoscopic retrograde cholangiopancreatography Perforation

Proposed criteria to differentiate heterogeneous eosinophilic gastrointestinal disorders of the esophagus, including eosinophilic esophageal myositis

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World Journal of Gastroenterology 2017年第13期23卷 2414-2423页

作者： Hiroki Sato Nao Nakajima Kazuya takahashi Go Hasegawa Ken-ichi Mizuno Satoru Hashimoto satoshi Ikarashi Kazunao Hayashi Yutaka Honda Junji Yokoyama Yuichi Sato Shuji Terai Division of Gastroenterology and Hepatology Niigata University Medical and Dental Hospital Division of Gastroenterology and Hepatology Saiseikai Niigata Daini Hospital Division of Cellular and Molecular Pathology Department of Cellular FunctionNiigata University Graduate School of Medical and Dental Sciences

AIM To define clinical criteria to differentiate eosinophilic gastrointestinal disorder(Eo GD) in the esophagus. METHODS Our criteria were defined based on the analyses of the clinical presentation of eosinophilic esophagitis(Eo E), subepithelial eosinophilic esophagitis(s Eo E) and eosinophilic esophageal myositis(Eo EM), identified by endoscopy, manometry and serum immunoglobulin E levels(s-Ig E), in combination with histological and polymerase chain reaction analyses on esophageal tissue samples.RESULTS In five patients with Eo E, endoscopy revealed longitudinal furrows and white plaques in all, and fixed rings in two. In one patient with s Eo E and four with Eo EM, endoscopy showed luminal compression only. Using manometry, failed peristalsis was observed in patients with Eo E and s Eo E with some variation, while Eo EM was associated with hypercontractile or hypertensive peristalsis, with elevated s-Ig E. Histology revealed the following eosinophils per high-power field values. Eo E = 41.4 ± 7.9 in the epithelium and 2.3 ± 1.5 in the subepithelium; s Eo E = 3 in the epithelium and 35 in the subepithelium(conventional biopsy); Eo EM = none in the epithelium, 10.7 ± 11.7 in the subepithelium(conventional biopsy or endoscopic mucosal resection) and 46.8 ± 16.5 in the muscularis propria(peroral esophageal muscle biopsy). Presence of dilated epithelial intercellular space and downward papillae elongation were specific to Eo E. Eotaxin-3, IL-5 and IL-13 were overexpressed in Eo E.CONCLUSION Based on clinical and histological data, we identified criteria, which differentiated between Eo E, s Eo E and Eo EM, and reflected a different pathogenesis between these esophageal Eo GDs.

关键词：嗜曙红的食道炎嗜曙红的食道的肌炎 Peroral 内视镜的肌切开术手提钻食管 Achalasia Peroral 食道的肌肉活体检视

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

Study on the Distribution at Species Level of Genus Candida in Human Oral Cavities, Using Culture and Multiplex PCR Methods

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Open Journal of Stomatology 2022年第4期12卷 119-129页

作者： Akira Fukatsu Osamu Tsuzukibashi Mana Fuchigami satoshi Uchibori Chiaki Komine Koji Umezawa Sachiyo Hayashi Yuji takahashi Taira Kobayashi Masanobu Wakami Hiroshi Murakami Masahiko Fukumoto Department of Laboratory Medicine for Dentistry for the Compromised Patient Nihon University School of Dentistry at Matsudo Chiba Japan Department of Fixed Prosthodontics Nihon University School of Dentistry at Matsudo Chiba Japan Department of Special Needs Dentistry Nihon University School of Dentistry at Matsudo Chiba Japan Department of Oral Implantology Nihon University School of Dentistry at Matsudo Chiba Japan

Purpose: Although the genus Candida is frequently isolated from human oral cavities, the distribution at the species level of these organisms has been little reported. The purpose of the present study was to assess the distribution at the species level of the genus Candida in human oral cavities. Methods: This study was performed using culture and Multiplex PCR methods. Moreover, the genotyping classification of C. albicans was analyzed with a PCR. Results: Of all subjects (n = 90), detection frequency of genus Candida was 42.2%. Genus Candida was not detected in the subjects between 0 to 9 years old, and there was no difference in the detection frequencies of this organism among each generation from 10s to 80s. C. albicans was the most dominant species, followed by C. parapsilosis, C. glabrata, and C. dubliniensis. Plural Candida species tended not to be detected in the individual sample. Genotype A was dominant in the C. albicans isolates. Conclusion: These results indicated that C. albicans of genotype A was dominant and that the genus Candida rarely coexists with other Candida species, in each individual oral cavity.

关键词： Candida Candida albicans Oral Cavity Multiplex PCR

Clinicopathological Study of Epithelial Metaplastic Breast Cancer

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Journal of Cancer Therapy 2016年第13期7卷 1039-1044页

作者： Masahiro Kitada Shunsuke Yasuda Nana takahashi satoshi Okazaki Kei Ishibashi satoshi Hayashi Department of Breast Disease Center Asahikawa Medical University Asahikawa Japan

Introduction: Metaplastic breast cancer (MBC) is a rare pathological type with an incidence rate of not more than 1%, and has been reported to be often detected after its progression and highly malignant with a high proportion of triple negative type tumors, with poor outcomes as compared to IDC [1] [2] [3]. We analyzed clinicopathological characteristics of patients who underwent surgery for epithelial MBC at our department. Patients and Methods: From January 2000 to March 2014, a total of 2120 patients underwent surgery for breast cancer, and MBC was diagnosed in 15 of these patients. Fourteen of the 15 had epithelial MBC and were included in this study. The present study compared clinopathological characteristics of MBC with those of IDC of triple negative type (TN type group) and IDC of non-triple negative type (IDC group). Results: Breast conserving surgery was performed in 7 patients with MBC (50%), a proportion clearly lower than the 64.3% in the IDC group. The mean tumor size was 3.8 cm, which was greater than the 2.13 cm in the TN type group and the 1.7 cm in the IDC group. About nuclear grade, the proportion of grade III was 57.1%, markedly higher than the 38.6% in the TN type group and the 12.6% in the IDC group. All patients were estrogen receptor (ER) and progesterone receptor (PgR) negative;11 patients were TN type tumors and 3 were HER2 type. Conclusion: We studied patients who underwent surgery for epithelial MBC. The examined cases showed clinopathological characteristics of the disease, including large tumors with a highly malignant nature at the initial detection, higher Ki-67 levels, ER and PgR negativity (all cases), mostly TN type, and a high recurrence rate.

关键词： Breast Cancer Metaplastic Breast Cancer Triple Negative Type Epithelial-Mesenchymal Transition