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Lansoprazole-associated collagenous colitis:Diffuse mucosal cloudiness mimicking ulcerative colitis

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World Journal of Gastroenterology 2009年第17期15卷 2166-2169页

作者： Mitsuro Chiba Takeshi Sugawara Haruhiko Tozawa Hidehiko Tsuda toru abe Takuo Tokairin Iwao Ono Eriko Ushiyama Division of Gastroenterology Nakadori General Hospital Akita 010-8577 Japan Department of Pathology Nakadori General Hospital Akita 010-8577 Japan Department of Internal Medicine Nakadori Rehabilitation Hospital Akita 010-8577 Japan

There have only been a few reports on lansoprazole-associated collagenous colitis. Colonic mucosa of collagenous colitis is known to be endoscopically normal. We present a case of collagenous colitis where the mucosa showed diffuse cloudiness mimicking ulcerative colitis. A 70-year-old woman developed watery diarrhea four to nine times a day. She had interstitial pneumonia at 67 and reflux esophagitis at 70 years. Lansoprazole 30 mg/d had been prescribed for reflux esophagitis for nearly 6 mo. Lansoprazole was withdrawn due to its possible side effect of diarrhea. Colonoscopy disclosed diffuse cloudiness of the mucosa which suggested ulcerative colitis. Consequently sulfasalazine 2 g/d was started. The patient's diarrhea dramatically disappeared on the following day. However, biopsy specimens showed subepithelial collagenous thickening and infi ltration of inflammatory cells in the lamina propria, confirming the diagnosis of collagenous colitis. One month after sulfasalazine therapy was initiated, colonoscopic and histological abnormalities resolved completely. Five months later the diarrhea recurred. The findings on colonoscopy and histology were the same as before, confirming a diagnosis of collagenous colitis relapse. We found that the patient had begun to take lansoprazole again 3 mo ahead of the recent diarrhea. Withdrawal of lansoprazole promptly resolved the diarrhea. Endoscopic and histological abnormalities were also completely resolved, similar to the first episode. Retrospectively, the date of commencement of sulfasalazine and discontinuation of lansoprazole in the first episode was found to be the same. We conclude that this patient had lansoprazole-associated collagenous colitis.

关键词：胶原性结肠炎溃疡性结肠炎兰索拉唑结肠黏膜弥漫柳氮磺胺吡啶返流性食管炎结肠镜检查

Serous cystadenocarcinoma of the mesentery in a man:case report and review of literature

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Gastroenterology Report 2014年第4期2卷 306-310页

作者： toru Obuchi Osamu Shimooki Akira Sasaki Tadashi abe Go Wakabayashi Department of Surgery Iwate Medical University School of MedicineIwateJapan Department of Surgery Iwate Prefectural Kuji HospitalIwateJapan

In February 2007,a 41-year-old Japanese male was admitted to our hospital with increasing upper abdominal pain.A contrast-enhanced computed tomography(CT)scan of the abdomen demonstrated a well-demarcated,hypodense cystic mass with a thickened wall in the *** laboratory results were within normal limits,except for increased carcinoembryonic antigen,carbohydrate antigen 19-9,DUPAN-2 and *** patient was diagnosed as having a mesenteric malignant cyst,and during a laparotomy,a right hemicolectomy with mesenteric cystectomy was performed without rupture in March *** the microscopic findings,there was a well-differentiated adenocarcinoma in the inner surface of the cyst and in the fibrous connective tissue of the hypertrophic cystic *** tumor cells were immunohistochemically reactive to cytokeratin(CK)7,CK18 and *** remnant of the malignancy was detected in the resected margin of the colon,cyst,liver or peritoneum nor was an uptake detected in an 18[F]-fluorodeoxyglucose positron emission tomography/CT examination of other ***,the malignancy was concluded to be a serous cystadenocarcinoma of the *** months after the operation,the patient died from peritonitis carcinomatosa due to a small intestine *** report suggests mesenteric cystadenocarcinomas originating in the ovary,oviduct and intestinal mucosa,but these were ruled out in our *** this report,we discuss a case of the malignant transformation of a cyst into adenocarcinoma,which to our knowledge has never been previously reported in a male patient.

关键词： Gastrointestinal surgery immunohistochemical mesenteric cyst cystadenocarcinoma

Risk factors for internal anal sphincter dysfunction in Japanese adults

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Open Journal of Gastroenterology 2013年第1期3卷 25-34页

作者： Tatsuya abe toru Kono Yoshikazu Hachiro Masao Kunimoto Hiroyuki Furukawa Department of Proctology Kunimoto Hospital Asahikawa Japan Division of Gastroenterologic and General Surgery Department of Surgery Asahikawa Medical University Asahikawa Japan

Purpose: The internal anal sphincter provides most of the resting anal tone and is the main muscle responseble for continence. This study was designed to estimate the prevalence of, and identify risk factors associated with, internal anal sphincter dysfunction in Japanese adults. Methods: Anorectal manometry was performed in 1193 women and 1124 men aged 20 years or older. The maximal resting pressure, measured by a rapid pull-through technique, was defined as the highest resting pressure recorded. Internal anal sphincter dysfunction was defined as a maximal resting pressure less than 30 mmHg. Potential risk factors were assessed through self-reports, interviews, physical examinations, and medical record reviews. Multivariate logistic regression analysis was used to identify independent risk factors for internal anal sphincter dysfunction. Results: Significant differences in maximal resting pressure were seen between women (58.1 ± 24.9 mmHg) and men (68.8 ± 23.5 mmHg, P < 0.001). Maximal resting pressure decreased significantly with increasing age in both sexes. The prevalence of internal anal sphincter dysfunction was 10.4% (15.5% in women, 5.1% in men). In a multivariate logistic regression model, age, mental disease, pelvic organ prolapse repair, and fecal incontinence were independently associated with a greater risk of internal anal sphincter dysfunction in women and men. Conclusions: Internal anal sphincter dysfunction is a common problem for women and men. Several of the identified risk factors are preventable or modifiable, and may direct future research in fecal incontinence therapy.

关键词： Fecal Incontinence Internal Anal Sphincter Anorectal Manometry Maximal Resting Pressure

Pulmonary <i>Mycobacterium avium </i>Complex Disease Requiring Differentiation from Recurrence of Lung Cancer during the Follow-Up Period for Lung Cancer

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Journal of Tuberculosis Research 2019年第4期7卷 220-227页

作者： Yoshihiro Kobashi Masaaki abe Daisuke Yoshioka Shigeki Kato toru Oga Department of Respiratory Medicine Kawasaki Medical School Kurashiki Japan

Case 1 was a 49-year-old woman who visited with a dry cough. She had an underlying disease of lung adenocarcinoma and received cancer immunotherapy because of an ALK-positive response and several cancer chemotherapies. The clinical effect was a complete response. Chest CT was performed because of continuous dry cough, and a new tumor shadow was recognized in the lingula portion of the left upper lobe. We performed CT-guided lung biopsy and could aspirate pus-fluid. The culture test for acid-fast bacilli was positive and the causative microorganism was identified as Mycobacterium avium by the DDH method. The final diagnosis was pulmonary abscess due to M. avium. Treatment using combined chemotherapy including CAM was performed and a good clinical response was obtained. Case 2 was a 67-year-old man who had a past history of surgical resection of lung adenocarcinoma eight and two years ago and received several cancer chemotherapies and radiation therapy. Because a new nodular shadow appeared in the right middle lobe one year ago and showed strong positivity on PET/CT, surgical resection was performed with the suspected recurrence of lung cancer. Subsequently, the histological diagnosis was epithelioid granuloma and a culture test of acid-fast bacilli was positive, with the identification of Mycobacterium intracellulare by the DDH method. Combined chemotherapy was not performed because the lesion was completely resected. Afterwards, a new nodular shadow appeared in the left lower lobe again and bronchoscopy was performed. Because M. intracellulare was isolated from the local specimen, we diagnosed the patient with recurrence of pulmonary MAC disease and combined chemotherapy including CAM was performed for one year. Finally, the nodular lesion disappeared. It is difficult to differentiate pulmonary MAC disease from lung cancer. Therefore, careful follow-up of patients with lung cancer while keeping in mind the possible complication of pulmonary MAC disease is necessary.

关键词： Pulmonary Mycobacterium avium Complex (MAC) Disease Lung Cancer Complication

STAT3 deficiency prevents hepatocarcinogenesis and promotes biliary proliferation in thioacetamide-induced liver injury

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World Journal of Gastroenterology 2017年第37期23卷 6833-6844页

作者： Mitsuhiko abe Takafumi Yoshida Jun Akiba Yu Ikezono Fumitaka Wada Atsutaka Masuda Takahiko Sakaue Toshimitsu Tanaka Hideki Iwamoto toru Nakamura Michio Sata Hironori Koga Akihiko Yoshimura Takuji Torimura Division of Gastroenterology Department of Medicine Kurume University School of Medi-cine Liver Cancer Division Research Center for Innovative Cancer Therapy Kurume University Kurume Clinical pharmacology Clinic Department of Diagnostic pathology Kurume University hospital Department of Microbiology Immun--ology Keio University School of Medicine

AIM To elucidate the role of STAT3 in hepatocarcinogenesis and biliary ductular proliferation following chronic liver injury. METHODS We investigated thioacetamide(TAA)-induced liver injury, compensatory hepatocyte proliferation, and hepatocellular carcinoma(HCC) development in hepatic STAT3-deficient mice. In addition, we evaluated TAAinduced biliary ductular proliferation and analyzed the activation of sex determining region Y-box9(SOX9) and Yes-associated protein(YAP), which regulate the transdifferentiation of hepatocytes to *** Both compensatory hepatocyte proliferation and HCC formation were significantly decreased in hepatic STAT3-deficient mice as compared with control mice. STAT3 deficiency resulted in augmentation of hepatic necrosis and fibrosis. On the other hand, biliary ductular proliferation increased in hepatic STAT3-deficient livers as compared with control livers. SOX9 and YAP were upregulated in hepatic STAT3-deficient *** STAT3 may regulate hepatocyte proliferation as well as transdifferentiation into cholangiocytes and serve as a therapeutic target for HCC inhibition and biliary regeneration.

关键词： Hepatocellular 癌 Ductular 反应表明抄写 3 的变换器和使活跃之物联系是的蛋白质决定区域 Y-box9 的性 Transdifferentiation

Rectal angiolipoma diagnosed after surgical resection: A case report

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World Journal of Gastroenterology 2007年第3期13卷 467-469页

作者： Mitsuru Ishizuka Hitoshi Nagata Kazutoshi Takagi toru Horie Akihito abe Keiichi Kubota Department of Gastroenterological Surgery Dokkyo University School of Medicine Tochigi Japan

Angiolipoma is a common benign tumor with a char- acteristic vascular component that usually occurs in subcutaneous tissue. Although lipomas are frequently encountered at colonoscopy as submucosal tumors, an- giolipomas are rarely found in the gastrointestinal tract including the large intestine. Here we report a 77-year old Japanese man who underwent transanal resection of a tumor that was diagnosed tentatively as a leiomyoma. Histologically, the tumor consisted of mature fat cells and blood vessels. Immunohistochemically, the tumor cells were negative for c-kit and HMB-45, which are consis- tently expressed in tumors such as gastrointestinal stro- mal tumor and angiomyolipoma. The tumor was there- fore diagnosed as an angiolipoma. This is thought to be the first case report of a surgically resected angiolipoma of the rectum.

关键词：血管脂肪瘤脂肪组织皮下组织诊断方法

Invasive group B streptococcal infection in a patient with post splenectomy for hypersplenism secondary to liver cirrhosis and portal hypertension

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World Journal of Emergency Medicine 2016年第1期7卷 68-70页

作者： Tomoya Okazaki toru Hifumi Arisa Manabe Hikari Matsumura Satoshi Egawa Hideyuki Hamaya Nastuyo Shinohara Koshiro Takano Hajime Shishido Yuko abe Kenya Kawakita Masanobu Hagiike Yasuhiro Kuroda Emergency Medical Center Kagawa University Hospital Kita Kagawa 761-0793 Japan

BACKGROUND:Splenectomy in patients with liver cirrhosis(LC)is expected to become more common owing to its efficacy on portal *** this report we describe an alarming case of group B streptococcus(GBS)infection after splenectomy in a patient with ***:A 72-year-old woman with a history of LC was admitted to our emergency department because of respiratory *** patient had received left lateral segmentectomy of the liver and splenectomy three months before *** examination revealed significant wheezing during inspiration and expiration,but no crackles and *** radiography and CT showed no infiltrates.A presumptive diagnosis of bronchial asthma caused by upper respiratory infection was *** days after admission,GBS infection was confirmed by blood culture and penicillin G was *** were given intravenously for a total of 12 ***:The patient was discharged on the 12th day after ***:Although efficacy of splenectomy in patients with LC has been reported,immune status should be evaluated for a longer *** who have undergone splenectomy are highly susceptible to bacteria;moreover,LC itself is an independent risk factor for mortality in patients with *** prophylaxis against GBS has not been established,immediate action should be *** physicians should be aware of invasive GBS infection in the context of the critical risk factors related to splenectomy and LC,particularly the expected increase of splenectomy performed in LC patients.

关键词： Group B streptococcal infection Splenectomy Liver cirrhosis

Early effects of Lansoprazole orally disintegrating tablets on intragastric pH in CYP2C19 extensive metabolizers

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World Journal of Gastroenterology 2008年第13期14卷 2049-2054页

作者： Hatsushi Yamagishi Tomoyuki Koike Shuichi Ohara toru Horii Ryousuke Kikuchi Shigeyuki Kobayashi Yasuhiko abe Katsunori Iijima Akira Imatani Kaori Suzuki Takanori Hishinuma Junichi Goto Tooru Shimosegawa Division of Gastroenterology Tohoku University Graduate School of Medicine 1-1 Seiryou-Machi Aobaku Sendai 9808574 Japan Division of Clinical Pharmacy Tohoku University Graduate School of Pharmaceutical Sciences 1-1 Seiryou-Machi Aobaku Sendai 9808574 Japan Division of Pharmacotherapy Tohoku University Graduate School of Pharmaceutical Sciences Department of Pharmaceutical Sciences Tohoku University Hospital 1-1 Seiryou-Machi Aobaku Sendai 9808574 Japan

AIM: To compare rabeprazole (RPZ; 10 mg) with Lansoprazole orally disintegrating tablets (LPZ; 30 mg OD) in terms of antisecretory activity and blood drug concentration after a single dose. METHODS: Eight H pylori-negative cytochrome P450 (CYP) 2C19 extensive metabolizers were assigned to receive a single oral dose of RPZ 10 mg or LPZ 30 mg OD. Twelve hour intragastric pH monitoring was perform- ed on the day of treatment. Blood samples were also collected after the administration of each drug. RESULTS: LPZ 30 mg OD induced a significantly earlier rise in blood drug concentration than RPZ 10 mg; consequently, LPZ 30 mg OD induced a significantly earlier rise in median pH in the third and fourth hours of the study. CONCLUSION: In H pylori-negative CYP2C19 extensive metabolizers, LPZ 30 mg OD induced a significantly faster inhibition of gastric acid secretion than RPZ 10 mg.

关键词：兰索拉唑口服药片胃液酸度血药浓度细胞色素

Risk Factors for Postoperative Acute Exacerbation of Idiopathic Interstitial Pneumonia Following Surgery for Primary Lung Cancer

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Open Journal of Respiratory Diseases 2014年第2期4卷 48-54页

作者： toru Tanaka Shinji abe Hiroki Hayashi Koichiro Kamio Yoshinobu Saito Jiro Usuki Arata Azuma Iwao Mikami Shuji Haraguchi Kiyoshi Koizumi Jitsuo Usuda Akihiko Gemma Department of Pulmonary Medicine and Oncology Nippon Medical School Tokyo Japan Department of Thoracic Surgery Graduate School of Medicine Nippon Medical School Tokyo Japan

Objective: Postoperative acute exacerbation of idiopathic interstitial pneumonia (IIP) is a serious complication in patients with lung cancer. This study was aimed to investigate risk factors for postoperative acute exacerbation of IIP in surgery for primary lung cancer. Method: We evaluated retrospectively 37 IIP patients combined with primary lung cancer who underwent lung resection for lung cancer from January 2006 and March 2010. Preoperative and perioperative clinical data were collected and analyzed. Results: Ten of 37 patients (27.0%) developed acute exacerbation of IIP after surgery for primary lung cancer and five patients (13.5%) died of progressive respiratory failure. There was no significant difference in preoperative clinical factors between acute exacerbation (AE) group and non-acute exacerbation (non-AE) group. In perioperative factors, the duration of anesthesia is significantly longer in AE group than in non-AE group. Conclusion: These data suggest that it is unable to predict postoperative acute exacerbation of IIP from preoperative clinical data. Perioperative and postoperative management might be important to prevent acute exacerbation of IIP combined lung cancer.

关键词： Postoperative Acute Exacerbation Idiopathic Interstitial Pneumonia Lung Cancer