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Dual therapy for third-line Helicobacter pylori eradication and urea breath test prediction

World Journal of Gastroenterology 2012年第21期18卷 2735-2738页

作者： Toshihiro Nishizawa Hidekazu Suzuki Takama Maekawa Naohiko Harada Tatsuya Toyokawa Toshio Kuwai Masanori ohara Takahiro Suzuki Masahiro Kawanishi Kenji Noguchi Toshiyuki Yoshio Shinji Katsushima Hideo Tsuruta Eiji Masuda Munehiro Tanaka Shunsuke Katayama Norio Kawamura Yuko Nishizawa Toshifumi Hibi Masahiko Takahashi Division of Gastroenterology National Hospital Organization Tokyo Medical CenterTokyo 1528902 Japan Division of Gastroenterology and Hepatology Department of Internal Medicine Keio University School of MedicineTokyo 1608582 Japan Division of Gastroenterology National Hospital Organization Kyoto Medical CenterKyoto 6128555 Japan Division of Gastroenterology National Kyushu Medical CenterFukuoka 8108563 Japan Division of Gastroenterology National Hospital Organization Fukuyama Medical CenterFukuyama 7208520 Japan Division of Gastroenterology National Hospital Organization Kure Medical CenterKure 7370023 Japan Division of Gastroenterology National Hospital Organization Hakodate Medical CenterHakodate 0418512 Japan Division of Gastroenterology National Hospital Organization Maizuru Medical CenterMaizuru 6258502 Japan Division of Gastroenterology National Hospital Organization Higashihiroshima Medical CenterHigashihiroshima 7390041 Japan Division of Gastroenterology National Hospital Organization Sendai Medical CenterSendai 9838520 Japan Division of Gastroenterology National Hospital Organization Osaka Medical CenterOsaka 5400006 Japan Division of Gastroenterology National Hospital Organization Ureshino Medical CenterUreshino 8430393 Japan Division of Gastroenterology National Hospital Organization Osaka Minami Medical CenterKawachinagano 5868521 Japan Division of Gastroenterology National Hospital Organization Fukuoka Higashi Medical CenterKoga 8113195 Japan Division of Gastroenterology National Hospital Organization Yonago Medical CenterYonago 6838518 Japan Division of Gastroenterology National Hospital Organization Disaster Medical CenterTachikawa 1900014 Japan Pharmaceutical Department National Center for Global Health and MedicineTokyo 1658655 Japan

We evaluated the efficacy and tolerability of a dual therapy with rabeprazole and amoxicillin (AMX) as an empiric third-line rescue therapy. In patients with failure of first-line treatment with a proton pump inhibitor (PPI)- AMX-clarithromycin regimen and second-line treatment with the PPI-AMX-metronidazole regimen, a third-line eradication regimen with rabeprazole (10 mg q.i.d.) and AMX (500 mg q.i.d.) was prescribed for 2 wk. Eradication was confirmed by the results of the 13C-urea breath test (UBT) at 12 wk after the therapy. A total of 46 patients were included; however, two were lost to followup. The eradication rates as determined by per-protocol and intention-to-treat analyses were 65.9% and 63.0%,respectively. The pretreatment UBT results in the subjects showing eradication failure; those patients showing successful eradication comprised 32.9 ± 28.8 permil and 14.8 ± 12.8 permil, respectively. The pretreatment UBT results in the subjects with eradication failure were significantly higher than those in the patients with successful eradication (P = 0.019). A low pretreatment UBT result (≤ 28.5 permil) predicted the success of the eradication therapy with a positive predictive value of 81.3% and a sensitivity of 89.7%. Adverse effects were reported in 18.2% of the patients, mainly diarrhea and stomatitis. Dual therapy with rabeprazole and AMX appears to serve as a potential empirical third-line strategy for patients with low values on pretreatment UBT.

关键词： Helicobacter pylori Amoxicillin Dual therapy Eradication Urea breath test

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Synchronous Double Primary Combined Hepatocellularcholangiocarcinoma and Cholangiolocarcinoma in a Cirrhotic Liver

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Journal of Clinical and Translational Hepatology 2023年第4期11卷 991-997页

作者： Masahiro Sakata Koji Kitada Rika Omote Hiroshi Sonobe Masashi Utsumi Naoyuki Tokunaga Takashi Fushimi Ryota Nagao Tatsuro Sakata Toshihiko Kaneyoshi Tatsuya Toyokawa Masaru Inagaki Department of Gastroenterology and Hepatology National Hospital OrganizationFukuyama Medical CenterFukuyamaHiroshimaJapan Department of Surgery National Hospital OrganizationFukuyama Medical CenterFukuyamaHiroshimaJapan Department of Laboratory and Pathology National Hospital OrganizationFukuyama Medical CenterFukuyamaHiroshimaJapan Department of Radiology National Hospital OrganizationFukuyama Medical CenterFukuyamaHiroshimaJapan

Both combined hepatocellular-cholangiocarcinoma(cHCCCCA)and cholangiolocarcinoma are rare primary liver ***-CCA is believed to originate from transformed hepatocellular carcinoma or liver stem/progenitor *** is characterized by ductular reaction-like anastomosing cords and glands resembling cholangioles or canals containing hepatocellular carcinoma components and adenocarcinoma *** to the 2019 revision of the World Health Organization criteria,a subtype with stem cell features as a subclassification of cHCC-CCA was abolished for lack of conclusive evidence of the stem cell origin *** led to the classification of cholangiolocarcinoma with hepatocytic differentiation as ***,cholangiolocarcinoma without hepatocytic differentiation is classified as a subtype of small-duct cholangiocarcinoma and is assumed to originate from the bile ***,we report the first case of double primary cHCC-CCA and cholangiolocarcinoma without hepatocytic differentiation in different hepatic segments of a cirrhotic *** believe this case supports the validity of the new World Health Organization criteria because the pathological finding of cHCC-CCA in this case shows the transformation of hepatocellular carcinoma to ***,this case may demonstrate that immature ductular cell stemness and mature hepatocyte cell stemness in hepatocarcinogenesis can coexist in the same *** results provide valuable insights into the mechanisms of growth,differentiation,and regulation of liver cancers.

关键词： Bile duct neoplasms Combined hepatocellular-cholangiocarcinoma Cholangiolocarcinoma Cirrhosis Liver neoplasms

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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(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

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Endoscopic diagnosis of cytomegalovirus gastritis after allogeneic hematopoietic stem cell transplantation

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World Journal of Gastroenterology 2010年第23期16卷 2907-2912页

作者： Yasuo Kakugawa Masahiro Kami Takahisa Matsuda Yutaka Saito Sung-Won Kim Takahiro Fukuda Shin-ichiro Mori Tadakazu Shimoda Ryuji Tanosaki Daizo Saito Division of Endoscopy National Cancer Center Hospital(Japan) Division of Exploratory Research Institute of Medical ScienceUniversity of Tokyo Division of Hematopoietic Stem Cell Transplantation National Cancer Center Hospital(Japan) Clinical Laboratory Division National Cancer Center Hospital(Japan)

AIM:To clarify the endoscopic and clinical findings of cytomegalovirus(CMV) gastritis after allogeneic hematopoietic stem cell transplantation(allo-SCT).METHODS:Between 1999 and 2005,523 patients underwent allo-SCT at our hospital,and 115 of these patients with gastrointestinal symptoms underwent ***:CMV gastritis was diagnosed pathologically in seven patients(1.3%) with the other 108 patients serving as *** of the seven patients developed positive CMV antigenemia,and five complained of abdominal *** of abdominal pain preceded CMV antigenemia in four of the f ive *** examination showed oozing(n=2),erosion(n=6),and redness(n=5) in the seven patients with CMV gastritis,while the control patients showed oozing(n=3),erosion(n=24),and redness(n=100).Erosion and oozing were more frequently documented in patients with CMV gastritis compared with the controls,and the differences were statistically significant(P=0.0012 and 0.029,respectively).CMV inclusion bodies were documented in 12 of 14 biopsy specimens obtained from erosive lesions,while they were identif ied in 4 of 15 biopsy specimens obtained from lesions other than erosions(P=0.0025).CONCLUSION:This study suggests that erosion and oozing,as well as abdominal pain,are useful indicators in the diagnosis of CMV gastritis following allo-SCT.

关键词： Cytomegalovirus gastritis Hematopoietic stem cell transplantation Cytomegalovirus antigenemia Esophagogastroduodenoscopy Graft-versus-host disease

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Long-term survival after resection of pancreatic cancer:A single-center retrospective analysis

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World Journal of Gastroenterology 2015年第1期21卷 262-268页

作者： Takehito Yamamoto Shintaro Yagi Hiromitsu Kinoshita Yusuke Sakamoto Kazuyuki Okada Kenji Uryuhara Takeshi Morimoto Satoshi Kaihara Ryo Hosotani Department of Surgery Kobe City Medical Center General HospitalHyogo 650-0047Japan Clinical Research center Kobe City Medical Center General HospitalHyogo 650-0047JapanChief Statistician

AIM: To retrospectively analyze factors affecting the long-term survival of patients with pancreatic cancer who underwent pancreatic ***: From January 2000 to December 2011,195 patients underwent pancreatic resection in our *** prognostic factors after pancreatic resection were analyzed in all 195 *** excluding the censored cases within an observational period,the clinicopathological characteristics of 20 patients who survived ≥ 5(n = 20) and < 5(n = 76) years were *** this comparison,we analyzed the patients who underwent surgery before June 2008 and were observed for more than 5 *** statistical analyses,the log-rank test was used to compare the cumulative survival rates,and the χ2 and Mann-Whitney tests were used to compare the two *** CoxHazard model was used for a multivariate analysis,and P values less than 0.05 were considered significant.A multivariate analysis was conducted on the factors that were significant in the univariate ***: The median survival for all patients was 27.1 months,and the 5-year actuarial survival rate was 34.5%.The median observational period was 595 *** the univariate analysis,the UICC stage was significantly associated with survival time,and the CA19-9 ≤ 200 U/m L,DUPAN-2 ≤ 180 U/m L,t u m o r s i ze ≤ 2 0 m m,R 0 re s e c t i o n,a b s e n c e o f lymph node metastasis,absence of extrapancreatic neural invasion,and absence of portal invasion were favorable prognostic *** multivariate analysis showed that tumor size ≤ 20 mm(HR = 0.40; 95%CI: 0.17-0.83,P = 0.012) and negative surgical margins(R0 resection)(HR = 0.48; 95%CI: 0.30-0.77,P = 0.003) were independent favorable prognostic *** the 96 patients,20 patients survived for 5 years or more,and 76 patients died within 5 years after *** of the 20 5-year survivors with the 76 non-survivors showed that lower concentrations of DUPAN-2(79.5 vs 312.5 U/mL,P = 0.032),tumor size ≤ 20 mm(

关键词： Pancreatic cancer Long-term survival Longterm surv

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Azacitidine decreases reactive oxygen species production in peripheral white blood cells:A case report

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World Journal of Clinical Cases 2020年第22期8卷 5657-5662页

作者： Hidekazu Hasunuma Naomi Shimizu Hiromitsu Yokota Ichiro Tatsuno Department of Blood Transfusion Toho University Medical Center Sakura HospitalSakura 2858741Japan Department of Hematology Toho University Medical Center Sakura HospitalSakura 2858741Japan Clinical Laboratory Program Education Development CenterFaculty of Science Toho UniversityFunabashi 2748510Japan center for Diabetes Metabolism and EndocrinologyToho University Medical Center Sakura HospitalSakura 2858741Japan

BACKGROUND In myelodysplastic syndrome(MDS),oxidative stress is closely related to iron overload and DNA damage.A recent study suggested the possibility that increased oxidative stress causes not only iron overload but also disease progression of MDS with DNA *** present a case of MDS with decreased reactive oxygen species(ROS)production in peripheral white blood cells(WBCs)and decreased diacron-reactive oxygen metabolites(d-ROMs)in serum after azacitidine *** SUMMARY A 74-year-old man presented to the hematological department with the chief complaint of *** vital signs were within normal limits at admission with a heart rate of 80 bpm and blood pressure of 135/60 *** tests indicated pancytopenia,a WBC count of 2190 cells/μL,a hemoglobin level of 6.2 g/dL and a platelet count of 7.4×104/μ*** patient was diagnosed with MDS with fibrosis after a bone marrow *** case showed decreased ROS production in WBCs,d-ROMs in serum and Wilms’tumor 1 after azacitidine therapy,after which his hematopoiesis *** Azacitidine therapy can improve hematopoiesis and decrease ROS and d-ROM production.

关键词： Myelodysplastic syndrome Reactive oxygen species Diacron-reactive oxygen metabolites Ferritin Azacitidine Case report

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Lamivudine treatment enabling right hepatectomy for hepatocellular carcinoma in decompensated cirrhosis

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World Journal of Gastroenterology 2012年第20期18卷 2586-2590页

作者： Koichi Honda Masataka Seike Shin-ichiro Maehara Koichiro Tahara Hideaki Anai Akira Moriuchi Toyokichi Muro First Department of Internal Medicine Oita UniversityOita 879-5593Japan Department of Surgery National Hospital Organization Oita Medical CenterOita 870-0263Japan Department of Pathology National Hospital Organization Oita Medical CenterOita 870-0263Japan Department of Gastroenterology and Hepatology National Hospital Organization Oita Medical CenterOita 870-0263Japan

A 69-year-old man was admitted to our hospital in October 2003,for further examination of two liver *** was diagnosed with hepatocellular carcinoma(HCC) arising from decompensated hepatitis B virus(HBV)-related ***-term lamivudine administration improved liver function dramatically despite repeated treatment for *** Child-Pugh score was 9 points at start of lamivudine treatment,improving to 5 points after 1 *** indocyanine green at 15 min after injection test score was 48%before lamivudine treat-ment,improving to 22%after 2 years and to 5%after 4 *** ablation controlled the HCC foci and maintained his liver *** April 2009,abdominal computed tomography revealed a tumor thrombus in the right portal *** his indocyanine green test results had improved to less than 10%,we performed a right hepatectomy,which was *** our knowledge,there have been no documented reports of patients undergoing successful right hepatectomy for HCC arising from decompensated *** findings observed in our patient indicate the importance of nucleoside analogs for treating HBV-related HCC.

关键词： Hepatitis B virus Lamivudine Hepatocellular carcinoma Decompensated cirrhosis Hepatectomy

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Granular cell tumor of the common bile duct: A japanese case

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World Journal of Gastroenterology 2012年第43期18卷 6324-6327页

作者： Junko Saito Michiko Kitagawa Hiroshi Kusanagi Nobuyasu Kano Eiji Ishii So Nakaji Nobuto Hirata Kazuei Hoshi Department of Gastroenterology Chikamori Hospital Kochi 780-8522 Japan Department of Surgery Kameda Medical Center Kamogawa 296-8602 Japan Department of Gastroenterology Kameda Medical Center Kamogawa 296-8602 Japan Department of Pathology Kameda Medical Center Kamogawa 296-8602 Japan

Granular cell tumor (GCT) of the biliary system is rare. It is reported that it occurs more commonly in young black women. We report here our seldom experience of a japanese case in whom icterus was found as a first symptom just after a caesarean operation. A 36-year-old japanese woman developed icterus after delivery by the Caesarean operation. A surgical operation was performed without can deny that there was a tumor-related change in a bile duct as a result of examination for various images. As a result of pathological evaluation, GCT was diagnosed. By the preoperative organization biomicroscopy result, it was not able to be attachd a right diagnosis. It was thought that this tumor, although rare, should be considered as one of the causes of biliary stenosis in the younger population.

关键词： japanese Granular cell tumor Common bile duct Icterus Endoscopic retrograde cholangiopancreatography

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Evaluation of sorafenib for hepatocellular carcinoma by contrast-enhanced ultrasonography:A pilot study

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World Journal of Gastroenterology 2012年第40期18卷 5753-5758页

作者： Kazue Shiozawa Manabu Watanabe Yoshinori Kikuchi Takahide Kudo Kenichi Maruyama Yasukiyo Sumino Division of Gastroenterology and Hepatology Department of Internal MedicineToho University Medical CenterOmori HospitalTokyo 143-8541Japan Department of Clinical Functional Physiology Toho University Medical CenterOmori HospitalTokyo 143-8541Japan

AIM:To determine the usefulness of arrival time parametric imaging(AtPI) using contrast-enhanced ultrasonography(CEUS) with Sonazoid in evaluating early response to sorafenib for hepatocellular carcinoma(HCC).METHODS:Fourteen advanced HCC patients who received sorafenib 400/800 mg/d for at least 4 wk and were followed up by CEUS were enrolled in this *** was performed before treatment and 2 and 4 wk after treatment,and images of the target lesion in the arterial phase were recorded for each *** images were analyzed by *** mapping(CM) images obtained by AtPI were compared before and after the *** these CM images,the mean arrival time of the contrast agent in the region of interest from the starting point [mean time(MT)] was *** each patient,differences between MT before and MT 2 and 4 wk after the treatment were compared with responses evaluated 4-8 wk after the treatment by dynamic computed tomography(CT),and statistical analysis was *** response evaluation criteria in solid tumors was used for the response ***:In CM images both 2 and 4 wk after the treatment,delays in the arrival time of the contrast agent were noted in 8 of the 14 *** the other 6 patients,no color changes were observed in the tumor,or red and/or yellow increase,suggesting a decrease in blood flow velocity between images 2 and 4 wk after the treatment and those before the *** CT could be performed 4-8 wk after the treatment in 13 of the 14 *** differences in the MT were 1.13 s and 1.015 s,2 and 4 wk after the treatment,respectively,in the 8 patients who showed stable disease(SD)/partial response(PR) on dynamic *** differences in the MT were-0.39 s and-0.95 s,2 and 4 wk after the treatment,respectively,in the 5 patients who showed progressive disease(PD).Differences in the median MT between SD/PR and PD groups were significant 2 and 4 wk after the treatment with P = 0.019 and P = 0.028,resp

关键词： Sorafenib Sonazoid Contrast-enhanced ul-trasonography Hepatocellular carcinoma Therapeutic response

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Vulnerable atherosclerotic plaque features:findings from coronary imaging

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Journal of Geriatric Cardiology 2021年第7期18卷 577-584页

作者： Osamu Kurihara Masamichi Takano Yasushi Miyauchi Kyoichi Mizuno Wataru Shimizu Cardiovascular center Chiba Hokusoh HospitalNippon Medical SchoolChibaJapan Mitsukoshi Health and Welfare Foundation TokyoJapan Division of Cardiology Nippon Medical SchoolTokyoJapan

Pathological studies have suggested that features of vulnerable atherosclerotic plaques likely to progress and lead to acute cardiovascular events have specific *** the progress of intravascular coronary imaging technology,some large prospective studies have detected features of vulnerable atherosclerotic plaques using these imaging ***,the rate of cardiovascular events,such as acute coronary syndrome,has been found to be considerably reduced in the limited follow-up period available in the statin ***,not all disrupted plaques lead to thrombus formation with clinical *** sub-occlusive or occlusive thrombus formation does not occur,a thrombus on a disrupted plaque will organize without any symptoms,forming a"healed plaque".Although vulnerable plaque detection using intracoronary imaging is focused on"thin-cap fibroatheroma"leading to plaque rupture,superficial plaque erosion is increasingly recognized;however,the underlying mechanism of thrombus formation on eroded plaques is not well *** of intravascular imaging,optical coherence tomography(OCT)has the highest image resolution and has enabled detailed characterization of the plaque in ***,we reviewed the status and limitations of intravascular imaging in terms of detecting vulnerable plaque through mainly OCT *** suggested that vulnerable plaque should be reconsidered in terms of eroded plaque and healed plaque and that both plaque and circulating blood should be assessed in greater detail accordingly.

关键词： coronary acute superficial

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