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Clinical utility of treatment method conversion during single-session endoscopic ultrasound-guided biliary drainage

World Journal of Gastroenterology 2020年第9期26卷 947-959页

作者： Kosuke Minaga Mamoru Takenaka Kentaro Yamao Ken Kamata Shunsuke Omoto Atsushi Nakai Tomohiro Yamazaki Ayana Okamoto Rei Ishikawa Tomoe Yoshikawa Yasutaka Chiba Tomohiro watanabe Masatoshi Kudo Department of Gastroenterology and Hepatology Kindai University Faculty of MedicineOsaka-Sayama 589-8511Japan Clinical Research Center Kindai University HospitalOsaka-Sayama 589-8511Japan

BACKGROUND Although several techniques for endoscopic ultrasound-guided biliary drainage(EUS-BD)are available at present,an optimal treatment algorithm of EUS-BD has not yet been *** To evaluate the clinical utility of treatment method conversion during single endoscopic sessions for difficult cases in initially planned *** This was a single-center retrospective analysis using a prospectively accumulated *** with biliary obstruction undergoing EUS-BD between May 2008 and April 2016 were *** primary outcome was to evaluate the improvement in EUS-BD success rates by converting the treatment methods during a single endoscopic *** outcomes were clarification of the factors leading to the conversion from the initial EUS-BD and the assessment of efficacy and safety of the conversion as judged by technical success,clinical success,and adverse events(AEs).RESULTS A total of 208 patients underwent EUS-BD during the study *** 18.8%(39/208)of the patients,the treatment methods were converted to another EUSBD technique from the initial *** obstruction was caused by pancreatobiliary malignancies,other malignant lesions,biliary stones,and other benign lesions in 22,11,4,and 2 patients,*** reasons for the difficulty with the initial EUS-BD were classified into the following 3 procedures:Target puncture(n=13),guidewire manipulation(n=18),and puncture tract dilation(n=8).Technical success was achieved in 97.4%(38/39)of the cases and clinical success was achieved in 89.5%of patients(34/38).AEs occurred in 10.3%of patients,including bile leakage(n=2),bleeding(n=1),and cholecystitis(n=1).The puncture target and drainage technique were altered in subsequent EUSBD procedures in 25 and 14 patients,*** final technical success rate with 95%CI for all 208 cases was 97.1%(95%CI:93.8%-98.9%),while that of the initially planned EUS-BD was 78.8%(95%CI:72.6%-84.2%).CONCLUSION Among multi-step pro

关键词： Endoscopic ultrasound Endoscopic ultrasound-guided biliary drainage Interventional endoscopic ultrasound Biliary drainage Biliary obstruction

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Impact of lipoprotein lipase gene polymorphisms on ulcerative colitis

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World Journal of Gastroenterology 2006年第39期12卷 6325-6330页

作者： Toshihito Kosaka Junji Yoshino Kazuo Inui Takao Wakabayashi Kazumu Okushima Takashi Kobayashi Hironao Miyoshi Yuta Nakamura Shigekazu Hayashi Taizou Shiraishi Masatoshi watanabe Takayuki Yamamoto Ai Nakahara Takahiko Katoh Department of Internal Medicine Second Teaching Hospital Fujita Health University School of Medicine 3-6-10 Otobashi Nakagawaku Nagoya 454-8509 Japan Department of Gastroenterology Nagoya Ekisaikai Hospital 4-66 Shounencho Nakagawaku Nagoya 454-8502 Japan Department of Pathologic Oncology Mie University Graduate School of Medicine 2-174 Edobashi Tsu Mie 514-8507 Japan School of Engineering Yokohama National University 79-5 Tokiwadai Hodogaya-ku Yokohama 240-8501 Japan Inflammatory bowel disease centre and department of surgery Yokkaichi Social Insulance Hospital 10-8 Hazuyamacho Yokkaichi Mie Japan Department of Public Health Miyazaki Medical College University of Miyazaki 5200 Kihara Miyazaki 889-1692 Japan

AIM： To examine the influence of lipoprotein lipase （LPL） gene polymorphism in ulcerative colitis （UC） patients.METHODS： Peripheral blood was obtained from 131 patients with UC and 106 healthy controls for DNA extraction. We determined LPL gene polymorphisms affecting the enzyme at Ser447stop, as well as Hind Ⅲ and Pvu Ⅱ polymorphisms using PCR techniques. PCR products were characterized by PCR-RFLP and direct sequencing. Polymorphisms were examined for association with clinical features in UC patients. Genotype frequencies for LPL polymorphisms were also compared between UC patients and controls.RESULTS： In patients with onset at age 20 years or younger, C/G and G/G genotypes for Ser447stop polymorphism were more prevalent than C/C genotype （OR = 3.13, 95% CI = 0.95-10.33）. Patients with H^＋/- or H^-/- genotype for Hind Ⅲ polymorphism also were more nu merous than those with H^＋/＋ genotype （OR = 2.51, 95% CI = 0.85-7.45）. In the group with H^＋/＋ genotype for Hind Ⅲ polymorphism, more patients had serum triglyceride concentrations over 150 mg/dL than patients with H^＋/- or H^- genotype （P 〈 0.01, OR = 6.46, 95% CI = 1.39-30.12）. Hypertriglycemia was also more prevalent in patients with P^＋/＋ genotypes for Pvu Ⅱ polymorphism （P 〈 0.05, OR = 3.0, 95% CI = 1.06-8.50）. Genotype frequency for LPL polymorphism did not differ significantly between UC patients and controls.

关键词： Ulcerative colitis Lipoprotein lipase Lipid metabolism Triglyceride

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Pretreatment AKR1B10 expression predicts the risk of hepatocellular carcinoma development after hepatitis C virus eradication

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World Journal of Gastroenterology 2016年第33期22卷 7569-7578页

作者： Ayato Murata Takuya Genda Takafumi Ichida Nozomi Amano Sho Sato Hironori Tsuzura Shunsuke Sato Yutaka Narita Yoshio Kanemitsu Yuji Shimada Katsuharu Hirano Katsuyori Iijima Ryo Wada Akihito Nagahara Sumio watanabe Department of Gastroenterology and Hepatology Juntendo University Shizuoka Hospital Department of Hepatology Shonan-East General Hospital Department of Pathology Juntendo University Shizuoka Hospital Department of Gastroenterology Juntendo University School of Medicine

AIM To clarify the association between aldo-keto reductase family 1 member B10(AKR1B10) expression and hepatocarcinogenesis after hepatitis C virus *** In this study,we enrolled 303 chronic hepatitis C patients who had achieved sustained virological response(SVR) through interferon-based antiviral therapy. Pretreatment AKR1B10 expression in the liver was immunohistochemically assessed and quantified as a percentage of positive staining area by using image-analysis software. A multivariate Cox analysis was used to estimate the hazard ratios(HRs) of AKR1B10 expression for hepatocellular carcinoma(HCC) development after achieving SVR. The cumulative incidences of HCC development were evaluated using Kaplan-Meier analysis and the log-rank *** Of the 303 chronic hepatitis C patients,153(50.5%) showed scarce hepatic AKR1B10 expression,quantified as 0%,which was similar to the expression in control normal liver tissues. However,the remaining 150 patients(49.5%) exhibited various degrees of AKR1B10 expression in the liver,with a maximal AKR1B10 expression of 73%. During the median follow-up time of 3.6 years(range 1.0-10.0 years),8/303 patients developed HCC. Multivariate analysis revealed that only high AKR1B10 expression(≥ 8%) was an independent risk factor for HCC development(HR = 15.4,95%CI: 1. 8- 1 3 2. 5,P = 0. 0 1 2). T h e 5- y e a r c u m u l a t i v e incidences of HCC development were 13.7% and 0.5% in patients with high and low AKR1B10 expression,respectively(P < 0.001). During the follow-up period after viral eradication,patients expressing high levels of AKR1B10 expressed markedly higher levels of alanine aminotransferase and α-fetoprotein than did patients exhibiting low AKR1B10 *** Chronic hepatitis C patients expressing high levels of hepatic AKR1B10 had an increased risk of HCC development even after SVR.

关键词： Human AKR1B10 protein Hepatocellular carcinoma Chronic hepatitis C Immunohistochemistry Risk factor Sustained virological response

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Vonoprazan 20 mg vs lansoprazole 30 mg for endoscopic submucosal dissection-induced gastric ulcers

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World Journal of Gastrointestinal Endoscopy 2016年第19期8卷 716-722页

作者： Kazuya Takahashi Yuichi Sato Junji Kohisa Jun watanabe Hiroki Sato Kenichi Mizuno Satoru Hashimoto Shuji Terai Department of Endoscopy Niigata University Medical and Dental Hospital Division of Gastroenterology and Hepatology Sado General Hospital Division of Gastroenterology and Hepatology Graduate School of Medical and Dental SciencesNiigata University Division of Gastroenterology and Hepatology Nagaoka Red Cross Hospital

AIM To compare the healing effects of vonoprazan and lansoprazole on gastric ulcers induced by endoscopic submucosal dissection(ESD).METHODS Data were obtained from a total of 26 *** patients were randomized to the vonoprazan group and 12 were randomized to the lansoprazole *** were administered either 20 mg vonoprazan or 30 mg lansoprazole per day after *** images just after ESD,on day 8,and on day 28 were used for the evaluation of the shrinking rate of ESD *** shrinking rates and the incidence of delayed bleeding were compared between the 2 *** The shrinking rates of ESD ulcers on day 8 [vonoprazangroup: 61.8%(range: 24.0%-91.1%),lansoprazole group: 71.3%(range: 25.2%-88.6%)] and on day 28 [vonoprazan group: 95.3%(range: 76.2%-100%),lansoprazole group: 97.2%(range: 81.1%-99.8%)] were not statistically different between the 2 *** day 28,most of the ulcers in both groups healed to more than 90%,whereas 3 of 14(21.4%) in the vonoprazan group and 1 of 12(8.3%) in the lansoprazole group had delayed ulcer healing,which was not statistically different(P = 0.356).The frequency of delayed bleeding was 0 in the both *** together,there were no significant differences between the two drug *** Our study indicates that vonoprazan is potent for the management of ESD ulcers although lansoprazole is also sufficient and cost-effective.

关键词： Lansoprazole Gastric cancer Endoscopic submucosal dissection Potassium-competitive acid blocker Proton pump inhibitor Vonoprazan

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Surgery for luminal Crohn's disease

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World Journal of Gastroenterology 2014年第1期20卷 78-90页

作者： Takayuki Yamamoto Toshiaki watanabe Inflammatory Bowel Disease Center and Department of Surgery Yokkaichi Social Insurance HospitalMie 510-0016Japan Department of Surgical Oncology The University of TokyoHongoTokyo 113-0033Japan

Many patients with Crohn’s disease (CD) require surgery. Indications for surgery include failure of medical treatment, bowel obstruction, fistula or abscess formation. The most common surgical procedure is resection. In jejunoileal CD, strictureplasty is an accepted surgical technique that relieves the obstructive symptoms, while preserving intestinal length and avoiding the development of short bowel syndrome. However, the role of strictureplasty in duodenal and colonic diseases remains controversial. In extensive colitis, after total colectomy with ileorectal anastomosis (IRA), the recurrence rates and functional outcomes are reasonable. For patients with extensive colitis and rectal involvement, total colectomy and end-ileostomy is safe and effective; however, a few patients can have subsequent IRA, and half of the patients will require proctectomy later. Proctocolectomy is associated with a high incidence of delayed perineal wound healing, but it carries a low recurrence rate. Patients undergoing proctocolectomy with ileal pouch-anal anastomosis had poor functional outcomes and high failure rates. Laparoscopic surgery has been introduced as a minimal invasive procedure. Patients who undergo laparoscopic surgery have a more rapid recovery of bowel function and a shorter hospital stay. The morbidity also is lower, and the rate of disease recurrence is similar compared with open procedures.

关键词： Crohn’ s disease, Laparoscopic surgery, Resection, Strictureplasty, Surgery

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Effect of double platinum agents, combination of miriplatintransarterial oily chemoembolization and cisplatinhepatic arterial infusion chemotherapy, in patients with hepatocellular carcinoma: Report of two cases

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World Journal of Clinical Cases 2017年第6期5卷 238-246页

作者： Kohei Ogawa Kenya Kamimura Yukari watanabe Yosuke Motai Daisuke Kumaki Ryoya Seki Akira Sakamaki Satoshi Abe Hirokazu Kawai Takeshi Suda Satoshi Yamagiwa Shuji Terai Division of Gastroenterology and Hepatology Graduate School of Medical and Dental Sciences Niigata University Department of Gastroenterology and Hepatology Uonuma Institute of Community Medicine Niigata Medical and Dental Hospital

Hepatocellular carcinoma(HCC) is one of the most common cancers and the third highest cause of cancerassociated mortality worldwide. The treatment of HCC is complicated by its variable biological behavior and the frequent coexistence of chronic liver disease, particularly cirrhosis. To date, multiple treatment modalities have been developed according to the stage of the tumor and the hepatic functional reserve, including transarterial treatments such as transarterial chemoembolization, transarterial oily chemoembolization(TOCE), and hepatic arterial infusion chemotherapy(HAIC). We conducted a phase I and II study of the combination therapy with double platinum agents, miriplatin and cisplatin, and confirmed its safety and efficacy. Here, we describe two cases of unresectable HCC who were successfully treated by miriplatin-TOCE/cisplatin-HAIC combination therapy, resulting in complete responses with no significant adverse events. This report will provide that the combination therapy can be the therapeutic option for HCC patients in the advanced stage.

关键词： Hepatocellular carcinoma Double platinum Transarterial oily chemoembolization Hepatic arterial infusion chemotherapy Combination

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Colorectal neuroendocrine carcinoma: A case report and review of the literature

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World Journal of Clinical Cases 2019年第14期7卷 1865-1875页

作者： Tomoaki Yoshida Kenya Kamimura Kazunori Hosaka Koji Doumori Hiromitsu Oka Akito Sato Yasuo Fukuhara Shoji watanabe Tomomi Sato Akira Yoshikawa Takashi Tomidokoro Shuji Terai Division of Gastroenterology and Hepatology Graduate School of Medical and Dental SciencesNiigata UniversityNiigata 951-8510Japan Division of Gastroenterology and Hepatology Nagaoka Chuo General HospitalNiigata 940-0861Japan

BACKGROUND Colorectal neuroendocrine carcinoma (NEC) is a rare tumor that demonstrates aggressive growth pattern with ingrowth into the tract, metastasis to the other organs, and invasion to the surrounding organs;these clinical characteristics result in poor prognosis. Surgical resection appears as an effective approach;however, because it is difficult to accurately diagnose NEC during the early stage and owing to its aggressive growth pattern, development of a reliable standard chemotherapy regimen and management strategies are essential. CASE SUMMARY Here, we report the case of patient with NEC showing an aggressive growth pattern that resulted in the rupture of the tumor to the outside the colon after stenting of the internal colonic stenosis. In addition, the tumor invaded into the duodenum, thereby causing duodenal stenosis that required an additional stent in the duodenum. This aggressive growth pattern is one of the main features of the NEC that is different from adenocarcinoma. To clarify the clinical characteristics, we reviewed 60 recently reported cases, including data on tumor location, size, treatment, and prognosis. CONCLUSION We consider that the information presented here is of great significance for the diagnosis, treatment, and management of symptoms of the patients with NEC.

关键词： Neuroendocrine carcinoma Colon Colorectal mixed adenoneuroendocrine carcinoma Growth Case report

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Clinical Utility of Procalcitonin for Differentiating between Cryptogenic Organizing Pneumonia and Community-Acquired Pneumonia

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International Journal of Clinical Medicine 2015年第6期6卷 372-376页

作者： Satoshi Takeda Nobuhiko Nagata Hiroyuki Miyazaki Takanori Akagi Taishi Harada Masaru Kodama Shinichiro Ushijima Takashi Aoyama Kentaro Wakamatsu Masaki Fujita Kentaro watanabe Department of Respiratory Medicine Fukuoka University Chikushi Hospital Chikushino Japan Department of Respiratory Medicine National Hospital Organization Omuta Hospital Omuta Japan Department of Respiratory Medicine Faculty of Medicine Fukuoka University Fukuoka Japan

Background: Differentiating cryptogenic organizing pneumonia (COP) from community-acquired pneumonia (CAP) can be difficult in some cases. Objective: To clarify the clinical utility of procalcitonin (PCT) levels for differentiating between COP and CAP. Methods: Blood PCT levels, leukocyte count, C-reactive protein concentration, number of segments involved on computed tomography (CT) images, and pneumonia severity assessment scale were retrospectively investigated from clinical charts and chest CT images of COP and CAP patients who were admitted to our hospital from 2012 to 2014. The clinical characteristics of COP patients were compared to those of CAP patients for whom causative organisms were not detected. Results: There were 16 COP and 94 CAP patients for whom causative organisms were not detected. Blood PCT levels of all COP patients were less than 0.16 ng/dL, and significantly lower than those of CAP patients (p = 0.0004), while the number of involved segments was significantly higher than that of CAP patients (p = 0.0001). Blood PCT levels and the number of involved segments remained independently significant for differentiating between COP and CAP by multivariate analysis. Receiver operating characteristics curve analysis revealed that 7 was the best cut-off number for involved segments to differentiate between COP and CAP patients with low PCT levels (sensitivity 85.7%, specificity 94.7%). Conclusion: A combination of PCT levels and number of involved segments on CT images is useful for differentiation between COP and CAP.

关键词： Cryptogenic Organizing Pneumonia Procalcitonin Community-Acquired Pneumonia Computed Tomography

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Comparison of Body Composition Two Months after High Caloric-Tofu Intake and Body Composition Six Months after the Experiment—In the Case of Elderly People

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Journal of Health Science 2019年第3期7卷 166-175页

作者： Naomi Katayama Yui Nakayama Shoko Kondo Nagoya Women’s University Nagoya City 4678610Japan Graduate School of Nagoya Women’s University Nagoya City 4678610Japan watanabe hospital Mihama TownChita-gun 4703235Japan

Japan becomes the super aged society. It is expected from now on that the population of the elderly person increases more and more. Therefore, disease prevention such as sarcopenia and frailty in the elderly person is required. This study tried the improvement of meal contents by taking in soy protein using caloric-tofu in daily life. The ten elderly people (one man, 9 women: from age 55 years old to 83 years old) who submitted the written consent of the subject participated in this study. We performed the gene analysis (β3AR, UCP1,β2AR) of the subject. The subject lived a normal life every day. The subject had eaten two high caloric-tofu a day. A caloric-tofu has 100 kcal. The subject participated in a study for two months. As for the subject, body composition was measured on the first day and two months after the start of the experiment, and six months after the end of the experiment. As a result, skeletal muscle rates of five people increased slightly, and body fat rate decreased slightly. However, five people changed into neither the skeletal muscle rate nor the body fat rate. Six months after the end of the experiment, the pair composition results were kept almost the same as at the end of the experiment. It can be highly appreciated that in the effective group, the pair composition could be maintained in a better condition than at the beginning of the experiment. For elderly people, the effective group, it is significant that intake of high caloric-tofu is effective in increasing the rate of skeletal muscle, and the effect is maintained even after half a year.

关键词： Elderly person gene analysis caloric-tofu skeletal muscle rate body fat rate

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Relationship between Walking Speed and Exercise Habits of Elderly People

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Journal of Health Science 2019年第3期7卷 193-197页

作者： Naomi Katayama Miki Kamijyo Shoko Kondo Nagoya Women’s University Nagoya City 4678610Japan Graduate School of Nagoya Women’s University Nagoya City 4678610Japan watanabe hospital Mihama TownChita-gun 4703235Japan

Japan becomes the super aged society. For Japan, the proportion of elderly people aged 65 and over is 27.3%. The Ministry of Health, Labor and Welfare estimates that in 2060, the proportion of the elderly people aged 75 or older to the total population will exceed 26.9%. Japan has nursing problems in a rapidly aging society. Therefore, the long-term care insurance system is being reviewed. The state, prefectures, and local governments are carrying out various campaigns from the perspective of long-term care prevention. One of them is fall prevention. Falling of the elderly often causes bedridden and death. Therefore, in this study, in order to examine the influence of exercise habits of the elderly on gait, the results of questionnaire survey and actual 10 m walking speed were obtained for elderly people who participated in the health class. As a result, walking speed was fast for people with exercise habits. As for exercise, walking speed was faster for those who continued with exercise such as walking than for those who did muscle training. By continuing the light exercise like walking, it might be possible to maintain the muscles of the lower limbs and cultivate a sense of balance or lead to the fall prevention of the elderly.

关键词： Elderly person walking speed exercise habit gymnastics

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