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Masuda D, Nakanishi I, Ohkubo K, Ito H, Matsumoto KI, Ichikawa H, Chatatikun M, Klangbud WK, Kotepui M, Imai M, Kawakami F, Kubo M, Matsui H, Tangpong J, Ichikawa T, Ozawa T, Yen HC, St Clair DK, Indo HP, Majima HJ. Mitochondria Play Essential Roles in Intracellular Protection against Oxidative Stress-Which Molecules among the ROS Generated in the Mitochondria Can Escape the Mitochondria and Contribute to Signal Activation in Cytosol? Biomolecules 2024; 14:128. [PMID: 38275757 PMCID: PMC10813015 DOI: 10.3390/biom14010128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 12/28/2023] [Accepted: 12/29/2023] [Indexed: 01/27/2024] Open
Abstract
Questions about which reactive oxygen species (ROS) or reactive nitrogen species (RNS) can escape from the mitochondria and activate signals must be addressed. In this study, two parameters, the calculated dipole moment (debye, D) and permeability coefficient (Pm) (cm s-1), are listed for hydrogen peroxide (H2O2), hydroxyl radical (•OH), superoxide (O2•-), hydroperoxyl radical (HO2•), nitric oxide (•NO), nitrogen dioxide (•NO2), peroxynitrite (ONOO-), and peroxynitrous acid (ONOOH) in comparison to those for water (H2O). O2•- is generated from the mitochondrial electron transport chain (ETC), and several other ROS and RNS can be generated subsequently. The candidates which pass through the mitochondrial membrane include ROS with a small number of dipoles, i.e., H2O2, HO2•, ONOOH, •OH, and •NO. The results show that the dipole moment of •NO2 is 0.35 D, indicating permeability; however, •NO2 can be eliminated quickly. The dipole moments of •OH (1.67 D) and ONOOH (1.77 D) indicate that they might be permeable. This study also suggests that the mitochondria play a central role in protecting against further oxidative stress in cells. The amounts, the long half-life, the diffusion distance, the Pm, the one-electron reduction potential, the pKa, and the rate constants for the reaction with ascorbate and glutathione are listed for various ROS/RNS, •OH, singlet oxygen (1O2), H2O2, O2•-, HO2•, •NO, •NO2, ONOO-, and ONOOH, and compared with those for H2O and oxygen (O2). Molecules with negative electrical charges cannot directly diffuse through the phospholipid bilayer of the mitochondrial membranes. Short-lived molecules, such as •OH, would be difficult to contribute to intracellular signaling. Finally, HO2• and ONOOH were selected as candidates for the ROS/RNS that pass through the mitochondrial membrane.
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Affiliation(s)
- Daisuke Masuda
- Department of Space Environmental Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima 890-8544, Kagoshima, Japan;
- Utilization & Engineering Department, Japan Manned Space Systems Corporation, 2-1-6 Tsukuba, Tsukuba 305-0047, Ibaraki, Japan
| | - Ikuo Nakanishi
- Quantum RedOx Chemistry Team, Institute for Quantum Life Science (iQLS), Quantum Life and Medical Science Directorate (QLMS), National Institutes for Quantum Science and Technology (QST), 4-9-1 Anagawa, Inage-ku, Chiba 263-8555, Japan;
| | - Kei Ohkubo
- Institute for Advanced Co-Creation Studies, Open and Transdisciplinary Research Initiatives, Osaka University, Suita 565-0871, Japan;
| | - Hiromu Ito
- Quantum RedOx Chemistry Team, Institute for Quantum Life Science (iQLS), Quantum Life and Medical Science Directorate (QLMS), National Institutes for Quantum Science and Technology (QST), 4-9-1 Anagawa, Inage-ku, Chiba 263-8555, Japan;
- Department of Maxillofacial Radiology, Field of Oncology, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima 890-8544, Kagoshima, Japan
| | - Ken-ichiro Matsumoto
- Quantitative RedOx Sensing Group, Department of Radiation Regulatory Science Research, Institute for Radiological Science (NIRS), Quantum Life and Medical Science Directorate (QLMS), National Institutes for Quantum Science and Technology (QST), 4-9-1 Anagawa, Inage-ku, Chiba 263-8555, Japan;
| | - Hiroshi Ichikawa
- Department of Medical Life Systems, Graduate School of Life and Medical Sciences, Doshisha University, Kyoto 610-0394, Kyoto, Japan;
| | - Moragot Chatatikun
- School of Allied Health Sciences, Walailak University, Thasala, Nakhon Si Thammarat 80161, Thailand; (M.C.); (W.K.K.); (M.K.); (J.T.)
- Center of Excellence Research for Melioidosis and Microorganisms, Walailak University, Thasala, Nakhon Si Thammarat 80161, Thailand
| | - Wiyada Kwanhian Klangbud
- School of Allied Health Sciences, Walailak University, Thasala, Nakhon Si Thammarat 80161, Thailand; (M.C.); (W.K.K.); (M.K.); (J.T.)
- Center of Excellence Research for Melioidosis and Microorganisms, Walailak University, Thasala, Nakhon Si Thammarat 80161, Thailand
| | - Manas Kotepui
- School of Allied Health Sciences, Walailak University, Thasala, Nakhon Si Thammarat 80161, Thailand; (M.C.); (W.K.K.); (M.K.); (J.T.)
| | - Motoki Imai
- Regenerative Medicine and Cell Design Research Facility, School of Allied Health Sciences, Kitasato University, 1-15-1 Kitasato, Sagamihara 252-0373, Kanagawa, Japan; (M.I.); (F.K.); (M.K.); (T.I.)
- Department of Molecular Diagnostics, School of Allied Health Sciences, Kitasato University, 1-15-1 Kitasato, Sagamihara 252-0373, Kanagawa, Japan
| | - Fumitaka Kawakami
- Regenerative Medicine and Cell Design Research Facility, School of Allied Health Sciences, Kitasato University, 1-15-1 Kitasato, Sagamihara 252-0373, Kanagawa, Japan; (M.I.); (F.K.); (M.K.); (T.I.)
- Department of Regulation Biochemistry, Kitasato University Graduate School of Medical Sciences, 1-15-1 Kitasato, Sagamihara 252-0373, Kanagawa, Japan
- Department of Health Administration, School of Allied Health Sciences, Kitasato University, 1-15-1 Kitasato, Sagamihara 252-0373, Kanagawa, Japan
| | - Makoto Kubo
- Regenerative Medicine and Cell Design Research Facility, School of Allied Health Sciences, Kitasato University, 1-15-1 Kitasato, Sagamihara 252-0373, Kanagawa, Japan; (M.I.); (F.K.); (M.K.); (T.I.)
- Division of Microbiology, Kitasato University School of Allied Health Sciences, 1-15-1 Kitasato, Minami-ku, Sagamihara 252-0373, Kanagawa, Japan
- Department of Environmental Microbiology, Graduate School of Medical Sciences, Kitasato University, 1-15-1 Kitasato, Minami-ku, Sagamihara 252-0373, Kanagawa, Japan
| | - Hirofumi Matsui
- Division of Gastroenterology, Graduate School of Comprehensive Human Science, University of Tsukuba, Tsukuba 305-8575, Ibaraki, Japan;
| | - Jitbanjong Tangpong
- School of Allied Health Sciences, Walailak University, Thasala, Nakhon Si Thammarat 80161, Thailand; (M.C.); (W.K.K.); (M.K.); (J.T.)
- Research Excellence Center for Innovation and Health Products (RECIHP), School of Allied Health Sciences, Walailak University, Thasala, Nakhon Si Thammarat 80160, Thailand
| | - Takafumi Ichikawa
- Regenerative Medicine and Cell Design Research Facility, School of Allied Health Sciences, Kitasato University, 1-15-1 Kitasato, Sagamihara 252-0373, Kanagawa, Japan; (M.I.); (F.K.); (M.K.); (T.I.)
- Department of Molecular Diagnostics, School of Allied Health Sciences, Kitasato University, 1-15-1 Kitasato, Sagamihara 252-0373, Kanagawa, Japan
| | - Toshihiko Ozawa
- Nihon Pharmaceutical University, 10281 Komuro, Ina-machi, Kitaadachi-gun, Saitama 362-0806, Saitama, Japan;
| | - Hsiu-Chuan Yen
- Department of Medical Biotechnology and Laboratory Science, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan;
- Department of Nephrology, Chang Gung Memorial Hospital at Linkou, Taoyuan 33305, Taiwan
| | - Daret K. St Clair
- Department of Toxicology and Cancer Biology, University of Kentucky College of Medicine, Lexington, KY 40536, USA;
| | - Hiroko P. Indo
- Department of Maxillofacial Radiology, Field of Oncology, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima 890-8544, Kagoshima, Japan
| | - Hideyuki J. Majima
- Department of Space Environmental Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima 890-8544, Kagoshima, Japan;
- Department of Maxillofacial Radiology, Field of Oncology, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima 890-8544, Kagoshima, Japan
- School of Allied Health Sciences, Walailak University, Thasala, Nakhon Si Thammarat 80161, Thailand; (M.C.); (W.K.K.); (M.K.); (J.T.)
- Research Excellence Center for Innovation and Health Products (RECIHP), School of Allied Health Sciences, Walailak University, Thasala, Nakhon Si Thammarat 80160, Thailand
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Indo HP, Masuda D, Sriburee S, Ito H, Nakanishi I, Matsumoto KI, Mankhetkorn S, Chatatikun M, Surinkaew S, Udomwech L, Kawakami F, Ichikawa T, Matsui H, Tangpong J, Majima HJ. Evidence of Nrf2/Keap1 Signaling Regulation by Mitochodria-Generated Reactive Oxygen Species in RGK1 Cells. Biomolecules 2023; 13:biom13030445. [PMID: 36979380 PMCID: PMC10046053 DOI: 10.3390/biom13030445] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 02/15/2023] [Accepted: 02/16/2023] [Indexed: 03/03/2023] Open
Abstract
It has been known that reactive oxygen species (ROS) are generated from the mitochondrial electron transport chain (ETC). Majima et al. proved that mitochondrial ROS (mtROS) caused apoptosis for the first time in 1998 (Majima et al. J Biol Chem, 1998). It is speculated that mtROS can move out of the mitochondria and initiate cellular signals in the nucleus. This paper aims to prove this phenomenon by assessing the change in the amount of manganese superoxide dismutase (MnSOD) by MnSOD transfection. Two cell lines of the same genetic background, of which generation of mtROS are different, i.e., the mtROS are more produced in RGK1, than in that of RGM1, were compared to analyze the cellular signals. The results of immunocytochemistry staining showed increase of Nrf2, Keap1, HO-1 and 2, MnSOD, GCL, GST, NQO1, GATA1, GATA3, GATA4, and GATA5 in RGK1 compared to those in RGM1. Transfection of human MnSOD in RGK1 cells showed a decrease of those signal proteins, suggesting mtROS play a role in cellular signals in nucleus.
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Affiliation(s)
- Hiroko P. Indo
- Department of Oncology, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima 890-8544, Japan
- Amanogawa Galactic Astronomy Research Center (AGARC), Graduate School of Sciences, Kagoshima University, Kagoshima 890-0065, Japan
- Correspondence: (H.P.I.); (H.J.M.)
| | - Daisuke Masuda
- Department of Space Environmental Medicine, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima 890-8544, Japan
- Utilization & Engineer Department, Japan Manned Space Systems Corporation, 21-6 Tsukuba, Tsukuba 305-0047, Japan
| | - Sompong Sriburee
- Department of Oncology, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima 890-8544, Japan
- Department of Radiologic Technology, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Hiromu Ito
- Department of Oncology, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima 890-8544, Japan
- Quantum RedOx Chemistry Team, Institute for Quantum Life Science, Quantum Life and Medical Science Directorate, National Institutes for Quantum Science and Technology, Chiba 263-8555, Japan
| | - Ikuo Nakanishi
- Quantum RedOx Chemistry Team, Institute for Quantum Life Science, Quantum Life and Medical Science Directorate, National Institutes for Quantum Science and Technology, Chiba 263-8555, Japan
| | - Ken-ichiro Matsumoto
- Quantitative RedOx Sensing Group, Department of Radiation Regulatory Science Research, National Institute of Radiological Sciences, Quantum Life and Medical Science Directorate, National Institutes for Quantum Science and Technology (QST), Chiba 263-8555, Japan
| | - Samlee Mankhetkorn
- Department of Radiologic Technology, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Moragot Chatatikun
- School of Allied Health Sciences, Walailak University, Thasala, Nakhon Si Thammarat 80160, Thailand
- Center of Excellence Research for Melioidosis and Microorganisms, Walailak University, Thasala, Nakhon Si Thammarat 80160, Thailand
| | - Sirirat Surinkaew
- School of Allied Health Sciences, Walailak University, Thasala, Nakhon Si Thammarat 80160, Thailand
- Research Excellence Center for Innovation and Health Products (RECIHP), School of Allied Health Sciences, Walailak University, Thasala, Nakhon Si Thammarat 80160, Thailand
| | - Lunla Udomwech
- School of Medicine, Walailak University, Thasala, Nakhon Si Thammarat 80161, Thailand
| | - Fumitaka Kawakami
- Department of Regulation Biochemistry, Graduate School of Medical Sciences, Kitasato University, 1-15-1 Kitasato, Sagamihara 252-0373, Japan
- Department of Health Administration, School of Allied Health Sciences, Kitasato University, 1-15-1 Kitasato, Sagamihara 252-0373, Japan
- Regenerative Medicine and Cell Design Research Facility, School of Allied Health Sciences, Kitasato University, 1-15-1 Kitasato, Sagamihara 252-0373, Japan
| | - Takafumi Ichikawa
- Department of Regulation Biochemistry, Graduate School of Medical Sciences, Kitasato University, 1-15-1 Kitasato, Sagamihara 252-0373, Japan
- Department of Health Administration, School of Allied Health Sciences, Kitasato University, 1-15-1 Kitasato, Sagamihara 252-0373, Japan
| | - Hirofumi Matsui
- Division of Gastroenterology, Graduate School of Comprehensive Human Sciences, University Tsukuba, Tsukuba 305-8575, Japan
| | - Jitbanjong Tangpong
- School of Allied Health Sciences, Walailak University, Thasala, Nakhon Si Thammarat 80160, Thailand
- Research Excellence Center for Innovation and Health Products (RECIHP), School of Allied Health Sciences, Walailak University, Thasala, Nakhon Si Thammarat 80160, Thailand
| | - Hideyuki J. Majima
- Department of Oncology, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima 890-8544, Japan
- Amanogawa Galactic Astronomy Research Center (AGARC), Graduate School of Sciences, Kagoshima University, Kagoshima 890-0065, Japan
- Department of Space Environmental Medicine, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima 890-8544, Japan
- School of Allied Health Sciences, Walailak University, Thasala, Nakhon Si Thammarat 80160, Thailand
- Center of Excellence Research for Melioidosis and Microorganisms, Walailak University, Thasala, Nakhon Si Thammarat 80160, Thailand
- Research Excellence Center for Innovation and Health Products (RECIHP), School of Allied Health Sciences, Walailak University, Thasala, Nakhon Si Thammarat 80160, Thailand
- Correspondence: (H.P.I.); (H.J.M.)
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3
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Tamaki S, Nagai Y, Shutta R, Masuda D, Yamashita S, Seo M, Yamada T, Yano M, Hayashi T, Yasumura Y, Hikoso S, Sotomi Y, Sakata Y. Relation of lymphopenia to comorbidity burden and its prognostic value in patients with acute decompensated heart failure with preserved left ventricular ejection fraction: a multicentre study. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Systemic inflammation resulting from comorbidities is postulated to play a central role in the pathophysiology of heart failure (HF) with preserved ejection fraction (HFpEF). Lymphopenia is a common manifestation of systemic inflammation and a prognostic factor in patients with HF. However, the association of lymphopenia with the comorbidity burden is unknown, and its prognostic value in patients with HFpEF admitted due to acute decompensated heart failure (ADHF) also remains elusive.
Purpose
We sought to clarify the relation of lymphopenia with the comorbidity burden, as well as its prognostic value and complementarity with the Get with the Guidelines-Heart Failure (GWTG-HF) risk score in ADHF patients with HFpEF.
Methods
Patients' data were extracted from the Prospective mUlticenteR obServational stUdy of patIenTs with Heart Failure with Preserved Ejection Fraction (PURSUIT-HFpEF), which is a prospective multicentre registry for patients with ADHF with a LVEF ≥50%. We analysed data of patients admitted between June 2016 and December 2020 who survived to discharge. The total lymphocyte count (per μL) and GWTG-HF risk score were obtained on admission, as previously reported. Comorbidity burden was defined as the number of comorbidities from the following: atrial fibrillation, hypertension, diabetes mellitus, coronary artery disease, chronic kidney disease, chronic obstructive pulmonary disease, anaemia, and obesity. The study endpoint was all-cause death.
Results
Over a median follow-up of 417 days, 181 of the 1013 included patients died. The proportion of patients with a total lymphocyte count in the lowest tertile was increasing with the increase in comorbidity burden (Figure 1). In the multivariate Cox analysis, a total lymphocyte count in the intermediate (hazard ratio [HR] 1.55, 95% confidence interval [CI] 1.00–2.41, p=0.0486) and lowest tertile (HR 2.23, 95% CI 1.47–3.38, p=0.0002) was independently associated with all-cause death. There was a significant difference in the all-cause death rate among the groups stratified by total lymphocyte count tertile (Figure 2). The total lymphocyte count had a higher C-statistic value (0.627) for the prediction of all-cause death than the GWTG-HF risk score, and the C-statistic value of the GWTG-HF risk score was improved when the total lymphocyte count was added (0.613 to 0.636, p=0.0260).
Conclusions
Lymphopenia was significantly associated with comorbidity burden. Furthermore, it was a useful marker of poor prognosis in hospitalised patients with acute HFpEF and was shown to be complementary to the contemporary HF prognostic score.
Funding Acknowledgement
Type of funding sources: Private company. Main funding source(s): Roche Diagnostics K.K.Fuji Film Toyama Chemical Co. Ltd.
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Affiliation(s)
- S Tamaki
- Rinku General Medical Center , Izumisano , Japan
| | - Y Nagai
- Rinku General Medical Center , Izumisano , Japan
| | - R Shutta
- Rinku General Medical Center , Izumisano , Japan
| | - D Masuda
- Rinku General Medical Center , Izumisano , Japan
| | - S Yamashita
- Rinku General Medical Center , Izumisano , Japan
| | - M Seo
- Osaka General Medical Center , Osaka , Japan
| | - T Yamada
- Osaka General Medical Center , Osaka , Japan
| | - M Yano
- Osaka Rosai Hospital , Sakai , Japan
| | - T Hayashi
- Osaka Police Hospital , Osaka , Japan
| | - Y Yasumura
- Amagasaki Chuo Hospital , Amagasaki , Japan
| | - S Hikoso
- Osaka University Graduate School of Medicine , Suita , Japan
| | - Y Sotomi
- Osaka University Graduate School of Medicine , Suita , Japan
| | - Y Sakata
- Osaka University Graduate School of Medicine , Suita , Japan
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4
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Ota K, Takeuchi T, Masuda D, Sanomura M, Kojima K, Nakanishi Y, Hoshimoto M, Higashino T, Imoto A, Okada T, Nouda S, Miyazaki H, Ozaki H, Fukuda KH, Kuramoto T, Sugawara N, Onishi T, Takahashi Y, Tsujimoto H, Yokoya Y, Kawabata K, Nishida S, Hakoda A, Iwatsubo T, Kawaguchi S, Kojima Y, Higuchi K. Risk factors for postoperative bleeding and early death in percutaneous endoscopic gastrostomy: A multicenter retrospective study. J Gastroenterol Hepatol 2022; 37:97-103. [PMID: 34478183 DOI: 10.1111/jgh.15680] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 07/29/2021] [Accepted: 08/30/2021] [Indexed: 01/23/2023]
Abstract
BACKGROUND AND AIM Comprehensive reports on the risk factors for bleeding and early death after percutaneous endoscopic gastrostomy (PEG) are limited. In this multicenter study, we retrospectively investigated the risk factors for bleeding and early death after PEG. METHODS Patients (n = 1234) who underwent PEG between 2015 and 2020 at Osaka Medical and Pharmaceutical University and its affiliated hospitals (11 institutions in total) were evaluated for postoperative bleeding and early death (within 60 days) after PEG according to patient characteristics, construction method, medical history, medications, preoperative hematological findings, and perioperative adverse events. Multivariate logistic regression was performed to identify independent predictors of bleeding and early death after PEG. RESULTS The risk factors for bleeding after PEG were PEG tube insertion using the modified introducer method (odds ratio [OR], 4.37; P = 0.0003), low platelet count (OR, 0.99; P = 0.014), antiplatelet therapy (OR, 2.11; P = 0.036), and heparinization (OR, 4.50; P = 0.007). Risk factors for early death were low body mass index (BMI) (OR, 0.89; P = 0.015), low serum albumin levels (OR, 0.50; P = 0.035), and comorbidity of active cancer (OR, 4.03; P < 0.0001). There was no significant association between bleeding and early death after PEG. CONCLUSIONS We identified several risk factors for bleeding and early death after PEG. Risk factors for bleeding were PEG tube insertion using the modified introducer method, low platelet count, antiplatelet therapy, and heparinization. Risk factors for early death were low BMI, low serum albumin levels, and comorbidity of active cancer.
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Affiliation(s)
- Kazuhiro Ota
- Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki, Osaka, Japan
| | - Toshihisa Takeuchi
- Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki, Osaka, Japan
| | - Daisuke Masuda
- Department of Gastroenterology, Osaka Kaisei Hospital, Osaka, Osaka, Japan
| | - Makoto Sanomura
- Department of Gastroenterology, Hokusetsu General Hospital, Takatsuki, Osaka, Japan
| | - Keishi Kojima
- Department of Internal Medicine, Sousei Hospital, Kadoma, Osaka, Japan
| | - Yoshihiko Nakanishi
- Department of Gastroenterology, Hirakata City Hospital, Hirakata, Osaka, Japan
| | | | - Takeshi Higashino
- Department of Gastroenterology, Shiroyama Hospital, Habikino, Osaka, Japan
| | - Akira Imoto
- Department of Internal Medicine, Aoyama Hospital, Fujiidera, Osaka, Japan
| | - Toshihiko Okada
- Department of Gastroenterology and Hepatology, Katsuragi Hospital, Kishiwada, Osaka, Japan
| | - Sadaharu Nouda
- Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki, Osaka, Japan.,Department of Gastroenterology, Midorigaoka Hospital, Takatsuki, Osaka, Japan
| | - Hirota Miyazaki
- Department of Gastroenterology, Hanwasumiyoshi General Hospital, Osaka, Osaka, Japan
| | - Haruhiko Ozaki
- Department of Gastroenterology, Osaka Kaisei Hospital, Osaka, Osaka, Japan
| | | | - Takanori Kuramoto
- Department of Internal Medicine, Sousei Hospital, Kadoma, Osaka, Japan
| | - Noriaki Sugawara
- Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki, Osaka, Japan.,Department of Gastroenterology, Hirakata City Hospital, Hirakata, Osaka, Japan
| | - Toshikazu Onishi
- Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki, Osaka, Japan.,Department of Gastroenterology, Seikeikai Hospital, Sakai, Osaka, Japan
| | - Yoshiaki Takahashi
- Department of Gastroenterology, Shiroyama Hospital, Habikino, Osaka, Japan
| | - Hiroyuki Tsujimoto
- Department of Internal Medicine, Aoyama Hospital, Fujiidera, Osaka, Japan
| | - Yuta Yokoya
- Department of Gastroenterology and Hepatology, Katsuragi Hospital, Kishiwada, Osaka, Japan
| | - Kazumi Kawabata
- Department of Gastroenterology, Hanwasumiyoshi General Hospital, Osaka, Osaka, Japan
| | - Shinya Nishida
- Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki, Osaka, Japan
| | - Akitoshi Hakoda
- Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki, Osaka, Japan
| | - Taro Iwatsubo
- Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki, Osaka, Japan
| | - Shimpei Kawaguchi
- Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki, Osaka, Japan
| | - Yuichi Kojima
- Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki, Osaka, Japan
| | - Kazuhide Higuchi
- Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki, Osaka, Japan
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5
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Ogura T, Okuda A, Miyano A, Imanishi M, Nishioka N, Yamada M, Yamda T, Kamiyama R, Masuda D, Higuchi K. EUS-guided versus percutaneous biliary access in patients with obstructive jaundice due to gastric cancer. Dig Liver Dis 2019; 51:247-252. [PMID: 30327252 DOI: 10.1016/j.dld.2018.09.015] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Revised: 09/12/2018] [Accepted: 09/16/2018] [Indexed: 12/11/2022]
Abstract
BACKGROUND Gastric cancer is sometimes complicated by obstructive jaundice. However, ERCP may be challenging in patients who have advanced gastric cancer, or recurrent gastric cancer after surgical resection that is complicated by obstructive jaundice. In such cases, percutaneous transhepatic biliary drainage (PTBD) is considered. Recently, EUS-guided biliary drainage (EUS-BD) has been developed. We conducted a retrospective study to compare the efficacy of EUS-BD and PTBD in patients with obstructive jaundice due to gastric cancer. METHODS Patients with gastric cancer complicated with obstructive jaundice who were contraindicated for standard ERCP were enrolled. RESULTS A total of 47 consecutive patients were enrolled during the study period. The technical success rates of PTBD and EUS-BD were 88.9% (16/18) and 96.7% (29/30), respectively (P = 0.64). The stent patency period, including patient death was equivalent between the two groups (EUS-BD vs. PTBD: 188.4 days vs. 200.9 days, P = 0.974). Time to stent dysfunction in the EUS-BD group (391.1 days) was not significantly different as compared to that in the PTBD group (398.1 days) (P = 0.78). Adverse events were relatively severe in the PTBD group. CONCLUSIONS Given the relative severity of adverse events in the PTBD group, EUS-BD might be the procedure of choice for gastric cancer patients with contraindications by inability to perform ERCP.
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Affiliation(s)
- Takeshi Ogura
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan.
| | - Atsushi Okuda
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Akira Miyano
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Miyuki Imanishi
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Nobu Nishioka
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Masanori Yamada
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Tadahiro Yamda
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Rieko Kamiyama
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Daisuke Masuda
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Kazuhide Higuchi
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
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Imoto A, Inoue Y, Ogura T, Masuda D, Asakuma M, Kurisu Y, Uchiyama K, Higuchi K. Recurrent Hepatic Inflammatory Pseudotumor in Asynchronism After Surgery of Inflammatory Pseudotumor Associated With Granulomatous Cholangitis. J Med Cases 2019. [DOI: 10.14740/jmc3245] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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7
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Ito T, Takada R, Omoto S, Tsuda M, Masuda D, Kato H, Matsumoto T, Moriyama I, Okabe Y, Shiomi H, Ishida E, Hatamaru K, Hashimoto S, Tanaka K, Kawamoto H, Yanagisawa A, Katayama T, Yazumi S. Analysis of Prognostic Factors in Pancreatic Metastases: A Multicenter Retrospective Analysis. Pancreas 2018; 47:1033-1039. [PMID: 30048381 DOI: 10.1097/mpa.0000000000001132] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVES Pancreatic metastases (PMs) account for 1% to 2% of pancreatic tumors, and their prognostic significance is poorly defined. We evaluated the incidence and clinical characteristics of primary tumors and defined prognostic factors. METHODS This retrospective study of 39 Japanese tertiary referral hospitals (January 2005 to August 2015) analyzed patient and tumor characteristics and survival time. Kaplan-Meier analysis and Cox proportional hazards models were applied to evaluate overall survival and prognostic factors, respectively. RESULTS We enrolled 159 patients with a pathologic diagnosis of PM. The most common primary tumor was renal cell carcinoma (38.4%), followed by lung cancer (24.5%), colorectal cancer (11.3%), and sarcoma (6.3%). Eight patients were lost during follow-up, and 151 patients were included for statistical analysis. Median overall survival was 43.0 months, and the 5-year survival rate was 42.6%. Multivariate analysis identified 3 independent prognostic factors: extrapancreatic metastasis (hazard ratio, 2.13; 95% confidence interval, 1.11-4.07; P = 0.02), tumor-related symptoms at diagnosis (hazard ratio, 5.39; 95% confidence interval, 2.92-9.91; P < 0.001), and pathologic diagnosis of primary tumors (P < 0.001). CONCLUSIONS Treatment strategies and prognoses for PMs completely differ according to the primary tumor type. A definitive pathologic diagnosis of PMs is essential for selecting the appropriate treatment.
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Affiliation(s)
| | - Ryoji Takada
- Department of Hepatobiliary and Pancreatic Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Shunsuke Omoto
- Department of Gastroenterology and Hepatology, Kindai University Faculty Medicine, Osaka-Sayama, Japan
| | - Motoyuki Tsuda
- Department of Gastroenterology and Hepatology, Graduate School of Medicine Kyoto University, Kyoto, Japan
| | - Daisuke Masuda
- 2nd Department of Internal Medicine, Osaka Medical College, Takatsuki, Japan
| | - Hironari Kato
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Toshihiko Matsumoto
- Department of Gastroenterology, National Hospital Organization Shikoku Cancer Center, Matsuyama, Japan
| | - Ichiro Moriyama
- Department of Hematology/Oncology, Shimane University Hospital, Shimane, Japan
| | - Yoshinobu Okabe
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Hideyuki Shiomi
- Division of Gastroenterology, Department of Internal Medicine, Graduate School of Medicine, Kobe University, Kobe, Japan
| | - Etsuji Ishida
- Department of Gastroenterology and Hepatology, Kurashiki Central Hospital, Okayama, Japan
| | - Keiichi Hatamaru
- Department of Gastroenterology and Hepatology, Japanese Red Cross Society, Wakayama Medical Center, Wakayama, Japan
| | - Shinichi Hashimoto
- Digestive and Lifestyle Diseases, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Kiyohito Tanaka
- Department of Gastroenterology, Kyoto Second Red Cross Hospital, Kyoto, Japan
| | - Hirofumi Kawamoto
- Department of Internal Medicine, Kawasaki Medical School General Medical Center, Okayama, Japan
| | - Akio Yanagisawa
- Department of Surgical Pathology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan
| | - Toshiro Katayama
- Faculty of Medical Engineering, Himeji Dokkyo University School of Health Care Sciences, Himeji, Japan
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Ogura T, Imanishi M, Kurisu Y, Onda S, Sano T, Takagi W, Okuda A, Miyano A, Amano M, Nishioka N, Yamada T, Masuda D, Takenaka M, Kitano M, Higuchi K. Prospective evaluation of digital single-operator cholangioscope for diagnostic and therapeutic procedures (with videos). Dig Endosc 2017; 29:782-789. [PMID: 28349613 DOI: 10.1111/den.12878] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Accepted: 03/22/2017] [Indexed: 12/16/2022]
Abstract
BACKGROUND AND AIM Recently, the digital single-operator cholangioscope (SPY-DS) has become available. This system may allow diagnosis by direct visualization and allow performance of various therapeutic procedures. The aim of the present study was to prospectively evaluate the clinical utility of DSOCS for diagnostic and therapeutic procedures for biliary disease. METHODS Technical success was defined as successful visualization of target lesions in the biliary tract and carrying out forceps biopsy as a diagnostic procedure, and successfully carrying out treatment such as guidewire insertion for the area of interest, electrohydraulic lithotripsy (EHL), or migrated stent removal. Also, the present study aimed at investigating diagnostic yield of the cholangioscopic findings and biopsy specimens. RESULTS A total of 55 consecutive patients were prospectively enrolled in this study; a diagnostic procedure was done in 33 patients, and a therapeutic procedure was done in 22 patients. Overall accuracy of visual findings was 93%, with a sensitivity of 83%, a specificity of 89%, positive predictive value (PPV) of 83%, and negative predictive value (NPV) of 100%. However, the overall accuracy of forceps biopsy was 89%, with a sensitivity, specificity, and PPV of 100%, and NPV of 90%. Overall technical success rate of therapeutic procedures such as selective guidewire insertion, EHL or migrated stent removal was 91% (20/22). Finally, adverse events were seen in two cases in the diagnostic group, but were not seen in the therapeutic group. CONCLUSION Although additional cases and a randomized, controlled study with another cholangioscope are needed, diagnostic and therapeutic procedures using SPY-DS appear to be feasible and safe.
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Affiliation(s)
- Takeshi Ogura
- 2nd Department of Internal Medicine , Osaka Medical College, Osaka, Japan
| | - Miyuki Imanishi
- 2nd Department of Internal Medicine , Osaka Medical College, Osaka, Japan
| | | | - Saori Onda
- 2nd Department of Internal Medicine , Osaka Medical College, Osaka, Japan
| | - Tastsushi Sano
- 2nd Department of Internal Medicine , Osaka Medical College, Osaka, Japan
| | - Wataru Takagi
- 2nd Department of Internal Medicine , Osaka Medical College, Osaka, Japan
| | - Atsushi Okuda
- 2nd Department of Internal Medicine , Osaka Medical College, Osaka, Japan
| | - Akira Miyano
- 2nd Department of Internal Medicine , Osaka Medical College, Osaka, Japan
| | - Mio Amano
- 2nd Department of Internal Medicine , Osaka Medical College, Osaka, Japan
| | - Nobu Nishioka
- 2nd Department of Internal Medicine , Osaka Medical College, Osaka, Japan
| | - Tadahiro Yamada
- 2nd Department of Internal Medicine , Osaka Medical College, Osaka, Japan
| | - Daisuke Masuda
- 2nd Department of Internal Medicine , Osaka Medical College, Osaka, Japan
| | - Mamoru Takenaka
- Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka-Sayama, Japan
| | - Masayuki Kitano
- Second Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan
| | - Kazuhide Higuchi
- 2nd Department of Internal Medicine , Osaka Medical College, Osaka, Japan
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9
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Ogura T, Onda S, Sano T, Takagi W, Okuda A, Miyano A, Nishioka N, Imanishi M, Amano M, Masuda D, Higuchi K. Evaluation of the safety of endoscopic radiofrequency ablation for malignant biliary stricture using a digital peroral cholangioscope (with videos). Dig Endosc 2017; 29:712-717. [PMID: 28181704 DOI: 10.1111/den.12837] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Accepted: 02/06/2017] [Indexed: 02/08/2023]
Abstract
BACKGROUND AND AIM The clinical impact of catheter-based radiofrequency ablation (RFA) under endoscopic retrograde cholangiopancreatography (ERCP) guidance has recently been reported; however, severe adverse events have also been noted. If tumor is not present in the biliary tract, severe adverse events such as perforation or bleeding as a result of vessel injury around the biliary tract may occur. In addition, the effectiveness of RFA may not be sufficient based solely on radiographic guidance. The aim of the present study was to evaluate the actual feasibility of intraductal RFA by peroral cholangioscope (POCS) evaluation before/after RFA. METHODS In this retrospective study carried out between July and September 2016, consecutive patients who underwent RFA for malignant biliary stricture and POCS evaluation before/after RFA were enrolled. Primary endpoint of this study was technical feasibility of RFA, which was evaluated by POCS. Secondary endpoints were rates and types of adverse event. RESULTS A total of 12 consecutive patients were retrospectively enrolled in this study. Stent placement using uncovered metal stents had been previously done in six patients before RFA. Tumor was seen in the biliary tract in all patients. RFA was technically successful in all patients, and clinical success was confirmed in all patients by POCS imaging. Adverse events were seen in only one patient. Median stent patency was 154 days. CONCLUSIONS RFA for malignant biliary stricture may be safe. To confirm the feasibility and efficacy of RFA, additional cases, prospective studies, and a comparison study between with and without endobiliary RFA are needed.
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Affiliation(s)
- Takeshi Ogura
- Second Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Saori Onda
- Second Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Tatsushi Sano
- Second Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Wataru Takagi
- Second Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Atsushi Okuda
- Second Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Akira Miyano
- Second Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Nobu Nishioka
- Second Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Miyuki Imanishi
- Second Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Mio Amano
- Second Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Daisuke Masuda
- Second Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Kazuhide Higuchi
- Second Department of Internal Medicine, Osaka Medical College, Osaka, Japan
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10
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Yamada S, Masuda D, Takeichi H, Nakamura Y, Iwazaki M. Intra-pericardial recurrent thymoma presenting with compression of the pulmonary trunk. Proceedings of Singapore Healthcare 2017. [DOI: 10.1177/2010105816667138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
A patient who had a second recurrent intra-pericardial thymoma is presented. The tumor was expanding in the pericardial space and compressed the pulmonary trunk. The obstruction of the pulmonary trunk could have resulted in a fatal outcome. Surgical management was required, and complete surgical resection and mediastinal adjuvant radiation therapy were effective in this patient’s management.
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Affiliation(s)
- Shunsuke Yamada
- Department of General Thoracic Surgery, Tokai University Hachioji Hospital, Japan
| | - Daisuke Masuda
- Department of General Thoracic Surgery, Tokai University Hachioji Hospital, Japan
| | - Haruka Takeichi
- Department of General Thoracic Surgery, Tokai University Hachioji Hospital, Japan
| | - Yusuke Nakamura
- Department of General Thoracic Surgery, Tokai University Hachioji Hospital, Japan
| | - Masayuki Iwazaki
- Department of General Thoracic Surgery, Tokai University School of Medicine, Japan
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11
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Imanishi M, Ogura T, Kurisu Y, Onda S, Takagi W, Okuda A, Miyano A, Amano M, Nishioka N, Masuda D, Higuchi K. A feasibility study of digital single-operator cholangioscopy for diagnostic and therapeutic procedure (with videos). Medicine (Baltimore) 2017; 96:e6619. [PMID: 28403110 PMCID: PMC5403107 DOI: 10.1097/md.0000000000006619] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Recently, the novel SpyGlass DS Direct Visualization system (SPY DS) has become available. This system offers several advantages over the conventional SPYGlass system. This study evaluated the clinical feasibility and efficacy of diagnostic and therapeutic procedures for biliary disorder using SPY DS.In this retrospective study, consecutive patients who had biliary disorder were enrolled between November 2015 and February 2016. All patients could not be diagnosed or treated by standard endoscopic retrograde cholangiopancreatography in our hospital or at another hospital.A total of 28 consecutive patients (21 men and 7 women; median age, 73 years; age range, 55-87 years) were retrospectively enrolled in this study. Among them, diagnostic procedure was performed in 20 patients, and 8 patients underwent therapeutic procedures. The technical success rate for diagnostic procedures was 100% (20/20). Diagnostic accuracy was 100% (19/19). The technical success rate for therapeutic procedures was 88% (7/8). Among these 8 patients, 4 patients with common bile duct stones underwent electrohydraulic lithotripsy. One patient successfully underwent guidewire insertion to remove a migrated plastic stent. The 3 remaining patients underwent SPY DS to insert a guidewire for left bile duct obstruction and for posterior bile duct branch. In the patient who underwent guidewire insertion for left hepatic bile duct obstruction cause by primary sclerosing cholangitis, we could not advance the guidewire into the left hepatic bile duct. No adverse events were seen. Median SPY DS insertion time was 21 min (range, 8-32 min).Single-operator cholangioscopy using SPY DS was feasible and had a marked clinical impact in patients with biliary disease. Additional case reports and prospective studies are needed to examine further applications of this system.
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Affiliation(s)
- Miyuki Imanishi
- Second Department of Internal Medicine, Osaka Medical College
| | - Takeshi Ogura
- Second Department of Internal Medicine, Osaka Medical College
| | | | - Saori Onda
- Second Department of Internal Medicine, Osaka Medical College
| | - Wataru Takagi
- Second Department of Internal Medicine, Osaka Medical College
| | - Atsushi Okuda
- Second Department of Internal Medicine, Osaka Medical College
| | - Akira Miyano
- Second Department of Internal Medicine, Osaka Medical College
| | - Mio Amano
- Second Department of Internal Medicine, Osaka Medical College
| | - Nobu Nishioka
- Second Department of Internal Medicine, Osaka Medical College
| | - Daisuke Masuda
- Second Department of Internal Medicine, Osaka Medical College
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12
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Amano M, Ogura T, Onda S, Takagi W, Sano T, Okuda A, Miyano A, Masuda D, Higuchi K. Prospective clinical study of endoscopic ultrasound-guided biliary drainage using novel balloon catheter (with video). J Gastroenterol Hepatol 2017; 32:716-720. [PMID: 27420770 DOI: 10.1111/jgh.13489] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/04/2016] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND AIM On endoscopic ultrasound (EUS)-guided biliary drainage, fistula dilation may be accompanied by leakage of bile juice, potentially along with bacteria or air, so this procedure should be kept as simple and short as possible. To date, various techniques to dilate the fistula have been reported. This prospective, single-center, single-arm study evaluated the technical feasibility and safety of EUS-guided biliary drainage using novel balloon catheters. METHODS Tip of novel balloon catheters is only 3 Fr and tapered, and the catheters also show favorable push ability. First, biliary tract was punctured using 19-G fine needle aspiration needle. Next, we immediately inserted the novel balloon catheter, and the biliary tract and intestinal wall were dilated. Then, we performed metallic stent placement without any dilation fistula. RESULTS A total of 20 patients were prospectively enrolled in this study. Technical success rate was 100%. Eleven patients underwent EUS-guided choledochoduodenostomy, and nine patients underwent EUS-guided hepaticogastrostomy. Median procedure time was only 11 min (range, 8-16 min) for EUS-guided choledochoduodenostomy and 14 min (range, 11-18 min) for EUS-guided hepaticogastrostomy. Adverse events were seen in 15% (3/20; self-limited abdominal pain n = 2, peritonitis n = 1). CONCLUSIONS Although additional cases and a randomized controlled comparison with another dilation technique such as the graded dilation or cystotome dilation technique are needed, our technique may be helpful for EUS-guided biliary drainage.
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Affiliation(s)
- Mio Amano
- Second Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Takeshi Ogura
- Second Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Saori Onda
- Second Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Wataru Takagi
- Second Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Tastsushi Sano
- Second Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Astushi Okuda
- Second Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Akira Miyano
- Second Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Daisuke Masuda
- Second Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Kazuhide Higuchi
- Second Department of Internal Medicine, Osaka Medical College, Osaka, Japan
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13
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Masuda R, Kijima H, Nito M, Wada A, Matsuzaki T, Ikoma Y, Nakazato K, Masuda D, Tanaka M, Kobayashi H, Inokuchi S, Iwazaki M. Lymphatic invasion is a significant indicator of poor patient prognosis in lung squamous cell carcinoma. Mol Med Rep 2017; 15:2067-2073. [PMID: 28260029 PMCID: PMC5364981 DOI: 10.3892/mmr.2017.6256] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2015] [Accepted: 08/22/2016] [Indexed: 11/28/2022] Open
Abstract
Pathological stage is the most important prognostic factor in patients with lung cancer, and is defined according to the tumor node metastasis classification system. The present study aimed to investigate the clinicopathological significance of lymphatic invasion in 103 patients who underwent surgical resection of lung squamous cell carcinoma (SqCC). The patients were divided into two groups, according to the degree of lymphatic invasion: Those with no or mild lymphatic invasion (ly0-1) and those with moderate or severe lymphatic invasion (ly2-3). Ly2-3 was associated with tumor size (P=0.028), lymph node metastasis (P<0.001), venous invasion (P=0.001) and histological differentiation (P=0.047). Statistical analysis using the Kaplan-Meier method and the log-rank test indicated that overall survival was significantly reduced in patients with ly2-3 compared with those with ly0-1 (P<0.001). Multivariate analysis identified ly2-3 as an independent predictor of mortality (hazard ratio, 2.580; 95% confidence interval, 1.376–4.839). In conclusion, moderate or severe lymphatic invasion (ly2-3) indicated a high malignant potential and may be considered an independent predictor of poor prognosis in patients with SqCC of the lung.
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Affiliation(s)
- Ryota Masuda
- Department of General Thoracic Surgery, Tokai University School of Medicine, Isehara, Kanagawa 259‑1193, Japan
| | - Hiroshi Kijima
- Department of Pathology and Bioscience, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori 036‑8562, Japan
| | - Madoka Nito
- Department of General Thoracic Surgery, Tokai University School of Medicine, Isehara, Kanagawa 259‑1193, Japan
| | - Atsushi Wada
- Department of General Thoracic Surgery, Tokai University School of Medicine, Isehara, Kanagawa 259‑1193, Japan
| | - Tomohiko Matsuzaki
- Department of General Thoracic Surgery, Tokai University School of Medicine, Isehara, Kanagawa 259‑1193, Japan
| | - Yoichiro Ikoma
- Department of General Thoracic Surgery, Tokai University School of Medicine, Isehara, Kanagawa 259‑1193, Japan
| | - Kenei Nakazato
- Department of General Thoracic Surgery, Tokai University School of Medicine, Isehara, Kanagawa 259‑1193, Japan
| | - Daisuke Masuda
- Department of General Thoracic Surgery, Tokai University School of Medicine, Isehara, Kanagawa 259‑1193, Japan
| | - Makiko Tanaka
- Department of Critical Care and Emergency Medicine, Tokai University School of Medicine, Isehara, Kanagawa 259‑1193, Japan
| | - Hiroyuki Kobayashi
- Department of Clinical Pharmacology, Tokai University School of Medicine, Isehara, Kanagawa 259‑1193, Japan
| | - Sadaki Inokuchi
- Department of Critical Care and Emergency Medicine, Tokai University School of Medicine, Isehara, Kanagawa 259‑1193, Japan
| | - Masayuki Iwazaki
- Department of General Thoracic Surgery, Tokai University School of Medicine, Isehara, Kanagawa 259‑1193, Japan
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14
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Ogura T, Onda S, Takagi W, Sano T, Okuda A, Masuda D, Yamamoto K, Miyano A, Kitano M, Takeuchi T, Fukunishi S, Higuchi K. Clinical utility of endoscopic ultrasound-guided biliary drainage as a rescue of re-intervention procedure for high-grade hilar stricture. J Gastroenterol Hepatol 2017; 32:163-168. [PMID: 27161286 DOI: 10.1111/jgh.13437] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/01/2016] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND AIM Re-intervention after stent placement for malignant hepatic hilum obstruction (HBO) is challenging. endoscopic ultrasound-guided biliary drainage (EUS-BD) has been developed as an alternative method for failed endoscopic retrograde cholangiopancreatography (ERCP). In this retrospective study, the clinical utility of EUS-BD as a rescue drainage technique for HBO patients who failed re-intervention under ERCP guidance was evaluated. METHODS Between April 2012 and August 2015, patients with HBO were enrolled. Patients' characteristics, kinds of metallic stents, configuration of stent placement, overall survival, stent patency, and results of re-intervention were reviewed, along with the re-intervention technical success rate. RESULTS The biliary stricture type was Bismuth type IV in 59% (23/39) and types IIIa and b in 20.5% (8/39) each. Biliary metallic stent placement was bilateral in 38.5% (15/39), and unilateral in 61.5% (24/39). Primary stent dysfunction was observed in 71.8% (28/39) of cases. Planned re-intervention under ERCP guidance was attempted in 26 patients. The technical success rate was 62% (16/26). For the 10 patients who failed re-intervention under ERCP guidance, EUS-BD was planned. The technical success rate was 100% (10/10). The procedure time was 25.8 min. Adverse events were not seen in any patients. Stent patency after re-intervention was not significantly different between ERCP (165 days) guidance and EUS-BD (152 days) guidance (P = 0.463) CONCLUSIONS: In conclusion, EUS-BD as a re-intervention method for metallic stent obstruction was safe and feasible. If ERCP was failed, EUS-BD may be one of option as re-intervention method for high-grade hilar stricture.
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Affiliation(s)
- Takeshi Ogura
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Saori Onda
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Wataru Takagi
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Tatsushi Sano
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Atsushi Okuda
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Daisuke Masuda
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | | | - Akira Miyano
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Masayuki Kitano
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Toshihisa Takeuchi
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Shinya Fukunishi
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Kazuhide Higuchi
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
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15
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Teranishi K, Masayasu N, Masuda D. Mechanism Underlying the Onset of Internal Blue Discoloration in Japanese Radish (Raphanus sativus) Roots. J Agric Food Chem 2016; 64:6745-6751. [PMID: 27530819 DOI: 10.1021/acs.jafc.6b02103] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The internal blue discoloration observed in Japanese radish (Raphanus sativus L.) roots is a physiological phenomenon caused by storage following harvest at approximately 20 °C and poses a serious problem for farmers. Here, we describe the mechanism underlying the onset of internal blue discoloration of three cultivars: Hukuhomare, SC8-260, and Yuto. Each cultivar was maintained under the same conditions. Additionally, Hukuhomare radish roots were maintained at three different cultivation conditions in a related experiment. The blue discoloration in radish roots was caused by the oxidation of 4-hydroxyglucobrassicin as a result of an increase in oxidative stress involving peroxidase. Thus, the extent of blue discoloration was influenced by the chemical balance involving 4-hydroxyglucobrassicin content, antioxidant capacity, and oxidation activity.
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Affiliation(s)
- Katsunori Teranishi
- Graduate School of Bioresources, Mie University , 1577 Kurimamachiya, Tsu, Mie 514-8507, Japan
| | - Nagata Masayasu
- Food Research Institute, National Agriculture and Food Research Organization , 2-1-12 Kannondai, Tsukuba, Ibaraki 305-8642, Japan
| | - Daisuke Masuda
- Sand Dune Agricultural Research Center, Agricultural Experiment Station, Ishikawa Agriculture and Forestry Research Center , I 5-2 Uchihisumi, Kahoku, Ishikawa 929-1126, Japan
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16
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Masuda D. Serum apolipoprotein B48 concentration is high in patients with impaired glucose tolerance and increases after oral glucose ingestion in patients with diabetes mellitus. Atherosclerosis 2016. [DOI: 10.1016/j.atherosclerosis.2016.07.689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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17
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Sairyo M, Masuda D, Kobayashi T, Matsuda H, Okada T, Kawase R, Nakatani K, Koseki M, Ohama T, Nishida M, Sakata Y, Yamashita S. DPP4 inhibitor, anagliptin, ameliorates fasting and postprandial hypertriglyceridemia. Atherosclerosis 2016. [DOI: 10.1016/j.atherosclerosis.2016.07.159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Ogura T, Onda S, Takagi W, Kitano M, Sano T, Okuda A, Miyano A, Masuda D, Takeuchi T, Fukunishi S, Higuchi K. Placement of a 6 mm, fully covered metal stent for main pancreatic head duct stricture due to chronic pancreatitis: a pilot study (with video). Therap Adv Gastroenterol 2016; 9:722-8. [PMID: 27582885 PMCID: PMC4984330 DOI: 10.1177/1756283x16651855] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Temporary stent placement is widely performed for pancreatic duct stenosis due to chronic pancreatitis. A fully covered self-expandable metal stent (FCSEMS) has a larger diameter, and therefore longer stent patency, and the effect of expansion of the main pancreatic duct stricture may be obtained. However, if stent migration upstream occurs, stent removal is extremely difficult. In addition, because of the diameter gap between the FCSEMS and the main pancreatic duct, stent-induced ductal change may occur. To prevent these adverse events, the technical feasibility, safety and efficacy of the placement of a novel 6 mm diameter FCSEMS with a long suture, to facilitate its removal in cases of stent migration upstream, were evaluated in a pilot study. METHODS Between December 2014 and August 2015, symptomatic chronic pancreatitis patients with abdominal pain and a main pancreatic head duct stricture were enrolled. Stent placement for main pancreatic duct stricture was performed under endoscopic retrograde cholangiopancreatography (ERCP) guidance and stent removal was performed within 6 months. RESULTS A total of 13 patients were retrospectively enrolled in this study. Metal stent insertion was successfully performed in all patients and clinical success was high (12/13, 92%). As adverse events, stent migration upstream was seen in two patients. Another 11 patients successfully underwent stent removal without any adverse events. During follow up (median 258 days), 2 patients still underwent pancreatic duct stenting because of continuing main pancreatic duct stricture. CONCLUSION In conclusion, this novel FCSEMS is acceptable for stent placement in cases of chronic pancreatitis with a main pancreatic duct stricture.
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Affiliation(s)
| | - Saori Onda
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Wataru Takagi
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Masayuki Kitano
- Department of Gastroenterology and Hepatology, Kinki University Faculty of Medicine, Osaka-sayama, Japan
| | - Tastsushi Sano
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Atsushi Okuda
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Akira Miyano
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Daisuke Masuda
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Toshihisa Takeuchi
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Shinya Fukunishi
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Kazuhide Higuchi
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
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Ogura T, Takagi W, Onda S, Masuda D, Takeuchi T, Fukunishi S, Higuchi K. Endoscopic ultrasound-guided biliary drainage with a novel fine-gauge balloon catheter: simplified technique using a coaxial guidewire. Endoscopy 2016; 47 Suppl 1:E573-4. [PMID: 26610090 DOI: 10.1055/s-0034-1393380] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Takeshi Ogura
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Wataru Takagi
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Saori Onda
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Daisuke Masuda
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Toshihisa Takeuchi
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Shinya Fukunishi
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Kazuhide Higuchi
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
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Ogura T, Takagi W, Onda S, Sano T, Masuda D, Fukunishi S, Higuchi K. Hole-making technique for the treatment for acute pancreatitis due to placement of a fully covered duodenal metallic stent. Endoscopy 2016; 47 Suppl 1 UCTN:E486-7. [PMID: 26479298 DOI: 10.1055/s-0034-1393146] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Takeshi Ogura
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Wataru Takagi
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Saori Onda
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Tatsushi Sano
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Daisuke Masuda
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Shinya Fukunishi
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Kazuhide Higuchi
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
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Ogura T, Takagi W, Onda S, Masuda D, Takeuchi T, Fukunishi S, Higuchi K. Spontaneous tearing of a duodenal metallic stent: a rare adverse event. Endoscopy 2016; 47 Suppl 1 UCTN:E495-6. [PMID: 26479302 DOI: 10.1055/s-0034-1393139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
- Takeshi Ogura
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Wataru Takagi
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Saori Onda
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Daisuke Masuda
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Toshihisa Takeuchi
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Shinya Fukunishi
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Kazuhide Higuchi
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
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Ogura T, Masuda D, Takeuchi T, Fukunishi S, Higuchi K. Fistula formation after EUS-guided hepaticogastrostomy. Gastrointest Endosc 2016; 84:365. [PMID: 26969096 DOI: 10.1016/j.gie.2016.02.041] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Accepted: 02/27/2016] [Indexed: 02/08/2023]
Affiliation(s)
- Takeshi Ogura
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Daisuke Masuda
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Toshihisa Takeuchi
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Shinya Fukunishi
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Kazuhide Higuchi
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
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Masuda D, Ogura T, Imoto A, Onda S, Sano T, Takagi W, Okuda A, Takeuchi T, Fukunishi S, Inoue T, Higuchi K. Choledochoduodenal Fistula after the Placement of a Partially Covered Metal Stent for Unresectable Pancreatic Cancer. Intern Med 2016; 55:1591-7. [PMID: 27301511 DOI: 10.2169/internalmedicine.55.6060] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
A 75-year-old Japanese man with type 2 diabetes mellitus suffered from unresectable pancreatic head cancer and was admitted to our institution due to acute cholangitis. A partially covered metal stent was placed at that time. 11 months later, he was readmitted for acute cholangitis. Upper endoscopy revealed complete stent distal migration and a small hole on the oral side of the ampulla. While attempting cannulation into the hole, an upstream biliary tract was revealed. Accordingly, we diagnosed the patient to have a choledochoduodenal fistula. After metal stent removal and balloon dilation, we placed two 7 Fr plastic stents, which successfully relieved the patient's cholangitis.
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Affiliation(s)
- Daisuke Masuda
- The Second Department of Internal Medicine, Osaka Medical College, Japan
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Ogura T, Masuda D, Takeuchi T, Fukunishi S, Higuchi K. Novel covered pancreatic metal stents for the treatment of bleeding after endoscopic pancreatic sphincterotomy. Gastrointest Endosc 2016; 83:1293-5. [PMID: 26555300 DOI: 10.1016/j.gie.2015.10.049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Accepted: 10/31/2015] [Indexed: 12/11/2022]
Affiliation(s)
- Takeshi Ogura
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Daisuke Masuda
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Toshihisa Takeuchi
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Shinya Fukunishi
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Kazuhide Higuchi
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
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Ogura T, Takagi W, Onda S, Masuda D, Kitano M, Imoto A, Higuchi K. Endoscopic ultrasound-guided drainage of a right liver abscess with a self-expandable metallic stent. Endoscopy 2016; 47 Suppl 1 UCTN:E397-8. [PMID: 26273779 DOI: 10.1055/s-0034-1392632] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
- Takeshi Ogura
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Wataru Takagi
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Saori Onda
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Daisuke Masuda
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Masayuki Kitano
- Department of Gastroenterology and Hepatology, Kinki University Faculty of Medicine, Osaka-Sayama, Japan
| | - Akira Imoto
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Kazuhide Higuchi
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
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Onda S, Ogura T, Kurisu Y, Masuda D, Sano T, Takagi W, Fukunishi S, Higuchi K. EUS-guided FNA for biliary disease as first-line modality to obtain histological evidence. Therap Adv Gastroenterol 2016; 9:302-12. [PMID: 27134660 PMCID: PMC4830098 DOI: 10.1177/1756283x15625584] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Few reports have described endoscopic ultrasound (EUS)-guided fine needle aspiration (FNA) for biliary lesions. In addition, adverse events were not completely examined in previous reports, due to the inclusion of cases in which biliary stents had already been placed. The present study aimed to investigate the diagnostic yield and adverse events of EUS-FNA for biliary lesions as the first-line diagnostic modality for consecutive prospectively registered patients. METHODS Inclusion criteria were as follows: (1) patients with suspected cholangiocarcinoma (CCA) based on computed tomography or other imaging modalities; (2) patients who had not previously undergone endoscopic retrograde cholangiopancreatography or EUS-FNA; (3) absence of surgically altered anatomy, such as Roux-en-Y anastomosis or duodenal obstruction caused by tumor invasion, through which an endoscope could not pass; and (4) provision of written informed consent to all procedures associated with the study. RESULTS A total of 47 consecutive patients with suspected CCA were registered to this study. Sensitivity and accuracy were 89% and 87%, respectively. On multivariate analysis, puncture site was the only factor associated with reduced diagnostic yield (hazard ration, 6.879; 95% confidence interval, 1.172-40.374; P = 0.033). Remarkably, no adverse events such as bleeding or bile leakage were associated with EUS-FNA in any of the 47 patients. CONCLUSIONS Our results suggest that EUS-FNA can be safely performed for biliary disease without biliary stenting. Furthermore, this procedure may warrant use as the first-line diagnostic method, although our results need to be validated in future prospective studies.
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Affiliation(s)
- Saori Onda
- Second Department of Internal Medicine, Osaka Medical College, Japan
| | | | | | - Daisuke Masuda
- Second Department of Internal Medicine, Osaka Medical College, Japan
| | - Tatsushi Sano
- Second Department of Internal Medicine, Osaka Medical College, Japan
| | - Wataru Takagi
- Second Department of Internal Medicine, Osaka Medical College, Japan
| | - Shinya Fukunishi
- Second Department of Internal Medicine, Osaka Medical College, Japan
| | - Kazuhide Higuchi
- Second Department of Internal Medicine, Osaka Medical College, Japan
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27
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Malak M, Masuda D, Ogura T, Imoto A, Abdelaal UM, Sabet EA, Abo Dahab LH, Higuchi K. Yield of endoscopic ultrasound-guided fine needle aspiration and endoscopic retrograde cholangiopancreatography for solid pancreatic neoplasms. Scand J Gastroenterol 2016; 51:360-7. [PMID: 26365063 DOI: 10.3109/00365521.2015.1086019] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE Both endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) and endoscopic retrograde cholangiopancreatography (ERCP) cytology may provide tissue diagnoses in solid pancreatic neoplasms. However, there are scant data comparing these two methods. This study aims at retrospectively comparing EUS-FNA and ERCP tissue sampling and ability of cytopathological diagnosis in solid pancreatic neoplasms and to determine usefulness and adverse events of combining both procedures. MATERIAL AND METHODS Two hundred and thirty four patients suspected to have solid pancreatic mass on abdominal ultrasound and/or computed tomography (CT) were enrolled. EUS-FNA (group A), ERCP cytology (group B) and combined procedures (Group C) performed in 105, 91 and 38 cases, respectively. RESULTS Sensitivity, specificity and accuracy were 98.9%, 93.3% and 98.1% for group A, and 72.1%, 60% and 71.4% for group B. Those for group C were all 100%. Sensitivity for malignancy in the pancreas head was 100% for group A and 82.4% for group B, and in the pancreas body and tail, 97.6% for group A and 57.1% for group B. EUS-FNA was more sensitive than ERCP cytology in diagnosing malignant pancreatic neoplasms 21-30 mm in size (p = 0.0068), 31-40 mm (p = 0.028) and ≥ 41 mm (p < 0.0001). Sensitivity for pancreatic malignancy with group C was 100% regardless of mass location or size. Adverse events were 1.9%, 6.6% and 2.6% following EUS-FNA, ERCP and combined procedures, respectively. CONCLUSIONS EUS-FNA is superior to ERCP cytology for diagnosis of solid pancreatic neoplasms. Although combination of both procedures provide efficient tissue diagnosis and with a minimal adverse events rate, a prospective study including larger number of patients is required.
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Affiliation(s)
- Mohamed Malak
- a Second Department of Internal Medicine , Osaka Medical College , 2-7, Daigakumachi , Osaka , Japan and.,b Department of Internal Medicine, Sohag Faculty of Medicine , Sohag University , Nasser city, Sohag , Egypt
| | - Daisuke Masuda
- a Second Department of Internal Medicine , Osaka Medical College , 2-7, Daigakumachi , Osaka , Japan and
| | - Takeshi Ogura
- a Second Department of Internal Medicine , Osaka Medical College , 2-7, Daigakumachi , Osaka , Japan and
| | - Akira Imoto
- a Second Department of Internal Medicine , Osaka Medical College , 2-7, Daigakumachi , Osaka , Japan and
| | - Usama M Abdelaal
- b Department of Internal Medicine, Sohag Faculty of Medicine , Sohag University , Nasser city, Sohag , Egypt
| | - Eman A Sabet
- b Department of Internal Medicine, Sohag Faculty of Medicine , Sohag University , Nasser city, Sohag , Egypt
| | - Lotfy H Abo Dahab
- b Department of Internal Medicine, Sohag Faculty of Medicine , Sohag University , Nasser city, Sohag , Egypt
| | - Kazuhide Higuchi
- a Second Department of Internal Medicine , Osaka Medical College , 2-7, Daigakumachi , Osaka , Japan and
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Ogura T, Chiba Y, Masuda D, Kitano M, Sano T, Saori O, Yamamoto K, Imaoka H, Imoto A, Takeuchi T, Fukunishi S, Higuchi K. Comparison of the clinical impact of endoscopic ultrasound-guided choledochoduodenostomy and hepaticogastrostomy for bile duct obstruction with duodenal obstruction. Endoscopy 2016; 48:163. [PMID: 26418074 DOI: 10.1055/s-0034-1393251] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
- Takeshi Ogura
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Yasutaka Chiba
- Clinical Research Center, Kinki University Hospital, Osaka-Sayama, Japan
| | - Daisuke Masuda
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Masayuki Kitano
- Department of Gastroenterology and Hepatology, Kinki University Faculty of Medicine, Osaka-Sayama, Japan
| | - Tatsushi Sano
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Onda Saori
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | | | - Hiroshi Imaoka
- Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Akira Imoto
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Toshihisa Takeuchi
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Shinya Fukunishi
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Kazuhide Higuchi
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
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Ogura T, Chiba Y, Masuda D, Kitano M, Sano T, Saori O, Yamamoto K, Imaoka H, Imoto A, Takeuchi T, Fukunishi S, Higuchi K. Comparison of the clinical impact of endoscopic ultrasound-guided choledochoduodenostomy and hepaticogastrostomy for bile duct obstruction with duodenal obstruction. Endoscopy 2016; 48:156-63. [PMID: 26382307 DOI: 10.1055/s-0034-1392859] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND STUDY AIM To date, only a few reports with small numbers of patients have described double stenting (biliary and duodenal), in particular endoscopic ultrasound (EUS)-guided biliary drainage, for patients with obstructive jaundice. In addition, no reports have sought to determine which EUS-guided biliary drainage route has better outcomes. The aim of the current study was to investigate adverse events and stent patency in patients who underwent EUS-guided biliary drainage and duodenal stenting. PATIENTS AND METHODS Patients who were admitted to the Osaka Medical College with obstructive jaundice caused by lower biliary obstruction and duodenal obstruction due to malignant tumor between June 2012 and April 2014 were retrospectively enrolled in the study. RESULTS A total of 39 patients were enrolled in the study; 13 underwent EUS-guided choledochoduodenostomy (EUS-CDS), and 26 underwent EUS-guided hepaticogastrostomy (EUS-HGS). Adjusted analyses for covariates using propensity scores showed that the EUS-HGS group had significantly longer stent patency than the EUS-CDS group (duodenal stent patency: median 113 vs. 34 days; hazard ratio [HR] 0.415, 95 % confidence interval [CI] 0.175 - 0.984; P = 0.046; biliary stent patency: median 133 vs. 37 days; HR 0.391, 95 %CI 0.156 - 0.981; P = 0.045). On logistic regression analysis, only EUS-CDS was associated with adverse events, in particular reflux cholangitis (OR 10.285, 95 %CI 1.686 - 62.733; P = 0.012). CONCLUSION In cases of obstructive jaundice with duodenal obstruction, EUS-HGS may be better than EUS-CDS, with longer stent patency and fewer adverse events.
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Affiliation(s)
- Takeshi Ogura
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Yasutaka Chiba
- Clinical Research Center, Kinki University Hospital, Osaka-Sayama, Japan
| | - Daisuke Masuda
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Masayuki Kitano
- Department of Gastroenterology and Hepatology, Kinki University Faculty of Medicine, Osaka-Sayama, Japan
| | - Tatsushi Sano
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Onda Saori
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | | | - Hiroshi Imaoka
- Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Akira Imoto
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Toshihisa Takeuchi
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Shinya Fukunishi
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Kazuhide Higuchi
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
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Ogura T, Sano T, Onda S, Masuda D, Imoto A, de Higuchi K. Endoscopic ultrasound-guided biliary drainage with a novel fine-gauge balloon catheter: one-step placement technique. Endoscopy 2016; 47 Suppl 1 UCTN:E245-6. [PMID: 26069985 DOI: 10.1055/s-0034-1391859] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Takeshi Ogura
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Tatsushi Sano
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Saori Onda
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Daisuke Masuda
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Akira Imoto
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Kazuh de Higuchi
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
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Ogura T, Kurisu Y, Yamamoto K, Masuda D, Imoto A, Fukunishi S, Higuchi K. Placement of a novel fully covered metallic stent for refractory pancreatic duct stricture. Endoscopy 2016; 47 Suppl 1 UCTN:E206-7. [PMID: 26062150 DOI: 10.1055/s-0034-1391652] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
- Takeshi Ogura
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | | | | | - Daisuke Masuda
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Akira Imoto
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Shinya Fukunishi
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Kazuhide Higuchi
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
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Imoto A, Masuda D, Okuda A, Takagi W, Onda S, Sano T, Amano M, Abderaal U, Ogura T, Kurisu Y, Higuchi K. Asymptomatic Duodenal Metastasis From Small Cell Lung Cancer Diagnosed by Endoscopic Ultrasound-Guided Fine-Needle Aspiration. J Med Cases 2016. [DOI: 10.14740/jmc2624w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Takagi W, Ogura T, Sano T, Onda S, Okuda A, Masuda D, Imoto A, Takeuchi T, Fukunishi S, Higuchi K. EUS-guided cholecystoduodenostomy for acute cholecystitis with an anti-stent migration and anti-food impaction system; a pilot study. Therap Adv Gastroenterol 2016; 9:19-25. [PMID: 26770264 PMCID: PMC4699274 DOI: 10.1177/1756283x15609285] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Recently, endoscopic ultrasound-guided gall bladder drainage (EUS-GBD) has been reported using a self-expandable metallic stent. To prevent stent migration and food flowing into the common bile duct through the cystic duct, we perform a novel EUS-guided cholecystoduodenostomy. The aim of our study was to evaluate the safety and feasibility of EUS-guided cholecystoduodenostomy with an anti-stent migration and anti-food impaction system. METHODS A total of 16 consecutive patients who underwent EUS-guided cholecystoduodenostomy for acute cholecystitis were included in this study. RESULTS Technical and clinical success was obtained in all patients. The median procedure time was 26.9 min (range 19-42 min). Median follow-up time was 181.5 days (range 18-604 days), and in this time, recurrence of acute cholecystitis was not seen in all patients. Adverse events such as stent migration and cholangitis were not seen in any patients, although pneumoperitoneum was seen in one patient. CONCLUSION Our technique may be favorable and effective for the prevention of adverse events on EUS-GBD.
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Affiliation(s)
- Wataru Takagi
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | | | - Tatsushi Sano
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Saori Onda
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Atsushi Okuda
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Daisuke Masuda
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Akira Imoto
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Toshihisa Takeuchi
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Shinya Fukunishi
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Kazuhide Higuchi
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
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Ogura T, Masuda D, Saori O, Wataru T, Sano T, Okuda A, Miyano A, Kitano M, Abdel-Aal UM, Takeuchi T, Fukunishi S, Higuchi K. Clinical Outcome of Endoscopic Ultrasound-Guided Liver Abscess Drainage Using Self-Expandable Covered Metallic Stent (with Video). Dig Dis Sci 2016; 61:303-8. [PMID: 26254774 DOI: 10.1007/s10620-015-3841-3] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2015] [Accepted: 08/01/2015] [Indexed: 02/06/2023]
Abstract
BACKGROUND Percutaneous drainage (PCD) is now the first-line drainage method for liver abscess because of its minimal invasiveness and high technical success rate. However, this procedure has several disadvantages, such as extra-drainage and self-tube removal. Recently, EUS-guided liver abscess drainage (EUS-AD) has been developed. However, only a few reports of EUS-AD have been reported. In addition, the clinical benefits of PCD and EUS-AD have not been reported. AIMS In the present study, the safety and feasibility of EUS-AD using fully covered SEMS (FCSEMS) and the clinical outcomes of EUS-AD and PCD were examined retrospectively. METHODS Twenty-seven consecutive patients who underwent PCD or EUS-AD between April 2012 and April 2015 were included in this study. EUS-AD was performed using FCSEMS. In addition, to prevent stent migration, 7-Fr pig tail plastic stent was placed within FCSEMS. RESULTS Technical success was achieved in all patients of both groups. Clinical success was 100 % in the EUS-AD group although it was 89 % in PCD group (P = 034). Three adverse events were seen in the PCD group (self-tube removal n = 1, tube migration n = 2), but no adverse events were seen in the EUS-AD group. The median hospital stay was significantly shorter in the EUS-AD group than in the PCD group (21 vs 41 days, P = 0.03). CONCLUSION Because of the short hospital stay, the high clinical success rate, and the low adverse event rate compared to PCD, EUS-AD has potential as a first-line treatment for liver abscess.
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Affiliation(s)
- Takeshi Ogura
- 2nd Department of Internal Medicine, Osaka Medical College, 1-1 Daigakuchou, Takatsukishi, Osaka, 464-8681, Japan.
| | - Daisuke Masuda
- 2nd Department of Internal Medicine, Osaka Medical College, 1-1 Daigakuchou, Takatsukishi, Osaka, 464-8681, Japan
| | - Onda Saori
- 2nd Department of Internal Medicine, Osaka Medical College, 1-1 Daigakuchou, Takatsukishi, Osaka, 464-8681, Japan
| | - Takagi Wataru
- 2nd Department of Internal Medicine, Osaka Medical College, 1-1 Daigakuchou, Takatsukishi, Osaka, 464-8681, Japan
| | - Tatsushi Sano
- 2nd Department of Internal Medicine, Osaka Medical College, 1-1 Daigakuchou, Takatsukishi, Osaka, 464-8681, Japan
| | - Atsushi Okuda
- 2nd Department of Internal Medicine, Osaka Medical College, 1-1 Daigakuchou, Takatsukishi, Osaka, 464-8681, Japan
| | - Akira Miyano
- 2nd Department of Internal Medicine, Osaka Medical College, 1-1 Daigakuchou, Takatsukishi, Osaka, 464-8681, Japan
| | - Masayuki Kitano
- Department of Gastroenterology and Hepatology, Kinki University Faculty of Medicine, Osaka-sayama, Japan
| | - Usama M Abdel-Aal
- Division of Gastroenterology, Department of Internal Medicine, Sohag University, Sohag, Egypt
| | - Toshihisa Takeuchi
- 2nd Department of Internal Medicine, Osaka Medical College, 1-1 Daigakuchou, Takatsukishi, Osaka, 464-8681, Japan
| | - Shinya Fukunishi
- 2nd Department of Internal Medicine, Osaka Medical College, 1-1 Daigakuchou, Takatsukishi, Osaka, 464-8681, Japan
| | - Kazuhide Higuchi
- 2nd Department of Internal Medicine, Osaka Medical College, 1-1 Daigakuchou, Takatsukishi, Osaka, 464-8681, Japan
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Ogura T, Masuda D, Takeuchi T, Fukunishi S, Higuchi K. Liver impaction technique to prevent shearing of the guidewire during endoscopic ultrasound-guided hepaticogastrostomy. Endoscopy 2015; 47:E583-E584. [PMID: 26649471 DOI: 10.1055/s-0034-1393381] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Affiliation(s)
- Takeshi Ogura
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Daisuke Masuda
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Toshihisa Takeuchi
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Shinya Fukunishi
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Kazuhide Higuchi
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
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Ogura T, Yamamoto K, Sano T, Onda S, Imoto A, Masuda D, Takagi W, Fukunishi S, Higuchi K. Stent length is impact factor associated with stent patency in endoscopic ultrasound-guided hepaticogastrostomy. J Gastroenterol Hepatol 2015; 30:1748-52. [PMID: 26083496 DOI: 10.1111/jgh.13021] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Revised: 05/21/2015] [Accepted: 05/24/2015] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND STUDY AIM Despite high technical and functional success rates with endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS), rates of adverse events have also been high. No reports have focused on EUS-HGS alone with a large sample size about predictors of stent patency. The present study examined predictors of stent patency in patients who underwent EUS-HGS. PATIENTS AND METHODS The consecutive 51 patients who underwent EUS-HGS using one metallic stent were retrospectively enrolled in this study. Baseline characteristics, stent length from the hepatic portion and in the luminal portion, kinds of stent dysfunction, and stent patency were reviewed. RESULTS Median duration of stent patency was significantly shorter with stent length in the luminal portion <3 cm (52 days) than with ≥3 cm (195 days; P < 0.01). On the other hand, median duration of stent patency did not differ significantly between ≥4 cm (194 days) and <4 cm (127 days; P = 0.1726). Length of stent in the luminal portion ≥3 cm (Hazard ration [HR], 9.242; 95% confidence interval [CI], 3.255-26.244, P < 0.05) and performance of chemotherapy (HR, 3.022; 95% CI, 1.448-6.304, P < 0.05) were also associated with long stent patency on the Cox proportional hazards model. CONCLUSION In conclusion, to obtain long-term stent patency, our data suggest that a stent length ≥3 cm in the luminal portion may be suitable for EUS-HGS.
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Affiliation(s)
- Takeshi Ogura
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | | | - Tatsushi Sano
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Saori Onda
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Akira Imoto
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Daisuke Masuda
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Wataru Takagi
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Shinya Fukunishi
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Kazuhide Higuchi
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
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Masuda D, Masuda R, Matsuzaki T, Imamura N, Aruga N, Tanaka M, Inokuchi S, Kijima H, Iwazaki M. Ki-67 labeling index affects tumor infiltration patterns of lung squamous cell carcinoma. Mol Med Rep 2015; 12:7303-9. [PMID: 26459875 PMCID: PMC4626199 DOI: 10.3892/mmr.2015.4354] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2014] [Accepted: 01/09/2015] [Indexed: 12/21/2022] Open
Abstract
Ki-67 is a nuclear protein that is expressed during the G1, S, G2 and M phases of the mitotic cell cycle. A previous study categorized tumor infiltration patterns (INF), of which INFc indicated cancer nests exhibiting infiltrative growth and an unclear boundary between tumor tissue and surrounding healthy tissue. The present study used the Ki-67 labeling index (Ki-67 LI) as an indicator of cell proliferation, in order to examine the factors affecting INF in lung squamous cell carcinoma (SqCC). SqCC specimens (89) were classified into two groups: High-grade cell proliferation (Ki-67 LI ≥30%) and low-grade cell proliferation (Ki-67 LI <30%). However, a high Ki-67 LI was significantly associated with cases that had an INFc component [INFc(+); P=0.03]. Univariate analyses indicated that INFc(+) was a predictor of venous invasion [P=0.032; odds ratio (OR), 2.615; 95% confidence interval (95% CI), 1.085–6.305], scirrhous stromal type (P<0.001; OR, 6.462; 95% CI, 2.483–16.817) and high Ki-67 LI (P=0.018; OR, 12.543; 95% CI, 1.531–102.777). Multivariate logistic analyses indicated that high Ki-67 LI was the strongest predictor of INFc(+) (P=0.028; OR, 8.027; 95% CI, 1.248–51.624). In conclusion, high-grade cell proliferation activity may contribute to aggressive infiltrative growth of lung SqCC.
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Affiliation(s)
- Daisuke Masuda
- Department of General Thoracic Surgery, Tokai University School of Medicine, Isehara, Kanagawa 259‑1193, Japan
| | - Ryota Masuda
- Department of General Thoracic Surgery, Tokai University School of Medicine, Isehara, Kanagawa 259‑1193, Japan
| | - Tomohiko Matsuzaki
- Department of General Thoracic Surgery, Tokai University School of Medicine, Isehara, Kanagawa 259‑1193, Japan
| | - Naoko Imamura
- Department of General Thoracic Surgery, Tokai University School of Medicine, Isehara, Kanagawa 259‑1193, Japan
| | - Naohiro Aruga
- Department of General Thoracic Surgery, Tokai University School of Medicine, Isehara, Kanagawa 259‑1193, Japan
| | - Makiko Tanaka
- Department of Pathology and Bioscience, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori 036‑8562, Japan
| | - Sadaki Inokuchi
- Department of Pathology and Bioscience, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori 036‑8562, Japan
| | - Hiroshi Kijima
- Department of Pathology and Bioscience, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori 036‑8562, Japan
| | - Masayuki Iwazaki
- Department of General Thoracic Surgery, Tokai University School of Medicine, Isehara, Kanagawa 259‑1193, Japan
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Ogura T, Sano T, Takagi W, Onda S, Masuda D, Imoto A, Higuchi K. Same-Session Balloon Dilation of Tight Esophageal Stenosis and Pseudocyst Drainage Using a Forward-Viewing Echoendoscope. Gastroenterology 2015; 149:541-3. [PMID: 26166316 DOI: 10.1053/j.gastro.2015.03.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2015] [Revised: 01/28/2015] [Accepted: 03/09/2015] [Indexed: 12/02/2022]
Affiliation(s)
- Takeshi Ogura
- 2(nd) Department of Internal Medicine, Osaka Medical College, Osaka, Japan.
| | - Tatsushi Sano
- 2(nd) Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Wataru Takagi
- 2(nd) Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Saori Onda
- 2(nd) Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Daisuke Masuda
- 2(nd) Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Akira Imoto
- 2(nd) Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Kazuhide Higuchi
- 2(nd) Department of Internal Medicine, Osaka Medical College, Osaka, Japan
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Indo HP, Tomiyoshi T, Suenaga S, Tomita K, Suzuki H, Masuda D, Terada M, Ishioka N, Gusev O, Cornette R, Okuda T, Mukai C, Majima HJ. MnSOD downregulation induced by extremely low 0.1 mGy single and fractionated X-rays and microgravity treatment in human neuroblastoma cell line, NB-1. J Clin Biochem Nutr 2015; 57:98-104. [PMID: 26388666 PMCID: PMC4566025 DOI: 10.3164/jcbn.15-20] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2015] [Accepted: 02/16/2015] [Indexed: 11/22/2022] Open
Abstract
A human neuroblastoma cell line, NB-1, was treated with 24 h of microgravity simulation by clinostat, or irradiated with extremely small X-ray doses of 0.1 or 1.0 mGy using single and 10 times fractionation regimes with 1 and 2 h time-intervals. A quantitative real-time reverse transcription polymerase chain reaction (qRT-PCR) examination was performed for apoptosis related factors (BAX, CYTC, APAF1, VDAC1–3, CASP3, CASP8, CASP9 P53, AIF, ANT1 and 2, BCL2, MnSOD, autophagy related BECN and necrosis related CYP-40. The qRT-PCR results revealed that microgravity did not result in significant changes except for a upregulation of proapoptotic VDAC2, and downregulations of proapoptotic CASP9 and antiapoptotic MnSOD. After 0.1 mGy fractionation irradiation, there was increased expression of proapoptotic APAF1 and downregulation of proapoptotic CYTC, VDAC2, VDAC3, CASP8, AIF, ANT1, and ANT2, as well as an increase in expression of antiapoptotic BCL2. There was also a decrease in MnSOD expression with 0.1 mGy fractionation irradiation. These results suggest that microgravity and low-dose radiation may decrease apoptosis but may potentially increase oxidative stress.
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Affiliation(s)
- Hiroko P Indo
- Department of Oncology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima 890-8544, Japan
| | - Tsukasa Tomiyoshi
- Department of Oncology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima 890-8544, Japan
| | - Shigeaki Suenaga
- Department of Oncology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima 890-8544, Japan
| | - Kazuo Tomita
- Department of Oncology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima 890-8544, Japan
| | - Hiromi Suzuki
- Department of Space Environmental Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima 890-8544, Japan ; Life Science Research Group, Department of Science and Applications, Japan Space Forum, 3-2-1 Surugadai, Chiyoda, Tokyo 100-0004, Japan
| | - Daisuke Masuda
- Department of Space Environmental Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima 890-8544, Japan ; Utilization & Engineering Department, Japan Manned Space Systems Corporation, 2-1-6 Tsukuba, Ibaraki 305-0047, Japan
| | - Masahiro Terada
- Department of Space Environmental Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima 890-8544, Japan ; Space Biosciences Division, NASA Ames Research Center, Moffett Field, California 94035, USA
| | - Noriaki Ishioka
- Department of Space Environmental Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima 890-8544, Japan ; Department of Space Biology and Microgravity Sciences, Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency, 2-1-1 Sengen, Tsukuba, Ibaraki 305-8505, Japan
| | - Oleg Gusev
- Department of Space Environmental Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima 890-8544, Japan ; Department of Space Biology and Microgravity Sciences, Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency, 2-1-1 Sengen, Tsukuba, Ibaraki 305-8505, Japan ; Department of Invertebrates Zoology and Functional Morphology, Institute of Fundamental Medicine and Biology, Kazan Federal University 420008, Kremevskaya str., 17 Kazan 420-008, Russia ; Anhydrobiosis Research Unit, National Institute of Agrobiological Sciences, 1-2 Ohwashi, Tsukuba, Ibaraki 305-8634, Japan
| | - Richard Cornette
- Anhydrobiosis Research Unit, National Institute of Agrobiological Sciences, 1-2 Ohwashi, Tsukuba, Ibaraki 305-8634, Japan
| | - Takashi Okuda
- Anhydrobiosis Research Unit, National Institute of Agrobiological Sciences, 1-2 Ohwashi, Tsukuba, Ibaraki 305-8634, Japan
| | - Chiaki Mukai
- Center for Applied Space Medicine and Human Research, Japan Aerospace Exploration Agency, 2-1-1 Sengen, Tsukuba, Ibaraki 305-8505, Japan
| | - Hideyuki J Majima
- Department of Oncology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima 890-8544, Japan ; Department of Space Environmental Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima 890-8544, Japan
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Hu M, Yang Y, Masuda D, Yamashita S, Tomlinson B. Is there a role for niacin in familial hypercholesterolaemia? Atherosclerosis 2015. [DOI: 10.1016/j.atherosclerosis.2015.04.383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Onda S, Ogura T, Sano T, Imoto A, Masuda D, Yamamoto K, Takeuchi T, Higuchi K. Successful removal of intrahepatic bile duct stone using a novel basket catheter. Gastrointest Endosc 2015; 81:1267. [PMID: 25440672 DOI: 10.1016/j.gie.2014.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2014] [Accepted: 09/02/2014] [Indexed: 12/11/2022]
Affiliation(s)
- Saori Onda
- Second Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Takeshi Ogura
- Second Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Tatsushi Sano
- Second Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Akira Imoto
- Second Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Daisuke Masuda
- Second Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | | | - Toshihisa Takeuchi
- Second Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Kazuhide Higuchi
- Second Department of Internal Medicine, Osaka Medical College, Osaka, Japan
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Ogura T, Onda S, Sano T, Takagi W, Kitano M, Masuda D, Imoto A, Fukunishi S, Higuchi K. EUS-Guided Antegrade Balloon Dilation From Right Hepatic Duct Combined With Retrograde Rendezvous Stent Placement. Gastroenterology 2015; 148:901-3. [PMID: 25758317 DOI: 10.1053/j.gastro.2015.03.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Revised: 02/06/2015] [Accepted: 03/02/2015] [Indexed: 12/19/2022]
Affiliation(s)
- Takeshi Ogura
- Second Department of Internal Medicine, Osaka Medical College, Osaka, Japan.
| | - Saori Onda
- Second Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Tatsushi Sano
- Second Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Wataru Takagi
- Second Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Masayuki Kitano
- Department of Gastroenterology and Hepatology, Kinki University Faculty of Medicine, Osaka-sayama, Japan
| | - Daisuke Masuda
- Second Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Akira Imoto
- Second Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Shinya Fukunishi
- Second Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Kazuhide Higuchi
- Second Department of Internal Medicine, Osaka Medical College, Osaka, Japan
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Fujiwara K, Inoue T, Yorifuji N, Iguchi M, Sakanaka T, Narabayashi K, Kakimoto K, Nouda S, Okada T, Ishida K, Abe Y, Masuda D, Takeuchi T, Fukunishi S, Umegaki E, Akiba Y, Kaunitz JD, Higuchi K. Combined treatment with dipeptidyl peptidase 4 (DPP4) inhibitor sitagliptin and elemental diets reduced indomethacin-induced intestinal injury in rats via the increase of mucosal glucagon-like peptide-2 concentration. J Clin Biochem Nutr 2015; 56:155-62. [PMID: 25759522 PMCID: PMC4345177 DOI: 10.3164/jcbn.14-111] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2014] [Accepted: 10/06/2014] [Indexed: 12/31/2022] Open
Abstract
The gut incretin glucagon-like peptide-1 (GLP-1) and the intestinotropic hormone GLP-2 are released from enteroendocrine L cells in response to ingested nutrients. Treatment with an exogenous GLP-2 analogue increases intestinal villous mass and prevents intestinal injury. Since GLP-2 is rapidly degraded by dipeptidyl peptidase 4 (DPP4), DPP4 inhibition may be an effective treatment for intestinal ulcers. We measured mRNA expression and DPP enzymatic activity in intestinal segments. Mucosal DPP activity and GLP concentrations were measured after administration of the DPP4 inhibitor sitagliptin (STG). Small intestinal ulcers were induced by indomethacin (IM) injection. STG was given before IM treatment, or orally administered after IM treatment with or without an elemental diet (ED). DPP4 mRNA expression and enzymatic activity were high in the jejunum and ileum. STG dose-dependently suppressed ileal mucosal enzyme activity. Treatment with STG prior to IM reduced small intestinal ulcer scores. Combined treatment with STG and ED accelerated intestinal ulcer healing, accompanied by increased mucosal GLP-2 concentrations. The reduction of ulcers by ED and STG was reversed by co-administration of the GLP-2 receptor antagonist. DPP4 inhibition combined with luminal nutrients, which up-regulate mucosal concentrations of GLP-2, may be an effective therapy for the treatment of small intestinal ulcers.
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Affiliation(s)
- Kaori Fujiwara
- Second Department of Internal Medicine, Osaka Medical College, 2-7 Daigakumachi, Takatsuki City, Osaka 569-8686, Japan
| | - Takuya Inoue
- Second Department of Internal Medicine, Osaka Medical College, 2-7 Daigakumachi, Takatsuki City, Osaka 569-8686, Japan
| | - Naoki Yorifuji
- Second Department of Internal Medicine, Osaka Medical College, 2-7 Daigakumachi, Takatsuki City, Osaka 569-8686, Japan
| | - Munetaka Iguchi
- Second Department of Internal Medicine, Osaka Medical College, 2-7 Daigakumachi, Takatsuki City, Osaka 569-8686, Japan
| | - Taisuke Sakanaka
- Second Department of Internal Medicine, Osaka Medical College, 2-7 Daigakumachi, Takatsuki City, Osaka 569-8686, Japan
| | - Ken Narabayashi
- Second Department of Internal Medicine, Osaka Medical College, 2-7 Daigakumachi, Takatsuki City, Osaka 569-8686, Japan
| | - Kazuki Kakimoto
- Second Department of Internal Medicine, Osaka Medical College, 2-7 Daigakumachi, Takatsuki City, Osaka 569-8686, Japan
| | - Sadaharu Nouda
- Second Department of Internal Medicine, Osaka Medical College, 2-7 Daigakumachi, Takatsuki City, Osaka 569-8686, Japan
| | - Toshihiko Okada
- Second Department of Internal Medicine, Osaka Medical College, 2-7 Daigakumachi, Takatsuki City, Osaka 569-8686, Japan
| | - Kumi Ishida
- Second Department of Internal Medicine, Osaka Medical College, 2-7 Daigakumachi, Takatsuki City, Osaka 569-8686, Japan
| | - Yosuke Abe
- Second Department of Internal Medicine, Osaka Medical College, 2-7 Daigakumachi, Takatsuki City, Osaka 569-8686, Japan
| | - Daisuke Masuda
- Second Department of Internal Medicine, Osaka Medical College, 2-7 Daigakumachi, Takatsuki City, Osaka 569-8686, Japan
| | - Toshihisa Takeuchi
- Second Department of Internal Medicine, Osaka Medical College, 2-7 Daigakumachi, Takatsuki City, Osaka 569-8686, Japan
| | - Shinya Fukunishi
- Second Department of Internal Medicine, Osaka Medical College, 2-7 Daigakumachi, Takatsuki City, Osaka 569-8686, Japan
| | - Eiji Umegaki
- Second Department of Internal Medicine, Osaka Medical College, 2-7 Daigakumachi, Takatsuki City, Osaka 569-8686, Japan
| | - Yasutada Akiba
- Greater Los Angeles Veterans Affairs Healthcare System and School of Medicine, Department of Medicine, University of California, Los Angeles, California, USA
| | - Jonathan D Kaunitz
- Greater Los Angeles Veterans Affairs Healthcare System and School of Medicine, Department of Medicine, University of California, Los Angeles, California, USA ; Greater Los Angeles Veterans Affairs Healthcare System and School of Medicine, Department of Surgery, University of California, Los Angeles, California, USA
| | - Kazuhide Higuchi
- Second Department of Internal Medicine, Osaka Medical College, 2-7 Daigakumachi, Takatsuki City, Osaka 569-8686, Japan
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Imoto A, Masuda D, Okuda A, Takagi W, Onda S, Sano T, Mikami T, Mohamed M, Ogura T, Higuchi K. A Duodenal Ulcer Caused by Pancreatic Ductal Hypertension with Chronic Pancreatitis. Intern Med 2015; 54:3151-5. [PMID: 26666602 DOI: 10.2169/internalmedicine.54.5779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
We herein describe the case of a 67-year-old woman with a duodenal ulcer thought to be caused by elevated pancreatic ductal pressure. The patient complained of continuous upper abdominal pain. Her medical history included idiopathic chronic pancreatitis. Endoscopy revealed a huge duodenal ulcer located on the inferior duodenal angle, which had not been seen on endoscopic retrograde pancreatography two months previously. A combination study using endoscopy and contrast imaging confirmed the relationship between the duodenal ulcer and the pancreatic branch duct. To our knowledge, this is the first case of duodenal ulcer thought to be caused by elevated pancreatic ductal pressure.
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Affiliation(s)
- Akira Imoto
- Second Department of Internal Medicine, Osaka Medical College, Japan
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Ogura T, Sano T, Onda S, Imoto A, Masuda D, Yamamoto K, Kitano M, Takeuchi T, Inoue T, Higuchi K. Endoscopic ultrasound-guided biliary drainage for right hepatic bile duct obstruction: novel technical tips. Endoscopy 2015; 47:72-5. [PMID: 25264761 DOI: 10.1055/s-0034-1378111] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Endoscopic ultrasound (EUS)-guided biliary drainage (EUS-BD) is not normally indicated for an obstructed right intrahepatic bile duct (IHBD). The technical feasibility and clinical efficacy of a novel technique of EUS-BD for right IHBD obstruction were evaluated. A total of 11 patients underwent drainage using either a left or a right biliary access route. The causes of obstructive jaundice were cholangiocarcinoma (n = 6), pancreatic cancer (n = 3), gastric cancer (n = 1), and colon cancer (n = 1). After placement of an uncovered metal stent to bridge the obstruction, a hepaticogastrostomy was completed using a covered stent. Mean procedure time was 33.9 ± 10.0 minutes. Technical and functional success were achieved in all patients, and no adverse events occurred. This novel method appears to be safe and effective for right IHBD obstruction.
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Affiliation(s)
- Takeshi Ogura
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Tatsushi Sano
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Saori Onda
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Akira Imoto
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Daisuke Masuda
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | | | - Masayuki Kitano
- Department of Gastroenterology and Hepatology, Kinki University Faculty of Medicine, Osaka-Sayama, Japan
| | - Toshihisa Takeuchi
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Takuya Inoue
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Kazuhide Higuchi
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
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Ogura T, Masuda D, Imoto A, Umegaki E, Higuchi K. EUS-guided gallbladder drainage and hepaticogastrostomy for acute cholecystitis and obstructive jaundice (with video). Endoscopy 2014; 46 Suppl 1 UCTN:E75-6. [PMID: 24639366 DOI: 10.1055/s-0033-1359135] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- Takeshi Ogura
- Second Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Daisuke Masuda
- Second Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Akira Imoto
- Second Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Eiji Umegaki
- Second Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Kazuhide Higuchi
- Second Department of Internal Medicine, Osaka Medical College, Osaka, Japan
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Ogura T, Kurisu Y, Masuda D, Imoto A, Onda S, Kamiyama R, Nishioka N, Uchiyama K, Higuchi K. Giant liver cyst caused by tuberculosis infection and masquerading as malignant peritonitis. Endoscopy 2014; 46 Suppl 1 UCTN:E191-2. [PMID: 24756290 DOI: 10.1055/s-0034-1365149] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
- Takeshi Ogura
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | | | - Daisuke Masuda
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Akira Imoto
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Saori Onda
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Rieko Kamiyama
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Nobu Nishioka
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Kazuhisa Uchiyama
- Department of General and Gastroenterological Surgery, Osaka Medical College, Osaka, Japan
| | - Kazuhide Higuchi
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
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Suga A, Yamada S, Takeichi H, Masuda D, Nakamura Y, Iwazaki M. Recurrence in regional pulmonary lymph nodes after surgery for isolated pulmonary metastasis from hepatocellular carcinoma. Gen Thorac Cardiovasc Surg 2014; 64:351-4. [PMID: 25359152 DOI: 10.1007/s11748-014-0490-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Accepted: 10/23/2014] [Indexed: 11/30/2022]
Abstract
Hepatocellular carcinoma occasionally metastasizes to extrahepatic organs, rarely to the mediastinal lymph nodes. We present the case of a 64-year-old man who presented with nodules in the upper and right lower lobes of the lung 4 years after undergoing resection of a hepatocellular carcinoma. We performed wedge resection of both lesions. Pathological examination showed that the lesion in the right upper lobe was non-small cell lung cancer and that in the right lower lobe hepatocellular carcinoma. We accordingly performed right upper lobectomy with lymph node dissection. Nine months later, enlarged subcarinal and segmental lymph nodes were detected and mediastinal lymph node metastases from the hepatocellular carcinoma diagnosed by transbronchial needle aspiration.
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Affiliation(s)
- Atsushi Suga
- Department of General Thoracic Surgery, Tokai University Hachioji Hospital, 1838 Ishikawa Hachioji, Tokyo, 192-0032, Japan.
| | - Shunsuke Yamada
- Department of General Thoracic Surgery, Tokai University Hachioji Hospital, 1838 Ishikawa Hachioji, Tokyo, 192-0032, Japan
| | - Haruka Takeichi
- Department of General Thoracic Surgery, Tokai University Hachioji Hospital, 1838 Ishikawa Hachioji, Tokyo, 192-0032, Japan
| | - Daisuke Masuda
- Department of General Thoracic Surgery, Tokai University Hachioji Hospital, 1838 Ishikawa Hachioji, Tokyo, 192-0032, Japan
| | - Yusuke Nakamura
- Department of General Thoracic Surgery, Tokai University Hachioji Hospital, 1838 Ishikawa Hachioji, Tokyo, 192-0032, Japan
| | - Masayuki Iwazaki
- Division of General Thoracic Surgery, Department of Surgery, Tokai University School of Medicine, Kanagawa, Japan
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Ogura T, Kurisu Y, Masuda D, Imoto A, Hayashi M, Malak M, Umegaki E, Uchiyama K, Higuchi K. Novel method of endoscopic ultrasound-guided hepaticogastrostomy to prevent stent dysfunction. J Gastroenterol Hepatol 2014; 29:1815-21. [PMID: 24720511 DOI: 10.1111/jgh.12598] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/27/2014] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND STUDY AIM The present study assesses the feasibility as well as the technical and functional success rates of a novel endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) technique called the locking stent method that uses end-bare covered metallic stents (EBCMS). METHODS Twenty consecutive patients who were histologically diagnosed with unresectable cancer complicated with obstructive jaundice underwent EUS-HGS due to failed endoscopic biliary drainage or inaccessible papilla. We retrospectively collected clinical data for these patients including technical and functional success rates and complications. RESULTS Seven were treated by EUS-HGS (EUS-HGS group), and 13 were treated using the locking stent EUS-HGS method (LS group). Technical and functional success rates were 100% in both groups. Procedural duration did not significantly differ between the EUS-HGS and LS groups (26.9 ± 9.0 versus 32.3 ± 11.1 min, P = 0.30). Two patients developed complications related to stent migration in the EUS-HGS group. In contrast, although mild post-procedural bile peritonitis required conservative treatment for a few days, none of the stents malfunctioned in the LS group. CONCLUSION Our method can safely and effectively prevent stent dysfunction, but validation in a prospective clinical trial is required.
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Affiliation(s)
- Takeshi Ogura
- 2nd Department of Internal Medicine, Osaka Medical College, Osaka, Japan
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Ogura T, Imoto A, Masuda D, Kamiyama R, Onda S, Higuchi K. Safe technique to treat occlusion of metallic endoscopic ultrasound-guided hepaticogastrostomy stent using a novel basket catheter (with video). Endoscopy 2014; 46 Suppl 1 UCTN:E234-5. [PMID: 24806374 DOI: 10.1055/s-0034-1365435] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
- Takeshi Ogura
- Second Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Akira Imoto
- Second Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Daisuke Masuda
- Second Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Rieko Kamiyama
- Second Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Saori Onda
- Second Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Kazuhide Higuchi
- Second Department of Internal Medicine, Osaka Medical College, Osaka, Japan
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