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Kuraoka N, Ujihara T, Sakai S, Okada H, Hashimoto S. Endoscopic hand-suturing for postoperative suture failure. Endoscopy 2024; 56:E179-E180. [PMID: 38388944 PMCID: PMC10883873 DOI: 10.1055/a-2257-3427] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/24/2024]
Affiliation(s)
- Naosuke Kuraoka
- Department of Gastroenterology, Saiseikai Kawaguchi General Hospital, Kawaguchi, Japan
| | - Tetsuro Ujihara
- Department of Gastroenterology, Saiseikai Kawaguchi General Hospital, Kawaguchi, Japan
| | - Shun Sakai
- Department of Gastroenterology, Saiseikai Kawaguchi General Hospital, Kawaguchi, Japan
| | - Haruhiko Okada
- Department of Gastrointestinal Surgery, Saiseikai Kawaguchi General Hospital, Kawaguchi, Japan
| | - Satoru Hashimoto
- Department of Gastroenterology, Saiseikai Kawaguchi General Hospital, Kawaguchi, Japan
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2
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Kuraoka N, Ujihara T, Sakai S. Cannulation of pancreaticojejunostomy anastomosis with a novel controllable catheter. J Hepatobiliary Pancreat Sci 2024. [PMID: 38183332 DOI: 10.1002/jhbp.1410] [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] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 11/30/2023] [Accepted: 12/08/2023] [Indexed: 01/08/2024]
Affiliation(s)
- Naosuke Kuraoka
- Department of Gastroenterology, Saiseikai Kawaguchi General Hospital, Kawaguchi, Saitama, Japan
| | - Tetsuro Ujihara
- Department of Gastroenterology, Saiseikai Kawaguchi General Hospital, Kawaguchi, Saitama, Japan
| | - Shun Sakai
- Department of Gastroenterology, Saiseikai Kawaguchi General Hospital, Kawaguchi, Saitama, Japan
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3
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Kuraoka N, Ujihara T, Kasahara H, Suzuki Y, Sakai S, Hashimoto S. The efficacy of a novel integrated outside biliary stent and nasobiliary drainage catheter system for acute cholangitis: a single center pilot study. Clin Endosc 2023; 56:795-801. [PMID: 37041733 PMCID: PMC10665624 DOI: 10.5946/ce.2022.289] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 12/13/2022] [Accepted: 12/14/2022] [Indexed: 04/13/2023] Open
Abstract
BACKGROUND/AIMS Endoscopic biliary drainage is the gold standard treatment for cholangitis. The two methods of biliary drainage are endoscopic biliary stenting and nasobiliary drainage. A novel integrated outside biliary stent and nasobiliary drainage catheter system (UMIDAS NB stent; Olympus Medical Systems) was recently developed. In this study, we evaluated the efficacy of this stent in the treatment of cholangitis caused by common bile duct stones or distal bile duct strictures. METHODS We conducted a retrospective pilot study by examining the medical records of patients who required endoscopic biliary drainage for cholangitis due to common bile duct stones or distal bile duct strictures, and who were treated with a UMIDAS NB stent, between December 2021 and July 2022. RESULTS Records of 54 consecutive patients were reviewed. Technical and clinical success rates were 47/54 (87.0%) and 52/54 (96.3%), respectively. Adverse events were observed in 12 patients, with six patients experiencing pancreatitis as an adverse event, following endoscopic retrograde cholangiopancreatography (ERCP). Regarding late adverse events, five cases of biliary stent migration into the bile duct were observed. Disease-related death occurred in one patient. CONCLUSION The outside-type UMIDAS NB stent is an efficacious new method for biliary drainage and can be applied to many indications.
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Affiliation(s)
- Naosuke Kuraoka
- Department of Gastroenterology, Saiseikai Kawaguchi General Hospital, Kawaguchi, Japan
| | - Tetsuro Ujihara
- Department of Gastroenterology, Saiseikai Kawaguchi General Hospital, Kawaguchi, Japan
| | - Hiromi Kasahara
- Department of Gastroenterology, Saiseikai Kawaguchi General Hospital, Kawaguchi, Japan
| | - Yuto Suzuki
- Department of Gastroenterology, Saiseikai Kawaguchi General Hospital, Kawaguchi, Japan
- Department of Gastroenterology, Dokkyo Medical University Saitama Medical Center, Koshigaya, Japan
| | - Shun Sakai
- Department of Gastroenterology, Saiseikai Kawaguchi General Hospital, Kawaguchi, Japan
| | - Satoru Hashimoto
- Department of Gastroenterology, Saiseikai Kawaguchi General Hospital, Kawaguchi, Japan
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Kuraoka N, Ujihara T, Sakai S, Hashimoto S. Electrohydraulic lithotripsy for a large biliary stone at a hepaticojejunal anastomosis site by refluxing water from a contrast catheter. Endosc Int Open 2023; 11:E466-E467. [PMID: 37180310 PMCID: PMC10169238 DOI: 10.1055/a-2041-2779] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/16/2023] Open
Affiliation(s)
- Naosuke Kuraoka
- Department of Gastroenterology, Saiseikai Kawaguchi General Hospital, Saitama, Japan
| | - Tetsuro Ujihara
- Department of Gastroenterology, Saiseikai Kawaguchi General Hospital, Saitama, Japan
| | - Shun Sakai
- Department of Gastroenterology, Saiseikai Kawaguchi General Hospital, Saitama, Japan
| | - Satoru Hashimoto
- Department of Gastroenterology, Saiseikai Kawaguchi General Hospital, Saitama, Japan
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Kuraoka N, Ujihara T, Hashimoto S. A case of cholestasis caused by inferior vena cava filter. J Hepatobiliary Pancreat Sci 2022; 29:e122-e123. [PMID: 35851574 DOI: 10.1002/jhbp.1217] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 05/26/2022] [Accepted: 07/06/2022] [Indexed: 12/24/2022]
Abstract
Cholestasis and obstructive jaundice can be caused by several factors. Kuraoka et al. report an extremely rare case of cholestasis due to occlusion of the distal bile duct by an inferior vena cava filter, which was confirmed on imaging. Jaundice improved after placement of a biliary stent.
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Affiliation(s)
- Naosuke Kuraoka
- Department of Gastroenterology, Saiseikai Kawaguchi General Hospital, Kawaguchi, Japan
| | - Tetsuro Ujihara
- Department of Gastroenterology, Saiseikai Kawaguchi General Hospital, Kawaguchi, Japan
| | - Satoru Hashimoto
- Department of Gastroenterology, Saiseikai Kawaguchi General Hospital, Kawaguchi, Japan
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6
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Kuraoka N, Hashimoto S, Matsui S. Remdesivir-Induced Pancreatitis in a Patient With Coronavirus Disease 2019. Pancreas 2022; 51:e88-e89. [PMID: 36206474 DOI: 10.1097/mpa.0000000000002088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
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Kuraoka N, Hashimoto S, Matsui S, Terai S. Outcomes of Endoscopic Ultrasound-Guided Biliary Drainage in a General Hospital for Patients with Endoscopic Retrograde Cholangiopancreatography-Difficult Transpapillary Biliary Drainage. J Clin Med 2021; 10:jcm10184105. [PMID: 34575216 PMCID: PMC8471391 DOI: 10.3390/jcm10184105] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 08/18/2021] [Accepted: 09/09/2021] [Indexed: 12/02/2022] Open
Abstract
Endoscopic ultrasound-guided biliary drainage (EUS-BD) has been developed as an alternative treatment for percutaneous transhepatic biliary drainage for patients with bile duct stenosis. At specialized hospitals, the high success rate and effectiveness of EUS-BD as primary drainage has been reported. However, the procedure is highly technical and difficult, and it has not been generally performed. In this study, we retrospectively examined the effectiveness of EUS-BD in ERCP-difficult patients with distal bile duct stenosis. We retrospectively examined 24 consecutive cases in which EUS-BD was performed at our hospital for distal bile duct stenosis from October 2018 to December 2020. EUS-guided choledochoduodenostomy (EUS-CDS) was selected for cases that could be approached from the duodenal bulb, and EUS-HGS was selected for other cases. In the EUS-CDS and EUS-HGS groups, the technical success rates were 83.3% (10/12] and 91.7% (11/12], respectively. An adverse event occurred in one case in the EUS-CDS group, which developed severe biliary peritonitis. The stent patency period was 91 and 101 days in the EUS-CDS and EUS-HGS groups, respectively. EUS-BD for ERCP-difficult patients with distal bile duct stenosis is considered to be an effective alternative for biliary drainage that can be performed not only in specialized hospitals but also in general hospitals.
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Affiliation(s)
- Naosuke Kuraoka
- Department of Gastroenterology, Saiseikai Kawaguchi General Hospital, 5-11-5 Nishikawaguchi, Kawaguchi, Saitama 332-8558, Japan; (S.H.); (S.M.)
- Correspondence: ; Tel.: +81-(48)-253-1551
| | - Satoru Hashimoto
- Department of Gastroenterology, Saiseikai Kawaguchi General Hospital, 5-11-5 Nishikawaguchi, Kawaguchi, Saitama 332-8558, Japan; (S.H.); (S.M.)
| | - Shigeru Matsui
- Department of Gastroenterology, Saiseikai Kawaguchi General Hospital, 5-11-5 Nishikawaguchi, Kawaguchi, Saitama 332-8558, Japan; (S.H.); (S.M.)
| | - Shuji Terai
- Department of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, 1-757 Asahimachidori, Niigata 951-8510, Japan;
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Kuraoka N, Hashimoto S, Matsui S. Endobiliary radiofrequency ablation through an EUS-guided hepaticogastrostomy fistula for hilar malignant biliary stenosis. Endosc Int Open 2021; 9:E699-E700. [PMID: 33937510 PMCID: PMC8062239 DOI: 10.1055/a-1393-5497] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Affiliation(s)
- Naosuke Kuraoka
- Department of Gastroenterology, Saiseikai Kawaguchi General Hospital
| | - Satoru Hashimoto
- Department of Gastroenterology, Saiseikai Kawaguchi General Hospital
| | - Shigeru Matsui
- Department of Gastroenterology, Saiseikai Kawaguchi General Hospital
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9
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Kuraoka N, Hashimoto S, Matsui S. Endoscopic ultrasound-guided hepaticogastrostomy using a new fully covered metallic stent without fistula dilatation. Dig Endosc 2020; 32:e122-e123. [PMID: 32609404 DOI: 10.1111/den.13726] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 04/22/2020] [Revised: 05/04/2020] [Accepted: 05/11/2020] [Indexed: 01/05/2023]
Affiliation(s)
- Naosuke Kuraoka
- Department of Gastroenterology, Saiseikai Kawaguchi General Hospital, Saitama, Japan
| | - Satoru Hashimoto
- Department of Gastroenterology, Saiseikai Kawaguchi General Hospital, Saitama, Japan
| | - Shigeru Matsui
- Department of Gastroenterology, Saiseikai Kawaguchi General Hospital, Saitama, Japan
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10
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Kuraoka N, Hara K, Okuno N, Kuwahara T, Mizuno N, Shimizu Y, Niwa Y, Terai S. Outcomes of EUS-guided choledochoduodenostomy as primary drainage for distal biliary obstruction with covered self-expandable metallic stents. Endosc Int Open 2020; 8:E861-E868. [PMID: 32617390 PMCID: PMC7297614 DOI: 10.1055/a-1161-8488] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 02/25/2020] [Indexed: 12/16/2022] Open
Abstract
Background and study aims Endoscopic ultrasonography-guided choledochoduodenostomy (EUS-CDS) is an alternative therapy for percutaneous transhepatic biliary drainage. Outcomes of EUS-CDS for distal biliary tract obstruction with a covered self-expandable metallic stent (SEMS) as a primary drainage technique are unclear because there are few relevant reports. This study aimed to determine outcomes in patients undergoing EUS-CDS using SEMS as the primary drainage technique for malignant distal biliary duct obstruction. Patients and methods This retrospective study was conducted at Aichi Cancer Center Hospital, from January 2010 to July 2018, using data from our database. Results EUS-CDS was performed as a primary drainage technique for 92 patients. The technical success rate was 92.8 %, and the clinical success rate was 91.6 %. The overall incidence of adverse events was 15.7 %. The median stent patency time for the EUS-CDS was 396 days. Nineteen patients required re-intervention because of cholangitis or jaundice. Conclusion EUS-CDS as a primary drainage technique using SEMS has high technical and clinical success rates. It should be considered an effective drainage method with respect to long-term stent patency, low re-intervention rates, and absence of severe complications.
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Affiliation(s)
- Naosuke Kuraoka
- Department of Gastroenterology, Aichi Cancer Center Hospital,Department of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University
| | - Kazuo Hara
- Department of Gastroenterology, Aichi Cancer Center Hospital
| | - Nozomi Okuno
- Department of Gastroenterology, Aichi Cancer Center Hospital
| | | | - Nobumasa Mizuno
- Department of Gastroenterology, Aichi Cancer Center Hospital
| | - Yasuhiro Shimizu
- Department of Gastroenterological Surgery, Aichi Cancer Center Hospital
| | - Yasumasa Niwa
- Department of Endoscopy, Aichi Cancer Center Hospital
| | - Shuji Terai
- Department of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University
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11
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Iwaya H, Hijioka S, Mizuno N, Kuwahara T, Okuno N, Tajika M, Tanaka T, Ishihara M, Hirayama Y, Onishi S, Ito A, Kuraoka N, Matsumoto S, Polmanee P, Shimizu Y, Yatabe Y, Niwa Y, Tamada K, Ido A, Hara K. Usefulness of septal thickness measurement on endoscopic ultrasound as a predictor of malignancy of branched-duct and mixed-type intraductal papillary mucinous neoplasm of the pancreas. Dig Endosc 2019; 31:672-681. [PMID: 30920028 DOI: 10.1111/den.13408] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [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: 09/13/2018] [Accepted: 03/25/2019] [Indexed: 12/15/2022]
Abstract
BACKGROUND AND AIM Septal thickness (ST) can predict a malignant branch-duct (BD) and mixed-type intraductal papillary mucinous neoplasm (IPMN) of the pancreas, but its cut-off value has not been established. The aim of the present study was to determine the optimal ST cut-off value to predict malignancy using endoscopic ultrasound (EUS). METHODS We retrospectively identified 200 patients with IPMN, including 132 with BD- and mixed-IPMN, who underwent surgical resection between 1989 and 2017. ST was defined as the septum or lesion wall with the maximum diameter in BD- and mixed-IPMN. The possibility of ST as a malignant predictor was examined, as well as the diagnostic ability of ST combined with mural nodule (MN) height for malignant IPMN. RESULTS Among the 132 IPMN patients, pathological diagnosis was benign in 81 (61.4%) and malignant in 51 (38.6%). Area under the curve for the diagnosis of malignancy using ST was 0.74 for pathological specimens, 0.70 for EUS and 0.56 for computed tomography. Multivariate analysis showed that the odds ratios for ST ≥2.5 mm and MN height ≥5 mm were 3.51 [95% confidence interval (CI), 1.55-7.97, P = 0.003] and 3.36 (95% CI, 1.52-7.45, P = 0.003), respectively. CONCLUSIONS Septal thickness was an independent predictive factor similar to MN height for malignant IPMN in a multivariate analysis. The ST on EUS appeared to be the thickness of a fibrotic septum associated with the malignant transformation of IPMN. An ST cut-off value of 2.5 mm might provide an accurate prediction of malignant IPMN.
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Affiliation(s)
- Hiromichi Iwaya
- Department of Gastroenterology, Aichi Cancer Center Hospital, Aichi, Japan.,Digestive and Lifestyle Diseases, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Susumu Hijioka
- Department of Gastroenterology, Aichi Cancer Center Hospital, Aichi, Japan.,Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Nobumasa Mizuno
- Department of Gastroenterology, Aichi Cancer Center Hospital, Aichi, Japan
| | - Takamichi Kuwahara
- Department of Gastroenterology, Aichi Cancer Center Hospital, Aichi, Japan
| | - Nozomi Okuno
- Department of Gastroenterology, Aichi Cancer Center Hospital, Aichi, Japan
| | - Masahiro Tajika
- Department of Endoscopy, Aichi Cancer Center Hospital, Aichi, Japan
| | - Tsutomu Tanaka
- Department of Endoscopy, Aichi Cancer Center Hospital, Aichi, Japan
| | - Makoto Ishihara
- Department of Endoscopy, Aichi Cancer Center Hospital, Aichi, Japan
| | - Yutaka Hirayama
- Department of Endoscopy, Aichi Cancer Center Hospital, Aichi, Japan
| | - Sachiyo Onishi
- Department of Endoscopy, Aichi Cancer Center Hospital, Aichi, Japan
| | - Ayako Ito
- Department of Gastroenterology, Aichi Cancer Center Hospital, Aichi, Japan
| | - Naosuke Kuraoka
- Department of Gastroenterology, Aichi Cancer Center Hospital, Aichi, Japan
| | - Shinpei Matsumoto
- Department of Gastroenterology, Aichi Cancer Center Hospital, Aichi, Japan
| | - Petcharee Polmanee
- Department of Gastroenterology, Aichi Cancer Center Hospital, Aichi, Japan
| | - Yasuhiro Shimizu
- Department of Gastrointestinal Surgery, Aichi Cancer Center Hospital, Aichi, Japan
| | - Yasushi Yatabe
- Department of Pathology and Molecular Diagnostics, Aichi Cancer Center Hospital, Aichi, Japan
| | - Yasumasa Niwa
- Department of Endoscopy, Aichi Cancer Center Hospital, Aichi, Japan
| | - Kiichi Tamada
- Department of Gastroenterology, Jichi Medical University, Tochigi, Japan
| | - Akio Ido
- Digestive and Lifestyle Diseases, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Kazuo Hara
- Department of Gastroenterology, Aichi Cancer Center Hospital, Aichi, Japan
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12
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Polmanee P, Hara K, Mizuno N, Hijioka S, Kuwahara T, Okuno N, Iwaya H, Tajika M, Tanaka T, Ishihara M, Hirayama Y, Ohnishi S, Toriyama K, Bhanthomkomol P, Ito A, Kuraoka N, Matsumoto S, Niwa Y. Outcomes of EUS-FNA in patients receiving antithrombotic therapy. Endosc Int Open 2019; 7:E15-E25. [PMID: 30648135 PMCID: PMC6327718 DOI: 10.1055/a-0735-9107] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Accepted: 06/21/2018] [Indexed: 12/11/2022] Open
Abstract
Background and study aims To investigate bleeding risk and thromboembolic risk in patients receiving antithrombotic therapy who underwent endoscopic ultrasound-guided fine-needls aspiration (EUS-FNA). Patients and methods A single-center retrospective study of 908 consecutive patients undergoing EUS-FNA for pancreatic and non-pancreatic lesions patients between March 2013 and March 2017 was performed. Antithrombotic management was classified into three groups: continuous, discontinuation, and heparin replacement. Results A total of 114 patients (12.6 %) were on antithrombotic drugs and 794 (84.6 %) were not. There were six cases of significant bleeding (0.7 %) four in the antithrombotic group (0.4 %) and two (0.2 %) in the non-antithrombotic group, (odds ratio, 9.59; 95 % confidence interval, 2.12 - 43.1; P = 0.006). Of the four cases in the antithrombotic group, two were on continuous treatment, one was on discontinuation treatment and one was on heparin replacement. All cases of non-significant bleeding occurred in the non-antithrombotic group (3 peri-tumoral hematomas, 1 submucosal hematoma, and 1 intraluminal bleed). The sole thromboembolic event (0.9 %) was a cerebral infarction in the antithrombotic group in a patient on thienopyridine who switched to aspirin before the procedure. Conclusions There was a slight increase in risk of bleeding in patients receiving antithrombotic therapy especially postoperative bleeding; however, there were no cases of severe bleeding was seen and only one case of cerebral infarction which occurred in a high-risk thromboembolic patients. We concluded that EUS-FNA in a safe procedure for patients on antithrombotics, even when antithrombotic therapy is not discontinued during EUS-FNA.
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Affiliation(s)
- Petcharee Polmanee
- Department of Gastroenterology Aichi Cancer Center Hospital, Nagoya, Japan,Department of Internal Medicine, Bhumibol Adulyadej Hospital, Saimai, Bangkok, Thailand
| | - Kazuo Hara
- Department of Gastroenterology Aichi Cancer Center Hospital, Nagoya, Japan,Corresponding author Kazuo Hara, MD Department of GastroenterologyAichi Cancer Center Hospital 1-1 KanokodenChikusa-ku, Nagoya 464-8681Japan+81-52-764-2942+81-52-764-2963
| | - Nobumasa Mizuno
- Department of Gastroenterology Aichi Cancer Center Hospital, Nagoya, Japan
| | - Susumu Hijioka
- Department of Gastroenterology Aichi Cancer Center Hospital, Nagoya, Japan
| | - Takamichi Kuwahara
- Department of Gastroenterology Aichi Cancer Center Hospital, Nagoya, Japan
| | - Nozomi Okuno
- Department of Gastroenterology Aichi Cancer Center Hospital, Nagoya, Japan
| | - Hiromichi Iwaya
- Department of Gastroenterology Aichi Cancer Center Hospital, Nagoya, Japan
| | - Masahiro Tajika
- Department of Gastroenterology Aichi Cancer Center Hospital, Nagoya, Japan
| | - Tsutomu Tanaka
- Department of Gastroenterology Aichi Cancer Center Hospital, Nagoya, Japan
| | - Makoto Ishihara
- Department of Gastroenterology Aichi Cancer Center Hospital, Nagoya, Japan
| | - Yutaka Hirayama
- Department of Gastroenterology Aichi Cancer Center Hospital, Nagoya, Japan
| | - Sachiyo Ohnishi
- Department of Gastroenterology Aichi Cancer Center Hospital, Nagoya, Japan
| | - Kazuhiro Toriyama
- Department of Gastroenterology Aichi Cancer Center Hospital, Nagoya, Japan
| | | | - Ayako Ito
- Department of Gastroenterology Aichi Cancer Center Hospital, Nagoya, Japan
| | - Naosuke Kuraoka
- Department of Gastroenterology Aichi Cancer Center Hospital, Nagoya, Japan
| | - Shinpei Matsumoto
- Department of Gastroenterology Aichi Cancer Center Hospital, Nagoya, Japan
| | - Yasumasa Niwa
- Department of Gastroenterology Aichi Cancer Center Hospital, Nagoya, Japan
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Tanaka H, Hijioka S, Iwaya H, Mizuno N, Kuwahara T, Okuno N, Ito A, Kuraoka N, Matsumoto S, Obata M, Kurita Y, Yasuda M, Shimizu Y, Kuroda H, Sato Y, Haneda M, Sasaki E, Yatabe Y, Hara K. Fibrolamellar Hepatocellular Carcinoma with Multiple Lung Metastases Treated with Multidisciplinary Therapy. Intern Med 2018; 57:3537-3543. [PMID: 30101933 PMCID: PMC6355421 DOI: 10.2169/internalmedicine.1243-18] [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] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
A 20-year old man was diagnosed with fibrolamellar hepatocellular carcinoma (FLHCC) with multiple lung metastases, and chemotherapy with FOLFOX was administered. Contrast enhanced CT after 3 cycles of FOLFOX showed no disease progression. We therefore performed surgical resection and radiofrequency ablation of the liver lesions and lung metastases, after obtaining the patient's informed consent. The liver lesions and lung metastases tested positive for DNAJB1-PRKACA. The treatment for FLHCC with extrahepatic metastasis has not been established; however, in a few cases, good long-term prognoses were obtained with multidisciplinary therapy. We herein report a case of FLHCC with multiple lung metastases that was treated with multidisciplinary therapies.
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Affiliation(s)
- Hiroki Tanaka
- Department of Gastroenterology, Aichi Cancer Center Hospital, Japan
- Department of Gastroenterology, Suzuka General Hospital, Japan
| | - Susumu Hijioka
- Department of Gastroenterology, Aichi Cancer Center Hospital, Japan
- Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Japan
| | - Hiromichi Iwaya
- Department of Gastroenterology, Aichi Cancer Center Hospital, Japan
| | - Nobumasa Mizuno
- Department of Gastroenterology, Aichi Cancer Center Hospital, Japan
| | | | - Nozomi Okuno
- Department of Gastroenterology, Aichi Cancer Center Hospital, Japan
| | - Ayako Ito
- Department of Gastroenterology, Aichi Cancer Center Hospital, Japan
| | - Naosuke Kuraoka
- Department of Gastroenterology, Aichi Cancer Center Hospital, Japan
| | | | - Masahiro Obata
- Department of Gastroenterology, Aichi Cancer Center Hospital, Japan
| | - Yusuke Kurita
- Department of Gastroenterology, Aichi Cancer Center Hospital, Japan
| | - Muneji Yasuda
- Department of Gastroenterology, Aichi Cancer Center Hospital, Japan
| | - Yasuhiro Shimizu
- Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Japan
| | - Hiroaki Kuroda
- Department of Thoracic Surgery, Aichi Cancer Center Hospital, Japan
| | - Yozo Sato
- Department of Diagnostic and Interventional Radiology, Aichi Cancer Center Hospital, Japan
| | - Masataka Haneda
- Department of Pathology and Molecular Diagnostics, Aichi Cancer Center Hospital, Japan
| | - Eiichi Sasaki
- Department of Pathology and Molecular Diagnostics, Aichi Cancer Center Hospital, Japan
| | - Yasushi Yatabe
- Department of Pathology and Molecular Diagnostics, Aichi Cancer Center Hospital, Japan
| | - Kazuo Hara
- Department of Gastroenterology, Aichi Cancer Center Hospital, Japan
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Yasuda M, Hara K, Kurita Y, Tanaka H, Obata M, Kuraoka N, Matsumoto S, Ito A, Iwaya H, Toriyama K, Okuno N, Kuwahara T, Hijioka S, Mizuno N, Onishi S, Hirayama Y, Ishihara M, Tanaka T, Tajika M, Niwa Y. A Novel Method of Diagnosing Aberrant Pancreas: Needle-based Confocal Laser Endomicroscopy. Intern Med 2018; 57:2827-2831. [PMID: 29780116 PMCID: PMC6207808 DOI: 10.2169/internalmedicine.0449-17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 01/04/2023] Open
Abstract
Aberrant pancreas is defined as pancreatic tissue present outside of the pancreas and is often found incidentally during esophagogastroduodenoscopy. Obtaining sufficient tissue to differentiate aberrant pancreas from other subepithelial lesions is sometimes difficult. Due to the lack of a definitive diagnosis, patients often undergo unnecessary surgery. We herein report the first case of aberrant pancreas in which the concomitant use of needle-based probe confocal laser endomicroscopy and fine-needle aspiration supported the final diagnosis. Needle-based probe confocal laser endomicroscopy provides a real-time in vivo histopathology evaluation and may be a feasible means of diagnosing aberrant pancreas.
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Affiliation(s)
- Muneji Yasuda
- Department of Gastroenterology, Aichi Cancer Center, Japan
| | - Kazuo Hara
- Department of Gastroenterology, Aichi Cancer Center, Japan
| | - Yusuke Kurita
- Department of Gastroenterology, Aichi Cancer Center, Japan
| | - Hiroki Tanaka
- Department of Gastroenterology, Aichi Cancer Center, Japan
| | - Masahiro Obata
- Department of Gastroenterology, Aichi Cancer Center, Japan
| | | | | | - Ayako Ito
- Department of Gastroenterology, Aichi Cancer Center, Japan
| | | | | | - Nozomi Okuno
- Department of Gastroenterology, Aichi Cancer Center, Japan
| | | | - Susumu Hijioka
- Department of Gastroenterology, Aichi Cancer Center, Japan
| | | | - Sachiyo Onishi
- Department of Endoscopy, Aichi Cancer Center Hospital, Japan
| | - Yutaka Hirayama
- Department of Endoscopy, Aichi Cancer Center Hospital, Japan
| | - Makoto Ishihara
- Department of Endoscopy, Aichi Cancer Center Hospital, Japan
| | - Tsutomu Tanaka
- Department of Endoscopy, Aichi Cancer Center Hospital, Japan
| | - Masahiro Tajika
- Department of Endoscopy, Aichi Cancer Center Hospital, Japan
| | - Yasumasa Niwa
- Department of Endoscopy, Aichi Cancer Center Hospital, Japan
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Kuraoka N, Hara K, Terai S, Yatabe Y, Horio Y. Peroral cholangioscopy of nivolumab-related (induced) ulcerative cholangitis in a patient with non-small cell lung cancer. Endoscopy 2018; 50:E259-E261. [PMID: 29969801 DOI: 10.1055/a-0640-2392] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [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: 12/13/2022]
Affiliation(s)
- Naosuke Kuraoka
- Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya, Japan.,Department of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Kazuo Hara
- Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Shuji Terai
- Department of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Yasushi Yatabe
- Department of Pathology and Molecular Diagnostics, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Yoshitsugu Horio
- Department of Thoracic Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
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Okuno N, Hara K, Mizuno N, Kuwahara T, Iwaya H, Ito A, Kuraoka N, Matsumoto S, Polmanee P, Niwa Y. Efficacy of the 6-mm fully covered self-expandable metal stent during endoscopic ultrasound-guided hepaticogastrostomy as a primary biliary drainage for the cases estimated difficult endoscopic retrograde cholangiopancreatography: A prospective clinical study. J Gastroenterol Hepatol 2018; 33:1413-1421. [PMID: 29424011 DOI: 10.1111/jgh.14112] [Citation(s) in RCA: 24] [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: 12/06/2017] [Revised: 01/19/2018] [Accepted: 01/22/2018] [Indexed: 12/21/2022]
Abstract
BACKGROUND AND AIM Endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) is performed as an alternative to the percutaneous or surgical approach. Despite high success rates, the adverse events rate is high. Recently, we used 6-mm fully covered self-expandable metal stents to prevent adverse events and allow easy re-intervention. The purposes were to evaluate the safety, feasibility, and clinical efficacy. METHODS A prospective study to confirm the safety of EUS-HGS was carried out in six patients, followed by a trial to evaluate the feasibility and efficacy of EUS-HGS in approximately 12 additional patients. We permitted a total of 18 to 20 patients in consideration of possibility such as the deviation after providing informed consent. RESULTS Twenty patients underwent EUS-HGS. No treatment-related adverse events described in the safety assessment criteria were seen. The technical and clinical success rates were 100% and 95%. The adverse event rate was 15%. Focal cholangitis was seen in two patients and fever in one patient. All cases were treated conservatively. Stent dysfunction was seen in 10 patients. The causes of stent dysfunction were biliary sludge (n = 6) and stent dislocation (n = 4). In nine cases, a new stent was easily inserted. Percutaneous drainage was selected in only one patient because of worsening general condition. CONCLUSIONS The 6-mm fully covered self-expandable metal stent is safe and effective, especially for avoiding serious adverse events and allowing easy re-intervention. (UMIN000006785).
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Affiliation(s)
- Nozomi Okuno
- Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Kazuo Hara
- Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Nobumasa Mizuno
- Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Takamichi Kuwahara
- Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Hiromichi Iwaya
- Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Ayako Ito
- Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Naosuke Kuraoka
- Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Shimpei Matsumoto
- Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Petcharee Polmanee
- Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya, Japan
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Okuno N, Hara K, Mizuno N, Kuwahara T, Iwaya H, Tajika M, Tanaka T, Ishihara M, Hirayama Y, Onishi S, Toriyama K, Ito A, Kuraoka N, Matsumoto S, Obata M, Yasuda M, Kurita Y, Tanaka H, Niwa Y. Infectious peritonitis after endoscopic ultrasound-guided biliary drainage in a patient with ascites. Int J Gastrointest Interv 2018. [DOI: 10.18528/gii180006] [Citation(s) in RCA: 3] [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: 11/22/2022] Open
Affiliation(s)
- Nozomi Okuno
- Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Kazuo Hara
- Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Nobumasa Mizuno
- Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Takamichi Kuwahara
- Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Hiromichi Iwaya
- Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Masahiro Tajika
- Department of Endoscopy, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Tsutomu Tanaka
- Department of Endoscopy, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Makoto Ishihara
- Department of Endoscopy, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Yutaka Hirayama
- Department of Endoscopy, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Sachiyo Onishi
- Department of Endoscopy, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Kazuhiro Toriyama
- Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Ayako Ito
- Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Naosuke Kuraoka
- Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Shimpei Matsumoto
- Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Masahiro Obata
- Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Muneji Yasuda
- Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Yusuke Kurita
- Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Hiroki Tanaka
- Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya, Japan
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Kobayashi T, Tsuchiya A, Kuraoka N, Yamamoto T, Honda Y, Yokoyama J, Kawai H, Yamagiwa S, Suda T, Terai S. [Series: Diagnosis at a Glance]. Nihon Naika Gakkai Zasshi 2016; 105:2263-7. [PMID: 30179061 DOI: pmid/30179061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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19
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Affiliation(s)
- Naosuke Kuraoka
- Department of Gastroenterology and Hepatology, Graduate School of Medical and Dental Science, Niigata University, Japan
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20
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Waguri N, Osaki A, Ikarashi S, Ogawa M, Kuraoka N, Ogawa K, Sato M, Aiba T, Yoneyama O, Furukawa K, Sugimura K, Igarashi K. Simultaneous combined balloon-occluded retrograde transvenous obliteration and partial splenic embolization for gastric fundal varices. United European Gastroenterol J 2015; 4:62-9. [PMID: 26966524 DOI: 10.1177/2050640615581966] [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] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Accepted: 03/22/2015] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND We previously reported the techniques and usefulness of simultaneous combined balloon-occluded retrograde transvenous obliteration (B-RTO) and partial splenic embolization (PSE), based on the hypothesis that concomitant PSE can diminish the increase in portal venous pressure after B-RTO. OBJECTIVE After experiencing more cases and performing longer-term follow-up, we re-evaluated the efficacy of simultaneous combined B-RTO and PSE for gastric fundal varices (GVs). METHODS We performed B-RTO in 36 consecutive patients treated for GVs from 2005 to 2013. Twenty-three patients underwent simultaneous combined B-RTO and PSE (Group 1) and 13 underwent B-RTO monotherapy (Group 2). The outcomes were retrospectively evaluated. RESULTS There were no significant differences in baseline characteristics between the two groups except that the splenic volumes were larger in Group 1 than 2. B-RTO was technically successful in 21 of 23 patients (91.3%) in Group 1 and in 12 of 13 patients (92.3%) in Group 2. In all patients with ruptured GVs (six in Group 1 and five in Group 2), complete hemostasis was obtained by B-RTO. Exacerbation of esophageal varices was significantly less frequent in Group 1 than 2 (p = 0.0017). CONCLUSION Concomitant PSE with B-RTO may contribute to prevention of the exacerbation of esophageal varices after B-RTO.
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Affiliation(s)
- Nobuo Waguri
- Department of Gastroenterology and Hepatology, Niigata City General Hospital, Niigata, Japan
| | - Akihiko Osaki
- Department of Gastroenterology and Hepatology, Niigata City General Hospital, Niigata, Japan
| | - Shunzo Ikarashi
- Department of Gastroenterology and Hepatology, Niigata City General Hospital, Niigata, Japan
| | - Masahiro Ogawa
- Department of Gastroenterology and Hepatology, Niigata City General Hospital, Niigata, Japan
| | - Naosuke Kuraoka
- Department of Gastroenterology and Hepatology, Niigata City General Hospital, Niigata, Japan
| | - Kohei Ogawa
- Department of Gastroenterology and Hepatology, Niigata City General Hospital, Niigata, Japan
| | - Munehiro Sato
- Department of Gastroenterology and Hepatology, Niigata City General Hospital, Niigata, Japan
| | - Tsuneo Aiba
- Department of Gastroenterology and Hepatology, Niigata City General Hospital, Niigata, Japan
| | - Osamu Yoneyama
- Department of Gastroenterology and Hepatology, Niigata City General Hospital, Niigata, Japan
| | - Koichi Furukawa
- Department of Gastroenterology and Hepatology, Niigata City General Hospital, Niigata, Japan
| | - Kazuhito Sugimura
- Department of Gastroenterology and Hepatology, Niigata City General Hospital, Niigata, Japan
| | - Kentarou Igarashi
- Department of Gastroenterology and Hepatology, Niigata City General Hospital, Niigata, Japan
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Ohta M, Sasamoto K, Kuraoka N, Nishimuta K. Glutamate activates neuronal discharges and rhythmical jaw movements in the rat. Fukuoka Igaku Zasshi 1999; 90:418-33. [PMID: 10624061] [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] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
Rhythmical jaw movements (RJM) were induced by stimulation of the cerebral peduncle or the oral cavity in the anesthetized rat and iontophoretic application of glutamate was examined on each reticular neuron with phase-dependent rhythmical activity during RJM (RJM-phasic neuron). Glutamate activated six neurons rhythmically with simultaneous rhythmical jaw movements in five rats. However, glutamate activated fifty of the other 52 RJM-phasic neurons tonically without RJM. Therefore, a small number of RJM-phasic neurons (10.3%) was involved in the generation of RJM. The rhythmical activities of most RJM-phasic neurons should have been synaptically induced by activities of those RJM-generator neurons. Glutamate receptor blocking agents, cyano-nitroquinoxaline-dione and D-amino-phosphono-valerate were examined and the former was more effective on 17 neurons although the latter was more effective on three and both were equally effective on 13. Inhibitory synaptic mechanism is not necessary for RJM-generation since bicuculline or strychnine did not significantly alter the rhythmical pattern of activity in any neuron.
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Affiliation(s)
- M Ohta
- Department of Oral Physiology, Faculty of Dentistry, Kyushu University, Fukuoka, Japan
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22
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Ohta M, Sasamoto K, Kishikawa N, Kuraoka N. Activity of the rat pontomedullary reticular neurons related to rhythmical jaw movements. Fukuoka Igaku Zasshi 1999; 90:403-17. [PMID: 10624060] [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] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
Electrical stimulation of the cerebral peduncle or oral mechanical or chemical stimulation induced rhythmical jaw movements (RJM) in the anesthetized rat. Extracellular recording was made from the pontomedullary reticular neurons in relation to RJM. The RJM-related activity was classified to a tonic, a transient and a phase-dependent rhythmical activities (116, 92 and 45 neurons, respectively). We found that the neurons showing the phase-dependent activities discharged exclusively or almost exclusively during RJM without responding to at least one of three kinds of RJM-inducing stimulation. Fourteen neurons were activated by all kinds of RJM-inducing stimulation and majority of them showed weak or no change in activity during RJM, although some showed the transient or the rhythmical activity during RJM. We propose that the phase-dependent rhythmical activity is necessary to generate RJM since any stimulation-induced RJM was reversibly blocked by microinjection of lidocaine or glutamate receptor blocking agents into the brainstem site concentrated by this type of neurons. No other type of activity was observed exclusively during RJM.
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Affiliation(s)
- M Ohta
- Department of Oral Physiology, Faculty of Dentistry, Kyushu University, Fukuoka, Japan
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