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Iijima K, Watanabe K, Shimodaira Y, Koizumi S, Fukuda S, Yoshida T, Ookubo R, Matsuhashi T, Jin M, Miura M, Shibata H. A Final Report on the Real Impact of the COVID-19 Pandemic on the Diagnosis of Gastrointestinal Cancer in Akita Prefecture, Japan in 2022. TOHOKU J EXP MED 2024:2024.J025. [PMID: 38658347 DOI: 10.1620/tjem.2024.j025] [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] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Affiliation(s)
- Katsunori Iijima
- Department of Gastroenterology, Akita University Graduate School of Medicine
| | - Kenta Watanabe
- Department of Gastroenterology, Akita University Graduate School of Medicine
| | - Yosuke Shimodaira
- Department of Gastroenterology, Akita University Graduate School of Medicine
| | - Shigeto Koizumi
- Department of Gastroenterology, Akita University Graduate School of Medicine
| | - Sho Fukuda
- Department of Gastroenterology, Akita University Graduate School of Medicine
| | - Tatsuki Yoshida
- Department of Gastroenterology, Akita University Graduate School of Medicine
| | - Ryo Ookubo
- Department of Gastroenterology, Akita University Graduate School of Medicine
| | - Tamotsu Matsuhashi
- Department of Gastroenterology, Akita University Graduate School of Medicine
| | | | - Masahito Miura
- Department of Gastroenterology, Omagari Kosei Medical Center
| | - Hiroyuki Shibata
- Department of Clinical Oncology & Center for Cancer Registry and Information Services, Akita University Graduate School of Medicine
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Kawade G, Kurata M, Matsuki Y, Fukuda S, Onishi I, Kinowaki Y, Watabe S, Ishibashi S, Ikeda M, Yamamoto M, Ohashi K, Kitagawa M, Yamamoto K. Mediation of Ferroptosis Suppressor Protein 1 Expression via 4-Hydroxy-2-Nonenal Accumulation Contributes to Acquisition of Resistance to Apoptosis and Ferroptosis in Diffuse Large B-Cell Lymphoma. J Transl Med 2024; 104:102027. [PMID: 38311062 DOI: 10.1016/j.labinv.2024.102027] [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: 06/02/2023] [Revised: 01/14/2024] [Accepted: 01/25/2024] [Indexed: 02/06/2024] Open
Abstract
Diffuse large B-cell lymphoma (DLBCL) is the most common non-Hodgkin lymphoma. New therapeutic strategies are needed for the treatment of refractory DLBCL. 4-Hydroxy-2-nonenal (4-HNE) is a cytotoxic lipid peroxidation marker, which alters intracellular signaling and induces genetic mutations. Lipid peroxidation is associated with nonapoptotic cell death, called ferroptosis. However, the relationship between 4-HNE accumulation and feroptotic regulators in DLBCL has not been fully evaluated. Here, we aimed to evaluate the accumulation of lipid peroxide and the expression of ferroptosis suppressor protein 1 (FSP1) in DLBCL using immunohistochemistry. We found a significant increase in the expression of FSP1 in cases with nuclear 4-HNE accumulation (P = .021). Both nuclear and cytoplasmic 4-HNE accumulation and FSP1 positivity were independent predictors of worse prognosis. In vitro exposure to 4-HNE resulted in its concentration- and time-dependent intracellular accumulation and increased expression of FSP1. Furthermore, short-term (0.25 and 1.0 μM) or long-term (0.25 μM) exposure to 4-HNE induced resistance to not only apoptosis but also ferroptosis. Taken together, regulation of FSP1 through 4-HNE accumulation may attenuate resistance to cell death in treatment-resistant DLBCL and might help develop novel therapeutic strategies for refractory DLBCL.
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Affiliation(s)
- Genji Kawade
- Department of Comprehensive Pathology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan; Department of Human Pathology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Morito Kurata
- Department of Comprehensive Pathology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yuko Matsuki
- Department of Comprehensive Pathology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Sho Fukuda
- Department of Comprehensive Pathology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Iichiroh Onishi
- Department of Comprehensive Pathology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yuko Kinowaki
- Department of Comprehensive Pathology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Shiori Watabe
- Department of Comprehensive Pathology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Sachiko Ishibashi
- Department of Comprehensive Pathology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Masumi Ikeda
- Department of Comprehensive Pathology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Masahide Yamamoto
- Department of Hematology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kenichi Ohashi
- Department of Human Pathology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Masanobu Kitagawa
- Department of Comprehensive Pathology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kouhei Yamamoto
- Department of Comprehensive Pathology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan; Department of Human Pathology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
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Fukuda S, Watanabe K, Takahashi S, Yoshida T, Fujimori S, Komatsu T, Shimodaira Y, Matsuhashi T, Iijima K. Disproportionate cancer worries in ultra-short-segment Barrett's esophagus in Japan. DEN Open 2024; 4:e329. [PMID: 38223912 PMCID: PMC10787273 DOI: 10.1002/deo2.329] [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] [Figures] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 12/14/2023] [Accepted: 12/18/2023] [Indexed: 01/16/2024]
Abstract
Objectives Although Barrett's esophagus (BE), especially ultra-short-segment BE (USSBE), is very frequently diagnosed in Japan, how subjects feel about receiving a diagnosis of BE is unclear. We therefore prospectively investigated cancer worry in subjects who received a BE diagnosis. Methods Self-administered questionnaires were sent to subjects who were diagnosed with BE at three health checkup institutes in Akita Prefecture, Japan. The cancer worry scale (CWS) was used to quantitatively assess the fear of developing cancer. The BE subjects were classified into USSBE <1 cm and non-USSBE ≥1 cm groups. Factors associated with the CWS were investigated using logistic regression analyses. Results A total of 325 (31%) subjects, comprising 229 USSBE and 96 non-USSBE patients were included in this study. Compared with the USSBE group, the non-USSBE group had a significantly higher frequency of a history of a BE diagnosis and perception of carcinogenesis. However, the CWS was similar between the USSBE and non-USSBE groups, with a median CWS of 12.5 (3.75) versus 12.7 (3.65). A multivariate logistic regression analysis revealed that while positive reflux symptoms were significantly associated with a positive CWS, the BE length was not significantly associated with it, with an odds ratio (95% confidence interval) of 1.3 (0.75-2.2). Conclusions A BE diagnosis promotes a similar level of worry about cancer among subjects, irrespective of the length of BE. In Japan, since USSBE poses a much lower cancer risk than non-USSBE, the former may frequently be associated with a disproportionate cancer worry relative to the latter. (UMIN000044010).
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Affiliation(s)
- Sho Fukuda
- Department of GastroenterologyAkita University Graduate School of MedicineAkitaJapan
| | - Kenta Watanabe
- Department of GastroenterologyAkita University Graduate School of MedicineAkitaJapan
| | - So Takahashi
- Department of GastroenterologyAkita University Graduate School of MedicineAkitaJapan
| | - Tatsuki Yoshida
- Department of GastroenterologyAkita University Graduate School of MedicineAkitaJapan
| | - Shusei Fujimori
- Department of GastroenterologyYokote Municipal HospitalAkitaJapan
| | - Taiga Komatsu
- Department of AnesthesiologyHonjo‐Daiichi HospitalAkitaJapan
| | - Yosuke Shimodaira
- Department of GastroenterologyAkita University Graduate School of MedicineAkitaJapan
| | - Tamotsu Matsuhashi
- Department of GastroenterologyAkita University Graduate School of MedicineAkitaJapan
| | - Katsunori Iijima
- Department of GastroenterologyAkita University Graduate School of MedicineAkitaJapan
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Takahashi S, Watanabe K, Fukuda S, Yoshida T, Dohmen T, Fujiwara J, Matsuyama M, Fujimori S, Funaoka M, Shirayama K, Horikawa Y, Fushimi S, Uchikoshi S, Onochi K, Okubo R, Hoshino T, Horii T, Kuramitsu T, Sakaki K, Ishii T, Komatsu T, Yoshida Y, Shirane K, Ono T, Shimodaira Y, Matsuhashi T, Iijima K. Helicobacter pylori Eradication Does Not Adversely Affect the Clinical Course of Gastric Cancer: A Multicenter Study on Screening Endoscopic Examination in Japan. Cancers (Basel) 2024; 16:733. [PMID: 38398125 PMCID: PMC10887210 DOI: 10.3390/cancers16040733] [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] [Subscribe] [Scholar Register] [Received: 01/06/2024] [Revised: 02/04/2024] [Accepted: 02/08/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND Since gastric cancers (GCs) detected after Helicobacter pylori (HP) eradication present with different morphological characteristics from conventional HP-positive GCs, delayed detection of early-stage GCs may be observed. This study aimed to investigate the clinical impact of HP eradication on diagnosing GC during screening endoscopy. METHODS Eleven health checkup institutions in Japan participated in the present study. All GC cases newly diagnosed by screening endoscopy between January 2016 and December 2020 were included. After propensity score matching, multivariable regression analysis was performed to estimate the effect of HP eradication on deep tumor invasion among HP-eradicated and HP-positive GC cases. RESULTS A total of 231 patients with GCs (134 HP-eradicated and 97 HP-positive cases) were enrolled. After propensity score matching, there were 81 cases in each group. The distribution of the depth of tumor invasion (pT1a, pT1b1, pT1b2, and pT2) between the HP-eradicated group and HP-positive group was similar (p = 0.82). In the propensity analysis, with HP-positive as the reference value, HP eradication was not significantly associated with T1b-T4-GCs and T1b2-T4-GCs, with odds ratios (95% confidence intervals) of 1.16 (0.48-2.81) and 1.16 (0.42-3.19), respectively. CONCLUSIONS HP eradication does not adversely affect the clinical course of GCs, supporting the recommendation of HP eradication in screening programs to reduce the total number of GC cases without delaying diagnosis.
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Affiliation(s)
- So Takahashi
- Department of Gastroenterology, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita 010-8543, Akita, Japan
- Department of Gastroenterology, Yuri Kumiai General Hospital, 38 Ienoushiro, Kawaguchi, Yurihonjo 015-8511, Akita, Japan
| | - Kenta Watanabe
- Department of Gastroenterology, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita 010-8543, Akita, Japan
| | - Sho Fukuda
- Department of Gastroenterology, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita 010-8543, Akita, Japan
| | - Tatsuki Yoshida
- Department of Gastroenterology, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita 010-8543, Akita, Japan
| | - Takahiro Dohmen
- Department of Gastroenterology, Yuri Kumiai General Hospital, 38 Ienoushiro, Kawaguchi, Yurihonjo 015-8511, Akita, Japan
| | - Junichi Fujiwara
- Department of Gastroenterology, Yuri Kumiai General Hospital, 38 Ienoushiro, Kawaguchi, Yurihonjo 015-8511, Akita, Japan
| | - Mari Matsuyama
- Department of Gastroenterology, Yuri Kumiai General Hospital, 38 Ienoushiro, Kawaguchi, Yurihonjo 015-8511, Akita, Japan
| | - Shusei Fujimori
- Department of Gastroenterology, Yokote Municipal Hospital, 5-31 Negishi, Yokote 013-8602, Akita, Japan
| | - Masato Funaoka
- Department of Gastroenterology, Yokote Municipal Hospital, 5-31 Negishi, Yokote 013-8602, Akita, Japan
| | - Kodai Shirayama
- Department of Gastroenterology, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita 010-8543, Akita, Japan
- Department of Gastroenterology, Yokote Municipal Hospital, 5-31 Negishi, Yokote 013-8602, Akita, Japan
| | - Yohei Horikawa
- Department of Gastroenterology, Hiraka General Hospital, 3-1 Yatsukuchi, Maego, Yokote 013-8610, Akita, Japan; (Y.H.)
| | - Saki Fushimi
- Department of Gastroenterology, Hiraka General Hospital, 3-1 Yatsukuchi, Maego, Yokote 013-8610, Akita, Japan; (Y.H.)
| | - Shu Uchikoshi
- Department of Gastroenterology, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita 010-8543, Akita, Japan
- Department of Gastroenterology, Hiraka General Hospital, 3-1 Yatsukuchi, Maego, Yokote 013-8610, Akita, Japan; (Y.H.)
| | - Kengo Onochi
- Department of Gastroenterology, Omagari Kosei Medical Center, 8-65 Omagaritori, Daisen 014-0027, Akita, Japan
| | - Ryo Okubo
- Department of Gastroenterology, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita 010-8543, Akita, Japan
- Department of Gastroenterology, Omagari Kosei Medical Center, 8-65 Omagaritori, Daisen 014-0027, Akita, Japan
| | - Takao Hoshino
- Department of Gastroenterology, Akita Kosei Medical Center, 1-1-1 Nishibukuro, Iijima, Akita 011-0948, Akita, Japan
| | - Toru Horii
- Department of Gastroenterology, Akita Kosei Medical Center, 1-1-1 Nishibukuro, Iijima, Akita 011-0948, Akita, Japan
| | - Taira Kuramitsu
- Department of Gastroenterology, Akita Kosei Medical Center, 1-1-1 Nishibukuro, Iijima, Akita 011-0948, Akita, Japan
| | - Kotaro Sakaki
- Department of Gastroenterology, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita 010-8543, Akita, Japan
- Department of Gastroenterology, Akita Kosei Medical Center, 1-1-1 Nishibukuro, Iijima, Akita 011-0948, Akita, Japan
| | - Toru Ishii
- Department of Gastroenterology, Akita Red Cross Hospital, 222-1 Nawashirosawa, Kamikitatesaruta, Akita 010-1495, Akita, Japan
| | - Taiga Komatsu
- Department of Gastroenterology, Honjo-Daiichi Hospital, 110 Iwabuchishita, Yurihonjo 015-8567, Akita, Japan
| | - Yuko Yoshida
- Department of Gastroenterology, Honjo-Daiichi Hospital, 110 Iwabuchishita, Yurihonjo 015-8567, Akita, Japan
| | - Kenji Shirane
- Department of Gastroenterology, Shirane Hospital, 5-29 Kyokuhokusakae, Akita 010-0922, Akita, Japan
| | - Tsuyoshi Ono
- Department of Gastroenterology, Omori Municipal Hospital, 245-205 Sugouta, Omori, Yokote 013-0525, Akita, Japan
| | - Yosuke Shimodaira
- Department of Gastroenterology, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita 010-8543, Akita, Japan
| | - Tamotsu Matsuhashi
- Department of Gastroenterology, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita 010-8543, Akita, Japan
| | - Katsunori Iijima
- Department of Gastroenterology, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita 010-8543, Akita, Japan
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Shimodaira Y, Fukuda S, Takahashi S, Iijima K. Iron overload in patients with Crohn's disease with short bowel syndrome who received long-term parenteral nutrition with trace elements. BMJ Case Rep 2024; 17:e254612. [PMID: 38272521 PMCID: PMC10826501 DOI: 10.1136/bcr-2023-254612] [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] [Indexed: 01/27/2024] Open
Abstract
Crohn's disease patients often need regular home parenteral nutrition (HPN) for intestinal failure due to multiple intestinal resections. Trace elements are necessary for long-term HPN but the requirement volume of iron is undetermined. We describe three patients with Crohn's disease with short bowel syndrome (SBS) who had iron overload as a result of long-term HPN including iron. Serum ferritin level was significantly decreased through depleting intravenous iron administration in all cases. One patient needed regular insulin injection and phlebotomy for diabetes mellitus due to hemochromatosis, and intravenous iron administration had a significant impact on the patient's health. Long-term routine intravenous iron administration should be cautious in SBS patients to avoid the overload.
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Affiliation(s)
- Yosuke Shimodaira
- School of Medicine, Akita University Graduate School of Medicine, Akita City, Japan
| | - Sho Fukuda
- School of Medicine, Akita University Graduate School of Medicine, Akita City, Japan
| | - So Takahashi
- School of Medicine, Akita University Graduate School of Medicine, Akita City, Japan
| | - Katsunori Iijima
- Department of Gastroenterology and Neurology, Akita University Graduate School of Medicine, Akita, Japan
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Nakamura Y, Yoshida S, Arita Y, Takeshita R, Kimura K, Aida Y, Asai S, Maezawa Y, Yoshitomi K, Chen W, Soma T, Kobayashi M, Fujiwara M, Fan B, Ishikawa Y, Fukuda S, Waseda Y, Tanaka H, Yokoyama M, Jinzaki M, Fujii Y. Can we avoid second transurethral resection according to VI-RADS score in patients with high-risk non-muscle-invasive bladder cancer? Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00645-0] [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: 02/12/2023]
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Kobayashi M, Matsuoka Y, Fukuda S, Kimura K, Fujiwara M, Nakamura Y, Ishikawa Y, Waseda Y, Tanaka H, Yoshida S, Yokoyama M, Fujii Y. Significance of MRI-ultrasound fusion targeted prostate biopsy for non-index PI-RADS ≥3 lesions in combination with index lesion-targeted biopsy and systematic biopsy. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00218-x] [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: 02/12/2023]
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Asai S, Kobayashi M, Fukuda S, Kimura K, Fujiwara M, Nakamura Y, Ishikawa Y, Waseda Y, Tanaka H, Yoshida S, Yokoyama M, Fujii Y. Significance of atypical nodules upgraded to category 3 in PI-RADS version 2.1 for the prostate cancer diagnosis. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)01026-6] [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: 02/12/2023]
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Tanaka H, Fukawa Y, Yamamoto K, Tanimoto K, Takemoto A, Hasumi H, Hirakawa A, Ishikawa Y, Fukuda S, Waseda Y, Yoshida S, Yokoyama M, Campbell S, Fujii Y. Renal parenchymal infiltration or micronodular spread in non-metastatic clear cell renal cell carcinoma: Prognostic impact and genomic backgrounds. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00515-8] [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: 02/12/2023]
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Fukuda S, Kobayashi M, Chen W, Fan B, Liu F, Afari J, Dhanji S, Ghassemzadeh S, Shah A, Schmeusser B, Greenwald R, Medline A, Kamal F, Ali A, Nakayama A, Meagher M, Patil D, Tanaka H, Saito K, Derweesh I, Master V, Fujii Y. Impact of preoperative C-reactive protein level on oncological outcomes after nephrectomy in patients with high-risk renal cell carcinoma: An analysis from the International Marker Consortium for Renal Cancer (INMARC) cohort. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00507-9] [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: 02/12/2023]
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Takahashi Y, Shimodaira Y, Yoshida T, Tajika M, Takahashi S, Watanabe K, Fukuda S, Koizumi S, Matsuhashi T, Iijima K. [A case of severe inflammatory bowel disease triggered by vaccination with SARS-CoV-2 mRNA]. Nihon Shokakibyo Gakkai Zasshi 2023; 120:325-329. [PMID: 37032096 DOI: 10.11405/nisshoshi.120.325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 04/11/2023]
Abstract
A 64-year-old woman received a third dose of SARS-CoV-2 mRNA vaccine. On the next day, she developed fever, diarrhea, and abdominal pain and had bloody stools. Total colonoscopy revealed deep ulceration on the whole colon. She was treated with corticosteroid and infliximab and her symptoms improved. She was diagnosed with severe enteritis resembling ulcerative colitis triggered by SARS-CoV-2 mRNA vaccination.
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Affiliation(s)
| | | | | | | | - So Takahashi
- Department of Gastroenterology, Akita University Hospital
| | - Kenta Watanabe
- Department of Gastroenterology, Akita University Hospital
| | - Sho Fukuda
- Department of Gastroenterology, Akita University Hospital
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Ikegami Y, Numaga J, Okano N, Fukuda S, Yamamoto H, Terada Y. Response to: The diagnosis of central retinal artery occlusion after mRNA-SARS-CoV-2 vaccination. QJM 2022; 115:882-883. [PMID: 35088865 DOI: 10.1093/qjmed/hcac012] [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: 01/10/2022] [Indexed: 12/15/2022] Open
Affiliation(s)
- Y Ikegami
- From the Department of Ophthalmology, Tokyo Metropolitan Geriatric Hospital, 35-2 Sakae-cho, Itabashi district, Tokyo 173-0015, Japan
| | - J Numaga
- From the Department of Ophthalmology, Tokyo Metropolitan Geriatric Hospital, 35-2 Sakae-cho, Itabashi district, Tokyo 173-0015, Japan
| | - N Okano
- From the Department of Ophthalmology, Tokyo Metropolitan Geriatric Hospital, 35-2 Sakae-cho, Itabashi district, Tokyo 173-0015, Japan
| | - S Fukuda
- From the Department of Ophthalmology, Tokyo Metropolitan Geriatric Hospital, 35-2 Sakae-cho, Itabashi district, Tokyo 173-0015, Japan
| | - H Yamamoto
- From the Department of Ophthalmology, Tokyo Metropolitan Geriatric Hospital, 35-2 Sakae-cho, Itabashi district, Tokyo 173-0015, Japan
| | - Y Terada
- From the Department of Ophthalmology, Tokyo Metropolitan Geriatric Hospital, 35-2 Sakae-cho, Itabashi district, Tokyo 173-0015, Japan
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Takahashi Y, Shimodaira Y, Matsuhashi T, Tsuji T, Fukuda S, Sugawara K, Saruta Y, Watanabe K, Iijima K. Nature and Clinical Outcomes of Acute Hemorrhagic Rectal Ulcer. Diagnostics (Basel) 2022; 12:diagnostics12102487. [PMID: 36292176 PMCID: PMC9600341 DOI: 10.3390/diagnostics12102487] [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: 09/08/2022] [Revised: 10/08/2022] [Accepted: 10/10/2022] [Indexed: 11/16/2022] Open
Abstract
Acute hemorrhagic rectal ulcer (AHRU) is a relatively rare disease that can lead to massive hematochezia. Although AHRU is a potentially life-threatening disease, its characteristics and clinical course are not fully understood. In this study, the clinical features were compared between AHRU and lower gastrointestinal bleeding (LGIB) from other causes (non-AHRU). Then, risk factors for all-cause in-hospital mortality in patients with AHRU were identified. A total of 387 consecutive adult patients with LGIB who were managed at two tertiary academic hospitals in Akita prefecture in Japan were retrospectively enrolled. Subjects were divided into AHRU and non-AHRU groups according to the source of bleeding. Regression analyses were used to investigate significant associations, and the results were expressed as odds ratios (ORs) and 95% confidence intervals (CIs). AHRU was found as the bleeding source in 72 (18.6%) of the patients. In comparison to non-AHRU, having AHRU was significantly associated with in-hospital onset, age > 65 years, and systolic blood pressure < 90 mmHg. The AHRU group had a significantly higher in-hospital mortality rate in comparison to the non-AHRU group (18.0% vs. 8.3, p = 0.02), and hypoalbuminemia (<2.5 g/dL) was significantly associated with in-hospital mortality in the AHRU group (OR, 4.04; 95%CI, 1.11−14.9; p = 0.03). AHRU accounts for a substantial portion (18.6%) of LGIB in our area, where the aging rate is the highest in Japan. Since AHRU is a potentially life-threatening disease that requires urgent identification and management, further studies to identify robust risk factors associated with serious clinical outcomes are required.
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Affiliation(s)
- Yasutaka Takahashi
- Department of Gastroenterology, Akita University Graduate School of Medicine, Akita 010-8543, Japan
- Department of Gastroenterology, Akita City Hospital, Akita 010-0933, Japan
| | - Yosuke Shimodaira
- Department of Gastroenterology, Akita University Graduate School of Medicine, Akita 010-8543, Japan
- Correspondence:
| | - Tamotsu Matsuhashi
- Department of Gastroenterology, Akita University Graduate School of Medicine, Akita 010-8543, Japan
| | - Tsuyotoshi Tsuji
- Department of Gastroenterology, Akita City Hospital, Akita 010-0933, Japan
| | - Sho Fukuda
- Department of Gastroenterology, Akita University Graduate School of Medicine, Akita 010-8543, Japan
| | - Kae Sugawara
- Department of Gastroenterology, Akita City Hospital, Akita 010-0933, Japan
| | - Youhei Saruta
- Department of Gastroenterology, Akita City Hospital, Akita 010-0933, Japan
| | - Kenta Watanabe
- Department of Gastroenterology, Akita University Graduate School of Medicine, Akita 010-8543, Japan
| | - Katsunori Iijima
- Department of Gastroenterology, Akita University Graduate School of Medicine, Akita 010-8543, Japan
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Horiuchi M, Uemura T, Suzuki Y, Kagawa Y, Fukuda S, Maeno K, Oguri T, Mori Y, Sone K, Takeda N, Fukumitsu K, Kanemitsu Y, Tajiri T, Ohkubo H, Ito Y, Niimi A. OA07.03 Association Between Genetic Variation in the ATP-binding Cassette Transporter ABCC10 and nab-PTX Treatment in Japanese Cohort. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.040] [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: 11/15/2022]
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15
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Matsuhashi T, Fukuda S, Abe Y, Mikami T, Tatsuta T, Hikichi T, Nakamura J, Onozato Y, Hatta W, Masamune A, Ohyauchi M, Ito H, Hanabata N, Araki Y, Yanagita T, Imamura H, Tsuji T, Sugawara K, Horikawa Y, Ohara S, Kondo Y, Dohmen T, Iijima K. Nature and treatment outcomes of bleeding post-bulbar duodenal ulcers. Dig Endosc 2022; 34:984-993. [PMID: 34609030 DOI: 10.1111/den.14160] [Citation(s) in RCA: 5] [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] [Received: 06/23/2021] [Revised: 09/29/2021] [Accepted: 10/01/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND Although post-bulbar duodenal ulcers (PBDUs) could become a source of upper gastrointestinal bleeding, the whole picture of the disease is unknown. We compared the characteristic features and treatment outcomes after endoscopic hemostasis between PBDUs and bulbar duodenal ulcers (BDUs). METHODS Data on duodenal ulcers with evidence of endoscopically-active bleeding were extracted from the data that were retrospectively collected from 12 institutes in Japan between 2011 and 2018. Rebleeding and in-hospital mortality were compared between patients with PBDUs and those with BDUs by logistic regression analyses. RESULTS Among 468 consecutive patients with bleeding duodenal ulcers, 96 (20.5%) had endoscopically-confirmed PBDUs. PBDUs were more frequently observed in patients with a poor general condition in comparison to BDUs. The rates of rebleeding and in-hospital mortality in patients with PBDUs were approximately three times higher than those in patients with BDUs (PBDU vs. BDU: 29.2% vs. 10.2% [P < 0.0001] and 14.6% vs. 5.1% [P = 0.0029], respectively). Although the high in-hospital mortality in PBDUs could be explained, to a lesser extent, by the likelihood of rebleeding, and, to a greater extent, by the patients' poor general condition, the presence of a PBDU itself was largely responsible for the high rebleeding rates in PBDUs. CONCLUSION This is the first study focusing on the nature and treatment outcomes of bleeding PBDUs. PBDUs were associated with much higher rebleeding and mortality rates in comparison to BDUs, and the likelihood of rebleeding may be derived from their unique anatomic location.
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Affiliation(s)
- Tamotsu Matsuhashi
- Department of Gastroenterology, Akita University Graduate School of Medicine, Akita, Japan
| | - Sho Fukuda
- Department of Gastroenterology, Akita University Graduate School of Medicine, Akita, Japan
| | - Yasuhiko Abe
- Division of Endoscopy, Yamagata University Hospital, Yamagata, Japan
| | - Tatsuya Mikami
- Division of Endoscopy, Hirosaki University Hospital, Aomori, Japan
| | - Tetsuya Tatsuta
- Department of Gastroenterology and Hematology, Hirosaki University Graduate School of Medicine, Aomori, Japan
| | - Takuto Hikichi
- Department of Endoscopy, Fukushima Medical University Hospital, Fukushima, Japan
| | - Jun Nakamura
- Department of Endoscopy, Fukushima Medical University Hospital, Fukushima, Japan
| | - Yusuke Onozato
- Department of Gastroenterology, Faculty of Medicine, Yamagata University Hospital, Yamagata, Japan
| | - Waku Hatta
- Division of Gastroenterology, Tohoku University Graduate School of Medicine, Miyagi, Japan
| | - Atsushi Masamune
- Division of Gastroenterology, Tohoku University Graduate School of Medicine, Miyagi, Japan
| | - Motoki Ohyauchi
- Department of Gastroenterology, Osaki Citizen Hospital, Miyagi, Japan
| | - Hirotaka Ito
- Department of Gastroenterology, Osaki Citizen Hospital, Miyagi, Japan
| | - Norihiro Hanabata
- Department of Gastroenterology, Aomori Prefectural Central Hospital, Aomori, Japan
| | - Yasumitsu Araki
- Department of Gastroenterology, Aomori Prefectural Central Hospital, Aomori, Japan
| | - Takumi Yanagita
- Department of Gastroenterology, Ohta Nishinouchi Hospital, Fukushima, Japan
| | - Hidemichi Imamura
- Department of Gastroenterology, Ohta Nishinouchi Hospital, Fukushima, Japan
| | - Tsuyotoshi Tsuji
- Department of Gastroenterology, Akita City Hospital, Akita, Japan
| | - Kae Sugawara
- Department of Gastroenterology, Akita City Hospital, Akita, Japan
| | - Youhei Horikawa
- Department of Gastroenterology, Hiraka General Hospital, Akita, Japan
| | - Shuichi Ohara
- Department of Gastroenterology, Tohoku Rosai Hospital, Miyagi, Japan
| | - Yutaka Kondo
- Department of Gastroenterology, Tohoku Rosai Hospital, Miyagi, Japan
| | - Takahiro Dohmen
- Department of Gastroenterology, Yuri Kumiai General Hospital, Akita, Japan
| | - Katsunori Iijima
- Department of Gastroenterology, Akita University Graduate School of Medicine, Akita, Japan
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16
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Tajika M, Matsuhashi T, Shimodaira Y, Fukuda S, Tsuji T, Sugawara K, Saruta Y, Takahashi Y, Watanabe K, Iijima K. Usefulness of the CHAMPS score for risk stratification in lower gastrointestinal bleeding. Sci Rep 2022; 12:7587. [PMID: 35534654 PMCID: PMC9085815 DOI: 10.1038/s41598-022-11666-y] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 04/25/2022] [Indexed: 12/24/2022] Open
Abstract
We have recently developed a simple prediction score, the CHAMPS score, to predict in-hospital mortality in patients with upper gastrointestinal bleeding. In this study, the primary outcome of this study was the usefulness of the CHAMPS score for predicting in-hospital mortality with lower gastrointestinal bleeding (LGIB). Consecutive adult patients who were hospitalized with LGIB at two tertiary academic medical centers from 2015 to 2020 were retrospectively enrolled. The performance for predicting outcomes with CHAMPS score was assessed by a receiver operating characteristic curve analysis, and compared with four existing scores. In 387 patients enrolled in this study, 39 (10.1%) of whom died during the hospitalization. The CHAMPS score showed good performance in predicting in-hospital mortality in LGIB patients with an AUC (95% confidence interval) of 0.80 (0.73–0.87), which was significantly higher in comparison to the existing scores. The risk of in-hospital mortality as predicted by the CHAMPS score was shown: low risk (score ≤ 1), 1.8%; intermediate risk (score 2 or 3), 15.8%; and high risk (score ≥ 4), 37.1%. The CHAMPS score is useful for predicting in-hospital mortality in patients with LGIB.
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Affiliation(s)
- Munehiko Tajika
- Department of Gastroenterology, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan
| | - Tamotsu Matsuhashi
- Department of Gastroenterology, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan
| | - Yosuke Shimodaira
- Department of Gastroenterology, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan.
| | - Sho Fukuda
- Department of Gastroenterology, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan
| | - Tsuyotoshi Tsuji
- Department of Gastroenterology, Akita City Hospital, Akita, Japan
| | - Kae Sugawara
- Department of Gastroenterology, Akita City Hospital, Akita, Japan
| | - Youhei Saruta
- Department of Gastroenterology, Akita City Hospital, Akita, Japan
| | | | - Kenta Watanabe
- Department of Gastroenterology, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan
| | - Katsunori Iijima
- Department of Gastroenterology, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan
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Uchida Y, Yokoyama M, Nakamura Y, Fukuda S, Uehara S, Tanaka H, Yoshida S, Matsuoka Y, Fujii Y. Assessment of erectile and ejaculatory functions after bladder-sparing therapy against muscle-invasive bladder cancer. J Sex Med 2022. [DOI: 10.1016/j.jsxm.2022.03.445] [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: 10/18/2022]
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18
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Fukuda S, Watanabe K, Yoshida T, Takahashi S, Fujimori S, Horikawa Y, Komatsu T, Shirane K, Shimodaira Y, Matsuhashi T, Iijima K. Low risk of esophageal adenocarcinoma among patients with ultrashort-segment Barrett's esophagus in Japan. Dig Endosc 2022; 34:757-765. [PMID: 34437742 DOI: 10.1111/den.14118] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [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: 05/07/2021] [Revised: 08/22/2021] [Accepted: 08/25/2021] [Indexed: 12/13/2022]
Abstract
OBJECTS Ultrashort-segment Barrett's esophagus (USSBE; length of <1 cm) is very frequently diagnosed in Japan, but the cancer risk of USSBE is unknown. In this study, by retrieving endoscopic images, we retrospectively investigated the incidence of esophageal adenocarcinoma (EAC) by the grade of Barrett's esophagus (BE) and compared the findings with those of gastric cancer by the degree of endoscopic gastric atrophy in the same population. METHODS Among consecutive participants who had undergone endoscopy for an annual health checkup in 2014, the 9121 who had received at least one follow-up endoscopy by December 2020 were enrolled in this study. Using the retrieved endoscopic images, we retrospectively evaluated BE and gastric atrophy. Information on the subsequent occurrence of EAC and gastric cancer as of December 2020 was also collected. The incidence of cancer by the extent of BE and gastric atrophy was calculated and expressed as the percentage per year. RESULTS On reviewing the endoscopic image in 2014, 4190 (45.9%) were found to have been diagnosed with BE, of whom 3318 (36.4%) were judged to have USSBE. During an observation period of 54.1 (17.9) months, 89 gastric cancers and only two EACs were identified. The incidence of EAC in USSBE was 0.0068%/year, which was nearly as low as the incidence of gastric cancer in atrophy-free patients (0.0068% vs. 0.0059%/year). CONCLUSIONS Although the prevalence of USSBE is quite high (36.4%), the incidence of EAC in USSBE is very low (0.0068%/year). Accordingly, USSBE can be excluded from targets for endoscopic surveillance in Japan.
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Affiliation(s)
- Sho Fukuda
- Department of Gastroenterology, Akita University Graduate School of Medicine, Akita, Japan
| | - Kenta Watanabe
- Department of Gastroenterology, Akita University Graduate School of Medicine, Akita, Japan
| | - Tatsuki Yoshida
- Department of Gastroenterology, Akita University Graduate School of Medicine, Akita, Japan
| | - So Takahashi
- Department of Gastroenterology, Akita University Graduate School of Medicine, Akita, Japan
| | - Shusei Fujimori
- Department of Gastroenterology, Yokote Municipal Hospital, Akita, Japan
| | - Yohei Horikawa
- Department of Gastroenterology, Hiraka General Hospital, Akita, Japan
| | - Taiga Komatsu
- Department of Anesthesiology, Honjo-Daiichi Hospital, Akita, Japan
| | | | - Yosuke Shimodaira
- Department of Gastroenterology, Akita University Graduate School of Medicine, Akita, Japan
| | - Tamotsu Matsuhashi
- Department of Gastroenterology, Akita University Graduate School of Medicine, Akita, Japan
| | - Katsunori Iijima
- Department of Gastroenterology, Akita University Graduate School of Medicine, Akita, Japan
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Asakawa A, Kawade G, Kurata M, Fukuda S, Onishi I, Kinowaki Y, Ishibashi S, Ikeda M, Watabe S, Kobayashi M, Ishibashi H, Okubo K, Kitagawa M, Yamamoto K. Stratification of lung squamous cell carcinoma based on ferroptosis regulators: Potential for new therapeutic strategies involving ferroptosis induction. Lung Cancer 2022; 165:82-90. [PMID: 35101731 DOI: 10.1016/j.lungcan.2022.01.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [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: 07/04/2021] [Revised: 08/20/2021] [Accepted: 01/19/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVES Lung squamous cell carcinoma (LSCC) exhibits poor response to treatment compared with other lung cancer subtypes, resulting in worse prognosis. Therefore, new therapeutic strategies are required for advanced LSCC. Ferroptosis is a recently discovered nonapoptotic cell death caused by intracellular lipid peroxidation that can bring about effective cell death in cancer cells resistant to apoptosis. Hence, ferroptosis is a potential therapeutic strategy for refractory cancer. MATERIALS AND METHODS In this study, we performed clinicopathological and molecular analyses on tumor specimens from 270 patients with squamous cell lung cancer, focusing on the expression of glutathione peroxidase 4 (GPX4) and ferroptosis suppressor protein 1 (FSP1), which are known to be key regulators of ferroptosis, and the accumulation of 4-hydroxynoneral (4-HNE), a lipid peroxidation marker. RESULTS Immunohistochemistry revealed that patients with low 4-HNE accumulation and low levels of GPX4 or FSP1 had significantly worse prognoses than other patients (P = 0.001). This stratification was an independent prognostic predictor (P = 0.003). A dramatic cell death synergistic effect was observed on LSCC-derived LK-2 and EBC1 cells treated with GPX4 and FSP1 inhibitors. This effect was completely inhibited by treatment with the ferroptosis inhibitor. Notably, this was not the case in LK-2 cells treated with the apoptosis inhibitor, and in these cells, ferroptosis was induced. CONCLUSION Ferroptosis regulators GPX4 and FSP1 are associated with lung squamous cell cancer cancer's prognosis. We present the clinicopathological and molecular basis of novel therapeutic strategies for refractory LSCC.
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Affiliation(s)
- Ayaka Asakawa
- Department of Thoracic Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8510, Japan
| | - Genji Kawade
- Department of Comprehensive Pathology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8510, Japan
| | - Morito Kurata
- Department of Comprehensive Pathology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8510, Japan
| | - Sho Fukuda
- Department of Comprehensive Pathology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8510, Japan
| | - Iichiroh Onishi
- Department of Comprehensive Pathology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8510, Japan
| | - Yuko Kinowaki
- Department of Comprehensive Pathology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8510, Japan
| | - Sachiko Ishibashi
- Department of Comprehensive Pathology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8510, Japan
| | - Masumi Ikeda
- Department of Comprehensive Pathology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8510, Japan
| | - Shiori Watabe
- Department of Comprehensive Pathology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8510, Japan
| | - Masashi Kobayashi
- Department of Thoracic Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8510, Japan
| | - Hironori Ishibashi
- Department of Thoracic Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8510, Japan
| | - Kenichi Okubo
- Department of Thoracic Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8510, Japan
| | - Masanobu Kitagawa
- Department of Comprehensive Pathology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8510, Japan
| | - Kouhei Yamamoto
- Department of Comprehensive Pathology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8510, Japan.
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20
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Uehara S, Matsuoka Y, Yamamoto K, Nakamura Y, Uchida Y, Fukuda S, Tanaka H, Yoshida S, Yokoyama M, Ohashi K, Fujii Y. MRI and MRI-targeted biopsy can detect cribriform cancer of the prostate. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00696-0] [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: 11/04/2022]
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21
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Ishikawa Y, Uehara S, Ishihara K, Hirose K, Soma T, Fujiwara M, Kobayashi M, Fan B, Nakamura Y, Uchida Y, Fukuda S, Tanaka H, Yoshida S, Yokoyama M, Matsuoka Y, Fujii Y. Variability in diagnostic performance of non-muscle invasive bladder cancer for each region using fluorescence cystoscopy with orally administered 5-aminolevulinic acid. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00317-7] [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: 11/30/2022]
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22
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Ishikawa Y, Sho U, Ishihara K, Hirose K, Soma T, Fujiwara M, Kobayashi M, Fan B, Nakamura Y, Uchida Y, Fukuda S, Tanaka H, Yoshida S, Yokoyama M, Matsuoka Y, Fujii Y. Orally administered 5-aminolevulinic acid can cause intraoperative hypotension in patients with bladder cancer undergoing transurethral resection. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00332-3] [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: 11/28/2022]
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23
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Tanaka H, Fukawa Y, Yamamoto K, Fukuda S, Uehara S, Yoshida S, Yokoyama M, Matsuoka Y, Campbell S, Fujii Y. Renal parenchymal infiltration is the primary determinant of prognosis of patients with non-metastatic clear cell renal cell carcinoma. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)01081-8] [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: 11/04/2022]
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24
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Tanaka H, Fukuda S, Yasuda Y, Patil D, Saidian A, Walia A, Meagher M, Perry J, Nguyen M, Narasimhan R, Yoshida S, Yokoyama M, Matsuoka Y, Master V, Derweesh I, Saito K, Fujii Y. Disparities in cancer-specific mortality between Asian and Caucasian patients with non-metastatic renal cell carcinoma: Analysis of the INMARC registry. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00223-8] [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: 11/25/2022]
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25
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Shimodaira Y, Watanabe K, Fukuda S, Watanabe N, Koizumi S, Matsuhashi T, Onochi K, Iijima K. Limited endoscopic mucosal inflammation on equivalent to Mayo endoscopic subscore of 0 unaffect clinical relapse of ulcerative colitis. Scand J Gastroenterol 2022; 57:165-168. [PMID: 34663142 DOI: 10.1080/00365521.2021.1991467] [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] [Indexed: 02/04/2023]
Abstract
BACKGROUND AND AIM Mayo endoscopic subscore is a simple and validated endoscopic score for ulcerative colitis but the range of inflammation was not considered for scoring. There were few reports analyzing the range of inflammation for clinical relapse using Mayo endoscopic subscore (MES). The aim of this study is to investigate the relapsing potential of limited mucosal inflammation on endoscopic remission equivalent to MES of 0. METHODS For this retrospective observational study, ulcerative colitis patients underwent total colonoscopy were enrolled. Small mucosal lesion (SML) was defined as limited inflammation of range less than 3 cm. Clinical relapse was analyzed using the Kaplan-Meier curve with log-rank test, and factors associated with clinical relapse was analyzed using the cox proportional hazard regression model. RESULTS A total of 102 periods with mucosal healing or modified MES of 0 with SML were analyzed. In 12-months observation periods, clinical relapse occurred more frequently in MES of 1 than in MES of 0 or modified MES of 0 with SML, but it was comparable between MES of 0 and modified MES of 0 with SML. When compared to patients with modified MES of 0 with SML, the hazard ratio in patients with MES of 1 (6.55; p = .028) was significantly high but similar in those with MES of 0 (2.59; p = .29). CONCLUSIONS Small mucosal inflammation in UC does not affect the clinical relapse if most of the mucosa achieved a score similar to MES of 0.
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Affiliation(s)
- Yosuke Shimodaira
- Department of Gastroenterology and Neurology, Akita University Graduate School of Medicine, Japan Akita City, Japan
| | - Kenta Watanabe
- Department of Gastroenterology and Neurology, Akita University Graduate School of Medicine, Japan Akita City, Japan
| | - Sho Fukuda
- Department of Gastroenterology and Neurology, Akita University Graduate School of Medicine, Japan Akita City, Japan
| | - Noboru Watanabe
- Department of Gastroenterology and Neurology, Akita University Graduate School of Medicine, Japan Akita City, Japan
| | - Shigeto Koizumi
- Department of Gastroenterology and Neurology, Akita University Graduate School of Medicine, Japan Akita City, Japan
| | - Tamotsu Matsuhashi
- Department of Gastroenterology and Neurology, Akita University Graduate School of Medicine, Japan Akita City, Japan
| | - Kengo Onochi
- Division of Gastroenterology, Omagari Kosei Medical Center, Daisen City, Japan
| | - Katsunori Iijima
- Department of Gastroenterology and Neurology, Akita University Graduate School of Medicine, Japan Akita City, Japan
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Ikegami Y, Numaga J, Okano N, Fukuda S, Yamamoto H, Terada Y. Combined central retinal artery and vein occlusion shortly after mRNA-SARS-CoV-2 vaccination. QJM 2022; 114:884-885. [PMID: 34791479 PMCID: PMC8689963 DOI: 10.1093/qjmed/hcab287] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Indexed: 11/23/2022] Open
Affiliation(s)
- Y Ikegami
- From the Department of Ophthalmology, Tokyo Metropolitan Geriatric Hospital, 35-2 Sakae-cho, Itabashi District, Tokyo 173-0015, Japan
- Address correspondence to Y. Ikegami, Department of Ophthalmology, Tokyo Metropolitan Geriatric Hospital, 35-2 Sakae-cho, Itabashi district, Tokyo 173-0015, Japan.
| | - J Numaga
- From the Department of Ophthalmology, Tokyo Metropolitan Geriatric Hospital, 35-2 Sakae-cho, Itabashi District, Tokyo 173-0015, Japan
| | - N Okano
- From the Department of Ophthalmology, Tokyo Metropolitan Geriatric Hospital, 35-2 Sakae-cho, Itabashi District, Tokyo 173-0015, Japan
| | - S Fukuda
- From the Department of Ophthalmology, Tokyo Metropolitan Geriatric Hospital, 35-2 Sakae-cho, Itabashi District, Tokyo 173-0015, Japan
| | - H Yamamoto
- From the Department of Ophthalmology, Tokyo Metropolitan Geriatric Hospital, 35-2 Sakae-cho, Itabashi District, Tokyo 173-0015, Japan
| | - Y Terada
- From the Department of Ophthalmology, Tokyo Metropolitan Geriatric Hospital, 35-2 Sakae-cho, Itabashi District, Tokyo 173-0015, Japan
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Yoshida T, Shimodaira Y, Fukuda S, Watanabe N, Koizumi S, Matuhashi T, Onochi K, Iijima K. Leucine-Rich Alpha-2 Glycoprotein in Monitoring Disease Activity and Intestinal Stenosis in Inflammatory Bowel Disease. TOHOKU J EXP MED 2022; 257:301-308. [DOI: 10.1620/tjem.2022.j042] [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] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Tatsuki Yoshida
- Department of Gastroenterology and Hepatology, Akita University Graduate School of Medicine
| | - Yosuke Shimodaira
- Department of Gastroenterology and Hepatology, Akita University Graduate School of Medicine
| | - Sho Fukuda
- Department of Gastroenterology and Hepatology, Akita University Graduate School of Medicine
| | - Noboru Watanabe
- Department of Gastroenterology and Hepatology, Akita University Graduate School of Medicine
| | - Shigeto Koizumi
- Department of Gastroenterology and Hepatology, Akita University Graduate School of Medicine
| | - Tamotu Matuhashi
- Department of Gastroenterology and Hepatology, Akita University Graduate School of Medicine
| | - Kengo Onochi
- Division of Gastroenterology, Omagari Kosei Medical Center
| | - Katsunori Iijima
- Department of Gastroenterology and Hepatology, Akita University Graduate School of Medicine
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28
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Matsuhashi T, Fukuda S, Mikami T, Tatsuta T, Hikichi T, Nakamura J, Abe Y, Onozato Y, Hatta W, Masamune A, Ohyauchi M, Ito H, Hanabata N, Araki Y, Yanagita T, Imamura H, Tsuji T, Sugawara K, Horikawa Y, Ohara S, Kondo Y, Dohmen T, Iijima K. Effects of anti-thrombotic drugs on all-cause mortality after upper gastrointestinal bleeding in Japan: A multicenter study with 2205 cases. Dig Endosc 2022; 34:113-122. [PMID: 33615547 DOI: 10.1111/den.13961] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [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: 12/09/2020] [Accepted: 02/16/2021] [Indexed: 12/13/2022]
Abstract
OBJECTS Although anti-thrombotic use is recognized as a risk factor for upper gastrointestinal bleeding (UGIB), there has been no clear evidence that it worsens the outcomes after the bleeding. The aim of this study is to investigate the effects of anti-thrombotic agents on in-hospital mortality following UGIB. METHODS Information on clinical parameters, including usage of anti-thrombotic agents, was retrospectively collected from consecutive patients with UGIB at 12 high-volume centers in Japan between 2011 and 2018. The all-cause in-hospital mortality rate was evaluated according to the usage of anti-thrombotic agents. RESULTS Clinical data were collected from 2205 patients with endoscopically confirmed UGIB. Six hundred and forty-five (29.3%) patients used anti-thrombotic agents. The all-cause in-hospital mortality rate was 5.7% (125 deaths). After excluding 29 cases in which death occurred due to end-stage malignancy, 96 deaths (bleeding-related, n = 22 ; non-bleeding-related, n = 74) were considered "preventable." Overall, the "preventable" mortality rate in anti-thrombotic users was significantly higher than that in non-users (6.0% vs. 3.7%, P < 0.05). However, the "preventable" mortality of anti-thrombotic users showed a marked improvement over time; although the rate in users remained significantly higher than that in non-users until 2015 (7.3% vs. 4.2%, P < 0.05), after 2016, the difference was no longer statistically significant (4.8% vs. 3.5%). CONCLUSIONS Although the usage of anti-thrombotic agents worsened the outcomes after UGIB, the situation has recently been improving. We speculate that the recent revision of the Japanese guidelines on the management of anti-thrombotic treatment after UGIB may have partly contributed to improving the survival of users of anti-thrombotic agents.
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Affiliation(s)
- Tamotsu Matsuhashi
- Department of Gastroenterology, Akita University Graduate School of Medicine, Akita, Japan
| | - Sho Fukuda
- Department of Gastroenterology, Akita University Graduate School of Medicine, Akita, Japan
| | - Tatsuya Mikami
- Division of Endoscopy, Hirosaki University Hospital, Aomori, Japan
| | - Tetsuya Tatsuta
- Department of Gastroenterology and Hematology, Hirosaki University Graduate School of Medicine, Aomori, Japan
| | - Takuto Hikichi
- Department of Endoscopy, Fukushima Medical University Hospital, Fukushima, Japan
| | - Jun Nakamura
- Department of Endoscopy, Fukushima Medical University Hospital, Fukushima, Japan
| | - Yasuhiko Abe
- Division of Endoscopy, Yamagata University Hospital, Yamagata, Japan
| | - Yusuke Onozato
- Department of Gastroenterology, Faculty of Medicine, Yamagata University Hospital, Yamagata, Japan
| | - Waku Hatta
- Division of Gastroenterology, Tohoku University Graduate School of Medicine, Miyagi, Japan
| | - Atsushi Masamune
- Division of Gastroenterology, Tohoku University Graduate School of Medicine, Miyagi, Japan
| | - Motoki Ohyauchi
- Department of Gastroenterology, Osaki Citizen Hospital, Miyagi, Japan
| | - Hirotaka Ito
- Department of Gastroenterology, Osaki Citizen Hospital, Miyagi, Japan
| | - Norihiro Hanabata
- Department of Gastroenterology, Aomori Prefectural Central Hospital, Aomori, Japan
| | - Yasumitsu Araki
- Department of Gastroenterology, Aomori Prefectural Central Hospital, Aomori, Japan
| | - Takumi Yanagita
- Department of Gastroenterology, Ohta Nishinouchi Hospital, Fukushima, Japan
| | - Hidemichi Imamura
- Department of Gastroenterology, Ohta Nishinouchi Hospital, Fukushima, Japan
| | - Tsuyotoshi Tsuji
- Department of Gastroenterology, Akita City Hospital, Akita, Japan
| | - Kae Sugawara
- Department of Gastroenterology, Akita City Hospital, Akita, Japan
| | - Youhei Horikawa
- Department of Gastroenterology, Hiraka General Hospital, Akita, Japan
| | - Shuichi Ohara
- Department of Gastroenterology, Tohoku Rosai Hospital, Miyagi, Japan
| | - Yutaka Kondo
- Department of Gastroenterology, Tohoku Rosai Hospital, Miyagi, Japan
| | - Takahiro Dohmen
- Department of Gastroenterology, Yuri Kumiai General Hospital, Akita, Japan
| | - Katsunori Iijima
- Department of Gastroenterology, Akita University Graduate School of Medicine, Akita, Japan
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Sekine Y, Yamamoto K, Kurata M, Honda A, Onishi I, Kinowaki Y, Kawade G, Watabe S, Nomura S, Fukuda S, Ishibashi S, Ikeda M, Yamamoto M, Kitagawa M. HADHB, a fatty acid beta-oxidation enzyme, is a potential prognostic predictor in malignant lymphoma. Pathology 2021; 54:286-293. [PMID: 34531036 DOI: 10.1016/j.pathol.2021.06.119] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [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: 11/17/2020] [Revised: 06/05/2021] [Accepted: 06/10/2021] [Indexed: 02/08/2023]
Abstract
In haematological malignancies, such as malignant lymphoma, reprogramming of fatty acid metabolism favours tumour cell survival and drug resistance. Hydroxyacyl-CoA dehydrogenase trifunctional multienzyme complex subunit alpha (HADHA), an enzyme involved in fatty acid beta-oxidation (FAO), is overexpressed in high-grade lymphoma and is a predictor of poor prognosis in diffuse large B-cell lymphoma (DLBCL). HADHB forms a heterodimer with HADHA and functions as an FAO enzyme together with HADHA; however, the relevance of its expression in malignant lymphoma is unknown. In this study, we investigated the roles and antitumour effects of HADHB expression in malignant lymphoma. Immunohistochemical analysis showed that HADHB was frequently overexpressed in the high-grade lymphoma subtype. HADHB overexpression was observed in 68% (87/128) of DLBCL cases and was an independent predictor of poor prognosis (p=0.001). In vitro analysis demonstrated that HADHB knockdown suppressed cell proliferation in LCL-K and MD901 cells (p<0.05). Additionally, treatment with the FAO inhibitor, ranolazine, increased cell death in control cells compared with that in HADHB knockdown LCL-K and MD901 cells (p<0.01). Cell death was also suppressed by the ferroptosis inhibitor, ferrosatin-1, in LCL-K and MD901 cells (p<0.05). Collectively, these findings provide basic evidence for the development of new cell death-based therapies for refractory malignant lymphoma. We plan to perform prospective studies and preclinical studies using animal models to confirm these results.
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Affiliation(s)
- Yuji Sekine
- Department of Comprehensive Pathology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan; Department of Cardiovascular Surgery, Nara Prefecture General Medical Centre, Nara, Japan
| | - Kouhei Yamamoto
- Department of Comprehensive Pathology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
| | - Morito Kurata
- Department of Comprehensive Pathology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Ayaka Honda
- Department of Comprehensive Pathology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Iichiroh Onishi
- Department of Comprehensive Pathology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yuko Kinowaki
- Department of Comprehensive Pathology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Genji Kawade
- Department of Comprehensive Pathology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Shiori Watabe
- Department of Comprehensive Pathology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Serina Nomura
- Department of Comprehensive Pathology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Sho Fukuda
- Department of Comprehensive Pathology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Sachiko Ishibashi
- Department of Comprehensive Pathology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Masumi Ikeda
- Department of Comprehensive Pathology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Masahide Yamamoto
- Department of Hematology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Masanobu Kitagawa
- Department of Comprehensive Pathology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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Matsuhashi T, Hatta W, Hikichi T, Fukuda S, Mikami T, Tatsuta T, Nakamura J, Abe Y, Onozato Y, Ogata Y, Masamune A, Ohyauchi M, Ito H, Hanabata N, Araki Y, Yanagita T, Imamura H, Tsuji T, Sugawara K, Horikawa Y, Ohara S, Kondo Y, Dohmen T, Kakuta Y, Nakamura T, Iijima K. A simple prediction score for in-hospital mortality in patients with nonvariceal upper gastrointestinal bleeding. J Gastroenterol 2021; 56:758-768. [PMID: 34143312 DOI: 10.1007/s00535-021-01797-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 03/26/2021] [Accepted: 05/29/2021] [Indexed: 02/04/2023]
Abstract
BACKGROUND No prediction scores for the mortality of both inpatients and outpatients who developed nonvariceal upper gastrointestinal bleeding (UGIB) without endoscopic findings have been established. We aimed to derive and validate a novel prediction score for in-hospital mortality. METHODS We conducted a three-stage, multicenter retrospective study. In the derivation stage, patients with nonvariceal UGIB at six institutions were enrolled to derive the prediction score by logistic regression analysis. External validation of the score was performed to analyze discrimination by patients at six other institutions. Then the performance of this score was compared with that of four existing scores. RESULTS We enrolled 1380 and 825 patients in the derivation and validation cohorts, respectively. A prediction score (CHAMPS-R Score) comprising seven variables (Charlson Comorbidity Index ≥ 2, in-hospital onset, albumin < 2.5 g/dL, altered mental status, Eastern Cooperative Oncology Group performance status ≥ 2, steroids, and rebleeding) with equal-weight scores was established, with high discriminative ability in both derivation and validation cohorts (c statistic, 0.91 and 0.80, respectively). When rebeeding was excluded from the score (an onset model; CHAMPS Score), this score also achieved high discriminative ability (c statistic, 0.90 and 0.81, respectively). The prediction scores had significantly higher discriminative ability than the Glasgow Blatchford Score, AIMS65, ABC Score, and clinical Rockall Score in both cohorts (all, p < 0.05). CONCLUSIONS We derived and externally validated prediction scores for in-hospital mortality in patients with nonvariceal UGIB. The CHAMPS Score might be optimal for managing such patients. Its mobile application is freely available ( https://apps.apple.com/app/id1565716902 for iOS and https://play.google.com/store/apps/details?id=hatta.CHAMPS for Android).
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Affiliation(s)
- Tamotsu Matsuhashi
- Department of Gastroenterology, Akita University Graduate School of Medicine, Akita, Japan
| | - Waku Hatta
- Division of Gastroenterology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan.
| | - Takuto Hikichi
- Department of Endoscopy, Fukushima Medical University Hospital, Fukushima, Japan
| | - Sho Fukuda
- Department of Gastroenterology, Akita University Graduate School of Medicine, Akita, Japan
| | - Tatsuya Mikami
- Division of Endoscopy, Hirosaki University Hospital, Hirosaki, Japan
| | - Tetsuya Tatsuta
- Department of Gastroenterology and Hematology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Jun Nakamura
- Department of Endoscopy, Fukushima Medical University Hospital, Fukushima, Japan
| | - Yasuhiko Abe
- Division of Endoscopy, Yamagata University Hospital, Yamagata, Japan
| | - Yusuke Onozato
- Department of Gastroenterology, Faculty of Medicine, Yamagata University Hospital, Yamagata, Japan
| | - Yohei Ogata
- Division of Gastroenterology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan
| | - Atsushi Masamune
- Division of Gastroenterology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan
| | - Motoki Ohyauchi
- Department of Gastroenterology, Osaki Citizen Hospital, Osaki, Japan
| | - Hirotaka Ito
- Department of Gastroenterology, Osaki Citizen Hospital, Osaki, Japan
| | - Norihiro Hanabata
- Department of Gastroenterology, Aomori Prefectural Central Hospital, Aomori, Japan
| | - Yasumitsu Araki
- Department of Gastroenterology, Aomori Prefectural Central Hospital, Aomori, Japan
| | - Takumi Yanagita
- Department of Gastroenterology, Ohta Nishinouchi Hospital, Kooriyama, Japan
| | - Hidemichi Imamura
- Department of Gastroenterology, Ohta Nishinouchi Hospital, Kooriyama, Japan
| | - Tsuyotoshi Tsuji
- Department of Gastroenterology, Akita City Hospital, Akita, Japan
| | - Kae Sugawara
- Department of Gastroenterology, Akita City Hospital, Akita, Japan
| | - Yohei Horikawa
- Department of Gastroenterology, Hiraka General Hospital, Yokote, Japan
| | - Shuichi Ohara
- Department of Gastroenterology, Tohoku Rosai Hospital, Sendai, Japan
| | - Yutaka Kondo
- Department of Gastroenterology, Tohoku Rosai Hospital, Sendai, Japan
| | - Takahiro Dohmen
- Department of Gastroenterology, Yuri Kumiai General Hospital, Yurihonjou, Japan
| | - Yoichi Kakuta
- Division of Gastroenterology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan
| | - Tomohiro Nakamura
- Department of Health Record Informatics, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Katsunori Iijima
- Department of Gastroenterology, Akita University Graduate School of Medicine, Akita, Japan
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Tanaka H, Yamaguchi Y, Fukuda S, Fukushima H, Uehara S, Yasuda Y, Yoshida S, Yokoyama M, Matsuoka Y, Campbell S, Fujii Y. Prognostic significance of radiologic infiltrative feature of primary renal tumor in metastatic renal cell carcinoma. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01019-8] [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: 11/17/2022]
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Kikuchi H, Fukuda S, Koike T, Shimodaira Y, Watanabe K, Saito M, Nakagawa K, Hatta W, Masamune A, Iijima K. Association of residual gastric acid secretion with persistent symptoms in gastroesophageal reflux disease patients receiving standard-dose proton pump inhibitor therapy. Esophagus 2021; 18:380-387. [PMID: 32737802 DOI: 10.1007/s10388-020-00765-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 04/25/2020] [Accepted: 07/24/2020] [Indexed: 02/03/2023]
Abstract
BACKGROUND Although a third of gastroesophageal reflux disease (GERD) patients are refractory to proton pump inhibitor (PPI) therapy, the underlying mechanism of the refractoriness remains unclear. We compared the level of gastric acid suppression during PPI treatment between responders and non-responders by directly measuring gastric acid secretion in GERD patients taking PPIs. METHODS Seventy-five consecutive patients receiving standard-dose PPI therapy for GERD were prospectively recruited, irrespective of persistent GERD symptoms. They were asked about their GERD symptoms using a validated questionnaire, and simultaneously underwent both a routine endoscopic examination and a gastric acid secretory testing using an endoscopic gastrin test. Associations between residual gastric acid secretion during PPI treatment and persistent GERD symptoms were analyzed by a logistic regression analysis. RESULTS Overall, 26 of 75 (34.7%) patients were judged to be positive for persistent GERD symptoms. The patients with and without persistent symptoms showed similar gastric acid secretion levels (1.3 [1.3] mEq/10 min vs. 1.4 [2.0] mEq/10 min). Sufficient gastric acid suppression, defined as < 0.6, was not significantly associated with persistent GERD symptoms (odds ratio 1.1, 95% confidence interval 0.40-3.5). CONCLUSIONS This study provided solid evidence to support that the gastric acid suppression level during PPI treatment does not differ between patients with and without persistent GERD symptoms. The insignificant role of residual gastric acid in the persistent GERD symptoms suggests that the use of medications other than those that enhance gastric acid inhibitory effects would be an essential approach for the management of PPI-refractory GERD.
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Affiliation(s)
- H Kikuchi
- Division of Gastroenterology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Sendai, 980-8574, Japan
| | - S Fukuda
- Department of Gastroenterology, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, Akita, 010-8543, Japan
| | - T Koike
- Division of Gastroenterology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Sendai, 980-8574, Japan
| | - Y Shimodaira
- Department of Gastroenterology, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, Akita, 010-8543, Japan
| | - K Watanabe
- Department of Gastroenterology, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, Akita, 010-8543, Japan
| | - M Saito
- Division of Gastroenterology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Sendai, 980-8574, Japan
| | - K Nakagawa
- Division of Gastroenterology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Sendai, 980-8574, Japan
| | - W Hatta
- Division of Gastroenterology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Sendai, 980-8574, Japan
| | - A Masamune
- Division of Gastroenterology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Sendai, 980-8574, Japan
| | - K Iijima
- Department of Gastroenterology, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, Akita, 010-8543, Japan.
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Yamasaki M, Takiguchi S, Omori T, Hirao M, Imamura H, Fujitani K, Tamura S, Akamaru Y, Kishi K, Fujita J, Hirao T, Demura K, Matsuyama J, Takeno A, Ebisui C, Takachi K, Takayama O, Fukunaga H, Okada K, Adachi S, Fukuda S, Matsuura N, Saito T, Takahashi T, Kurokawa Y, Yano M, Eguchi H, Doki Y. Multicenter prospective trial of total gastrectomy versus proximal gastrectomy for upper third cT1 gastric cancer. Gastric Cancer 2021; 24:535-543. [PMID: 33118118 DOI: 10.1007/s10120-020-01129-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [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: 07/10/2020] [Accepted: 09/28/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND The appropriate surgical procedure for patients with upper third early gastric cancer is controversial. We compared total gastrectomy (TG) with proximal gastrectomy (PG) in this patient population. METHODS A multicenter, non-randomized trial was conducted, with patients treated with PG or TG. We compared short- and long-term outcomes between these procedures. RESULTS Between 2009 and 2014, we enrolled 254 patients from 22 institutions; data from 252 were included in the analysis. These 252 patients were assigned to either the PG (n = 159) or TG (n = 93) group. Percentage of body weight loss (%BWL) at 1 year after surgery, i.e., the primary endpoint, in the PG group was significantly less than that of the TG group (- 12.8% versus - 16.9%; p = 0.0001). For short-term outcomes, operation time was significantly shorter for PG than TG (252 min versus 303 min; p < 0.0001), but there were no group-dependent differences in blood loss and postoperative complications. For long-term outcomes, incidence of reflux esophagitis in the PG group was significantly higher than that of the TG group (14.5% versus 5.4%; p = 0.02), while there were no differences in the incidence of anastomotic stenosis between the two (5.7% versus 5.4%; p = 0.92). Overall patient survival rates were similar between the two groups (3-year survival rates: 96% versus 92% in the PG and TG groups, respectively; p = 0.49). CONCLUSIONS Patients who underwent PG were better able to control weight loss without worsening the prognosis, relative to those in the TG group. Optimization of a reconstruction method to reduce reflux in PG patients will be important.
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Affiliation(s)
- Makoto Yamasaki
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, 2-2-E2, Yamadaoka, Suita, Osaka, 565-0879, Japan.
| | - S Takiguchi
- Department of Gastroenterological Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - T Omori
- Department of Surgery, Osaka International Cancer Institute, Osaka, Japan
| | - M Hirao
- Department of Surgery, National Hospital Organization, Osaka National Hospital, Osaka, Japan
| | - H Imamura
- Department of Surgery, Toyonaka Municipal Hospital, Osaka, Japan
| | - K Fujitani
- Department of Surgery, Osaka General Medical Center, Osaka, Japan
| | - S Tamura
- Department of Surgery, Yao Municipal Hospital, Osaka, Japan
| | - Y Akamaru
- Department of Surgery, Ikeda Municipal Hospital, Osaka, Japan
| | - K Kishi
- Department of Surgery, Osaka Police Hospital, Osaka, Japan
| | - J Fujita
- Department of Surgery, Sakai City Medical Center, Osaka, Japan
| | - T Hirao
- Department of Surgery, Japan Community Health Care Organization Osaka Hospital, Osaka, Japan
| | - K Demura
- Department of Surgery, Japan Community Health Care Organization Osaka Hospital, Osaka, Japan
| | - J Matsuyama
- Department of Surgery, Higashiosaka City Medical Center, Osaka, Japan
| | - A Takeno
- Department of Surgery, Kansai Rosai Hospital, Hyogo, Japan
| | - C Ebisui
- Department of Surgery, Suita Municipal Hospital, Osaka, Japan
| | - K Takachi
- Department of Surgery, Kinki Central Hospital, Hyogo, Japan
| | - O Takayama
- Department of Surgery, Saiseikai Senri Hospital, Osaka, Japan
| | - H Fukunaga
- Department of Surgery, Itami Municipal Hospital, Osaka, Japan
| | - K Okada
- Department of Surgery, Hyogo Prefectural Nishinomiya Hospital, Hyogo, Japan
| | - S Adachi
- Department of Surgery, Nishinomiya Municipal Central Hospital, Hyogo, Japan
| | - S Fukuda
- Department of Surgery, Kindai University Nara Hospital, Osaka, Japan
| | - N Matsuura
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, 2-2-E2, Yamadaoka, Suita, Osaka, 565-0879, Japan
| | - T Saito
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, 2-2-E2, Yamadaoka, Suita, Osaka, 565-0879, Japan
| | - T Takahashi
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, 2-2-E2, Yamadaoka, Suita, Osaka, 565-0879, Japan
| | - Y Kurokawa
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, 2-2-E2, Yamadaoka, Suita, Osaka, 565-0879, Japan
| | - M Yano
- Department of Surgery, Suita Municipal Hospital, Osaka, Japan
| | - H Eguchi
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, 2-2-E2, Yamadaoka, Suita, Osaka, 565-0879, Japan
| | - Y Doki
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, 2-2-E2, Yamadaoka, Suita, Osaka, 565-0879, Japan
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Sano R, Ishii Y, Yamanaka M, Yasui Y, Kemmochi Y, Kuroki F, Sugimoto M, Fukuda S, Sasase T, Miyajima K, Nakae D, Ohta T. Glomerular hyperfiltration with hyperglycemia in the spontaneously diabetic Torii (SDT) fatty rat, an obese type 2 diabetic model. Physiol Res 2021; 70:45-54. [PMID: 33453716 DOI: 10.33549/physiolres.934533] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Glomerular hyperfiltration is observed in an early stage of kidney diseases including diabetic nephropathy. A better understanding of pathophysiological changes in glomerular hyperfiltration is essential for development of new therapies to prevent kidney disease progression. In this study, we investigated glomerular changes including glomerular filtration rate (GFR) and glomerular size in the Spontaneously Diabetic Torii (SDT) fatty rat, an obese type 2 diabetic model, and we also evaluated pharmacological effects of the sodium glucose cotransporter 2 inhibitor dapagliflozin on the renal lesions. Dapagliflozin was administered to SDT fatty rats from 5 to 17 weeks of age. Blood and urinary biochemical parameters were periodically measured. GFR was determined by transdermal GFR monitor at 16 weeks of age and histopathological analysis was performed at 17 weeks of age. SDT fatty rat developed severe hyperglycemia and exhibited pathophysiological abnormalities in the kidney, such as an increased GFR, glomerular hypertrophy and tissue lesions. Dapagliflozin achieved good glycemic control during the experimental period, inhibited the increase in GFR, and improved histopathological abnormalities in tubules. These results suggest that the SDT fatty rat is a useful model for analyzing the pathogenesis of diabetic nephropathy during its early stage and dapagliflozin improves not only hyperglycemia but also glomerular hyperfiltration and tubule lesions in SDT fatty rat.
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Affiliation(s)
- R Sano
- Biological/Pharmacological Research Laboratories, Central Pharmaceutical Research Institute, Japan Tobacco Inc., Osaka, Japan.
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Shimodaira Y, Onochi K, Watanabe K, Takahashi S, Fukuda S, Watanabe N, Koizumi S, Matsuhashi T, Iijima K. Effect of acid-reducing agents on clinical relapse in ulcerative colitis with pH-dependent-released 5-aminosalicylic acid: a multicenter retrospective study in Japan. Intest Res 2020; 19:225-231. [PMID: 32806877 PMCID: PMC8100376 DOI: 10.5217/ir.2020.00023] [Citation(s) in RCA: 2] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 05/25/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND/AIMS 5-Aminosalicylic acid (5-ASA) is a basic drug for inducing and maintaining remission for ulcerative colitis. One of its formulations has a coating with a pH-dependent degradation that ensures the release 5-ASA at the terminal ileum. No evidence has been shown concerning the effects of proton pump inhibitors (PPIs) or H2 receptor antagonists (H2RAs) on the clinical course of ulcerative colitis patients in remission. The present study assessed the effect of PPIs or H2RAs on the relapse of ulcerative colitis patients in clinical remission maintained by pH-dependent released 5-ASA. METHODS Ulcerative colitis patients who had been prescribed time- or pH-dependent-released 5-ASA between January 2015 and December 2018 were enrolled in this multicenter retrospective study. The period of remission until relapse occurred was analyzed among the patients taking time-dependent-released 5-ASA or pH-dependent-released 5-ASA with/without PPIs or H2RAs. RESULTS One hundred and nineteen patients were analyzed in this study. In the primary endpoint, the relapse rate was higher in patients taking pH-dependent-released 5-ASA and PPIs or H2RAs than in those taking the pH-dependent-released 5-ASA without PPIs or H2RAs, while the relapse rate was similar in patients taking the time-dependent-released 5-ASA with or without PPIs or H2RAs concomitantly. Patients with a short duration of disease and middle-aged patients more frequently showed relapse with PPIs or H2RAs than the other patients. CONCLUSIONS The coadministration of PPIs or H2RAs affects the clinical course of ulcerative colitis in remission maintained by pH-dependent-released 5-ASA.
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Affiliation(s)
- Yosuke Shimodaira
- Department of Gastroenterology and Neurology, Akita University Graduate School of Medicine, Akita, Japan
| | - Kengo Onochi
- Division of Gastroenterology, Omagari Kosei Medical Center, Daisen, Japan
| | - Kenta Watanabe
- Department of Gastroenterology and Neurology, Akita University Graduate School of Medicine, Akita, Japan
| | - So Takahashi
- Department of Gastroenterology and Neurology, Akita University Graduate School of Medicine, Akita, Japan
| | - Sho Fukuda
- Department of Gastroenterology and Neurology, Akita University Graduate School of Medicine, Akita, Japan
| | - Noboru Watanabe
- Department of Gastroenterology and Neurology, Akita University Graduate School of Medicine, Akita, Japan
| | - Shigeto Koizumi
- Department of Gastroenterology and Neurology, Akita University Graduate School of Medicine, Akita, Japan
| | - Tamotsu Matsuhashi
- Department of Gastroenterology and Neurology, Akita University Graduate School of Medicine, Akita, Japan
| | - Katsunori Iijima
- Department of Gastroenterology and Neurology, Akita University Graduate School of Medicine, Akita, Japan
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Fukuda S, Shimodaira Y, Watanabe K, Takahashi S, Sugawara K, Suzuki Y, Watanabe N, Koizumi S, Matsuhashi T, Iijima K. Risks for Rebleeding and In-Hospital Mortality after Gastrointestinal Bleeding in a Tertiary Referral Center in Japan. Digestion 2020; 101:31-37. [PMID: 31722351 DOI: 10.1159/000504088] [Citation(s) in RCA: 12] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Accepted: 10/11/2019] [Indexed: 02/04/2023]
Abstract
BACKGROUND Gastrointestinal bleeding (GIB) is one of the most common medical emergencies. We investigated the overall mortality after GIB in our institute and analyzed the prognostic factors in upper GIB (UGIB) and lower GIB (LGIB) separately. SUMMARY Between January 2010 and December 2018, 190 patients diagnosed with GIB in our hospital were retrospectively enrolled. Clinical records and biological data were collected. Risks for rebleeding and in-hospital mortality were assessed by a logistic regression analysis. Overall, the rebleeding rate and in-hospital mortality were 22.6 and 7.6%, respectively. GIB itself was not the direct cause of death in any cases. While older age (>65 years) was a significant risk factor for rebleeding in UGIB with an OR of 6.1 and 95% CI of 1.3-29.1, a poorer performance status (PS; ≥3) was a strong risk factor for rebleeding in LGIB, with an OR of 11.8 and 95% CI of 1.7-83.8. Poor PS and tachycardia (>100/min) were significantly associated with mortality in both UGIB and LGIB. In contrast, hypoalbuminemia (<3.0 g/dL) was associated with the mortality in LGIB alone. Key Messages: There were considerable differences in the risk factors for rebleeding and in-hospital mortality between UGIB and LGIB. The overall in-hospital mortality was 7.9% after GIB, including that a substantial portion of patients with GIB died from systemic complications after successful endoscopic hemostasis. Physicians need to diligently perform systematic treatment for GIB, which may be particularly important in societies of advancing aging, like Japan.
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Affiliation(s)
- Sho Fukuda
- Department of Gastroenterology, Akita University Graduate School of Medicine, Akita, Japan
| | - Yosuke Shimodaira
- Department of Gastroenterology, Akita University Graduate School of Medicine, Akita, Japan
| | - Kenta Watanabe
- Department of Gastroenterology, Akita University Graduate School of Medicine, Akita, Japan
| | - So Takahashi
- Department of Gastroenterology, Akita University Graduate School of Medicine, Akita, Japan
| | - Kae Sugawara
- Department of Gastroenterology, Akita University Graduate School of Medicine, Akita, Japan
| | - Yusato Suzuki
- Department of Gastroenterology, Akita University Graduate School of Medicine, Akita, Japan
| | - Noboru Watanabe
- Department of Gastroenterology, Akita University Graduate School of Medicine, Akita, Japan
| | - Shigeto Koizumi
- Department of Gastroenterology, Akita University Graduate School of Medicine, Akita, Japan
| | - Tamotsu Matsuhashi
- Department of Gastroenterology, Akita University Graduate School of Medicine, Akita, Japan
| | - Katsunori Iijima
- Department of Gastroenterology, Akita University Graduate School of Medicine, Akita, Japan,
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Tanaka H, Shimada W, Fukuda S, Fukushima H, Moriyama S, Uehara S, Kijima T, Yoshida S, Yokoyama M, Ishioka J, Matsuoka Y, Saito K, Campbell S, Fujii Y. Novel classification model of tumour shape irregularity: Significance for predicting potential oncologic risks in clinically localised renal cell carcinoma. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33072-x] [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: 11/29/2022] Open
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Muto J, Fukuda S, Shirakata Y, Tsuda T, Tan E, Dai X, Shiraishi K, Mori H, Murakami M, Higashiyama S, Sayama K. 796 Effect of novel disaccharide for construction of living skin equivalents. J Invest Dermatol 2020. [DOI: 10.1016/j.jid.2020.03.811] [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: 10/24/2022]
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Yamauchi R, Takeyama Y, Takata K, Fukunaga A, Sakurai K, Tanaka T, Fukuda H, Fukuda S, Kunimoto H, Umeda K, Morihara D, Yokoyama K, Irie M, Shakado S, Sakisaka S, Hirai F. Hepatitis B Virus Reactivation after Receiving Cancer Chemotherapy under Administration of Leuprorelin Acetate. Intern Med 2020; 59:1163-1166. [PMID: 31956202 PMCID: PMC7270765 DOI: 10.2169/internalmedicine.3805-19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 12/30/2022] Open
Abstract
An 88-year-old man was admitted for elevated liver enzyme levels. Nine years earlier, the patient had been diagnosed with diffuse large B-cell lymphoma (DLBCL) and undergone rituximab, cyclophosphamide, doxorubicin hydrochloride, oncovin, prednisone (R-CHOP) therapy. This patient previously had had a hepatitis B virus (HBV) infection before chemotherapy. After the chemotherapy, he was administered an luteinizing hormone-releasing hormone (LHRH) agonist for prostate cancer. We diagnosed him with HBV reactivation because of positive serum HBV-DNA. HBV reactivation can occur a long time after chemotherapy, particularly if another treatment with immunity-altering drugs is added. In such cases, additional surveillance may be required to detect HBV reactivation.
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Affiliation(s)
- Ryo Yamauchi
- Department of Gastroenterology and Medicine, Fukuoka University Faculty of Medicine, Japan
| | - Yasuaki Takeyama
- Department of Gastroenterology and Medicine, Fukuoka University Faculty of Medicine, Japan
| | - Kazuhide Takata
- Department of Gastroenterology and Medicine, Fukuoka University Faculty of Medicine, Japan
| | | | | | - Takashi Tanaka
- Department of Gastroenterology and Medicine, Fukuoka University Faculty of Medicine, Japan
| | - Hiromi Fukuda
- Department of Gastroenterology and Medicine, Fukuoka University Faculty of Medicine, Japan
| | - Sho Fukuda
- Department of Gastroenterology and Medicine, Fukuoka University Faculty of Medicine, Japan
| | - Hideo Kunimoto
- Department of Gastroenterology and Medicine, Fukuoka University Faculty of Medicine, Japan
| | - Kaoru Umeda
- Department of Gastroenterology and Medicine, Fukuoka University Faculty of Medicine, Japan
| | - Daisuke Morihara
- Department of Gastroenterology and Medicine, Fukuoka University Faculty of Medicine, Japan
| | - Keiji Yokoyama
- Department of Gastroenterology and Medicine, Fukuoka University Faculty of Medicine, Japan
| | - Makoto Irie
- Department of Gastroenterology, Fukuoka University Nishijn Hospital, Japan
| | - Satoshi Shakado
- Department of Gastroenterology and Medicine, Fukuoka University Faculty of Medicine, Japan
| | - Shotaro Sakisaka
- Department of Gastroenterology and Medicine, Fukuoka University Faculty of Medicine, Japan
- General Medical Research Center, Fukuoka University Faculty of Medicine, Japan
| | - Fumihito Hirai
- Department of Gastroenterology and Medicine, Fukuoka University Faculty of Medicine, Japan
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Shimodaira Y, Sugawara K, Fukuda S, Suzuki Y, Watanabe N, Koizumi S, Ohba R, Hiroshima Y, Matsuhashi T, Nanjo H, Iijima K. Aggressive Inflammatory Myofibroblastic Tumor without Anaplastic Lymphoma Kinase Gene Rearrangement in the Rectum with Liver Metastasis. Intern Med 2020; 59:495-499. [PMID: 31588090 PMCID: PMC7056365 DOI: 10.2169/internalmedicine.3686-19] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 12/24/2022] Open
Abstract
Inflammatory myofibroblastic tumor is a rare intermediate-grade tumor. We herein report the case of an 81-year-old man with rectal ulceration and abnormal retroperitoneal soft tissue with a high serum level of IgG4. The administration of prednisolone reduced the retroperitoneal lesion; however, the rectal ulceration expanded. Surgical resection was performed. A histopathological examination revealed proliferating spindle cells accompanied by inflammatory cells and plasma cells. Liver metastasis emerged two months after surgical resection, and the histology of the proliferating spindle cells sampled by a fine-needle biopsy was similar to that of the rectal tissue. The patient ultimately died of inflammatory myofibroblastic tumor.
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Affiliation(s)
- Yosuke Shimodaira
- Department of Gastroenterology and Neurology, Akita University Graduate School of Medicine, Japan
| | - Kae Sugawara
- Department of Gastroenterology and Neurology, Akita University Graduate School of Medicine, Japan
| | - Sho Fukuda
- Department of Gastroenterology and Neurology, Akita University Graduate School of Medicine, Japan
| | - Yusato Suzuki
- Department of Gastroenterology and Neurology, Akita University Graduate School of Medicine, Japan
| | - Noboru Watanabe
- Department of Gastroenterology and Neurology, Akita University Graduate School of Medicine, Japan
| | - Shigeto Koizumi
- Department of Gastroenterology and Neurology, Akita University Graduate School of Medicine, Japan
| | - Reina Ohba
- Department of Gastroenterology and Neurology, Akita University Graduate School of Medicine, Japan
| | - Yuko Hiroshima
- Division of Clinical Pathology, Akita University Hospital, Japan
| | - Tamotsu Matsuhashi
- Department of Gastroenterology and Neurology, Akita University Graduate School of Medicine, Japan
| | - Hiroshi Nanjo
- Division of Clinical Pathology, Akita University Hospital, Japan
| | - Katsunori Iijima
- Department of Gastroenterology and Neurology, Akita University Graduate School of Medicine, Japan
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Amano M, Izumi C, Kim YJ, Park SJ, Park SW, Tanaka H, Hozumi T, Ling LH, Yu CM, Fukuda S, Otsuji Y, Song JK, Sohn DW. P914 Changes of echocardiographic parameters in primary mitral regurgitation and determinants of symptom: an assessment from the Asian valve registry data. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.550] [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: 11/14/2022] Open
Abstract
Abstract
[Background]Clinicians often have a difficulty in determining the presence of mitral regurgitation (MR)-relatedsymptoms because of subjectivity.However, there are few actual measurement data for echocardiographic left ventricular (LV) and left atrial (LA) size related to the severity of MR and the relationship between MR-related symptoms and these echocardiographic parameters.
[Purpose] The purpose of this study was to clarify actual values for echocardiographic parameters related to severity of MR and determinant factors of MR-related symptoms.
[Methods] Among patients enrolled in the Asian Valve Registry, we investigated 778 consecutive patients with primary MR showing sinus rhythm. Symptoms were determined by NYHA (≤ II or ≥ III).
[Results]MR severity was mild in 106, moderate in 285, and severe in 387 patients. LA volume index, LV end-diastolic diameter, and LV mass index increased with increasing MR grade [LA volume index: 47.9 (mild), 56.2 (moderate), and 64.9 ml/m2(severe) (p < 0.001), LV end-diastolic diameter: 51.2, 54.5, 58.1 mm (p < 0.001), and LV mass index: 101, 109, 123 g/m2(p < 0.001)]. Regarding moderate and severe MR, 70 patients (10.4%) were symptomatic. Table shows multivariable analysis for being symptomatic in moderate and severe MR patients. LV mass index (p = 0.040), ejection fraction (p < 0.001), female gender (p = 0.004), and heart rate (p = 0.007) were independent factors for MR-related symptoms.
[Conclusions] LV and LA parameters on echocardiography worsened as MR severity progressed. Larger LV mass index and lower ejection fraction were independent determinant factors for MR-related symptoms. We should also pay attention to LV hypertrophy in patients with primary MR.
Determinant factors for mitral regurgita Model 1 Model 2 OR (95% CI) P-value OR (95% CI) P-value Age, per 1-y increment 1.03 (1.00-1.05) 0.035 1.02 (0.99-1.05) 0.053 Sex (female) 2.23 (1.20-4.16) 0.011 2.28 (1.31-3.98) 0.004 Hear rate, per 1 bpm increment 1.03 (1.00-1.05) 0.025 1.03 (1.01-1.05) 0.007 LVDs index, per 1 mm increment 0.99 (0.90-1.09) 0.90 EF, per 1% increment 0.95 (0.92-0.99) 0.019 0.96 (0.93-0.98) <0.001 LV mass index, per 10 g/m2increment 1.12 (1.01-1.25) 0.033 1.09 (1.005-1.18) 0.040 LA volume index, per 10 mL/m2increment 0.96 (0.90-1.03) 0.23 E wave, per 1cm/s increment 1.81 (0.70-4.66) 0.23 TR pressure gradient >40 mmHg 2.11 (0.97-4.57) 0.057 Hypertention 1.40 (0.75-2.63) 0.29
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Affiliation(s)
- M Amano
- National Cerebral and Cardiovascular Center, Cardiovascular Medicine, Osaka, Japan
| | - C Izumi
- National Cerebral and Cardiovascular Center, Cardiovascular Medicine, Osaka, Japan
| | - Y J Kim
- Seoul National University Hospital, Cardiology, Seoul, Korea (Republic of)
| | - S J Park
- Samsung Medical Center, Cardiology, Seoul, Korea (Republic of)
| | - S W Park
- Samsung Medical Center, Cardiology, Seoul, Korea (Republic of)
| | - H Tanaka
- Kobe University, Cardiovascular Medicine, Kobe, Japan
| | - T Hozumi
- Wakayama Medical University, Cardiovascular Medicine, Wakayama, Japan
| | - L H Ling
- National Heart Centre Singapore, Singapore, Singapore
| | - C M Yu
- The University of Hong Kong, Medicine and Therapeutics, Hong Kong, Hong Kong
| | - S Fukuda
- University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Y Otsuji
- University of Occupational and Environmental Health, Kitakyushu, Japan
| | - J K Song
- Asan Medical Center, Seoul, Korea (Republic of)
| | - D W Sohn
- Seoul National University Hospital, Cardiology, Seoul, Korea (Republic of)
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Aso A, Nakamura T, Fukuyama Y, Fukuda S, Sibao K, Araki M, Meno K, Yakebe D, Omura S, Mori T, Takenaka K, Murasato Y. P1912Incidence of silent cerebral thromboembolism in catheter ablation for atrial fibrillation under the use of DOAC: Comparison of cryoballoon versus radiofrequency ablation system. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0659] [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: 11/14/2022] Open
Abstract
Abstract
Background
Silent cerebral thromboembolism (CE) in catheter ablation for atrial fibrillation (AF) is not rare. Prior our study has reported lower incidence of silent CE in AF radiofrequency (RF) ablation using irrigated-tip catheter than conventional 4 or 8mm-tip catheter. In addition, the incidence of silent CE in AF ablation under direct oral anticoagulant (DOAC) was equivalent to continuous therapeutic warfarin. Recently pulmonary vein isolation (PVI) using cryoballoon (CB) has emerged as an alternative technique to RF ablation because some studies suggested that the efficacy for PVI by CB was equivalent to RF. However, incidence of silent CE in CB ablation under the use of DOAC is unknown.
Objective
We aimed to evaluate the incidence new silent CE in AF ablation using CB system compared with irrigated RF system under the use of DOAC.
Methods
322 consecutive patients with paroxysmal or persistent AF (155 using CB system, 167 using RF system) who underwent the first AF ablation were taking DOAC more than one month prior to the procedure. Throughout AF ablation procedure, heparin was administered to maintain activated clotting time (ACT) between 300 and 400 seconds. Head MRI was performed in all patients within 24 hours after the procedure.
Results
In 14 (9.0%) patients using CB and in 20 (12.0%) patients using RF, head MRI showed new embolic lesions without neurological symptom (P=0.469). Although the amount of heparin during the procedure in group CB was significantly less than in group RF (16134±3125 U vs. 18689±5222 U; P<0.0001), amount of heparin per hour in group CB was more than in group RF (8335±1955 U/h vs. 6143±1918 U/h; P<0.0001) because procedure time in group CB was shorter than in group RF (121.3±34.1 min vs. 189.5±47.4 min; P<0.0001). Mean ACT in both groups was maintained high level (3367±25.3 sec. vs. 338.6±23.5 sec.; P=0.479). In univariate analysis, minimum ACT during procedure, as before puncture of interatrial septum, were significantly correlated with the incidence of silent CE (P=0.027).
Conclusions
The incidence of silent CE in AF ablation using CB system was lower than RF system, although it was not a significant difference between different ablation techniques for AF. In AF ablation, the use of CB may be preferred rather than RF as ablation system in regard to risk reduction of thromboembolic complications.
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Affiliation(s)
- A Aso
- National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - T Nakamura
- National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Y Fukuyama
- National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - S Fukuda
- National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - K Sibao
- National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - M Araki
- National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - K Meno
- National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - D Yakebe
- National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - S Omura
- National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - T Mori
- National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - K Takenaka
- National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Y Murasato
- National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
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Fukuda S, Suda K, Ohara S, Nishino M, Chiba M, Takemoto T, Soh J, Mitsudomi T. P2.17-41 Treatment Outcomes of Pulmonary Resection in NSCLC Patients with Autoimmune Diseases. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1952] [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: 10/25/2022]
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44
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Takeuchi A, Oguri T, Fukuda S, Kagawa Y, Sone K, Takakuwa O, Uemura T, Maeno K, Fukumitsu K, Kanemitsu Y, Ohkubo H, Takemura M, Ito Y, Niimi A. EP1.01-12 SNPs of Organic Cation Transporter 6 Associate with the Efficacy of Platinum Combination Chemotherapy. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1979] [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: 10/25/2022]
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45
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Karasawa K, Omatsu T, Okonogi N, Murata H, Fukuda S, Kamada T. A Clinical Trial of Curative Accelerated Partial-Breast Irradiation for Stage I Breast Cancer using Carbon Ion Radiotherapy. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.670] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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46
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Hoi S, Takata T, Sugihara T, Ida A, Ogawa M, Mae Y, Fukuda S, Munemura C, Isomoto H. SAT-189 PREDICTIVE VALUE OF CORTICAL THICKNESS MEASURED BY ULTRASONOGRAPHY FOR RENAL IMPAIRMENT. Kidney Int Rep 2019. [DOI: 10.1016/j.ekir.2019.05.223] [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: 11/25/2022] Open
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Fukuda S, Shimogonya Y, Yonemoto N. Differences in Cerebral Aneurysm Rupture Rate According to Arterial Anatomies Depend on the Hemodynamic Environment. AJNR Am J Neuroradiol 2019; 40:834-839. [PMID: 30975650 DOI: 10.3174/ajnr.a6030] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Accepted: 03/11/2019] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Cerebral aneurysms have significantly different rupture rates depending on their size and location. The mechanisms underlying these differences are unclear. We examined whether anatomic rupture risks are dependent on the hemodynamic environment on the aneurysmal surface. MATERIALS AND METHODS Patient-specific geometries and flow rates of 84 cerebral aneurysms (42 anterior communicating artery and 42 MCA aneurysms) were acquired from our clinical study, the Computational Fluid Dynamics Analysis of Blood Flow in Cerebral Aneurysms: Prospective Observational Study. Pulsatile blood flow was simulated to calculate hemodynamic metrics with special attention to wall shear stress magnitude and temporal disturbance. Multivariate analyses were performed to identify associations between hemodynamic metrics and known rupture predictors (age, sex, hypertension, smoking history, location, and size). RESULTS All the wall shear stress magnitude-based metrics showed a significant negative association with size and location (P < .03), but not other risk factors. All the wall shear stress disturbance-based metrics were significantly related to size (P < .001). Only normalized transverse wall shear stress, a metric for multidirectional wall shear stress disturbance, was related to location (P = .03). The normalized transverse wall shear stress had the highest odds ratio for location and size among hemodynamic metrics (odds ratios, 1.275 and 1.579; 95% confidence intervals, 1.020-1.693 and 1.238-2.219, respectively). Among the arterial geometric parameters, the aspect ratio had the second strongest association with all hemodynamic metrics, after our newly proposed aspect ratio-asphericity index. CONCLUSIONS The differences in aneurysm rupture rates according to size and location may reflect differences in hemodynamic environments in qualitatively different ways. An enhanced multidirectional wall shear stress disturbance may be especially associated with aneurysm rupture.
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Affiliation(s)
- S Fukuda
- From the Department of Neurosurgery (S.F.), National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - Y Shimogonya
- College of Engineering (Y.S.), Nihon University, Koriyama, Japan
| | - N Yonemoto
- Department of Biostatistics (N.Y.), Kyoto University, Kyoto, Japan
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Yamauchi R, Takata K, Shinagawa Y, Tanaka T, Fukuda H, Fukuda S, Kunimoto H, Umeda K, Morihara D, Yokoyama K, Takeyama Y, Irie M, Shakado S, Mizoguchi M, Hisano S, Yoshimitsu K, Sakisaka S. Hepatocellular Carcinoma Arising in a Non-cirrhotic Liver with Secondary Hemochromatosis. Intern Med 2019; 58:661-665. [PMID: 30449774 PMCID: PMC6443541 DOI: 10.2169/internalmedicine.0973-18] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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: 12/26/2022] Open
Abstract
A 70-year-old man was admitted for treatment of a single liver nodule that was detected by contrast-enhanced computed tomography. Twenty years earlier, the patient had been diagnosed with myelodysplastic syndrome-refractory anemia and secondary hemochromatosis but had not received erythrocyte transfusions. The current histological, computed tomography, and magnetic resonance imaging findings revealed hepatocellular carcinoma (HCC) and non-cirrhotic liver hemochromatosis. The liver tumor was treated using radiofrequency ablation therapy. Secondary hemochromatosis may be a risk factor for HCC, even if the liver is not cirrhotic. In such cases, additional surveillance may be required to detect the development of HCC.
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Affiliation(s)
- Ryo Yamauchi
- Department of Gastroenterology and Medicine, Fukuoka University Faculty of Medicine, Japan
| | - Kazuhide Takata
- Department of Gastroenterology and Medicine, Fukuoka University Faculty of Medicine, Japan
| | | | - Takashi Tanaka
- Department of Gastroenterology and Medicine, Fukuoka University Faculty of Medicine, Japan
| | - Hiromi Fukuda
- Department of Gastroenterology and Medicine, Fukuoka University Faculty of Medicine, Japan
| | - Sho Fukuda
- Department of Gastroenterology and Medicine, Fukuoka University Faculty of Medicine, Japan
| | - Hideo Kunimoto
- Department of Gastroenterology and Medicine, Fukuoka University Faculty of Medicine, Japan
| | - Kaoru Umeda
- Department of Gastroenterology and Medicine, Fukuoka University Faculty of Medicine, Japan
| | - Daisuke Morihara
- Department of Gastroenterology and Medicine, Fukuoka University Faculty of Medicine, Japan
| | - Keiji Yokoyama
- Department of Gastroenterology and Medicine, Fukuoka University Faculty of Medicine, Japan
| | - Yasuaki Takeyama
- Department of Gastroenterology and Medicine, Fukuoka University Faculty of Medicine, Japan
| | - Makoto Irie
- Department of Gastroenterology and Medicine, Fukuoka University Faculty of Medicine, Japan
| | - Satoshi Shakado
- Department of Gastroenterology and Medicine, Fukuoka University Faculty of Medicine, Japan
| | - Mikirou Mizoguchi
- Department of Pathology, Fukuoka University Faculty of Medicine, Japan
| | - Satoshi Hisano
- Department of Pathology, Fukuoka University Faculty of Medicine, Japan
| | - Kengo Yoshimitsu
- Department of Radiology, Fukuoka University Faculty of Medicine, Japan
| | - Shotaro Sakisaka
- Department of Gastroenterology and Medicine, Fukuoka University Faculty of Medicine, Japan
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49
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Round WH, Ng KH, Rodriguez L, Thayalan K, Tang F, Srivastava R, Fukuda S, Krisanachinda A, Deng X, Han Y. AFOMP policy number 6: code of ethics for medical physicists in AFOMP Countries. Australas Phys Eng Sci Med 2018; 41:809-810. [PMID: 30406922 DOI: 10.1007/s13246-018-0708-x] [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: 07/26/2018] [Accepted: 10/31/2018] [Indexed: 10/27/2022]
Abstract
This policy statement, which is the sixth of a series of documents prepared by the Asia-Oceania Federation of Organizations for Medical Physics (AFOMP) Professional Development Committee, gives guidance on how medical physicists in AFOMP countries should conduct themselves in an ethical manner in their professional practice (Ng et al. in Australas Phys Eng Sci Med 32:175-179, 2009; Round et al. in Australas Phys Eng Sci Med 33:7-10, 2010; Round et al. in Australas Phys Eng Sci Med 34:303-307, 2011; Round et al. in Australas Phys Eng Sci Med 35:393-398, 2012; Round et al. in Australas Phys Eng Sci Med 38:217-221, 2015). It was developed after the ethics policies and codes of conducts of several medical physics societies and other professional organisations were studied. The policy was adopted at the Annual General Meeting of AFOMP held in Jaipur, India, in November 2017.
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Affiliation(s)
- W H Round
- , 100 Te Awa Road, R D 3, 3283, Hamilton, New Zealand.
| | - K H Ng
- Department of Biomedical Imaging, University of Malaya, Kuala Lumpur, Malaysia
| | - L Rodriguez
- Jose R. Reyes Memorial Medical Center, Manila, Philippines
| | - K Thayalan
- Medical Physics Division, Dr Kamashi Memorial Hospital, Chennai, India
| | - F Tang
- Department of Clinical Oncology, Queen Mary Hospital, Hong Kong, Hong Kong
| | - R Srivastava
- Department of Radiation Oncology, Ghent University Hospital, C. Heymanslaan 10, Radiotherapiepark, 9000, Ghent, Belgium
| | - S Fukuda
- Radiation Quality Control Section, Clinical Research Cluster, National Institute of Radiological Sciences (NIRS), National Institutes for Quantum and Radiological Science and Technology (QST), Chiba, Japan
| | - A Krisanachinda
- Department of Radiology, Chulalongkorn University, Bangkok, Thailand
| | - X Deng
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China
| | - Y Han
- Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University, Seoul, Republic of Korea
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50
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Nishikawa T, Miyamatsu N, Higashiyama A, Hojo M, Nishida Y, Fukuda S, Ichiura K, Kubo S, Ueba T, Okamura T. Difference in water intake between persons with a history of cerebral infarction and healthy persons. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky214.051] [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] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
| | - N Miyamatsu
- Department of Clinical Nursing, Shiga University of Medical Science, Shiga, Japan
| | - A Higashiyama
- Department of Preventive Medicine and Epidemiologic Informatics, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - M Hojo
- Department of Neurosurgery, Shiga General Hospital, Shiga, Shiga, Japan
| | - Y Nishida
- Foundation for Biomedical Research and Innovation, Hyogo, Japan
| | - S Fukuda
- Department of Neurosurgery, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - K Ichiura
- Department of Clinical Nursing, Shiga University of Medical Science, Shiga, Japan
| | - S Kubo
- Foundation for Biomedical Research and Innovation, Hyogo, Japan
| | - T Ueba
- Department of Neurosurgery, Kochi Medical School, Kochi University, Kochi, Japan
| | - T Okamura
- Department of Preventive Medicine and Public Health, School of Medicine, Keio University, Tokyo, Japan
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