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Ban T, Kubota Y, Takahama T, Sasoh S, Joh T. A stent-removing thread sticking adjacent to the duodenoscope elevator identified using the double-scope technique. Endosc Int Open 2024; 12:E269-E270. [PMID: 38420149 PMCID: PMC10901639 DOI: 10.1055/a-2238-1054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 12/22/2023] [Indexed: 03/02/2024] Open
Affiliation(s)
- Tesshin Ban
- Department of Gastroenterology and Hepatology, Gamagori City Hospital, Gamagori, Japan
| | - Yoshimasa Kubota
- Department of Gastroenterology and Hepatology, Gamagori City Hospital, Gamagori, Japan
| | - Takuya Takahama
- Department of Gastroenterology and Hepatology, Gamagori City Hospital, Gamagori, Japan
| | - Shun Sasoh
- Department of Gastroenterology and Hepatology, Gamagori City Hospital, Gamagori, Japan
| | - Takashi Joh
- Department of Gastroenterology and Hepatology, Gamagori City Hospital, Gamagori, Japan
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Ban T, Kubota Y, Yano T, Naka Mieno M, Takahama T, Sasoh S, Tanida S, Ando T, Nakamura M, Joh T. Impact of a Time-Related Benchmark on the Adenoma Detection Rate in Surveillance Colonoscopy: A STROBE Statement-Oriented Cross-Sectional Cohort Study. Turk J Gastroenterol 2023; 34:1212-1219. [PMID: 37823319 PMCID: PMC10765203 DOI: 10.5152/tjg.2023.22883] [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] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 03/12/2023] [Indexed: 10/13/2023]
Abstract
BACKGROUND/AIMS Colorectal adenomas are precursor lesions of globally increasing colorectal cancer. Hence, a high adenoma detection rate in colonoscopy is pivotal. We investigated the clinical impact of stratified colonoscopy observation time combined with observation time/intubation time ratio on the detection of colorectal adenomas. MATERIALS AND METHODS We conducted a single-center retrospective study including 369 consecutive patients who underwent colonoscopy following fecal immunochemical tests between May 2021 and April 2022. The primary outcome measure was the impact of the stratified observation time and observation time/ intubation time ratio (category 1: <6.0 minutes and <1.0, category 2: <6.0 minutes and ≥1.0, category 3: ≥6.0 minutes and <1.0, and category 4: ≥6.0 minutes and ≥1.0) on adenoma detection rate. RESULTS Cecum intubation was obtained in 367 patients (99.5%). Adenomas were detected in 226 patients (61.2%). From the univariate analysis, age ≥53 years, habitual alcohol intake, colonoscopy attachment (+), and observation time with observation time/intubation time ratio categories 3 and 4 were determined as significant factors for adenoma detection rate. From the logistic regression analysis, age ≥ 53 years (odds ratio: 4.86, 95% CI: 2.25-10.52), habitual alcohol intake (odds ratio: 2.26, 95% CI: 1.33-3.82), category 3 (odds ratio: 3.66, 95% CI: 1.81-7.45), and category 4 (odds ratio: 5.60, 95% CI: 2.92-10.73) were significant factors for adenoma detection rate. CONCLUSION We propose the observation time with observation time/intubation time ratio combined benchmark (with categories' thresholds based on observation time >6 minutes and scope withdrawal time exceeding intubation time [observation time/intubation time ratio > 1]) as a novel colonoscopy quality indicator. These findings represent an important educational message for endoscopists.
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Affiliation(s)
- Tesshin Ban
- Department of Gastroenterology and Hepatology, Gamagori City Hospital, Gamagori, Japan
- Division of Medicine, Deparment of Gastroenterology, Jichi Medical University, Shimotsuke, Japan
| | - Yoshimasa Kubota
- Department of Gastroenterology and Hepatology, Gamagori City Hospital, Gamagori, Japan
| | - Tomonori Yano
- Division of Medicine, Deparment of Gastroenterology, Jichi Medical University, Shimotsuke, Japan
| | - Makiko Naka Mieno
- Department of Medical Informatics, Center for Information, Jichi Medical University, Shimotsuke, Japan
| | - Takuya Takahama
- Department of Gastroenterology and Hepatology, Gamagori City Hospital, Gamagori, Japan
| | - Shun Sasoh
- Department of Gastroenterology and Hepatology, Gamagori City Hospital, Gamagori, Japan
| | - Satoshi Tanida
- Department of Gastroenterology and Hepatology, Gamagori City Hospital, Gamagori, Japan
| | - Tomoaki Ando
- Department of Gastroenterology and Hepatology, Gamagori City Hospital, Gamagori, Japan
| | - Makoto Nakamura
- Department of Gastroenterology and Hepatology, Gamagori City Hospital, Gamagori, Japan
| | - Takashi Joh
- Department of Gastroenterology and Hepatology, Gamagori City Hospital, Gamagori, Japan
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Kubota Y, Ban T, Takahama T, Sasoh S, Itoh T, Nakamura Y, Joh T. Endoscopic removal of a large ingested squeeze ball at the duodenojejunal flexure using multiple devices. Endoscopy 2023; 55:E670-E671. [PMID: 37100415 PMCID: PMC10132937 DOI: 10.1055/a-2058-8879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
Affiliation(s)
- Yoshimasa Kubota
- Department of Gastroenterology and Hepatology, Gamagori City Hospital, Gamagori, Aichi, Japan
| | - Tesshin Ban
- Department of Gastroenterology and Hepatology, Gamagori City Hospital, Gamagori, Aichi, Japan
| | - Takuya Takahama
- Department of Gastroenterology and Hepatology, Gamagori City Hospital, Gamagori, Aichi, Japan
| | - Shun Sasoh
- Department of Gastroenterology and Hepatology, Gamagori City Hospital, Gamagori, Aichi, Japan
| | - Tsuyoshi Itoh
- Department of Gastrointestinal Surgery, Gamagori City Hospital, Gamagori, Aichi, Japan
| | - Yoshinori Nakamura
- Department of Gastrointestinal Surgery, Gamagori City Hospital, Gamagori, Aichi, Japan
| | - Takashi Joh
- Department of Gastroenterology and Hepatology, Gamagori City Hospital, Gamagori, Aichi, Japan
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Tanida S, Kubo R, Yoshii S, Takahama T, Sasoh S, Kubota Y, Ban T, Ando T, Nakamura M, Joh T. Upadacitinib Plus Intensive Granulocyte and Monocyte Adsorptive Apheresis for Ulcerative Colitis Achieved Ulcer Healing for Pyoderma Gangrenosum. J Clin Med Res 2023; 15:446-455. [PMID: 38189038 PMCID: PMC10769604 DOI: 10.14740/jocmr5005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 10/13/2023] [Indexed: 01/09/2024] Open
Abstract
A 44-year-old woman who had been diagnosed with ulcerative colitis (UC) at 22 years old was diagnosed with severe flare-up of UC based on endoscopic findings associated with new-onset active pyoderma gangrenosum (PG) on both lower legs after she decided to discontinue UC treatment. Systemic treatment with intravenous prednisolone at 30 mg/day had achieved insufficient response to UC and PG, resulting in a diagnosis of corticosteroid-refractory UC and PG. Combination therapy with upadacitinib at 45 mg/day plus intensive granulocyte and monocyte adsorptive apheresis (GMA) was started to achieve clinical remission of UC. Ten weeks after starting this combination therapy, clinical improvement of UC was achieved with PG ulcer healing on both lower legs. A combination of upadacitinib plus intensive GMA may offer an effective therapeutic option for patients with active PG in addition to UC but has yet to be approved for induction or maintenance treatment of PG worldwide. PG is a dermatological involvement in UC patients that requires attention.
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Affiliation(s)
- Satoshi Tanida
- Education and Research Center for Community Medicine, Nagoya City University Graduate School of Medical Sciences, Mizuho-ku, Nagoya, Aichi 467-8601, Japan
- Division of Gastroenterology, Gamagori City Hospital, Hirata, Gamagori, Aichi 443-8501, Japan
| | - Ryoji Kubo
- Division of Dermatology, Gamagori City Hospital, Hirata, Gamagori, Aichi 443-8501, Japan
| | - Shoichiro Yoshii
- Division of Dermatology, Gamagori City Hospital, Hirata, Gamagori, Aichi 443-8501, Japan
| | - Takuya Takahama
- Division of Gastroenterology, Gamagori City Hospital, Hirata, Gamagori, Aichi 443-8501, Japan
| | - Shun Sasoh
- Division of Gastroenterology, Gamagori City Hospital, Hirata, Gamagori, Aichi 443-8501, Japan
| | - Yoshimasa Kubota
- Division of Gastroenterology, Gamagori City Hospital, Hirata, Gamagori, Aichi 443-8501, Japan
| | - Tesshin Ban
- Division of Gastroenterology, Gamagori City Hospital, Hirata, Gamagori, Aichi 443-8501, Japan
| | - Tomoaki Ando
- Division of Gastroenterology, Gamagori City Hospital, Hirata, Gamagori, Aichi 443-8501, Japan
| | - Makoto Nakamura
- Division of Gastroenterology, Gamagori City Hospital, Hirata, Gamagori, Aichi 443-8501, Japan
| | - Takashi Joh
- Division of Gastroenterology, Gamagori City Hospital, Hirata, Gamagori, Aichi 443-8501, Japan
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Ban T, Kubota Y, Takahama T, Sasoh S, Tanida S, Ando T, Nakamura M, Joh T. A novel concept of passive loop-forming wire-guided biliary cannulation using an ultra-deep angled tip guidewire (with video). Endosc Int Open 2023; 11:E963-E969. [PMID: 37828976 PMCID: PMC10567138 DOI: 10.1055/a-2157-3941] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 08/17/2023] [Indexed: 10/14/2023] Open
Abstract
Background and study aims Wire-guided biliary cannulation (WGBC) is a standard technique during endoscopic retrograde cholangiopancreatography-related interventions. However, no dedicated guidewire is available. We investigated a novel "passive loop-forming WGBC" concept using a 0.035-inch ultra-deep angled tip guidewire. Patients and methods This single-arm, single-center, retrospective study included consecutive 111 patients who underwent passive loop-forming WGBC as the first biliary intervention between October 2021 and December 2022. Results WGBCs were completed within 5 minutes and overall were performed at a median papillary negotiation time of 81 seconds (interquartile range [IQR], 39-170) and 114 seconds (IQR, 49-303) in 83 (74.8%) and 106 (95.5%) cases, respectively. Logistic regression analysis identified age ≥ 80 years (odds ratio [OR]: 3.56, 95% confidence interval [CI]: 1.12-11.31) and unintentional pancreatic guidewire insertion (OR: 17.67, 95% CI: 5.75-54.31) as significant risk factors for failed WGBC within 5 minutes. Among the 106 obtained cannulations, the guidewire leading part formed a small-looped tip and wide-looped body in 83 (78.3%) and 23 (21.7%) cases, respectively. Adverse events included post-procedure pancreatitis (2/111 [1.8%]) and guidewire penetration (3/111 [2.7%]). Conclusions Passive loop-forming WGBC using an ultra-deep angled tip guidewire is a feasible procedure.
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Affiliation(s)
- Tesshin Ban
- Department of Gastroenterology and Hepatology, Gamagori City Hospital, Gamagori, Japan
- Department of Medicine, Division of Gastroenterology, Jichi Medical University, Shimotsuke, Japan
| | - Yoshimasa Kubota
- Department of Gastroenterology and Hepatology, Gamagori City Hospital, Gamagori, Japan
| | - Takuya Takahama
- Department of Gastroenterology and Hepatology, Gamagori City Hospital, Gamagori, Japan
| | - Shun Sasoh
- Department of Gastroenterology and Hepatology, Gamagori City Hospital, Gamagori, Japan
| | - Satoshi Tanida
- Department of Gastroenterology and Hepatology, Gamagori City Hospital, Gamagori, Japan
| | - Tomoaki Ando
- Department of Gastroenterology and Hepatology, Gamagori City Hospital, Gamagori, Japan
| | - Makoto Nakamura
- Department of Gastroenterology and Hepatology, Gamagori City Hospital, Gamagori, Japan
| | - Takashi Joh
- Department of Gastroenterology and Hepatology, Gamagori City Hospital, Gamagori, Japan
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Ban T, Kubota Y, Takahama T, Sasoh S, Ando T, Nakamura M, Joh T. Simple endoscopic transpapillary gallbladder aspiration/irrigation using a double-pigtail plastic stent system. Endosc Int Open 2023; 11:E814-E815. [PMID: 37664785 PMCID: PMC10473884 DOI: 10.1055/a-2132-5258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 07/11/2023] [Indexed: 09/05/2023] Open
Affiliation(s)
- Tesshin Ban
- Department of Gastroenterology and Hepatology, Gamagori City Hospital, Gamagori, Japan
| | - Yoshimasa Kubota
- Department of Gastroenterology and Hepatology, Gamagori City Hospital, Gamagori, Japan
| | - Takuya Takahama
- Department of Gastroenterology and Hepatology, Gamagori City Hospital, Gamagori, Japan
| | - Shun Sasoh
- Department of Gastroenterology and Hepatology, Gamagori City Hospital, Gamagori, Japan
| | - Tomoaki Ando
- Department of Gastroenterology and Hepatology, Gamagori City Hospital, Gamagori, Japan
| | - Makoto Nakamura
- Department of Gastroenterology and Hepatology, Gamagori City Hospital, Gamagori, Japan
| | - Takashi Joh
- Department of Gastroenterology and Hepatology, Gamagori City Hospital, Gamagori, Japan
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Tanida S, Yoshii S, Kubo R, Takahama T, Sasoh S, Kubota Y, Ban T, Ando T, Nakamura M, Joh T. A Rare Case of New-Onset Crohn's Disease in a Patient With Chronic Palmoplantar Pustulosis. J Clin Med Res 2023; 15:243-249. [PMID: 37187712 PMCID: PMC10181355 DOI: 10.14740/jocmr4896] [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: 02/25/2023] [Accepted: 04/12/2023] [Indexed: 05/17/2023] Open
Abstract
A 44-year-old woman who had been diagnosed with palmoplantar pustulosis (PPP) at 34 years old was diagnosed with moderate Crohn's disease (CD) based on endoscopic, radiological, and pathological findings. As treatment with corticosteroids, ultraviolet, and cyclosporin had achieved partial response, PPP had been refractory in a chronic continuous state. Oral prednisolone was initially started to treat CD, but clinical remission was not achieved. Intravenous ustekinumab was subsequently started at 260 mg for clinical remission of CD. Eight weeks after starting ustekinumab, clinical remission and mucosal healing were achieved and PPP manifestations on the palms and soles were markedly improved. Ustekinumab appears to offer an effective therapeutic option for patients with PPP but has yet to be approved for this induction in Japan. CD is a rare gastrointestinal involvement in PPP patients that requires attention.
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Affiliation(s)
- Satoshi Tanida
- Education and Research Center for Community Medicine, Nagoya City University Graduate School of Medical Sciences, Mizuho-ku, Nagoya, Aichi 467-8601, Japan
- Division of Gastroenterology, Gamagori City Hospital, Gamagori, Aichi 443-8501, Japan
- Corresponding Author: Satoshi Tanida, Education and Research Center for Community Medicine, Nagoya City University Graduate School of Medical Sciences, Mizuho-ku, Nagoya, Aichi 467-8601, Japan.
| | - Shoichiro Yoshii
- Division of Dermatology, Gamagori City Hospital, Gamagori, Aichi 443-8501, Japan
| | - Ryoji Kubo
- Division of Dermatology, Gamagori City Hospital, Gamagori, Aichi 443-8501, Japan
| | - Takuya Takahama
- Division of Gastroenterology, Gamagori City Hospital, Gamagori, Aichi 443-8501, Japan
| | - Shun Sasoh
- Division of Gastroenterology, Gamagori City Hospital, Gamagori, Aichi 443-8501, Japan
| | - Yoshimasa Kubota
- Division of Gastroenterology, Gamagori City Hospital, Gamagori, Aichi 443-8501, Japan
| | - Tesshin Ban
- Division of Gastroenterology, Gamagori City Hospital, Gamagori, Aichi 443-8501, Japan
| | - Tomoaki Ando
- Division of Gastroenterology, Gamagori City Hospital, Gamagori, Aichi 443-8501, Japan
| | - Makoto Nakamura
- Division of Gastroenterology, Gamagori City Hospital, Gamagori, Aichi 443-8501, Japan
| | - Takashi Joh
- Division of Gastroenterology, Gamagori City Hospital, Gamagori, Aichi 443-8501, Japan
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Tanida S, Ozeki K, Katano T, Tanaka M, Shimura T, Kubota E, Kataoka H, Takahama T, Sasoh S, Kubota Y, Ban T, Ando T, Nakamura M, Joh T. Induction Therapy With a Combination of Weekly Adalimumab Plus Intensive Granulocyte and Monocyte Adsorptive Apheresis in Patients With Ulcerative Colitis and Failure of Conventional Agents, Biologics and Janus Kinase Inhibitor. J Clin Med Res 2023; 15:181-186. [PMID: 37035853 PMCID: PMC10079367 DOI: 10.14740/jocmr4887] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 03/14/2023] [Indexed: 03/31/2023] Open
Abstract
Every-week (ew) adalimumab (ADA) maintenance following induction therapy with a standard induction regimen has recently been approved for use in Japan. The efficacy and safety of combination therapy with ew-ADA maintenance following standard induction regimen plus intensive granulocyte and monocyte adsorptive apheresis (GMA) (two sessions/week) for the treatment of refractory ulcerative colitis (UC) displaying failure of conventional, biologics and Janus kinase inhibitor have not been evaluated previously. The present retrospective study evaluated the 10-week efficacy of this combination therapy among refractory UC patients. Six patients were given initial ADA combination therapy (ADA at 160 mg in week 0, ADA 80 mg in week 2, and 40 mg in week 4, followed by ew-ADA at 40 mg/week) plus intensive GMA. One patient (16.6%) achieved clinical remission and two patients (33.3%) achieved endoscopic improvement by week 10. After excluding two patients who discontinued treatment, mean full Mayo score (P = 0.14), endoscopic subscore (P = 0.18) and C-reactive protein level (P = 0.27) at 10 weeks were numerically decreased compared with baseline in the remaining four cases, although the differences were not significant. Use of ew-ADA maintenance following standard induction regimen plus intensive GMA appears unlikely to achieve satisfactory induction of clinical remission in UC patients for whom conventional agents, biologics and Janus kinase inhibitors have failed.
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Affiliation(s)
- Satoshi Tanida
- Education and Research Center for Community Medicine, Nagoya City University Graduate School of Medical Sciences, Mizuho-cho, Mizuho-ku, Nagoya, Aichi 467-8601, Japan
- Division of Gastroenterology, Gamagori City Hospital, Hirata, Gamagori, Aichi 443-8501, Japan
- Corresponding Author: Satoshi Tanida, Education and Research Center for Community Medicine, Nagoya City University Graduate School of Medical Sciences, Mizuho-cho, Mizuho-ku, Nagoya, Aichi 467-8601, Japan.
| | - Keiji Ozeki
- Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Mizuho-cho, Mizuho-ku, Nagoya, Aichi 467-8601, Japan
| | - Takahito Katano
- Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Mizuho-cho, Mizuho-ku, Nagoya, Aichi 467-8601, Japan
| | - Mamoru Tanaka
- Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Mizuho-cho, Mizuho-ku, Nagoya, Aichi 467-8601, Japan
| | - Takaya Shimura
- Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Mizuho-cho, Mizuho-ku, Nagoya, Aichi 467-8601, Japan
| | - Eiji Kubota
- Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Mizuho-cho, Mizuho-ku, Nagoya, Aichi 467-8601, Japan
| | - Hiromi Kataoka
- Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Mizuho-cho, Mizuho-ku, Nagoya, Aichi 467-8601, Japan
| | - Takuya Takahama
- Division of Gastroenterology, Gamagori City Hospital, Hirata, Gamagori, Aichi 443-8501, Japan
| | - Shun Sasoh
- Division of Gastroenterology, Gamagori City Hospital, Hirata, Gamagori, Aichi 443-8501, Japan
| | - Yoshimasa Kubota
- Division of Gastroenterology, Gamagori City Hospital, Hirata, Gamagori, Aichi 443-8501, Japan
| | - Tesshin Ban
- Division of Gastroenterology, Gamagori City Hospital, Hirata, Gamagori, Aichi 443-8501, Japan
| | - Tomoaki Ando
- Division of Gastroenterology, Gamagori City Hospital, Hirata, Gamagori, Aichi 443-8501, Japan
| | - Makoto Nakamura
- Division of Gastroenterology, Gamagori City Hospital, Hirata, Gamagori, Aichi 443-8501, Japan
| | - Takashi Joh
- Division of Gastroenterology, Gamagori City Hospital, Hirata, Gamagori, Aichi 443-8501, Japan
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Ban T, Kubota Y, Hayashi K, Takahama T, Sasoh S, Ando T, Joh T. A novel technique of endoscopic introducer-assisted transpapillary gallbladder aspiration prior to drainage in a patient with acute cholecystitis. Endoscopy 2023; 55:E480-E481. [PMID: 36858347 PMCID: PMC9977566 DOI: 10.1055/a-2020-9680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Affiliation(s)
- Tesshin Ban
- Department of Gastroenterology and Hepatology, Gamagori City Hospital, Gamagori, Aichi, Japan
| | - Yoshimasa Kubota
- Department of Gastroenterology and Hepatology, Gamagori City Hospital, Gamagori, Aichi, Japan
| | - Kazuki Hayashi
- Department of Gastroenterology, Nagoya City East Medical Center, Nagoya, Aichi, Japan
| | - Takuya Takahama
- Department of Gastroenterology and Hepatology, Gamagori City Hospital, Gamagori, Aichi, Japan
| | - Shun Sasoh
- Department of Gastroenterology and Hepatology, Gamagori City Hospital, Gamagori, Aichi, Japan
| | - Tomoaki Ando
- Department of Gastroenterology and Hepatology, Gamagori City Hospital, Gamagori, Aichi, Japan
| | - Takashi Joh
- Department of Gastroenterology and Hepatology, Gamagori City Hospital, Gamagori, Aichi, Japan
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Ban T, Kubota Y, Takahama T, Sasoh S, Tanida S, Ando T, Nakamura M, Joh T. Potential Risk of Misjudgment in the Decision-making Process Based on the 2018 Tokyo Guidelines in Older Patients with Acute Cholecystitis. Intern Med 2022; 62:1425-1430. [PMID: 36198593 DOI: 10.2169/internalmedicine.0352-22] [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: 04/07/2023] Open
Abstract
Objective The 2018 Tokyo Guidelines (TG18) were published to facilitate the decision-making processes (DMP), including the diagnosis and operation of acute cholecystitis (AC). However, only a few guidelines consider older adults. This study evaluated the DMP based on the TG18, focusing on older patients with AC. Methods This was a single-armed, single-center retrospective study. The primary outcome measure was the "undiagnosable" AC rate, and the secondary outcome measure was the degree of concordance of "unfit for surgery" decisions. Patients Two hundred and nine patients with AC. Results Sixty (28.7%) of 209 patients with AC were "undiagnosable" on admission based on the TG18 criteria. The numbers and rate of "undiagnosable" AC in patients ≤59, 60-79, and ≥80 years old were 4 (10.0%), 20 (24.4%), and 36 (41.4%), respectively (P<0.001). The multiple logistic regression analysis following the univariate analysis revealed that age >73 years old was the most significant risk factor for undiagnosable AC (P=0.006, odds ratio [OR]: 3.06, 95% confidence interval [CI]: 1.38-6.81). Female sex (P=0.033, OR: 2.09, 95% CI: 1.06-4.09) and severe AC (P=0.049, OR: 2.97, 95% CI: 1.01-8.76) were also significant risk factors for undiagnosable AC. The number of cases unfit for surgery based on the Charlson Comorbidity Index and American Society of Anesthesiologists physical status was 90 (43.1%) and 75 (35.9%), respectively. The κ value between these 2 indicators revealed a minimal concordance of 0.33 (95% CI: 0.20-0.47). Conclusion The DMP based on the TG18 potentially harbors a misjudgment risk, especially in older patients with AC (UMIN000047715).
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Affiliation(s)
- Tesshin Ban
- Department of Gastroenterology and Hepatology, Gamagori City Hospital, Japan
| | - Yoshimasa Kubota
- Department of Gastroenterology and Hepatology, Gamagori City Hospital, Japan
| | - Takuya Takahama
- Department of Gastroenterology and Hepatology, Gamagori City Hospital, Japan
| | - Shun Sasoh
- Department of Gastroenterology and Hepatology, Gamagori City Hospital, Japan
| | - Satoshi Tanida
- Department of Gastroenterology and Hepatology, Gamagori City Hospital, Japan
| | - Tomoaki Ando
- Department of Gastroenterology and Hepatology, Gamagori City Hospital, Japan
| | - Makoto Nakamura
- Department of Gastroenterology and Hepatology, Gamagori City Hospital, Japan
| | - Takashi Joh
- Department of Gastroenterology and Hepatology, Gamagori City Hospital, Japan
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Ban T, Kubota Y, Okubo D, Murase T, Takahama T, Sasoh S, Tanida S, Ando T, Nakamura M, Joh T. A Transanal Endoscopic Ultrasound-guided Fine-needle Aspiration Biopsy for an Intrapelvic Tumor Diagnosed as Recurrence of a Smooth Muscle Tumor of Uncertain Malignant Potential Following Uterine Morcellation. Intern Med 2022; 62:1287-1292. [PMID: 36130890 DOI: 10.2169/internalmedicine.0435-22] [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: 11/06/2022] Open
Abstract
A transoral endoscopic ultrasound-guided fine-needle aspiration biopsy (EUS-FNAB) is a well-established tissue-sampling method. However, performing a transanal EUS-FNAB remains challenging. Uterine morcellation has emerged as a minimally invasive approach for benign tumor treatment. However, uterine myomas are heterogeneous and include malignant and indeterminate malignant cells. We herein report a rare case of intrapelvic tumor diagnosed by a transanal EUS-FNAB as a recurrence of smooth muscle tumors of uncertain malignant potential following uterine morcellation. Physicians should be aware that a previous uterine myoma resected under morcellation has the possibility of intra-abdominal recurrence. A transanal EUS-FNAB is a practical option for making a pathological diagnosis.
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Affiliation(s)
- Tesshin Ban
- Department of Gastroenterology and Hepatology, Gamagori City Hospital, Japan
| | - Yoshimasa Kubota
- Department of Gastroenterology and Hepatology, Gamagori City Hospital, Japan
| | - Daikoh Okubo
- Department of Gynecology, Gamagori City Hospital, Japan
| | - Takayuki Murase
- Department of Pathology and Molecular Diagnostics, Nagoya City University Graduate School of Medical Sciences, Japan
| | - Takuya Takahama
- Department of Gastroenterology and Hepatology, Gamagori City Hospital, Japan
| | - Shun Sasoh
- Department of Gastroenterology and Hepatology, Gamagori City Hospital, Japan
| | - Satoshi Tanida
- Department of Gastroenterology and Hepatology, Gamagori City Hospital, Japan
| | - Tomoaki Ando
- Department of Gastroenterology and Hepatology, Gamagori City Hospital, Japan
| | - Makoto Nakamura
- Department of Gastroenterology and Hepatology, Gamagori City Hospital, Japan
| | - Takashi Joh
- Department of Gastroenterology and Hepatology, Gamagori City Hospital, Japan
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Ban T, Kubota Y, Takahama T, Sasoh S, Ando T, Nakamura M, Joh T. Two-devices-in-one-channel method for preventing the preceding stent migration in case of multiple indwelling biliary inside plastic stents. Endoscopy 2022; 54:E948-E949. [PMID: 35835149 PMCID: PMC9736809 DOI: 10.1055/a-1881-3926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Tesshin Ban
- Department of Gastroenterology and Hepatology, Gamagori City Hospital, Gamagori, Aichi, Japan
| | - Yoshimasa Kubota
- Department of Gastroenterology and Hepatology, Gamagori City Hospital, Gamagori, Aichi, Japan
| | - Takuya Takahama
- Department of Gastroenterology and Hepatology, Gamagori City Hospital, Gamagori, Aichi, Japan
| | - Shun Sasoh
- Department of Gastroenterology and Hepatology, Gamagori City Hospital, Gamagori, Aichi, Japan
| | - Tomoaki Ando
- Department of Gastroenterology and Hepatology, Gamagori City Hospital, Gamagori, Aichi, Japan
| | - Makoto Nakamura
- Department of Gastroenterology and Hepatology, Gamagori City Hospital, Gamagori, Aichi, Japan
| | - Takashi Joh
- Department of Gastroenterology and Hepatology, Gamagori City Hospital, Gamagori, Aichi, Japan
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Ban T, Kubota Y, Takahama T, Sasoh S, Ando T, Nakamura M, Joh T. Depictability of the upper gastrointestinal tract on forward‐viewing radial endoscopic ultrasonography versus standard upper esophagogastroduodenoscopy. DEN Open 2022; 2:e89. [PMID: 35310711 PMCID: PMC8828211 DOI: 10.1002/deo2.89] [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] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Revised: 12/07/2021] [Accepted: 12/19/2021] [Indexed: 11/19/2022]
Abstract
Objectives Esophagogastroduodenoscopy (EGD) is a widely used modality for investigating the upper gastrointestinal (GI) tract, similar to endoscopic ultrasonography (EUS) for the pancreaticobiliary system. A recent and novel forward‐viewing radial EUS has potential as an EGD. However, this potential has not yet been evaluated and reported in the literature. We compared the depictability of the upper GI tract on EUS using a standard EGD. Methods This was a prospective study in a single session in an identical patient and it was conducted at a single center. Results Sixty‐nine participants were enrolled in this study. A forward‐viewing radial EUS revealed equivalent visualizing performance compared with the standard EGD, except for the retroflex view of the three angular areas. Depiction scores of the anterior wall, lesser curvature, and posterior wall of the angulus in the retroflex view in the forward‐viewing radial EUS were 1.94 (95% confidence interval [CI], 1.36–2.52), 2.03 (95% CI, 1.48–2.58), and 1.93 (95% CI, 1.35–2.50), respectively. These scores were significantly lower compared with those of standard EGD scores of 2.97 (95% CI, 2.86–3.08), 2.97 (95% CI, 2.86–3.78), and 2.96 (95% CI, 2.83–3.09], respectively; p < 0.001). The rate of full‐mark score in these three angular areas was significantly lower in the forward‐viewing radial EUS than in the standard EGD (21/69, 30.4%; 23/69, 33.3%; 21/69, 30.4% vs. 67/69; 97.1%, 67/69; 97.1%, 66/69; 95.7%, p < 0.001 for all). Conclusions Although forward‐viewing radial EUS has the potential to simultaneously investigate the upper GI and pancreaticobiliary systems, it is too early to introduce it for this purpose.
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Affiliation(s)
- Tesshin Ban
- Department of Gastroenterology and Hepatology Gamagori Municipal Hospital Aichi Japan
| | - Yoshimasa Kubota
- Department of Gastroenterology and Hepatology Gamagori Municipal Hospital Aichi Japan
| | - Takuya Takahama
- Department of Gastroenterology and Hepatology Gamagori Municipal Hospital Aichi Japan
| | - Shun Sasoh
- Department of Gastroenterology and Hepatology Gamagori Municipal Hospital Aichi Japan
| | - Tomoaki Ando
- Department of Gastroenterology and Hepatology Gamagori Municipal Hospital Aichi Japan
| | - Makoto Nakamura
- Department of Gastroenterology and Hepatology Gamagori Municipal Hospital Aichi Japan
| | - Takashi Joh
- Department of Gastroenterology and Hepatology Gamagori Municipal Hospital Aichi Japan
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Ban T, Kubota Y, Nakamura M, Ando T, Sasoh S, Ichikawa H, Takahama T, Urano M, Joh T. Unusual Gastrointestinal Hemorrhaging Mimicking a Rupture of Solitary Gastric Varices Due to a Gastric Gastrointestinal Stromal Tumor with Exogenous Growth. Intern Med 2022; 61:653-656. [PMID: 34433723 PMCID: PMC8943378 DOI: 10.2169/internalmedicine.8003-21] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Gastric gastrointestinal stromal tumors can lead to upper gastrointestinal hemorrhaging, which is usually caused by dimpling or ulceration on the tumor surface. While rare, pedunculated gastric gastrointestinal stromal tumors outside the stomach can present as a huge mass with delayed complaints. We herein report an unusual hemorrhaging mimicking a rupture of solitary gastric varices due to a pedunculated gastric gastrointestinal stromal tumor. In this case, contrast-enhanced computed tomography (CECT) was essential for tumor detection. An endoscopic investigation revealed dilated, aberrant veins and arteries in the submucosa of this tumor, recognized as solitary gastric varices.
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Affiliation(s)
- Tesshin Ban
- Department of Gastroenterology and Hepatology, Gamagori Municipal Hospital, Japan
| | - Yoshimasa Kubota
- Department of Gastroenterology and Hepatology, Gamagori Municipal Hospital, Japan
| | - Makoto Nakamura
- Department of Gastroenterology and Hepatology, Gamagori Municipal Hospital, Japan
| | - Tomoaki Ando
- Department of Gastroenterology and Hepatology, Gamagori Municipal Hospital, Japan
| | - Shun Sasoh
- Department of Gastroenterology and Hepatology, Gamagori Municipal Hospital, Japan
| | - Hiroshi Ichikawa
- Department of Gastroenterology and Hepatology, Gamagori Municipal Hospital, Japan
| | - Takuya Takahama
- Department of Gastroenterology and Hepatology, Gamagori Municipal Hospital, Japan
| | - Makoto Urano
- Department of Diagnostic Pathology, School of Medicine, Fujita Health University, Japan
| | - Takashi Joh
- Department of Gastroenterology and Hepatology, Gamagori Municipal Hospital, Japan
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Abstract
A 65-year-old man presented with a case of pure yolk sac tumor in the pineal region. The patient was admitted with a gait disturbance and elevated alpha-fetoprotein levels in serum and cerebrospinal fluid. He underwent total resection of the tumor. Cisplatin-vinblastine-bleomycin therapy was interrupted because of severe syndrome of inappropriate secretion of antidiuretic hormone, and there was recurrence of the tumor. Five months after the operation, he died in spite of carboplatin-etoposide therapy. A review of the literature revealed no previous report of pineal yolk sac tumor in an elderly patient. Problems in the diagnosis and treatment of such cases are discussed.
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Affiliation(s)
- M Kirikae
- Department of Neurosurgery, Iwate Medical University School of Medicine, Japan
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Nakajima T, Ishibashi K, Komoda K, Kawazoe K, Sasoh S, Sasaki T. [A case of yolk sac tumor of the anterior mediastinum]. Nihon Kyobu Geka Gakkai Zasshi 1994; 42:1203-1207. [PMID: 7525792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
A 26-year-old male was clinically diagnosed as having a anterior mediastinal yolk sac tumor because of the elevation of the serum AFP (26,765 ng/ml) and a large mass lesion (13 x 12 x 8 cm) in the anterior mediastinum and right thoracic cavity. After three courses of chemotherapy with CDDP and VP-16, the mediastinal mass reduced in size significantly but the serum AFP level did not reach within normal range. We suspected that the tumor took a resistance to drugs, accordingly the operation was performed. The tumor was completely removed and there were small viable foci of the tumor in part of the tumor. The histological examination revealed the findings of yolk sac tumor. After the operation, the serum AFP level decreased within normal range. He is alive without evidence of recurrence during 18 months after operation. It was noticed that the serum AFP is a useful indicator for determining the chance of operation after chemotherapy.
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Affiliation(s)
- T Nakajima
- Department of Third Surgery, Iwate Medical University, Morioka, Japan
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