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Hitomi Y, Ueno K, Aiba Y, Nishida N, Kono M, Sugihara M, Kawai Y, Kawashima M, Khor SS, Sugi K, Kouno H, Kouno H, Naganuma A, Iwamoto S, Katsushima S, Furuta K, Nikami T, Mannami T, Yamashita T, Ario K, Komatsu T, Makita F, Shimada M, Hirashima N, Yokohama S, Nishimura H, Sugimoto R, Komura T, Ota H, Kojima M, Nakamuta M, Fujimori N, Yoshizawa K, Mano Y, Takahashi H, Hirooka K, Tsuruta S, Sato T, Yamasaki K, Kugiyama Y, Motoyoshi Y, Suehiro T, Saeki A, Matsumoto K, Nagaoka S, Abiru S, Yatsuhashi H, Ito M, Kawata K, Takaki A, Arai K, Arinaga T, Abe M, Harada M, Taniai M, Zeniya M, Ohira H, Shimoda S, Komori A, Tanaka A, Ishigaki K, Nagasaki M, Tokunaga K, Nakamura M. A genome-wide association study identified PTPN2 as a population-specific susceptibility gene locus for primary biliary cholangitis. Hepatology 2024:01515467-990000000-00853. [PMID: 38652555 DOI: 10.1097/hep.0000000000000894] [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] [Received: 10/24/2023] [Accepted: 02/22/2024] [Indexed: 04/25/2024]
Abstract
BACKGROUND AIMS Previous genome-wide association studies (GWAS) have indicated the involvement of shared (population-non-specific) and non-shared (population-specific) susceptibility genes in the pathogenesis of primary biliary cholangitis (PBC) among European and East-Asian populations. Although a meta-analysis of these distinct populations has recently identified more than 20 novel PBC susceptibility loci, analyses of population-specific genetic architecture are still needed for a more comprehensive search for genetic factors in PBC. APPROACH RESULTS Protein tyrosine phosphatase non-receptor type 2 (PTPN2) was identified as a novel PBC susceptibility gene locus through a GWAS and subsequent genome-wide meta-analysis involving 2,181 cases and 2,699 controls from the Japanese population (GWAS-lead variant: rs8098858, p=2.6×10-8). In-silico and in-vitro functional analyses indicated that the risk allele of rs2292758, which is a primary functional variant, decreases PTPN2 expression by disrupting Sp1 binding to the PTPN2 promoter in T follicular helper cells (Tfh) and plasmacytoid dendritic cells (pDCs). Infiltration of PTPN2-positive T-cells and pDCs were confirmed in the portal area of the PBC-liver by immunohistochemistry. Furthermore, transcriptomic analysis of PBC-liver samples indicated the presence of a compromised negative feedback loop in-vivo between PTPN2 and IFNG in patients carrying the risk allele of rs2292758. CONCLUSIONS PTPN2, a novel susceptibility gene for PBC in the Japanese population, may be involved in the pathogenesis of PBC via an insufficient negative feedback loop caused by the PTPN2 risk allele of rs2292758 in IFN signaling. This suggests that PTPN2 could be a potential molecular target for PBC treatment.
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Affiliation(s)
- Yuki Hitomi
- Department of Human Genetics, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan
| | - Kazuko Ueno
- Genome Medical Science Project, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yoshihiro Aiba
- Clinical Research Center, NHO Nagasaki Medical Center, Omura, Japan
| | - Nao Nishida
- The Research Center for Hepatitis and Immunology, National Center for Global Health and Medicine, Ichikawa, Japan
- Department of Genomic Function and Diversity, Medical Research Institute, Tokyo Medical and Dental University, Tokyo, Japan
| | - Michihiro Kono
- Laboratory for Human Immunogenetics, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
| | - Mitsuki Sugihara
- Division of Biomedical Information Analysis, Medical Research Center for High Depth Omics, Medical Institute of Bioregulation, Kyushu University, Fukuoka, Japan
| | - Yosuke Kawai
- Genome Medical Science Project, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan
| | | | - Seik-Soon Khor
- Genome Medical Science Project, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan
- Singapore Centre for Environmental Life Sciences Engineering, Nanyang Technological University, Singapore, Singapore
| | - Kazuhiro Sugi
- Headquarters of PBC Research in NHO Study Group for Liver Disease in Japan (NHOSLJ), Clinical Research Center, NHO Nagasaki Medical Center, Omura, Japan
| | - Hirotaka Kouno
- Headquarters of PBC Research in NHO Study Group for Liver Disease in Japan (NHOSLJ), Clinical Research Center, NHO Nagasaki Medical Center, Omura, Japan
| | - Hiroshi Kouno
- Headquarters of PBC Research in NHO Study Group for Liver Disease in Japan (NHOSLJ), Clinical Research Center, NHO Nagasaki Medical Center, Omura, Japan
| | - Atsushi Naganuma
- Headquarters of PBC Research in NHO Study Group for Liver Disease in Japan (NHOSLJ), Clinical Research Center, NHO Nagasaki Medical Center, Omura, Japan
| | - Satoru Iwamoto
- Headquarters of PBC Research in NHO Study Group for Liver Disease in Japan (NHOSLJ), Clinical Research Center, NHO Nagasaki Medical Center, Omura, Japan
| | - Shinji Katsushima
- Headquarters of PBC Research in NHO Study Group for Liver Disease in Japan (NHOSLJ), Clinical Research Center, NHO Nagasaki Medical Center, Omura, Japan
| | - Kiyoshi Furuta
- Headquarters of PBC Research in NHO Study Group for Liver Disease in Japan (NHOSLJ), Clinical Research Center, NHO Nagasaki Medical Center, Omura, Japan
| | - Toshiki Nikami
- Headquarters of PBC Research in NHO Study Group for Liver Disease in Japan (NHOSLJ), Clinical Research Center, NHO Nagasaki Medical Center, Omura, Japan
| | - Tomohiko Mannami
- Headquarters of PBC Research in NHO Study Group for Liver Disease in Japan (NHOSLJ), Clinical Research Center, NHO Nagasaki Medical Center, Omura, Japan
| | - Tsutomu Yamashita
- Headquarters of PBC Research in NHO Study Group for Liver Disease in Japan (NHOSLJ), Clinical Research Center, NHO Nagasaki Medical Center, Omura, Japan
| | - Keisuke Ario
- Headquarters of PBC Research in NHO Study Group for Liver Disease in Japan (NHOSLJ), Clinical Research Center, NHO Nagasaki Medical Center, Omura, Japan
| | - Tatsuji Komatsu
- Headquarters of PBC Research in NHO Study Group for Liver Disease in Japan (NHOSLJ), Clinical Research Center, NHO Nagasaki Medical Center, Omura, Japan
| | - Fujio Makita
- Headquarters of PBC Research in NHO Study Group for Liver Disease in Japan (NHOSLJ), Clinical Research Center, NHO Nagasaki Medical Center, Omura, Japan
| | - Masaaki Shimada
- Headquarters of PBC Research in NHO Study Group for Liver Disease in Japan (NHOSLJ), Clinical Research Center, NHO Nagasaki Medical Center, Omura, Japan
| | - Noboru Hirashima
- Headquarters of PBC Research in NHO Study Group for Liver Disease in Japan (NHOSLJ), Clinical Research Center, NHO Nagasaki Medical Center, Omura, Japan
| | - Shiro Yokohama
- Headquarters of PBC Research in NHO Study Group for Liver Disease in Japan (NHOSLJ), Clinical Research Center, NHO Nagasaki Medical Center, Omura, Japan
| | - Hideo Nishimura
- Headquarters of PBC Research in NHO Study Group for Liver Disease in Japan (NHOSLJ), Clinical Research Center, NHO Nagasaki Medical Center, Omura, Japan
| | - Rie Sugimoto
- Headquarters of PBC Research in NHO Study Group for Liver Disease in Japan (NHOSLJ), Clinical Research Center, NHO Nagasaki Medical Center, Omura, Japan
| | - Takuya Komura
- Headquarters of PBC Research in NHO Study Group for Liver Disease in Japan (NHOSLJ), Clinical Research Center, NHO Nagasaki Medical Center, Omura, Japan
| | - Hajime Ota
- Headquarters of PBC Research in NHO Study Group for Liver Disease in Japan (NHOSLJ), Clinical Research Center, NHO Nagasaki Medical Center, Omura, Japan
| | - Motoyuki Kojima
- Headquarters of PBC Research in NHO Study Group for Liver Disease in Japan (NHOSLJ), Clinical Research Center, NHO Nagasaki Medical Center, Omura, Japan
| | - Makoto Nakamuta
- Headquarters of PBC Research in NHO Study Group for Liver Disease in Japan (NHOSLJ), Clinical Research Center, NHO Nagasaki Medical Center, Omura, Japan
| | - Naoyuki Fujimori
- Headquarters of PBC Research in NHO Study Group for Liver Disease in Japan (NHOSLJ), Clinical Research Center, NHO Nagasaki Medical Center, Omura, Japan
| | - Kaname Yoshizawa
- Headquarters of PBC Research in NHO Study Group for Liver Disease in Japan (NHOSLJ), Clinical Research Center, NHO Nagasaki Medical Center, Omura, Japan
| | - Yutaka Mano
- Headquarters of PBC Research in NHO Study Group for Liver Disease in Japan (NHOSLJ), Clinical Research Center, NHO Nagasaki Medical Center, Omura, Japan
| | - Hironao Takahashi
- Headquarters of PBC Research in NHO Study Group for Liver Disease in Japan (NHOSLJ), Clinical Research Center, NHO Nagasaki Medical Center, Omura, Japan
| | - Kana Hirooka
- Headquarters of PBC Research in NHO Study Group for Liver Disease in Japan (NHOSLJ), Clinical Research Center, NHO Nagasaki Medical Center, Omura, Japan
| | - Satoru Tsuruta
- Headquarters of PBC Research in NHO Study Group for Liver Disease in Japan (NHOSLJ), Clinical Research Center, NHO Nagasaki Medical Center, Omura, Japan
| | - Takeaki Sato
- Headquarters of PBC Research in NHO Study Group for Liver Disease in Japan (NHOSLJ), Clinical Research Center, NHO Nagasaki Medical Center, Omura, Japan
| | - Kazumi Yamasaki
- Clinical Research Center, NHO Nagasaki Medical Center, Omura, Japan
| | - Yuki Kugiyama
- Clinical Research Center, NHO Nagasaki Medical Center, Omura, Japan
| | | | - Tomoyuki Suehiro
- Clinical Research Center, NHO Nagasaki Medical Center, Omura, Japan
| | - Akira Saeki
- Clinical Research Center, NHO Nagasaki Medical Center, Omura, Japan
| | - Kosuke Matsumoto
- Clinical Research Center, NHO Nagasaki Medical Center, Omura, Japan
| | - Shinya Nagaoka
- Clinical Research Center, NHO Nagasaki Medical Center, Omura, Japan
| | - Seigo Abiru
- Clinical Research Center, NHO Nagasaki Medical Center, Omura, Japan
| | | | - Masahiro Ito
- Clinical Research Center, NHO Nagasaki Medical Center, Omura, Japan
| | - Kazuhito Kawata
- Hepatology Division, Department of Internal Medicine II, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Akinobu Takaki
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Kuniaki Arai
- Department of Gastroenterology, Kanazawa University Graduate School of Medicine, Kanazawa, Japan
| | - Teruko Arinaga
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Masanori Abe
- Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Matsuyama, Japan
| | - Masaru Harada
- The Third Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Makiko Taniai
- Department of Medicine and Gastroenterology, Tokyo Women's Medical University, Tokyo, Japan
| | - Mikio Zeniya
- Department of Gastroenterology and Hepatology, Tokyo Jikei University School of Medicine, Tokyo, Japan
| | - Hiromasa Ohira
- Department of Gastroenterology and Rheumatic Diseases, Fukushima Medical University of Medicine, Fukushima, Japan
| | - Shinji Shimoda
- Division of Gastroenterology and Hepatology, Third Department of Internal Medicine, Kansai Medical University, Hirakata, Japan
| | - Atsumasa Komori
- Clinical Research Center, NHO Nagasaki Medical Center, Omura, Japan
- Department of Hepatology, Nagasaki University Graduate School of Biomedical Sciences, Omura, Japan
| | - Atsushi Tanaka
- Department of Medicine, Teikyo University School of Medicine, Tokyo, Japan
| | - Kazuyoshi Ishigaki
- Laboratory for Human Immunogenetics, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
| | - Masao Nagasaki
- Division of Biomedical Information Analysis, Medical Research Center for High Depth Omics, Medical Institute of Bioregulation, Kyushu University, Fukuoka, Japan
- Human Biosciences Unit for the Top Global Course Center for the Promotion of Interdisciplinary Education and Research, Kyoto University, Kyoto, Japan
| | - Katsushi Tokunaga
- Genome Medical Science Project, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan
| | - Minoru Nakamura
- Clinical Research Center, NHO Nagasaki Medical Center, Omura, Japan
- Division of Biomedical Information Analysis, Medical Research Center for High Depth Omics, Medical Institute of Bioregulation, Kyushu University, Fukuoka, Japan
- Headquarters of PBC Research in NHO Study Group for Liver Disease in Japan (NHOSLJ), Clinical Research Center, NHO Nagasaki Medical Center, Omura, Japan
- Department of Hepatology, Nagasaki University Graduate School of Biomedical Sciences, Omura, Japan
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Omori T, Ohmiya N, Watanabe K, Hirai F, Nakamura M, Kitamura K, Ozeki K, Oka S, Kawano S, Handa O, Kawai M, Ninomiya K, Sagawa T, Wakamatsu T, Araki A, Koike Y, Kato S, Hashimoto S, Mannami T, Nakaji K, Tanaka S, Matsui T. Nationwide multicenter study on adverse events associated with a patency capsule: Additional survey of appropriate use of patency capsule study. J Gastroenterol Hepatol 2024; 39:337-345. [PMID: 37842961 DOI: 10.1111/jgh.16365] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 08/21/2023] [Accepted: 09/10/2023] [Indexed: 10/17/2023]
Abstract
BACKGROUND AND AIM The PillCam patency capsule (PC) without a radio frequency identification tag was released to preclude retention of the small bowel capsule endoscope (CE) in Japan in 2012. We conducted a multicenter study to determine tag-less PC-related adverse events (AEs). METHODS We first conducted a retrospective survey using a standardized data collection sheet for the clinical characteristics of PC-related AEs among 1096 patients collected in a prospective survey conducted between January 2013 and May 2014 (Cohort 1). Next, we retrospectively investigated additional AEs that occurred before and after Cohort 1 within the period June 2012 and December 2014 among 1482 patients (Cohort 2). RESULTS Of the 2578 patients who underwent PC examinations from both cohorts, 74 AEs occurred among 61 patients (2.37%). The main AEs were residual parylene coating in 25 events (0.97%), PC-induced small bowel obstruction, suspicious of impaction, in 23 events (0.89%), and CE retention even after patency confirmation in 10 events (0.39%). Residual parylene coating was significantly associated with Crohn's disease (P < 0.01). Small bowel obstruction was significantly associated with physicians with less than 1 year of experience handling the PC and previous history of postprandial abdominal pain (P < 0.01 and P < 0.03, respectively). CE retention was ascribed to erroneous judgment of PC localization in all cases. CONCLUSIONS This large-scale multicenter study provides evidence supporting the safety and efficiency of a PC to preclude CE retention. Accurate PC localization in patients without excretion and confirmation of previous history of postprandial abdominal pain before PC examinations is warranted (UMIN000010513).
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Affiliation(s)
- Teppei Omori
- Institute of Gastroenterology, Tokyo Women's Medical University, Tokyo, Japan
| | - Naoki Ohmiya
- Department of Advanced Endoscopy, Fujita Health University School of Medicine, Toyoake, Japan
| | - Kenji Watanabe
- Department of Internal Medicine for Inflammatory Bowel Disease, Toyama University, Toyama, Japan
| | - Fumihito Hirai
- Department of Gastroenterology and Medicine, Fukuoka University Faculty of Medicine, Fukuoka, Japan
| | - Masanao Nakamura
- Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kazuya Kitamura
- Department of Gastroenterology, Tonami General Hospital, Toyama, Japan
| | - Keiji Ozeki
- Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Shiro Oka
- Department of Gastroenterology, Hiroshima University, Hiroshima, Japan
| | - Seiji Kawano
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
| | - Osamu Handa
- Depatment of Gastroenterology, Kawasaki Medical School, Okayama, Japan
| | - Mikio Kawai
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Hyogo Medical University, Nishinomiya, Japan
| | | | - Tamotsu Sagawa
- Department of Gastroenterology, Hokkaido Cancer Center, Sapporo, Japan
| | - Takahiro Wakamatsu
- Wakamatsu Clinic, Osaka, Japan
- Department of Gastroenterology and Hepatology, Kansai Medical University, Osaka, Japan
| | - Akihiro Araki
- Health Management Center, Toranomon Hospital, Tokyo, Japan
| | - Yuji Koike
- Department of Gastroenterology, Yokohama Municipal Citizen's Hospital, Yokohama, Japan
| | - Shingo Kato
- Department of Gastroenterology and Hepatology, Saitama Medical Center, Saitama Medical University, Saitama, Japan
| | - Shinichi Hashimoto
- Department of Gastroenterology and Hepatology, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan
| | - Tomohiko Mannami
- Department of Gastroenterology, National Hospital Organization Okayama Medical Center, Okayama, Japan
- Department of Internal Medicine, Chugoku Central Hospital, Hiroshima, Japan
| | | | - Shinji Tanaka
- Department of Endoscopy and Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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Iwamuro M, Tanaka T, Ennishi D, Matsueda K, Yoshioka M, Miyahara K, Sakaguchi C, Nishimura M, Nagahara T, Mannami T, Takenaka R, Oka S, Inoue M, Takimoto H, Inaba T, Kobayashi S, Toyokawa T, Tsugeno H, Suzuki S, Sawada S, Tanaka S, Tsuzuki T, Okada H. Long-term outcomes of patients with primary intestinal follicular lymphoma managed with watch-and-wait strategy. Sci Rep 2023; 13:5858. [PMID: 37041184 PMCID: PMC10090188 DOI: 10.1038/s41598-023-32736-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Accepted: 03/31/2023] [Indexed: 04/13/2023] Open
Abstract
Patients with primary intestinal follicular lymphoma are often followed-up without a specific treatment, and this approach is called the "watch-and-wait approach." However, the long-term outcomes of this patient group have not been sufficiently investigated. We enrolled patients with primary intestinal follicular lymphoma who were diagnosed before 2016 and managed with the watch-and-wait approach in 20 institutions. We retrospectively investigated the overall, disease-specific, and event-free survival rates as well as the rate of spontaneous regression. Among the 248 patients with follicular lymphoma with gastrointestinal involvement, 124 had localized disease (stage I or II1). We analyzed the data of 73 patients who were managed using the watch-and-wait approach. During the mean follow-up period of 8.3 years, the follicular lymphoma had spontaneously resolved in 16.4% of the patients. The 5-year and 10-year overall survival rates were 92.9% and 87.1%, respectively. With disease progression (n = 7), initiation of therapy (n = 7), and histologic transformation to aggressive lymphoma (n = 0) defined as events, the 5-year and 10-year event-free survival rates were 91.1% and 86.9%, respectively. No patient died of progressive lymphoma. Thus, both 5-year and 10-year disease-specific survival rates were 100%. In conclusion, an indolent long-term clinical course was confirmed in the patients with primary intestinal follicular lymphoma. The watch-and-wait strategy is a reasonable approach for the initial management of these patients.
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Affiliation(s)
- Masaya Iwamuro
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, Okayama, 700-8558, Japan.
| | - Takehiro Tanaka
- Department of Pathology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, Okayama, 700-8558, Japan
| | - Daisuke Ennishi
- Department of Hematology and Oncology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, Okayama, 700-8558, Japan
| | - Kazuhiro Matsueda
- Department of Gastroenterology and Hepatology, Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki, Okayama, 710-8602, Japan
| | - Masao Yoshioka
- Department of Internal Medicine, Okayama Saiseikai General Hospital, 2-25 Kokutai-cho, Kita-ku, Okayama, Okayama, 700-8511, Japan
| | - Koji Miyahara
- Department of Internal Medicine, Hiroshima City Hospital, 7-33 Motomachi, Naka-ku, Hiroshima, Hiroshima, 730-8518, Japan
| | - Chihiro Sakaguchi
- Department of Endoscopy, National Hospital Organization Shikoku Cancer Center, Kou 160, Minamiumemotomachi, Matsuyama, 791-0280, Japan
| | - Mamoru Nishimura
- Department of Internal Medicine, Okayama City Hospital, 3-20-1 Kitanagase Omote-cho, Kita-ku, Okayama, Okayama, 700‑8557, Japan
| | - Teruya Nagahara
- Department of Gastroenterology, Mitoyo General Hospital, 708 Himehama, Toyohama-cho, Kan'onji, Kagawa, 769-1695, Japan
| | - Tomohiko Mannami
- Department of Gastroenterology, National Hospital Organization Okayama Medical Center, 1711-1 Tamasu, Kita-ku, Okayama, Okayama, 701-1192, Japan
| | - Ryuta Takenaka
- Department of Internal Medicine, Tsuyama Chuo Hospital, 1756 Kawasaki, Tsuyama, Okayama, 708‑0841, Japan
| | - Shohei Oka
- Department of Gastroenterology, Nippon Kokan Fukuyama Hospital, 1844 Tsunoshita, Daimon-cho, Fukuyama, Hiroshima, 721-0927, Japan
| | - Masafumi Inoue
- Department of Gastroenterology, Japanese Red Cross Okayama Hospital, 2-1-1 Aoe, Kita-ku, Okayama, Okayama, 700-8607, Japan
| | - Hidetaka Takimoto
- Department of Internal Medicine, Kagawa Rosai Hospital, 3-3-1 Joto-cho, Marugame, Kagawa, 763‑8502, Japan
| | - Tomoki Inaba
- Department of Gastroenterology, Kagawa Prefectural Central Hospital, 1-2-1 Asahi-machi, Takamatsu, Kagawa, 760-8557, Japan
| | - Sayo Kobayashi
- Department of Internal Medicine, Fukuyama City Hospital, 5-23-1 Zao-cho, Fukuyama, Hiroshima, 721-8511, Japan
| | - Tatsuya Toyokawa
- Department of Gastroenterology, National Hospital Organization Fukuyama Medical Center, 4-14-17 Okinogami-cho, Fukuyama, Hiroshima, 720-8520, Japan
| | - Hirofumi Tsugeno
- Department of Gastroenterology, Okayama Rosai Hospital, 1-10 Chikkomidorimachi, Minami-ku, Okayama, Okayama, 702-8055, Japan
| | - Seiyuu Suzuki
- Department of Gastroenterology, Sumitomo Besshi Hospital, 3-1 Ojicho, Niihama, Ehime, 792‑8543, Japan
| | - Sachiko Sawada
- Department of Internal Medicine, St. Mary's Hospital, 650 Nibuno, Himeji, Hyogo, 670-0801, Japan
| | - Shouichi Tanaka
- Department of Gastroenterology, National Hospital Organization Iwakuni Clinical Center, 1-1-1 Atago-cho, Iwakuni, Yamaguchi, 740-8510, Japan
| | - Takao Tsuzuki
- Department of Internal Medicine, Japanese Red Cross Society Himeji Hospital, 1-12-1 Shimoteno, Himeji, Hyogo, 670-8540, Japan
| | - Hiroyuki Okada
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, Okayama, 700-8558, Japan
- Department of Internal Medicine, Japanese Red Cross Society Himeji Hospital, 1-12-1 Shimoteno, Himeji, Hyogo, 670-8540, Japan
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Wakatsuki T, Mannami T, Furutachi S, Numoto H, Umekawa T, Mitsumune M, Sakaki T, Nagahara H, Fukumoto Y, Yorifuji T, Shimizu S. Glasgow‐Blatchford score combined with nasogastric aspirate as a new diagnostic algorithm for patients with nonvariceal upper gastrointestinal bleeding. DEN Open 2023; 3:e185. [PMCID: PMC9663679 DOI: 10.1002/deo2.185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 10/15/2022] [Accepted: 10/22/2022] [Indexed: 11/17/2022]
Affiliation(s)
- Toshiyuki Wakatsuki
- Department of Gastroenterology National Hospital Organization Okayama Medical Center Okayama Japan
| | - Tomohiko Mannami
- Department of Gastroenterology National Hospital Organization Okayama Medical Center Okayama Japan
| | - Shinichi Furutachi
- Department of Gastroenterology National Hospital Organization Okayama Medical Center Okayama Japan
| | - Hiroki Numoto
- Department of Gastroenterology National Hospital Organization Okayama Medical Center Okayama Japan
| | - Tsuyoshi Umekawa
- Department of Gastroenterology National Hospital Organization Okayama Medical Center Okayama Japan
| | - Mayu Mitsumune
- Department of Gastroenterology National Hospital Organization Okayama Medical Center Okayama Japan
| | - Tsukasa Sakaki
- Department of Gastroenterology National Hospital Organization Okayama Medical Center Okayama Japan
| | - Hanako Nagahara
- Department of Gastroenterology National Hospital Organization Okayama Medical Center Okayama Japan
| | - Yasushi Fukumoto
- Department of Gastroenterology National Hospital Organization Okayama Medical Center Okayama Japan
| | - Takashi Yorifuji
- Department of Epidemiology, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences Okayama Japan
| | - Shin'ichi Shimizu
- Department of Gastroenterology National Hospital Organization Okayama Medical Center Okayama Japan
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5
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Matsumoto K, Kato H, Fujii M, Ueki T, Saragai Y, Tsugeno H, Mannami T, Okada H. Efficacy of intraductal placement of nonflared fully-covered metal stent for refractory perihilar benign biliary strictures: A multicenter prospective study with long-term observation. J Hepatobiliary Pancreat Sci 2022; 29:1300-1307. [PMID: 35657019 DOI: 10.1002/jhbp.1188] [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: 02/10/2022] [Revised: 04/21/2022] [Accepted: 04/25/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Endoscopic fully-covered self-expandable metal stents (FCSEMSs) are used to treat benign biliary strictures (BBSs); however, treatment for perihilar BBSs is technically challenging. The aim of this study was to evaluate the usefulness of an unflared FCSEMS designed for intraductal placement in patients with refractory perihilar BBS. METHODS Twenty-two consecutive patients with perihilar BBS unresolved by endoscopic plastic stent placement at 13 tertiary medical centers were prospectively enrolled. The FCSEMS was placed above the papilla and removed after 4 months. The primary outcome was stricture resolution at 4 months, and the secondary outcomes were technical success, stent removal, adverse events, and recurrence. RESULTS The technical success rate of intraductal FCSEMS placement was 100%, and plastic stent placement at contralateral or side branch was performed in 86% of patients. The rate of successful stent removal at 4 months was 100%, and stricture resolution was observed in 91% of patients. Stent migration or stent-induced de novo stricture did not occur in any patient. The stricture recurrence rate was 16%, and the median (interquartile range) follow-up duration was 2.8 (1.6-3.3) years. CONCLUSIONS Intraductal placement of unflared FCSEMS is effective treatment for refractory perihilar BBS.
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Affiliation(s)
- Kazuyuki Matsumoto
- Department of Gastroenterology and Hepatology, Okayama University Hospital, Okayama, Japan
| | - Hironari Kato
- Department of Gastroenterology and Hepatology, Okayama University Hospital, Okayama, Japan
| | - Masakuni Fujii
- Department of Internal Medicine, Okayama Saiseikai General Hospital, Okayama, Japan
| | - Toru Ueki
- Departments of Internal Medicine, Fukuyama City Hospital, Hiroshima, Japan
| | - Yosuke Saragai
- Department of Gastroenterology, Iwakuni Medical Center, Hiroshima, Japan
| | - Hirofumi Tsugeno
- Department of Gastroenterology, Tsuyama Central Hospital, Okayama, Japan
| | - Tomohiko Mannami
- Department of Gastroenterology, National Hospital Organization Okayama Medical Center, Okayama, Japan
| | - Hiroyuki Okada
- Department of Gastroenterology and Hepatology, Okayama University Hospital, Okayama, Japan
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Mannami T, Tanaka T, Fujiwara N. Gastric adenocarcinoma of fundic gland type with two closely located lesions endoscopically resected en masse. Endoscopy 2022; 54:E413-E414. [PMID: 34496435 DOI: 10.1055/a-1559-2158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
- Tomohiko Mannami
- Department of Gastroenterology, National Hospital Organization Okayama Medical Center, Okayama, Japan
| | - Takehiro Tanaka
- Department of Pathology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
| | - Nobukiyo Fujiwara
- Department of Internal Medicine, Chugoku Central Hospital, Fukuyama, Japan
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7
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Takimoto K, Matsuura N, Nakano Y, Tsuji Y, Takizawa K, Morita Y, Nagami Y, Hirasawa K, Araki H, Yamaguchi N, Aoyagi H, Matsuhashi T, Iizuka T, Saegusa H, Yamazaki K, Hori S, Mannami T, Hanaoka N, Mori H, Kobara H, Takeuchi Y, Ono H. Efficacy of polyglycolic acid sheeting with fibrin glue for perforations related to gastrointestinal endoscopic procedures: a multicenter retrospective cohort study. Surg Endosc 2022; 36:5084-5093. [PMID: 34816305 DOI: 10.1007/s00464-021-08873-5] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 11/07/2021] [Indexed: 12/31/2022]
Abstract
OBJECTIVES Gastrointestinal (GI) perforations are one of the major adverse events of endoscopic procedures. Polyglycolic acid (PGA) sheets with fibrin glue have been reported to close GI perforations. However, its clinical outcome has not yet been fully investigated; thus, we conducted a multicenter retrospective observational study to assess the efficacy of PGA sheeting for GI perforation. METHODS The medical records of patients who underwent PGA sheeting for endoscopic GI perforations between April 2013 and March 2018 in 18 Japanese institutions were retrospectively analyzed. PGA sheeting was applied when the clip closure was challenging or failed to use. Perforations were filled with one or several pieces of PGA sheets followed by fibrin glue application through an endoscopic catheter. Nasal or percutaneous drainage and endoscopic clipping were applied as appropriate. Clinical outcomes after PGA sheeting for intraoperative or delayed perforations were separately evaluated. RESULTS There were 66 intraoperative and 24 delayed perforation cases. In intraoperative cases, successful closure was attained in 60 cases (91%). The median period from the first sheeting to diet resumption was 6 days (interquartile range [IQR], 4-8.8 days). Large perforation size (≥ 10 mm) and duodenal location showed marginal significant relationship to higher closure failure of intraoperative perforations. In delayed perforation cases, all cases had successful closure. The median period from the first sheeting to diet resumption was 10 days (IQR, 6-37.8 days). No adverse events related to PGA sheeting occurred. CONCLUSION Endoscopic PGA sheeting could be a therapeutic option for GI perforations related to GI endoscopic procedures.
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Affiliation(s)
- Kengo Takimoto
- Department of Gastroenterology, National Hospital Organization Kyoto Medical Center, Kyoto, Japan.
- Department of Gastroenterology, Uji Tokushukai Medical Center, Kyoto, Japan.
- Department of Gastroenterology, Uji Tokushukai Medical Center, 145, Ishibashi, Makishima-cho, Uji-city, Kyoto, Japan.
| | - Noriko Matsuura
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Yoshiko Nakano
- Department of Gastroenterology, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
| | - Yosuke Tsuji
- Department of Gastroenterology, Graduate School of Medicine, the University of Tokyo, Tokyo, Japan
| | - Kohei Takizawa
- Division of Endoscopy, Shizuoka Cancer Center, Shizuoka, Japan
| | - Yoshinori Morita
- Department of Gastroenterology, International Clinical Cancer Research Center, Kobe University Hospital, Kobe, Japan
- Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yasuaki Nagami
- Department of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Kingo Hirasawa
- Division of Endoscopy, Yokohama City University Medical Center, Yokohama, Japan
| | - Hiroshi Araki
- Department of Gastroenterology, Gifu University Hospital, Gifu, Japan
| | - Naoyuki Yamaguchi
- Department of Gastroenterology and Hepatology, Nagasaki University Hospital, Nagasaki, Japan
| | - Hiroyuki Aoyagi
- Department of Gastroenterology, Fukui Prefectural Hospital, Fukui, Japan
| | - Tamotsu Matsuhashi
- Department of Gastroenterology, Akita University Graduate School of Medicine, Akita, Japan
| | - Toshiro Iizuka
- Department of Gastroenterology, Toranomon Hospital, Tokyo, Japan
| | - Hisanobu Saegusa
- Department of Gastroenterology, Shinonoi General Hospital, Nagano, Japan
| | - Kenji Yamazaki
- Department of Gastroenterology, Gifu Prefectural General Medical Center, Gifu, Japan
| | - Shinichiro Hori
- Department of Internal Medicine, Shikoku Cancer Center, Ehime, Japan
| | - Tomohiko Mannami
- Department of Gastroenterology, Chugoku Central Hospital, Fukuyama, Japan
| | - Noboru Hanaoka
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Hirohito Mori
- Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University, Kagawa, Japan
| | - Hideki Kobara
- Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University, Kagawa, Japan
| | - Yoji Takeuchi
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Hiroyuki Ono
- Division of Endoscopy, Shizuoka Cancer Center, Shizuoka, Japan
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8
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Yamasaki Y, Uedo N, Akamatsu T, Kagawa T, Higashi R, Dohi O, Furukawa M, Takahashi Y, Inoue T, Tanaka S, Takenaka R, Iguchi M, Kawamura T, Tsuzuki T, Yamasaki T, Yamashina T, Nasu J, Mannami T, Yamauchi A, Matsueda K, Aizawa S, Mitsuhashi T, Okada H. Nonrecurrence Rate of Underwater EMR for ≤20-mm Nonampullary Duodenal Adenomas: A Multicenter Prospective Study (D-UEMR Study). Clin Gastroenterol Hepatol 2022; 20:1010-1018.e3. [PMID: 34217879 DOI: 10.1016/j.cgh.2021.06.043] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [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: 06/24/2021] [Accepted: 06/25/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND AND AIMS Endoscopic resection of nonampullary duodenal adenoma is often challenging, and its technique has not yet been standardized. To overcome the practical difficulty of conventional endoscopic mucosal resection, underwater endoscopic mucosal resection (UEMR) was recently developed; therefore, we investigated the effectiveness and safety of UEMR for nonampullary duodenal adenoma. METHODS A multicenter, prospective cohort study was conducted at 21 institutions in Japan. We enrolled patients with no more than 2 nonampullary duodenal adenomas ≤20 mm in size, who were planned to undergo UEMR. After UEMR, follow-up endoscopies were scheduled at 2 and 12 months after the procedure, and biopsy specimens were taken from the post-UEMR scars. The primary endpoint was the proportion of patients with histologically proven nonrecurrence at follow-up endoscopy and biopsy. RESULTS A total of 155 patients with 166 lesions underwent UEMR. One patient with a non-neoplastic lesion in the resected specimen and 10 patients with 10 lesions who were lost to follow-up were excluded. Finally, 144 patients with 155 lesions who received all follow-up endoscopies were analyzed for the primary endpoint. The proportion of patients with proven nonrecurrence was 97.2% (n = 140 of 144; 95% confidence interval, 92.8%-99.1%) which exceeded the predefined threshold value (92%). Two cases of delayed bleeding (1.2%) occurred and they were successfully managed by clips. All recurrences were successfully treated by additional endoscopic treatment. CONCLUSIONS This multicenter, prospective cohort study demonstrated effectiveness and safety of UEMR for nonampullary duodenal adenomas ≤20 mm in size. (University Hospital Medical Network Clinical Trials Registry, Number: UMIN000030414).
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Affiliation(s)
- Yasushi Yamasaki
- Department of Gastroenterology, Okayama University Hospital, Okayama, Japan
| | - Noriya Uedo
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan.
| | - Takuji Akamatsu
- Department of Gastroenterology and Hepatology, Japanese Red Cross Society Wakayama Medical Center, Wakayama, Japan
| | - Tomo Kagawa
- Department of Gastroenterology, Kagawa Prefectural Central Hospital, Takamatsu, Japan
| | - Reiji Higashi
- Department of Internal Medicine, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan
| | - Osamu Dohi
- Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Masanori Furukawa
- Division of Endoscopy, Nara Medical University Hospital, Nara, Japan
| | - Yu Takahashi
- Third Department of Internal Medicine, Kansai Medical University, Osaka, Japan
| | - Takuya Inoue
- Department of Gastroenterology and Hepatology, Osaka General Medical Center, Osaka, Japan
| | - Shouichi Tanaka
- Department of Gastroenterology, National Hospital Organization Iwakuni Clinical Center, Iwakuni, Japan
| | - Ryuta Takenaka
- Department of Internal Medicine, Tsuyama Chuo Hospital, Tsuyama, Japan
| | - Mikitaka Iguchi
- Second Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan
| | - Takuji Kawamura
- Department of Gastroenterology, Kyoto Second Red Cross Hospital, Kyoto, Japan
| | - Takao Tsuzuki
- Department of Internal Medicine, Japanese Red Cross Society Himeji Hospital, Himeji, Japan
| | - Tomoaki Yamasaki
- Department of Gastroenterology, Osaka City General Hospital, Osaka, Japan
| | - Takeshi Yamashina
- Department of Gastroenterology and Hepatology, Osaka Red Cross Hospital, Osaka, Japan
| | - Junichiro Nasu
- Department of Internal Medicine, Okayama Saiseikai General Hospital, Okayama, Japan
| | - Tomohiko Mannami
- Department of Gastroenterology, National Hospital Organization Okayama Medical Center, Okayama, Japan
| | - Atsushi Yamauchi
- Department of Gastroenterology and Hepatology, Tazuke Kofukai Medical Research Institute, Kitano Hospital, Osaka, Japan
| | - Kazuhiro Matsueda
- Department of Gastroenterology and Hepatology, Kurashiki Central Hospital, Kurashiki, Japan
| | - Shigeyuki Aizawa
- Department of Gastroenterology, Nara Prefecture Seiwa Medical Center, Nara, Japan
| | - Toshiharu Mitsuhashi
- Center for Innovative Clinical Medicine, Okayama University Hospital, Okayama, Japan
| | - Hiroyuki Okada
- Department of Gastroenterology, Okayama University Hospital, Okayama, Japan
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9
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Mannami T, Sakaki T, Tanaka T, Fukumoto Y, Wakatsuki T, Furutachi S, Shimizu S, Umekawa T, Mitsumune M, Nagahara H, Ikeda G, Fujiwara N. Esophageal xanthoma with nearby coexistent squamous cell carcinoma observed using magnifying endoscopy with narrow-band imaging. Clin J Gastroenterol 2022; 15:325-332. [PMID: 34994961 DOI: 10.1007/s12328-021-01583-4] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 12/21/2021] [Indexed: 11/26/2022]
Abstract
We report the case of a 63-year-old man who underwent annual surveillance esophagogastroduodenoscopy, during which a small squamous cell carcinoma and a tiny yellowish granular lesion were found in the middle esophagus, slightly apart from each other. Magnifying endoscopy with narrow-band imaging of the yellowish granular lesion showed yellowish spots and blots scattered within an approximately 2-mm area. The larger spots appeared nodular and were overlaid with tortuous microvessels. Subsequently, both the lesions were excised en masse via endoscopic submucosal dissection, and the yellowish lesion was determined to be xanthoma. Histologically, an aggregated nest of foam cells surrounded by intrapapillary capillary vessels filled the intraepithelial papillae; the foam cells also extended inferiorly, below the rete ridges, and were sparsely distributed through the lamina propria mucosae. To our knowledge, the latter finding is the first to be described in literature, which leads us to postulate that the number of foam cells in the lamina propria mucosae may affect how thick and yellow a xanthoma appears on endoscopy. We believe that this case that presents a highly detailed comparison between endoscopic and histologic findings improves our understanding of the endoscopic appearance of esophageal xanthomas and may facilitate a precise diagnosis of this rare disease.
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Affiliation(s)
- Tomohiko Mannami
- Department of Gastroenterology, National Hospital Organization Okayama Medical Center, 1711-1 Tamasu, Kita-ku, Okayama, 701-1192, Japan.
| | - Tsukasa Sakaki
- Department of Gastroenterology, National Hospital Organization Okayama Medical Center, 1711-1 Tamasu, Kita-ku, Okayama, 701-1192, Japan
| | - Takehiro Tanaka
- Department of Pathology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, 700-8558, Japan
| | - Yasushi Fukumoto
- Department of Gastroenterology, National Hospital Organization Okayama Medical Center, 1711-1 Tamasu, Kita-ku, Okayama, 701-1192, Japan
| | - Toshiyuki Wakatsuki
- Department of Gastroenterology, National Hospital Organization Okayama Medical Center, 1711-1 Tamasu, Kita-ku, Okayama, 701-1192, Japan
| | - Shinichi Furutachi
- Department of Gastroenterology, National Hospital Organization Okayama Medical Center, 1711-1 Tamasu, Kita-ku, Okayama, 701-1192, Japan
| | - Shin'ichi Shimizu
- Department of Gastroenterology, National Hospital Organization Okayama Medical Center, 1711-1 Tamasu, Kita-ku, Okayama, 701-1192, Japan
| | - Tsuyoshi Umekawa
- Department of Gastroenterology, National Hospital Organization Okayama Medical Center, 1711-1 Tamasu, Kita-ku, Okayama, 701-1192, Japan
| | - Mayu Mitsumune
- Department of Gastroenterology, National Hospital Organization Okayama Medical Center, 1711-1 Tamasu, Kita-ku, Okayama, 701-1192, Japan
| | - Hanako Nagahara
- Department of Gastroenterology, National Hospital Organization Okayama Medical Center, 1711-1 Tamasu, Kita-ku, Okayama, 701-1192, Japan
| | - Genyo Ikeda
- Department of Internal Medicine, Chugoku Central Hospital, Fukuyama, 720-0001, Japan
| | - Nobukiyo Fujiwara
- Department of Internal Medicine, Chugoku Central Hospital, Fukuyama, 720-0001, Japan
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10
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Mannami T, Fujiwara N, Ikeda G, Wakatsuki T, Fukumoto Y, Furutachi S, Shimizu S. Esophageal anisakiasis observed using magnifying endoscopy with narrow-band imaging. Endoscopy 2021; 53:E83-E84. [PMID: 32590853 DOI: 10.1055/a-1195-2273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
- Tomohiko Mannami
- Department of Gastroenterology, National Hospital Organization Okayama Medical Center, Okayama, Japan
| | - Nobukiyo Fujiwara
- Department of Internal Medicine, Chugoku Central Hospital, Fukuyama, Japan
| | - Genyo Ikeda
- Department of Internal Medicine, Chugoku Central Hospital, Fukuyama, Japan
| | - Toshiyuki Wakatsuki
- Department of Gastroenterology, National Hospital Organization Okayama Medical Center, Okayama, Japan
| | - Yasushi Fukumoto
- Department of Gastroenterology, National Hospital Organization Okayama Medical Center, Okayama, Japan
| | - Shin'ichi Furutachi
- Department of Gastroenterology, National Hospital Organization Okayama Medical Center, Okayama, Japan
| | - Shin'ichi Shimizu
- Department of Gastroenterology, National Hospital Organization Okayama Medical Center, Okayama, Japan
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11
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Nagami Y, Sakai T, Yamamura M, Nakatani M, Katsuno T, Suekane T, Uno H, Minamino H, Okuyama M, Okamoto J, Kumamoto M, Noguchi A, Yamamori K, Takaishi O, Ochi M, Miyazaki T, Tsuji S, Ikehara H, Kawaguchi K, Hayashi T, Mannami T, Kakimoto K, Naito Y, Hashimoto S, Li Z, Komeda Y, Kishino T, Yamamoto Y, Iguchi M, Akamatsu T, Horii T, Miura K, Yamashina T, Sugihara Y, Watanabe N, Kiyotoki S, Fujii R, Murata M, Ono S, Narasaka T, Kitamura S, Kono M, Kato M, Kawaratani H, Tanaka K, Yaoita T, Yamaguchi S, Abe K, Kawamura T, Kinoshita Y, Imai K, Fujinami H, Yada T, Miyamoto H, Yoshida H, Fujiwara Y. Continuous warfarin administration versus heparin bridging therapy in post colorectal polypectomy haemorrhage: a study protocol for a multicentre randomised controlled trial (WHICH study). Trials 2021; 22:33. [PMID: 33413599 PMCID: PMC7791998 DOI: 10.1186/s13063-020-04975-y] [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: 08/19/2020] [Accepted: 12/14/2020] [Indexed: 11/30/2022] Open
Abstract
Background Endoscopic removal of colorectal adenoma is considered an effective treatment for reducing the mortality rates associated with colorectal cancer. Warfarin, a type of anticoagulant, is widely used for the treatment and prevention of thromboembolism; however, bleeding may increase with its administration after polypectomy. In recent times, a high incidence of bleeding after endoscopic polypectomy has been reported in patients receiving heparin bridge therapy. However, previous studies have not compared the bleeding rate after endoscopic colorectal polypectomy between patients who continued with anticoagulant therapy and those who received heparin bridge therapy. We hypothesised that endoscopic colorectal polypectomy under the novel treatment with continuous warfarin is not inferior to endoscopic colorectal polypectomy under standard treatment with heparin bridge therapy with respect to the rate of postoperative bleeding. This study aims to compare the efficacy of endoscopic colorectal polypectomy with continuous warfarin administration and endoscopic colorectal polypectomy with heparin bridge therapy with respect to the rate of postoperative bleeding. Methods We will conduct a prospective multicentre randomised controlled non-inferiority trial of two parallel groups. We will compare patients scheduled to undergo colorectal polypectomy under anticoagulant therapy with warfarin. There will be 2 groups, namely, a standard treatment group (heparin bridge therapy) and the experimental treatment group (continued anticoagulant therapy). The primary outcome measure is the rate of postoperative bleeding. On the contrary, the secondary outcomes include the rate of cumulative bleeding, rate of overt haemorrhage (that does not qualify for the definition of haemorrhage after endoscopic polypectomy), incidence of haemorrhage requiring haemostasis during endoscopic polypectomy, intraoperative bleeding during endoscopic colorectal polypectomy requiring angiography, abdominal surgery and/or blood transfusion, total rate of bleeding, risk factors for postoperative bleeding, length of hospital stay, incidence of thromboembolism, prothrombin time-international ratio (PT-INR) 28 days after the surgery, and incidence of serious adverse events. Discussion The results of this randomised controlled trial will provide valuable information for the standardisation of management of anticoagulants in patients scheduled to undergo colorectal polypectomy. Trial registration UMIN-CTR UMIN000023720. Registered on 22 August 2016
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Affiliation(s)
- Yasuaki Nagami
- Department of Gastroenterology, Osaka City University Graduate School of Medicine, 1-4-3, Asahimachi, Abeno-ku, Osaka, 545-8585, Japan.
| | - Taishi Sakai
- Department of Gastroenterology, Osaka City University Graduate School of Medicine, 1-4-3, Asahimachi, Abeno-ku, Osaka, 545-8585, Japan.,Department of Gastroenterology, Baba Memorial Hospital, Osaka, Japan
| | - Masafumi Yamamura
- Department of Gastroenterology, Osaka City University Graduate School of Medicine, 1-4-3, Asahimachi, Abeno-ku, Osaka, 545-8585, Japan
| | - Masami Nakatani
- Department of Gastroenterology, Minamiosaka Hospital, Osaka, Japan
| | - Takayuki Katsuno
- Department of Gastroenterology, Izumiotsu Municipal Hospital, Osaka, Japan
| | - Takehisa Suekane
- Department of Gastroenterology, Osaka City General Hospital, Osaka, Japan
| | - Hironori Uno
- Department of Gastroenterology, Osaka Ekisaikai Hospital, Osaka, Japan
| | - Hiroaki Minamino
- Department of Gastroenterology, Baba Memorial Hospital, Osaka, Japan.,Department of Gastroenterology, Ishikiriseiki Hospital, Osaka, Japan
| | - Masatsugu Okuyama
- Department of Gastroenterology, Kashiwara Municipal Hospital, Osaka, Japan
| | - Junichi Okamoto
- Department of Gastroenterology, Ikuwakai Memorial Hospital, Osaka, Japan
| | | | - Atsushi Noguchi
- Department of Gastroenterology, Asakayama General Hospital, Osaka, Japan
| | - Kazuki Yamamori
- Department of Gastroenterology, Nagayoshi General Hospital, Osaka, Japan
| | - Osamu Takaishi
- Department of Gastroenterology, Naniwa Ikuno Hospital, Osaka, Japan
| | - Masahiro Ochi
- Department of Internal Medicine, Meijibashi Hospital, Osaka, Japan
| | - Takako Miyazaki
- Center for Inflammatory Bowel Disease, Division of Internal Medicine, Hyogo College of Medicine, Hyogo, Japan
| | - Shigetsugu Tsuji
- Department of Gastroenterology, Ishikawa Prefectural Central Hospital, Ishikawa, Japan
| | - Hisatomo Ikehara
- Department of Gastroenterology, Nihon University Hospital, Tokyo, Japan
| | - Koichiro Kawaguchi
- Division of Gastroenterology and Nephrology, Faculty of Medicine, Tottori University, Tottori, Japan
| | - Tomoyuki Hayashi
- Department of Gastroenterology, Kanazawa University, Ishikawa, Japan
| | - Tomohiko Mannami
- Department of Gastroenterology, Okayama Medical Center, Okayama, Japan
| | - Kazuki Kakimoto
- Second Department of Internal Medicine, Osaka Medical Collage, Osaka, Japan
| | - Yoshihide Naito
- Department of Gastroenterology and Hepatology, Fukui Prefectural Hospital, Fukui, Japan
| | - Satoru Hashimoto
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Zhaoliang Li
- Department of Gastroenterology, Takarazuka City Hospital, Hyogo, Japan
| | - Yoriaki Komeda
- Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Takaaki Kishino
- Department of Gastroenterology and Hepatology, Center for Digestive and Liver Diseases, Nara City Hospital, Nara, Japan
| | - Yoshinobu Yamamoto
- Department of Gastroenterological Oncology, Hyogo Cancer Center, Hyogo, Japan
| | - Mikitaka Iguchi
- Second Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan
| | - Takuji Akamatsu
- Department of Gastroenterology and Hepatology, Japanese Red Cross Society Wakayama Medical Center, Wakayama, Japan
| | - Toshiki Horii
- Department of Gastroenterology, Yuri Kumiai General Hospital, Akita, Japan
| | - Ko Miura
- Department of Gastroenterology, Tsuyama Chuo Hospital, Okayama, Japan
| | - Takeshi Yamashina
- Department of Gastroenterology and Hepatology, Osaka Red Cross Hospital, Osaka, Japan
| | - Yuusaku Sugihara
- Department of Gastroenterology and Hepatology, Okayama University Hospital, Okayama, Japan
| | - Noboru Watanabe
- Department of Gastroenterology, Graduate School of Medicine, Akita University, Akita, Japan
| | - Shu Kiyotoki
- Department of Gastroenterology, Shuto General Hospital, Yanai, Japan
| | - Ryoji Fujii
- Department of Gastroenterology, Tonan Hospital, Hokkaido, Japan
| | - Masaki Murata
- Department of Gastroenterology, Shiga University of Medical Science, Shiga, Japan
| | - Satoshi Ono
- Department of Gastroenterology, Chiba-Nishi General Hospital, Chiba, Japan
| | - Toshiaki Narasaka
- Department of Gastroenterology, University of Tsukuba, Ibaraki, Japan
| | - Shinji Kitamura
- Department of Gastroenterology and Oncology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Mitsuhiro Kono
- Department of Gastroenterology, Osaka City University Graduate School of Medicine, 1-4-3, Asahimachi, Abeno-ku, Osaka, 545-8585, Japan.,Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Motohiko Kato
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.,Division of Research and Development for Minimally Invasive Treatment, Cancer Center, Keio University School of Medicine, Tokyo, Japan
| | - Hideto Kawaratani
- Department of Gastroenterology, Nara Medical University, Nara, Japan
| | - Kyosuke Tanaka
- Department of Endoscopy, Mie University Hospital, Mie, Japan
| | - Takao Yaoita
- Department of Gastroenterology, Yamagata University Faculty of Medicine, Yamagata, Japan
| | | | - Keiichiro Abe
- Department of Gastroenterology, Dokkyo Medical University, Tochigi, Japan
| | - Takuji Kawamura
- Department of Gastroenterology, Kyoto Second Red Cross Hospital, Kyoto, Japan
| | - Yosuke Kinoshita
- Department of Gastroenterology, Osaka City University Graduate School of Medicine, 1-4-3, Asahimachi, Abeno-ku, Osaka, 545-8585, Japan.,Department of Gastroenterology, Ishikiriseiki Hospital, Osaka, Japan
| | - Kenichiro Imai
- Division of Endoscopy, Shizuoka Cancer Centre, Shizuoka, Japan
| | - Haruka Fujinami
- Department of Gastroenterology, Toyama University Hospital, Toyama, Japan
| | - Tomoyuki Yada
- Division of Gastroenterology & Hepatology, Kohnodai Hospital, National Center for Global Health and Medicine, Chiba, Japan
| | - Hayato Miyamoto
- Department of Gastroenterology, Hanwa Sumiyoshi General Hospital, Osaka, Japan
| | - Hisako Yoshida
- Department of Medical Statistics, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Yasuhiro Fujiwara
- Department of Gastroenterology, Osaka City University Graduate School of Medicine, 1-4-3, Asahimachi, Abeno-ku, Osaka, 545-8585, Japan
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12
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Migita K, Nakamura M, Aiba Y, Kozuru H, Abiru S, Komori A, Fujita Y, Temmoku J, Asano T, Sato S, Furuya M, Naganuma A, Yoshizawa K, Shimada M, Ario K, Mannami T, Kohno H, Kaneyoshi T, Komura T, Ohira H, Yatsuhashi H. Association of soluble T cell immunoglobulin domain and mucin-3 (sTIM-3) and mac-2 binding protein glycosylation isomer (M2BPGi) in patients with autoimmune hepatitis. PLoS One 2020; 15:e0238540. [PMID: 33347507 PMCID: PMC7751864 DOI: 10.1371/journal.pone.0238540] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Accepted: 08/18/2020] [Indexed: 12/23/2022] Open
Abstract
Background Autoimmune hepatitis (AIH) is a disorder of unknown etiology in which immune-mediated liver injury progress to cirrhosis or hepatocellular carcinoma (HCC). The aim of the present study was to determine whether circulating soluble TIM3 (sTIM3) is elevated in patients with AIH patients and whether sTIM-3 levels are associated with clinical parameters of AIH. Methods We enrolled 123 Japanese patients with AIH who were identified from the National Hospital Organization–AIH-liver–network database, as well as 32 patients with chronic hepatitis C (CHC), 30 patients with primary biliary cholangitis (PBC) and healthy control subjects. Serum sTIM-3 concentrations were quantified by ELISA. Results Serum levels of sTIM-3 were significantly higher in AIH patients (median 4865 pg/ml; [interquartile range (IQR); 3122–7471]) compared to those in CHC (1026 pg/ml [IQR: 806–1283] p<0.001), PBC (2395 pg/ml [IQR: 2012–3422] p<0.001) or healthy controls (1285 pg/ml [IQR: 1098–1812] p<0.001). In AIH group, serum sTIM-3 were correlated with alanine aminotransferase (ALT), or total bilirubin (TB) and negatively correlated with serum levels of albumin (Alb). Serum levels of sTIM-3 were also strongly correlated with Mac-2 binding protein glycosylation isomer (M2BPGi) levels, but did not correlate with the histological grade of liver fibrosis. Steroid treatment of AIH patients significantly reduced serum sTIM-3 levels (2147±623pg/ml versus 1321±378pg/ml, p<0.001). Conclusions Circulating sTIM-3 levels were elevated in AIH patients and are associated with AIH disease activity and AIH-related liver damage. These findings indicate that serum sTIM-3 correlated with disease status of AIH and could be useful biomarkers to detect autoimmune-mediated liver injury. Our data suggest a possible link between the TIM-3/GAL-9 pathway and AIH severity or phenotype, and further investigations of the TIM-3 pathway and AIH pathophysiology is warranted.
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Affiliation(s)
- Kiyoshi Migita
- Clinical Research Center, Nagasaki Medical Center, Nagasaki, Japan
- Department of Rheumatology, Fukushima Medical University, Fukushima, Japan
- * E-mail:
| | - Minoru Nakamura
- Clinical Research Center, Nagasaki Medical Center, Nagasaki, Japan
| | - Yoshihiro Aiba
- Clinical Research Center, Nagasaki Medical Center, Nagasaki, Japan
| | - Hideko Kozuru
- Clinical Research Center, Nagasaki Medical Center, Nagasaki, Japan
| | - Seigo Abiru
- Clinical Research Center, Nagasaki Medical Center, Nagasaki, Japan
| | - Atsumasa Komori
- Clinical Research Center, Nagasaki Medical Center, Nagasaki, Japan
| | - Yuya Fujita
- Department of Rheumatology, Fukushima Medical University, Fukushima, Japan
| | - Junpei Temmoku
- Department of Rheumatology, Fukushima Medical University, Fukushima, Japan
| | - Tomoyuki Asano
- Department of Rheumatology, Fukushima Medical University, Fukushima, Japan
| | - Shuzo Sato
- Department of Rheumatology, Fukushima Medical University, Fukushima, Japan
| | - Makiko Furuya
- Department of Rheumatology, Fukushima Medical University, Fukushima, Japan
| | - Atsushi Naganuma
- National Hospital Organization, Takasaki Medical Center, Takasaki, Japan
| | - Kaname Yoshizawa
- National Hospital Organization, Shinsyu-Ueda Medical Center, Ueda, Nagano, Japan
| | - Masaaki Shimada
- National Hospital Organization, Nagoya Medical Center, Nagoya, Aichi, Japan
| | - Keisuke Ario
- National Hospital Organization, Ureshino Medical Center, Ureshino, Saga, Japan
| | - Tomohiko Mannami
- National Hospital Organization, Okayama Medical Center, Okayama, Okayama, Japan
| | - Hiroshi Kohno
- National Hospital Organization, Kure Medical Center, Kure, Hiroshima, Japan
| | - Toshihiko Kaneyoshi
- National Hospital Organization, Fukuyama Medical Center, Kanazawa, Ishikawa, Japan
| | - Takuya Komura
- National Hospital Organization, Kanazawa Medical Center, Kanazawa, Ishikawa, Japan
| | - Hiromasa Ohira
- Department of Gastroenterology, Fukushima Medical University, Fukushima, Japan
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13
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Ueno K, Aiba Y, Hitomi Y, Shimoda S, Nakamura H, Gervais O, Kawai Y, Kawashima M, Nishida N, Kohn SS, Kojima K, Katsushima S, Naganuma A, Sugi K, Komatsu T, Mannami T, Matsushita K, Yoshizawa K, Makita F, Nikami T, Nishimura H, Kouno H, Kouno H, Ohta H, Komura T, Tsuruta S, Yamauchi K, Kobata T, Kitasato A, Kuroki T, Abiru S, Nagaoka S, Komori A, Yatsuhashi H, Migita K, Ohira H, Tanaka A, Takikawa H, Nagasaki M, Tokunaga K, Nakamura M. Integrated GWAS and mRNA Microarray Analysis Identified IFNG and CD40L as the Central Upstream Regulators in Primary Biliary Cholangitis. Hepatol Commun 2020; 4:724-738. [PMID: 32363322 PMCID: PMC7193132 DOI: 10.1002/hep4.1497] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 12/16/2019] [Accepted: 12/21/2019] [Indexed: 12/18/2022] Open
Abstract
Genome‐wide association studies (GWASs) in European and East Asian populations have identified more than 40 disease‐susceptibility genes in primary biliary cholangitis (PBC). The aim of this study is to computationally identify disease pathways, upstream regulators, and therapeutic targets in PBC through integrated GWAS and messenger RNA (mRNA) microarray analysis. Disease pathways and upstream regulators were analyzed with ingenuity pathway analysis in data set 1 for GWASs (1,920 patients with PBC and 1,770 controls), which included 261 annotated genes derived from 6,760 single‐nucleotide polymorphisms (P < 0.00001), and data set 2 for mRNA microarray analysis of liver biopsy specimens (36 patients with PBC and 5 normal controls), which included 1,574 genes with fold change >2 versus controls (P < 0.05). Hierarchical cluster analysis and categorization of cell type–specific genes were performed for data set 2. There were 27 genes, 10 pathways, and 149 upstream regulators that overlapped between data sets 1 and 2. All 10 pathways were immune‐related. The most significant common upstream regulators associated with PBC disease susceptibility identified were interferon‐gamma (IFNG) and CD40 ligand (CD40L). Hierarchical cluster analysis of data set 2 revealed two distinct groups of patients with PBC by disease activity. The most significant upstream regulators associated with disease activity were IFNG and CD40L. Several molecules expressed in B cells, T cells, Kupffer cells, and natural killer–like cells were identified as potential therapeutic targets in PBC with reference to a recently reported list of cell type–specific gene expression in the liver. Conclusion: Our integrated analysis using GWAS and mRNA microarray data sets predicted that IFNG and CD40L are the central upstream regulators in both disease susceptibility and activity of PBC and identified potential downstream therapeutic targets.
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Affiliation(s)
- Kazuko Ueno
- Genome Medical Science Project National Center for Global Health and Medicine Tokyo Japan.,Department of Human Genetics Graduate School of Medicine University of Tokyo Tokyo Japan
| | - Yoshihiro Aiba
- Clinical Research Center National Hospital Organization of Nagasaki Medical Center Omura Japan
| | - Yuki Hitomi
- Department of Human Genetics Graduate School of Medicine University of Tokyo Tokyo Japan.,Department of Microbiology Hoshi University School of Pharmacy and Pharmaceutical Sciences Tokyo Japan
| | - Shinji Shimoda
- Department of Medicine and Biosystemic Science Kyushu University Graduate School of Medical Sciences Fukuoka Japan
| | - Hitomi Nakamura
- Clinical Research Center National Hospital Organization of Nagasaki Medical Center Omura Japan
| | - Olivier Gervais
- Human Biosciences Unit for the Top Global Course Center for the Promotion of Interdisciplinary Education and Research Kyoto University Kyoto Japan
| | - Yosuke Kawai
- Genome Medical Science Project National Center for Global Health and Medicine Tokyo Japan.,Department of Human Genetics Graduate School of Medicine University of Tokyo Tokyo Japan
| | | | - Nao Nishida
- Genome Medical Science Project National Center for Global Health and Medicine Tokyo Japan.,Department of Human Genetics Graduate School of Medicine University of Tokyo Tokyo Japan
| | - Seik-Soon Kohn
- Genome Medical Science Project National Center for Global Health and Medicine Tokyo Japan.,Department of Human Genetics Graduate School of Medicine University of Tokyo Tokyo Japan
| | - Kaname Kojima
- Tohoku Medical Megabank Organization Tohoku University Sendai Japan
| | - Shinji Katsushima
- Headquarters of PBC Research National Hospital Organization Study Group for Liver Disease in Japan Omura Japan
| | - Atsushi Naganuma
- Headquarters of PBC Research National Hospital Organization Study Group for Liver Disease in Japan Omura Japan
| | - Kazuhiro Sugi
- Headquarters of PBC Research National Hospital Organization Study Group for Liver Disease in Japan Omura Japan
| | - Tatsuji Komatsu
- Headquarters of PBC Research National Hospital Organization Study Group for Liver Disease in Japan Omura Japan
| | - Tomohiko Mannami
- Headquarters of PBC Research National Hospital Organization Study Group for Liver Disease in Japan Omura Japan
| | - Kouki Matsushita
- Headquarters of PBC Research National Hospital Organization Study Group for Liver Disease in Japan Omura Japan
| | - Kaname Yoshizawa
- Headquarters of PBC Research National Hospital Organization Study Group for Liver Disease in Japan Omura Japan
| | - Fujio Makita
- Headquarters of PBC Research National Hospital Organization Study Group for Liver Disease in Japan Omura Japan
| | - Toshiki Nikami
- Headquarters of PBC Research National Hospital Organization Study Group for Liver Disease in Japan Omura Japan
| | - Hideo Nishimura
- Headquarters of PBC Research National Hospital Organization Study Group for Liver Disease in Japan Omura Japan
| | - Hiroshi Kouno
- Headquarters of PBC Research National Hospital Organization Study Group for Liver Disease in Japan Omura Japan
| | - Hirotaka Kouno
- Headquarters of PBC Research National Hospital Organization Study Group for Liver Disease in Japan Omura Japan
| | - Hajime Ohta
- Headquarters of PBC Research National Hospital Organization Study Group for Liver Disease in Japan Omura Japan
| | - Takuya Komura
- Headquarters of PBC Research National Hospital Organization Study Group for Liver Disease in Japan Omura Japan
| | - Satoru Tsuruta
- Headquarters of PBC Research National Hospital Organization Study Group for Liver Disease in Japan Omura Japan
| | - Kazuhiko Yamauchi
- Headquarters of PBC Research National Hospital Organization Study Group for Liver Disease in Japan Omura Japan
| | - Tatsuro Kobata
- Headquarters of PBC Research National Hospital Organization Study Group for Liver Disease in Japan Omura Japan
| | - Amane Kitasato
- Department of Surgery National Hospital Organization of Nagasaki Medical Center Omura Japan
| | - Tamotsu Kuroki
- Clinical Research Center National Hospital Organization of Nagasaki Medical Center Omura Japan.,Department of Surgery National Hospital Organization of Nagasaki Medical Center Omura Japan.,Department of Hepatology Graduate School of Biomedical Sciences Nagasaki University Omura Japan
| | - Seigo Abiru
- Clinical Research Center National Hospital Organization of Nagasaki Medical Center Omura Japan
| | - Shinya Nagaoka
- Clinical Research Center National Hospital Organization of Nagasaki Medical Center Omura Japan
| | - Atsumasa Komori
- Clinical Research Center National Hospital Organization of Nagasaki Medical Center Omura Japan.,Department of Hepatology Graduate School of Biomedical Sciences Nagasaki University Omura Japan
| | - Hiroshi Yatsuhashi
- Clinical Research Center National Hospital Organization of Nagasaki Medical Center Omura Japan.,Department of Hepatology Graduate School of Biomedical Sciences Nagasaki University Omura Japan
| | - Kiyoshi Migita
- Clinical Research Center National Hospital Organization of Nagasaki Medical Center Omura Japan.,Department of Gastroenterology and Rheumatic Diseases Fukushima Medical University of Medicine Fukushima Japan
| | - Hiromasa Ohira
- Department of Gastroenterology and Rheumatic Diseases Fukushima Medical University of Medicine Fukushima Japan
| | - Atsushi Tanaka
- Department of Medicine Teikyo University School of Medicine Tokyo Japan
| | - Hajime Takikawa
- Department of Medicine Teikyo University School of Medicine Tokyo Japan
| | - Masao Nagasaki
- Human Biosciences Unit for the Top Global Course Center for the Promotion of Interdisciplinary Education and Research Kyoto University Kyoto Japan
| | - Katsushi Tokunaga
- Genome Medical Science Project National Center for Global Health and Medicine Tokyo Japan.,Department of Human Genetics Graduate School of Medicine University of Tokyo Tokyo Japan
| | - Minoru Nakamura
- Clinical Research Center National Hospital Organization of Nagasaki Medical Center Omura Japan.,Headquarters of PBC Research National Hospital Organization Study Group for Liver Disease in Japan Omura Japan.,Department of Hepatology Graduate School of Biomedical Sciences Nagasaki University Omura Japan.,Headquarters of PBC-GWAS Consortium in Japan National Hospital Organization of Nagasaki Medical Center Graduate School of Biomedical Sciences Nagasaki University Omura Japan
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14
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Maeda M, Saeki I, Sakaida I, Aikata H, Araki Y, Ogawa C, Kariyama K, Nouso K, Kitamoto M, Kobashi H, Sato S, Shibata H, Joko K, Takaki S, Takabatake H, Tsutsui A, Takaguchi K, Tomonari T, Nakamura S, Nagahara T, Hiraoka A, Matono T, Koda M, Mandai M, Mannami T, Mitsuda A, Moriya T, Yabushita K, Tani J, Yagi T, Yamasaki T. Complications after Radiofrequency Ablation for Hepatocellular Carcinoma: A Multicenter Study Involving 9,411 Japanese Patients. Liver Cancer 2020; 9:50-62. [PMID: 32071909 PMCID: PMC7024979 DOI: 10.1159/000502744] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Accepted: 08/15/2019] [Indexed: 02/04/2023] Open
Abstract
INTRODUCTION Radiofrequency ablation (RFA) for hepatocellular carcinoma (HCC) is considered a safe and minimally invasive procedure. We previously reported that the mortality and complication rates for RFA were 0.038% (5/13,283 patients) and 3.54% (579 complications/16,346 procedures), respectively, from 1999 to 2010 (previous period). In this study, we investigated the clinical criteria for RFA and the mortality and complication rates from 2011 to 2015 (recent period). METHODS Data were collected from 25 centers by using a questionnaire developed by the Chugoku-Shikoku Society for Local Ablation Therapy of HCC. The criteria for RFA, RFA modification, use of image-guidance modalities, mortality, and complications during the previous and recent periods were compared. RESULTS We evaluated 11,298 procedures for 9,411 patients, including those that involved new devices (bipolar RFA and internally adjustable electrode system). The criterion of hepatic function for RFA increased from a Child-Pugh score ≤8 during the previous period to ≤9 during the recent period. The criteria regarding the tumor location and other risk factors have been expanded recently because of the increased use of several modifications of the RFA procedure and image-guidance modalities. The mortality rate was 0.064% (6/9,411 patients), and the complication rate was 2.92% (330 complications/11,298 procedures). There was no difference in mortality rates between the 2 periods (p = 0.38), but the complication rates was significantly lower during the recent period (p = 0.038). DISCUSSION AND CONCLUSIONS Our findings confirmed that RFA, including the use of new devices, is a low-risk procedure for HCC, despite the expansion of the criteria for RFA during the recent period.
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Affiliation(s)
- Masaki Maeda
- aDepartment of Gastroenterology and Hepatology, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan
| | - Issei Saeki
- aDepartment of Gastroenterology and Hepatology, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan
| | - Isao Sakaida
- aDepartment of Gastroenterology and Hepatology, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan
| | - Hiroshi Aikata
- cDepartment of Gastroenterology and Metabolism, Applied Life Sciences, Institute of Biomedical and Health Science, Hiroshima University, Hiroshima, Japan
| | - Yasuyuki Araki
- dDivision of Internal Medicine, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan
| | - Chikara Ogawa
- eDivision of Gastroenterology and Hepatology, Takamatsu Red Cross Hospital, Kagawa, Japan
| | - Kazuya Kariyama
- fDivision of Gastroenterology and Hepatology, Okayama City Hospital, Okayama, Japan
| | - Kazuhiro Nouso
- fDivision of Gastroenterology and Hepatology, Okayama City Hospital, Okayama, Japan
| | - Mikiya Kitamoto
- gDepartment of Gastroenterology, Hiroshima Prefectural Hospital, Hiroshima, Japan
| | - Haruhiko Kobashi
- hDivision of Gastroenterology and Hepatology, Japanese Red Cross Okayama Hospital, Okayama, Japan
| | - Shuichi Sato
- iDepartment of Hepatology, Shimane University Hospital, Shimane, Japan
| | - Hiroshi Shibata
- jDivision of Gastroenterology and Hepatology, Tokushima Prefectural Central Hospital, Tokushima, Japan
| | - Kouji Joko
- kDivision of Gastroenterology and Hepatology, Matsuyama Red Cross Hospital, Ehime, Japan
| | - Shintaro Takaki
- lDivision of Gastroenterology and Hepatology, Hiroshima Red Cross and Atomic Bomb Survivors Hospital, Hiroshima, Japan
| | - Hiroyuki Takabatake
- mDivision of Gastroenterology and Hepatology, Kurashiki Central Hospital, Okayama, Japan
| | - Akemi Tsutsui
- nDepartment of Hepatology, Kagawa Prefectural Central Hospital, Kagawa, Japan
| | - Koichi Takaguchi
- nDepartment of Hepatology, Kagawa Prefectural Central Hospital, Kagawa, Japan
| | - Tetsu Tomonari
- oDepartment of Gastroenterology and Hepatology, Tokushima University Graduate School, Tokushima, Japan
| | - Shinichiro Nakamura
- pDepartment of Gastroenterology and Hepatology, Okayama University Hospital, Okayama, Japan
| | - Takakazu Nagahara
- qDivision of Gastroenterology and Hepatology, Tottori Prefectural Kousei Hospital, Tottori, Japan
| | - Atsushi Hiraoka
- rGastroenterology Center, Ehime Prefectural Central Hospital, Ehime, Japan
| | - Tomomitsu Matono
- sDivision of Medicine and Clinical Science, Department of Multidisciplinary Internal Medicine, Tottori University Faculty of Medicine, Tottori, Japan
| | - Masahiko Koda
- tDepartment of Internal Medicine, Hino Hospital, Tottori, Japan
| | - Mari Mandai
- uDivision of Internal Medicine, Okayama Saiseikai General Hospital, Okayama, Japan
| | - Tomohiko Mannami
- vDivision of Gastroenterology and Hepatology, Chugoku Central Hospital, Hiroshima, Japan,wDepartment of Gastroenterology, National Hospital Organization Okayama Medical Center, Okayama, Japan
| | - Akeri Mitsuda
- xDivision of Gastroenterology and Hepatology, Tottori Red Cross Hospital, Tottori, Japan
| | - Takashi Moriya
- yDivision of Gastroenterology and Hepatology, Chugoku Rousai Hospital, Hiroshima, Japan
| | - Kazuhisa Yabushita
- zDivision of Internal Medicine, Fukuyama City Hospital, Hiroshima, Japan
| | - Joji Tani
- aDepartment of Gastroenterology and Hepatology, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan
| | - Takahito Yagi
- bDepartment of Oncology and Laboratory, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan
| | - Takahiro Yamasaki
- aDepartment of Gastroenterology and Hepatology, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan,bDepartment of Oncology and Laboratory, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan,*Takahiro Yamasaki, MD, PhD, Department of Oncology and Laboratory, Yamaguchi University Graduate School of Medicine, Minami-kogushi, Ube, Yamaguchi 755-8505 (Japan), E-Mail
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15
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Mannami T, Fujiwara N, Ikeda G, Mishima T, Kuroi T, Muraoka T, Ohtawa Y. Gastrointestinal hemorrhage caused by the direct invasion of a hepatocellular carcinoma successfully treated with polyglycolic acid sheet shielding. Endoscopy 2019; 51:E20-E21. [PMID: 30469150 DOI: 10.1055/a-0747-5467] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
- Tomohiko Mannami
- Department of Internal Medicine, Chugoku Central Hospital, Fukuyama, Japan.,Department of Gastroenterology, National Hospital Organization Okayama Medical Center, Okayama, Japan
| | - Nobukiyo Fujiwara
- Department of Internal Medicine, Chugoku Central Hospital, Fukuyama, Japan
| | - Genyo Ikeda
- Department of Internal Medicine, Chugoku Central Hospital, Fukuyama, Japan
| | - Takahito Mishima
- Department of Internal Medicine, Chugoku Central Hospital, Fukuyama, Japan
| | - Taiga Kuroi
- Department of Internal Medicine, Chugoku Central Hospital, Fukuyama, Japan
| | - Takayuki Muraoka
- Department of Surgery, Chugoku Central Hospital, Fukuyama, Japan
| | - Yasuyuki Ohtawa
- Department of Surgery, Chugoku Central Hospital, Fukuyama, Japan
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16
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Mannami T, Fujiwara N, Ikeda G, Ebara H, Omote S, Ohtawa Y, Waku T. Hepatobiliary and Pancreatic: A pancreatic stone causing biliary obstruction through major papillary impaction. J Gastroenterol Hepatol 2018; 33:1166. [PMID: 29878593 DOI: 10.1111/jgh.14085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Affiliation(s)
- T Mannami
- Department of Internal Medicine, Chugoku Central Hospital, Fukuyama, Japan
| | - N Fujiwara
- Department of Internal Medicine, Chugoku Central Hospital, Fukuyama, Japan
| | - G Ikeda
- Department of Internal Medicine, Chugoku Central Hospital, Fukuyama, Japan
| | - H Ebara
- Department of Internal Medicine, Chugoku Central Hospital, Fukuyama, Japan
| | - S Omote
- Department of Internal Medicine, Chugoku Central Hospital, Fukuyama, Japan
| | - Y Ohtawa
- Department of Surgery, Chugoku Central Hospital, Fukuyama, Japan
| | - T Waku
- Department of Surgery, Chugoku Central Hospital, Fukuyama, Japan
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17
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Nakanishi H, Doyama H, Ishikawa H, Uedo N, Gotoda T, Kato M, Nagao S, Nagami Y, Aoyagi H, Imagawa A, Kodaira J, Mitsui S, Kobayashi N, Muto M, Takatori H, Abe T, Tsujii M, Watari J, Ishiyama S, Oda I, Ono H, Kaneko K, Yokoi C, Ueo T, Uchita K, Matsumoto K, Kanesaka T, Morita Y, Katsuki S, Nishikawa J, Inamura K, Kinjo T, Yamamoto K, Yoshimura D, Araki H, Kashida H, Hosokawa A, Mori H, Yamashita H, Motohashi O, Kobayashi K, Hirayama M, Kobayashi H, Endo M, Yamano H, Murakami K, Koike T, Hirasawa K, Miyaoka Y, Hamamoto H, Hikichi T, Hanabata N, Shimoda R, Hori S, Sato T, Kodashima S, Okada H, Mannami T, Yamamoto S, Niwa Y, Yashima K, Tanabe S, Satoh H, Sasaki F, Yamazato T, Ikeda Y, Nishisaki H, Nakagawa M, Matsuda A, Tamura F, Nishiyama H, Arita K, Kawasaki K, Hoppo K, Oka M, Ishihara S, Mukasa M, Minamino H, Yao K. Evaluation of an e-learning system for diagnosis of gastric lesions using magnifying narrow-band imaging: a multicenter randomized controlled study. Endoscopy 2017. [PMID: 28637065 DOI: 10.1055/s-0043-111888] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Background and study aim Magnifying narrow-band imaging (M-NBI) is useful for the accurate diagnosis of early gastric cancer (EGC). However, acquiring skill at M-NBI diagnosis takes substantial effort. An Internet-based e-learning system to teach endoscopic diagnosis of EGC using M-NBI has been developed. This study evaluated its effectiveness. Participants and methods This study was designed as a multicenter randomized controlled trial. We recruited endoscopists as participants from all over Japan. After completing Test 1, which consisted of M-NBI images of 40 gastric lesions, participants were randomly assigned to the e-learning or non-e-learning groups. Only the e-learning group was allowed to access the e-learning system. After the e-learning period, both groups received Test 2. The analysis set was participants who scored < 80 % accuracy on Test 1. The primary end point was the difference in accuracy between Test 1 and Test 2 for the two groups. Results A total of 395 participants from 77 institutions completed Test 1 (198 in the e-learning group and 197 in the non-e-learning group). After the e-learning period, all 395 completed Test 2. The analysis sets were e-learning group: n = 184; and non-e-learning group: n = 184. The mean Test 1 score was 59.9 % for the e-learning group and 61.7 % for the non-e-learning group. The change in accuracy in Test 2 was significantly higher in the e-learning group than in the non-e-learning group (7.4 points vs. 0.14 points, respectively; P < 0.001). Conclusion This study clearly demonstrated the efficacy of the e-learning system in improving practitioners' capabilities to diagnose EGC using M-NBI.Trial registered at University Hospital Medical Information Network Clinical Trials Registry (UMIN000008569).
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Affiliation(s)
- Hiroyoshi Nakanishi
- Department of Gastroenterology, Ishikawa Prefectural Central Hospital, Kanazawa, Japan
| | - Hisashi Doyama
- Department of Gastroenterology, Ishikawa Prefectural Central Hospital, Kanazawa, Japan
| | - Hideki Ishikawa
- Department of Molecular-Targeting Cancer Prevention, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Noriya Uedo
- Department of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
| | - Takuji Gotoda
- Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Mototsugu Kato
- Division of Endoscopy, Hokkaido University Hospital, Sapporo, Japan
| | - Shigeaki Nagao
- Department of Internal Medicine, National Defense Medical College, Saitama, Japan
| | - Yasuaki Nagami
- Department of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Hiroyuki Aoyagi
- Department of Gastroenterology, Fukui Prefectural Hospital, Fukui, Japan
| | - Atsushi Imagawa
- Department of Gastroenterology, Mitoyo General Hospital, Kan-onji, Japan
| | - Junichi Kodaira
- Department of Gastroenterology, Keiyukai Sapporo Hospital, Sapporo, Japan
| | - Shinya Mitsui
- Center for Gastroenterology, Teine-Keijinkai Hospital, Sapporo, Japan
| | - Nozomu Kobayashi
- Department of Diagnostic Imaging, Tochigi Cancer Center, Utsunomiya, Japan
| | - Manabu Muto
- Department of Clinical oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hajime Takatori
- Department of Gastroenterology, Kanazawa University Hospital, Kanazawa, Japan
| | - Takashi Abe
- Department of Gastroenterology, Takarazuka Municipal Hospital, Takarazuka, Japan
| | - Masahiko Tsujii
- Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Jiro Watari
- Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Japan
| | - Shuhei Ishiyama
- Department of Internal Medicine, Okayama Saiseikai General Hospital, Okayama, Japan
| | - Ichiro Oda
- Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan
| | - Hiroyuki Ono
- Division of Endoscopy, Shizuoka Cancer Center, Shizuoka, Japan
| | - Kazuhiro Kaneko
- Endoscopy Division, National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - Chizu Yokoi
- Department of Gastroenterology, National Center for Global Health and Medicine, Tokyo, Japan
| | - Tetsuya Ueo
- Department of Gastroenterology, Oita Red Cross Hospital, Oita, Japan
| | - Kunihisa Uchita
- Department of Gastroenterology, Kochi Red Cross Hospital, Kochi, Japan
| | - Kenshi Matsumoto
- Department of Gastroenterology, Juntendo University School of Medicine, Tokyo, Japan
| | - Takashi Kanesaka
- Department of Gastroenterology and Hepatology, Osaka Red Cross Hospital, Osaka, Japan
| | - Yoshinori Morita
- Division of Gastroenterology, Department of Internal Medicine, Graduate School of Medicine, Kobe University, Kobe, Japan
| | - Shinichi Katsuki
- Center of Gastroenterology, Otaru Ekisaikai Hospital, Otaru, Japan
| | - Jun Nishikawa
- Department of Gastroenterology and Hepatology, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Katsuhisa Inamura
- Department of Gastroenterology, Tonami General Hospital, Tonami, Japan
| | - Tetsu Kinjo
- Department of Endoscopy, University of the Ryukyus, Okinawa, Japan
| | - Katsumi Yamamoto
- Department of Gastroenterology, Toyonaka Municipal Hospital, Toyonaka, Japan
| | - Daisuke Yoshimura
- Department of Internal Medicine, Saiseikai Fukuoka General Hospital, Fukuoka, Japan
| | - Hiroshi Araki
- Division of Endoscopy, Gifu University Hospital, Gifu, Japan
| | - Hiroshi Kashida
- Department of Gastroenterology and Hepatology, Kinki University Faculty of Medicine, Osaka-sayama, Japan
| | - Ayumu Hosokawa
- Department of Gastroenterology and Hematology, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Hirohito Mori
- Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University, Kagawa, Japan
| | - Haruhiro Yamashita
- Department of Gastroenterology, National Hospital Organization Okayama Medical Center, Okayama, Japan
| | - Osamu Motohashi
- Department of Gastroenterology, Kanagawa Cancer Center, Yokohama, Japan
| | - Kazuhiko Kobayashi
- Department of Gastroenterology, Matsusaka Chuo General Hospital, Matsusaka, Japan
| | - Michiaki Hirayama
- Department of Gastroenterological Medicine, Tonan Hospital, Sapporo, Japan
| | | | - Masaki Endo
- Department of Gastroenterology and Hepatology, School of Medicine, Iwate Medical University, Morioka, Japan
| | - Hiroo Yamano
- Digestive Disease Center, Akita Red Cross Hospital, Akita, Japan
| | | | - Tomoyuki Koike
- Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Kingo Hirasawa
- Gastroenterological Center, Yokohama City University Medical Center, Yokohama, Japan
| | - Youichi Miyaoka
- Department of Endoscopy, Shimane Prefectural Central Hospital, Izumo, Japan
| | | | - Takuto Hikichi
- Department of Endoscopy, Fukushima Medical University Hospital, Fukushima, Japan
| | - Norihiro Hanabata
- Department of Gastroenterology and Hepatology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Ryo Shimoda
- Departments of Internal Medicine and Gastrointestinal Endoscopy, Saga Medical School, Saga, Japan
| | - Shinichiro Hori
- Department of Endoscopy, National Hospital Organization Shikoku Cancer Center, Matsuyama, Japan
| | - Tadashi Sato
- Department of Gastroenterology and Division of Endoscopy, Faculty of Medicine, University of Yamanashi, Yamanashi, Japan
| | - Shinya Kodashima
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hiroyuki Okada
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
| | - Tomohiko Mannami
- Department of Gastroenterology, Chugoku Central Hospital, Fukuyama, Japan
| | - Shojiro Yamamoto
- Division of Gastroenterology and Hematology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Yasumasa Niwa
- Departments of Endoscopy, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Kazuo Yashima
- Department of Gastroenterology, Tottori University Hospital, Yonago, Japan
| | - Satoshi Tanabe
- Department of Gastroenterology, Kitasato University School of Medicine, Sagamihara, Japan
| | - Hiro Satoh
- Department of Gastroenterology, Yokohama Sakae Kyosai Hospital, Yokohama, Japan
| | - Fumisato Sasaki
- Department of Gastroenterology, Kagoshima University Medical and Dental Hospital, Kagoshima, Japan
| | - Tetsuro Yamazato
- Department of Gastroenterology, Tokyo Metropolitan Cancer Detection Center, Tokyo, Japan
| | - Yoshiou Ikeda
- Endoscopy Center, Ehime University Hospital, Toon, Japan
| | - Hogara Nishisaki
- Department of Gastroenterological Oncology, Hyogo Cancer Center, Hyogo, Japan
| | - Masahiro Nakagawa
- Department of Internal Medicine, Hiroshima City Hospital, Hiroshima, Japan
| | - Akio Matsuda
- Department of Gastroenterology, Nanpuh Hospital, Kagoshima, Japan
| | - Fumio Tamura
- Division of Gastroenterology, Kumamoto Regional Medical Center, Kumamoto, Japan
| | - Hitoshi Nishiyama
- Department of Gastroenterology, National Hospital Organization Nagasaki Medical Center, Nagasaki, Japan
| | - Keiko Arita
- Arita Gastro-intestinal Hospital, Oita, Japan
| | - Keisuke Kawasaki
- Division of Gastroenterology, Matsuyama Red Cross Hospital, Matsuyama, Japan
| | - Kazushige Hoppo
- Division of Gastroenterology, Yamatotakada Municipal Hospital, Yamatotakada, Japan
| | - Masashi Oka
- Department of Gastroenterology and Hepatology, Faculty of Medicine, Saitama Medical University, Saitama, Japan
| | | | - Michita Mukasa
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Fukuoka, Japan
| | - Hiroaki Minamino
- Department of Gastroenterology, Izumiotsu Municipal Hospital, Izumiotsu, Japan
| | - Kenshi Yao
- Department of Endoscopy, Fukuoka University Chikushi Hospital, Fukuoka, Japan
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Senoo S, Mannami T, Tamura T, Fujiwara N, Ikeda G, Komoda M, Ohtawa Y, Fujimoto Y, Sato N, Kambara T, Waku T, Kenmotsu M, Kurimoto E, Okada T, Harita S, Sonobe H. [HER2-Positive Advanced Gastric Cancer with Disseminated Intravascular Coagulation and Diffuse Bone Marrow Carcinomatosis Successfully Treated with S-1/Trastuzumab Chemotherapy--A Case Report]. Gan To Kagaku Ryoho 2015; 42:2471-2475. [PMID: 26809307] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Trastuzumab, a humanized monoclonal antibody against human epidermal growth factor receptor 2 (HER2), has been proven to result in a survival benefit for the treatment of patients with HER2-positive advanced gastric cancer (AGC). However, data are lacking for the treatment of those with disseminated intravascular coagulation (DIC) and diffuse bone marrow carcinomatosis. A 77-year-old woman presented with back pain and fatigue since 2 months. Esophagogastroduodenoscopy showed a scirrhous lesion in the gastric corpus, which was biopsied and identified as signet-ring cell carcinoma with HER2 overexpression on immunohistochemistry. Laboratory testing, bone scintigraphy, and bone marrow biopsy were conducted, and she was diagnosed with HER2-positive AGC with DIC and diffuse bone marrow carcinomatosis. She underwent chemotherapy with the following regimen: oral administration of 80 mg/m2 S-1 for 2 weeks and 6 mg/kg trastuzumab infusion on day 6 every 3 weeks, which significantly improved the DIC. She was discharged from the hospital 73 days after admission and survived for 438 days after diagnosis. To the best of our knowledge, this is the first case report in which HER2-positive AGC complicated by DIC with diffuse bone marrow carcinomatosis was successfully treated with combined chemotherapy consisting of S-1 plus trastuzumab.
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Affiliation(s)
- Satoru Senoo
- 1Dept. of Internal Medicine, Chugoku Central Hospital
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19
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Mannami T, Ikeda G, Seno S, Sonobe H, Fujiwara N, Komoda M, Edahiro S, Ohtawa Y, Fujimoto Y, Sato N, Kambara T, Waku T. Capsule Endoscope Aspiration after Repeated Attempts for Ingesting a Patency Capsule. Case Rep Gastroenterol 2015; 9:347-52. [PMID: 26600772 PMCID: PMC4649712 DOI: 10.1159/000441382] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Capsule endoscope aspiration into the respiratory tract is a rare complication of capsule endoscopy. Despite the potential seriousness of this complication, no accepted methods exist to accurately predict and therefore prevent it. We describe the case of an 85-year-old male who presented for evaluation of iron deficiency anemia. He complained of dysphagia while ingesting a patency capsule, with several attempts over a period of 5 min before he was successful. Five days later, he underwent capsule endoscopy, where he experienced similar symptoms in swallowing the capsule. The rest of the examination proceeded uneventfully. On reviewing the captured images, the capsule endoscope was revealed to be aspirated, remaining in the respiratory tract for approximately 220 s before images of the esophagus and stomach appeared. To our knowledge, this is the first documented case of a patient who experienced capsule endoscope aspiration after ingestion of a patency capsule. This case suggests that repeated attempts required for ingesting the patency capsule can predict capsule endoscope aspiration. We presume that paying sufficient attention to the symptoms of a patient who ingests a patency capsule could help us prevent serious complications such as aspiration of the capsule endoscope. In addition, this experience implies the potential risk for ingesting the patency capsule. We must be aware that the patency capsule could also be aspirated and there may be more unrecognized aspiration cases.
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Affiliation(s)
| | - Genyo Ikeda
- Department of Internal Medicine, Fukuyama, Japan
| | - Satoru Seno
- Department of Internal Medicine, Fukuyama, Japan
| | - Hiroshi Sonobe
- Department of Laboratory Medicine and Pathology, Fukuyama, Japan
| | | | | | | | - Yasuyuki Ohtawa
- Department of Surgery, Chugoku Central Hospital, Fukuyama, Japan
| | - Yoshimi Fujimoto
- Department of Surgery, Chugoku Central Hospital, Fukuyama, Japan
| | - Naohiro Sato
- Department of Surgery, Chugoku Central Hospital, Fukuyama, Japan
| | - Takeshi Kambara
- Department of Surgery, Chugoku Central Hospital, Fukuyama, Japan
| | - Toshihiko Waku
- Department of Surgery, Chugoku Central Hospital, Fukuyama, Japan
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20
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Mannami T, Seno S, Sonobe H, Ikeda G, Kambara T, Ohtawa Y, Waku T. Lymphangioma of the anal canal: first description of the endoscopic features. Endoscopy 2015; 46 Suppl 1 UCTN:E545-6. [PMID: 25409063 DOI: 10.1055/s-0034-1377766] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
- Tomohiko Mannami
- Department of Internal Medicine, Chugoku Central Hospital, Fukuyama, Japan
| | - Satoru Seno
- Department of Internal Medicine, Chugoku Central Hospital, Fukuyama, Japan
| | - Hiroshi Sonobe
- Department of Laboratory Medicine and Pathology, Chugoku Central Hospital, Fukuyama, Japan
| | - Genyo Ikeda
- Department of Internal Medicine, Chugoku Central Hospital, Fukuyama, Japan
| | - Takeshi Kambara
- Department of Surgery, Chugoku Central Hospital, Fukuyama, Japan
| | - Yasuyuki Ohtawa
- Department of Surgery, Chugoku Central Hospital, Fukuyama, Japan
| | - Toshihiko Waku
- Department of Surgery, Chugoku Central Hospital, Fukuyama, Japan
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21
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Iwamuro M, Okada H, Kawano S, Shiode J, Takenaka R, Imagawa A, Inaba T, Suzuki S, Nishimura M, Mizuno M, Araki M, Mannami T, Ueki T, Kobashi H, Fukatsu H, Tanaka S, Omoto A, Kawai Y, Kitagawa T, Toyokawa T, Takata K, Yoshino T, Takaki A, Yamamoto K. A multicenter survey of enteroscopy for the diagnosis of intestinal follicular lymphoma. Oncol Lett 2015; 10:131-136. [PMID: 26170988 DOI: 10.3892/ol.2015.3251] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [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: 10/07/2014] [Accepted: 04/27/2015] [Indexed: 12/19/2022] Open
Abstract
The importance of enteroscopy examinations to investigate the entire length of the small intestines has been emphasized in follicular lymphoma patients with intestinal involvement. The aim of the present study was to determine the current state of enteroscopy examinations, including the performance rate, and the prevalence of small intestinal lesions in a patient population in Japan. A retrospective multicenter survey of 17 institutions collected the case information of 110 follicular lymphoma patients with gastrointestinal involvement. The results of the enteroscopy examinations were reviewed, and in order to identify potential factors affecting the performance rate of enteroscopy, patient gender, age at lymphoma diagnosis, histopathological grade, clinical stage, the date of the initial diagnosis and the annual volume of enteroscopy at the institution were compared between the patients who underwent one or more enteroscopy procedures and the patients who did not undergo enteroscopy. A total of 34 patients (30.9%) underwent enteroscopy, and 24 of these (70.6%) presented with involvement in the jejunum and/or ileum. It was found that more patients diagnosed in recent years and more patients treated at an ultra-high volume institution (≥101 enteroscopy examinations/year) underwent an enteroscopy. In conclusion, although the prevalence of small intestinal lesions was high (70.6%) in the follicular lymphoma patients presenting with intestinal involvement, the performance rate of enteroscopy was only 30.9%, and thus the majority of the patients have not undergone enteroscopy examinations. Further investigation is required to define the clinical significance of enteroscopy at the initial diagnostic work-up and during the follow-up period of these patients.
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Affiliation(s)
- Masaya Iwamuro
- Department of Molecular Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan
| | - Hiroyuki Okada
- Department of Endoscopy, Okayama University Hospital, Okayama 700-8558, Japan
| | - Seiji Kawano
- Department of Endoscopy, Okayama University Hospital, Okayama 700-8558, Japan
| | - Junji Shiode
- Department of Internal Medicine, Okayama Saiseikai General Hospital, Okayama 700-8511, Japan
| | - Ryuta Takenaka
- Department of Internal Medicine, Tsuyama Chuo Hospital, Tsuyama 708-0841, Japan
| | - Atsushi Imagawa
- Department of Gastroenterology, Mitoyo General Hospital, Kanonji 769-1695, Japan
| | - Tomoki Inaba
- Department of Gastroenterology, Kagawa Prefectural Central Hospital, Takamatsu 760-8557, Japan
| | - Seiyu Suzuki
- Department of Internal Medicine, Sumitomo Besshi Hospital, Niihama 792-8543, Japan
| | - Mamoru Nishimura
- Department of Internal Medicine, Okayama City Hospital, Okayama 700-8557, Japan
| | - Motowo Mizuno
- Department of Internal Medicine, Hiroshima City Hospital, Hiroshima 730-8518, Japan
| | - Masashi Araki
- Department of Internal Medicine, Kagawa Rosai Hospital, Marugame 763-8502, Japan
| | - Tomohiko Mannami
- Department of Internal Medicine, Chugoku Central Hospital, Fukuyama 720-0001, Japan
| | - Toru Ueki
- Department of Internal Medicine, Fukuyama City Hospital, Fukuyama 721-8511, Japan
| | - Haruhiko Kobashi
- Department of Hepatology, Japanese Red Cross Okayama Hospital, Okayama 700-8607, Japan
| | - Haruka Fukatsu
- Department of Internal Medicine, St. Mary's Hospital, Himeji 670-0801, Japan
| | - Shouichi Tanaka
- Department of Gastroenterology, Iwakuni Clinical Center, Iwakuni 740-8510, Japan
| | - Akiyoshi Omoto
- Department of Internal Medicine, Ako Central Hospital, Ako 678-0241, Japan
| | - Yoshinari Kawai
- Department of Gastroenterology, Onomichi Municipal Hospital, Onomichi 722-8503, Japan
| | - Takashi Kitagawa
- Department of Surgery, Kitagawa Hospital, Okayama 709-0497, Japan
| | - Tatsuya Toyokawa
- Department of Gastroenterology, Fukuyama Medical Center, Fukuyama 720-8520, Japan
| | - Katsuyoshi Takata
- Department of Pathology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan
| | - Tadashi Yoshino
- Department of Pathology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan
| | - Akinobu Takaki
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan
| | - Kazuhide Yamamoto
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan
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Yamagishi K, Iso H, Kokubo Y, Saito I, Yatsuya H, Ishihara J, Inoue M, Tsugane S, Sobue T, Hanaoka T, Ogata J, Baba S, Mannami T, Okayama A, K. Y, Miyakawa K, Saito F, Koizumi A, Sano Y, Hashimoto I, Ikuta T, Tanaba Y, Miyajima Y, Suzuki N, Nagasawa S, Furusugi Y, Nagai N, Sanada H, Hatayama Y, Kobayashi F, Uchino H, Shirai Y, Kondo T, Sasaki R, Watanabe Y, Miyagawa Y, Kobayashi Y, Machida M, Kishimoto Y, Takara E, Fukuyama T, Kinjo M, Irei M, Sakiyama H, Imoto K, Yazawa H, Seo T, Seiko A, Ito F, Shoji F, Saito R, Murata A, Minato K, Motegi K, Fujieda T, Abe T, Katagiri M, Suzuki M, Matsui K, Doi M, Terao A, Ishikawa Y, Tagami T, Doi H, Urata M, Okamoto N, Ide F, Sueta H, Sakiyama H, Onga N, Takaesu H, Uehara M, Horii F, Asano I, Yamaguchi H, Aoki K, Maruyama S, Ichii M, Takano M, Matsushima S, Natsukawa S, Akabane M, Konishi M, Okada K, Honda Y, Sakurai KYS, Tsuchiya N, Sugimura H, Tsubono Y, Kabuto M, Tominaga S, Iida M, Ajiki W, Ioka A, Sato S, Yasuda N, Nakamura K, Kono S, Suzuki K, Takashima Y, Yoshida M, Maruyama E, Yamaguchi M, Matsumura Y, Sasaki S, Watanabe S, Kadowaki T, Noda M, Mizoue T, Kawaguchi Y, Shimizu H. Dietary intake of saturated fatty acids and incident stroke and coronary heart disease in Japanese communities: the JPHC Study. Eur Heart J 2013; 34:1225-32. [DOI: 10.1093/eurheartj/eht043] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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23
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Ninomiya K, Mannami T, Seno S, Suzuki Y, Tamura T, Kimura K, Kubo T, Masunari T, Okada T, Kiguchi T, Sezaki N, Harita S, Nakata Y, Sonobe H. [A case of advanced gastric cancer with multiple bone metastases and disseminated intravascular coagulation successfully treated by combination chemotherapy of S-1 plus docetaxel]. Gan To Kagaku Ryoho 2012; 39:1719-1722. [PMID: 23152027] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Advanced gastric cancer (AGC) accompanied by disseminated intravascular coagulation(DIC)has a poor prognosis, and has no established therapy. Here, we report a case of a 69-year-old woman referred to our hospital due to severe anemia and thrombocytopenia. Esophagogastroduodenoscopy demonstrated an AGC in the cardiac part of the stomach, which was histologically diagnosed as poorly-differentiated adenocarcinoma. Bone scintigraphy showed multiple metastases to the bone marrow. Her diagnosis was DIC resulting from AGC, with multiple bone metastases. She underwent chemotherapy with the following regimen: 60mg/m2 docetaxel(DOC)infusion on day 1 and daily oral administration of 100 mg/m2 S-1 for two weeks every three weeks. DIC subsided rapidly after initiation of the therapy and resolved in 12 days. She was discharged from the hospital 56 days after admission and survived 303 days. To our knowledge, this is the first case of AGC reported in the Japanese and English literature to obtain long-term survival in this setting. Combined chemotherapy of S-1 plus DOC may play an important role in the treatment of AGC developing DIC.
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Munemasa M, Yoshino T, Kobayashi K, Miyake T, Takase-Sakugawa S, Mannami T, Shinagawa K, Tanimoto M, Akagi T. Expression of thyroglobulin on follicular dendritic cells of thyroid mucosa-associated lymphoid tissue (MALT) lymphoma. Acta Med Okayama 2009; 63:71-8. [PMID: 19404338 DOI: 10.18926/amo/31834] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Reportedly, thyroid mucosa-associated lymphoid tissue (MALT) lymphoma is closely associated with Hashimoto's thyroiditis. However, it remains unknown which antigen is closely associated with thyroid MALT lymphoma. We examined whether B cell response to thyroglobulin (Tg), which is a common thyroid-specific autoantigen, is related etiologically to the pathogenesis of thyroid MALT lymphoma. Expression of human Tg antigens and Cluster of differentiation (CD) 35 was examined immunohistochemically in 15 cases of thyroid MALT lymphoma using paraffin-embedded, formalin-fixed tissue specimens. In all cases of thyroid MALT lymphoma, human Tg was detected immunohistochemically in the follicular epithelial cells and follicular dendritic cells (FDCs). These FDCs were positive by double immunostaining for anti-human Tg rabbit polyclonal antibody (Ab) and for CD35. Results showed that the Tg, a thyroid autoantigen, had immunostained the germinal center of the thyroid MALT lymphoma. The Tg was present in the FDCs, as revealed by the staining pattern of the germinal center;this fact was confirmed by double immunostaining of anti-human Tg mouse monoclonal Ab and anti-CD35 mouse monoclonal Ab. The results of our study suggest that Tg is an autoantigen that is recognized by thyroid MALT lymphoma cells.
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Affiliation(s)
- Mitsuru Munemasa
- Department of Pathology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan.
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Mannami T, Ohfuji Y, Fujiwara K, Enomura K, Ohta T, Kunisue H, Nomura S, Eguchi K, Oda W, Yamadori I, Yamashita H. [Ciliated hepatic foregut cyst: report of a case and a summary of the 24 cases reported in Japan]. Nihon Shokakibyo Gakkai Zasshi 2008; 105:235-243. [PMID: 18250595] [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: 05/25/2023]
Abstract
We report a 52-year-old patient with a small hepatic mass which was ultrasonographically anechoic with scattered high echoic spots, and appearing slightly hyperattenuating relative to the surrounding parenchyma on unenhanced CT scans. Laparotomy revealed that the lesion was a unilocular cyst containing a mucinous fluid. The histologic diagnosis was ciliated hepatic foregut cyst (CHFC). The CHFC is a rare congenital cystic tumor which derives from the embryologic foregut. Up to 2006, only 24 cases, including our case, had been reported in Japan. The patients were 13 men and 11 women, aged between 41 years and 79 years. All of the lesions were solitary and unilocular. In 22 cases, the CHFC was located in the medial segment of the left lobe, mostly just beneath the hepatic surface. In all 24 Japanese cases, the cystic wall was benign histologically. However, reports of 3 malignant cases overseas indicates we should treat this disease cautiously.
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Affiliation(s)
- Tomohiko Mannami
- Department of Gastroenterology, National Hospital Organization Okayama Medical Center
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26
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Sakata T, Okamoto A, Mannami T, Tomoike H, Miyata T. Prevalence of protein S deficiency in the Japanese general population: the Suita Study. J Thromb Haemost 2004; 2:1012-3. [PMID: 15140145 DOI: 10.1111/j.1538-7836.2004.00742.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Sakata T, Okamoto A, Mannami T, Matsuo H, Miyata T. Protein C and antithrombin deficiency are important risk factors for deep vein thrombosis in Japanese. J Thromb Haemost 2004; 2:528-30. [PMID: 15009480 DOI: 10.1111/j.1538-7836.2004.00603.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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28
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Okamoto A, Sakata T, Mannami T, Baba S, Katayama Y, Matsuo H, Yasaka M, Minematsu K, Tomoike H, Miyata T. Population-based distribution of plasminogen activity and estimated prevalence and relevance to thrombotic diseases of plasminogen deficiency in the Japanese: the Suita Study. J Thromb Haemost 2003; 1:2397-403. [PMID: 14629475 DOI: 10.1046/j.1538-7836.2003.00419.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Reduced plasminogen activity with a normal level of antigen is commonly observed in Japanese individuals. The first reported patient with plasminogen deficiency was accompanied with deep vein thrombosis. The present study examines whether heterozygous or homozygous deficiency of plasminogen is a risk factor for thrombotic disease. This study measures the plasminogen activity of 4517 individuals in the general population, determines the cut-off to define plasminogen deficiency, and identifies plasminogen deficiencies in the control groups and thrombotic disease groups. In another study, we examined the phenotypes of consecutive patients with homozygous plasminogen deficiency detected in our hospital. We found 173 and two of 4517 individuals to have heterozygous and homozygous deficiency with normal plasminogen antigen level, respectively, and 19 to have heterozygous deficiency with reduced antigen levels. The incidence of plasminogen deficiency in an age- and sex-matched control group (13/324, 4.01% for deep vein thrombosis or 13/330, 3.94% for stroke) selected from the 4517 individuals was not significantly different from those in patients with deep vein thrombosis (3/108, 2.78%) or cardioembolic stroke (6/110, 5.55%). Among 19 patients with homozygous plasminogen deficiency showing about 10% plasminogen activity, none had deep vein thrombosis. These findings indicate that neither heterozygous nor homozygous plasminogen deficiency constitutes a significant risk factor for thrombotic disease.
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Affiliation(s)
- A Okamoto
- Laboratory of Clinical Chemistry, Department of Preventive Cardiology, Department of Medicine, National Cardiovascular Center, Osaka, Japan
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29
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Asagoe K, Fujimoto W, Yoshino T, Mannami T, Liu Y, Kanzaki H, Arata J. Intravascular lymphomatosis of the skin as a manifestation of recurrent B-cell lymphoma. J Am Acad Dermatol 2003; 48:S1-4. [PMID: 12582370 DOI: 10.1067/mjd.2003.112] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Intravascular lymphomatosis (IVL) is a rare type of lymphoma with a poor prognosis. Its distinctive clinical and histopathologic features are generated by the proliferation of neoplastic mononuclear cells within blood vessels. We describe a patient with IVL of the skin as a manifestation of a recurrent diffuse large B-cell lymphoma of ureteral origin. Lymphoma cells were located both within the vessels and the parenchyma in an early cutaneous lesion. After recurrence in the skin, lymphoma cells gradually located only in the vascular lumina. This transition suggests that cells localized within the vessels were selected as a consequence of chemotherapy. Immunohistochemical examination revealed that the expression of surface adhesion molecules of lymphoma cells did not significantly change. The results of polymerase chain reaction revealed that the ureteral and cutaneous tumors were identical in clonality. Our findings suggest that conventional diffuse large B-cell lymphoma can change into IVL.
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Affiliation(s)
- Kenji Asagoe
- Department of Dermatology, Okayama University Medical School, Okayama, Japan.
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Takagi S, Iwai N, Baba S, Mannami T, Ono K, Tanaka C, Miyata T, Miyazaki S, Nonogi H, Goto Y. A GPVI polymorphism is a risk factor for myocardial infarction in Japanese. Atherosclerosis 2002; 165:397-8. [PMID: 12417295 DOI: 10.1016/s0021-9150(02)00241-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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31
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Ota S, Shinagawa K, Ueoka H, Tada S, Tabata M, Hamazaki S, Kondo E, Kiura K, Mannami T, Shibayama T, Niiya K, Harada M. Spontaneous regression of metastatic endometrial stromal sarcoma. Jpn J Clin Oncol 2002; 32:71-4. [PMID: 11948233 DOI: 10.1093/jjco/hyf017] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Spontaneous regression of malignancy is rare and there appear to be no reports of spontaneous regression of endometrial stromal sarcoma. We report a rare case of metastatic endometrial stromal sarcoma that regressed spontaneously. A 58-year-old woman was admitted to hospital in January 1996 when her chest radiograph showed multiple nodular shadows in the left lower lung field. Computed tomography of the chest revealed bilateral nodules. Segmentectomy of the left lower lobe was performed by thoracoscopy. She had a past history of uterine myoma with metrorrhagia for which she had undergone a hystero-oophorectomy 10 years earlier. She also had a vaginal polyp removed 1 year earlier. The lung pathology was studied and the surgical specimens of the uterus and vagina were re-examined. The diagnosis was endometrial stromal sarcoma primarily arising in the uterus. The vaginal polyp and the pulmonary nodules were considered to be metastases. Samples of lung and vaginal tissues were positive for both estrogen and progesterone receptors. The patient was discharged without treatment in February 1996 and followed up in the outpatient clinic. The tumor shadow measuring 2 mm in diameter on admission was enlarged to 4 mm in diameter 1 year later. Surprisingly, spontaneous regression of the lung disease occurred at 33 months, the tumor size decreasing to 2 mm in diameter and to 1 mm at 46 months. No evidence of tumor enlargement was detected at the last follow-up in July 2001. Although the precise mechanism of tumor regression is unknown, metastatic endometrial stromal sarcoma may spontaneously regress.
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Affiliation(s)
- Seisuke Ota
- Second Department of Internal Medicine, Okayama University Medical School, Okayama, Japan.
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Sakugawa ST, Yoshino T, Mannami T, Munemasa M, Ichimura K, Okada H, Mizuno M, Tanimoto M, Harada M, Akagi T. Correlation Between Histological Evaluation and PCR-based Clonality Analysis of Gastric MALT Lymphomas Treated by Eradication of Helicobacter pylori. J Clin Exp Hematop 2002. [DOI: 10.3960/jslrt.42.61] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Tsujita Y, Baba S, Yamauchi R, Mannami T, Kinoshita M, Yamamoto R, Katsuya T, Higaki J, Ogihara T, Ogata J, Iwai N. Association analyses between genetic polymorphisms of endothelial nitric oxide synthase gene and hypertension in Japanese: The Suita Study. J Hypertens 2001; 19:1941-8. [PMID: 11677358 DOI: 10.1097/00004872-200111000-00003] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Endothelium-derived nitric oxide plays a key role in the regulation of vascular tone. Recently, endothelial nitric oxide synthase (eNOS) gene polymorphisms were reported to be associated with hypertension or coronary spasm. We investigated the association between the eNOS gene polymorphisms and hypertension in a large population-based sample of 4055 Japanese. DESIGN AND METHODS We investigated two polymorphisms of the eNOS gene, Glu298Asp polymorphism of exon 7 and T(-786)C polymorphism of the promoter region. The genotype distribution in hypertensive subjects was compared to that in the other subjects. The influence of the genotype on blood pressure values was analyzed in the subjects not taking hypertensive medication. The promoter activities of the eNOS gene with the (-786)T or (-786)C allele were measured by a luciferase reporter gene assay. RESULTS There was significant linkage disequilibrium between the two polymorphisms (P < 0.0001). The genotype distribution of the Glu298Asp or T(-786)C polymorphism did not differ between the hypertensive and the other subjects. No significant differences in the blood pressure of subjects not taking hypertensive medication were observed among the three genotypes of Glu298Asp or T(-786)C polymorphisms. No significant differences in the promoter activity were observed between bovine endothelial cells transfected with the (-786)T and (-786)C alleles. CONCLUSIONS Our data suggested that these polymorphisms of the eNOS gene are unlikely to be major factors in the susceptibility to hypertension in the Japanese population studied.
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Affiliation(s)
- Y Tsujita
- National Cardiovascular Center, Suita, Osaka, Japan
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Baba S, Mannami T, Konishi M, Sasaki S. Anthropometric measures, blood pressure and major laboratory examination results in the health check-up examination among the JPHC study participants at baseline survey. Japan Public Health Center-based Prospective Study on Cancer and Cardiovascular Diseases. J Epidemiol 2001; 11:S87-93. [PMID: 11763144 DOI: 10.2188/jea.11.6sup_87] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Health check-up data were compared in all 11 populations included in the cohort. The collected sample size was 23,313 in Cohort I and 24,654 in Cohort II. Height was greater in two urban populations, and body mass index (BMI) was largest in the two populations in Okinawa prefecture. Blood pressure was higher in the populations in northeast part of Japan and Okinawa prefecture, and lower in Suita. Serum total cholesterol level was higher in Okinawa and two urban populations, and lower in the populations in northeast part of Japan, and in Arikawa and Saku.
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Affiliation(s)
- S Baba
- Department of Preventive Cardiology, National Cardiovascular Center, Japan
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Mannami T, Yoshino T, Oshima K, Takase S, Kondo E, Ohara N, Nakagawa H, Ohtsuki H, Harada M, Akagi T. Clinical, histopathological, and immunogenetic analysis of ocular adnexal lymphoproliferative disorders: characterization of malt lymphoma and reactive lymphoid hyperplasia. Mod Pathol 2001; 14:641-9. [PMID: 11454995 DOI: 10.1038/modpathol.3880366] [Citation(s) in RCA: 103] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Malignant lymphomas and reactive lymphoid hyperplasia (RLH) in the ocular adnexa are sometimes difficult to differentiate morphologically and have often been categorized together as a lymphoproliferative disorder. Immunogenotypic characters of these diseases have not yet been well clarified. This study included 76 cases of ocular adnexal lymphoproliferative disorders. These consisted of 52 cases of malignant lymphoma (43 primary and 9 secondary), 22 of RLH, and 2 borderline cases. There were slightly more male than female subjects. Diagnoses were based on morphology and immunophenotypic characteristics. Clonalities were detected by means of polymerase chain reaction (PCR), and immunoglobulin heavy-chain variable region (VH) genes were sequenced in 10 cases of mucosa-associated lymphoid tissue (MALT) lymphoma. MALT lymphoma constituted 86% (37 cases) of the primary lymphomas. MALT lymphomas were more indolent, more rarely disseminated, and had a lower death rate than the other primary lymphomas. Two patients exhibited coexistence of MALT and diffuse large B-cell lymphoma. The average age of patients with RLH was 5.5 years younger than that of those with MALT lymphoma. One of the cases of RLH later progressed to malignant lymphoma. B-cell clonality was detected by PCR in 57%, 55%, and 0% of primary lymphomas, MALT lymphomas and RLHs, respectively. Sequencing of VH genes revealed that the VH3 family was the most commonly expressed germline VH family (70%) and that DP-63, DP-54 and DP-47 genes were frequently found in the MALT lymphomas examined. PCR analysis was useful for differentiation between MALT lymphoma and RLH. Sequence analysis of VH genes showed that an autoimmune mechanism may be involved in the lymphomagenesis of ocular adnexal MALT lymphoma.
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Affiliation(s)
- T Mannami
- Second Department of Internal Medicine, Okayama University Medical School, Okayama, Japan
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36
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Iwai N, Baba S, Mannami T, Katsuya T, Higaki J, Ogihara T, Ogata J. Association of sodium channel gamma-subunit promoter variant with blood pressure. Hypertension 2001; 38:86-9. [PMID: 11463765 DOI: 10.1161/01.hyp.38.1.86] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The SCNN1G gene, located on human chromosome 16p12, encodes the gamma subunit of the amiloride-sensitive epithelial sodium channel, and mutations in SCNN1G can result in Liddle's syndrome or pseudohypoaldosteronism type I. We identified sequence variations in the promoter region of SCNN1G and examined the association between this polymorphism and blood pressure in a large cohort (n=4075) representing the general population in Japan. We found T(-1290)C, T(-501)G, G(-173)A, and G(-104)T polymorphisms in the promoter region of SCNN1G and confirmed the existence of T387C and T474C polymorphisms in exon 3 and the C1947G polymorphism in exon 13. Because the genotypes of the T(-1290)C, T(-501)G, G(-104)T, and T474C polymorphisms were in tight linkage disequilibrium, we selected the T474C and G(-173)A polymorphisms for an association study. The G(-173)A polymorphism of SCNN1G had a significant effect on systolic pressure (P=0.0050) and pulse pressure (P=0.0050). The AA genotype was associated with an 11 mm Hg drop in systolic pressure and an 8 mm Hg drop in pulse pressure and with a higher prevalence of hypotension (P=0.0195). A transient transfection assay using MDCK cells and human renal epithelial cells indicated that the promoter activity of the G(-173) allele was higher than that of the A(-173) allele. Although the effects of the A(-173) allele were recessive and although the AA genotype was found in just 0.7% of our study population, we observed that this variation of human SCNN1G had significant effects on blood pressure.
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Affiliation(s)
- N Iwai
- Research Institute, the Department of Hypertension and Nephrology, National Cardiovascular Center, Osaka University School of Medicine, Suita, Osaka, Japan.
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Takagi S, Baba S, Iwai N, Fukuda M, Katsuya T, Higaki J, Mannami T, Ogata J, Goto Y, Ogihara T. The aldehyde dehydrogenase 2 gene is a risk factor for hypertension in Japanese but does not alter the sensitivity to pressor effects of alcohol: the Suita study. Hypertens Res 2001; 24:365-70. [PMID: 11510748 DOI: 10.1291/hypres.24.365] [Citation(s) in RCA: 84] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Excessive alcohol consumption is a potent risk factor for high blood pressure. About half of Japanese show an extremely high sensitivity to alcohol, which is due to a genetic deficiency in an isoenzyme of aldehydede-hydrogenase with a low Km (ALDH2). It is possible that the effects of alcohol consumption on blood pressure differ according to the ALDH2 genotype. The purpose of the present study was to assess the influence of the ALDH2 genotype on the pressor effects of alcohol. The influence of the ALDH2 genotype on blood pressure was investigated in a large cohort (4,000 subjects) representing the general population in Japan. The genotype was determined by the TaqMan method. The genotype was significantly associated with alcohol consumption, gamma-GTP level, and HDL cholesterol level in both males and females. The odds ratio for the presence of hypertension for the Glu/Glu genotype in comparison to other genotypes was 1.67 (p< 0.0001, odds ratio=1.37-2.08, 95% confidence interval) among males. In contrast, the ALDH2 genotype had no significant effects on blood pressure among females. To investigate whether the ALDH2 genotype affected the sensitivity to the pressor effects of alcohol, we analyzed the effects of the ALDH2 genotype (Lys/Lys+Lys/Glu=0, Glu/Glu=1) and the level of alcohol consumption on blood pressure values after adjusting for age and BMI (residuals after adjusting for age and BMI). Among males, while the level of alcohol consumption significantly affected systolic, diastolic and pulse pressure, no significant interaction was observed between the ALDH2 genotype and the level of alcohol consumption in determining blood pressure levels. These results suggest that the Glu/Glu genotype is a potent risk factor for hypertension among males mainly through its association with the level of alcohol consumption, and that the ALDH2 genotype does not affect the sensitivity to the pressor effects of alcohol.
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Affiliation(s)
- S Takagi
- National Cardiovascular Center, Suita, Japan
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38
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Mannami T, Katsuya T, Baba S, Inamoto N, Ishikawa K, Higaki J, Ogihara T, Ogata J. Low potentiality of angiotensin-converting enzyme gene insertion/deletion polymorphism as a useful predictive marker for carotid atherogenesis in a large general population of a Japanese city: the Suita study. Stroke 2001; 32:1250-6. [PMID: 11387483 DOI: 10.1161/01.str.32.6.1250] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE Some previous studies, almost all western, have investigated whether there is a relationship between the insertion/deletion (I/D) polymorphism of the angiotensin-converting enzyme (ACE) and carotid atherosclerosis. The results, however, have not been consistently positive. Further, there have been few investigations based on a large, general population. Therefore, the present study aimed to clarify whether ACE gene deletion polymorphism was associated with carotid atherosclerosis in a large Japanese general population with a more homogeneous genetic background than Caucasian populations. METHODS Subjects aged 30 to 86 years were randomly selected from Suita City, located in Osaka, the second largest urban area of Japan, and included 1894 men and 2137 women. With the aid of high-resolution ultrasonography, carotid atherosclerosis was evaluated using our atherosclerotic indexes of intimal-medial thickness (IMT), plaque number (PN), plaque score (PS), and percentage of stenosis of the carotid artery assessed using high-resolution B-mode ultrasonography. ACE gene I/D polymorphism was detected by polymerase chain reaction. RESULTS There were no significant differences among the ACE genotypes for age and conventional cardiovascular risk factors, except for systolic blood pressure (SBP) and the percentage of hypertension in men. The values of IMT, PN, and PS as carotid atherosclerotic indexes were not significantly different among genotypes for either sex. After adjusting for age, body mass index, smoking habit, high-density lipoprotein cholesterol, triglycerides, presence of hypertension, presence of diabetes mellitus, and presence of hyperlipidemia, the estimated ORs for the presence of IMT >/=1.10 mm (defined as thickened IMT), according to ACE genotype (DD versus II, DD+ID versus II, and DD versus ID+II), for men were 0.80 (95% CI 0.60 to 1.23), 0.89 (0.62 to 1.29), and 0.89 (0.70 to 1.28), respectively. On the other hand, the ORs for women after the same adjustment were 0.92 (95% CI 0.58 to 1.35), 0.93 (0.59 to 1.45), and 0.91 (0.59 to 1.27), respectively. CONCLUSIONS Our present data suggest that ACE I/D polymorphism is not potentially a useful predictive marker for carotid atherogenesis when investigated in a large and homogeneous general Japanese population of 4031 subjects, a finding similar to that in a Caucasian population study, the Perth Carotid Ultrasound Disease Assessment Study, an Australian study based on a general population using 1111 subjects.
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Affiliation(s)
- T Mannami
- Department of Preventive Cardiology, National Cardiovascular Center, Suita, Osaka, Japan.
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Imakita M, Yutani C, Strong JP, Sakurai I, Sumiyoshi A, Watanabe T, Mitsumata M, Kusumi Y, Katayama S, Mano M, Baba S, Mannami T, Masuda J, Sueishi K, Tanaka K. Second nation-wide study of atherosclerosis in infants, children and young adults in Japan. Atherosclerosis 2001; 155:487-97. [PMID: 11254921 DOI: 10.1016/s0021-9150(00)00595-5] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
This paper reports the results of the second nation-wide cooperative study of atherosclerosis in young Japanese, aged from 1 month to 39 years, who were autopsied between 1991 and 1995. Atherosclerotic lesions in 1066 aortas and 974 coronary arteries were classified into fatty streaks, fibrous plaques and complicated lesions and quantificated with the point-counting method. The results of this study were compared with those of the former study, which was conducted 13 years earlier in almost the same fashion as this study. Atherosclerosis of aorta, which was determined by surface involvement (SI) of atherosclerotic lesions and atherosclerotic index (AI), increased with age in both sexes of the former and the present studies and their tendency for the progression of the extent of atherosclerotic lesions appeared to be similar. In the coronary arteries, the mean values of SI and AI in the males of the present study were greater significantly than those in the male of the former studies and in the female of the both studies in the third and fourth decades. This difference suggests that atherosclerotic lesions are increasing in young Japanese males. It also suggests that these subjects may be increasingly susceptible to atherosclerotic cardiovascular disease with increasing age.
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Affiliation(s)
- M Imakita
- Department of Pathology, National Cardiovascular Center, Japan.
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Tsujita Y, Iwai N, Katsuya T, Higaki J, Ogihara T, Tamaki S, Kinoshita M, Mannami T, Ogata J, Baba S. Lack of association between genetic polymorphism of CYP11B2 and hypertension in Japanese: the Suita Study. Hypertens Res 2001; 24:105-9. [PMID: 11325068 DOI: 10.1291/hypres.24.105] [Citation(s) in RCA: 62] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Aldosterone synthase (CYP11B2) is a key enzyme in the biosynthesis of aldosterone. Recently, a polymorphism in the 5'-flanking region of the CYP11B2 gene [T(-344)C] has been reported to be associated with blood pressure and plasma aldosterone levels. We investigated the association between this polymorphism and hypertension in a large population-based sample of 4,000 Japanese. The genotype distribution in hypertensive subjects (n=1,535) was compared to that in normotensive subjects (n=2,514). In subjects not receiving antihypertensive medication, the influence of the genotype on blood pressure values adjusted for clinical covariates was analyzed. All analyses were performed separately for men and women. The genotype distribution did not differ between hypertensive and normotensive subjects in either men (frequency of C allele: 30.3% vs. 31.4%, p=0.48) or women (31.5% vs. 31.7%, p=0.93). There were no significant differences in systolic blood pressure, diastolic blood pressure, or pulse pressure among the three genotypes in either men or women who had not received hypertensive medication. Our data suggest that the T(-344)C polymorphism of CYP11B2 is unlikely to influence blood pressure status in the Japanese population.
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Affiliation(s)
- Y Tsujita
- Research Institute, National Cardiovascular Center, Suita, Japan
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Ishikawa K, Baba S, Katsuya T, Iwai N, Asai T, Fukuda M, Takiuchi S, Fu Y, Mannami T, Ogata J, Higaki J, Ogihara T. T+31C polymorphism of angiotensinogen gene and essential hypertension. Hypertension 2001; 37:281-5. [PMID: 11230286 DOI: 10.1161/01.hyp.37.2.281] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A common variant at codon 235 of the angiotensinogen gene with methionine to threonine amino acid substitution (AGT M235T) has been reported as a genetic risk for essential hypertension. However, the frequency of AGT T235 was heterogeneous among races, and a positive association between AGT M235T and hypertension was not settled. To examine the association in a general population of Japanese (n=4013), we introduced the TaqMan polymerase chain reaction method and examined the relation between hypertension and T+31C polymorphism, which was in absolute linkage disequilibrium with AGT M235T. The C+31 allele of AGT was significantly associated with the positive family history of hypertension (FH) but not with the presence of hypertension or blood pressure. The subjects with CC tended to have hypertensive relatives, especially a hypertensive father or siblings, and its statistical significance was stronger in men. Adjustment of confounding factor did not alter the results of simple association study, suggesting that this positive association with FH is independent and significant. Our findings revealed that the TaqMan polymerase chain reaction method is a powerful tool for genetic association study with a large number of subjects and that AGT T+31C is significantly associated with paternal FH.
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Affiliation(s)
- K Ishikawa
- Department of Geriatric Medicine, Osaka University Medical School, Osaka, Japan
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Abstract
BACKGROUND Low grade mucosa-associated lymphoid tissue (MALT) lymphomas usually are confined to single extranodal organs. Although some case reports have been published, clinicopathologic characteristics of multiorgan MALT lymphomas remain unclear. METHODS The authors evaluated 7 MALT lymphoma cases involving multiorgans in the past 7 years. In this period, they experienced 304 cases of MALT lymphomas. They analyzed the clinicopathologic features of these cases, including examination of clonal comparison among the lesions. RESULTS The patients, 4 females and 3 males, were aged 55-68 years old (average, 60.1 years). Four cases showed multiple organ involvement at the initial diagnosis or after a short period. In the other three cases, primary foci were the stomach, thyroid gland, and ocular adnexa; after a rather long period (3 years or more), distant metastases were found. Although intestinal primary lymphomas are rather rare, six of the seven cases showed large intestinal involvement. Lymph node involvement was proven in only three cases. The patients were rather resistant to the various therapeutic approaches. Although six patients are alive, five are with disease. DNA analyses revealed that in five of the cases evaluated, identical clones were detected among the different affected organs. CONCLUSIONS Multiorgan MALT lymphomas are rather rare. Most cases probably derived from a single clone, and lymphoma cells may selectively move among MALTs via a homing system with preferential involvement of the colon. Because multiorgan MALT lymphomas rarely achieve complete remission by treatment with combination chemotherapy or irradiation, MALT lymphomatous lesions should be checked carefully, especially in the large intestine.
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Affiliation(s)
- T Yoshino
- Department of Pathology, Okayama University Medical School, Okayama, Japan.
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Mannami T, Baba S, Ogata J. Potential of carotid enlargement as a useful indicator affected by high blood pressure in a large general population of a Japanese city: the Suita study. Stroke 2000; 31:2958-65. [PMID: 11108756 DOI: 10.1161/01.str.31.12.2958] [Citation(s) in RCA: 46] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE Few studies have examined whether there is a relationship between carotid arterial diameter and cardiovascular risk factors in a large general population. The aim of this study was to investigate cross-sectionally whether, in a randomly selected general large population of a Japanese city, there is a relationship between common carotid artery (CCA) diameter and conventional cardiovascular risk factors. METHODS The subjects of the present study were randomly selected from the residents of the city of Suita, located in the second largest urban area of Japan, and consisted of 2284 men and 2568 women aged 30 to 89 years. The outer and inner CCA diameters and intima-media thickness (IMT) of CCA were detected and measured by a single physician with high-resolution ultrasonography. We assessed cross-sectionally by age/sex group the relationships between IMT or CCA diameters and cardiovascular risk factors, especially blood pressure levels divided into 3 groups: the normal group of subjects had a diastolic blood pressure (DBP) <85 mm Hg and systolic blood pressure (SBP) <130 mm Hg and were not taking antihypertensive medication; the high group of subjects had DBP >/=90 mm Hg and/or SBP >/=140 mm Hg and/or were taking antihypertensive medication; and the moderate group consisted of all other subjects. RESULTS The outer and inner CCA diameters for the high group were significantly (P:<0.05) enlarged in comparison with those for the moderate and normal groups in all age/sex groups of both sexes after adjustment for body mass index, pack-years of smoking, alcohol consumption, and total serum cholesterol. Multiple regression analysis showed that age, body mass index, SBP, pack-years of smoking, alcohol consumption, and IMT were positively and significantly (P:<0.005) related to both outer and inner CCA diameters in both sexes except for between alcohol consumption and outer CCA diameter in women and showed that only serum total cholesterol level was negatively and significantly (P:<0.01) related to inner CCA diameter in both sexes. CONCLUSIONS Our present study showed that the outer and inner CCA diameters correlated with conventional cardiovascular risk factors, including high blood pressure and IMT. These findings suggest that the outer and inner CCA diameters may be a useful indicator of carotid atherosclerosis, particularly in relation to high blood pressure.
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Affiliation(s)
- T Mannami
- Department of Preventive Cardiology, National Cardiovascular Center, Suita, Japan.
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Yoshino T, Mannami T, Ichimura K, Takenaka K, Nose S, Yamadori I, Akagi T. Two cases of histiocytic necrotizing lymphadenitis (Kikuchi-Fujimoto's disease) following diffuse large B-cell lymphoma. Hum Pathol 2000; 31:1328-31. [PMID: 11070128 DOI: 10.1053/hupa.2000.18504] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Histiocytic necrotizing lymphadenitis (HNL) is often mistaken for malignant lymphoma clinically and is also sometimes difficult to differentiate from lymphoma even histopathologically. In this report, we describe the first 2 reported cases of HNL following non-Hodgkin's lymphomas. The patients were 27- and 30-year-old women who developed cervical and axillary lymph node swellings, respectively, in the course of remission of diffuse large B-cell lymphoma. The affected lymph nodes showed the typical histology of HNL: irregular-shaped "necrotic" foci with histiocytes engulfing apoptotic bodies intermingled with large-sized blastic lymphocytes. These findings mimicked the partial involvement of large-cell lymphoma. However, the blastic cells were almost exclusively T cells, and numerous apoptotic bodies were present, which excluded the possibility of recurrence of diffuse large B-cell lymphoma.
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Affiliation(s)
- T Yoshino
- Department of Pathology, Internal Medicine Okayama University Medical School, Okayama, Japan
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45
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Kojima K, Mannami T, Yoshino T, Kawasaki H, Sasaki K, Maeda T, Furuya K, Harada M, Hara M. Histologic transformation of follicular lymphoma after allogeneic bone marrow transplantation. Bone Marrow Transplant 2000; 26:581-3. [PMID: 11019852 DOI: 10.1038/sj.bmt.1702547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
A 38-year-old man with refractory follicular lymphoma underwent allogeneic BMT from an HLA-identical sibling donor. He had generalized lymphadenopathy, hepatosplenomegaly and lymphoma infiltration of the marrow, all of which disappeared within 3 months following transplantation. Six months post-transplant, progressive hepatomegaly developed in the absence of splenomegaly and lymphadenopathy, and he died from hepatic failure. Autopsy disclosed diffuse large B cell lymphoma of the liver, into which the follicular lymphoma had transformed. Future issues to be investigated should include the optimal timing of allogeneic BMT for low-grade lymphomas.
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MESH Headings
- Adult
- Bone Marrow Transplantation/adverse effects
- Cell Transformation, Neoplastic/pathology
- Fatal Outcome
- Hepatomegaly/etiology
- Humans
- Liver/pathology
- Lymphoma, B-Cell/genetics
- Lymphoma, B-Cell/pathology
- Lymphoma, Follicular/genetics
- Lymphoma, Follicular/pathology
- Lymphoma, Follicular/therapy
- Lymphoma, Large B-Cell, Diffuse/genetics
- Lymphoma, Large B-Cell, Diffuse/pathology
- Male
- Neoplasms, Second Primary/genetics
- Neoplasms, Second Primary/pathology
- Sequence Analysis, DNA
- Sequence Homology
- Transplantation, Homologous/adverse effects
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Affiliation(s)
- K Kojima
- Department of Medicine, Ehime Prefectural Central Hospital, Matsuyama, Japan
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Mannami T, Baba S, Ogata J. Strong and significant relationships between aggregation of major coronary risk factors and the acceleration of carotid atherosclerosis in the general population of a Japanese city: the Suita Study. Arch Intern Med 2000; 160:2297-303. [PMID: 10927726 DOI: 10.1001/archinte.160.15.2297] [Citation(s) in RCA: 58] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND Carotid arterial intimal-medial thickness (IMT) measured by high-resolution B-mode ultrasonography has come to be used as a noninvasive surrogate end point to measure progression of atherosclerosis. However, there are no detailed data on the relationship between aggregation of coronary risk factors and carotid atherogenesis. METHODS Cross-sectional assessment of the relationship between carotid atherosclerosis detected by high-resolution ultrasonography and integration of major coronary risk factors by age and sex. Subjects aged 30 to 86 years were randomly selected from Suita, located in Osaka, the second largest urban area of Japan, including 1896 men and 2102 women. Carotid atherosclerosis was evaluated by using our atherosclerotic indexes of IMT, plaque number, plaque score, and percentage of stenosis of the carotid artery assessed using ultrasonography by sex and age group classified by number of major coronary risk factors (ie, hypertension [diastolic blood pressure > or =90 mm Hg and/or systolic blood pressure > or 140 mm Hg or receiving medication], smoking [current smoker], and hypercholesterolemia [serum total cholesterol level > or =5.68 mmol/L [220 mg/dL] or receiving medication]). RESULTS The mean carotid atherosclerotic index value, especially the mean IMT value, of the subjects with 1 major coronary risk factor was on average 0.028 mm (3.2%) higher for men and 0.025 mm (2.9%) higher for women than that of the subjects without major coronary risk factors; for subjects with 2 risk factors, 0.054 mm (6.3%) higher for men and 0.053 mm (6.2%) higher for women; and for high-risk subjects with 3 major risk factors, 0.135 mm (15.8%) higher for men and 0.137 mm (15.4%) higher for women. The percentage of the subjects with severe stenosis of at least 50% increased stepwise with increases in the number of coronary risk factors and showed a significant difference (P<.05) between men and women, ie, 2.4% vs 0. 6% (P =.01) among the subjects with no risk factors; 6.7% vs 1.5% (P<.001), subjects with 1 risk factor; 10.7% vs 2.7% (P<.001), subjects with 2 risk factors; and 18.6% vs 5.0% (P =.01), high-risk subjects. CONCLUSIONS Aggregation of established major coronary risk factors strongly influenced carotid atherogenesis in both sexes. There were significant differences between sexes in the acceleration or progression of carotid atherosclerosis.
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Affiliation(s)
- T Mannami
- Department of Preventive Cardiology, National Cardiovascular Center, Fujishirodai, Suita, Osaka, Japan.
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Higaki J, Baba S, Katsuya T, Sato N, Ishikawa K, Mannami T, Ogata J, Ogihara T. Deletion allele of angiotensin-converting enzyme gene increases risk of essential hypertension in Japanese men : the Suita Study. Circulation 2000; 101:2060-5. [PMID: 10790347 DOI: 10.1161/01.cir.101.17.2060] [Citation(s) in RCA: 160] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND The Framingham Study recently revealed that the homozygous deletion polymorphism of the angiotensin-converting enzyme gene (ACE DD) is associated with increased risk for essential hypertension in a male-specific manner. However, this association has not been confirmed in races other than whites. METHODS AND RESULTS Using a large number of Japanese subjects (n=5014) that were randomly selected from the general population (the Suita Study), we examined the association between ACE DD and hypertension. The frequency of DD (17.1%) in hypertensive men was significantly higher (P<0.0015) than that (11.8%) in other mildly hypertensive or normotensive men, and the estimated odds prevalence for hypertension (DD vs II) was 1.75 (95% CI 1.21 to 2.53). In contrast, no significant association was confirmed in women (OR 1.17, 95% CI 0.79 to 1.72). CONCLUSIONS Despite the lower frequency of the DD genotype in Japanese than in whites, the ACE gene polymorphism was associated with increased risk for hypertension, suggesting that this polymorphism is a mild but certain genetic risk factor for essential hypertension in men.
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Affiliation(s)
- J Higaki
- Department of Geriatric Medicine, Osaka University Medical School, Suita, Osaka, Japan
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Abstract
The incidence of indolent lymphomas in the lymph nodes and extranodal regions is quite different. Follicular lymphoma (FL) is most common in the nodes, and it seems to be least common in the gastrointestinal (GI) tract, where mucosa-associated lymphoid tissue lymphoma arises most frequently. The authors report that the incidence of FL is unexpectedly high in the duodenum compared with other portions of the GI tract. FL was detected in only eight of 222 cases of GI lymphoma (3.6%). However, five cases of FL arose in the duodenum, which accounted for 38.5% of 13 duodenal lymphomas. Only in two patients did FL arise in either the stomach or the colorectum, and in the remaining patients FL was widespread with lymphomatous polyposis. Duodenal FL was composed of neoplastic follicles with small cleaved cells in dominance, and the immunophenotype of the lymphoma cells was CD10+, BCL-2+, CD20+, CD75+, CD79+, CD3-, CD5-, cyclin D1-, CD23-, and CD45RO-. All the patients were women age 37 to 66 years (average age, 52.4 yrs). In all patients the lymphoma was present around the ampulla of Vater, and four of five patients showed multiple small-size polyps. Although lymphoma cell infiltration was confined to the submucosa in the four patients examined, the regional lymph nodes were involved partially in two patients without distant metastasis. All patients are alive at 2 to 50 months of follow up (average, 27 mos), which is comparable with the prognosis for indolent nodal lymphomas. These results suggest that the duodenum has a distinct background of histogenesis of the lymphomas and that biopsy specimens from the duodenum with multiple polyps should be examined carefully.
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Affiliation(s)
- T Yoshino
- Department of Pathology, Okayama University Medical School, Japan.
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Imakita M, Yutani C, Sakurai I, Sumiyoshi A, Watanabe T, Mitsumata M, Kusumi Y, Katayama S, Mano M, Baba S, Mannami T, Sueishi K, Tanaka K. The second nationwide study of atherosclerosis in infants, children, and young adults in Japan. Comparison with the first study carried out 13 years ago. Ann N Y Acad Sci 2000; 902:364-8. [PMID: 10865864 DOI: 10.1111/j.1749-6632.2000.tb06339.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- M Imakita
- Department of Pathology, National Cardiovascular Center, Osaka, Japan.
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Mannami T, Baba S, Konishi M, Terao A, Kitamura A, Iida M, Shimamoto T. Comparison of the prevalence of asymptomatic carotid atherosclerosis detected by high-resolution ultrasonography in rural and urban middle-aged Japanese men. J Stroke Cerebrovasc Dis 2000; 9:106-12. [PMID: 17895206 DOI: 10.1053/jscd.2000.5864] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/1999] [Accepted: 11/10/1999] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND AND PURPOSE We have recently shown that extracranial carotid atherosclerosis is not uncommon in urban regions of Japan. Rural data have, however, been scarcely reported. The aim of this study was to investigate the prevalence of asymptomatic extracranial carotid lesions in rural populations compared with urban populations. METHODS The subjects in the rural region consisted of 249 men, aged 50 to 69 years. Urban subjects were 610 men of the same age range. Carotid ultrasound examinations were performed with 7.5-MHz high-resolution ultrasonography. RESULTS Detection of severe atherosclerosis (stenosis of 50%) was significantly higher (P<.05) in rural subjects (9.6%) than in urban subjects (4.6%). Multiple regression analysis of carotid atherosclerosis showed significant relationships with age, fasting blood glucose, hypertension, pack-years of smoking, total serum cholesterol, and high-density lipoprotein cholesterol for the rural subjects as well as for the urban subjects (P<.05). CONCLUSION The present cross-sectional study showed that, in middle-aged men, the prevalence of severe carotid atherosclerosis was higher in rural populations compared with urban populations of Japan. This was attributed to long-term exposure to hypertension.
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Affiliation(s)
- T Mannami
- Department of Preventive Cardiology, National Cardiovascular, Center, Suita, Osaka, Japan
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