92 results on '"Kachi K"'
Search Results
2. Differences of symptoms and standardized weight index between patients with early-onset and late-onset anorexia nervosa
- Author
-
Matsumoto, H., Takei, N., Kawai, M., Saito, F., Kachi, K., Ohashi, Y., Takeuchi, H., and Mori, N.
- Published
- 2001
3. Childhood-onset schizophrenia and obstetric complications: a case–control study
- Author
-
Matsumoto, H., Takei, N., Saito, H., Kachi, K., and Mori, N.
- Published
- 1999
- Full Text
- View/download PDF
4. <Case Report> High-Dose-Rate Interstitial Radiotherapy for the Glioblastoma Multiforme
- Author
-
UCHIYAMA, G., OGATA, H., ARAKI, T., KOIZUMI, K., HlHARA, T., KACHI, K., MONZAWA, S., MATSUSAKO, M., AKIYAMA, S., SANO, H., FUKAMACHI, A., and NUKUI, H.
- Subjects
CT compatible stereotactic head holder ,glioblastoma multiforme ,high-dose-rate interstitial radiotherapy ,Iridium-192-equipped remote-afterloading system ,nervous system diseases - Abstract
Glioblastoma multiforme is characterized by its resistance to any kind of treatment. We report a patient with recurrent glioblastoma multiforme treated by intraoperative high-dose-rate interstitial rediotherapy with an Iridium-192-equipped remote-afterloading system. This technique was effective only in preventing tumor growth for a few months.
- Published
- 1990
5. Ensuring safe retrieval of migrated metal stent using endoscopic sheath device.
- Author
-
Okamoto Y, Kachi K, Kato A, Yoshida M, and Kataoka H
- Subjects
- Humans, Male, Prosthesis Failure, Cholangiopancreatography, Endoscopic Retrograde instrumentation, Cholangiopancreatography, Endoscopic Retrograde adverse effects, Treatment Outcome, Female, Device Removal methods, Foreign-Body Migration etiology, Foreign-Body Migration surgery, Stents adverse effects
- Published
- 2024
- Full Text
- View/download PDF
6. The Lreu_1276 protein from Limosilactobacillus reuteri represents a third family of dihydroneopterin triphosphate pyrophosphohydrolases in bacteria.
- Author
-
Kachi K, Sato T, Nagasawa M, Cann I, and Atomi H
- Subjects
- Pterins metabolism, Escherichia coli genetics, Escherichia coli metabolism, Recombinant Proteins metabolism, Recombinant Proteins genetics, Neopterin analogs & derivatives, Bacterial Proteins genetics, Bacterial Proteins metabolism, Limosilactobacillus reuteri genetics, Limosilactobacillus reuteri enzymology, Limosilactobacillus reuteri metabolism, Pyrophosphatases genetics, Pyrophosphatases metabolism
- Abstract
Tetrahydrofolate is a cofactor involved in C
1 metabolism including biosynthesis pathways for adenine and serine. In the classical tetrahydrofolate biosynthesis pathway, the steps removing three phosphate groups from the precursor 7,8-dihydroneopterin triphosphate (DHNTP) remain unclear in many bacteria. DHNTP pyrophosphohydrolase hydrolyzes pyrophosphate from DHNTP and produces 7,8-dihydroneopterin monophosphate. Although two structurally distinct DHNTP pyrophosphohydrolases have been identified in the intestinal bacteria Lactococcus lactis and Escherichia coli , the distribution of their homologs is limited. Here, we aimed to identify a third DHNTP pyrophosphohydrolase gene in the intestinal lactic acid bacterium Limosilactobacillus reuteri . In a gene operon including genes involved in dihydrofolate biosynthesis, we focused on the lreu_1276 gene, annotated as Ham1 family protein or XTP/dITP diphosphohydrolase, as a candidate encoding DHNTP pyrophosphohydrolase. The Lreu_1276 recombinant protein was prepared using E. coli and purified. Biochemical analyses of the reaction product revealed that the Lreu_1276 protein displays significant pyrophosphohydrolase activity toward DHNTP. The optimal reaction temperature and pH were 35°C and around 7, respectively. Substrate specificity was relatively strict among 17 tested compounds. Although previously characterized DHNTP pyrophosphohydrolases prefer Mg2+ , the Lreu_1276 protein exhibited maximum activity in the presence of Mn2+ , with a specific activity of 28.2 ± 2.0 µmol min-1 mg-1 in the presence of 1 mM Mn2+ . The three DHNTP pyrophosphohydrolases do not share structural similarity to one another, and the distribution of their homologs does not overlap, implying that the Lreu_1276 protein represents a third structurally novel DHNTP pyrophosphohydrolase in bacteria., Importance: The identification of a structurally novel DHNTP pyrophosphohydrolase in L. reuteri provides valuable information in understanding tetrahydrofolate biosynthesis in bacteria that possess lreu_1276 homologs. Interestingly, however, even with the identification of a third family of DHNTP pyrophosphohydrolases, there are still a number of bacteria that do not harbor homologs for any of the three genes while possessing other genes involved in the biosynthesis of the pterin ring structure. This suggests the presence of an unrecognized DHNTP pyrophosphohydrolase gene in bacteria. As humans do not harbor DHNTP pyrophosphohydrolase, the high structural diversity of enzymes responsible for a reaction in tetrahydrofolate biosynthesis may provide an advantage in designing inhibitors targeting a specific group of bacteria in the intestinal microbiota., Competing Interests: The authors declare no conflict of interest.- Published
- 2024
- Full Text
- View/download PDF
7. Potential of Anti-Leukotriene Drugs as New Therapeutic Agents for Inhibiting Cholangiocarcinoma Progression.
- Author
-
Kito Y, Kachi K, Yoshida M, Hori Y, Kato A, Sahashi H, Toyohara T, Kuno K, Adachi A, Urakabe K, and Kataoka H
- Subjects
- Humans, Cell Line, Tumor, Acetates pharmacology, Acetates chemistry, Male, Cyclopropanes pharmacology, Cyclopropanes therapeutic use, Cell Movement drug effects, Female, Middle Aged, Proto-Oncogene Proteins c-akt metabolism, Disease Progression, Leukotrienes metabolism, Phosphorylation drug effects, Aged, Leukotriene D4 metabolism, MAP Kinase Signaling System drug effects, Cholangiocarcinoma drug therapy, Cholangiocarcinoma metabolism, Cholangiocarcinoma pathology, Cell Proliferation drug effects, Receptors, Leukotriene metabolism, Leukotriene Antagonists pharmacology, Leukotriene Antagonists therapeutic use, Bile Duct Neoplasms drug therapy, Bile Duct Neoplasms metabolism, Bile Duct Neoplasms pathology, Sulfides pharmacology, Quinolines pharmacology, Hydroxyurea analogs & derivatives, Hydroxyurea pharmacology, Hydroxyurea therapeutic use
- Abstract
Cholangiocarcinoma (CCA) is a cancer with a poor prognosis due to difficulties in diagnosis and limited treatment options, highlighting the urgent need for new targeted therapies. In a clinical setting, we found that leukotriene levels in bile were higher than in serum. Immunohistochemical analysis of surgically resected samples also revealed that CysLT receptor 1 (CysLTR1) was more highly expressed in CCA than in normal bile duct tissue, prompting us to investigate leukotriene as a potential therapeutic target in CCA. In vitro studies using CCA cell lines expressing CysLTR1 showed that leukotriene D4, a major ligand of CysLTR1, promoted cell proliferation, with increased phosphorylation of AKT and extracellular signal-regulated kinase 1/2 (ERK1/2). Additionally, treatment with two clinically available anti-allergic drugs-zileuton, an inhibitor of CysLT formation, and montelukast, a CysLTR1 inhibitor-had inhibitory effects on cell proliferation and migratory capacity, accompanied by the reduced phosphorylation of AKT and ERK1/2. Furthermore, the simultaneous administration of both drugs synergistically enhanced the inhibitory effect on cell proliferation. Our study suggests that use of these drugs may represent a novel approach to treat CCA through drug repositioning.
- Published
- 2024
- Full Text
- View/download PDF
8. Sensitive detection of pathological seeds of α-synuclein, tau and prion protein on solid surfaces.
- Author
-
Orrú CD, Groveman BR, Hughson AG, Barrio T, Isiofia K, Race B, Ferreira NC, Gambetti P, Schneider DA, Masujin K, Miyazawa K, Ghetti B, Zanusso G, and Caughey B
- Subjects
- Humans, Animals, Mice, Brain metabolism, Brain pathology, Prions metabolism, Lewy Body Disease metabolism, tau Proteins metabolism, alpha-Synuclein metabolism, alpha-Synuclein analysis, Prion Proteins metabolism
- Abstract
Prions or prion-like aggregates such as those composed of PrP, α-synuclein, and tau are key features of proteinopathies such as prion, Parkinson's and Alzheimer's diseases, respectively. Their presence on solid surfaces may be biohazardous under some circumstances. PrP prions bound to solids are detectable by ultrasensitive real-time quaking-induced conversion (RT-QuIC) assays if the solids can be immersed in assay wells or the prions transferred to pads. Here we show that prion-like seeds can remain detectable on steel wires for at least a year, or even after enzymatic cleaning and sterilization. We also show that contamination of larger objects with pathological seeds of α-synuclein, tau, and PrP can be detected by simply assaying a sampling medium that has been transiently applied to the surface. Human α-synuclein seeds in dementia with Lewy bodies brain tissue were detected by α-synuclein RT-QuIC after drying of tissue dilutions with concentrations as low as 10-6 onto stainless steel. Tau RT-QuIC detected tau seeding activity on steel exposed to Alzheimer's disease brain tissue diluted as much as a billion fold. Prion RT-QuIC assays detected seeding activity on plates exposed to brain dilutions as extreme as 10-5-10-8 from prion-affected humans, sheep, cattle and cervids. Sampling medium collected from surgical instruments used in necropsies of sporadic Creutzfeldt-Jakob disease-infected transgenic mice was positive down to 10-6 dilution. Sensitivity for prion detection was not sacrificed by omitting the recombinant PrP substrate from the sampling medium during its application to a surface and subsequent storage as long as the substrate was added prior to performing the assay reaction. Our findings demonstrate practical prototypic surface RT-QuIC protocols for the highly sensitive detection of pathologic seeds of α-synuclein, tau, and PrP on solid objects., Competing Interests: BC, CDO, BG and AH are inventors on patent applications pertaining to RT-QuIC technology. The other authors have declared that no competing interests exist. Mention of trade names or commercial products in this article is solely for the purpose of providing specific information and does not imply recommendation or endorsement by the US Government., (Copyright: This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication.)
- Published
- 2024
- Full Text
- View/download PDF
9. Incidence of Pancreatic Injury and Pancreatitis in Patients Treated With Immune Checkpoint Inhibitors.
- Author
-
Hori Y, Naitoh I, Naiki-Ito A, Kawai T, Yoshida M, Kato A, Kachi K, Sahashi H, Adachi A, Toyohara T, Kito Y, Yamamoto T, Takahashi S, and Kataoka H
- Subjects
- Humans, Male, Female, Middle Aged, Incidence, Aged, Risk Factors, Retrospective Studies, Adult, Neoplasms drug therapy, Pancreas pathology, Pancreas immunology, Pancreas diagnostic imaging, Aged, 80 and over, Immune Checkpoint Inhibitors adverse effects, Pancreatitis chemically induced, Pancreatitis epidemiology, Pancreatitis immunology
- Abstract
Introduction: Immune checkpoint inhibitors (ICIs) are being increasingly used to treat advanced malignancies. ICI-induced pancreatic injury (ICI-PI), which is an immune-related adverse event that may be a risk factor of ICI-associated pancreatitis, is not well documented in the literature., Methods: Consecutive patients who received ICIs for advanced malignancies from August 2015 through October 2022 were analyzed for the incidence of ICI-PI based on the Common Terminology Criteria for Adverse Events and ICI-associated pancreatitis. The imaging, clinical, and pathological findings of ICI-associated pancreatitis were also assessed., Results: This study enrolled 843 patients. In multivariable analyses, dual or simultaneous immunotherapy and ≥10 cycles of ICI administration were significant predictive factors for all grades of pancreatic injury, including grade ≥3. Notably, patients who received simultaneous immunotherapy exhibited a higher incidence of grade ≥3 pancreatic injuries compared with those receiving asynchronous immunotherapy in univariable analysis ( P = 0.032). One-fifth of the patients (16/70) with grade ≥3 pancreatic injuries had imaging evidence of pancreatitis similar to mild acute pancreatitis. ICI-associated pancreatitis was observed in 5.7% (48/843) of patients, including 1.8% (15/843) with moderate-to-severe pancreatitis (grade ≥2). Symptomatic cases (0.36%, 3/843) were treated with steroids with favorable outcomes. Immunohistochemistry for CD4 and CD8 revealed greater infiltration of CD8 + than CD4 + lymphocytes., Discussion: Simultaneous immunotherapy and dual immunotherapy are risk factors of ICI-PI. Although most patients diagnosed with ICI-PI and ICI-associated pancreatitis were asymptomatic and had a low mortality likelihood, long-term outcomes, including endocrine and exocrine function, should be carefully monitored., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of The American College of Gastroenterology.)
- Published
- 2024
- Full Text
- View/download PDF
10. 3-Fr microcatheter-assisted endoscopic ultrasound-guided rendezvous technique with a 22-gauge needle and a 0.018-inch guidewire for difficult biliary cannulation.
- Author
-
Natsume M, Yoshida M, Hayashi K, Naitoh I, Hori Y, Kato A, Kenta K, and Kataoka H
- Subjects
- Humans, Endosonography methods, Needles, Drainage methods, Ultrasonography, Interventional, Cholangiopancreatography, Endoscopic Retrograde methods, Catheterization methods
- Abstract
Endoscopic ultrasound-guided rendezvous with a 22-gauge needle and a 0.018-inch guidewire, assisted by a 3-Fr microcatheter, effectively addresses challenges in biliary cannulation, improving guidewire manipulation and reducing risks of injury and leakage. Natsume and colleagues describe the successful extraction of common bile duct stones to demonstrate the efficacy of this technique., (© 2023 Japanese Society of Hepato-Biliary-Pancreatic Surgery.)
- Published
- 2024
- Full Text
- View/download PDF
11. Percutaneous single-operator cholangioscopy-assisted antegrade biliary recanalization with over-the-wire 3F microcatheter manipulation.
- Author
-
Adachi A, Yoshida M, Hori Y, Kato A, Kachi K, Sahashi H, and Kataoka H
- Abstract
Competing Interests: Conflict of Interest The authors declare that they have no conflict of interest.
- Published
- 2024
- Full Text
- View/download PDF
12. Dual role of autotaxin as novel biomarker and therapeutic target in pancreatic neuroendocrine neoplasms.
- Author
-
Toyohara T, Yoshida M, Miyabe K, Hayashi K, Naitoh I, Kondo H, Hori Y, Kato A, Kachi K, Asano G, Sahashi H, Adachi A, Kuno K, Kito Y, Matsuo Y, and Kataoka H
- Subjects
- Animals, Humans, Mice, Biomarkers, Cell Line, Disease Models, Animal, Phosphoric Diester Hydrolases genetics, Phosphoric Diester Hydrolases metabolism, RNA Interference, Neuroendocrine Tumors drug therapy, Neuroendocrine Tumors genetics, Pancreatic Neoplasms drug therapy, Pancreatic Neoplasms genetics
- Abstract
Pancreatic neuroendocrine neoplasms (panNENs) are rare pancreatic neoplasms, and descriptions of treatment remain limited. Autotaxin (ATX) is a secreted autocrine motility factor involved in the production of lysophosphatidic acid (LPA), a lipid mediator that promotes the progression of various cancers. The aim of this study was to clarify the importance of the ATX-LPA axis in panNENs and to confirm its contribution to panNEN progression using clinical data, cell lines, and a mouse model. Serum ATX level was higher in patients with panNEN than in patients with other pancreatic diseases (chronic pancreatitis, pancreatic ductal adenocarcinoma [PDAC], intraductal papillary mucinous neoplasm, autoimmune pancreatitis) and healthy controls, and 61% of clinical specimens stained strongly for ATX. In a case we encountered, serum ATX level fluctuated with disease progression. An in vitro study showed higher ATX mRNA expression in panNEN cell lines than in PDAC cell lines. Cell proliferation and migration in panNEN cell lines were stimulated via the ATX-LPA axis and suppressed by RNA interference or inhibitors. An in vivo study showed that intraperitoneal injection of GLPG1690, an ATX inhibitor, suppressed tumor progression in a xenograft model. These findings revealed that ATX expression is significantly elevated in panNEN and is related to the progression of panNEN. We showed the potential of ATX as a novel biomarker and therapeutic target., (© 2023 The Authors. Cancer Science published by John Wiley & Sons Australia, Ltd on behalf of Japanese Cancer Association.)
- Published
- 2023
- Full Text
- View/download PDF
13. Use of a transpapillary stent as a guidepost for endoscopic ultrasound-guided pancreatic duct drainage in the treatment of disconnected pancreatic duct syndrome.
- Author
-
Hori Y, Kato A, Naitoh I, Hayashi K, Yoshida M, Kachi K, and Kataoka H
- Subjects
- Humans, Stents, Ultrasonography, Interventional, Treatment Outcome, Pancreatic Ducts diagnostic imaging, Pancreatic Ducts surgery, Drainage
- Abstract
Competing Interests: The authors declare that they have no conflict of interest.
- Published
- 2023
- Full Text
- View/download PDF
14. Basket-assisted method for removal of floating pancreatic stones by electronic hydraulic lithotripsy through peroral pancreatoscopy.
- Author
-
Kato A, Yoshida M, Hori Y, Kachi K, Sahashi H, Adachi A, and Kataoka H
- Abstract
Competing Interests: Conflict of Interest The authors declare that they have no conflict of interest.
- Published
- 2023
- Full Text
- View/download PDF
15. Successful removal of a fractured pancreatic stent using a novel thin-tapered drill dilator.
- Author
-
Hori Y, Kato A, Kachi K, Ichino Y, Naitoh I, Yoshida M, and Kataoka H
- Abstract
Competing Interests: Conflict of Interest The authors declare that they have no conflict of interest.
- Published
- 2023
- Full Text
- View/download PDF
16. The novel technique of drainage stenting using a tapered sheath dilator in endoscopic ultrasound-guided biliary drainage.
- Author
-
Kato A, Yoshida M, Hori Y, Kachi K, Sahashi H, Toyohara T, Adachi A, Kuno K, Kito Y, and Kataoka H
- Abstract
During endoscopic ultrasound-guided biliary drainage (EUS-BD), there is a risk for bile leakage until stent deployment, which can result in severe peritonitis, particularly when passing a drainage stent becomes challenging despite tract dilation. There is no established method or dedicated device to optimize EUS-BD. Therefore, we have developed a novel stent deployment technique using the tapered sheath dilator. To address the safety and technical aspects of the EUS-BD technique, we retrospectively analyzed 11 consecutive patients who underwent EUS-BD using the tapered sheath dilator. The procedure involved the insertion of a guidewire, followed by mechanical dilation using the tapered sheath dilator. Subsequently, the inner catheter was removed and drainage stents (up to 6 Fr in diameter) were deployed through the outer sheath. We found a 100% technical success rate for tract dilation and stent deployment; moreover, all patients achieved clinical success. The median time for dilation was 40 s (range, 8-198), whereas the median time from dilation to stent deployment was 10 min (range, 6-19). Notably, no cases of bile leakage or peritonitis were observed. In conclusion, the use of the integrated device for tract dilation and stent delivery system might provide a safe and straightforward technique for drainage stenting during EUS-BD., Competing Interests: None., (© 2023 The Authors. DEN Open published by John Wiley & Sons Australia, Ltd on behalf of Japan Gastroenterological Endoscopy Society.)
- Published
- 2023
- Full Text
- View/download PDF
17. A Case of Allergic Bronchopulmonary Aspergillosis With Failure of Benralizumab and Response to Dupilumab.
- Author
-
Kotetsu Y, Ogata H, Sha K, Moriwaki A, and Yoshida M
- Abstract
We report a case of a 68-year-old woman who was being treated for bronchial asthma and developed allergic bronchopulmonary aspergillosis (ABPA) that was unresponsive to benralizumab therapy but went into remission with dupilumab therapy. The patient presented with an exacerbation of dry cough and was diagnosed with ABPA based on new diagnostic criteria. Despite the attempted therapeutic intervention, the patient declined to use systemic corticosteroids due to concerns about potential side effects. Subsequently, itraconazole and benralizumab were administered, with temporary relief before relapse. Given the patient's refusal to continue itraconazole and benralizumab, dupilumab was administered as an alternative therapy, which resulted in significant improvement of both symptoms and imaging. Although the use of biological agents for ABPA lacks clear evidence, our results suggest that dupilumab may provide an effective therapeutic strategy., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Kotetsu et al.)
- Published
- 2023
- Full Text
- View/download PDF
18. Tezepelumab treatment for allergic bronchopulmonary aspergillosis.
- Author
-
Ogata H, Sha K, Kotetsu Y, Enokizu-Ogawa A, Katahira K, Ishimatsu A, Taguchi K, Moriwaki A, and Yoshida M
- Abstract
An 82-year-old man had been diagnosed with asthma. He experienced repeated exacerbations requiring treatment with a systemic corticosteroid despite being treated with medications including high-dose fluticasone furoate/umeclidinium/vilanterol, montelukast sodium, and theophylline; treatment with mepolizumab was then initiated. The patient had been free from exacerbations for 15 months; however, he suffered from post-obstructive pneumonia and atelectasis secondary to mucoid impaction in the right middle lobe of the lung, accompanied by a productive cough, wheezing, dyspnea, and right chest pain. In addition to the development of mucus plugs, the levels of serum IgE specific to Aspergillus spp. became positive; a definite diagnosis of allergic bronchopulmonary aspergillosis (ABPA) was established. The patient underwent treatment with tezepelumab. Over 3 months, the mucus plugs and pulmonary opacities diminished gradually in parallel with the improvement in the control of asthmatic symptoms. Tezepelumab might provide a novel steroid-sparing strategy for the management of ABPA, although further studies are required., Competing Interests: None declared., (© 2023 The Authors. Respirology Case Reports published by John Wiley & Sons Australia, Ltd on behalf of The Asian Pacific Society of Respirology.)
- Published
- 2023
- Full Text
- View/download PDF
19. Concomitant Pancreatic Ductal Adenocarcinoma and Type 1 Autoimmune Pancreatitis: A Potential Issue in the Diagnosis of Carcinoma by Endoscopic Ultrasound-guided Fine-needle Biopsy.
- Author
-
Kachi K, Naitoh I, Ban T, Hayashi K, Yoshida M, Hori Y, Natsume M, Kato A, Kito Y, Saito K, Matsuo Y, Kato H, Naiki-Ito A, Takahashi S, Notohara K, and Kataoka H
- Subjects
- Male, Humans, Middle Aged, Biopsy, Fine-Needle methods, Ultrasonography, Interventional, Endoscopic Ultrasound-Guided Fine Needle Aspiration, Pancreatic Neoplasms, Autoimmune Pancreatitis diagnostic imaging, Pancreatitis diagnostic imaging, Autoimmune Diseases diagnostic imaging, Pancreatic Neoplasms diagnostic imaging, Pancreatic Neoplasms pathology, Carcinoma, Pancreatic Ductal diagnostic imaging
- Abstract
We herein report a 64-year-old man with concomitant pancreatic ductal adenocarcinoma (PDAC) and type 1 autoimmune pancreatitis (AIP). An endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) from the pancreatic head mass revealed level 2 histology of AIP and atypical glands. We diagnosed definitive focal AIP using the clinical diagnostic criteria. Computed tomography revealed that the pancreatic mass had not been reduced by steroid therapy. Surgery was performed after a histological PDAC diagnosis was made via a transpapillary biliary biopsy. The resected specimen revealed PDAC associated with AIP. It is important to consider the cooccurrence of PDAC and AIP even if the histological diagnosis via an EUS-FNB is AIP.
- Published
- 2023
- Full Text
- View/download PDF
20. Theoretical step approach with 'Three-pillar' device assistance for successful endoscopic transpapillary gallbladder drainage.
- Author
-
Yoshida M, Naitoh I, Hayashi K, Hori Y, Kato A, Kachi K, Asano G, Sahashi H, Toyohara T, Kuno K, Kito Y, and Kataoka H
- Subjects
- Humans, Gallbladder, Retrospective Studies, Drainage methods, Stents, Cholecystitis, Acute surgery, Laparoscopy
- Abstract
Background: Endoscopic transpapillary gallbladder drainage (ETGBD) has been reported as an alternative procedure for acute cholecystitis but remains a challenging procedure., Aims: To elucidate the efficacy of a strategic approach for ETGBD that utilizes a four-step classification system and the optional use of 'Three-pillar' assistance with the following devices: cholangioscopy (SpyGlass DS, SG), a flex-type guidewire (Flex-GW), and a 3-Fr microcatheter (3-Fr Micro)., Methods: A total of 115 patients undergoing ETGBD were studied retrospectively. Characteristics and technical outcomes were compared between conventional ETGBD technique (Classical ETGBD, N = 50) and strategic ETGBD with optional Three-pillar assistance (Strategic ETGBD, N = 65)., Results: SG-assistance (15/65, 23.1%) was as an excellent troubleshooter in Category 1 (failure to identify the cystic duct [CD] orifice) and Category 2 (failure to advance the GW across the CD takeoff due to unfavorable angle). Flex-GW (19/65, 29.2%) worked for Category 3b (failure of GW access to the GB due to multiple tortuosities). 3-Fr Micro (11/65, 16.9%) was effective for Category 3a (failure of GW access to the GB due to CD obstruction) and Category 4 (failure of drainage stent insertion to the GB). The overall technical success rate was significantly higher for Strategic ETGBD (63/65, 96.9%) compared with Classical ETGBD (36/50, 72.0%) (p = 0.0001)., Conclusions: Strategic ETGBD, which includes the Three-pillar assistance options of SG in the initial steps, Flex-GW for tortuous CD, and 3-Fr Micro for stenotic CD, achieved a significantly higher success rate than for Classical ETGBD., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Yoshida et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
- Published
- 2023
- Full Text
- View/download PDF
21. Clinical impact of bile-derived exosomal microRNAs as novel diagnostic and prognostic biomarkers for biliary tract cancers.
- Author
-
Yoshida M, Yukawa H, Hayashi K, Naitoh I, Miyabe K, Hori Y, Natsume M, Jinno N, Kato A, Kachi K, Asano G, Sahashi H, Toyohara T, Kuno K, Kito Y, Kondo H, Hirano A, Okumura F, Anbe K, Baba Y, Kataoka H, and Tanaka Y
- Subjects
- Humans, Prognosis, Bile metabolism, Gene Expression Profiling methods, Biomarkers, Tumor genetics, Biomarkers, MicroRNAs metabolism, Biliary Tract Neoplasms diagnosis, Biliary Tract Neoplasms genetics, Exosomes genetics, Exosomes metabolism
- Abstract
Sampling of bile juice during endoscopic retrograde cholangiopancreatography (ERCP) has potential benefit of being amenable to the identification of novel biomarkers in liquid biopsy. This study reports the results of a global investigation of exosomal microRNAs (miRNAs) in bile to identify potential biomarkers for biliary tract cancers (BTCs). Eighty-eight bile samples collected during ERCP (45 BTC and 43 noncancer control samples) were enrolled in this study. Eleven BTC samples and nine control samples were assigned as the discovery set. Exosomes in bile and serum samples were collected using a glass membrane column with size-controlled macroporous glass (MPG), and exosomal miRNA expression profiles were evaluated using comprehensive miRNA microarray analysis (3D-Gene). For validation, exosomal miRNA in the bile samples of 34 BTCs and 34 controls were comprehensively evaluated using 3D-Gene. In the discovery set, eight exosomal miRNAs in bile were identified as significant aberrant expression markers, while no miRNA with aberrant expression in serum was identified. In a comparison of the discovery and validation sets, miR-451a and miR-3619-3p were identified as reproducible upregulated markers, and the combination of the two bile miRNAs showed an excellent area under the curve (0.819) value for diagnosing BTCs. In addition, high miR-3619-3p expression in bile reflects poorer prognosis of BTCs (hazard ratio = 2.89). The MPG-extracted exosomal miRNAs in bile aspirated during ERCP provide a convenient new approach for diagnosing biliary diseases. Bile-derived miRNA analysis with miR-451a and miR-3619-3p represents a potentially valuable diagnostic strategy for identifying BTCs as well as a predictive indicator of BTC prognosis., (© 2022 The Authors. Cancer Science published by John Wiley & Sons Australia, Ltd on behalf of Japanese Cancer Association.)
- Published
- 2023
- Full Text
- View/download PDF
22. A 3-Fr microcatheter is suitable for a 0.018-inch guidewire during endoscopic ultrasound-guided biliary drainage.
- Author
-
Kato A, Yoshida M, Kachi K, Hori Y, Naitoh I, Hayashi K, and Kataoka H
- Subjects
- Humans, Drainage, Catheterization, Ultrasonography, Interventional, Stents, Endosonography, Cholestasis
- Abstract
Competing Interests: The authors declare that they have no conflict of interest.
- Published
- 2022
- Full Text
- View/download PDF
23. Duration of Intensive Respiratory Support and Risk of Long-term Respiratory Failure in Patients with COVID-19.
- Author
-
Ogata H, Jingushi Y, Katahira K, Ishimatsu A, Kotetsu Y, Sha K, Enokizu-Ogawa A, Taguchi K, Moriwaki A, and Yoshida M
- Subjects
- Humans, Oxygen Inhalation Therapy, COVID-19, Respiratory Insufficiency etiology, Respiratory Insufficiency therapy, Noninvasive Ventilation
- Published
- 2022
- Full Text
- View/download PDF
24. The Prognostic Performance of Lung Diffusing Capacity in Preserved Ratio Impaired Spirometry: An Observational Cohort Study.
- Author
-
Ogata H, Sha K, Kotetsu Y, Enokizu-Ogawa A, Katahira K, Ishimatsu A, Taguchi K, Moriwaki A, and Yoshida M
- Subjects
- Humans, Cohort Studies, Prognosis, Pulmonary Diffusing Capacity, Spirometry methods, Lung, Forced Expiratory Volume, Pulmonary Disease, Chronic Obstructive diagnosis, Pulmonary Disease, Chronic Obstructive epidemiology
- Abstract
Purpose: Similar to chronic obstructive pulmonary disease (COPD), the diffusing capacity of the lung (D
LCO ) might be decreased and associated with poor prognosis in preserved ratio impaired spirometry (PRISm), a clinical entity as a prodromal phase of COPD. The aims of the present study were to evaluate the distributions of DLCO and to assess the association between DLCO and mortality among subjects with PRISm., Patients and Methods: We conducted an observational cohort study at the National Hospital Organization Fukuoka National Hospital. We classified the 899 patients ≥ 40 years of age with an assessment of DLCO into five groups based on spirometry: preserved spirometry, PRISm, mild COPD, moderate COPD, and severe/very severe COPD. The prevalence of low DLCO (< 80% per predicted) was compared among the five groups. Using PRISm patients with follow-up data, we further investigated the association of low DLCO with all-cause mortality., Results: The prevalence of low DLCO in the PRISm group (58.8%) was significantly higher than that in the preserved-spirometry group (21.8%), the mild-COPD group (23.5%), and the moderate-COPD group (36.0%) (all P < 0.01), and it was comparable to that in the severe/very severe-COPD group (63.2%). The results remained unchanged after adjusting for potential confounders. Among the PRISm subjects, the overall survival rate was significantly lower in the low-DLCO group than in the preserved-DLCO group ( P < 0.01). The multivariable-adjusted hazard ratio (HR) for all-cause mortality was significantly higher in the low-DLCO group than in the preserved-DLCO group (HR = 10.10 (95% confidence interval 2.33-43.89))., Conclusion: Diffusing capacity was more impaired in PRISm subjects than in those with preserved spirometry or mild to moderate COPD. Regarding PRISm, low DLCO was a significant risk factor for all-cause mortality. Clinicians should assess DLCO in the management of PRISm to predict the future risk of overall death., Competing Interests: The authors declare that they have no competing interests in this work., (© 2022 Ogata et al.)- Published
- 2022
- Full Text
- View/download PDF
25. Urolithin A targets the AKT/WNK1 axis to induce autophagy and exert anti-tumor effects in cholangiocarcinoma.
- Author
-
Sahashi H, Kato A, Yoshida M, Hayashi K, Naitoh I, Hori Y, Natsume M, Jinno N, Kachi K, Asano G, Toyohara T, Kito Y, Ammanamanchi S, and Kataoka H
- Abstract
Urolithin A (UA; 3,8-dihydroxybenzo[c]chromen-6-one), a metabolite generated by intestinal bacteria during the biotransformation of ellagitannins, has gained considerable attention in treating several cancers. Cholangiocarcinoma (CCA) remains one of the most lethal cancers; it grows in a special environment constantly exposed to both blood and bile. Since UA is known to undergo enterohepatic recirculation, we hypothesized that UA might have significant antitumor effects in CCA. Here, we investigated the therapeutic potential of UA in CCA and aimed to elucidate its mechanisms, including autophagy. UA treatment inhibited cell proliferation and induced G2/M phase cell cycle arrest in CCA cells. UA also suppressed cell migration and invasion, but did not cause apoptosis. Furthermore, Western blotting and immunocytochemistry demonstrated increased LC3-II accumulation, while electron microscopy demonstrated induced autophagosomes after UA treatment, suggesting that UA upregulated autophagy in CCA cells. In xenograft mice treated with UA, tumor growth was inhibited with increased LC3-II levels. On the other hand, phospho-kinase array demonstrated downregulation of the AKT/WNK1 pathway. LC3-II expression was elevated in WNK1 knocked down cells, indicating that WNK1 is the key signal for regulating autophagy. Thus, UA exerted antitumor effects by suppressing the AKT/WNK1 signaling pathway and inducing autophagy. In conclusion, UA, a natural, well-tolerated compound, may be a promising therapeutic candidate for advanced CCA., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Sahashi, Kato, Yoshida, Hayashi, Naitoh, Hori, Natsume, Jinno, Kachi, Asano, Toyohara, Kito, Ammanamanchi and Kataoka.)
- Published
- 2022
- Full Text
- View/download PDF
26. Use of Endoscopic Scraper and Cell Block Technique as a Replacement for Conventional Brush for Diagnosing Malignant Biliary Strictures.
- Author
-
Kato A, Kato H, Naitoh I, Hayashi K, Yoshida M, Hori Y, Kachi K, Asano G, Sahashi H, Toyohara T, Kuno K, Kito Y, Takahashi S, and Kataoka H
- Abstract
Histological evidence is essential for diagnosing malignant biliary strictures. However, conventional brush cytology remains the primary method used worldwide, despite its low diagnostic sensitivity and accuracy, as it is technically easy, rapid, and cost-effective. The aim of this study was to evaluate the diagnostic performance of a recently introduced endoscopic scraper, the simplicity of which is comparable to that of a conventional brush, by comparing diagnostic yields and the number of collected cells. The sensitivity of the endoscopic scraper when using the cell block technique was significantly higher than when using brush cytology or a brush with the cell block technique (53.6% vs. 30.9%, p < 0.001; 53.6% vs. 31.6%, p = 0.024, respectively). Quantitative digital image analysis of cell block sections revealed that the median number of cells obtained with the endoscopic scraper was significantly higher than when using the brush (1917 vs. 1014 cells, p = 0.042). Furthermore, seven cases (8.3%; 7/84) were diagnosed by immunohistochemical analysis of the cell block section obtained from the endoscopic scraper. Given its simplicity and greater capacity for sample acquisition, use of the endoscopic scraper in conjunction with the cell block technique could replace brush cytology for the histological diagnosis of malignant biliary strictures.
- Published
- 2022
- Full Text
- View/download PDF
27. Various innovative roles for 3-Fr microcatheters in pancreaticobiliary endoscopy.
- Author
-
Yoshida M, Naitoh I, Hayashi K, Hori Y, Natsume M, Kato A, Kachi K, Asano G, Sahashi H, Toyohara T, Kito Y, and Kataoka H
- Subjects
- Endoscopy, Gastrointestinal, Humans, Catheterization, Catheters
- Abstract
With the development of newer devices and technical innovations, pancreaticobiliary endoscopy is expanding to assume more advanced therapeutic roles. As with other devices, slimmed-down "3-Fr microcatheters" are considered to be opening new windows toward entirely new therapeutic techniques for various purposes. Our practical experience with a total of 34 consecutive patients in whom 3-Fr microcatheters were applied during pancreaticobiliary endoscopic procedures clarified the potential roles of this instrument in pancreaticobiliary endoscopy. The major benefits of 3-Fr microcatheters involve their slimness and flexibility. Applications of 3-Fr microcatheters could be categorized into three groups according to the characteristics of usage: (1) utilization as a cannulation catheter for peroral digital cholangioscopy (n = 15); (2) selective advancement through deep flexures or severely stenotic ducts (n = 11); or (3) two-devices-in-one-channel technique (n = 8). The microcatheter worked successfully for cannulation of cholangioscopy in all but one case (14/15, 93.3%). For selective advancement, the microcatheter worked for troubleshooting in 9 of 11 cases (81.8%). With the two-devices-in-one-channel technique, the microcatheter proved satisfactory in all cases (8/8, 100%). In total, the microcatheter was successfully maneuvered in 31 of 34 cases (91.1%), following the failure of procedures using conventional endoscopic techniques. In terms of adverse events, cystic duct injury was only observed in two cases (5.8%), who recovered under conservative observation, because its slimness could minimize the damage. We believe that 3-Fr microcatheters offer effective and safe salvage troubleshooting during various endoscopic pancreaticobiliary procedures that face troublesome situations with conventional strategies., (© 2021 Japan Gastroenterological Endoscopy Society.)
- Published
- 2022
- Full Text
- View/download PDF
28. Relevance of gene mutations and methylation to the growth of pancreatic intraductal papillary mucinous neoplasms based on pyrosequencing.
- Author
-
Asano G, Miyabe K, Kato H, Yoshida M, Sawada T, Okamoto Y, Sahashi H, Atsuta N, Kachi K, Kato A, Jinno N, Natsume M, Hori Y, Naitoh I, Hayashi K, Matsuo Y, Takahashi S, Suzuki H, and Kataoka H
- Subjects
- Adult, Aged, Aged, 80 and over, Chromogranins genetics, Cyclin-Dependent Kinase Inhibitor p16 genetics, Disease Progression, Female, GTP-Binding Protein alpha Subunits, Gs genetics, Genetic Predisposition to Disease, Humans, Long Interspersed Nucleotide Elements, Male, Middle Aged, Pancreatic Intraductal Neoplasms pathology, Pancreatic Neoplasms pathology, Phenotype, Tumor Suppressor Proteins genetics, Biomarkers, Tumor genetics, DNA Methylation, DNA Mutational Analysis, High-Throughput Nucleotide Sequencing, Mutation, Pancreatic Intraductal Neoplasms genetics, Pancreatic Neoplasms genetics
- Abstract
We aimed to assess some of the potential genetic pathways for cancer development from non-malignant intraductal papillary mucinous neoplasm (IPMN) by evaluating genetic mutations and methylation. In total, 46 dissected regions in 33 IPMN cases were analyzed and compared between malignant-potential and benign cases, or between malignant-potential and benign tissue dissected regions including low-grade IPMN dissected regions accompanied by malignant-potential regions. Several gene mutations, gene methylations, and proteins were assessed by pyrosequencing and immunohistochemical analysis. RASSF1A methylation was more frequent in malignant-potential dissected regions (p = 0.0329). LINE-1 methylation was inversely correlated with GNAS mutation (r = - 0.3739, p = 0.0105). In cases with malignant-potential dissected regions, GNAS mutation was associated with less frequent perivascular invasion (p = 0.0128), perineural invasion (p = 0.0377), and lymph node metastasis (p = 0.0377) but significantly longer overall survival, compared to malignant-potential cases without GNAS mutation (p = 0.0419). The presence of concordant KRAS and GNAS mutations in the malignant-potential and benign dissected regions were more frequent among branch-duct IPMN cases than among the other types (p = 0.0319). Methylation of RASSF1A, CDKN2A, and LINE-1 and GNAS mutation may be relevant to cancer development, IPMN subtypes, and cancer prognosis., (© 2022. The Author(s).)
- Published
- 2022
- Full Text
- View/download PDF
29. DPYD, down-regulated by the potentially chemopreventive agent luteolin, interacts with STAT3 in pancreatic cancer.
- Author
-
Kato H, Naiki-Ito A, Suzuki S, Inaguma S, Komura M, Nakao K, Naiki T, Kachi K, Kato A, Matsuo Y, and Takahashi S
- Subjects
- Aged, Animals, Apoptosis, Carcinoma, Pancreatic Ductal metabolism, Carcinoma, Pancreatic Ductal pathology, Cell Proliferation, Cricetinae, Female, Humans, Male, Mice, Pancreatic Neoplasms metabolism, Pancreatic Neoplasms pathology, Prognosis, STAT3 Transcription Factor genetics, Survival Rate, Tumor Cells, Cultured, Xenograft Model Antitumor Assays, Carcinoma, Pancreatic Ductal drug therapy, Dihydrouracil Dehydrogenase (NADP) antagonists & inhibitors, Gene Expression Regulation, Neoplastic drug effects, Luteolin pharmacology, Pancreatic Neoplasms drug therapy, STAT3 Transcription Factor metabolism
- Abstract
The 5-year survival rate of pancreatic ductal carcinoma (PDAC) patients is <10% despite progress in clinical medicine. Strategies to prevent the development of PDAC are urgently required. The flavonoids Luteolin (Lut) and hesperetin (Hes) may be cancer-chemopreventive, but effects on pancreatic carcinogenesis in vivo have not been studied. Here, the chemopreventive effects of Lut and Hes on pancreatic carcinogenesis are assessed in the BOP-induced hamster PDAC model. Lut but not Hes suppressed proliferation of pancreatic intraepithelial neoplasia (PanIN) and reduced the incidence and multiplicity of PDAC in this model. Lut also inhibited the proliferation of hamster and human pancreatic cancer cells in vitro. Multi-blot and microarray assays revealed decreased phosphorylated STAT3 (pSTAT3) and dihydropyrimidine dehydrogenase (DPYD) on Lut exposure. To explore the relationship between DPYD and STAT3 activity, the former was silenced by RNAi or overexpressed using expression vectors, and the latter was inactivated by small molecule inhibitors or stimulated by IL6 in human PDAC cells. DPYD knock-down decreased, and overexpression increased, pSTAT3 and cell proliferation. DPYD expression was decreased by inactivation of STAT3 and increased by its activation. The frequency of pSTAT3-positive cells and DPYD expression was significantly correlated and was decreased in parallel by Lut in the hamster PDAC model. Finally, immunohistochemical analysis in 73 cases of human PDAC demonstrated that DPYD expression was positively correlated with the Ki-67 labeling index, and high expression was associated with poor prognosis. These results indicate that Lut is a promising chemopreventive agent for PDAC, targeting a novel STAT3-DPYD pathway., (© The Author(s) 2021. Published by Oxford University Press.)
- Published
- 2021
- Full Text
- View/download PDF
30. Anti-Allergic Drug Suppressed Pancreatic Carcinogenesis via Down-Regulation of Cellular Proliferation.
- Author
-
Kachi K, Kato H, Naiki-Ito A, Komura M, Nagano-Matsuo A, Naitoh I, Hayashi K, Kataoka H, Inaguma S, and Takahashi S
- Subjects
- Animals, Carcinogens toxicity, Cricetinae, Humans, Male, Pancreatic Neoplasms metabolism, Pancreatic Neoplasms pathology, Tumor Cells, Cultured, Acetates pharmacology, Anti-Asthmatic Agents pharmacology, Cell Proliferation, Cyclopropanes pharmacology, Leukotriene D4 metabolism, Nitrosamines toxicity, Pancreatic Neoplasms drug therapy, Quinolines pharmacology, Receptors, Leukotriene metabolism, Sulfides pharmacology
- Abstract
Pancreatic cancer is a fatal disease, and thus its chemoprevention is an important issue. Based on the recent report that patients with allergic diseases have a low risk for pancreatic cancer, we examined the potential chemopreventive effect of anti-allergic agents using a hamster pancreatic carcinogenesis model. Among the three anti-allergic drugs administered, montelukast showed a tendency to suppress the incidence of pancreatic cancer. Further animal study revealed a significantly decreased incidence of pancreatic cancer in the high-dose montelukast group compared with controls. The development of the pancreatic intraepithelial neoplasia lesions was also significantly suppressed. The Ki-67 labeling index was significantly lower in pancreatic carcinomas in the high-dose montelukast group than in controls. In vitro experiments revealed that montelukast suppressed proliferation of pancreatic cancer cells in a dose-dependent manner with decreased expression of phospho-ERK1/2. Montelukast induced G1 phase arrest. Conversely, leukotriene D
4 (LTD4 ), an agonist of CYSLTR1, increased cellular proliferation of pancreatic cancer cells with an accumulation of phospho-ERK1/2. In our cohort, pancreatic ductal adenocarcinoma patients with high CYSLTR1 expression showed a significantly unfavorable clinical outcome compared with those with low expression. Our results indicate that montelukast exerts a chemopreventive effect on pancreatic cancer via the LTD4 -CYSLTR1 axis and has potential for treatment of pancreatic carcinogenesis.- Published
- 2021
- Full Text
- View/download PDF
31. Four-Step Classification of Endoscopic Transpapillary Gallbladder Drainage and the Practical Efficacy of Cholangioscopic Assistance.
- Author
-
Yoshida M, Naitoh I, Hayashi K, Jinno N, Hori Y, Natsume M, Kato A, Kachi K, Asano G, Atsuta N, Sahashi H, and Kataoka H
- Subjects
- Drainage, Gallbladder diagnostic imaging, Gallbladder surgery, Humans, Retrospective Studies, Cholecystitis, Acute surgery, Laparoscopy
- Abstract
Background/aims: Although endoscopic transpapillary gallbladder drainage (ETGBD) has been reported as an alternative procedure for acute cholecystitis, it requires advanced endoscopic techniques. In terms of the certainty of achieving drainage, it remains a challenging procedure. The aim of the current study was to elucidate the practical efficacy of cholangioscopic assistance and to develop a new classification that could be used to evaluate the technical difficulty of ETGBD and provide a theoretical strategy to apply cholangioscopy appropriately for difficult ETGBD., Methods: A total of 101 patients undergoing ETGBD were retrospectively studied. The characteristics and technical outcomes of ETGBD with conventional ETGBD (C-ETGBD) and SpyGlass DS-assisted ETGBD (SG-ETGBD) were evaluated. The characteristics and technique-dependent factors of unsuccessful C-ETGBD/SG-ETGBD were evaluated using the classification based on the steps of the procedure. The predictive factors of successful C-ETGBD/SG-ETGBD were examined., Results: C-ETGBD was successful in 73 patients (72.3%). SG-ETGBD was successful in 11 of 13 patients (84.6%) who had C-ETGBD failure. Optional SG-ETGBD significantly increased the final success rate (94.1%) compared to C-ETGBD alone (p=0.003). ETGBD procedures could be classified into four steps. SG-assistance worked as an excellent troubleshooter in step 1 (failure to identify the cystic duct orifice) and step 2 (failure of guidewire advancement across the downturned angle of cystic duct takeoff). Magnetic resonance cholangiopancreatography could provide predictive information based on the classification., Conclusions: Optional SG-ETGBD achieved a significantly higher success rate than C-ETGBD alone. Step classification is helpful for determining the technical difficulty of ETGBD and developing a theoretical strategy to apply cholangioscopy in a coordinated manner.
- Published
- 2021
- Full Text
- View/download PDF
32. Impact of physiologically shaped pancreatic stent for chronic pancreatitis.
- Author
-
Hori Y, Ichino Y, Naitoh I, Hayashi K, Yoshida M, Natsume M, Jinno N, Kato A, Kachi K, Asano G, Atsuta N, Sahashi H, Kataoka H, and Ohara H
- Subjects
- Adult, Aged, Aged, 80 and over, Constriction, Pathologic prevention & control, Endoscopy, Digestive System adverse effects, Female, Humans, Male, Middle Aged, Pain etiology, Pain prevention & control, Pancreatic Ducts pathology, Pancreatitis, Chronic complications, Prosthesis Failure etiology, Treatment Outcome, Endoscopy, Digestive System methods, Pancreatitis, Chronic surgery, Prosthesis Design, Stents adverse effects, Stents economics
- Abstract
Endoscopic pancreatic stenting is used to prevent main pancreatic duct obstruction and relieve painful symptoms of chronic pancreatitis. However, the stent typically needs to be exchanged and the rate of adverse events is high. Few studies have evaluated the effect of stent shape on those outcomes. We evaluated the adverse events, stent patency, and total medical cost within 90 days of patients who received an 8.5 French (Fr) physiologically shaped pancreatic stent by comparing these features with those associated with a conventional straight-type stent for ≥ 90 days. The total stent-related adverse event rate was significantly lower for the physiologically shaped pancreatic stent (physiologically shaped, 6.7% [2/30]; straight-type, 50.6% [44/87]; P < 0.001). Stent occlusion was significantly less frequent (P < 0.001) and the total medical costs were significantly lower (P = 0.002) for the physiologically shaped stent. The stent-related adverse event rate was significantly higher for the 10 Fr straight type stent than for the 8.5 Fr physiologically shaped stent (10 Fr, straight-type vs. 8.5 Fr, physiologically shaped: 36.1% [13/36] vs. 6.7% [2/30]; P = 0.007). In conclusion, a physiologically shaped pancreatic stent was superior to a straight-type stent in terms of the patency rate and medical costs.
- Published
- 2021
- Full Text
- View/download PDF
33. Autotaxin in ascites promotes peritoneal dissemination in pancreatic cancer.
- Author
-
Jinno N, Yoshida M, Hayashi K, Naitoh I, Hori Y, Natsume M, Kato A, Kachi K, Asano G, Atsuta N, Sahashi H, and Kataoka H
- Subjects
- Animals, Ascites metabolism, Ascites pathology, Carcinoma, Pancreatic Ductal metabolism, Female, Heterografts, Humans, Mice, Mice, Inbred BALB C, Mice, Nude, Neoplasm Invasiveness pathology, Pancreatic Neoplasms metabolism, Peritoneal Neoplasms metabolism, Pancreatic Neoplasms, Carcinoma, Pancreatic Ductal secondary, Pancreatic Neoplasms pathology, Peritoneal Neoplasms secondary, Phosphoric Diester Hydrolases metabolism
- Abstract
Peritoneal dissemination and malignant ascites in pancreatic ductal adenocarcinoma (PDAC) patients represent a major clinical issue. Lysophosphatidic acid (LPA) is a lipid mediator that modulates the progression of various cancers. Based on the increasing evidence showing that LPA is abundant in malignant ascites, we focused on autotaxin (ATX), which is a secreted enzyme that is important for the production of LPA. This study aimed to elucidate the importance of the ATX-LPA axis in malignant ascites in PDAC and to determine whether ATX works as a molecular target for treating peritoneal dissemination. In a PDAC peritoneal dissemination mouse model, the amount of ATX was significantly higher in ascites than in serum. An in vitro study using two PDAC cell lines, AsPC-1 and PANC-1, showed that ATX-LPA signaling promoted cancer cell migration via the activation of the downstream signaling, and this increased cell migration was suppressed by an ATX inhibitor, PF-8380. An in vivo study showed that PF-8380 suppressed peritoneal dissemination and decreased malignant ascites, and these results were validated by the biological analysis as well as the in vitro study. Moreover, there was a positive correlation between the amount of ATX in ascites and the degree of disseminated cancer progression. These findings demonstrated that ATX in ascites works as a promotor of peritoneal dissemination, and the targeting of ATX must represent a useful and novel therapy for peritoneal dissemination of PDAC., (© 2020 The Authors. Cancer Science published by John Wiley & Sons Australia, Ltd on behalf of Japanese Cancer Association.)
- Published
- 2021
- Full Text
- View/download PDF
34. Metachronous Pancreatic Ductal Adenocarcinoma with Adjacent Serous Cystadenoma that Was Preoperatively Diagnosed by EUS-FNA: A Case Report and Review of the Literature.
- Author
-
Yoshida M, Naitoh I, Hayashi K, Jinno N, Natsume M, Hori Y, Kato A, Kachi K, Asano G, Matsuo Y, Takahashi S, and Kataoka H
- Subjects
- Aged, Carcinoma, Pancreatic Ductal diagnostic imaging, Cystadenoma, Serous diagnostic imaging, Endoscopic Ultrasound-Guided Fine Needle Aspiration, Humans, Male, Pancreatic Neoplasms diagnostic imaging, Carcinoma, Pancreatic Ductal pathology, Cystadenoma, Serous pathology, Pancreatic Neoplasms pathology
- Abstract
Pancreatic serous cystic neoplasms (SCNs), such as serous cystadenoma (SCA), are generally recognized as benign because malignant counterparts of SCNs have been extremely rare. In clinical practice, pancreatic cystic neoplasms diagnosed as SCNs have been managed by conservative observation, as long as the patients remained asymptomatic. We herein report a case of metachronous ductal adenocarcinoma that was discovered during long-term follow-up of SCN and review the related literature. To our knowledge, this was the first reported case of the local presence of ductal adenocarcinoma adjacent to SCA that was preoperatively diagnosed by endoscopic ultrasound-guided fine-needle aspiration.
- Published
- 2020
- Full Text
- View/download PDF
35. Prophylactic technique for preventing inward stent migration during placement of multiple plastic stents in a patient with surgically altered anatomy.
- Author
-
Kachi K, Hori Y, Hayashi K, Naitoh I, Yoshida M, and Kataoka H
- Subjects
- Humans, Plastics, Treatment Outcome, Cholangiopancreatography, Endoscopic Retrograde, Stents adverse effects
- Abstract
Competing Interests: The authors declare that they have no conflict of interest.
- Published
- 2020
- Full Text
- View/download PDF
36. Laterally Spreading Adenocarcinoma Involving the Lower Bile Duct and Duodenum Expressing Heterogeneous Immunohistochemical Phenotypes.
- Author
-
Miyabe K, Notohara K, Asano G, Kachi K, Kato A, Natsume M, Jinno N, Hori Y, Yoshida M, Naitoh I, Hayashi K, Ohara H, Takahashi S, and Kataoka H
- Subjects
- Adenocarcinoma surgery, Adenoma surgery, Aged, Ampulla of Vater, Common Bile Duct diagnostic imaging, Common Bile Duct pathology, Common Bile Duct Neoplasms surgery, Duodenal Neoplasms diagnostic imaging, Duodenal Neoplasms surgery, Duodenum diagnostic imaging, Duodenum pathology, Humans, Male, Neoplasm Invasiveness, Neoplasms, Multiple Primary surgery, Tomography, X-Ray Computed, Adenocarcinoma pathology, Adenoma pathology, Common Bile Duct Neoplasms pathology, Duodenal Neoplasms pathology, Neoplasms, Multiple Primary pathology
- Abstract
A 70-year-old man was admitted to our hospital due to elevated levels of hepatobiliary and pancreatic enzymes. Computed tomography showed contrast-enhanced mucosal hypertrophy from the duodenal papilla to the distal bile duct. Endoscopic examinations revealed a laterally spreading granular tumor and ampullary swelling. After surgical resection, an examination revealed well-differentiated adenocarcinoma of the ampulla with tubular adenoma spreading from the distal common bile duct to the second part of the duodenum showing both bile duct and duodenal phenotypes. To our knowledge, this is the first case of a tumor spreading from the bile duct to the duodenum that exhibited multiple phenotypes.
- Published
- 2019
- Full Text
- View/download PDF
37. Premarket safety population size associated with approval of expedited program drugs and orphan drugs.
- Author
-
Illoh K
- Subjects
- Humans, United States, United States Food and Drug Administration, Drug Approval statistics & numerical data, Marketing statistics & numerical data, Orphan Drug Production standards, Orphan Drug Production statistics & numerical data, Patient Safety standards, Patient Safety statistics & numerical data, Prescription Drugs standards
- Published
- 2019
- Full Text
- View/download PDF
38. Factors That Affect Stent-Related Complications in Patients with Malignant Obstruction of the Esophagus or Gastric Cardia.
- Author
-
Iwasaki H, Mizushima T, Suzuki Y, Fukusada S, Kachi K, Ozeki T, Anbe K, Tsukamoto H, Okumura F, Joh T, and Sano H
- Subjects
- Adenocarcinoma complications, Aged, Aged, 80 and over, Antineoplastic Agents therapeutic use, Carcinoma, Squamous Cell complications, Chemoradiotherapy, Constriction, Pathologic, Deglutition Disorders etiology, Esophageal Fistula epidemiology, Esophageal Neoplasms complications, Esophageal Perforation epidemiology, Esophageal Stenosis etiology, Esophagoscopy, Female, Fever epidemiology, Gastroscopy, Humans, Logistic Models, Male, Middle Aged, Multivariate Analysis, Odds Ratio, Palliative Care, Pneumonia, Aspiration epidemiology, Postoperative Hemorrhage epidemiology, Prosthesis Failure, Radiotherapy, Retrospective Studies, Stomach Diseases etiology, Adenocarcinoma surgery, Carcinoma, Squamous Cell surgery, Cardia surgery, Deglutition Disorders surgery, Esophageal Neoplasms surgery, Esophageal Stenosis surgery, Postoperative Complications epidemiology, Self Expandable Metallic Stents, Stomach Diseases surgery
- Abstract
Background/aims: Self-expandable metallic stent (SEMS) placement is effective for dysphagia that results from malignant obstruction of the esophagus or gastric cardia; however, stent-related complications may be life-threatening. Thus, the goal of this study was to identify risk factors associated with complications following esophageal stenting., Methods: Of the 71 patients who underwent SEMS placement for dysphagia as a result of malignant stricture of the esophagus or gastric cardia, 53 patients with squamous cell carcinoma or adenocarcinoma, without previous SEMS placement, without a fistula, and without recurrent tumor after surgery were retrospectively identified. The occurrence of stent-related complications was used as an endpoint., Results: Stent-related complications were identified in 26 patients (49.1%), and major complications occurred in 14 patients (26.4%). The use of an Ultraflex stent (odds ratio [OR], 6.81; 95% confidence interval [CI], 1.54 to 30.00; p=0.011) and prior chemotherapy (OR, 6.13; 95% CI, 1.46 to 25.70; p=0.013) were significantly associated with stent-related complications. Moreover, the use of an Ultraflex stent (OR, 19.60; 95% CI, 2.26 to 170.00; p=0.007) and prior radiation (OR, 25.70; 95% CI, 2.37 to 280.00; p=0.008) significantly increased the risk of major complications., Conclusions: The use of an Ultraflex stent and prior radiation and/or chemotherapy may represent risk factors for complications following esophageal SEMS placement.
- Published
- 2017
- Full Text
- View/download PDF
39. Bleeding risk of endoscopic ultrasound-guided fine-needle aspiration in patients undergoing antithrombotic therapy.
- Author
-
Inoue T, Okumura F, Sano H, Kobayashi Y, Ishii N, Suzuki Y, Fukusada S, Kachi K, Ozeki T, Anbe K, Iwasaki H, Mizushima T, Ito K, and Yoneda M
- Subjects
- Adult, Aged, Aged, 80 and over, Digestive System Diseases diagnosis, Digestive System Diseases surgery, Female, Follow-Up Studies, Humans, Incidence, Japan epidemiology, Male, Middle Aged, Postoperative Hemorrhage epidemiology, Retrospective Studies, Risk Assessment, Risk Factors, Survival Rate trends, Young Adult, Blood Loss, Surgical statistics & numerical data, Endoscopic Ultrasound-Guided Fine Needle Aspiration adverse effects, Endoscopy, Gastrointestinal adverse effects, Fibrinolytic Agents therapeutic use, Postoperative Hemorrhage etiology, Thromboembolism prevention & control, Ultrasonography, Doppler
- Abstract
Objectives: Bleeding events related to endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) are rare. However, for patients treated with antithrombotic agents, the bleeding risk of EUS-FNA is uncertain. Hence, the aim of this study was to assess the bleeding event rate associated with EUS-FNA in patients receiving antithrombotic treatment., Methods: A retrospective study was conducted in 742 consecutive patients who underwent EUS-FNA for solid lesions between 2008 and 2015. We compared the bleeding event rates among patients who were not administered antithrombotic agents, those whose agent use was discontinued, those who continued treatment with aspirin or cilostazol, and those who were administered heparin as a replacement., Results: There were 131 patients (17.7 %) treated with antithrombotic agents. Seven experienced bleeding events, and the overall bleeding event rate was 0.9 % (7/742). All bleeding events were intraoperative; there were no postoperative bleeding episodes. Subgroup analysis by antithrombotic agent revealed bleeding event rates of 1.0 % (6/611), 0 % (0/62), 1.6 % (1/61), and 0 % (0/8) for the non-administration, discontinuation of agents, continuation of aspirin or cilostazol, and heparin replacement groups, respectively. Only one severe bleeding event necessitated hemostatic treatment (1/742; 0.1 %); this occurred in a patient in the non-administration group, and there were no severe bleeding events in patients receiving antithrombotic treatment., Conclusions: The present study found a low incidence of EUS-FNA-related bleeding in patients receiving antithrombotic treatment. The bleeding event rate was low even in patients who underwent EUS-FNA while continuing aspirin or cilostazol., (© 2016 Japan Gastroenterological Endoscopy Society.)
- Published
- 2017
- Full Text
- View/download PDF
40. Epstein-Barr virus exploits host endocytic machinery for cell-to-cell viral transmission rather than a virological synapse.
- Author
-
Nanbo A, Kachi K, Yoshiyama H, and Ohba Y
- Subjects
- Burkitt Lymphoma, Epithelial Cells metabolism, Epithelial Cells virology, Epstein-Barr Virus Infections genetics, Epstein-Barr Virus Infections metabolism, Herpesvirus 4, Human genetics, Humans, Intercellular Adhesion Molecule-1, Synapses metabolism, Endocytosis, Epstein-Barr Virus Infections physiopathology, Epstein-Barr Virus Infections virology, Herpesvirus 4, Human physiology, Synapses virology
- Abstract
Epstein-Barr virus (EBV) establishes a lifelong latent infection in B lymphocytes and often is found in epithelial cells. Several lines of evidence indicate that viral transmission mediated by cell-to-cell contact is the dominant mode of infection by EBV for epithelial cells. However, its detailed molecular mechanism has not been fully elucidated. We investigated the role of host membrane trafficking machinery in this process. We have found that adhesion molecules critical for this process are expressed in EBV-positive and -negative Burkitt's lymphoma (BL) cells and multiple epithelial cell lines. Treatment with blocking antibodies against β1 and β2 integrin families and their ligands suppressed EBV transmission in a dose-dependent manner. We also confirmed that adhesion molecules are upregulated in co-cultured BL cells. Immunofluorescence staining revealed that the intracellular adhesion molecule 1 (ICAM-1) distributed to the cell surface and partially co-localized with recycling endosomes in co-cultured BL cells. Moreover, cell-to-cell EBV transmission was inhibited upon blocking endocytic recycling by expression of a dominant-negative form of a small GTPase Rab11 or by knockdown of Rab11, supporting the notion that the endocytic pathway-dependent trafficking of ICAM-1 to the cell surface of BL cells contributes to viral transmission by stabilizing cell-to-cell contact between the donor cells and recipient cells. Finally, we demonstrated that co-cultivation upregulated clathrin-mediated endocytosis in the recipient cells, allowing EBV to be internalized. Taken together, our findings demonstrate that EBV exploits host endocytic machinery in both donor and recipient cells, a process which is facilitated by cell-to-cell contact, thereby promoting successful viral transmission.
- Published
- 2016
- Full Text
- View/download PDF
41. Trends in the Prevalence of Coronary Heart Disease in the U.S.: National Health and Nutrition Examination Survey, 2001-2012.
- Author
-
Yoon SS, Dillon CF, Illoh K, and Carroll M
- Subjects
- Adult, Aged, Female, Humans, Male, Middle Aged, Nutrition Surveys, Prevalence, United States epidemiology, Myocardial Ischemia epidemiology
- Abstract
Introduction: This study evaluated recent trends in the prevalence of coronary heart disease in the U.S. population aged ≥40 years., Methods: A total of 21,472 adults aged ≥40 years from the 2001-2012 National Health and Nutrition Examination Survey were included in the analysis. The analysis was conducted in 2015. Coronary heart disease included myocardial infarction, angina, and any other type of coronary heart disease, which were defined as a history of medical diagnosis of these specific conditions. Angina was also defined as currently taking anti-angina medication or having Rose Angina Questionnaire responses that scored with a Grade ≥1. Trends from 2001 to 2012 were analyzed overall, within demographic subgroups, and by major coronary heart disease risk factors., Results: Between 2001 and 2012, the overall prevalence of coronary heart disease significantly decreased from 10.3% to 8.0% (p-trend<0.05). The prevalence of angina significantly decreased from 7.8% to 5.5% and myocardial infarction prevalence decreased from 5.5% to 4.7% (p-trend <0.05 for both groups). Overall coronary heart disease prevalence significantly decreased among women, adults aged >60 years, non-Hispanic whites, non-Hispanic blacks, adults who did not complete high school, adults with more than a high school education, and adults who had health insurance (p-trend <0.05 for all groups)., Conclusions: The overall prevalence of coronary heart disease including angina and myocardial infarction decreased significantly over the 12-year survey period. However, this reduction was seen mainly among persons without established coronary heart disease risk factors. There was no change in coronary heart disease prevalence among those with specific coronary heart disease risk factors., (Published by Elsevier Inc.)
- Published
- 2016
- Full Text
- View/download PDF
42. Feasibility of the placement of a novel 6-mm diameter threaded fully covered self-expandable metal stent for malignant hilar biliary obstructions (with videos).
- Author
-
Inoue T, Okumura F, Naitoh I, Fukusada S, Kachi K, Ozeki T, Anbe K, Iwasaki H, Mizushima T, Kobayashi Y, Ishii N, Ito K, Kondo H, Hayashi K, Yoneda M, and Sano H
- Subjects
- Aged, Aged, 80 and over, Bile Duct Neoplasms complications, Carcinoma complications, Cholangiocarcinoma complications, Cholangiopancreatography, Endoscopic Retrograde, Cholangiopancreatography, Magnetic Resonance, Cholestasis diagnostic imaging, Cholestasis etiology, Feasibility Studies, Female, Gallbladder Neoplasms complications, Humans, Male, Middle Aged, Multidetector Computed Tomography, Retrospective Studies, Cholestasis surgery, Endoscopy, Digestive System, Self Expandable Metallic Stents
- Abstract
Background and Aims: Uncovered self-expandable metal stents (USEMSs) are used to treat unresectable malignant hilar biliary obstructions (MHBOs). However, ingrowth is not prevented, and reintervention is often troublesome. A novel 6-mm threaded fully covered self-expandable metal stent (T-FCSEMS) is available that may mitigate these issues. We aimed to clarify the safety and efficacy of T-FCSEMS placement for MHBO., Methods: Thirty patients underwent T-FCSEMS placements for MHBOs between 2014 and 2015. T-FCSEMSs were used for initial stenting in 17 patients (initial group) and for reinterventions for USEMS occlusions caused by ingrowth in 13 patients (reintervention group). The technical success rates, times to recurrent biliary obstruction, and the reintervention success rates were evaluated., Results: The technical success rates were 94% (16/17) and 92% (12/13) in the initial group and reintervention group, respectively. Intrahepatic bile duct occlusions caused liver abscesses 8 days and 22 days after T-FCSEMS placements in 2 cases (7%) in the initial group, in which T-FCSEMSs were placed across the intrahepatic bile duct bifurcation. The median times to recurrent biliary obstruction were 210 days in the initial group after bilateral placement and 112 days and 152 days in the reintervention group after bilateral and unilateral placements, respectively. During reintervention, T-FCSEMS removal was successful in all patients in whom it was attempted, and the success rate of endoscopic reintervention was 100% in both groups., Conclusions: T-FCSEMS placement is a promising option for both initial stenting and reintervention for MHBO. However, we should consider the possibility of intrahepatic bile duct occlusion., (Copyright © 2016 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.)
- Published
- 2016
- Full Text
- View/download PDF
43. Long-term outcomes of endoscopic gallbladder stenting in high-risk surgical patients with calculous cholecystitis (with videos).
- Author
-
Inoue T, Okumura F, Kachi K, Fukusada S, Iwasaki H, Ozeki T, Suzuki Y, Anbe K, Nishie H, Mizushima T, and Sano H
- Subjects
- Aged, Aged, 80 and over, Cholecystitis etiology, Drainage, Female, Humans, Male, Middle Aged, Recurrence, Time Factors, Watchful Waiting, Cholecystitis surgery, Endoscopy, Digestive System, Gallstones complications, Stents
- Abstract
Background and Aims: Recently, endoscopic gallbladder stenting (EGBS) has been performed to prevent recurrences in high-risk surgical patients with cholecystitis. However, evidence regarding the long-term outcomes of EGBS is sparse. We investigated the cholecystitis recurrence rate in high-risk surgical patients with acute calculous cholecystitis and compared the cholecystitis recurrence rates in patients in whom EGBS was performed with those in patients who were observed after percutaneous drainage., Methods: We studied 64 consecutive high-risk surgical patients with acute calculous cholecystitis who required gallbladder decompression between 2007 and 2014. We divided the patient cohort into patients who underwent observation after percutaneous drainage between 2007 and 2011 (OAPD group) and those who underwent EGBS between 2012 and 2014 (EGBS group), and we compared the groups., Results: The technical success rate of EGBS was 82.9% based on the intention-to-treat analysis. The cholecystitis recurrence rates were 17.2% in the OAPD group and 0% in the EGBS group, a difference that was significant (P = .043). There was also a significant difference between the groups with respect to the time to recurrent cholecystitis, which was determined by using Kaplan-Meier analysis (P = .015). The overall biliary event rates were 24.1% in the OAPD group and 9.1% in the EGBS group, and no significant difference was noted (P = .207)., Conclusion: EGBS reduced the recurrence of cholecystitis in high-risk surgical patients with calculous cholecystitis. However, stent-related adverse events may occur, and modifications are necessary to reduce these., (Copyright © 2016 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.)
- Published
- 2016
- Full Text
- View/download PDF
44. Assessment of Factors Affecting the Usefulness and Diagnostic Yield of Core Biopsy Needles with a Side Hole in Endoscopic Ultrasound-Guided Fine-Needle Aspiration.
- Author
-
Inoue T, Okumura F, Mizushima T, Nishie H, Iwasaki H, Anbe K, Ozeki T, Kachi K, Fukusada S, Suzuki Y, and Sano H
- Subjects
- Adult, Aged, Aged, 80 and over, Digestive System Neoplasms diagnostic imaging, Equipment Design, Equipment Safety, Female, Gastrointestinal Tract diagnostic imaging, Gastrointestinal Tract pathology, Humans, Male, Middle Aged, Multivariate Analysis, Needles adverse effects, Predictive Value of Tests, Retrospective Studies, Sensitivity and Specificity, Statistics, Nonparametric, Digestive System Neoplasms diagnosis, Endoscopic Ultrasound-Guided Fine Needle Aspiration instrumentation, Needles statistics & numerical data
- Abstract
Background/aims: A barbed puncture needle with a side hole was recently developed to improve sample quality and quantity in endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA). In this study, we retrospectively assessed the usefulness of this puncture needle., Methods: Factors affecting diagnostic yield, safety, and diagnostic accuracy were investigated in 76 patients who consecutively underwent EUS-FNA for neoplastic lesions at our hospital between January and December 2013., Results: The procedure was successful in all cases; the rates of sample collection and determination of the correct diagnosis were 92.1% and 89.5%, respectively. The mean number of needle passes required for diagnosis was 1.1. Complications included mild intraluminal bleeding in two patients (2.6%). Multivariate analysis revealed that lesion size (≤20 mm) was significantly associated with a decreased chance of determining the correct diagnosis., Conclusions: Core biopsy needles with a side hole are safe and provide a satisfactory diagnostic yield. However, the side hole may potentially reduce the rate of making the correct diagnosis in small lesions.
- Published
- 2016
- Full Text
- View/download PDF
45. Local administration of amphotericin B and percutaneous endoscopic necrosectomy for refractory fungal-infected walled-off necrosis: a case report and literature review.
- Author
-
Inoue T, Ichikawa H, Okumura F, Mizushima T, Nishie H, Iwasaki H, Anbe K, Ozeki T, Kachi K, Fukusada S, Suzuki Y, and Sano H
- Subjects
- Adult, Candidiasis drug therapy, Candidiasis surgery, Chronic Disease, Endoscopy, Digestive System, Humans, Male, Necrosis, Pancreatitis, Chronic drug therapy, Pancreatitis, Chronic surgery, Amphotericin B administration & dosage, Candidiasis therapy, Pancreatitis, Chronic therapy
- Abstract
Walled-off necrosis (WON) caused by fungal infection is very rare, and its treatment is more difficult than that of bacterial infection. We present the first case of a patient with refractory fungal-infected WON treated with percutaneous endoscopic necrosectomy and local administration of amphotericin B.A Japanese man in his 30s was hospitalized with severe necrotizing pancreatitis and multiple organ failure. Computed tomography imaging of the abdomen 1 month after the onset of pancreatitis revealed infected WON. Percutaneous drainage revealed purulent necrotic fluid, and culture of the fluid revealed the presence of Candida albicans and C glabrata. WON was treated by percutaneous endoscopic necrosectomy and local administration of amphotericin B. Consequently, the patient's condition improved, and Candida species were not detected in subsequent cultures.The combination of endoscopic necrosectomy with local administration of amphotericin B may be effective in treating refractory fungal-infected WON.
- Published
- 2015
- Full Text
- View/download PDF
46. Localized IgG4-related Cholecystitis Mimicking Gallbladder Cancer.
- Author
-
Inoue T, Okumura F, Mizushima T, Nishie H, Iwasaki H, Anbe K, Ozeki T, Kachi K, Fukusada S, Suzuki Y, Watanabe K, and Sano H
- Subjects
- Biomarkers metabolism, Cholecystitis pathology, Cholecystitis surgery, Diagnosis, Differential, Female, Gallbladder Neoplasms pathology, Humans, Immunoglobulin G immunology, Middle Aged, Treatment Outcome, Anti-Inflammatory Agents therapeutic use, Cholecystectomy methods, Cholecystitis diagnosis, Gallbladder Neoplasms diagnosis, Immunoglobulin G metabolism, Prednisolone therapeutic use
- Abstract
We encountered a case of localized IgG4-cholecystitis mimicking gallbladder cancer with focal/segmental type1 autoimmune pancreatitis (AIP). In this case, we were unable to exclude a diagnosis of gallbladder cancer and thus performed radical cholecystectomy. Type1 AIP is often associated with gallbladder lesions, accompanied by generally diffuse, circumferential thickening of the gallbladder wall. Although localized IgG4-related cholecystitis is extremely rare, differentiating this condition from gallbladder cancer is often very difficult.
- Published
- 2015
- Full Text
- View/download PDF
47. Chemotherapy treatment of a pregnant woman with progressive gastric cancer.
- Author
-
Nishie H, Mizushima T, Suzuki Y, Fukusada S, Inoue T, Kachi K, Ozeki T, Anbe K, Iwasaki H, Okumura F, and Sano H
- Subjects
- Adenocarcinoma pathology, Adult, Fatal Outcome, Female, Humans, Infant, Newborn, Meningeal Carcinomatosis etiology, Paclitaxel administration & dosage, Pregnancy, Pregnancy Complications, Neoplastic pathology, Pregnancy Outcome, Stomach Neoplasms pathology, Adenocarcinoma drug therapy, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Cesarean Section methods, Pregnancy Complications, Neoplastic drug therapy, Stomach Neoplasms drug therapy
- Abstract
We herein describe a rare case of gastric cancer that was treated with chemotherapy during pregnancy. A woman in her thirty's at 23 weeks of gestation was admitted to the hospital with epigastralgia and left cervical lymph node swelling. She had been previously diagnosed with metastatic adenocarcinoma at another hospital. Findings from a CT scan and esophagogastroduodenoscopy revealed progressive gastric cancer, and the pathology indicated poorly differentiated adenocarcinoma. Chemotherapy was administered at 24 weeks of gestation, without the development of severe toxicity. At 32 weeks of gestation, a healthy baby girl (birth weight 1,442 g, Apgar score 7/8) was delivered by caesarean section. The child continued to show no abnormalities at 12 months after delivery.
- Published
- 2015
- Full Text
- View/download PDF
48. Solid pseudopapillary neoplasm of the pancreas associated with familial adenomatous polyposis.
- Author
-
Inoue T, Nishi Y, Okumura F, Mizushima T, Nishie H, Iwasaki H, Anbe K, Ozeki T, Kachi K, Fukusada S, Suzuki Y, Mizuno A, Kajikawa M, Watanabe K, and Sano H
- Subjects
- Adenomatous Polyposis Coli pathology, Adenomatous Polyposis Coli surgery, Adult, Biopsy, Fine-Needle methods, Diagnosis, Differential, Humans, Male, Pancreatic Neoplasms pathology, Pancreatic Neoplasms surgery, Pancreaticoduodenectomy, Tomography, X-Ray Computed, Adenomatous Polyposis Coli diagnosis, Endoscopic Ultrasound-Guided Fine Needle Aspiration methods, Pancreas pathology, Pancreatectomy methods, Pancreatic Neoplasms diagnosis
- Abstract
A man in his thirties visited our hospital for an evaluation of a 12×10-mm pancreatic solid tumor that was accidentally detected on computed tomography performed for follow-up of familial adenomatous polyposis (FAP). We diagnosed the patient with a solid pseudopapillary neoplasm (SPN) based on endoscopic ultrasound-guided fine-needle aspiration, and he underwent pancreaticoduodenectomy. Small SPN tumors appear as solid tumors, without typical features of SPN, making the definitive diagnosis more difficult. The genetic background of FAP patients can predispose them to SPN, and imaging of the pancreas should be performed at prescribed intervals in FAP patients.
- Published
- 2015
- Full Text
- View/download PDF
49. Roles of cell signaling pathways in cell-to-cell contact-mediated Epstein-Barr virus transmission.
- Author
-
Nanbo A, Terada H, Kachi K, Takada K, and Matsuda T
- Subjects
- Animals, Cell Line, Epithelial Cells metabolism, Epithelial Cells virology, Epstein-Barr Virus Infections genetics, Epstein-Barr Virus Infections virology, Extracellular Signal-Regulated MAP Kinases genetics, Extracellular Signal-Regulated MAP Kinases metabolism, Humans, Epstein-Barr Virus Infections metabolism, Epstein-Barr Virus Infections transmission, Herpesvirus 4, Human physiology, Signal Transduction
- Abstract
Epstein-Barr virus (EBV), a human gamma herpesvirus, establishes a life-long latent infection in B lymphocytes and epithelial cells following primary infection. Several lines of evidence indicate that the efficiency of EBV infection in epithelial cells is accelerated up to 10(4)-fold by coculturing with EBV-infected Burkitt's lymphoma (BL) cells compared to infection with cell-free virions, indicating that EBV infection into epithelial cells is mainly mediated via cell-to-cell contact. However, the molecular mechanisms involved in this pathway are poorly understood. Here, we establish a novel assay to assess cell-to-cell contact-mediated EBV transmission by coculturing an EBV-infected BL cell line with an EBV-negative epithelial cell line under stimulation for lytic cycle induction. By using this assay, we confirmed that EBV was transmitted from BL cells to epithelial cells via cell-to-cell contact but not via cell-to-cell fusion. The inhibitor treatments of extracellular signal-regulated kinase (ERK) and nuclear factor (NF)-κB pathways blocked EBV transmission in addition to lytic induction. The blockage of the phosphoinositide 3-kinase (PI3K) pathway impaired EBV transmission coupled with the inhibition of lytic induction. Knockdown of the RelA/p65 subunit of NF-κB reduced viral transmission. Moreover, these signaling pathways were activated in cocultured BL cells and in epithelial cells. Finally, we observed that viral replication was induced in cocultured BL cells. Taken together, our data suggest that cell-to-cell contact induces multiple cell signaling pathways in BL cells and epithelial cells, contributing to the induction of the viral lytic cycle in BL cells and the enhancement of viral transmission to epithelial cells.
- Published
- 2012
- Full Text
- View/download PDF
50. Case of "slow" stroke from carotid artery occlusion treated by delayed but cautious endovascular intervention.
- Author
-
Illoh K, Supsupin E, Shaltoni HM, and Cacayorin ED
- Abstract
In a challenging case of carotid occlusion with slowly evolving stroke, we used brain imaging to facilitate endovascular revascularization resulting in the relief of the patient's symptoms. Patients with carotid occlusion and continued neurological worsening or fluctuations present enormous treatment challenges. These patients may present "slow" strokes with subacute infarcts that present significant challenges and risks during attempts at revascularization of the occluded artery. We present such a case in which we used multimodal imaging techniques, including MR-perfusion, to facilitate endovascular revascularization. Our approach of delayed but cautious intra-arterial thrombolytic therapy, guided by brain imaging, and followed by stent placement across the residual stenosis, enabled revascularization of the occluded artery without overt in-hospital complications.
- Published
- 2011
- Full Text
- View/download PDF
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.