92 results on '"Wataru Takagi"'
Search Results
2. Prognostic Impact of the Early Use of Tolvaptan in Elderly Patients with Acute Decompensated Heart Failure
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Tomoaki Okada, Toru Miyoshi, Akihiro Oka, Ryu Tsushima, Yuya Sudo, Kosuke Seiyama, Wataru Takagi, Tomohiro Kawaguchi, Masatomo Ozaki, Masahiro Sogo, Satoko Ugawa, Kazumasa Nosaka, Masahiko Takahashi, Keisuke Okawa, and Masayuki Doi
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acute decompensated heart failure ,elderly patients ,prognosis ,tolvaptan ,Medicine - Abstract
The number of elderly patients with acute decompensated heart failure (ADHF) is increasing, and it is often difficult to treat. This study aimed to evaluate the efficacy and safety of using tolvaptan early after hospitalization in elderly patients with ADHF and the prognosis one year after hospitalization. This study enrolled 185 patients with ADHF who were admitted for the first time. Tolvaptan was administered within 24 h after admission. These patients were assigned to two groups: over 80 years old (n = 109) and under 80 years old (n = 76). There were no significant differences between the two groups in the occurrence of MACCE within one year (25% vs. 20%, p = 0.59). All-cause mortality was significantly higher in the over-80 group (12% vs. 2%, p = 0.01). There were no significant differences in the incidence of worsening renal failure (11% vs. 7%, p = 0.46) and hypernatremia (5% vs. 9%, p = 1.0), and in the duration of hospitalization (19.2 days vs. 18.8 days, p = 0.8). Tolvaptan might be effective and safe in elderly patients with ADHF, and there was no difference in the incidence of MACCE within one year.
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- 2023
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3. Fulminant myocarditis after the second dose of COVID‐19 mRNA vaccination
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Akihiro Oka, Yuya Sudo, Toru Miyoshi, Masatomo Ozaki, Yuta Kimura, Wataru Takagi, Satoko Ugawa, Tomoaki Okada, Kazumasa Nosaka, and Masayuki Doi
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COVID‐19 mRNA vaccination ,fulminant myocarditis ,steroid pulse therapy ,Medicine ,Medicine (General) ,R5-920 - Abstract
Abstract Myocarditis is an adverse event associated with coronavirus disease 2019 (COVID‐19) mRNA vaccination. A 50‐year‐old man presented with dyspnea and resting chest pain after receiving the second dose of the COVID‐19 mRNA vaccine and developed cardiogenic shock. Fulminant myocarditis was diagnosed by endomyocardial biopsy and treated with intravenous corticosteroids.
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- 2022
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4. Molecular mechanism of nutrient uptake in developing embryos of oviparous cloudy catshark (Scyliorhinus torazame)
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Yuki Honda, Nobuhiro Ogawa, Marty Kwok-Shing Wong, Kotaro Tokunaga, Shigehiro Kuraku, Susumu Hyodo, and Wataru Takagi
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Medicine ,Science - Abstract
Forms of embryonic nutrition are highly diverse in cartilaginous fishes, which contain oviparity, yolk-sac viviparity and several types of matrotrophic viviparity (histotrophy, oophagy, and placentotrophy). The molecular mechanisms of embryonic nutrition are poorly understood in these animals as few species are capable of reproducing in captivity. Oviparous cartilaginous fishes solely depend on yolk nutrients for their growth and development. In the present study, we compared the contribution to embryonic nutrition of the embryonic intestine with the yolk sac membrane (YSM). RNA-seq analysis was performed on the embryonic intestine and YSM of the oviparous cloudy catshark Scyliorhinus torazame to identify candidate genes involved in nutrient metabolism to further the understanding of nutrient utilization of developing embryos. RNA-seq discovery was subsequently confirmed by quantitative PCR analysis and we identified increases in several amino acid transporter genes (slc3a1, slc6a19, slc3a2, slc7a7) as well as genes involved in lipid absorption (apob and mtp) in the intestine after ‘pre-hatching’, which is a developmental event marked by an early opening of the egg case about 4 months before hatching. Although a reciprocal decrease in the nutritional role of YSM was expected after the intestine became functional, we observed similar increases in gene expression among amino acid transporters, lipid absorption molecules, and lysosomal cathepsins in the extraembryonic YSM in late developmental stages. Ultrastructure of the endodermal cells of YSM showed that yolk granules were incorporated by endocytosis, and the number of granules increased during development. Furthermore, the digestion of yolk granules in the YSM and nutrient transport through the basolateral membrane of the endodermal cells appeared to be enhanced after pre-hatching. These findings suggest that nutrient digestion and absorption is highly activated in both intestine and YSM after pre-hatching in catshark embryos, which supports the rapid growth at late developmental stages.
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- 2022
5. CTCF binding landscape in jawless fish with reference to Hox cluster evolution
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Mitsutaka Kadota, Yuichiro Hara, Kaori Tanaka, Wataru Takagi, Chiharu Tanegashima, Osamu Nishimura, and Shigehiro Kuraku
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Medicine ,Science - Abstract
Abstract The nuclear protein CCCTC-binding factor (CTCF) contributes as an insulator to chromatin organization in animal genomes. Currently, our knowledge of its binding property is confined mainly to mammals. In this study, we identified CTCF homologs in extant jawless fishes and performed ChIP-seq for the CTCF protein in the Arctic lamprey. Our phylogenetic analysis suggests that the lamprey lineage experienced gene duplication that gave rise to its unique paralog, designated CTCF2, which is independent from the previously recognized duplication between CTCF and CTCFL. The ChIP-seq analysis detected comparable numbers of CTCF binding sites between lamprey, chicken, and human, and revealed that the lamprey CTCF protein binds to the two-part motif, consisting of core and upstream motifs previously reported for mammals. These findings suggest that this mode of CTCF binding was established in the last common ancestor of extant vertebrates (more than 500 million years ago). We analyzed CTCF binding inside Hox clusters, which revealed a reinforcement of CTCF binding in the region spanning Hox1-4 genes that is unique to lamprey. Our study provides not only biological insights into the antiquity of CTCF-based epigenomic regulation known in mammals but also a technical basis for comparative epigenomic studies encompassing the whole taxon Vertebrata.
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- 2017
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6. A shift in anterior–posterior positional information underlies the fin-to-limb evolution
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Koh Onimaru, Shigehiro Kuraku, Wataru Takagi, Susumu Hyodo, James Sharpe, and Mikiko Tanaka
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S. canicula ,C. milii ,fin-to-limb transition ,Medicine ,Science ,Biology (General) ,QH301-705.5 - Abstract
The pectoral fins of ancestral fishes had multiple proximal elements connected to their pectoral girdles. During the fin-to-limb transition, anterior proximal elements were lost and only the most posterior one remained as the humerus. Thus, we hypothesised that an evolutionary alteration occurred in the anterior–posterior (AP) patterning system of limb buds. In this study, we examined the pectoral fin development of catshark (Scyliorhinus canicula) and revealed that the AP positional values in fin buds are shifted more posteriorly than mouse limb buds. Furthermore, examination of Gli3 function and regulation shows that catshark fins lack a specific AP patterning mechanism, which restricts its expression to an anterior domain in tetrapods. Finally, experimental perturbation of AP patterning in catshark fin buds results in an expansion of posterior values and loss of anterior skeletal elements. Together, these results suggest that a key genetic event of the fin-to-limb transformation was alteration of the AP patterning network.
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- 2015
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7. A possible principal function of corticosteroid signaling that is conserved in vertebrate evolution: Lessons from receptor-knockout small fish
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Susumu Hyodo, Wataru Takagi, and Tatsuya Sakamoto
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0301 basic medicine ,medicine.drug_class ,Endocrinology, Diabetes and Metabolism ,Clinical Biochemistry ,Oryzias ,Biochemistry ,Evolution, Molecular ,Gene Knockout Techniques ,Mice ,03 medical and health sciences ,Receptors, Glucocorticoid ,0302 clinical medicine ,Endocrinology ,Mineralocorticoid receptor ,Glucocorticoid receptor ,Mineralocorticoids ,biology.animal ,medicine ,Animals ,Receptor ,Glucocorticoids ,Molecular Biology ,Zebrafish ,Gene knockout ,Behavior, Animal ,biology ,Vertebrate ,Cell Biology ,biology.organism_classification ,Cell biology ,Receptors, Mineralocorticoid ,030104 developmental biology ,Mineralocorticoid ,Molecular Medicine ,hormones, hormone substitutes, and hormone antagonists ,030217 neurology & neurosurgery ,Glucocorticoid ,medicine.drug - Abstract
Corticosteroid receptors are critical for homeostasis maintenance, but understanding of the principal roles of the glucocorticoid receptor (GR) and mineralocorticoid receptor (MR) throughout vertebrates is limited. Lines of constitutive GR-knockout zebrafish and MR-knockout medaka have recently been generated as the first adult-viable corticosteroid receptor-knockout animals, in contrast to the lethality of these receptor knockouts in mice. Here, we describe behavioral and physiological modifications following disruption of corticosteroid receptor function in these animal models. We suggest these data point toward a potentially conserved function of corticosteroid receptors in integrating brain-behavior and visual responses in vertebrates. Finally, we discuss how future work in cartilaginous fishes (Chondrichthyes) will further advance understanding of the unity and diversity of corticosteroid receptor function, since distinct orthologs of GR and MR derived from an ancestral corticoid receptor appear in these basal jawed vertebrates.
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- 2018
8. Regulation by Progestins, Corticosteroids and RU486 of Activation of Elephant Shark and Human Progesterone Receptors: An Evolutionary Perspective
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Yoshinao Katsu, Susumu Hyodo, Wataru Takagi, Xiaozhi Lin, Michael E. Baker, and Shigeho Ijiri
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medicine.medical_specialty ,medicine.drug_class ,medicine.medical_treatment ,Antagonist ,Biology ,Steroid ,Basal (phylogenetics) ,chemistry.chemical_compound ,Endocrinology ,chemistry ,Corticosterone ,Internal medicine ,Progesterone receptor ,medicine ,Corticosteroid ,Receptor ,Progestin - Abstract
We investigated progestin and corticosteroid activation of the progesterone receptor (PR) from elephant shark (Callorhinchus milii), a cartilaginous fish belonging to the oldest group of jawed vertebrates. Comparison with human PR experiments provides insights into the evolution of steroid activation of human PR. At 1 nM steroid, elephant shark PR is activated by progesterone, 17-hydroxy-progesterone, 20b-hydroxy-progesterone, 11-deoxycorticosterone (21-hydroxyprogesterone) and 11-deoxycortisol. At 1 nM steroid, human PR is activated only by progesterone and11-deoxycorticosterone indicating increased specificity for progestins and corticosteroids during the evolution of human PR. RU486, an important clinical antagonist of human PR, did not inhibit progesterone activation of elephant shark PR. Cys-528 in elephant shark PR corresponds to Gly-722 in human PR, which is essential for RU486 inhibition of human PR. Confirming the importance of this site on elephant shark PR, RU486 inhibited progesterone activation of the Cys528Gly mutant PR. There also was a decline in activation of elephant shark Cys528Gly PR by 11-deoxycortisol, 17-hydroxy-progesterone and 20b-hydroxy-progesterone and an increase in activation of human Gly722Cys PR by 11-deoxycortisol and decreased activation by corticosterone. One or more of these changes may have selected for the mutation corresponding to human glycine-722 PR that first evolved in platypus PR, a basal mammal.
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- 2021
9. N-terminal domain regulates steroid activation of elephant shark glucocorticoid and mineralocorticoid receptors
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Hiroshi Urushitani, Susumu Hyodo, Satomi Kohno, Xiaozhi Lin, Yoshinao Katsu, Wataru Takagi, Michael E. Baker, and Islam Md Shariful
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0301 basic medicine ,Hydrocortisone ,medicine.medical_treatment ,Endocrinology, Diabetes and Metabolism ,Clinical Biochemistry ,Biochemistry ,chemistry.chemical_compound ,0302 clinical medicine ,Endocrinology ,Glucocorticoid receptor ,Mineralocorticoid receptor ,Corticosterone ,Receptor ,Progesterone ,Aldosterone ,Mifepristone ,030220 oncology & carcinogenesis ,Molecular Medicine ,Glucocorticoid ,medicine.drug ,Transcriptional Activation ,congenital, hereditary, and neonatal diseases and abnormalities ,medicine.medical_specialty ,medicine.drug_class ,Recombinant Fusion Proteins ,chemical and pharmacologic phenomena ,Biology ,Steroid ,Evolution, Molecular ,03 medical and health sciences ,Hormone Antagonists ,Receptors, Glucocorticoid ,Allosteric Regulation ,Protein Domains ,Internal medicine ,medicine ,biochemistry ,Animals ,Humans ,Molecular Biology ,Dose-Response Relationship, Drug ,Cell Biology ,030104 developmental biology ,HEK293 Cells ,Receptors, Mineralocorticoid ,chemistry ,Nuclear receptor ,Mineralocorticoid ,Sharks ,human activities - Abstract
Orthologs of human glucocorticoid receptor (GR) and human mineralocorticoid receptor (MR) first appear in cartilaginous fishes. Subsequently, the MR and GR diverged to respond to different steroids: the MR to aldosterone and the GR to cortisol and corticosterone. We report that cortisol, corticosterone and aldosterone activate full-length elephant shark GR, and progesterone, which activates elephant shark MR, does not activate elephant shark GR. However, progesterone inhibits steroid binding to elephant shark GR, but not to human GR. Together, this indicates partial functional divergence of elephant shark GR from the MR. Deletion of the N-terminal domain (NTD) from elephant shark GR (truncated GR) reduced the response to corticosteroids, while truncated and full-length elephant shark MR had similar responses to corticosteroids. Swapping of NTDs of elephant shark GR and MR yielded an elephant shark MR chimera with full-length GR-like increased activation by corticosteroids and progesterone compared to full-length elephant shark MR. Elephant shark MR NTD fused to GR DBD+LBD had similar activation as full-length MR, indicating that the MR NTD lacked GR-like NTD activity. We propose that NTD activation of human GR evolved early in GR divergence from the MR.
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- 2020
10. Electrohydraulic Lithotripsy for Difficult Bile Duct Stones under Endoscopic Retrograde Cholangiopancreatography and Peroral Transluminal Cholangioscopy Guidance
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Nobu Nishioka, Wataru Takagi, Takeshi Ogura, Atsushi Okuda, Rieko Kamiyama, Kazuhide Higuchi, Miyuki Imanishi, and Akira Miyano
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Male ,Natural Orifice Endoscopic Surgery ,medicine.medical_specialty ,Stone clearance ,Clinical effectiveness ,Common bile duct ,Pilot Projects ,Gallstones ,Choledcholithiasis ,Electrohydraulic lithotripsy ,03 medical and health sciences ,0302 clinical medicine ,Lithotripsy ,medicine ,Humans ,endoscopic retrograde ,Aged ,Retrospective Studies ,Aged, 80 and over ,Cholangiopancreatography, Endoscopic Retrograde ,Mouth ,Endoscopic retrograde cholangiopancreatography ,Hepatology ,medicine.diagnostic_test ,Bile duct ,business.industry ,Gastroenterology ,Retrospective cohort study ,Middle Aged ,medicine.disease ,Surgery ,Cholangiopancreatography ,Biliary Tract Surgical Procedures ,medicine.anatomical_structure ,Treatment Outcome ,Endoscopic ultrasound intervention ,030220 oncology & carcinogenesis ,Acute pancreatitis ,Feasibility Studies ,030211 gastroenterology & hepatology ,Original Article ,Female ,business - Abstract
Background/Aims Electrohydraulic lithotripsy (EHL) under endoscopic retrograde cholangiopancreatography (ERCP) guidance can be an option to treat difficult stones. Recently, a digital, single-operator cholangioscope (SPY-DS) has become available. Peroral transluminal cholangioscopy (PTLC) using SPY-DS has also been reported. In this retrospective study, the technical feasibility and clinical effectiveness of EHL for difficult bile duct stones under ERCP guidance and under PTLC guidance was examined. Methods In this pilot study, patients with difficult bile duct stones between July 2016 and July 2017 were retrospectively enrolled. Results Forty-two consecutive patients underwent EHL using a SPY-DS; 34 patients underwent EHL under ERCP guidance, and the other 8 patients underwent EHL under PTLC guidance. Median procedure time was 31 minutes (range, 19 to 66 minutes). The median number of EHL sessions was 1 (range, 1 to 2), and that of ERCP sessions was also 1 (range, 1 to 3). The rate of complete stone clearance was 98% (41/42). Adverse events such as cholangitis and acute pancreatitis were seen in 14% (6/42), which could be treated conservatively. Conclusions EHL using SPY-DS was technically feasible, not only under ERCP guidance, but also PTLC guidance. A prospective clinical study of EHL using SPY-DS is needed.
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- 2018
11. Circulating adipocyte fatty acid-binding protein is a predictor of cardiovascular events in patients with stable angina undergoing percutaneous coronary intervention
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Hiroshi Ito, Tomoyuki Nishibe, Naoaki Matsuo, Toru Miyoshi, Keisuke Okawa, Masayuki Doi, Kazumasa Nosaka, Wataru Takagi, and Satoshi Hirohata
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0301 basic medicine ,Male ,medicine.medical_specialty ,lcsh:Diseases of the circulatory (Cardiovascular) system ,medicine.medical_treatment ,030204 cardiovascular system & hematology ,Fatty Acid-Binding Proteins ,Coronary artery disease ,03 medical and health sciences ,0302 clinical medicine ,Percutaneous Coronary Intervention ,Postoperative Complications ,Interquartile range ,Predictive Value of Tests ,Internal medicine ,medicine ,Humans ,Cumulative incidence ,Myocardial infarction ,Angina, Stable ,Prospective Studies ,Aged ,Retrospective Studies ,Aged, 80 and over ,Adipocyte ,business.industry ,Hazard ratio ,Percutaneous coronary intervention ,Middle Aged ,medicine.disease ,Fatty acid ,030104 developmental biology ,Cardiovascular Diseases ,lcsh:RC666-701 ,Heart failure ,Conventional PCI ,Cardiology ,Female ,lipids (amino acids, peptides, and proteins) ,Risk factor ,Cardiology and Cardiovascular Medicine ,business ,Biomarkers ,Follow-Up Studies ,Research Article - Abstract
Background Adipocyte fatty acid-binding protein (A-FABP) is expressed in both adipocytes and macrophages. Recent studies have shown that A-FABP is secreted by adipocytes and that the A-FABP concentration is associated with obesity, insulin resistance, and atherosclerosis. We have reported that the coronary atherosclerotic burden is associated with the serum A-FABP concentration. In the present study, we investigated whether the serum A-FABP concentration is associated with prognosis in patients with stable angina pectoris who have undergone percutaneous coronary intervention (PCI). Methods This was a prospective single-center trial. In total, 130 patients with stable angina pectoris undergoing their first PCI were enrolled from August 2008 to July 2010 at Kagawa Prefectural Central Hospital. The primary endpoints were cardiovascular death, nonfatal myocardial infarction, nonfatal stroke, revascularization, and hospitalization for heart failure. Results During the follow-up (median, 50 months; interquartile range, 23–66 months), 49 cardiovascular events occurred. Kaplan–Meier analysis showed that the cumulative incidence of the primary endpoints in the high A-FABP group (median A-FABP concentration of ≥ 18.6 ng/ml) was greater than that in the low A-FABP group. Cox analysis showed that the A-FABP concentration was an independent predictor of cardiovascular events adjusted for age and the presence of multi-vessel disease (hazard ratio, 1.03; 95% confidence interval, 1.01–1.04; p = 0.01). Conclusion The serum A-FABP concentration is associated with prognosis in patients with stable angina undergoing PCI, suggesting that the serum A-FABP concentration could be useful for risk assessment of secondary prevention. Trial registration UMIN Clinical Trials Registry UMIN000029283 (registration date: September 25, 2017), retrospectively registered.
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- 2017
12. Evaluation of the safety of endoscopic radiofrequency ablation for malignant biliary stricture using a digital peroral cholangioscope (with videos)
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Atsushi Okuda, Tatsushi Sano, Saori Onda, Kazuhide Higuchi, Nobu Nishioka, Daisuke Masuda, Akira Miyano, Takeshi Ogura, Mio Amano, Miyuki Imanishi, and Wataru Takagi
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Male ,medicine.medical_specialty ,Radiofrequency ablation ,Perforation (oil well) ,Constriction, Pathologic ,Risk Assessment ,law.invention ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,law ,Clinical endpoint ,Humans ,Medicine ,Radiology, Nuclear Medicine and imaging ,Prospective cohort study ,Aged ,Retrospective Studies ,Aged, 80 and over ,Cholangiopancreatography, Endoscopic Retrograde ,Cholestasis ,Endoscopic retrograde cholangiopancreatography ,medicine.diagnostic_test ,business.industry ,Gastroenterology ,Retrospective cohort study ,Middle Aged ,Surgery ,Catheter ,Treatment Outcome ,surgical procedures, operative ,Bile Duct Neoplasms ,Biliary tract ,030220 oncology & carcinogenesis ,Catheter Ablation ,Feasibility Studies ,Female ,030211 gastroenterology & hepatology ,Patient Safety ,Radiology ,business ,therapeutics ,Follow-Up Studies - Abstract
Background and Aim The clinical impact of catheter-based radiofrequency ablation (RFA) under endoscopic retrograde cholangiopancreatography (ERCP) guidance has recently been reported; however, severe adverse events have also been noted. If tumor is not present in the biliary tract, severe adverse events such as perforation or bleeding as a result of vessel injury around the biliary tract may occur. In addition, the effectiveness of RFA may not be sufficient based solely on radiographic guidance. The aim of the present study was to evaluate the actual feasibility of intraductal RFA by peroral cholangioscope (POCS) evaluation before/after RFA. Methods In this retrospective study carried out between July and September 2016, consecutive patients who underwent RFA for malignant biliary stricture and POCS evaluation before/after RFA were enrolled. Primary endpoint of this study was technical feasibility of RFA, which was evaluated by POCS. Secondary endpoints were rates and types of adverse event. Results A total of 12 consecutive patients were retrospectively enrolled in this study. Stent placement using uncovered metal stents had been previously done in six patients before RFA. Tumor was seen in the biliary tract in all patients. RFA was technically successful in all patients, and clinical success was confirmed in all patients by POCS imaging. Adverse events were seen in only one patient. Median stent patency was 154 days. Conclusions RFA for malignant biliary stricture may be safe. To confirm the feasibility and efficacy of RFA, additional cases, prospective studies, and a comparison study between with and without endobiliary RFA are needed.
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- 2017
13. Prospective clinical study of endoscopic ultrasound-guided biliary drainage using novel balloon catheter (with video)
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Wataru Takagi, Mio Amano, Takeshi Ogura, Kazuhide Higuchi, Astushi Okuda, Daisuke Masuda, Akira Miyano, Saori Onda, and Tastsushi Sano
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Endoscopic ultrasound ,medicine.medical_specialty ,Abdominal pain ,Hepatology ,medicine.diagnostic_test ,business.industry ,Fistula ,Gastroenterology ,Balloon catheter ,Video-Assisted Surgery ,medicine.disease ,digestive system diseases ,03 medical and health sciences ,0302 clinical medicine ,Fine-needle aspiration ,Biliary tract ,030220 oncology & carcinogenesis ,medicine ,030211 gastroenterology & hepatology ,Radiology ,Biliary Tract Surgical Procedures ,medicine.symptom ,business - Abstract
Background and Aim On endoscopic ultrasound (EUS)-guided biliary drainage, fistula dilation may be accompanied by leakage of bile juice, potentially along with bacteria or air, so this procedure should be kept as simple and short as possible. To date, various techniques to dilate the fistula have been reported. This prospective, single-center, single-arm study evaluated the technical feasibility and safety of EUS-guided biliary drainage using novel balloon catheters. Methods Tip of novel balloon catheters is only 3 Fr and tapered, and the catheters also show favorable push ability. First, biliary tract was punctured using 19-G fine needle aspiration needle. Next, we immediately inserted the novel balloon catheter, and the biliary tract and intestinal wall were dilated. Then, we performed metallic stent placement without any dilation fistula. Results A total of 20 patients were prospectively enrolled in this study. Technical success rate was 100%. Eleven patients underwent EUS-guided choledochoduodenostomy, and nine patients underwent EUS-guided hepaticogastrostomy. Median procedure time was only 11 min (range, 8–16 min) for EUS-guided choledochoduodenostomy and 14 min (range, 11–18 min) for EUS-guided hepaticogastrostomy. Adverse events were seen in 15% (3/20; self-limited abdominal pain n = 2, peritonitis n = 1). Conclusions Although additional cases and a randomized controlled comparison with another dilation technique such as the graded dilation or cystotome dilation technique are needed, our technique may be helpful for EUS-guided biliary drainage.
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- 2017
14. Clinical utility of endoscopic ultrasound-guided biliary drainage as a rescue of re-intervention procedure for high-grade hilar stricture
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Saori Onda, Shinya Fukunishi, Tastsushi Sano, Kazuhiro Yamamoto, Masayuki Kitano, Toshihisa Takeuchi, Daisuke Masuda, Kazuhide Higuchi, Akira Miyano, Takeshi Ogura, Wataru Takagi, and Atsushi Okuda
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Endoscopic ultrasound ,medicine.medical_specialty ,Biliary drainage ,Endoscopic retrograde cholangiopancreatography ,Hepatology ,medicine.diagnostic_test ,business.industry ,medicine.medical_treatment ,Gastroenterology ,Hilum (biology) ,Stent ,Retrospective cohort study ,digestive system diseases ,Surgery ,03 medical and health sciences ,surgical procedures, operative ,0302 clinical medicine ,030220 oncology & carcinogenesis ,medicine ,030211 gastroenterology & hepatology ,Adverse effect ,business ,Re intervention - Abstract
Background and aim Re-intervention after stent placement for malignant hepatic hilum obstruction (HBO) is challenging. endoscopic ultrasound-guided biliary drainage (EUS-BD) has been developed as an alternative method for failed endoscopic retrograde cholangiopancreatography (ERCP). In this retrospective study, the clinical utility of EUS-BD as a rescue drainage technique for HBO patients who failed re-intervention under ERCP guidance was evaluated. Methods Between April 2012 and August 2015, patients with HBO were enrolled. Patients' characteristics, kinds of metallic stents, configuration of stent placement, overall survival, stent patency, and results of re-intervention were reviewed, along with the re-intervention technical success rate. Results The biliary stricture type was Bismuth type IV in 59% (23/39) and types IIIa and b in 20.5% (8/39) each. Biliary metallic stent placement was bilateral in 38.5% (15/39), and unilateral in 61.5% (24/39). Primary stent dysfunction was observed in 71.8% (28/39) of cases. Planned re-intervention under ERCP guidance was attempted in 26 patients. The technical success rate was 62% (16/26). For the 10 patients who failed re-intervention under ERCP guidance, EUS-BD was planned. The technical success rate was 100% (10/10). The procedure time was 25.8 min. Adverse events were not seen in any patients. Stent patency after re-intervention was not significantly different between ERCP (165 days) guidance and EUS-BD (152 days) guidance (P = 0.463) CONCLUSIONS: In conclusion, EUS-BD as a re-intervention method for metallic stent obstruction was safe and feasible. If ERCP was failed, EUS-BD may be one of option as re-intervention method for high-grade hilar stricture.
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- 2017
15. Early detection of nonperitoneal recurrence may contribute to survival benefit after curative gastrectomy for gastric cancer
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Wataru Takagi, Hayato Omori, Keiichi Fujiya, Yutaka Tanizawa, Noriyuki Nishiwaki, Fumiko Hirata, Masanori Tokunaga, Rie Makuuchi, Taiichi Kawamura, Etsuro Bando, Masanori Terashima, and Makoto Hikage
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Adult ,Male ,Cancer Research ,medicine.medical_specialty ,medicine.medical_treatment ,Early detection ,Asymptomatic ,03 medical and health sciences ,0302 clinical medicine ,Gastrectomy ,Stomach Neoplasms ,Surgical oncology ,medicine ,Humans ,Prospective Studies ,Aged ,Neoplasm Staging ,Aged, 80 and over ,Chemotherapy ,business.industry ,Gastroenterology ,Cancer ,General Medicine ,Middle Aged ,Prognosis ,medicine.disease ,Surgery ,Survival Rate ,Oncology ,Lymphatic Metastasis ,030220 oncology & carcinogenesis ,Female ,030211 gastroenterology & hepatology ,Neoplasm Recurrence, Local ,Hepatectomy ,medicine.symptom ,business ,Follow-Up Studies ,Abdominal surgery - Abstract
There is no evidence that strict follow-up using cross-sectional imaging after curative gastrectomy benefits survival; however, nonperitoneal recurrence detected early might be treated with additional surgery. The present study examined whether early detection of recurrence by imaging modalities could increase survival, particularly in patients with nonperitoneal recurrence. We retrospectively analyzed 218 patients with recurrent gastric cancer after curative gastrectomy performed from 2002 to 2014. The patients were divided into an asymptomatic group (n = 117) and a symptomatic group (n = 101), according to the presence of symptoms at the time of recurrence, to compare clinicopathological characteristics and long-term survival. Peritoneal recurrence was less frequent in the asymptomatic group (22.2%) than in the symptomatic group (62.4%), the median time to recurrence was shorter (12.7 months vs 18.9 months; P
- Published
- 2016
16. Transcriptional Activation of Elephant Shark Mineralocorticoid Receptor by Corticosteroids, Progesterone and Spironolactone
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Yoshinao Katsu, Byrappa Venkatesh, Susumu Hyodo, Sumika Otake, Wataru Takagi, Nisha E. Pillai, Kaori Oka, Xiaozhi Lin, Satomi Kohno, and Michael E. Baker
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Amphibian ,Fish Proteins ,Transcriptional Activation ,medicine.medical_specialty ,medicine.drug_class ,Molecular Networks (q-bio.MN) ,Ovary ,030209 endocrinology & metabolism ,Biology ,Spironolactone ,bepress|Medicine and Health Sciences|Other Medicine and Health Sciences ,Biochemistry ,bepress|Life Sciences|Ecology and Evolutionary Biology ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Mineralocorticoid receptor ,bepress|Life Sciences ,Corticosterone ,Adrenal Cortex Hormones ,biology.animal ,Internal medicine ,medicine ,Animals ,Humans ,Quantitative Biology - Molecular Networks ,Receptor ,Molecular Biology ,Progesterone ,030304 developmental biology ,0303 health sciences ,Aldosterone ,Activator (genetics) ,Cell Biology ,bepress|Medicine and Health Sciences ,medicine.anatomical_structure ,Endocrinology ,Receptors, Mineralocorticoid ,chemistry ,Nuclear receptor ,Mineralocorticoid ,Organ Specificity ,FOS: Biological sciences ,physiology ,Sharks ,Corticosteroid ,human activities ,bepress|Life Sciences|Ecology and Evolutionary Biology|Evolution - Abstract
The mineralocorticoid receptor (MR) is a nuclear receptor and part of a large and diverse family of transcription factors that also includes receptors for glucocorticoids, progesterone, androgens, and estrogens. The corticosteroid aldosterone is the physiological activator of the MR in humans and other terrestrial vertebrates; however, its activator is not known in cartilaginous fish, the oldest group of extant jawed vertebrates. Here, we analyzed the ability of corticosteroids and progesterone to activate the full-length MR from the elephant shark (Callorhinchus milii). On the basis of their measured activities, aldosterone, cortisol, 11-deoxycorticosterone, corticosterone, 11-deoxcortisol, progesterone, and 19-norprogesterone are potential physiological mineralocorticoids. However, aldosterone, the physiological mineralocorticoid in humans and other terrestrial vertebrates, is not found in cartilaginous or ray-finned fish. Although progesterone activates MRs in ray-finned fish, progesterone does not activate MRs in humans, amphibians, or alligator, suggesting that during the transition to terrestrial vertebrates, progesterone lost the ability to activate the MR. Both elephant shark MR and human MR are expressed in the brain, heart, ovary, testis, and other nonepithelial tissues, suggesting that MR expression in diverse tissues evolved in the common ancestor of jawed vertebrates. Our data suggest that 19-norprogesterone- and progesterone-activated MR may have unappreciated functions in reproductive physiology.
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- 2019
17. Secular Decreasing Trend in Plasma Eicosapentaenoic and Docosahexaenoic Acids among Patients with Acute Coronary Syndrome from 2011 to 2019: A Single Center Descriptive Study
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Toru Miyoshi, Hiroshi Ito, Masahiro Sogo, Wataru Takagi, Keisuke Okawa, Masahiko Takahashi, Kazumasa Nosaka, Masayuki Doi, Kosuke Seiyama, and Tomoaki Okada
- Subjects
Male ,Acute coronary syndrome ,medicine.medical_specialty ,eicosapentaenoic acid ,Docosahexaenoic Acids ,descriptive study ,lcsh:TX341-641 ,030204 cardiovascular system & hematology ,Single Center ,Article ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,8,11,14-Eicosatrienoic Acid ,Sex Factors ,Internal medicine ,arachidonic acid ,Medicine ,Humans ,030212 general & internal medicine ,Acute Coronary Syndrome ,Aged ,Retrospective Studies ,chemistry.chemical_classification ,Aged, 80 and over ,Nutrition and Dietetics ,business.industry ,Atherosclerotic cardiovascular disease ,Age Factors ,atherosclerotic cardiovascular disease ,Middle Aged ,docosahexaenoic acid ,medicine.disease ,Eicosapentaenoic acid ,Lipids ,Residual risk ,chemistry ,Docosahexaenoic acid ,Fatty Acids, Unsaturated ,Arachidonic acid ,Female ,lipids (amino acids, peptides, and proteins) ,Hydroxymethylglutaryl-CoA Reductase Inhibitors ,business ,lcsh:Nutrition. Foods and food supply ,Food Science ,Polyunsaturated fatty acid ,polyunsaturated fatty acids - Abstract
Despite intensive lipid-lowering interventions, patients treated with statins develop atherosclerotic cardiovascular disease (ASCVD), and these patients have an increased risk of developing recurrent cardiovascular events during follow-up. Therefore, there is a need to focus on the residual risks in patients in statin therapy to further reduce ASCVD. The aim of this study was to retrospectively investigate the 10-year trend (2011&ndash, 2019) regarding changes in polyunsaturated fatty acids (PUFAs) in patients with acute coronary syndrome (ACS) in a single center. We included 686 men and 203 women with ACS admitted to Kagawa Prefectural Central Hospital. Plasma PUFAs, including eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), arachidonic acid (AA), and dihomo-&gamma, linolenic acid (DGLA), were measured at admission for suspected ACS. A secular decreasing trend in the levels of EPA and DHA and the EPA/AA ratio, but not of AA and DGLA, was observed. The analyses based on age (>, 70 or <, 70 years) and sex showed that the decreasing trend in the levels of EPA and DHA did not depend on age and remained significant only in men. Further studies are needed to obtain robust evidence to justify that the administration of n-3 PUFA contributes to the secondary prevention of ACS.
- Published
- 2021
18. Technical tips for peroral transluminal cholangioscopy using novel single-operator cholangioscope (with videos)
- Author
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Wataru Takagi, Yoshitaka Kurisu, Kazuhide Higuchi, and Takeshi Ogura
- Subjects
Endoscopic ultrasound ,medicine.medical_specialty ,Endoscopic retrograde cholangiopancreatography ,Hepatology ,medicine.diagnostic_test ,Peroral cholangiography ,business.industry ,Ampulla of Vater ,medicine.disease ,Percutaneous transhepatic cholangiodrainage ,Electrohydraulic lithotripsy ,Biliary disease ,03 medical and health sciences ,0302 clinical medicine ,medicine.anatomical_structure ,Biliary tract ,030220 oncology & carcinogenesis ,medicine ,030211 gastroenterology & hepatology ,Surgery ,Radiology ,business - Abstract
Endoscopic retrograde cholangiopancreatography (ERCP) is the gold-standard modality for diagnosis and therapy of bilio-pancreatic disease. In particular, peroral cholangiography (POCS) is a useful modality not only for diagnosing biliary disease, but also for therapeutic procedures such as electrohydraulic lithotripsy. The SPY-DS single-operator cholangioscope has recently become available, and offers favorable visualization, a wide view, suction function and a larger accessory working channel. However, if the duodenoscope cannot be advanced into the ampulla of Vater for reasons such as surgical anatomy, POCS cannot be performed. On the other hand, percutaneous transhepatic cholangiodrainage (PTCD) has been developed as an alternative endoscopic ultrasound-guided approach to the biliary tract. Peroral transluminal cholangioscopy (PTLC) using SPY-DS is a novel approach. Because transluminal interventional procedures under endoscopic ultrasound guidance have recently been developed, our technique may have clinical impact for selected cases.
- Published
- 2016
19. Risk factors for complications after pharyngolaryngectomy with total esophagectomy
- Author
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Wataru Takagi, Masahiro Nakagawa, Takashi Kitani, Yasuhiro Tsubosa, Yuko Kitagawa, Atsushi Imai, Ayako Shimada, Katsushi Takebayashi, Tomoyuki Kamijo, Hiroya Takeuchi, Masato Nagaoka, Yoshiyuki Iida, Tetsuro Onitsuka, Eisuke Booka, and Masahiro Niihara
- Subjects
medicine.medical_specialty ,medicine.medical_treatment ,Esophageal cancer ,Tracheal necrosis ,03 medical and health sciences ,0302 clinical medicine ,Surgical oncology ,medicine ,Total esophagectomy ,business.industry ,General surgery ,Gastroenterology ,Cancer ,Hypopharyngeal cancer ,medicine.disease ,Pharyngolaryngectomy ,Cardiothoracic surgery ,Esophagectomy ,030220 oncology & carcinogenesis ,Original Article ,030211 gastroenterology & hepatology ,business ,Thoracic esophageal cancer - Abstract
Background Pharyngolaryngectomy with total esophagectomy (PLTE) is an effective surgical treatment for synchronous or metachronous hypopharyngeal or laryngeal cancer and thoracic esophageal cancer, although it is more invasive than esophagectomy and total pharyngolaryngectomy. The aim of this study was to identify risk factors for complications after PLTE. Methods From November 2002 to December 2014, a total of 8 patients underwent PLTE at the Shizuoka Cancer Center Hospital, Shizuoka, Japan. We investigated the clinicopathological characteristics, surgical procedures, and postoperative complications of these patients. Results Of the 8 patients, 5 underwent one-stage PLTE and 3 underwent staged PLTE. There was no mortality in this study. Two cases of tracheal necrosis, two of anastomotic leakage, and one of ileus were observed as postoperative complications. Two patients who underwent one-stage PLTE with standard mediastinal lymph node dissection developed tracheal necrosis and severe anastomotic leakage. Conclusion One-stage PLTE and standard mediastinal lymph node dissection were identified as the risk factors for severe postoperative complications. Staged PLTE or transhiatal esophagectomy should be considered when PLTE is performed and standard mediastinal lymph node dissection should be avoided when one-stage PLTE is performed with transthoracic esophagectomy.
- Published
- 2016
20. Choledochoduodenal Fistula after the Placement of a Partially Covered Metal Stent for Unresectable Pancreatic Cancer
- Author
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Shinya Fukunishi, Wataru Takagi, Kazuhide Higuchi, Daisuke Masuda, Saori Onda, Toshihisa Takeuchi, Takeshi Ogura, Atsushi Okuda, Tatsushi Sano, Takuya Inoue, and Akira Imoto
- Subjects
Male ,Choledochoduodenal fistula ,medicine.medical_specialty ,Cholangitis ,medicine.medical_treatment ,03 medical and health sciences ,0302 clinical medicine ,Japan ,Intestinal Fistula ,Internal Medicine ,Humans ,Medicine ,Small hole ,Ampulla ,Device Removal ,Aged ,Unresectable Pancreatic Cancer ,business.industry ,Upper endoscopy ,Stent ,General Medicine ,equipment and supplies ,Pancreatic Neoplasms ,Diabetes Mellitus, Type 2 ,Metals ,Biliary tract ,030220 oncology & carcinogenesis ,Balloon dilation ,Stents ,030211 gastroenterology & hepatology ,Radiology ,business - Abstract
A 75-year-old Japanese man with type 2 diabetes mellitus suffered from unresectable pancreatic head cancer and was admitted to our institution due to acute cholangitis. A partially covered metal stent was placed at that time. 11 months later, he was readmitted for acute cholangitis. Upper endoscopy revealed complete stent distal migration and a small hole on the oral side of the ampulla. While attempting cannulation into the hole, an upstream biliary tract was revealed. Accordingly, we diagnosed the patient to have a choledochoduodenal fistula. After metal stent removal and balloon dilation, we placed two 7 Fr plastic stents, which successfully relieved the patient's cholangitis.
- Published
- 2016
21. Stent length is impact factor associated with stent patency in endoscopic ultrasound-guided hepaticogastrostomy
- Author
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Saori Onda, Tatsushi Sano, Kazuhide Higuchi, Shinya Fukunishi, Takeshi Ogura, Daisuke Masuda, Kazuhiro Yamamoto, Wataru Takagi, and Akira Imoto
- Subjects
Endoscopic ultrasound ,medicine.medical_specialty ,Hepatology ,medicine.diagnostic_test ,business.industry ,Proportional hazards model ,medicine.medical_treatment ,Hazard ratio ,Gastroenterology ,Stent ,equipment and supplies ,Stent patency ,Confidence interval ,Surgery ,Hepaticogastrostomy ,surgical procedures, operative ,Medicine ,In patient ,cardiovascular diseases ,business - Abstract
BACKGROUND AND STUDY AIM Despite high technical and functional success rates with endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS), rates of adverse events have also been high. No reports have focused on EUS-HGS alone with a large sample size about predictors of stent patency. The present study examined predictors of stent patency in patients who underwent EUS-HGS. PATIENTS AND METHODS The consecutive 51 patients who underwent EUS-HGS using one metallic stent were retrospectively enrolled in this study. Baseline characteristics, stent length from the hepatic portion and in the luminal portion, kinds of stent dysfunction, and stent patency were reviewed. RESULTS Median duration of stent patency was significantly shorter with stent length in the luminal portion
- Published
- 2015
22. Facilitated NaCl Uptake in the Highly Developed Bundle of the Nephron in Japanese Red Stingray Hemitrygon akajei Revealed by Comparative Anatomy and Molecular Mapping
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Marty Kwok Sing Wong, Kotaro Tokunaga, Waichiro Godo, Susumu Hyodo, Kazuhiro Saito, Wataru Takagi, Shigehiro Kuraku, Tatsuya Sakamoto, Mitsutaka Kadota, Naotaka Aburatani, and Kazuya Kofuji
- Subjects
0106 biological sciences ,0301 basic medicine ,biology ,urogenital system ,Reabsorption ,Zoology ,Nephron ,biology.organism_classification ,010603 evolutionary biology ,01 natural sciences ,Catshark ,Scyliorhinus torazame ,03 medical and health sciences ,030104 developmental biology ,medicine.anatomical_structure ,Houndshark ,Stingray ,medicine ,Batoidea ,Animal Science and Zoology ,Stenohaline - Abstract
Batoidea (rays and skates) is a monophyletic subgroup of elasmobranchs that diverged from the common ancestor with Selachii (sharks) about 270 Mya. A larger number of batoids can adapt to low-salinity environments, in contrast to sharks, which are mostly stenohaline marine species. Among osmoregulatory organs of elasmobranchs, the kidney is known to be dedicated to urea retention in ureosmotic cartilaginous fishes. However, we know little regarding urea reabsorbing mechanisms in the kidney of batoids. Here, we performed physiological and histological investigations on the nephrons in the red stingray (Hemitrygon akajei) and two shark species. We found that the urine/plasma ratios of salt and urea concentrations in the stingray are significantly lower than those in cloudy catshark (Scyliorhinus torazame) under natural seawater, indicating that the kidney of stingray more strongly reabsorbs these osmolytes. By comparing the three-dimensional images of nephrons between stingray and banded houndshark (Triakis scyllium), we showed that the tubular bundle of stingray has a more compact configuration. In the compact tubular bundle of stingray kidney, the distal diluting tubule was highly developed and frequently coiled around the proximal and collecting tubules. Furthermore, co-expression of NKAα1 (Na+/K +-ATPase) and NKCC2 (Na+- K+-2Cl– cotransporter 2) mRNAs was prominent in the coiled diluting segment. These findings imply that NaCl reabsorption is greatly facilitated in the stingray kidney, resulting in a higher reabsorption rate of urea. Lowering the loss of osmolytes in the glomerular filtrate is likely favorable to the adaptability of batoids to a wide range of environmental salinity.
- Published
- 2020
23. Inner ear development in cyclostomes and evolution of the vertebrate semicircular canals
- Author
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Yasuhiro Oisi, Wataru Takagi, Shinnosuke Higuchi, Juan Pascual-Anaya, Shigeru Kuratani, and Fumiaki Sugahara
- Subjects
0301 basic medicine ,Organogenesis ,Lateral canal ,03 medical and health sciences ,Mice ,0302 clinical medicine ,biology.animal ,otorhinolaryngologic diseases ,Eptatretus burgeri ,medicine ,Animals ,Inner ear ,Phylogeny ,Zebrafish ,Multidisciplinary ,biology ,Lamprey ,Vertebrate ,Gene Expression Regulation, Developmental ,Lampreys ,Anatomy ,biology.organism_classification ,Arctic lamprey ,Semicircular Canals ,030104 developmental biology ,medicine.anatomical_structure ,Vertebrates ,Sharks ,Hagfishes ,sense organs ,Otic vesicle ,030217 neurology & neurosurgery ,Hagfish - Abstract
Jawed vertebrates have inner ears with three semicircular canals, the presence of which has been used as a key to understanding evolutionary relationships. Ostracoderms, the jawless stem gnathostomes, had only two canals and lacked the lateral canal1–3. Lampreys, which are modern cyclostomes, are generally thought to possess two semicircular canals whereas the hagfishes—which are also cyclostomes—have only a single canal, which used to be regarded as a more primitive trait1,4. However, recent molecular and developmental analyses have strongly supported the monophyly of cyclostomes5–7, which has left the evolutionary trajectory of the vertebrate inner ear unclear8. Here we show the differentiation of the otic vesicle of the lamprey Lethenteron camtschaticum and inshore hagfish Eptatretus burgeri. This is the first time, to our knowledge, that the development of the hagfish inner ear is reported. We found that canal development in the lamprey starts with two depressions—which is reminiscent of the early developmental pattern of the inner ear in modern gnathostomes. These cyclostome otic vesicles show a pattern of expression of regulatory genes, including OTX genes, that is comparable to that of gnathosomes. Although two depressions appear in the lamprey vesicle, they subsequently fuse to form a single canal that is similar to that of hagfishes. Complete separation of the depressions results in anterior and posterior canals in gnathostomes. The single depression of the vesicle in hagfishes thus appears to be a secondarily derived trait. Furthermore, the lateral canal in crown gnathostomes was acquired secondarily—not by de novo acquisition of an OTX expression domain, but by the evolution of a developmental program downstream of the OTX genes. The differentiation of the inner ear in the lamprey Lethenteron camtschaticum and hagfish Eptatretus burgeri sheds light on the evolution of the semicircular canals of jawed vertebrates.
- Published
- 2018
24. Prospective histological evaluation of a 20G core trap with a forward-cutting bevel needle for EUS-FNA of pancreatic lesions
- Author
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Saori Onda, Tatsushi Sano, Takeshi Ogura, Nobu Nishioka, Kazuhide Higuchi, Wataru Takagi, Mio Amano, Atsushi Okuda, Yoshitaka Kurisu, Miyuki Imanishi, and Akira Miyano
- Subjects
Endoscopic ultrasound ,Male ,medicine.medical_specialty ,Bevel needle ,03 medical and health sciences ,0302 clinical medicine ,Pancreatic cancer ,Internal medicine ,medicine ,Humans ,Prospective Studies ,Prospective cohort study ,Endoscopic Ultrasound-Guided Fine Needle Aspiration ,Pancreas ,Aged ,Aged, 80 and over ,Core (anatomy) ,medicine.diagnostic_test ,business.industry ,Reproducibility of Results ,Equipment Design ,Hepatology ,Middle Aged ,medicine.disease ,Pancreatic Neoplasms ,Fine-needle aspiration ,030220 oncology & carcinogenesis ,030211 gastroenterology & hepatology ,Surgery ,Female ,Radiology ,business ,Abdominal surgery - Abstract
Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) has been established as a method to obtain tissues of various organs. To obtain sufficient tissue has clinical impact to facilitate the diagnosis by clinical pathologists, the assessment and subtyping of various neoplasms, and for further immunohistochemical investigations of tumor type. Recently, a novel 20G core trap with a forward-cutting beveled FNA needle (ProC-F) has become available. The aim of this prospective study was to evaluate the feasibility and diagnostic yield of EUS-FNA for pancreatic lesions using this needle. In this study, the first puncture was performed using the ProC-F. Only tissue obtained with the first puncture using the ProC-F was used to evaluate diagnostic yield of ProC-F. The second puncture was performed using a 22G standard FNA needle using the same technique as for the first puncture. Second puncture was performed if the endosonographer did not feel that sufficient tissue had not been obtained by first puncture. Fifty-three consecutive patients who underwent EUS-FNA for pancreatic lesions were prospectively enrolled. The technical success rate of EUS-FNA using the ProC-F was 98.1% (52/53). The rate of adequate tissue obtained by ProC-F was 96.2% (50/52). On the other hand, the rate of adequate tissue obtained by the standard needle was 71.1%. The sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV), and accuracy of the ProC-F and the standard needle were 92.5, 100, 100, 76.9, and 94.0%, and 85.2, 100, 100, 55.6, and 87.5%, respectively. Diagnostic yield of ProC-F about sensitivity (P = 0.027), NPV (P = 0.035), and accuracy (P = 0.004) was significantly higher than of standard needle. Adverse events were not seen in any patients. Although only tissue obtained by the first puncture was evaluated, the rate of adequate tissue and the histologic diagnostic yield for pancreatic lesions were extremely high using the ProC-F.
- Published
- 2017
25. Robotic surgery for gastric cancer
- Author
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Yuichiro Miki, Rie Makuuchi, Hayato Omori, Etsuro Bando, Taichi Tatsubayashi, Shinsaku Honda, Wataru Takagi, Taaichi Kawamura, Fumiko Hirata, Masanori Tokunaga, Masanori Terashima, and Yutaka Tanizawa
- Subjects
Cancer Research ,medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,General surgery ,Forceps ,Gastroenterology ,General Medicine ,Da Vinci Surgical System ,Surgery ,Clinical trial ,Dissection ,Robotic Surgical Procedures ,Oncology ,Gastrectomy ,Stomach Neoplasms ,Surgical oncology ,medicine ,Humans ,Minimally Invasive Surgical Procedures ,Laparoscopy ,Robotic surgery ,business ,Abdominal surgery - Abstract
Laparoscopic gastrectomy is a widely used minimally invasive surgery for gastric cancer. However, skillful techniques are required to perform lymph node dissection using straight shaped forceps, particularly for D2 dissection. Robotic surgery using the da Vinci surgical system is anticipated to be a powerful tool for performing difficult techniques using high-resolution three-dimensional (3D) images and the EndoWrist equipped with seven degrees of freedom. Attempts are being made to apply robotic surgery in gastrectomy procedures mainly in Japan, South Korea, and Europe. Although definite superiority to laparoscopic gastrectomy is yet to be proven, robotic surgery has been reported to have a shorter learning curve and offer more precise dissection for total gastrectomy. Hence, its oncological efficacy needs to be verified in a clinical trial.
- Published
- 2015
26. Early eicosapentaenoic acid treatment after percutaneous coronary intervention reduces acute inflammatory responses and ventricular arrhythmias in patients with acute myocardial infarction: A randomized, controlled study
- Author
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Mutsumi Iwamoto, Hiroshi Ito, Toru Miyoshi, Wataru Takagi, Masayuki Doi, Keisuke Okawa, Rie Nakayama, Satoshi Hirohata, Kazumasa Nosaka, Masahito Kajiya, and Ko Takeda
- Subjects
Male ,medicine.medical_specialty ,Endpoint Determination ,medicine.medical_treatment ,law.invention ,Percutaneous Coronary Intervention ,Randomized controlled trial ,law ,Interquartile range ,Internal medicine ,medicine ,Clinical endpoint ,Humans ,Prospective Studies ,cardiovascular diseases ,Myocardial infarction ,Stroke ,Anterior Wall Myocardial Infarction ,Aged ,Inflammation ,biology ,business.industry ,C-reactive protein ,Percutaneous coronary intervention ,Arrhythmias, Cardiac ,medicine.disease ,Combined Modality Therapy ,C-Reactive Protein ,Treatment Outcome ,Eicosapentaenoic Acid ,Conventional PCI ,Cardiology ,biology.protein ,Female ,Cardiology and Cardiovascular Medicine ,business - Abstract
We examined whether early loading of eicosapentaenoic acid (EPA) reduces clinical adverse events by 1 month, accompanied by a decrease in C-reactive protein (CRP) values in patients with acute myocardial infarction (MI).Acute MI triggers an inflammatory reaction, which plays an important role in myocardial injury. EPA could attenuate the inflammatory response.This prospective, open-label, blinded endpoint, randomized trial consisted of 115 patients with acute MI. They were randomly assigned to the EPA group (57 patients) and the control group (58 patients). After percutaneous coronary intervention (PCI), 1800 mg/day of EPA was initiated within 24h. The primary endpoint was composite events, including cardiac death, stroke, re-infarction, ventricular arrhythmias, and paroxysmal atrial fibrillation within 1 month.Administration of EPA significantly reduced the primary endpoint within 1 month (10.5 vs 29.3%, p=0.01), especially the incidence of ventricular arrhythmias (7.0 vs 20.6%, p=0.03). Peak CRP values after PCI in the EPA group were significantly lower than those in the control group (median [interquartile range], 8.2 [5.6-10.2] mg/dl vs 9.7 [7.6-13.9] mg/dl, p0.01). Logistic regression analysis showed that EPA use was an independent factor related to ventricular arrhythmia until 1 month, with an odds ratio of 0.29 (95% confidence interval, 0.09 to 0.96, p=0.04).Early EPA treatment after PCI in the acute stage of MI reduces the incidence of ventricular arrhythmias, and lowers CRP values.
- Published
- 2014
27. CTCF binding landscape in jawless fish with reference to Hox cluster evolution
- Author
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Osamu Nishimura, Wataru Takagi, Chiharu Tanegashima, Shigehiro Kuraku, Kaori Tanaka, Mitsutaka Kadota, and Yuichiro Hara
- Subjects
0301 basic medicine ,Most recent common ancestor ,Fish Proteins ,CCCTC-Binding Factor ,Chromatin Immunoprecipitation ,Science ,Insulator (genetics) ,Article ,Evolution, Molecular ,03 medical and health sciences ,Phylogenetics ,Gene Duplication ,Gene duplication ,Animals ,Humans ,Hox gene ,Phylogeny ,Genetics ,Homeodomain Proteins ,Multidisciplinary ,Binding Sites ,biology ,Lamprey ,Lampreys ,Sequence Analysis, DNA ,biology.organism_classification ,Chromatin ,030104 developmental biology ,CTCF ,Multigene Family ,Medicine ,Protein Binding - Abstract
The nuclear protein CCCTC-binding factor (CTCF) contributes as an insulator to chromatin organization in animal genomes. Currently, our knowledge of its binding property is confined mainly to mammals. In this study, we identified CTCF homologs in extant jawless fishes and performed ChIP-seq for the CTCF protein in the Arctic lamprey. Our phylogenetic analysis suggests that the lamprey lineage experienced gene duplication that gave rise to its unique paralog, designated CTCF2, which is independent from the previously recognized duplication between CTCF and CTCFL. The ChIP-seq analysis detected comparable numbers of CTCF binding sites between lamprey, chicken, and human, and revealed that the lamprey CTCF protein binds to the two-part motif, consisting of core and upstream motifs previously reported for mammals. These findings suggest that this mode of CTCF binding was established in the last common ancestor of extant vertebrates (more than 500 million years ago). We analyzed CTCF binding inside Hox clusters, which revealed a reinforcement of CTCF binding in the region spanning Hox1-4 genes that is unique to lamprey. Our study provides not only biological insights into the antiquity of CTCF-based epigenomic regulation known in mammals but also a technical basis for comparative epigenomic studies encompassing the whole taxon Vertebrata.
- Published
- 2017
28. Distributional shift of urea production site from the extraembryonic yolk sac membrane to the embryonic liver during the development of cloudy catshark (Scyliorhinus torazame)
- Author
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Kumi Hasegawa, Susumu Hyodo, Hironori Tanaka, Shuntaro Ogawa, Makiko Kajimura, and Wataru Takagi
- Subjects
030110 physiology ,0301 basic medicine ,medicine.medical_specialty ,Physiology ,Biochemistry ,Andrology ,03 medical and health sciences ,chemistry.chemical_compound ,Internal medicine ,Sequence Homology, Nucleic Acid ,medicine ,Urea homeostasis ,Animals ,Urea ,Yolk sac ,Cloning, Molecular ,Molecular Biology ,Yolk Sac ,biology ,Base Sequence ,Gene Expression Regulation, Developmental ,Embryo ,Ornithine ,biology.organism_classification ,Scyliorhinus torazame ,Catshark ,Enzymes ,030104 developmental biology ,Endocrinology ,medicine.anatomical_structure ,chemistry ,Liver ,Urea cycle ,Oviparity ,Elasmobranchii - Abstract
Urea is an essential osmolyte for marine cartilaginous fishes. Adult elasmobranchs and holocephalans are known to actively produce urea in the liver, muscle and other extrahepatic organs; however, osmoregulatory mechanisms in the developing cartilaginous fish embryo with an undeveloped urea-producing organ are poorly understood. We recently described the contribution of extraembryonic yolk sac membranes (YSM) to embryonic urea synthesis during the early developmental period of the oviparous holocephalan elephant fish (Callorhinchus milii). In the present study, to test whether urea production in the YSM is a general phenomenon among oviparous Chondrichthyes, we investigated gene expression and activities of ornithine urea cycle (OUC) enzymes together with urea concentrations in embryos of the elasmobranch cloudy catshark (Scyliorhinus torazame). The intracapsular fluid, in which the catshark embryo develops, had a similar osmolality to seawater, and embryos maintained a high concentration of urea at levels similar to that of adult plasma throughout development. Relative mRNA expressions and activities of catshark OUC enzymes were significantly higher in YSM than in embryos until stage 32. Concomitant with the development of the embryonic liver, the expression levels and activities of OUC enzymes were markedly increased in the embryo from stage 33, while those of the YSM decreased from stage 32. The present study provides further evidence that the YSM contributes to embryonic urea homeostasis until the liver and other extrahepatic organs become fully functional, and that urea-producing tissue shifts from the YSM to the embryonic liver in the late developmental period of oviparous marine cartilaginous fishes.
- Published
- 2017
29. Endoscopic ultrasound-guided choledochoduodenostomy for obstructive jaundice with venous collaterals around the bile duct wall (with video)
- Author
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Toshihisa Takeuchi, Saori Onda, Takeshi Ogura, Shinya Fukunishi, Kazuhide Higuchi, and Wataru Takagi
- Subjects
Endoscopic ultrasound ,medicine.medical_specialty ,Hepatology ,medicine.diagnostic_test ,Bile duct ,business.industry ,Gastroenterology ,medicine.anatomical_structure ,medicine ,Radiology, Nuclear Medicine and imaging ,Obstructive jaundice ,Radiology ,business ,Images and Videos - Published
- 2017
30. Prospective evaluation of digital single-operator cholangioscope for diagnostic and therapeutic procedures (with videos)
- Author
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Tadahiro Yamada, Atsushi Okuda, Takeshi Ogura, Mamoru Takenaka, Kazuhide Higuchi, Yoshitaka Kurisu, Akira Miyano, Nobu Nishioka, Mio Amano, Miyuki Imanishi, Daisuke Masuda, Saori Onda, Wataru Takagi, Tastsushi Sano, and Masayuki Kitano
- Subjects
Male ,medicine.medical_specialty ,Biliary Tract Diseases ,Therapeutic Procedure ,Risk Assessment ,Sensitivity and Specificity ,Prospective evaluation ,Electrohydraulic lithotripsy ,Biliary disease ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,Japan ,Predictive Value of Tests ,Biopsy ,medicine ,Humans ,Minimally Invasive Surgical Procedures ,Radiology, Nuclear Medicine and imaging ,Prospective Studies ,Adverse effect ,Aged ,Aged, 80 and over ,Cholangiopancreatography, Endoscopic Retrograde ,Endoscopic retrograde cholangiopancreatography ,medicine.diagnostic_test ,business.industry ,General surgery ,Biopsy, Needle ,Gastroenterology ,Middle Aged ,medicine.disease ,Immunohistochemistry ,Biliary Tract Surgical Procedures ,Treatment Outcome ,Biliary tract ,030220 oncology & carcinogenesis ,030211 gastroenterology & hepatology ,Female ,Radiology ,business ,Cholangiography - Abstract
Background and Aim Recently, the digital single-operator cholangioscope (SPY-DS) has become available. This system may allow diagnosis by direct visualization and allow performance of various therapeutic procedures. The aim of the present study was to prospectively evaluate the clinical utility of DSOCS for diagnostic and therapeutic procedures for biliary disease. Methods Technical success was defined as successful visualization of target lesions in the biliary tract and carrying out forceps biopsy as a diagnostic procedure, and successfully carrying out treatment such as guidewire insertion for the area of interest, electrohydraulic lithotripsy (EHL), or migrated stent removal. Also, the present study aimed at investigating diagnostic yield of the cholangioscopic findings and biopsy specimens. Results A total of 55 consecutive patients were prospectively enrolled in this study; a diagnostic procedure was done in 33 patients, and a therapeutic procedure was done in 22 patients. Overall accuracy of visual findings was 93%, with a sensitivity of 83%, a specificity of 89%, positive predictive value (PPV) of 83%, and negative predictive value (NPV) of 100%. However, the overall accuracy of forceps biopsy was 89%, with a sensitivity, specificity, and PPV of 100%, and NPV of 90%. Overall technical success rate of therapeutic procedures such as selective guidewire insertion, EHL or migrated stent removal was 91% (20/22). Finally, adverse events were seen in two cases in the diagnostic group, but were not seen in the therapeutic group. Conclusion Although additional cases and a randomized, controlled study with another cholangioscope are needed, diagnostic and therapeutic procedures using SPY-DS appear to be feasible and safe.
- Published
- 2017
31. Tu1358 PILOT STUDY OF DUMBBELL-TYPE COVERED SELF-EXPANDABLE METAL STENT DEPLOYMENT FOR BENIGN PANCREATIC DUCT STRICTURE
- Author
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Masanori Yamada, Atsushi Okuda, Daisuke Masuda, Rieko Kamiyama, Akira Imoto, Miyuki Imanishi, Nobu Nishioka, Kazuhide Higuchi, Tatsushi Sano, Saori Ueno, Akira Miyano, Wataru Takagi, Mio Amano, and Takeshi Ogura
- Subjects
medicine.medical_specialty ,business.industry ,Stent deployment ,Self expandable ,Pancreatic duct stricture ,Gastroenterology ,Medicine ,Radiology, Nuclear Medicine and imaging ,Dumbbell ,business ,Surgery - Published
- 2019
32. Tu1378 EUS-GUIDED ANTEGRADE METAL STENT DEPLOYMENT FOR BENIGN HEPATICOJEJUNOSTOMY ANASTOMOSIS STRICTURE
- Author
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Mio Amano, Daisuke Masuda, Rieko Kamiyama, Saori Ueno, Akira Miyano, Nobu Nishioka, Tatsushi Sano, Akira Imoto, Masanori Yamada, Atsushi Okuda, Takeshi Ogura, Wataru Takagi, Kazuhide Higuchi, and Miyuki Imanishi
- Subjects
medicine.medical_specialty ,Stent deployment ,business.industry ,Gastroenterology ,medicine ,Radiology, Nuclear Medicine and imaging ,Anastomosis ,business ,Surgery - Published
- 2019
33. Tu1398 TECHNICAL FEASIBILITY STUDY OF EUS-GUIDED ANTEGRADE DILATION FOR HEPATICOJEJUNOSTOMY ANASTOMOTIC STRICTURE USING NOVEL ENDOSCOPIC DEVICE
- Author
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Kazuhide Higuchi, Masanori Yamada, Daisuke Masuda, Wataru Takagi, Nobu Nishioka, Atsushi Okuda, Akira Miyano, Tatsushi Sano, Miyuki Imanishi, Akira Imoto, Takeshi Ogura, Saori Ueno, Mio Amano, and Rieko Kamiyama
- Subjects
medicine.medical_specialty ,Technical feasibility ,business.industry ,Gastroenterology ,medicine ,Dilation (morphology) ,Radiology, Nuclear Medicine and imaging ,Radiology ,Anastomosis ,business - Published
- 2019
34. Sa1434 CLINICAL EVALUATIN OF THE NOVEL UNCOVERDE METAL STENT FOR MALIGNANT HILAR STRICTURE USING THROUGH THE MESH TECHNIQUE
- Author
-
Masanori Yamada, Akira Imoto, Wataru Takagi, Tatsushi Sano, Rieko Kamiyama, Miyuki Imanishi, Takeshi Ogura, Nobu Nishioka, Akira Miyano, Mio Amano, Kazuhide Higuchi, Atsushi Okuda, Saori Ueno, and Daisuke Masuda
- Subjects
medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Gastroenterology ,Medicine ,Stent ,Radiology, Nuclear Medicine and imaging ,Radiology ,business - Published
- 2019
35. Tu1377 EUS-GUIDED VERSUS PERCUTANEOUS BILIARY ACCESS IN PATIENTS WITH OBSTRUCTIVE JAUNDICE DUE TO GASTRIC CANCER
- Author
-
Takeshi Ogura, Wataru Takagi, Atsushi Okuda, Kazuhide Higuchi, Akira Imoto, Tatsushi Sano, Nobu Nishioka, Miyuki Imanishi, Daisuke Masuda, Mio Amano, Rieko Kamiyama, Saori Ueno, Akira Miyano, and Masanori Yamada
- Subjects
medicine.medical_specialty ,Percutaneous ,business.industry ,Internal medicine ,Gastroenterology ,medicine ,Cancer ,Radiology, Nuclear Medicine and imaging ,Obstructive jaundice ,In patient ,business ,medicine.disease - Published
- 2019
36. Tu1359 DIAGNOSTIC YIELD OF BILE CYTOLOGY UNDER ENDOSCOPIC TRANSPAPILLARY GALLBLADDER DRAINAGE AND EUS-FNA FOR THICK-WALLED GALLBLADDERS
- Author
-
Wataru Takagi, Mio Amano, Takeshi Ogura, Atsushi Okuda, Daisuke Masuda, Kazuhide Higuchi, Miyuki Imanishi, Akira Imoto, Saori Ueno, Akira Miyano, Rieko Kamiyama, Nobu Nishioka, Masanori Yamada, and Tatsushi Sano
- Subjects
medicine.medical_specialty ,Yield (engineering) ,medicine.anatomical_structure ,business.industry ,Gallbladder ,Cytology ,Gastroenterology ,Medicine ,Radiology, Nuclear Medicine and imaging ,Radiology ,Drainage ,business - Published
- 2019
37. Placement of a 6 mm, fully covered metal stent for main pancreatic head duct stricture due to chronic pancreatitis: a pilot study (with video)
- Author
-
Takeshi Ogura, Masayuki Kitano, Shinya Fukunishi, Wataru Takagi, Tastsushi Sano, Toshihisa Takeuchi, Daisuke Masuda, Atsushi Okuda, Kazuhide Higuchi, Akira Miyano, and Saori Onda
- Subjects
Abdominal pain ,medicine.medical_specialty ,pancreatic duct stent placement ,medicine.medical_treatment ,Stent patency ,Pancreatic head ,chronic pancreatitis ,03 medical and health sciences ,ERCP ,0302 clinical medicine ,Medicine ,cardiovascular diseases ,lcsh:RC799-869 ,Original Research ,Pancreatic duct ,business.industry ,Gastroenterology ,Stent ,medicine.disease ,equipment and supplies ,Surgery ,Pancreatic Duct Stenosis ,medicine.anatomical_structure ,surgical procedures, operative ,030220 oncology & carcinogenesis ,covered metal stent ,Pancreatitis ,lcsh:Diseases of the digestive system. Gastroenterology ,030211 gastroenterology & hepatology ,Radiology ,medicine.symptom ,business ,Duct (anatomy) - Abstract
Background: Temporary stent placement is widely performed for pancreatic duct stenosis due to chronic pancreatitis. A fully covered self-expandable metal stent (FCSEMS) has a larger diameter, and therefore longer stent patency, and the effect of expansion of the main pancreatic duct stricture may be obtained. However, if stent migration upstream occurs, stent removal is extremely difficult. In addition, because of the diameter gap between the FCSEMS and the main pancreatic duct, stent-induced ductal change may occur. To prevent these adverse events, the technical feasibility, safety and efficacy of the placement of a novel 6 mm diameter FCSEMS with a long suture, to facilitate its removal in cases of stent migration upstream, were evaluated in a pilot study. Methods: Between December 2014 and August 2015, symptomatic chronic pancreatitis patients with abdominal pain and a main pancreatic head duct stricture were enrolled. Stent placement for main pancreatic duct stricture was performed under endoscopic retrograde cholangiopancreatography (ERCP) guidance and stent removal was performed within 6 months. Results: A total of 13 patients were retrospectively enrolled in this study. Metal stent insertion was successfully performed in all patients and clinical success was high (12/13, 92%). As adverse events, stent migration upstream was seen in two patients. Another 11 patients successfully underwent stent removal without any adverse events. During follow up (median 258 days), 2 patients still underwent pancreatic duct stenting because of continuing main pancreatic duct stricture. Conclusion: In conclusion, this novel FCSEMS is acceptable for stent placement in cases of chronic pancreatitis with a main pancreatic duct stricture.
- Published
- 2016
38. Sulfate transporters involved in sulfate secretion in the kidney are localized in the renal proximal tubule II of the elephant fish (Callorhinchus milii)
- Author
-
Taro Watanabe, Kumi Hasegawa, Wataru Takagi, Justin D. Bell, Susumu Hyodo, John A. Donald, Tes Toop, Akira Kato, and Michael F. Romero
- Subjects
0301 basic medicine ,Fish Proteins ,medicine.medical_specialty ,Fluid and Electrolyte Homeostasis ,DNA, Complementary ,Embryo, Nonmammalian ,Physiology ,Xenopus ,Kidney ,Kidney Tubules, Proximal ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Physiology (medical) ,Internal medicine ,medicine ,Animals ,Secretion ,Tissue Distribution ,Amino Acid Sequence ,Sulfate ,biology ,Membrane transport protein ,Sulfates ,Membrane Transport Proteins ,Transporter ,Nephrons ,biology.organism_classification ,030104 developmental biology ,medicine.anatomical_structure ,Endocrinology ,chemistry ,biology.protein ,Oocytes ,Elephant fish ,030217 neurology & neurosurgery ,Electric Fish - Abstract
Most vertebrates, including cartilaginous fishes, maintain their plasma SO42−concentration ([SO42−]) within a narrow range of 0.2–1 mM. As seawater has a [SO42−] about 40 times higher than that of the plasma, SO42−excretion is the major role of kidneys in marine teleost fishes. It has been suggested that cartilaginous fishes also excrete excess SO42−via the kidney. However, little is known about the underlying mechanisms for SO42−transport in cartilaginous fish, largely due to the extraordinarily elaborate four-loop configuration of the nephron, which consists of at least 10 morphologically distinguishable segments. In the present study, we determined cDNA sequences from the kidney of holocephalan elephant fish ( Callorhinchus milii) that encoded solute carrier family 26 member 1 (Slc26a1) and member 6 (Slc26a6), which are SO42−transporters that are expressed in mammalian and teleost kidneys. Elephant fish Slc26a1 (cmSlc26a1) and cmSlc26a6 mRNAs were coexpressed in the proximal II (PII) segment of the nephron, which comprises the second loop in the sinus zone. Functional analyses using Xenopus oocytes and the results of immunohistochemistry revealed that cmSlc26a1 is a basolaterally located electroneutral SO42−transporter, while cmSlc26a6 is an apically located, electrogenic Cl−/SO42−exchanger. In addition, we found that both cmSlc26a1 and cmSlc26a6 were abundantly expressed in the kidney of embryos; SO42−was concentrated in a bladder-like structure of elephant fish embryos. Our results demonstrated that the PII segment of the nephron contributes to the secretion of excess SO42−by the kidney of elephant fish. Possible mechanisms for SO42−secretion in the PII segment are discussed.
- Published
- 2016
39. Anterior mediastinum tumor diagnosed by EUS-guided FNA from the hypopharynx
- Author
-
Yoshitaka Kurisu, Kazuhide Higuchi, Wataru Takagi, Takeshi Ogura, and Shinya Fukunishi
- Subjects
Male ,medicine.medical_specialty ,business.industry ,Gastroenterology ,Anterior mediastinum ,Mediastinal Neoplasms ,Hypopharynx ,Text mining ,medicine ,Carcinoma, Squamous Cell ,Humans ,Radiology, Nuclear Medicine and imaging ,Radiology ,business ,Tomography, X-Ray Computed ,Endoscopic Ultrasound-Guided Fine Needle Aspiration ,Aged - Published
- 2016
40. EUS-guided FNA for biliary disease as first-line modality to obtain histological evidence
- Author
-
Yoshitaka Kurisu, Daisuke Masuda, Tatsushi Sano, Wataru Takagi, Shinya Fukunishi, Kazuhide Higuchi, Saori Onda, and Takeshi Ogura
- Subjects
Endoscopic ultrasound ,medicine.medical_specialty ,Endoscopic retrograde cholangiopancreatography ,medicine.diagnostic_test ,business.industry ,First line ,Gastroenterology ,medicine.disease ,Biliary cancer ,Biliary disease ,03 medical and health sciences ,0302 clinical medicine ,Fine-needle aspiration ,030220 oncology & carcinogenesis ,medicine ,030211 gastroenterology & hepatology ,lcsh:Diseases of the digestive system. Gastroenterology ,Radiology ,lcsh:RC799-869 ,business ,Original Research - Abstract
Background: Few reports have described endoscopic ultrasound (EUS)-guided fine needle aspiration (FNA) for biliary lesions. In addition, adverse events were not completely examined in previous reports, due to the inclusion of cases in which biliary stents had already been placed. The present study aimed to investigate the diagnostic yield and adverse events of EUS-FNA for biliary lesions as the first-line diagnostic modality for consecutive prospectively registered patients. Methods: Inclusion criteria were as follows: (1) patients with suspected cholangiocarcinoma (CCA) based on computed tomography or other imaging modalities; (2) patients who had not previously undergone endoscopic retrograde cholangiopancreatography or EUS-FNA; (3) absence of surgically altered anatomy, such as Roux-en-Y anastomosis or duodenal obstruction caused by tumor invasion, through which an endoscope could not pass; and (4) provision of written informed consent to all procedures associated with the study. Results: A total of 47 consecutive patients with suspected CCA were registered to this study. Sensitivity and accuracy were 89% and 87%, respectively. On multivariate analysis, puncture site was the only factor associated with reduced diagnostic yield (hazard ration, 6.879; 95% confidence interval, 1.172–40.374; P = 0.033). Remarkably, no adverse events such as bleeding or bile leakage were associated with EUS-FNA in any of the 47 patients. Conclusions: Our results suggest that EUS-FNA can be safely performed for biliary disease without biliary stenting. Furthermore, this procedure may warrant use as the first-line diagnostic method, although our results need to be validated in future prospective studies.
- Published
- 2016
41. EUS-guided cholecystoduodenostomy for acute cholecystitis with an anti-stent migration and anti-food impaction system; a pilot study
- Author
-
Daisuke Masuda, Akira Imoto, Wataru Takagi, Shinya Fukunishi, Atsushi Okuda, Toshihisa Takeuchi, Takeshi Ogura, Kazuhide Higuchi, Tatsushi Sano, and Saori Onda
- Subjects
medicine.medical_specialty ,Common bile duct ,business.industry ,Impaction ,medicine.medical_treatment ,Gastroenterology ,Stent ,medicine.disease ,System a ,digestive system diseases ,03 medical and health sciences ,0302 clinical medicine ,medicine.anatomical_structure ,Pneumoperitoneum ,030220 oncology & carcinogenesis ,medicine ,Acute cholecystitis ,Cystic duct ,030211 gastroenterology & hepatology ,lcsh:Diseases of the digestive system. Gastroenterology ,Radiology ,lcsh:RC799-869 ,business ,Adverse effect ,Original Research - Abstract
Background: Recently, endoscopic ultrasound-guided gall bladder drainage (EUS-GBD) has been reported using a self-expandable metallic stent. To prevent stent migration and food flowing into the common bile duct through the cystic duct, we perform a novel EUS-guided cholecystoduodenostomy. The aim of our study was to evaluate the safety and feasibility of EUS-guided cholecystoduodenostomy with an anti-stent migration and anti-food impaction system. Methods: A total of 16 consecutive patients who underwent EUS-guided cholecystoduodenostomy for acute cholecystitis were included in this study. Results: Technical and clinical success was obtained in all patients. The median procedure time was 26.9 min (range 19–42 min). Median follow-up time was 181.5 days (range 18–604 days), and in this time, recurrence of acute cholecystitis was not seen in all patients. Adverse events such as stent migration and cholangitis were not seen in any patients, although pneumoperitoneum was seen in one patient. Conclusion: Our technique may be favorable and effective for the prevention of adverse events on EUS-GBD.
- Published
- 2016
42. A Duodenal Ulcer Caused by Pancreatic Ductal Hypertension with Chronic Pancreatitis
- Author
-
Takashi Mikami, Malak Mohamed, Wataru Takagi, Tatsushi Sano, Akira Imoto, Takeshi Ogura, Daisuke Masuda, Kazuhide Higuchi, Saori Onda, and Atsushi Okuda
- Subjects
medicine.medical_specialty ,Abdominal pain ,Contrast imaging ,Gastroenterology ,Catheterization ,Internal medicine ,Pancreatitis, Chronic ,Internal Medicine ,Medicine ,Humans ,Medical history ,Pancreatic carcinoma ,Aged ,medicine.diagnostic_test ,business.industry ,Pancreatic Ducts ,Endoscopy ,General Medicine ,medicine.disease ,Surgery ,Abdominal Pain ,Duodenal ulcer ,Treatment Outcome ,Upper abdominal pain ,Duodenal Ulcer ,Chronic Disease ,Hypertension ,Pancreatitis ,Female ,medicine.symptom ,business - Abstract
We herein describe the case of a 67-year-old woman with a duodenal ulcer thought to be caused by elevated pancreatic ductal pressure. The patient complained of continuous upper abdominal pain. Her medical history included idiopathic chronic pancreatitis. Endoscopy revealed a huge duodenal ulcer located on the inferior duodenal angle, which had not been seen on endoscopic retrograde pancreatography two months previously. A combination study using endoscopy and contrast imaging confirmed the relationship between the duodenal ulcer and the pancreatic branch duct. To our knowledge, this is the first case of duodenal ulcer thought to be caused by elevated pancreatic ductal pressure.
- Published
- 2015
43. Endoscopic ultrasound-guided biliary drainage with a novel fine-gauge balloon catheter: simplified technique using a coaxial guidewire
- Author
-
Shinya Fukunishi, Saori Onda, Toshihisa Takeuchi, Kazuhide Higuchi, Wataru Takagi, Takeshi Ogura, and Daisuke Masuda
- Subjects
Endoscopic ultrasound ,medicine.medical_specialty ,Biliary drainage ,Catheters ,medicine.diagnostic_test ,business.industry ,Gastroenterology ,Balloon catheter ,Endosonography ,Jaundice, Obstructive ,Medicine ,Drainage ,Humans ,Female ,Radiology ,Ultrasonography ,Coaxial ,business ,Ultrasonography, Interventional ,Aged - Published
- 2015
44. Hole-making technique for the treatment for acute pancreatitis due to placement of a fully covered duodenal metallic stent
- Author
-
Wataru Takagi, Kazuhide Higuchi, Shinya Fukunishi, Tatsushi Sano, Saori Onda, Daisuke Masuda, and Takeshi Ogura
- Subjects
Male ,medicine.medical_specialty ,Endoscope ,medicine.medical_treatment ,Duodenal stenosis ,medicine ,Humans ,Aged ,business.industry ,Gastroenterology ,Stent ,equipment and supplies ,medicine.disease ,Surgery ,Stenosis ,medicine.anatomical_structure ,Pancreatitis ,Acute Disease ,Duodenum ,Vomiting ,Acute pancreatitis ,Stents ,Radiology ,Duodenal Obstruction ,medicine.symptom ,business - Abstract
Duodenal stent placement has been developed as an alternative to surgical gastrojejunostomy [1]. Compared with uncovered metallic stents, duodenal fully covered metallic stents offer advantages, such as the prevention of tumor ingrowth, and thus lower occlusion rates [2]. However, duodenal fully covered metallic stents also have several disadvantages, such as stent migration [3]. Acute pancreatitis is another adverse event associated with duodenal stent placement, occurring at a frequency of approximately 4% [4,5]. In previous reports, acute pancreatitis has been treated conservatively. If a fully covered metallic stent is placed in the duodenum, the frequency of acute pancreatitis may be increased, and the treatment of acute pancreatitis may prove difficult. We report herein a novel treatment for acute pancreatitis due to duodenal placement of a fully covered metallic stent. A 78-year-old man was admitted to our hospital because of vomiting and obstructive jaundice. He was undergoing chemotherapy for bladder cancer. Computed tomography showed a duodenal stenosis, attributed to lymph node metastasis. No other site of stenosis was detected, so we attempted duodenal stent placement. First, we advanced the endoscope into the duodenum, and contrast medium was injected. The second part of the duodenum was obstructed (●" Fig.1). Then, we placed a fully covered metallic stent (ComVi, 20mm×12 cm; TaeWoong Medical, Seoul, South Korea) in the duodenum (●" Fig.2). Although the vomiting resolved completely, acute pancreatitis developed. Computed tomography showed dilatation of the Fig.1 A duodenal stenosis is apparent (arrows) in a 78-year-oldmanadmittedwith vomitingand obstructive jaundice.
- Published
- 2015
45. Endoscopic hemostasis for tumor bleeding using intraductal radiofrequency ablation
- Author
-
Takeshi Ogura, Saori Ueno, Kazuhide Higuchi, Wataru Takagi, Shinya Fukunishi, and Toshihisa Takeuchi
- Subjects
Aged, 80 and over ,Male ,0301 basic medicine ,medicine.medical_specialty ,business.industry ,Radiofrequency ablation ,Hemostasis, Endoscopic ,Gastroenterology ,Hemorrhage ,Surgery ,law.invention ,Cholangiocarcinoma ,03 medical and health sciences ,Endoscopic hemostasis ,030104 developmental biology ,0302 clinical medicine ,Text mining ,Bile Duct Neoplasms ,law ,030220 oncology & carcinogenesis ,Catheter Ablation ,Humans ,Medicine ,Radiology ,business - Published
- 2016
46. Sa1302 PROSPECTIVE EVALUATION OF DIGITAL SINGLE-OPERATOR CHOLANGIOSCOPE FOR DIAGNOSTIC AND THERAPEUTIC PROCEDURES
- Author
-
Atsushi Okuda, Akira Imoto, Saori Onda, Kazuhide Higuchi, Wataru Takagi, Daisuke Masuda, Akira Miyano, Takeshi Ogura, Miyuki Imanishi, Mio Amano, Nobu Nishioka, and Tatsushi Sano
- Subjects
medicine.medical_specialty ,Operator (computer programming) ,business.industry ,Gastroenterology ,medicine ,Radiology, Nuclear Medicine and imaging ,Medical physics ,business ,Prospective evaluation - Published
- 2018
47. Su1404 EUS-GUIDED FNA FOR BILE DUCT LESIONS TO OBTAIN HISTOLOGICAL EVIDENCE AS FIRST-LINE MODALITY
- Author
-
Saori Onda, Kazuhide Higuchi, Akira Miyano, Wataru Takagi, Akira Imoto, Miyuki Imanishi, Nobu Nishioka, Atsushi Okuda, Tatsushi Sano, Takeshi Ogura, and Daisuke Masuda
- Subjects
medicine.medical_specialty ,medicine.anatomical_structure ,Modality (human–computer interaction) ,Bile duct ,business.industry ,First line ,Gastroenterology ,medicine ,Radiology, Nuclear Medicine and imaging ,Radiology ,business - Published
- 2018
48. Su1392 CLINICAL EVALUATION OF EUS-GUIDED TRANSLUMINAL BILIARY DRAINAGE USING NOVEL BALLOON CATHETER
- Author
-
Saori Onda, Akira Imoto, Akira Miyano, Atsushi Okuda, Wataru Takagi, Nobu Nishioka, Miyuki Imanishi, Kazuhide Higuchi, Daisuke Masuda, Tatsushi Sano, and Takeshi Ogura
- Subjects
Biliary drainage ,medicine.medical_specialty ,business.industry ,Gastroenterology ,Balloon catheter ,medicine ,Radiology, Nuclear Medicine and imaging ,Radiology ,business ,Clinical evaluation - Published
- 2018
49. Mo1321 PROSPECTIVE COMPARISON STUDY OF FRANSEEN NEEDLE AND STANDARD NEEDLE USE FOR PANCREATIC LESIONS UNDER EUS-GUIDANCE
- Author
-
Masanori Yamada, Nobu Nishioka, Kazuhide Higuchi, Atsushi Okuda, Takeshi Ogura, Tatsushi Sano, Mio Amano, Akira Miyano, Rieko Kamiyama, Akira Imoto, Saori Ueno, Daisuke Masuda, Miyuki Imanishi, and Wataru Takagi
- Subjects
03 medical and health sciences ,medicine.medical_specialty ,0302 clinical medicine ,business.industry ,030220 oncology & carcinogenesis ,Gastroenterology ,medicine ,Comparison study ,030211 gastroenterology & hepatology ,Radiology, Nuclear Medicine and imaging ,Radiology ,business - Published
- 2018
50. Su1412 COMPARATIVE STUDY OF THE CLINICAL BENFIT OF EUS-GUIDED HEPATICOGSATROSTOMY AND CHOLEDOCHODUODENOSTOMY FOR BILE DUCT OBSTRUCTION COMPLICATED WITH DUODENAL OBSTRUCTION
- Author
-
Nobu Nishioka, Saori Onda, Tatsushi Sano, Takeshi Ogura, Wataru Takagi, Atsushi Okuda, Daisuke Masuda, Kazuhide Higuchi, Miyuki Imanishi, Mio Amano, Akira Miyano, and Akira Imoto
- Subjects
medicine.medical_specialty ,medicine.anatomical_structure ,Bile duct ,business.industry ,Gastroenterology ,medicine ,Radiology, Nuclear Medicine and imaging ,Radiology ,business - Published
- 2018
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