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1. Risk of Pancreatitis Following Biliary Stenting With/Without Endoscopic Sphincterotomy: A Randomized Controlled Trial

Author

Kato, Shin, Kuwatani, Masaki, Onodera, Manabu, Kudo, Taiki, Sano, Itsuki, Katanuma, Akio, Uebayashi, Minoru, Eto, Kazunori, Fukasawa, Mitsuharu, Hashigo, Shunpei, Iwashita, Takuji, Yoshida, Makoto, Taya, Yoko, Kawakami, Hiroshi, Kato, Hironari, Nakai, Yousuke, Kobashigawa, Kasen, Kawahata, Shuhei, Shinoura, Susumu, Ito, Kei, Kubo, Kimitoshi, Yamato, Hiroaki, Hara, Kazuo, Maetani, Iruru, Mukai, Tsuyoshi, Shibukawa, Goro, and Itoi, Takao

Published
2022
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3. Risk factors for recurrent biliary obstruction following endoscopic biliary stenting in patients with unresectable ampullary cancer: A multicenter retrospective study.

Author

Sugiura, Ryo, Kuwatani, Masaki, Kin, Toshifumi, Matsumoto, Ryusuke, Ikeda, Yuki, Sano, Itsuki, Hirata, Koji, Yoshida, Makoto, Masaki, Yoshiharu, Ono, Michihiro, Hirata, Hajime, Yamato, Hiroaki, Onodera, Manabu, Nakamura, Hideaki, Taya, Yoko, Ehira, Nobuyuki, Nakajima, Masahito, Kawabata, Hidemasa, Ihara, Hideyuki, and Kudo, Taiki

Subjects
BILIARY tract cancer, GALLSTONES
Abstract

Objectives: Unresectable ampullary cancer (AC) is a rare disease entity. The risk factors for recurrent biliary obstruction (RBO) following endoscopic biliary stenting (EBS) for unresectable AC remain unknown. In this study we aimed to evaluate the cumulative RBO rate and to identify risk factors for RBO following palliative EBS in patients with unresectable AC. Methods: This multicenter retrospective observational study enrolled consecutive patients with unresectable AC who had undergone palliative EBS between April 2011 and December 2021. The cumulative rate of and risk factors for RBO following palliative EBS were evaluated via multivariate analysis. Results: The study analysis comprised 107 patients with a median age of 84 years (interquartile range 79–88 years). Plastic stents (PSs) and self‐expandable metal stents (SEMSs) were placed in 53 and 54 patients, respectively. Functional success was accomplished in 104 (97.2%) patients. Of these, RBO occurred in 62 (59.6%) patients, with obstruction and complete/partial migration occurring in 47 and 15 patients, respectively. The median time to RBO was 190 days. Multivariate analysis showed that PS was associated with a higher rate of RBO compared to SEMS (hazard ratio [HR] 2.48; P < 0.01) and that the presence of common bile duct stones/sludge immediately after EBS was an independent risk factor for RBO (HR 1.99; P = 0.04). Conclusions: The use of SEMS compared to PS during EBS reduced the time to RBO in patients with unresectable AC. Common bile duct stones/sludge immediately after EBS was a risk factor for RBO. [ABSTRACT FROM AUTHOR]

Published
2024
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5. High and low negative pressure suction techniques in EUS-guided fine-needle tissue acquisition by using 25-gauge needles: a multicenter, prospective, randomized, controlled trial

Author

Kawakami, H., Kudo, T., Kuwatani, M., Eto, K., Abe, Y., Kawahata, S., Sakamoto, N., Mitsuhashi, T., Matsuno, Y., Marukawa, K., Moriya, J., Oba, K., Hayashi, T., Ishiwatari, Y., Ono, M., Hasegawa, T., Nakanishi, K., Ogino, J., Sanuma, H., Yasuda, I., Doi, S., Toda, K., Yamauchi, T., Kawaguchi, J., Uemura, S., Hirose, Y., Mukai, T., Nakashima, M., Yamada, T., Etori, M., Inoue, T., Yamada, R., Takei, Y., Shiraishi, T., Yoneda, M., Katanuma, A., Maguchi, H., Yane, K., Shinohara, T., Sugimura, T., Nakajima, Y., Kawakubo, K., Isayama, H., Nakai, Y., Yamamoto, N., Tanaka, M., Kudo, Taiki, Kawakami, Hiroshi, Hayashi, Tsuyoshi, Yasuda, Ichiro, Mukai, Tsuyoshi, Inoue, Hiroyuki, Katanuma, Akio, Kawakubo, Kazumichi, Ishiwatari, Hirotoshi, Doi, Shinpei, Yamada, Reiko, Maguchi, Hiroyuki, Isayama, Hiroyuki, Mitsuhashi, Tomoko, and Sakamoto, Naoya

Published
2014
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6. Long-term outcomes and risk factors of recurrent biliary obstruction after permanent endoscopic biliary stenting for choledocholithiasis in high-risk patients

Author

Sugiura, Ryo, Naruse, Hirohito, Yamato, Hiroaki, Kudo, Taiki, Yamamoto, Yoshiya, Hatanaka, Kazuteru, Ito, Jun, Kinoshita, Kenji, Miyamoto, Shuichi, Higashino, Masayuki, Hayasaka, Shuhei, and Sakamoto, Naoya

Subjects
common bile duct stone, long-term outcome, endoscopic biliary stenting, permanent endoscopic biliary stenting, recurrent biliary obstruction
Abstract

Objective To elucidate the long-term outcomes of permanent endoscopic biliary stenting (EBS) and risk factors for recurrent biliary obstruction (RBO) in high-risk or elderly patients with common bile duct (CBD) stones. Methods The electronic database of Hakodate Municipal Hospital was searched to identify elderly or high-risk patients with CBD stones who had undergone permanent EBS using a plastic stent without stone removal and were followed up between April 2011 and May 2019, with no further intervention until symptoms occurred. Results We analyzed a total of 47 patients, of whom 19 (40.4%) were men, with a median age of 86 years (interquartile range 80-90 years). RBO and death without biliary disease occurred in 14 (29.8%) and 19 (40.4%) patients, respectively. The cumulative RBO rates at 20, 40, and 60 months were 22.1%, 31.8%, and 35.5%, respectively. The median time to RBO was 13.0 and 38.0 months in the group with CBD stone >= 15 mm and 11-14 mm in diameter, respectively. The cumulative RBO incidence rate in the group with CBD stone

Published
2020

7. Ultrastructural Assessment and Proteomic Analysis in Myofibrillogenesis in the Heart Primordium After Heartbeat Initiation in Rats

Author

Ichise, Nobutoshi, Sato, Tatsuya, Fusagawa, Hiroyori, Yamazaki, Hiroya, Kudo, Taiki, Ogon, Izaya, and Tohse, Noritsugu

Subjects
Physiology, Physiology (medical)
Abstract

Myofibrillogenesis is an essential process for cardiogenesis and is closely related to excitation-contraction coupling and the maintenance of heartbeat. It remains unclear whether the formation of myofibrils and sarcomeres is associated with heartbeat initiation in the early embryonic heart development. Here, we investigated the association between the ultrastructure of myofibrils assessed by transmission electron microscopy and their proteomic profiling assessed by data-independent acquisition mass spectrometry (DIA-MS) in the rat heart primordia before and after heartbeat initiation at embryonic day 10.0, when heartbeat begins in rats, and in the primitive heart tube at embryonic day 11.0. Bundles of myofilaments were scattered in a few cells of the heart primordium after heartbeat initiation, whereas there were no typical sarcomeres in the heart primordia both before and after heartbeat initiation. Sarcomeres with Z-lines were identified in cells of the primitive heart tube, though myofilaments were not aligned. DIA-MS proteome analysis revealed that only 43 proteins were significantly upregulated by more than 2.0 fold among a total of 7,762 detected proteins in the heart primordium after heartbeat initiation compared with that before heartbeat initiation. Indeed, of those upregulated proteins, 12 (27.9%) were constituent proteins of myofibrils and 10 (23.3%) were proteins that were accessories and regulators for myofibrillogenesis, suggesting that upregulated proteins that are associated with heartbeat initiation were enriched in myofibrillogenesis. Collectively, our results suggest that the establishment of heartbeat is induced by development of bundles of myofilaments with upregulated proteins associated with myofibrillogensis, whereas sarcomeres are not required for the initial heartbeat.

Published
2022
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18. Non‐negligible rate of needle tract seeding after endoscopic ultrasound‐guided fine‐needle aspiration for patients undergoing distal pancreatectomy for pancreatic cancer

Author

Yane, Kei, primary, Kuwatani, Masaki, additional, Yoshida, Makoto, additional, Goto, Takuma, additional, Matsumoto, Ryusuke, additional, Ihara, Hideyuki, additional, Okuda, Toshinori, additional, Taya, Yoko, additional, Ehira, Nobuyuki, additional, Kudo, Taiki, additional, Adachi, Takeya, additional, Eto, Kazunori, additional, Onodera, Manabu, additional, Sano, Itsuki, additional, Nojima, Masanori, additional, and Katanuma, Akio, additional

Published
2020
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21. High and low negative pressure suction techniques in EUS- guided fine- needle tissue acquisition by using 25-gauge needles: a multicenter, prospective, randomized, controlled trial

Author

Kudo, Taiki, Kawakami, Hiroshi, Hayashi, Tsuyoshi, Yasuda, Ichiro, Mukai, Tsuyoshi, Inoue, Hiroyuki, Katanuma, Akio, Kawakubo, Kazumichi, Ishiwatari, Hirotoshi, Doi, Shinpei, Yamada, Reiko, Maguchi, Hiroyuki, Isayama, Hiroyuki, Mitsuhashi, Tomoko, and Sakamoto, Naoya

Abstract

Background: EUS-guided FNA (EUS-FNA) has a high diagnostic accuracy for pancreatic diseases. However, although most reports have typically focused on cytology, histological tissue quality has rarely been investigated. The effectiveness of EUS-FNA combined with high negative pressure (HNP) suction was recently indicated for tissue acquisition, but has not thus far been tested in a prospective, randomized clinical trial. Objective: To evaluate the adequacy of EUS-FNA with HNP for the histological diagnosis of pancreatic lesions by using 25-gauge needles. Design: Prospective, single-blind, randomized, controlled crossover trial. Setting: Seven tertiary referral centers. Patients: Patients referred for EUS-FNA of pancreatic solid lesions. From July 2011 to April 2012, 90 patients underwent EUS-FNA of pancreatic solid masses by using normal negative pressure (NNP) and HNP with 2 respective passes. The order of the passes was randomized, and the sample adequacy, quality, and histology were evaluated by a single expert pathologist. Intervention: EUS-FNA by using NNP and HNP. Main Outcome Measurements: The adequacy of tissue acquisition and the accuracy of histological diagnoses made by using the EUS-FNA technique with HNP. Results: We found that 72.2% (65/90) and 90% (81/90) of the specimens obtained using NNP and HNP, respectively, were adequate for histological diagnosis (P = .0003, McNemar test). For 73.3% (66/90) and 82.2% (74/90) of the specimens obtained by using NNP and HNP, respectively, an accurate diagnosis was achieved (P = .06, McNemar test). Pancreatitis developed in 1 patient after this procedure, which subsided with conservative therapy. Limitations: This was a single-blinded, crossover study. Conclusion: Biopsy procedures that combine the EUS-FNA with HNP techniques are superior to EUS-FNA with NNP procedures for tissue acquisition.

Published
2014

22. Prospective, multicenter, observational study of tissue acquisition through EUS-guided fine-needle biopsy using a 25G Franseen needle

Author

Kuwatani, Masaki, primary, Sugiura, Ryo, additional, Yane, Kei, additional, Taya, Yoko, additional, Ihara, Hideyuki, additional, Onodera, Manabu, additional, Eto, Kazunori, additional, Sano, Itsuki, additional, Kudo, Taiki, additional, Mitsuhashi, Tomoko, additional, Katanuma, Akio, additional, and Sakamoto, Naoya, additional

Published
2019
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23. A Prospective Multicenter Study Evaluating Bleeding Risk after Endoscopic Ultrasound-Guided Fine Needle Aspiration in Patients Prescribed Antithrombotic Agents

Author

Kawakubo, Kazumichi, primary, Yane, Kei, additional, Eto, Kazunori, additional, Ishiwatari, Hirotoshi, additional, Ehira, Nobuyuki, additional, Haba, Shin, additional, Matsumoto, Ryusuke, additional, Shinada, Keisuke, additional, Yamato, Hiroaki, additional, Kudo, Taiki, additional, Onodera, Manabu, additional, Okuda, Toshinori, additional, Taya-Abe, Yoko, additional, Kawahata, Shuhei, additional, Kubo, Kimitoshi, additional, Kubota, Yoshimasa, additional, Kuwatani, Masaki, additional, Kawakami, Hiroshi, additional, Katanuma, Akio, additional, Ono, Michihiro, additional, Hayashi, Tsuyoshi, additional, Uebayashi, Minoru, additional, and Sakamoto, Naoya, additional

Published
2018
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25. Sa1026 Risk of Bleeding After Endoscopic Ultrasnography-Guided Fine Needle Aspiration for Patients With Antithrombotic Agents; a Prospective Multicenter Study

Author

Kawakubo, Kazumichi, primary, Yane, Kei, additional, Eto, Kazunori, additional, Ishiwatari, Hirotoshi, additional, Ehira, Nobuyuki, additional, Haba, Shin, additional, Matsumoto, Ryusuke, additional, Shinada, Keisuke, additional, Yamato, Hiroaki, additional, Kudo, Taiki, additional, Onodera, Manabu, additional, Okuda, Toshinori, additional, Taya, Yoko, additional, Kawahata, Shuhei, additional, Kubo, Kimitoshi, additional, Kubota, Yoshimasa, additional, Kuwatani, Masaki, additional, Kawakami, Hiroshi, additional, Katanuma, Akio, additional, Ono, Michihiro, additional, Hayashi, Tsuyoshi, additional, Uebayashi, Minoru, additional, and Sakamoto, Naoya, additional

Published
2016
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27. Lower incidence of complications in endoscopic nasobiliary drainage for hilar cholangiocarcinoma

Author

Kawakubo, Kazumichi, primary, Kawakami, Hiroshi, additional, Kuwatani, Masaki, additional, Haba, Shin, additional, Kudo, Taiki, additional, Taya, Yoko A, additional, Kawahata, Shuhei, additional, Kubota, Yoshimasa, additional, Kubo, Kimitoshi, additional, Eto, Kazunori, additional, Ehira, Nobuyuki, additional, Yamato, Hiroaki, additional, Onodera, Manabu, additional, and Sakamoto, Naoya, additional

Published
2016
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32. Weekly nanoparticle albumin-bound paclitaxel(nab-PTX) as second-or later-line treatment for unresectable or recurrent gastric cancer in practice.

Author

Yagisawa, Masataka, primary, Sogabe, Susumu, additional, Iwanaga, Ichiro, additional, Oshino, Tomohiro, additional, Yamamura, Takahiro, additional, Hirata, Hajime, additional, Nakajima, Masahito, additional, Suzuki, Kazuharu, additional, Shimono, Joji, additional, Takasaka, Takuma, additional, Takahashi, Kazuhiro, additional, Kobayashi, Yoshimitsu, additional, Kudo, Taiki, additional, Okada, Kohei, additional, Dazai, Masayoshi, additional, Oda, Hisashi, additional, and Miyagishima, Takuto, additional

Published
2015
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35. Transpapillary dilation of refractory severe biliary stricture or main pancreatic duct by using a wire-guided diathermic dilator (with video)

Author

1000080399823, Kawakami, Hiroshi, 1000050431375, Kuwatani, Masaki, Kawakubo, Kazumichi, Eto, Kazunori, Haba, Shin, Kudo, Taiki, Abe, Yoko, Kawahata, Shuhei, 1000010334418, Sakamoto, Naoya, 1000080399823, Kawakami, Hiroshi, 1000050431375, Kuwatani, Masaki, Kawakubo, Kazumichi, Eto, Kazunori, Haba, Shin, Kudo, Taiki, Abe, Yoko, Kawahata, Shuhei, 1000010334418, and Sakamoto, Naoya

Published
2014

36. Safety and Utility of Single-Session Endoscopic Ultrasonography and Endoscopic Retrograde Cholangiopancreatography for the Evaluation of Pancreatobiliary Diseases

Author

Kawakubo, Kazumichi, 1000080399823, Kawakami, Hiroshi, 1000050431375, Kuwatani, Masaki, Haba, Shin, Kudo, Taiki, Abe, Yoko, Kawahata, Shuhei, Onodera, Manabu, Ehira, Nobuyuki, Eto, Kazunori, 1000010334418, Sakamoto, Naoya, Kawakubo, Kazumichi, 1000080399823, Kawakami, Hiroshi, 1000050431375, Kuwatani, Masaki, Haba, Shin, Kudo, Taiki, Abe, Yoko, Kawahata, Shuhei, Onodera, Manabu, Ehira, Nobuyuki, Eto, Kazunori, 1000010334418, and Sakamoto, Naoya

Abstract

Endoscopic ultrasound (EUS) and endoscopic retrograde cholangiopancreatography (ERCP) are essential for diagnosing and treating pancreatobiliary diseases. Single-session EUS and ERCP are considered to be essential in reducing the duration of hospital stays; however, complications are a primary concern. The aim of this study was to evaluate the safety and efficacy of single-session EUS and ERCP. Sixty-eight patients underwent single-session EUS and ERCP at a tertiary referral center between June 2008 and December 2012. We retrospectively reviewed patient data from a prospectively maintained EUS-ERCP database and evaluated the procedural characteristics and complications. Thirty-eight patients (56%) underwent diagnostic EUS, and 30 patients (44%) underwent EUS fine-needle aspiration, which had an overall accuracy of 100%. Sixty patients (89%) underwent therapeutic ERCP, whereas the remaining eight procedures were diagnostic. Thirteen patients underwent biliary stone extraction, and 48 underwent biliary drainage. The median total procedural time was 75 minutes. Complications were observed in seven patients (10%). Six complications were post-ERCP pancreatitis,,which were resolved using conservative management. One patient developed Mallory-Weiss syndrome, which required endoscopic hemostasis. No sedation-related cardiopulmonary complications were observed. Single-session EUS and ERCP provided accurate diagnosis and effective management with a minimal complication rate.

Published
2014

37. Difference from Bile Duct Cancer and Relationship between Bile Duct Wall Thickness And Serum IgG/IgG4 Levels in IgG4-Related Sclerosing Cholangitis

Author

1000050431375, Kuwatani, Masaki, 1000080399823, Kawakami, Hiroshi, 1000090377416, Zen, Yoh, Kawakubo, Kazumichi, Kudo, Taiki, Abe, Yoko, Kubo, Kimitoshi, 1000010334418, Sakamoto, Naoya, 1000050431375, Kuwatani, Masaki, 1000080399823, Kawakami, Hiroshi, 1000090377416, Zen, Yoh, Kawakubo, Kazumichi, Kudo, Taiki, Abe, Yoko, Kubo, Kimitoshi, 1000010334418, and Sakamoto, Naoya

Abstract

Background/Aims: IgG4-related sclerosing cholangitis (IgG4-SC) is a newly established entity. The purpose of this study was to investigate the differences in intraductal ultrasonography (IDUS) findings between IgG4-SC and bile duct (BD) cancer (BDC) as well as the relationship among BD wall thickness, serological and pathological findings in IgG4-SC. Methodology: Based on the diagnostic criteria of IgG4-SC, we reviewed patients in our hospital between April 2005 and June 2013, and analyzed the data obtained from 32 patients with IgG4-SC and 40 patients with BDC. Results: Regarding IDUS findings, significantly more cases in BDC indicated rigid/papillary inner margin than in IgG4-SC, while biopsy was more efficient. There were no significant correlations between BD wall thickness and serum IgG/IgG4 levels or the number of IgG4-positive cells of the BD specimens. All the IgG4-SC patients without steroid treatment revealed discordant results in the shifts of IgG, IgG4 and BD wall thickness between the 1st and 2nd examinations, while all patients with steroid had completely concordant results of the shifts. Conclusions: IDUS findings alone are insufficient for differentiation between IgG4-SC and BDC. BD wall thickness, serum IgG and IgG4 proportionally shift and reflect the effect of steroid on IgG4-SC after steroid treatment, not before it.

Published
2014

38. Difference from Bile Duct Cancer and Relationship between Bile Duct Wall Thickness And Serum IgG/IgG4 Levels in IgG4-Related Sclerosing Cholangitis

Author

Kuwatani, Masaki, Kawakami, Hiroshi, Zen, Yoh, Kawakubo, Kazumichi, Kudo, Taiki, Abe, Yoko, Kubo, Kimitoshi, Sakamoto, Naoya, Kuwatani, Masaki, Kawakami, Hiroshi, Zen, Yoh, Kawakubo, Kazumichi, Kudo, Taiki, Abe, Yoko, Kubo, Kimitoshi, and Sakamoto, Naoya

Abstract

Background/Aims: IgG4-related sclerosing cholangitis (IgG4-SC) is a newly established entity. The purpose of this study was to investigate the differences in intraductal ultrasonography (IDUS) findings between IgG4-SC and bile duct (BD) cancer (BDC) as well as the relationship among BD wall thickness, serological and pathological findings in IgG4-SC. Methodology: Based on the diagnostic criteria of IgG4-SC, we reviewed patients in our hospital between April 2005 and June 2013, and analyzed the data obtained from 32 patients with IgG4-SC and 40 patients with BDC. Results: Regarding IDUS findings, significantly more cases in BDC indicated rigid/papillary inner margin than in IgG4-SC, while biopsy was more efficient. There were no significant correlations between BD wall thickness and serum IgG/IgG4 levels or the number of IgG4-positive cells of the BD specimens. All the IgG4-SC patients without steroid treatment revealed discordant results in the shifts of IgG, IgG4 and BD wall thickness between the 1st and 2nd examinations, while all patients with steroid had completely concordant results of the shifts. Conclusions: IDUS findings alone are insufficient for differentiation between IgG4-SC and BDC. BD wall thickness, serum IgG and IgG4 proportionally shift and reflect the effect of steroid on IgG4-SC after steroid treatment, not before it.

Published
2014

39. Single-step simultaneous side-by-side placement of a self-expandable metallic stent with a 6-Fr delivery system for unresectable malignant hilar biliary obstruction: a feasibility study

Author

Kawakubo, Kazumichi, primary, Kawakami, Hiroshi, additional, Kuwatani, Masaki, additional, Kudo, Taiki, additional, Abe, Yoko, additional, Kawahata, Shuhei, additional, Kubo, Kimitoshi, additional, Kubota, Yoshimasa, additional, and Sakamoto, Naoya, additional

Published
2014
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42. Safety and Utility of Single-Session Endoscopic Ultrasonography and Endoscopic Retrograde Cholangiopancreatography for the Evaluation of Pancreatobiliary Diseases

Author

Kawakubo, Kazumichi, primary, Kawakami, Hiroshi, additional, Kuwatani, Masaki, additional, Haba, Shin, additional, Kudo, Taiki, additional, Abe, Yoko, additional, Kawahata, Shuhei, additional, Onodera, Manabu, additional, Ehira, Nobuyuki, additional, Yamato, Hiroaki, additional, Eto, Kazunori, additional, and Sakamoto, Naoya, additional

Published
2014
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44. Tu1913 CTNNB1 Mutational Analysis of Solid-Pseudopapillary Neoplasms of the Pancreas Using Endoscopic Ultrasound-Guided Fine-Needle Aspiration and Next-Generation Deep Sequencing

Author

Kubota, Yoshimasa, primary, Kawakami, Hiroshi, additional, Natsuizaka, Mitsuteru, additional, Kawakubo, Kazumichi, additional, Marukawa, Katsuji, additional, Kudo, Taiki, additional, Abe, Yoko, additional, Kubo, Kimitoshi, additional, Kuwatani, Masaki, additional, Hatanaka, Yutaka, additional, Mitsuhashi, Tomoko, additional, Matsuno, Yoshihiro, additional, and Sakamoto, Naoya, additional

Published
2014
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46. CTNNB1 mutational analysis of solid-pseudopapillary neoplasms of the pancreas using endoscopic ultrasound-guided fine-needle aspiration and next-generation deep sequencing

Author

Kubota, Yoshimasa, primary, Kawakami, Hiroshi, additional, Natsuizaka, Mitsuteru, additional, Kawakubo, Kazumichi, additional, Marukawa, Katsuji, additional, Kudo, Taiki, additional, Abe, Yoko, additional, Kubo, Kimitoshi, additional, Kuwatani, Masaki, additional, Hatanaka, Yutaka, additional, Mitsuhashi, Tomoko, additional, Matsuno, Yoshihiro, additional, and Sakamoto, Naoya, additional

Published
2014
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47. Human equilibrative nucleoside transporter 1 and Notch3 can predict gemcitabine effects in patients with unresectable pancreatic cancer

Author

Eto, Kazunori, Kawakami, Hiroshi, Kuwatani, Masaki, Kudo, Taiki, Abe, Yoko, Kawahata, Shuhei, Takasawa, Akira, Fukuoka, Midori, Matsuno, Yoshihiro, Asaka, Masahiro, Sakamoto, Naoya, Eto, Kazunori, Kawakami, Hiroshi, Kuwatani, Masaki, Kudo, Taiki, Abe, Yoko, Kawahata, Shuhei, Takasawa, Akira, Fukuoka, Midori, Matsuno, Yoshihiro, Asaka, Masahiro, and Sakamoto, Naoya

Abstract

Background: Pancreatic ductal carcinoma (PDC) is one of the most lethal human carcinomas. Expression patterns of some genes may predict gemcitabine (GEM) treatment efficacy. We examined predictive indicators of survival in GEM-treated patients by quantifying the expression of several genes in pre-treatment endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) samples from patients with PDC. Methods: The expressions of human equilibrative nucleoside transporter 1 (hENT1), deoxycitidine kinase, ribonucleoside reductase 1, ribonucleoside reductase 2 and Notch3 in EUS-FNA tissue samples from 71 patients with unresectable PDC were quantified using real-time reverse transcription-polymerase chain reactions and examined for correlations with GEM sensitivity. Results: The log-rank test detected no significant differences in overall survival between GEM-treated patients with low and high mRNA levels of all genes examined. However, low Notch3 mRNA expression was significantly associated with longer overall survival in a multivariate analysis for survival (P = 0.0094). High hENT1 expression level was significantly associated with a longer time to progression (P = 0.039). Interaction tests for GEM administration and hENT1 or Notch3 mRNA expression were statistically significant (P = 0.0054 and 0.0047, respectively). Conclusion: hENT1 and Notch3 mRNA expressions in EUS-FNA specimens were the key predictive biomarkers of GEM effect and GEM sensitivity in patients with unresectable PDC.

Published
2013

48. Covered Metallic Stent for Ischemic Hilar Biliary Stricture

Author

1000080399823, Kawakami, Hiroshi, 1000050431375, Kuwatani, Masaki, Eto, Kazunori, Kudo, Taiki, 1000010113507, Asaka, Masahiro, 1000080399823, Kawakami, Hiroshi, 1000050431375, Kuwatani, Masaki, Eto, Kazunori, Kudo, Taiki, 1000010113507, and Asaka, Masahiro

Abstract

Compared with surgery, endoscopic treatment is safe and highly effective for a postoperative hilar benign bile duct stricture (BDS). However, the long-term outcome of conventional placement of a single biliary stent for hilar benign BDS is generally poor. Although the placement of multiple biliary stents is preferred, multiple stenting in a BDS is difficult. Alternatively, single or multiple stent placement above the papilla ("inside stent") or fully-covered self-expandable metallic stents (SEMSs) are feasible approaches for benign BDS. Nevertheless, controversy remains regarding whether and how to perform endoscopic biliary drainage for a hilar benign BDS. In patients with hilar benign BDS, endoscopic biliary drainage can be performed by placing conventional plastic stents across the papilla, plastic stents above the papilla, or fully covered SEMSs. Individualized treatment should be considered. We report the placement of a fully-covered SEMS for a hilar benign biliary stricture after extended left hepatectomy.

Published
2012

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