フルテキストURL fulltext.pdf
著者 Tanabe, Katsuyuki| Kanzaki, Hiromitsu| Wada, Takahira| Nakashima, Yuri| Sugiyama, Hitoshi| Okada, Hiroyuki| Wada, Jun|
キーワード case report gastric cancer IgA nephropathy nivolumab steroid
発行日 2020-05-22
出版物タイトル MEDICINE
99巻
21号
出版者 LIPPINCOTT WILLIAMS & WILKINS
ISSN 0025-7974
資料タイプ 学術雑誌論文
言語 English
OAI-PMH Set 岡山大学
著作権者 © 2020 the Author(s).
論文のバージョン publisher
PubMed ID 32481351
DOI 10.1097/MD.0000000000020464
Web of Science KeyUT 000551508200106
関連URL isVersionOf https://doi.org/10.1097/MD.0000000000020464
JaLCDOI 10.18926/AMO/57377
フルテキストURL 73_5_457.pdf
著者 Iwamuro, Masaya| Takahara, Masahiro| Yamazaki, Tatsuhiro| Tanaka, Takehiro| Kondo, Yoshitaka| Hiraoka, Sakiko| Okada, Hiroyuki|
抄録 A 60-year-old Caucasian male was diagnosed with lung adenocarcinoma and multiple metastases to the bone, spleen, and brain. He underwent radiotherapy for the brain and lumbar spine metastases, plus chemotherapy (cisplatin and pemetrexed). The chemotherapy was discontinued due to vomiting and hyponatremia, and nivolumab was then administered. Eight months later, 18F-fluorodeoxyglucose positron emission tomography showed tracer uptake in the colon. Colonoscopy revealed a reddish multinodular polyp in the sigmoid colon. The polyp showed irregular microvessels. No colonic mucosal surface structures were observed. Colonic metastasis of the lung carcinoma was highly suspected; the polyp was therefore surgically removed. The histological analysis revealed granulation tissue and suppurative inflammation without neoplastic changes. We diagnosed the lesion as a granulation polyp. Despite the difficulty in diagnosing these lesions due to their rarity and similarity to metastatic colon tumors, we suggest that recognizing the endoscopic features of the polyp surface may allow a preoperative diagnosis.
キーワード colonoscopy colonic neoplasms granulation polyp
Amo Type Case Report
発行日 2019-10
出版物タイトル Acta Medica Okayama
73巻
5号
出版者 Okayama University Medical School
開始ページ 457
終了ページ 461
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2019 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 31649373
Web of Science KeyUT 000491886600012
JaLCDOI 10.18926/AMO/56940
フルテキストURL 73_4_367.pdf
著者 Mifune-Morioka, Tomoyo| A. Uchida, Haruhito| Fukushima, Kazuhiko| Watanabe, Mayu| Ouchi, Chihiro| Mise, Koki| Kawakita, Chieko| Kano, Yuzuki| Onishi, Akifumi| Toma, Kishio| Eguchi, Jun| Wada, Nozomu| Ikeda, Fusao| Sasaki, Erika| Suganami, Yu| Kishida, Masayuki| Sugiyama, Hitoshi| Okada, Hiroyuki| Wada, Jun|
抄録 Eight years prior to her present admission, a 61-year-old Japanese woman was diagnosed with autoimmune hepatitis, slowly progressive insulin-dependent diabetes mellitus, and chronic thyroiditis; she had been treated with oral prednisolone (PSL). After she suddenly discontinued PSL, she newly developed systemic lupus erythematosus. A combination therapy of oral PSL and intravenous cyclophosphamide resulted in remission. She was finally diagnosed with autoimmune polyglandular syndrome (APS) type 3 (3A ,3B, 3D), complicated with four different autoimmune diseases. Since patients with type 3 APS may present many manifestations over a long period of time, they should be carefully monitored.
キーワード autoimmune polyglandular syndrome type 3 systemic lupus erythematosus autoimmune hepatitis slowly progressive insulin-dependent diabetes mellitus chronic thyroiditis
Amo Type Case Report
発行日 2019-08
出版物タイトル Acta Medica Okayama
73巻
4号
出版者 Okayama University Medical School
開始ページ 367
終了ページ 372
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2019 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 31439961
JaLCDOI 10.18926/AMO/56935
フルテキストURL 73_4_333.pdf
著者 Kuwaki, Kenji| Nouso, Kazuhiro| Miyashita, Manabi| Makino, Yasuhiro| Hagihara, Hiroaki| Moriya, Akio| Adachi, Takuya| Wada, Nozomu| Yasunaka, Yuki| Yasunaka, Tetsuya| Takeuchi, Yasuto| Onishi, Hideki| Nakamura, Shinichiro| Ikeda, Fusao| Shiraha, Hidenori| Takaki, Akinobu| Okada, Hiroyuki|
抄録 Steroids are often administered at the time of transcatheter arterial chemoembolization (TACE), a standard treatment of hepatocellular carcinoma (HCC), with the expectation of preventing postembolization syndrome. Here we investigated the precise effects of steroids on TACE. We prospectively enrolled 144 HCC patients from 10 hospitals who underwent TACE. Three hospitals used steroids (steroid group, n=77) and the rest did not routinely use steroids (control group, n=67). The occurrence of adverse events and the algetic degree at 1-5 days post-treatment were compared between the groups. Fever (grades 0-2) after TACE was significantly less in the steroid group (56/21/0) compared to the control group (35/29/3, p=0.005, Cochran-Armitage test for trend). The suppressive effect of steroids against fever was prominent in females (p=0.001). Vomiting (G0/G1/ G2-) was also less frequent in the steroid group (70/5/2) versus the control group (53/10/3), but not significantly (p=0.106). The algetic degree and the grade of hematological adverse events, including hyperglycemia, did not differ between the groups. We conclude that the administration of steroids was useful for the prevention of adverse events after TACE in patients with HCC.
キーワード antipyretic hepatocellular carcinoma therapeutic chemoembolization steroid
Amo Type Original Article
発行日 2019-08
出版物タイトル Acta Medica Okayama
73巻
4号
出版者 Okayama University Medical School
開始ページ 333
終了ページ 339
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2019 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 31439956
JaLCDOI 10.18926/AMO/56646
フルテキストURL 73_2_109.pdf
著者 Abe, Makoto| Iwamuro, Masaya| Kawahara, Yoshiro| Kanzaki, Hiromitsu| Kawano, Seiji| Tanaka, Takehiro| Tsumura, Munechika| Makino, Takuma| Noda, Yohei| Marunaka, Hidenori| Nishizaki, Kazunori| Okada, Hiroyuki|
抄録 The efficacy and safety of endoscopic submucosal dissection (ESD) for superficial cancer of the pharynx are still unclear. To identify clinicopathological features of superficial pharyngeal cancer, and the efficacy and safety of ESD, we retrospectively assessed 70 pharyngeal cancers in 59 patients who underwent ESD. Of these patients, 61.0% and 50.8% had a history of esophageal cancer and head and neck cancer, respectively. The median tumor size was 15 mm, and 75.7% of the lesions were located at the piriform sinus. The en bloc resection rate was 94.9%. Treatment-related adverse events occurred in 8 cases, but there was no treatment-related death. The lateral margin was positive for neoplasm in 3 lesions (4.3%) and inconclusive in 27 lesions (38.6%), but no local recurrence was observed. Cervical lymph node metastasis was observed in 6 patients, and was successfully treated by cervical lymph node dissection. The three-year overall survival rate was 91.5% (95%CI: 76.6-97.3%) and the cause-specific survival rate was 97.6% (95%CI: 84.9-99.7%). In conclusion, ESD for superficial pharyngeal cancer was safe and effective. “Resect and watch” is probably a feasible and rational strategy for treatment of patients with superficial pharyngeal cancer.
キーワード endoscopic submucosal dissection superficial cancer pharynx endoscopic resection
Amo Type Original Article
発行日 2019-04
出版物タイトル Acta Medica Okayama
73巻
2号
出版者 Okayama University Medical School
開始ページ 109
終了ページ 115
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2019 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 31015745
JaLCDOI 10.18926/AMO/56463
フルテキストURL 73_1_81.pdf
著者 Sugihara, Yuusaku| Harada, Keita| Oka, Shohei| Yasutomi, Eriko| Yamasaki, Yasushi| Inokuchi, Toshihiro| Kinugasa, Hideaki| Takahara, Masahiro| Hiraoka, Sakiko| Otsuka, Fumio| Okada, Hiroyuki|
抄録 Endoscopic submucosal dissection (ESD) is reportedly one of the standard treatment strategies for large superficial colorectal neoplasms in Japan because of its high en bloc resection rate. A few technical issues regarding ESD should be considered, one of which is the selection of the Endo-cut I mode versus the Swift-coagulation mode as the electrosurgical unit mode setting during submucosal dissection. We seek to determine which of these two modes is more suitable for submucosal dissections of colorectal tumors with regard to procedure time and safety.
キーワード endoscopic submucosal dissection electrosurgical mode colorectal tumor
Amo Type Clinical Study Protocol
発行日 2019-02
出版物タイトル Acta Medica Okayama
73巻
1号
出版者 Okayama University Medical School
開始ページ 81
終了ページ 84
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2019 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 30820059
JaLCDOI 10.18926/AMO/56457
フルテキストURL 73_1_43.pdf
著者 Ikeda, Ailee| Takaki, Akinobu| Yasunaka, Tetsuya| Oyama, Atsushi| Adachi, Takuya| Wada, Nozomu| Onishi, Hideki| Ikeda, Fusao| Shiraha, Hidenori| Yoshida, Kazuhiro| Kuise, Takashi| Nobuoka, Daisuke| Yoshida, Ryuichi| Umeda, Yuzo| Yagi, Takahito| Fujiwara, Toshiyoshi| Okada, Hiroyuki|
抄録 Post-orthotopic liver transplantation (OLT) hepatitis B recurrence is well-controlled with a nucleos(t)ide analogue and hepatitis B immunoglobulin (HBIG) combination, but the high cost and the potential risk of unknown infection associated with HBIG remain unresolved issues. Low-cost recombinant hepatitis B virus (HBV) vaccine administration is a potential solution to these problems. We retrospectively analyzed the rate and predictive factors of HBV vaccine success in 49 post-OLT patients: liver cirrhosis-type B (LC-B), n=28 patients; acute liver failure-type B (ALF-B), n=8; and non-HBV-related end-stage liver disease (non-B ESLD) who received a liver from anti-hepatitis B core antibody-positive donors, n=13. A positive anti-hepatitis B surface antibody response was achieved in 29% (8/28) of the LC-B group, 88% (7/8) of the ALF-B group, and 44% (4/9) of the adult non-B ESLD group. All four non-B ESLD infants showed vaccine success. The predictive factors for a good response in LC-B were young age, marital donor, and high donor age. ALF-B and non-B ESLD infants are thus good vaccination candidates. LC-B patients with marital donors are also good candidates, perhaps because the donated liver maintains an efficient immune memory to HBV, as the donors had already been infected in adulthood and showed adequate anti-HBV immune responses.
キーワード acute liver failure hepatitis B hepatitis B vaccine liver cirrhosis liver transplantation
Amo Type Original Article
発行日 2019-02
出版物タイトル Acta Medica Okayama
73巻
1号
出版者 Okayama University Medical School
開始ページ 41
終了ページ 50
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2019 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 30820053
JaLCDOI 10.18926/AMO/56378
フルテキストURL 72_6_595.pdf
著者 Sugihara, Yuusaku| Harada, Keita| Kato, Ryo| Yamauchi, Kenji| Sakae, Hiroyuki| Kawano, Seiji| Hiraoka, Sakiko| Kawahara, Yoshiro| Otsuka, Fumio| Okada, Hiroyuki|
抄録 The indications for peroral endoscopic myotomy (POEM) have been expanded to include diffuse esophageal spasm (DES). A 67-year-old Japanese man presented with a 4-year history of dysphagia. Endoscopy and upper gastrography revealed abnormal peristaltic movements involving interruption of normal peristalsis, and a diverticulum located at the 2 o’clock esophageal position. High-resolution manometry indicated DES. POEM with a long (15 cm) myotomy was performed for the abnormal contractions, which subsequently disappeared along with dysphagia improvement. Our results suggest that esophageal motility disorders accompanying a diverticulum may be eliminated by POEM without treating the diverticulum itself. We speculate that POEM ameliorates esophageal diverticulum by reducing internal esophageal pressure.
キーワード diffuse esophageal spasm (DES) diverticulum, peroral endoscopic myotomy (POEM) high-resolution manometry (HRM)
Amo Type Case Report
発行日 2018-12
出版物タイトル Acta Medica Okayama
72巻
6号
出版者 Okayama University Medical School
開始ページ 595
終了ページ 600
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2018 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 30573915
NAID 120006545163
JaLCDOI 10.18926/AMO/56178
フルテキストURL 72_4_401.pdf
著者 Wada, Nozomu| Ikeda, Fusao| Mori, Chizuru| Takaguchi, Koichi| Fujioka, Shin-ichi| Kobashi, Haruhiko| Morimoto, Yoichi| Kariyama, Kazuya| Sakaguchi, Kosaku| Hashimoto, Noriaki| Moriya, Akio| Kawaguchi, Mitsuhiko| Miyatake, Hirokazu| Hagihara, Hiroaki| Kubota, Junichi| Takayama, Hiroki| Takeuchi, Yasuto| Yasunaka, Tetsuya| Takaki, Akinobu| Iwasaki, Yoshiaki| Okada, Hiroyuki|
抄録 Daclatasvir (DCV) + asunaprevir (ASV) combination therapy has become available for patients with hepatitis C virus (HCV) serogroup 1 infection. We studied the efficacy of this therapy by focusing on the factors associated with sustained virological responses (SVR) including resistance-associated variants (RAVs) and mixed infection of different HCV genotypes. We enrolled 951 HCV serogroup 1-positive patients who received this combination therapy at our hospital or affiliated hospitals. The presence of RAVs in non-structural (NS) regions 3 and 5A was analyzed by direct sequencing. HCV genotypes were determined by PCR with genotype-specific primers targeting HCV core and NS5B regions. SVR was achieved in 91.1% of patients. Female sex, age > 70 years, and RAVs were significantly associated with non-SVR (p<0.01 for all). Propensity score-matching results among the patients without RAVs regarding sex, age, and fibrosis revealed that mixed HCV infection determined by HCV NS5B genotyping showed significantly lower SVR rates than 1B-mono infection (p=0.02). Female sex and RAVs were significant factors associated with treatment failure of this combination therapy for patients with HCV serogroup 1 infection. Mixed HCV infection other than 1B-mono infection would be useful for predicting treatment failure.
キーワード mixed genotype daclatasvir asunaprevir HCV serogrouping 1 infection
Amo Type Original Article
発行日 2018-08
出版物タイトル Acta Medica Okayama
72巻
4号
出版者 Okayama University Medical School
開始ページ 401
終了ページ 406
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2018 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 30140089
JaLCDOI 10.18926/AMO/56074
フルテキストURL 72_3_283.pdf
著者 Namba, Shihoko| Ikeda, Fusao| Takaguchi, Koichi| Shimomura, Yasuyuki| Yasunaka, Tetsuya| Okada, Hiroyuki|
抄録 We investigated whether a small amount of blood collected by fingertip blood sampling would be adequate in a mass examination for hepatitis virus infection in Japan. A cross-sectional survey was conducted at health fairs in Kasaoka City and Shodoshima Island, where participants took the hepatitis screening test. A total of 114 consecutive individuals who took the hepatitis screening test were enrolled. Twenty microliters of plasma was successfully obtained from all participants. Among the participants, two had positive results for HBs antigen and two were positive for anti-HCV; all four were > 60 years old and rarely visited the hospital. Thirty-three and 38 patients chronically infected with HBV and HCV, respectively, were examined for confirmatory assays at participating hospitals. All subjects with undetectable serum levels of HBs antigen and anti-HCV had undetectable levels of both markers in fingertip blood, and the levels in serum and fingertip blood were significantly correlated (p<0.01). The lower detection limit of HBs antigen was defined as 0.005 IU/ml, and the cut-off value of anti-HCV was 1.0 by using 10-μl fingertip blood samples. The fingertip blood sampling described herein may be adequate in mass examinations for hepatitis virus testing in Japan.
キーワード fingertip hepatitis test HBV HCV Japan
Amo Type Original Article
発行日 2018-06
出版物タイトル Acta Medica Okayama
72巻
3号
出版者 Okayama University Medical School
開始ページ 283
終了ページ 287
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2018 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 29926006
JaLCDOI 10.18926/AMO/55850
フルテキストURL 72_2_105.pdf
著者 Kato, Ryo| Iwamuro, Masaya| Hiraoka, Sakiko| Takashima, Shiho| Inokuchi, Toshihiro| Takahara, Masahiro| Kondo, Yoshitaka| Tanaka, Takehiro| Okada, Hiroyuki|
抄録 To analyze the clinical characteristics of patients with ulcerative colitis who have upper gastrointestinal lesions, we retrospectively reviewed the data of 216 patients with ulcerative colitis who underwent esophagogastroduodenoscopy at our institute in April 2008-March 2016. We investigated the endoscopic features and compared the clinical characteristics between the patients with and without upper gastrointestinal lesions. Forty-two patients (19.4%) had upper gastrointestinal lesions, including multiple erosions (n=18), bamboo joint-like appearance (n=17), mucosa with white spots (n=4), friable mucosa (n=2), ulcer (n=1), and purulent deposits within the mucosa (n=1) in the stomach and/or duodenum. Compared to the patients without upper gastrointestinal lesions, those with upper gastrointestinal lesions showed significantly more frequent extraintestinal manifestations (19.0% vs. 8.0%, p<0.05) and a significant history of colectomy (33.3% vs. 12.1%, p<0.01). There were no significant differences with regard to the sex ratio, age at esophagogastroduodenoscopy, gastrointestinal symptoms, time since the diagnosis of ulcerative colitis, type of colitis at the initial diagnosis of ulcerative colitis, or gastric atrophy between the groups. In conclusion, gastroduodenal lesions were identified in 19.4% of the patients with ulcerative colitis. Esophagogastroduodenoscopy is particularly recommended for ulcerative colitis patients who show extraintestinal manifestations and for those who have undergone a colectomy.
キーワード ulcerative colitis esophagogastroduodenoscopy gastritis
Amo Type Original Article
発行日 2018-04
出版物タイトル Acta Medica Okayama
72巻
2号
出版者 Okayama University Medical School
開始ページ 105
終了ページ 113
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2018 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 29674758
JaLCDOI 10.18926/AMO/55849
フルテキストURL 72_2_99.pdf
著者 Sugihara, Yuusaku| Harada, Keita| Kato, Ryo| Yamauchi, Kenji| Takashima, Shiho| Takei, Daisuke| Yamasaki, Yasushi| Inokuchi, Toshihiro| Takahara, Masahiro| Hiraoka, Sakiko| Okada, Hiroyuki|
抄録 Peroral endoscopic myotomy (POEM) for treatment of esophageal motility disorders has recently been reported to be highly effective and less invasive than other treatment. POEM was recently introduced in Okayama University Hospital under the supervision of a physician from a high-volume center. To verify the safety and efficacy of POEM during its introduction in our institution. We examined 10 cases in whom POEM was performed between January 2016 and April 2017. The patients included 7 men and 3 women, with a median age (range) of 49 years (17-74) and median symptom duration of 6 years (1-21). Seven patients had a straight esophagus, and the remaining 3 had a sigmoid esophagus. According to the Chicago classification, 6 patients were diagnosed with type I achalasia, 2 with type II achalasia, and 2 with distal esophagus spasm. Treatment outcomes and adverse events were evaluated. Treatment success was defined as a > 3 decrease in Eckardt score or a score of <3 at the time of discharge. The treatment success rate was 90%, with the average Eckardt score decreasing significantly, from 4.7 to 0.9 (p<0.05). No mucosal perforation, severe infection, mediastinitis, severe bleeding, or gastroesophageal reflux occurred intraoperatively or postoperatively. POEM was introduced to Okayama University Hospital, and the first 10 cases were accomplished safely and effectively under the supervision of an expert physician from a high-volume center.
キーワード achalasia Eckardt score peroral endoscopic myotomy (POEM)
Amo Type Original Article
発行日 2018-04
出版物タイトル Acta Medica Okayama
72巻
2号
出版者 Okayama University Medical School
開始ページ 99
終了ページ 104
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2018 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 29674757
JaLCDOI 0
フルテキストURL J_Gastroenterol_Hepatol_62_4_925.pdf
著者 Horiguchi, higeru| Kato, Hironari| Shiraha, Hidenori| Tsutsumi, Koichiro| Yamamoto, Naoki| Matsumoto, Kazuyuki| Tomoda, Takeshi| Uchida, Daisuke| Akimoto, Yutaka| Mizukawa, Syou| Tanaka, Takehiro| Ichimura, Koichi| Takaki, Akinobu| Yagi, Takahito| Okada, Hiroyuki|
キーワード WHO2010 dynamic CT microvessel density pancreatic neuroendocrine neoplasm pathological grade
備考 This is an Accepted Manuscript of an article published by John Wiley & Sons|
発行日 2017-04
出版物タイトル Journal of Gastroenterology and Hepatology
32巻
4号
出版者 John Wiley & Sons
開始ページ 925
終了ページ 931
ISSN 0815-9319
NCID AA10727383
資料タイプ 学術雑誌論文
言語 English
OAI-PMH Set 岡山大学
著作権者 https://creativecommons.org/licenses/by-nc-nd/4.0/deed.ja
論文のバージョン author
PubMed ID 27637470
DOI 10.1111/jgh.13594
Web of Science KeyUT 000398534100030
関連URL isVersionOf https://doi.org/10.1111/jgh.13594
JaLCDOI 10.18926/AMO/55662
フルテキストURL 72_1_47.pdf
著者 Ako, Soichiro| Nakamura, Shinichiro| Nouso, Kazuhiro| Dohi, Chihiro| Wada, Nozomu| Morimoto, Yuki| Takeuchi, Yasuto| Yasunaka, Tetsuya| Kuwaki, Kenji| Onishi, Hideki| Ikeda, Fusao| Shiraha, Hidenori| Takaki, Akinobu| Okada, Hiroyuki|
抄録 Transcatheter arterial chemoembolization (TACE) is often performed before radiofrequency ablation (RFA) for the treatment of early-stage hepatocellular carcinoma (HCC). TACE prior to RFA can expand the ablated area and reduce the tumor size, facilitating complete ablation. However, the factors correlated with size reduction remain uncertain. The aim of this study was to identify the factors associated with size reduction by TACE and develop a formula to predict the reduction rate. A total of 100 HCC patients treated with TACE followed by RFA at least 20 days later were enrolled. The tumor size was measured at the time of TACE and RFA, and correlations between the reduction rate and 13 clinical factors were examined. A formula to predict the reduction rate was built using the factors obtained by the analysis. Reduction in the tumor size was observed in 69 nodules, and the median reduction rate was 16.2%. A multivariate regression analysis revealed that a large tumor size (p< 0.01) and a long interval between the therapies (p= 0.01) were factors for a high tumor reduction rate, with tumor size more strongly related to the degree of reduction. A size reduction of more than 10% can be expected by waiting 20 days after TACE when the size of the tumor at TACE is over 25 mm in diameter. The tumor size
キーワード hepatocellular carcinoma transcatheter arterial chemoembolization radiofrequency ablation interval size reduction
Amo Type Original Article
発行日 2018-02
出版物タイトル Acta Medica Okayama
72巻
1号
出版者 Okayama University Medical School
開始ページ 47
終了ページ 52
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2018 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 29463938
JaLCDOI 10.18926/AMO/55584
フルテキストURL 71_6_475.pdf
著者 Takei, Daisuke| Harada, Keita| Takashima, Shiho| Inokuchi, Toshihiro| Nakarai, Asuka| Sugihara, Yusaku| Takahara, Masanobu| Hiraoka, Sakiko| Okada, Hiroyuki|
抄録 Several reports discussed colonoscopic surveillance after polypectomy and endoscopic mucosal resection (EMR) for colorectal polyps, but only a few reports focused on prognostic analyses, and none involved metachronous neoplasia after colorectal endoscopic submucosal dissection (ESD). We conducted the present study to assess the risk of adenoma recurrence requiring endoscopic treatment, and to establish appropriate post-ESD colonoscopic surveillance. We enrolled 116 patients who had undergone colorectal ESD at Okayama University Hospital between February 2008 and July 2014 and had been followed-up >12 months. We retrospectively analyzed clinicopathological features of 101 lesions from 101 patients. Metachronous adenomas were detected in 21 cases (20.8%). We divided the patients into 2 groups according to the occurrence of metachronous adenomas. Our comparison of clinicopathological characteristics between these groups showed that in the metachronous adenomas group the number of synchronous adenomas at index colonoscopy was high and the rate of laterally spreading tumor-nongranular (LST-NG) was higher. A multivariate analysis indicated that the number of synchronous adenomas was significantly associated with metachronous adenomas (HR: 2.54, 95%CI: 1.04-6.52, p<0.05). The colonoscopic surveillance planning after colorectal ESD should be more meticulous for patients with more synchronous adenomas.
キーワード endoscopic submucosal dissection laterally spreading tumor metachronous recurrence local recurrence post-ESD colonoscopic surveillance
Amo Type Original Article
発行日 2017-12
出版物タイトル Acta Medica Okayama
71巻
6号
出版者 Okayama University Medical School
開始ページ 475
終了ページ 483
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2017 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 29276220
JaLCDOI 10.18926/AMO/55436
フルテキストURL 71_5_391.pdf
著者 Iwamuro, Masaya| Takata, Katsuyoshi| Hayashi, Eiko| Kawano, Seiji| Hiraoka, Sakiko| Kawahara, Yoshiro| Yoshino, Tadashi| Okada, Hiroyuki|
抄録  To evaluate the usefulness of colonoscopy for the detection of ileal involvement in patients with intestinal follicular lymphoma, seventeen patients with intestinal follicular lymphoma who underwent colonoscopy and biopsy sampling from the terminal ileum were enrolled. The patients were divided into 2 groups: cases with ileal involvement (n=6) and cases without ileal involvement (n=11). Patients’ clinical backgrounds were compared between the two groups. Subsequently, 10 board-certified endoscopists independently evaluated the endoscopic pictures and determined whether the ileum was involved with follicular lymphoma. Infiltration of follicular lymphoma cells were identified in 6 patients (35.3%). Cases with positive ileal involvement were diagnosed with follicular lymphoma at a younger age than were cases without ileal involvement (55.4±7.4 vs. 68.1±10.3 years, p=0.011). Macroscopically, in patients with ileal involvement, there were multiple polypoid elevations smaller than 5 mm in 4 cases, single polypoid elevation smaller than 5 mm in 1 case, and single polypoid elevation larger than 5 mm in 1 case. In patients without ileal involvement, there were no lesions in the terminal ileum in 7 cases, and multiple polypoid elevations smaller than 5 mm were seen in 4 cases. The accuracy of the macroscopic evaluation by 10 board-certified endoscopists was 68.8%. Colonoscopy is particularly recommended during the initial workup of patients with follicular lymphoma diagnosed at age ≤ 60 years. The diagnosis of ileal involvement based on morphology alone is difficult; thus, biopsy and pathologic diagnosis are required for accurate diagnosis.
キーワード follicular lymphoma colonoscopy ileal neoplasms terminal ileum small intestine
Amo Type Original Article
発行日 2017-10
出版物タイトル Acta Medica Okayama
71巻
5号
出版者 Okayama University Medical School
開始ページ 391
終了ページ 398
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2017 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 29042696
JaLCDOI 10.18926/AMO/55435
フルテキストURL 71_5_381.pdf
著者 Yoshida, Kazuhiro| Umeda, Yuzo| Takaki, Akinobu| Nagasaka, Takeshi| Yoshida, Ryuichi| Nobuoka, Daisuke| Kuise, Takashi| Takagi, Kosei| Yasunaka, Tetsuya| Okada, Hiroyuki| Yagi, Takahito| Fujiwara, Toshiyoshi|
抄録 Determining the indications for and timing of liver transplantation (LT) for acute liver failure (ALF) is essential. The King’s College Hospital (KCH) guidelines and Japanese guidelines are used to predict the need for LT and the outcomes in ALF. These guidelines’ accuracy when applied to ALF in different regional and etiological backgrounds may differ. Here we compared the accuracy of new (2010) Japanese guidelines that use a simple scoring system with the 1996 Japanese guidelines and the KCH criteria for living donor liver transplantation (LDLT). We retrospectively analyzed 24 adult ALF patients (18 acute type, 6 sub-acute type) who underwent LDLT in 1998-2009 at our institution. We assessed the accuracies of the 3 guidelines’ criteria for ALF. The overall 1-year survival rate was 87.5%. The new and previous Japanese guidelines were superior to the KCH criteria for accurately predicting LT for acute-type ALF (72% vs. 17%). The new Japanese guidelines could identify 13 acute-type ALF patients for LT, based on the timing of encephalopathy onset. Using the previous Japanese guidelines, although the same 13 acute-type ALF patients (72%) had indications for LT, only 4 patients were indicated at the 1st step, and it took an additional 5 days to decide the indication at the 2nd step in the other 9 cases. Our findings showed that the new Japanese guidelines can predict the indications for LT and provide a reliable alternative to the previous Japanese and KCH guidelines.
キーワード living donor liver transplantation acute liver failure fulminant hepatic failure
Amo Type Original Article
発行日 2017-10
出版物タイトル Acta Medica Okayama
71巻
5号
出版者 Okayama University Medical School
開始ページ 381
終了ページ 390
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2017 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 29042695
JaLCDOI 10.18926/AMO/54193
フルテキストURL 70_2_139.pdf
著者 Iwamuro, Masaya| Kondo, Eisei| Otsuka, Fumio| Takata, Katsuyoshi| Yoshino, Tadashi| Kawahara, Yoshiro| Okada, Hiroyuki|
抄録 Esophagogastroduodenoscopy revealed small duodenal lesions in a 56-year-old Japanese man and a 92-year-old Japanese woman with stage IV follicular lymphoma. Magnifying endoscopy examination revealed tiny white deposits in the second duodenal portion of the former patient and slightly enlarged duodenal villi in the latter. In both cases, biopsy revealed infiltration of follicular lymphoma cells and incipient formation of neoplastic follicles. Here, we discuss the usefulness of magnifying endoscopy and narrow-band imaging for the detection of small duodenal lesions in follicular lymphoma cases.
キーワード intestinal follicular lymphoma duodenal neoplasms gastrointestinal endoscope narrow-band imaging
Amo Type Case Reports
発行日 2016-04
出版物タイトル Acta Medica Okayama
70巻
2号
出版者 Okayama University Medical School
開始ページ 139
終了ページ 144
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2016 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 27094839
Web of Science KeyUT 000377626300009
著者 Tsutsumi, Koichiro| Kawamoto, Hirofumi| Hirao, Ken| Sakakihara, Ichiro| Yamamoto, Naoki| Noma, Yasuhiro| Fujii, Masakuni| Kato, Hironari| Ogawa, Tsuneyoshi| Ishida, Etsuji| Kuwaki, Kenji| Nouso, Kazuhiro| Okada, Hiroyuki| Yamamoto, Kazuhide|
発行日 2012-09
出版物タイトル Pancreatology
12巻
5号
資料タイプ 学術雑誌論文
JaLCDOI 10.18926/AMO/49667
フルテキストURL 67_2_93.pdf
著者 Kita, Masahide| Yokota, Kenji| Okada, Hiroyuki| Take, Susumu| Takenaka, Ryuta| Kawahara, Yoshiro| Oguma, Keiji| Matsushita, Osamu| Yamamoto, Kazuhide|
抄録 Atrophy of the gastric mucosa is a precursor of intestinal-type gastric cancer, and Helicobacter pylori infection causes atrophic gastritis. The aim of this study was to determine whether the genetic diversity of H. pylori virulence genes is associated with the development and progression of gastric atrophy in humans. We isolated and cultured H. pylori strains from patients with gastric ulcer and duodenal ulcer accompanied by atrophic gastritis in background mucosa. H. pylori strains were stored at -80℃ prior to the experiments being carried out. We analyzed iceA, babA, vacA, cagA, and cagE genes by PCR. The cagA gene was analyzed through sequencing of the C-terminal region containing the EPIYA motif, which is related to tyrosine phosphorylation. Severe atrophy was observed in patients with gastric ulcer. The major phenotype of the vacA gene was s1c/m1 (93オ). The cagA gene was detected in all strains. The cagE gene was not detected in 2 and 5 strains from the mild cases and severe cases, respectively. The major cagA EPIYA motif, which is amino acids repeat in the C terminus, was the A-B-D type (44 of 58 strains). The virulence genes were not statistically associated with the severity of atrophy in the background gastric mucosa in humans. Not only identification of bacterial virulence factors but also studies of the host response will be necessary to investigate the progression of gastric atrophy and subsequent cancer development in humans.
キーワード Helicobacter pylori virulence genes chronic atrophic gastritis
Amo Type Original Article
発行日 2013-04
出版物タイトル Acta Medica Okayama
67巻
2号
出版者 Okayama University Medical School
開始ページ 93
終了ページ 98
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2013 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 23603925
Web of Science KeyUT 000317801700003
関連URL http://ousar.lib.okayama-u.ac.jp/metadata/52508