Hidemi Goto

Nagoya University, Nagoya, Aichi, Japan

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Publications (575)2037.87 Total impact

  • Gastrointestinal endoscopy. 11/2014;
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    ABSTRACT: Malignant ascites due to peritoneal metastasis is one of the major problems caused by advanced gastrointestinal cancer. Although drainage of a large amount of ascitic fluid improves symptoms such as abdominal fullness, it may lead to protein loss and renal dysfunction. Cell-free and concentrated ascites reinfusion therapy (CART) may help avoid such complications due to paracentesis. The purpose of this study was to evaluate the safety of CART. We performed a total of 51 sessions of CART in 5 patients, 4 of whom had gastric cancer and 1 appendiceal cancer. We retrospectively evaluated laboratory data immediately prior to CART, on the following day, 1 week later and 2 weeks later. We also measured the amount of total protein and albumin in collected and concentrated ascites. The mean amount of collected ascites was 4,007 ml. All the patients exhibited improvement of symptoms such as abdominal fullness. Four patients developed fever (>38°C) immediately after reinfusion of the concentrated ascites and 3 of these patients required corticosteroid administration. The mean total protein and albumin in the collected ascites were 122 and 64 g, respectively, and those in the concentrated ascites 75 and 39 g, respectively. The serum levels of total protein, albumin and creatinine after CART were almost identical to those prior to CART. Blood hemoglobin concentration was significantly decreased 1 day after CART and returned to baseline levels in 1-2 weeks. CART does not cause renal dysfunction and does not decrease serum albumin; therefore, repeated CART is safe and may be used to improve the symptoms of malignant ascites from gastrointestinal cancer.
    Molecular and Clinical Oncology 11/2014; 2(6):1103-1106.
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    ABSTRACT: Background/Aims: We classified intestinal lymphangiectasia (IL) into two categories, the white and non-white villi types, and evaluated their clinical characteristics and therapeutic responses. Methods: Of the 988 patients who underwent double-balloon enteroscopy, 14 consecutive patients (7 men and 7 women, median age at onset 34 years) were enrolled with immunohistochemically confirmed IL with protein-losing enteropathy. Results: Enteroscopically the white villi type (n = 8) showed white plaques and white-tipped villi were scattered in the small bowel, while non-white villi type (n = 6) showed that apparently normal but under more detailed observation, low and round villi with a normal color were diffused. The serum albumin levels and fecal α1-antitrypsin clearance before treatment were significantly worse in the non-white villi type (p = 0.017 and 0.039, respectively), whereas the serum immunoglobulin A and M levels were significantly lower in the white villi type (p = 0.010 and 0.046, respectively). At gastroscopy, a non-cirrhotic snakeskin appearance was significantly observed in the non-white villi type (p = 0.015). The corticosteroid response was better in the non-white villi type (p = 0.015). Conclusion: Two distinct subgroups were found in IL. This classification was useful in pathophysiological clustering and in predicting the therapeutic response. © 2014 S. Karger AG, Basel.
    Digestion 10/2014; 90(3):155-166. · 1.94 Impact Factor
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    ABSTRACT: This study evaluated the efficacy and safety of transnasal endoscopy (TNE) with flexible spectral imaging color enhancement (FICE) for detection of superficial cancer in the pharyngeal and esophageal regions for high-risk populations. Patients who previously had head and neck or esophageal squamous cell carcinoma were enrolled. Screening was conducted using TNE with conventional white-light endoscopy (WLE) followed by FICE chromoendoscopy. For observation of the pharyngeal region, the Valsalva maneuver was employed. 99 patients were eligible. Six esophageal cancers were detected in four patients (4.0%). The sensitivity, specificity, and accuracy for the detection of cancer were 25.0% (95% CI, 3.4- 71.0), 97.8% (95% CI, 92.1-99.8), and 94.9 % (95% CI, 88.4-98.1), respectively for WLE; 100% (95% CI, 45.4%- 100%), 96.8% (95% CI, 90.7%-99.3%), and 96.9% (95% CI, 89.3%-99.1%), respectively for FICE chromoendoscopy. Pain in the nose and nasal hemorrhage were observed in 3 (3.0%) and 2 patients (2.0%), respectively. Following the Valsalva maneuver, endoscopic scores significantly increased from a mean of 1.1 (0.8-1.4) to 2.0 (1.3-2.6) (p<0.05). TNE with the Valsalva maneuver is a promising screening method for the pharyngeal and esophageal regions. TNE with FICE chromoendoscopy for detecting pharyngeal and esophageal cancer was more sensitive than WLE.
    Hepatogastroenterology. 09/2014; 61(134):1627-34.
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    ABSTRACT: The striatin family of proteins, comprising STRN, STRN3, and STRN4, are multidomain–containing proteins that associate with additional proteins to form a large protein complex. We previously reported that STRN4 directly associated with protein kinases, such as MINK1, TNIK and MAP4K4, which are associated with tumor suppression or tumor progression. However, it remains unclear whether STRN4 is associated with tumor progression. In this report, we examined the role that STRN4 plays in cancer malignancy. We show that depletion of STRN4 suppresses proliferation, migration, invasion and the anchorage-independent growth of cancer cells. Additionally, STRN4 knockdown increased the sensitivity of pancreatic cancer cells to gemcitabine. Finally, we show that STRN4 knockdown suppressed the proliferation and metastasis of cancer cells in mice. Our results demonstrate a possible role of STRN4 in tumor progression.This article is protected by copyright. All rights reserved.
    Cancer Science 09/2014; · 3.48 Impact Factor
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    ABSTRACT: Background & AimsThe population of patients chronically infected with hepatitis C virus (HCV) is aging and the number of older patients with HCV-related hepatocellular carcinoma (HCC) is increasing. The purpose of this study was to elucidate the effects of peginterferon and ribavirin combination therapy on prevention of HCC in older patients with chronic hepatitis C (CH-C).Methods We compared the sustained virological response (SVR) and treatment discontinuation rates between older (≥ 65 years) and younger patients (< 65 years) among 1280 CH-C patients treated with peginterferon alfa-2b and ribavirin. Cumulative incidence of HCC was determined by Kaplan-Meier analysis and factors associated with liver carcinogenesis were analyzed by Cox proportional hazards regression.ResultsOlder patients had a significantly lower SVR rate and a significantly higher discontinuation rate of treatment than younger patients. Fifty patients developed HCC during median follow-up period of 47 months. Cox proportional hazards regression analysis indicated that the following were independent risk factors associated with the development of HCC: older age, male, advanced fibrosis, Non-SVR in all patients: higher gamma-glutamyltranspeptidase (GGT), Non-SVR in older patients. Older patients who achieved SVR had a significantly reduced rate of HCC compared with those who did not achieve SVR, especially those who had GGT over 44IU/L.Conclusions The SVR rate was lower and the combination therapy discontinuation rate was higher in older CH-C patients than in younger patients. However, older patients who achieved SVR had a markedly lower rate of HCC development compared to older patients who did not achieve SVR.
    Journal of Gastroenterology and Hepatology 08/2014; · 3.33 Impact Factor
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    ABSTRACT: Magnetic anchor-guided endoscopic submucosal dissection (MAG-ESD) was developed to reduce adverse events such as bleeding and perforation and to facilitate ESD. However, the external electromagnet required miniaturization to make it suitable for daily clinical practice.
    Gastrointestinal endoscopy. 07/2014;
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    ABSTRACT: Background The aetiology for nonsteroidal anti-inflammatory drug (NSAID)-induced small intestinal injuries has not been well characterised.AimTo determine the risk factors of symptomatic NSAID-induced small intestinal injuries, including diaphragm disease.Methods Of the 1262 symptomatic patients who underwent videocapsule endoscopy and/or double-balloon enteroscopy, 156 consecutive patients were verified as having taken NSAIDs. Their CYP2C9*2, *3 and *13 single nucleotide polymorphisms (SNPs) were determined by allelic discrimination with Taqman 5’-nuclease assays.ResultsOf the 156 NSAIDs users, 31 patients (20%) were diagnosed with NSAID-induced small intestinal injury. Multivariate analysis indicated that the presence of comorbidities and the use of oxicams (meloxicam, ampiroxicam and lornoxicam) or diclofenac were associated with an increased risk of NSAID-induced small intestinal injury (adjusted OR: 2.97, 95% CI: 1.05–8.41, P = 0.041 and adjusted OR: 7.05, 95% CI: 2.04–24.40, P = 0.002, respectively). The combination of aspirin and non-aspirin NSAID was more damaging than aspirin alone. Age, sex, concomitant use of proton pump inhibitors, indications for NSAIDs use, duration of NSAIDs use and CYP2C9*2, *3 and *13SNPs were unrelated. The use of meloxicam and CYP2C9*3SNPs were significantly associated with an increased risk for diaphragm disease (adjusted OR: 183.75, 95% CI: 21.34–1582.38; P < 0.0001 and adjusted OR: 12.94, 95% CI: 1.55–108.36, P = 0.018, respectively).Conclusions The use of specific NSAIDs and the factors interfering with NSAIDs metabolism might associate with small intestinal injury, especially with diaphragm disease.
    Alimentary Pharmacology & Therapeutics 07/2014; · 4.55 Impact Factor
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    ABSTRACT: Background & Aims: The single nucleotide polymorphism (SNP) of interleukin 28B (IL28B) and the mutations in the NS5A region of hepatitis C virus (HCV) genotype 1 have been associated with response to interferon (IFN) therapy. However, these relationships in patients with HCV genotype 2 are not well understood. The aim of this study was to investigate whether the SNP of IL28B (rs8099917) and amino acid substitutions in the NS5A region in patients with HCV genotype 2 affect the response to IFN and ribavirin combination therapy. Methods: The study enrolled 286 patients with chronic hepatitis C genotype 2. Patients received pegylated-IFN-alpha 2b once each week plus oral ribavirin daily for 24 weeks. Results: Of the 286 patients, 215 (75.2%) achieved sustained virologic response (SVR). Rate of SVR was similar in patients with IL28B TT allele (76%) and those with TG or GG alleles (72%). Patients with SVR were younger than those without SVR (p<0.001). SVR was achieved in 65.9% of patients with wild-type IFN sensitivity-determining region (ISDR) and 83.5% of patients with mutant-type (p<0.001). There were no significant differences in other factors, including sex, alanine aminotransferase, platelet count, HCV viral load, HCV genotype, and IL28B genotype. The factors related to SVR on multivariate analysis were age (p=0.019) and ISDR (p=0.003). Conclusions: ISDR sequence variations are significantly associated with IFN responsiveness in patients with HCV genotype 2. The SNP of IL28B was not associated with SVR in patients with HCV genotype 2.
    Journal of Gastroenterology and Hepatology 07/2014; · 3.33 Impact Factor
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    ABSTRACT: Background and AimThe Agile patency capsule (PC; Given Imaging Ltd, Yoqneam, Israel) is used as a dummy prior to capsule endoscopy (CE) to avoid retention of the CE capsule. However, impaction of the PC's inner radio frequency identification (RFID) tag in a stricture could cause small-bowel ileus. Recently, the RFID tag-less PC was introduced into clinical practice. Herein, we aimed to retrospectively evaluate the usefulness of the tag-less PC.Methods Of 154 patients who were scheduled to undergo CE, 100 consecutive patients (65%) who underwent PC evaluation were enrolled in the present study. Primary study end point was the retention rate of the CE capsule after successful passage of the PC. Secondary end point was analysis of the significant factors affecting the passage of the PC.ResultsIn total, 87 patients (87%) had bowel patency confirmed by PC evaluation. There was no capsule retention in any of these 87 patients during CE. Abnormal findings were obtained from 60 CE, and 41 patients received new or modified treatment. Multivariate analysis of factors related to the confirmation of patency demonstrated that stenosis on imaging was the most influential factor (P = 0.002, odds ratio 16.387). The results confirmed that passage of the PC depends on stenosis on imaging.Conclusions Use of the tag-less PC confirmed gastrointestinal tract patency for most of the patients who did not have stenosis on imaging and allowed estimation of the patency for patients who did have stenosis on imaging.
    Digestive Endoscopy 06/2014; · 1.61 Impact Factor
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    ABSTRACT: (Background and Aims) The combination of nucleos(t)ide analogue (NA) and anti-hepatitis B immunoglobulin (HBIg) is established as safe and effective prophylaxis against hepatitis B virus (HBV) reactivation after liver transplantation. However, essential weak point of this regimen is high cost. The hepatitis B (HB) vaccine is one of the attractive alternatives that costs lower, and enables some patients to have a sufficiently high titer of anti-hepatitis B surface antibodies (HBsAb). Almost no data exist on whether NA can be stopped safely in such successfully vaccinated patients. We investigated the incidence of HB vaccine escape mutants in liver recipients who could get sufficient HBsAb titer after liver transplantation and stopped NA.(Patients and Methods) Among 18 HBV carriers and 7 non-HBV patients received grafts from anti-hepatitis core antibody (HBcAb) positive donors, 2 HBV carriers and 6 non-HBV patients who could get HBsAb titers >100 IU/l for >3 months after posttransplant vaccination were weaned from NA. In the patients who showed viremia, we analyzed amino acid sequences of the HB envelope protein and performed statistical analysis for the factors associated with viremia.(Results) Among 8 patients who could get sufficient HBsAb after vaccination and stopped NA, HBV-DNA appeared in 4 patients after a median of 12 months. Sequence analysis showed various amino acid mutations in the HB envelope region, including the a-determinant. Frequent vaccination was shown as a statistically significant risk factor for inducing viremia.(Conclusions) Although HB vaccine is an effective substitute for prophylaxis against HBV reactivation in some patients after liver transplantation, frequent vaccination could be a risk factor for producing escape mutants. Our data demonstrated not only that caution must be exercised in stopping NA in effectively vaccinated patients, especially in whom were administered frequently, but also the importance for setting stopping rule of vaccination in transplanted patients. Liver Transpl , 2014. © 2014 AASLD.
    Liver Transplantation 06/2014; · 3.94 Impact Factor
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    ABSTRACT: Acetate is the major short-chain fatty acid produced by commensal bacteria in the gut and is known as a nutrient source for epithelial cells of the mucosa. Acetate also suppresses interleukin (IL)-2 production in T cells by inhibiting nuclear factor of activated T cells (NFAT) nuclear translocation via tubulin-α acetylation. Using acetylation of tubulin-α as a biomarker, we have examined the influence of acetate in the large intestine. Because of high concentrations of acetate in fecal material, tubulin-α acetylation is dominant in the proximal large intestine relative to other sections of the large intestine and is induced in epithelial cells of the colonic mucosa. Flagellin stimulation induces IL-8 production in epithelial cells and acetate suppresses this IL-8 production via tubulin-α acetylation. Flagellin stimulation activates nuclear factor-κB, CREB and AP-1, but not NFAT. Of these transcription factors, acetate specifically inhibits AP-1 activation. Acetate impairs flagellin-induced activation of the Rap1-MEK-ERK-Elk-1 pathway with acetylation of tubulin-α that is bound to Rap1, resulting in reduced expression of c-Fos, a subunit of AP-1. These findings reveal a novel action of acetate via tubulin-α acetylation in epithelial cells of the colonic mucosa.Immunology and Cell Biology advance online publication, 29 April 2014; doi:10.1038/icb.2014.31.
    Immunology and Cell Biology 04/2014; · 3.93 Impact Factor
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    ABSTRACT: Background and AimIn therapeutic endoscopic retrograde cholangiography (ERC) using a balloon-assisted enteroscope, each instrument insertion requires a long time, which prolongs the duration of the procedure. We conducted a retrospective single-center study to compare instrument insertability of a double-balloon enteroscope (DBE) with a 2.8-mm instrument channel diameter and a prototype short single-balloon enteroscope (SBE) with a 3.2-mm instrument channel diameter.Methods We used a stop-watch to measure instrument insertion time from the instrument channel port to the tip of the enteroscope when balloon-assisted ERC was done. The instruments were divided into two groups (outer diameter larger or smaller than 2 mm). Lengths from the instrument channel port to the tip of the DBE (EI-530B; FUJIFILM, Tokyo, Japan) and the prototype SBE (SIF-Y0004-V01; Olympus Medical Systems, Tokyo, Japan) were identical (1680 mm). ERC using DBE was carried out in four cases, as was ERC using SBE.ResultsThere was a significant time difference (P = 0.001) when using instruments whose outer diameters were >2 mm (53.5 ± 19.0 s in DBE vs 28.4 ± 8.4 s in SBE).Conclusion The prototype SBE with a 3.2-mm channel demonstrated not only that many types of instrument can be used, but also that the time required to insert instruments may be shorter than that with DBE with a 2.8-mm channel.
    Digestive Endoscopy 04/2014; 26(S2). · 1.61 Impact Factor
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    ABSTRACT: This paper presents a new colonoscope navigation system. CT colonography is utilized for colon diagnosis based on CT images. If polyps are found while CT colonography, colonoscopic polypectomy can be performed to remove them. While performing a colonoscopic examination, a physician controls colonoscope based on his/her experience. Inexperienced physicians may occur complications such as colon perforation while colonoscopic examinations. To reduce complications, a navigation system of colonoscope while performing the colonoscopic examinations is necessary. We propose a colonoscope navigation system. This system has a new colonoscope tracking method. This method obtains a colon centerline from a CT volume of a patient. A curved line (colonoscope line) representing the shape of colonoscope inserted to the colon is obtained by using electromagnetic sensors. A coordinate system registration process that employs the ICP algorithm is performed to register the CT and sensor coordinate systems. The colon centerline and colonoscope line are registered by using a line registration method. The position of the colonoscope tip in the colon is obtained from the line registration result. Our colonoscope navigation system displays virtual colonoscopic views generated from the CT volumes. A viewpoint of the virtual colonoscopic view is a point on the centerline that corresponds to the colonoscope tip. Experimental results using a colon phantom showed that the proposed colonoscope tracking method can track the colonoscope tip with small tracking errors.
    SPIE Medical Imaging; 03/2014
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    ABSTRACT: AimHepatocellular carcinoma develops even in some patients who achieve a sustained virological following treatment for hepatitis C virus infection. This study investigated the relationship between changes in fibrosis, as assessed by sequential biopsies, and development of hepatocellular carcinoma in patients who achieved a sustained virological response for hepatitis C virus.Methods We enrolled 97 patients with sustained virological responses who had undergone initial biopsies before therapy and sequential biopsies at an average of 5.8 ± 1.9 years after the initial biopsy. Factors associated with hepatocellular carcinoma were retrospectively analyzed.ResultsThe liver fibrosis stage regressed in 44 patients (45%), remained stable in 47 patients (48%), and progressed in 6 patients (6%). The fibrosis stage significantly decreased, from 1.54 ± 0.86 units to 1.16 ± 1.07 units. Hepatocellular carcinoma was identified in 12 patients (12.4%). The cumulative incidence of hepatocellular carcinoma in patients with progressive fibrosis was significantly higher than that in patients with regressed or stable fibrosis (P < 0.001). A Cox proportional hazards regression analysis confirmed that progressive fibrosis in sequential liver biopsies (hazard ratio [HR], 8.30; P = 0.001) and low platelet counts before treatment (HR, 8.69; P = 0.006) were significant independent factors associated with the development of hepatocellular carcinoma in patients with a sustained virological response.Conclusions Progressive fibrosis, assessed by sequential biopsies, was significantly correlated with development of hepatocellular carcinoma in patients who had achieved a sustained virological response for hepatitis C virus.
    Hepatology Research 03/2014; · 2.07 Impact Factor
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    ABSTRACT: Small bowel tumors (SBTs) are uncommon, insidious in presentation, and frequently represent a diagnostic challenge. The advent of video capsule endoscopy (VCE) and double-balloon endoscopy (DBE) is a significant breakthrough for visual diagnosis of SBTs throughout the small bowel. Contrast-enhanced computed tomography (CECT) and fluoroscopic enteroclysis had significantly lower diagnostic yields of tumors that were 10 mm or smaller in diameter, but VCE and DBE had high diagnostic yields regardless of tumor size. Regarding SBTs larger than 10 mm in diameter, CECT had a significantly lower diagnostic yield of epithelial tumors compared to subepithelial tumors, whereas fluoroscopic enteroclysis and DBE had high diagnostic yields regardless of the tumor type. VCE had a slightly lower diagnostic yield of subepithelial tumors (78%) compared to epithelial tumors. Therefore, a combined examination method by using CECT and VCE is useful for screening of SBTs. In case suspicious of stenosis, patency capsule should be performed to confirm passage before VCE. DBE is useful for further precise examination including biopsy and ultrasonography by using miniature probe, and enteroscopic treatment. After medical, enteroscopic, and surgical treatment, VCE is helpful for follow-up. DBE is safe and useful in resecting the SBTs deep within the small bowel without laparotomy. Indications of enteroscopic resection may be benign tumors regardless of epithelial or subepithelial type, localizing in the mucosal or submucosal layer, which are symptomatic at present or possibly symptomatic or transforming in the future. Malignant tumors localized in the mucosal layer may be indications although detecting at an early stage is challenging. In this review article, we describe management of SBTs/polyps by various modalities.
    Annals of translational medicine. 03/2014; 2(3):30.
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    ABSTRACT: The mechanisms of drug resistance in cancer are not fully elucidated. To study the drug resistance of gastric cancer, we analyzed gene expression and DNA methylation profiles of 5-fluorouracil (5-FU)- and cisplatin (CDDP)-resistant gastric cancer cells and biopsy specimens. Drug-resistant gastric cancer cells were established with culture for >10 months in a medium containing 5-FU or CDDP. Endoscopic biopsy specimens were obtained from gastric cancer patients who underwent chemotherapy with oral fluoropyrimidine S-1 and CDDP. Gene expression and DNA methylation analyses were performed using microarray, and validated using real-time PCR and pyrosequencing, respectively. Out of 17,933 genes, 541 genes commonly increased and 569 genes decreased in both 5-FU- and CDDP-resistant AGS cells. Genes with expression changed by drugs were related to GO term 'extracellular region' and 'p53 signaling pathway' in both 5-FU- and CDDP-treated cells. Expression of 15 genes including KLK13 increased and 12 genes including ETV7 decreased, in both drug-resistant cells and biopsy specimens of two patients after chemotherapy. Out of 10,365 genes evaluated with both expression microarray and methylation microarray, 74 genes were hypermethylated and downregulated, or hypomethylated and upregulated in either 5-FU-resistant or CDDP-resistant cells. Of these genes, expression of 21 genes including FSCN1, CPT1C and NOTCH3, increased from treatment with a demethylating agent. There are alterations of gene expression and DNA methylation in drug-resistant gastric cancer; they may be related to mechanisms of drug resistance and may be useful as biomarkers of gastric cancer drug sensitivity.
    Oncology Reports 02/2014; · 2.30 Impact Factor
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    ABSTRACT: Copper toxicity steadily affects the livers of patients with Wilson disease. However, the toxic effect of copper on serum aspartate and alanine aminotransferase levels remains to be clarified as a prerequisite for diagnostic tests. The clinical records of 33 cases were analyzed to clarify the natural history of Wilson disease. Phenotypes were simplified into hepatic, acute, and neurologic. The bio-low stage of both enzymes was less than 40 IU/L, the bio-moderate stage was intermediate between 40 and 200 IU/L, and the bio-high stage was more than 200 IU/L of either or both enzymes. Rebounded enzyme levels at the recovery period from anemia were presumed to be the chronic baselines when pre-anemic enzyme levels were not available in the acute phenotype. We investigated whether these enzyme levels may provide information useful for screening patients. The natural history of chronic Wilson disease consisted of the first increasing and second decreasing phases. The clinical courses of a 4-year-old boy and 12-year-old girl were representative of the 2 phases, respectively. All but one patient were in the decreasing phase. Negative correlations were obtained between age and enzyme level in the decreasing phase. The hepatic phenotype may be a prototype found throughout the 2 phases, and acute and neurologic phenotypes may be major complications in the bio-moderate and bio-low stages of the decreasing phase, respectively. Biochemical staging may provide a better understanding of Wilson disease when combined with phenotypes. Bio-high stage patients should be referred to a medical center for diagnosis.
    Nagoya journal of medical science 02/2014; 76(1-2):139-48.
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    ABSTRACT: Until the approval of patency capsule, capsule endoscopy (CE) has not been routinely applied for the diagnosis of Crohn's disease (CD) in Japan. We aimed to survey current situation of CE use for patients with CD in Japan. The nationwide survey of 40 Japanese institutions identified 94 patients with established CD (eCD) and 80 patients with suspected CD (sCD), who were examined by CE. Types and positive rates of mucosal injury under CE and capsule retention rate were investigated. In sCD, final diagnosis after CE was also analyzed. Patients with eCD comprised 82 patients of ileitis or ileocolitis type, while 12 patients had CD of colitis type. CE identified mucosal injuries in 83 of 94 patients. Eight of 12 patients with eCD of colitis type had ileal lesions under CE, thereby being reclassified as ileocolitis type. In patients with sCD, CE detected mucosal injuries in 58 patients. Linear ulceration and cobblestone appearance were depicted in 22 and 3 patients, respectively, thereby resulting in established diagnosis of CD in 23 patients. Mucosal lesion was not found in 22 patients with sCD, who were diagnosed as not having CD. Capsule retention rate was not statistically different between patients with eCD and those with sCD (7.4% vs 6.3%, P = 1.0). CE is useful for the evaluation of small bowel mucosal injuries in Japanese patients with sCD and eCD. Possible intestinal stricture needs to be carefully evaluated before CE even in patients with sCD.
    Journal of Gastroenterology and Hepatology 01/2014; 29(1):96-101. · 3.33 Impact Factor
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    ABSTRACT: Background To assess the diagnostic ability and safety of endoscopic retrograde cholangiopancreatography (ERCP) in in-depth preoperative examination of children patients with pancreaticobiliary maljunction (PBM). Methods In 63 patients with a definite diagnosis of PBM, the ability to visualize the bile and main pancreatic ducts was compared between ERCP, which was performed in 63 patients with a definite diagnosis of PBM, and magnetic resonance cholangiopancreatography (MRCP), which was performed before ERCP in 29 patients. For ERCP, its complications were also evaluated. Results The intrahepatic bile ducts could be visualized using ERCP in 44 patients (69.8%) and using MRCP in 18 (62.1%). The extrahepatic bile ducts could be visualized using ERCP in 59 patients (93.7%) and using MRCP in 29 (100%). The rates of the visualization of the main pancreatic duct and pancreaticobiliary ductal union were significantly higher in using ERCP than in using MRCP (96.8 vs. 41.4% and 90.5 vs. 37.9%, respectively; P < 0.0001). As complications, hyperamylasemia developed in 12 patients (19%), but no other severe complications such as pancreatitis were observed. Conclusions ERCP as part of an in-depth preoperative examination of children with PBM is useful and safe.
    Journal of Pediatric Surgery. 01/2014;

Publication Stats

6k Citations
2,037.87 Total Impact Points

Institutions

  • 1988–2014
    • Nagoya University
      • • Division of Endoscopy
      • • Division of Gastroenterology and Hepatology
      • • Clinical Laboratory
      • • Department of Preventive Medicine
      • • Division of of Internal Medicine
      • • Division of Biological Chemistry
      Nagoya, Aichi, Japan
  • 2012–2013
    • Aichi Gakuin University
      • Department of Medicine
      Nagoya-shi, Aichi-ken, Japan
    • Japanese Red Cross Kyoto Daiichi Hospital
      Kioto, Kyōto, Japan
  • 2006–2013
    • Fujita Health University
      • Department of Internal Medicine
      Nagoya, Aichi, Japan
    • Broad Institute of MIT and Harvard
      Cambridge, Massachusetts, United States
  • 1997–2013
    • Aichi Cancer Center
      Ōsaka, Ōsaka, Japan
  • 2006–2012
    • National Hospital Organization Nagoya Medical Center
      Nagoya, Aichi, Japan
  • 2010
    • Aichi Medical University
      Okazaki, Aichi, Japan
  • 2005–2010
    • University Hospital Medical Information Network
      Edo, Tōkyō, Japan
  • 2003–2010
    • Ogaki Municipal Hospital
      Gihu, Gifu, Japan
  • 2006–2009
    • Nagoya Memorial Hospital
      Nagoya, Aichi, Japan
  • 2005–2009
    • Nagoya City University
      • Department of Pathology
      Nagoya, Aichi, Japan
  • 1997–2004
    • Nagoya Second Red Cross Hospital
      Nagoya, Aichi, Japan
  • 1998–2000
    • Nagai Internal Medicine Clinic
      Okayama, Okayama, Japan
  • 1995–1999
    • Toyohashi Municipal Hospital
      Toyohasi, Aichi, Japan
    • Nagoya Institute of Technology
      • Department of Materials Science and Engineering
      Nagoya, Aichi, Japan