Hidemi Goto

Nagoya University, Nagoya, Aichi, Japan

Are you Hidemi Goto?

Claim your profile

Publications (560)1942.95 Total impact

  • [Show abstract] [Hide abstract]
    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
  • [Show abstract] [Hide abstract]
    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
  • [Show abstract] [Hide abstract]
    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
  • [Show abstract] [Hide abstract]
    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
  • [Show abstract] [Hide abstract]
    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
  • [Show abstract] [Hide abstract]
    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
  • Source
    [Show abstract] [Hide abstract]
    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
  • [Show abstract] [Hide abstract]
    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
  • Source
    [Show abstract] [Hide abstract]
    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
  • [Show abstract] [Hide abstract]
    ABSTRACT: Background and Aim Transabdominal ultrasonography (US) is commonly used for the initial screening of bilio-pancreatic diseases in Asian countries due to its widespread availability, the non-invasiveness and the cost-effectiveness. However, it is considered that US has limits to observe the area, namely the blind area. The observation of the pancreatic tail is particularly difficult. The goal of this study was to examine the pancreatic tail region that cannot be visualized on transverse scanning of the upper abdomen using US with spatial positional information and factors related to visualization, and observation of the tail from the splenic hilum. Methods Thirty-nine patients with pancreatic/biliary tract disease underwent CT and US with GPS-like technology and fusion imaging for measurement of the real pancreatic length and the predicted/real unobservable (PU and RU) length of the pancreatic tail. RU from US on transverse scanning and the real pancreatic length were used to determine the unobservable area (UA: RU/the real pancreatic length). Relationships of RU with physical and hematological variables that might influence visualization of the pancreatic tail were investigated. Results The real pancreatic length was 160.9 ± 16.4 mm, RU was 41.0 ± 17.8 mm, and UA was 25.3 ± 10.4%. RU was correlated with BMI (R = 0.446, P = 0.004) and waist circumferences (R = 0.354, P = 0.027), and strongly correlated with PU (R = 0.788, P < 0.001). The pancreatic tail was visible from the splenic hilum in 22 (56%) subjects and was completely identified in 13 (33%) subjects. Conclusions Combined GPS-like technology with fusion imaging was useful for the objective estimation of the pancreatic blind area.
    European Journal of Radiology. 01/2014;
  • [Show abstract] [Hide abstract]
    ABSTRACT: The hepatoprotective action of ursodeoxycholic acid (UDCA) was previously suggested to be partially dependent on its antioxidative effect. Doxorubicin (DOX) and reactive oxygen species have also been implicated in the overexpression of P-glycoprotein (P-gp), which is encoded by the MDR1 gene and causes antitumor multidrug resistance. In the present study, we assessed the effects of UDCA on the expression of MDR1 mRNA, P-gp, and intracellular reactive oxygen species levels in DOX-treated HepG2 cells and compared them to those of other bile acids. DOX-induced increases in reactive oxygen species levels and the expression of MDR1 mRNA were inhibited by N-acetylcysteine, an antioxidant, and the DOX-induced increase in reactive oxygen species levels and DOX-induced overexpression of MDR1 mRNA and P-gp were inhibited by UDCA. Cells treated with UDCA showed improved rhodamine 123 (Rho123) uptake, which was decreased in cells treated with DOX alone. Moreover, cells exposed to DOX for 24h combined with UDCA accumulated more DOX than that of cells treated with DOX alone. Thus, UDCA may have inhibited the overexpression of P-gp by suppressing DOX-induced reactive oxygen species production. Chenodeoxycholic acid (CDCA) also exhibited these effects, whereas deoxycholic acid and litocholic acid were ineffective. In conclusion, UDCA and CDCA had an inhibitory effect on the induction of P-gp expression and reactive oxygen species by DOX in HepG2 cells. The administration of UDCA may be beneficial due to its ability to prevent the overexpression of reactive oxygen species and acquisition of multidrug resistance in hepatocellular carcinoma cells.
    European journal of pharmacology 12/2013; · 2.59 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Autophagy can degrade aggregate-prone proteins, but excessive autophagy can have adverse effects. It would be beneficial if autophagy could be enhanced in a cell type-specific manner, but this has been difficult because the basic mechanism of autophagy is common. In the present study we found that inhibition of Niemann-Pick-type C1-like 1 (NPC1L1) by ezetimibe activates autophagy only in hepatocytes and small intestinal epithelia, but not in other cells. Ezetimibe induced accumulation of free cholesterol in the late endosome/lysosome and increased partitioning of a Ragulator component, LAMTOR1, in rafts. The latter change led to downregulation of mTORC1 activity by decreasing mTOR recruitment to the late endosome/lysosome and activated autophagy. A primary effect of ezetimibe was found to be a decrease of free cholesterol in the plasma membrane, because all the results caused by ezetimibe were suppressed by supplementation of cholesterol as a methyl-β-cyclodextrin complex. By enhancing autophagy in human primary hepatocytes with ezetimibe, insoluble mutant α1-antitrypsin Z was reduced significantly. Conclusion: Inhibition of NPC1L1 by ezetimibe activates autophagy in human hepatocytes by modulating cholesterol homeostasis. Ezetimibe may be utilized to ameliorate liver degeneration in α1-antitrypsin deficiency. (Hepatology 2013;).
    Hepatology 11/2013; · 12.00 Impact Factor
  • Journal of clinical gastroenterology 10/2013; · 2.21 Impact Factor
  • Gastrointestinal endoscopy 10/2013; · 6.71 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Abstract Objective. Inflammatory bowel disease (IBD) is a chronic debilitating disease associated with severe damage to the intestinal mucosa. Glucagon-like peptide-2 (GLP-2) is a potent and specific gastrointestinal growth factor. GLP-2 released from enteroendocrine cells is inactivated by dipeptidyl peptidase-4 (DPP-4). The aim of this study was to examine whether the DPP-4 inhibitor anagliptin improves experimental murine colitis. Material and methods. Male C57BL/6 mice aged 8 weeks were exposed to 1.5% dextran sulfate sodium (DSS) in drinking water for 7 days to induce experimental colitis. Anagliptin (0.1% in diet) was administrated from 2 days before the beginning of DSS to 7 days after the end of DSS. Changes in body weight and disease activity index were evaluated daily. Histological colitis severity, cellular proliferation and gene expression were determined in colonic tissues. Results. Treatment with anagliptin clearly improved body weight loss and disease activity index in the recovery phase. Histological score in the DSS + anagliptin group at day 14 was significantly lower than that in the DSS alone group. Treatment with anagliptin increased the Ki67-positive rate at days 10 and 14, and tended to increase insulin-like growth factor-1 mRNA expression in the DSS + anagliptin group. Conclusion. In this model of experimental colitis, the DPP-4 inhibitor anagliptin facilitated the restoration of mucosal damage, thereby resulting in the acceleration of healing. These findings suggest a new and novel therapeutic approach for the treatment of IBD.
    Scandinavian journal of gastroenterology 10/2013; 48(10):1152-9. · 2.08 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: To our knowledge, this is the first report of Cowden syndrome complicated by a gastrointestinal stromal tumor (GIST) of the small bowel. A 42-year-old female patient was found to have an abdominal mass that was diagnosed as the cause of anemia and was surgically extracted. The surgical specimen was found to be a GIST. During the same period, the patient underwent an endoscopic examination of the entire gastrointestinal tract. She was also diagnosed as having Cowden syndrome based on gastrointestinal polyps and skin, thyroid and breast lesions. Cowden syndrome is associated with germline mutations in the tumorsuppressor gene PTEN. PTEN expression may be essential to tumor growth and is a predictive biomarker of the prognosis of both diseases. The present report of such a case is expected to further the analysis of Cowden syndrome.
    Digestive Endoscopy 09/2013; · 1.61 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: An accurate diagnosis of pancreatic fibrosis is clinically important and may have potential for staging chronic pancreatitis. The aim of this study was to diagnose the grade of pancreatic fibrosis through a quantitative analysis of endoscopic ultrasound elastography (EUS-EG). From September 2004 to October 2010, 58 consecutive patients examined by EUS-EG for both pancreatic tumors and their upstream pancreas before pancreatectomy were enrolled. Preoperative EUS-EG images in the upstream pancreas were statistically quantified, and the results were retrospectively compared with postoperative histological fibrosis in the same area. For the quantification of EUS-EG images, 4 parameters (mean, standard deviation, skewness, and kurtosis) were calculated using novel software. Histological fibrosis was graded into 4 categories (normal, mild fibrosis, marked fibrosis, and severe fibrosis) according to a previously reported scoring system. The fibrosis grade in the upstream pancreas was normal in 24 patients, mild fibrosis in 19, marked fibrosis in 6, and severe fibrosis in 9. Fibrosis grade was significantly correlated with all 4 quantification parameters (mean r = -0.75, standard deviation r = -0.54, skewness r = 0.69, kurtosis r = 0.67). According to the receiver operating characteristic analysis, the mean was the most useful parameter for diagnosing pancreatic fibrosis. Using the mean, the area under the ROC curves for the diagnosis of mild or higher-grade fibrosis, marked or higher-grade fibrosis and severe fibrosis were 0.90, 0.90, and 0.90, respectively. An accurate diagnosis of pancreatic fibrosis may be possible by analyzing EUS-EG images.
    Journal of Gastroenterology 09/2013; · 3.79 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: To elucidate the effect of liver transplantation (LT) on brain dysfunctions in cirrhotic patients who had no clinical evidence of hepatic encephalopathy (HE), we performed a prospective study of voxel-based diffusion tensor imaging (DTI) and detailed cognitive examination. We assessed 12 consecutive patients as transplant candidates by DTI, with neurological and cognitive examinations just before and at 6 months after LT. After LT, cirrhotic patients showed significant improvement in visual reproduction, digit symbol, digit span, Stroop test, and Trail-making test scores, suggesting recovery of frontal-temporal function. As for voxel-based DTI, increased mean diffusivity (MD) and reduced fractional anisotropy (FA) values were found before LT in the frontal and temporal lobes of cirrhotic patients. After LT, the unusual FA and MD values observed in the frontal and temporal lobes preoperatively were significantly reduced. End-stage cirrhotic patients without clinical evidence of HE showed increased MD and decreased FA values in both frontal and temporal lobes. These parameters improved after LT, in line with cognitive function. MD and FA values might be of value as a biomarker in end-stage cirrhotic patients for investigating brain tissue dysfunctions and evaluating the efficacy of LT.
    Clinical neurology and neurosurgery 09/2013; · 1.30 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: This Phase II trial was designed to evaluate the safety and efficacy of neoadjuvant oxaliplatin and capecitabine and bevacizumab without radiotherapy in patients with poor-risk rectal cancer. Patients with magnetic resonance imaging-defined poor-risk rectal cancer received neoadjuvant oxaliplatin and capecitabine and bevacizumab followed by total mesorectal excision or more extensive surgery. Between February 2010 and December 2011, 32 patients were enrolled in this study. The completion rate of the scheduled chemotherapy was 91%. Reasons for withdrawal were refusal to continue therapy in two patients and disease progression in one, with two of these three patients not undergoing surgery. Among the 29 patients who completed the scheduled chemotherapy, one refused surgery within 8 weeks after the completion of chemotherapy, which was the period stipulated by the protocol, and another had rectal perforation, requiring urgent laparotomy. As a result, the completion rate of this experimental treatment was 84%. Of the 30 patients who underwent surgery, the R0 resection rate was 90% and a postoperative complication occurred in 43%. A pathological complete response was observed in 13% and good tumor regression was exhibited in 37%. Neoadjuvant oxaliplatin and capecitabine plus bevacizumab for poor-risk rectal cancer caused a high rate of anastomotic leakage and experienced a case with perforation during chemotherapy, both of which were bevacizumab-related toxicity. Although the short-term results with the completion rate of 84.4% and the pathological complete response rate of 13.3% were satisfactory, we have to reconsider the necessity of bevacizumab in neoadjuvant chemotherapy (UMIN number, 000003507).
    Japanese Journal of Clinical Oncology 08/2013; · 1.90 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Hepatic portal venous gas is a rare condition that occurs when intraluminal gas or gas produced by intestinal bacteria enters the portal venous circulation. It has recently been recognized as a rare complication of colon procedures by endoscopy or barium enema. Given the frequency of these procedures in patients with inflammatory bowel disease, hepatic portal venous gas may occur more frequently in these patients than previously reported. Here, we report a woman with Crohn's disease who developed hepatic portal venous gas following colonoscopy who was treated with conservative therapy.
    Nagoya journal of medical science 08/2013; 75(3-4):273-8.

Publication Stats

5k Citations
1,942.95 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
  • 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