Hidemi Goto

Nagoya University, Nagoya, Aichi, Japan

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Publications (588)2256.52 Total impact

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    ABSTRACT: To evaluate long-term prognosis following cyclosporine treatment by examining the rate of surgery avoidance among cyclosporine responders. We retrospectively reviewed clinical records for 29 patients diagnosed with severe steroid-refractory ulcerative colitis in our hospital from August 1997 to August 2008 and treated with cyclosporine by continuous intravenous infusion. All patients were treated with intravenous corticosteroids for more than 5 d prior to cyclosporine therapy. Administration was continued for up to 21 d under serum monitoring to maintain cyclosporine levels between 400 and 600 ng/mL. Clinical activity was assessed before and after cyclosporine therapy using the clinical activity index score, with a reduction of ≥ 5 considered to indicate a response. Among responders, we defined cases not requiring surgery for more than 5 years as exhibiting long-term efficacy of cyclosporine. Factors considered to be possibly predictive of long-term efficacy of cyclosporine were sex, age, disease duration, clinical activity index score, C-reactive protein level, hemoglobin level, disease extent, endoscopic findings, and clinical course. Cyclosporine was not discontinued due to side effects in any patient. Nineteen (65.5%) of 29 patients were considered responders. A statistically significant (P = 0.004) inverse association was observed between an endoscopic finding of "mucosal bleeding" and responsive cases. Fifteen (9 males, 6 females) of these 19 patients were followed for 5 years or more, of whom 9 (60%) exhibited long-term efficacy of cyclosporine. Of the 10 non-responders, 9 (90%) underwent surgery within 6 mo of cyclosporine therapy. None of the following factors had a significant impact on the long-term efficacy of cyclosporine: sex, age, duration of disease, clinical activity index score, C-reactive protein level, hemoglobin level, extent of disease, endoscopic findings, or clinical course. In contrast, a significant association was observed for maintenance therapy with azathioprine after cyclosporine therapy (P = 0.0014). Maintenance therapy with azathioprine might improve the long-term efficacy of continuously infused cyclosporine for severe steroid-refractory ulcerative colitis patients.
    World journal of gastroenterology : WJG. 01/2015; 21(1):254-61.
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    ABSTRACT: Small-bowel bleeding has a majority of obscure gastrointestinal bleeding, but is caused by various kinds of diseases. For its diagnosis, history taking and physical examination is requisite, leading to suspicion of what diseases are involved. Next, cross-sectional imaging such as computed tomography should be performed, followed by latest enteroscopy, videocapsule endoscopy and deep enteroscopy according to the severity of hemorrhage and patient conditions. After comprehensive diagnosis, medical, enteroscopic, or surgical treatment should be selected.
    Digestive Endoscopy 01/2015; · 1.61 Impact Factor
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    ABSTRACT: Hepatocellular carcinoma (HCC) is one of the most common malignant diseases worldwide. While curative therapies, including resection, liver transplantation, and percutaneous ablation (percutaneous ethanol injection and radiofrequency ablation), are applicable for only a portion of the HCC population, transcatheter arterial chemoembolization (TACE) has been recognized as an effective palliative treatment option for patients with advanced HCC. TACE is also used even for single HCCs in which it is difficult to perform surgical resection or locoregional treatment due to systemic co-morbidities or anatomical problems. TACE has become widely adopted in the treatment of HCC. By using computed tomography-angiography, TACE is capable of performing diagnosis and treatment at the same time. Furthermore, TACE plays an important role in the multidisciplinary treatment for HCC when combined with other treatment. In this review, we first discuss the history of TACE, and then review the previous findings about techniques of achieving a locoregional treatment effect (liver infarction treatment, e.g., ultra-selective TACE, balloon-occluded TACE), and the use of TACE as a drug delivery system for anti-cancer agents (palliative, e.g., platinum complex agents, drug-eluting beads) for multiple lesions.
    World journal of hepatology. 12/2014; 6(12):844-50.
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    ABSTRACT: Secondary stomach cancer in lesions of the remnant stomach occurs relatively soon after distal gastrectomy using the Billroth I reconstruction procedure. Prophylactic eradication of Helicobacter pylori after endoscopic resection of early gastric cancer should be used to prevent the development of metachronous gastric carcinoma. However, the effect of H. pylori eradication on the gastric remnant has not been clearly determined. Eight patients who were H. pylori-positive after distal gastrectomy for primary gastric cancer underwent eradication therapy and were followed by endoscopy for 9 years. Upper gastroenteroscopy series were done before and at 1, 3, 5, 7 and 9 years after eradication, and biopsy specimens were taken from the lesser and greater curvatures, respectively. Histological changes, including chronic inflammation, activity, atrophy, and intestinal metaplasia, were evaluated using the updated Sydney system. Successful eradication was confirmed using the urea breath test in all eight patients. Chronic inflammation scores were improved after eradication at both the lesser (mean scores ± SD: before eradication, 2.9 ± 0.5; 1 year after, 2.3 ± 0.4; 3 years, 1.8 ± 0.3; 5 years, 1.5 ± 0.3; 7 years, 1.3 ± 0.3; and 9 years, 1.0 ± 0.3) and greater curvatures (before, 2.9 ± 0.4; 1 year after, 1.9 ± 0.3; 3 years, 1.4 ± 0.4; 5 years, 1.3 ± 0.3; 7 years, 1.1 ± 0.2; and 9 years, 0.6 ± 0.3). Atrophy scores improved more quickly after eradication than chronic inflammation scores at both the lesser (before, 2.4 ± 0.5; 1 year after, 1.8 ± 0.4; 3 years, 0.8 ± 0.3; 5 years, 0.3 ± 0.1; 7 years, 0.0; and 9 years, 0.0) and greater curvatures (before, 2.2 ± 0.4; 1 year after, 1.3 ± 0.3; 3 years, 0.5 ± 0.3; 5 years, 0.0; 7 years, 0.0; and 9 years, 0.0). No secondary stomach cancers were found on endoscopy. Undergoing H. pylori eradication improved possible precancerous lesions of the gastric remnant among patients who had undergone distal gastrectomy. Prophylactic H. pylori eradication in the gastric remnant may be useful in preventing the development of metachronous gastric carcinoma. © 2014 Journal of Gastroenterology and Hepatology Foundation and Wiley Publishing Asia Pty Ltd.
    Journal of Gastroenterology and Hepatology 12/2014; 29 Suppl S4:60-64. · 3.63 Impact Factor
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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.
  • Gastrointestinal Endoscopy 11/2014; · 4.90 Impact Factor
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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. · 2.03 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: 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 09/2014; · 1.31 Impact Factor
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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; · 3.53 Impact Factor
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    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 08/2014; · 2.16 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; · 4.90 Impact Factor
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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; · 3.79 Impact Factor
  • Kohei Funasaka, Ryoji Miyahara, Kazuhiro Furukawa, Eizaburo Ohno, Masanao Nakamura, Hiroki Kawashima, Akihiro Itoh, Yoshiki Hirooka, Osamu Watanabe, Osamu Maeda, Takafumi Ando, Hidemi Goto
    Gastroenterology 05/2014; 146(5):S-336-S-337. · 13.93 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; · 4.21 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

Publication Stats

6k Citations
2,256.52 Total Impact Points


  • 1988–2014
    • Nagoya University
      • • Division of Endoscopy
      • • Division of Gastroenterology and Hepatology
      • • Department of Preventive Medicine
      • • Division of of Internal Medicine
      • • Division of General Medicine
      • • Division of Biological Chemistry
      Nagoya, Aichi, Japan
  • 2006–2013
    • Fujita Health University
      • Department of Internal Medicine
      Nagoya, Aichi, Japan
    • Broad Institute of MIT and Harvard
      Cambridge, Massachusetts, United States
  • 2012
    • Japanese Red Cross Kyoto Daiichi Hospital
      Kioto, Kyōto, Japan
  • 2006–2012
    • National Hospital Organization Nagoya Medical Center
      Nagoya, Aichi, Japan
  • 2005–2012
    • Ogaki Municipal Hospital
      Gihu, Gifu, Japan
  • 1997–2011
    • Aichi Cancer Center
      Ōsaka, Ōsaka, Japan
  • 2007–2010
    • University Hospital Medical Information Network
      Edo, Tōkyō, Japan
  • 2006–2009
    • Nagoya Memorial Hospital
      Nagoya, Aichi, Japan
  • 2005–2007
    • 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