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ABSTRACT: A 70-year-old woman was admitted for investigation of an abdominal tumor. Abdominal CT revealed an ascending colonic mass measuring 10×10cm, with evidence of liver and lung metastasis. Colonoscopy revealed a cancerous lesion with a central ulcer in the ascending colon. Upper gastrointestinal endoscopy revealed an ulcerative lesion in the descending part of the duodenum. Histologically, the tumor showed features of neuroendocrine carcinoma. The patient died of the primary cancer two and a half months after admission. Autopsy revealed a fistula connecting the ascending colonic mass with the ulcerative lesion in the duodenum.
Nippon Shokakibyo Gakkai zasshi The Japanese journal of gastro-enterology 04/2013; 110(4):622-9.
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ABSTRACT: PURPOSE: Treatment of ulcerative colitis with drugs during pregnancy potentially may harm the mother and the unborn child. Granulocytapheresis depletes elevated/activated myeloid lineage leucocytes as sources of inflammatory cytokines. We were interested in the safety and efficacy of granulocytapheresis in patients who had ulcerative colitis flare up during pregnancy. METHODS: Three pregnant cases with active ulcerative colitis received Adacolumn granulocytapheresis, up to 10 sessions within 3-6 weeks. Case 1: a 33-year-old woman with left-sided colitis and bloody diarrhoea 7-9 times/day showed loss of mucosal vascular patterns, and contact bleeding from the rectum to the sigmoid colon. Case 2: a 36-year-old woman with pancolitis and bloody diarrhoea 6-8 times/day had loss of mucosal vascular patterns and pus from the rectum to the sigmoid colon. Case 3: a 36-year-old woman with pancolitis and diarrhoea 4-5 times/day (first episode) had erosions and pus in the mucosa from the rectum to the transverse colon. RESULTS: Colitis flare was in weeks 5, 13 and 22 of pregnancy in cases 1, 2, 3, respectively. The corresponding granulocytapheresis sessions were 5, 7, and 10, reflecting an increasing trend with the pregnancy week. Patients 1 and 2 achieved complete remission, patient 3 achieved clinical remission. CONCLUSION: In these three cases with active ulcerative colitis during pregnancy, granulocytapheresis as a non-pharmacologic treatment was effective and safe. In case 3 that did not respond well to the initial granulocytapheresis sessions, a moderate dose of prednisolone enhanced the efficacy of granulocytapheresis and tapering of prednisolone shortly after administration was not associated with relapse.
Archives of Gynecology 02/2013; · 0.91 Impact Factor
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Jun Inoue,
Yoshiyuki Ueno,
Kaori Kawamura,
Takeshi Yamamoto, Yutaka Mano,
Masahito Miura,
Tomoo Kobayashi,
Hirofumi Niitsuma,
Yasuteru Kondo,
Eiji Kakazu,
Masashi Ninomiya,
Osamu Kimura,
Noriyuki Obara,
Naoki Kawagishi,
Yoshitaka Kinouchi,
Tooru Shimosegawa
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ABSTRACT: The viral factors of hepatitis B virus (HBV), such as genotypes and mutations, were reported to affect the development of fulminant hepatitis B (FHB), but the mechanism is still unclear.
To investigate HBV mutations associated with FHB, especially in the subgenotype B1/Bj HBV (HBV/B1), which are known to cause FHB frequently in Japan.
A total of 96 serum samples from acute self-limited hepatitis B (AHB) patients and 13 samples from FHB patients were used for full-genome/partial sequencing. A total of 107 chronic infection patients with HBV were also examined for the distribution of mutants.
In the analysis of full-genome sequences of HBV/B1 (FHB, n=11; non-FHB, n=35) including those from the databases, mutations at nt 1961 [T1961V (not T)] and nt 1962 [C1962D (not C)], which change S21 in the core protein, were found more frequently in FHB than in non-FHB (100% vs. 20%, 55% vs. 3%, respectively). When our FHB and AHB samples were compared, T1961V and C1962D were significantly more frequent in FHB than in AHB, both in the overall analysis (46% vs. 6%, 39% vs. 3%, respectively) and in HBV/B1 (100% vs. 29%, 100% vs. 14%, respectively). A newly developed PCR system detecting T1961V showed that HBV/B1 and low viral load were independent factors for the mutation among chronic infection patients.
T1961V/C1962D mutations were found frequently in FHB, especially in HBV/B1. The resulting S21 substitution in the core protein may play important roles in the development of FHB.
Journal of clinical virology: the official publication of the Pan American Society for Clinical Virology 07/2012; 55(2):147-52. · 3.12 Impact Factor
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Hiroki Takahashi,
Kenji Noguchi,
Masahiro Iwabuchi,
Mikako Sugimura,
Satoshi Awabuchi,
Hiromichi Akojima,
Kenji Kimura,
Nobukazu Tanabe, Yutaka Mano,
Nobuyuki Chida,
Katsuaki Ukai,
Keiichi Tadokoro,
Shin Teshima,
Toshihiro Saitoh,
Hiroyoshi Suzuki
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ABSTRACT: Here we report a case of advanced gastric cancer seen after total proctocolectomy for an early colon cancer associated with
ulcerative colitis (UC). A 42-year-old man, diagnosed with UC at the age of 21, had undergone total proctocolectomy at the
age of 38 for an early ascending colon cancer. Three years later the patient developed tarry stools and epigastric discomfort.
Laboratory data showed anemia together with elevated serum p53 antibody. Gastric endoscopy showed thickening folds around
a lesion in the stomach body. The pathological diagnosis was poorly differentiated adenocarcinoma with signet-ring cell carcinoma.
Total gastrectomy was performed and the resected specimens showed a diffuse infiltrating tumor (scirrhous gastric carcinoma),
11×15cm in size, with multiple lymph node metastases. Histopathological examination revealed diffuse infiltration of cancer
cells throughout the gastric wall and invasion of the serosa. Results of cytology on abdominal lavage were positive for cancer
cells. Likewise, immunohistochemical staining showed gastric mucin phenotype cancer cells positive for p53. In conclusion,
it is important to bear in mind that patients with UC, especially chronically active pancolitis, potentially bear the risk
of upper gastrointestinal complications.
KeywordsUlcerative colitis–Gastric cancer–Colon cancer–p53–Signet-ring cell carcinoma
Clinical Journal of Gastroenterology 05/2012; 4(4):212-217.
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Hiroki Takahashi,
Ryouichi Takahashi,
Katsuaki Ukai,
Kaori Sugawara,
Yoko Yamao,
Kaori Shiotsuka,
Hiromichi Akoshima,
Mikako Sugimura,
Kenji Noguchi,
Kenji Kimura,
Nobukazu Tanabe,
Masahiro Iwabuchi, Yutaka Mano,
Keiichi Tadokoro
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ABSTRACT: A 74-year-old man was admitted to our hospital with abdominal pain and bloody stool. The patients' history showed that he had had occlusion of the proximal common trunk of the celiac artery (CA) and the superior mesenteric artery (SMA). The inferior mesenteric artery (IMA), and the marginal artery of the colon had developed well. It was assumed that almost the entire visceral blood might be supplied by the IMA to the CA and the SMA. Our investigation revealed that the patient had advanced cancer of the sigmoid colon, which had caused intestinal obstruction. Sigmoidectomy was performed with care to avoid injuring the IMA and the marginal arcade artery. Normal hemodynamics were successfully established followed by sigmoidectomy, and cure was obtained in this patient.
Nippon Shokakibyo Gakkai zasshi The Japanese journal of gastro-enterology 01/2012; 109(6):936-43.
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Hiroki Takahashi,
Nobuyuki Chida,
Kenji Kimura,
Yoko Yamao,
Kaori Shiotuka,
Hideaki Ritsuno,
Satoshi Awabuchi,
Hiromichi Akoshima,
Mikako Sugimura,
Kenji Noguchi,
Nobukazu Tanabe,
Masahiro Iwabuchi, Yutaka Mano,
Keiichi Tadokoro,
Hiroyoshi Suzuki
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ABSTRACT: In this report, we present a rare case of Ewing's sarcoma with a peripheral primitive neuroectodermal tumor (ES/pPNET) arising from the abdominal cavity in a 20-year-old woman. The patient complained of upper abdominal pain. Radiological imaging showed a 15-cm mass penetrating to the proxymal jejunum in the upper abdominal cavity and peritoneal disseminations. Immunohistochemical studies revealed that the tumor was ES/pPNET. Although the patient underwent radiation therapy, she died of the disease two months after diagnosis. ES/pPNET in the abdominal cavity is extremely rare and our case showed aggressive behavior and an unfortunate outcome.
Nippon Shokakibyo Gakkai zasshi The Japanese journal of gastro-enterology 10/2009; 106(10):1524-30.
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Takayuki Kogure,
Yoshiyuki Ueno,
Koji Fukushima,
Futoshi Nagasaki,
Yasuteru Kondo,
Jun Inoue,
Yasunori Matsuda,
Eiji Kakazu,
Takeshi Yamamoto,
Hiroyoshi Onodera,
Yutaka Miyazaki,
Hiromasa Okamoto,
Takehiro Akahane,
Tomoo Kobayashi, Yutaka Mano,
Takao Iwasaki,
Motoyasu Ishii,
Tooru Shimosegawa
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ABSTRACT: To evaluate the efficacy of pegylated interferon alpha-2b (peg-IFN alpha-2b) plus ribavirin (RBV) therapy in Japanese patients with chronic hepatitis C (CHC) genotype Ib and a high viral load.
One hundred and twenty CHC patients (58.3% male) who received peg-IFN alpha-2b plus RBV therapy for 48 wk were enrolled. Sustained virological response (SVR) and clinical parameters were evaluated.
One hundred (83.3%) of 120 patients completed 48 wk of treatment. 53 patients (44.3%) achieved SVR. Early virological response (EVR) and end of treatment response (ETR) rates were 50% and 73.3%, respectively. The clinical parameters (SVR vs non-SVR) associated with SVR, ALT (108.4 IU/L vs 74.5 IU/L, P = 0.063), EVR (76.4% vs 16.4%, P < 0.0001), adherence to peg-IFN (>or= 80% of planned dose) at week 12 (48.1% vs 13.6%, P = 0.00036), adherence to peg-IFN at week 48 (54.7% vs 16.2%, P < 0.0001) and adherence to RBV at week 48 (56.1% vs 32.1%, P = 0.0102) were determined using univariate analysis, and EVR and adherence to peg-IFN at week 48 were determined using multivariate analysis. In the older patient group (> 56 years), SVR in females was significantly lower than that in males (17% vs 50%, P = 0.0262). EVR and adherence to Peg-IFN were demonstrated to be the main factors associated with SVR.
Peg-IFN alpha-2b plus RBV combination therapy demonstrated good tolerability in Japanese patients with CHC and resulted in a SVR rate of 44.3%. Treatment of elderly female patients is still challenging and maintenance of adherence to peg-IFN alpha-2b is important in improving the SVR rate.
World Journal of Gastroenterology 12/2008; 14(47):7225-4230. · 2.47 Impact Factor
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ABSTRACT: Hepatitis E virus (HEV) is one of the major causative agents of acute hepatitis in many developing countries. Recent intensive examination has revealed the existence of non-imported cases in industrialized countries. The patient was a 25-year-old Japanese female with acute hepatitis. Laboratory test demonstrated positive anti-nuclear antibody (ANA), anti-smooth muscle antibody (ASMA) and high level of serum immunoglobulin G (IgG). The patient was negative for serum markers of hepatitis A, B or C virus infection. She demonstrated a clinical course similar to severe autoimmune hepatitis, including response to prednisolone therapy. After a few years, with the availability of tests for the serum antibodies to HEV, we examined the frozen stocked sera of the patient and found her exact diagnosis was acute hepatitis E. Although we could not detect HEV-RNA, which is positive only in limited period of acute phase, serum IgA and IgG antibodies to HEV were positive and the titer of IgA and IgG antibodies were declined with the time course. In conclusion, we must take into consideration of HEV infection for the diagnosis of acute cryptogenic hepatitis including autoimmune hepatitis. Further studies are feasible to understand the pathogenesis of liver injuries induced by HEV infections.
The Tohoku Journal of Experimental Medicine 07/2005; 206(2):173-9. · 1.24 Impact Factor
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ABSTRACT: In ileal epithelial cells, apical sodium-dependent bile acid transporter (ASBT) is responsible for the uptake of bile acids from the lumen. Furthermore, ASBT is expressed in the apical plasma membrane of intrahepatic bile duct cells (BECs). Using cultured immortalized mouse intrahepatic BECs that form monolayers or cysts, vectorial transport of bile acids was studied. [3H]-taurocholic acid ([3H]-TCA) was transported through monolayers transcellularly almost exclusively from the apical to the basolateral side in a Na(+)- and a temperature-dependent manner. Transport of [3H]-TCA was inhibited by 59.3+/-18.6% in the presence of taurochenodeoxycholic acid. Uptake of lysyl fluorescein-conjugated bile acid, Cholyl-[Nepsilon-NBD]-lysine, was seen in a Na(+)- and a temperature-dependent manner from the apical side of BECs that form monolayer or cysts. Reverse transcription-polymerase chain reaction for mRNAs in the cells showed presence of mRNAs for ASBT and farnesoid X receptor (FXR), a nuclear bile acid receptor. In conclusion, intrahepatic BECs transport bile acids mainly from the apical to the basolateral side in concert with ASBT and maybe FXR in the cells.
Hepatology Research 11/2003; 27(2):151-157. · 2.20 Impact Factor
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Liver Transplantation 01/2003; 8(12):1198-9. · 3.39 Impact Factor
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ABSTRACT: Up-regulation of CD11a expression on CD4+ T lymphocytes is considered to be one of the mechanisms involved in the initiation of the Th-1-mediated immune response. In this study, peripheral blood mononuclear cells from patients with primary biliary cirrhosis (PBC) were evaluated for CD11a(high) CD2(low) T cells and populations of type 1 (Th-1) and type 2 (Th-2) helper T cells. CD11a(high) CD2(low) T cells were found in PBC (7/15) and in active rheumatoid arthritis (4/4), but not in chronic hepatitis C (0/5) or in healthy subjects (0/6). The population of Th-1 had a positive correlation with that of CD4+ CD11a(high) CD2+ cells in patients with PBC (P = 0.034). The serum levels of interferon-gamma also had a weak correlation with the population of CD4+ CD11a(high) CD2(low) cells (P = 0.050). There was no statistically significant correlation of Th-2 population (P = 0.295) or serum interleukin-4 level (P = 0.685) with the population of CD4+ CD11a(high) CD2(low) cells. These results suggest that CD4+ CD11a(high) cells play a role in Th-1-predominance and in the autoimmune process of PBC.
Digestive Diseases and Sciences 07/2002; 47(6):1209-15. · 2.12 Impact Factor
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In Vitro Cellular & Developmental Biology - Animal 04/1998; 34(7):512-514. · 1.31 Impact Factor
