Toru Ueki

Publications (8)13.01 Total impact

• Article: [Classification of the bleeding pattern in colonic diverticulum is useful to predict the risk of bleeding or re-bleeding after endoscopic treatment].

  Yoko Kominami, Hirotoki Ohe, Sayo Kobayashi, Reiji Higashi, Daisuke Uchida, Yuki Morimoto, Asuka Nakarai, Norifumi Numata, Ken Hirao, Tsuneyoshi Ogawa, Toru Ueki, Masahiro Nakagawa, Yasuyuki Araki, Motowo Mizuno, Kazuaki Chayama
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  ABSTRACT: We examined the re-bleeding rate after endoscopic hemostasis according to the bleeding pattern in patients with an acute lower gastrointestinal hemorrhage from colonic diverticula in 34 patients with active bleeding (Type 1) and 49 patients with exposed vessels and/or erosions in the base of diverticulum and no active bleeding (Type 2). Endoscopic hemostasis was performed by clipping the exposed vessel or erosions (direct method) or the entire diverticular orifice (reefing method). The incidence of re-bleeding was significantly higher in the Type 1 group than in the Type 2 group (p=0.002). All Type 1 cases were treated by the reefing method. In contrast, 14 of the 49 Type 2 cases were treated by the direct method, and no re-bleeding was observed in these cases. Of the other 35 Type 2 cases treated by reafing, rebleeding was seen in 5 cases. More effective endoscopic treatment is needed to prevent early re-bleeding, especially for Type 1 patients. The direct method may therefore reduce the rate of re-bleeding in Type 2 patients.
  Nippon Shokakibyo Gakkai zasshi The Japanese journal of gastro-enterology 01/2012; 109(3):393-9.
• Article: [Cerebral sinus thrombosis complicating ulcerative colitis].

  Asuka Nakarai, Hirotoki Ohe, Daisuke Uchida, Norifumi Numata, Yoko Kominami, Hiroshi Matsushita, Shintaro Nanba, Shigeru Ota, Tsuneyoshi Ogawa, Manabu Kurome, Toru Ueki, Masahiro Nakagawa, Yasuyuki Araki, Motowo Mizuno
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  ABSTRACT: A 40-year-old woman with ulcerative colitis (UC) was admitted to our hospital because of diminution of consciousness and left palsy. UC had been diagnosed 6 years before, but had not been treated. MRI revealed complete obstruction of the superior sagittal sinus. Cerebral sinus thrombosis, as a complication of UC, was diagnosed. We started anticoagulant therapy, but she passed away 5 days later. UC has been reported to show hypercoagulation status, leading to deep vein thrombosis within the body which sometimes causes pulmonary infarction, but occurrence of cerebral sinus thrombosis is rare.
  Nippon Shokakibyo Gakkai zasshi The Japanese journal of gastro-enterology 03/2011; 108(3):451-7.
• Article: [Dynamic computed tomography is useful for the diagnosis and colonoscopic treatment of colonic diverticular bleeding].

  Yoko Kominami, Hirotoki Ohe, Sayo Kobayashi, Daisuke Uchida, Norifumi Numata, Hiroshi Matsushita, Yuki Morimoto, Asuka Nakarai, Shintarou Nanba, Shigeru Ohta, Tsuneyoshi Ogawa, Manabu Kurome, Toru Ueki, Masahiro Nakagawa, Yasuyuki Araki, Motowo Mizuno
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  ABSTRACT: We investigated whether emergency dynamic computed tomography (CT) is helpful to identify bleeding colonic diverticulum treatable by colonoscopy. We enrolled 95 consecutive patients given diagnoses of colonic diverticular bleeding at Hiroshima City Hospital in the present study, of whom 60 underwent CT before colonoscopy (CT group), and 35 underwent colonoscopy alone (CS group). In the CT group, bleeding diverticula were identified and treated by colonoscopy in 31 of 32 (96.9%) patients in whom extravasation was detected by CT. The interval between bleeding being recognized and CT (median 1.0 hours) in patients in whom extravasation was detected by CT was shorter than that in whom extravasation was not detected (median 5.0 hours). To identify and treat bleeding diverticula by colonoscopy, the use of emergency dynamic CT prior to colonoscopy is recommended.
  Nippon Shokakibyo Gakkai zasshi The Japanese journal of gastro-enterology 02/2011; 108(2):223-30.
• Article: [A case of gangliocytic paraganglioma with lymphoid metastasis].

  Daisuke Uchida, Tsuneyoshi Ogawa, Toru Ueki, Yoko Kominami, Norifumi Numata, Hiroshi Matsusita, Yuki Morimoto, Asuka Nakarai, Shigeru Ota, Shintaro Nanba, Shinichi Takada, Shota Iwado, Manabu Kurome, Hirotoki Ohe, Ryoichi Okamoto, Syuji Uematsu, Masahiro Nakagawa, Kiyotaka Ishida, Yasuyuki Araki, Motowo Mizuno
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  ABSTRACT: We report a 67-year-old woman who had stiff shoulders and anemia. Upper gastrointestinal endoscopy revealed a pedunclated nodular submucosal tumor with erosions and surface ulcers in the second portion of the duodenum. These endoscopic findings were thought to be characteristic of gangliocytic paraganglioma. CT scan revealed suspected lymph node metastasis, thus the tumor was resected with pancreaticoduodenectomy and was found to be a gangliocytic paraganglioma associated with lymph nodal metastasis. Due to the rarity of the disease there is no consensus regarding treatment. Although this tumor is considered benign, the possibility exists for regional lymph nodal spread. The treatment should be well planned with continuous careful evaluation.
  Nippon Shokakibyo Gakkai zasshi The Japanese journal of gastro-enterology 09/2010; 107(9):1456-65.
• Article: Carbon dioxide insufflation is useful for obtaining clear images of the bile duct during peroral cholangioscopy (with video).

  Toru Ueki, Motowo Mizuno, Shigeru Ota, Tsuneyoshi Ogawa, Hiroshi Matsushita, Daisuke Uchida, Norifumi Numata, Asuka Ueda, Yuuki Morimoto, Yoko Kominami, Shintaro Nanba, Manabu Kurome, Hirotoki Ohe, Masahiro Nakagawa, Yasuyuki Araki
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  ABSTRACT: Peroral cholangioscopy (POCS) is useful for the diagnosis of various bile duct lesions. However, it is often difficult to obtain clear images because of bile or biliary sludge in the bile duct, even after vigorous irrigation of the bile duct with saline solution. Therefore, this study investigated whether inflation with carbon dioxide (CO(2)) yields clearer images of the bile duct than conventional saline solution irrigation during POCS. To evaluate the clinical utility and safety of CO(2) insufflation into the bile duct to obtain clear images in POCS observations by comparing this method with conventional saline solution irrigation. A single center. Case-control study. Nineteen patients with suspected biliary diseases. CO(2) insufflation into the bile duct during POCS. The quality and safety of this method. The quality of the images of the bile duct lumen with CO(2) insufflation (10 patients) was significantly superior to those with saline solution irrigation (9 patients) in both clarity (P < .05) and color (P < .05). In particular, extremely clear images could be obtained from the middle part of common bile duct to the right and left hepatic duct. No serious POCS-related complications occurred. There was no significant change in the venous partial pressure of the CO(2) level during the procedure. The number of patients examined was small. CO(2) insufflation is useful for obtaining clear images of the bile duct during POCS, which makes it possible to determine the qualitative diagnosis and the extent of various bile duct lesions.
  Gastrointestinal endoscopy 05/2010; 71(6):1046-51. · 6.71 Impact Factor
• Article: [Case of pseudoaneurysm ruptured into gallbladder and successfully treated with arterial embolization].

  Koji Miyahara, Toru Ueki, Motowo Mizuno, Sayo Kobayashi, Naoko Kajikawa, Syota Iwado, Manabu Kurome, Hirotoki Ohe, Shuji Uematsu, Ryoichi Okamoto, Kunihiro Shiraga, Masahiro Nakagawa, Kazuhiro Nouso, Yasuyuki Araki, Masaki Urashima
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  ABSTRACT: A 79-year-old man was admitted with hematemesis. Emergency upper gastrointestinal tract endoscopy revealed bleeding from the papilla of Vater. Computed tomography showed cholecystitis with a gallstone and a hematoma in the gallbladder. Angiography demonstrated a pseudoaneurysm of the anterior branch of the right hepatic artery. Emergency selective transcatheter arterial embolization (TAE) was performed, with intravascular microcoils, and complete occlusion of the pseudoaneurysm was achieved. This case shows embolization is effective in the treatment of pseudoaneurysm rupturing in the gallbladder.
  Nippon Shokakibyo Gakkai zasshi The Japanese journal of gastro-enterology 06/2008; 105(5):699-704.
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  Article: Regression of hepatocellular carcinoma during vitamin K administration.

  Kazuhiro Nouso, Shuji Uematsu, Kunihiro Shiraga, Ryoichi Okamoto, Ryo Harada, Shoko Takayama, Wakako Kawai, Shigeru Kimura, Toru Ueki, Nobuaki Okano, Masahiro Nakagawa, Motowo Mizuno, Yasuyuki Araki, Yasushi Shiratori
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  ABSTRACT: An 85-year-old man with HCV infection and diabetes mellitus was diagnosed as having hepatocellular carcinoma (HCC, 13 cm in diameter) based on high serum alpha-fetoprotein (AFP), AFP-L3, and des-gamma-carboxy prothrombin levels as well as typical enhancement pattern on contrast-enhanced CT. The patient did not receive any interventional treatments because of advanced age and the advanced stage of HCC. He chose to take vitamin K, which was reported to suppress the growth of HCC in vitro. Three months after starting vitamin K, all three tumor markers were normalized and HCC was markedly regressed, showing no enhancement in the early arterial phase on CT. Here we present the report describing the regression of HCC during the administration of vitamin K.
  World Journal of Gastroenterology 12/2005; 11(42):6722-4. · 2.47 Impact Factor
• Article: Prediction of the ablated area by the spread of microbubbles during radiofrequency ablation of hepatocellular carcinoma.

  Kazuhiro Nouso, Kunihiro Shiraga, Shuji Uematsu, Ryoichi Okamoto, Ryo Harada, Shoko Takayama, Wakako Kawai, Shigeru Kimura, Toru Ueki, Nobuaki Okano, Masahiko Nakagawa, Motowo Mizuno, Yasuyuki Araki, Yasushi Shiratori
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  ABSTRACT: Radiofrequency ablation (RFA) is effective for the treatment of hepatocellular carcinoma (HCC). To prevent the ablation of adjacent organs and vessels, the spread of microbubbles generated by heating during RFA was observed by ultrasonography (US) and used to predict the ablated area; however, several reports documented that discrepancies existed between the spread of microbubbles and the ablated area. Patients and The spread of microbubbles during RFA was observed by US in 24 patients with HCC and the areas were compared with the defect of enhancement in contrast enhanced (CE)-US, using Levovist in the same plane. During the ablation, the posterior margin was obscure but the border could be visualized 5 min after the ablation. The size of the area of hyperechogenicity 5 min after ablation and that of the defect observed by CE-US was found to correlate (r(2)=0.91, P<0.0001). The shape of the hyperechogenicity corresponded well to the defect area, even in cases showing irregular spread of the microbubbles. The observation of microbubbles during RFA can predict the ablated area and might be useful to prevent the unfavorable ablation of adjacent organs and vessels.
  Liver international: official journal of the International Association for the Study of the Liver 11/2005; 25(5):967-72. · 3.82 Impact Factor