[Show abstract][Hide abstract]ABSTRACT: Several studies of 48 weeks pioglitazone therapy demonstrated significant improvements in nonalcoholic steatohepatitis (NASH). The aim of the study is to assess long term effects of over 2 years pioglitazone therapy with NASH. Twenty-three patients with NASH were treated with pioglitazone for over 2 yrs (46.5 ± 11.9 months) and fifteen performed biopsy before and at the 2 yrs after treatment. Piogilitazone therapy improved aminotransferase level rapidly within 3 months and has sustained the long biochemical improvements. TG level (p = 0.012), HbA1c (p = 0.006) and 2 hr plasma glucose level in 75 gOGTT (p = 0.005) were significantly improved. Histologic features including steatosis (p = 0.006), lobular inflammation (p = 0.02), fibrosis (p = 0.02) were improved. Weight gain was the main adverse effect, averaging 1.5 kg in 2 yrs. In conclusion, These finding suggest that over 2 yrs of pioglitazone therapy can lead to the long-term improvement in biochemical and histological features of NASH.
[Show abstract][Hide abstract]ABSTRACT: Case1 was a 52-year-old man who had recurrence of postoperative intra-abdominal disseminations from gastrointestinal stromal tumor (GIST) of the jejunum. Case2 was a 66-year-old man who had GIST of the jejunum with multiple liver metastases. Two cases presented hemoperitoneum caused by administration of imatinib mesylate, and we conducted emergent surgery. In spite of surgically non-curative cases, it is suggested that the surgical management for GIST of high grade group with peritoneal exposure should be followed by the administration of imatinib mesylate.
Article · Dec 2008 · Nippon Shokakibyo Gakkai zasshi The Japanese journal of gastro-enterology
[Show abstract][Hide abstract]ABSTRACT: At the treatment of bile duct stones using EST, we sometimes experienced the difficult cases, even if the stones were small. For these cases, we tried endoscopic papillary balloon dilatation, and as a result knoches were made. And after the disappearance of the knoch, we could easily remove the stone. So we prospectively examined how often and at what cases, the knoches were made immediately after EST. As a result, knoches were present for 25% (13/52) of patients even after EST. Narrow distal segments of knoch-present patients were longer than that of knoch-absent patients, significantly. As a result, some function of sphincter was shown to be remained for a quarter of patients even after EST, and for these cases, the treatment of the stones may be difficult.
Article · Dec 2007 · Nippon Shokakibyo Gakkai zasshi The Japanese journal of gastro-enterology
[Show abstract][Hide abstract]ABSTRACT: We report two cases of patients with hepatocellular carcinoma (HCC) that developed in cryptogenic cirrhosis suggestive of nonalcoholic steatohepatitis (NASH) as background liver disease. Case 1 was a 68-year-old woman, and case 2 was a 46-year-old man. They were admitted to our department for evaluation and treatment of HCC. The causes of the underlying liver disease were not determined from blood tests. However, histological analysis of non-tumor tissues of the liver revealed cirrhosis with few fat droplets. Both patients had undergone liver biopsy 26 years before the treatment of HCC. Histological review of the biopsy specimens revealed NASH (case 1) and fatty liver (case 2), respectively. It was suggested that these cases progressed from NASH and fatty liver, respectively, to NASH-related cirrhosis (so called burned-out NASH), eventually, developing HCC. These findings suggest that substantial number of burned-out NASH cases may be included in those with cryptogenic cirrhosis. These two patients are indicative cases that may reveal the long-term natural course of fatty liver and NASH.
Article · Jun 2007 · Nippon Shokakibyo Gakkai zasshi The Japanese journal of gastro-enterology
[Show abstract][Hide abstract]ABSTRACT: We experienced two cases of chronic hepatitis C with sustained virological response (SVR) in whom HCV RNA reappeared after the end of IFN treatment. Case 1 was a 54-year-old man with HCV/2a, who achieved SVR by IFN-α2b for 26 weeks. Twelve years later, his ALT level flared up and HCV/2a reemerged temporally, accompanied by a marked increase of anti-C22 antibody. Case 2 was a 68-year-old man with HCV/1b, who achieved SVR by IFN-β for 2 weeks and IFN-α2b/Ribavirin for 22 weeks After 26 months HCV/1b reappeared and continued to be positive without an elevation of ALT. Pairwise comparison and phylogenetic analysis within the NS5B 1,087-nucleotide sequence revealed that the HCV isolates obtained at the time points of pretreatment and reemergence shared 99.3% identity and are virtually the same strains. These results suggest that SVR patients have a potential risk for HCV reactivation even 12 years after the end of therapy.
[Show abstract][Hide abstract]ABSTRACT: The use of percutaneous endoscopic gastrostomy (PEG) has widely spread in recent years, even in Japan. In our hospital, we have performed this procedure in over 20 patients per year recently. In this study, we investigated the usefulness of PEG in home health care from the view point of cost effectiveness. We found that medical expenses decreased remarkably when patients underwent PEG because they could switch from hospital care to home health care, shortening there by the period of hospital care. The role of PEG in home health care will be more important also from cost effectiveness.
Article · Jan 2004 · Gan to kagaku ryoho. Cancer & chemotherapy