研究者詳細 - 寺井　崇二

論文 - 寺井　崇二

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Rare paraneoplastic syndromes in digestive systems caused by lung cancer. 国際誌

Hiroteru Kamimura, Tomohiro Iwasaki, Kazunao Hayashi, Shuji Terai

BMJ case reports 14 ( 2 ) 2021年2月

記述言語：英語掲載種別：研究論文（学術雑誌）

We observed a rare case of two different digestive paraneoplastic syndromes that improved with the treatment of the neoplasms. The first syndrome was chronic intestinal pseudo-obstruction (CIPO), which is a subtype of paraneoplastic syndromes called a paraneoplastic neurological syndrome (PNS). The second was Stauffer's syndrome, which is a unique paraneoplastic syndrome characterised by non-metastatic intrahepatic cholestasis associated with neoplasms. Here, we report the case of a 55-year-old man who presented with two concurrent paraneoplastic syndromes in the digestive system. The intestinal pseudo-obstruction and elevated biliary enzyme levels improved as the lung cancer responded to chemotherapy. In this case, CIPO as a PNS led to the detection of lung cancer. To our knowledge, this is the first report of Stauffer's syndrome caused by lung adenocarcinoma.

DOI： 10.1136/bcr-2020-240161

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Immunoglobulin therapy for successful management of prolonged, recurrent jaundice in a young adult male with combined immunodeficiency.

Chiyumi Oda, Atsunori Tsuchiya, Atsushi Kimura, Kentaro Tominaga, Kazunao Hayashi, Takashi Ushiki, Hajime Umezu, Shuji Terai

Clinical journal of gastroenterology 14 ( 4 ) 1197 - 1201 2021年2月

記述言語：英語掲載種別：研究論文（学術雑誌）

Jaundice may be persistent in drug-induced liver injury associated with vanishing bile duct syndrome. However, recurrent jaundice is atypical, following bile flow restoration. Here, we report a 28-year-old man with prolonged, recurrent jaundice (more than 300 days) and combined immunodeficiency (CID) of B-cells, T-cells, and natural killer (NK) cells. Hypogammaglobulinemia was observed throughout his hospitalization, and peripheral blood flow cytometry detected a few B-cells (2% of CD19 + cells and 2% of CD20 + cells). We further detected the dysfunction of T-cells and NK cells. Based on these findings, CID was diagnosed. We presumed that hypogammaglobulinemia was related to the jaundice. After regular injections of intravenous immunoglobulin (IVIG), the stool color gradually turned brown. However, the color returned to white as IgG levels decreased. The brown-to-white stool pattern was repeated with another IVIG administration, suggesting that the patient's serum immunoglobulin levels were related to the jaundice. On follow-up, IVIG was performed every two to three weeks, and his total bilirubin improved gradually. Immunoglobulin replacement therapy could be one of the treatment choices for jaundice with CID.

DOI： 10.1007/s12328-021-01347-0

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Multiple Tumor-Like Fatty Changes in the Liver Disappeared After Hepatitis C Virus Eradication With Direct-Acting Antiviral Treatment. 査読国際誌

Norihiro Sakai, Kenya Kamimura, Shuji Terai

The American journal of gastroenterology 116 ( 2 ) 237 - 237 2021年2月

Changes in disease characteristics of primary biliary cholangitis: An observational retrospective study from 1982 to 2016. 国際誌

Masaaki Takamura, Yasunobu Matsuda, Naruhiro Kimura, Masafumi Takatsuna, Toru Setsu, Atsunori Tsuchiya, Akihiko Osaki, Nobuo Waguri, Masahiko Yanagi, Toru Takahashi, Soichi Sugitani, Yuka Kobayashi, Akira Yoshikawa, Toru Ishikawa, Toshiaki Yoshida, Toshiaki Watanabe, Hitoshi Bannai, Tomoyuki Kubota, Kazuhiro Funakoshi, Hiroto Wakabayashi, So Kurita, Norio Ogata, Masashi Watanabe, Yuhsaku Mita, Shigeki Mori, Motoya Sugiyama, Toru Miyajima, Sumio Takahashi, Shuichi Sato, Kisei Ishizuka, Hironobu Ohta, Yutaka Aoyagi, Shuji Terai

Hepatology research : the official journal of the Japan Society of Hepatology 51 ( 2 ) 166 - 175 2021年2月

記述言語：英語掲載種別：研究論文（学術雑誌）

AIM: Disease characteristics of primary biliary cholangitis have changed recently. However, detailed studies on the subject have been limited. Therefore, we aimed to clarify disease characteristics of patients with recent primary biliary cholangitis using the cohort from Niigata University and 21 affiliated hospitals. METHODS: Overall, 508 patients were enrolled in this study from 1982 to 2016, divided into three cohorts according to their year of diagnosis: ≤1999, 2000-2009 and ≥2010. We compared differences in clinical characteristics, response to ursodeoxycholic acid and prognosis. RESULTS: The male-to-female ratio increased incrementally from 1:16.4 (≤1999) to 1:3.8 (≥2010) (P < 0.001). In women, the median age at diagnosis increased incrementally from 54.0 years (≤1999) to 60.5 years (≥2010) (P < 0.001) and serum albumin decreased gradually (P = 0.001), which might have affected the increase in the Fibrosis-4 Index and albumin-bilirubin score. The ursodeoxycholic acid response rate according to the Barcelona criteria increased incrementally from 26.7% (≤1999) to 78.4% (≥2010) (P < 0.010), and those according to other criteria (Paris-I, Rotterdam and Toronto) were approximately ≥80% in all cohorts. Ten-year survival rate in the ≤1999 and 2000-2009 cohorts were 98.6% and 95.6%, respectively. These earlier cohorts were also characterized by a higher rate of asymptomatic state and mild histology (83.5% [≤1999] and 84.7% [2000-2009], and 93.6% [≤1999] and 91.1% [2000-2009]). CONCLUSIONS: Patients with primary biliary cholangitis were characterized by older age at diagnosis and an increase in male to female ratio as well as higher response rates of ursodeoxycholic acid and longer survival, resulting from the early recognition of primary biliary cholangitis.

DOI： 10.1111/hepr.13586

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【肝硬変診療ガイドラインの改正をめぐって】肝腎症候群

坂牧僚, 薛徹, 阿部寛幸, 上村顕也, 高村昌昭, 寺井崇二

消化器・肝臓内科 9 ( 2 ) 155 - 159 2021年2月

Acute on chronicの新展開当科における我が国の新診断基準でのAcute On Chronic Liver Failure症例の検討

野尻俊介, 土屋淳紀, 阿部聡司, 坂牧僚, 上村博輝, 上村顕也, 高村昌昭, 寺井崇二

肝臓 62 ( 2 ) 107 - 107 2021年2月

Molecular Mechanisms and Treatment of Sarcopenia in Liver Disease: A Review of Current Knowledge. 国際誌

Hiroteru Kamimura, Takeki Sato, Kazuki Natsui, Takamasa Kobayashi, Tomoaki Yoshida, Kenya Kamimura, Atsunori Tsuchiya, Toshiko Murayama, Junji Yokoyama, Hirokazu Kawai, Masaaki Takamura, Shuji Terai

International journal of molecular sciences 22 ( 3 ) 2021年1月

記述言語：英語掲載種別：研究論文（学術雑誌）

Sarcopenia is characterized by progressive and generalized loss of skeletal muscle mass and strength that occurs with aging or in association with various diseases. The condition is prevalent worldwide and occurs more frequently in patients with chronic diseases owing to the intrinsic relationship of muscles with glucose, lipid, and protein metabolism. Liver cirrhosis is characterized by the progression of necro-inflammatory liver diseases, which leads to fibrosis, portal hypertension, and a catabolic state, which causes loss of muscle tissue. Sarcopenia is of significant concern in the state of liver cirrhosis because sarcopenia has been associated with higher mortality, increased hospital admissions, worse post-liver transplant outcomes, decreased quality of life, and increased risk for other complications associated with cirrhosis. Therefore, sarcopenia is also an important feature of liver cirrhosis, representing a negative prognostic factor and influencing mortality. An increased understanding of sarcopenia could lead to the development of novel therapeutic approaches that could help improve the cognitive impairment of cirrhotic patients; therefore, we present a review of the mechanisms and diagnosis of sarcopenia in liver disease and existing therapeutic approaches.

DOI： 10.3390/ijms22031425

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Usefulness of an artificial intelligence system for the detection of esophageal squamous cell carcinoma evaluated with videos simulating overlooking situation. 国際誌

Kotaro Waki, Ryu Ishihara, Yusuke Kato, Ayaka Shoji, Takahiro Inoue, Katsunori Matsueda, Muneaki Miyake, Yusaku Shimamoto, Hiromu Fukuda, Noriko Matsuura, Yoichiro Ono, Kenshi Yao, Satoru Hashimoto, Shuji Terai, Masayasu Ohmori, Kyosuke Tanaka, Motohiko Kato, Takashi Shono, Hideaki Miyamoto, Yasuhito Tanaka, Tomohiro Tada

Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society 33 ( 7 ) 1101 - 1109 2021年1月

記述言語：英語掲載種別：研究論文（学術雑誌）

OBJECTIVES: Artificial intelligence (AI) systems have shown favorable performance in the detection of esophageal squamous cell carcinoma (ESCC). However, previous studies were limited by the quality of their validation methods. In this study, we evaluated the performance of an AI system with videos simulating situations in which ESCC has been overlooked. METHODS: We used 17,336 images from 1376 superficial ESCCs and 1461 images from 196 noncancerous and normal esophagi to construct the AI system. To record validation videos, the endoscope was passed through the esophagus at a constant speed without focusing on the lesion to simulate situations in which ESCC has been missed. Validation videos were evaluated by the AI system and 21 endoscopists. RESULTS: We prepared 100 video datasets, including 50 superficial ESCCs, 22 noncancerous lesions, and 28 normal esophagi. The AI system had sensitivity of 85.7% (54 of 63 ESCCs) and specificity of 40%. Initial evaluation by endoscopists conducted with plain video (without AI support) had average sensitivity of 75.0% (47.3 of 63 ESCC) and specificity of 91.4%. Subsequent evaluation by endoscopists was conducted with AI assistance, which improved their sensitivity to 77.7% (P = 0.00696) without changing their specificity (91.6%, P = 0.756). CONCLUSIONS: Our AI system had high sensitivity for the detection of ESCC. As a support tool, the system has the potential to enhance detection of ESCC without reducing specificity. (UMIN000039645).

DOI： 10.1111/den.13934

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Transcatheter Arterial Embolization Using Microspheres for Palliating Pain from Bone Metastasis in a Patient with Cholangiocellular Carcinoma.

Shinichi Morita, Shunsuke Sugawara, Takeshi Suda, Didik Prasetyo, Takahiro Hoshi, Satoshi Abe, Kazuyoshi Yagi, Shuji Terai

Internal medicine (Tokyo, Japan) 60 ( 2 ) 241 - 246 2021年1月

記述言語：英語掲載種別：研究論文（学術雑誌）

A 72-year-old man with intractable left shoulder pain due to bone metastasis from cholangiocellular carcinoma was admitted to our hospital. Computed tomography showed an osteoblastic metastatic lesion of the left scapula. Since the pain persisted even after the administration of opioids and external irradiation, microspheres were injected through a catheter; the catheter tip was placed at the arteries feeding the metastatic lesion. After the intervention, the shoulder pain was alleviated without any procedure-related complications, leading to a reduction in the opioid dose. This case suggests the efficacy of transcatheter arterial embolization using microspheres for palliating pain from bone metastasis.

DOI： 10.2169/internalmedicine.5351-20

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Comparison of Oral and Esophageal Microbiota in Patients with Achalasia Before and After Peroral Endoscopic Myotomy. 国際誌

Kazuya Takahashi, Hiroki Sato, Takeshi Mizusawa, Kentaro Tominaga, Satoshi Ikarashi, Kazunao Hayashi, Ken-Ichi Mizuno, Satoru Hashimoto, Junji Yokoyama, Shuji Terai

The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology 32 ( 1 ) 42 - 52 2021年1月

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND/AIMS: Patients with achalasia have a high incidence of esophageal squamous cell carcinoma (ESCC), which may be associated with alterations in oral and esophageal microbiota caused by food stasis. This study compared the oral and esophageal microbiota of patients with achalasia before and after peroral endoscopic myotomy (POEM). It also compared patients with achalasia to those with ESCC. MATERIALS AND METHODS: The study prospectively examined 6 patients with achalasia and 14 with superficial ESCC. Oral samples obtained from the buccal mucosa using a swab and esophageal samples obtained from the mid-esophagus using a brush via endoscopy were analyzed by 16S rRNA metagenome sequencing. Additionally, endoscopic and histological findings of patients with achalasia before and after POEM were prospectively compared. RESULTS: In patients with achalasia, Streptococcus was most abundant in both the oral and the esophageal microbiota, and these microbiota were significantly different. Although the overall structure of the oral and esophageal microbiota did not change after POEM, the relative abundance rate of Haemophilus and Neisseria increased in the esophagus, and endoscopic findings of inflammation improved after POEM (P = .04). The relative abundance of microbiota was not different among patients with achalasia from those with ESCC. CONCLUSIONS: The oral and esophageal microbiota were significantly different in patients with achalasia, and some of the composition of the esophageal microbiota changed after POEM. However, these findings and disease-specific microbiota should be further evaluated in large-scale studies.

DOI： 10.5152/tjg.2020.19995

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The development of mesenchymal stem cell therapy in the present, and the perspective of cell-free therapy in the future. 国際誌

Yusuke Watanabe, Atsunori Tsuchiya, Shuji Terai

Clinical and molecular hepatology 27 ( 1 ) 70 - 80 2021年1月

記述言語：英語掲載種別：研究論文（学術雑誌）

Cirrhosis is a chronic condition that can lead to liver failure. Currently, the viable option for decreasing mortality is liver transplantation. However, transplant surgery is highly invasive. Therefore, cell-based therapy has been developed as an alternative. Based on promising findings from preclinical research, some new trials have been registered. One of them was autologous bone marrow cell infusion therapy and found that ameliorating liver fibrosis activated liver regeneration. Now, majority of trials focus on low-immunogenicity mesenchymal stem cells (MSCs) appropriate for allogeneic administration. However, despite about 20 years of research, only a limited number of cell-based therapies have entered routine practice. Furthermore, potential shortcomings of cell-based therapy include a limit on the number of cells, which may be administered, as well as their failure to infiltrate target organs. On the other hand, these research show that MSCs act as "conducting cells" and regulate host cells including macrophages via extracellular vesicles (EVs) or exosome signals, leading to ameliorate liver fibrosis and promote regeneration. Therefore, the concept of cell-free therapy, which makes use of cell-derived EVs or exosomes, is attracting attention. Cell-free therapies may be safely administered in large doses and are able to infiltrate target organs. However, development of cell-free therapy exhibits its own set of challenges and such therapy may not be completely curative in the context of liver disease. This review describes the history of cell-based therapy research and recent advances in cell-free therapy, as well as discussing the need for more effective therapies.

DOI： 10.3350/cmh.2020.0194

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Sofosbuvir plus velpatasvir treatment for hepatitis C virus in patients with decompensated cirrhosis: a Japanese real-world multicenter study.

Yuki Tahata, Hayato Hikita, Satoshi Mochida, Norifumi Kawada, Nobuyuki Enomoto, Akio Ido, Hitoshi Yoshiji, Daiki Miki, Yoichi Hiasa, Yasuhiro Takikawa, Ryotaro Sakamori, Masayuki Kurosaki, Hiroshi Yatsuhashi, Ryosuke Tateishi, Yoshiyuki Ueno, Yoshito Itoh, Taro Yamashita, Tatsuya Kanto, Goki Suda, Yasunari Nakamoto, Naoya Kato, Yasuhiro Asahina, Kentaro Matsuura, Shuji Terai, Kazuhiko Nakao, Masahito Shimizu, Taro Takami, Norio Akuta, Ryoko Yamada, Takahiro Kodama, Tomohide Tatsumi, Tomomi Yamada, Tetsuo Takehara

Journal of gastroenterology 56 ( 1 ) 67 - 77 2021年1月

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND: Real-world data on the efficacy and safety of sofosbuvir plus velpatasvir (SOF/VEL) treatment for patients with hepatitis C virus (HCV)-related decompensated cirrhosis are limited in Japan. METHODS: A total of 190 patients with compensated (108) or decompensated (82) cirrhosis who initiated direct-acting antiviral (DAA) treatment between February 2019 and August 2019 were enrolled. Sustained virologic response (SVR) was defined as undetectable serum HCV-RNA at 12 weeks after the end of treatment (EOT). RESULTS: The SVR12 rates were 92.6% in patients with compensated cirrhosis and 90.2% in patients with decompensated cirrhosis (p = 0.564), and the treatment completion rates were 98.1% and 96.3%, respectively (p = 0.372). In patients with decompensated cirrhosis, 3 patients discontinued treatment and 2 patients died because of liver-related events. In patients with decompensated cirrhosis with SVR12, 50% of patients with Child-Pugh class B at baseline showed improvement to class A at SVR12, and 27% and 9% of patients with Child-Pugh class C at baseline showed improvement to class B and class A at SVR12, respectively. Patients who achieved SVR12 showed elevated serum albumin levels at the EOT, which were further elevated at SVR12, but no elevated serum albumin levels after the EOT were observed in patients with baseline serum albumin levels less than 2.8 g/dl. CONCLUSIONS: Real-world efficacy of SOF/VEL treatment for patients with decompensated cirrhosis was similar to Japanese phase 3 study, although treatment discontinuation and death related to liver disease occurred. In patients with poor hepatic reserve, whether it improves continuously after viral clearance requires further evaluation.

DOI： 10.1007/s00535-020-01733-4

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【新しい肝硬変診療〜ガイドライン2020を紐解く〜】肝硬変診療の課題と今後の展望

寺井崇二, 坂牧僚

日本消化器病学会雑誌 118 ( 1 ) 41 - 45 2021年1月

記述言語：日本語出版者・発行元：(一財)日本消化器病学会

肝硬変診療ガイドライン2020では、11項目のfuture research questionが挙げられており、これらが特に重点的な今後の課題である。非ウイルス性肝硬変の治療では、アルコール性では減酒によるハームリダクションという概念が提唱されている。非アルコール性では、現時点では肝硬変の線維化を改善する薬物療法はなく、今後のさらなる新薬の開発が期待される。加えてトルバプタンやアルブミンの最適な使用法や、新たに追加されたacute-on-chronic liver failure(ACLF)、肝肺症候群と門脈圧亢進に関連した肺動脈性肺高血圧症の項目の病態について記述する。(著者抄録)

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2021&ichushi_jid=J01118&link_issn=&doc_id=20210122320006&doc_link_id=%2Fck8syokb%2F2021%2F011801%2F006%2F0041-0045%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fck8syokb%2F2021%2F011801%2F006%2F0041-0045%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

Visceral Adipose Tissue Index and Hepatocellular Carcinoma Are Independent Predictors of Outcome in Patients with Cirrhosis Having Endoscopic Treatment for Esophageal Varices. 査読国際誌

Naruhiro Kimura, Atsunori Tsuchiya, Chiyumi Oda, Atsushi Kimura, Kazunori Hosaka, Kentaro Tominaga, Kazunao Hayashi, Junji Yokoyama, Shuji Terai

Digestive diseases (Basel, Switzerland) 39 ( 1 ) 58 - 65 2021年

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND: The relationship between the amount of adipose tissue and advanced-stage liver cirrhosis with esophageal varices (EV) is unknown. We aimed to reveal the prognostic significance of adipose tissues in patients with liver cirrhosis. METHODS: We enrolled 87 patients with EV who received initial endoscopic treatment and underwent scheduled treatments in our hospital. Computed tomography (CT) images were obtained of a 5-mm slice at the umbilical level. We evaluated the effect of mortality based on the visceral adipose tissue index (VATI), subcutaneous adipose tissue index (SATI), and visceral to subcutaneous adipose tissue ratio (VSR). RESULTS: Cox hazard multivariate analysis showed that the presence of hepatocellular carcinoma (HCC; hazard ratio [HR]: 4.650, 95% confidence interval [CI]: 1.750-12.353, p = 0.002), γ-GTP (HR: 1.003, 95% CI: 1.001-1.006, p = 0.026), and VATI (HR: 1.057, 95% CI: 1.030-1.085, p < 0.001) significantly affected mortality. Cox hazard multivariate analysis for liver-related death was also significantly affected by HCC (HR: 1.057, 95% CI: 1.030-1.085, p < 0.001) and VATI (HR: 1.052, 95% CI: 1.019-1.086, p = 0.002). The difference between the Child-Pugh scores 12 months after treatment and that during initial treatment were significantly positively correlated with VATI (r = 0.326, p = 0.027). Patients with high VATI had a significantly higher frequency of HCC after EV treatment by Kaplan-Meier analysis (p = 0.044). CONCLUSION: Our findings suggest that VATI measured by CT could significantly predict mortality in cirrhosis patients through decreasing liver function and increasing HCC frequency, and appropriately controlling VATI could improve their prognosis.

DOI： 10.1159/000508867

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[Problems and future questions in the clinical practice of liver cirrhosis].

Shuji Terai, Akira Sakamaki

Nihon Shokakibyo Gakkai zasshi = The Japanese journal of gastro-enterology 118 ( 1 ) 41 - 45 2021年

Increase in muscle mass associated with the prebiotic effects of 1-kestose in super-elderly patients with sarcopenia.

Kentaro Tominaga, Atsunori Tsuchiya, Oki Nakano, Yasutoshi Kuroki, Kentaro Oka, Ayaka Minemura, Asami Matsumoto, Motomichi Takahashi, Yoshihiro Kadota, Takumi Tochio, Yusuke Niwa, Tomoaki Yoshida, Masatoshi Sato, Takeshi Yokoo, Satoru Hashimoto, Junji Yokoyama, Jun Matsuzawa, Katsuya Fujimori, Shuji Terai

Bioscience of microbiota, food and health 40 ( 3 ) 150 - 155 2021年

記述言語：英語掲載種別：研究論文（学術雑誌）

Sarcopenia causes functional disorders and decreases the quality of life. Thus, it has attracted substantial attention in the aging modern world. Dysbiosis of the intestinal microbiota is associated with sarcopenia; however, it remains unclear whether prebiotics change the microbiota composition and result in the subsequent recovery of muscle atrophy in elderly patients with sarcopenia. This study aimed to assess the effects of prebiotics in super-elderly patients with sarcopenia. We analyzed the effects of 1-kestose on the changes in the intestinal microbiota and body composition using a next-generation sequencer and a multi-frequency bioimpedance analysis device. The Bifidobacterium longum population was significantly increased in the intestine after 1-kestose administration. In addition, in all six patients after 12 weeks of 1-kestose administration, the skeletal muscle mass index was greater, and the body fat percentage was lower. This is the first study to show that administration of a prebiotic increased the population of B. longum in the intestinal microbiota and caused recovery of muscle atrophy in super-elderly patients with sarcopenia.

DOI： 10.12938/bmfh.2020-063

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Novel Strategy for Diagnosis of Focal Nodular Hyperplasia Using Gadolinium Ethoxybenzyl Diethylenetriaminepentaacetic Acid: Enhanced Magnetic Resonance Imaging and Magnetic Resonance Elastography

Nobutaka Takeda, Atsunori Tsuchiya, Kazuki Natsui, Yui Ishii, Yoshihisa Arao, Naruhiro Kimura, Kentaro Tominaga, Suguru Takeuchi, Kazunao Hayashi, Masaaki Takamura, Shuji Terai

CASE REPORTS IN GASTROENTEROLOGY 15 ( 2 ) 507 - 512 2021年

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：KARGER

Focal nodular hyperplasia (FNH) is the second most frequent benign liver tumor, and it is a fiber-rich stiff lesion. Typically, FNH can be diagnosed by imaging without biopsy. However, liver biopsy and diagnostic resection may be required to differentiate atypical FNH from other liver tumors, such as hepatocellular adenoma (HCA). Therefore, improved noninvasive diagnostic methods are needed. We experienced 2 cases where combination of magnetic resonance elastography (MRE) and gadolinium ethoxybenzyl diethylenetriaminepentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI) helped diagnose FNH. A 36-year-old woman and 17-year-old boy with liver tumors measuring 40 mm in diameter each showed hypointense nodule centers, indicating a central scar, surrounded by hyperintense signals during the hepatobiliary phase of Gd-EOB-DTPA-enhanced MRI. To rule out HCA, we performed MRE and liver biopsy. On MRE, the mean stiffness of the mass was 11.6 kPa (mean stiffness of the background liver was 1.7 kPa) and 11.1 kPa (mean stiffness of the background liver was 2.4 kPa) in the first and second patients, respectively. Histological examination of both specimens showed CK7-positive bile-ductular proliferations, abundant fibrous tissue, and few Ki-67-positive cells. Based on these results, we diagnosed these tumors as FNH. Combination of Gd-EOB-DTPA-enhanced MRI and MRE can evaluate the character and stiffness of lesion and help in the diagnosis of FNH.

DOI： 10.1159/000516552

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Clinical characteristics of immunoglobulin IgG4-related sclerosing cholangitis: Comparison of cases with and without autoimmune pancreatitis in a large cohort

Naitoh, I., Kamisawa, T., Tanaka, A., Nakazawa, T., Kubota, K., Takikawa, H., Unno, M., Masamune, A., Kawa, S., Nakamura, S., Okazaki, K., Furumatsu, K., Sawai, S., Goto, T., Okumura, T., Suzuki, D., Otsuka, M., Kobori, I., Tamano, M., Koizumi, M., Hiasa, Y., Kawabe, N., Hirooka, Y., Yamamoto, S., Asano, Y., Inui, K., Horiguchi, A., Watanabe, H., Toya, D., Hatayama, K., Ueki, T., Kinoshita, N., Sugimoto, M., Ohira, H., Mukai, T., Tomita, E., Iwata, K., Shimizu, S., Suetsugu, J., Shimizu, M., Tsuji, K., Ishida, R., Ito, M., Furukawa, R., Sakamoto, N., Araki, M., Tanno, S., Sakamoto, Y., Ito, T., Takai, S., Ikeya, S., Yamada, T., Kudara, N., Shimizu, A., Hanada, K., Ichiki, Y., Kitada, H., Hifumi, M., Kimura, H., Kurosaki, M., Izumi, N., Sumi, H., Haruta, J.-I., Hayashi, K., Harada, R., Inoue, M., Nakamura, S., Ito, T., Tomishima, K., Isayama, H., Oura, K., Masaki, T., Shimokawahara, N., Tanoue, S., Maemura, K., Ido, A., Mizushima, I., Kawano, M., Yoshida, K., Naganuma, M., Murata, M., Nishio, A., Fujita, Y., Teratani, T., Matsubara, S., Tamai, H., Yoshida, Y., Azemoto, R., Kamata, K., Watanabe, T., Kurosu, T., Koizumi, W., Fujita, J., Seki, H., Ueda, Y., Fukumoto, T., Kousaki, T., Uchida, K., Ochiai, T., Kawasaki, T., Tanaka, M., Ishida, E., Notohara, K., Mori, H., Mori, T., Kawabata, H., Miyata, M., Sakagami, J., Itoh, Y., Shiokawa, M., Seno, H., Watanabe, N., Kataoka, H., Aoki, T., Fujishiro, M., Niihara, T., Nishimata, H., Mitoro, A., Yoshiji, H., Yoshida, M., Ikeda, M., Tomita, K., Hokari, R., Hayasaka, K., Amano, Y., Shioji, K., Hayashi, K., Terai, S., Nakajima, M., Yamahana, J., Matsumoto, R., Kikuchi, H., Kanamori, A., Kiriyama, S., Iwatsu, S., Kato, Y., Horiguchi, S., Yagi, T., Okada, H., Ohkawa, K., Hirao, M., Hiramatsu, N., Oza, N., Imamura, H., Baba, T., Nakano, S., Shinobi, T., Ryozawa, S., Motoya, M., Nakase, H., Kinoshita, N., Ito, K., Miyake, T., Kohge, N., Tobita, H., Joshita, S., Umemura, T., Kawaguchi, S., Ohno, K., Sonobe, K., Satoh, A., Shimosegawa, T., Miura, F., Yagi, M., Sano, K., Kin, T., Katanuma, A., Koike, K., Miura, S., Kawashima, Y., Kagawa, T., Azuma, S., Watanabe, M., Honjyo, M., Itoi, T., Honda, A., Kobayashi, K., Asano, T., Mizuno, S., Nishino, T., Taniguchi, H., Tajiri, K., Yasuda, I., Tanaka, Y., Oe, S., Harada, M., Kurata, M., Fukasawa, M., Enomoto, N., Kawaji, Y., Kitano, M., Nishise, Y., Hirakawa, H., Ishizawa, T., Ueno, Y., Kaino, M., Fujimoto, Y., Sakaida, I.

Digestive and Liver Disease 53 ( 10 ) 2021年

Liver cirrhosis with ruptured splenic artery aneurysm leading to hepatitis c treatment: A case report

Hojo, Y., Kamimura, H., Owaki, T., Kimura, R., Iwasawa, T., Watanabe, Y., Takatsuna, M., Ikarashi, S., Takamura, M., Setsu, T., Arao, Y., Horii, Y., Sato, T., Terai, S.

Kanzo/Acta Hepatologica Japonica 62 ( 11 ) 2021年

Predicting Cervical Lymph Node Metastasis Following Endoscopic Surgery in Superficial Head and Neck Carcinoma. 国際誌

Ryuichi Okabe, Yushi Ueki, Riuko Ohashi, Manabu Takeuchi, Satoru Hashimoto, Takeshi Takahashi, Ryusuke Shodo, Keisuke Yamazaki, Hiroshi Matsuyama, Hajime Umezu, Shuji Terai, Yoichi Ajioka, Arata Horii

Frontiers in surgery 8 813260 - 813260 2021年

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND: Early detection of head and neck carcinoma (HNC) as superficial HNC (SHNC) identified using recently developed optical techniques, such as magnifying endoscopy and narrow-band imaging (NBI), in combination with endoscopic surgeries enables minimally invasive treatment with favorable outcomes for HNC. This study aimed to identify the predictive factors for the rare but important clinical issue of SHNC, namely cervical lymph node metastasis (CLNM), following endoscopic resection. METHODS: Sixty-nine patients with SHNC who underwent endoscopic resection were enrolled in the study. Clinical data, preoperative endoscopic findings, pathological findings, and treatment outcomes were retrospectively reviewed. Because the pharyngeal mucosa lacks the muscularis mucosa, we measured tumor thickness in permanent pathology as an alternative to the depth of invasion. Correlations with the occurrence of CLNM were statistically examined. RESULTS: The 5-year disease-specific survival rate was 100%. Of 69 patients, 3 (4.3%) developed CLNM. All had subepithelial but not epithelial tumors. The 0-IIa type in the macroscopic findings, type B2/B3 vessels in narrow-band imaging, tumors ≥ pathological stage T2, lymphatic invasion, positive surgical margins, and tumor thickness >1,000 μm showed significant correlations with CLNM following endoscopic resection. Furthermore, the classification of type B vessels was significantly associated with tumor thickness. CONCLUSION: The treatment outcomes following endoscopic resection for SHNC were favorable. The risk of CLNM following endoscopic resection in SHNC can be predicted by several preoperative endoscopic and postoperative pathological findings. Among them, the classification of type B vessels, which correlated with both tumor thickness and CLNM, might be a useful predictive factor.

DOI： 10.3389/fsurg.2021.813260

PubMed

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