2024/04/18 更新

写真a

ウチダ ダイスケ
内田 大輔
UCHIDA Daisuke
所属
岡山大学病院 講師(特任)
職名
講師(特任)
外部リンク

学位

  • 医学博士 ( 岡山大学大学院医歯薬学総合研究科 )

研究キーワード

  • 消化器病学

  • 遺伝子治療

  • 消化器内視鏡

  • レギュラトリーサイエンス

研究分野

  • ライフサイエンス / 腫瘍診断、治療学

  • ライフサイエンス / 消化器内科学  / Gastroenterology

  • ライフサイエンス / 医療技術評価学  / レギュラトリーサイエンス

学歴

  • 岡山大学   Graduate School of Medicine , Dentistry and Pharmaceutical Sciences  

    2011年4月 - 2014年9月

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  • 岡山大学   Medical School   Faculty of Medicine

    2000年4月 - 2006年3月

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経歴

  • 岡山大学   新医療研究開発センター   講師

    2023年1月 - 現在

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  • 東京医科大学病院   消化器内科   兼任講師

    2022年12月 - 現在

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  • 岡山大学   新医療研究開発センター   助教

    2022年4月 - 2023年1月

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  • 医薬品医療機器総合機構   医療機器審査第二部   審査専門員(臨床医学担当)

    2020年4月 - 2022年3月

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  • 岡山大学   新医療研究開発センター   助教

    2018年6月 - 2020年3月

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  • 岡山大学   消化器内科   医員

    2011年4月 - 2018年5月

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  • 広島市立広島市民病院   内科   内科後期研修医

    2008年4月 - 2011年3月

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  • 広島市立広島市民病院   研修部   初期臨床研修医

    2006年4月 - 2008年3月

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▼全件表示

委員歴

  • 独立行政法人医薬品医療機器総合機構   外部専門委員  

    2022年4月 - 現在   

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論文

  • MicroRNA-34a-5p: A pivotal therapeutic target in gallbladder cancer. 国際誌

    Takashi Oda, Koichiro Tsutsumi, Taisuke Obata, Eijiro Ueta, Tatsuya Kikuchi, Soichiro Ako, Yuki Fujii, Tatsuhiro Yamazaki, Daisuke Uchida, Kazuyuki Matsumoto, Shigeru Horiguchi, Hironari Kato, Hiroyuki Okada, Ryota Chijimatsu, Motoyuki Otsuka

    Molecular therapy. Oncology   32 ( 1 )   200765 - 200765   2024年3月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Gallbladder cancer incidence has been increasing globally, and it remains challenging to expect long prognosis with the current systemic chemotherapy. We identified a novel nucleic acid-mediated therapeutic target against gallbladder cancer by using innovative organoid-based gallbladder cancer models generated from KrasLSL-G12D/+; Trp53f/f mice. Using comprehensive microRNA expression analyses and a bioinformatics approach, we identified significant microRNA-34a-5p downregulation in both murine gallbladder cancer organoids and resected human gallbladder cancer specimens. In three different human gallbladder cancer cell lines, forced microRNA-34a-5p expression inhibited cell proliferation and induced cell-cycle arrest at the G1 phase by suppressing direct target (CDK6) expression. Furthermore, comprehensive RNA sequencing revealed the significant enrichment of gene sets related to the cell-cycle regulators after microRNA-34a-5p expression in gallbladder cancer cells. In a murine xenograft model, locally injected microRNA-34a-5p mimics significantly inhibited gallbladder cancer progression and downregulated CDK6 expression. These results provide a rationale for promising therapeutics against gallbladder cancer by microRNA-34a-5p injection, as well as a strategy to explore therapeutic targets against cancers using organoid-based models, especially for those lacking useful genetically engineered murine models, such as gallbladder cancer.

    DOI: 10.1016/j.omton.2024.200765

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  • MicroRNA-451a inhibits gemcitabine-refractory biliary tract cancer progression by suppressing the MIF-mediated PI3K/AKT pathway. 国際誌

    Taisuke Obata, Koichiro Tsutsumi, Eijiro Ueta, Takashi Oda, Tatsuya Kikuchi, Soichiro Ako, Yuki Fujii, Tatsuhiro Yamazaki, Daisuke Uchida, Kazuyuki Matsumoto, Shigeru Horiguchi, Hironari Kato, Hiroyuki Okada, Motoyuki Otsuka

    Molecular therapy. Nucleic acids   34   102054 - 102054   2023年12月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Gemcitabine is an effective chemotherapeutic agent for biliary tract cancers (BTCs), including gallbladder cancer (GBC) and cholangiocarcinoma (CCA). However, few other effective agents are currently available, particularly for GEM-refractory BTCs. We previously identified microRNA-451a (miR-451a) as a potential therapeutic target in GBC. To elucidate the antineoplastic effects of miR-451a and its underlying mechanisms, we transfected miR-451a into GBC, gemcitabine-resistant GBC (GR-GBC), and gemcitabine-resistant CCA (GR-CCA) cell lines. Furthermore, mimicking in vivo conditions, tumorigenic GBC organoids and three-dimensional (3D) cell culture systems were employed to investigate the anti-proliferative effects of miR-451a on BTCs, and its effect on stem cell properties. We found that miR-451a significantly inhibited cell proliferation, induced apoptosis, and reduced chemoresistant phenotypes, such as epithelial-mesenchymal transition, in both GBC and GR-GBC. The principal mechanism is probably the negative regulation of the phosphatidylinositol 3-kinase/AKT pathway, partially accomplished by directly downregulating macrophage migration inhibitory factor. The Gene Expression Omnibus database revealed that miR-451a was the most significantly downregulated microRNA in CCA tissues. The introduction of miR-451a resulted in similar antineoplastic effects in GR-CCA. Furthermore, miR-451a reduced cell viability in 3D spheroid models and tumorigenic GBC organoids. These findings suggest that the supplementation of miR-451a is a potential treatment strategy for GEM-refractory BTCs.

    DOI: 10.1016/j.omtn.2023.102054

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  • Successful removal of a proximally migrated pancreatic stent using a novel device delivery system. 国際誌

    Akihiro Matsumi, Kazuyuki Matsumoto, Daisuke Uchida, Shigeru Horiguchi, Koichiro Tsutsumi, Hironari Kato, Motoyuki Otsuka

    Endoscopy   55 ( S 01 )   E641-E642   2023年12月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1055/a-2063-3408

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  • Usefulness of red dichromatic imagining for peroral cholangioscopy. 国際誌

    Kazuyuki Matsumoto, Yuki Fujii, Daisuke Uchida, Shigeru Horiguchi, Koichiro Tsutsumi, Hironari Kato

    Endoscopy   55 ( S 01 )   E264-E265   2023年12月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1055/a-1966-0534

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  • Usefulness of the artificial intelligence-mediated virtual chromoendoscopy in peroral cholangioscopy. 国際誌

    Ryosuke Sato, Kazuyuki Matsumoto, Hideaki Kinugasa, Daisuke Uchida, Shigeru Horiguchi, Hironari Kato, Motoyuki Otsuka

    Endoscopy   55 ( S 01 )   E971-E972   2023年12月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1055/a-2142-4555

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  • 特発性肺線維症に対する肺移植後に重症膵炎を発症し、診断に苦慮した膵頭部癌の一例

    矢杉 賢吾, 堀口 しげる, 小幡 泰介, 佐藤 亮介, 織田 崇志, 菊池 達也, 松三 明宏, 宮本 和也, 森本 光作, 寺澤 裕之, 藤井 祐樹, 山崎 辰洋, 内田 大輔, 松本 和幸, 堤 康一郎, 加藤 博也, 大塚 基之

    日本消化器病学会中国支部例会・日本消化器内視鏡学会中国支部例会プログラム・抄録集   120回・131回   85 - 85   2023年11月

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    記述言語:日本語   出版者・発行元:日本消化器病学会-中国支部  

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  • Cysts or necrotic components in pancreatic ductal adenocarcinoma is associated with the risk of EUS-FNA/B complications including needle tract seeding. 国際誌

    Hiroyuki Terasawa, Kazuyuki Matsumoto, Takehiro Tanaka, Takeshi Tomoda, Taiji Ogawa, Yuki Ishihara, Tatsuya Kikuchi, Taisuke Obata, Takashi Oda, Akihiro Matsumi, Kazuya Miyamoto, Kosaku Morimoto, Yuki Fujii, Tatsuhiro Yamazaki, Daisuke Uchida, Shigeru Horiguchi, Koichiro Tsutsumi, Hironari Kato, Motoyuki Otsuka

    Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.]   2023年10月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: EUS-FNA/B for pancreatic ductal adenocarcinoma (PDAC) is generally considered to be safe; however, while the incidence is low, there are occurrences of complications. Among these complications, there are serious ones like needle tract seeding (NTS), and it is not known than which types of tumors have the risks of EUS-FNA/B complications. This study aimed to evaluate the risk of EUS-FNA/B complications in patients with PDAC, focusing on morphological features. METHODS: Overall, 442 patients who underwent EUS-FNA/B for solid pancreatic masses between January 2018 and May 2022 in four institutions were retrospectively surveyed. Finally, 361 patients histopathologically diagnosed with PDAC were analyzed. Among these patients, 79 tumors with cysts or necrotic components were compared with 282 tumors without cysts or necrotic components. The incidence and risk of EUS-FNA/B complications including NTS were evaluated. RESULTS: There were 9 (2.4 %) of total EUS-FNA/B complications and 3 (0.8 %) of NTS. The incidence of total complication rate and NTS in tumors with cysts or necrotic components were significantly higher than in those without cysts or necrotic components (total complication 6.3 % vs. 1.4 %, p = 0.026, NTS 3.7 % vs. 0 %, p = 0.01). The transgastric route of puncture (OR: 93.3, 95 % CI: 3.81-2284.23) and the existence of cysts or necrotic components (OR: 7.3, 95 % CI: 1.47-36.19) were risk factors for EUS-FNA/B complications identified by the multivariate analysis. CONCLUSIONS: We should pay attention to the risks of EUS-FNA/B complications, including NTS, when the tumor has cysts or necrotic components.

    DOI: 10.1016/j.pan.2023.10.018

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  • The efficacy of non-anesthesiologist-administered propofol sedation with a target-controlled infusion system during double-balloon endoscopic retrograde cholangiopancreatography. 国際誌

    Kazuya Miyamoto, Kazuyuki Matsumoto, Taisuke Obata, Ryosuke Sato, Akihiro Matsumi, Kosaku Morimoto, Taiji Ogawa, Hiroyuki Terasawa, Yuki Fujii, Tatsuhiro Yamazaki, Daisuke Uchida, Shigeru Horiguchi, Koichiro Tsutsumi, Hironari Kato, Motoyuki Otsuka

    BMC gastroenterology   23 ( 1 )   296 - 296   2023年9月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: The sedation method used during double-balloon endoscopic retrograde cholangiopancreatography (DB-ERCP) differs among countries and/or facilities, and there is no established method. This study aimed to evaluate the efficacy of non-anesthesiologist-administered propofol (NAAP) sedation using a target-controlled infusion (TCI) system during DB-ERCP. METHODS: This retrospective study was conducted between May 2017 and December 2020 at an academic center. One hundred and fifty-six consecutive patients who underwent DB-ERCP were sedated by gastroenterologists using diazepam (n = 77) or propofol with a TCI system (n = 79), depending on the period. The primary endpoint was a comparison of poor sedation rates between the two groups. Poor sedation was defined as a condition requiring the use of other sedative agents or discontinuation of the procedure. Secondary endpoints were sedation-related adverse events and risk factors for poor sedation. RESULTS: Poor sedation occurred significantly more often in the diazepam sedation group (diazepam sedation, n = 12 [16%] vs. propofol sedation, n = 1 [1%]; P = 0.001). Vigorous body movements (3 or 4) (diazepam sedation, n = 40 [52%] vs. propofol sedation, n = 28 [35%]; P = 0.038) and hypoxemia (< 85%) (diazepam sedation, n = 7 [9%] vs. propofol sedation, n = 1 [1%]; P = 0.027) occurred significantly more often in the diazepam sedation group. In the multivariate analysis, age < 70 years old (OR, 10.26; 95% CI, 1.57-66.98; P = 0.015), BMI ≥ 25 kg/m2 (OR, 11.96; 95% CI, 1.67-85.69; P = 0.014), and propofol sedation (OR, 0.06; 95% CI, 0.01-0.58; P = 0.015) were associated factors for poor sedation. CONCLUSIONS: NAAP sedation with the TCI system during DB-ERCP was safer and more effective than diazepam sedation.

    DOI: 10.1186/s12876-023-02936-8

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  • 結節を有するIPMNの良悪性診断における新規TIC解析プログラムを用いた造影EUSの有用性

    宮本 和也, 松本 和幸, 内田 大輔, 小幡 泰介, 佐藤 亮介, 織田 崇志, 菊池 達也, 松三 明宏, 森本 光作, 寺澤 裕之, 藤井 佑樹, 山崎 辰洋, 堀口 繁, 堤 康一郎, 加藤 博也, 大塚 基之

    膵臓   38 ( 3 )   A345 - A345   2023年7月

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    記述言語:日本語   出版者・発行元:(一社)日本膵臓学会  

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  • 当院における術後膵空腸吻合部狭窄に対する内視鏡治療成績の検討

    森本 光作, 山崎 辰洋, 小幡 泰介, 佐藤 亮介, 織田 崇志, 菊池 達也, 松三 明宏, 宮本 和也, 寺澤 裕之, 藤井 佑樹, 内田 大輔, 松本 和幸, 堀口 繁, 堤 康一郎, 加藤 博也, 大塚 基之

    膵臓   38 ( 3 )   A337 - A337   2023年7月

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    記述言語:日本語   出版者・発行元:(一社)日本膵臓学会  

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  • 高齢者における膵癌術前化学療法の有効性と安全性の検討

    藤井 佑樹, 堀口 繁, 佐藤 亮介, 小幡 泰介, 松三 明宏, 宮本 和也, 森本 光作, 寺澤 裕之, 山崎 辰洋, 内田 大輔, 松本 和幸, 堤 康一郎, 加藤 博也, 大塚 基之

    膵臓   38 ( 3 )   A316 - A316   2023年7月

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    記述言語:日本語   出版者・発行元:(一社)日本膵臓学会  

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  • A Comparison of the Efficacy of Plastic Stent Placement Above and Across the Sphincter of Oddi for Benign Biliary Hilar Stricture.

    Hitomi Himei, Hironari Kato, Yosuke Saragai, Yuki Fujii, Tatsuhiro Yamazaki, Daisuke Uchida, Kazuyuki Matsumoto, Shigeru Horiguchi, Koichiro Tsutsumi, Hiroyuki Okada

    Acta medica Okayama   77 ( 3 )   291 - 299   2023年6月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    We investigated the efficacy and safety of endoscopic plastic stent (PS) placement for hilar benign biliary strictures (BBSs) and compared cases with PS placement above (inside stent, IS) and across (usual stent, US) the sphincter of Oddi. Patients who underwent initial endoscopic PS placement for hilar BBSs between August 2012 and December 2021 were retrospectively analyzed. Hilar BBSs in 88 patients were investigated. Clinical success was achieved in 81 of these cases (92.0%), including 38 patients in the IS group and 43 patients in the US group. Unexpected stent exchange (uSE) before the first scheduled PS exchange occurred in 18 cases (22.2%). The median time from first stent placement to uSE was 35 days. There was no significant difference in the rate and median time to uSE between the two groups. The rates of adverse events such as pancreatitis or cholangitis in the two groups did not significantly differ. However, the rate of difficult stent removal in the IS group (15.8%) was significantly higher than that in the US group (0%) (p=0.0019). US placement is preferable to IS placement for scheduled stent exchange, as it offers the same effectiveness and risk of adverse events with easier stent removal.

    DOI: 10.18926/AMO/65494

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  • 長期経過を追えた膵Intraductal oncocytic papillary neoplasm(IOPN)の1例

    藤井 佑樹, 佐藤 亮介, 小幡 泰介, 松三 明宏, 宮本 和也, 森本 光作, 寺澤 裕之, 山崎 辰洋, 内田 大輔, 松本 和幸, 堀口 繁, 堤 康一郎, 加藤 博也, 大塚 基之

    日本消化器病学会中国支部例会プログラム・抄録集   119回   67 - 67   2023年6月

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    記述言語:日本語   出版者・発行元:日本消化器病学会-中国支部  

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  • 進行胆道癌に対するゲムシタビン・シスプラチン・S-1併用療法の治療成績についての検討

    小幡 泰介, 松本 和幸, 佐藤 亮介, 菊池 達也, 織田 崇志, 松三 明宏, 宮本 和也, 森本 光作, 寺澤 裕之, 藤井 佑樹, 山崎 辰洋, 内田 大輔, 堀口 繁, 堤 康一郎, 加藤 博也, 大塚 基之

    日本消化器病学会中国支部例会プログラム・抄録集   119回   65 - 65   2023年6月

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    記述言語:日本語   出版者・発行元:日本消化器病学会-中国支部  

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  • 肝内結石に対して内視鏡用イントロデューサーEndoSheatherが有用であった1例

    佐藤 亮介, 藤井 佑樹, 小幡 泰介, 松三 明宏, 宮本 和也, 森本 光作, 寺澤 裕之, 山崎 辰洋, 内田 大輔, 松本 和幸, 堤 康一郎, 堀口 繁, 加藤 博也, 大塚 基之

    日本消化器内視鏡学会中国支部例会   130回   83 - 83   2023年6月

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    記述言語:日本語   出版者・発行元:日本消化器内視鏡学会-中国支部  

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  • 悪性輸入脚症候群に対して超音波内視鏡下消化管ドレナージが有効であった1例

    森本 光作, 松本 和幸, 小幡 泰介, 佐藤 亮介, 織田 崇志, 菊池 達也, 松三 明宏, 宮本 和也, 寺澤 裕之, 藤井 佑樹, 山崎 辰洋, 内田 大輔, 堀口 繁, 堤 康一郎, 加藤 博也, 大塚 基之

    日本消化器内視鏡学会中国支部例会   130回   83 - 83   2023年6月

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    記述言語:日本語   出版者・発行元:日本消化器内視鏡学会-中国支部  

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  • 当院の胆膵内視鏡診療における放射線量の検討

    山崎 辰洋, 松本 和幸, 小幡 泰介, 松三 明宏, 宮本 和也, 森本 光作, 寺澤 裕之, 藤井 佑樹, 内田 大輔, 堀口 繁, 堤 康一郎, 加藤 博也

    Gastroenterological Endoscopy   65 ( Suppl.1 )   875 - 875   2023年4月

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    記述言語:日本語   出版者・発行元:(一社)日本消化器内視鏡学会  

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  • 選択的胆管seekingのためのデバイス選択

    小幡 泰介, 内田 大輔, 加藤 博也, 佐藤 亮介, 松三 明宏, 宮本 和也, 森本 光作, 寺澤 裕之, 藤井 佑樹, 山崎 辰洋, 松本 和幸, 堀口 繁, 堤 康一郎, 大塚 基之

    Gastroenterological Endoscopy   65 ( Suppl.1 )   971 - 971   2023年4月

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    記述言語:日本語   出版者・発行元:(一社)日本消化器内視鏡学会  

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  • 選択的胆管seekingのためのデバイス選択

    小幡 泰介, 内田 大輔, 加藤 博也, 佐藤 亮介, 松三 明宏, 宮本 和也, 森本 光作, 寺澤 裕之, 藤井 佑樹, 山崎 辰洋, 松本 和幸, 堀口 繁, 堤 康一郎, 大塚 基之

    Gastroenterological Endoscopy   65 ( Suppl.1 )   971 - 971   2023年4月

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    記述言語:日本語   出版者・発行元:(一社)日本消化器内視鏡学会  

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  • 当院の胆膵内視鏡診療における放射線量の検討

    山崎 辰洋, 松本 和幸, 小幡 泰介, 松三 明宏, 宮本 和也, 森本 光作, 寺澤 裕之, 藤井 佑樹, 内田 大輔, 堀口 繁, 堤 康一郎, 加藤 博也

    Gastroenterological Endoscopy   65 ( Suppl.1 )   875 - 875   2023年4月

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    記述言語:日本語   出版者・発行元:(一社)日本消化器内視鏡学会  

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  • Risk Factors for Ceftriaxone-Associated Pseudolithiasis in Adults. 国際誌

    Akihiro Matsumi, Takeshi Tomoda, Hiroyuki Terasawa, Yuki Fujii, Tatsuhiro Yamazaki, Daisuke Uchida, Kazuyuki Matsumoto, Shigeru Horiguchi, Koichiro Tsutsumi, Hironari Kato

    Digestion   1 - 7   2023年3月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    INTRODUCTION: Ceftriaxone (CTRX) is known to occasionally cause pseudolithiasis. This condition is often observed in children; however, few studies have reported the incidence and risk factors for CTRX-associated pseudolithiasis. METHODS: In this single-center retrospective study, we investigated the incidence of and risk factors for CTRX-associated pseudolithiasis in adults. All patients underwent computed tomography to confirm pseudolithiasis before and after CTRX administration. RESULTS: The study included 523 patients. Pseudolithiasis was detected in 89 patients (17%). Data analysis showed that abdominal area-related biliary diseases at the site of infection (odds ratio [OR] 0.19, 95% confidence interval [CI] 0.064-0.53, p = 0.0017), CTRX administration for >3 days (OR 5.0, 95% CI: 2.5-9.9, p < 0.0001), CTRX dose of 2 mg (OR 5.2, 95% CI: 2.8-9.6, p < 0.0001), fasting period >2 days (OR 3.2, 95% CI: 1.6-6.4, p = 0.0010), and estimated glomerular filtration rate <30 mL/min/1.73 m2 (OR 3.4, 95% CI: 1.6-7.5, p = 0.0022) were independent factors for pseudolithiasis. CONCLUSIONS: CTRX-associated pseudolithiasis may occur in adults and should be considered in the differential diagnosis in patients who develop abdominal pain or liver enzyme elevation after CTRX administration, particularly in patients with chronic kidney disease, in those who are fasting, in and those who receive high-dose CTRX therapy.

    DOI: 10.1159/000529522

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  • 膵癌化学療法における血中自己抗体を用いた治療効果予測の可能性

    松本 和幸, 高木 章乃夫, 高原 政宏, 小幡 泰介, 藤井 佑樹, 山崎 辰洋, 内田 大輔, 堀口 繁, 堤 康一郎, 加藤 博也

    日本消化器病学会雑誌   120 ( 臨増総会 )   A292 - A292   2023年3月

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    記述言語:日本語   出版者・発行元:(一財)日本消化器病学会  

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  • EUS-HGSにおけるダブルガイドワイヤー法の有用性

    松三 明宏, 藤井 佑樹, 小幡 泰介, 佐藤 亮介, 織田 崇志, 菊池 達也, 宮本 和也, 森本 光作, 寺澤 裕之, 山崎 辰洋, 内田 大輔, 松本 和幸, 堀口 繁, 堤 康一郎, 加藤 博也, 大塚 基之

    日本消化器病学会雑誌   120 ( 臨増総会 )   A321 - A321   2023年3月

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    記述言語:日本語   出版者・発行元:(一財)日本消化器病学会  

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  • 胆嚢オルガノイドを用いた発癌モデルより同定したmiR-34a-5p補充による胆嚢癌治療の開発

    織田 崇志, 堤 康一郎, 小幡 泰介, 菊池 達也, 松三 明宏, 宮本 和也, 森本 光作, 寺澤 裕之, 藤井 佑樹, 山崎 辰洋, 赤穂 宗一郎, 内田 大輔, 松本 和幸, 堀口 繁, 加藤 博也, 大塚 基之

    日本消化器病学会雑誌   120 ( 臨増総会 )   A328 - A328   2023年3月

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    記述言語:日本語   出版者・発行元:(一財)日本消化器病学会  

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  • 後期高齢者におけるIPMNの治療移行割合についての検討

    宮本 和也, 松本 和幸, 小幡 泰介, 佐藤 亮介, 織田 崇志, 菊池 達也, 松三 明宏, 森本 光作, 寺澤 裕之, 藤井 佑樹, 山崎 辰洋, 内田 大輔, 堀口 繁, 堤 康一郎, 加藤 博也, 大塚 基之

    日本消化器病学会雑誌   120 ( 臨増総会 )   A378 - A378   2023年3月

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    記述言語:日本語   出版者・発行元:(一財)日本消化器病学会  

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  • 【胆膵EUSのトラブルシューティング】治療的EUS EUS-guided biliary drainage(EUS-BD) 処置後の腹痛

    加藤 博也, 内田 大輔, 松本 和幸, 堀口 繁, 堤 康一郎

    消化器内視鏡   34 ( 12 )   2011 - 2015   2022年12月

  • Gastric linitis plastica with autoimmune pancreatitis diagnosed by an endoscopic ultrasonography-guided fine-needle biopsy: A case report. 国際誌

    Ryosuke Sato, Kazuyuki Matsumoto, Hiromitsu Kanzaki, Akihiro Matsumi, Kazuya Miyamoto, Kosaku Morimoto, Hiroyuki Terasawa, Yuki Fujii, Tatsuhiro Yamazaki, Daisuke Uchida, Koichiro Tsutsumi, Shigeru Horiguchi, Hironari Kato

    World journal of clinical cases   10 ( 31 )   11607 - 11616   2022年11月

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    記述言語:英語  

    BACKGROUND: Gastric linitis plastica (GLP) is a subset of gastric cancer with a poor prognosis. It is difficult to obtain a definitive diagnosis by endoscopic mucosal biopsies, and the usefulness of an endoscopic ultrasonography-guided fine-needle biopsy (EUS-FNB) for GLP has been recently reported. Meanwhile, autoimmune diseases are occasionally known to coexist with malignant tumors as paraneoplastic syndrome. We herein report the usefulness of an EUS-FNB for detecting GLP and the possibility of paraneoplastic syndrome coexisting with GLP. CASE SUMMARY: An 81-year-old man was admitted to our hospital for a 1-mo history of epigastric pain that increased after eating. His laboratory data revealed high levels of serum carbohydrate antigen 19-9 and immunoglobulin-G4. Endoscopic examinations showed giant gastric folds and reddish mucosa; however, no epithelial changes were observed. The gastric lumen was not distensible by air inflation, suggesting GLP. Computed tomography showed the thickened gastric wall, the diffuse enlargement of the pancreas, and the peripancreatic rim, which suggested autoimmune pancreatitis (AIP) coexisting with GLP. Because the pathological findings of the endoscopic biopsy showed no malignancy, he underwent an EUS-FNB and was diagnosed with GLP. He received chemotherapy for unresectable gastric cancer due to peritoneal metastasis, after which both the gastric wall thickening and diffuse enlargement of the pancreas were improved. CONCLUSION: An EUS-FNB for GLP with a negative endoscopic biopsy is useful, and AIP may develop as a paraneoplastic syndrome.

    DOI: 10.12998/wjcc.v10.i31.11607

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  • ペムブロリズマブが奏功した高頻度マイクロサテライト不安定性を有する肝内胆管癌の1例

    角田 太助, 藤井 佑樹, 堀口 繁, 松三 明宏, 宮本 和也, 森本 光作, 寺澤 裕之, 山崎 辰洋, 内田 大輔, 松本 和幸, 堤 康一郎, 加藤 博也

    日本消化器病学会中国支部例会・日本消化器内視鏡学会中国支部例会プログラム・抄録集   118回・129回   90 - 90   2022年11月

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    記述言語:日本語   出版者・発行元:日本消化器病学会-中国支部  

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  • SpyGlass DSによるEHLと胆道鏡用バスケットが有用であった肝内結石の1例

    松三 明宏, 藤井 佑樹, 松本 和幸, 小幡 泰介, 織田 崇志, 菊池 達也, 宮本 和也, 森本 光作, 寺澤 裕之, 山崎 辰洋, 内田 大輔, 堀口 繁, 堤 康一郎, 加藤 博也

    日本消化器病学会中国支部例会・日本消化器内視鏡学会中国支部例会プログラム・抄録集   118回・129回   146 - 146   2022年11月

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    記述言語:日本語   出版者・発行元:日本消化器病学会-中国支部  

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  • Linitis plastica型胃癌の診断に超音波内視鏡ガイド下針生検が有用であった1例

    佐藤 亮介, 寺澤 裕之, 松本 和幸, 松三 明宏, 宮本 和也, 森本 光作, 藤井 佑樹, 山崎 辰洋, 内田 大輔, 堤 康一郎, 堀口 繁, 加藤 博也

    日本消化器病学会中国支部例会・日本消化器内視鏡学会中国支部例会プログラム・抄録集   118回・129回   139 - 139   2022年11月

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    記述言語:日本語   出版者・発行元:日本消化器病学会-中国支部  

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  • アンメットメディカルニーズへの挑戦 当院における膵消化管神経内分泌腫瘍に対するペプチド受容体放射性核種療法(PRRT)導入後の現状

    藤井 佑樹, 堀口 繁, 内田 大輔, 松本 和幸, 加藤 博也

    日本消化器病学会中国支部例会・日本消化器内視鏡学会中国支部例会プログラム・抄録集   118回・129回   77 - 77   2022年11月

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    記述言語:日本語   出版者・発行元:日本消化器病学会-中国支部  

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  • Stent-in-stent techniqueにて抜去した胆管金属ステントの2例

    松三 明宏, 松本 和幸, 小幡 泰介, 織田 崇志, 菊池 達也, 宮本 和也, 森本 光作, 寺澤 裕之, 藤井 佑樹, 山崎 辰洋, 内田 大輔, 堀口 繁, 堤 康一郎, 加藤 博也

    胆道   36 ( 3 )   349 - 349   2022年9月

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    記述言語:日本語   出版者・発行元:(一社)日本胆道学会  

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  • 生体肝移植後胆管狭窄に対する内視鏡治療

    山崎 辰洋, 松本 和幸, 加藤 博也, 松三 明宏, 宮本 和也, 寺澤 裕之, 藤井 佑樹, 内田 大輔, 堀口 繁, 堤 康一郎

    胆道   36 ( 3 )   344 - 344   2022年9月

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    記述言語:日本語   出版者・発行元:(一社)日本胆道学会  

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  • 『胆膵疾患と性差』分枝型IPMNの性差による画像的特徴と長期経過の検討

    宮本 和也, 松本 和幸, 松三 明宏, 森本 光作, 寺澤 裕之, 藤井 佑樹, 山崎 辰洋, 内田 大輔, 堀口 繁, 堤 康一郎, 加藤 博也

    日本高齢消化器病学会誌   25 ( 1 )   161 - 161   2022年7月

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    記述言語:日本語   出版者・発行元:(NPO)日本高齢消化器病学会  

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  • Plasma KRAS mutations predict the early recurrence after surgical resection of pancreatic cancer. 国際誌

    Soichiro Ako, Hironari Kato, Kazuhiro Nouso, Hideaki Kinugasa, Hiroyuki Terasawa, Hiroshi Matushita, Saimon Takada, Yosuke Saragai, Sho Mizukawa, Shinichiro Muro, Daisuke Uchida, Takeshi Tomoda, Kazuyuki Matsumoto, Shigeru Horiguchi, Daisuke Nobuoka, Ryuichi Yoshida, Yuzo Umeda, Takahito Yagi, Hiroyuki Okada

    Cancer biology & therapy   22 ( 10-12 )   564 - 570   2021年12月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: The technique to analyze circulating tumor DNA (ctDNA) in body fluid (so-called "liquid biopsy") is recently developed. AIMS: Our aim was to assess the utility of liquid biopsy for predicting progression of pancreatic ductal adenocarcinoma (PDAC) after surgical resection or chemotherapy. METHODS: A total of 72 patients with PDAC were retrospectively enrolled for this study, 33 treated surgically and 39 given chemotherapy, either FOLFIRINOX (oxaliplatin/irinotecan/fluorouracil/leucovorin) or gemcitabine plus nab-paclitaxel. Prior to treatment, patients were screened for the presence of KRAS mutations (G12D and G12V) in plasma using droplet digital polymerase chain reaction, and outcomes were compared. RESULTS: KRAS mutations were identified in plasma samples of 12 patients (36%) underwent surgical resection. Patients with plasma KRAS mutations had significantly shorter disease-free survival (DFS) and overall survival (p < .01 and p = .01, respectively). Of 10 clinical variables analyzed, plasma KRAS mutation was the factor predictive of DFS in multivariate analysis (RR = 3.58, 95% CI: 1.36-9.60; p = .01). Although 12 patients (31%) given chemotherapy tested positive for plasma KRAS mutations, there was no demonstrable relation between plasma KRAS mutations and progression-free survival (PFS) or overall survival (OS) (p = .35 and p = .68, respectively). CONCLUSIONS: In patients with PDAC, detection of KRAS mutations in plasma proved independently predictive of early recurrence after surgical resection but did not correlate with PFS following chemotherapy.

    DOI: 10.1080/15384047.2021.1980312

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  • Risk Factors for the Development of High-risk Stigmata in Branch-duct Intraductal Papillary Mucinous Neoplasms.

    Tatsuhiro Yamazaki, Takeshi Tomoda, Hironari Kato, Kazuya Miyamoto, Akihiro Matsumi, Eijiro Ueta, Yuki Fujii, Yosuke Saragai, Daisuke Uchida, Kazuyuki Matsumoto, Shigeru Horiguchi, Koichiro Tsutsumi, Hiroyuki Okada

    Internal medicine (Tokyo, Japan)   60 ( 20 )   3205 - 3211   2021年10月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Objective Strict follow-up is recommended for branch-duct intraductal papillary mucinous neoplasms (BD-IPMNs) to avoid missing the development of high-risk stigmata (HRS) at a premalignant stage. This study explored the risk factors associated with the development of HRS during follow-up. Methods We performed a retrospective analysis of 283 patients with BD-IPMN, treated at Okayama University Hospital in Japan between January 2009 and December 2016. Only patients with imaging studies indicative of classical features of BD-IPMN without HRS and followed for over one year were included in the study. We performed radiological follow-up every six months and collected patients' demographic data, cyst characteristics, and clinical outcomes and used univariate logistic regression models to determine the odds of developing HRS. Results Ten patients (3.5%) developed HRS after a median surveillance period of 55.8 months. The main pancreatic duct (MPD) size (5-9 mm) and cyst growth rate (>2.5 mm/year) were both suggested to be possible risk factors for the development of HRS [odds ratio, 14.2; 95% confidence interval (CI), 3.1-65.2, p=0.0006, and odds ratio, 6.1; 95% CI 1.5-25.5, p=0.014]. Regarding the number of worrisome features (WFs), the rate of HRS development was 2.0% (4/199) in cases with no WF, 1.6% (1/62) in cases with single WF and 22.7% (5/22) in cases with multiple WFs, respectively. The rate of HRS development was significantly higher in cases with multiple WFs than in the other cases (p<0.0001). Conclusion MPD dilation, rapid cyst growth, and multiple WFs were significant risk factors for the development of HRS. In the presence of such features, it is necessary to closely follow the development of HRS and avoid missing the best opportunity to perform surgical intervention.

    DOI: 10.2169/internalmedicine.7168-21

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  • Laminin-411 and -511 Modulate the Proliferation, Adhesion, and Morphology of Gastric Cancer Cells. 国際誌

    Masaya Iwamuro, Hidenori Shiraha, Atsushi Oyama, Daisuke Uchida, Shigeru Horiguchi, Hiroyuki Okada

    Cell biochemistry and biophysics   79 ( 2 )   407 - 418   2021年6月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Laminins (Ln), a type of extracellular matrix glycoprotein, are key regulators of cellular behavior. Recent work revealed that in various tumor cell lines, laminin isoforms influence specific responses, such as cell anchorage, survival, proliferation, migration, organization, and specialization. The contribution of laminin isoforms to the function of gastric cancer cells, however, remain unclear. Here, we revealed that in gastric cancer, laminin isoforms Ln411, Ln421, Ln511, and Ln521 promote cellular proliferation; Ln511 and Ln521 increase cell cytoplasmic volume; Ln511 hampers invadopodia formation in some cells, Ln511 enables prompt adhesion of cells to plates, and Ln411 and Ln511 do not alter the gastric cancer stem cell markers CD44 and Lgr5. These results indicate that Ln411 and Ln511 dynamically modulate the proliferation, adhesion, and morphology of gastric cancer cells in different ways that are independent of stem cell properties. In particular, Ln511 showed a high affinity for gastric cancer cells. Our observations broaden the possible options for controlling cancer cell progression and metastasis by modulating laminin-integrin interactions.

    DOI: 10.1007/s12013-021-00972-3

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  • Efficacy of low dose rectal diclofenac for preventing post-endoscopic retrograde cholangiopancreatography pancreatitis: Propensity score-matched analysis. 国際誌

    Takeshi Tomoda, Hironari Kato, Kazuya Miyamoto, Akihiro Matsumi, Eijiro Ueta, Yuuki Fujii, Yousuke Saragai, Tatsuhiro Yamazaki, Daisuke Uchida, Kazuyuki Matsumoto, Shigeru Horiguchi, Koichiro Tsutsumi, Hiroyuki Okada

    Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society   33 ( 4 )   656 - 662   2021年5月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: Acute pancreatitis is a major adverse event of endoscopic retrograde cholangiopancreatography (ERCP). Rectal administration of non-steroidal anti-inflammatory drugs (NSAIDs) decreases the incidence of post-ERCP pancreatitis (PEP). However, the efficacy of low dose rectal NSAIDs for preventing PEP remains controversial. METHODS: We performed a retrospective study of 301 patients with native papilla and a body weight of <50 kg who underwent ERCP between September 2010 and October 2019. After July 2016, a 25 mg dose of rectal diclofenac was routinely administered within 15 min before ERCP (NSAIDs group, n = 72) and the control group (n = 229) consisted of patients undergoing ERCP before this date without treatment. We compared the incidence of PEP between the two groups using propensity score matching. RESULTS: A total of 66 pairs of patients in each group were selected. The patients and procedural-related factors were similar in both groups. In total, 15 patients (11.4%) developed PEP: 12.1% (8/66) in the NSAIDs group and 10.6% (7/66) in the control group (Odds ratio (OR) 1.2; 95% confidence interval (CI) 0.4-3.5; P = 0.78). There was no significant difference in incidence of other adverse events related to ERCP between the two groups. CONCLUSIONS: Prophylactic administration of a 25 mg dose of rectal diclofenac did not reduce the incidence of PEP in patients with a native papilla and a body weight of <50 kg in this study and a certain dose of rectal NSAIDs, such as a 100-mg dose, should be administered regardless of body weight to prevent PEP.

    DOI: 10.1111/den.13828

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  • Treatment outcomes, including risk factors of stone recurrence, for hepatolithiasis using balloon-assisted endoscopy in patients with hepaticojejunostomy (with video). 国際誌

    Yuki Ishihara, Kazuyuki Matsumoto, Hironari Kato, Koichiro Tsutsumi, Takeshi Tomoda, Akihiro Matsumi, Kazuya Miyamoto, Tatsuhiro Yamazaki, Yosuke Saragai, Yuki Fujii, Daisuke Uchida, Shigeru Horiguchi, Hiroyuki Okada

    Surgical endoscopy   35 ( 4 )   1895 - 1902   2021年4月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND AND STUDY AIMS: Endoscopic treatment outcomes for hepatolithiasis in patients with altered anatomy are not well known. The aim of this study was to evaluate the treatment outcomes of hepatolithiasis in patients with hepaticojejunostomy (HJ) using short-type double-balloon endoscopy (sDBE) and to assess the risk factors for stone recurrence. PATIENTS AND METHODS: This was a retrospective cohort study that consisted of 73 patients with hepatolithiasis who underwent bowel reconstruction with HJ at an academic center. Stone removal was performed using sDBE. After balloon-occluded cholangiography using sDBE, peroral direct cholangioscopy (PDCS) using ultraslim endoscopy was performed to check for residual stones, depending on the bowel reconstruction method. Recurrence was defined as the development of cholangitis from stones. RESULTS: The success rate of reaching the HJ site was 92% (67/73), and the complete stone removal rate was 93% (62/67) with multiple sessions (mean number 1.5 ± 0.9). The occurrence rate of procedure-related adverse events was 6.8%. Among 58 patients evaluated for stone recurrence, 13 (22%) developed recurrence during a median follow-up period of 2.7 years (interquartile range: 1.5-4.8). Multivariate analyses determined that a stone diameter ≥ 8 mm [odds ratio (OR), 5.57; 95% confidence interval (CI), 1.39-37.2; p = 0.013] and performing PDCS (OR, 0.16; 95% CI, 0.0084-0.90; p = 0.036) were significant factors for stone recurrence. CONCLUSIONS: Endoscopic treatment using sDBE for hepatolithiasis was effective and safe. PDCS might reduce the rate of stone recurrence by detecting stones that are too small to confirm on fluoroscopic images.

    DOI: 10.1007/s00464-020-08139-6

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  • The efficacy of pancreatic juice cytology with liquid-based cytology for evaluating malignancy in patients with intraductal papillary mucinous neoplasm

    Kazuya Miyamoto, Kazuyuki Matsumoto, Hironari Kato, Ryuichi Yoshida, Yuzo Umeda, Hirohumi Inoue, Takehiro Tanaka, Akihiro Matsumi, Yosuke Saragai, Yuki Fujii, Tatsuhiro Yamazaki, Daisuke Uchida, Takeshi Tomoda, Shigeru Horiguchi, Takahito Yagi, Hiroyuki Okada

    BMC Gastroenterology   20 ( 1 )   2020年12月

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    掲載種別:研究論文(学術雑誌)   出版者・発行元:Springer Science and Business Media LLC  

    <title>Abstract</title>
    <sec>
    <title>Background</title>
    Pancreatic juice cytology (PJC) is a tool for diagnosing malignant intraductal papillary mucinous neoplasm (IPMN); however, the accuracy is insufficient using the conventional method. Liquid-based cytology (LBC) improves the cell recovery rate, and almost all cells can be evaluated. We evaluated the efficacy of PJC with LBC for malignant IPMN.


    </sec>
    <sec>
    <title>Methods</title>
    We retrospectively analyzed 90 patients with suspected malignant IPMN who underwent PJC before pancreatectomy. PJC with smear and LBC methods was conducted in 52 patients (between June 2003 to December 2011) and 38 patients (between January 2012 to December 2018). Based on the imaging studies, all of the patients were classified according to the international consensus guidelines for IPMN revised in 2017.


    </sec>
    <sec>
    <title>Results</title>
    Of the 90 patients, 43 (48%) had malignant IPMN (high-grade dysplasia or invasive carcinoma), and the remaining patients had non-malignant IPMN (intermediate- or low-grade dysplasia). LBC increased the accuracy of PJC for the diagnosis of malignant IPMN (smear method: 56% [29/52] vs. LBC method: 76% [29/38]; <italic>P</italic> = 0.044). In a multivariate analysis, LBC was a significant factor influencing the accurate diagnosis of PJC (odds ratio: 3.52; <italic>P</italic> = 0.021). Furthermore, LBC increased the accuracy of PJC for malignant IPMN in patients with worrisome features (smear method: 66% [19/29] vs. LBC method: 93% [14/15]; <italic>P</italic> = 0.043).


    </sec>
    <sec>
    <title>Conclusions</title>
    LBC increases the accuracy of PJC for diagnosing malignant IPMN compared with the conventional smear method.


    </sec>

    DOI: 10.1186/s12876-020-01465-y

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    その他リンク: http://link.springer.com/article/10.1186/s12876-020-01465-y/fulltext.html

  • Effectiveness of Menghini-Type Needles for Endoscopic Ultrasound-Guided Fine-Needle Aspiration of Pancreatic Masses. 国際誌

    Sho Mizukawa, Hironari Kato, Kazuyuki Matsumoto, Shinichiro Muro, Yutaka Akimoto, Daisuke Uchida, Takeshi Tomoda, Naoki Yamamoto, Shigeru Horiguchi, Koichiro Tsutsumi, Hirofumi Inoue, Noriyuki Tanaka, Hiroyuki Okada

    Digestive diseases and sciences   66 ( 9 )   3171 - 3178   2020年10月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: Cutting needles are thought to be effective as biopsy needles. A few types of cutting needles are available for endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA), and the Menghini-type needle is an end-type cutting needle. AIMS: A prospective randomized controlled trial was conducted to compare the results of EUS-FNA using a Menghini-type needle (needle M) versus a conventional needle (needle S). METHODS: The main eligibility criteria were as follows: patients with a pancreatic mass referred for EUS-FNA, ≥ 20 years old, and a performance status < 4. The primary outcome was the sample quality. The secondary outcomes were factors associated with the sample quality, diagnostic accuracy, and adverse events. RESULTS: A total of 97 patients were enrolled in this study. The sample quality for total puncture with needle M (92.8%) was significantly higher than that with needle S (81.4%) (p = 0.0305). The tumor size (p = 0.033) and type of needle (p = 0.031) were significant factors associated with adequate tissue collection in univariate and multivariate analyses (odds ratio [OR] 2.71; 95% confidence interval [CI] 1.12-6.54; p = 0.027 for tumor size, and OR 2.93; 95% CI 1.23-8.21; p = 0.0153 for type of needle). The diagnostic accuracy of each needle was 88.7% (86/97) with needle M and 73.2% (71/97) with needle S. Adverse events occurred in 2 of the 97 patients (0.02%). CONCLUSION: A Menghini-type needle was able to obtain core tissue for histology more effectively than a conventional aspiration needle. TRIAL REGISTRATION NUMBERS: UMIN registration number of 000020668.

    DOI: 10.1007/s10620-020-06628-1

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  • 悪性遠位胆管閉塞に対するself expandable metallic stentを用いた胆管ドレナージの治療成績の検討

    宮本 和也, 加藤 博也, 松三 明宏, 藤井 佑樹, 皿谷 洋祐, 山崎 辰洋, 内田 大輔, 友田 健, 松本 和幸, 堀口 繁, 岡田 裕之

    日本消化器病学会雑誌   117 ( 臨増大会 )   A790 - A790   2020年10月

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    記述言語:日本語   出版者・発行元:(一財)日本消化器病学会  

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  • 悪性胆道狭窄に対するMetallic stent留置に伴う胆嚢炎の検討

    松三 明宏, 友田 健, 宮本 和也, 皿谷 洋祐, 藤井 佑樹, 山崎 辰洋, 内田 大輔, 松本 和幸, 堀口 繁, 加藤 博也, 岡田 裕之

    Gastroenterological Endoscopy   62 ( Suppl.2 )   2149 - 2149   2020年10月

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    記述言語:日本語   出版者・発行元:(一社)日本消化器内視鏡学会  

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  • Evaluation of Local Recurrence of Pancreatic Cancer by KRAS Mutation Analysis Using Washes from Endoscopic Ultrasound-Guided Fine-Needle Aspiration. 国際誌

    Kazuyuki Matsumoto, Hironari Kato, Kazuhiro Nouso, Soichiro Ako, Hideaki Kinugasa, Shigeru Horiguchi, Yosuke Saragai, Saimon Takada, Shuntaro Yabe, Shinichiro Muro, Daisuke Uchida, Takeshi Tomoda, Hiroyuki Okada

    Digestive diseases and sciences   65 ( 10 )   2907 - 2913   2020年10月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND AND AIMS: The sensitivity of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) for diagnosing the recurrence of pancreatic cancer is usually low because of difficulties in obtaining adequate samples for pathological examinations. We evaluated the efficacy of highly sensitive KRAS mutation analysis using EUS-FNA washes to detect cancer recurrence. METHODS: Nineteen consecutive patients with suspected pancreatic cancer recurrence after surgical resection were enrolled. All underwent EUS-FNA, and samples were obtained for pathological examination. After the first session, the inside of the FNA needle was washed with saline for DNA extraction. KRAS mutations were examined using digital droplet PCR (dPCR). RESULTS: The median needle puncture number used to obtain adequate pathological samples was two (range 1-6). In ten patients pathologically diagnosed with malignant pancreatic cancer, nine patients tested positive for a KRAS mutation. All patients who were not diagnosed with a malignant pancreatic cancer tested negative for a KRAS mutation. About half of surgically resected primary cancers (9/19) showed double KRAS mutations (G12V and G12D); however, all but one wash sample showed a single KRAS mutation, G12D. After including one patient who showed a malignant recurrence during follow-up, the sensitivities of a pathological diagnosis and KRAS analysis to detect recurrence were 90.9% and 81.8%, respectively. CONCLUSIONS: KRAS mutation analysis of needle wash samples using dPCR is a new methodology for the diagnosis of the local recurrence of pancreatic cancer. The diagnostic ability of dPCR with a one-time needle wash sample was comparable to a pathological diagnosis with multiple samplings.

    DOI: 10.1007/s10620-019-06006-6

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  • 急性膵炎後Pancreatic fluid collectionに対する内視鏡治療の現状

    山崎 辰洋, 加藤 博也, 宮本 和也, 松三 明宏, 上田 英次郎, 藤井 佑樹, 皿谷 洋祐, 内田 大輔, 友田 健, 松本 和幸, 岡田 裕之

    Gastroenterological Endoscopy   62 ( Suppl.2 )   2134 - 2134   2020年10月

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    記述言語:日本語   出版者・発行元:(一社)日本消化器内視鏡学会  

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  • 膵切除後膵液漏に対する内視鏡的膵管ドレナージ術の検討

    上田 英次郎, 加藤 博也, 内田 大輔, 松三 明宏, 宮本 和也, 藤井 佑樹, 皿谷 洋祐, 山崎 辰洋, 松本 和幸, 友田 健, 堤 康一郎, 堀口 繁, 岡田 裕之

    Gastroenterological Endoscopy   62 ( Suppl.2 )   2132 - 2132   2020年10月

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    記述言語:日本語   出版者・発行元:(一社)日本消化器内視鏡学会  

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  • 当院における肝門部領域良性胆道狭窄に対するInside stentの有用性の検討

    皿谷 洋祐, 加藤 博也, 上田 英次郎, 松三 明宏, 宮本 和也, 藤井 佑樹, 山崎 辰洋, 内田 大輔, 友田 健, 堀口 繁, 堤 康一郎, 岡田 裕之

    胆道   34 ( 3 )   582 - 582   2020年8月

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    記述言語:日本語   出版者・発行元:日本胆道学会  

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  • Decreased Serum Antioxidant Marker is Predictive of Early Recurrence in the Same Segment after Radical Ablation for Hepatocellular Carcinoma.

    Taiko Muro, Shinichiro Nakamura, Akinobu Takaki, Hideki Onishi, Nozomu Wada, Tetsuya Yasunaka, Daisuke Uchida, Atsushi Oyama, Takuya Adachi, Hidenori Shiraha, Hiroyuki Okada

    Acta medica Okayama   74 ( 4 )   275 - 283   2020年8月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Radiofrequency ablation (RFA) for hepatocellular carcinoma (HCC) is a promising method for controlling tumors, although it does not entirely eliminate recurrence. Oxidative stress is associated with the progression of hepatocarcinogenesis, while also acting as an anticancer response. The objective of the present study was to investigate the factors influencing post-RFA outcomes. We recruited 235 newly diagnosed HCC patients who received RFA for single tumors. The patients with recurrence were sub-grouped into early and segmental recurrence groups. The characteristics of the sub-grouped patients were evaluated, including by measuring oxidative stress marker reactive oxygen metabolites and antioxidant marker OXY-adsorbent tests. The factors associated with poor survival were a high Child-Pugh score and early recurrence within 2 years in the same segment. The patients who experienced recurrence within 2 years in the same segment showed a larger tumor diameter than did others. According to a multivariate analysis, the OXY values were also significantly low in these patients. In conclusion, maintaining the antioxidant reservoir function with a high OXY value might be necessary to prevent early recurrence within the RFA-treated segment.

    DOI: 10.18926/AMO/60364

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  • 当院における肝門部領域良性胆道狭窄に対するInside stentの有用性の検討

    皿谷 洋祐, 加藤 博也, 上田 英次郎, 松三 明宏, 宮本 和也, 藤井 佑樹, 山崎 辰洋, 内田 大輔, 友田 健, 堀口 繁, 堤 康一郎, 岡田 裕之

    胆道   34 ( 3 )   582 - 582   2020年8月

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    記述言語:日本語   出版者・発行元:日本胆道学会  

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  • EUSガイド下エタノール注入療法を施行したインスリノーマの1例

    松本 和幸, 加藤 博也, 稲垣 兼一, 宮本 和也, 山崎 辰洋, 藤井 祐樹, 内田 大輔, 友田 健, 堀口 繁, 岡田 裕之

    膵臓   35 ( 3 )   A449 - A449   2020年7月

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    記述言語:日本語   出版者・発行元:(一社)日本膵臓学会  

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  • EUS画像に基づいたIPMN組織亜型予測診断

    藤井 佑樹, 松本 和幸, 加藤 博也, 上田 英次郎, 宮本 和也, 松三 明宏, 皿谷 洋祐, 山崎 辰洋, 内田 大輔, 友田 健, 堀口 繁, 堤 康一郎, 八木 孝仁, 花田 敬士, 岡田 裕之

    膵臓   35 ( 3 )   A288 - A288   2020年7月

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    記述言語:日本語   出版者・発行元:(一社)日本膵臓学会  

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  • 【消化器疾患とステント治療】良性膵管狭窄に対する内視鏡的ステント治療

    松本 和幸, 加藤 博也, 内田 大輔, 堤 康一郎, 堀口 繁, 松三 明宏, 宮本 和也, 藤井 祐樹, 山崎 辰洋, 皿谷 洋祐, 友田 健, 岡田 裕之

    消化器・肝臓内科   8 ( 1 )   50 - 56   2020年7月

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    記述言語:日本語   出版者・発行元:(有)科学評論社  

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  • IPMN国際診療ガイドライン2017の検証 分枝型IPMN経過観察症例におけるHRS出現のリスク因子

    山崎 辰洋, 友田 健, 加藤 博也, 宮本 和也, 松三 明宏, 皿谷 洋祐, 内田 大輔, 松本 和幸, 堀口 繁, 堤 康一朗, 岡田 裕之

    膵臓   35 ( 3 )   A202 - A202   2020年7月

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    記述言語:日本語   出版者・発行元:(一社)日本膵臓学会  

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  • The Long-Term Outcomes of Endoscopic Papillectomy and Management of Cases of Incomplete Resection: A Single-Center Study. 査読 国際誌

    Shinichiro Muro, Hironari Kato, Akihiro Matsumi, Yuki Ishihara, Yosuke Saragai, Shuntaro Yabe, Saimon Takata, Daisuke Uchida, Takeshi Tomoda, Kazuyuki Matsumoto, Shigeru Horiguchi, Hiroyuki Okada

    Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract   25 ( 5 )   1247 - 1252   2020年6月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: Endoscopic papillectomy is increasingly performed as an alternative to surgery for early ampullary tumors. AIM: This retrospective study aimed to evaluate the long-term results of endoscopic papillectomy, the management of cases with incomplete endoscopic resection, and the long-term recurrence rates. METHODS: All 46 patients who underwent endoscopic papillectomy for ampullary tumors between November 2003 and March 2018 were retrospectively evaluated. RESULTS: The final pathological diagnoses were adenoma (n = 44) and adenocarcinoma (n = 2). Histopathological evaluations after endoscopic papillectomy revealed that complete resection was achieved in 19 patients (19/46, 41.3%). Among the 27 patients with incomplete resection, the margin was histopathologically positive in 14 patients and difficult to evaluate in 13. Additional surgery was performed for 2 of the 14 patients with positive margins. Excluding 2 patients who received additional surgery, 7 of the 25 patients with incomplete resection had recurrence, and 18 had no recurrence during the follow-up period. Ten (77%) of the 13 patients in whom the margin was difficult to evaluate had no recurrence. CONCLUSION: Approximately 80% of the patients in whom the histopathological evaluation of the resected margin was difficult had no recurrence even after approximately 5 years of follow-up. Thus, careful observation may be considered for these patients.

    DOI: 10.1007/s11605-020-04532-7

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  • 超音波内視鏡検査時の十二指腸穿孔に対しOver-The-Scope Clip(OTSC)Systemによる創閉鎖が有効であった1例

    藤井 佑樹, 松本 和幸, 神崎 洋光, 松三 明宏, 宮本 和也, 皿谷 洋祐, 山崎 辰洋, 内田 大輔, 友田 健, 堀口 繁, 加藤 博也, 岡田 裕之

    日本消化器内視鏡学会中国支部例会   124回   55 - 55   2020年6月

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    記述言語:日本語   出版者・発行元:日本消化器内視鏡学会-中国支部  

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  • 胆管内で断裂したガイドワイヤーに対してSpy Glass DSを用いて回収可能であった一例

    河原 聡一郎, 友田 健, 宮本 和也, 松三 明宏, 藤井 佑樹, 山崎 辰洋, 皿谷 洋祐, 内田 大輔, 松本 和幸, 堀口 繁, 加藤 博也, 岡田 裕之

    日本消化器内視鏡学会中国支部例会   124回   57 - 57   2020年6月

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    記述言語:日本語   出版者・発行元:日本消化器内視鏡学会-中国支部  

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  • Serum REIC/Dickkopf-3 Protein Level Predicts Disease-Free Survival in Patients with Hepatocellular Carcinoma. 査読

    Atsushi Oyama, Daisuke Uchida, Hidenori Shiraha, Hiroaki Sawahara, Ryo Kato, Masaya Iwamuro, Shigeru Horiguchi, Hiroyuki Okada

    Acta medica Okayama   74 ( 3 )   237 - 243   2020年6月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    The physiological role of the reduced expression of immortalized cells (REIC)/Dickkopf-3 (Dkk-3) protein in patients with hepatocellular carcinoma (HCC) remains unclear. In this study, we evaluated the effect of the REIC/Dkk-3 protein on HCC cell proliferation and assessed the relationship between the serum REIC/Dkk-3 protein level and the prognosis in patients with HCC. We evaluated the REIC/Dkk-3 protein-induced anticancer effects on Huh7 and Hep3B cells (HCC cell lines) in the presence of peripheral blood mononuclear cells (PBMCs), and found that combination treatment with REIC/Dkk-3 protein and PBMCs reduced the proliferation of HCC cells (Hep3B: 82.0%±16.3%; Huh7: 72.6%±9.1%). We also studied 194 HCC patients who underwent primary liver resection or primary radiofrequency ablation from 2008 to 2017. Serum REIC/Dkk-3 protein levels were measured by an enzyme-linked immunosorbent assay and compared to the prognostic data. The 3-year disease-free survival of the REIC/Dkk-3 high group was significantly higher than that in the REIC/Dkk-3 low group. In conclusion, this is the first study investigating the relationship between HCC patient survival and serum REIC/Dkk-3 protein levels in a large population. Based on the results, the serum REIC/Dkk-3 protein level should be considered a new prognostic marker for patients with HCC.

    DOI: 10.18926/AMO/59957

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  • 中国地方の消化器内視鏡学のState of the art 術後再建腸管例に対する経空腸的EUS-FNAの検討

    山崎 辰洋, 友田 健, 宮本 和也, 松三 明宏, 藤井 佑樹, 皿谷 洋祐, 内田 大輔, 松本 和幸, 堀口 繁, 堤 康一朗, 加藤 博也, 岡田 裕之

    日本消化器内視鏡学会中国支部例会   124回   28 - 28   2020年6月

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    記述言語:日本語   出版者・発行元:日本消化器内視鏡学会-中国支部  

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  • Oxidative Stress Management in Chronic Liver Diseases and Hepatocellular Carcinoma. 査読 国際誌

    Daisuke Uchida, Akinobu Takaki, Atsushi Oyama, Takuya Adachi, Nozomu Wada, Hideki Onishi, Hiroyuki Okada

    Nutrients   12 ( 6 )   2020年5月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Chronic viral hepatitis B and C and non-alcoholic fatty liver disease (NAFLD) have been widely acknowledged to be the leading causes of liver cirrhosis and hepatocellular carcinoma. As anti-viral treatment progresses, the impact of NAFLD is increasing. NAFLD can coexist with chronic viral hepatitis and exacerbate its progression. Oxidative stress has been recognized as a chronic liver disease progression-related and cancer-initiating stress response. However, there are still many unresolved issues concerning oxidative stress, such as the correlation between the natural history of the disease and promising treatment protocols. Recent findings indicate that oxidative stress is also an anti-cancer response that is necessary to kill cancer cells. Oxidative stress might therefore be a cancer-initiating response that should be down regulated in the pre-cancerous stage in patients with risk factors for cancer, while it is an anti-cancer cell response that should not be down regulated in the post-cancerous stage, especially in patients using anti-cancer agents. Antioxidant nutrients should be administered carefully according to the patients' disease status. In this review, we will highlight these paradoxical effects of oxidative stress in chronic liver diseases, pre- and post-carcinogenesis.

    DOI: 10.3390/nu12061576

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  • 増大傾向を認める脾原発炎症性偽腫瘍の1例

    姫井 人美, 友田 健, 宮本 和也, 松三 明宏, 皿谷 洋祐, 藤井 佑樹, 山崎 辰洋, 内田 大輔, 松本 和幸, 堀口 繁, 堤 康一郎, 加藤 博也, 岡田 裕之

    日本消化器病学会中国支部例会プログラム・抄録集   113回   110 - 110   2020年5月

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    記述言語:日本語   出版者・発行元:日本消化器病学会-中国支部  

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  • 【肝膵内視鏡治療におけるトラブルシューティング】EUS下治療における偶発症予防とトラブルシューティング WONに対する内視鏡的ネクロセクトミー こんなときどうする?

    加藤 博也, 内田 大輔, 友田 健, 松本 和幸, 堀口 繁, 堤 康一郎, 岡田 裕之

    消化器内視鏡   32 ( 3 )   431 - 436   2020年3月

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    記述言語:日本語   出版者・発行元:(株)東京医学社  

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  • Correction to: Outcomes of endoscopic treatment for malignant biliary obstruction in patients with surgically altered anatomy: analysis of risk factors for clinical failure. 査読 国際誌

    Takeshi Tomoda, Hironari Kato, Kazuya Miyamoto, Akihiro Matsumi, Eijiro Ueta, Yuuki Fujii, Yousuke Saragai, Tatsuhiro Yamazaki, Daisuke Uchida, Kazuyuki Matsumoto, Shigeru Horiguchi, Koichiro Tsutsumi, Hiroyuki Okada

    Surgical endoscopy   35 ( 1 )   239 - 240   2020年2月

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    記述言語:英語  

    There are several places where the P-value and Odds ratio in Table 3 are incorrect: these are shown in the corrected Table 3 below.

    DOI: 10.1007/s00464-020-07399-6

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  • Promising Gene Therapy Using an Adenovirus Vector Carrying REIC/Dkk-3 Gene for the Treatment of Biliary Cancer. 査読 国際誌

    Emi Tanaka, Daisuke Uchida, Hidenori Shiraha, Hironari Kato, Atsushi Ohyama, Masaya Iwamuro, Masami Watanabe, Hiromi Kumon, Hiroyuki Okada

    Current gene therapy   20 ( 1 )   64 - 70   2020年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: We previously demonstrated that the reduced expression in immortalized cells (REIC)/dikkopf-3 (Dkk-3) gene was downregulated in various malignant tumors, and that an adenovirus vector carrying the REIC/Dkk-3 gene, termed Ad-REIC induced cancer-selective apoptosis in pancreatic cancer and hepatocellular carcinoma. OBJECTIVE: In this study, we examined the therapeutic effects of Ad-REIC in biliary cancer using a second- generation Ad-REIC (Ad-SGE-REIC). METHODS: Human biliary cancer cell lines (G-415, TFK-1) were used in this study. The cell viability and apoptotic effect of Ad-SGE-REIC were assessed in vitro using an MTT assay and Hoechst staining. The anti-tumor effect in vivo was assessed in a mouse xenograft model. We also assessed the therapeutic effects of Ad-SGE-REIC therapy with cisplatin. Cell signaling was assessed by Western blotting. RESULTS: Ad-SGE-REIC reduced cell viability, and induced apoptosis in biliary cancer cell lines via the activation of the c-Jun N-terminal kinase pathway. Ad-SGE-REIC also inhibited tumor growth in a mouse xenograft model. This effect was further enhanced in combination with cisplatin. CONCLUSION: Ad-SGE-REIC induced apoptosis and inhibited tumor growth in biliary cancer cells. REIC/Dkk-3 gene therapy using Ad-SGE-REIC is an attractive therapeutic tool for biliary cancer.

    DOI: 10.2174/1566523220666200309125709

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  • Single-session esophagogastroduodenoscopy and endoscopic ultrasound using a forward-viewing radial scan ultrasonic endoscope. 査読 国際誌

    Uchida D, Kato H, Matsumoto K, Ishihara Y, Matsumi A, Saragai Y, Takada S, Yabe S, Muro S, Tomoda T, Horiguchi S, Okada H

    BMC gastroenterology   19 ( 1 )   220 - 220   2019年12月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1186/s12876-019-1141-7

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  • Utility of Endoscopic Ultrasound-Guided Fine Needle Aspiration in the Diagnosis of Local Recurrence of Pancreaticobiliary Cancer after Surgical Resection. 査読 国際誌

    Matsumoto K, Kato H, Horiguchi S, Tomoda T, Matsumi A, Ishihara Y, Saragai Y, Takada S, Muro S, Uchida D, Okada H

    Gut and liver   14 ( 5 )   652 - 658   2019年12月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.5009/gnl19200

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  • A Phase I/Ib trial of Ad-REIC in liver cancer: study protocol. 査読 国際誌

    Oyama A, Shiraha H, Uchida D, Iwamuro M, Kato H, Takaki A, Ikeda F, Onishi H, Yasunaka T, Takeuchi Y, Wada N, Iwasaki Y, Sakata M, Okada H, Kumon H

    Future oncology (London, England)   15 ( 31 )   3547 - 3554   2019年11月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.2217/fon-2019-0115

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  • 胃全摘後の再建腸管を有する十二指腸乳頭部腺腫に対してUnderwater endoscopic papillectomyを施行した1例

    山崎 辰洋, 内田 大輔, 山崎 泰史, 宮本 和也, 松三 明宏, 藤井 佑樹, 皿谷 洋祐, 友田 健, 松本 和幸, 堀口 繁, 加藤 博也, 岡田 裕之

    日本消化器病学会中国支部例会プログラム・抄録集   112回   138 - 138   2019年11月

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    記述言語:日本語   出版者・発行元:日本消化器病学会-中国支部  

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  • 【結石除去を極める】胆石 術後再建腸管症例における結石除去(BE-ERCP) Roux-en-Y再建症例(乳頭あり症例) 査読

    加藤 博也, 堤 康一郎, 内田 大輔, 友田 健, 松本 和幸, 堀口 繁, 岡田 裕之

    消化器内視鏡   31 ( 11 )   1648 - 1653   2019年11月

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    記述言語:日本語   出版者・発行元:(株)東京医学社  

    乳頭を有するRoux-en-Y再建に対するバルーン内視鏡を用いた総胆管結石治療は、スコープの挿入・胆管挿管・乳頭処置・結石除去、それぞれのステップにおいて手技上のコツがある。挿入においては、Y脚を確実に認識し、縫合線を越えて挿入すること、ループを完全に解除せずに挿入することが重要である。挿管の際にもまずはループを残した状態で試みて、スコープのトルクとアングルで挿管に適した位置に乳頭をポジショニングしなければならない。乳頭処置においてEST(内視鏡的乳頭括約筋切開術)を行う際は、通常の解剖と異なり口側隆起の認識が困難であるため出血・穿孔に対しより注意が必要であり、状況に応じてEPBD(内視鏡的乳頭バルーン拡張術)・EPLBD(内視鏡的乳頭ラージバルーン拡張術)を積極的に併用することが重要である。結石除去をスコープの引き抜きのみで行うのは消化管穿孔のリスクがあるため、スコープのアングルも併用しながら行う。(著者抄録)

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  • 内視鏡的乳頭切除術後膵管狭窄に対してEUSランデブー法を用いて膵管ステント留置を行った一例

    小川 泰司, 友田 健, 加藤 博也, 宮本 和也, 松三 明宏, 上田 英次郎, 藤井 祐樹, 皿谷 洋祐, 山崎 辰洋, 内田 大輔, 松本 和幸, 堀口 繁, 堤 康一郎, 岡田 裕之

    日本消化器病学会中国支部例会プログラム・抄録集   112回   137 - 137   2019年11月

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    記述言語:日本語   出版者・発行元:日本消化器病学会-中国支部  

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  • 再発性急性膵炎を契機に診断された主膵管型IPMNの1例

    松枝 真由, 内田 大輔, 上田 英次郎, 松三 明宏, 宮本 和也, 皿谷 洋祐, 山崎 辰洋, 藤井 佑樹, 友田 健, 松本 和幸, 堀口 繁, 堤 康一郎, 加藤 博也, 岡田 裕之

    日本消化器病学会中国支部例会プログラム・抄録集   112回   107 - 107   2019年11月

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    記述言語:日本語   出版者・発行元:日本消化器病学会-中国支部  

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  • Contrast-enhanced harmonic endoscopic ultrasound using time-intensity curve analysis predicts pathological grade of pancreatic neuroendocrine neoplasm. 査読

    Takada S, Kato H, Saragai Y, Muro S, Uchida D, Tomoda T, Matsumoto K, Horiguchi S, Tanaka N, Okada H

    Journal of medical ultrasonics (2001)   46 ( 4 )   449 - 458   2019年10月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1007/s10396-019-00967-x

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  • プラスティックステントによる悪性遠位胆管狭窄の術前ドレナージの検討

    高田 斎文, 吉田 龍一, 安井 和也, 加藤 博也, 松三 明宏, 石原 祐基, 皿谷 洋祐, 室 信一郎, 内田 大輔, 友田 健, 堀口 繁, 八木 孝仁, 岡田 裕之

    Gastroenterological Endoscopy   61 ( Suppl.2 )   2191 - 2191   2019年10月

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    記述言語:日本語   出版者・発行元:(一社)日本消化器内視鏡学会  

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  • DPC公開データからみる日本の胆管結石、胆管炎診療の現状 内科的治療を行った症例での検討

    山崎 辰洋, 加藤 博也, 松三 明宏, 石原 裕基, 皿谷 洋祐, 室 信一郎, 内田 大輔, 友田 健, 松本 和幸, 堀口 繁, 岡田 裕之

    胆道   33 ( 3 )   529 - 529   2019年10月

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    記述言語:日本語   出版者・発行元:日本胆道学会  

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  • 当院における胆道病変に対するEUS-FNAの現状

    皿谷 洋祐, 松本 和幸, 加藤 博也, 松三 明宏, 宮本 和也, 藤井 佑樹, 山崎 辰洋, 内田 大輔, 友田 健, 堀口 繁, 堤 康一郎, 岡田 裕之

    胆道   33 ( 3 )   525 - 525   2019年10月

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    記述言語:日本語   出版者・発行元:日本胆道学会  

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  • 膵EUS-FNAの精度向上を目指して 胆膵領域の実地臨床におけるEUS-FNAの現状と問題点 ゲノム医療時代を迎えて

    堀口 繁, 加藤 博也, 堤 康一郎, 友田 健, 松本 和幸, 内田 大輔, 山崎 辰洋, 皿谷 洋祐, 宮本 和也, 松三 明宏, 上田 英次郎, 岡田 裕之

    日本臨床細胞学会雑誌   58 ( Suppl.2 )   561 - 561   2019年10月

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    記述言語:日本語   出版者・発行元:(公社)日本臨床細胞学会  

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  • Potential Factors Affecting Results of Short-Type Double-Balloon Endoscope-Assisted Endoscopic Retrograde Cholangiopancreatography. 査読 国際誌

    Daisuke Uchida, Koichiro Tsutsumi, Hironari Kato, Akihiro Matsumi, Yosuke Saragai, Takeshi Tomoda, Kazuyuki Matsumoto, Shigeru Horiguchi, Hiroyuki Okada

    Digestive diseases and sciences   65 ( 5 )   1460 - 1470   2019年9月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: Short-type double-balloon endoscope (DBE)-assisted endoscopic retrograde cholangiopancreatography (ERCP) has been developed as an alternative approach for cases with a surgically altered gastrointestinal anatomy. However, this technique is sometimes technically challenging and carries a risk of severe adverse events. AIMS: To evaluate the factors affecting the technical success rate and adverse events of DBE-ERCP. METHODS: A total of 319 patients (805 procedures) with a surgically altered gastrointestinal anatomy underwent short DBE-ERCP. The factors affecting the technical success rate and adverse events, and the learning curve of the trainees were retrospectively evaluated. RESULTS: The technical success rate of all procedures was 90.7%. Adverse events occurred in 44 (5.5%) procedures. A multivariate analysis indicated that Roux-en-Y reconstruction and first-time short DBE-ERCP were factors affecting the technical failure and adverse event rates, while the modified Child method after subtotal stomach-preserving pancreaticoduodenectomy reconstruction was a non-risk factor for adverse events. The trainee caseload did not affect the technical success or adverse event rates significantly; however, trainees tended to perform cases involving the modified Child method after subtotal stomach-preserving pancreaticoduodenectomy reconstruction. The success rate of scope insertion increased according to experience; however, the overall success rate did not differ to a statistically significant extent. CONCLUSION: Short DBE-ERCP was useful and safe for managing cases with a surgically altered anatomy; however, trainees should concentrate on accumulating experience with easy cases, such as those with the modified Child method after subtotal stomach-preserving pancreaticoduodenectomy reconstruction or a history of DBE-ERCP.

    DOI: 10.1007/s10620-019-05857-3

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  • Successful removal of impacted large bile duct stones using electrohydraulic lithotripsy with an ultraslim endoscope after Billroth II gastrectomy. 査読 国際誌

    Matsumoto K, Kato H, Horiguchi S, Uchida D, Tomoda T, Muro S, Okada H

    Endoscopy   51 ( 9 )   E265 - E266   2019年9月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1055/a-0896-2498

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  • Underwater endoscopic papillectomy using double-balloon endoscopy. 査読 国際誌

    Yamazaki T, Uchida D, Yamasaki Y, Tomoda T, Matsumoto K, Kato H, Okada H

    Endoscopy   52 ( 2 )   E55-E56   2019年9月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1055/a-0992-9084

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  • Acute pancreatitis associated with massive bleeding due to a duodenal ulcer. 査読

    Uchida D, Kawai Y, Kato H, Okada H

    Clinical journal of gastroenterology   12 ( 4 )   301 - 306   2019年8月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1007/s12328-019-00942-6

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  • A "Back Light System" for Identification of Sites for Endoscopic Ultrasound-Guided Fine-Needle Aspiration in Solid Pancreatic Masses: A Prospective, Randomized Study with a Crossover Design. 査読 国際誌

    Ryo Harada, Hironari Kato, Soichiro Fushimi, Hirofumi Inoue, Daisuke Uchida, Yutaka Akimoto, Takeshi Tomoda, Kazuyuki Matsumoto, Yasuhiro Noma, Naoki Yamamoto, Shigeru Horiguchi, Koichiro Tsutsumi, Hiroyuki Okada

    Clinical endoscopy   52 ( 4 )   334 - 339   2019年7月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND/AIMS: We applied a back light system (BLS) with a magnifying glass to improve the ability to assess the adequacy of specimen sampling using endosonography. We conducted this study to evaluate the efficacy of the BLS in sampling of specimens by endoscopic ultrasound-guided fine needle aspiration of solid pancreatic masses. METHODS: This was a prospective, randomized, crossover, single-center clinical trial. An endosonographer evaluated adequacy on gross visual inspection and identified whitish specimen sampling sites with and without the BLS according to a randomization sequence in the first and second passes with a 25-G needle. On cytological evaluation, the presence of well-defined pancreatic ductal epithelium was evaluated by a cytopathologist who was blinded to any clinical information. RESULTS: A total of 80 consecutive patients were eligible during the study period. Adequacy was observed for 52 specimens (65%) with the BLS and 54 (68%) without the BLS (p=0.88). In assessment of specimen adequacy on gross examination, only fair agreement was observed both with and without BLS (kappa score 0.40 and 0.29, respectively). CONCLUSION: The BLS did not influence the ability to identify specimen sampling sites or reliable assessment of specimen site adequacy using gross visual inspection.

    DOI: 10.5946/ce.2019.004

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  • Comparison Between Endoscopic Biliary Stenting Combined with Balloon Dilation and Balloon Dilation Alone for the Treatment of Benign Hepaticojejunostomy Anastomotic Stricture. 査読 国際誌

    Takeshi Tomoda, Hironari Kato, Kazuya Miyamoto, Yousuke Saragai, Sho Mizukawa, Shuntaro Yabe, Saimon Takata, Shinichiro Muro, Daisuke Uchida, Kazuyuki Matsumoto, Shigeru Horiguchi, Koichiro Tsutsumi, Ken Hirao, Tsuneyoshi Ogawa, Hiroyuki Okada

    Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract   24 ( 6 )   1352 - 1358   2019年6月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: Hepaticojejunostomy anastomotic stricture (HJAS) is an important complication of biliary reconstructive surgery but has no standard treatment. We aimed to evaluate the outcomes of endoscopic treatment for benign HJAS and identify the risk factors for its recurrence. METHODS: This study retrospectively analyzed 176 patients who underwent endoscopic retrograde cholangiopancreatography (ERCP) for HJAS between April 2008 and March 2016. The outcome of endoscopic biliary stenting combined with balloon dilation (EBS group) and balloon dilation alone (balloon group) was evaluated. RESULTS: The scope was successfully inserted into the HJ site in 93.8% patients (165/176), and 139 patients underwent endoscopic treatment after HJAS was confirmed. Successful biliary drainage was achieved in 137 patients by using ERCP and rendezvous procedures. Among these, 103 patients were included in balloon group and 34 patients were in EBS group. HJAS was resolved in 132 patients; five died from recurrence of primary disease. The 1 (3)-year bile duct patency rates in the balloon and EBS groups were 62.5% (46.6%) and 89.4% (84.7%), respectively (p = 0.015). Univariate analysis showed that balloon dilation (p = 0.009) and early HJAS formation (time from surgery to ERCP < 1 year) (p = 0.02) were risk factors for HJAS recurrence. In the multivariate analysis, balloon dilatation was identified as independent risk factors for HJAS recurrence. CONCLUSIONS: Balloon dilation without stent deployment and early HJAS formation are risk factors for HJAS recurrence after endoscopic treatment. Stent deployment might be recommended for definite resolution of HJAS.

    DOI: 10.1007/s11605-019-04297-8

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  • 切除不能局所進行膵癌:化学療法と化学放射線療法 当院における局所進行膵癌患者に対する化学放射線療法と化学療法の治療成績の検討

    皿谷 洋祐, 堀口 繁, 加藤 博也, 松三 明宏, 石原 裕基, 高田 斎文, 室 信一郎, 内田 大輔, 友田 健, 松本 和幸, 岡田 裕之

    膵臓   34 ( 3 )   A74 - A74   2019年6月

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    記述言語:日本語   出版者・発行元:(一社)日本膵臓学会  

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  • 膵頭部領域疾患の術前における閉塞性黄疸の至適マネージメント プラスティックステントによる膵頭部領域癌の術前胆管ドレナージの検討

    高田 斎文, 加藤 博也, 岡田 裕之, 石原 祐基, 松三 明宏, 皿谷 洋祐, 室 信一郎, 内田 大輔, 友田 健, 松本 和幸, 堀口 繁

    膵臓   34 ( 3 )   A91 - A91   2019年6月

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    記述言語:日本語   出版者・発行元:(一社)日本膵臓学会  

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  • Diagnostic Ability of Convex-Arrayed Endoscopic Ultrasonography for Major Vascular Invasion in Pancreatic Cancer. 査読 国際誌

    Fujii Y, Matsumoto K, Kato H, Saragai Y, Takada S, Mizukawa S, Muro S, Uchida D, Tomoda T, Horiguchi S, Tanaka N, Okada H

    Clinical endoscopy   52 ( 5 )   479 - 485   2019年5月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.5946/ce.2018.163

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  • 十二指腸乳頭部腫瘍の内視鏡切除術の現況と非完全切除例の取り扱いに関する検討

    室 信一郎, 加藤 博也, 岡田 裕之, 松三 明宏, 石原 裕基, 皿谷 洋祐, 矢部 俊太郎, 高田 斎文, 内田 大輔, 友田 健, 松本 和幸, 堀口 繁

    Gastroenterological Endoscopy   61 ( Suppl.1 )   923 - 923   2019年5月

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    記述言語:日本語   出版者・発行元:(一社)日本消化器内視鏡学会  

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  • 肝胆膵癌治療のup-to-date 当院における切除不能膵癌に対するFOLFIRINOX、GEM+nab-PTX併用についての検討

    皿谷 洋祐, 堀口 繁, 加藤 博也, 松三 明宏, 石原 裕基, 高田 斎文, 室 信一郎, 内田 大輔, 友田 健, 松本 和幸, 岡田 裕之

    日本消化器病学会中国支部例会プログラム・抄録集   111回   60 - 60   2019年5月

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    記述言語:日本語   出版者・発行元:日本消化器病学会-中国支部  

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  • 標準治療無効後に膵癌薬物療法を行い、抗腫瘍効果を示した切除不能p-NET(G2)の1例

    山崎 辰洋, 室 信一郎, 加藤 博也, 松三 明宏, 石原 裕基, 皿谷 洋祐, 高田 斎文, 内田 大輔, 友田 健, 松本 和幸, 堀口 繁, 岡田 裕之

    日本消化器病学会中国支部例会プログラム・抄録集   111回   90 - 90   2019年5月

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    記述言語:日本語   出版者・発行元:日本消化器病学会-中国支部  

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  • 術後胆管空腸吻合部良性狭窄に対するバルーン拡張単独治療の成績及び再狭窄関連因子に関する検討

    松三 明宏, 友田 健, 岡田 裕之, 加藤 博也, 石原 裕基, 皿谷 洋祐, 矢部 俊太郎, 高田 斎文, 室 信一郎, 内田 大輔, 松本 和幸, 堀口 繁

    Gastroenterological Endoscopy   61 ( Suppl.1 )   882 - 882   2019年5月

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    記述言語:日本語   出版者・発行元:(一社)日本消化器内視鏡学会  

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  • Biliary cannulation technique with ultraslim endoscope for a patient with Billroth II gastrectomy. 査読 国際誌

    Saragai Y, Uchida D, Kato H, Tomoda T, Matsumoto K, Horiguchi S, Okada H

    Endoscopy   51 ( 2 )   E38 - E39   2019年2月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1055/a-0800-8178

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  • Paradoxical Roles of Oxidative Stress Response in the Digestive System before and after Carcinogenesis. 査読 国際誌

    Takaki A, Kawano S, Uchida D, Takahara M, Hiraoka S, Okada H

    Cancers   11 ( 2 )   2019年2月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.3390/cancers11020213

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  • 当科における膵癌と血栓症についての検討

    堀口 繁, 加藤 博也, 友田 健, 松本 和幸, 内田 大輔, 室 信一郎, 高田 斎文, 皿谷 洋祐, 岡田 裕之

    日本内科学会雑誌   108 ( Suppl. )   172 - 172   2019年2月

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    記述言語:日本語   出版者・発行元:(一社)日本内科学会  

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  • Utility of liquid biopsy using urine in patients with pancreatic ductal adenocarcinoma. 査読 国際誌

    Terasawa H, Kinugasa H, Ako S, Hirai M, Matsushita H, Uchida D, Tomoda T, Matsumoto K, Horiguchi S, Kato H, Nouso K, Okada H

    Cancer biology & therapy   20 ( 10 )   1348 - 1353   2019年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1080/15384047.2019.1638685

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  • [Metachronous intraductal papillary mucinous carcinoma five years after cholecystectomy for gallbladder cancer in a patient with pancreaticobiliary maljunction]. 査読

    Ikeda A, Matsumoto K, Kato H, Tanaka N, Ako S, Muro S, Uchida D, Tomoda T, Horiguchi S, Okada H

    Nihon Shokakibyo Gakkai zasshi = The Japanese journal of gastro-enterology   116 ( 3 )   241 - 248   2019年

  • 肝門部悪性胆道狭窄に対してEUS下両葉ドレナージが有用であった1例

    内田 大輔, 加藤 博也, 松三 昭宏, 石原 裕基, 皿谷 洋祐, 高田 斎文, 室 信一郎, 友田 健, 松本 和幸, 堀口 繁, 岡田 裕之

    日本消化器病学会中国支部例会プログラム・抄録集   110回   148 - 148   2018年12月

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    記述言語:日本語   出版者・発行元:日本消化器病学会-中国支部  

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  • 近位空腸の異所性膵から発生した膵腺房細胞癌の1例

    石原 裕基, 内田 大輔, 加藤 博也, 松三 明宏, 皿谷 洋祐, 矢部 俊太郎, 高田 斎文, 室 信一郎, 友田 健, 松本 和幸, 堀口 繁, 岡田 裕之

    日本消化器病学会中国支部例会プログラム・抄録集   110回   124 - 124   2018年12月

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    記述言語:日本語   出版者・発行元:日本消化器病学会-中国支部  

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  • IPMN診断における膵液細胞診 Liquid based cytologyの有用性ついての検討

    宮本 和也, 松本 和幸, 加藤 博也, 松三 明宏, 石原 裕基, 皿谷 洋祐, 矢部 俊太郎, 室 信一郎, 高田 斎文, 内田 大輔, 友田 健, 堀口 繁, 岡田 裕之

    日本消化器病学会中国支部例会プログラム・抄録集   110回   124 - 124   2018年12月

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    記述言語:日本語   出版者・発行元:日本消化器病学会-中国支部  

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  • Efficacy and safety of chemotherapy after endoscopic double stenting for malignant duodenal and biliary obstructions in patients with advanced pancreatic cancer: a single-institution retrospective analysis. 査読 国際誌

    Kazuyuki Matsumoto, Hironari Kato, Shigeru Horiguchi, Koichiro Tsutsumi, Yosuke Saragai, Saimon Takada, Sho Mizukawa, Shinichiro Muro, Daisuke Uchida, Takeshi Tomoda, Hiroyuki Okada

    BMC gastroenterology   18 ( 1 )   157 - 157   2018年10月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: Advanced pancreatic cancer is accompanied not only by bile duct obstruction, but also occasionally by duodenal obstruction. With new advances in chemotherapy and improvement in the management of stent dysfunction, the life expectancy of patients with pancreatic cancer has increased. This study aimed to evaluate the efficacy and safety of chemotherapy for advanced pancreatic cancer, as well as to analyze the prognostic factors, following endoscopic double stenting. METHODS: This retrospective study was conducted from January 1, 2007 to October 31, 2015 at an academic center. Fifty consecutive patients with pancreatic cancer who had undergone endoscopic double stenting, comprising duodenal and biliary stenting, were analyzed. We reviewed the patients records and analyzed the data of stent dysfunction rates after double stenting, reintervention for stent dysfunction, chemotherapy after double stenting, adverse events associated with chemotherapy after double stenting, survival times following double stenting, and overall survival times. The hospital's institutional review board for human research approved this study. RESULTS: The overall survival time and the survival time following double stenting were 10.9 months (IQR 6.0-18.4 months) and 2.4 months (IQR 1.4-5.2 months), respectively. After double stenting, duodenal stent dysfunction occurred in 6 patients (12%), and biliary stent dysfunction occurred in 12 patients (24%), respectively. All patients who experienced stent dysfunction underwent endoscopic reintervention, and all of the procedures were successful. Twenty-one (42%) patients were treated with chemotherapy post double stenting; 9 patients received chemotherapy as a first-line treatment, 9 as a second-line treatment, and 3 as a third-line treatment. During chemotherapy, 8 (38%) patients had grade 3-4 adverse events, which were manageable. Chemotherapy post double stenting (OR, 0.19; 95% CI, 0.059-0.60; P = .0051), reintervention for biliary stent dysfunction (OR, 0.21; 95% CI, 0.081-0.50; P = .0002), and performance status (< 2) (OR, 0.28; 95% CI, 0.098-0.71; P = .0064) were significant prognostic factors after double stenting. CONCLUSIONS: Systemic chemotherapy was manageable, even in patients with double stenting. Chemotherapy after double stenting and appropriate reintervention for stent obstructions potentially prolonged the survival of patients with advance pancreatic cancer.

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  • Dipeptide γ-secretase inhibitor treatment enhances the anti-tumor effects of cisplatin against gastric cancer by suppressing cancer stem cell properties. 査読 国際誌

    Kato R, Iwamuro M, Shiraha H, Horiguchi S, Tanaka E, Matsumoto K, Ohyama A, Sawahara H, Nagahara T, Uchida D, Tsutsumi K, Okada H

    Oncology letters   16 ( 4 )   5426 - 5432   2018年10月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.3892/ol.2018.9301

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  • IgG4陰性自己免疫性膵炎の臨床的特徴と長期予後についての検討

    室 信一郎, 堀口 繁, 加藤 博也, 皿谷 洋祐, 高田 斎文, 水川 翔, 内田 大輔, 友田 健, 松本 和幸, 植木 亨, 岡田 裕之

    日本消化器病学会雑誌   115 ( 臨増大会 )   A754 - A754   2018年10月

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    記述言語:日本語   出版者・発行元:(一財)日本消化器病学会  

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  • 当院における肝内胆管癌術後化学療法の検討

    高田 斎文, 堀口 繁, 岡田 裕之, 皿谷 洋祐, 水川 翔, 室 信一郎, 内田 大輔, 松本 和幸, 加藤 博也, 楳田 祐三, 八木 孝仁

    日本消化器病学会雑誌   115 ( 臨増大会 )   A772 - A772   2018年10月

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    記述言語:日本語   出版者・発行元:(一財)日本消化器病学会  

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  • 当院における出血ハイリスク総胆管結石症例に対する内視鏡治療

    皿谷 洋祐, 加藤 博也, 水川 翔, 高田 斎文, 室 信一郎, 内田 大輔, 友田 健, 松本 和幸, 堀口 繁, 岡田 裕之

    Gastroenterological Endoscopy   60 ( Suppl.2 )   2084 - 2084   2018年10月

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    記述言語:日本語   出版者・発行元:(一社)日本消化器内視鏡学会  

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  • Beneficial and Paradoxical Roles of Anti-Oxidative Nutritional Support for Non-Alcoholic Fatty Liver Disease. 査読 国際誌

    Uchida D, Takaki A, Adachi T, Okada H

    Nutrients   10 ( 8 )   2018年7月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.3390/nu10080977

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  • The intra-conduit release method is useful for avoiding migration of metallic stents during EUS-guided hepaticogastrostomy (with video). 査読

    Daisuke Uchida, Hirofumi Kawamoto, Hironari Kato, Daisuke Goto, Takeshi Tomoda, Kazuyuki Matsumoto, Naoki Yamamoto, Shigeru Horiguchi, Koichiro Tsutsumi, Hiroyuki Okada

    Journal of medical ultrasonics (2001)   45 ( 3 )   399 - 403   2018年7月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    PURPOSE: Although EUS-guided hepaticogastrostomy (EUS-HGS) with a covered self-expandable metal stent (SEMS) is a useful procedure, it is associated with severe adverse events, including stent migration. We, therefore, developed an intra-conduit release method, and investigated whether the technique yields a safer and more stable procedure. METHODS: The intra-conduit release method is a procedure to release the SEMS in the working channel conduit of the scope for anchoring between the liver and stomach to avoid stent migration. Forty-three patients who underwent EUS-HGS at two high-volume centers in Japan were enrolled in this retrospective study, and the safety and usefulness of this method were evaluated retrospectively. RESULTS: The intra-conduit release method was applied in 36 cases. The technical success rate of EUS-HGS with the intra-conduit release method was significantly higher in comparison with the conventional method. Additionally, the rate of early adverse events was significantly lower than that for the conventional method. CONCLUSION: The intra-conduit release method during EUS-HGS is useful for a stable procedure that avoids early adverse events.

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  • 膵癌術後再発に対するEUS-FNAの有用性 洗浄液を用いた遺伝子変異解析も含めて

    松本 和幸, 加藤 博也, 赤穂 宗一郎, 吉田 龍一, 楳田 祐三, 信岡 大輔, 皿谷 洋祐, 高田 斎文, 室 信一郎, 内田 大輔, 友田 健, 堀口 繁, 能祖 一裕, 八木 孝仁, 岡田 裕之

    膵臓   33 ( 3 )   516 - 516   2018年5月

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    記述言語:日本語   出版者・発行元:(一社)日本膵臓学会  

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  • 膵NET術後再発予測におけるダイナミックCTの有用性についての検討

    堀口 繁, 加藤 博也, 松本 和幸, 友田 健, 内田 大輔, 室 信一郎, 水川 翔, 高田 斎文, 皿谷 洋祐, 田中 顕之, 八木 孝仁, 岡田 裕之

    膵臓   33 ( 3 )   525 - 525   2018年5月

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    記述言語:日本語   出版者・発行元:(一社)日本膵臓学会  

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  • Re-intervention with endoscopic ultrasound-guided hepaticogastrostomy for unresectable hilar biliary drainage using a multipath occlusion balloon 査読

    Daisuke Uchida, Hironari Kato, Hiroyuki Okada

    Endoscopy   50 ( 4 )   450 - 452   2018年4月

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    記述言語:英語   出版者・発行元:Georg Thieme Verlag  

    DOI: 10.1055/s-0044-100719

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  • 当院における慢性膵炎に対する内視鏡治療戦略

    皿谷 洋祐, 内田 大輔, 水川 翔, 高田 斎文, 室 信一郎, 友田 健, 松本 和幸, 堀口 繁, 加藤 博也, 岡田 裕之

    Gastroenterological Endoscopy   60 ( Suppl.1 )   789 - 789   2018年4月

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    記述言語:日本語   出版者・発行元:(一社)日本消化器内視鏡学会  

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  • 当院における超音波内視鏡下嚢胞ドレナージ術の現状

    内田 大輔, 加藤 博也, 皿谷 洋祐, 高田 斎文, 水川 翔, 室 信一郎, 友田 健, 松本 和幸, 堀口 繁, 岡田 裕之

    Gastroenterological Endoscopy   60 ( Suppl.1 )   737 - 737   2018年4月

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    記述言語:日本語   出版者・発行元:(一社)日本消化器内視鏡学会  

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  • Swing Tipを用いたERCPトラブルシューティング

    内田 大輔, 加藤 博也, 皿谷 洋祐, 高田 斎文, 水川 翔, 室 信一郎, 友田 健, 松本 和幸, 堀口 繁, 岡田 裕之

    Gastroenterological Endoscopy   60 ( Suppl.1 )   743 - 743   2018年4月

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    記述言語:日本語   出版者・発行元:(一社)日本消化器内視鏡学会  

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  • An Intrapancreatic Accessory Spleen That Was Difficult to Diagnose Due to Temporal Changes after Splenectomy. 査読

    Daisuke Uchida, Koichiro Tsutsumi, Hironari Kato, Hiroyuki Okada

    Internal medicine (Tokyo, Japan)   57 ( 5 )   681 - 685   2018年3月

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    記述言語:英語  

    Accessory spleen (AS) is common anomaly, and 20% of AS cases occur in the pancreatic tail. An intrapancreatic AS can be difficult to distinguish from pancreatic neoplasms. In most cases, an AS is described as a hypervascular and solitary tumor, but an AS sometimes takes other forms. We herein report a rare case of an intrapancreatic AS with temporal changes in its appearance after splenectomy, which mimicked aspects of pancreatic cancer. Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) and 99mTc sulfur colloid scintigraphy were useful for the diagnosis.

    DOI: 10.2169/internalmedicine.9271-17

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  • 切除不能膵癌に対するFOLFIRINOX/GEM+nabPTX投与の後治療についての検討

    水川 翔, 堀口 繁, 加藤 博也, 皿谷 洋祐, 高田 斎文, 室 信一郎, 内田 大輔, 松本 和幸, 友田 健, 岡田 裕之

    日本消化器病学会雑誌   115 ( 臨増総会 )   A305 - A305   2018年3月

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    記述言語:日本語   出版者・発行元:(一財)日本消化器病学会  

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  • Efficacy of endoscopic treatment using double-balloon enteroscopy for postoperative bile leakage in patients with hepaticojejunostomy. 査読 国際誌

    Kazuyuki Matsumoto, Koichiro Tsutsumi, Hironari Kato, Shigeru Horiguchi, Yosuke Saragai, Saimon Takada, Sho Mizukawa, Shinichiro Muro, Daisuke Uchida, Takeshi Tomoda, Hiroyuki Okada

    Endoscopy international open   6 ( 2 )   E211-E216 - E216   2018年2月

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    記述言語:英語  

    Background and study aims  Endoscopic treatment for post-operative bile is technically challenging in patients with altered gastrointestinal anatomy. This study evaluated the effectiveness of using a short-type double-balloon enteroscope to treat postoperative bile leakage after hepaticojejunostomy.

    DOI: 10.1055/s-0043-125143

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  • 急性膵炎後fluid collectionに対する超音波内視鏡下嚢胞ドレナージの治療成績

    松三 明宏, 松本 和幸, 加藤 博也, 内田 大輔, 室 信一郎, 友田 健, 堀口 繁, 岡田 裕之

    日本内科学会雑誌   107 ( Suppl. )   233 - 233   2018年2月

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    記述言語:日本語   出版者・発行元:(一社)日本内科学会  

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  • Endoscopic balloon dilatation for benign hepaticojejunostomy anastomotic stricture using short double-balloon enteroscopy in patients with a prior Whipple's procedure: a retrospective study. 査読 国際誌

    Sho Mizukawa, Koichiro Tsutsumi, Hironari Kato, Shinichiro Muro, Yutaka Akimoto, Daisuke Uchida, Kazuyuki Matsumoto, Takeshi Tomoda, Shigeru Horiguchi, Hiroyuki Okada

    BMC gastroenterology   18 ( 1 )   14 - 14   2018年1月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: Endoscopic retrograde cholangiography using a short double-balloon endoscope (DB-ERC) is a promising minimally-invasive method for accessing hepaticojejunostomy (HJ) anastomosis in patients with surgically altered anatomy. We aimed to evaluate the immediate and long-term outcomes of balloon dilatation for benign HJ anastomotic stricture (HJAS) in patients who had previously undergone Whipple's procedure using a DB-ERC. METHODS: We conducted a retrospective analysis of 46 patients who underwent balloon dilatation alone with a DB-ERC for benign HJAS between November 2008 and November 2014. The median follow-up duration was 3.5 (interquartile range [IQR], 1.9-5.1) years. RESULTS: The technical and clinical success rates were 100%, and adverse events occurred in 7% (3/46, cholangitis). The median hospitalization period was seven (IQR, 5-10) days. Of 42 patients (91%) followed-up for > 1 year, 24 (51%) had recurrent HJAS at a median of 1.2 (IQR, 0.6-2.9) years after balloon dilatation. The cumulative anastomotic patency rates at 1, 2, and 3 years were 73, 55, and 49%, respectively. In univariate analysis, early stricture formation (< 1 year) was a risk factor for recurrent stenosis, although no statistically significant risk factors were observed in multivariate analysis. CONCLUSIONS: Endoscopic balloon dilatation with DB-ERC for benign HJAS is effective and safe, having good immediate technical success and few adverse events. Further improvements to this procedure are needed to prevent recurrent HJAS.

    DOI: 10.1186/s12876-018-0742-x

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  • Indications for Endoscopic Ultrasound-Guided Pancreatic Drainage: For Benign or Malignant Cases? 査読

    Daisuke Uchida, Hironari Kato, Yosuke Saragai, Saimon Takada, Sho Mizukawa, Shinichiro Muro, Yutaka Akimoto, Takeshi Tomoda, Kazuyuki Matsumoto, Shigeru Horiguchi, Hiroyuki Okada

    Canadian Journal of Gastroenterology and Hepatology   2018   8216109   2018年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Hindawi Limited  

    Background and Aims. Recurrent pancreatitis associated with pancreatic strictures requires treatment with endoscopic retrograde pancreatography (ERP), but it is sometimes technically unsuccessful. Endoscopic ultrasound-guided pancreatic drainage (EUS-PD) was developed as an alternative to a surgical approach after failed ERP
    however, the indications for EUS-PD are unclear. In this study, we evaluated the outcomes of EUS-PD and established the indications for EUS-PD. Methods. A total of 15 patients had indications for EUS-PD for recurrent pancreatitis due to pancreatic strictures. There were eight patients with benign pancreatic strictures and seven with malignant pancreatic strictures. The success rate, adverse events, and long-term outcomes were evaluated. Results. The technical success rates of benign and malignant strictures were 75% (6/8) and 100% (7/7), respectively, and clinical success was achieved in 100% (6/6) and 87.5% of cases (6/7), respectively. Rendezvous procedures were performed in two patients with benign strictures. The adverse event (AE) rate was 26.7% (4/15) and included cases of peritonitis, bleeding, and stent migration. Reinterventions were performed in three patients with benign strictures and two with malignant strictures. Conclusions. EUS-PD was an appropriate treatment for not only benign strictures but also malignant strictures with recurrent pancreatitis after failed ERP. However, the AE rate was high, and reinterventions were required in some cases during long-term follow-up. The indications for EUS-PD should be considered carefully, and careful follow-up is needed.

    DOI: 10.1155/2018/8216109

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  • Endoscopic Ultrasound-Guided Hepaticogastrostomy Is Effective for Repeated Recurrent Cholangitis after Surgery: Two Case Reports. 査読 国際誌

    Matsumi A, Kato H, Saragai Y, Mizukawa S, Takada S, Muro S, Uchida D, Tomoda T, Matsumoto K, Iwamuro M, Horiguchi S, Kawahara Y, Okada H

    Case reports in gastrointestinal medicine   2018   7201967 - 7201967   2018年

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    記述言語:英語  

    DOI: 10.1155/2018/7201967

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  • Recurrent bleeding from a hepatic artery pseudoaneurysm after biliary stent placement 査読

    Kenji Yamauchi, Daisuke Uchida, Hironari Kato, Hiroyuki Okada

    Internal Medicine   57 ( 1 )   49 - 52   2018年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Japanese Society of Internal Medicine  

    A 78-year-old woman was admitted with benign biliary stenosis. A plastic stent was placed at the left branch to prevent obstructive cholangitis. Two weeks after the procedure, the patient was readmitted with cholangitis caused by hemobilia. However, computed tomography (CT), endoscopic retrograde cholangiopan-creatography (ERCP), peroral cholangioscopy, and abdominal angiography failed to establish the bleeding source. At the seventh bleeding, CT revealed a hepatic artery pseudoaneurysm for which coil embolization was successfully performed. Hemobilia after plastic stent placement is extremely rare. We urge clinicians to consider the possibility of a pseudoaneurysm near the stent when trying to identify the bleeding source.

    DOI: 10.2169/internalmedicine.8983-17

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  • Usefulness of a Cannula with a Flexible Tip (Swing Tip) for Managing Severe Biliary Stricture. 査読 国際誌

    Uchida D, Kato H, Saragai Y, Takada S, Muro S, Tomoda T, Matsumoto K, Horiguchi S, Okada H

    Canadian journal of gastroenterology & hepatology   2018   7125714 - 7125714   2018年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1155/2018/7125714

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  • Comparison of two fluoroscopic images to ensure efficient scope insertion for biliary intervention in patients with Roux-en-Y hepaticojejunostomy 査読

    Koichiro Tsutsumi, Hironari Kato, Ken Hirao, Sho Mizukawa, Shinichiro Muro, Yutaka Akimoto, Daisuke Uchida, Kazuyuki Matsumoto, Takeshi Tomoda, Shigeru Horiguchi, Shuntaro Yabe, Hiroyuki Seki, Yasuhiro Noma, Naoki Yamamoto, Ryo Harada, Tsuneyoshi Ogawa, Hiroyuki Okada

    ENDOSCOPY   49 ( 12 )   1256 - 1261   2017年12月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:GEORG THIEME VERLAG KG  

    Background and study aims No standard procedure for endoscopic retrograde cholangiopancreatography is available for patients with Roux-en-Y hepaticojejunostomy (RYHJ) with side-to-end hepaticojejunostomy. We therefore explored methods of efficient scope insertion at a hepaticojejunostomy site.
    Patients and methods Patients with suspected biliary disease were prospectively enrolled. Based on two fluoroscopic images obtained on scope insertion into each lumen of a two-pronged Roux-en-Y anastomosis, we selected the lumen in which the distal end of the scope progressed toward the patient's liver or head. The accuracy of this method for selecting the correct lumen leading to the hepaticojejunostomy site was investigated.
    Results Of the 33 included patients, successful insertion to the hepaticojejunostomy site was achieved in 32 (97%), 26 (81%) of whom had undergone the imaging method. The accuracy of the method was 88% (23/26). The time required for insertion between the anastomotic site and the hepaticojejunostomy site was shorter when the lumen selection had been correct (13 minutes [7 - 30] (n = 23) vs. 18 minutes [8 - 28] (n = 9); P = 0.95).
    Conclusion This method based on two fluoroscopic images was useful for achieving efficient scope insertion in patients with RYHJ.

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  • Usefulness of a newly designed plastic stent for endoscopic re-intervention in patients with malignant hilar biliary obstruction 査読

    Takeshi Tomoda, Hironari Kato, Hirofumi Kawamoto, Shinichiro Muro, Yutaka Akimoto, Daisuke Uchida, Kazuyuki Matsumoto, Shigeru Horiguchi, Koichiro Tsutsumi, Hiroyuki Okada

    ENDOSCOPY   49 ( 11 )   1087 - 1091   2017年11月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:GEORG THIEME VERLAG KG  

    Background and study aims We designed a new 7-Fr plastic stent for treating self-expandable metal stent (SEMS) obstruction in patients with malignant hilar biliary obstruction (MHBO) via endoscopic re-intervention with the stent-in-stent (SIS) method and evaluated its efficacy.
    Patients and methods A total of 33 consecutive patients who underwent endoscopic re-intervention for metal stent obstruction after multi-branched SEMS placement were enrolled. The initial SEMSs were placed in two or three biliary branches in 14 and 19 patients, respectively. We retrospectively evaluated the technical and clinical success, and adverse events. Technical success was defined as successful plastic stent placement into all target branches through the lumen of the SEMS.
    Results The technical success rates were 85.7% (12/14) and 78.9% (15/19) in patients who underwent two-or three-branched biliary drainage, respectively. The clinical success rate was 100% in the 27 patients in whom technical success was achieved. We achieved successful plastic stent placement in more than two branches, using the new plastic stent combined with a conventional plastic stent, in 97.0% (32/33).
    Conclusions This new plastic stent was technically feasible for treating stent obstruction via re-intervention with SIS methods.

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  • Promising therapeutic efficacy of a novel reduced expression in immortalized cells/dickkopf-3 expressing adenoviral vector for hepatocellular carcinoma 査読

    Hiroaki Sawahara, Hidenori Shiraha, Daisuke Uchida, Hironari Kato, Ryo Kato, Atsushi Oyama, Teruya Nagahara, Masaya Iwamuro, Shigeru Horiguchi, Koichiro Tsutsumi, Mari Mandai, Tetsushige Mimura, Nozomu Wada, Yasuto Takeuchi, Kenji Kuwaki, Hideki Onishi, Shinichiro Nakamura, Masami Watanabe, Masakiyo Sakaguchi, Akinobu Takaki, Kazuhiro Nouso, Takahito Yagi, Yasutomo Nasu, Hiromi Kumon, Hiroyuki Okada

    JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY   32 ( 10 )   1769 - 1777   2017年10月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:WILEY  

    Background and Aim: Reduced expression in immortalized cells (REIC)/dickkopf-3 (Dkk-3) is a tumor suppressor gene that is downregulated in various cancers. In our previous study of prostate cancer, the REIC/Dkk-3-expressing adenoviral vector (Ad-REIC) was found to induce cancer-selective apoptosis. This study recently developed a novel super gene expression (SGE) system and used this system to re-construct an Ad-REIC vector, termed the Ad-SGE-REIC, to achieve more effective therapeutic outcomes. In this study, the therapeutic effects of Ad-SGE-REIC on hepatocellular carcinoma (HCC) was assessed.
    Methods: Human HCC cell lines (HLE, Huh7, HepG2, HLF, SK-Hep1, and PLC), human HCC tissues, and mouse HCC cell line (Hepa1-6) were used in this study. REIC/Dkk-3 expression was assessed by immunoblotting and immunohistochemistry. The relative cell viability and the apoptotic effect were examined in vitro, and the anti-tumor effects of Ad-SGE-REIC treatment were analyzed in the mouse xenograft model. This study additionally assessed anti-tumor immunological effects on the immunocompetent mice.
    Results: REIC/Dkk-3 expression was decreased in HCC cell lines and HCC tissues. Ad-SGE-REIC reduced cell viability and induced apoptosis in HCC cell lines (HLE and Huh7), inhibited tumor growth in the mouse xenograft model, and demonstrated in vivo anti-cancer immunostimulatory effects on the HCC cell line (Hepa1-6).
    Conclusions: Ad-SGE-REIC treatment not only enhanced cell killing effects in vitro but also elicited significant therapeutic effects, with tumor growth suppression, in vivo. REIC/Dkk-3 gene therapy using Ad-SGE-REIC potentially represents an innovative new therapeutic tool for HCC.

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  • 分枝型IPMNの手術適応について 国際診療ガイドラインの見直しも含めて

    室 信一郎, 加藤 博也, 水川 翔, 内田 大輔, 秋元 悠, 友田 健, 松本 和幸, 堀口 繁, 山本 直樹, 堤 康一郎, 岡田 裕之

    Gastroenterological Endoscopy   59 ( Suppl.2 )   2183 - 2183   2017年9月

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    記述言語:日本語   出版者・発行元:(一社)日本消化器内視鏡学会  

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  • A Multicenter, Prospective, Randomized Controlled Trial Evaluating the Efficacy of Rectal Diclofenac and Sublingual Nitroglycerin as a Combined Prophylactic Treatment for Post-ERCP Pancreatitis (vol 70, pg 405, 2016) 査読

    Takeshi Tomoda, Hironari Kato, Sho Mizukawa, Shinichiro Muro, Yutaka Akimoto, Daisuke Uchida, Kazuyuki Matsumoto, Naoki Yamamoto, Shigeru Horiguchi, Koichiro Tsutsumi, Hiroyuki Okada

    ACTA MEDICA OKAYAMA   71 ( 4 )   357 - +   2017年8月

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    記述言語:英語   出版者・発行元:OKAYAMA UNIV MED SCHOOL  

    DOI: 10.18926/AMO/55314

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  • Long-term outcomes and risk factors of biliary stent dysfunction after endoscopic double stenting for malignant biliary and duodenal obstructions 査読

    Kazuyuki Matsumoto, Hironari Kato, Koichiro Tsutsumi, Sho Mizukawa, Syuntaro Yabe, Hiroyuki Seki, Yutaka Akimoto, Daisuke Uchida, Takeshi Tomoda, Naoki Yamamoto, Shigeru Horiguchi, Kenji Kuwaki, Hiroyuki Okada

    DIGESTIVE ENDOSCOPY   29 ( 5 )   617 - 625   2017年7月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:WILEY  

    Background and AimFew reports describe the endoscopic double-stenting procedure for malignant biliary and duodenal obstructions. We evaluated the clinical outcomes from double stenting, and analyzed the risk factors for biliary stent dysfunction following double stenting.
    MethodsEighty-one patients who underwent endoscopic double stenting for malignant biliary and duodenal obstructions were retrospectively analyzed. We determined the stent dysfunction rate and the biliary stent dysfunction risk factors, and analyzed the endoscopic reintervention results.
    ResultsOverall survival time and survival time following double stenting were 365 (38-1673) days and 73 (20-954) days, respectively. After double stenting, the 3-month and 6-month duodenal stent dysfunction rates were 14% and 41%, respectively. Reintervention technical success rate was 100% (10/10), and mean gastric outlet obstruction scoring system scores improved from 0.7 to 2.4 points (P &lt; 0.001). The 3-month and 6-month biliary stent dysfunction rates were 26% and 41%, respectively. The reintervention technical and clinical success rates were 95% (20/21) and 81% (17/21), respectively. Risk factors for biliary stent dysfunction following double stenting were events associated with duodenal stent dysfunction (odds ratio [OR], 11.1; 95% confidence interval [CI], 2.09-87.4; P = 0.0044) and the biliary stent end's location (OR, 6.93; 95% CI, 1.37-40.2; P = 0.0019).
    ConclusionsSome patients had stent dysfunction irrespective of the survival period after double stenting. Endoscopic reintervention was technically feasible and clinically effective even after double stenting. Duodenal stent dysfunction and biliary stent end's location were risk factors for biliary stent dysfunction.

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  • Association between periodontitis and prognosis of pancreatobiliary tract cancer: A pilot study. 査読 国際誌

    Takayuki Maruyama, Takaaki Tomofuji, Tatsuya Machida, Hironari Kato, Koichiro Tsutsumi, Daisuke Uchida, Akinobu Takaki, Toshiki Yoneda, Hisataka Miyai, Hirofumi Mizuno, Daisuke Ekuni, Hiroyuki Okada, Manabu Morita

    Molecular and clinical oncology   6 ( 5 )   683 - 687   2017年5月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Several studies have indicated that periodontitis is a risk factor for cancer. However, the association between periodontitis and the prognosis of pancreatobiliary tract cancer remains unclear. The aim of this pilot study was to investigate the association between periodontitis and prognosis of pancreatobiliary tract cancer. A total of 22 patients diagnosed with pancreatobiliary tract cancer were analyzed. Oral health status, including severity of periodontitis, general health status and biochemical serum markers were evaluated. The Kaplan-Meier method and Cox proportional hazards model were used to assess factors affecting the prognosis of pancreatobiliary tract cancer. The Kaplan-Meier analysis demonstrated that low body mass index, high concentration of serum C-reactive protein (CRP) and severe periodontitis were significant prognostic factors for survival rate. The Cox proportional hazards model revealed that serum carbohydrate antigen 19-9 concentration [hazard ratio (HR)=1.002; 95% confidence interval (CI): 1.000-1.004] and serum CRP concentration (HR=2.57; 95% CI: 1.15-5.74) were significantly associated with the prognosis of pancreatobiliary tract cancer. In addition, cancer patients with severe periodontitis had higher serum CRP concentrations compared with those without severe periodontitis. Therefore, severe periodontitis indirectly affected the prognosis of pancreatobiliary tract cancer through promoting systemic inflammation.

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  • Predictive factors for outcomes of patients undergoing endoscopic therapy for bile leak after hepatobiliary surgery 査読

    Shuntaro Yabe, Hironari Kato, Sho Mizukawa, Yutaka Akimoto, Daisuke Uchida, Hiroyuki Seki, Takeshi Tomoda, Kazuyuki Matsumoto, Naoki Yamamoto, Shigeru Horiguchi, Koichiro Tsutsumi, Hiroyuki Okada

    DIGESTIVE ENDOSCOPY   29 ( 3 )   353 - 361   2017年5月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:WILEY  

    Background and Aim: Endoscopic procedures are used as first-line treatment for bile leak after hepatobiliary surgery. Advances have been made in endoscopic techniques and devices, but few reports have described the effectiveness of endoscopic procedures and the management principles based on severity of bile leak. We evaluated the effectiveness of an endoscopic procedure for the treatment of bile leak after hepatobiliary surgery.
    Methods: Fifty-eight patients underwent an endoscopic procedure for suspected bile leak after hepatobiliary surgery; the presence of bile leak on endoscopic retrograde cholangiopancreatography (ERCP) was evaluated retrospectively. Two groups were created based on bile leak severity at ERCP. We defined success as follows: technical, successful placement of the plastic stent at the intended bile duct; clinical, improvement in symptoms of bile leak; and eventual, disappearance of bile leak at ERCP. We evaluated several factors that influenced the success of the endoscopic procedure and the differences between bile leak severity.
    Results: Success rates were as follows: technical, 90%; clinical, 79%; and eventual, 71%. Median interval between first endoscopic procedure and achievement of eventual success was 135 days (IQR, 86-257 days). Bile leak severity was the only independent factor associated with eventual success (P = 0.01).
    Conclusions: Endoscopic therapy is safe and effective for postoperative bile leak. Bile leak severity is the most important factor influencing successful endoscopic therapy.

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  • 超音波内視鏡を用いた膵疾患診療 基本から応用まで 閉塞性膵炎に対するEUS下膵管ドレナージの有用性に関する検討

    友田 健, 加藤 博也, 水川 翔, 室 信一郎, 秋元 悠, 内田 大輔, 松本 和幸, 堀口 繁, 堤 康一郎

    膵臓   32 ( 3 )   330 - 330   2017年5月

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    記述言語:日本語   出版者・発行元:(一社)日本膵臓学会  

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  • 膵NETの診療ガイドラインの問題点と今後の展望 PNET術後再発予測因子に関する検討

    堀口 繁, 加藤 博也, 水川 翔, 室 信一郎, 内田 大輔, 友田 健, 松本 和幸, 田中 顕之, 八木 孝仁, 岡田 裕之

    膵臓   32 ( 3 )   402 - 402   2017年5月

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    記述言語:日本語   出版者・発行元:(一社)日本膵臓学会  

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  • 急性膵炎の後期合併症に対する手術・インターベンション治療の現状と課題 急性膵炎後fluid collectionに対する超音波内視鏡下嚢胞ドレナージ術の現状

    内田 大輔, 加藤 博也, 水川 翔, 室 信一郎, 秋元 悠, 友田 健, 松本 和幸, 堀口 繁, 堤 康一郎, 岡田 裕之

    膵臓   32 ( 3 )   448 - 448   2017年5月

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    記述言語:日本語   出版者・発行元:(一社)日本膵臓学会  

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  • Suitable Liquid Biopsy Samples for Detecting Kras Mutations in Patients with Pancreatic Cancer 査読

    Soichiro Ako, Kazuhiro Nouso, Hideaki Kinugasa, Chihiro Dohi, Hiroshi Matsushita, Sho Mizukawa, Shinichiro Muro, Yutaka Akimoto, Daisuke Uchida, Takeshi Tomoda, Kazuyuki Matsumoto, Shigeru Horiguchi, Koichiro Tsutsumi, Hironari Kato, Hiroyuki Okada

    Gastroenterology   152 ( 5 )   S490   2017年4月

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    掲載種別:研究論文(学術雑誌)   出版者・発行元:Elsevier {BV}  

    DOI: 10.1016/s0016-5085(17)31819-x

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  • Dynamic computed tomography is useful for prediction of pathological grade in pancreatic neuroendocrine neoplasm 査読

    Shigeru Horiguchi, Hironari Kato, Hidenori Shiraha, Koichiro Tsutsumi, Naoki Yamamoto, Kazuyuki Matsumoto, Takeshi Tomoda, Daisuke Uchida, Yutaka Akimoto, Syou Mizukawa, Takehiro Tanaka, Koichi Ichimura, Akinobu Takaki, Takahito Yagi, Hiroyuki Okada

    JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY   32 ( 4 )   925 - 931   2017年4月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:WILEY  

    Background and Aim Pathological grading is important in defining the therapeutic strategy in pancreatic neuroendocrine neoplasm (PNEN) but is difficult for unresectable cases. Endoscopic ultrasound (EUS)-guided fine needle aspiration (FNA) is useful in the diagnosis of PNEN, but its usefulness for pathological grading is not well established. No studies have examined the diagnostic ability of dynamic computed tomography (CT) for pathological grading of PNEN. We investigated the usefulness of EUS-FNA and dynamic CT in the diagnosis and pathological grading of PNEN.
    Methods In this retrospective study, 39 PNEN patients finally diagnosed via EUS-FNA and/or surgical resection underwent dynamic CT. Pathological samples were diagnosed based on WHO2010; staging was based on the European Neuroendocrine Tumor Society classification. The proportion of the quantification value in the tumor to the pancreatic parenchyma in arterial phase was defined as the CT ratio. Immunohistochemical staining with CD31 was performed to evaluate microvessel density (MVD). We evaluated the relationship between pathological grade, CT ratio, and MVD.
    Results By using EUS-FNA, 35 of 39 (90%) cases were diagnosed as PNEN. As for pathological grade, 15 of 35 (43%) cases could be identified correctly. CT ratio could predict pathological Grade 3 disease. The sensitivity, specificity, and diagnostic accuracy were 100%, 94%, and 95%. MVD was significantly correlated with CT ratio (r=0.83, P&lt;0.0001) and pathological grade (P=0.0074).
    Conclusions Computed tomography ratio has a relationship with pathological grade in PNEN, which would help decide therapeutic strategy in unresectable cases and cases in which pathological grading is difficult.

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  • 当院におけるEUS下胆道ドレナージの現状

    内田 大輔, 加藤 博也, 岡田 裕之, 水川 翔, 室 信一郎, 秋元 悠, 友田 健, 松本 和幸, 堀口 繁, 堤 康一郎

    Gastroenterological Endoscopy   59 ( Suppl.1 )   994 - 994   2017年4月

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    記述言語:日本語   出版者・発行元:(一社)日本消化器内視鏡学会  

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  • 経乳頭的に留置した胆管・膵管ステントの迷入症例の検討

    室 信一郎, 加藤 博也, 水川 翔, 秋元 悠, 内田 大輔, 友田 健, 松本 和幸, 堀口 繁, 堤 康一郎, 岡田 裕之

    Gastroenterological Endoscopy   59 ( Suppl.1 )   1091 - 1091   2017年4月

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    記述言語:日本語   出版者・発行元:(一社)日本消化器内視鏡学会  

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  • Redox Signaling in NASH 査読

    A. Takaki, D. Uchida, K. Yamamoto

    Liver Pathophysiology: Therapies and Antioxidants   169 - 180   2017年3月

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    記述言語:英語   掲載種別:論文集(書籍)内論文   出版者・発行元:Elsevier  

    The pathogenesis of nonalcoholic fatty liver disease (NAFLD) is multifactorial and difficult to unify. The progression of benign nonalcoholic fatty liver (NAFL) to progressive nonalcoholic steatohepatitis (NASH) is acknowledged to be a multiple parallel hit process. Oxidative stress is one of the main factors that drives progression of NAFL to NASH, although it is also essential for vital cellular processes. Overaccumulation of long chain fatty acid results in mitochondrial ?-oxidation pathway activation followed by reactive oxygen species (ROS) production. ROS can mediate the oxidative stress response in hepatocytes, Kupffer cells, or hepatic stellate cells resulting in hepatocyte damage, and in proinflammatory and profibrogenic responses that should be well balanced. ROS detoxification pathway signaling is often damaged in NAFLD following ROS accumulation. Inactivation of pro-oxidant production pathways and activation of detoxifying signaling pathways are the required treatment approach.

    DOI: 10.1016/B978-0-12-804274-8.00012-6

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  • [Corrigendum] Loss of Runt‑related transcription factor 3 induces resistance to 5‑fluorouracil and cisplatin in hepatocellular carcinoma. 査読

    Kataoka J, Shiraha H, Horiguchi S, Sawahara H, Uchida D, Nagahara T, Iwamuro M, Morimoto H, Takeuchi Y, Kuwaki K, Onishi H, Nakamura S, Takaki A, Nouso K, Yagi T, Yamamoto K, Okada H

    Oncology reports   37 ( 3 )   1921 - 1921   2017年3月

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  • Utility of serum DNA as a marker for KRAS mutations in pancreatic cancer tissue 査読

    Soichiro Ako, Kazuhiro Nouso, Hideaki Kinugasa, Chihiro Dohi, Hiroshi Matushita, Sho Mizukawa, Shinichiro Muro, Yutaka Akimoto, Daisuke Uchida, Takeshi Tomoda, Kazuyuki Matsumoto, Shigeru Horiguchi, Koichiro Tsutsumi, Hironari Kato, Hiroyuki Okada

    PANCREATOLOGY   17 ( 2 )   285 - 290   2017年3月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:ELSEVIER SCIENCE BV  

    Background/Objectives: The detection of cancer-specific DNA in peripheral blood, known as a liquid biopsy, has been reported recently. Most such studies have used plasma as a sample; however, whether or not serum can be used as effectively is unclear. We attempted to clarify suitable samples for detecting KRAS mutations in circulating DNA in the blood of pancreatic cancer patients using droplet digital polymerase chain reaction (PCR).
    Methods: DNA was extracted from the tissue, plasma, and serum of 40 pancreatic cancer patients. The presence of KRAS mutations G12D, G12V, and G12R was analyzed by droplet digital PCR.
    Results: The amount of DNA isolated from the serum was much higher than that from plasma (1.0-to 42.0-fold). At least 1 KRAS mutation was observed in 93% of cancer tissues, whereas we detected the mutations in only 48% of the serum and plasma DNA samples. The G12D mutation was the most prevalent of the three mutations, followed by the G12V mutation. The presence of the G12D KRAS mutation in the plasma, serum, or tissue did not correlate to the overall survival; however, the prognosis of the patients with a KRAS mutation at G12V in the plasma or serum was significantly poorer than that of the patients without the mutation (P &lt; 0.01).
    Conclusions: Serum and plasma were found to be good materials for detecting cancer-specific DNA in the peripheral blood and the presence of KRAS mutations in blood-derived DNA may be used as a prognostic biomarker for patients with pancreatic cancer. (C) 2017 IAP and EPC. Published by Elsevier B.V. All rights reserved.

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  • A comparative evaluation of treatment methods for bile duct stones after hepaticojejunostomy between percutaneous transhepatic cholangioscopy and peroral, short double-balloon enteroscopy 査読

    Koichiro Tsutsumi, Hironari Kato, Shuntaro Yabe, Sho Mizukawa, Hiroyuki Seki, Yutaka Akimoto, Daisuke Uchida, Kazuyuki Matsumoto, Takeshi Tomoda, Naoki Yamamoto, Shigeru Horiguchi, Hirofumi Kawamoto, Hiroyuki Okada

    THERAPEUTIC ADVANCES IN GASTROENTEROLOGY   10 ( 1 )   54 - 67   2017年1月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:SAGE PUBLICATIONS LTD  

    Background: Bile duct stones after hepaticojejunostomy are considered a troublesome adverse event. Although percutaneous transhepatic procedures using a cholangioscopy is performed to treat these bile duct stones, a peroral endoscopic procedure using a short, double-balloon enteroscope (sDBE) is an alternative. This study aimed to compare the immediate and long-term outcomes of both treatments for bile duct stones in patients who underwent prior hepaticojejunostomy.
    Methods: Between October 2001 and May 2013, 40 consecutive patients were treated for bile duct stones after hepaticojejunostomy at a tertiary care hospital. Initial success with biliary access, biliary intervention-related technical success, clinical success, adverse events, hospitalization duration, and stone-free survival were retrospectively evaluated.
    Results: The initial success rates for biliary access were 100% (8/8) with percutaneous transhepatic cholangioscopy (PTCS) and 91% (29/32) with sDBE. In three patients in whom biliary access during initial sDBE failed, successful access with subsequent PTCS was achieved, and biliary intervention-related technical success and clinical success were eventually achieved in all 40 patients. The rate of adverse events was significantly lower with sDBE than with PTCS (10% versus 45%; p = 0.025). The median hospitalization duration for complete stone clearance was significantly shorter with sDBE than with PTCS (10 versus 35 days; p &lt; 0.001). During the median 7.2 year or 3.1 year follow up, the probabilities of being stone-free at 1, 2, and 3 years were 100%, 73%, and 64% for PTCS and 85%, 65%, and 59% for sDBE, respectively (p = 0.919).
    Conclusions: sDBE was useful, with few adverse events and short hospitalization; therefore, experienced endoscopists can consider it as first-line treatment for bile duct stones in patients with prior hepaticojejunostomy.

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  • The serum oxidative/anti-oxidative stress balance becomes dysregulated in patients with non-alcoholic steatohepatitis associated with hepatocellular carcinoma 査読

    Yasuyuki Shimomura, Akinobu Takaki, Nozomu Wada, Tetsuya Yasunaka, Fusao Ikeda, Takayuki Maruyama, Naofumi Tamaki, Daisuke Uchida, Hideki Onishi, Kenji Kuwaki, Shinichiro Nakamura, Kazuhiro Nouso, Yasuhiro Miyake, Kazuko Koike, Takaaki Tomofuji, Manabu Morita, Kazuhide Yamamoto, Hiroyuki Okada

    Internal Medicine   56 ( 3 )   243 - 251   2017年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Japanese Society of Internal Medicine  

    Objective Oxidative stress is associated with the progression of chronic liver disease. Non-alcoholic fatty liver disease (NAFLD) is also an oxidative stress-related disease. However, the oxidative/anti-oxidative balance has not been fully characterized in NAFLD. The objective of the present study was to investigate the balance between oxidative stress and the anti-oxidative activity in NAFLD, including non-alcoholic steatohepatitis (NASH)-related hepatocellular carcinoma (HCC). Patients We recruited 69 patients with histologically proven NAFLD without HCC (NAFLD
    n=58), and with NASH-related HCC (NASH-HCC
    n=11). The 58 NAFLD patients included patients with non-alcoholic fatty liver (NAFL
    n=14) and NASH (n=44). Methods The serum levels of reactive oxygen metabolites (ROM) and anti-oxidative markers (OXY) were determined and then used to calculate the oxidative index. The correlations among such factors as ROM, OXY, oxidative index, and clinical characteristics were investigated. Results In NAFLD, ROM positively correlated with the body mass index (BMI), hemoglobin A1c (HbA1c), C-reactive protein (CRP), and the histological grade or inflammatory scores, while only high HbA1c and CRP levels were significant factors that correlated with a higher ROM according to a multivariate analysis. OXY positively correlated with the platelet counts, albumin, and creatinine levels, while negatively correlating with age. However, it improved after treatment intervention. The oxidative index positively correlated with BMI, CRP, and HbA1c. The NASH-HCC patients exhibited a lower OXY than the NASH patients, probably due to the effects of aging. Conclusion Oxidative stress correlated with the levels of NASH activity markers, while the anti-oxidative function was preserved in younger patients as well as in patients with a well-preserved liver function. The NASH-HCC patients tended to be older and exhibited a diminished anti-oxidative function.

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  • The Serum Oxidative/Anti-oxidative Stress Balance Becomes Dysregulated in Patients with Non-alcoholic Steatohepatitis Associated with Hepatocellular Carcinoma 査読

    Yasuyuki Shimomura, Akinobu Takaki, Nozomu Wada, Tetsuya Yasunaka, Fusao Ikeda, Takayuki Maruyama, Naofumi Tamaki, Daisuke Uchida, Hideki Onishi, Kenji Kuwaki, Shinichiro Nakamura, Kazuhiro Nouso, Yasuhiro Miyake, Kazuko Koike, Takaaki Tomofuji, Manabu Morita, Kazuhide Yamamoto, Hiroyuki Okada

    INTERNAL MEDICINE   56 ( 2 )   243 - 251   2017年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:JAPAN SOC INTERNAL MEDICINE  

    Objective Oxidative stress is associated with the progression of chronic liver disease. Non-alcoholic fatty liver disease (NAFLD) is also an oxidative stress-related disease. However, the oxidative/anti-oxidative balance has not been fully characterized in NAFLD. The objective of the present study was to investigate the balance between oxidative stress and the anti-oxidative activity in NAFLD, including non-alcoholic steatohepatitis (NASH)-related hepatocellular carcinoma (HCC).
    Patients We recruited 69 patients with histologically proven NAFLD without HCC (NAFLD; n=58), and with NASH-related HCC (NASH-HCC; n=11). The 58 NAFLD patients included patients with non-alcoholic fatty liver (NAFL; n=14) and NASH (n=44).
    Methods The serum levels of reactive oxygen metabolites (ROM) and anti-oxidative markers (OXY) were determined and then used to calculate the oxidative index. The correlations among such factors as ROM, OXY, oxidative index, and clinical characteristics were investigated.
    Results In NAFLD, ROM positively correlated with the body mass index (BMI), hemoglobin A1c (HbA1c), C-reactive protein (CRP), and the histological grade or inflammatory scores, while only high HbA1c and CRP levels were significant factors that correlated with a higher ROM according to a multivariate analysis. OXY positively correlated with the platelet counts, albumin, and creatinine levels, while negatively correlating with age. However, it improved after treatment intervention. The oxidative index positively correlated with BMI, CRP, and HbA1c. The NASH-HCC patients exhibited a lower OXY than the NASH patients, probably due to the effects of aging.
    Conclusion Oxidative stress correlated with the levels of NASH activity markers, while the anti-oxidative function was preserved in younger patients as well as in patients with a well-preserved liver function. The NASH-HCC patients tended to be older and exhibited a diminished anti-oxidative function.

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  • Outcomes of management for biliary stricture after living donor liver transplantation with hepaticojejunostomy using short-type double-balloon enteroscopy 査読

    Takeshi Tomoda, Koichiro Tsutsumi, Hironari Kato, Sho Mizukawa, Syuntaro Yabe, Yutaka Akimoto, Hiroyuki Seki, Daisuke Uchida, Kazuyuki Matsumoto, Naoki Yamamoto, Shigeru Horiguchi, Hiroyuki Okada

    SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES   30 ( 12 )   5338 - 5344   2016年12月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:SPRINGER  

    To evaluate the outcomes of management for biliary stricture (BS) after living donor liver transplantation (LDLT) using short-type double-balloon enteroscopy.
    This study retrospectively evaluated 20 patients who underwent endoscopic retrograde cholangiography using short-type double-balloon enteroscopy (sDB-ERC) upon suspicion of BS after LDLT with hepaticojejunal (HJ) reconstruction at Okayama University Hospital.
    Scope insertion to the HJ site and sDB-ERC succeeded in 85 % (17/20) and 82.4 % (14/17) of patients, respectively. Of 14 patients who required treatment for BS, 11 were successfully treated using sDB-ERC, and 3 were successfully treated using sDB-ERC and rendezvous procedures. Adverse events occurred in 2.9 % of all sessions (2/68). After resolution of BS, 7 patients (50 %) experienced a recurrence. Of these, 6 (85.7 %) were treated with only balloon dilation, and 1 (14.3 %) was treated with both balloon dilation and stent deployment (P = 0.029).
    sDB-ERC is a useful procedure for diagnosis and treatment for BS after LDLT with HJ reconstruction. Balloon dilation combined with stent deployment might be recommended for definite resolution of BS.

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  • 膵癌との鑑別を要した膵内副脾の一例

    堤 康一郎, 加藤 博也, 堀口 繁, 山本 直樹, 友田 健, 松本 和幸, 秋元 悠, 内田 大輔, 室 信一郎, 岡田 裕之

    超音波医学   43 ( 6 )   777 - 777   2016年11月

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    記述言語:日本語   出版者・発行元:(公社)日本超音波医学会  

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  • A Prospective Randomized Controlled Study Comparing EUS Sonopsy CY(R) and 22-gauge Biopsy Needles for Endoscopic Ultrasound-guided Fine-Needle Aspiration of Solid Pancreatic Mass Lesions 査読

    Sho Mizukawa, Hironari Kato, Shinichiro Muro, Yutaka Akimoto, Daisuke Uchida, Takeshi Tomoda, Kazuyuki Matsumoto, Naoki Yamamoto, Shigeru Horiguchi, Koichiro Tsutsumi, Hiroyuki Okada, Hirofumi Inoue, Noriyuki Tanaka

    ACTA MEDICA OKAYAMA   70 ( 5 )   417 - 420   2016年10月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:OKAYAMA UNIV MED SCHOOL  

    Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) is a standard procedure for precise histological diagnosis of pancreas tumors, but it is sometimes difficult to obtain adequate specimens. EUS Sonopsy CY (R) is a newly designed needle with original features. This randomized study will compare the tissue collection rate of EUS Sonopsy CY (R) to that of a conventional needle in EUS-FNA. The major eligibility criteria are as follows: Patients with a pancreatic mass referred for EUS-FNA; age &gt;= 20 years, and performance status &lt; 4. The primary outcome is the tissue collection rate. This study will elucidate the efficacy of EUS Sonopsy CY (R).

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  • miR‑1246 and miR‑4644 in salivary exosome as potential biomarkers for pancreatobiliary tract cancer. 査読

    Machida T, Tomofuji T, Maruyama T, Yoneda T, Ekuni D, Azuma T, Miyai H, Mizuno H, Kato H, Tsutsumi K, Uchida D, Takaki A, Okada H, Morita M

    Oncology reports   36 ( 4 )   2375 - 2381   2016年10月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.3892/or.2016.5021

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  • A Multicenter, Prospective, Randomized Controlled Trial Evaluating the Efficacy of Rectal Diclofenac and Sublingual Nitroglycerin as a Combined Prophylactic Treatment for Post-ERCP Pancreatitis 査読

    Takeshi Tomoda, Hironari Kato, Sho Mizukawa, Shinichiro Muro, Yutaka Akimoto, Daisuke Uchida, Kazuyuki Matsumoto, Naoki Yamamoto, Shigeru Horiguchi, Koichiro Tsutsumi, Hiroyuki Okada

    ACTA MEDICA OKAYAMA   70 ( 5 )   405 - 408   2016年10月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:OKAYAMA UNIV MED SCHOOL  

    Acute pancreatitis is the major complication of endoscopic retrograde cholangiopancreatography (ERCP). A preliminary research suggested that the administration of nonsteroidal anti-inflammatory drugs (NSAIDs) with nitroglycerin might reduce the incidence of post-ERCP pancreatitis (PEP) more effectively than NSAIDs alone. We conduct a two-arm, multicenter, prospective, randomized, superiority trial to evaluate the additional effect of nitroglycerin for prevention of PEP. A total of 900 patients randomly receive 50 mg diclofenac suppository either alone or with 5 mg isosorbide dinitrate sublingual tablet. The primary endpoint is the occurrence of PEP. This study will clarify whether NSAIDs plus nitroglycerin can prevent PEP.

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  • 術後胆汁漏に対する内視鏡的胆管ドレナージ術の有用性の検討

    矢部 俊太郎, 加藤 博也, 水川 翔, 秋元 悠, 内田 大輔, 關 博之, 友田 健, 松本 和幸, 山本 直樹, 堀口 繁, 堤 康一郎

    Gastroenterological Endoscopy   58 ( Suppl.2 )   1934 - 1934   2016年10月

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    記述言語:日本語   出版者・発行元:(一社)日本消化器内視鏡学会  

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  • ERCP関連処置合併症に対するcovered self-expandable metallic stentの有用性

    水川 翔, 加藤 博也, 矢部 俊太郎, 秋元 悠, 關 博之, 内田 大輔, 友田 健, 松本 和幸, 堀口 繁, 山本 直樹, 堤 康一郎, 岡田 裕之

    Gastroenterological Endoscopy   58 ( Suppl.2 )   1930 - 1930   2016年10月

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    記述言語:日本語   出版者・発行元:(一社)日本消化器内視鏡学会  

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  • PNETの診断治療に関する検討

    堀口 繁, 加藤 博也, 水川 翔, 矢部 俊太郎, 内田 大輔, 秋元 悠, 關 博之, 松本 和幸, 友田 健, 山本 直樹, 堤 康一郎, 岡田 裕之

    日本消化器病学会雑誌   113 ( 臨増大会 )   A676 - A676   2016年9月

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    記述言語:日本語   出版者・発行元:(一財)日本消化器病学会  

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  • Diagnosing Pancreatic Tumors Using Contrast-enhanced Harmonic Endoscopic Ultrasonography with Sonazoid 査読

    Naoki Yamamoto, Hironari Kato, Sho Mizukawa, Shinichiro Muro, Yutaka Akimoto, Daisuke Uchida, Takeshi Tomoda, Kazuyuki Matsumoto, Shigeru Horiguchi, Koichiro Tsutsumi, Hiroyuki Okada

    ACTA MEDICA OKAYAMA   70 ( 4 )   323 - 325   2016年8月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:OKAYAMA UNIV MED SCHOOL  

    Contrast-enhanced harmonic endoscopic ultrasonography (CH-EUS) with contrast agent enabled us to assess the hemodynamics closely, despite limited data in pancreatic tumors. We have initiated a prospective, single arm, and non-randomized study to clarify the accuracy and safety of CH-EUS with Sonazoid and time-intensity curve (TIC) analysis for diagnosing benign or malignant pancreatic tumors. A total of 200 patients will undergo CH-EUS and TIC analysis. Receiver operating characteristic (ROC) analysis will be used to determine the optimal parameter cutoff values for TIC analysis. This will clarify whether CH-EUS and TIC can further improve the diagnosis of pancreatic tumors over conventional EUS.

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  • Efficacy and Safety of Endoscopic Ultrasound-guided Ethanol Ablation Therapy for Pancreatic Neuroendocrine Tumors 査読

    Kazuyuki Matsumoto, Hironari Kato, Koichiro Tsutsumi, Sho Mizukawa, Syuntaro Yabe, Hiroyuki Seki, Yutaka Akimoto, Daisuke Uchida, Takeshi Tomoda, Naoki Yamamoto, Shigeru Horiguchi, Hiroyuki Okada

    ACTA MEDICA OKAYAMA   70 ( 4 )   313 - 316   2016年8月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:OKAYAMA UNIV MED SCHOOL  

    Recently, endoscopic ultrasonography (EUS)-guided ethanol ablation for small pancreatic neuroendocrine tumors (p-NETs) has been reported. However, the efficacy and safety of the technique remain unclear. We have launched a prospective pilot study of EUS-guided ethanol ablation for p-NETs. The major eligibility criteria are the presence of a pathologically diagnosed grade (G) 1 or G2 p-NET, a tumor size of &lt;= 2cm, and being a poor candidate for surgery. A total of 5 patients will be treated. The primary endpoint will be the complete ablation rate at 1 month after treatment.

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  • 化学療法を施行した胆嚢NECの3例

    堀口 繁, 加藤 博也, 水川 翔, 室 信一郎, 内田 大輔, 秋元 悠, 松本 和幸, 友田 健, 山本 直樹, 堤 康一郎, 岡田 裕之

    胆道   30 ( 3 )   562 - 562   2016年8月

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    記述言語:日本語   出版者・発行元:日本胆道学会  

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  • 術後再建腸管を有する膵胆道疾患に対する新たなダブルバルーン内視鏡(EI-580BT)の有用性に関する検討

    友田 健, 堤 康一郎, 水川 翔, 室 信一郎, 内田 大輔, 秋元 悠, 松本 和幸, 山本 直樹, 堀口 繁, 加藤 博也, 岡田 裕之

    胆道   30 ( 3 )   527 - 527   2016年8月

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    記述言語:日本語   出版者・発行元:日本胆道学会  

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  • Endoscopic ultrasonography-guided drainage of intra-abdominal fluid collection after liver transplantation: a case series of six patients 査読

    Daisuke Uchida, Koichiro Tsutsumi, Hironari Kato, Hiroyuki Okada

    JOURNAL OF MEDICAL ULTRASONICS   43 ( 3 )   421 - 426   2016年7月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:SPRINGER JAPAN KK  

    Intra-abdominal fluid collection associated with infection is a major complication after liver transplantation (LT). However, post-LT recipients are at high risk for requiring various interventions and surgeries, due to their poor, immunosuppressed conditions. We herein describe six patients with symptomatic or growing intra-abdominal fluid collection after LT who underwent endoscopic ultrasonography (EUS)-guided drainage. There were five males and one female, and the median age was 47 years (24-60 years). All procedures were technically and clinically successful in all patients. The median number of endoscopic sessions was 2.5 (1-4 sessions) until resolution. Procedure-related adverse events occurred in two patients and included peritonitis, bleeding, and stent migration, which improved conservatively or endoscopically. During the median follow-up period of 63 months (17-110 months), recurrence occurred in one patient. EUS-guided drainage is an effective and safe treatment for intra-abdominal fluid collection even in post-LT recipients.

    DOI: 10.1007/s10396-016-0720-2

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  • Biliary Anastomotic Stricture After Adult Living Donor Liver Transplantation With Duct-to-Duct Reconstruction: Outcome After Endoscopic Treatment Including Rendezvous Procedure 査読

    Takeshi Tomoda, Hironari Kato, Sho Mizukawa, Syuntaro Yabe, Yutaka Akimoto, Hiroyuki Seki, Daisuke Uchida, Kazuyuki Matsumoto, Naoki Yamamoto, Shigeru Horiguchi, Koichiro Tsutsumi, Hiroyuki Okada

    TRANSPLANTATION   100 ( 7 )   1500 - 1506   2016年7月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:LIPPINCOTT WILLIAMS & WILKINS  

    Background. To evaluate the outcomes and investigate the factors associated with restricture after endoscopic treatment. Methods. Between April 2001 and July 2014, 98 patients experienced biliary anastomotic stricture (BAS) after living donor liver transplantation (LDLT) with duct-to-duct reconstruction, and all were first referred to Okayama University Hospital for endoscopic stent deployment. When deployment was unsuccessful, a percutaneous transhepatic procedure was used. Treatment outcomes, including stricture resolution, BAS recurrence, and risk factors of BAS recurrence, were evaluated retrospectively. Results. Successful stent deployment was achieved in 90 of 98 patients (91.8%) by both procedures. Among the 90 patients, stricture resolution was eventually observed in 72. The median number of endoscopic retrograde cholangiographies performed was 5. After a median follow-up period of 48.8 months from stent removal, BAS recurrence that required intervention occurred in 22 patients (30.6%). In multivariate analysis, portal vein stenosis after LDLT was associated with BAS recurrence after endoscopic treatment (P = 0.03). Among the 22 patients who required reintervention, 16 (73%) had their stents removed, and recurrence after retreatment occurred in 3 patients (18.8%). Conclusions. Endoscopic treatment is a useful procedure for the treatment for BAS after LDLT with duct-to-duct reconstruction. Portal vein stenosis may be one of the risks associated with the recurrence of BAS.

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  • Synergistic anti-pancreatic cancer immunological effects by treatment with reduced expression in immortalized cells/dickkopf-3 protein and peripheral blood mononuclear cells 査読

    Daisuke Uchida, Hidenori Shiraha, Hironari Kato, Hiroaki Sawahara, Teruya Nagahara, Masaya Iwamuro, Junro Kataoka, Shigeru Horiguchi, Masami Watanabe, Akinobu Takaki, Kazuhiro Nouso, Yasutomo Nasu, Hiromi Kumon, Kazuhide Yamamoto

    JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY   31 ( 6 )   1154 - 1159   2016年6月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:WILEY-BLACKWELL  

    Background and AimReduced expression in immortalized cells/dickkopf-3 (REIC/DKK3) is a reported tumor suppressor gene and has potential to become an innovative therapy for various cancers. We examined the antitumor immunological effects of human REIC/DKK3 protein against pancreatic cancer.
    MethodsActivation of extracellular signal-regulated kinases 1 and 2, mammalian target of rapamycin, and signal transducer and activator of transcription 3 by REIC/DKK3 protein was assessed in human peripheral blood mononuclear cells using immunoblotting. Pancreatic cancer cell lines (AsPC-1 and MIA Paca-2) were cocultured with peripheral blood mononuclear cells, and the anticancer effects of REIC/DKK3 protein were assessed using the methyl thiazole tetrazolium, cytotoxicity, and enzyme-linked immunospot assays. The antitumor immunological effects of the combined treatment with REIC/DKK3 protein and peripheral blood mononuclear cells were also assessed in a pancreatic cancer model using non-obese diabetic/severe combined immunodeficiency mice.
    ResultsThe REIC/DKK3 protein activated extracellular signal-regulated kinases 1 and 2, mammalian target of rapamycin, and signal transducer and activator of transcription 3 in peripheral blood mononuclear cells. REIC/DKK3 protein inhibited in vitro cancer cell viability and enhanced cytotoxicity when incubated with peripheral blood mononuclear cells. REIC/DKK3 protein induced significant production of interferon gamma from lymphocytes incubated with pancreatic cancer cells, indicating that CD8+ T cells were activated in the peripheral blood mononuclear cells when cocultured with AsPC-1 and MIA Paca-2 in the presence of REIC/DKK3 protein. Combined treatment with REIC/DKK3 protein and peripheral blood mononuclear cells produced in vivo anticancer immunostimulatory effects on pancreatic cancer cells.
    ConclusionsThe REIC/DKK3 protein and peripheral blood mononuclear cells synergistically enhanced anticancer immunological effects against pancreatic cancer cells. The observed immunomodulatory effect of combined treatment likely occurs in adenovirus-mediated REIC/DKK3 gene therapy and provides important clues to the therapeutic mechanisms involving immune cells.

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  • Loss of Runt-related transcription factor 3 induces resistance to 5-fluorouracil and cisplatin in hepatocellular carcinoma 査読

    Junro Kataoka, Hidenori Shiraha, Shigeru Horiguchi, Hiroaki Sawahara, Daisuke Uchida, Teruya Nagahara, Masaya Iwamuro, Hiroki Morimoto, Yasuto Takeuchi, Kenji Kuwaki, Hideki Onishi, Shinichiro Nakamura, Akinobu Takaki, Kazuhiro Nouso, Takahito Yagi, Kazuhide Yamamoto, Hiroyuki Okada

    ONCOLOGY REPORTS   35 ( 5 )   2576 - 2582   2016年5月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:SPANDIDOS PUBL LTD  

    Runt-related transcription factor 3 (RUNX3) is known to function as a tumor suppressor in gastric cancer and other types of cancers, including hepatocellular carcinoma (HCC). However, its role has not been fully elucidated. In the present study, we aimed to evaluate the role of RUNX3 in HCC. We used the human HCC cell lines Hep3B, Huh7 and HLF; RUNX3 cDNA was introduced into Hep3B and Huh7 cells, which were negative for endogenous RUNX3 expression, and RUNX3 siRNA was transfected into HLF cells, which were positive for endogenous RUNX3. We analyzed the expression of RUNX3 and multidrug resistance-associated protein (MRP) by immunoblotting. MTT assays were used to determine the effects of RUNX3 expression on 5-fluorouracil (5-FU) and cisplatin (CDDP) sensitivity. Finally, 23 HCC specimens resected from patients with HCC at Okayama University Hospital were analyzed, and correlations among immunohistochemical expression of RUNX3 protein and MRP protein were evaluated in these specimens. Exogenous RUNX3 expression reduced the expression of MRP1, MRP2, MRP3 and MRP5 in the RUNX3-negative cells, whereas knockdown of RUNX3 in the HLF cells stimulated the expression of these MRPs. An inverse correlation between RUNX3 and MRP expression was observed in the HCC tissues. Importantly, loss of RUNX3 expression contributed to 5-FU and CDDP resistance by inducing MRP expression. These data have important implications in the study of chemotherapy resistance in HCC.

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  • Promising Therapeutic Efficacy of a Novel REIC/Dkk-3 Expressing Adenoviral Vector for Hepatocellular Carcinoma 査読

    Sawahara Hiroaki, Hidenori Shiraha, Daisuke Uchida, Masakiyo Sakaguchi, Masami Watanabe, Yasutomo Nasu, Hiromi Kumon, Hiroyuki Okada

    GASTROENTEROLOGY   150 ( 4 )   S1153 - S1153   2016年4月

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    記述言語:英語   出版者・発行元:W B SAUNDERS CO-ELSEVIER INC  

    DOI: 10.1016/S0016-5085(16)33891-4

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  • Development of a Novel REIC/DKK-3-Encoding Adenoviral Agent: Its Robust and Promising Therapeutic Effects in Pancreatic Cancer 査読

    Daisuke Uchida, Hidenori Shiraha, Hironari Kato, Sawahara Hiroaki, Masakiyo Sakaguchi, Masami Watanabe, Yasutomo Nasu, Hiromi Kumon, Hiroyuki Okada

    GASTROENTEROLOGY   150 ( 4 )   S294 - S294   2016年4月

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    記述言語:英語   出版者・発行元:W B SAUNDERS CO-ELSEVIER INC  

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  • Effectiveness of peroral direct cholangioscopy using an ultraslim endoscope for the treatment of hepatolithiasis in patients with hepaticojejunostomy (with video) 査読

    Kazuyuki Matsumoto, Koichiro Tsutsumi, Hironari Kato, Yutaka Akimoto, Daisuke Uchida, Takeshi Tomoda, Naoki Yamamoto, Yasuhiro Noma, Shigeru Horiguchi, Hiroyuki Okada, Kazuhide Yamamoto

    SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES   30 ( 3 )   1249 - 1254   2016年3月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:SPRINGER  

    Background Hepatolithiasis is a postoperative complication of hepaticojejunostomy (HJ) performed for various pancreatobiliary diseases. Hepatolithiasis can cause repeated cholangitis. Complete stone removal and bile stasis elimination are therefore necessary. Here, we evaluated the effectiveness of peroral direct cholangioscopy (PDCS) using an ultraslim endoscope for treating hepatolithiasis in HJ patients.
    Methods We studied 14 patients with hepatolithiasis who underwent bowel reconstruction with HJ between April 2012 and May 2014. Diagnostic and therapeutic endoscopic retrograde cholangiography using a short double-balloon enteroscope (DBE) was initially performed. Following stone removal, the DBE was exchanged for an ultraslim endoscope through the balloon overtube for PDCS.
    Results The success rate of PDCS procedure was 85.7 % (12/14). In 5 of 12 (41.7 %) patients with successful PDCS, the residual stones were detected and removed completely using a 5-Fr basket catheter and suction after normal saline irrigation. In the remaining 7 (58.3 %) patients, no residual stone was detected. The median procedure time was 14 min (range 8-36) with no serious postoperative complications. The median follow-up time after PDCS was 21 months (range 5-26), and only 1 patient (8.3 %) had IHBD stone recurrence with an anastomotic stricture.
    Conclusions PDCS using an ultraslim endoscope appears to be useful for detecting and removing residual stones following hepatolithiasis treatment using a DBE. The combined use of a DBE and PDCS may reduce the risk of hepatolithiasis recurrence in HJ patients.

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  • Pancreatic Hepatoid Carcinoma Mimicking a Solid Pseudopapillary Neoplasm: A Challenging Case on Endoscopic Ultrasound-guided Fine-needle Aspiration 査読

    Yutaka Akimoto, Hironari Kato, Kazuyuki Matsumoto, Ryo Harada, Shinsuke Oda, Soichiro Fushimi, Shou Mizukawa, Shuntaro Yabe, Daisuke Uchida, Hiroyuki Seki, Takeshi Tomoda, Naoki Yamamoto, Shigeru Horiguchi, Koichiro Tsutsumi, Takahito Yagi, Hiroyuki Okada

    INTERNAL MEDICINE   55 ( 17 )   2405 - 2411   2016年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:JAPAN SOC INTERNAL MEDICINE  

    A 59-year-old man was admitted to our hospital for treatment of a 45 mm pancreatic mass found during a medical examination. Endoscopic ultrasound-guided fine-needle aspiration cytology showed polygonal cells with pseudopapillary structures. The tumor cells were positive for nuclear/cytoplasmic beta-catenin and CD10, and negative for chromogranin A. After a tentative diagnosis of a solid pseudopapillary neoplasm, middle pancreatectomy was performed. Histologically, polygonal cells with abundant eosinophilic cytoplasm formed in the trabeculae and were immunohistochemically positive for HepPar1 and protein induced by vitamin K absence or antagonist-II. The tumor was finally diagnosed to be pancreatic hepatoid carcinoma. No recurrence occurred for 12 months, even without adjuvant chemotherapy.

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  • Oxidative stress balance is dysregulated and represents an additional target for treating cholangiocarcinoma 査読

    Daisuke Uchida, Akinobu Takaki, Hisashi Ishikawa, Yasuko Tomono, Hironari Kato, Koichiro Tsutsumi, Naofumi Tamaki, Takayuki Maruyama, Takaaki Tomofuji, Ryuichiro Tsuzaki, Tetsuya Yasunaka, Kazuko Koike, Hiroshi Matsushita, Fusao Ikeda, Yasuhiro Miyake, Hidenori Shiraha, Kazuhiro Nouso, Ryuichi Yoshida, Yuzo Umeda, Susumu Shinoura, Takahito Yagi, Toshiyoshi Fujiwara, Manabu Morita, Masaki Fukushima, Kazuhide Yamamoto, Hiroyuki Okada

    FREE RADICAL RESEARCH   50 ( 7 )   732 - 743   2016年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:TAYLOR & FRANCIS LTD  

    Background: Pancreatico-biliary malignancies exhibit similar characteristics, including obesity-related features and poor prognosis, and require new treatment strategies. Oxidative stress is known to induce DNA damage and carcinogenesis, and its reduction is viewed as being favorable. However, it also has anti-infection and anti-cancer functions that need to be maintained. To reveal the effect of oxidative stress on cancer progression, we evaluated oxidative stress and anti-oxidative balance in pancreatic cancer (PC) and cholangiocarcinoma (CC) patients, as well as the effect of add-on antioxidant treatment to chemotherapy in a mouse cholangiocarcinoma model.
    Methods: We recruited 84 CC and 80 PC patients who were admitted to our hospital. Serum levels of reactive oxygen metabolites (ROM) and the anti-oxidative OXY-adsorbent test were determined and the balance of these tests was defined as an oxidative index. A diabetic mouse-based cholangiocarcinoma model was utilized to evaluate the effects of add-on antioxidant therapy on cholangiocarcinoma chemotherapy.
    Results: Serum ROM was higher and anti-oxidant OXY was lower in CC patients with poor outcomes. These parameters were not significantly different in PC patients. In mice, vitamin E administration induced antioxidant hemeoxygenase (HO)-1 protein expression in cancer tissue, while the number of stem-like cells increased. L-carnitine administration improved intestinal microbiome and biliary acid balance, upregulated the hepatic mitochondrial membrane uptake related gene Cpt1 in non-cancerous tissue, and did not alter stem-like cell numbers.
    Conclusion: Oxidative stress balance was dysregulated in cholangiocarcinoma with poor outcome. The mitochondrial function-supporting agent L-carnitine is a good candidate to control oxidative stress conditions.

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  • [Radical surgery after successful chemotherapy in a case of primary small cell carcinoma of the liver]. 査読

    Yutaka Akimoto, Koichiro Tsutsumi, Hironari Kato, Hidenori Hata, Hiroyuki Sakae, Daisuke Uchida, Takeshi Tomoda, Kazuyuki Matsumoto, Yasuhiro Noma, Naoki Yamamoto, Shigeru Horiguchi, Ryo Harada, Hiroyuki Okada, Hiroyuki Yanai, Takahito Yagi, Kazuhide Yamamoto

    Nihon Shokakibyo Gakkai zasshi = The Japanese journal of gastro-enterology   112 ( 11 )   2024 - 34   2015年11月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

    A 52-year-old woman was admitted to our hospital with right upper quadrant pain with gallbladder wall thickening and multiple liver tumors. Endoscopic ultrasound-guided biopsy revealed small cell carcinomas of both the gallbladder and liver. After 10 cycles of chemotherapy with etoposide and cisplatin, marked shrinkage of the tumors was evident on computed tomography. The patient subsequently underwent hepatectomy and resection of the extrahepatic bile duct and gallbladder with curative intent. Although no viable tumor cells were found in the resected specimens, we confirmed phagocytosis of tumor cells killed by chemotherapy in the resected liver specimen. Therefore, we suspected that the patient had primary small cell carcinoma of the liver that had been successfully treated. This is a rare case of primary small cell carcinoma of the liver that showed pathological complete response to chemotherapy with etoposide and cisplatin.

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  • 当院における生体肝移植後の胆管狭窄に対する内視鏡治療

    友田 健, 加藤 博也, 内田 大輔, 秋元 悠, 松本 和幸, 山本 直樹, 堀口 繁, 堤 康一郎, 高木 章乃夫, 岡田 裕之, 八木 孝仁

    移植   50 ( 4-5 )   481 - 481   2015年10月

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    記述言語:日本語   出版者・発行元:(一社)日本移植学会  

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  • Hepatic stellate cells promote upregulation of epithelial cell adhesion molecule and epithelial-mesenchymal transition in hepatic cancer cells 査読

    Teruya Nagahara, Hidenori Shiraha, Hiroaki Sawahara, Daisuke Uchida, Yasuto Takeuchi, Masaya Iwamuro, Junro Kataoka, Shigeru Horiguchi, Takeshi Kuwaki, Hideki Onishi, Shinichiro Nakamura, Akinobu Takaki, Kazuhiro Nouso, Kazuhide Yamamoto

    ONCOLOGY REPORTS   34 ( 3 )   1169 - 1177   2015年9月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:SPANDIDOS PUBL LTD  

    Microenvironment plays an important role in epithelial-mesenchymal transition (EMT) and sternness of cells in hepatocellular carcinoma (HCC). Epithelial cell adhesion molecule (EpCAM) is known as a tumor stemness marker of HCC. To investigate the relationship between microenvironment and sternness, we performed an in vitro co-culture assay. Four HCC cell lines (HepG2, Hep3B, HuH-7 and PLC/PRF/5) were co-cultured with the TWNT-1 immortalized hepatic stellate cells (HSCs), which create a microenvironment with HCC. Cell proliferation ability was analyzed by flow cytometry (FCM) and 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay, while migration ability was assessed by a wound healing assay. Expression of EpCAM was analyzed by immunoblotting and FCM. HCC cell lines were co-cultured with TWNT-1 treated with small interfering RNA (siRNA) for TGF-beta and HB-EGF; we then analyzed proliferation, migration ability and protein expression using the methods described above. Proliferation ability was unchanged in HCC cell lines co-cultured with TWNT-1. Migration ability was increased in HCC cell lines (HepG2, Hep3B, HuH-7 and PLC/PRF/5) directly (216.2 +/- 67.0, 61.0 +/- 22.0, 124.0 +/- 66.2 and 51.5 +/- 40.3%) and indirectly (102.5 +/- 22.0, 84.6 +/- 30.9, 86.1 +/- 25.7 and 73.9 +/- 29.7%) co-cultured with TWNT-1 compared with the HCC uni-culture. Immunoblot analysis revealed increased EpCAM expression in the HCC cell lines co-cultured with TWNT-1. Flow cytometry revealed that the population of E-cadherin(-)/N-cadherin(+) and EpCAM-positive cells increased and accordingly, EMT and stemness in the HCC cell line were activated. These results were similar in the directly and indirectly co-cultured samples, indicating that humoral factors were at play. Conversely, HCC cell lines co-cultured with siRNA-treated TWNT-1 showed decreased migration ability, a decreased population of EpCAM-positive and E-cadherin(-)/N-cadherin(+) cells. Taken together, humoral factors secreted from TWNT-1 promote upregulation of EpCAM and EMT in hepatic cancer cells.

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  • Walled-off necrosisに対するstep-up approachによる内視鏡的治療成績

    秋元 悠, 加藤 博也, 松本 和幸, 内田 大輔, 友田 健, 山本 直樹, 堀口 繁, 堤 康一郎, 岡田 裕之

    Gastroenterological Endoscopy   57 ( Suppl.2 )   2209 - 2209   2015年9月

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    記述言語:日本語   出版者・発行元:(一社)日本消化器内視鏡学会  

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  • 当院におけるmodified FOLFIRINOXの治療成績についての検討

    堀口 繁, 加藤 博也, 水川 翔, 矢部 俊太郎, 關 博之, 秋元 悠, 内田 大輔, 友田 健, 松本 和幸, 山本 直樹, 堤 康一郎, 那須 淳一郎, 岡田 裕之, 山本 和秀

    日本消化器病学会雑誌   112 ( 臨増大会 )   A899 - A899   2015年9月

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    記述言語:日本語   出版者・発行元:(一財)日本消化器病学会  

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  • デバイス突破を目的としたSoehendra stent retrieverを用いた拡張術

    松本 和幸, 加藤 博也, 堤 康一郎, 秋元 悠, 内田 大輔, 友田 健, 山本 直樹, 堀口 繁, 岡田 裕之

    Gastroenterological Endoscopy   57 ( Suppl.2 )   2200 - 2200   2015年9月

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    記述言語:日本語   出版者・発行元:(一社)日本消化器内視鏡学会  

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  • 胆管空腸吻合術後の肝内結石治療における細径内視鏡を用いた経口直接胆道鏡の有用性

    松本 和幸, 堤 康一郎, 加藤 博也, 秋元 悠, 内田 大輔, 友田 健, 山本 直樹, 堀口 繁, 八木 孝仁, 岡田 裕之

    胆道   29 ( 3 )   503 - 503   2015年8月

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    記述言語:日本語   出版者・発行元:日本胆道学会  

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  • Efficacy of Endoscopic Over 3-branched Partial Stent-in-Stent Drainage Using Self-expandable Metallic Stents in Patients With Unresectable Hilar Biliary Carcinoma 査読

    Daisuke Uchida, Hironari Kato, Shinichiro Muro, Yasuhiro Noma, Naoki Yamamoto, Shigeru Horiguchi, Ryo Harada, Koichiro Tsutsumi, Hirofumi Kawamoto, Hiroyuki Okada, Kazuhide Yamamoto

    JOURNAL OF CLINICAL GASTROENTEROLOGY   49 ( 6 )   529 - 536   2015年7月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:LIPPINCOTT WILLIAMS & WILKINS  

    Background:The treatment of biliary stricture is crucially important for continuing stable chemotherapy for unresectable biliary carcinoma; however, there is no consensus regarding the use of hilar biliary drainage. In this study, we examined the efficacy of endoscopic over 3-branched biliary drainage using self-expandable metallic stents (SEMSs) in patients with unresectable malignant hilar biliary stricture (HBS).Methods:A total of 77 patients with unresectable HBS treated with a SEMS and chemotherapy were retrospectively reviewed. There were 59 patients with cholangiocarcinoma and 18 patients with gallbladder carcinoma. The patients were divided into 2 groups (4- or 3-branched group and 2- or 1-branched group) and compared with respect to the duration of stent patency and overall survival.Results:A comparison of the patients' baseline characteristics showed no significant differences between the 4- or 3-branched group and the 2- or 1-branched group. Neither the duration of patency nor survival time exhibited significant differences between the 2 groups, although, among the patients achieving disease control , the duration of patency period and survival time of the 4- or 3-branched group were significantly higher than those observed in the 2- or 1-branched group (P=0.0231 and 0.0466).Conclusions:The use of endoscopic over 3-branched biliary drainage with a SEMS may improve the duration of patency in patients with HBS.

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  • Successful biliary drainage using a metal stent through the gastric stoma 査読

    Kazuyuki Matsumoto, Hironari Kato, Koichiro Tsutsumi, Yutaka Akimoto, Daisuke Uchida, Takeshi Tomoda, Naoki Yamamoto, Yasuhiro Noma, Shigeru Horiguchi, Hiroyuki Okada, Kazuhide Yamamoto

    WORLD JOURNAL OF GASTROENTEROLOGY   21 ( 24 )   7594 - 7597   2015年6月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:BAISHIDENG PUBLISHING GROUP INC  

    We report a case of biliary drainage for malignant stricture using a metal stent with an ultrathin endoscope through the gastric stoma. A 78-year-old female was referred to our hospital for jaundice and fever. She had undergone percutaneous endoscopic gastrostomy (PEG) for esophageal obstruction after radiation therapy for cancer of the pharynx. Abdominal contrast-enhanced computed tomography showed a 3-cm enhanced mass in the middle bile duct and dilatation of the intrahepatic bile duct. We initially performed endoscopic retrograde cholangiopancreatography (ERCP) with a trans-oral approach. However, neither the side-viewing endoscope nor the ultrathin endoscope passed through the esophageal orifice. Thus, we eventually performed ERCP via the PEG stoma using an ultrathin endoscope. We performed biliary drainage with a 6F introducer self-expanding metal stent. The cytology findings obtained by brush cytology showed malignancy. Her laboratory results were restored to normal levels after drainage and no complication occurred.

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  • PNETの集学的治療 当院及び関連病院におけるPNET治療についての検討

    堀口 繁, 加藤 博也, 秋元 悠, 内田 大輔, 松本 和幸, 友田 健, 野間 康宏, 山本 直樹, 堤 康一郎, 伏見 聡一郎, 藤井 雅邦, 植木 亨, 八木 孝仁, 山本 和秀

    膵臓   30 ( 3 )   320 - 320   2015年5月

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    記述言語:日本語   出版者・発行元:(一社)日本膵臓学会  

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  • 膵疾患の分子病態 Basics and Applications 網羅的糖鎖解析によるIPMNの悪性度診断能の検討

    秋元 悠, 能祖 一裕, 加藤 博也, 宮原 孝治, 内田 大輔, 友田 健, 松本 和幸, 野間 康宏, 山本 直樹, 堀口 繁, 堤 康一郎, 岡田 裕之, 山本 和秀

    膵臓   30 ( 3 )   268 - 268   2015年5月

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    記述言語:日本語   出版者・発行元:(一社)日本膵臓学会  

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  • 胆管空腸吻合術後の肝内結石治療に対するDB-ERCPの有用性と工夫

    堤 康一郎, 加藤 博也, 内田 大輔, 秋元 悠, 友田 健, 松本 和幸, 野間 康宏, 山本 直樹, 堀口 繁, 岡田 裕之, 山本 和秀

    Gastroenterological Endoscopy   57 ( Suppl.1 )   765 - 765   2015年4月

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    記述言語:日本語   出版者・発行元:(一社)日本消化器内視鏡学会  

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  • 巨大結石に対するEPLBDの有用性及び安全性の検討 超高齢者に対してもEPLBDは安全に施行可能か?

    友田 健, 加藤 博也, 秋元 悠, 内田 大輔, 松本 和幸, 野間 康宏, 山本 直樹, 堀口 繁, 堤 康一郎, 岡田 裕之, 山本 和秀

    Gastroenterological Endoscopy   57 ( Suppl.1 )   740 - 740   2015年4月

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    記述言語:日本語   出版者・発行元:(一社)日本消化器内視鏡学会  

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  • Potential of adenovirus-mediated REIC/Dkk-3 gene therapy for use in the treatment of pancreatic cancer 査読

    Daisuke Uchida, Hidenori Shiraha, Hironari Kato, Teruya Nagahara, Masaya Iwamuro, Junro Kataoka, Shigeru Horiguchi, Masami Watanabe, Akinobu Takaki, Kazuhiro Nouso, Yasutomo Nasu, Takahito Yagi, Hiromi Kumon, Kazuhide Yamamoto

    JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY   29 ( 5 )   973 - 983   2014年5月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:WILEY-BLACKWELL  

    Background and AimThe reduced expression in immortalized cells REIC/the dickkopf 3 (Dkk-3) gene, tumor suppressor gene, is downregulated in various malignant tumors. In a prostate cancer study, an adenovirus vector carrying the REIC/Dkk-3 gene (Ad-REIC) induces apoptosis. In the current study, we examined the effects of REIC/Dkk-3 gene therapy in pancreatic cancer.
    MethodsREIC/Dkk-3 expression was assessed by immunoblotting and immunohistochemistry in the pancreatic cancer cell lines (ASPC1, MIAPaCa2, Panc1, BxPC3, SUIT-2, KLM1, and T3M4) and pancreatic cancer tissues. The Ad-REIC agent was used to investigate the apoptotic effect in vitro and antitumor effects in vivo. We also assessed the therapeutic effects of Ad-REIC therapy with gemcitabine.
    ResultsThe REIC/Dkk-3 expression was lost in the pancreatic cancer cell lines and decreased in pancreatic cancer tissues. Ad-REIC induced apoptosis and inhibited cell growth in the ASPC1 and MIAPaCa2 lines in vitro, and Ad-REIC inhibited tumor growth in the mouse xenograft model using ASPC1 cells. The antitumor effect was further enhanced in combination with gemcitabine. This synergistic effect may be caused by the suppression of autophagy via the enhancement of mammalian target of rapamycin signaling.
    ConclusionsAd-REIC induces apoptosis and inhibits tumor growth in pancreatic cancer cell lines. REIC/Dkk-3 gene therapy is an attractive therapeutic tool for pancreatic cancer.

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  • Effect of hepatic arterial infusion chemotherapy of 5-fluorouracil and cisplatin for advanced hepatocellular carcinoma in the nationwide survey of primary liver cancer in Japan 査読

    K. Nouso, K. Miyahara, D. Uchida, K. Kuwaki, N. Izumi, M. Omata, T. Ichida, M. Kudo, Y. Ku, N. Kokudo, M. Sakamoto, O. Nakashima, T. Takayama, O. Matsui, Y. Matsuyama, K. Yamamoto

    British Journal of Cancer   109 ( 7 )   1904 - 1907   2013年10月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Background:The efficacy of hepatic arterial infusion chemotherapy for the treatment of advanced hepatocellular carcinoma (HCC) remains unclear.Methods:The outcome of 476 patients with HCC who underwent hepatic arterial infusion chemotherapy with 5-fluorouracil and cisplatin (HAIC) were compared with 1466 patients who did not receive active therapy.Results:A survival benefit of the therapy after adjusting for known risk factors was observed (hazard ratio, 0.48
    95% CI, 0.41-0.56
    P&lt
    0.0001). In propensity score-matched analysis (n=682), median survival time was longer for patients who underwent chemotherapy (14.0 months) than for patients who did not receive active treatment (5.2 months, P&lt
    0.0001).Conclusion:For advanced HCC, HAIC is considered to be an effective treatment. © 2013 Cancer Research UK.

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  • 当院におけるTherapeutic EUSの現状

    内田 大輔, 加藤 博也, 友田 健, 松本 和幸, 榊原 一郎, 山本 直樹, 野間 康弘, 園山 隆之, 堤 康一郎, 山本 和秀

    Gastroenterological Endoscopy   54 ( Suppl.2 )   2780 - 2780   2012年9月

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    記述言語:日本語   出版者・発行元:(一社)日本消化器内視鏡学会  

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  • A case of celiac artery dissection diagnosed with EUS 査読

    Daisuke Uchida, Kazuhiro Nouso, Hironari Kato, Koichiro Tsutsumi, Kazuhide Yamamoto

    GASTROINTESTINAL ENDOSCOPY   76 ( 2 )   424 - 424   2012年8月

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    記述言語:英語   出版者・発行元:MOSBY-ELSEVIER  

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  • Classification of the bleeding pattern in colonic diverticulum is useful to predict the risk of bleeding or re-bleeding after endoscopic treatment 査読

    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

    Journal of Japanese Society of Gastroenterology   109 ( 3 )   393 - 399   2012年3月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

    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.

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  • Cerebral sinus thrombosis complicating ulcerative colitis 査読

    Asuka Nakarai, Ohe Hirotoki, Daisuke Uchida, Norifumi Numata, Yoko Kominami, Hiroshi Matsushita, Shintaro Nanba, Ota Shigeru, Tsuneyoshi Ogawa, Manabu Kurome, Toru Ueki, Masahiro Nakagawa, Yasuyuki Araki, Motowo Mizuno

    Journal of Japanese Society of Gastroenterology   108 ( 3 )   451 - 457   2011年3月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

    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.

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  • Dynamic computed tomography is useful for the diagnosis and colonoscopic treatment of colonic diverticular bleeding 査読

    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

    Journal of Japanese Society of Gastroenterology   108 ( 2 )   223 - 230   2011年2月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

    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.

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  • A case of gangliocytic paraganglioma with lymphoid metastasis 査読

    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

    Journal of Japanese Society of Gastroenterology   107 ( 9 )   1456 - 1465   2010年9月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

    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.

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  • Carbon dioxide insufflation is useful for obtaining clear images of the bile duct during peroral cholangioscopy (with video) 査読

    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

    Gastrointestinal Endoscopy   71 ( 6 )   1046 - 1051   2010年5月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Background: 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 (CO2) yields clearer images of the bile duct than conventional saline solution irrigation during POCS. Objective: To evaluate the clinical utility and safety of CO2 insufflation into the bile duct to obtain clear images in POCS observations by comparing this method with conventional saline solution irrigation. Setting: A single center. Design: Case-control study. Patients: Nineteen patients with suspected biliary diseases. Interventions: CO2 insufflation into the bile duct during POCS. Main Outcome Measurements: The quality and safety of this method. Result: The quality of the images of the bile duct lumen with CO2 insufflation (10 patients) was significantly superior to those with saline solution irrigation (9 patients) in both clarity (P &lt
    .05) and color (P &lt
    .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 CO2 level during the procedure. Limitations: The number of patients examined was small. Conclusions: CO2 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. © 2010 American Society for Gastrointestinal Endoscopy.

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  • Outcomes of endoscopic treatment for malignant biliary obstruction in patients with surgically altered anatomy: analysis of risk factors for clinical failure. 国際誌

    Takeshi Tomoda, Hironari Kato, Kazuya Miyamoto, Akihiro Matsumi, Eijiro Ueta, Yuuki Fujii, Yousuke Saragai, Tatsuhiro Yamazaki, Daisuke Uchida, Kazuyuki Matsumoto, Shigeru Horiguchi, Koichiro Tsutsumi, Hiroyuki Okada

    Surgical endoscopy   35 ( 1 )   232 - 238   2020年1月

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    記述言語:英語  

    BACKGROUND: To evaluate the outcomes of endoscopic retrograde cholangiopancreatography (ERCP) for malignant biliary obstruction (MBO) using short-type double-balloon enteroscope (sDBE) in patients with surgically altered anatomy. METHODS: A total of 45 patients with surgically altered anatomy underwent ERCP using sDBE for the treatment of MBO between April 2011 and March 2019. We retrospectively evaluated the clinical and technical success (insertion and biliary intervention success), adverse events, and risk factors for clinical failure. RESULTS: The scope was successfully inserted in the target site in 82.2% of patients (37/45), and among them, biliary intervention success was achieved in 86.4% (32/37). The overall technical success rate was 71.1% (32/45) and clinical success rate was 68.9% (31/45), with an adverse event rate of 11.1%. In multivariate analysis, the presence of peritoneal dissemination (odds ratio, 7.3; 95% confidence interval, 1.5-43.5, p = 0.02) was as an independent risk factor for clinical failure. The clinical success rate was 38.5% in patients with peritoneal dissemination and 81.3% in those without peritoneal dissemination. CONCLUSION: Endoscopic treatment using sDBE in patients without peritoneal dissemination provided favorable outcomes, and it can be an initial treatment for MBO in patients with surgically altered anatomy.

    DOI: 10.1007/s00464-020-07385-y

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  • 【胆膵内視鏡トラブルシューティング-こうやって切り抜けろ-】EUS-HGSにおける手技の工夫 ダブルガイドワイヤー法について

    内田 大輔, 加藤 博也, 松三 明宏, 宮本 和也, 山崎 辰洋, 藤井 佑樹, 皿谷 洋祐, 友田 健, 松本 和幸, 堀口 繁, 堤 康一郎, 岡田 裕之

    胆と膵   40 ( 6 )   529 - 533   2019年6月

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    記述言語:日本語   出版者・発行元:医学図書出版(株)  

    超音波内視鏡下肝内胆管ドレナージ術(EUS-HGS)は、経乳頭的アプローチが困難な症例において、経皮的胆管ドレナージ術や外科的胆道再建術に替わる有用な胆道ドレナージ法であるが、手技的な困難性も相まって、胆汁性腹膜炎、出血、穿孔、ステント逸脱などの重篤な偶発症も報告されている。EUS-HGSの手技は穿刺、拡張、ステント留置と、多くのstepを要する手技であるが、これらの処置をより安全に行ううえで、安定したスコープ保持およびデバイスデリバリーのための処置軸の保持が重要である。当施設では、EUS-HGSをより安全に施行するために、ダブルガイドワイヤー法を用いている。ダブルガイドワイヤー法は、同軸に2本のガイドワイヤーを留置し処置軸を安定させることで、より安全にデバイスデリバリーを行う方法である。本稿では、ダブルガイドワイヤー法によるEUS-HGSの実際について画像を提示しながら解説する。(著者抄録)

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  • 【消化器ステンティングのすべて】胆膵 良性胆管狭窄における経乳頭的アプローチ

    加藤 博也, 内田 大輔, 友田 健, 松本 和幸, 堀口 繁, 岡田 裕之

    消化器内視鏡   31 ( 5 )   812 - 818   2019年5月

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    記述言語:日本語   出版者・発行元:(株)東京医学社  

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  • Immuno-Oncology時代の消化器がん診療 難治性消化器癌に対するREIC/Dkk-3遺伝子治療

    内田 大輔, 白羽 英則, 岡田 裕之

    日本消化器病学会雑誌   116 ( 臨増総会 )   A113 - A113   2019年3月

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    記述言語:日本語   出版者・発行元:(一財)日本消化器病学会  

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  • 膵・胆管合流異常に合併した胆嚢癌術後に膵管内乳頭粘液性腺癌(IPMC)を発生した1例

    池田 愛璃, 松本 和幸, 加藤 博也, 田中 顕之, 赤穂 宗一郎, 室 信一郎, 内田 大輔, 友田 健, 堀口 繁, 岡田 裕之

    日本消化器病学会雑誌   116 ( 3 )   241 - 248   2019年3月

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    記述言語:日本語   出版者・発行元:(一財)日本消化器病学会  

    症例は71歳、女性。胆管非拡張型の膵・胆管合流異常(PBM)および胆嚢隆起性病変に対して5年前に腹腔鏡下胆嚢摘出術を施行し、病理結果は胆嚢癌であった。術後、緩徐に主膵管が拡張し、頭部の主膵管内に腫瘤が出現したため膵頭十二指腸切除術を施行した。病理では主膵管内に乳頭状に発育する腫瘍であり、免疫染色で膵胆道型の膵管内乳頭粘液性腺癌と診断した。PBMでは膵臓の悪性腫瘍にも注意が必要である。(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=2019&ichushi_jid=J01118&link_issn=&doc_id=20190325280008&doc_link_id=130007610333&url=https%3A%2F%2Fci.nii.ac.jp%2Fnaid%2F130007610333&type=CiNii&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00003_1.gif

  • 【Biliary access大辞典】経乳頭的biliary access カニュレーションテクニック ESTナイフを用いたカニュレーションテクニック

    加藤 博也, 松三 明宏, 石原 裕基, 矢部 峻太郎, 室 信一郎, 内田 大輔, 友田 健, 松本 和幸, 堀口 繁, 岡田 裕之

    胆と膵   39 ( 臨増特大 )   975 - 980   2018年11月

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    記述言語:日本語   出版者・発行元:医学図書出版(株)  

    ESTナイフを用いたカニュレーションは、極端な見下ろしや見上げなど、乳頭の位置が通常のカテーテルでは挿管困難な位置にくる場合や、術後や腫瘍の浸潤のために消化管が固定され、スコープの動きが制限される場合に有用である。ESTナイフのスペックは、ブレードまでの先端長、ブレードの長さによってさまざまである。ブレード長については、基本的にブレードを鉗子口から完全に出した状態で操作するため、長くないほうが乳頭との距離を離さずにすむが、逆にあまりに短いとESTが困難となるのでバランスのとれたものを使用するとよい。造影法による挿管、wire-guidedによる挿管、両者を組み合わせての挿管、さまざまな方法があるが、カテーテルの向きを胆管軸に合わせるという基本的な部分は造影法と同様であるが、ESTナイフをカテーテルとして使用する独自のポイントもおさえておかなければならない。(著者抄録)

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  • 【胆膵ドレナージupdate】[胆道ドレナージ] 肝門部悪性胆道狭窄に対する経乳頭的胆道ドレナージ

    加藤 博也, 矢部 俊太郎, 室 信一郎, 内田 大輔, 友田 健, 松本 和幸, 堀口 繁, 岡田 裕之

    消化器内視鏡   30 ( 11 )   1523 - 1530   2018年11月

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    記述言語:日本語   出版者・発行元:(株)東京医学社  

    肝門部悪性胆道狭窄に対する経乳頭的胆道ドレナージは切除、非切除によってドレナージ領域や使用するステントが異なる。切除症例に対しては、残肝側をドレナージするのが原則であり、内視鏡的経鼻胆管ドレナージ(ENBD)を基本としたプラスチックステントによるドレナージを行う。非切除症例に対しては、re-interventionを含め手技的に可能であれば金属ステントによる両葉ドレナージを行う。金属ステントの両葉留置の方法として、従来のpartial stent-in-stent法(PSIS)に加え、デリバリーの細径化によりside-by-side法(SBS)による留置を行うことが可能となった。PSISでは、2本目の留置の際のステントの間隙をガイドワイヤーやカテーテル、さらにはステントデリバリーを通過させることが、また、SBSでは展開の際ステントの乳頭側を一致させることが手技上のポイントである。いずれの手技も普段からガイドワイヤーや金属ステントの扱いに慣れておくことが重要である。(著者抄録)

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  • REIC/Dkk-3遺伝子導入における胆道癌の新規治療法開発

    田中 瑛美, 内田 大輔, 白羽 英則, 加藤 博也, 岡田 裕之

    日本消化器病学会雑誌   115 ( 臨増大会 )   A744 - A744   2018年10月

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    記述言語:日本語   出版者・発行元:(一財)日本消化器病学会  

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  • 良性胆道狭窄に対する内視鏡治療の現況

    加藤 博也, 内田 大輔, 友田 健, 松本 和幸, 堀口 繁, 岡田 裕之

    胆道   32 ( 4 )   732 - 742   2018年10月

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    記述言語:日本語   出版者・発行元:日本胆道学会  

    良性胆管狭窄の内視鏡治療は、ガイドワイヤーによる狭窄突破、狭窄部拡張、ステント留置が基本的な流れである。ステントについてはメタリックステント(MS)の有用性の報告が多く見られる。狭窄の改善率や再狭窄率において、プラスティックステント(PS)の複数本留置とMS留置に大きな差はないが、手技的にはMS留置の方が容易であり、交換頻度も少ないという点で有用である。実際の治療においては原疾患によって治療のストラテジーが異なることを理解しておかなければならない。慢性膵炎は術後胆管狭窄と比較して狭窄の改善率が低く、再狭窄率も高いため、症例によっては手術も選択肢の一つとなる。一方、術後胆管狭窄はいったん改善すれば長期予後も良好であるが、生体肝移植後は手技成功率やステント抜去率が低く治療が難しい傾向にある。原発性硬化性胆管炎に伴う胆管狭窄は、PS留置の前に胆管拡張のみで経過をみることが感染回避に重要である。(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=2018&ichushi_jid=J02149&link_issn=&doc_id=20181107090004&doc_link_id=10.11210%2Ftando.32.732&url=https%3A%2F%2Fdoi.org%2F10.11210%2Ftando.32.732&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

  • 膵癌術後再発に対するEUS-FNAの有用性 洗浄液を用いた遺伝子変異解析も含めて

    松本 和幸, 加藤 博也, 赤穂 宗一郎, 吉田 龍一, 楳田 祐三, 信岡 大輔, 皿谷 洋祐, 高田 斎文, 室 信一郎, 内田 大輔, 友田 健, 堀口 繁, 能祖 一裕, 八木 孝仁, 岡田 裕之

    膵臓   33 ( 3 )   516 - 516   2018年5月

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    記述言語:日本語   出版者・発行元:日本膵臓学会  

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  • "消化管吻合部の縫合線"を利用した、術後再建腸管症例に対するERCPのスコープ挿入手技

    堤 康一郎, 加藤 博也, 堀口 繁, 松本 和幸, 友田 健, 内田 大輔, 秋元 悠, 室 信一郎, 水川 翔, 岡田 裕之

    Gastroenterological Endoscopy   59 ( 8 )   1644 - 1652   2017年8月

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    記述言語:日本語   出版者・発行元:(一社)日本消化器内視鏡学会  

    術後再建腸管を有する胆膵疾患に対するERCPは、バルーン内視鏡の開発により可能となった。しかし手技の標準化はなされておらず、複雑な分岐を伴う再建術式(膵頭十二指腸切除後Child変法、胃切除後Billroth-II法、胃切除後および胃温存Roux-en-Y法)に対し、試行錯誤しながら、目的部位への到達を目指して挿入を試みているのが現状である。われわれは、空腸空腸吻合部での挿入方向の判別方法として"吻合部の縫合線"を利用し、高い目的部位到達率を得ている(95.6%[347/363])。正確な挿入陰向の判別によって、術者のストレス軽減に加え、挿入時間の短縮や安全で確実な手技遂行の達成が期待される。(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=2017&ichushi_jid=J00192&link_issn=&doc_id=20170912190007&doc_link_id=10.11280%2Fgee.59.1644&url=https%3A%2F%2Fdoi.org%2F10.11280%2Fgee.59.1644&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_2.gif

  • Gender Differences in Clinicopathological Features of 20 Cases With Solid Pseudopapillary Neoplasms of the Pancreas

    Yutaka Akimoto, Hironari Kato, Ryo Harada, Daisuke Uchida, Hiroyuki Seki, Takeshi Tomoda, Kazuyuki Matsumoto, Naoki Yamamoto, Shigeru Horiguchi, Koichiro Tsutsumi, Shin-ichiro Muro, Toru Ueki, Shinsuke Oda, Soichiro Fushimi, Takahito Yagi, Hiroyuki Okada

    PANCREAS   46 ( 6 )   831 - 831   2017年7月

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    記述言語:英語   掲載種別:研究発表ペーパー・要旨(国際会議)   出版者・発行元:LIPPINCOTT WILLIAMS & WILKINS  

    Web of Science

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  • 【ERCPのエキスパートを目指して】肝門部マルチステンティングの実際とコツ

    加藤 博也, 室 信一郎, 秋元 悠, 内田 大輔, 友田 健, 松本 和幸, 堀口 繁, 堤 康一郎, 河本 博文, 岡田 裕之

    消化器内視鏡   29 ( 5 )   879 - 884   2017年5月

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    記述言語:日本語   出版者・発行元:(株)東京医学社  

    悪性肝門部胆管狭窄に対するマルチステンティングを成功させるにはデバイスの知識が不可欠であり、特にガイドワイヤーの知識と適切な使い分けは重要である。(1)目的とする胆管を探るためのガイドワイヤー、(2)カテーテルや金属ステント(MS)を目的とする胆管へ運ぶためのガイドワイヤー、(3)2本目、3本目のMSを留置する際の目印となるガイドワイヤー、の3つが必要である。MSを留置する際は、その順序が重要であり、左葉あるいは右後区域の胆管への留置をまず先に行い、最後に右前区域の胆管に留置するのが基本である。細かなテクニックとして、バルーンによる前拡張を行うことや、狭窄突破困難な場合のSoehendra Stent Retriever(SSR)の使用法を理解しておかなければならない。介助者のテクニック、特にガイドワイヤーテクニックは成否を分ける要素となるので、日頃からスコープ操作のみならず、介助者としても技術を磨いておく必要がある。(著者抄録)

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  • 難治性肝細胞癌に対するREIC/Dkk-3を用いた遺伝子治療

    大山 淳史, 澤原 大明, 内田 大輔, 白羽 英則, 岡田 裕之

    肝臓   58 ( Suppl.1 )   A282 - A282   2017年4月

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    記述言語:日本語   出版者・発行元:(一社)日本肝臓学会  

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  • 膵神経内分泌腫瘍における液状化検体細胞診(LBC)を用いた免疫染色の有用性の検討

    秋元悠, 加藤博也, 田中顕之, 井上博文, 皿谷洋祐, 高田斎文, 水川翔, 室信一郎, 内田大輔, 友田健, 松本和幸, 堀口繁, 堤康一郎, 岡田裕之

    膵臓   32 ( 3 )   2017年

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  • Effectiveness and safety of peroral direct cholangioscopy using an ultraslim endoscope for the treatment of hepatolithiasis in patients with hepaticojejunostomy

    Kazuyuki Matsumoto, Koichiro Tsutsumi, Hironari Kato, Naoki Yamamoto, Shigeru Horiguchi, Yutaka Akimoto, Daisuke Uchida, Takeshi Tomoda, Hiroyuki Okada

    JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY   31   221 - 222   2016年11月

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    記述言語:英語   掲載種別:研究発表ペーパー・要旨(国際会議)   出版者・発行元:WILEY-BLACKWELL  

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  • 【胆膵内視鏡自由自在〜基本手技を学び応用力をつける集中講座〜】内視鏡システムと内視鏡操作に関する基本知識 術後再建腸管に対するバルーン内視鏡挿入操作の基本と挿入のコツ

    堤 康一郎, 加藤 博也, 水川 翔, 室 信一郎, 秋元 悠, 内田 大輔, 友田 健, 松本 和幸, 山本 直樹, 堀口 繁, 岡田 裕之

    胆と膵   37 ( 臨増特大 )   1137 - 1143   2016年11月

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    記述言語:日本語   出版者・発行元:医学図書出版(株)  

    術後再建腸管を有する胆膵疾患症例に対する内視鏡的アプローチは、バルーン内視鏡の開発、導入により、高い成功率で可能となってきた。また、2016年4月、ERCP関連処置におけるバルーン内視鏡加算が保険収載され、本手技のさらなる普及が期待される。しかし、その第一関門である目的部位(主乳頭や胆管空腸吻合部)への到達は、いまだ難渋することも少なくない。本稿では、術後再建腸管症例に対するバルーン内視鏡の挿入手技を安全、確実、かつ効率よく行うための基本操作とコツについて解説する。手術記録とスケッチの確認は必須で、とくに、"消化管吻合部の縫合線"は挿入ルートを決める際のメルクマールとして非常に有用である。また、アタッチメントの装着、CO2送気、適切な前処置や麻酔の施行が、挿入性向上や安全な手技遂行のために重要である。本手技の標準化に向けて、まずは術式、再建法の理解と、それに基づく挿入手技の確立が必要である。(著者抄録)

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  • 【Interventional EUSのすべて】胆道病変におけるEUS-FNAの実際

    加藤 博也, 松本 和幸, 水川 翔, 秋元 悠, 内田 大輔, 友田 健, 山本 直樹, 堀口 繁, 堤 康一郎, 岡田 裕之

    消化器内視鏡   28 ( 10 )   1607 - 1612   2016年10月

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    記述言語:日本語   出版者・発行元:(株)東京医学社  

    胆道病変に対してEUS-FNAを施行する際、常に念頭におく必要があるのは、胆汁漏出の危険性である。胆管のEUS-FNAにおいて、胆管の長軸方向に穿刺する場合には、胆管内にステントを留置して漏出の予防に努める。また、短軸方向に穿刺する場合は穿刺角度をスコープ位置や上下アングルで工夫し、胆管をかすめるように穿刺する。胆嚢のEUS-FNAにおいても、胆嚢壁を穿刺する場合には胆管と同様、内腔が針に当たらない角度、距離を調整して穿刺する。また、胆嚢腫瘍が体部あるいは底部に存在し、肝への浸潤が疑われる場合には、浸潤部を狙って穿刺するのも一つの方法である。また、良・悪性の診断のみであれば、近傍のリンパ節を穿刺して診断する場合もある。手技的に難易度の高い症例もあり、胆汁漏出という重篤な偶発症も起こりうるため、適応を十分考慮して行うことと、場合によっては肝実質やリンパ節の穿刺で代替するという発想が必要である。(著者抄録)

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  • Novel REIC/Dkk-3-encoding adenoviral vector as a promising therapeutic agent for pancreatic cancer

    H. Sawahara, H. Shiraha, D. Uchida, H. Kato, T. Nagahara, M. Iwamuro, J. Kataoka, S. Horiguchi, M. Watanabe, M. Sakaguchi, A. Takaki, K. Nouso, Y. Nasu, H. Kumon, H. Okada

    CANCER GENE THERAPY   23 ( 8 )   278 - 283   2016年8月

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    記述言語:英語   出版者・発行元:NATURE PUBLISHING GROUP  

    Reduced expression in immortalized cells (REIC)/dickkopf-3 (Dkk-3), a tumor suppressor gene, is downregulated in various cancers. We previously reported the tumor-inhibitory effects of the REIC/Dkk-3 gene, delivered by a conventional adenoviral vector (Ad-CAG-REIC) in pancreatic cancer. Here, we developed an Ad-REIC vector with a novel gene expression system, termed the super gene expression (SGE) system, and assessed its therapeutic effects relative to those of Ad-CAG-REIC in pantreatic cancer cells. Human pancreatic cancer cell lines ASPC1 and MIAPaCa2 were used. REIC/Dkk-3 expression was assessed by western blot analysis. Relative cell viability and apoptotic effects were examined in vitro. The anti-tumor effects of Ad-REIC treatment were assessed in the mouse xenograft model. Compared with Ad-CAG-REIC, Ad-SGE-REIC elicited a significant increase in REIC protein expression in the cells studied, Relative to Ad-CAG-REIC, Ad-SGE-REIC reduced cell viability and induced apoptosis in the ASPC1 and MIAPaCa2 cell lines in vitro, and achieved superior tumor growth inhibition in the mouse xenograft model. Compared with conventional Ad-REIC agents, Ad-SGE-REIC provided enhanced inhibitory effects against tumor growth. Our results indicate that Ad-SGE-REIC is an innovative therapeutic tool for pancreatic cancer.

    DOI: 10.1038/cgt.2016.31

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  • Treatment of Bile Duct Stones in Patients With Prior Hepaticojejunostomy: A Percutaneous Approach Using Cholangioscopy vs. an Endoscopic Approach Using Short Double-Balloon Enteroscopy

    Koichiro Tsutsumi, Hironari Kato, Shuntaro Yabe, Syo Mizukawa, Hiroyuki Seki, Yutaka Akimoto, Daisuke Uchida, Kazuyuki Matsumoto, Takeshi Tomoda, Naoki Yamamoto, Shigeru Horiguchi, Hiroyuki Okada

    GASTROINTESTINAL ENDOSCOPY   83 ( 5 )   AB619 - AB619   2016年5月

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    記述言語:英語   掲載種別:研究発表ペーパー・要旨(国際会議)   出版者・発行元:MOSBY-ELSEVIER  

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  • 胆嚢神経内分泌癌(NEC)の1例

    堀口 繁, 加藤 博也, 内田 大輔, 秋元 悠, 関 博之, 友田 健, 松本 和幸, 山本 直樹, 堤 康一郎, 植木 亨, 岡田 裕之

    胆道   30 ( 2 )   290 - 297   2016年5月

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    記述言語:日本語   出版者・発行元:日本胆道学会  

    胆嚢神経内分泌癌(Neuroendocrine carcinoma:NEC)は稀な疾患であり、既報の多くは症例報告にとどまっている。今回我々は超音波内視鏡下穿刺吸引法でNECと診断し切除標本にて腺癌成分を含まないことを証明しえた純粋な胆嚢NECを経験したので報告する。画像所見上、MRIの拡散強調画像にて病変部の拡散能の著明な低下がみられ、このことはNECの細胞密度の高さを反映しているものと考えられた。薬物治療は、現在までにプラチナ系薬剤を中心とした化学療法の有用性が報告されており本報告でもVP-16、CDDPを用いた化学療法(EP療法)を施行した。当院では本症例の他に、腺癌成分を併存する可能性のある胆嚢NECに対してEP療法を施行した2例を経験しており併せて考察を行う。本疾患は希少疾患のため未だ診断方法、治療についてコンセンサスを得られておらず、今後症例の集積を行うことが必要と考えられた。(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=2016&ichushi_jid=J02149&link_issn=&doc_id=20160620040016&doc_link_id=%2Fdw1tando%2F2016%2F003002%2F016%2F0290-0297%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fdw1tando%2F2016%2F003002%2F016%2F0290-0297%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

  • 膵Solid Pseudopapillary Neoplasm 20例の臨床病理学的特徴 性別による比較

    秋元 悠, 加藤 博也, 原田 亮, 内田 大輔, 關 博之, 友田 健, 松本 和幸, 山本 直樹, 堀口 繁, 堤 康一郎, 室 信一郎, 植木 亨, 小田 晋輔, 伏見 聡一郎, 八木 孝仁, 岡田 裕之

    膵臓   31 ( 2 )   135 - 144   2016年4月

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    記述言語:日本語   出版者・発行元:日本膵臓学会  

    当院および当院関連施設における膵Solid pseudopapillary neoplasm(以下、SPN)20例の臨床病理学的特徴につき、男女別に比較検討を行った。男性は4例(20%)、女性は16例(80%)であった。男性の年齢中央値は39歳と女性(年齢中央値29歳)より年齢が高い傾向にあり、男性が全例無症状であったのに対して女性では約半数で腹痛を認めた。画像所見は、男性で嚢胞を伴う症例が1例(25%)、石灰化を認める症例が1例(25%)であったのに対して、女性では嚢胞を伴う症例が13例(81%)、石灰化を認める症例が8例(50%)であった。FNAの正診率は男性で50%であったのに対して女性では92%であった。男性1例女性1例で血管浸潤を認めたが、リンパ節転移や遠隔転移は男女ともに認めなかった。全例で術後無再発生存しており男女間で臨床経過に差を認めなかった。(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=2016&ichushi_jid=J02025&link_issn=&doc_id=20160513040002&doc_link_id=%2Fcq0pancr%2F2016%2F003102%2F003%2F0135-0144%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fcq0pancr%2F2016%2F003102%2F003%2F0135-0144%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

  • 【膵疾患の分子病態】網羅的糖鎖解析によるIPMNの悪性度診断能の検討

    秋元 悠, 能祖 一裕, 加藤 博也, 宮原 孝治, 水川 翔, 矢部 俊太郎, 内田 大輔, 關 博之, 友田 健, 松本 和幸, 山本 直樹, 堀口 繁, 堤 康一郎, 岡田 裕之

    膵臓   31 ( 1 )   25 - 31   2016年2月

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    記述言語:日本語   出版者・発行元:日本膵臓学会  

    糖鎖は、主として細胞表面に存在し細胞接着や情報伝達に関与している。癌に関しては、浸潤、転移の際に構造が変貌することが知られている。我々は、過去に膵癌、肝癌においてフコシル化多分枝糖鎖の高発現が診断や予後予測に有用であることを報告した。膵管内乳頭粘液腫瘍(IPMN)は、ガイドラインの絶対的手術適応にて切除しても、癌でない症例が約3〜4割含まれている。膵切除のリスクを考えると術前診断能は十分とは言えず、新たなバイオマーカーの開発が求められている。我々はIPMNの悪性度診断における網羅的糖鎖解析の有用性を検討し、invasive IPMNでフコシル化多分枝糖鎖の発現が有意に高いことを報告した。興味深いことに、最も診断能が高かったm/z3195糖鎖は、過去に我々が膵管癌の診断や予後との関連を示した糖鎖と同一であった。フコシル化多分枝糖鎖の高発現は、IPMNの悪性度診断に有用である可能性が示唆された。(著者抄録)

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  • Time-dependent image changes after ethanol injection into the pancreas: an experimental study using a porcine model. 国際誌

    Kazuyuki Matsumoto, Hironari Kato, Koichiro Tsutsumi, Soichiro Fushimi, Masaya Iwamuro, Shinsuke Oda, Sho Mizukawa, Yutaka Akimoto, Daisuke Uchida, Takeshi Tomoda, Naoki Yamamoto, Shigeru Horiguchi, Hiroyuki Okada

    Ecancermedicalscience   10   663 - 663   2016年

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    記述言語:英語  

    BACKGROUND: Ethanol, a commonly available agent, has been used to successfully ablate cystic and solid lesions in the pancreas. The aim of this study is to investigate the effects of an ethanol injection into the porcine pancreas and observe the time-dependent image changes in the pancreatic parenchyma. METHODS: Pure ethanol was injected into the pancreatic tail using a 25-gauge EUS needle with direct ultrasound guidance under celiotomy: 1 mL and 2 mL were injected, respectively. The abdomen was closed after the injection. MRI was performed before the procedure, immediately after, and on postoperative day (POD) seven. Blood samples were taken before the procedure and on PODs one, three, five, and seven. The pigs were euthanised on POD seven. RESULTS: Immediately after the injection, linear high signal areas in the pancreatic tail on T2 and rounded speckled high signal areas on DWI images were detected in both animals, measuring 35 × 32 mm in the 1 mL injected pig and 42 × 38mm in the 2 mL injected pig. After POD seven, rounded high signal areas were noted on T2 images, measuring 22 × 18 mm and 36 × 28 mm respectively. On POD one, the 1 mL injected animal had a 53% elevation in serum amylase while the 2 mL injected animal had a 66% elevation. Histologically, cystic and necrotic changes in the parenchyma were observed, measuring 23 × 22 mm and 40 × 35 mm respectively. CONCLUSIONS: Our results, which are limited to normal pancreas, suggested that a 1 mL injection caused localised changes within the pancreas while a 2 mL injection induced more widespread changes beyond the pancreas. The effective area of ethanol was widespread immediately after injection, and then the area was reduced with cystic and necrosis changes.

    DOI: 10.3332/ecancer.2016.663

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  • Clinical outcome of endoscopic double stenting for the treatment of malignant biliary and duodenal obstruction due to pancreatic cancer

    Kazuyuki Matsumoto, Hironari Kato, Koichiro Tsutsumi, Sho Mizukawa, Shuntaro Yabe, Yutaka Akimoto, Daisuke Uchida, Hiroyuki Seki, Takeshi Tomoda, Naoki Yamamoto, Shigeru Horiguchi, Hiroyuki Okada

    JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY   30   225 - 225   2015年12月

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    記述言語:英語   掲載種別:研究発表ペーパー・要旨(国際会議)   出版者・発行元:WILEY-BLACKWELL  

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  • エトポシドとシスプラチンの併用療法(EP療法)が著効し組織学的CRが得られた肝原発小細胞癌の1切除例

    秋元 悠, 堤 康一郎, 加藤 博也, 幡 英典, 榮 浩行, 内田 大輔, 友田 健, 松本 和幸, 野間 康宏, 山本 直樹, 堀口 繁, 原田 亮, 岡田 裕之, 柳井 広之, 八木 孝仁, 山本 和秀

    日本消化器病学会雑誌   112 ( 11 )   2024 - 2034   2015年11月

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    記述言語:日本語   出版者・発行元:(一財)日本消化器病学会  

    52歳女性。主訴は右上腹部痛。巨大な肝腫瘤と多発性肝腫瘤、胆嚢壁肥厚を認め、EUS-FNAにて小細胞癌と診断。エトポシド、シスプラチン併用療法が著効したため、根治目的に肝中央二区域・胆管切除術、胆嚢摘出術施行。病理では泡沫細胞の集簇を認め、viableな腫瘍細胞は認めなかった。画像、病理所見より、肝原発小細胞癌と最終診断した。化学療法著効後に根治切除でき、組織学的CRが得られた貴重な1例である。(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=2015&ichushi_jid=J01118&link_issn=&doc_id=20151113150011&doc_link_id=130005107579&url=https%3A%2F%2Fci.nii.ac.jp%2Fnaid%2F130005107579&type=CiNii&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00003_1.gif

  • FOLFIRINOX with modified regimen therapy for advanced pancreatic cancer in Okayama university hospital

    Shigeru Horiguchi, Hironari Kato, Yutaka Akimoto, Daisuke Uchida, Takeshi Tomoda, Kazuyuki Matsumoto, Naoki Yamamoto, Koichiro Tsutsumi, Junichiro Nasu, Kazuhide Yamamoto

    ANNALS OF ONCOLOGY   26   119 - 120   2015年11月

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    記述言語:英語   掲載種別:研究発表ペーパー・要旨(国際会議)   出版者・発行元:OXFORD UNIV PRESS  

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  • Serum oxidative-anti-oxidative stress balance is dysregulated in patients with non-alcoholic steatohepatitis and related hepatocellular carcinoma

    Yasuyuki Shimomura, Akinobu Takaki, Nozomu Wada, Daisuke Uchida, Yasuto Takeuchi, Tetsuya Yasunaka, Fusao Ikeda, Hideki Onishi, Kenji Kuwaki, Shinichiro Nakamura, Kazuhiro Nouso, Yasuhiro Miyake, Kazuko Koike

    HEPATOLOGY   62   1297A - 1297A   2015年10月

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    記述言語:英語   掲載種別:研究発表ペーパー・要旨(国際会議)   出版者・発行元:WILEY-BLACKWELL  

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  • 【ERCPマスターへのロードマップ】トラブルシューティング編 膵管プラスチックステント迷入に対する内視鏡的回収法

    松本 和幸, 加藤 博也, 堤 康一郎, 水川 翔, 矢部 俊太郎, 内田 大輔, 秋元 悠, 關 博之, 友田 健, 山本 直樹, 堀口 繁, 岡田 裕之

    胆と膵   36 ( 臨増特大 )   1081 - 1086   2015年10月

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    記述言語:日本語   出版者・発行元:医学図書出版(株)  

    内視鏡的膵管ステンティング(EPS)は、さまざまな膵疾患の治療に対し広く行われている。その一方で、EPSに伴う偶発症の一つに、まれであるがステント迷入がある。ステントの回収には内視鏡的回収法が最も低侵襲であり、まず試みられるべき手技であるが、膵管は径が細く、屈曲や狭窄も存在する場合があり回収に難渋することが多い。さらに、専用の回収デバイスが少ないため、さまざまなアイデアやテクニックを用いて回収を試みているのが現状である。われわれはステント迷入を迷入したステントの位置と膵管の状態により四つのTypeに分類した。すなわち、Type Aはステントが狭窄のない主膵管内に迷入しているもの、Type Bはステントが主膵管狭窄部を跨いで迷入しているもの、Type Cはステント近位側が主膵管狭窄部より奥に迷入しているもの、Type Dはステント近位側が分枝膵管内に迷入しているものである。それぞれのType別にステントの内視鏡的回収法について紹介する。(著者抄録)

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  • 【EUS下胆道ドレナージ〜EUS-BDの安全な導入へ向けて〜】EUS-BDにおける使用デバイスの選択 超音波内視鏡、穿刺針、ガイドワイヤー、ダイレーター

    加藤 博也, 水川 翔, 矢部 俊太郎, 秋元 悠, 内田 大輔, 關 博之, 友田 健, 松本 和幸, 山本 直樹, 堀口 繁, 堤 康一郎, 岡田 裕之

    胆と膵   36 ( 8 )   751 - 756   2015年8月

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    記述言語:日本語   出版者・発行元:医学図書出版(株)  

    EUS-BDはステント留置にいたるまでに、穿刺、ガイドワイヤーによるseeking、穿刺ルートの拡張、というステップを踏まなければならない。それぞれのステップにおけるデバイスに専用のものはなく、さまざまなデバイスを取捨選択して使用しているのが現状である。穿刺には19GのFNA針を用いるがスコープに負荷がかからない針を選択する必要がある。ガイドワイヤーはseeking性能とleading性能をともに有する0.025インチのガイドワイヤーが望ましいが、状況に応じてそれぞれの性能に秀でたガイドワイヤーに変更しなければならないこともあり、さまざまなガイドワイヤーの特徴を知っておかなければならない。穿刺ルートの拡張には通電による拡張と、非通電による拡張があるが、それぞれの利点、欠点を理解し、適切なデバイスを選択しなければならない。今後、EUS-BDをより普及させるためには専用のデバイスの開発が急務である。(著者抄録)

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  • Efficacy and Safety of Endoscopic Treatment of Hepatolithiasis Using a Short Double-Balloon Enteroscope in Patients With Prior Hepaticojejunostomy

    Koichiro Tsutsumi, Hironari Kato, Daisuke Uchida, Yutaka Akimoto, Kazuyuki Matsumoto, Takeshi Tomoda, Yasuhiro Noma, Naoki Yamamoto, Sigeru Horiguchi, Hiroyuki Okada, Kazuhide Yamamoto

    GASTROINTESTINAL ENDOSCOPY   81 ( 5 )   AB361 - AB361   2015年5月

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    記述言語:英語   掲載種別:研究発表ペーパー・要旨(国際会議)   出版者・発行元:MOSBY-ELSEVIER  

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  • Adenovirus-Mediated Overexpression of REIC/DKK-3 Inhibits Cell Growth and Induces Apoptosis in Pancreatic Cancer and Hepatocellular Carcinoma

    Sawahara Hiroaki, Hidenori Shiraha, Daisuke Uchida, Hironari Kato, Masami Watanabe, Hiromi Kumon, Yasutomo Nasu, Kazuhide Yamamoto

    GASTROENTEROLOGY   148 ( 4 )   S954 - S954   2015年4月

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    記述言語:英語   掲載種別:研究発表ペーパー・要旨(国際会議)   出版者・発行元:W B SAUNDERS CO-ELSEVIER INC  

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  • Oxidative Stress Balance Is Dysregulated in Cholangiocarcinoma That Could Be Improved With L-Carnitine Administration

    Daisuke Uchida, Akinobu Takaki, Yasuko Tomono, Kazuhide Yamamoto

    GASTROENTEROLOGY   148 ( 4 )   S967 - S967   2015年4月

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    記述言語:英語   掲載種別:研究発表ペーパー・要旨(国際会議)   出版者・発行元:W B SAUNDERS CO-ELSEVIER INC  

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  • REIC/Dkk-3遺伝子導入による肝細胞癌治療の検討

    澤原 大明, 内田 大輔, 白羽 英則, 永原 照也, 岩室 雅也, 片岡 淳朗, 堀口 繁, 竹内 康人, 桑木 健志, 大西 秀樹, 中村 進一郎, 高木 章乃夫, 能祖 一裕, 山本 和秀

    日本消化器病学会雑誌   112 ( 臨増総会 )   A345 - A345   2015年3月

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    記述言語:日本語   出版者・発行元:(一財)日本消化器病学会  

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  • γ-secretase inhibitorによるNotch経路阻害は膵癌幹細胞を阻害し抗癌剤治療効果を増強する可能性がある

    堀口 繁, 白羽 英則, 内田 大輔, 永原 照也, 片岡 淳朗, 岩室 雅也, 加藤 博也, 高木 章乃夫, 能祖 一裕, 山本 和秀

    日本消化器病学会雑誌   111 ( 臨増大会 )   A951 - A951   2014年9月

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    記述言語:日本語   出版者・発行元:(一財)日本消化器病学会  

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  • 膵/胆道癌の分子標的・免疫と治療応用 REIC/Dkk-3遺伝子による膵癌治療

    内田 大輔, 白羽 英則, 山本 和秀

    日本消化器病学会雑誌   111 ( 臨増大会 )   A702 - A702   2014年9月

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    記述言語:日本語   出版者・発行元:(一財)日本消化器病学会  

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  • 膵癌におけるγセクレターゼ阻害剤を用いた幹細胞抑制による抗癌剤増強効果の検討

    堀口 繁, 白羽 英則, 内田 大輔, 永原 照也, 片岡 淳朗, 岩室 雅也, 加藤 博也, 高木 章乃夫, 能祖 一裕, 山本 和秀

    膵臓   29 ( 3 )   553 - 553   2014年6月

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    記述言語:日本語   出版者・発行元:日本膵臓学会  

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  • The Efficacy of REIC/DKK-3 Gene Therapy for Pancreatic Cancer

    Daisuke Uchida, Hidenori Shiraha, Hironari Kato, Teruya Nagahara, Masaya Iwamuro, Junro Kataoka, Sigeru Horiguchi, Masami Watanabe, Yasutomo Nasu, Hiromi Kumon, Kazuhide Yamamoto

    GASTROENTEROLOGY   146 ( 5 )   S301 - S301   2014年5月

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    記述言語:英語   掲載種別:研究発表ペーパー・要旨(国際会議)   出版者・発行元:W B SAUNDERS CO-ELSEVIER INC  

    Web of Science

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  • 肝癌におけるNotchシグナル活性化とその治療ターゲットとしての可能性

    白羽 英則, 片岡 淳朗, 堀口 繁, 岩室 雅也, 永原 照也, 内田 大輔, 仁科 慎一, 竹内 康人, 桑木 健志, 大西 秀樹, 中村 進一郎, 高木 章乃夫, 能祖 一裕, 山本 和秀

    肝臓   55 ( Suppl.1 )   A229 - A229   2014年4月

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    記述言語:日本語   出版者・発行元:(一社)日本肝臓学会  

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  • 肝細胞癌は、肝星細胞と液性因子を介したインテラクションにより幹細胞化が進行する

    永原 照也, 白羽 英則, 内田 大輔, 岩室 雅也, 片岡 淳朗, 堀口 繁, 山本 和秀

    日本消化器病学会雑誌   111 ( 臨増総会 )   A273 - A273   2014年3月

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    記述言語:日本語   出版者・発行元:(一財)日本消化器病学会  

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  • γセクレターゼ阻害剤を用いた膵癌幹細胞治療についての検討

    堀口 繁, 白羽 英則, 内田 大輔, 永原 照也, 岩室 雅也, 片岡 淳朗, 加藤 博也, 高木 章乃夫, 能祖 一裕, 山本 和秀

    日本消化器病学会雑誌   111 ( 臨増総会 )   A289 - A289   2014年3月

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    記述言語:日本語   出版者・発行元:(一財)日本消化器病学会  

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  • REIC/Dkk-3遺伝子導入による膵癌治療の検討

    内田 大輔, 白羽 英則, 加藤 博也, 永原 照也, 岩室 雅也, 片岡 淳郎, 堀口 繁, 堤 康一郎, 那須 保友, 公文 裕巳, 山本 和秀

    膵臓   28 ( 3 )   371 - 371   2013年6月

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    記述言語:日本語   出版者・発行元:日本膵臓学会  

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  • 肝癌におけるRUNX3発現低下はNotchシグナルを介し癌幹細胞化とEMTを制御する

    白羽 英則, 片岡 淳朗, 堀口 繁, 岩室 雅也, 永原 照也, 内田 大輔, 仁科 慎一, 高木 章乃夫, 萩原 宏明, 桑木 健志, 大西 秀樹, 中村 進一郎, 能祖 一裕, 山本 和秀

    肝臓   54 ( Suppl.1 )   A151 - A151   2013年4月

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    記述言語:日本語   出版者・発行元:(一社)日本肝臓学会  

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  • RUNX3欠失はmultidrug resistant protein発現を介してgemcitabine感受性に影響を与える

    堀口 繁, 白羽 英則, 内田 大輔, 永原 照也, 片岡 淳朗, 岩室 雅也, 松原 稔, 加藤 博也, 高木 章乃夫, 能祖 一裕, 八木 孝仁, 山本 和秀

    日本消化器病学会雑誌   110 ( 臨増総会 )   A210 - A210   2013年2月

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    記述言語:日本語   出版者・発行元:(一財)日本消化器病学会  

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  • 肝癌EMTマーカーとしてのPIVKA-II

    白羽 英則, 堀口 繁, 岩室 雅也, 片岡 淳朗, 永原 照也, 内田 大輔, 高木 章乃夫, 萩原 宏明, 桑木 健志, 大西 秀樹, 中村 進一郎, 能祖 一裕, 山本 和秀

    日本消化器病学会雑誌   110 ( 臨増総会 )   A387 - A387   2013年2月

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    記述言語:日本語   出版者・発行元:(一財)日本消化器病学会  

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  • 膵癌において、CD44の発現は、RUNX3発現は逆相関する(CD44 expression correlates negatively with runt-related transcription factor 3 in pancreatic ductal adenocarcinoma)

    堀口 繁, 白羽 英則, 内田 大輔, 永原 照也, 岩室 雅也, 片岡 淳朗, 加藤 博也, 高木 章乃夫, 能祖 一裕, 山本 和秀

    日本癌学会総会記事   71回   179 - 180   2012年8月

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    記述言語:英語   出版者・発行元:日本癌学会  

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  • 肝細胞癌において、カルボキシラーゼ活性低下はEMT進行に寄与する(Deactivation of GGCX induced epithelial-mesenchymal transition in hepatocellular carcinoma)

    白羽 英則, 片岡 淳朗, 中村 進一郎, 能祖 一裕, 堀口 繁, 岩室 雅也, 永原 照也, 松原 稔, 内田 大輔, 桑木 健志, 萩原 宏明, 大西 秀樹, 山本 和秀

    日本癌学会総会記事   71回   142 - 142   2012年8月

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    記述言語:英語   出版者・発行元:日本癌学会  

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  • 肝細胞癌において、MRP発現とEMT進行は相関する(MRP expression correlates with epithelial-mesenchymal transition progression in hepatocellular carcinoma)

    片岡 淳朗, 白羽 英則, 中村 進一郎, 能祖 一裕, 堀口 繁, 岩室 雅也, 永原 照也, 松原 稔, 内田 大輔, 桑木 健志, 萩原 宏明, 大西 秀樹, 山本 和秀

    日本癌学会総会記事   71回   144 - 144   2012年8月

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    記述言語:英語   出版者・発行元:日本癌学会  

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受賞

  • PanCAN Young Investigator Award

    2013年7月   日本膵臓学会  

    内田 大輔

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共同研究・競争的資金等の研究

  • 膵神経内分泌腫瘍に対する治癒率向上と膵機能温存を目指した内視鏡的低侵襲治療法の開発

    研究課題/領域番号:23ck0106900h0001  2023年10月 - 2026年03月

    国立研究開発法人日本医療研究開発機構(AMED)  革新的がん医療実用化研究事業 

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    担当区分:研究分担者 

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  • 超音波内視鏡診断支援プログラムの社会実装に向けた基盤整備

    研究課題/領域番号:23K11932  2023年04月 - 2026年03月

    日本学術振興会  科学研究費助成事業 基盤研究(C)  基盤研究(C)

    内田 大輔

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    配分額:4680000円 ( 直接経費:3600000円 、 間接経費:1080000円 )

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  • 消化器がん幹細胞標的療法としての遺伝子治療開発

    研究課題/領域番号:23K07438  2023年04月 - 2026年03月

    日本学術振興会  科学研究費助成事業  基盤研究(C)

    白羽 英則, 岩室 雅也, 大西 秀樹, 堀口 繁, 内田 大輔, 竹内 康人

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    配分額:4550000円 ( 直接経費:3500000円 、 間接経費:1050000円 )

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  • 胆膵癌に対する抗PD-1モノクローナル抗体併用REIC遺伝子治療

    2019年04月 - 2022年03月

    日本学術振興会  科学研究費補助金 若手研究 

    内田 大輔

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    担当区分:研究代表者  資金種別:競争的資金

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  • 抗癌剤耐性胆膵癌における耐性獲得機序の解明とREIC遺伝子治療の有効性の検討

    2017年04月 - 2019年03月

    日本学術振興会  科学研究費補助金 若手研究(B) 

    内田 大輔

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    担当区分:研究代表者  資金種別:競争的資金

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  • 消化器癌における新規癌関連遺伝子REICの機能解析と臨床応用に関する研究

    2015年04月 - 2017年03月

    日本学術振興会  科学研究費補助金 基盤研究(C) 

    加藤 博也

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    資金種別:競争的資金

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