Faculty Profiles - MATSUMOTO Kazuyuki

Papers - MATSUMOTO Kazuyuki

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Anti-programmed cell death-1 antibody as a new serological marker for type 1 autoimmune hepatitis. International journal

Kazuyuki Matsumoto, Yasuhiro Miyake, Hiroshi Matsushita, Atsuyuki Ohnishi, Fusao Ikeda, Hidenori Shiraha, Akinobu Takaki, Kazuhiro Nouso, Kazuhide Yamamoto

Journal of gastroenterology and hepatology 29 ( 1 ) 110 - 5 2014.1

Language：English Publishing type：Research paper (scientific journal)

BACKGROUND AND AIM: Recently, the association of the dysfunction of programmed cell death (PD)-1 expressed on activated lymphocytes with the pathogenesis of autoimmune hepatitis (AIH) has been speculated. This study aimed to investigate the association of serum anti-PD-1 antibodies with clinical characteristics of type 1 AIH. METHODS: Serum samples before the initiation of prednisolone treatment were obtained from 52 type 1 AIH patients, 24 patients with drug-induced liver injury (DILI), 30 patients with acute viral hepatitis (AVH), 11 patients with primary sclerosing cholangitis (PSC), and 62 healthy volunteers. Titers of serum anti-PD-1 antibodies were measured by indirect enzyme-linked immunosorbent assay. The cutoff level was represented by a mean absorbance + 2 standard deviations in healthy volunteers. RESULTS: Prevalence of serum anti-PD-1 antibodies was 63% in type 1 AIH patients, 8% in DILI patients, 13% in AVH patients, 18% in PSC patients, and 3% in healthy volunteers. In type 1 AIH patients, titers of serum anti-PD-1 antibodies were correlated with serum levels of bilirubin (r = 0.31, P = 0.030) and alanine aminotransferase (r = 0.31, P = 0.027) but not serum immunoglobulin G levels. Positivity for serum anti-PD-1 antibodies was associated with the later normalization of serum alanine aminotransferase levels after the initiation of prednisolone and the disease relapse. CONCLUSIONS: Serum anti-PD-1 antibodies would be useful for the discrimination of type 1 AIH from DILI, AVH, and PSC as an auxiliary diagnostic marker. Furthermore, anti-PD-1 antibodies may be associated with clinical characteristics of type 1 AIH.

DOI： 10.1111/jgh.12340

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Usefulness of early-phase peritoneal lavage for treating severe acute pancreatitis.

Kazuyuki Matsumoto, Yasuhiro Miyake, Morihito Nakatsu, Tatsuya Toyokawa, Masaharu Ando, Mamoru Hirohata, Hironari Kato, Kazuhide Yamamoto

Internal medicine (Tokyo, Japan) 53 ( 1 ) 1 - 6 2014

Language：English Publishing type：Research paper (scientific journal)

OBJECTIVE: To improve the prognosis of severe acute pancreatitis, preventing infectious complications, particularly infected pancreatic necrosis, is important. The present study evaluated the efficacy of peritoneal lavage for improving the prognosis of patients with severe acute pancreatitis. PATIENTS: We retrospectively reviewed the cases of 23 consecutive patients with severe acute pancreatitis who were treated with peritoneal lavage. RESULTS: Peritoneal lavage was started within 72 hours after the initial onset of symptoms in 20 patients (87%). The duration of peritoneal lavage, which was significantly correlated with the number of prognostic factors according to the revised Japanese criteria, Ranson score and serum C-reactive protein level at the start of peritoneal lavage, was a median of seven (3-22) days. There were no adverse events associated with the peritoneal lavage. Eight patients (35%) concurrently underwent continuous regional arterial infusion. Five days after starting peritoneal lavage, the patients' clinical conditions significantly improved. Overall, the survival rate was 96%. One patient (4%) died due to rupture of a pseudoaneurysm of the splenic artery. Complications occurred in seven patients (30%). Infectious complications were observed in three patients (13%) (one patient developed infected pancreatic necrosis and bacteremia, and two patients developed bacteremia). Pseudocysts and pancreatic fistulas developed in five and one patient, respectively. The incidence of complications was lower in the patients receiving peritoneal lavage within 72 hours from the initial onset of symptoms than in the remaining patients (20% vs. 100%; p=0.005). CONCLUSION: We speculate that peritoneal lavage reduces the mortality and incidence of complications in patients with severe acute pancreatitis.

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A case of delayed bleeding 9 days after endoscopic ultrasound-guided pancreatic pseudocyst drainage. International journal

Tomoaki Matsumori, Akio Katanuma, Hiroyuki Maguchi, Kuniyuki Takahashi, Manabu Osanai, Kei Yane, Toshifumi Kin, Ryo Takaki, Kazuyuki Matsumoto, Katsushige Gon, Akiko Tomonari

Endoscopy 46 Suppl 1 UCTN E245-6 2014

Successful removal of a pancreatic duct stone in a patient with Whipple resection, using a short single-balloon enteroscope with a transparent hood. International journal

Kei Yane, Akio Katanuma, Manabu Osanai, Hiroyuki Maguchi, Kuniyuki Takahashi, Toshifumi Kin, Ryo Takaki, Kazuyuki Matsumoto, Katsushige Gon, Tomoaki Matsumori, Akiko Tomonari

Endoscopy 46 Suppl 1 UCTN E86-7 2014

ENDOSCOPIC BALLOON DILATATION USING A SHORT SINGLE- BALLOON ENTEROSCOPE IN A PATIENT WITH AN ANASTOMOTIC STRICTURE AFTER PANCREATICODUODENECTOMY FOR INTRADUCTAL PAPILLARY MUCINOUS NEOPLASM : A CASE REPORT

YANE Kei, MAGUCHI Hiroyuki, OSANAI Manabu, TAKAHASHI Kuniyuki, KATANUMA Akio, KIN Toshifumi, TAKAKI Ryo, MATSUMOTO Kazuyuki, GON Katsushige, MATSUMORI Tomoaki, TOMONARI Akiko

Gastroenterological Endoscopy 56 ( 3 ) 477 - 483 2014

Language：Japanese Publisher：Japan Gastroenterological Endoscopy Society

A 53-year-old woman had undergone pancreaticoduodenectomy (SSPPD-IIA) for an intraductal papillary mucinous neoplasm (IPMN) in November 2009. Nineteen months after the surgery, abdominal CT showed a dilated remnant main pancreatic duct and a small soft tissue density mass. Findings suggested a pancreaticojejunal anastomosis stricture or a recurrent IPMN. Subsequently, the patient was admitted to our hospital with acute pancreatitis. We tried to observe the pancreaticojejunal anastomosis using a prototype short single-balloon enteroscope (Short SBE). However, the first attempt at ERCP was unsuccessful due to difficulty in finding the anastomotic site. In a second attempt 25 months after the surgery it was possible to find the anastomosis using a Short SBE with a transparent hood. We performed balloon dilatation of the anastomotic stricture and removed white protein plugs. The filling defects in the main pancreatic duct disappeared following pancreatography, and it was decided that there was no apparent tumor recurrence. During the following 14 months, no recurrence of the IPMN or pancreatitis has occurred. ERCP using Short SBE is a useful option for the management of a pancreaticojejunal anastomosis stricture.

DOI： 10.11280/gee.56.477

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Other Link： http://search.jamas.or.jp/link/ui/2014178210

Serial changes of serum growth factor levels and liver regeneration after partial hepatectomy in healthy humans. International journal

Kazuyuki Matsumoto, Yasuhiro Miyake, Yuzo Umeda, Hiroshi Matsushita, Hiroaki Matsuda, Akinobu Takaki, Hiroshi Sadamori, Kazuhiro Nouso, Takahito Yagi, Toshiyoshi Fujiwara, Kazuhide Yamamoto

International journal of molecular sciences 14 ( 10 ) 20877 - 89 2013.10

Language：English Publishing type：Research paper (scientific journal)

This study aimed to investigate the associations of the serial changes of serum levels of various growth factors with liver regeneration after hepatectomy in healthy liver donors. Sixteen healthy liver donors who underwent conventional liver resection were included. Serum levels of various growth factors before hepatectomy and on postoperative day (POD) 1, 3, 5 and 7 were measured. Liver volume data calculated by multi-detector computed tomography using workstation. The ratio of remnant liver volume on POD 0 to liver volume before the operation was 51% ± 20%. The ratio of liver volume on POD 14 to liver volume on POD 0 were inversely correlated with remnant liver volume on POD 0 (r = -0.91). The ratio of liver volume on POD 14 to liver volume on POD 0 were significantly correlated with serum hepatocyte growth factor (HGF) levels on POD 1 (r = 0.54), serum leptin levels on POD 1 (r = 0.54), and serum macrophage colony-stimulating factor (M-CSF) levels on POD 5 (r = 0.76) and POD 7 (r = 0.80). These results suggest that early-phase elevation of serum levels of HGF, leptin and M-CSF may be associated with the acceleration of liver regeneration after hepatectomy in humans.

DOI： 10.3390/ijms141020877

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[Two cases of lymphoepithelial cyst of the pancreas confirmed by contrast-enhanced endoscopic ultrasound].

Kazuyuki Matsumoto, Hironari Kato, Takeshi Tomoda, Ichiro Sakakihara, Yasuhiro Noma, Naoki Yamamoto, Takayuki Sonoyama, Koichiro Tsutsumi, Hiroshi Sadamori, Hiroyuki Okada, Takahito Yagi, Kazuhide Yamamoto

Nihon Shokakibyo Gakkai zasshi = The Japanese journal of gastro-enterology 110 ( 10 ) 1823 - 30 2013.10

Language：Japanese Publishing type：Research paper (scientific journal)

We report our experience with two cases of lymphoepithelial cysts (LECs) of the pancreas. Both patients were in their sixties. Contrast-enhanced computed tomography revealed masses in the pancreas with multilocular cystic lesions. Endoscopic ultrasound (EUS) findings presented highly echo-dense structures in the cystic masses; however, contrast-enhanced EUS revealed only the septum inside each mass without enhancing the dense structures. Contrast-enhanced EUS was useful for defining the contents in the cystic lesions; therefore, it may be useful for the diagnosis of LEC.

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造影EUSで観察した膵lymphoepithelial cystの2例

松本和幸, 加藤博也, 友田健, 榊原一郎, 野間康宏, 山本直樹, 園山隆之, 堤康一郎, 貞森裕, 岡田裕之, 八木孝仁, 山本和秀

日本消化器病学会雑誌 110 ( 10 ) 1823 - 1830 2013.10

A case of acute afferent loop syndrome treated by transgastric drainage with EUS. International journal

Kazuyuki Matsumoto, Hironari Kato, Takeshi Tomoda, Ichiro Sakakihara, Naoki Yamamoto, Yasuhiro Noma, Takayuki Sonoyama, Koichiro Tsutsumi, Hiroyuki Okada, Kazuhide Yamamoto, Hirofumi Kawamoto

Gastrointestinal endoscopy 77 ( 1 ) 132 - 3 2013.1

Efficacy, Safety, and Long-Term Follow-Up Results of EUS-Guided Transmural Drainage for Pancreatic Pseudocyst. International journal

Shin Kato, Akio Katanuma, Hiroyuki Maguchi, Kuniyuki Takahashi, Manabu Osanai, Kei Yane, Toshifumi Kim, Maki Kaneko, Ryo Takaki, Kazuyuki Matsumoto, Tomoaki Matsumori, Katsushige Gon, Akiko Tomonari

Diagnostic and therapeutic endoscopy 2013 924291 - 924291 2013

Language：English Publishing type：Research paper (scientific journal)

Background and Aim. EUS-guided transmural drainage (EUS-GTD) is now considered a minimally invasive and effective alternative to surgery for drainage of symptomatic pancreatic pseudocysts. However, the technique is rather difficult, and sometimes serious complications occur to patients undergoing this procedure. We retrospectively evaluated efficacy, safety, and long-term follow-up results of EUS-GTD for pancreatic pseudocyst. Methods. Sixty-seven patients with pancreatic pseudocyst who underwent EUS-GTD from April 2000 to March 2011 were enrolled. We retrospectively evaluated (1) technical success, (2) clinical success, (3) adverse event of procedure, and (4) long-term follow-up results. Results. Total technical success rate was 88%. Ninety-one percent of external drainage, 79% of internal drainage, and 66% of puncture and aspiration only achieved clinical success. There was only one case with an adverse event, perforation (1.5%). The case required emergency operation. Total recurrence rate was 23.9%. Median follow-up period was 33.9 months. The recurrence rates in the cases of stent remaining, spontaneously dislodged, removed on schedule, external tube removal, and aspiration only were 10.0%, 12.5%, 42.9%, 50%, and 0%, respectively. Conclusion. EUS-GTD is a relatively safe and effective therapeutic method. However, further analysis should be done by larger series to determine the method of EUS-GTD for pancreatic pseudocyst.

DOI： 10.1155/2013/924291

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Partial stent-in-stent placement of biliary metallic stents using a short double-balloon enteroscopy. International journal

Koichiro Tsutsumi, Hironari Kato, Takeshi Tomoda, Kazuyuki Matsumoto, Ichiro Sakakihara, Naoki Yamamoto, Yasuhiro Noma, Takayuki Sonoyama, Hiroyuki Okada, Kazuhide Yamamoto

World journal of gastroenterology 18 ( 45 ) 6674 - 6 2012.12

Language：English Publishing type：Research paper (scientific journal)

Endoscopic intervention is less invasive than percutaneous or surgical approaches and should be considered the primary drainage procedure in most cases with obstructive jaundice. Recently, therapeutic endoscopic retrograde cholangiopancreatography (ERCP) using double-balloon enteroscopy (DBE) has been shown to be feasible and effective, even in patients with surgically altered anatomies. On the other hand, endoscopic partial stent-in-stent (PSIS) placement of self-expandable metallic stents (SEMSs) for malignant hilar biliary obstruction in conventional ERCP has also been shown to be feasible, safe and effective. We performed PSIS placement of SEMSs for malignant hilar biliary obstruction due to liver metastasis using a short DBE in a patient with Roux-en-Y anastomosis and achieved technical and clinical success. This procedure can result in quick relief from obstructive jaundice in a single session and with short-term hospitalization, even in patients with surgically altered anatomies.

DOI： 10.3748/wjg.v18.i45.6674

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Peppermint oil solution is useful as an antispasmodic drug for esophagogastroduodenoscopy, especially for elderly patients. International journal

Atsushi Imagawa, Hidenori Hata, Morihito Nakatsu, Yasunari Yoshida, Keiko Takeuchi, Toshihiro Inokuchi, Takayuki Imada, Yoshiyasu Kohno, Masahiro Takahara, Kazuyuki Matsumoto, Hirokazu Miyatake, Satoru Yagi, Masaharu Ando, Mamoru Hirohata, Shigeatsu Fujiki, Ryuta Takenaka

Digestive diseases and sciences 57 ( 9 ) 2379 - 84 2012.9

Language：English Publishing type：Research paper (scientific journal)

BACKGROUND: Although hyoscine butyl bromide (HB) and glucagon (GL) are often used as antispasmodic drugs during esophagogastroduodenoscopy (EGD), these agents may cause adverse effects. Recently, it was reported that peppermint oil solution (PO) was very effective and had few side effects. AIM: We clarified the efficacy and usefulness of PO as an antispasmodic during upper endoscopy, especially for elderly patients. METHODS: This study was a non-randomized prospective study. The antispasmodic score (1-5, where 5 represents no spasm) was defined according to the degree of spasms of the antrum and difficulty of biopsy. We compared the antispasmodic scores between non-elderly patients (younger than 70) and elderly patients (70 years old or older) according to the antispasmodic agent. RESULTS: A total of 8,269 (Group PO: HB: GL: NO (no antispasmodic) = 1,893: 6,063: 157: 156) EGD procedures were performed. There was no significant difference in the antispasmodic score between Group PO (mean score ± standard deviation: 4.025 ± 0.925) and Group HB (4.063 ± 0.887). Among the non-elderly patients, those in Group PO (n = 599, 3.923 ± 0.935) had a worse antispasmodic score than those in Group HB (n = 4,583, 4.062 ± 0.876, P < 0.001). However, among the elderly patients, those in Group PO (n = 1,294, 4.073 ± 0.917) had similar scores to those in Group HB (n = 1,480, 4.064 ± 0.921, P = 0.83), and significantly better scores than those in Group GL (n = 69, 3.797 ± 0.933, P < 0.05). CONCLUSION: Peppermint oil was useful as an antispasmodic during EGD, especially for elderly patients.

DOI： 10.1007/s10620-012-2194-4

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Hydrogen-rich water prevents progression of nonalcoholic steatohepatitis and accompanying hepatocarcinogenesis in mice. International journal

Daisuke Kawai, Akinobu Takaki, Atsuko Nakatsuka, Jun Wada, Naofumi Tamaki, Tetsuya Yasunaka, Kazuko Koike, Ryuichiro Tsuzaki, Kazuyuki Matsumoto, Yasuhiro Miyake, Hidenori Shiraha, Manabu Morita, Hirofumi Makino, Kazuhide Yamamoto

Hepatology (Baltimore, Md.) 56 ( 3 ) 912 - 21 2012.9

Language：English Publishing type：Research paper (scientific journal)

UNLABELLED: Oxidative stress is a strong contributor to the progression from simple fatty liver to nonalcoholic steatohepatitis (NASH). Molecular hydrogen is an effective antioxidant that reduces cytotoxic reactive oxygen species. In this study, we investigated the effects of hydrogen-rich water and the drug pioglitazone on the progression of NASH in mouse models. A methionine-choline-deficient (MCD) diet mouse model was prepared. Mice were divided into three experimental groups and fed for 8 weeks as follows: (1) MCD diet + control water (CW group); (2) MCD diet + hydrogen-rich water (HW group); and (3) MCD diet mixed with pioglitazone (PGZ group). Plasma alanine aminotransferase levels, hepatic expression of tumor necrosis factor-α, interleukin-6, fatty acid synthesis-related genes, oxidative stress biomarker 8-hydroxydeoxyguanosine (8-OHdG), and apoptosis marker terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick-end labeling (TUNEL)-positive cells in the liver were decreased in the HW and PGZ groups. The HW group showed a smaller decrease in hepatic cholesterol; however, stronger antioxidative effects in serum and lower peroxisome proliferator-activated receptor-α expression in the liver were seen in comparison with the PGZ group. We then investigated the effects of hydrogen in the prevention of hepatocarcinogenesis in STAM mice, known as the NASH-related hepatocarcinogenesis model. Eight-week-old male STAM mice were divided into three experimental groups as follows: (1) control water (CW-STAM); (2) hydrogen-rich water (HW-STAM); and (3) pioglitazone (PGZ-STAM). After 8 weeks, hepatic tumors were evaluated. The number of tumors was significantly lower in the HW-STAM and PGZ-STAM groups than in the CW-STAM group. The maximum tumor size was smaller in the HW-STAM group than in the other groups. CONCLUSION: Consumption of hydrogen-rich water may be an effective treatment for NASH by reducing hepatic oxidative stress, apoptosis, inflammation, and hepatocarcinogenesis.

DOI： 10.1002/hep.25782

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Serum levels of soluble adhesion molecules as prognostic factors for acute liver failure. International journal

Atsuyuki Ohnishi, Yasuhiro Miyake, Hiroshi Matsushita, Kazuyuki Matsumoto, Akinobu Takaki, Tetsuya Yasunaka, Kazuko Koike, Fusao Ikeda, Hidenori Shiraha, Kazuhiro Nouso, Kazuhide Yamamoto

Digestion 86 ( 2 ) 122 - 8 2012

Language：English Publishing type：Research paper (scientific journal)

BACKGROUND/AIMS: In patients with septic shock, the degree of liver dysfunction is correlated with serum levels of soluble intercellular adhesion molecule (sICAM)-1. We aimed to assess the usefulness of serum levels of soluble adhesion molecules as prognostic factors for acute liver failure (ALF). METHODS: Serum levels of soluble platelet endothelial cell adhesion molecule (sPECAM)-1, sICAM-3, soluble endothelial (sE) selectin, sICAM-1, soluble platelet selectin, and soluble vascular cell adhesion molecule-1 on admission were measured in 37 ALF patients and 34 healthy controls. RESULTS: Twenty-two ALF patients (59%) reached to fatal outcomes. Serum levels of sPECAM-1, sICAM-3, sE-selectin and sICAM-1 were higher in ALF patients than healthy controls. In 37 ALF patients, by the multivariate logistic regression analysis, ratio of direct to total bilirubin (per 0.1 increase; OR 0.11, 95% CI 0.01-0.99), serum sPECAM-1 level (per 100 ng/ml increase; OR 4.37, 95% CI 1.23-15.5) and serum sICAM-1 level (per 100 ng/ml increase; OR 0.49, 95% CI 0.27-0.89) were associated with fatal outcomes. Using receiver operating characteristics curve, each area under the curve of serum sPECAM-1 and sICMA-1 levels as prognostic factors was 0.71 and 0.74, respectively. CONCLUSION: Serum sPECAM-1 and sICAM-1 levels may be useful for predicting the prognosis of ALF.

DOI： 10.1159/000339496

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Effect of low-dose gemcitabine on unresectable pancreatic cancer in elderly patients. International journal

Kazuyuki Matsumoto, Yasuhiro Miyake, Hironari Kato, Hirofumi Kawamoto, Atsushi Imagawa, Tatsuya Toyokawa, Morihito Nakatsu, Masaharu Ando, Mamoru Hirohata, Kazuhide Yamamoto

Digestion 84 ( 3 ) 230 - 5 2011

Language：English Publishing type：Research paper (scientific journal)

BACKGROUND/AIMS: The efficacy of gemcitabine (GEM) on unresectable pancreatic cancer has been reported. However, in elderly patients, severe toxicities are frequently observed. In this study we aimed to assess the efficacy of low-dose GEM on unresectable pancreatic cancer in elderly patients. METHODS: We reviewed 68 elderly patients (≥65 years) with unresectable pancreatic cancer. Thirty-six patients were treated with low-dose GEM (600-800 mg/m(2); GEM group), and the other 32 received best supportive care (BSC group). RESULTS: Median survival was 7.6 and 2.3 months in the GEM and BSC groups, respectively. In the GEM group, the median survival period was longer in 24 patients showing partial response or stable disease than in 12 patients showing progressive disease (11.4 vs. 5.3 months). Furthermore, the patients showing progressive disease had better 6-month survival than patients in the BSC group. Thirteen patients (36%) developed severe toxicities (grade 3 or 4). Low-dose GEM, stage of disease and performance status were associated with the prognosis. CONCLUSIONS: Low-dose GEM may improve the prognosis of elderly patients with unresectable pancreatic cancer. Furthermore, frequencies of severe toxicity seem lower in patients treated with low-dose GEM compared with previous reports.

DOI： 10.1159/000330384

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Large Waist Circumference Is a Risk Factor for Reflux Esophagitis in Japanese Males Reviewed

Hisae Yasuhara, Yasuhiro Miyake, Tatsuya Toyokawa, Kazuyuki Matsumoto, Masahiro Takahara, Takayuki Imada, Satoru Yagi, Hirokazu Miyatake, Morihito Nakatsu, Masaharu Ando, Mamoru Hirohata

DIGESTION 81 ( 3 ) 181 - 187 2010

A case of hepatic angiomyolipoma difficult to distinguish from hepatocellular carcinoma. International journal

Masahiro Takahara, Yasuhiro Miyake, Kazuyuki Matsumoto, Daisuke Kawai, Eisuke Kaji, Tatsuya Toyokawa, Morihito Nakatsu, Masaharu Ando, Mamoru Hirohata

World journal of gastroenterology 15 ( 23 ) 2930 - 2 2009.6

Language：English Publishing type：Research paper (scientific journal)

We report a case of hepatic angiomyolipoma with uncommon clinical features. A 56-year-old man presented with a hepatic tumor in the caudate lobe. The tumor was hypoechoic on ultrasonography, showed early-phase hyperattenuation on enhanced computed tomography and did not absorb iron on superparamagnetic iron oxide-enhanced magnetic resonance imaging. Hepatocellular carcinoma was highly suspected, and the patient underwent hepatic resection. Histologically, the tumor was mainly composed of smooth muscle cells and contained small amounts of adipose cells and blood vessels. On immunohistochemical staining, the smooth muscle cells were positive for a melanocytic cell-specific monoclonal antibody. In cases with uncommon features of angiomyolipoma, it is quite difficult to distinguish angiomyolipoma from hepatocellular carcinoma.

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A combination treatment of entecavir and early-phase corticosteroid in severe exacerbation of chronic hepatitis B. International journal

Kazuyuki Matsumoto, Yasuhiro Miyake, Hirokazu Miyatake, Masahiro Takahara, Takayuki Imada, Satoru Yagi, Tatsuya Toyokawa, Morihito Nakatsu, Masaharu Ando, Mamoru Hirohata

World journal of gastroenterology 15 ( 13 ) 1650 - 2 2009.4

Language：English Publishing type：Research paper (scientific journal)

Of patients with severe exacerbation of chronic hepatitis B accompanied by jaundice and coagulopathy, 20%-30% have a fatal outcome. In this report, we describe 2 cases of severe exacerbation of chronic hepatitis B with jaundice and coagulopathy who were successfully treated with a combination of entecavir and corticosteroid. In both cases, rapid reductions in serum hepatitis B virus (HBV)-DNA levels were observed, and corticosteroid was stopped after serum HBV-DNA levels became undetectable. Entecavir treatment was continued. Generally, entecavir treatment reduced serum HBV-DNA levels rapidly, although the improvement in liver function was delayed by a few weeks. During this time lag, liver cell injury continued and the disease progressed. Corticosteroid suppressed the excessive host immune response and was useful for stopping progressive deterioration. A combination of entecavir and early-phase corticosteroid may be a useful treatment in severe exacerbation of chronic hepatitis B.

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R-CHOP療法で完全寛解が得られた肝原発悪性リンパ腫の1例

浅木彰則, 三宅康広, 安東正晴, 安原ひさ恵, 松本和幸, 高原政宏, 河合大介, 加地英輔, 豊川達也, 大西亨, 宮谷克也, 中津守人

日本消化器病学会雑誌 106 ( 3 ) 389 - 396 2009.3

Low dose gemcitabine improves the prognosis of elderly patients with unresectable advanced pancreatic cancer Reviewed

Kazuyuki Matsumoto, Tatsuya Toyokawa, Yasuhiro Miyake, Hisae Yasumara, Masahiro Takahara, Eisuke Kaji, Morihito Nakatsu, Masaharu Ando, Mamoru Hirohata

GASTROENTEROLOGY 134 ( 4 ) A453 - A454 2008.4

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Papers - MATSUMOTO Kazuyuki