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BACKGROUND: Histone deacetylase (HDAC) class I and IIa are highly expressed in hepatocellular carcinoma (HCC) and associated with decreased survival. However, clinically used pan and class I inhibitors have serious adverse events. In this study, we assessed the antitumor effects and tolerability of class IIa HDAC inhibitor (HDACI) with lenvatinib, which is a standard therapy for HCC. METHODS AND RESULT: Combination therapy with class IIa HDACI and lenvatinib exerted synergistic antitumor effect in human HCC cell lines. In mouse models, this therapy showed significant antitumor effects, and few adverse events occurred. In immunoblotting, the expression of fibroblast growth factor receptor 4 (FGFR4) and fibroblast growth factor 19 (FGF19) was high in cell lines that showed a high antitumor effect. In addition, class IIa HDACI administration decreased the expression of FGFR4. In the small interfering RNA (siRNA) analysis, knockdown of HDAC9, which is an isoform of HDAC class IIa, reduced the expression of FGFR4 and induced apoptosis. Immunohistochemistry of human clinical specimens showed a positivity rate of 32% for FGFR4 and 84% for HDAC9 in HCC, and all FGFR4-positive patients were HDAC9 positive. CONCLUSION: Class IIa HDACI and lenvatinib combination therapy induces apoptosis by downregulating FGFR4 and blocking the FGFR signaling in FGFR4-positive HCC cell lines and has demonstrated synergistic antitumor effects and safety. This combination therapy overcomes the problems of conventional therapies and will be beneficial for FGFR4-positive HCC patients.

DOI： 10.1007/s12072-023-10484-2

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BACKGROUND: Albumin-bilirubin (ALBI) grade is an index of liver function based on total bilirubin (T-BIL) and albumin levels, and its usefulness has been widely reported. This study aimed to investigate the effect of different methods of measuring T-BIL and albumin levels on the ALBI grade in patients with liver disease. METHODS: In total, 170 patients from our hospital were included in this study. Correlations between T-BIL levels measured using the vanadate oxidation and enzymatic methods were analysed. Similarly, a correlation analysis of albumin levels between the bromocresol green (BCG) and modified bromocresol purple (BCP) methods was performed. Additionally, the ALBI grade was calculated for patients with liver disease, and the differences between each method of albumin measurement were compared. RESULTS: No differences were observed in the measured T-BIL values between the two methods. Contrastingly, the albumin levels of 100 random samples and 70 liver disease patients obtained using the modified BCP method were significantly lower than those measured using the BCG method. The rate of change in the modified ALBI grade between the BCG and BCP methods was 25.7%. CONCLUSIONS: Caution should be taken when comparing ALBI grades with those measured by other facilities because the method of albumin measurement can affect the ALBI grade. Standardization of albumin measurement is needed worldwide.

DOI： 10.1177/00045632221143685

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We investigated the association between iron overload, oxidative stress (8-oxo-7,8-dihydroguanine: 8-oxo-dG scores), Wnt/β-catenin pathway activation (expression of glutamine synthetase: GS), and tumor hyperintensity in the Gd-EOB-DTPA-enhanced MRI hepatobiliary phase (relative enhancement ratio: RER). This was a retrospective analysis of 94 hepatocellular carcinoma (HCC) patients who underwent surgical resection. In HBV-, HCV-, and alcohol-associated HCC, serum ferritin levels in the high and low RER groups were equivalent. In contrast, ferritin levels were elevated in the 'high RER' group of patients with nonalcoholic fatty liver disease (NAFLD)-HCC. As predictors of GS positivity, high RER had a sensitivity of 57.2% and a specificity of 100%. High serum ferritin had a sensitivity of 85.7% and a specificity of 85.7%. All cases with serum ferritin ≥275.5 ng/mL and high RER were 8-oxo-dG- and iron staining-positive. Additionally, GS positivity was seen in all cases with "serum ferritin levels above the upper limits or iron staining-positive" and '8-oxo-dG high' cases. Therefore, combining serum ferritin levels with RER may increase the accuracy with which activated Wnt/β-catenin signaling is predicted in NAFLD-HCC. We suggest that 8-oxo-dG accumulates following increased oxidative stress due to hepatic tissue iron deposition; this may activate Wnt/β-catenin signaling and trigger carcinogenesis.

DOI： 10.3390/cancers14092066

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A 50-year-old woman with adrenal Cushing's syndrome and chronic hepatitis C developed an acute exacerbation of chronic hepatitis C before adrenectomy. After administration of glecaprevir/pibrentasvir was started, her transaminase levels normalized promptly and a rapid virological response also was achieved. Laparoscopic left adrenectomy was then performed safely.

Other Link： https://onlinelibrary.wiley.com/doi/full-xml/10.1002/ccr3.5337

DOI： 10.1002/ccr3.5337

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A 77-year-old man was referred to our hospital because of a hepatic tumor. Blood biochemistry showed elevated serum alfa-fetoprotein, protein induced by vitamin K absence-II, and carbohydrate antigen 19-9 levels. Gd-EOB-DTPA-enhanced magnetic resonance imaging revealed a 95-mm-sized tumor in liver S7. The tumor showed heterogeneous hyperintensity in the arterial phase, slightly washed out from the portal vein phase, and hypointensity in the hepatocellular phase. Post-enlargement segmental resection was performed, and the pathological diagnosis was combined hepatocellular cholangiocarcinoma. Seven months after surgery, multiple liver tumors were found, and biopsy revealed combined hepatocellular-cholangiocarcinoma. Hepatic arterial infusion chemotherapy with cisplatin was initiated. However, the patient developed a pulmonary abscess, which was treated with antibiotics. He then underwent treatment with lenvatinib, 11 months after surgery. At 8 weeks follow-up, a complete response (according to the modified Response Evaluation Criteria in Solid Tumors [RECIST]) and a partial response (RECIST version 1.1) was noted. To the best of our knowledge, thus far, only a single case of lenvatinib treatment of unresectable mixed liver cancer has been reported. In that case, lenvatinib was used as a third-line treatment. The present report is the first to describe lenvatinib as a first-line therapy for unresectable combined hepatocellular-cholangiocarcinoma, which resulted in a meaningful response. This case provides useful insights into the choice of appropriate drug treatment in this disease in the absence of randomized controlled trials of drug treatment.

DOI： 10.1159/000523895

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Language：Japanese   Publisher：(一社)日本臨床検査医学会  

当院で2019年にアルブミン製剤が投与された436症例(男260例、女176例、年齢中央値67歳)、投与回数1808回を対象に、アルブミン製剤の適正使用について検討した。1808回中1748回(96.7%)で投与前にアルブミン値が測定されていた。アルブミン製剤の1回使用量は25g以下が93.4%、50g以上の使用は3.7%にみられた。適応病態別の投与回数は出血性ショック20回、敗血症・循環血漿量減少266回、人工心肺を使用する心臓手術84回、肝硬変131回、ネフローゼ12回、体外循環実施時39回、血漿交換70回、重症熱傷45回、肺水腫・浮腫1141回で、明らかな不適切使用はみられなかった。「使用指針」遵守率は出血性ショックで70%、低蛋白に起因する肺水腫・浮腫で77%、人工心肺を使用する心臓手術で87%、ネフローゼで92%、敗血症・循環血漿量減少で94%であった。他の病態では100%遵守されていると判断された。

Other Link： https://search.jamas.or.jp/default/link?pub_year=2021&ichushi_jid=J07482&link_issn=&doc_id=20220127350002&doc_link_id=%2Fco3rinsy%2F2021%2F006912%2F002%2F0903-0908%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fco3rinsy%2F2021%2F006912%2F002%2F0903-0908%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

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BACKGROUND AND AIM: Reliable predictors for hepatocellular carcinoma (HCC) are urgently needed. The psoas muscle index (PMI) is a simple and rapid method for evaluating muscle atrophy. Furthermore, the neutrophil/lymphocyte ratio (NLR) is a prognostic factor that is easy to calculate in everyday clinical practice. We aimed to investigate the value of the PMI and NLR as prognostic factors for patients receiving nonsurgical HCC therapy, hepatic arterial infusion chemotherapy (HAIC), transcatheter arterial chemoembolization (TACE), or molecular targeted drugs such as sorafenib (SOR) and lenvatinib (LEN). METHODS: We enrolled 87 patients with HCC who were treated with HAIC, TACE, SOR, or LEN. The primary endpoint was overall survival (OS) with variable PMI or NLR status. For Barcelona Clinic Liver Cancer (BCLC)-B patients, useful prognostic factors were examined by comparing the OS between stratified groups. Prognostic factors including PMI and NLR were evaluated by univariate and multivariate analysis. RESULTS: Analysis of HAIC or TACE (HAIC/TACE) and SOR or LEN (SOR/LEN) patients showed significant differences in OS between low and high PMI. In patients treated with TACE, there was a significant difference in OS between low and high NLR. For BCLC-B and low PMI, the prognosis was significantly worse for SOR/LEN than for TACE, although there was no difference for high PMI, suggesting that PMI may be useful for treatment selection. In addition, the prognostic formula composed of PMI, NLR, and up-to-seven criteria developed in the present study may be useful. CONCLUSION: PMI and NLR are considered to be independent prognostic factors for HCC.

Other Link： https://onlinelibrary.wiley.com/doi/full-xml/10.1002/jgh3.12676

DOI： 10.1002/jgh3.12676

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Springer Science and Business Media LLC  

<title>Abstract</title>Non-alcoholic steatohepatitis (NASH)-related HCC is associated with oxidative stress. However, the mechanisms underlying the development of NASH-related HCC is unclear. MUTYH is one of the enzymes that is involved in repair of oxidative DNA damage. The aim of this study was to investigate the association between MUTYH and NASH-related hepatocarcinogenesis. MUTYH wild-type (<italic>Mutyh</italic>^+/+), heterozygous (<italic>Mutyh</italic>^+/−), and MUTYH-null (<italic>Mutyh</italic>^−/−) mice were fed a high-fat high-cholesterol (HFHC) diet or HFHC + high iron diet (20 mice per group) for 9 months. Five of 20 <italic>Mutyh</italic>^−/− mice fed an HFHC + high iron diet developed liver tumors, and they developed more liver tumors than other groups (especially vs. Mutyh^+/+ fed an HFHC diet, <italic>P</italic> = 0.0168). Immunohistochemical analysis revealed significantly higher accumulation of oxidative stress markers in mice fed an HFHC + high iron diet. The gene expression profiles in the non-tumorous hepatic tissues were compared between wild-type mice that developed no liver tumors and MUTYH-null mice that developed liver tumors. Gene Set Enrichment Analysis identified the involvement of the Wnt/β-catenin signaling pathway and increased expression of <italic>c-Myc</italic> in MUTYH-null liver. These findings suggest that MUTYH deficiency is associated with hepatocarcinogenesis in patients with NASH with hepatic iron accumulation.

Other Link： http://www.nature.com/articles/s41598-021-83138-8

DOI： 10.1038/s41598-021-83138-8

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INTRODUCTION: In quantitative assays for hepatitis B virus (HBV) DNA, although the amplification reaction signal is detected for low-positive cases, quantification remains challenging. HBV reactivation has been reported in many studies, but only a few have focused on HBV low-positive cases. This study aimed to determine the reactivation rate and risk factors for HBV reactivation in low-positive cases. METHODS: In this retrospective cohort study, we analyzed 7498 patients who had their HBV DNA measured at Sapporo Medical University Hospital between April 2008 and November 2020. Patient selection criteria were defined as follows: hepatitis B surface antigen was negative; HBV DNA was detectable but not quantifiable at least once. HBV DNA was monitored according to the guidelines for HBV reactivation. RESULTS: In total, 49,086 HBV DNA quantitative tests were performed. HBV DNA levels of 2578 tests were detectable but not quantifiable. Eighty patients met the criteria in this study. The median observation period was 497 days, and the 2-year reactivation rate was 15%. Ten patients had low HBV DNA positivity at baseline. Malignant lymphoma was observed in 15 patients; chemotherapy was used to treat other solid tumors in 35 patients, and immunosuppressive therapy was used in 30 patients. Multivariate analysis revealed that HBV DNA detected below the quantification level at baseline was an independent risk factor for HBV reactivation (adjusted hazard ratio 5.82; P = 0.010). CONCLUSIONS: Patients with low HBV DNA positivity, especially at baseline, are at high risk for HBV reactivation and therefore require closer monitoring.

DOI： 10.1016/j.jiac.2021.06.009

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Language：Japanese   Publisher：(一社)日本臨床衛生検査技師会  

Other Link： https://search.jamas.or.jp/default/link?pub_year=2021&ichushi_jid=J02467&link_issn=&doc_id=20211019360023&doc_link_id=%2Fcg6jjomt%2F2021%2F007004%2F023%2F0773-0777%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fcg6jjomt%2F2021%2F007004%2F023%2F0773-0777%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

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Our pathological study of a case of poorly differentiated lymphocyte-rich hepatocellular carcinoma suggested that immune checkpoint inhibitor may be an effective therapy. The histological type is an important factor in determining treatment choices.

Other Link： https://onlinelibrary.wiley.com/doi/full-xml/10.1002/ccr3.4764

DOI： 10.1002/ccr3.4764

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Language：Japanese   Publisher：(株)医学書院  

Other Link： https://search.jamas.or.jp/default/link?pub_year=2021&ichushi_jid=J01561&link_issn=&doc_id=20210301120015&doc_link_id=10.11477%2Fmf.1413207125&url=https%3A%2F%2Fdoi.org%2F10.11477%2Fmf.1413207125&type=%E5%8C%BB%E6%9B%B8.jp_%E3%82%AA%E3%83%BC%E3%83%AB%E3%82%A2%E3%82%AF%E3%82%BB%E3%82%B9&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00024_2.gif

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Authorship：Corresponding author   Language：English   Publishing type：Research paper (scientific journal)   Publisher：Wiley  

It is sometimes difficult to distinguish between multiple cancers and metastases using only diagnostic imaging, particularly when multiple hypervascular tumors are found in multiple organs. We present a case in which the preoperative histological evaluation was essential to determine the management of a hypervascular pancreatic tumor and liver tumor.

Other Link： https://onlinelibrary.wiley.com/doi/full-xml/10.1002/ccr3.3691

DOI： 10.1002/ccr3.3691

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Language：Japanese   Publisher：(一社)日本感染症学会  

Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2020&ichushi_jid=J00276&link_issn=&doc_id=20200131460003&doc_link_id=10.11150%2Fkansenshogakuzasshi.94.97&url=https%3A%2F%2Fdoi.org%2F10.11150%2Fkansenshogakuzasshi.94.97&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

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Language：Japanese   Publisher：(一社)日本肝臓学会  

Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2019&ichushi_jid=J00263&link_issn=&doc_id=20190806060002&doc_link_id=10.2957%2Fkanzo.60.294&url=https%3A%2F%2Fdoi.org%2F10.2957%2Fkanzo.60.294&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

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Language：Japanese   Publisher：(一社)日本臨床化学会  

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BACKGROUND: Lack of a model that mirrors Helicobacter pylori-induced gastric mucosal inflammation has hampered investigation of early host-bacterial interactions. We used an ex vivo model of human stomach, gastric epithelial organoid monolayers (gastroid monolayers) to investigate interactions of H pylori infection and the apical junctional complex and interleukin-8 (IL-8) expression. METHOD: Morphology of human antral mucosal gastroid monolayers was evaluated using histology, immunohistochemical (IHC) staining, and transmission electron microscopy (TEM). Functional and gross changes in the apical junctional complexes were assessed using transepithelial electrical resistance (TEER), cytotoxicity assays, and confocal laser scanning microscopy. IL-8 expression was evaluated by real-time quantitative PCR and ELISA. RESULTS: When evaluated by IHC and TEM, the morphology of gastroid monolayers closely resembled in vivo human stomach. Following inoculation of H pylori, TEER transiently declined (up to 51%) in an H pylori density-dependent manner. TEER recovered by 48 hours post-infection and remained normal despite continued presence and replication of H pylori. Confocal scanning microscopy showed minimal disruption of zonula occludens-1 or E-cadherin structure. IL-8 production was unchanged by infection with either CagA-positive or CagA-negative H pylori and JNK and MEK inhibitors did not suppress IL-8 production, whereas p38 and IKK inhibitor significantly did. CONCLUSION: Human gastroid monolayers provide a model for experimental H pylori infection more consistent with in vivo human infections than seen with typical gastric epithelial cell lines. This ex vivo system should lead to better understanding of H pylori host-pathogen interactions.

DOI： 10.1111/hel.12583

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：S. Karger AG  

Introduction: Liver transplantation for hepatocellular carcinoma (HCC) has been established as a curative therapy of underlying liver disease and cancer. However, the role of liver transplantation remains controversial for patients with HCC beyond Milan criteria. Case Presentation: A man in his 50s who was diagnosed as having two foci of HCC and advanced liver cirrhosis was referred to our hospital for further examination and treatment. Both foci of HCC were located in segment 8 of the liver and measured 39 and 9 mm. Endoscopy showed esophageal varices that had a high risk of bleeding. After endoscopic ligation of the esophageal varices, he underwent transcatheter arterial chemoembolization (TACE) for downstaging of the advanced HCCs. No further liver deterioration was observed after TACE, and HCC staging was successfully downstaged to within the Milan criteria. One hundred ten days after TACE, he underwent liver transplantation; at 2.5 years after transplantation, he remains alive without HCC recurrence. Discussion/Conclusion: There are only a few treatment options available for patients with advanced HCC and severe liver damage. Multidisciplinary treatment such as locoregional treatments and prophylaxis of variceal bleeding may result in tumor downstaging, enabling radical liver transplantation without further exacerbation of liver damage.

DOI： 10.1159/000499703

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Elsevier BV  

Iron is an essential for organisms and the liver plays a major role in its storage. In pathologic conditions, where iron absorption from the intestine or iron uptake into the hepatocytes is increased, excess iron accumulates in the hepatocytes, leading to hepatocyte injury through the production of free radicals. Iron exerts its toxicity by catalyzing the generation of reactive oxygen species (ROS). ROS causes cell injury by inducing damage to the lysosomal, cytoplasmic, nuclear and mitochondrial membranes, apoptosis through activation of the caspase cascade, and hyperoxidation of fatty chains. In this manuscript, we reviewed the articles regarding role of iron in hepatic inflammation and hepatocellular carcinoma.

DOI： 10.1016/j.freeradbiomed.2018.07.006

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Language：Japanese   Publisher：(一社)日本臨床衛生検査技師会  

Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2019&ichushi_jid=J02467&link_issn=&doc_id=20190122440009&doc_link_id=%2Fcg6jjomt%2F2019%2F006801%2F009%2F0056-0060%26dl%3D0&url=http%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fcg6jjomt%2F2019%2F006801%2F009%2F0056-0060%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

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Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：Japan Society of Hepatology  

DOI： 10.2957/kanzo.60.294

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DOI： 10.1016/j.freeradbiomed.2018.09.010

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Other Link： https://search.jamas.or.jp/default/link?pub_year=2018&ichushi_jid=J00263&link_issn=&doc_id=20180330040004&doc_link_id=10.2957%2Fkanzo.59.180&url=https%3A%2F%2Fdoi.org%2F10.2957%2Fkanzo.59.180&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

DOI： 10.2957/kanzo.59.180

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DOI： 10.1155/2018/2154361

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DOI： 10.1128/IAI.00389-17

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DOI： 10.1111/hel.12376

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DOI： 10.2957/kanzo.58.105

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DOI： 10.1111/1751-2980.12309

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DOI： 10.1002/hep.27774

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Baishideng Publishing Group Co  

DOI： 10.4254/wjh.v7.i3.593

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DOI： 10.5754/hge13857

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DOI： 10.2957/kanzo.55.162

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BACKGROUND: The rate of onset of hepatocellular carcinoma (HCC) in patients with nonalcoholic steatohepatitis (NASH) has been reported recently to be comparable to that of patients with chronic hepatitis C. However, the precise mechanism contributing to carcinogenesis in the former remains unclear. Although increased oxidative stress is presumed to play a role in carcinogenesis in patients with NASH, this relationship remains to be directly proven. In this study, we investigated the involvement of oxidative DNA damage in hepatocarcinogenesis in patients with NASH. METHODS: Patients with nonalcoholic fatty liver disease who were treated at our university hospital were eligible for enrolment in the study(n = 49). The study cohort included 30 patients with NASH without HCC (NASH without HCC), six HCC patients with NASH (NASH-HCC), and 13 patients with simple steatosis. Quantitative immunohistochemistry with a KS-400 image analyzing system was used for 8-hydroxy-2'-deoxyguanosine (8-OHdG) detection. RESULTS: The 8-OHdG content in the liver tissue of NASH-HCC patients was significantly different from that in the other patients. The median immunostaining intensity was 8.605 in the NASH-HCC cases, which was significantly higher than that in the cases of NASH without HCC (4.845; P = 0.003). Multivariate analysis using hepatic 8-OHdG content as a factor in addition to age and fasting blood sugar revealed a significant difference in clinicopathological factors between NASH-HCC and NASH without HCC cases. Old age (P = 0.015) and high relative immunostaining intensity for intrahepatic 8-OHdG (P = 0.037) were identified as independent factors. CONCLUSIONS: 8-OHdG content in liver tissue may serve a marker of oxidative stress and could be a particularly useful predictor of hepatocarcinogenesis.

DOI： 10.1007/s00535-012-0739-0

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Language：Japanese   Publisher：The Japanese Society of Hematology  

A 78-year-old woman was diagnosed with multiple myeloma (MM: IgG κ type, stage IIIA, ISS III) at a nearby hospital in August 2010. High-dose dexamethasone therapy was ineffective, and she was treated with 2 courses of bortezomib. She was referred to our hospital with back pain and dyspnea in November. She was diagnosed with interstitial pneumonia (IP) and improved rapidly with steroid pulse therapy. Because the involvement of bortezomib was suspected in IP, lenalidomide therapy was selected for MM. Lenalidomide (15 mg) was administered for 2 courses. The patient achieved a PR and the treatment is still ongoing with a good response. According to the interim report on PMS (post-marketing surveillance), 3 of the 1,177 patients treated with lenalidomide developed IP. The dose level was 25 mg in 2 cases and 10 mg in 1 case. The outcomes of these patients were death in 1 case, not recovered in 1 case, and unknown in 1 case. When lenalidomide is used to treat bortezomib-induced IP, there are no rules or regulations about its dose level. In the present case, the dose of lenalidomide (15 mg) was based on the retreatment dose after bone marrow suppression. Low-dose lenalidomide therapy was effective and safe against MM with a bortezomib-associated lung disorder.

Other Link： https://jlc.jst.go.jp/DN/JALC/10019534809?from=CiNii

DOI： 10.11406/rinketsu.54.451

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DOI： 10.11405/nisshoshi.110.248

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DOI： 10.11405/nisshoshi.108.1405

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DOI： 10.1111/j.1872-034X.2011.00821.x

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大腸内視鏡検査の女性被験者が女性医師を希望するかどうかについて、アンケート調査を実施した。対象は連続110名(平均年齢53.6歳)で、アンケート調査は検査前後に行った。1)検査前、56%が女性医師による検査を希望していた。特に50歳未満の若年者や検査未経験者は有意に高率に女性医師を希望していた。また、就業女性や無症状スクリーニング被験者も女性医師を希望する傾向が強かった。2)検査後も女性医師を希望する傾向は変わらず、検査前に女性医師を希望した被験者の90%、どちらでもよいと回答していた73%が、次回検査は女性内視鏡医を希望していた。3)女性内視鏡医の育成が必要であるとともに、男性内視鏡医も技術面だけでなく、被験者に対する心遣いや安心感の提供等、精神面の配慮も心がけることが重要と考えられた。

DOI： 10.11280/gee.52.3347

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DOI： 10.1007/s00280-009-1215-2

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Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：(一社)日本肝臓学会  

DOI： 10.2957/kanzo.51.501

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DOI： 10.1007/s12328-009-0111-y

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DOI： 10.11405/nisshoshi.106.1327

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Language：Japanese   Publisher：The Japanese Society of Internal Medicine  

Other Link： https://jlc.jst.go.jp/DN/JALC/00330166346?from=CiNii

DOI： 10.2169/naika.98.862

PubMed

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Language：Japanese   Publisher：(一社)日本消化器内視鏡学会  

症例1(60歳男性)。日曜大工で釘を誤飲し受診となった。X線では胃内に釘が確認され、内視鏡で摘出を試みたが、釘は胃内になく空腸以降に移動しており、経口的ダブルバルーン小腸内視鏡(DBE)で下部空腸に釘を認め、回収した。症例2(35歳男性)。10年前に過敏性腸症候群の診断を受け、4年前より腸閉塞症状を繰り返し、前医で慢性特発性偽性腸閉塞(CIIP)と診断された。腸管内圧減圧目的に胃瘻の造設、イレウス管の留置がされたものの、今回、イレウス管が断裂し内視鏡での摘出が困難なため、著者らの施設へ紹介受診となった。X線およびCTでは小腸内に断裂したイレウス管が認められ、経口的DBEにて下部空腸内のイレウス管を回収した。症例3(78歳女性)。11年前に回腸狭窄による腸閉塞で回腸部分切除術が行われ、数年前より腹部膨満感が続いていた。著者らの施設へ紹介受診となり、内視鏡ならびにガストログラフィン造影を行なったところ回腸に7cmの狭窄が認められた。更にこの狭窄部を経口的DBEで調べたところPTPが見つかり、これを回収ネットにて回収した。

DOI： 10.11280/gee1973b.50.2684

Ichushi

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

Docetaxel and paclitaxel are demonstrated to be effective for use as salvage therapy for advanced gastric cancer. Both drugs are taxane derivatives but there is only partial cross-resistance between them. For breast cancer and ovarian cancer, there have been several reports that showed docetaxel is effective for paclitaxel-resistant cancer, and vice versa. We experienced two cases of advanced gastric cancer effectively treated by sequential therapy of docetaxel and paclitaxel. One patient was a 43-year-old woman with a type 4 gastric carcinoma, and the other a 51-year-old woman who had suffered a recurrence of the gastric cancer after a total gastrectomy. At first, chemotherapy failed, so we chose docetaxel/high-dose 5-FU (HDFU) for the second-line therapy. After resistance to Docetaxel/HDFU, paclitaxel was effective for third-line treatment of both patients.

PubMed

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PubMed

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Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：The Japanese Society of Hematology  

A 57-year-old male with right ocular adnexal mucosa-associated lymphoid tissue lymphoma (MALT lymphoma) was successfully treated with local radiation therapy. The gastroendoscopic examination revealed a slight inflammatory change of the gastric mucosa, and the urease test was positive. Eradication therapy against <i>Helicobacter pylori</i> was successfully done, however, the patient developed gastric MALT lymphoma two years after the initial treatment. Southern blot analysis of the immunoglobulin heavy chain gene rearrangement revealed that the lymphoma cells from the ocular adnexal and gastric MALT lymphomas were identical, indicating that the gastric MALT lymphoma was not the primary but the metastatic region from the ocular adnexal MALT lymphoma. Further, immunohistochemical staining demonstrated the expression of integrin &alpha;4&beta;7 on ocular adnexal MALT lymphoma cells, which is essential for the adhesion of lymphocytes to gastrointestinal mucosa. These results indicate that ocular adnexal MALT lymphoma cells can metastasize to the stomach, depending on the adhesional function of integrin &alpha;4&beta;7.

Other Link： http://search.jamas.or.jp/link/ui/2007162208

DOI： 10.11406/rinketsu.48.56

PubMed

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

We started a department of medical oncology and the risk management system of cancer chemotherapy since April in 2004. After that, chemotherapy administration increased steadily in numbers, especially on an outpatient basis. For reliable venous access, we made active use of a central venous Port (more than 60% of cases) as a rout of administration. Fifty five patients with advanced colorectal cancer were treated by FOLFIRI or FOLFOX regimen from April 2005 to June 2006. Two hundred sixty four cycles of FOLFIRI and 276 cycles of FOLFOX were administered. One hundred sixteen cycles (44%) and 117 cycles (42%) were performed through home therapy, respectively. Twenty five out of 55 patients could shift to home therapy using an infusor. Nine out of 30 patients wanted to continue on an inpatient basis, because their private insurance for medical care did not support the outpatient chemotherapy.

PubMed

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Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：The Japanese Society of Hematology  

A 72-year-old male was admitted to our hospital to determine the cause of neck lymphadenopathies. He was diagnosed pathologically by a lymph node biopsy as having peripheral T-cell lymphoma (PTCL). He also had developed eosinophilia and his serum concentration of Interleukin-5 (IL-5) was extremely high. Immunostaining of a resected lymph node revealed that there were lymphoma cells which were stained with anti-IL-5 antibody. After 2 courses of CHOP therapy, the lymphadenopathies and eosinophilia disappeared and the concentration of serum IL-5 was normalized. It was suggested that IL-5 produced by lymphoma cells had induced his eosinophilia.

Other Link： https://jlc.jst.go.jp/DN/JALC/00288263616?from=CiNii

DOI： 10.11406/rinketsu.47.1457

PubMed

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J-GLOBAL

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J-GLOBAL

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J-GLOBAL

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J-GLOBAL

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J-GLOBAL

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J-GLOBAL

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J-GLOBAL

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Language：Japanese   Publisher：産業開発機構(株)  

Ichushi

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Language：Japanese   Publisher：(一社)日本臨床検査医学会  

腹部超音波検査実習の学習資料として、マニュアルの有用性について検討した。選択臨床実習で当講座を選択し、腹部超音波検査実習を行った医学部6年生12名を対象とした。マニュアルの記録断面例5断面の描出による実技試験(5点満点)については5点が11名、4点が1名、病変画像5枚についての口頭試問(5点満点)は5点が7名、4点が5名であった。アンケート調査結果について、記録断面例の描出では右肋間走査での胆嚢・肝臓の描出および膵の描出で習熟度がやや低い傾向を認めたが、他部位の描出の習熟度はおおむね良好であった。マニュアル実施基準の理解度は平均3.8点、12名中11名が学習資料としてマニュアルは適切であるとの意見であった。マニュアルを学習資料とした腹部超音波検査実習により基本的走査法のみならず、医学生として十分な基礎的知識が得られたと考えられた。

Other Link:： https://search.jamas.or.jp/default/link?pub_year=2022&ichushi_jid=J07482&link_issn=&doc_id=20220606440002&doc_link_id=%2Fco3rinsy%2F2022%2F007005%2F002%2F0369-0372%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fco3rinsy%2F2022%2F007005%2F002%2F0369-0372%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

Ichushi

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Language：Japanese   Publisher：(株)アークメディア  

Ichushi

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J-GLOBAL

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J-GLOBAL

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Language：Japanese   Publisher：(株)先端医学社  

Other Link:： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2017&ichushi_jid=J03103&link_issn=&doc_id=20170816300008&doc_link_id=%2Fae6helib%2F2017%2F002104%2F010%2F0363-0369%26dl%3D0&url=http%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fae6helib%2F2017%2F002104%2F010%2F0363-0369%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

Ichushi

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Language：Japanese   Publisher：(有)科学評論社  

Other Link:： http://search.jamas.or.jp/link/ui/2014089327

Ichushi

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Language：Japanese   Publisher：(一社)日本肝臓学会  

Ichushi

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Language：Japanese   Publisher：(一社)日本肝臓学会  

Ichushi

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J-GLOBAL

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J-GLOBAL

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Language：Japanese   Publisher：(株)アークメディア  

Ichushi

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Language：Japanese   Publisher：国家公務員共済組合連合会  

早期胃癌に対する治療の妥当性について検討した。対象は2000年7月〜2006年4月までに内視鏡的粘膜下層剥離術(ESD)を行った早期胃癌199例225病変で、観察期間は中央値1.7年であった。1)一括・断端陰性切除率は88.9%であり、治癒切除率78.7%、準治癒切除率3.1%、非治癒切除率18.2%であった。2)非治癒切除42例中29例(12.9%)が病理学的非治癒(うち24例に追加手術)、13例(5.8%)が技術的非治癒(うち3例に追加手術、7例に追加内視鏡治療)であった。3)非治癒切除例の27例に行った追加手術は、開腹手術14例、腹腔鏡下手術10例、3例は他院での手術であった。このうち開腹下幽門側胃切除術(ODG)9例と腹腔鏡下幽門側胃切除術(LDG)9例を比べ、LDGでは手術時間の延長を認めたが、術中出血量は少なく、術後排ガスまでの日数、食事開始までの日数、術後在院日数が短かった。4)全199例中1例を除き現在まで再発を認めず、早期胃癌に対する当院の治療方針は妥当と考えられた。

Other Link:： http://search.jamas.or.jp/link/ui/2007335217

Ichushi

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Language：Japanese   Publisher：国家公務員共済組合連合会  

Other Link:： http://search.jamas.or.jp/link/ui/2006285966

Ichushi

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