Details of a Researcher - TSUJI Yoshihisa

Papers - TSUJI Yoshihisa

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Experience of Endoscopy in the Kingdom of Bhutan

Nikaido Mitsuhiro, Miyamoto Shin'ichi, Kodama Yuzo, Uza Norimitsu, Tsuji Yoshihisa, Tsunoda Shigeru, Uemura Tadahiro, Okajima Hideaki, Maeda Sae, Takahashi Yoko, Muramoto Kanami, Ishii Ayuko, Nishi Yoko, Higuchi Hirokazu, Muto Manabu, Matsubara Kazuo, Chiba Tsutomu

ヒマラヤ学誌 : Himalayan Study Monographs ( The Association for the Studies of Himalaya, Kyoto University ; Kyoto University Bhutan Friendship Program ; The Leading Graduate Program for Primatology and Wildlife Science, Kyoto University ) 17 77 - 84 2016.03

We provided medical care in the Kingdom of Bhutan from January to March in 2014 through the international medical support program of Kyoto University Hospital. Bhutan is a small, developing country with a population of about 700, 000 citizens located at the southern foot of the Himalayas. There are only 244 medical doctors in Bhutan (one-tenth of the number of doctors relative to population in Japan). Because of the shortage of doctors and the limited medical resources, patients with difficult-to-treat conditions are transferred to India or other countries. Gastrointestinal endoscopy is performed by the country's only gastroenterologist and six surgeons, mainly in Jigme Dorji Wangchuk National Referral Hospital (JDWNRH) at Thimphu. Several years before, a Bhutanese surgeon had learned to perform endoscopic retrograde cholangiopancreatography (ERCP) in Thailand. However, ERCP cannot be established in Bhutanese routine clinical practice because of its technical difficulty. Although a duodenoscope and some devices for ERCP are available, at least one patient who needs ERCP is transferred to India every month. In this context, I was asked to reintroduce ERCP into JDWNRH. ERCP was performed in 23 cases involving 17 patients with the cooperation of Bhutanese doctors, nurses, and technicians. My experience leads me to believe that we can build a platform to continue ERCP in JDWNRH. During the 10 weeks, I also helped to perform about 900 endoscopies, mainly esophagogastroduodenoscopy, and I taught endoscopic techniques and diagnostic approaches to Bhutanese doctors. In this report, I describe the current status of endoscopy in Bhutan including the incidence of Bhutanese gastrointestinal disorders and the experience specifically related to introducing ERCP.

DOI CiNii

Evaluation of Tumor-associated Stroma and Its Relationship with Tumor Hypoxia Using Dynamic Contrast-enhanced CT and (18)F Misonidazole PET in Murine Tumor Models.

Sho Koyasu, Yoshihisa Tsuji, Hiroshi Harada, Yuji Nakamoto, Tomomi Nobashi, Hiroyuki Kimura, Kohei Sano, Koji Koizumi, Masatsugu Hamaji, Kaori Togashi

Radiology 278 ( 3 ) 734 - 41 2016.03 [Refereed] [International journal]

PURPOSE: To determine the relationship between the fractional interstitial volume (Fis), as calculated at dynamic contrast material-enhanced (DCE) computed tomography (CT), and tumor-associated stroma and to analyze its spatial relationship with tumor hypoxia in several xenograft tumor models. MATERIALS AND METHODS: All animal experiments were approved by the animal research committee. Mice with three different xenograft tumors (U251, CFPAC-1, and BxPC-3; n = 6, n = 8, and n = 6, respectively) underwent DCE CT then hypoxia imaging with fluorine 18 ((18)F) fluoromisonidazole (FMISO) positron emission tomography (PET) within 24 hours. Immunohistochemical analysis was performed in harvested tumors to detect hypoxia markers and to quantify microvascular and stromal density. Two DCE CT parameters (amount of interstitial space associated with the amount of stroma [Fis] and flow velocity [Fv]) were identified and quantitatively validated by using immunohistochemistry. FMISO uptake within the tumor was also assessed in relation to DCE CT parameters. Imaging and immunohistochemical parameters were assessed by using the Kruskal-Wallis test, Wilcoxon rank-sum test with Bonferroni correction, and Pearson correlation coefficient. RESULTS: Almost no α-smooth muscle actin-positive cells were found in the U251 xenograft, while abundant stroma was found in the entire BxPC-3 xenograft and in the periphery of the CFPAC-1 xenograft. Quantitative analysis showed a significant correlation (R = 0.83, P < .0001) between Fis and stromal density. FMISO uptake had a negative correlation with Fis (R = -0.58, P < .0001) and Fv (R = -0.53, P < .0001). CONCLUSION: DCE CT can be used to quantify parameters associated with tumor-associated stroma. Tumor hypoxia was Complementarily localized in tumor-associated stroma in these models.

DOI PubMed

Acute Pancreatitis-Progress and Challenges: A Report on an International Symposium.

Elham Afghani, Stephen J Pandol, Tooru Shimosegawa, Robert Sutton, Bechien U Wu, Santhi Swaroop Vege, Fred Gorelick, Morihisa Hirota, John Windsor, Simon K Lo, Martin L Freeman, Markus M Lerch, Yoshihisa Tsuji, Gil Y Melmed, Wahid Wassef, Julia Mayerle

Pancreas 44 ( 8 ) 1195 - 210 2015.11 [Refereed] [International journal]

An international symposium entitled "Acute pancreatitis: progress and challenges" was held on November 5, 2014 at the Hapuna Beach Hotel, Big Island, Hawaii, as part of the 45th Anniversary Meeting of the American Pancreatic Association and the Japanese Pancreas Society. The course was organized and directed by Drs. Stephen Pandol, Tooru Shimosegawa, Robert Sutton, Bechien Wu, and Santhi Swaroop Vege. The symposium objectives were to: (1) highlight current issues in management of acute pancreatitis, (2) discuss promising treatments, (3) consider development of quality indicators and improved measures of disease activity, and (4) present a framework for international collaboration for development of new therapies. This article represents a compilation and adaptation of brief summaries prepared by speakers at the symposium with the purpose of broadly disseminating information and initiatives.

DOI PubMed

Efficacy of recombinant human soluble thrombomodulin in preventing walled-off necrosis in severe acute pancreatitis patients

Takaaki Eguchi, Yoshihisa Tsuji, Hiroshi Yamashita, Takumi Fukuchi, Atsushi Kanamori, Kei Matsumoto, Takashi Hasegawa, Akio Koizumi, Ryuki Kitada, Masahiro Tsujimae, Taro Lwatsubo, Shintaro Koyama, Satoshi Ubukata, Mikio Fujita, Akihiko Okada

PANCREATOLOGY ( KARGER ) 15 ( 5 ) 485 - 490 2015.09 [Refereed] [International journal]

Objective: To investigate the efficacy of recombinant human soluble thrombomodulin (rTM) in preventing the development of walled-off necrosis (WON) in severe acute pancreatitis (SAP) patients. Methods: We retrospectively analyzed 54 SAP patients divided into two groups: SAP patients treated by rTM (rTM group, 24 patients) and not treated by rTM (control group, 30 patients). rTM was administered to patients with disseminated intravascular coagulation (DIC). Initially, on the admission day, we recorded patient severity and pancreatic necrosis/ischemia positive or negative. Then we investigated development of WON using 4 weeks later CT/MRI. Finally we compared the proportions of patients developing WON in the rTM group and the control group. Results: On the admission day, the condition of patients treated by rTM was significantly worse than patients in the control group; rTM group vs. control: 71.8 +/- 13.9 vs. 59.8 +/- 15.3 years for age, 10.7 +/- 3.5 vs. 8.0 +/- 4.4 for Acute Physiology and Chronic Health Evaluation II (APACHE II) score, and 33 +/- 1.8 vs. 2.2 +/- 1.8 for sequential organ failure assessment (SOFA) score (p < 0.05). We found no significant differences on the admission day in rate of pancreatic necrosis/ischemia between patients treated by rTM and controls (58.3% vs. 63.3%, p = 0.71). Nevertheless, the proportion of patients developing WON was significantly lower among those administered rTM than in those not administered rTM {29.2% (7/24 patients) vs. 56.7% (17/30 patients), p < 0.05). Conclusion: Treatment of SAP patients treated by rTM may prevent progression from pancreatic necrosis/ischemia to WON. Copyright (C) 2015, IAP and EPC. Published by Elsevier India, a division of Reed Elsevier India Pvt. Ltd. This is an open access article under the CC BY-NC-ND license.

DOI PubMed

Activation-Induced Cytidine Deaminase Contributes to Pancreatic Tumorigenesis by Inducing Tumor-Related Gene Mutations.

Yugo Sawai, Yuzo Kodama, Takahiro Shimizu, Yuji Ota, Takahisa Maruno, Yuji Eso, Akira Kurita, Masahiro Shiokawa, Yoshihisa Tsuji, Norimitsu Uza, Yuko Matsumoto, Toshihiko Masui, Shinji Uemoto, Hiroyuki Marusawa, Tsutomu Chiba

Cancer research 75 ( 16 ) 3292 - 301 2015.08 [Refereed] [International journal]

Pancreatic ductal adenocarcinoma (PDAC) develops via an accumulation of various gene mutations. The mechanism underlying the mutations in PDAC development, however, is not fully understood. Recent insight into the close association between the mutation pattern of various cancers and specific mutagens led us to investigate the possible involvement of activation-induced cytidine deaminase (AID), a DNA editing enzyme, in pancreatic tumorigenesis. Our immunohistochemical findings revealed AID protein expression in human acinar ductal metaplasia, pancreatic intraepithelial neoplasia, and PDAC. Both the amount and intensity of the AID protein expression increased with the progression from precancerous to cancerous lesions in human PDAC tissues. To further assess the significance of ectopic epithelial AID expression in pancreatic tumorigenesis, we analyzed the phenotype of AID transgenic (AID Tg) mice. Consistent with our hypothesis that AID is involved in the mechanism of the mutations underlying pancreatic tumorigenesis, we found precancerous lesions developing in the pancreas of AID Tg mice. Using deep sequencing, we also detected Kras and c-Myc mutations in our analysis of the whole pancreas of AID Tg mice. In addition, Sanger sequencing confirmed the presence of Kras, c-Myc, and Smad4 mutations, with the typical mutational footprint of AID in precancerous lesions in AID Tg mice separated by laser capture microdissection. Taken together, our findings suggest that AID contributes to the development of pancreatic precancerous lesions by inducing tumor-related gene mutations. Our new mouse model without intentional manipulation of specific tumor-related genes provides a powerful system for analyzing the mutations involved in PDAC.

DOI PubMed

Role of Early Prediction of Pancreatic Necrosis in Evaluating Severity of Acute Pancreatitis in the Early Stage

Yoshihisa Tsuji, Yuzo Kodama, Tsutomu Chiba

GASTROENTEROLOGY ( W B SAUNDERS CO-ELSEVIER INC ) 148 ( 4 ) S683 - S683 2015.04

Usefulness of Adalimumab for Treating a Case of Intestinal Behçet's Disease With Trisomy 8 Myelodysplastic Syndrome.

Masamichi Kimura, Yoshihisa Tsuji, Masako Iwai, Masahiro Inagaki, Ali Madian, Takuya Yoshino, Minoru Matsuura, Hiroshi Nakase

Intestinal research 13 ( 2 ) 166 - 9 2015.04 [Refereed] [International journal]

Behçet's disease (BD) is a systemic vasculitis, while myelodysplastic syndrome (MDS) is a heterogeneous group of clonal hematologic disorders characterized by ineffective hematopoiesis. Some studies suggest a relationship between MDS and BD, especially intestinal BD, and trisomy 8 seems to play an important role in both diseases. There are several reports on patients with BD comorbid with MDS involving trisomy 8 that frequently have intestinal lesions refractory to conventional medical therapies. Tumor necrosis factor (TNF)-α is strongly involved in the pathophysiology of several autoimmune diseases such as rheumatoid arthritis, inflammatory bowel disease, and BD. In addition, TNF-α plays an important role in the pathophysiology of MDS by inhibiting normal hematopoiesis and inducing the programmed cell death of normal total bone marrow cells and normal CD34+ cells. Recent clinical reports demonstrate the favorable effect of TNF-α antagonists in patients with refractory intestinal BD and in those with MDS. We present the case of a patient with intestinal BD and MDS involving trisomy 8 who was successfully treated with adalimumab.

DOI PubMed

Evaluation of tumour hypoxia and cancer stroma using F-18-misonidazole PET and dynamic contrast enhanced CT in tumor-bearing mice models

S. Koyasu, Y. Nakamoto, H. Harada, Y. Tsuji, H. Kimura, K. Sano, T. Nobashi, K. Togashi

EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING ( SPRINGER ) 41 S387 - S387 2014.10 [Refereed]

Evaluation of intratumoral microenvironment with 18F-misonidazole PET and dynamic contrast enhanced CT in tumor-bearing mice models

Sho Koyasu, Yuji Nakamoto, Hiroshi Harada, Hiroyuki Kimura, Kohei Sano, Koji Koizumi, Yoshihisa Tsuji, Tomomi Nobashi, Kensuke Kurihara, Kaori Togashi

JOURNAL OF NUCLEAR MEDICINE ( SOC NUCLEAR MEDICINE INC ) 55 2014.05 [Refereed]

Long-term efficacy of infliximab for refractory ulcerative colitis: results from a single center experience.

Satoshi Yamada, Takuya Yoshino, Minoru Matsuura, Naoki Minami, Takahiko Toyonaga, Yusuke Honzawa, Yoshihisa Tsuji, Hiroshi Nakase

BMC gastroenterology 14 80 - 80 2014.04 [Refereed] [International journal]

BACKGROUND: The long-term efficacy of infliximab (IFX) for patients with refractory ulcerative colitis (UC) is unclear. The aim of this study was to assess the long-term outcomes of IFX treatment in patients with refractory UC. METHODS: Thirty-three patients with refractory UC who received IFX treatment at Kyoto University Hospital between 2003 and 2013 were retrospectively evaluated. IFX intensification was defined as a dose escalation (up to 10 mg/kg) and/or shorter intervals between infusions (every 4-6 weeks). RESULTS: Of the 33 patients who received scheduled infusions of IFX, 24 (72.7%) achieved clinical remission within 8 weeks after initiating IFX treatment. Of these 24 responders, 17 (70.8%) experienced a relapse of UC and required IFX intensification, and 16 (66.7%) eventually maintained clinical remission with IFX treatment, including IFX intensification. Of the 33 patients, 6 (18.2%) underwent colectomy during IFX treatment. Multivariate regression analysis showed that a serum C-reactive protein (CRP) concentration <5 mg/L two weeks after starting IFX was a predictor of a positive clinical response to IFX induction therapy. No severe adverse events occurred in UC patients treated with IFX. CONCLUSION: IFX intensification was necessary for long-term maintenance of remission and to prevent colectomy in patients with refractory UC.

DOI PubMed

Subtraction color map of contrast-enhanced and unenhanced CT for the prediction of pancreatic necrosis in early stage of acute pancreatitis.

Yoshihisa Tsuji, Naoki Takahashi, Joel G Fletcher, David M Hough, Brendan P McMenomy, David M Lewis, Santhi S Vege, Suresh T Chari, Cynthia H McCollough, Katharine L Grant, Ernst Klotz

AJR. American journal of roentgenology 202 ( 4 ) W349-56 2014.04 [Refereed] [International journal]

OBJECTIVE: The objective of our study was to evaluate the accuracy of subtraction color-map images created from contrast-enhanced CT (CECT) and unenhanced CT for the diagnosis of pancreatic necrosis in the early stage of acute pancreatitis. MATERIALS AND METHODS: Forty-eight patients underwent unenhanced CT and CECT within 72 hours from the onset of acute pancreatitis. Subtraction color-map images were created from unenhanced CT and CECT using a 3D nonrigid registration method. Three radiologists reviewed two image sets: CECT alone and subtraction color-map images in conjunction with CECT. Readers evaluated each image set for the presence of pancreatic necrosis. The reference standard for pancreatic necrosis was CT or MRI 1 week or more after the onset of acute pancreatitis. The performance of each image set for the prediction of pancreatic necrosis was calculated and compared using the McNemar test. RESULTS: Eleven of the 48 patients developed pancreatic necrosis. There were no technical failures creating the subtraction images. The sensitivity, specificity, and accuracy for predicting pancreatic necrosis with CECT were 64%, 97%, and 90%, respectively, for reader 1; 73%, 87%, and 83% for reader 2; and 73%, 87%, and 83% for reader 3. The sensitivity, specificity, and accuracy for predicting pancreatic necrosis with the subtraction color maps were 100%, 100%, and 100%, respectively, for reader 1; 100%, 95%, and 96% for reader 2; and 82%, 92%, and 90% for reader 3. Accuracy significantly improved with the addition of subtraction color maps compared with CECT alone for reader 1 (p = 0.03) and reader 2 (p = 0.02) but not for reader 3 (p = 0.37). CONCLUSION: A subtraction color map is accurate in the diagnosis of pancreatic necrosis in the early stage of acute pancreatitis.

DOI PubMed

Comparative Analysis of Perfusion CT Algorithms in the Detection of Early-Stage Pancreatic Necrosis

吉田司, 三谷洋介, 熊谷健, 松枝和宏, 山本博, 辻喜久, 渡邊祐司

倉敷中央病院年報 76 2014

J-GLOBAL

Acute pancreatitis and innate immunity

WATANABE Tomohiro, TSUJI Yoshihisa, CHIBA Tsutomu

Suizo ( Japan Pancreas Society ) 29 ( 1 ) 45 - 50 2014 [Refereed] [Invited]

It has been generally accepted that pathogenic intra-acinar trypsinogen activation followed by auto-digestion of the pancreas plays a critical role in the development of acute pancreatitis. However, recent studies suggest that auto-digestion by activated trypsin alone cannot fully account for the pathogenesis of acute pancreatitis since experimental acute pancreatitis is successfully induced even without the full-activation of trypsinogen. Although intra-acinar trypsinogen activation followed by auto-digestion of the pancreas is an initial step of acute pancreatitis, pathogenic immune reactions are involved in the sustained pancreatic inflammation. In this regard, recent studies highlight the importance of innate immune responses mediated by intestinal microflora translocated into the pancreas and by endogenous auto-antigens released from the necrotic pancreatic tissue.

DOI CiNii J-GLOBAL

膵perfusion CTの現状と今後

辻喜久

Japanese Journal of Diagnostic Imaging 32 ( 1 ) 2014 [Refereed]

J-GLOBAL

Pancreatic Blood Flow Measurements in the Pig Pancreatitis Model Using Perfusion CT with Deconvolution Method

Yoshihisa Tsuji, Kazutaka Yamada, Miori Kisimoto, Shujiro Yazumi, Hiroyoshi Isoda, Tsutomu Chiba

ABDOMINAL IMAGING: COMPUTATIONAL AND CLINICAL APPLICATIONS ( SPRINGER-VERLAG BERLIN ) 8676 94 - 102 2014 [Refereed]

Introduction: We compared pancreatic blood flow (PBF) measured by perfusion CT with deconvolution method and Laser Doppler Flow (LDF) to determine whether uncollected contrast material from the pancreas affects measurement of perfusion CT, using porcine pancreatitis model (n = 7). Materials and Methods: The pancreas was divided into head and tail. We arranged that PBF of tail was circulated by single input/output vessel. Ischemic pancreatitis was induced to tail, shutting off input/output vessel for 30 min. PBF was measured both by perfusion CT with deconvolution method and LDF, during the overall course. We calculated uncollected ratio of contrast material, assuming area-under-curve differences between the input and output vessels correspond to uncollected. Results: tail PBF measured by perfusion CT with deconvolution was significantly correlated with LDF, despite of pancreatitis (P < 0.05). The uncollected ratio was 19 %. Discussion: Although the uncollected ratio was not few, result of perfusion CT was significantly related with LDF.

DOI

Perfusion in the tissue surrounding pancreatic cancer and the patient's prognosis.

Yoshihiro Nishikawa, Yoshihisa Tsuji, Hiroyoshi Isoda, Yuzo Kodama, Tsutomu Chiba

BioMed research international 2014 648021 - 648021 2014 [Refereed] [International journal]

OBJECTIVE: The objective was to investigate the relationship between prognosis in case of pancreatic cancer and perfusion in tissue surrounding pancreatic cancer using perfusion CT. METHODS: We enrolled 17 patients diagnosed with inoperable pancreatic adenocarcinoma. All patients were examined by perfusion CT and then underwent chemotherapy using gemcitabine. The time density curve (TDC) of each CT pixel was analyzed to calculate area under the curve (AUC) and blood flow (BF) using a mathematical algorithm based on the single-compartment model. To measure the AUC and BF of tumor (AUCT and BFT) and peritumoral tissue (AUCPTT and BFPTT), regions of interest were manually placed on the cancer and in pancreatic tissue within 10 mm of proximal pancreatic parenchyma. Survival days from the date of perfusion CT were recorded. Correlation between AUC or BF and survival days was assessed. RESULTS: We found a significant correlation between AUCPTT or BFPTT and survival days (P = 0.04 or 0.0005). Higher AUCPTT or BFPTT values were associated with shorter survival. We found no significant correlation between AUCT or BFT and survival. CONCLUSIONS: Our results suggest that assessments of perfusion in pancreatic tissue within 10 mm of proximal pancreatic parenchyma may be useful in predicting prognosis.

DOI PubMed

Risk of cancer in patients with autoimmune pancreatitis.

Masahiro Shiokawa, Yuzo Kodama, Kenichi Yoshimura, Chiharu Kawanami, Jun Mimura, Yukitaka Yamashita, Masanori Asada, Masataka Kikuyama, Yoshihiro Okabe, Tetsuro Inokuma, Masaya Ohana, Hiroyuki Kokuryu, Kazuo Takeda, Yoshihisa Tsuji, Ryuki Minami, Yojiro Sakuma, Katsutoshi Kuriyama, Yuji Ota, Wataru Tanabe, Takahisa Maruno, Akira Kurita, Yugo Sawai, Norimitsu Uza, Tomohiro Watanabe, Hironori Haga, Tsutomu Chiba

The American journal of gastroenterology 108 ( 4 ) 610 - 7 2013.04 [Refereed] [International journal]

OBJECTIVES: Although simultaneous occurrences of autoimmune pancreatitis (AIP) and cancer are occasionally observed, it remains largely unknown whether cancer and AIP occur independently or these disorders are interrelated. The aim of this study was to examine the relationship between AIP and cancer. METHODS: We conducted a multicenter, retrospective cohort study. One hundred and eight patients who met the Asian diagnostic criteria for AIP were included in the study. We calculated the proportion, standardized incidence ratio (SIR), relative risk, and time course of cancer development in patients with AIP. We also analyzed the clinicopathological characteristics of AIP patients with cancer in comparison with those without cancer. RESULTS: Of the 108 AIP patients, 18 cancers were found in 15 patients (13.9%) during the median follow-up period of 3.3 years. The SIR of cancer was 2.7 (95% confidence interval (CI) 1.4-3.9), which was stratified into the first year (6.1 (95% CI 2.3-9.9)) and subsequent years (1.5 (95% CI 0.3-2.8)) after AIP diagnosis. Relative risk of cancer among AIP patients at the time of AIP diagnosis was 4.9 (95% CI 1.7-14.9). In six of eight patients whose cancer lesions could be assessed before corticosteroid therapy for AIP, abundant IgG4-positive plasma cell infiltration was observed in the cancer stroma. These six patients experienced no AIP relapse after successful cancer treatment. CONCLUSIONS: Patients with AIP are at high risk of having various cancers. The highest risk for cancer in the first year after AIP diagnosis and absence of AIP relapse after successful treatment of the coexisting cancers suggest that AIP may develop as a paraneoplastic syndrome in some patients.

DOI PubMed

Technique and clinical applications of hepatic perfusion ct with dual-input algorithms

Sho Koyasu, Yoshihisa Tsuji

Computed Tomography: New Research ( Nova Science Publishers, Inc. ) 65 - 73 2013.03

Perfusion computed tomography (CT) is a new technology used to evaluate tissue hemodynamics. More specifically, Perfusion CT is a technique used to obtain a time density curve (TDC) of targeted tissue from an image dataset of dynamic contrasted enhanced CT to measure several perfusion parameters in normal and pathologic tissue in patients with liver disease (e.g., malignant and inflammatory disease). Since liver perfusion involves two input vessels, the hepatic artery and portal vein, we must measure hepatic arterial and portal perfusion separately to truly evaluate hepatic perfusion. Actually, advanced perfusion algorithms that measure hepatic perfusion require both TDCs for administered contrast material in the hepatic artery and portal vein. This chapter reviews the techniques and clinical applications of hepatic perfusion CT based on dual-input algorithms. © 2013 Nova Science Publishers, Inc. All rights reserved.

Relationship between pancreatic perfusion parameters and clinical complications of severe acute pancreatitis.

Tsubasa Watanabe, Yoshihisa Tsuji, Naoki Takahashi, Tsukasa Yoshida, Masashi Tamaoki, Osamu Kikuchi, Yuji Watanabe, Yuzo Kodama, Hiroyoshi Isoda, Hiroshi Yamamoto, Tsutomu Chiba

Pancreas 42 ( 1 ) 180 - 2 2013.01 [Refereed] [International journal]

DOI PubMed

原発性硬化性胆管炎として長期経過観察されたIgG4関連硬化性胆管炎の3例

南竜城, 栗田亮, 栗山勝利, 佐久間洋二朗, 大田悠司, 田邊渉, 丸野貴久, 塩川雅広, 澤井勇悟, 辻喜久, 宇座徳光, 児玉裕三

胆道 27 ( 3 ) 2013

J-GLOBAL

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Papers - TSUJI Yoshihisa