研究者詳細 - 辻　喜久

論文 - 辻　喜久

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IgG4-related autoimmune pancreatitis involving the colonic mucosa.

Kenji Ueno, Tomohiro Watanabe, Yukiko Kawata, Tomoyuki Gotoh, Yoshihisa Tsuji, Hiroshi Ida, Shinsuke Tada, Shujiro Yazumi, Tsutomu Chiba

European journal of gastroenterology & hepatology 20 ( 11 ) 1118 - 21 2008年11月 [査読有り] [国際誌]

We report a case of autoimmune pancreatitis involving the colonic mucosa. Although serum level of IgG4 was normal, computed tomography and endoscopic retrograde cholangiopancreatography showed diffuse enlargement of the pancreas and irregular narrowing of the pancreatic ducts, respectively. Colonoscopy revealed a polypoidal lesion in the ascending colon. A lymphoplasmacytic infiltration was seen both in the pancreas and in the polypoidal lesion of the colon. Furthermore, immunohistochemical analysis showed abundant IgG4-positive plasma cells in these lesions. This is the first case report of a simultaneous occurrence of autoimmune pancreatitis and a colonic polypoidal lesion, both of which are characterized with increased IgG4 responses.

DOI PubMed

Are prophylactic antibiotics really ineffective in reducing the risk of pancreatic necrosis?

Yoshihisa Tsuji, Tsutomu Chiba

The American journal of gastroenterology 103 ( 8 ) 2145 - 6 2008年08月 [査読有り] [国際誌]

DOI PubMed

Biliary complications in donors for living donor liver transplantation.

Seiji Shio, Shujiro Yazumi, Kohei Ogawa, Kazunori Hasegawa, Yoshihisa Tsuji, Masaya Kida, Junichi Yamauchi, Hiroshi Ida, Shinsuke Tada, Shinji Uemoto, Tsutomu Chiba

The American journal of gastroenterology 103 ( 6 ) 1393 - 8 2008年06月 [査読有り] [国際誌]

OBJECTIVES: With the increasing number of living donor liver transplantations, biliary complications in donors have emerged as a major postoperative problem. The aim of the present study was to characterize the features of the biliary complications that occur in donors. METHODS: The study subjects comprised 731 consecutive patients who donated liver grafts (434 right-lobe and 297 left-lobe grafts) for transplantation at Kyoto University Hospital from July 1999 to December 2006. Donors whose biliary complications could not be cured by conservative therapy were referred for endoscopic treatment. RESULTS: Postoperative biliary complications occurred in 55 (7.5%) donors. Initially, 48 of these 55 donors had biliary leakage and 7 had biliary stricture. Subsequently, 5 of 48 donors with leakage developed biliary stricture. The respective incidences of biliary leakage and overall biliary complications were significantly higher among donors of right-lobe grafts (9.9% and 11.1%) than among donors of left-lobe grafts (1.7% and 2.4%). Among 55 donors with biliary complications, 24 were cured by conservative therapy, and 1 was converted to surgical repair due to ileus. Endoscopic treatment was successful in 24 of 30 (80%) donors treated by endoscopic retrograde cholangiography, while the remaining 6 (20%) patients underwent surgery due to difficulties with cannulation (N = 2), excessive biliary leakage (N = 2), or complete biliary obstruction (N = 2). CONCLUSIONS: Donors of right-lobe grafts have a significantly higher incidence of biliary complications than donors of left-lobe grafts. When conservative therapy fails, endoscopic treatment is effective for these complications, and should be attempted as the first-line therapy before surgical repair.

DOI PubMed

Surround modulation in visual cortex can predict border-ownership selectivity: psychophysical study of border-ownership-dependent tilt aftereffect.

Tadashi Sugihara, Yoshihisa Tsuji, Ko Sakai

Journal of the Optical Society of America. A, Optics, image science, and vision 25 ( 6 ) 1426 - 34 2008年06月 [査読有り] [国際誌]

Recent physiological studies revealed that neurons in the macaque visual cortex encode the direction of a figure along a contour (border ownership, BO). Although their cortical mechanisms have not been clarified, a computational model for BO has suggested that surround modulation in early vision can play an important role. Here we examined psychophysically how the strength of BO-dependent tilt aftereffect (BO-TAE) is modulated by a stimulus outside the adapted location in relation to the strength of surround modulation reported in physiological experiments. The results showed systematic change of the strength of BO-TAE, depending on the difference in orientation and spatial frequency between the bars placed outside and at the adapted location, indicating a crucial role of surround modulation in the neural mechanism underlying BO selectivity.

PubMed

[Marked effect of combination chemotherapy with tegafur-gimeracil-oteracil potassium and gemcitabine on a suspected case of pancreas cancer or gallbladder cancer metastasis to bone: further diagnosis of disseminated carcinomatosa of bone marrow recurrence after the 23 years of gastric cancer operation by autopsy findings].

Akihiro Sakai, Yoshihisa Tsuji, Osamu Kikuchi, Akiko Jinno, Wataru Tanabe, Yoshihiko Terashima, Yuki Maeda, Akira Doi, Takako Hata, Naoki Yamamoto, Ikuo Aoyama, Osamu Arai, Yoshie Kiyosuke, Sachiko Katayama, Ken Hirao, Masatsugu Miyoshi, Hirokazu Mouri, Kazuhiro Matsueda, Hiroshi Yamamoto

Gan to kagaku ryoho. Cancer & chemotherapy 35 ( 3 ) 529 - 32 2008年03月 [査読有り] [国内誌]

A 70-year-old woman who underwent proximal gastrectomy for gastric cancer (poorly-differentiated adenocarcinoma) of Stage IIIB at age 46 visited our hospital April 2004 because of exacerbated pain by movement in the buttocks since November 2003. She showed multiple bone metastasis by CT (computerized tomography). Pancreas cancer or gallbladder cancer was suspected by CT, and a high tumor marker score (CA19-9 18,625 U/mL, DUPAN-II 15,000 U/ mL elevations were acknowledged). Although her symptoms were severe with performance status (PS) 4, she was administered combination chemotherapy with gemcitabine and cisplatin. After 2 cycle therapy, her PS was improved to 2, but the tumor markers had elevated. So we changed the chemotherapy menu to S-1 and gemcitabine. Her tumor markers lowered and PS was improved to 1. There was a remarkable response to this chemotherapy, and the result of CT and bone scintigraphy suggested that her bone metastasis was improved. Because of hematologic relapse due to DIC at 1 year after the first treatment, she was readmitted to our hospital and later died. The autopsical result revealed recurrence of gastric cancer 23 years post-operatively.

PubMed

Obesity as a risk factor for GERD in Japan.

Masahiro Sakaguchi, Hiroshi Oka, Takashi Hashimoto, Yutaka Asakuma, Miyuki Takao, Goki Gon, Makoto Yamamoto, Yoshihisa Tsuji, Norihiko Yamamoto, Mamoru Shimada, Kyowon Lee, Kiyoshi Ashida

Journal of gastroenterology 43 ( 1 ) 57 - 62 2008年 [査読有り] [国内誌]

BACKGROUND: In Europe and the United States, it is known that obesity, which is increasing, is closely associated with gastroesophageal reflux disease (GERD), but in Japan no definite consensus has been reached on this relationship. Clarification of the relationship between the two is an important issue. METHODS: After screening, gastrointestinal endoscopic examinations were conducted on 1813 subjects who were surveyed using a questionnaire in which they recorded body weight, height, weight loss or gain, chief complaints, and underlying disease to prospectively examine the relationship between obesity and GERD. Differences in GERD prevalence and esophageal hiatal hernia prevalence in thin (body mass index less than 18.5 kg/m2), normal (18.5 to 25.0), and obese (greater than 25.0) subjects were examined, and the differences in GERD prevalence in patients with weight loss or gain were also investigated. RESULTS: GERD prevalence was 20.96% in the thin group, 24.42% in the normal group, and 31.86% in the obese group, indicating a significantly higher prevalence in the obese group compared with the other groups. The prevalence of hernia was also significantly higher in the obese group. GERD prevalence in the weight gain group was significantly higher than in the unchanged weight group and weight loss group. CONCLUSIONS: Both GERD prevalence and the prevalence of hernia were significantly higher in obese subjects, and the prevalence of GERD in subjects who had gained weight was also significantly higher. From these results, it was concluded that obesity is a risk factor for GERD in Japan.

DOI PubMed

Small bowel anisakiasis with self-limiting clinical course.

Tomohiro Watanabe, Sakiko Ohta, Satoru Iwamoto, Yoshihisa Tsuji, Shuko Morita, Isao Doi, Yasunori Ueda, Tsutomu Chiba

Internal medicine (Tokyo, Japan) 47 ( 24 ) 2191 - 2 2008年 [査読有り] [国内誌]

PubMed

Perfusion computerized tomography can predict pancreatic necrosis in early stages of severe acute pancreatitis.

Yoshihisa Tsuji, Hiroshi Yamamoto, Shujiro Yazumi, Yuji Watanabe, Kazuhiro Matsueda, Hiroyuki Yamamoto, Tsutomu Chiba

Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association 5 ( 12 ) 1484 - 92 2007年12月 [査読有り] [国際誌]

BACKGROUND & AIMS: The mortality rate associated with severe acute pancreatitis (SAP) with necrosis remains high because early prediction of pancreatic necrosis is difficult. We evaluated whether perfusion computerized tomography (CT), which is used to identify early stage ischemia in the brain, could detect ischemic changes in the pancreas in the early stages of SAP and predict development of necrosis. PATIENTS AND METHODS: Thirty consecutive patients with a diagnosis of SAP according to the Atlanta criteria and whose score was greater than 6 were enrolled in this study. All patients were hospitalized within 3 days after onset of symptoms indicative of acute pancreatitis and underwent perfusion CT. Three weeks later, all patients underwent conventional contrast-enhanced CT to detect progression of their disease. RESULTS: Perfusion CT showed that 10 of the 30 patients had pancreatic ischemia at the time of diagnosis. Contrast-enhanced CT disclosed that pancreatic necrosis developed in 9 of these 10 patients, but not in the 20 patients who did not have pancreatic ischemia. The sensitivity and specificity of perfusion CT for predicting pancreatic necrosis was calculated to be 100% and 95.3%, respectively. CONCLUSIONS: Perfusion CT is a useful tool for early detection of ischemic changes in the pancreas that lead to pancreatic necrosis.

PubMed

[Prevention and treatment of nonsteroidal anti-inflammatory drug-induced gastric ulcers with proton pump inhibitor].

Yoshihisa Tsuji, Toshiyuki Itoh, Tsutomu Chiba

Nihon rinsho. Japanese journal of clinical medicine 65 ( 10 ) 1831 - 4 2007年10月 [査読有り] [国内誌]

PubMed

Case of ampullary cancer presented unique progress in the bile duct

Norihiko Yamamoto, Masayoshi Nishihara, Makoto Yamamoto, Goki Gon, Masahiko Honda, Yoshihisa Tsuji, Mamoru Shimada, An-Na Nishiwaki, Kyo-Won Lee, Masahiro Sakaguchi, Hiroshi Oka, Tadashi Obayashi

Gastroenterological Endoscopy 49 ( 2 ) 212 - 217 2007年02月

We herein report a case of ampullary cancer in 74-year-old man who underwent pancreaticodoudenectomy. Endoscopic Retrograde Cholangio- pancreatography (ERCP) revealed the ampullary cancer which was grew into the bile duct. However, The tumor did not invade to the pancreushead and the duodenum. It was diagnosed pathologically as the special type of well-differentiated tubular adenocarcinoma which was presented as unique progress in the bile duct. We discuss this case with references.

Border-ownership-dependent tilt aftereffect in incomplete figures

Tadashi Sugihara, Yoshihisa Tsuji, Ko Sakai

JOURNAL OF THE OPTICAL SOCIETY OF AMERICA A-OPTICS IMAGE SCIENCE AND VISION ( OPTICAL SOC AMER ) 24 ( 1 ) 18 - 24 2007年01月 [査読有り]

A recent physiological finding of neural coding for border ownership (BO) that defines the direction of a figure with respect to the border has provided a possible basis for figure-ground segregation. To explore the underlying neural mechanisms of BO, we investigated stimulus configurations that activate BO circuitry through psychophysical investigation of the BO-dependent tilt aftereffect (BO-TAE). Specifically, we examined robustness of the border ownership signal by determining whether the BO-TAE is observed when gestalt factors are broken. The results showed significant BO-TAEs even when a global shape was not explicitly given due to the ambiguity of the contour, suggesting a contour-independent mechanism for BO coding. (c) 2006 Optical Society of America.

Usefulness of perfusion computed tomography for early detection of pancreatic ischemia in severe acute pancreatitis.

Yoshihisa Tsuji, Yuji Watanabe, Kazuhiro Matsueda, Hiroyuki Yamamoto, Etsuji Ishida, Hiroshi Yamamoto

Journal of gastroenterology and hepatology 21 ( 9 ) 1506 - 8 2006年09月 [査読有り] [国際誌]

PubMed

[A case of goblet cell carcinoid of the appendix presented as a metastatic ovarian tumor and peritoneal dissemination, and diagnosed by autopsy].

Atsushi Yamada, Hiroshi Yamamoto, Osamu Arai, Yoshie Kiyosuke, Yoshihisa Tsuji, Masato Nakatsuji, Hirotoshi Fukatsu, Masatsugu Miyoshi, Hiroyuki Kono, Hirokazu Mouri, Kazuhiro Matsueda, Takashi Tezen, Junnosuke Shimamura, Choutatsu Tsukayam

Nihon Shokakibyo Gakkai zasshi = The Japanese journal of gastro-enterology 102 ( 7 ) 905 - 11 2005年07月 [査読有り] [国内誌]

PubMed

Heidenhain variant of Creutzfeldt-Jakob disease: diffusion-weighted MRI and PET characteristics.

Yoshihisa Tsuji, Hiroshi Kanamori, Gaku Murakami, Masayuki Yokode, Takahiro Mezaki, Katsumi Doh-ura, Ken Taniguchi, Kozo Matsubayashi, Hidenao Fukuyama, Toru Kita, Makoto Tanaka

Journal of neuroimaging : official journal of the American Society of Neuroimaging 14 ( 1 ) 63 - 6 2004年01月 [査読有り] [国際誌]

Creutzfeldt-Jakob disease (CJD) is characterized by rapidly progressive dementia with a variety of neurological disorders and a fatal outcome. The authors present a case with visual disturbance as a leading symptom and rapid deterioration in global cognitive functions. The cerebrospinal fluid was positive for 14-3-3 protein, and diffusion-weighted magnetic resonance imaging (MRI) showed marked hyperintensity in the parieto-occipital cortices, where hypometabolism was clearly detected on positron emission tomography (PET). Pattern-reversal visual evoked potentials showed prolonged P100 latencies and increased N/5/P100 amplitudes. All these findings supported a diagnosis of the Heidenhain variant of CJD, whereas a long clinical course, a lack of myoclonus, and an absence of periodic synchronous discharges on electroencephalography were atypical. Diffusion-weighted MRI and PE1 in combination with visual evoked potential recording and 14-3-3 protein detection may be useful for the early diagnosis of CJD.

PubMed

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