Authorship：Lead author   Language：Japanese   Publishing type：Research paper (scientific journal)  

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

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Authorship：Corresponding author   Language：Japanese   Publishing type：Research paper (scientific journal)  

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

DOI： 10.1016/j.ejca.2018.01.081

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

DOI： 10.1093/jscr/rjx200

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

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

DOI： 10.12659/AJCR.903777

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Authorship：Lead author   Language：Japanese   Publishing type：Research paper (scientific journal)  

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

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

DOI： 10.1016/S0140-6736(16)30583-9

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Authorship：Lead author   Language：English   Publishing type：Research paper (scientific journal)  

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

The purpose of this study was to describe the cyst infection of intraductal papillary mucinous neoplasm in 2 patients. The patients were 62- and 74-year-old men. The initial symptom was acute febrile abdominal pain. Laboratory tests revealed severe infection (C-reactive protein concentrations were 23.3 μg/mL in patient 1 and 22.3 μg/mL in patient 2) and multilocular cystic masses (the diameters were 70 mm in patient 1 and 50 mm in patient 2) at the pancreatic head that involved peripancreatic vessels were demonstrated by computed tomography. Laboratory and radiographic findings were markedly improved by endoscopic transpapillary drainage. The enteric bacteria were detected in the drainage specimens. Curative resection was achieved, and histological findings indicated a carcinoma in situ in patient 1 and an invasive carcinoma in patient 2. Neither hyperamylasemia nor histological fat necrosis, frequently observed in acute pancreatitis, was evident. Both patients were free from recurrence after surgery (17 months in patient 1, and 18 months in patient 2). Cyst infection is an unknown complication of intraductal papillary mucinous neoplasm. Transpapillary drainage is highly recommended as an initial intervention. It is difficult to distinguish between cyst infection and unresectable invasive carcinoma with imaging modalities; however, surgical intervention after drainage may contribute to long-term survival. © 2014 by Lippincott Williams & Wilkins.

DOI： 10.1097/MPA.0000000000000036

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

AIM: To present our experiences in studying the clinicopathological features of small nonfunctioning pancreatic neuroendocrine tumors (NF-pNETs). METHODS: The subjects included 9 patients with NFpNETs who underwent pancreatectomy between April 1996 and September 2012. The surgical procedure, histopathological findings, and prognosis were assessed. RESULTS: All tumors were incidentally detected by computed tomography. The median diameter was 10 mm (5-32 mm). One patient was diagnosed with von Hippel-Lindau disease, and the others were sporadic cases. For the histopathological findings, 7 patients were G1; 1 patient was G2; and 1 patient, whose tumor was 22 mm, had neuroendocrine carcinoma (NEC). One patient who had a tumor that was 32 mm had direct invasion to a regional lymph node and 1 patient with NEC, had regional lymph node metastases. Six of the 7 patients with sporadic NF-pNETs, excluding the patient with NEC, had tumors that were smaller than 10 mm. Tumors smaller than 10 mm showed no malignancy and lacked lymph node metastasis. CONCLUSION: Sporadic NF-pNETs smaller than 10 mm tend to have less malignant potential. These findings suggest that lymphadenectomy may be omitted for small NF-pNETs after further investigation. © 2014 Baishideng Publishing Group Inc. All rights reserved.

DOI： 10.3748/wjg.v20.i47.17949

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

AIM: To evaluate the clinical utility of hepatic clearance (HC) measured with technetium-99m-diethylenetriaminepenta-acetic acid-galactosyl human serum albumin (99mTc-GSA) single-photon emission computed tomography (SPECT) to estimate the degree of liver fibrosis.

DOI： 10.3748/wjg.v20.i44.16714

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

The symptoms of gallbladder cancer (GBC) are vague and non-specific. Therefore, GBC is often detected at an advanced or metastatic stage. The most effective treatment for GBC is surgical resection, however the majority of GBC cases are unresectable at the time of diagnosis. Therefore, numerous GBC patients undergo chemotherapy. This study reports the case of a 60-year-old female with GBC who underwent successful surgical curative resection following a single dose of the chemotherapeutic agent, S-1, twice daily for 4 weeks followed by a 14-day rest period for 36 months. S-1 is a novel orally administered drug composed of a combination of the 5-fluorouracil (5-FU) prodrug, tegafur, 5-chloro-2,4-dihydroxypyridine (CDHP) and oteracil potassium in a 1:0.4:1 molar concentration ratio. The focus of the present study was the candidate factors that affect the therapeutic efficacy of S-1-based chemotherapy. In particular, the gene expression involved in the S-1 metabolic pathway was investigated by assessing the intratumoral dihydropyrimidine dehydrogenase (DPD), thymidylate synthase (TS) and orotate phosphoribosyltransferase gene expression. The surgical specimen exhibited high intratumoral DPD gene expression levels compared with those observed in previously reported non S-1 responsive cases of biliary tract cancer. Due to the results obtained in the current study, we hypothesize that CDHP enhanced the antitumor efficacy of 5-FU by inhibiting the excess DPD protein produced by the tumor. © 2014, Spandidos Publications. All rights reserved.

DOI： 10.3892/ol.2014.2565

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

症例は72歳の女性で,多数のリンパ節腫大を伴う4cm大の膵頭部腫瘍に対し幽門輪温存膵頭十二指腸切除を施行した.病理組織学的検査所見ではリンパ節転移陽性の多形細胞型膵退形成癌と診断されたが,術後4年経過後も無再発生存中である.膵退形成癌は予後不良とされているが,長期生存例も報告されている.その特徴は不明であるが,過去の報告からは免疫応答の関与が長期生存に寄与する可能性が示唆されている.本例も間質に好中球とCD8陽性リンパ球の顕著な浸潤を認め,同様の機序が推察された.治療は切除が第一選択で,報告された長期生存例も全て切除例である.本例は多数の腫大リンパ節を認めたものの,画像所見から通常型膵管癌以外の特殊な組織型を想定して切除し長期生存が得られている貴重な症例である.本疾患の治療戦略を明らかにするためには,欧米と分類を統一して複雑な用語を整理し,多数例での解析を行うことが重要であると考えられた.(著者抄録)

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Authorship：Lead author   Language：Japanese   Publishing type：Research paper (scientific journal)  

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

83歳女。脾静脈非再建の上腸間膜静脈・脾静脈合流部切除を併施した幽門輪温存膵頭十二指腸切除術後、補助化学療法を施行中であったが下血を繰り返すようになった。上部消化管内視鏡で膵空腸吻合部に静脈瘤を認め、出血源と考えられた。CTでは脾静脈から下腸間膜静脈、横行結腸辺縁静脈、回結腸静脈に連続する側副血行路を認め、横行結腸付近で一部欠損していた。膵腸吻合部にも側副血行路の形成を認めた。膵腸腸吻合部静脈瘤に対し部分的脾動脈塞栓術を施行したが、その後も出血を認めたため、遠位脾腎静脈吻合術を施行し、脾静脈を3cmほど膵背面から遊離し、左腎静脈と端側吻合した。術後1週のCTでは横行結腸間膜内と膵腸吻合部の側副血行路が消失しており、脾腎静脈吻合部の開存性は良好であった。脾静脈瘤術後1年3ヵ月の現在、消化管出血は認めていない。

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

症例は75歳,男性.タール便を主訴に診断された十二指腸第2部から3部にかけての全周性十二指腸側方発育型腺腫を約6年間経過観察ののち切除した.半年に1回の内視鏡,低緊張性十二指腸造影を行い,最終的に生検で癌が検出され膵頭十二指腸切除(PD)を行ったが,切除時点ではリンパ節転移を伴う進行癌であった.十二指腸腺腫は前癌病変と考えられ切除が推奨される.本例は病変の大部分が腺腫であり,癌の局在はごく一部に限られていたため,生検での癌の検出が困難であった.さらに画像的にも大きな変化がなく経過したため経過中早期の癌の診断が困難であった.癌の確定診断がない状態で侵襲の大きいPDを受けることに患者が同意できなかったことが長期の経過観察となった要因と考えられた.本例は十二指腸腺腫の自然史と,長期にわたる経過観察の危険性を示す症例であると考えられた.(著者抄録)

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

Pancreatic hamartoma is a rare tumor, and its characteristic histopathologic features have not yet been fully evaluated. In this study, we collected 9 cases of pancreatic hamartoma to elucidate distinctive histopathologic features that can serve to establish this tumor as a clear disease entity and thus formulate useful histopathologic criteria for this tumor. The cases comprised 4 men and 5 women with a mean age of 62.7 years. The average tumor diameter was 3.3 cm. All patients underwent surgical treatment, and none showed any recurrence postoperatively. Macroscopically, pancreatic hamartomas were well-demarcated tumors with a solid or solid and cystic appearance. Microscopically, these tumors comprised mature acini and small-sized to medium-sized ducts showing a distorted architecture with various amounts of fibrous stroma. Strikingly, the tumors consistently lacked concentric elastic fibers in their duct walls, peripheral nerves, and well-formed islets of Langerhans, all of which exist in both the normal and atrophic pancreas. Immunohistochemically, scattered chromogranin A-positive neuroendocrine cells were observed in the acinar and ductal components. Ductal components were positive for S-100 protein. Spindle-shaped stromal cells expressed CD34 and/or c-kit. These histopathologic features were distinct from those of 5 cases of pancreatic ductal adenocarcinoma, 3 cases of type 1 autoimmune pancreatitis (lymphoplasmacytic sclerosing pancreatitis), 3 cases of alcoholic chronic pancreatitis, and 5 cases of normal pancreas. In conclusion, pancreatic hamartomas share some distinctive histopathologic features and clinical outcomes (neither recurrence nor metastasis) that allow them to be interpreted as malformative lesions. The term 'hamartoma' is appropriate for these unique lesions. © 2013 Lippincott Williams and Wilkins.

DOI： 10.1097/PAS.0b013e318283ce4c

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Authorship：Lead author   Language：Japanese   Publishing type：Research paper (scientific journal)  

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

Aims: Cirrhotic patients commonly have a liver zinc deficiency, which may aggravate liver fibrosis due to the lack of antioxidative effects of zinc. This study examined the ability of polaprezinc, N-(3-aminopropionyl)-l-histidinato zinc, to prevent fibrosis in a rat model of thioacetamide (TAA)-induced hepatic fibrosis. Main methods: Liver cirrhosis was induced by orally administering TAA for 20 weeks. The rats were cotreated with one of the following for the last 10 weeks of TAA treatment: (1) polaprezinc (50 or 200 mg/kg/day); (2) l-carnosine (155 mg/kg/day), which contained equal amounts of l-carnosine as 200 mg/kg/day polaprezinc; (3) zinc sulfate (112 mg/kg/day) or (4) zinc-l-aspartic complex (317.8 mg/kg/day). Both zinc supplementations contained equal amounts of zinc as high-dose polaprezinc. Key findings: Hepatic zinc levels fell significantly in rats treated with TAA for 20 weeks. Cotreating with high-dose polaprezinc and zinc-l-aspartic complex for 10 weeks prevented hepatic zinc loss. Hepatic hydroxyproline and tissue inhibitor of metalloproteinases-1 (TIMP-1) were significantly higher in rats treated with TAA for 20 weeks than 10 weeks, whereas polaprezinc prevented changes in these fibrosis markers and reduced hepatic transforming growth factor-β1 protein concentration, macroscopic and histologic changes. TAA caused oxidative stress-related changes in the liver that were prevented by high-dose polaprezinc and partially by zinc-l-aspartic complex. Treatment with l-carnosine, low-dose polaprezinc or zinc sulfate for 10 weeks did not affect liver fibrosis progression or oxidative stress-related changes. Significance: Polaprezinc may prevent ongoing fibrosis by preventing zinc depletion, oxidative stress and fibrosis markers in cirrhotic livers. © 2011 Elsevier Inc. All rights reserved.

DOI： 10.1016/j.lfs.2011.10.022

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

A primary benign schwannoma of the liver is extremely rare and is difficult to preoperatively discriminate from a malignant tumor. We compared the imaging and pathological findings, and examined the possibility of preoperatively diagnosing a benign liver schwannoma. A 72-year-old woman was admitted to our hospital because of a 4.6-cm mass in the liver. A malignant tumor was suspected, and a right hepatectomy was performed. After this, the diagnosis of a primary benign schwannoma of the liver was made through pathological examination. Contrast-enhanced ultrasonography (CEUS) with Sonazoid showed minute blood flows into the septum and solid areas of the tumor in the vascular phase; most likely due to increased arterial flow associated with infiltration of chronic inflammatory cells. In the postvascular phase, CEUS showed contrast defect of cystic areas and delayed enhancement of solid areas; most likely due to aggregation of siderophores. Because discriminating between a benign and malignant schwannoma of the liver is difficult, surgery is generally recommended. However, the two key findings from CEUS may be useful in discriminating ancient schwannoma by recognizing the hemorrhage involved in the secondary degeneration and aggregation of siderophores. © 2012 Baishideng.

DOI： 10.3748/wjg.v18.i35.4967

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

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Event date： 2012.5 - 2012.6

Language：Japanese   Presentation type：Poster presentation  

Venue：大阪  

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Event date： 2011.8

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：久留米  

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Event date： 2010.8

Language：Japanese   Presentation type：Poster presentation  

Venue：津  

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Event date： 2010.5

Language：Japanese   Presentation type：Poster presentation  

Venue：仙台  

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