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| 1 | Practical guidelines for diagnosis and early management of drug-induced liver injury显示文摘The spectrum of drug-induced liver injury (DILI) is both diverse and complex. The fi rst step in diagnosis is a suspicion of DILI based on careful consideration of recent comprehensive reports on the disease. There are some situations in which the suspicion of DILI is particularly strong. Exclusion of other possible etiologies according to the pattern of liver injury is essential for the diagnosis. In patients with suspected DILI,diagnostic scales,such as the Councils for International Organizations of Medical Sciences/ Roussel Uclaf Causality Assessment Method (CIOMS/ RUCAM) scale,may be helpful for the fi nal diagnosis. Early management of DILI involves prompt withdrawal of the drug suspected of being responsible,according to serum levels of alanine aminotransferase (ALT),alkaline phosphatase (ALP),and total bilirubin (T-Bil). However,as DILI patients may show resolution of liver injury without discontinuation of the drug,it should be carefully evaluated whether the suspected drug should be discontinued immediately with adequate consideration of the importance of the medication. | Kazuto Tajiri Yukihiro Shimizu | 2008 | World Journal of Gastroenterology2008,14,44: | 57 |
| 2 | Branched-chain amino acids in liver diseases显示文摘Branched chain amino acids(BCAAs)have been shown to affect gene expression,protein metabolism,apoptosis and regeneration of hepatocytes,and insulin resistance.They have also been shown to inhibit the proliferation of liver cancer cells in vitro,and are essential for lymphocyte proliferation and dendritic cell maturation.In patients with advanced chronic liver disease,BCAA concentrations are low,whereas the concentrations of aromatic amino acids such as phenylalanine and tyrosine are high,conditions that may be closely associated with hepatic encephalopathy and the prognosis of these patients.Based on these basic observations,patients with advanced chronic liver disease have been treated clinically with BCAA-rich medicines,with positive effects. | Kazuto Tajiri Yukihiro Shimizu | 2013 | World Journal of Gastroenterology2013,19,43: | 16 |
| 3 | Liver physiology and liver diseases in the elderly显示文摘The liver experiences various changes with aging that could affect clinical characteristics and outcomes in patients with liver diseases.Both liver volume and blood flow decrease significantly with age.These changes and decreased cytochrome P450 activity can affect drug metabolism,increasing susceptibility to drug-induced liver injury.Immune responses against pathogens or neoplastic cells are lower in the elderly,although these individuals may be predisposed to autoimmunity through impairment of dendritic cell maturation and reduction of regulatory T cells.These changes in immune functions could alter the pathogenesis of viral hepatitis and autoimmune liver diseases,as well as the development of hepatocellular carcinoma.Moreover,elderly patients have significantly decreased reserve functions of various organs,reducing their tolerability to treatments for liver diseases.Collectively,aged patients show various changes of the liver and other organs that could affect the clinical characteristics and management of liver diseases in these patients. | Kazuto Tajiri Yukihiro Shimizu | 2013 | World Journal of Gastroenterology2013,19,46: | 15 |
| 4 | Fucoidan enhances intestinal barrier function by upregulating the expression of claudin-1显示文摘AIM:To evaluate the protective effects of fucoidan on oxidative stress-induced barrier disruption in human intestinal epithelial cells.METHODS:In Caco-2 cell monolayer models,the disruption of barrier function by oxidative stress is mediated by H2O2.The integrity of polarized Caco-2 cell monolayers was determined by measuring the transepithelial resistance(TER)and permeability was estimated by measuring the paracellular transport of FITC-labeled4-kDa dextran(FD4).The protective effects of fucoidan on epithelial barrier functions on polarized Caco-2 cell monolayers were evaluated by TER and FD4 flux.The expression of tight junction(TJ)proteins was assessed using reverse-transcription polymerase chain reaction(RT-PCR)and immunofluorescence staining.RESULTS:Without H2O2treatment,fucoidan significantly increased the TER compared to control(P<0.05),indicating a direct enhancement of intestinal epithelial barrier function.Next,H2O2disrupted the epithelial barrier function in a time-dependent manner.Fucoidan prevented the H2O2-induced destruction in a dosedependent manner.Fucoidan significantly decreased H2O2-induced FD4 flux(P<0.01),indicating the prevention of disruption in paracellular permeability.RTPCR showed that Caco-2 cells endogenously expressed claudin-1 and-2,and occludin and that H2O2reduced the mRNA expression of these TJ proteins.Treatment with fucoidan attenuated the reduction in the expressions of claudin-1 and claudin-2 but not occludin.Immunofluorescence staining revealed that the expression of claudin-1 was intact and high on the cell surface.H2O2disrupted the integrity of claudin-1.Treatment with fucoidan dramatically attenuated the expression of claudin-1.CONCLUSION:Fucoidan enhanced intestinal epithelial barrier function by upregulating the expression of claudin-1.Thus,fucoidan may be an appropriate therapy for the treatment of inflammatory bowel diseases. | Atsushi Iraha Hiroshi Chinen Akira Hokama Takumi Yonashiro Tetsu Kinjo Kazuto Kishimoto Manabu Nakamoto Tetsuo Hirata Nagisa Kinjo Futoshi Higa Masao Tateyama Fukunori Kinjo Jiro Fujita | 2013 | World Journal of Gastroenterology2013,19,33: | 15 |
| 5 | Development of osteomalacia in a post-liver transplant patient receiving adefovir dipivoxil显示文摘We report the case of a patient treated with living donor-related liver transplantation who suffered from osteomalacia during adefovir dipivoxil (ADV)-containing antiviral therapy for lamivudine-resistant hepatitis B virus infection. The patient had generalized bone pain,with severe hypophosphatemia after 20 mo of ADV therapy. Radiographic studies demonstrated the presence of osteomalacia. The peak plasma ADV level was 38 ng/mL after administration of ADV at 10mg/day. It was also found that ADV affected the metabolism of tacrolimus,a calcineurin-inhibitor,and caused an increase in the plasma levels of tacrolimus. The disability was reversed with the withdrawal of ADV and with mineral supplementation. ADV can cause an elevation of plasma tacrolimus levels,which may be associated with renal dysfunction. High levels of ADV and tacrolimus can cause nephrotoxicity and osteomalacia. This case highlights the importance of considering a diagnosis of osteomalacia in liver transplantation recipients treated with both ADV and tacrolimus. | Masami Minemura Yoshiharu Tokimitsu Kazuto Tajiri Yasuhiro Nakayama Kengo Kawai Hiroshi Kudo Katsuharu Hirano Yoshinari Atarashi Yutaka Yata Satoshi Yasumura Terumi Takahara Toshiro Sugiyama | 2010 | World Journal of Hepatology2010,2,12: | 13 |
| 6 | Diagnosis of intestinal tuberculosis using a monoclonal antibody to Mycobacterium tuberculosis显示文摘AIM:To investigate the utility of immunohistochemical(IHC) staining with an antibody to Mycobacterium tuberculosis(M.tuberculosis) for the diagnosis of intestinal tuberculosis(TB).METHODS:We retrospectively identified 10 patients(4 males and 6 females;mean age = 65.1 ± 13.6 years) with intestinal TB.Clinical characteristics,including age,gender,underlying disease,and symptoms were obtained.Chest radiograph and laboratory tests,including sputum Ziehl-Neelsen(ZN) staining,M.tuberculosis culture,and sputum polymerase chain reaction(PCR) for tubercle bacilli DNA,as well as Tuberculin skin test(TST) and QuantiFERON-TB gold test(QFT),were examined.Colonoscopic records recorded on the basis of Sato's classification were also reviewed,in addition to data from intestinal biopsies examined for histopathological findings,including hematoxylin and eosin staining,and ZN staining,as well as M.tuberculosis culture,and PCR for tubercle bacilli DNA.For the present study,archived formalin-fixed paraffin-embedded(FFPE) intestinal tissue samples were immunohistochemically stained using a commercially available species-specific monoclonal antibody to the 38-kDa antigen of the M.tuberculosis complex.These sections were also stained with the pan-macrophage marker CD68 antibody.RESULTS:From the clinical data,we found that no patients were immunocompromised,and that the main symptoms were diarrhea and weight loss.Three patients displayed active pulmonary TB,six patients(60%) had a positive TST,and 4 patients(40%) had a positive QFT.Colonoscopic findings revealed that all patients had type 1 findings(linear ulcers in a circumferential arrangement or linear ulcers arranged circumferentially with mucosa showing multiple nodules),all of which were located in the right hemicolon and/or terminal ileum.Seven patients(70%) had concomitant healed lesions in the ileocecal area.No acid-fast bacilli were detected with ZN staining of the intestinal tissue samples,and both M.tuberculosis culture and PCR for tubercle bacilli DNA were negative in all samples.The histopathological data revealed that tuberculous granulomas were present in 4 cases(40%).IHC staining in archived FFPE samples with anti-M.tuberculosis monoclonal antibody revealed positive findings in 4 patients(40%);the same patients in which granulomas were detected by hematoxylin and eosin staining.M.tuberculosis antigens were found to be mostly intracellular,granular in pattern,and primarily located in the CD68 + macrophages of the granulomas.CONCLUSION:IHC staining with a monoclonal antibody to M.tuberculosis may be an efficient and simple diagnostic tool in addition to classic examination methods for the diagnosis of intestinal TB. | Yasushi Ihama Akira Hokama Kenji Hibiya Kazuto Kishimoto Manabu Nakamoto Tetsuo Hirata Nagisa Kinjo Haley L Cash Futoshi Higa Masao Tateyama Fukunori Kinjo Jiro Fujita | 2012 | World Journal of Gastroenterology2012,18,47: | 12 |
| 7 | Real-time in situ three-dimensional integral videography and surgical navigation using augmented reality: a pilot study显示文摘To evaluate the feasibility and accuracy of a three-dimensional augmented reality system incorporating integral videography for imaging oral and maxillofacial regions, based on preoperative computed tomography data. Three-dimensional surface models of the jawbones, based on the computed tomography data, were used to create the integral videography images of a subject's maxillofacial area. The three-dimensional augmented reality system (integral videography display, computed tomography, a position tracker and a computer) was used to generate a three-dimensional overlay that was projected on the surgical site via a half-silvered mirror. Thereafter, a feasibility study was performed on a volunteer. The accuracy of this system was verified on a solid model while simulating bone resection. Positional registration was attained by identifying and tracking the patient/surgical instrument's position. Thus, integral videography images of jawbones, teeth and the surgical tool were superimposed in the correct position. Stereoscopic images viewed from various angles were accurately displayed. Change in the viewing angle did not negatively affect the surgeon's ability to simultaneously observe the three-dimensional images and the patient, without special glasses. The difference in three-dimensional position of each measuring point on the solid model and augmented reality navigation was almost negligible (<1 mm); this indicates that the system was highly accurate. This augmented reality system was highly accurate and effective for surgical navigation and for overlaying a three-dimensional computed tomography image on a patient's surgical area, enabling the surgeon to understand the positional relationship between the preoperative image and the actual surgical site, with the naked eye. | Hideyuki Suenaga Huy Hoang Tran Hongen Liao Ken Masamune Takeyoshi Dohi Kazuto Hoshi Yoshiyuki Mori Tsuyoshi Takato | 2013 | International Journal of Oral Science2013,5,2: | 11 |
| 8 | Evolution of gastric surgery techniques and outcomes显示文摘Surgical management of gastric cancer improves survival.However,for some time,surgeons have had diverse opinions about the extent of gastrectomy.Researchers have conducted many clinical studies,making slow but steady progress in determining the optimal surgical approach.The extent of lymph node dissection has been one of the major issues in surgery for gastric cancer.Many trials demonstrated that D2 dissection resulted in greater morbidity and mortality than D1 dissection.However,long-term outcomes demonstrated that D2 dissection resulted in longer survival than D1 dissection.In 2004,the Japan Clinical Oncology Group reported a pivotal trial which was performed to determine whether para-aortic lymph node dissection combined with D2 dissection was superior to D2 dissection alone and found no benefit of the additional surgery.Gastrectomy with pancreatectomy,splenectomy,and bursectomy was initially recommended as part of the D2 dissection.Now,pancreas-preserving total gastrectomy with D2 dissection is standard,and ongoing trials are addressing the role of splenectomy.Furthermore,the feasibility and safety of laparoscopic gastrectomy are well established.Survival and quality of life are increasingly recognized as the most important endpoints.In this review,we present perspectives on surgical techniques and important trials of these techniques in gastric cancer patients. | Hironori Shiozaki Yusuke Shimodaira Elena Elimova Roopma Wadhwa Kazuki Sudo Kazuto Harada Jeannelyn S.Estrella Prajnan Das Brian Badgwell Jaffer A.Ajani | 2016 | Chinese Journal of Cancer2016,35,8: | 9 |
| 9 | Endoscopic and radiographic features of gastrointestinal involvement in vasculitis显示文摘Vasculitis is an inflammation of vessel walls,followed by alteration of the blood flow and damage to the dependent organ.Vasculitis can cause local or diffuse pathologic changes in the gastrointestinal (GI) tract.The variety of GI lesions includes ulcer,submucosal edema,hemorrhage,paralytic ileus,mesenteric ischemia,bowel obstruction,and life-threatening perforation.The endoscopic and radiographic features of GI involvement in vasculitisare reviewed with the emphasis on small-vessel vasculitis by presenting our typicalcases,including Churg-Strauss syndrome,HenochSch nlein purpura,systemic lupus erythematosus,and Beh et's disease.Important endoscopic features are ischemic enterocolitis and ulcer.Characteristic computed tomographic findings include bowel wall thickening with the target sign and engorgement of mesenteric vessels with comb sign.Knowledge of endoscopic and radiographic GI manifestations can help make an early diagnosis and establish treatment strategy. | Akira Hokama Kazuto Kishimoto Yasushi Ihama Chiharu Kobashigawa Manabu Nakamoto Tetsuo Hirata Nagisa Kinjo Futoshi Higa Masao Tateyama Fukunori Kinjo Kunitoshi Iseki Seiya Kato Jiro Fujita | 2012 | World Journal of Gastrointestinal Endoscopy2012,4,3: | 9 |
| 10 | Liver involvement in systemic infection显示文摘The liver is often involved in systemic infections,resulting in various types of abnormal liver function test results.In particular,hyperbilirubinemia in the range of 2-10 mg/dL is often seen in patients with sepsis,and several mechanisms for this phenomenon have been proposed.In this review,we summarize how the liver is involved in various systemic infections that are not considered to be primarily hepatotropic.In most patients with systemic infections,treatment for the invading microbes is enough to normalize the liver function tests.However,some patients may show severe liver injury or fulminant hepatic failure,requiring intensive treatment of the liver. | Masami Minemura Kazuto Tajiri Yukihiro Shimizu | 2014 | World Journal of Hepatology2014,6,9: | 9 |
| 11 | 胃肠的淀粉样变性病的内视镜、组织病理学说的特征显示文摘 Amyloidosis is a rare disorder, characterized by the extracellular deposition of an abnormal fibrillar protein, which disrupts tissue structure and function. Amyloidosis can be acquired or hereditary, and systemic or localized to a single organ, such as the gastrointestinal (GI) tract. Clinical manifestations may vary from asymptomatic to fatal forms. Primary amyloidosis (monoclonal immunoglobulin light chains, AL) is the most common form of amyloidosis. AL amyloidosis has been associated with plasma cell dyscrasias, such as, mul- tiple myeloma. Secondary amyloidosis is caused by the deposition of fragments of the circulating acute-phase reactant, serum amyloid A protein (SAA). Common causes of AA amyloidosis are chronic inflammatory dis-orders. Although GI symptoms are usually nonspecific, histopathological patterns of amyloid deposition are associated with clinical and endoscopic features. Amyloid deposition in the muscularis mucosae, submucosa, and muscularis propria has been dominant in AL amyloidosis, leading to polypoid protrusions and thickening of the valvulae conniventes, whereas granular amyloid deposition mainly in the propria mucosae has been related to AA amyloidosis, resulting in the fine granular appearance, mucosal friability, and erosions. As a result, AL amyloidosis usually presents with constipation, mechanical obstruction, or chronic intestinal pseudoobstruction while AA amyloidosis presents with diarrhea and malabsorption Amyloidotic GI symptoms are mostly refractory and have a negative impact on quality of life and survival. Diagnosing GI amyloidosis requires high suspicion of evaluating endoscopists. Because of the absence of specific treatments for reducing the abundance of the amyloidogenic precursor protein, we should be aware of certain associations between patterns of amyloid deposition and clinical and endoscopic features. | Akira Hokama Kazuto Kishimoto Manabu Nakamoto Chiharu Kobashigawa Tetsuo Hirata Nagisa Kinjo Fukunori Kinjo Seiya Kato Jiro Fujita | 2011 | World Journal of Gastrointestinal Endoscopy2011,3,8: | 6 |
| 12 | Recent advances in the management of pruritus in chronic liver diseases显示文摘Pruritus is a symptom found in patients with chronic liver diseases,especially cholestatic liver diseases such as primary biliary cholangitis.This symptom impairs patient quality of life by disturbing sleep and may lead to consideration of liver transplantation.Mechanisms implicated in pruritus have been associated with the peripheral and central nervous systems,leading to the development of various therapeutic options.Little evidence for the efficacy of most of these treatments is currently available,indicating a need for further investigations. | Kazuto Tajiri Yukihiro Shimizu | 2017 | World Journal of Gastroenterology2017,23,19: | 5 |
| 13 | Distal pancreatectomy with resection of the celiac axis and reconstruction of the hepatic artery for carcinoma of the body and tail of the pancreas显示文摘 | Masaru Konishi Taira Kinoshita Toshio Nakagori Kazuto Inoue Tatsuya Oda Takahiro Kimata Hiroyuki Kikuchi Munemasa Ryu | 2000 | Journal of Hepato - Biliary - Pancreatic Surgery2000,,2: | 4 |
| 14 | Endoscopic and histopathological study on the duodenum of Strongyloides stercoralis hyperinfection显示文摘AIM:To investigate endoscopic and histopathological findings in the duodenum of patients with Strongyloides stercoralis(S.stercoralis)hyperinfection. METHODS:Over a period of 23 years(1984-2006),we investigated 25 patients withS.stercoralis hyperinfection who had had an esophagogastroduodenoscopy before undergoing treatment for strongyloidiasis.The clinical and endoscopic findings were analyzed retrospectively. RESULTS:Twenty-four(96%)of the patients investigated were under immunocompromised condition which was mainly due to a human T lymphotropic virus type 1(HTLV-1)infection.The abnormal endoscopic findings,mainly edematous mucosa,white villi and erythematous mucosa,were observed in 23(92%) patients.The degree of duodenitis including villous atrophy/destruction and inflammatory cell infiltration corresponded to the severity of the endoscopic findings. The histopathologic yield for identifying larvae was 71.4% by duodenal biopsy.The endoscopic findings of duodenitis were more severe in patients whose biopsies were positive for larvae than those whose biopsies were negative(Endoscopic severity score:4.86±2.47vs 2.71 ±1.38,P<0.05). CONCLUSION:Our study clearly demonstrates that,in addition to stool analysis,endoscopic observation and biopsies are very important.We also emphasize that S.stercoralis and HTLV-1 infections should be ruled out before immunosuppressive therapy is administered in endemic regions. | Kazuto Kishimoto Akira Hokama Tetsuo Hirata Yasushi Ihama Manabu Nakamoto Nagisa Kinjo Fukunori Kinjo Jiro Fujita | 2008 | World Journal of Gastroenterology2008,14,11: | 4 |
| 15 | Planning of anatomical liver segmentectomy and subsegmentectomy with 3-dimensional simulation software显示文摘 | Takeshi Takamoto Takuya Hashimoto Satoshi Ogata Kazuto Inoue Yoshikazu Maruyama Akiyuki Miyazaki Masatoshi Makuuchi | 2013 | The American Journal of Surgery2013,,: | 4 |
| 16 | Clinical and radiological feature of lymphoepithelial cyst of the pancreas显示文摘A lymphoepithelial cyst(LEC)of the pancreas is a rare benign lesion.Because patients with LEC of the pancreas have a good prognosis,it is important that these lesions are accurately differentiated from other more aggressive pancreatic neoplasms for an appropriate treatment strategy.Previous studies have reported that a definitive diagnosis of LEC often cannot be obtained based solely on the findings of preoperative imaging(e.g.,Computed tomography or Magnetic resonance imaging).In this study,we reviewed four cases of pancreatic LECs to investigate the feature of LECs.We reviewed these cases with regard to symptoms,imaging findings,surgical procedures,and other clinical factors.We found that LEC was associated with unique characteristics on imaging findings.A preoperative diagnosisof LEC may be possible by comprehensively evaluating its clinical and imaging findings. | Hirofumi Terakawa Isamu Makino Hisatoshi Nakagawara Tomoharu Miyashita Hidehiro Tajima Hirohisa Kitagawa Takashi Fujimura Dai Inoue Kazuto Kozaka Toshifumi Gabata Tetsuo Ohta | 2014 | World Journal of Gastroenterology2014,20,45: | 4 |
| 17 | BRAF inhibitor:a novel therapy for ameloblastoma in mandible显示文摘Ameloblastoma is a benign but locally aggressive odontogenie neoplasm that accounts for 10% of all tumors arising in the mandible and maxilla (1).Eighty percent of ameloblastomas arise in the mandible,and they are usually found in young adults.It frequently recurs if not adequately resected.Therefore,the standard therapy for this tumor is complete bone resection with an adequate margin of safety: marginal or segmental osteotomy.However,aesthetic deformities,functional impairments and psychological impairments after radical surgery for large ameloblastoma, have been serious issues (1). | Masanobu Abe Liang Zong Takahiro Abe Hideyuki Takeshima Jiafu Ji Toshikazu Ushijima Kazuto Hoshi | 2018 | Chinese Journal of Cancer Research2018,30,6: | 3 |
| 18 | A case of hemangiopericytoma of the soft palate with articulate disorder and dysphagia显示文摘We report a case of hemangiopericytoma of the soft palate of 60-year-old patient, who noticed a mass of the soft palate and experienced difficulty in speaking. We found a pediculate, hard, elastic mass measuring 38 mm (cross-sectional diameter). Computed tomography (CT) scans and dynamic magnetic resonance imaging (MRI) confirmed irregularly shaped mass and revealed a heterogeneous internal composition, consistent with vascular tumors. We excised the tumor under general anesthesia. Histopathological diagnosis was based on positive immunoreactivity of CD99 and vimentin and weak, positive staining of CD34. Three and half years following tumor excision, there is no recurrence or metastasis. | Yasuyuki Michi Miho Suzuki Kazuto Kurohara Kiyoshi Harada | 2013 | International Journal of Oral Science2013,5,2: | 3 |
| 19 | Survival benefits of portal vein resection for pancreatic cancer显示文摘 | Toshio Nakagohri Taira Kinoshita Masaru Konishi Kazuto Inoue Shinichiro Takahashi | 2003 | The American Journal of Surgery2003,,2: | 2 |
| 20 | Systemic abnormalities in liver disease显示文摘Systemic abnormalities often occur in patients with liver disease. In particular, cardiopulmonary or renal diseases accompanied by advanced liver disease can be serious and may determine the quality of life and prognosis of patients. Therefore, both hepatologists and non-hepatologists should pay attention to such abnormalities in the management of patients with liver diseases. | Masami Minemura Kazuto Tajiri Yukihiro Shimizu | 2009 | World Journal of Gastroenterology2009,15,24: | 2 |