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1.
Clin J Gastroenterol ; 17(3): 563-566, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38430348

RESUMEN

Fever, abdominal pain, and liver dysfunction are almost inevitable complications of transcatheter arterial chemo embolization (TACE) for hepatocellular carcinoma, but these symptoms may also be due to bile duct obstruction caused by shedding of necrotic tumor material into the bile duct. A 68-year-old man presented with persistent fever, liver dysfunction, and abdominal pain after TACE. Computed tomography revealed stone-like hyperdensities in the bile duct. Endoscopic retrograde cholangiopancreatography revealed these structures to be necrotic material from hepatocellular carcinoma. We believe this is an instructive case of an often overlooked situation.


Asunto(s)
Carcinoma Hepatocelular , Quimioembolización Terapéutica , Neoplasias Hepáticas , Necrosis , Humanos , Masculino , Anciano , Carcinoma Hepatocelular/terapia , Carcinoma Hepatocelular/patología , Quimioembolización Terapéutica/efectos adversos , Neoplasias Hepáticas/terapia , Neoplasias Hepáticas/patología , Neoplasias Hepáticas/diagnóstico por imagen , Necrosis/etiología , Síndrome , Colangiopancreatografia Retrógrada Endoscópica , Tomografía Computarizada por Rayos X
2.
World J Clin Cases ; 11(23): 5462-5467, 2023 Aug 16.
Artículo en Inglés | MEDLINE | ID: mdl-37637693

RESUMEN

BACKGROUND: We have previously demonstrated that the first wave of the coronavirus disease 2019 (COVID-19) pandemic caused exacerbations in ulcerative colitis (UC) patients, probably through psychological and physical stress. However, successive waves of the COVID-19 pandemic continuously followed the first. The effects of this chronic stress on the disease condition in UC patients are of interest. AIM: To clarify the effect of chronic stress from COVID-19 on disease condition in patients aggravated after the first wave. METHODS: Our previous study investigated 289 consecutive UC outpatients treated in one center during March and April 2020, the period of the first wave of the COVID-19 pandemic. In this study, an identical group of 289 UC patients was evaluated using UC-disease activity index (UC-DAI), endoscopic mucosal appearance score, and Matts pathological grade scoring. RESULTS: Of the 289 UC patients included in the study in 2020, 10 patients dropped out as of 2021 and another 11 patients dropped out as of 2022, making three groups for 2020, 2021 and 2022. No significant differences in characteristics were found among the three groups. UC-DAI scores had aggravated during the period of the first wave of the COVID-19 pandemic, but significantly recovered in 2021 and remained stable in 2022. Matts grade scores significantly recovered in 2021 from those in 2020 and remained stable in 2022. CONCLUSION: Disease activity of UC patients recovered in 2021 and remained stable in 2022, aggravated by the stress of the first wave of COVID-19 in 2020 despite persistence of the pandemic.

3.
World J Gastroenterol ; 29(23): 3703-3714, 2023 Jun 21.
Artículo en Inglés | MEDLINE | ID: mdl-37398885

RESUMEN

BACKGROUND: Shear wave speed (SWS), shear wave dispersion (SWD), and attenuation imaging (ATI) are new diagnostic parameters for non-alcoholic fatty liver disease. To differentiate between non-alcoholic steatohepatitis (NASH) and non-alcoholic fatty liver (NAFL), we developed a clinical index we refer to as the "NASH pentagon" consisting of the 3 abovementioned parameters, body mass index (BMI), and Fib-4 index. AIM: To investigate whether the area of the NASH pentagon we propose is useful in discriminating between NASH and NAFL. METHODS: This non-invasive, prospective, observational study included patients diagnosed with fatty liver by abdominal ultrasound between September 2021 and August 2022 in whom shear wave elastography, SWD, and ATI were measured. Histological diagnosis based on liver biopsy was performed in 31 patients. The large pentagon group (LP group) and the small pentagon group (SP group), using an area of 100 as the cutoff, were compared; the NASH diagnosis rate was also investigated. In patients with a histologically confirmed diagnosis, receiver-operating characteristic (ROC) curve analyses were performed. RESULTS: One hundred-seven patients (61 men, 46 women; mean age 55.1 years; mean BMI 26.8 kg/m2) were assessed. The LP group was significantly older (mean age: 60.8 ± 15.2 years vs 46.4 ± 13.2 years; P < 0.0001). Twenty-five patients who underwent liver biopsies were diagnosed with NASH, and 6 were diagnosed with NAFL. On ROC curve analyses, the areas under the ROC curves for SWS, dispersion slope, ATI value, BMI, Fib-4 index, and the area of the NASH pentagon were 0.88000, 0.82000, 0.58730, 0.63000, 0.59333, and 0.93651, respectively; the largest was that for the area of the NASH pentagon. CONCLUSION: The NASH pentagon area appears useful for discriminating between patients with NASH and those with NAFL.


Asunto(s)
Diagnóstico por Imagen de Elasticidad , Enfermedad del Hígado Graso no Alcohólico , Masculino , Humanos , Femenino , Persona de Mediana Edad , Anciano , Enfermedad del Hígado Graso no Alcohólico/patología , Índice de Masa Corporal , Estudios Prospectivos , Ultrasonografía , Diagnóstico por Imagen de Elasticidad/métodos , Curva ROC , Hígado/diagnóstico por imagen , Hígado/patología , Biopsia
4.
Oxf Med Case Reports ; 2023(2): omac157, 2023 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-36860962

RESUMEN

Eosinophilic pancreatitis (EP) is very rare and characterised by infiltration of eosinophils into the pancreatic parenchyma. A 40-year-old man was diagnosed with total-colitis-type ulcerative colitis at the age of 15 years. He was then diagnosed with steroid-dependent ulcerative colitis. He was given golimumab, which resulted in remission. Ten months after beginning golimumab, he was urgently hospitalised with a diagnosis of acute pancreatitis. Hence, endoscopic ultrasound-guided fine needle biopsy was performed to obtain a definitive diagnosis. Pathologically, abundant infiltration of eosinophils was observed in the edematous intralobular stroma of the pancreas. He was diagnosed with EP, and treated with corticosteroids.

5.
Intern Med ; 62(19): 2833-2837, 2023 Oct 01.
Artículo en Inglés | MEDLINE | ID: mdl-36792191

RESUMEN

A 70-year-old Japanese man with a submucosal gastric mass that continued to increase in size underwent endoscopic submucosal dissection using the pocket creation method. Histologically, some epithelial cell nuclei were enlarged, but there was little atypia overall and no sign of malignancy, suggesting a diagnosis of submucosal heterotopic gastric gland (SHGG). SHGG that enlarges over time has been associated with gastric cancer, but a preoperative diagnosis is difficult. This case was very valuable, as it enabled us to follow the course of SHGG over a period of about nine years, from the onset to enlargement.


Asunto(s)
Resección Endoscópica de la Mucosa , Neoplasias Gástricas , Masculino , Humanos , Anciano , Endoscopía , Neoplasias Gástricas/cirugía , Neoplasias Gástricas/patología , Mucosa Gástrica/cirugía , Mucosa Gástrica/patología
6.
J Clin Med ; 11(17)2022 Aug 25.
Artículo en Inglés | MEDLINE | ID: mdl-36078916

RESUMEN

OBJECTIVES: Endoscopic-ultrasound-guided hepaticogastrostomy (EUS-HGS) with plastic stent placement is associated with a high incidence of adverse events that may be reduced using an endoscopic retrograde cholangiopancreatography (ERCP) contrast catheter in the track dilation step. In this study, we evaluated the usefulness of track dilation and bile aspiration performed with an ERCP contrast catheter in EUS-HGS with plastic stent placement. METHODS: In a multicenter setting, 22 EUS-HGS cases dilated with an ERCP contrast catheter were analyzed retrospectively and compared between a bile aspiration group and no bile aspiration group. RESULTS: Overall, adverse events occurred in three (13.6%) cases of bile leakage, three (13.6%) cases of peritonitis, and one (4.5%) case of bleeding. Comparing patients with and without bile aspiration, 6 of the 11 patients (54.5%) with no bile aspiration had adverse events, whereas only 1 of the 11 patients (9.1%) who had bile aspiration, as much bile as possible, had an adverse event (bleeding). In univariate analysis, the only factor affecting the occurrence of adverse events was bile aspiration whenever possible (odds ratio, 12.0; 95%CI 1.12-128.84). CONCLUSIONS: In EUS-HGS with plastic stent placement, track dilation and bile aspiration with an ERCP contrast catheter may be useful in reducing adverse events.

8.
DEN Open ; 2(1): e103, 2022 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-35873508

RESUMEN

Objectives: Early obstruction of a self-expandable metal stent placed for distal malignant biliary obstruction is more likely to occur in the presence of duodenal invasion. An anti-reflux self-expandable metal stent (ARMS) has been developed for the purpose of preventing duodenal fluid reflux into the bile duct. In this study, we evaluated the usefulness and safety of a duckbill-type ARMS (D-ARMS) in the situation of duodenal invasion. Methods: We retrospectively analyzed 10 consecutive patients who received D-ARMS for distal malignant biliary obstruction with duodenal invasion. We evaluated non-occlusion cholangitis, recurrent biliary obstruction (RBO), and adverse events after D-ARMS placement. Results: There were no cases of non-occlusion cholangitis. RBO was observed in 2 patients (20%), and time to RBO was 236 days and 117 days, respectively. The causes of RBO were overgrowth and sludge formation. The median time to RBO was 382 days (range, 117-382 days). Only one adverse event was observed (cholecystitis). Conclusions: D-ARMS shows potential as an optimal ARMS.

9.
Clin J Gastroenterol ; 14(1): 123-128, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33079335

RESUMEN

A 43-year-old Japanese man diagnosed with Cronkhite-Canada Syndrome (CCS) underwent endoscopic submucosal dissection for Helicobacter pylori-negative gastric cancer. Histologically, the completely resected specimen showed large and small irregular glands composed of foveolar epithelial-like atypical cells, and it was immunohistochemically MUC5AC positive overall, MUC6 positive except for the surface layer and nearby parts, and MUC2 negative. The patient was diagnosed with gastric-phenotype, low-grade, well-differentiated adenocarcinoma. This is a case of gastric cancer developing in CCS definitively without H. pylori infection. We conclude that H. pylori infection is not an absolute condition in gastric cancer associated with CCS. Elucidation of the true malignant potential of CCS excluding the effects of H. pylori infection is needed.


Asunto(s)
Resección Endoscópica de la Mucosa , Infecciones por Helicobacter , Helicobacter pylori , Poliposis Intestinal , Neoplasias Gástricas , Adulto , Mucosa Gástrica , Infecciones por Helicobacter/complicaciones , Humanos , Poliposis Intestinal/complicaciones , Masculino , Neoplasias Gástricas/complicaciones , Neoplasias Gástricas/microbiología , Neoplasias Gástricas/cirugía
10.
Food Chem ; 148: 388-95, 2014 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-24262573

RESUMEN

We produced low temperature (15 °C) processed green tea (LTPGT) with higher aroma contents than normal green tea (Sencha). Normal temperature processed green tea (NTPGT), involved storing at 25 °C, and Sencha had no storing process. Sensory evaluation showed LTPGT had higher levels of floral and sweet odorants than NTPGT and Sencha. Aroma extract dilution analysis and gas chromatography-mass spectrometry-olfactometry indicated LTPGT had 12 aroma compounds with high factor dilution values (FD). Amongst LTPGT's 12 compounds, indole, jasmine lactone, cis-jasmone, coumarin, and methyl epijasmonate contributed to floral, fruity and sweet characters. In particular, indole increased initially, peaking at 16 h, then gradually decreased. Feeding experiments suggested [(15)N]indole and [(15)N]oxygenated indoles (OX-indoles) were produced from [(15)N]anthranilic acid. We proposed the increase in indole was due to transformation of anthranilic acid during the 16 h storage and the subsequent decline in indole level was due to its conversion to OX-indoles.


Asunto(s)
Camellia sinensis/química , Odorantes/análisis , Extractos Vegetales/química , Té/química , Almacenamiento de Alimentos , Cromatografía de Gases y Espectrometría de Masas , Temperatura
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