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| 1 | Correlation between hepatic blood flow and liver function in alcoholic liver cirrhosis显示文摘AIM:To elucidate the correlation between hepatic blood flow and liver function in alcoholic liver cirrhosis(AL-LC).METHODS:The subjects included 35 patients with ALLC(34 men,1 woman;mean age,58.9±10.7 years;median age,61 years;range:37-76 years).All patientswere enrolled in this study after obtaining written informed consent.Liver function was measured with tests measuring albumin(Alb),prothrombin time(PT),brain natriuretic peptide(BNP),branched amino acid and tyrosine ratio(BTR),branched chain amino acid(BCAA),tyrosine,ammonia(NH3),cholinesterase(Ch E),immunoreactive insulin(IRI),total bile acid(TBA),and the retention rate of indocyanine green 15 min after administration(ICG R15).Hepatic blood flow,hepatic arterial tissue blood flow(HATBF),portal venous tissue blood flow(PVTBF),and total hepatic tissue blood flow(THTBF)were simultaneously calculated using xenon computed tomography.RESULTS:PVTBF,HATBF and THTBF were 30.2±10.4,20.0±10.7,and 50.3±14.9 m L/100 m L/min,respectively.Alb,PT,BNP,BTR,BCAA,tyrosine,NH3,Ch E,IRI,TBA,and ICG R15 were 3.50±0.50 g/d L,72.0%±11.5%,63.2±56.7 pg/m L,4.06±1.24,437.5±89.4μmol/L,117.7±32.8μmol/L,59.4±22.7μg/d L,161.0±70.8 IU/L,12.8±5.0μg/d L,68.0±51.8μmol/L,and 28.6%±13.5%,respectively.PVTBF showed a significant negative correlation with ICG R15(r=-0.468,P<0.01).No significant correlation was seen between ICG 15R,HATBF and THTBF.There was a significant correlation between PVTBF and Alb(r=0.2499,P<0.05),and NH3 tended to have an inverse correlation with PVTBF(r=-0.2428,P=0.0894).There were also many significant correlations between ICG R15 and liver function parameters,including Alb,NH3,PT,BNP,TBA,BCAA,and tyrosine(r=-0.2156,P<0.05;r=0.4318,P<0.01;r=0.4140,P<0.01;r=0.3610,P<0.05;r=0.5085,P<0.001;r=0.4496,P<0.01;and r=0.4740,P<0.05,respectively).CONCLUSION:Our investigation showed that there is a close correlation between liver function and hepatic blood flow. | Hideaki Takahashi Ryuta Shigefuku Yoshihito Yoshida Hiroki Ikeda Kotaro Matsunaga Nobuyuki Matsumoto Chiaki Okuse Shigeru Sase Fumio Itoh Michihiro Suzuki | 2014 | World Journal of Gastroenterology2014，20，45： | 14 |
| 2 | Pancreatic involvement in chronic viral hepatitis显示文摘AIM: To elucidate the frequency and characteristics of pancreatic disorders in the course of chronic viral hepatitis. METHODS: We prospectively assessed the serum pancreatic enzyme levels and imaging findings in patients with chronic viral hepatitis and healthy control subjects. RESULTS: Serum amylase (t-Amy), salivary amylase (s-Amy), pancreatic amylase (p-Amy) and serum lipase levels were higher in hepatitis patients in comparison to control subjects. However, in asymptomatic viral carriers, only the serum t-Amy levels were higher than those of the controls. The levels of each enzyme rose with the progression of liver disease in patients with hepatitis B or C; whereas the levels of each enzyme within the same clinical stage of the disease did not differ between patients diagnosed with either hepatitis B or hepatitis C virus. Imaging findings demonstrated chronic pancreatitis in only 1 out of 202 patients (0.5%).CONCLUSION: Our data suggest that serum levels of pancreatic enzymes increase with the progression of liver disease in patients diagnosed with viral hepatitis. Pancreatic disease, asymptomatic in most cases, may represent an extrahepatic manifestation of chronic viral hepatitis. | Yoshiki Katakura Hiroshi Yotsuyanagi Kiyoe Hashizume Chiaki Okuse Noriaki Okuse Kohji Nishikawa Michihiro Suzuki Shiro Iino Fumio Itoh | 2005 | World Journal of Gastroenterology2005，11，23： | 5 |
| 3 | Fatal liver failure caused by reactivation of lamivudine-resistant hepatitis B virus:A case report显示文摘We present a case of fetal liver failure caused by the activation of lamivudine-resistant hepatitis B virus (HBV) nine months after lamivudine treatment. A 57-year old man visited our hospital for the treatment of decompensated chronic hepatitis B. Lamivudine was started in December 2001. Subsequently, serum HBV was negative for HBV DNA with seroconversion from HBeAg to anti-HBe and improvement of liver function. However, HBV DNA and HBeAg were again detected in September 2002. He was complicated by breakthrough hepatitis and admitted to our hospital in November for severely impaired liver function. Vidarabine treatment was started and serum HBV DNA and alanine aminotransferase (ALT) decreased transiently. However, after the start of α-interferon treatment, HBV DNA level increased and liver function deteriorated. He died 1 mo after admission. An analysis of amino acid sequences in the polymerase region revealed that rtM204I/V with rtL80I/V occurred at the time of viral breakthrough. After the start of antiviral treatment, rtL180M was detected in addition to rtM204I/V and rtL80I/V, and became predominant in the terminal stage of the disease. HBV clone with a high replication capacity may be produced by antiviral treatment leading to the worsening of liver function. Antiviral therapy for patients with breakthrough hepatitis in advanced liver disease should be carefully performed. | Yuka Suzuki Hiroshi Yotsuyanagi Chiaki Okuse Yoshihiko Nagase Hideaki Takahashi Kyoji Moriya Michihiro Suzuki Kazuhiko Koike Shiro Iino Fumio Itoh | 2007 | World Journal of Gastroenterology2007，13，6： | 4 |
| 4 | Risk factors for retinopathy associated with interferonα-2b and ribavirin combination therapy in patients with chronic hepatitis C显示文摘AIM: To elucidate the frequency and risk factors for retinopathy in patients with chronic hepatitis C who are treated by interferon-ribavirin combination therapy. METHODS: We prospectively analyzed 73 patients with histologically confirmed chronic hepatitis C, who underwent combination therapy for 24 wk. Optic fundi were examined before, and 2, 4, 12 and 24 wk after the start of combination therapy. RESULTS: Fourteen patients (19%) developed retinopathy, which was initially diagnosed by the appearance of a cotton wool spot in 12 patients. Retinal hemorrhage was observed in 5 patients. No patient complained of visual disturbance. Retinopathy disappeared in 9 patients (64%) despite the continuation of combination therapy. However, retinopathy persisted in 5 patients with retinal hemorrhage. A comparison of the clinical background between the groups with and without retinopathy showed no significant differences in age, gender, viral genotype, RNA level, white blood cell count, platelet count, prothrombin time, complications by diabetes mellitus or hypertension, or pretreatment arteriosclerotic changes in the optic fundi. However, multiple logistic regression analysis revealed that complication by hypertension was observed with a high frequency in the group with retinopathy (P = 0.004, OR=245.918, 95% CI=5.6-10786.2). CONCLUSION: Retinopathy associated with combination therapy of interferon a-2b and ribavirin tends to develop in patients with hypertension. | Chiaki Okuse Hiroshi Yotsuyanagi Yoshihiko Nagase Yuhtaro Kobayashi Kiyomi Yasuda Kazuhiko Koike Shiro Iino Michihiro Suzuki Fumio Itoh | 2006 | World Journal of Gastroenterology2006，12，23： | 4 |
| 5 | Need for pancreatic stenting after sphincterotomy in patients with difficult cannulation显示文摘AIM:To investigate the need for pancreatic stenting after endoscopic sphincterotomy(EST)in patients with difficult biliary cannulation.METHODS:Between April 2008 and August 2013,2136 patients underwent endoscopic retrograde cholangiopancreatography(ERCP)-related procedures.Among them,55 patients with difficult biliary cannulation who underwent EST after bile duct cannulation using the pancreatic duct guidewire placement method(P-GW)were divided into two groups:a stent group(n=24;pancreatic stent placed)and a no-stent group(n=31;no pancreatic stenting).We retrospectively compared the two groups to examine the need for pancreatic stenting to prevent post-ERCP pancreatitis(PEP)in patients undergoing EST after biliary cannulation by P-GW.RESULTS:No differences in patient characteristics or endoscopic procedures were observed between the two groups.The incidence of PEP was 4.2%(1/24)and29.0%(9/31)in the Stent and no-stent groups,respectively,with the no-stent group having a significantly higher incidence(P=0.031).The PEP severity was mild for all the patients in the stent group.In contrast,8 had mild PEP and 1 had moderate PEP in the no-stent group.The mean serum amylase levels(means±SD)3 h after ERCP(183.1±136.7 vs 463.6±510.4 IU/L,P=0.006)and on the day after ERCP(209.5±208.7vs 684.4±759.3 IU/L,P=0.002)were significantly higher in the no-stent group.A multivariate analysis identified the absence of pancreatic stenting(P=0.045;odds ratio,9.7;95%CI:1.1-90)as a significant risk factor for PEP.CONCLUSION:In patients with difficult cannulation in whom the bile duct is cannulated using P-GW,a pancreatic stent should be placed even if EST has been performed. | Kazunari Nakahara Chiaki Okuse Keigo Suetani Yosuke Michikawa Shinjiro Kobayashi Takehito Otsubo Fumio Itoh | 2014 | World Journal of Gastroenterology2014，20，26： | 4 |
| 6 | Thrombomodulin in the management of acute cholangitisinduced disseminated intravascular coagulation显示文摘AIM: To evaluate the need for thrombomodulin(r TM) therapy for disseminated intravascular coagulation(DIC) in patients with acute cholangitis(AC)-induced DIC. METHODS: Sixty-six patients who were diagnosedwith AC-induced DIC and who were treated at our hospital were enrolled in this study. The diagnoses of AC and DIC were made based on the 2013 Tokyo Guidelines and the DIC diagnostic criteria as defined by the Japanese Association for Acute Medicine, respectively. Thirty consecutive patients who were treated with r TM between April 2010 and September 2013(r TM group) were compared to 36 patients who were treated without r TM(before the introduction of r TM therapy at our hospital) between January 2005 and January 2010(control group). The two groups were compared in terms of patient characteristics at the time of DIC diagnosis(including age, sex, primary disease, severity of cholangitis, DIC score, biliary drainage, and anti-DIC drugs), the DIC resolution rate, DIC score, the systemic inflammatory response syndrome(SIRS) score, hematological values, and outcomes. Using logistic regression analysis based on multivariate analyses, we also examined factors that contributed to persistent DIC. RESULTS: There were no differences between the r TM group and the control group in terms of the patients' backgrounds other than administration. DIC resolution rates on day 9 were higher in the r TM group than in the control group(83.3% vs 52.8%, P < 0.01). The mean DIC scores on day 7 were lower in the r TM group than in the control group(2.1 ± 2.1 vs 3.5 ± 2.3, P = 0.02). The mean SIRS scores on day 3 were significantly lower in the r TM group than in the control group(1.1 ± 1.1 vs 1.8 ± 1.1, P = 0.03). Mortality on day 28 was 13.3% in the r TM group and 27.8% in the control group; these rates were not significantly different(P = 0.26). Multivariate analysis identified only the absence of biliary drainage as significantly associated with persistent DIC(P < 0.01, OR = 12, 95%CI: 2.3-60). Although the difference did not reach statistical significance, primary diseases(malignancies)(P = 0.055, OR = 3.9, 95%CI: 0.97-16) and the non-use of r TM had a tendency to be associated with persistent DIC(P = 0.08, OR = 4.3, 95%CI: 0.84-22).CONCLUSION: The add-on effects of r TM are anticipated in the treatment of AC-induced DIC, although biliary drainage for AC remains crucial. | Keigo Suetani Chiaki Okuse Kazunari Nakahara Yosuke Michikawa Yohei Noguchi Midori Suzuki Ryo Morita Nozomi Sato Masaki Kato Fumio Itoh | 2015 | World Journal of Gastroenterology2015，21，2： | 4 |
| 7 | Obstructive jaundice caused by secondary pancreatic tumor from malignant solitary fibrous tumor of pleura:A case report显示文摘对胸膜的恶意的独居的含纤维的肿瘤的手术后的双边的多重肺转移的全身的化疗上的一个 77 岁的人受不了瘙痒和黄疸。血检查显示出肝胆管酶的提高的层次。腹的计算断层摄影术在胰腺的头与外部改进显示出一个肿瘤,与 intra 肝、额外肝的胆汁管的膨胀伴随了。他作为把妨碍的黄疸被一个胰腺的头肿瘤引起了被诊断。胰腺的头肿瘤大概作为胸膜的恶意的独居的含纤维的肿瘤的转移被诊断,因为腹的 CT 上的胰腺的头肿瘤上的调查结果类似于胸膜的恶意的独居的含纤维的肿瘤的主要的肺损害上的那些。胰腺的肿瘤在胆总管的劣等的部分在金属性的斯滕特氏印模膏的培植以后很快成长了。病人死于肺的癌性淋巴管炎。尸体揭示了从胰腺的头传播了到肝的核的一个肿瘤。用显微镜,和骨胶原免职展出原子 atypicality 或分割的塑造锭子的房间被观察。Immunohistochemically 胰腺的头肿瘤房间为 alpha 光滑的肌肉肌动朊(alpha-SMA ) 或 CD117 染色是否定的,但是为 vimentin, CD34 和 CD99 积极。这些调查结果与胸膜的恶意的独居的含纤维的肿瘤上的那些一致。我们报导一个第二等的胰腺的肿瘤从胸膜的恶意的独居的含纤维的肿瘤引起的妨碍的黄疸的第一个案例。 | Norie Yamada Chiaki Okuse Masahito Nomoto Mayu Orita Yoshiki Katakura Toshiya Ishii Takuo Shinmyo Hiroaki Osada Ichiro Maeda Hiroshi Yotsuyanagi Michihiro Suzuki Fumio Itoh | 2006 | World Journal of Gastroenterology2006，12，30： | 2 |
| 8 | Efficacy of MK615 for the treatment of patients with liver disorders显示文摘AIM:To investigate the hepatoprotective effect of MK615,a Japanese apricot extract,in an animal model,and its clinical therapeutic effect.METHODS:Wistar rats were administered physiological saline(4 mL/kg) or MK615 solution(4 mL/kg) for 7 d.On the sixth d,acute hepatic injury was induced by administering a single intraperitoneal injection(ip) of D-galactosamine hydrochloride(D-GalN)(600 mg/kg).Plasma levels of alanine aminotransferase(ALT) and aspartate aminotransferase(AST) were determined,and liver tissues were used for histopathological analysis.Fifty-eight patients with liver disorders [hepatitis C(n = 40),non-alcoholic fatty liver disease(n = 15),and autoimmune liver disease(n = 3)] were orally administered commercially available Misatol ME-containing MK615(13 g/d) daily for 12 wk.Blood and urine were sampled immediately before and 6 wk,12 wk,and 16 wk after the start of intake to measure various biochemical parameters.The percentage change in ALT and AST levels after 12 wk from the pre-intake baseline served as a primary endpoint.RESULTS:D-GalN effectively induced acute hepatic injury in the rats.At 48 h after the ip injection of D-GalN,the plasma levels of ALT(475.6 ± 191.5 IU/L vs 225.3 ± 194.2 IU/L,P < 0.05) and AST(1253.9 ± 223.4 IU/L vs 621.9 ± 478.2 IU/L,P < 0.05) in the MK615 group were significantly lower than the control group.Scattered single cell necrosis,loss of hepatocytes,and extensive inflammatory cell infiltration were observed in hepatic tissue samples collected from the control group.However,these findings were less pronounced in the group receiving MK615.At the end of the clinical study,serum ALT and AST levels were significantly decreased compared with pre-intake baseline levels from 103.5 ± 58.8 IU/L to 71.8 ± 39.3 IU/L(P < 0.05) and from 93.5 ± 55.6 IU/L to 65.5 ± 34.8 IU/L(P < 0.05),respectively.A reduction of ≥ 30% from the pre-study baseline ALT level was observed in 26(45%) of the 58 patients,while 25(43%) patients exhibited similar AST level reductions.The chronic hepatitis C group exhibited significant ALT and AST level reductions from 93.4 ± 51.1 IU/L to 64.6 ± 35.1 IU/L(P < 0.05) and from 94.2 ± 55.5 IU/L to 67.2 ± 35.6 IU/L(P < 0.05),respectively.A reduction of ≥ 30% from the pre-study baseline ALT level was observed in 20(50%) of the 40 patients.ALT levels in both the combined ursodeoxycholic acid(UDCA) treatment and the UDCA uncombined groups were significantly lower after Misatol ME administration.MK615 protected hepatocytes from D-GalN-induced cytotoxicity in rats.Misatol ME decreased elevated ALT and AST levels in patients with liver disorders.CONCLUSION:These results suggest that MK615 and Misatol ME are promising hepatoprotective agents for patients with liver disorders. | Atsushi Hokari Tomohisa Ishikawa Hisao Tajiri Takahide Matsuda Osamu Ishii Nobuyuki Matsumoto Chiaki Okuse Hideaki Takahashi Takeshi Kurihara Ko-ichi Kawahara Ikuro Maruyama Mikio Zeniya | 2012 | World Journal of Gastroenterology2012，18，31： | 2 |
| 9 | Tolvaptan for improvement of hepatic edema: A phase 3, multicenter, randomized, double‐blind, placebo‐controlled trial显示文摘 | Isao Sakaida Seiji Kawazoe Kozo Kajimura Takafumi Saito Chiaki Okuse Koichi Takaguchi Mitsuru Okada Kiwamu Okita | 2014 | Hepatol Res2014，，1： | 1 |
| 10 | Covered Metal Stenting for Malignant Lower Biliary Stricture with Pancreatic Duct Obstruction: Is Endoscopic Sphincterotomy Needed?显示文摘 | Kazunari Nakahara Chiaki Okuse Keigo Suetani Yosuke Michikawa Shinjiro Kobayashi Takehito Otsubo Fumio Itoh Peter V. Draganov | 2013 | Gastroenterology Research and Practice2013，，： | 1 |
| 11 | Does elevation of serum creatinine in patients with chronic hepatitis C under therapy of telaprevir mean renal impairment?显示文摘 | Katsuomi Matsui Atsuko Kamijo‐Ikemori Takeshi Sugaya Hiroki Ikeda Chiaki Okuse Yugo Shibagaki Takashi Yasuda Kenjiro Kimura | 2015 | Nephrology2015，，11： | 1 |
| 12 | Acute hepatitis B of genotype H resulting in persistent infection显示文摘A 47-year-old man presented with general fatigue and dark urine.The laboratory data showed increased levels of hepatic transaminases.The patient was positive for hepatitis B virus(HBV)markers and negative for antihuman immunodeficiency virus.The HBV-DNA titer was set to 7.7 log copies/mL.The patient was diagnosed with acute hepatitis B.The HBV infection route was obscure.The serum levels of hepatic transaminases decreased to normal ranges without any treatment,but the HBVDNA status was maintained for at least 26 mo,indicating the presence of persistent infection.We isolated HBV from the acute-phase serum and determined the genome sequence.A phylogenetic analysis revealed that the isolated HBV was genotype H.In this patient,the elevated peak level of HBV-DNA and the risk alleles at human genome single nucleotide polymorphisms s3077and rs9277535 in the human leukocyte antigen-DP locus were considered to be risk factors for chronic infection.This case suggests that there is a risk of persistent infection by HBV genotype H following acute hepatitis;further cases of HBV genotype H infection must be identified and characterized.Thus,the complete determination of the HBV genotype may be essential during routine clinical care of acute hepatitis B outpatients. | Norie Yamada Ryuta Shigefuku Ryuichi Sugiyama Minoru Kobayashi Hiroki Ikeda Hideaki Takahashi Chiaki Okuse Michihiro Suzuki Fumio Itoh Hiroshi Yotsuyanagi Kiyomi Yasuda Kyoji Moriya Kazuhiko Koike Takaji Wakita Takanobu Kato | 2014 | World Journal of Gastroenterology2014，20，11： | 1 |
| 13 | Enteral metallic stenting by balloon enteroscopy for obstruction of surgically reconstructed intestine显示文摘We present three cases of self-expandable metallic stent(SEMS) placement using a balloon enteroscope(BE) and its overtube(OT) for malignant obstruction of surgically reconstructed intestine. A BE is effective for the insertion of an endoscope into the deep bowel. However, SEMS placement is impossible through the working channel, because the working channel of BE is too small and too long for the stent device. Therefore, we used a technique in which the BE is inserted as far as the stenotic area; thereafter, the BE is removed, leaving only the OT, and then the stent is placed by inserting the stent device through the OT. In the present three cases, a modification of this technique resulted in the successful placement of the SEMS for obstruction of surgically reconstructed intestine, and the procedures were performed without serious complications. We consider that the present procedure is extremely effective as a palliative treatment for distal bowel stenosis, such as in the surgically reconstructed intestine. | Kazunari Nakahara Chiaki Okuse Nobuyuki Matsumoto Keigo Suetani Ryo Morita Yosuke Michikawa Shun-ichiro Ozawa Kosuke Hosoya Shinjiro Kobayashi Takehito Otsubo Fumio Itoh | 2015 | World Journal of Gastroenterology2015，21，24： | 1 |
| 14 | Pathophysiological analysis of nonalcoholic fatty liver disease by evaluation of fatty liver changes and blood flow using xenon computed tomography: can early-stage nonalcoholic steatohepatitis be distinguished from simple steatosis?显示文摘 | Ryuta Shigefuku Hideaki Takahashi Minoru Kobayashi Hiroki Ikeda Kotaro Matsunaga Chiaki Okuse Nobuyuki Matsumoto Shiro Maeyama Shigeru Sase Michihiro Suzuki Fumio Itoh | 2012 | Journal of Gastroenterology2012，，11： | 1 |
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