Publications by authors named "Ikezawa K"
Objectives: Endoscopic ultrasonography (EUS) plays an important role in the diagnosis of pancreatobiliary diseases. However, an appropriate sedation method for EUS has not been established. Therefore, this study aimed to examine the safety and complications of sedation with pentazocine or pethidine hydrochloride for outpatient diagnostic EUS.
View Article and Find Full Text PDFTreatment strategies for preventing liver fibrosis have not yet been established. Letrozole, widely used for breast cancer, has recently been reported to suppress liver fibrosis in murine models. Therefore, we aimed to validate the suppressive effects of letrozole on liver fibrosis in the clinical setting.
View Article and Find Full Text PDFPurpose: To evaluate differences in body composition at intensive care unit (ICU) admission between patients with and without ICU-acquired weakness (ICU-AW).
Materials And Methods: This single-center, retrospective cohort study was conducted at Tsukuba Memorial Hospital's mixed ICU in Japan. We included patients who could walk unassisted before admission, received rehabilitation post-admission, and survived for at least 48 h.
Antiapoptotic protein, including Mcl-1, expression is frequently observed in pancreatic cancer. Gemcitabine plus nabpaclitaxel (GnP) is the standard chemotherapy for metastatic pancreatic cancer (MPC); however, predictive markers for its efficacy remain unestablished. This study evaluated the association between GnP's therapeutic effects and Mcl-1 expression in tissue samples obtained using endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) for pancreatic tumor or percutaneous ultrasound-guided biopsy for metastatic liver tumor.
View Article and Find Full Text PDFArticle Synopsis
- * An abscopal effect, where treatment effects occur in non-irradiated areas, can be linked to radiation-induced immune responses, but its clinical significance in immunotherapy is still unclear due to limited cases.
- * A case study showed that after stereotactic body radiotherapy (SBRT), the combination of atezolizumab and bevacizumab led to a complete response in a patient with advanced HCC, highlighting the potential of combining these therapies post-radiotherapy for improving treatment outcomes.
Article Synopsis
- The study investigated the detection of gBRCA mutations in pancreatic cancer patients and the effectiveness of olaparib maintenance therapy for those mutations.
- Out of 84 patients tested, 11.9% had gBRCA mutations, with a higher mutation rate found in individuals with a family history of Hereditary Breast and Ovarian Cancer (HBOC).
- Most patients who received olaparib after platinum-based chemotherapy showed positive responses, with a median treatment duration of 17.5 months for chemotherapy and 11 months for olaparib maintenance therapy.
Article Synopsis
- The study investigates how self-expandable metallic stents (SEMSs) affect radiation doses compared to plastic stents (PSs) during biliary decompression, using a water-equivalent phantom for evaluation.
- Results show that SEMSs generally cause smaller dose differences in radiation delivery compared to PSs, particularly in proximal and distal locations, which is statistically significant.
- However, significant dose variations were noted at the surfaces of the radiopaque markers on SEMSs, suggesting that while SEMSs can be used safely in patients undergoing radiation therapy, careful monitoring of dose distribution is essential.
[Ulcerative colitis diagnosed with facial pyoderma gangrenosum: a case report].
Nihon Shokakibyo Gakkai Zasshi
June 2024
Pyoderma gangrenosum (PG) is a sterile inflammatory skin condition that is frequently associated with immune-related diseases, including inflammatory bowel disease (IBD). PG causes noninfectious ulcers. Facial PG is uncommon while PG usually occurs on the trunk and lower limbs.
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- - Pancreatic acinar cell carcinoma (PACC) is a rare cancer that doesn't have its own specific treatment, so therapies are adapted from those used for pancreatic ductal adenocarcinoma (PDAC).
- - The case study discusses an older patient with recurrent PACC who achieved long-term survival through systemic chemotherapy, chemoradiotherapy, and maintenance therapy guided by a pathogenic BRCA2 variant.
- - The study highlights that BRCA variants are more common in PACC patients compared to those with PDAC, affecting treatment decisions and outcomes, and emphasizes the importance of early genomic testing in PACC treatment.
Article Synopsis
- Patients with advanced pancreatic cancer often suffer from taste disturbances (dysgeusia) and zinc deficiency during chemotherapy, prompting a study on the effects of zinc supplementation.
- A study involving 33 patients evaluated the impact of zinc acetate hydrate over 12 weeks, finding significant increases in serum zinc levels and gradual improvement in taste issues—a 42.4% improvement by the end of the study.
- The results suggest that zinc supplementation not only enhances taste perception but may also help maintain nutritional status, as evidenced by stable serum albumin levels in patients who responded to treatment.
Article Synopsis
- Endoscopic ultrasound-guided tissue acquisition (EUS-TA) is important for diagnosing pancreatic cancer and initiating targeted therapies, but sample insufficiency is a common issue that needs to be addressed.
- A study conducted at the Osaka International Cancer Institute involved 42 patients, comparing the effectiveness of oil blotting paper versus filter paper for fixing EUS-TA samples for analysis.
- Results showed that samples fixed with oil blotting paper had significantly larger tissue areas and a higher frequency of abundant tumor cells, suggesting it enhances sample adequacy for molecular testing.
Gastrointestinal: Enlarged pancreatic tail mass during chemotherapy for pancreatic cancer.
J Gastroenterol Hepatol
August 2024
Main pancreatic duct (MPD) dilatation is reported to be a risk factor for pancreatic cancer (PC). Although magnetic resonance cholangiopancreatography (MRCP) and ultrasonographic modalities are valuable for monitoring the pancreas, there is limited information on the efficacy of different imaging modalities in measuring MPD diameter. To improve pancreatic imaging, we developed a specialized ultrasound approach focusing on the pancreas (special pancreatic US).
View Article and Find Full Text PDFPortal Vein Aneurysm in a Patient with Cirrhosis Type C Controlled by Direct-Acting Antiviral Treatment.
Case Rep Gastroenterol
February 2024
Introduction: Portal vein aneurysm (PVA) is a rare saccular or fusiform portal vein dilatation. The management and optimal treatment of PVA remain unknown.
Case Presentation: A 53-year-old man with hepatitis C virus (HCV) infection was diagnosed with PVA measuring 28 mm in diameter.
Background And Aim: Recently, the use of various endoscopic procedures performed under X-ray fluoroscopy guidance has increased. With the popularization of such procedures, diagnostic reference levels (DRLs) have been widely accepted as the global standard for various procedures with ionizing radiation. The Radiation Exposure from Gastrointestinal Fluoroscopic Procedures (REX-GI) study aimed to prospectively collect actual radiation exposure (RE) data and establish DRLs in gastrointestinal endoscopy units.
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- - Pancreatic acinar cell carcinoma is a rare type of pancreatic cancer, primarily affecting males and occasionally children, with a higher chance of elevated serum lipase levels in patients.
- - This cancer typically presents as large tumors (around 5 cm) in the pancreas, especially at the head, and requires immunostaining for accurate diagnosis; it has a better prognosis than pancreatic ductal adenocarcinoma despite a high recurrence rate after surgery.
- - Genetic testing is crucial for treatment planning, as this type of cancer has a unique genetic profile that suggests sensitivity to certain therapies, such as platinum-based drugs and PARP inhibitors, due to its lack of common mutations found in other pancreatic cancers.
Background: Intraductal papillary mucinous neoplasia (IPMN) is a risk factor for pancreatic cancer (PC). PC concomitant with IPMN shows rapid progression similar to de novo PC, therefore, the appropriate observation interval (OI) is not yet clear.
Patients And Method: This was a multicenter retrospective observational study, and patients with PC concomitant with IPMN were analyzed.
Objective: Adequate biliary decompression is important in treating bile leaks, and endoscopic transpapillary drainage is widely used for this purpose. As an indicator to evaluate the usefulness of endoscopic drainage for postoperative biliary leakage, we focused on external drain removability, which affects quality of life, after endoscopic treatment. Our aim was to clarify the success rate of external tube removal after endoscopic drainage for postoperative biliary leakage and to examine associated factors.
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- The study investigates the effectiveness of chemotherapy for older adults (≥70 years) with metastatic biliary tract cancer (BTC), a common issue since most BTC patients are diagnosed in this age group.
- Using data from a large Japanese cancer registry, researchers analyzed the outcomes of 207 older patients with metastatic BTC to determine how chemotherapy impacts their overall survival compared to best supportive care.
- Results showed that chemotherapy significantly improved survival rates (6.4 months vs. 1.8 months) in patients under 80, while treatment types varied by age; younger patients often received combination therapy, whereas older patients tended to undergo monotherapy.
Background: Nanoliposomal irinotecan (nal-IRI) plus 5-fluorouracil (5-FU)/levo-leucovorin (Levo-LV) was approved for unresectable pancreatic cancer (UR-PC) in March 2020 in Japan. Levo-LV is administered by intravenous infusion over 120 min following 90 min intravenous infusion of nal-IRI (conventional method), causing a significant burden on both patients and the outpatient chemotherapy room owing to the prolonged administration time. Thus, from July 2021, we introduced the simultaneous intravenous administration of nal-IRI and Levo-LV (parallel method) with the approval of the institutional regimen committee.
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- Pancreatic cancer (PC) has a poor prognosis, and this study examines how hospital volume affects outcomes in patients with metastatic PC using a decade's worth of data from the Osaka Cancer Registry.
- The research categorizes hospitals into high-volume, middle-volume, and low-volume based on the number of PC diagnoses, analyzing overall survival (OS) rates among these groups.
- Findings show that patients treated at high-volume hospitals have significantly better OS compared to those at middle and low-volume hospitals, indicating that hospital volume is an important factor in treatment outcomes for metastatic PC.
Article Synopsis
- Undifferentiated carcinoma (UC) of the pancreas is a rare and aggressive type of pancreatic cancer with a median survival of less than one year, although cases with osteoclast-like giant cells (UCOGCs) may have better outcomes.
- The World Health Organization classifies UC into three subtypes (anaplastic, sarcomatoid, and carcinosarcoma) and distinguishes UCOGCs based on their unique histological features.
- Currently, surgical resection is the only curative treatment, but promising results from paclitaxel-based chemotherapy and anti-programmed death-ligand 1 therapies highlight potential avenues for improving UC treatment options.
Article Synopsis
- This study investigated the radiation exposure to the lens of the eyes for medical staff during endoscopic retrograde cholangiopancreatography (ERCP) procedures.
- It found that the median annual radiation doses to the eyes were 3.7 mSv for operators, 2.2 mSv for assistants, and 2.4 mSv for nurses, indicating varying levels of exposure among staff.
- The research also showed a strong link between patient radiation exposure and occupational exposure for medical staff, underscoring the necessity of protective eyewear, which provided varying degrees of shielding effectiveness.