Publications by authors named "Kazushige Uchida"
We started a registry for cases of immunoglobulin (Ig)G4-related disease (IgG4-RD) in December 2019 to clarify the clinical profile of IgG4-RD. In this study, clinical information from 854 cases registered by February 16, 2024 was analyzed from multiple perspectives. Diagnosis of IgG4-RD was made in 808 cases, comprising 638 definite, 38 probable, and 132 possible.
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- A study was conducted to evaluate a new endoscopic clip that emits near-infrared (NIR) fluorescence to help identify cancer location during robot-assisted surgery for gastrointestinal cancer.
- * Six patients had these NIR fluorescent clips placed before surgery, and the detection of fluorescence was tested during the procedure.
- * The clips successfully emitted detectable fluorescence in all patients, improving the accuracy of finding resection lines without significant variances in patient demographics.
Article Synopsis
- A study in Japan involving 1,364 patients with autoimmune pancreatitis (AIP) aimed to assess the long-term risks of malignancies, particularly pancreatic cancer (PC).
- The results indicated that AIP patients had a higher risk of developing malignancies, especially PC, with the risk increasing shortly after diagnosis and persisting over time.
- Maintenance steroid therapy was found to lower cancer risk and enhance overall survival, despite its negative effects on conditions like diabetes and osteoporosis.
Background: Opportunistic infections associated with immunosuppressive treatments for inflammatory bowel disease pose an important safety concern. Here we report the case of a patient with active ulcerative colitis and cryptococcal pneumonia who was treated with vedolizumab combined with fluconazole.
Case Presentation: A 56-year-old Japanese man with ulcerative colitis and a history of Sweet's syndrome who was taking prednisolone and azathioprine presented with a moderate exacerbation of ulcerative colitis, abdominal pain, diarrhea, and bloody stools along with cytomegalovirus infection.
Objective Steroid pulse therapy is a regimen involving the intravenous administration of supra-pharmacological doses of corticosteroids in the short term. It is used to treat various inflammatory and autoimmune conditions. However, the strengths and limitations of steroid pulse therapy for induction of remission in type 1 autoimmune pancreatitis (AIP) are unknown.
View Article and Find Full Text PDFIn 1995, Yoshida et al. proposed first the concept of "autoimmune pancreatitis" (AIP). Since then, AIP has been accepted as a new pancreatic inflammatory disease and is now divided two subtypes.
View Article and Find Full Text PDFIgG4-related disease (IgG4-RD) is a fibroinflammatory disorder recognized as a novel clinical entity with either synchronous or metachronous multiorgan involvement. Autoimmune pancreatitis (AIP) is classified into two types: type 1 AIP as a pancreatic manifestation of IgG4-RD and type 2 AIP with granulocytic epithelial lesion and occasional association with ulcerative colitis. Although the pathogenic mechanism still remains unclear, possible multipathogenic factors such as genetic factors, disease-specific or related antigens, and abnormal innate or adaptive immunity may be involved in the development of IgG4-RD.
View Article and Find Full Text PDFVascular endothelial growth factor inhibitors and checkpoint inhibitors are effective treatments for solid tumors. These new classes of anti-cancer agents frequently cause kidney-related side effects. Although their anti-cancer effects may be enhanced when used in combination, the severity of their kidney-related side effects is unknown.
View Article and Find Full Text PDFBackground: Pancreatic acinar cell carcinoma is rare; it accounts for 1% of all malignant pancreatic exocrine tumors. Although surgical resection is an option for curative treatment, the safety and efficacy of conversion surgery in patients with pancreatic acinar cell carcinoma with metastasis remain unknown.
Case: A 67-year-old man with epigastric pain and a pancreatic tumor was referred to our hospital.
Article Synopsis
- A nationwide survey in Japan aimed to identify the clinicoepidemiological traits of immunoglobulin G4 (IgG4)-related disease (IgG4-RD) in patients with cancer.
- The study assessed various types of IgG4-RD, finding autoimmune pancreatitis most prevalent, while highlighting that IgG4-RD patients had a significantly higher cancer prevalence compared to the general population.
- Notably, the research revealed that 30.5% of cancer cases were diagnosed before the IgG4-RD diagnosis, suggesting a potential connection between the two conditions.
Article Synopsis
- Due to new insights and updates to the Japanese autoimmune pancreatitis (AIP) diagnostic criteria in 2018, the existing 2013 consensus guidelines needed revision.
- A group of 20 AIP specialists analyzed 5218 articles from 1963 to 2019 to extract clinical statements and developed 39 clinical questions and statements across various aspects of AIP.
- A modified Delphi method was used to validate these statements, and with moderator evaluation, the revised Japanese consensus guidelines for AIP were proposed in 2020.
The effectiveness of azathioprine (AZA) in preventing relapse and maintaining autoimmune pancreatitis (AIP) remission has been reported; however, most of these studies are case series with no randomized control trials available in the literature. Therefore, this study performed a systematic review and meta-analysis of the existing literature on this subject to determine the clinical efficacy of AZA as maintenance therapy for AIP patients. A systematic search was performed to identify studies on the clinical efficacy of AZA as maintenance therapy in AIP patients.
View Article and Find Full Text PDFBackground: Stimulation of Toll-like receptor 3 (TLR3) induces autoimmune-mediated pancreatitis in susceptible mice, whereas stimulation of TLR4 causes nonautoimmune-mediated pancreatitis. However, the effects of TLR2 stimulation on the pancreas are unknown.
Aims: We investigated the role of TLR2 stimulation on pancreatic damage by repeatedly stimulating mice with TLR2 ligands.
Background: /Object: Some patients with type 1 autoimmune pancreatitis (AIP), the pancreatic manifestation of IgG4-related disease, have normal serum IgG4. The aim of this study is to investigate the diagnostic value of measuring serum free light chains (FLCs) in type 1 AIP.
Materials And Methods: Thirty-seven patients with type 1 AIP, and 21 healthy, 17 alcoholic chronic pancreatitis (ACP), 21 idiopathic chronic pancreatitis (ICP) and 20 pancreatic cancer (PC) patients were enrolled.
Article Synopsis
- The study analyzed pancreatic FDG uptake in 4,248 cancer patients who underwent follow-up PET/CT scans at Kochi Medical School from 2015 to 2019, excluding those with a history of pancreatic cancer.
- Of the 14 patients (0.3%) showing FDG uptake in the pancreas, diagnoses included pancreatic metastases, secondary primary pancreatic cancer, and other conditions, with about 29% being new pancreatic cancers.
- The findings suggest that unexpected pancreatic FDG uptake often indicates malignancies, highlighting the importance of considering both primary and metastatic cancers during evaluation.
IgG4-related disease (IgG4-RD) represents an immune-mediated fibroinflammatory condition with peculiar histopathologic changes that can affect various organs. In 2012 its unified nomenclature was published, which allows to abandon other synonymous names. Up to now, only little is known about its epidemiology around the world.
View Article and Find Full Text PDFAim: The optimal choice between sorafenib (SOR) or lenvatinib (LEN) as the first-line treatment for unresectable hepatocellular carcinoma (u-HCC) remains debatable. Using propensity score matching, this study compares the outcomes of SOR and LEN in the molecular-targeted agent (MTA) sequential treatment of u-HCC patients.
Methods: This retrospective, multicenter, observational study recruited 137 u-HCC patients who underwent primary treatment with LEN (n = 52) or SOR (n = 85) between June 2017 and June 2020 after regorafenib was approved as the secondary treatment for u-HCC.
An asymptomatic 76-year-old man presented to our department for the treatment of gastric cancer. Esophagogastroduodenoscopy revealed a superficial elevated lesion with an irregular central depression in the lower third of the stomach; this was confirmed to be adenocarcinoma by biopsy, while abdominal contrast-enhanced CT revealed no abnormal lesions. Based on the patient's clinical diagnosis of early gastric cancer, we planned laparoscopic gastrectomy with preoperative placement of four endoscopic marking clips equipped with indocyanine green-conjugated resin to determine the resection margin.
View Article and Find Full Text PDFObjectives: The objective of this study was to clarify the role of pancreatectomy for patients with resectable and borderline resectable pancreatic ductal adenocarcinoma aged 80 years or older using a nationwide audit by the Japan Pancreas Society.
Methods: Data were collected from 39 institutions from 2007 to 2014. The primary endpoint was overall survival, and secondary endpoints were surgical outcomes and predictive factors for prognosis.
Background/aim: We evaluated urinary levels of porphyrin metabolites, such as uroporphyrin (UP) and coproporphyrin (CP), after 5-Aminolevulinic acid (ALA) administration in patients with or without pancreatic cancer (PaC).
Patients And Methods: Sixty-seven subjects with PaC, 11 with pancreatitis, and 9 with normal pancreas (NP) were enrolled. Urine samples from all subjects were collected prior to ALA administration and at more than 4 hours after ALA administration.
Purpose: Intraoperative identification of the cancer location is often difficult to conduct during laparoscopic surgery, especially in early-stage cancers. This study aimed to investigate the feasibility and accuracy of a novel endoscopic clip resin-conjugated fluorescent indocyanine green during laparoscopic surgery for gastrointestinal cancer.
Methods: Preoperative placement of endoscopic marking clips equipped with resin-conjugated fluorescent indocyanine green was performed to determine the resection margin in eight patients with gastrointestinal cancer.
Background: IgG4-related disease (IgG4-RD) is a systemic inflammatory disease, which includes type 1 autoimmune pancreatitis (AIP). Interleukin-35 (IL-35) exhibits immunosuppressive effects in several autoimmune diseases. However, the expression of IL-35 had not been reported so far in type 1 AIP.
View Article and Find Full Text PDFObjectives: It is important for diagnosing early chronic pancreatitis (CP), which may be improved by therapeutic intervention. We aimed to examine the pancreatic ductal changes on magnetic resonance cholangiopancreatography (MRCP) in patients with early CP defined by the Japanese Diagnostic Criteria.
Methods: This retrospective study included patients suspected early CP and performed both endoscopic ultrasonography (EUS) and MRCP from January 2010 to August 2018.
Background: The molecular basis of type 1 autoimmune pancreatitis (AIP) remains unclear. Recent attention on the role of extracellular vesicles microRNA (EV miRNA) in immune homeostasis has prompted us to perform an extensive miRNA screening of serum-derived EV in AIP.
Methods: EV miRNA expression was analyzed using microarrays in AIP, chronic pancreatitis (CP), and healthy adult (HC) samples (n = 10 from each group).