Publications by authors named "Yasuda I"
Critical limb ischemia (CLI) is the most advanced stage of peripheral arterial disease, posing a high risk of mortality. Sphingomyelin, a sphingolipid synthesized by sphingomyelin synthases (SMSs) 1 and 2, plays an essential role in signal transduction as a component of lipid rafts. However, the role of sphingomyelin in the inflammation of ischemic skeletal muscles remains unclear.
View Article and Find Full Text PDFBackground And Aims: Endoscopic ultrasound (EUS)-guided transmural drainage with on-demand endoscopic necrosectomy (EN) is increasingly utilized to manage walled-off necrosis (WON). It has not been fully elucidated how EN and its timing are correlated with treatment outcomes compared to the drainage-based approach.
Methods: Within a multi-institutional cohort of 423 patients with pancreatic fluid collections including 227 patients with WON, we identified 153 patients who received the step-up treatment following the initial EUS-guided drainage of symptomatic WON, including 102 EN patients and 51 non-EN (drainage) patients.
Background And Aims: EUS-guided hepaticogastrostomy (EUS-HGS) carries a risk of serious adverse events (AEs). A newly designed, partially covered laser-cut stent with antimigration anchoring hooks and a thin tapered tip (7.2F), called a Hook stent (Zeon Medical, Tokyo, Japan), has been developed to prevent serious AEs associated with EUS-HGS.
View Article and Find Full Text PDFWe report a rare case of a patient with initially unresectable gallbladder cancer who underwent conversion surgery with durvalumab in combination with gemcitabine plus cisplatin and achieved an R0 resection. A 68 year-old woman was found to have gallbladder cancer and multiple enlarged lymph nodes around the suprapancreatic rim and hepatic hilum invading the proper hepatic artery on computed tomography. The diagnosis was cT3cN2cM0, cStage IVB.
View Article and Find Full Text PDFDisconnected pancreatic duct syndrome: diagnostic and therapeutic challenges and future directions.
Expert Rev Gastroenterol Hepatol
October 2024
Introduction: Disconnected pancreatic duct syndrome (DPDS) is a pathological condition that causes various symptoms due to the continuous secretion of pancreatic enzymes from the pancreas upstream, which has been separated due to disconnection of the pancreatic duct (DPD) for various reasons.Acute necrotizing pancreatitis includes a certain probability of DPDS appearance, which makes it necessary to provide various treatments for DPDS. Furthermore, DPDS can impact long-term results, such as recurrence and impaired pancreatic function.
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- *The Subcommittee defined five types of I-EUS procedures based on their purpose and method: EUS-guided sampling, EUS-guided through-the-needle examination, EUS-guided drainage/anastomosis, ESCR procedures, and EUS-guided delivery.
- *The proposed classifications aim to clarify I-EUS procedures and will be updated as new techniques and concepts arise in the field.*
Transient receptor potential canonical 6 (TRPC6) variants, which were initially detected in adult-onset familial focal segmental glomerulosclerosis (FSGS), were also identified in pediatric-onset one. Here, we present a patient with adult-onset steroid-resistant nephrotic syndrome (SRNS) who harbored a likely pathogenic TRPC6 variant and partially responded to calcineurin inhibitors (CNIs). A 44-year-old woman with stable rheumatoid arthritis, systemic lupus erythematosus, and Sjögren's syndrome was presented with nephrotic syndrome.
View Article and Find Full Text PDFBackground: A number of antibody test kits for detecting prior SARS-CoV-2 infection and post-immunization status have been commercialized. Indirect immunoperoxidase assay (IIP) is a conventional method to test antibodies. We evaluated the diagnostic accuracy and antibody titer profile of the IIP in COVID-19 and pre- and post-vaccination.
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- The study investigates the impact of comorbidity status, measured by the Charlson Comorbidity Index (CCI), on clinical outcomes following EUS-guided treatment for pancreatic fluid collections (PFCs) using data from two cohorts: a clinical cohort of 406 patients and a nationwide cohort of 4053 patients from Japan.
- Findings indicate that higher CCI scores are linked to increased in-hospital mortality risk, with adjusted odds ratios showing a notable rise in risk as CCI increases.
- The results suggest that CCI could be useful for predicting periprocedural mortality risk in patients undergoing this treatment, although it did not correlate with the likelihood of procedure-related adverse events.
Article Synopsis
- The study focuses on the importance of measuring hepatitis B surface antigen (HBsAg) for the management of chronic hepatitis B virus infection (CHB) and examines preS1 protein expression in patients.
- Researchers used seven monoclonal antibodies to analyze preS1 from various hepatitis B genotypes, discovering that the epitopes crucial for recognition are largely located in the aa33-47 region.
- Findings indicate that preS1 expression remains stable across different HBsAg levels and genotypes, emphasizing its potential as a therapeutic target in treating CHB.
Article Synopsis
- Pembrolizumab, nivolumab, and the combination therapies have emerged as first-line treatments for advanced esophageal cancer, although their efficacy on primary tumors was previously unclear.
- In a study of 23 patients experiencing esophageal dysphagia, significant improvement in swallowing was noted in 82.6%, with a median time to improvement of about 26 days.
- While 10 patients experienced immune-related adverse events, the treatments provided high response rates and prolonged survival, indicating promising effectiveness against primary tumors.
Article Synopsis
- The WONDER-02 trial is a randomized controlled study aimed at comparing the effectiveness of plastic stents versus lumen-apposing metal stents (LAMSs) for treating symptomatic pancreatic pseudocysts through endoscopic ultrasound (EUS) drainage.
- The trial will enroll 80 patients from 26 centers in Japan, dividing them into two groups of 40 to receive either type of stent and assessing outcomes like pseudocyst size reduction and overall health improvements.
- The results will help determine if plastic stents are just as effective as LAMSs, potentially influencing future treatment guidelines for pancreatic pseudocyst patients.
Background: Patients with isolated IgG4-related sclerosing cholangitis (IgG4-SC) often undergo unnecessary resection. The aim of this study was to validate the revised Japanese diagnostic criteria for isolated IgG-4-SC and to improve awareness about this condition in the population.
Methods: This was a Japanese retrospective multicenter study.
Article Synopsis
- * Investigations showed low serum ceruloplasmin levels, high urinary copper excretion, and a known mutation in the ATP7B gene linked to copper metabolism.
- * A new mutation was identified in the patient's other allele, classified as 'likely pathogenic' based on guidelines from the American College of Medical Genetics, confirming a diagnosis of Wilson's disease.
Article Synopsis
- Anamorelin, Japan's first treatment for cancer cachexia, was introduced in 2021, prompting a study at Toyama University Hospital to assess its prescription trends among patients from July 2021 to December 2022.
- The analysis involved 88 cases, focusing on demographics, cancer types, prescription locations, and changes in meal intake, revealing that anamorelin was mainly used during chemotherapy, particularly for pancreatic cancer patients in outpatient settings.
- Results showed that around 30% of patients experienced increased meal intake, and those starting anamorelin during chemotherapy had a significantly longer treatment duration (55 days) compared to those receiving only supportive care (12 days), highlighting the need for personalized treatment strategies.
Walled-off necrosis (WON) develops as local complications after acute necrotizing pancreatitis. Although less invasive interventions such as endoscopic ultrasonography (EUS)-guided drainage and endoscopic necrosectomy are selected over surgical interventions, delayed and step-up interventions are still preferred to avoid procedure-related adverse events. However, there is a controversy about the appropriate timing of drainage and subsequent necrosectomy.
View Article and Find Full Text PDFObjectives: Tetracyclines are the standard treatment for rickettsiosis, including Japanese spotted fever (JSF), a tick-borne rickettsiosis caused by Rickettsia japonica. While some specialists in Japan advocate combining fluoroquinolones with tetracyclines for treating JSF, the negative aspects of combination therapy have not been thoroughly evaluated. Whether fluoroquinolones should be combined with tetracyclines for JSF treatment is controversial.
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- The TOKYO criteria, initially proposed for standardized reporting of endoscopic transpapillary biliary drainage outcomes, face limitations in newer techniques like endoscopic ultrasound and device-assisted endoscopy.
- A new committee is updating these criteria to better reflect current clinical practices in managing various biliary conditions, recognizing the need for comprehensive outcome evaluations beyond just stent patency.
- The revised TOKYO criteria 2024 aim to enhance the design and reporting of clinical studies by introducing a "stent-demanding time" concept for a more thorough assessment of endoscopic biliary drainage outcomes.
Article Synopsis
- Quasi-liquid layers (QLLs) on ice surfaces are heterogeneous, varying in structure from nanometers to millimeters and significantly influencing the ice's chemical and physical properties.
- Using molecular dynamics simulations and machine learning, the study reveals that QLLs do not consist of static solid and liquid water mixtures, but rather dynamic domains of molecules that frequently change behavior.
- The characteristics and ordering of these domains depend on temperature and crystal structure, providing new molecular-level insights into how the surface properties of ice work.
Article Synopsis
- Postoperative pancreatic fistulas (POPFs) are frequent complications following pancreatic surgery, and their management is crucial for patient recovery.
- Endoscopic ultrasonography (EUS)-guided drainage is the preferred treatment for both POPFs and pancreatic fluid collections (PFCs), but approaches must be adjusted based on the presence of fluid collections and surgical drains.
- The review emphasizes the need for further research to clarify the guidelines for managing POPFs, particularly concerning intervention timing and methods, comparing them to the treatment of PFCs following acute pancreatitis.
[A case of small intestinal endometriosis with bowel obstruction and perforation].
Nihon Shokakibyo Gakkai Zasshi
May 2024
Article Synopsis
- - A 47-year-old woman experienced ongoing lower abdominal pain for over two weeks, leading to a diagnosis of small bowel obstruction caused by a mass in the terminal ileum after imaging tests.
- - Despite initial treatment efforts, her condition worsened, and emergency surgery was performed, revealing severe stenosis and an ileal perforation.
- - Pathological analysis confirmed the patient had intestinal endometriosis, highlighting the need to consider this rare condition in cases of bowel obstruction in women of childbearing age.
Article Synopsis
- This study compares two methods for treating pancreatic stones in chronic pancreatitis: extracorporeal shock wave lithotripsy (ESWL) and peroral pancreatoscopy-guided lithotripsy (POPS-L).
- A retrospective analysis of 66 patients showed that POPS-L had a higher stone clearance rate (78.9%) compared to ESWL (70.2%), although the difference was not statistically significant.
- POPS-L also required fewer treatment sessions on average (1 session) compared to ESWL (5 sessions), while both methods had similar complication and recurrence rates.