89 results match your criteria: "Aiseikai Yamashina Hospital[Affiliation]"

Background: While R-CHOP has been one of the standard therapies for untreated high-tumor-burden (HTB) follicular lymphoma (FL) for over 2 decades, obinutuzumab plus bendamustine (OB) is also currently regarded as the standard of care since its approval in 2018 in Japan; however, the long-term efficacy and safety of OB in the daily clinical practice has not been thoroughly evaluated.

Methods: We conducted a multicenter retrospective study for the clinical outcome of 53 patients with HTB FL treated by OB as the frontline therapy between 2018 and 2021 in the Kyoto Hematology Clinical Study Group (KOTOSG). All patients had at least 2-year follow-up period.

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Background: The MANTIS Closure Device (MCD; Boston Scientific, Marlborough, Massachusetts, USA) is a reopenable clip with a sharp claw used for closure after endoscopic submucosal dissection (ESD). We evaluated the effectiveness of the MCD for fast and complete closure after colorectal ESD.

Methods: Cases involving closure with the MCD after ESD of 20-60-mm colorectal lesions between April 2023 and January 2024 were reviewed.

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Objectives: Diagnostic ability of sessile serrated lesions (SSL) and SSL with dysplasia (SSLD) using blue laser/light imaging (BLI) has not been well examined. We analyzed the diagnostic accuracy of BLI for SSL and SSLD using several endoscopic findings compared to those of narrow band imaging (NBI).

Materials And Methods: This was a subgroup analysis of prospective studies.

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Objectives: Detailed superiority of CAD EYE (Fujifilm, Tokyo, Japan), an artificial intelligence for polyp detection/diagnosis, compared to endoscopists is not well examined. We examined endoscopist's ability using movie sets of colorectal lesions which were detected and diagnosed by CAD EYE accurately.

Methods: Consecutive lesions of ≤10 mm were examined live by CAD EYE from March-June 2022 in our institution.

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Article Synopsis
  • A multi-institutional study examined 100 patients with diffuse large B-cell lymphoma (DLBCL) who were ineligible for transplants after their initial treatment, aiming to create a predictive model for outcomes.
  • Key findings revealed that the median age of these patients was 76, with median progression-free survival of 11.5 months and overall survival of 21.9 months.
  • Three factors (low lymphocyte-to-monocyte ratio, high lactate dehydrogenase, and high C-reactive protein) were identified as strong predictors of overall survival, leading to the development of the Kyoto Prognostic Index for assessing treatment response in these patients.
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Background And Aim: A hemostatic gel, PuraStat (3-D Matrix, Tokyo, Japan), is used for various gastrointestinal hemostasis. In this study, we analyzed the efficacy of PuraStat for perioperative bleeding (POB) and prevention of delayed bleeding (DB) to colorectal cold snare polypectomy (CSP) with continuous anticoagulant.

Methods: This was a single-center, retrospective study.

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Article Synopsis
  • Azacitidine (AZA) is a standard treatment for patients with myelodysplastic syndrome (MDS) who cannot undergo transplantation, but early treatment often faces interruptions due to hematological toxicities.
  • A multicenter retrospective study involving 212 MDS patients examined factors affecting survival during the early phase of AZA therapy, specifically focusing on severe cytopenia and its impact on patient outcomes.
  • The study identified that severe thrombocytopenia and very poor risk cytogenetics are key independent prognostic factors, leading to the creation of the Kyoto Conditional Survival Scoring System to better assess patient risks during AZA treatment.
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Multiple myeloma reduces cellular and humoral immunity. Optimal prediction of antibody response to anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine in patients with MM and related disorders is essential to prevent coronavirus disease 2019 (COVID-19) during the SARS-CoV-2 pandemic. This study analyzed the humoral response to the anti-SARS-CoV-2 messenger ribonucleic acid (mRNA) vaccine and its associated factor in 83 patients from June to November 2021 at seven member institutions of the Kyoto Clinical Hematology Study Group.

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B-cell receptor (BCR) signaling is critically activated and stable for mantle cell lymphoma (MCL), but the underlying mechanism of the activated BCR signaling pathway is not clear. The pathogenic basis of miR-17-92 cluster remains unclear although the oncogenic microRNA (miRNA) miR-17-92 cluster is highly expressed in patients with MCL. We revealed that miR-17-92 cluster overexpression is partly dependent on SOX11 expression and chromatin acetylation of MIR17HG enhancer regions.

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Objectives: Oral sulfate solution (OSS) is used for bowel preparation (BP) during colonoscopy. The way of taking this agent can be used a same-day regimen (only on the day of colonoscopy) and split regimen (the day before and on the day of colonoscopy) for receiving it. In this study, we analyzed the efficacy of a same-day regimen of 480 ml OSS for insufficient bowel preparation (BP) with high-concentrated polyethylene glycol (H-PEG).

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Article Synopsis
  • - The study evaluated the effectiveness of texture and color enhancement imaging (TXI) compared to narrow band imaging (NBI) for detecting polyps in the right side of the colon during colonoscopy in patients aged 40 and above, involving 381 participants across three institutions.
  • - Researchers conducted a 30-second additional observation (Add-30-s) using either TXI or NBI after initial viewing with white light to compare detection rates of adenomas and sessile serrated lesions.
  • - Results showed that TXI was noninferior to NBI, with similar detection rates of polyps between both methods, indicating that TXI can be a viable alternative to NBI for polyp detection in colon examinations.
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Article Synopsis
  • The study analyzed delayed bleeding rates after colorectal endoscopic submucosal dissection in patients taking direct oral anticoagulants (DOACs) and compared them to patients on warfarin.
  • Among different DOACs, dabigatran had the highest delayed bleeding rate, whereas rivaroxaban showed a significantly lower rate than warfarin.
  • Risk factors for delayed bleeding in the DOAC group included heparin bridging therapy, rectal lesion location, and longer procedure times.
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Introduction: In light-emitting diode (LED) and LASER colonoscopy, linked color imaging (LCI) and blue light/laser imaging (BLI) are used for lesion detection and characterization worldwide. We analyzed the difference of LCI and BLI images of colorectal lesions between LED and LASER in a multinational study.

Methods: We prospectively observed lesions with white light imaging (WLI), LCI, and BLI using both LED and LASER colonoscopies from January 2020 to August 2021.

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The prognostic impact of patient-related factors, including age, nutritional parameters, and inflammation status, in higher-risk myelodysplastic syndromes (HR-MDS) has been largely unexplored. This multicenter retrospective study aimed to establish a real-world practice-based prognostic model for HR-MDS by considering both disease- and patient-related parameters in 233 patients treated with AZA monotherapy at seven institutions. We found that anemia, presence of circulating blasts in peripheral blood, low absolute lymphocyte count, low total cholesterol (T-cho) and albumin serum levels, complex karyotype, and del(7q) or  - 7 were poor prognostic factors.

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Standard Endoscopic Mucosal Resection vs Precutting Endoscopic Mucosal Resection Using Novel Disk-Tip Snare for Colorectal Lesions.

Dig Dis Sci

May 2023

Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hhirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan.

Introduction: SOUTEN (KANEKA Co., Tokyo, Japan) is a unique snare with a disk tip. We analyzed the efficacy of precutting endoscopic mucosal resection with SOUTEN (PEMR-S) for colorectal lesions.

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Background And Purpose: Anti-CD20 monoclonal antibodies (MoAbs), rituximab (RIT), and obinutuzumab (OBZ) are the central components of immunochemotherapy for B-cell lymphoma (BCL). However, these agents potentially cause B-cell depletion, resulting in the impairment of antibody (Ab) production. During the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, the optimal prediction of Ab response against anti-SARS-CoV-2 vaccination is critically important in patients with BCL treated by B-cell depletion therapeutics to prevent coronavirus disease 2019 (COVID-19).

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Background: Primary ocular adnexal mucosa-associated lymphoid tissue (MALT) lymphoma (POAML) is the most common subtype of indolent ocular adnexal lymphomas. Although radiotherapy (RT) is the standard of care for localized POAML, it can occasionally lead to permanent side effects. Other treatment strategies, such as rituximab (R) monotherapy and immunochemotherapy, have been used for POAML treatment, but their long-term benefits and relative merits remain unclear.

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In the current Japanese aging society, a high number of very elderly patients (age ranged from 80 to 93) with diffuse large B-cell lymphoma (DLBCL, most frequent hematological malignancy), who require chemotherapy are encountered. However, standard chemotherapy can result in severe adverse effects in elderly patients. Although various scoring systems are available to assess frailty, they are too complicated to immediately make a therapeutic decision, and studies on indications for chemotherapy in elderly patients are few.

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Article Synopsis
  • A new compact and cost-effective 3-color LED endoscopic system (ELUXEO-Lite) was evaluated for diagnosing colorectal tumors using magnified blue light imaging (BLI-LED).
  • The study analyzed data from 37 lesions, comparing diagnostic accuracy and image quality between the new LED system and a traditional blue laser imaging (BLI-LASER) system.
  • Results showed that BLI-LED was just as effective as BLI-LASER in characterizing colorectal tumors, with similar diagnostic accuracy and image quality metrics among both experts and non-experts.
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Case Report: A 65-year-old man without any symptoms received colonoscopy for cancer screening and underwent cold snare polypectomy (CSP) for a 3-mm rectal lesion at a local clinic. A histopathological examination revealed neuroendocrine tumor (NET) G1 with a positive margin. The patient was referred to our hospital for further treatment.

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Analysis of Texture and Color Enhancement Imaging for Improving the Visibility of Non-polypoid Colorectal Lesions.

Dig Dis Sci

December 2022

Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan.

Article Synopsis
  • A new endoscopic system using 5-color LEDs (EVIS X1) was studied for its effectiveness in visualizing non-polypoid colorectal lesions through texture and color enhancement imaging (TXI).
  • In a review of 101 lesions across different imaging modes (white light, narrow band, and TXI), TXI provided significantly better visibility scores compared to white light imaging, though not significantly different from narrow band imaging.
  • Although TXI improved visibility over white light, narrow band imaging still held higher accuracy and confidence levels for diagnosing specific lesion types, indicating a potential benefit of TXI mainly for better visibility rather than overall diagnostic performance.
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The usefulness of combining the pocket-creation method with a traction device using a scissor-type knife for colorectal endoscopic submucosal dissection.

Indian J Gastroenterol

April 2022

Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan.

Article Synopsis
  • The study investigates the impact of combining the pocket-creation method (PCM) with a traction device (S-O clip) and a scissor-type knife (Clutch Cutter) on procedure times for colorectal endoscopic submucosal dissection (ESD).
  • A total of 95 cases using the PCM+SO+CC technique were compared to 103 cases using PCM+CC alone, with results showing that the combined method significantly reduced ESD procedure times.
  • Key findings indicated that shorter ESD times occurred regardless of tumor size, location, morphology, endoscopist experience, and fibrosis severity, highlighting the effectiveness of the combined approach in enhancing procedural efficiency.
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Carfilzomib (CFZ) constitutes powerful combinatory therapy for relapsed/refractory multiple myeloma (RRMM); however, cardiovascular adverse events (CVAEs) have been shown as major treatment obstacles with the use of CFZ. Along with our multi-institutional prospective observational study by the Kyoto Clinical Hematology Study Group on the efficacy and safety of CFZ-based treatments (UMIN000025108), we here performed an ad hoc analysis of CFZ-related CVAEs in 50 patients with RRMM. We analyzed the association between CFZ-related CVAEs and pre-planned examinations, including patients' background, electrocardiographic findings, echocardiographic findings, and serum/plasma levels of 18 potential candidate biomarkers.

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