Publications by authors named "Fumimasa Tomooka"
Background/aims: This study aimed to compare the stent patency between the novel multi-hole self-expandable metallic stent (MH-SEMS) and conventional partially covered SEMS (PC-SEMS) for malignant distal biliary obstruction (MDBO) in patients with pancreatic carcinoma.
Methods: This retrospective study compared stent patency between patients with MH-SEMS (n=43) and those with PC-SEMS (n=94). Secondary outcomes were overall survival (OS), incidence of recurrent biliary obstruction (RBO), causes of RBO, and adverse events (AEs).
Covert hepatic encephalopathy (CHE) can worsen the quality of life and prognosis of patients with cirrhosis. We analyzed the risk factors of CHE and identified patients at high risk for overt hepatic encephalopathy (HE) who would benefit from therapeutic interventions. We included 145 patients without a history of or treatment for overt HE.
View Article and Find Full Text PDFAim: This study aimed to assess the prognostic significance of hand grip strength (HGS) and skeletal muscle mass index (SMI) in patients with alcohol-related cirrhosis.
Methods: 535 patients with liver cirrhosis (LC) were assessed for HGS and computed tomography (CT)-based SMI. They were categorized into alcohol-related liver disease (ARLD; n = 226), metabolic dysfunction-associated steatohepatitis (MASH; n = 119), and virus-related cirrhosis (VC, n = 190) groups.
Aim: This study aimed to determine the predictive ability of the histological stage (HS) compared with biochemical response to ursodeoxycholic acid (UDCA) (BR) on developing complications in patients with primary biliary cholangitis (PBC).
Methods: Overall, 226 patients with asymptomatic PBC treated with UDCA were enrolled. Pathological staging was conducted based on the Scheuer and Nakanuma classifications, which were graded for liver fibrosis (fibrosis) and bile duct loss (BDL).
As endoscopy is increasingly being used to diagnose superficial nonampullary duodenal epithelial tumors (SNADETs), there is a growing need for their early detection and minimally invasive treatment. This study investigated the diagnostic accuracy of biopsy specimens for SNADETs. We conducted a retrospective analysis of clinicopathologic data from 98 patients with SNADETs who had undergone endoscopic resection.
View Article and Find Full Text PDFAim: The incidence of intrahepatic distant recurrence (IDR) of hepatocellular carcinoma (HCC) still remains high after radiofrequency ablation (RFA). However, serum alpha-fetoprotein (AFP) has insufficient screening power. This study aimed to identify risk factors for IDR in patients with post-RFA HCC.
View Article and Find Full Text PDFRecently, endoscopic ultrasound-guided tissue acquisition (EUS-TA) has been widely used to diagnose pancreatic ductal adenocarcinoma (PDAC). The histological examination of core tissues acquired using novel biopsy needles is the primary diagnostic approach for patients with PDAC. However, in patients with early-stage PDAC, such as Stages 0 and I, EUS-TA can be challenging, and its diagnostic accuracy may be limited.
View Article and Find Full Text PDFArticle Synopsis
- - The study evaluated the effectiveness of inside stent therapy for patients with unresectable malignant hilar biliary obstruction, showing a high clinical success rate of 95.5% in resolving jaundice.
- - Analysis identified factors influencing stent patency duration; unilateral drainage and chemotherapy were linked to significantly longer stent patency compared to bilateral drainage and no chemotherapy.
- - The procedure was considered safe, with only a small percentage of patients experiencing early adverse events such as cholangitis and pancreatitis.
Article Synopsis
- The study aimed to determine if the levels of von Willebrand factor (VWF) and a protein called ADAMTS13 can predict the progression of esophagogastric varices (EGV) in patients with liver cirrhosis caused by hepatitis C after successful antiviral treatment.
- Researchers analyzed 47 patients who achieved a sustained virologic response (SVR) after direct-acting antiviral (DAA) therapy; 18 of these patients showed signs of EGV progression post-treatment.
- Results indicated that a higher VWF-to-ADAMTS13 ratio (greater than 2.3) was a significant risk factor for EGV progression, suggesting that this ratio can help identify patients at risk for complications
Article Synopsis
- - The study evaluated how the COVID-19 pandemic affected the treatment of acute cholangitis due to choledocholithiasis by analyzing medical records from April 2017 to December 2022 during a declared state of emergency in Japan.
- - Results showed an increase in the number of endoscopic retrograde cholangiopancreatography (ERCP) cases and successful stone removals after the state of emergency. Additionally, patients treated during this time tended to be in better health, while those on certain medications and with previous health issues were fewer.
- - The findings indicated that the pandemic led to more efficient single-stage endoscopic treatments and shorter hospital stays without increasing safety risks for patients undergoing ERCP.
Article Synopsis
- Lipopolysaccharides (LPSs) are linked to the progression of hepatocellular carcinoma (HCC), but the exact mechanisms are still unclear.
- The study hypothesizes that epiregulin (EREG), produced in the presence of LPS by liver cells, is a key factor in HCC growth by affecting the epidermal growth factor receptor (EGFR) in tumors.
- Experiments in a mouse model show that LPS treatment not only increases tumor size and EREG levels but also enhances blood vessel formation and expression of IL-8, indicating EREG's role in tumor growth and invasion.
Article Synopsis
- Portal vein thrombosis (PVT) is a serious condition often found in patients with liver cirrhosis, linked to high mortality rates, and is influenced by enzyme and factor imbalances causing increased blood clotting.
- A study involving 345 liver cirrhosis patients identified two groups: 40 with PVT and 305 without, noticing that 81% were excluded due to various health issues.
- The findings showed that lower plasma levels of ADAMTS-13 activity indicate a higher risk for developing PVT, making it a potential diagnostic and prognostic biomarker, especially in Japanese patients.
Article Synopsis
- A 48-year-old man with a history of pulmonary and ocular sarcoidosis was diagnosed with hepatic sarcoidosis after biopsies showed non-caseating granulomas in the liver.
- Diagnostic imaging revealed lymphadenopathy and liver infiltration, leading to treatment with ursodeoxycholic acid and later prednisone.
- After five years on a low dose of prednisone, the patient showed significant improvement, with follow-up biopsies indicating minimal inflammation and stable fibrosis levels.
Article Synopsis
- The study aimed to examine the von Willebrand factor to ADAMTS13 ratio (VWF:Ag/ADAMTS13:AC) as a biomarker for predicting outcomes in patients with acute kidney injury (AKI) related to liver cirrhosis (LC).
- Researchers compared 91 patients with AKI against 91 control patients without AKI, measuring plasma levels of VWF and ADAMTS13 to identify risk factors.
- Results showed that higher VWF:Ag/ADAMTS13:AC ratios were linked to increased risk of AKI onset, higher 90-day mortality rates, and poorer treatment responses, suggesting this ratio could be a significant predictor for patients with LC.
Endogenous lipopolysaccharide (LPS) that translocates via the disrupted intestinal barrier plays an essential role in the progression of alcohol-related liver disease (ALD). Vitamin D deficiency is observed in ALD, and it participates in regulating gut barrier function. The current study aimed to examine the association between vitamin D deficiency and endotoxemia in patients with ALD-related cirrhosis.
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- * An initial attempt to treat his condition using endoscopic techniques was unsuccessful due to adhesions, leading to a successful placement of a plastic stent that improved his symptoms.
- * After replacing the plastic stent with a metal one due to frequent occlusions, the patient experienced cholangitis again and the metal stent had migrated; however, he was able to undergo a successful retreatment through the existing fistula.
Article Synopsis
- The study examined adverse events following the placement of self-expandable metal stents (SEMSs) in patients with malignant distal biliary obstruction (MDBO) across 26 hospitals from April 2018 to March 2021.
- Out of 1425 patients, 16% experienced early adverse events and 27.6% faced recurrent biliary obstruction (RBO), with specific risk factors identified for conditions like acute pancreatitis and cholecystitis depending on SEMS type and placement.
- Key findings highlighted that certain anatomical factors and SEMS designs influenced the occurrence of complications, including food impaction, stent migration, and tumor ingrowth, informing better patient management strategies.
Article Synopsis
- Alcohol significantly contributes to liver cirrhosis (LC), and this study focused on identifying a surrogate marker for sarcopenia in LC patients with different causes, particularly comparing alcoholic cirrhosis (AC) and nonalcoholic cirrhosis (NAC).
- The analysis involved 451 patients out of 775, measuring handgrip strength, skeletal muscle mass, and endotoxin activity (EA), revealing that AC patients had higher platelet counts and lower blood urea nitrogen levels compared to NAC patients.
- Key risk factors for sarcopenia included age, sex, liver function, and hemoglobin levels, with hemoglobin being a strong predictor of sarcopenia; combining hemoglobin with endotoxin
Concurrent Ulcerative Colitis in a Pregnant Patient with Rheumatoid Arthritis.
Intern Med
February 2024
We herein report a rare concurrent case of ulcerative colitis (UC) in a pregnant woman with rheumatoid arthritis (RA), which was well managed by biologics. When a 32-year-old woman with seropositive RA became pregnant, she began experiencing hematochezia; colonoscopy revealed diffuse inflammation with multiple ulcers. Based on clinical examinations and pathological assessments, she was diagnosed with severe UC.
View Article and Find Full Text PDFGlucagon-like peptide-1 receptor agonist, semaglutide attenuates chronic liver disease-induced skeletal muscle atrophy in diabetic mice.
Biochim Biophys Acta Mol Basis Dis
October 2023
Article Synopsis
- A glucagon-like peptide-1 receptor agonist (GLP-1RA), specifically semaglutide, shows promise for treating skeletal muscle atrophy associated with chronic liver disease (CLD) in diabetic conditions.
- In mouse models, semaglutide reduced muscle atrophy, enhanced grip strength, and promoted muscle growth by inhibiting protein breakdown pathways and protecting against liver injury.
- The therapeutic effects of semaglutide were linked to its ability to stimulate GLP-1 receptors in muscle cells, activating several beneficial molecular pathways, leading to improved muscle health in the context of CLD.
The renin-angiotensin-aldosterone system has gained attention due to its role as a mediator of liver fibrosis and hepatic stellate cell (HSC) activation. Meanwhile, the natriuretic peptide (NP) system, including atrial NP (ANP) and C-type NP (CNP), is a counter-regulatory hormone regulated by neprilysin. Although the combination of an angiotensin receptor and a neprilysin inhibitor (sacubitril/valsartan: SAC/VAL) has shown clinical efficacy in patients with heart failure, its potential effects on hepatic fibrosis have not been clarified.
View Article and Find Full Text PDFChanges in Coagulation and Fibrinolytic Factors in Patients With Cirrhotic Refractory Ascites Undergoing Cell-free and Concentrated Ascites Reinfusion Therapy: A Retrospective Observational Study in Japan.
In Vivo
May 2023
Article Synopsis
- The study examined the safety and feasibility of cell-free and concentrated ascites reinfusion therapy (CART) for patients with cirrhosis and refractory ascites, focusing on changes in coagulation factors in the ascitic fluid.
- Out of 23 patients, CART led to significant decreases in body weight and waist circumference, along with increases in important proteins and coagulation factors in the reinfused fluid.
- The results indicate that CART is both effective and safe, resulting in improved patient symptoms as measured by the Ascites Symptom Inventory-7 scale.
Article Synopsis
- - The study investigated a potential marker for sarcopenia in patients with liver cirrhosis, analyzing data from 424 patients divided into sarcopenia (Group S) and nonsarcopenia (Group NS) groups.
- - Results indicated that Group S had significantly lower handgrip strength, skeletal muscle index, and hemoglobin levels, while showing higher levels of certain collagen biomarkers compared to Group NS.
- - The study concluded that hemoglobin levels could serve as a predictive biomarker for sarcopenia in liver cirrhosis patients, suggesting the need for further research in this area.