6 results on '"Akitoshi Hakoda"'
Search Results
2. A case of recurrent massive thickening of the gastric wall caused by pancreatitis of the gastric ectopic pancreas: Detailed pathogenesis based on imaging
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Shun Sasaki, Kazuhiro Ota, Ryo Tanaka, Yoshiro Imai, Yuichi Kojima, Hiroshi Akutagawa, Taro Iwatsubo, Noriaki Sugawara, Akitoshi Hakoda, Hironori Tanaka, Yosuke Mori, Sang‐Woong Lee, Toshihisa Takeuchi, and Hiroki Nishikawa
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computed tomography ,ectopic pancreas ,gastroscopy ,histopathology ,pancreatitis ,Diseases of the digestive system. Gastroenterology ,RC799-869 - Abstract
Abstract A 40‐year‐old Japanese male presented with epigastric pain and loss of appetite at a general hospital three years ago. Computed tomography revealed massive thickening of the gastric wall, and gastroscopy revealed diffuse erythema and edematous thickening of the gastric mucosa. Thereafter, epigastric pain and gastric wall thickening recurred frequently, causing an inability to intake food. Conservative treatment was marginally effective; therefore, a distal gastrectomy was performed. Postoperatively, the patient resumed food intake without complications. Histopathological examination of the surgical specimen revealed Heinrich type 1 gastric ectopic pancreas (EP) with pancreatitis. In this case, the gastric wall's massive thickening was caused by gastric EP's pancreatitis. Although there are some reports of pancreatitis of gastric EP, there are no detailed reports of endoscopic findings, including endoscopic ultrasonography and the disease progression. Recurrent pancreatitis of EP leads to forming a septum within the gastric wall, resulting in a hematoma. Eventually, irreversible narrowing of the gastric lumen may occur, as observed in the present case. We consider this an important case report presenting detailed pathogenesis supported by endoscopic and pathohistological findings of surgical specimens. Our study will help in the early diagnosis and better management of the condition.
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- 2023
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3. A case of recurrent massive thickening of the gastric wall caused by pancreatitis of the gastric ectopic pancreas: Detailed pathogenesis based on imaging
- Author
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Shun Sasaki, Kazuhiro Ota, Ryo Tanaka, Yoshiro Imai, Yuichi Kojima, Hiroshi Akutagawa, Taro Iwatsubo, Noriaki Sugawara, Akitoshi Hakoda, Hironori Tanaka, Yosuke Mori, Sang‐Woong Lee, Toshihisa Takeuchi, and Hiroki Nishikawa
- Subjects
General Medicine - Published
- 2022
4. Risk factors for postoperative bleeding and early death in percutaneous endoscopic gastrostomy: A multicenter retrospective study
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Shinya Nishida, Yoshiaki Takahashi, Kirie Hashimoto Fukuda, Makoto Sanomura, Keishi Kojima, Yuichi Kojima, Akitoshi Hakoda, Toshikazu Onishi, Toshihiko Okada, Haruhiko Ozaki, Kazumi Kawabata, Akira Imoto, Hirota Miyazaki, Taro Iwatsubo, Kazuhiro Ota, Hiroyuki Tsujimoto, Shimpei Kawaguchi, Daisuke Masuda, Yuta Yokoya, Noriaki Sugawara, Takeshi Higashino, Kazuhide Higuchi, Sadaharu Nouda, Takanori Kuramoto, Yoshihiko Nakanishi, Toshihisa Takeuchi, and Masahiro Hoshimoto
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medicine.medical_specialty ,medicine.medical_treatment ,Postoperative Hemorrhage ,Gastroenterology ,Risk Factors ,Neoplasms ,Internal medicine ,Percutaneous endoscopic gastrostomy ,medicine ,Humans ,Medical history ,Adverse effect ,Serum Albumin ,Retrospective Studies ,Gastrostomy ,Hepatology ,Mortality, Premature ,business.industry ,Retrospective cohort study ,Odds ratio ,Perioperative ,medicine.disease ,Comorbidity ,business ,Platelet Aggregation Inhibitors - Abstract
BACKGROUND AND AIM Comprehensive reports on the risk factors for bleeding and early death after percutaneous endoscopic gastrostomy (PEG) are limited. In this multicenter study, we retrospectively investigated the risk factors for bleeding and early death after PEG. METHODS Patients (n = 1234) who underwent PEG between 2015 and 2020 at Osaka Medical and Pharmaceutical University and its affiliated hospitals (11 institutions in total) were evaluated for postoperative bleeding and early death (within 60 days) after PEG according to patient characteristics, construction method, medical history, medications, preoperative hematological findings, and perioperative adverse events. Multivariate logistic regression was performed to identify independent predictors of bleeding and early death after PEG. RESULTS The risk factors for bleeding after PEG were PEG tube insertion using the modified introducer method (odds ratio [OR], 4.37; P = 0.0003), low platelet count (OR, 0.99; P = 0.014), antiplatelet therapy (OR, 2.11; P = 0.036), and heparinization (OR, 4.50; P = 0.007). Risk factors for early death were low body mass index (BMI) (OR, 0.89; P = 0.015), low serum albumin levels (OR, 0.50; P = 0.035), and comorbidity of active cancer (OR, 4.03; P
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- 2021
5. Prospective multicenter evaluation of moving cell metallic stents in endoscopic multiple stent deployment for hepatic hilar obstruction
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Takeshi Ogura, Mamoru Takenaka, Takuya Ikegawa, Kazuya Ueshima, Junichi Kawai, Atsushi Nakai, Akitoshi Hakoda, Saori Ueno, Jun Matsuno, Kazuhide Higuchi, Atsushi Okuda, Shunsuke Omoto, Kousuke Minaga, and Hideyuki Shiomi
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medicine.medical_specialty ,medicine.medical_treatment ,Technical success ,Self Expandable Metallic Stents ,law.invention ,Randomized controlled trial ,law ,Stent deployment ,medicine ,Humans ,Prospective Studies ,Retrospective Studies ,Cholestasis ,Endoscopic retrograde cholangiopancreatography ,Hepatology ,medicine.diagnostic_test ,business.industry ,Liver Diseases ,Stent ,Surgery ,Treatment Outcome ,Bile Duct Neoplasms ,Biliary tract ,Stents ,Delivery system ,business ,Single session - Abstract
Background and aim Bilateral stent deployment for malignant biliary obstruction (MHBO) can be achieved using side-by-side (SBS) or stent-in-stent (SIS) procedures. Compared with SBS techniques, the procedural steps of SIS are technically complex due to the necessity of introducing the delivery system into a contralateral biliary tract through the mesh of the SEMS. To overcome this issue, a novel uncovered SEMS, the HILZO Moving Cell Stent (MCS) has been released. The present study examined the technical feasibility of treating MHBO using bilateral deployment of this novel stent without dilating the mesh of the first stent to achieve insertion of the second stent within a single session, using a prospective, multicenter setting. Method The primary outcome in the present study was the technical success rate. Technical success was defined as deployment of bilateral MCSs into two or more biliary tracts using SIS without a dilation device in a single-session. Results A total of 27 patients with complications of MHBO were enrolled in this study. Bilateral SIS using two MCS was successfully performed in 23 patients without using dilation devices among 27 patients (initial technical success rate; 85.2%). Median time to recurrent biliary obstruction (TRBO) was 271 days. Stent dysfunction was observed in 12 patients (44.4%), and re-intervention was successfully performed in all patients without one patient who instead received best supportive care. Conclusions The SIS technique using MCS without dilation of the mesh may be technically feasible and safe. In addition, this may be useful for re-intervention. Further comparative randomized trials are needed.
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- 2021
6. Clinical impact of recombinant thrombomodulin administration on disseminated intravascular coagulation due to severe acute cholangitis (Recover‐AC study)
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Kei Ito, Shinsuke Koshita, Megumi Takagi, Shunsuke Omoto, Seitaro Ikeoka, Kazunari Nakahara, Masayuki Kitano, Takaaki Eguchi, Junya Sato, Mitsuhito Koizumi, Kazuhide Higuchi, Masahiro Itonaga, Akitoshi Hakoda, Kanno Yoshihide, Yousuke Michikawa, Mamoru Takenaka, Taira Kuroda, Ryo Morita, Akihiko Okada, and Takeshi Ogura
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Disseminated intravascular coagulation ,medicine.medical_specialty ,Endoscopic retrograde cholangiopancreatography ,Multivariate analysis ,Hepatology ,APACHE II ,medicine.diagnostic_test ,business.industry ,030204 cardiovascular system & hematology ,Thrombomodulin ,medicine.disease ,Gastroenterology ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Propensity score matching ,Etiology ,Medicine ,030211 gastroenterology & hepatology ,Surgery ,business ,Survival rate - Abstract
BACKGROUND AND AIM Recombinant thrombomodulin (rhTM) is potentially effective in the treatment of disseminated intravascular coagulation (DIC). Several studies related to drugs for the treatment of acute cholangitis have shown negative results in improvement of overall survival (OS) with rhTM. The aim of this multicenter study was to evaluate the clinical effectiveness of rhTM in patients with acute cholangitis and sepsis-induced DIC who underwent biliary drainage. METHODS A total of 284 consecutive patients, who were complicated with sepsis-induced DIC due to severe acute cholangitis, were included (rhTM group, n = 173; non-rhTM, n = 111) in this study. The primary outcome was the DIC resolution rate at 7 days after starting treatment. The 28-day survival rate was secondarily evaluated. RESULTS DIC scores in the rhTM group improved significantly compared with the non-rhTM group on day 7 (P = .020). According to multivariate analysis, etiology of cholangitis (malignant, HR 2.28), rhTM (non-administration, HR 4.13), and DIC score (≥5, HR 2.46) were significant factors associated with failed DIC resolution on day 7. Propensity score matching created 103 matched pairs. Survival rate at day 28 was significantly higher in rhTM group (94.3%) compared with non-rhTM group (82.6%; P = .048) after propensity score matching. rhTM (non-administration, HR 2.870), DIC score (≥5, HR 2.751), and APACHE II score (≥20, HR 9.310) were significant factors associated with decreasing survival rate at day 28. CONCLUSION In conclusion, rhTM seemed to improve patient survival, but future studies should only include patients with benign or malignant disease and should be performed according to APACHE II scores.
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- 2021
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