13 results on '"Akitoshi Hakoda"'
Search Results
2. 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
3. Impact of HLA disparity on the risk of overall mortality in patients with grade II–IV acute GVHD on behalf of the HLA Working Group of Japan Society for Hematopoietic Cell Transplantation
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Tetsuya Eto, Makoto Murata, Tatsuo Ichinohe, Hirohisa Nakamae, Kazuhiro Ikegame, Ayumi Shintani, Takahiro Fukuda, Akitoshi Hakoda, Toshiro Kawakita, Takashi Toya, Naoyuki Uchida, Takafumi Kimura, Satoko Morishima, Junya Kanda, Yoshihiro Inamoto, Shigeo Fuji, Masatsugu Tanaka, Seitaro Terakura, Toshihiro Miyamoto, Yoshiko Atsuta, and Tadakazu Kondo
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Oncology ,Transplantation ,medicine.medical_specialty ,Multivariate analysis ,Hematopoietic cell ,business.industry ,Hematopoietic Stem Cell Transplantation ,Graft vs Host Disease ,Subgroup analysis ,Hematology ,Disease ,Human leukocyte antigen ,surgical procedures, operative ,Japan ,immune system diseases ,hemic and lymphatic diseases ,Internal medicine ,Cohort ,medicine ,Humans ,Stem cell ,Unrelated Donors ,business ,Retrospective Studies - Abstract
Acute graft-versus-host disease (aGVHD) is a major cause of morbidity and mortality after allogeneic hematopoietic cell transplantation (HCT). Stem cell source or HLA disparity may exert a significant impact on the overall survival (OS) after the development of aGVHD. In order to clarify this point, we performed a retrospective analysis using a database of the Japan Society for HCT. We analyzed the clinical outcomes of 10,035 patients who developed grade II-IV aGVHD. The median age of the patients was 48 years. The probability of 2-year OS after the onset of grade II-IV aGVHD in the study cohort was 54.1%. The multivariate analysis showed that the HLA ≥2-loci mismatched related donor and HLA 1-locus mismatched unrelated donor were significantly associated with an inferior OS after grade II-IV aGVHD. In a subgroup analysis, peripheral blood stem cells and HLA disparity were associated with an inferior OS in patients who received related or unrelated HCT. Thus, the clinical outcome after grade II-IV aGVHD significantly varied as per the combination of the presence of HLA disparity and stem cell source. Further research using other databases is necessary to confirm our findings.
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- 2021
4. 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
5. 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
6. Association Between Obstructive Sleep Apnea and Gastroesophageal Reflux Adjusted for Obesity in Patients With Sleep Disorders: a Case-control Study
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Yuichi Kojima, Haruhiko Ozaki, Kazuhiro Ota, Shinya Nishida, Taro Iwatsubo, Kazuhide Higuchi, Toshihisa Takeuchi, Shimpei Kawaguchi, Yosuke Mori, Hirohisa Tanimura, Noriyuki Nakajima, Akitoshi Hakoda, Hironori Tanaka, and Noriaki Sugawara
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medicine.medical_specialty ,business.industry ,Reflux ,Case-control study ,medicine.disease ,Sleep in non-human animals ,Obesity ,respiratory tract diseases ,Obstructive sleep apnea ,Internal medicine ,Medicine ,In patient ,business ,Association (psychology) - Abstract
Background: The association between obstructive sleep apnea syndrome (OSAS) and gastroesophageal reflux disease has been reported in multiple studies and meta-analyses. Although obesity has been cited as a common risk factor for both conditions, in Far East Asia, sleep apnea is often attributed to craniofacial anatomy, and patients with obstructive sleep apnea are not necessarily obese. In the present study, we investigated whether there is an association between obstructive sleep apnea and gastroesophageal reflux after adjusting for obesity.Method: The subjects were 230 patients with sleep disorders who visited the Sleep Center at Osaka Kaisei Hospital between May 2016 and November 2017. All patients underwent esophagogastroduodenoscopy. They were diagnosed with sleep disorders by a respiratory specialist, and all patients with suspected OSAS underwent polysomnography/portable monitoring. BMI was measured from the height and weight of all patients, and they were categorized into three groups: non-obese OSAS, obese OSAS, and control (non-OSAS). The presence or absence of reflux esophagitis in each group was compared using the Los Angeles classification.Results: There were 138 patients in the obese OSAS group, 71 patients in the non-obese OSAS group, and 21 patients in the control group. There was a greater prevalence of reflux esophagitis both in the obese and non-obese OSAS groups compared with the control group (both ppp=0.64).Conclusions: In patients with sleep disorders, OSAS is associated with gastroesophageal reflux regardless of obesity. Alcohol consumption is also a major factor in non-obese patients with OSAS. Since alcohol consumption is associated with the risk of esophageal squamous cell carcinoma and gastroesophageal reflux is associated with the risk of esophageal adenocarcinoma, regular upper gastrointestinal endoscopy is thought to be necessary in patients at risk.
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- 2021
7. Effects of a novel endoscopic reporting system with voice recognition on the endoscopic procedure time and report preparation time: propensity score matching analysis
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Yuma Inoue, Yuichi Kojima, Koichi Ikeo, Yasuki Nakagawa, Hayato Miyamoto, Toshihisa Takeuchi, Takashi Abe, Kazumi Kawabata, Taro Iwatsubo, Yuta Yokota, Junichi Miyazaki, Kazuhide Higuchi, and Akitoshi Hakoda
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medicine.medical_specialty ,Matching (statistics) ,medicine.diagnostic_test ,Esophagogastroduodenoscopy ,business.industry ,Speech recognition ,Gastroenterology ,Endoscopic Procedure ,Colorectal surgery ,Confidence interval ,Endoscopy, Gastrointestinal ,Treatment Outcome ,Voice Recognition ,Japan ,Propensity score matching ,medicine ,Humans ,business ,Propensity Score ,Reporting system ,Abdominal surgery ,Retrospective Studies - Abstract
BACKGROUND With the increase in endoscopic procedures, endoscopists are spending more time creating reports. Although medical reports have largely become electronic, most of the current reporting systems require manual operation. This study aimed to evaluate the efficacy of a novel endoscopic reporting system that uses voice recognition (VR) technology. METHODS We retrospectively reviewed consecutive patients who underwent esophagogastroduodenoscopy between September 2019 and March 2020 at a general hospital in Japan. The novel reporting system, used during endoscopic procedures, is equipped with VR and provides automatic responses by playing back recognized words. Differences in total time spent on the endoscopic procedure and report preparation between the manual entry (ME) and VR groups were evaluated using a propensity score matching method. RESULTS We enrolled 356 patients: 226 and 130 patients in the ME and VR groups, respectively. Propensity score matching created 101 matched pairs. After matching, the median report preparation time (311 vs. 383 s, P = 0.009) and median total time (765 vs. 842 s, P = 0.053) in the VR group were shorter than those in the ME group. The VR system independently shortened the total and report preparation times by 156 s (95% confidence interval, - 274 to - 37 s; P = 0.009) and 118 s (95% confidence interval, - 220 to - 15 s; P = 0.023), respectively, on multiple linear regression analysis. CONCLUSIONS The VR system could save the report preparation time and the total time. This novel system may improve the efficiency of endoscopy-related tasks.
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- 2021
8. Administration of a standard dose of vonoprazan fumarate delays gastric emptying in Japanese healthy adults: a prospective clinical trial
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Yuichi Kojima, Naofumi Osaka, Akitoshi Hakoda, Shimpei Kawaguchi, Taro Iwatsubo, Kazuhiro Ota, Kazuhide Higuchi, Koji Nakada, Michiaki Takii, Shinya Nishida, Hideki Tawa, Toshihisa Takeuchi, Satoshi Kikutani, Hideaki Kanaoka, and Shun Sasaki
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medicine.medical_specialty ,Vonoprazan ,Gastroenterology ,03 medical and health sciences ,0302 clinical medicine ,Japan ,Internal medicine ,Medicine ,Humans ,Pyrroles ,Prospective Studies ,Breath test ,Sulfonamides ,medicine.diagnostic_test ,Gastric emptying ,business.industry ,digestive, oral, and skin physiology ,Proton Pump Inhibitors ,Hepatology ,Clinical trial ,Gastric Emptying ,030220 oncology & carcinogenesis ,Gastric acid ,030211 gastroenterology & hepatology ,Ghrelin ,business ,Abdominal surgery - Abstract
There is no established view of how gastric acid suppression affects the time for gastric emptying. Vonoprazan fumarate shows potent and durable gastric acid inhibitory effects, but its effects on gastric emptying have not been studied widely. We investigated the effects of vonoprazan fumarate on gastric emptying and measured serum gastrin and plasma ghrelin levels in healthy adults. Ten participants were administered 10 mg vonoprazan fumarate daily for 14 days, then 20 mg vonoprazan fumarate daily for 14 days. The gastric emptying breath test was performed and serum gastrin levels were measured at baseline and after each medication administration period. The protocol was then repeated, with the gastric emptying breath test and serum gastrin and plasma desacyl-ghrelin levels measured at baseline and the end of the medication trial. Mean serum gastrin levels increased in a dose-dependent manner [baseline: 104.7 ± 50.4, after 10 mg protocol: 328 ± 123.8, after 20 mg protocol: 555 ± 378.8 (pg/mL, mean ± standard deviation), p = 0.0008]. There was a significant difference between the gastric emptying breath test Tmax at baseline and just after the 20 mg protocol (baseline: 45.5 ± 15.3, after 20 mg protocol: 60.5 ± 19.6 min, p = 0.0418). Plasma desacyl-ghrelin levels increased significantly just after the 20 mg protocol compared to those at baseline [baseline: 222.3 ± 106.4, after 20 mg protocol: 366.2 ± 178.6 (fmol/mL), p = 0.0008]. In healthy adults, 14 days of vonoprazan fumarate administration at 20 mg/day delayed gastric emptying. This clinical trial was registered in the University hospital Medical Information Network Clinical Trial Registry (Trial No. UMIN000039199 and UMIN000042969).
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- 2021
9. Risk Factors and Prediction of Bleeding after Endoscopic Submucosal Dissection in Patients on Antithrombotic Therapy: The SAMURAI Model
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Yuichi Kojima, Tomoyuki Koike, Norimasa Yoshida, Kazunari Murakami, Yasuhiro Fujiwara, Kenta Hamada, Hidekazu Suzuki, Hajime Isomoto, Kazuhide Higuchi, Yuji Naito, Takahisa Furuta, Tomoki Inaba, Toshihisa Takeuchi, Mitsushige Sugimoto, Eriko Koizumi, Hiromi Kataoka, Shinsaku Fukuda, Naotaka Ogasawara, Kotaro Shibagaki, Akitoshi Hakoda, Akihito Nagahara, and Hideki Kobara
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medicine.medical_specialty ,Rivaroxaban ,business.industry ,Warfarin ,Odds ratio ,Institutional review board ,chemistry.chemical_compound ,chemistry ,Edoxaban ,Informed consent ,Emergency medicine ,Antithrombotic ,medicine ,Apixaban ,business ,medicine.drug - Abstract
Background: Bleeding after gastric endoscopic submucosal dissection (ESD) remains problematic, especially in patients receiving antithrombotic therapy. Thus, our study aimed to identify the risk factors and to create a prediction model for post-ESD bleeding in patients receiving antithrombotic therapy. Methods: Patients receiving antithrombotic therapy who underwent gastric ESD at Osaka Medical College Hospital and at 18 referral hospitals all over Japan were enrolled. Risks of post-ESD bleeding were calculated using multivariable logistic regression. The dataset was randomly divided into derivation cohort (70%) and validation cohort (30%). We created a prediction model using derivation cohort. The accuracy of the model was evaluated using the validation cohort. We compared this model with an existing scoring method, using NRI (net reclassification improvement) and IDI (integrated discrimination improvement). Findings: The study enrolled 1207 patients. Post-ESD bleeding occurred in 142 (11·8%) cases. Multivariable analysis yielded an odds ratio of 1·73 for aspirin, 4·18 for P2Y12 receptor antagonist, 1·42 for cilostazol, 0·80 for other antiplatelet agents, 4·12 for warfarin, 3·76 for dabigatran, 5·14 for apixaban, 6·74 for edoxaban, 4·22 for rivaroxaban, and 1·56 for heparin bridging. The prediction model (SAMURAI model) was created for patients receiving antithrombotic therapy, and it had a good predictive ability with a C-statistic of 0·74. The model had a significantly better predictive ability than a previously reported model (NRI=0·41, 0·15–0·66, p=0·002, IDI=0·05, 0·02–0·08, p=0·002). Interpretation: In this study, the risk of post-ESD bleeding for each antithrombotic agent was evaluated. Use of the SAMURAI model will allow the proactive management of post-ESD bleeding risk during antithrombotic therapy. Funding: 2nd Department of Internal Medicine, Osaka Medical College, Japan Declaration of Interest: The authors declare that there are no conflicts of interest associated with this manuscript. Ethical Approval: This study was conducted according to the guidelines of the Declaration of Helsinki. The study was approved by the Ethics Committee of Osaka Medical College (trial number: 693) and by the institutional review board of each participating institution before the recruitment of patients. Informed consent for this study was obtained in the form of opt-out on the website of each participating hospital. All authors had access to the study data and reviewed and approved the final manuscript.
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- 2021
10. Is a proton-pump inhibitor necessary after endoscopic submucosal dissection for superficial esophageal neoplasms? A propensity score analysis
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Yoshiaki Takahashi, Shinpei Kawaguchi, Kazuhide Higuchi, Taro Iwatsubo, Kazuhiro Ota, Yuichi Kojima, Akitoshi Hakoda, Shinya Nishida, Toshihisa Takeuchi, Hideaki Kanaoka, and Masatsugu Shiba
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medicine.medical_specialty ,business.industry ,medicine.drug_class ,Gastroenterology ,Proton-pump inhibitor ,Endoscopic submucosal dissection ,Esophageal Ulcer ,Surgery ,03 medical and health sciences ,0302 clinical medicine ,endoscopic submucosal dissection ,030220 oncology & carcinogenesis ,Propensity score matching ,superficial esophageal squamous cell carcinoma ,Medicine ,lcsh:Diseases of the digestive system. Gastroenterology ,030211 gastroenterology & hepatology ,lcsh:RC799-869 ,business ,proton-pump inhibitor ,Original Research - Abstract
Background: Little is known about the efficacy of proton-pump inhibitor (PPI) therapy in the management of esophageal ulcers after endoscopic submucosal dissection (ESD). Therefore, the objective of this study was to investigate the efficacy of PPI in ulcer healing following ESD for superficial esophageal neoplasms, using a propensity score analytic approach. Methods: This retrospective cohort study was conducted at a single referral center. Between April 2005 and August 2015, 199 consecutive patients with superficial esophageal cancer and esophageal dysplasia underwent ESD. For patients with PPI administration, intravenous PPI therapy was commenced immediately after ESD, and oral PPI was administered daily from post-operative day 3, until ulcer healing was identified. We compared the remnant-ulcer rate at 4 weeks after esophageal ESD between the PPI administration and non-PPI groups, using propensity scores and the inverse probability of treatment weighting (IPTW) method. Results: After exclusions, a total of 88 patients were analyzed. The remnant-ulcer rate at 4 weeks after ESD was 25.5% (12/47) and 14.6% (6/41) in the PPI administration and non-PPI groups ( p = 0.21). After adjusting for background factors using IPTW, the risk of a remnant ulcer in the PPI administration group was not decreased significantly compared with that in the non-PPI group [odds ratio (OR) = 2.42, 95% confidence interval (CI): 0.73–7.97, p = 0.15]. Furthermore, PPI therapy did not decrease significantly the remnant-ulcer rate on logistic regression analysis after adjusting for the propensity score (OR = 2.40, 95% CI: 0.69–8.32, p = 0.15). Conclusion: PPI administration does not promote ulcer healing after ESD for superficial esophageal squamous cell carcinoma.
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- 2020
11. Effect of echoendoscope angle on success of guidewire manipulation during endoscopic ultrasound-guided hepaticogastrostomy
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Akira Imoto, Saori Ueno, Takeshi Ogura, Nobu Nishioka, Akitoshi Hakoda, Kazuhide Higuchi, Tadahiro Yamada, and Masanori Yamada
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Endoscopic ultrasound ,medicine.medical_specialty ,Receiver operating characteristic ,medicine.diagnostic_test ,business.industry ,Gastroenterology ,Intrahepatic bile ducts ,Limiting ,Catheterization ,Endosonography ,Hepaticogastrostomy ,Biliary Tract Surgical Procedures ,Odd ratio ,medicine ,Humans ,Radiology ,business ,Area under the roc curve ,Ultrasonography, Interventional ,Fluoroscopic imaging ,Aged ,Retrospective Studies - Abstract
Background With endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS), guidewire manipulation might be a critically limiting step for nonexperts. However, the causes of difficult guidewire manipulation remain unclear. The aim of this study was to evaluate factors associated with successful guidewire manipulation. Methods This retrospective cohort study included consecutive patients who underwent EUS-HGS between October 2018 and October 2019. We measured scope angle between the long and needle axes of the echoendoscope using still fluoroscopic imaging immediately after puncturing the intrahepatic bile duct. Factors associated with successful guidewire insertion were assessed by multivariable analysis using logistic regression. Result The influence of the angle between the fine-needle aspiration (FNA) needle and echoendoscope on failed guidewire insertion was assessed using receiver operating characteristic (ROC) curves. Area under the ROC curve was 0.86 (95 % confidence interval [CI] 0.00 – 0.76), and an angle of 135° offered 88.0 % sensitivity and 82.9 % specificity for predicting successful guidewire insertion. According to multivariable analysis, only angle between the FNA needle and echoendoscope > 135° was independently associated with successful guidewire insertion (odd ratio 0.03, 95 %CI 0.01 – 0.14; P Conclusion The angle between the FNA needle and echoendoscope might be associated with successful guidewire manipulation during EUS-HGS. Adjusting this angle to 135° before puncturing the intrahepatic bile duct might be helpful in achieving successful guidewire manipulation during EUS-HGS.
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- 2020
12. Impact of HLA Disparity on the Risk of Overall Mortality in Patients Who Developed Grade II-IV Acute GVHD
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Takashi Toya, Masatsugu Tanaka, Satoko Morishima, Junya Kanda, Takahiro Fukuda, Kazuhiro Ikegame, Yoshihiro Inamoto, Ayumi Shintani, Naoyuki Uchida, Shigeo Fuji, Tatsuo Ichinohe, Makoto Murata, Toshihiro Miyamoto, Hirohisa Nakamae, Tadakazu Kondo, Akitoshi Hakoda, Toshiro Kawakita, Yoshiko Atsuta, Seitaro Terakura, Takafumi Kimura, and Tetsuya Eto
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Transplantation ,medicine.medical_specialty ,business.industry ,Internal medicine ,medicine ,Molecular Medicine ,Immunology and Allergy ,In patient ,Cell Biology ,Hematology ,Human leukocyte antigen ,business - Published
- 2021
13. The peripheral neuropathy with paclitaxel after oxaliplatin for the patients with gastric cancer
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Takayuki Kii, Hitoshi Nishitani, Takahiro Miyamoto, Akitoshi Hakoda, Kazuhide Higuchi, Fukutarou Shimamoto, Ken Asaishi, Shin Kuwakado, Tetsuji Terazawa, and Masahiro Gotoh
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Oncology ,medicine.medical_specialty ,business.industry ,Cancer ,Hematology ,medicine.disease ,Oxaliplatin ,chemistry.chemical_compound ,Peripheral neuropathy ,Paclitaxel ,chemistry ,Internal medicine ,Medicine ,business ,medicine.drug - Published
- 2015
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