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2. Association of fatty pancreas with pancreatic endocrine and exocrine function.

Author

Hayato Miyake, Junichi Sakagami, Hiroaki Yasuda, Yoshio Sogame, Ryusuke Kato, Kanetoshi Suwa, Katsuyuki Dainaka, Tomoki Takata, Isao Yokota, and Yoshito Itoh

Subjects
Medicine, Science
Abstract

AIM:The purpose of this study was to clarify whether fatty pancreas might lead to impaired pancreatic endocrine or exocrine function. MATERIAL AND METHODS:The study involved 109 participants who had undergone the glucagon stimulation test and N-benzoyl-L-tyros-p-amino benzoic acid (BT-PABA) test to assess pancreatic function as well as unenhanced abdominal computed tomography (CT). Pancreatic endocrine impairment was defined as ΔC peptide immunoreactivity less than 2 [mmol/L] in the glucagon stimulation test, and pancreatic exocrine impairment was defined as a urinary PABA excretion rate less than 70% on the BT-PABA test. We defined as the mean CT value of pancreas / CT value of spleen (P/S ratio) as a marker to assess fatty pancreas. We analyzed the association between fatty pancreas and pancreatic impairment using the logistic regression model. The odds ratio (OR) is shown per 0.1 unit. RESULTS:Pancreatic endocrine function was impaired in 33.0% of the participants, and 56.9% of those were regarded as having pancreatic exocrine impairment. The P/S ratio was significantly correlated with pancreatic endocrine impairment in univariate analysis (OR = 0.61, 95% confidence interval (CI) = 0.43-0.83, P = 0.0013) and multivariate analysis (OR = 0.38, 95% CI = 0.22-0.61, P < .0001) for all participants. Similar significant relationships were observed in both univariate (OR = 0.70, 95% CI = 0.49-0.99, P = 0.04) and multivariate (OR = 0.39, 95% CI = 0.21-0.66, P = 0.0002) analyses for the participants without diabetes (n = 93). The amount of pancreatic fat was not associated with exocrine impairment in univariate analysis (OR = 0.80, 95% CI = 0.59-1.06, P = 0.12). CONCLUSION:Fatty pancreas was associated with pancreatic endocrine impairment but did not have a clear relationship with pancreatic exocrine impairment.

Published
2018
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3. Clinical practice of acute pancreatitis in Japan: An analysis of nationwide epidemiological survey in 2016

Author

Atsushi Masamune, Kazuhiro Kikuta, Shin Hamada, Ichiro Tsuji, Yoshifumi Takeyama, Tooru Shimosegawa, Kazuichi Okazaki, Ryotaro Matsumoto, Kiyoshi Kume, Shin Miura, Tetsuya Takikawa, Seiji Hongo, Yu Tanaka, Toshitaka Sakai, Masayuki Ueno, Jun Unno, Masao Toki, Mamoru Nishimura, Katsuya Kitamura, Kasen Kobashigawa, Kiyoshi Ashida, Kuniyuki Takahashi, Takashi Watanabe, Yuichirou Sato, Akihiko Satoh, Naoki Yoshida, Kei Tanaka, Hiromu Kondo, Noriaki Suzuki, Hiroko Sato, Akira Mitoro, Kazuhiro Minami, Eisuke Iwasaki, Kosuke Okuwaki, Tsuyoshi Mukai, Yasushi Kudo, Shunjiro Azuma, Yasuhito Takeda, Morimichi Setsuda, Kohei Tsuchida, Atsushi Irisawa, Daisuke Motoya, Nakao Shirahata, Keisuke Iwata, Noriko Oza, Yasunori Kawaguchi, Atsumi Hoshino, Atsuyuki Hirano, Ichiro Sakakihara, Noriko Watanabe, Hiroyuki Funayama, Yuji Nakamura, Tatuo Yamamoto, H.Hiroshi Uchida, Yusuke Iizawa, Mahiro Imamura, Masanari Sekine, Kazuo Inui, Satoshi Yamamoto, Syuichi Sato, Shuji Ishii, Takayuki Yakushijin, Katsutoshi Yamamoto, Tomohiro Masaka, Motoyuki Yoshida, Toshihiko Arizumi, Manabu Goto, Mamoru Takenaka, Hiroyuki Miyakawa, Yuichiro Otsuka, Masaaki Nishi, Kanetoshi Suwa, Junichi Sakagami, Masahiro Satoh, Hideaki Koga, Tadayuki Takagi, Masatsugu Nagahama, Katsuko Hatayama, Naoya Kaneko, Masafumi Mori, Yousuke Nakai, Yuji Iwashita, Kunio Iwatsuka, Kazunao Hayashi, Shuji Terai, Hiroyuki Kaneto, Takao Nishikawa, Midori Uchi, Mitsuyoshi Honjo, Tomofumi Takagi, Kazuhiro Mizukami, Tetsuo Tamura, Toshifumi Gushima, Ai Sato, Kyoko Shimizu, Yukio Aruga, Kouji Nonogaki, Miyuki Kaino, Takuji Iwashita, Mio Tsuruoka, Masato Miura, Hirofumi Hasegawa, Tetsunari Takai, Hiroyuki Yokota, Toshio Fujisawa, Kota Uetsuki, Takashi Kobayashi, Naohisa yamaji, Takao Itoi, Takashi Muraki, Takayuki Watanabe, Osamu Inatomi, Tomoyuki Ushijima, Yusuke Takehara, Hiroshi Kawamura, Mitsuharu Fukasawa, Hideki Hagiwara, Hiroyuki Tamura, Takashi Moriya, Masaki Kuwatani, Yuki Kawaji, Terumi Kamisawa, Makoto Abue, Masanori Fukunishi, Hirohiko Onoyama, Satoshi Mochizuki, Kimi Sumimoto, Masanori Koyabu, Akiyoshi Nishio, Masayuki Sakao, Yoshiki Imamura, Hajime Ohta, Naruo Nishimura, Masahiro Shiihara, Hideaki Anan, Masayo Motoya, Mitsuru Chiba, Tomohiro Deguchi, Yasuhide Kofunato, Naoya Sawada, Kazuhiro Katada, Shimpei Matsumoto, Syunichi Higashide, Hiroyuki Okano, Masaharu Ishida, Masato Yamazaki, Naoshi Tamura, Takeshi Muraoka, Norimitsu Uza, Yuzo Kodama, Shinichiro Muro, Nao Fujimori, Takaaki Ikeda, Naoto Shimokawahara, Naoya Otsu, Yoichi Yano, Shuichiro Sugawara, Kenta Takaura, Yasuhiro Ogura, Takayuki Furuuchi, Masayuki Shibasaki, and Masanobu Kishimoto

Subjects
Adult, Male, medicine.medical_specialty, Carbapenem, Endocrinology, Diabetes and Metabolism, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Japan, Risk Factors, Internal medicine, Epidemiology, medicine, Humans, Aged, Aged, 80 and over, Hepatology, business.industry, Incidence, Incidence (epidemiology), Gastroenterology, Gallstones, Middle Aged, medicine.disease, Clinical Practice, Parenteral nutrition, Pancreatitis, 030220 oncology & carcinogenesis, Etiology, Acute pancreatitis, Female, 030211 gastroenterology & hepatology, business, medicine.drug
Abstract

Background To provide updates on clinical practice of acute pancreatitis (AP) in Japan, we conducted a nationwide epidemiological survey. Methods This study consisted of a two-staged survey; the number of AP patients was estimated by the first-stage survey and their clinical features were examined by the second-stage survey. We surveyed AP patients who had visited hospitals in 2016. Results The estimated number of AP patients in 2016 was 78,450, with an overall incidence of 61.8 per 100,000 persons. We obtained detailed clinical information of 2994 AP patients, including 706 (23.6%) severe cases classified according to the Japanese severity criteria. The male-to-female sex ratio was 2.0, and the mean age at onset was 59.9 years in males and 66.5 years in females. Alcohol was the most common etiology (42.8%) in males and gallstones in females (37.7%). The AP-associated mortality was 6.1% in severe AP cases, which was decreased by 40% compared to the 2011 survey. Antibiotics were administered to most cases, with carbapenem being frequently used. Enteral nutrition was given in 31.8% of severe cases, but majority cases received after 48 h. Among the 107 patients who received intervention for walled-off necrosis, five patients received surgery-first approach, 66 received endoscopic ultrasound-guided transluminal drainage, and 19 underwent step-up approach. Conclusions We clarified the current status of AP in Japan including the significant reduction of mortality in severe cases, shift to endoscopic approaches for walled-off necrosis, and poor compliance of the recommendations in the guidelines including management of enteral nutrition and antibiotic administration.

Published
2020
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4. A case of mass-forming pancreatitis with 68Ga-DOTATOC accumulation

Author

Kanetoshi Suwa, Yoshito Itoh, Toshifumi Doi, Akio Yanagisawa, Hiroaki Yasuda, Katsuyuki Dainaka, Satoru Yasukawa, Hayato Miyake, Masayuki Mizuno, Chiemi Mizuno, Ryusuke Kato, Junichi Sakagami, and Yoshio Sogame

Subjects
03 medical and health sciences, medicine.medical_specialty, 0302 clinical medicine, business.industry, 030220 oncology & carcinogenesis, Internal medicine, medicine, Pancreatitis, business, medicine.disease, Gastroenterology, 030218 nuclear medicine & medical imaging
Published
2017
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5. Endoscopic ultrasound-guided fenestration for the duodenal duplication cyst causing acute pancreatitis: A case report

Author

Yoshito Itoh, Hiroaki Yasuda, Toshifumi Doi, Junichi Sakagami, Keisho Kataoka, Hideyuki Konishi, Tatsuro Tajiri, Taizo Furukawa, Hayato Miyake, Kanetoshi Suwa, Ryusuke Kato, and Yoshio Sogame

Subjects
Endoscopic ultrasound, medicine.medical_specialty, Hepatology, medicine.diagnostic_test, business.industry, Endocrinology, Diabetes and Metabolism, General surgery, Duodenal duplication, Gastroenterology, medicine.disease, Surgery, medicine, Acute pancreatitis, Cyst, Fenestration, business
Published
2016
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6. Usefulness of contrast-enhanced endoscopic ultrasonography for mural lesions of branch duct IPMN

Author

Hayato Miyake, Kanetoshi Suwa, Keisho Kataoka, Ryusuke Kato, Yoshio Sogame, Toshifumi Doi, Junichi Sakagami, Hiroaki Yasuda, and Yoshito Itoh

Subjects
medicine.medical_specialty, Hepatology, business.industry, Endocrinology, Diabetes and Metabolism, media_common.quotation_subject, Gastroenterology, Mural, Endoscopic ultrasonography, Branch Duct, Internal medicine, medicine, Contrast (vision), Radiology, business, media_common
Published
2016
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