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LC, Acute : O-055 ; Protection from liver fibrosis by a PPAR agonist
( Keiko Iwaisako ),( Yong Han Paik ),( Michael Haimer ),( Kojiro Taura ),( Yuzo Kodama ),( Claude Sirlin ),( Elizabeth Yu ),( Ruth T Yu ),( Michael Downes ),( Ronald M Evans ),( David A Brenner ),( Be 대한간학회 2012 춘·추계 학술대회 (KASL) Vol.2012 No.1
Background: Peroxisome Proliferator-Activated Receptor delta (PPAR), a member of the nuclear receptor family, is emerging as a key metabolic regulator with pleiotropic actions on various tissues including fat, skeletal muscle and liver. The aim of our study was to assess the effect of a new and highly selective PPAR agonist KD3010 in experimental mouse models of liver fibrosis induced by carbon tetrachloride (CCl4) injections or bile duct ligation (BDL). Methods: Male adult C57/B6 mice were treated daily with vehicle or KD3010 by oral gavage. Liver fibrosis was induced by repeated intraperitoneal injections of CCl4 or BDL. For in vitro study, primary hepatocytes were isolated and incubated with/without KD3010. Results: PPAR agonist KD3010 ameliorates liver injury induced by CCl4 injections. Deposition of extracellular matrix proteins was lower in the KD3010 group as compared to the control group. The hepatoprotective and antifibrotic effect of KD3010 was confirmed in a model of cholestasis-induced liver injury and fibrosis using BDL for three weeks. Primary hepatocytes incubated with KD3010 were protected from serum starvation or CCl4-induced cell death, in part due to reduced reactive oxygen species (ROS) production. Conclusions: The PPAR agonist KD3010 has hepatoprotective and antifibrotic effects in animal models of liver fibrosis suggesting a new mechanistic and therapeutic approach in treating patients with chronic liver diseases.
( Kei Saito ),( Yousuke Nakai ),( Hiroyuki Isayama ),( Ryuichi Yamamoto ),( Kazumichi Kawakubo ),( Yuzo Kodama ),( Akio Katanuma ),( Atsushi Kanno ),( Masahiro Itonaga ),( Kazuhiko Koike ) 대한소화기학회 2021 Gut and Liver Vol.15 No.1
Background/Aims: The aim of this study was to evaluate the safety and efficacy of partially covered self-expandable metallic stents (PCSEMS) in patients undergoing neoadjuvant chemo (radio) therapy (NAC) for pancreatic cancer (PC). Methods: This was a prospective multicenter study to evaluate the safety and efficacy of PC-SEMS in patients receiving NAC for resectable and borderline resectable PC. The primary endpoint was the rate of recurrent biliary obstruction (RBO). Results: Twenty-six patients with PC (three with resectable PC and 23 with borderline resectable PC) who underwent NAC at seven Japanese centers were included in the analysis. Both the technical and functional success rates of PCSEMS placement were 100%. Early stent-related complications were observed in three patients (11.5%): mild pancreatitis (n=2) and mild liver abscess (n=1). The median time to surgery or palliation was 4.0 months. Surgical resection was eventually performed in 73.1% of patients, and stent removal during surgery was successful in all patients. RBO was observed in nine patients (34.6%): seven with stent occlusion, one with kinking and one with migration. The RBO rates in resected cases and nonresected cases were 36.8% and 28.6%, respectively. Conclusions: Biliary drainage by PCSEMS was safe and feasible in patients undergoing NAC for resectable and borderline resectable PC. (Gut Liver 2021;15:135-141)
Yoshiko Nakano,Toshitatsu Takao,Yoshinori Morita,Shinwa Tanaka,Takashi Toyonaga,Eiji Umegaki,Yuzo Kodama 대한소화기내시경학회 2020 Clinical Endoscopy Vol.53 No.5
Background/Aims: Mucosal cutting biopsy (MCB) is useful for the histopathological diagnosis of gastric subepithelial tumors (SETs). However, there is little information on cases in which MCB did not establish a diagnosis. In the current study, we aimed to investigatethe characteristics of cases in which MCB was unsuccessful. Methods: Cases in which MCB was used to histopathologically diagnose gastric SETs at Kobe University Hospital between August 2012and October 2018 were retrospectively reviewed. Results: Forty-five cases in which MCB was used to diagnose 43 gastric SETs in 43 patients were analyzed. The median tumor sizewas 20 mm (range, 8–50 mm). Pathological examinations resulted in definitive and suspected diagnoses and no diagnosis in 29(gastrointestinal stromal tumor: n=17, leiomyoma: n=7, aberrant pancreas: n=3, others: n=2), 6, and 10 cases, respectively. Failure toexpose the tumor according to retrospective examinations of endoscopic images was significantly associated with no diagnosis. Otherpossible explanations included a less elevated tumor, biopsy of the surrounding field instead of the tumor due to the mobility, and poorendoscope maneuverability due to the tumor being close to the cardia. Conclusions: Clear exposure of gastric SETs during MCB may improve the diagnostic rate of such examinations.
Arata Sakai,Hideyuki Shiomi,Takao Iemoto,Ryota Nakano,Takuya Ikegawa,Takashi Kobayashi,Atsuhiro Masuda,Yuzo Kodama 대한소화기내시경학회 2020 Clinical Endoscopy Vol.53 No.4
In this study, we assessed a series of our cases in which endoscopic self-expandable metal stents (SEMSs) were used to treat malignantafferent loop obstruction (ALO) that arose after pancreaticoduodenectomy (PD). We retrospectively examined the records of 7 patientswho underwent endoscopic SEMS placement for malignant ALO following PD. Clinical success was achieved in all cases. The medianprocedure time was 30 min (range, 15–50 min). There were no cases of stent occlusion, and no procedure-related adverse events wereencountered. All patients died of their primary disease, and the median overall survival period was 155 days (range, 96–374 days). Are-intervention involving endoscopic ultrasound-guided hepaticogastrostomy combined with antegrade stenting was performed forobstructive jaundice and acute cholangitis in 1 case. In conclusion, endoscopic SEMS placement may be an effective and safe treatmentfor malignant ALO that arises after PD.
Hiroya Sakaguchi,Toshitatsu Takao,Yoshitaka Takegawa,Yuki Koga,Kazunori Yamanaka,Masataka Sagata,Shinwa Tanaka,Yoshinori Morita,Takashi Toyonaga,Yuzo Kodama 대한소화기내시경학회 2021 Clinical Endoscopy Vol.54 No.1
Background/Aims: Application of polyglycolic acid (PGA) sheets using fibrin glue in post-endoscopic submucosal dissection (ESD)ulcers to prevent bleeding has been reported to be difficult with the conventional delivery method because of gravity. This studyassessed the usefulness of the envelope-based delivery system with and against gravity in living pigs. Methods: PGA sheets were applied on post-ESD ulcers with and against gravity six times each using the conventional and envelopemethods, respectively. The PGA sheet delivery time and the endoscopic and histological findings of the treated ulcer floors werecompared. Results: With gravity, the median PGA sheet application time was 1.00 (0.68–1.30) min/cm2 and 0.32 (0.18–0.52) min/cm2 with theconventional and envelope techniques (p=0.002), respectively, and against gravity, it was 1.20 (1.13–1.63) min/cm2 and 0.50 (0.39–0.58) min/cm2 (p=0.002), respectively. Against gravity, the endoscopic and histological findings revealed that the conventional grouphad insufficient fixation of the PGA sheets, but the envelope groups had sufficient fixation. The results with gravity were similarbetween the groups. Conclusions: The envelope method makes it possible to deliver PGA sheets to the stomach quickly and cover ulcers appropriatelyboth with and against gravity in living pigs.