論文 - 河上 洋
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Kuwatani M., Kawakami H., Makiyama H., Onodera M., Matsumoto K., Karasawa G., Asaka M.
Internal Medicine 46 ( 18 ) 1557 - 1564 2007年9月
記述言語：日本語 掲載種別：研究論文（学術雑誌） 出版者・発行元：Internal Medicine
A 58-year-old male had been diagnosed as having autoimmune pancreatitis (AIP) from the results of serological examinations and image findings. He was treated with prednisolone (PSL) for 3.5 months. Fifteen months later, follow-up CT revealed the main pancreatic duct (MPD) dilatation in the pancreas body to tail and right hydronephrosis caused by complicated retroperitoneal mass. We diagnosed him as having recurrent AIP with retroperitoneal fibrosis, and restarted PSL treatment. After one month, Examinations indicated amelioration of the MPD dilatation and right hydronephrosis, but not the right renal failure. This case indicates the importance of maintenance of PSL treatment. © 2007 The Japanese Society of Internal Medicine.
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Kawakami H., Kuwatani M., Onodera M., Hirano S., Kondo S., Nakanishi Y., Itoh T., Asaka M.
Internal Medicine 46 ( 15 ) 1191 - 1195 2007年8月
記述言語：日本語 掲載種別：研究論文（学術雑誌） 出版者・発行元：Internal Medicine
Hepatolithiasis associated with cholangiocellular carcinoma is occasionally a calcium bilirubinate stone. Primary cholesterol hepatolithiasis associated with cholangiocellular carcinoma is rare; only 6 cases have been reported in the literature. A 55-year-old man was admitted to our hospital because of an elevated level of carbohydrate antigen 19-9. Various imaging studies demonstrated a mass in the segment VII of the liver. The patient underwent a curative surgical operation. Histopathological examination revealed that it was cholangiocellular carcinoma located in the periphery of the liver. A cholesterol stone was present, encircled by the cholangiocellular carcinoma. Minor inflammatory changes were observed around the stone. © 2007 The Japanese Society of Internal Medicine.
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Nakanishi Y., Ito T., Kubota K., Takeda H., Yonemori A., Kawakami H., Zen Y., Kondo S.
Surgery Today 37 ( 8 ) 708 - 712 2007年8月
記述言語：英語 掲載種別：研究論文（学術雑誌） 出版者・発行元：Surgery Today
Spindle cell-type undifferentiated carcinoma arising from the extrahepatic bile duct is extremely rare. We herein report a case of this type of carcinoma in the common bile duct of the hepatic hilus. A 59-year-old man was admitted to our hospital complaining of jaundice. The laboratory data revealed an elevation of the serum carbohydrate antigen 19-9 level. Cholangiography revealed a complete obliteration of the left hepatic bile duct and stenosis of the bile duct from the superior to the right hepatic bile duct. Computed tomography showed the tumor to measure 15 × 12 mm in the hepatic hilus, with the obliteration of the right to main trunk of the portal vein and a swollen lymph node in the hepato-duodenum ligament. Arteriography revealed a kink of the right hepatic artery; therefore an encasement of the right hepatic artery was suspected. We preoperatively diagnosed hilus bile duct carcinoma and scheduled a right trisection hepatectomy. Intraoperative frozen sections taken from the tumor and tissues around the hepatic arteries showed spindle and inflammatory cells; therefore an inflammatory pseudotumor was diagnosed intraoperatively. As the right hepatic bile duct was occluded, a right lobe hepatectomy was performed. However, a permanent section revealed both spindle cells and poorly differentiated tubular adenocarcinoma cells positive for CAM5.2, AE1/AE3, and vimentin. On the basis of these findings, the tumor was finally diagnosed to be spindle cell-type undifferentiated carcinoma. Unfortunately, the patient died of pulmonary infarction 11 days after the operation. © 2007 Springer-Verlag.
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Primary acinar cell carcinoma of the ampulla of Vater
Kawakami H., Kuwatani M., Onodera M., Hirano S., Kondo S., Nakanishi Y., Itoh T., Asaka M.
Journal of Gastroenterology 42 ( 8 ) 694 - 697 2007年8月
記述言語：日本語 掲載種別：研究論文（学術雑誌） 出版者・発行元：Journal of Gastroenterology
Acinar cell carcinoma of the pancreatobiliary system is a relatively rare malignant neoplasm arising usually in the pancreatic parenchyma. We experienced a 68-year-old woman who presented with obstructive jaundice due to an ampullary mass 1.0 cm in diameter, detected by abdominal computed tomography and endoscopic examination. The patient underwent a curative surgical operation, and histopathological examination revealed that the tumor was confined to the ampulla of Vater with no continuity to the pancreatic parenchyma. The tumor cells showed acinar or tubular arrangement with eosinophilic to basophilic granular cytoplasm, findings identical to those of acinar cell carcinoma of the pancreas. Immunohistochemically, the tumor cells were positive for lipase. From these findings, we concluded that the tumor was primary acinar cell carcinoma arising in the ampulla of Vater, probably originating from heterotopic pancreatic tissue. This is the first reported case of primary acinar cell carcinoma in the ampulla of Vater. © Springer-Verlag Tokyo 2007.
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Kitagami H., Kondo S., Hirano S., Kawakami H., Egawa S., Tanaka M.
Pancreas 35 ( 1 ) 42 - 46 2007年7月
記述言語：日本語 掲載種別：研究論文（学術雑誌） 出版者・発行元：Pancreas
OBJECTIVES: Acinar cell carcinoma (ACC) of the pancreas is a rare tumor, and many aspects remain unclear because no large-scale clinical studies have been conducted. METHODS: The present study investigated the clinical characteristics, treatment, and therapeutic outcomes of 115 patients registered in the Pancreatic Cancer Registry of the Japan Pancreas Society, and therapeutic plans were reviewed. RESULTS: Although ACC has been associated with advanced stage and poor prognosis, this tumor was resectable in 76.5% of the patients, and the 5-year survival rate after resection was favorable, being 43.9%. CONCLUSIONS: Confirming the diagnosis of ACC preoperatively is difficult, but this diagnosis should be kept in mind while planning surgery for ordinary pancreatic cancer. Once the diagnosis has been confirmed, a possibility of surgical resection should be pursued to achieve better prognosis. If ACC is unresectable or recurrent, chemotherapy is likely to prove useful. Multidisciplinary therapy centering on the role of surgery will need to be established. © 2007 Lippincott Williams & Wilkins, Inc.
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膵漿液性嚢胞腺腫solid-variant typeと考えられた１例—自験例と報告例の画像所見の検討— 査読あり
Kuwatani M., Kawakami H., Onodera M., Hirano S., Kondo S., Itoh T., Koshiyama T., Kawakami A., Asaka M.
Gastroenterological Endoscopy 49 ( 5 ) 1303 - 1309 2007年5月
担当区分：責任著者 記述言語：日本語 掲載種別：研究論文（学術雑誌） 出版者・発行元：Gastroenterological Endoscopy
A 70-year-old female was admitted to our hospital for workup and treatment of a 23 X 16mm mass in the pancreas head. Ultrasonography showed a hypoechoic solid lesion, whereas, abdominal CT revealed a hypervascular tumor with clear boundaries. Endoscopic ultrasonography demonstrated a hypoechoic mass with lateral shadow and a tiny anechoic lesion. According to these findings, we diagnosed it as endocrine tumor of the pancreas head and performed subtotal stomach preserving pancreatoduodenectomy. The final diagnosis was 'solid-variant type of serous cystadenoma'. When we diagnose a hypervascular and well-demarcated tumor, we need to notice sporadic hyperechoic spots in US, acoustic enhancement in EUS and high-intensity area in MRCP, which seem to represent solid-variant type of SCA.
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Kawakami H., Kuwatani M., Hirano S., Kondo S., Nakanishi Y., Itoh T., Asaka M.
Internal Medicine 46 ( 6 ) 273 - 277 2007年3月
記述言語：日本語 掲載種別：研究論文（学術雑誌） 出版者・発行元：Internal Medicine
Pancreatic endocrine tumors are rare tumors classified into "functioning" and "nonfunctioning" tumors. A 68-year-old man was admitted to our hospital with the chief compliant of abdominal pain. Various imaging studies demonstrated a mass in the head of the pancreas with intraductal growth into the main pancreatic duct and an intraportal mass. The patient underwent a curative surgical operation. Histopathological examination revealed that it was nonfunctioning endocrine carcinoma of the pancreas. This is the first reported case of a pancreatic endocrine tumor with intraductal growth into the main pancreatic duct and tumor thrombus within the portal vein. © 2007 The Japanese Society of Internal Medicine.
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G-CSF産生膵管癌の1例 査読あり
河上 洋，桑谷将城，藤谷好弘，上林 実，小西康平，牧山裕顯，橋野 聡，久保田佳奈子，伊藤智雄，浅香正博
日本消化器病学会雑誌 104 ( 2 ) 233 - 238 2007年2月
担当区分：筆頭著者, 責任著者 記述言語：日本語 掲載種別：研究論文（学術雑誌） 出版者・発行元：Japanese Journal of Gastroenterology
We report a case of pancreatic ductal adenocarcinoma producing granulocyte-colony stimulating factor (G-CSF). A 56-year-old Japanese man was admitted to our hospital with back pain and high fever. An abdominal CT scan revealed masses in the pancreatic body to the tail, and both lobes of the liver. A biopsy specimen of the hepatic tumor demonstrated metastatic poorly differentiated adenocarcinoma We administered oral S-1 in combination with gemcitabine. However, his general condition gradually worsened, and a high serum level of G-CSF persisted. He died 135 days after admission. The diagnosis of autopsy was pancreatic ductal adenocarcinoma. Immunohistochemical staining showed the presence of G-CSF in tumor cells. The final diagnosis was G-CSF-producing pancreatic carcinoma.
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Miseki T., Kawakami H., Natsuizaka M., Darmanin S., Cui H., Chen J., Fu Q., Okada F., Shindo M., Higashino F., Asaka M., Hamuro J., Kobayashi M.
Cancer Gene Therapy 14 ( 1 ) 39 - 44 2007年1月
記述言語：英語 掲載種別：研究論文（学術雑誌） 出版者・発行元：Cancer Gene Therapy
We have recently reported that the intra-tumoral injection of adrenomedullin (AM) antagonist (AMA; AM (22-52)) peptides significantly reduced the in vivo growth of a pancreatic cancer cell line in severely combined immunodeficient (SCID) mice. In the present study, we examined the effects of intra-tumoral and intra-muscular transfers of naked DNA encoding AMA on the in vivo growth of cancer cell lines. We demonstrate that these treatments induce the regression of a pancreatic cancer cell line and a breast cancer cell line inoculated in SCID mice. Furthermore, CD31-positive cells disappear completely from tumor tissues, following treatment, indicating that neo-vascularization is entirely inhibited. These results suggest that the intra-tumoral or intra-muscular transfer of naked DNA encoding AMA might be a promising alternative modality for treating human cancers. © 2007 Nature Publishing Group All rights reserved.
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Kato M., Asaka M., Ono S., Nakagawa M., Nakagawa S., Shimizu Y., Chuma M., Kawakami H., Komatsu Y., Hige S., Takeda H.
Journal of Gastroenterology 42 ( SUPPL.17 ) 16 - 20 2007年1月
記述言語：日本語 掲載種別：研究論文（学術雑誌） 出版者・発行元：Journal of Gastroenterology
Because most gastric cancers develop from a background of Helicobacter pylori-infected gastric mucosa, H. pylori plays an important role in gastric carcinogenesis. Therefore, eradication of H. pylori may inhibit the incidence of gastric cancers. In experimental studies, H. pylori eradication has proved to act as a prophylaxis against gastric cancer. However, the results of recent randomized controlled studies are absolutely contradictory. In Japan, mucosal gastric cancer is usually resected by endoscopic treatment. As only a small part of the gastric mucosa is resected, secondary gastric cancer after endoscopic resection of the primary gastric cancer often develops at another site in the stomach. A nonrandomized Japanese study involving 132 early gastric cancer patients reported that eradication of H. pylori after endoscopic resection tended to reduce the development of secondary gastric cancer. Also, a retrospective multicenter survey indicated that the incidence rate of secondary gastric cancer in H. pylori-eradicated patients was about one-third that among patients in the noneradication group. We conducted a large-scale multicenter randomized trial to confirm the effect of H. pylori eradication on secondary and residual gastric cancer after endoscopic resection. This study was begun in 2003 and is ongoing at present. Diagnosis of a new carcinoma at another site of the stomach is defined as the primary end point, and recurrence of tumors at the resection site as a secondary end point. A total of 542 subjects have been enrolled in the study. This study will have the statistical power to demonstrate whether H. pylori eradication decreases the incidence and recurrence of gastric cancer. © Springer-Verlag Tokyo 2007.
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Neutrophils secrete MIP-1β after adhesion to laminin contained in basement membrane of blood vessels
Chiba K., Zhao W., Chen J., Wang J., Cui H., Kawakami H., Miseki T., Satoshi H., Tanaka J., Asaka M., Kobayashi M.
British Journal of Haematology 127 ( 5 ) 592 - 597 2004年12月
記述言語：日本語 掲載種別：研究論文（学術雑誌） 出版者・発行元：British Journal of Haematology
We have recently demonstrated that granulocyte colony-stimulating factor (G-CSF) stimulated the production of epithelial-cell-derived-neutrophil attractant-78 (ENA-78) by neutrophils and that ENA-78 might promote the accumulation of neutrophils that had migrated from the intravascular space into inflammatory tissues. In this study, we examined whether other chemokines could be secreted by neutrophils that had accumulated after migrating from the intravascular space into the inflammatory tissues. We demonstrated that adhesion to laminin contained in the basement membrane and Matrigel, which is an artificial basement membrane model, induced macrophage inflammatory protein-1β (MIP-1β) in neutrophils and that MIP-1β secreted by neutrophils induced the chemotaxis of dendritic cells. These findings suggest that neutrophils transmigrating through the basement membrane are stimulated to secrete MIP-1β by the basement membrane, inducing the transmigration of dendritic cells from the intravascular space into inflammatory tissues. We propose that neutrophils intervene between innate immune response and specific immune response by secreting MIP-1β during the transmigration through the basement membrane.
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Osanai M., Maguchi H., Katanuma A., Kawakami H., Amizuka H., Itoh H., Takahashi K., Koizumi K., Mitsui S., Izumi S., Watanabe S., Nomura M., Yoshida H., Sakurai Y., Tsuji K., Jong-Hong K.
Gastroenterological Endoscopy 44 ( 5 ) 904 - 911 2002年12月
記述言語：日本語 掲載種別：研究論文（学術雑誌） 出版者・発行元：Gastroenterological Endoscopy
A 46-year-old man was admitted to the hospital with alcoholic chronic pancreatitis complicated by infectious pseudocysts. As multiple pseudocysts were seen, both transduodenal and percutaneous drainage of the cysts were performed to improve the general condition. The ERCP finding revealed some strictures of the main pancreatic duct in the head. It was highly suspected that multiple pseudocysts were caused by those pancreatic ductal strictures. Then we performed endoscopic transpapillary stenting of the pancreatic duct. The postoperative course was uneventful without recurrence of the pseudocysts.
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特発性筋肉内血腫を発症したアルコール性肝硬変の2例 査読あり
Yoshida H., Tsuji K., Kawakami H., Katanuma A., Sakurai Y., Jong-Hon K., Koizumi K., Mitsui S., Gotoh M., Yoshida A., Hayashi T., Tanaka Y., Izumi S., Watanabe S., Takahashi K., Nomura M., Maguchi H., Shinohara T.
Japanese Journal of Gastroenterology 99 ( 11 ) 1350 - 1354 2002年11月
記述言語：日本語 掲載種別：研究論文（学術雑誌） 出版者・発行元：Japanese Journal of Gastroenterology
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Kawakami H., Nomura M., Amizuka H., Haruyama Y., Izumi S., Watanabe S., Osanai M., Katanuma A., Itoh H., Takahashi K., Yoshida H., Sakurai Y., Tsuji K., Kang J., Maguchi H., Nakamura F., Dohke M., Shinohara T.
Japanese Journal of Gastroenterology 99 ( 9 ) 1063 - 1068 2002年9月
記述言語：日本語 掲載種別：研究論文（学術雑誌） 出版者・発行元：Japanese Journal of Gastroenterology
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Kawakami H., Maguchi H., Takahashi K., Itoh H., Katanuma A., Osanai M., Amizuka H., Yoshida H., Hayashi T.
Gastroenterological Endoscopy 44 ( 10 ) 1843 - 1849 2002年1月
記述言語：日本語 掲載種別：研究論文（学術雑誌） 出版者・発行元：Gastroenterological Endoscopy
We report a case in which endoscopic pancreatic stenting was effective for the postoperative stricture of the anastomosis of the main pancreatic duct and the duodenal bulb. A 32-year -old Japanese male with a history of reccurent acute pancreatitis was admitted to our hospital with severe abdominal pain and back pain, and the serum level of pancreatic enzymes was elevated. He had been injured by traffic accident and undergone operation of the pancreas twice at the age 20. He was treated by the conservative therapy, and the condition was improved biochemically. However, endoscopic retrograde pancreatography showed a stricture of the anastomosis of the main pancreatic duct and the duodenal bulb, and dilatation of the distal pancreatic duct. The stricture was considered to be the cause of recurrent acute pancreatitis and endoscopic pancreatic stent placing was performed. General condition got better after treatment, and the serum level of pancreatic enzymes was normalized. The stent was naturally removed after 3 months with no recurrence. MRCP revealed no recurrence of the stricture. He has been free from complications after the stent removal. In conclusion, endoscopic pancreatic stenting can be one of the therapeutic alternatives for the postoperative stricture of the anastomosis of the main pancreatic duct and digestive tract. © 2002, Japan Gastroenterological Endoscopy Society. All rights reserved.
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短期間にIs型からIIa+IIc型へと肉眼形態が変化したS状結腸sm癌の1例 査読あり
Izumi S., Nomura M., Kawakami H.
Stomach and Intestine 36 ( 13 ) 2001年12月
記述言語：日本語 掲載種別：研究論文（学術雑誌） 出版者・発行元：Stomach and Intestine
A 49-year-old woman was referred to our center for positive fecal occult blood. Colonoscopic examination revealed a sessile lesion (Is type), approximately 10 mm in size, in the sigmoid colon. Morphologically, it was considered to be an elevated lesion due to massive submucosal invasion. Colonoscopic examination 30 days later revealed that the lesion had metamorphosed to a flat lesion with disappearance of the elevation in the center. In the area where the elevation had disappeared, an irregular shallow depression with uneven surface was observed. From these colonoscopic findings, it was diagnosed as a superficial depressed cancer (IIa + IIc type) with massive submucosal invasion. Barium enema radiograph revealed a round radiolucent lesion with a thin, irregular barium collection in the center, 10 mm in size. The profile view showed a semilunar deformity. From these findings combined with high-frequency ultrasound probe findings, the lesion was finally diagnosed as IIa + IIc type cancer with massive submucosal invasion at the center. Laparoscopic sigmoidectomy was perfomed. In the resected specimen, there was a IIa + IIc type lesion measuring 8×8 mm in size. Histologically, it was a well differentiated adenocarcinoma with massive submucosal invasion at the center. The tumor border was covered with normal mucosa. The case was thought to be noteworthy for considering the natural course of colorectal cancer.
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Bone marrow dysplasia with basophilic cells in a patient with angiocentric lymphoma
Mori A., Hashino S., Imamura M., Kahata K., Kawakami H., Kobayashi S., Tanaka J., Musashi M., Asaka M.
Acta Haematologica 99 ( 2 ) 98 - 101 1998年3月
記述言語：日本語 掲載種別：研究論文（学術雑誌） 出版者・発行元：Acta Haematologica
We report a 46-year-old man suffering from angiocentric lymphoma of the skin. On admission, he had atypical cells rich in basophilic granules in the bone marrow and peripheral blood, in addition to skin eruptions and bone marrow dysplasia. Immediately after diagnosis, the patient was treated with multidrug combination chemotherapy. At first, the chemotherapy markedly relieved the skin eruption and bone marrow dysplasia, and atypical cells in the bone marrow and peripheral blood disappeared rapidly. However, the disease gradually became resistant to chemotherapy, resulting in a gradual deterioration of the skin eruption and bone marrow dysplasia, and reappearance of atypical cells. The levels of serum cytokines such as interleukin-4 and interleukin-6, and of soluble interleukin-2 receptor correlated well with the disease states. These results suggest that the lymphoma cells directly or indirectly induce the production of these cytokines and that a dysregulated cytokine network, which might be caused by lymphoma cells, induces an increase in atypical cells.
DOI： 10.1159/000040820
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Mori A., Hashino S., Imamura M., Kahata K., Kawakami H., Shibata M., Kobayashi S., Tanaka J., Asaka M.
Bone Marrow Transplantation 21 ( 6 ) 615 - 617 1998年3月
記述言語：日本語 掲載種別：研究論文（学術雑誌） 出版者・発行元：Bone Marrow Transplantation
We report a case of bone marrow infarction in a 20-year-old woman with acute lymphocytic leukemia (ALL) who underwent unrelated bone marrow transplantation (BMT). Hematopoietic engraftment occurred on day 9 and, thereafter, the patient developed acute dermal and hepatic graft-versus-host disease (GVHD). She also experienced severe arthralgia in her knee joints on day 21. Immunosuppressive therapy with prednisolone (PSL) for acute GVHD was given, and the arthralgia improved rapidly, correlating with the improvement in dermal and hepatic GVHD. Based on the laboratory findings and analysis of magnetic resonance images, she was diagnosed as having bone marrow infarction. The cause of the bone marrow infarction was thought to be acute CVHD-related microangiopathy.