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| 1 | Unexpected metastasis of intraductal papillary neoplasm of the bile duct without an invasive component to the brain and lungs:A case report显示文摘BACKGROUND Despite an expanding number of studies on intraductal papillary neoplasm of the bile duct(IPNB),distant metastasis remains unexplained especially in cases of carcinoma in situ.In the present study,we report a rare and interesting case of IPNB without invasive components that later metastasized to lungs and brain.CASE SUMMARY A 69-year-old male was referred to our hospital due to suspected cholangiocarcinoma.Laboratory tests on admission reported a mild elevation of alkaline phosphatase,γ-glutamyl transpeptidase,and total bilirubin in serum.Endoscopic retrograde cholangiography revealed a filling defect in the common bile duct(CBD)extending to the left hepatic duct.Peroral cholangioscopy delineated a tumor in the CBD that had a papillary pattern.Multidetector computed tomography and magnetic resonance cholangiopancreatography detected partial blockage ot interlude in the CBD leading to cholestasis without evidence of metastasis.Therefore,a diagnosis of IPNB cT1N0M0 was established.Left hepatectomy with bile duct reconstruction was performed.Pathological examination confirmed an intraepithelial neoplasia pattern without an invasive component and an R0 resection achievement.The patient was monitored carefully by regular examinations.However,at 32 mo after the operation,a 26 mm tumor in the lungs and a 12 mm lesion in the brain were detected following a suspicious elevated CA 19-9 level.Video-assisted thoracoscopic surgery of left upper lobectomy and stereotactic radiotherapy are indicated.In addition to histopathological results,a genomic profiling analysis using whole exome sequencing subsequently confirmed lung metastasis originating from bile duct cancer.CONCLUSION This case highlights the important role of genomic profiling analysis using whole exome sequencing in identifying the origin of metastasis in patients with IPNB. | Nguyen Hai Nam Kojiro Taura Masashi Kanai Keita Fukuyama Norimitsu Uza Hirona Maeda Yojiro Yutaka Toyofumi F Chen-Yoshikawa Manabu Muto Shinji Uemoto | 2020 | World Journal of Gastroenterology2020，26，3： | 5 |
| 2 | Tests for Serum Levels of Trefoil Factor Family Proteins Can Improve Gastric Cancer Screening显示文摘 | Susumu Aikou Yasukazu Ohmoto Toshiaki Gunji Nobuyuki Matsuhashi Hiroshi Ohtsu Hirona Miura Kensuke Kubota Yukinori Yamagata Yasuyuki Seto Atsushi Nakajima James R. Goldenring Michio Kaminishi Sachiyo Nomura | 2011 | Gastroenterology2011，，3： | 2 |
| 3 | Etoposide prevents apoptosis in mouse liver with D-gahctosamine/lipopolysaccharide-induced fulminant hepatic failure resulting in reduction of lethality 显示文摘 | Nakama T Hirona Moriuchi A | 2001 | Hepatology2001，33，6： | 1 |
| 4 | Subcellular localization of KL-6 mucin in colorectal carcinoma celllines: Association with metastatic potential and cell morphology显示文摘 | Qian Guo Wei Tang Yoshinori Inagaki Norihiro Kokudo Yasuhiko Sugawara Hirona Karako Munehiro Nakata Masatoshi Makuuchi | 2007 | Oncology Reports2007，，5： | 1 |
| 5 | Effect of chitosan, pectic acid, lysozme, and chitinase on the growth of several phytopathogens显示文摘 | Hirona S Nagao N | 1989 | Agric Biol Chem1989，53，11： | 1 |
| 6 | Effect of storage temperature on invertasej,sucrose-6-phosphate synthase and UDP-glucose pyrophosphorylase activities of Japanese processing potatoes显示文摘 | Hirona K Ishibashi K Koaze H | 2005 | Food Preservation Science2005，31，2： | 1 |
| 7 | Hop-resistant lactobacillus brevis contains a novel plasmid harboring a mutidrug resistancelike gene显示文摘 | SAMI M YAMASHITA H HIRONA T | 1997 | Journal of Fermentation and Bioengineering1997，87，1： | 1 |
| 8 | Expression of inducible nitric oxide synthase in rat experinental auto immune myocarditis with special reference to changes in cardiac hemodynamics 显示文摘 | Hirona S Islam M O Nakazawa M | 1997 | Circ Res1997，80，1： | 1 |
| 9 | Newly developed self-expandable Niti-S MD colonic metal stent for malignant colonic obstruction显示文摘BACKGROUND Colonic stents are increasingly used to treat acute malignant colonic obstructions.The Wall Flex and Niti-S D type stents are the commonly used self-expandable metallic stents available in Japan since 2012.Wall Flex stent has a risk of stentrelated perforation because of its axial force,while the Niti-S D type stent has a risk of obstructive colitis because of its weaker radial force.Niti-S MD type stents not only overcome these limitations but also permit delivery through highly flexible-tipped smaller-caliber colonoscopes.AIM To compare the efficacy and safety of the newly developed Niti-S MD type colonic stents.METHODS This single-center retrospective observational study included 110 patients with endoscopic self-expandable metallic stents placed between November 2011 and December 2018:Wall Flex(Group W,n=37),Niti-S D type(Group N,n=53),and Niti-S MD type(Group MD,n=20).The primary outcome was clinical success,defined as a resolution of obstructive colonic symptoms,confirmed by clinical and radiological assessment within 48 h.The secondary outcome was technical success,defined as accurate stent placement with adequate stricture coverage on the first attempt without complications.RESULTS The technical success rate was 100%in Groups W,N,and MD,and the overall clinical success rate was 89.2%(33/37),96.2%(51/53),and 100%(20/20)in Groups W,N,and MD,respectively.Early adverse events included pain(3/37,8.1%),poor expansion(1/37,2.7%),and fever(1/37,2.6%)in Group W and perforation due to obstructive colitis(2/53,3.8%)in Group N(likely due to poor expansion).Late adverse events(after 7 d)included stent-related perforations(4/36,11.1%)and stent occlusion(1/36,2.8%)in Group W and stent occlusion(2/51,3.9%)in Group N.The stent-related perforation rate in Group W was significantly higher than that in Group N(P<0.05).No adverse event was observed in Group MD.CONCLUSION In our early and limited experience,the newly developed Niti-S MD type colonic stent was effective and safe for treating acute malignant colonic obstruction. | Yuki Miyasako Toshio Kuwai Sauid Ishaq Kanae Tao Hirona Konishi Ryoichi Miura Yuki Sumida Kazutaka Kuroki Yuzuru Tamaru Ryusaku Kusunoki Atsushi Yamaguchi Hirotaka Kouno Hiroshi Kohno | 2020 | World Journal of Gastrointestinal Surgery2020，12，4： | 0 |
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