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Thrombomodulin in the management of acute cholangitisinduced disseminated intravascular coagulation

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World Journal of Gastroenterology 2015年第2期21卷 533-540页

作者： Keigo Suetani Chiaki Okuse Kazunari Nakahara Yosuke Michikawa Yohei Noguchi Midori Suzuki Ryo Morita Nozomi Sato Masaki Kato Fumio itoh Department of Gastroenterology and Hepatology St.Marianna UniversitySchool of MedicineKawasaki 216-8511Japan

AIM: To evaluate the need for thrombomodulin(r TM) therapy for disseminated intravascular coagulation(DIC) in patients with acute cholangitis(AC)-induced DIC. METHODS: Sixty-six patients who were diagnosedwith AC-induced DIC and who were treated at our hospital were enrolled in this study. The diagnoses of AC and DIC were made based on the 2013 Tokyo Guidelines and the DIC diagnostic criteria as defined by the Japanese Association for Acute Medicine, respectively. Thirty consecutive patients who were treated with r TM between April 2010 and September 2013(r TM group) were compared to 36 patients who were treated without r TM(before the introduction of r TM therapy at our hospital) between January 2005 and January 2010(control group). The two groups were compared in terms of patient characteristics at the time of DIC diagnosis(including age, sex, primary disease, severity of cholangitis, DIC score, biliary drainage, and anti-DIC drugs), the DIC resolution rate, DIC score, the systemic inflammatory response syndrome(SIRS) score, hematological values, and outcomes. Using logistic regression analysis based on multivariate analyses, we also examined factors that contributed to persistent DIC. RESULTS: There were no differences between the r TM group and the control group in terms of the patients' backgrounds other than administration. DIC resolution rates on day 9 were higher in the r TM group than in the control group(83.3% vs 52.8%, P < 0.01). The mean DIC scores on day 7 were lower in the r TM group than in the control group(2.1 ± 2.1 vs 3.5 ± 2.3, P = 0.02). The mean SIRS scores on day 3 were significantly lower in the r TM group than in the control group(1.1 ± 1.1 vs 1.8 ± 1.1, P = 0.03). Mortality on day 28 was 13.3% in the r TM group and 27.8% in the control group; these rates were not significantly different(P = 0.26). Multivariate analysis identified only the absence of biliary drainage as significantly associated with persistent DIC(P < 0.01, OR = 12, 95%CI: 2.

关键词： Disseminated intravascular coagulation Acute chola

Use of color Doppler ultrasonography in the diagnosis of anomalous connection in pancreatobiliary disease

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World Journal of Gastroenterology 2005年第7期11卷 1018-1022页

作者： Hiroki Kawashima Yoshiki Hirooka Akihiro itoh Senju Hashimoto Terutomo itoh Kazuo Hara Akira Kanamori Naoki Ohmiya Yasumasa Niwa Hidemi Goto Department of Gastroenterology Department of Endoscopy

AIM: To estimate the detectability of anomalous connection in pancreatobiliary disease (ACPBD) cases, measuring gallbladder wall blood flow (GWBF).METHODS: In the retrospective study, we enrolled 42subjects with gallbladder wall thickening. GWBF velocity was determined as an average value of the peak velocity of color signals on the gallbladder wall, three times in each case. Based on the findings on endoscopic ultrasonography (EUS) or endoscopic retrograde cholangiopancreatography (ERCP), the 42 subjects were divided into 11 cases with ACPBD and 31 cases without ACPBD. In the prospective study, the subjects were 92 cases with gallbladder wall thickening. Using the cut-off level of the flow velocity obtained in the retrospective study, the usefulness of measuring GWBF velocity in diagnosing ACPBD was ***: In the retrospective study, imaging of GWBF was obtained in 40 of the 42 subjects. The mean GWBF velocity of the ACPBD cases was 29.4±3.9 cm/s(mean±SD), which was significantly different (P＜0.0001;95% CI 5.48-13.2) from that of the without ACPBD cases(20.1±5.9 cm/s). Based on this result, we prepared a receiver operating characteristic curve, and the cut-off level appropriate for diagnosing ACPBD was estimated to be 25 cm/s. In the prospective study, GWBF was detected in 86 of the 92 subjects. Based on the EUS or ERCP findings, the 92 subjects were divided into 15 cases with ACPBD and 77 cases without ACPBD. When a cut-off level of 25 cm/s was employed, ACPBD could be diagnosed with a sensitivity of 87.0% (13/15) and a specificity of87.3% (62/71).CONCLUSION: Measurement of GWBF velocity, which is less invasive and provides objective values, is very useful for diagnosing ACPBD prior to the development of malignant tumors in cases with gallbladder wall thickening.

关键词： Color Doppler ultrasonography Anomalous connection in pancreatobiliary disease Gallbladder cancer Gallbladder wall blood flow Endoscopic ultrasonography

A Scale of Parental Anxiety about Pediatric Emergency Medical Care Services of Japan: Development, Reliability, Validity, Generalizability and Usefulness

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Health 2017年第10期9卷 1427-1458页

作者： Ikuko Sobue Kimie Tanimoto Susumu itoh Division of Nursing Science Graduate School of Biomedical & Health Sciences Hiroshima University Hiroshima Japan Division of Nursing Science Faculty of Medicine Kagawa University Kagawa Japan Division of Medical Science Faculty of Medicine Kagawa University Kagawa Japan

Aim: The purpose of this study was to develop a scale, “parental anxiety about pediatric emergency medical care services” (PAPEMCS), and to evaluate its psychometric properties. Methods: Participants were 14,510 parents with children 6 years old or younger in Kagawa Prefecture. Using each half of the participants, exploratory factor analysis was performed to generate items and factors for the PAPEMCS, and confirmatory factor analysis (CFA) was used to establish the construct validity. The generalizability of the PAPEMCS was evaluated by congruence tests and multigroup CFA. The usefulness of the PAPEMCS was established by the relationship between the PAPEMCS and non-urgent usage of pediatric emergency medical care services (PEMCS). Results: The PAPEMCS compromised 4 factors: “anxiety about quality of PEMCS”, “anxiety about PEMCS system”, “anxiety about public support”, and “anxiety about private support”. All reliability estimates (polychoric ordinal alpha coefficients, item-rest correlations), the item discrimination, 5 fit indices for CFA, the convergent validity (indicator reliabilities, composite reliabilities, average variance extracteds), and the discriminant validity fulfilled the acceptability thresholds. All generalizability estimates fulfilled the predetermined levels of acceptability (Tucker’s congruence coefficients, congruence tests, strict factorial invariance). The usefulness of the PAPEMCS was established by the higher scores of the PAPEMCS being related to non-urgent usage of PEMCS. Conclusions: The PAPEMCS demonstrated satisfactory reliability, validity, generalizability and usefulness. The PAPEMCS is useful to quantify the contents and extent of parental anxiety about PEMCS, and to clarify the mechanisms of non-urgent PEMCS usage.

关键词： Parental Anxiety Pediatric Emergency Medical Care Services Reliability Validity Generalizability and Usefulness Scale Development

Inorganic Crystalline Materials from Oil Paintings in the 19th Century

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材料科学与工程（中英文A版） 2011年第1X期1卷 23-28页

作者： Takashiro Akitsu Nobuyuki Nakamura Harumi itoh Department of Chemistry Faculty of Science Tokyo University of Science 1-3Kagurzaka Shinjuku-ku Tokyo 162-8601 Japan Yamaryo Art Conservation Studio 5-6-18 Kyounancho Musashino Tokyo 180-0023 Japan

Tree Network Formation in Poisson Equation Models and the Implications for the Maximum Entropy Production Principle

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Natural Science 2014年第7期6卷 514-527页

作者： Hiroshi Serizawa Takashi Amemiya Kiminori itoh Graduate School of Environment and Information Sciences Yokohama National University Yokohama Japan

This paper presents not only practical but also instructive mathematical models to simulate tree network formation using the Poisson equation and the Finite Difference Method (FDM). Then, the implications for entropic theories are discussed from the viewpoint of Maximum Entropy Production (MEP). According to the MEP principle, open systems existing in the state far from equilibrium are stabilized when entropy production is maximized, creating dissipative structures with low entropy such as the tree-shaped network. We prepare two simulation models: one is the Poisson equation model that simulates the state far from equilibrium, and the other is the Laplace equation model that simulates the isolated state or the state near thermodynamic equilibrium. The output of these equations is considered to be positively correlated to entropy production of the system. Setting the Poisson equation model so that entropy production is maximized, tree network formation is advanced. We suppose that this is due to the invocation of the MEP principle, that is, entropy of the system is lowered by emitting maximal entropy out of the system. On the other hand, tree network formation is not observed in the Laplace equation model. Our simulation results will offer the persuasive evidence that certifies the effect of the MEP principle.

关键词： Dissipative Structure Far from Equilibrium Fractal Poisson Equation Maximum Entropy Production (MEP) Principle Minimum Entropy Production (MinEP) Principle Tree Network

Glycolytic Synchronization in Yeast Cells via ATP and Other Metabolites: Mathematical Analyses by Two-Dimensional Reaction-Diffusion Models

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Natural Science 2014年第10期6卷 719-732页

作者： Hiroshi Serizawa Takashi Amemiya Kiminori itoh Graduate School of Environment and Information Sciences Yokohama National University Yokohama Japan

Possibilities of synchronized oscillations in glycolysis mediated by various extracellular metabolites are investigated theoretically using two-dimensional reaction-diffusion systems, which originate from the existing seven-variable model. Our simulation results indicate the existence of alternative mediators such as ATP and 1,3-bisphosphoglycerate, in addition to already known acetaldehyde or pyruvate. Further, it is also suggested that the alternative intercellular communicator plays a more important role in the respect that these can synchronize oscillations instantaneously not only with difference phases but also with different periods. Relations between intercellular coupling and synchronization mechanisms are also analyzed and discussed by changing the values of parameters such as the diffusion coefficient and the cell density that can reflect in tercellular coupling strength.

关键词： Acetaldehyde ATP Glycolytic Oscillation Intercellular Coupling Reaction-Diffusion Model Synchronization

Mechanism of Surface-Enhanced Raman Scattering and Its Application to Highly Sensitive Protein Detection

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光谱学与光谱分析 2009年第2期29卷 396-398页

作者： Ozaki Y itoh T Yoshida K Kitahama Y Han X X Zhao B School of Science and Technology Kwansei Gakuin University Sanda Hyogo Japan Health Technology Research Center National Institute of Advanced Industrial Science and Technology (AIST) Takamatsu Kagawa Japan State Key Laboratory of Supramolecular Structure and Materials Jilin University Changchun 130012 China

Surface-enhanced resonance Raman scattering(SERRS)has recently attracted great interest in analytical science due toenormous enhancement factors that have decreased the detec-tionli mits of a wide variety of molecules... 详细信息

关键词：共振拉曼散射电磁群电磁波单分子灵敏度

Sufficient noise and turbulence can induce phytoplankton patchiness

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Natural Science 2010年第4期2卷 320-328页

作者： Hiroshi Serizawa Takashi Amemiya Kiminori itoh 不详

Phytoplankton patchiness ubiquitously obser- ved in marine ecosystems is a simple phy- sical phenomenon. Only two factors are required for its formation: one is persistent variations of inhomogeneous distributions in the phytopl- ankton population and the other is turbulent stirring by eddies. It is not necessary to assume continuous oscillations such as limit cycles for realization of the first factor. Instead, a certain amount of noise is enough. Random fluctua-tions by environmental noise and turbulent ad-vection by eddies seem to be common in open oceans. Based on these hypotheses, we pro-pose seemingly the simplest method to simulate patchiness formation that can create realistic images. Sufficient noise and turbulence can induce patchiness formation even though the system lies on the stable equilibrium conditions. We tentatively adopt the two-component model with nutrients and phytoplankton, however, the choice of the mathematical model is not essen-tial. The simulation method proposed in this study can be applied to whatever model with stable equilibrium states including one-com-ponent ones.

关键词： Eddy Fluctuation Noise Patchiness Reaction-Advection-Diffusion Model Turbulence

Electrohydraulic lithotripsy and rendezvous nasal endoscopic cholangiography for common bile duct stone: A case report

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World Journal of Clinical Cases 2019年第10期7卷 1149-1154页

作者： Koichi Kimura Kensuke Kudo Tomoharu Yoshizumi Takeshi Kurihara Shohei Yoshiya Yohei Mano Kazuki Takeishi Shinji itoh Noboru Harada Toru Ikegami Tetsuo Ikeda Department of Endoscopy and Endoscopic Surgery Fukuoka Dental CollegeFukuoka 814-0175Japan Department of Surgery and Science Graduate School of Medical SciencesKyushu UniversityFukuoka 812-8582Japan

BACKGROUND In patients with large stones in the common bile duct(CBD),advanced treatment modalities are generally ***,we present an interesting case of a huge CBD stone treated with electrohydraulic lithotripsy(EHL)by the percutaneous approach and rendezvous endoscopic retrograde cholangiography(ERC)using a nasal *** SUMMARY A 91-year-old woman underwent ERC for a symptomatic large CBD stone with a diameter of 50 *** was referred to our institution after the failure of lithotomy by ERC,and after undergoing percutaneous transhepatic biliary *** attempted to fragment the stone by transhepatic cholangioscopy using ***,the stones were too large and partly soft clay-like for ***,we attempted lithotomy with ERC and cholangioscopy by the rendezvous technique using a nasal endoscope and achieved complete *** complication was observed at the end of this *** Cholangioscopy by rendezvous technique using a nasal endoscope is a feasible and safe endoscopic method for removing huge CBD stones.

关键词： Common bile duct stone Electrohydraulic lithotripsy Rendezvous technique Endoscopic retrograde cholangiography Nasal endoscop Case report