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Review of the diagnosis and management of gastrointestinal bezoars

World Journal of Gastrointestinal Endoscopy 2015年第4期7卷 336-345页

作者： Masaya Iwamuro Hiroyuki Okada Kazuhiro Matsueda Tomoki Inaba Chiaki Kusumoto atsushi imagawa Kazuhide Yamamoto Department of Molecular Hepatology Okayama University Graduate School of Medicine Dentistry and harmaceutical Sciences Department of Endoscopy Okayama University Hospital Department of Gastroenterology Kurashiki Central Hospital Department of Gastroenterology Kagawa Prefectural Central Hospital Department of Gastroenterology Nippon Kokan Fukuyama Hospital Department of Gastroenterology Mitoyo General Hospital Department of Gastroenterology and Hepatology Okayama University Graduate School of MedicineDentistryand Pharmaceutical Sciences

The formation of a bezoar is a relatively infrequentdisorder that affects the gastrointestinal *** are mainly classified into four types dependingon the material constituting the indigestible mass of thebezoar phytobezoars, trichobezoars, pharmacobezoars,and lactobezoars. Gastric bezoars often cause ulcerativelesions in the stomach and subsequent bleeding,whereas small intestinal bezoars present with smallbowel obstruction and ileus. A number of articles haveemphasized the usefulness of Coca-Cola？ administrationfor the dissolution of phytobezoars. However, persimmonphytobezoars may be resistant to such dissolutiontreatment because of their harder consistency comparedto other types of phytobezoars. Better understanding ofthe etiology and epidemiology of each type of bezoarwill facilitate prompt diagnosis and *** we provide an overview of the prevalence, classification,predisposing factors, and manifestations ofbezoars. Diagnosis and management strategies arealso discussed, reviewing mainly our own case *** progress in basic research regarding persimmonphytobezoars is also briefly reviewed.

关键词： Bezoars Gastrointestinal endoscopy Persimmonphytobezoar Trichobezoar Endoscopic removal Gastric ulcer Ileus

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Diagnostic role of 18F-fluorodeoxyglucose positron emission tomography for follicular lymphoma with gastrointestinal involvement

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World Journal of Gastroenterology 2012年第44期18卷 6427-6436页

作者： Masaya Iwamuro Hiroyuki Okada Katsuyoshi Takata Katsuji Shinagawa Shigeatsu Fujiki Junji Shiode atsushi imagawa Masashi Araki Toshiaki Morito Mamoru Nishimura Motowo Mizuno Tomoki Inaba Seiyu Suzuki Yoshinari Kawai Tadashi Yoshino Yoshiro Kawahara Akinobu Takaki Kazuhide Yamamoto Department of Gastroenterology and Hepatology Okayama University Graduate School of MedicineDentistryand Pharmaceutical SciencesOkayama 700-8558Japan Department of Endoscopy Okayama University HospitalOkayama 700-8558Japan Department of Pathology Okayama University Graduate School of MedicineDentistryand Pharmaceutical SciencesOkayama 700-8558Japan Department of Hematology and Oncology Okayama University Graduate School of MedicineDentistryand Pharmaceutical SciencesOkayama 700-8558Japan Department of Internal Medicine Tsuyama Central HospitalTsuyama 708-0841Japan Department of Internal Medicine Okayama Saiseikai General HospitalOkayama 700-8511Japan Department of Gastroenterology Mitoyo General HospitalKanonji 769-1695Japan Department of Internal Medicine Kagawa Rosai HospitalMarugame 763-8502Japan Department of Anatomic Pathology Kagawa Rosai HospitalMarugame 763-8502Japan Department of Internal Medicine Okayama Citizens' HospitalOkayama 700-8557Japan Department of Internal Medicine Hiroshima City HospitalHiroshima 730-8518Japan Department of Gastroenterology Kagawa Prefectural Central HospitalTakamatsu 760-8557Japan Department of Internal Medicine Sumitomo Besshi HospitalNiihama 792-8543Japan Department of Gastroenterology Onomichi Municipal HospitalOnomichi 722-8503Japan

AIM:To investigate the capacity for 18F-fluorodeoxyglucose(18F-FDG) positron emission tomography(PET) to evaluate patients with gastrointestinal lesions of follicular ***:This retrospective case series consisted of 41 patients with follicular lymphoma and gastrointestinal involvement who underwent 18F-FDG-PET and endoscopic evaluations at ten different institutions between November 1996 and October *** for endoscopic,radiological,and biological examinations performed were retrospectively reviewed from clinical records.A semi-quantitative analysis of 18F-FDG uptake was performed for each involved area by calculating the maximum standardized uptake value(SUVmax).Based on the positivity of 18F-FDG uptake in the gastrointestinal lesions analyzed,patients were subdivided into two *** identify potential predictive factors for 18F-FDG positivity,these two groups were compared with respect to gender,age at diagnosis of lymphoma,histopathological grade,pattern of follicular dendritic cells,mitotic rate,clinical stage,soluble interleukin-2 receptor levels detected by 18F-FDG-PET,lactate dehydrogenase(LDH) levels,hemoglobin levels,bone marrow involvement,detectability of gastrointestinal lesions by computed tomography(CT) scanning,and follicular lymphoma international prognostic index(FLIPI) ***:Involvement of follicular lymphoma in the stomach,duodenum,jejunum,ileum,cecum,colon,and rectum was identified in 1,34,6,3,2,3,and 6 patients,*** patient had esophageal *** total,19/41(46.3%) patients exhibited true-positive 18F-FDG uptake in the lesions present in their gastrointestinal *** contrast,false-negative 18F-FDG uptake was detected in 24 patients(58.5%),while false-positive 18F-FDG uptake was detected in 5 patients(12.2%).In the former case,2/19 patients had both 18F-FDG-positive lesions and 18F-FDGnegative lesions in the gastrointestinal *** patients with 18F-FDG avidity,the SUVmax value of the involved gast

关键词： Follicular lymphoma Gastrointestinal endoscopy F-fluorodeoxyglucose positron emission tomography Gastrointestinal lymphoma Duodenal neoplasm

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Advances in managing hepatocellular carcinoma

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Frontiers of Medicine 2014年第2期8卷 175-189页

作者： Marielle Reataza David K. imagawa University of California lrvine Medical Center Orange CA 92868 USA Division of Hepatobiliary and Pancreas Surgery Department of Surgery University of California Irvine Medical Center Orange CA 92868 USA

Multiple modalities for treatment of hepatocellular carcinoma are available, depending on tumor size and number. Surgical resection remains the gold standard, so long as the residual liver function reserve is sufficient. In patients with advanced cirrhosis, liver transplantation is the preferred option, as these patients may not have adequate hepatic reserve after resection. Salvage liver transplantation has also become an option for a select few patients who recur after surgical resection. Ablative techniques have been used for palliation as well as to either completely destroy the tumor, act as an adjunct to resection, or downstage the tumor to meet Milan criteria such that a patient may be a candidate for liver transplantation. Radiofrequency ablation, microwave ablation, chemoembolization, radioembolization, and irreversible electroporation have all been used in this capacity. Currently, sorafenib is the only US Food and Drug Administration-approved chemotherapeutic for hepatocellular carcinoma. The efficacy of sorafenib, in combination with other agents, transarterial chemoembolization, and surgical resection is currently being investigated. Sunitinib and brivanib, tyrosine kinase inhibitors, have failed as potential first- or second-line options for chemotherapy. Bevacizumab in combination with erlotinib is also currently being studied. Final analysis for ramucirumab and axitinib are pending. Tivantinib, a selective mesenchymai-epithelial transition factor （MET） inhibitor, is also undergoing clinical trials for efficacy in MET- high tumors. This review serves to emphasize the current and new technologies emerging in the treatment of hepatoeellular carcinoma.

关键词： hepatocellular carcinoma radiofrequency ablation microwave ablation chemoembolization radioembolization sorafenib irreversible electroporation

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Scale Effects on Magnet Systems of Heliotron-Type Reactors

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Plasma Science and Technology 2005年第1期7卷 2626-2628页

作者： S.imagawa A.Sagara National Institute for Fusion Science 322-6 Oroshi-cho Toki 509-5292 JapanNational Institute for Fusion Science 322-6 Oroshi-cho Toki 509-5292 Japan

For power plants heliotron-type reactors have attractive advantages, such asno current-disruptions, no current-drive, and wide space between helical coils for the maintenanceof in-vessel components. However, one disadvantage is that a major radius has to be large enough toobtain large Q-value or to produce sufficient space for blankets. Although the larger radius isconsidered to increase the construction cost, the influence has not been understood clearly, *** effects on superconducting magnet systems have been estimated under the conditions of aconstant energy confinement time and similar geometrical parameters. Since the necessary magneticfield with a larger radius becomes lower, the increase rate of the weight of the coil support to themajor radius is less than the square root. The necessary major radius will be determined mainly bythe blanket space. The appropriate major radius will be around 13 m for a reactor similar to theLarge Helical Device (LHD).

关键词： helical reactor superconducting magnet blanket

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Safety and efficacy of self-expandable metallic stents in malignant small bowel obstructions

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World Journal of Gastroenterology 2016年第40期22卷 9022-9027页

作者： Akiyoshi Tsuboi Toshio Kuwai Tomoyuki Nishimura Sumio Iio Takeshi Mori Hiroki imagawa Toshiki Yamaguchi atsushi Yamaguchi Hirotaka Kouno Hiroshi Kohno Department of Gastroenterology National Hospital Organization Kure Medical Center and Chugoku Cancer Center

In this report, we present 3 cases of malignant small bowel obstruction, treated with palliative care using endoscopic self-expandable metallic stent(SEMS) placement, with the aim to identify the safety and efficacy of this procedure. Baseline patient characteristics, procedure methods, procedure time, technical and clinical success rates, complications, and patient outcomes were obtained. All 3 patients had pancreatic cancer with small bowel strictures. One patient received the SEMS using colonoscopy, while the other 2 patients received SEMS placement via double balloon endoscopy using the through-the-overtube technique. The median procedure time was 104 min. The technical and clinical success rates were 100%. Post-treatment, obstructive symptoms in all patients improved, and a low-residue diet could be tolerated. All stents remained within the patients until their deaths. The median overall survival time(stent patency time) was 76 d. SEMS placement is safe and effective as a palliative treatment for malignant small bowel obstruction.

关键词： Self-expandable metallic stents Malignant small bowel obstructions Endoscopy Case report Pancreatic cancer

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Endoscopic submucosal dissection for early esophageal neoplasms using the stag beetle knife

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World Journal of Gastroenterology 2018年第15期24卷 1632-1640页

作者： Toshio Kuwai Toshiki Yamaguchi Hiroki imagawa Ryoichi Miura Yuki Sumida Takeshi Takasago Yuki Miyasako Tomoyuki Nishimura Sumio Iio atsushi Yamaguchi Hirotaka Kouno Hiroshi Kohno Sauid Ishaq Department of Gastroenterology National Hospital Organization Kure Medical Center and Chugoku Cancer Center Department of Gastroenterology DGH SGU WI Birmingham City University

AIM To determine short-and long-term outcomes of endoscopic submucosal dissection(ESD) using the stag beetle(SB) knife, a scissor-shaped *** Seventy consecutive patients with 96 early esophageal neoplasms, who underwent ESD using a SB knife at Kure Medical Center and Chugoku Cancer Center, Japan, between April 2010 and August 2016, were retrospectively evaluated. Clinicopathological characteristics of lesions and procedural adverse events were assessed. Therapeutic success was evaluated on the basis of en bloc, histologically complete, and curative or non-curative resection rates. Overall and tumor-specific survival, local or distant recurrence, and 3-and 5-year cumulative overall metachronous cancer rates were also *** Eligible patients had dysplasia/intraepithelial neoplasia(22%) or early cancers(squamous cell carcinoma, 78%). The median procedural time was 60 min and on average, the lesions measured 24 mm in diameter, yielding 33-mm tissue defects. The en bloc resection rate was 100%, with 95% and 81% of dissections deemed histologically complete and curative, respectively. All procedures were completed without accidental incisions/perforations or delayed bleeding. During follow-up(mean, 35 ± 23 mo), no local recurrences or metastases were observed. The 3-and 5-year survival rates were 83% and 70%, respectively, with corresponding rates of 85% and 75% for curative resections and 74% and 49% for noncurative resections. The 3-and 5-year cumulative rates of metachronous cancer in the patients with curative resections were 14% and 26%, *** ESD procedures using the SB knife are feasible, safe, and effective for treating early esophageal neoplasms, yielding favorable short-and long-term outcomes.

关键词： Neoplasms Stag beetle knife Esophageal Endoscopic submucosal dissection Outcome measures

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Biochemical and Immunochemical Characterization of Caenorhabditis elegans Metallothioneins I and II Induced by Cadmium

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Biomedical and Environmental Sciences 1990年第3期3卷 315-325页

作者： MASAOMI KONDO MASAYOSHI imagawa KOHJI MARUYAMA YOSHIHIRO OKADA SUSUMU TSUNASAWA TSUTOMU NISHIHARA Faculty of Pharmaceutical Sciences Institute for Protein Research Osaka University Suita Osaka 565Japan

Metallothioneins in Caenorhahditis elegans (CeMT-Ⅰ and Ⅱ) were punned by the combination of gel filtration ion-exchange *** high-performance liquid *** acid compositions and amino-terminal sequences of CeMT-Ⅰ and Ⅱ were slightly different from those of vertebrate MTs previously reported, although cysteine residue contents were relatively *** immunoassay using anti-CeMT-Ⅱ antibody showed the difference of antigenicity to rat MT-Ⅰ and Ⅱ and even to CeMT-Ⅰ. Immunohistochemical staining revealed the existence of CeMT-Ⅱ in the intestine and the eggs, suggesting the role of MT in detoxification and homeostasis of heavv metals. 1990 Academic ***.

关键词： Biochemical and Immunochemical Characterization of Caenorhabditis elegans Metallothioneins I and II Induced by Cadmium II

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Risk Factors for Abuse in Children with Congenital Heart Disease Presenting at a Pediatric Tertiary Care Hospital

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Congenital Heart Disease 2023年第6期18卷 657-670页

作者： Kristi K.Westphaln Karen Kay imagawa Lorena Espinosa Smith Julia Srivastava Nancy A.Pike School of Nursing University of CaliforniaLos AngelesCaliforniaUSA Department of Pediatrics Children’s Hospital Los AngelesAudrey Hepburn CARES CenterLos AngelesCaliforniaUSA Keck School of Medicine of the University of Southern California Los AngelesCaliforniaUSA Department of Pediatrics Critical Care MedicineChildren’s Hospital Los AngelesLos AngelesCaliforniaUSA Department of Pediatrics Heart Institute Children’s Hospital Los AngelesLos AngelesCaliforniaUSA

Background:Congenital heart disease(CHD)is a chronic medical condition often diagnosed at birth and requires surgical intervention,multiple hospitalizations,and lifelong *** can put signiﬁcant stress on the family,leading to altered maternal mental health,bonding and attachment issues,and the potential for child *** purpose of this study is to explore the characteristics of a sample of young children with CHD who experienced hospitalization with concurrent concern for child abuse in a free-standing pediatric tertiary care ***:Electronic medical records were reviewed for children aged 0–5 years old who were hospitalized with concern for child abuse between 2016 and *** were extracted related to the history of presenta-tion,and sociodemographics including SDOH,admission,and discharge condition/*** statis-tics were used to characterize the sample and correlations to identify an association with abuse ***:Out of 251 hospitalizations involving concern for child abuse,49(19.5%)had a diagnosis of *** majority of cases were neglect(51%),<1 year of age(80%),male(57%),Hispanic ethnicity(45%),and publicly insured(90%).CHD severity was moderate to severe(71%)with multiple co-occurring medical conditions(genetic syn-drome,failure to thrive(FTT),prematurity,history of a feeding tube,developmental delay,and intrauterine drug exposure).Correlations associated with physical abuse were age,maternal mental health,head injury,and history of Child Protective Services(CPS)*** correlated with age,FTT,head injury,history of a feeding tube,previous CPS involvement,and substance *** speciﬁcally related to prenatal substance use included age,maternal mental health status,history of domestic violence,CPS involvement,feeding tube,FTT,lack of housing,employment status,and public ***:Our study highlights the risk for abuse in children with CHD,regardless of defect *** most com

关键词： Child maltreatment intrauterine substance exposure failure to thrive

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Megasession Hair Transplantation in Asians

Megasession Hair Transplantation in Asians

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中华医学会整形外科学分会第十一次全国会议、中国人民解放军整形外科学专业委员会学术交流会、中国中西医结合学会医学美容专业委员会全国会议

作者： Kenichiro imagawa Yokobi Clinic Yokohama Japan

In hair transplantation,a large quantity of donor hair is required?in the cases of extensive baldness as NorwoodⅢ-Ⅶand the maximum number of the grafts per session has increased every ***(over 25oo grafts ) and Gigasession(over 4000 grafts ) are very popular in the West,but to say nothing of Gigasession,Megasession is still unusual in Asian countries.

关键词： Megasession Hair Transplantation in Asians

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Repetitive administration of cultured human CD34+cells improve adenine-induced kidney injury in mice

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World Journal of Stem Cells 2023年第4期15卷 268-280页

作者： Takayasu Ohtake Shoichi Itaba Amankeldi A Salybekov Yin Sheng Tsutomu Sato Mitsuru Yanai Makoto imagawa Shigeo Fujii Hiroki Kumagai Masamitsu Harata Takayuki Asahara Shuzo Kobayashi Regenerative Medicine The Center for Cell Therapy&Regenerative MedicineShonan Kamakura General HospitalKamakura 247-8533KanagawaJapan Kidney Disease and Transplant center Shonan Kamakura General HospitalKamakura 247-8533KanagawaJapan Regenerative Medicine Shonan Research Institute of Innovative MedicineKamakura 247-8533KanagawaJapan Kamakura Techno-science Inc. Kamakura 248-0036Japan Advanced Medicine Science Tokai University School of MedicineIsehara 259-1193Japan Department of Pathology Sapporo Tokushukai HospitalSapporo 004-0041Japan Department of Pathology Sapporo Medical CenterSapporo 004-0041Japan Human Life CORD Japan Inc Chuo-ku 103-0012TokyoJapan Cell Processing and Cell/Genome Analysis Center The Center for Cell Therapy&Regenerative MedicineShonan Kamakura General HospitalKamakura 247-8533KanagawaJapan Kidney Disease and Transplant Center Shonan Kamakura General HospitalKamakura 247-8533KanazawaJapan

BACKGROUND There is no established treatment to impede the progression or restore kidney function in human chronic kidney disease(CKD).AIM To examine the efficacy of cultured human CD34+cells with enhanced proliferating potential in kidney injury in *** Human umbilical cord blood(UCB)-derived CD34+cells were incubated for one week in vasculogenic conditioning *** culture significantly increased the number of CD34+cells and their ability to form endothelial progenitor cell colony-forming *** tubulointerstitial injury of the kidney was induced in immunodeficient non-obese diabetic/severe combined immunodeficiency mice,and cultured human UCB-CD34+cells were administered at a dose of 1×106/mouse on days 7,14,and 21 after the start of adenine *** Repetitive administration of cultured UCB-CD34+cells significantly improved the time-course of kidney dysfunction in the cell therapy group compared with that in the control *** interstitial fibrosis and tubular damage were significantly reduced in the cell therapy group compared with those in the control group(P<0.01).Microvasculature integrity was significantly preserved(P<0.01)and macrophage infiltration into kidney tissue was dramatically decreased in the cell therapy group compared with those in the control group(P<0.001).CONCLUSION Early intervention using human cultured CD34+cells significantly improved the progression of tubulointerstitial kidney *** administration of cultured human UCB-CD34+cells significantly improved tubulointerstitial damage in adenine-induced kidney injury in mice via vasculoprotective and anti-inflammatory effects.

关键词： Chronic kidney disease CD34+cell Adenine Tubulointerstitial injury Quality and quantity control culture Umbilical cord blood

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