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Comparing reduced-dose sodium phosphate tablets to 2L of polyethylene glycol: A randomized study

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World Journal of Gastroenterology 2017年第24期23卷 4454-4461页

作者： Soichiro Ako Koji Takemoto Eriko Yasutomi Chihiro Sakaguchi Mayu Murakami Tomoko Sunami Shohei Oka Hamada Kenta Noriko Okazaki Yuki Baba Yasushi Yamasaki Toshiyuki Asato daisuke kawai Ryuta Takenakai Hirohumi Tsugeno Sakiko Hiraoka Jun Kato Shigeatsu Fujiki Department of Gastroenterology Tsuyama Chuo HospitalTsuyama City Department of Gastroenterology and Hepatology Okayama University Graduate School of MedicineDentistry and Pharmaceutical Sciences Second Department of Internal Medicine Wakayama Medical UniversityWakayama city

To compare the tolerability and quality of bowel cleansing between 2 L polyethylene glycol (PEG) and reduced-dose sodium phosphate (NaP) tablets as a preparation for colonoscopy. METHODSTwo hundred patients were randomly assigned to the PEG or NaP groups at the same ratio. The NaP group patients took 30 tablets with 2 L of clear liquid, while the PEG group patients took 2L of PEG. Tolerability was assessed by a questionnaire about taste, volume, and the overall impression. The bowel cleansing quality was evaluated by colonoscopists. RESULTSAlthough NaP showed better tolerability in terms of taste, volume and overall impression (P < 0.01, P < 0.01 and P = 0.02, respectively), the overall cleansing quality was better in the PEG group (P < 0.01). A subgroup analysis, stratified by sex and age, indicated that NaP was associated with better tolerability and equivalent bowel cleansing quality in females of < 50 years of age. CONCLUSIONDespite the better tolerability, the use of 30 NaP tablets with 2 L of clear liquid should be limited due to its lower cleansing quality; however, in certain cases the regimen may deserve consideration, particularly in cases involving young women.

关键词： Colonoscopy Sodium phosphate tablets Polyethylene glycol Preparation

Current perspectives of viral

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World Journal of Gastroenterology 2024年第18期30卷 2402-2417页

作者： daisuke Usuda Yuki Kaneoka Rikuo Ono Masashi Kato Yuto Sugawara Runa Shimizu Tomotari Inami Eri Nakajima Shiho Tsuge Riki Sakurai Kenji kawai Shun Matsubara Risa Tanaka Makoto Suzuki Shintaro Shimozawa Yuta Hotchi Ippei Osugi Risa Katou Sakurako Ito Kentaro Mishima Akihiko Kondo Keiko Mizuno Hiroki Takami Takayuki Komatsu Tomohisa Nomura Manabu Sugita Department of Emergency and Critical Care Medicine Juntendo University Nerima HospitalNerima 177-8521TokyoJapan Department of Sports Medicine Faculty of MedicineJuntendo UniversityBunkyo 113-8421TokyoJapan

Viral hepatitis represents a major danger to public health,and is a globally leading cause of *** five liver-specific viruses:Hepatitis A virus,hepatitis B virus,hepatitis C virus,hepatitis D virus,and hepatitis E virus,each have their own unique epidemiology,structural biology,transmission,endemic patterns,risk of liver complications,and response to antiviral *** remain few options for treatment,in spite of the increasing prevalence of viral-hepatitiscaused liver ***,chronic viral hepatitis is a leading worldwide cause of both liver-related morbidity and mortality,even though effective treatments are available that could reduce or prevent most patients’*** 2016,the World Health Organization released its plan to eliminate viral hepatitis as a public health threat by the year 2030,along with a discussion of current gaps and prospects for both regional and global eradication of viral ***,treatment is sufficiently able to prevent the disease from reaching advanced ***,future therapies must be extremely safe,and should ideally limit the period of treatment necessary.A better understanding of pathogenesis will prove beneficial in the development of potential treatment strategies targeting infections by viral *** review aims to summarize the current state of knowledge on each type of viral hepatitis,together with major innovations.

关键词： Hepatitis A virus Hepatitis B virus Hepatitis C virus Hepatitis D virus Hepatitis E virus Current perspectives

Atypical lipomatous tumor in the ligamentum teres of liver:A case report and review of the literature

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World Journal of Clinical Cases 2018年第12期6卷 548-553页

作者： daisuke Usuda Kento Takeshima Ryusho Sangen Kisuke Nakamura Kei Hayashi Hideyuki Okamura Yasuhiro kawai Yuji Kasamaki Yoshitsugu Iinuma Hitoshi Saito Tsugiyasu Kanda Sachio Urashima Department of Community Medicine Kanazawa Medical University Himi Municipal Hospital Department of Infectious Diseases Kanazawa Medical University Department of General and Digestive Surgery Kanazawa Medical University Himi Municipal Hospital Department of Gastroenterology Kanazawa Medical University Himi Municipal Hospital

A 61-year-old male was referred to our hospital with a three-month history of persistent epigastralgia and right hypochondralgia. Initial examination revealed a fist-size mass at the epigastric fossa. Ultrasonography showed a hemangioma and a mosaic echoic lesion in the ventromedian with poor blood-flow signal and linear hyperechoic part inside, and a clear border to the surroundings. Dynamic computed tomography revealed a highly enhanced effect from the portal-venous phase continuing to the equilibrium phase. T1-weighted gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid-enhanced image revealed a high intensity effect at the early phase that continued to the next phase. On the other hand, it contained a low intensity area by a fat suppression of that image. In addition, a T2-weighted image did not show a high intensity effect. Laparotomy was performed on the second day of hospitalization. The tumor had arisen from the ligamentum teres of the liver, and no metastasis or invasion of other organs was noted. It consisted of a lipid component of mature adipocytes and a fibrous component of deep dyeing pleomorphic or multinuclear atypical stromal cells. Immunohistochemical study of the atypical stromal cells demonstrated that they were positive for MDM2 and CDK4. A pathological diagnosis of atypical lipomatous tumor(ALT) was made, and the patient was discharged on the eighth day following the procedure. At the 6-mo follow-up dynamic CT, the patient was free of recurrence or metastasis. We experienced a patient with ALT in the ligamentum teres of the liver. This case suggests the need for a careful and detailed examination when encountering patients presenting with a mass; when neoplastic lesion is confirmed by image inspection, we should thoroughly investigate, including further image investigations and pathologic examination. The latter is the most important.

关键词： Liposarcoma Atypical lipomatous tumor Malignant adipose mesenchymal tumor Ligamentum teres of liver Operation

Effect of double platinum agents, combination of miriplatintransarterial oily chemoembolization and cisplatinhepatic arterial infusion chemotherapy, in patients with hepatocellular carcinoma: Report of two cases

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World Journal of Clinical Cases 2017年第6期5卷 238-246页

作者： Kohei Ogawa Kenya Kamimura Yukari Watanabe Yosuke Motai daisuke Kumaki Ryoya Seki Akira Sakamaki Satoshi Abe Hirokazu kawai Takeshi Suda Satoshi Yamagiwa Shuji Terai Division of Gastroenterology and Hepatology Graduate School of Medical and Dental Sciences Niigata University Department of Gastroenterology and Hepatology Uonuma Institute of Community Medicine Niigata Medical and Dental Hospital

Hepatocellular carcinoma(HCC) is one of the most common cancers and the third highest cause of cancerassociated mortality worldwide. The treatment of HCC is complicated by its variable biological behavior and the frequent coexistence of chronic liver disease, particularly cirrhosis. To date, multiple treatment modalities have been developed according to the stage of the tumor and the hepatic functional reserve, including transarterial treatments such as transarterial chemoembolization, transarterial oily chemoembolization(TOCE), and hepatic arterial infusion chemotherapy(HAIC). We conducted a phase I and II study of the combination therapy with double platinum agents, miriplatin and cisplatin, and confirmed its safety and efficacy. Here, we describe two cases of unresectable HCC who were successfully treated by miriplatin-TOCE/cisplatin-HAIC combination therapy, resulting in complete responses with no significant adverse events. This report will provide that the combination therapy can be the therapeutic option for HCC patients in the advanced stage.

关键词： Hepatocellular carcinoma Double platinum Transarterial oily chemoembolization Hepatic arterial infusion chemotherapy Combination

Implication for Designing a REDD+ Program in a Frontier of Oil Palm Plantation Development: Evidence in East Kalimantan, Indonesia

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Open Journal of Forestry 2014年第3期4卷 259-277页

作者： daisuke Terauchi Ndan Imang Martinus Nanang Masayuki kawai Mustofa Agung Sardjono Fadjar Pambudhi Makoto Inoue Center for Social Forestry Mulawarman University Samarinda Indonesia Department of Global Agricultural Sciences Graduate School of Agricultural and Life Sciences The University of Tokyo Tokyo Japan Department of Human Geography Graduate School of Arts and Sciences The University of Tokyo Tokyo Japan

To examine the REDD+ (Reducing Emissions from Deforestation and Forest Degradation) program as an alternative to an oil palm plantation in West Kutai district of East Kalimantan, we determined the profitability of land use and REDD+, and the land use preferences and practices of the local people, as well as their participation in and preferences for forestry programs. Our findings indicate the following: 1) the profitability of an oil palm plantation was higher than that from other land uses and the REDD+ program;2) the local preferences for land uses were mostly consistent with the profitability of the land uses, except for oil palm plantation due to non-financial concerns;3) the local people combined each land use in accordance with their various needs;and 4) the local people were interested in a Forest and Land Rehabilitation (RHL) program in nonforestry zones. Considering these evidences, an improved RHL program based on an intensive agroforestry system and a conservation-based REDD+ program based on existing customary conservation forest management by the local people are proposed. Given the high opportunity cost and the low preference for an oil palm plantation, designing the REDD+ program by paying attention to the non-financial benefits for a community is a way forward. To enhance the non-financial benefits, it is important to take into consideration local preferences and livelihood activities in designing the REDD+ program. This study also implies the need for a reconsideration of the position of participation of local people in the safeguards of REDD+.

关键词： REDD+ Oil Palm Plantation Local People Land Use Preference Land Use Profitability

Hemorrhagic shock due to submucosal esophageal hematoma along with mallory-weiss syndrome:A case report

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World Journal of Clinical Cases 2022年第27期10卷 9911-9920页

作者： Jiro Oba daisuke Usuda Shiho Tsuge Riki Sakurai Kenji kawai Shun Matsubara Risa Tanaka Makoto Suzuki Hayabusa Takano Shintaro Shimozawa Yuta Hotchi Kenki Usami Shungo Tokunaga Ippei Osugi Risa Katou Sakurako Ito Kentaro Mishima Akihiko Kondo Keiko Mizuno Hiroki Takami Takayuki Komatsu Tomohisa Nomura Manabu Sugita Department of Emergency and Critical Care Medicine Juntendo University Nerima HospitalNerima-ku 177-8521TokyoJapan Faculty of Medicine Juntendo UniversityBunkyo-ku 113-8421TokyoJapan

BACKGROUND Esophageal submucosal hematoma is a rare *** the exact etiology remains uncertain,vessel fragility with external factors is believed to have led to submucosal bleeding and hematoma formation;the vessel was ruptured by a sudden increase in pressure due to nausea,and the hematoma was enlarged by antiplatelet or anticoagulant *** conditions are rare,with a better *** present the first known case of submucosal esophageal hematoma-subsequent hemorrhagic shock due to Mallory-Weiss *** SUMMARY A 73-year-old female underwent endovascular treatment for an unruptured cerebral *** patient received aspirin and clopidogrel before surgery and heparin during surgery,and was well during the *** hours after returning to the ICU,she complained of chest discomfort,vomited 500 m L of fresh blood,and entered hemorrhagic *** submucosal hematoma with Mallory-Weiss syndrome was diagnosed through an endoscopic examination and computed *** addition to a massive fluid and erythrocyte transfusion,we performed a temporary compression for hemostasis with a Sengstaken-Blakemore(S-B)***,she became hemodynamically *** postoperative day 1,we performed an upper gastrointestinal endoscopy and confirmed no expansion of the hematoma nor any recurring bleeding;therefore,we removed the S-B tube and clipped the gastric mucosal laceration at the esophagogastric *** started oral intake on postoperative day *** patient made steady progress,and was discharged on postoperative day *** We present the first known case of submucosal esophageal hematoma subsequent hemorrhagic shock due to Mallory-Weiss syndrome.

关键词： Esophageal submucosal hematoma Hemorrhagic shock Mallory-Weiss syndrome Antithrombotic therapy Anticoagulant therapy Case report

Amebic liver abscess by Entamoeba histolytica

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World Journal of Clinical Cases 2022年第36期10卷 13157-13166页

作者： daisuke Usuda Shiho Tsuge Riki Sakurai Kenji kawai Shun Matsubara Risa Tanaka Makoto Suzuki Hayabusa Takano Shintaro Shimozawa Yuta Hotchi Shungo Tokunaga Ippei Osugi Risa Katou Sakurako Ito Kentaro Mishima Akihiko Kondo Keiko Mizuno Hiroki Takami Takayuki Komatsu Jiro Oba Tomohisa Nomura Manabu Sugita Department of Emergency and Critical Care Medicine Juntendo University Nerima HospitalNerima 177-8521TokyoJapan Department of Sports Medicine Faculty of MedicineJuntendo UniversityBunkyo 113-8421TokyoJapan

Amebic liver abscesses(ALAs)are the most commonly encountered extraintestinal manifestation of human invasive amebiasis,which results from Entamoeba histolytica(***)spreading *** can be complicated by liver abscess in 9%of cases,and ALAs led to almost 50000 fatalities worldwide in *** there have been fewer and fewer cases in the past several years,ALAs remain an important public health problem in endemic *** causes both amebic colitis and liver abscess by breaching the host’s innate defenses and invading the intestinal *** often enter the circulatory system,where they are filtered in the liver and produce abscesses,and develop into severe invasive diseases such as *** clinical presentation can appear to be colitis,including upper-right abdominal pain accompanied by a fever in ALA *** diagnosis requires nonspecific liver imaging as well as detecting *** antibodies;however,these antibodies cannot be used to distinguish between a previous infection and an acute ***,diagnostics primarily aim to use PCR or enzyme-linked immunosorbent assay to detect *** can be treated medically,and percutaneous catheter drainage is only necessary in approximately 15%of *** indicated treatment is to administer an amebicidal drug(such as tinidazole or metronidazole)and paromomycin or other luminal cysticidal agent for clinical *** is good with almost universal *** which diagnostic methods are most efficacious will necessitate further analysis of similar clinical cases.

关键词： Amebic liver abscess Entamoeba histolytica Polymerase chain reaction Enzyme-linked immunosorbent assay Percutaneous catheter drainage Amebicidal drug

High doses of dextromethorphan induced shock and convulsions in a 19-year-old female:A case report

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World Journal of Clinical Cases 2023年第16期11卷 3870-3876页

作者： Shintaro Shimozawa daisuke Usuda Toru Sasaki Shiho Tsuge Riki Sakurai Kenji kawai Shun Matsubara Risa Tanaka Makoto Suzuki Yuta Hotchi Shungo Tokunaga Ippei Osugi Risa Katou Sakurako Ito Suguru Asako Kentaro Mishima Akihiko Kondo Keiko Mizuno Hiroki Takami Takayuki Komatsu Jiro Oba Tomohisa Nomura Manabu Sugita Department of Emergency and Critical Care Medicine Juntendo University Nerima HospitalNerima-city 177-8521TokyoJapan Clinical Training Center Juntendo University Nerima HospitalNerima-city 177-8521TokyoJapan Department of Sports Medicine Faculty of MedicineJuntendo UniversityBunkyo-city 113-8421TokyoJapan

BACKGROUND Dextromethorphan is a prevalent antitussive agent that can be easily obtained as an over-the-counter *** has been a growing number of reported cases of toxicity in recent ***,there are numerous instances of mild symptoms,with only a limited number of reports of severe cases necessitating intensive *** presented the case of a female who ingested 111 tablets of dextromethorphan,leading to shock and convulsions and requiring intensive care that ultimately saved her *** SUMMARY A 19-year-old female was admitted to our hospital via ambulance,having overdosed on 111 tablets of dextromethorphan(15 mg)obtained through an online importer in a suicide *** patient had a history of drug abuse and multiple self-inflicted *** the time of admission,she exhibited symptoms of shock and altered ***,upon arrival at the hospital,the patient experienced recurrent generalized clonic convulsions and status epilepticus,necessitating tracheal *** convulsions were determined to have been caused by decreased cerebral perfusion pressure secondary to shock,and noradrenaline was administered as a *** lavage and activated charcoal were also administered after *** systemic management in the intensive care unit,the patient’s condition stabilized,and the need for vasopressors *** patient regained consciousness and was *** patient was subsequently transferred to a psychiatric facility,as suicidal ideation *** We report the first case of shock caused by an overdose of dextromethorphan.

关键词： Dextromethorphan Drug overdose Shock Symptom Treatment Case report

Secondary pulmonary infection by Fusarium solani and Aspergillus niger during systemic steroid treatment for COVID-19:A case report

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世界临床病例杂志 2023年第26期11卷 6280-6288页

作者： daisuke Usuda Masashi Kato Yuto Sugawara Runa Shimizu Tomotari Inami Shiho Tsuge Riki Sakurai Kenji kawai Shun Matsubara Risa Tanaka Makoto Suzuki Shintaro Shimozawa Yuta Hotchi Ippei Osugi Risa Katou Sakurako Ito Kentaro Mishima Akihiko Kondo Keiko Mizuno Hiroki Takami Takayuki Komatsu Jiro Oba Tomohisa Nomura Manabu Sugita Department of Emergency and Critical Care Medicine Juntendo University Nerima HospitalNerima 177-8521TokyoJapan Department of Sports Medicine Juntendo UniversityBunkyo 113-8421TokyoJapan

BACKGROUND Coronavirus disease 2019(COVID-19)-associated invasive pulmonary aspergillosis presents a diagnostic challenge due to its non-specific clinical/imaging features,as well as the fact that the proposed clinically diagnostic algorithms do not necessarily apply to COVID-19 *** addition,Fusarium *** a rare cause of opportunistic life-threatening fungal *** Fusarium infection in an immunocompromised host is intractable,with a high likelihood of resulting *** our knowledge,this is the first case of secondary pulmonary infection by Fusarium solani(***)and Aspergillus niger(***)during systemic steroid treatment for *** SUMMARY A 62-year-old male was transported to our hospital by ambulance with a complaint of fever and *** established a diagnosis of pneumococcal pneumonia,complicated with COVID-19 and septic shock,together with acute renal *** was admitted to the intensive care unit,to be treated with piperacillin/tazobactam,vancomycin,and 6.6 mg per day of dexamethasone sodium phosphate,along with noradrenaline as a vasopressor,ventilator management,and continuous *** condition improved,and we finished the vasopressor on the fifth hospital *** administered dexamethasone for ten days,and finished the course of *** the eleventh day,patient respiratory deterioration was observed,and a computed tomography scan showed an exacerbation of bilateral ground-glass-opacity-like consolidation,together with newly appeared cavitary lesions in the *** changed antibiotics to meropenem plus *** addition,a fungal infection was considered as a possibility based on microscopic findings of sputum,and we began coadministration of ***,the pneumonia worsened,and the patient died on the seventeenth day of ***,*** and *** were identified from sputum collected on the twelfth *** was believed that he developed a cell-mediated immune defic

关键词： Fusarium solani Aspergillus niger Pulmonary infection Cell-mediated immune deficiency Coronavirus disease 2019 Case report