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Proposed criteria to differentiate heterogeneous eosinophilic gastrointestinal disorders of the esophagus, including eosinophilic esophageal myositis

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World Journal of Gastroenterology 2017年第13期23卷 2414-2423页

作者： Hiroki Sato Nao Nakajima Kazuya Takahashi go hasegawa Ken-ichi Mizuno Satoru Hashimoto Satoshi Ikarashi Kazunao Hayashi Yutaka Honda Junji Yokoyama Yuichi Sato Shuji Terai Division of Gastroenterology and Hepatology Niigata University Medical and Dental Hospital Division of Gastroenterology and Hepatology Saiseikai Niigata Daini Hospital Division of Cellular and Molecular Pathology Department of Cellular FunctionNiigata University Graduate School of Medical and Dental Sciences

AIM To define clinical criteria to differentiate eosinophilic gastrointestinal disorder(Eo GD) in the esophagus. METHODS Our criteria were defined based on the analyses of the clinical presentation of eosinophilic esophagitis(Eo E), subepithelial eosinophilic esophagitis(s Eo E) and eosinophilic esophageal myositis(Eo EM), identified by endoscopy, manometry and serum immunoglobulin E levels(s-Ig E), in combination with histological and polymerase chain reaction analyses on esophageal tissue samples.RESULTS In five patients with Eo E, endoscopy revealed longitudinal furrows and white plaques in all, and fixed rings in two. In one patient with s Eo E and four with Eo EM, endoscopy showed luminal compression only. Using manometry, failed peristalsis was observed in patients with Eo E and s Eo E with some variation, while Eo EM was associated with hypercontractile or hypertensive peristalsis, with elevated s-Ig E. Histology revealed the following eosinophils per high-power field values. Eo E = 41.4 ± 7.9 in the epithelium and 2.3 ± 1.5 in the subepithelium; s Eo E = 3 in the epithelium and 35 in the subepithelium(conventional biopsy); Eo EM = none in the epithelium, 10.7 ± 11.7 in the subepithelium(conventional biopsy or endoscopic mucosal resection) and 46.8 ± 16.5 in the muscularis propria(peroral esophageal muscle biopsy). Presence of dilated epithelial intercellular space and downward papillae elongation were specific to Eo E. Eotaxin-3, IL-5 and IL-13 were overexpressed in Eo E.CONCLUSION Based on clinical and histological data, we identified criteria, which differentiated between Eo E, s Eo E and Eo EM, and reflected a different pathogenesis between these esophageal Eo GDs.

关键词：嗜曙红的食道炎嗜曙红的食道的肌炎 Peroral 内视镜的肌切开术手提钻食管 Achalasia Peroral 食道的肌肉活体检视

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World Journal of Clinical Cases 2019年第21期7卷 3553-3561页

作者： Takeshi Mizusawa Kenya Kamimura Hiroki Sato Takeshi Suda Hiroyuki Fukunari go hasegawa Osamu Shibata Shinichi Morita Akira Sakamaki Junji Yokoyama Yu Saito Yoshihisa Hori Yuduru Maruyama Fumitoshi Yoshimine Takahiro Hoshi Shinichi Morita Tsutomu Kanefuji Masaaki Kobayashi Shuji Terai Department of Internal Medicine Niigata Prefectural Tokamachi HospitalTokamachiNiigata 948-0065Japan Division of Gastroenterology and Hepatology Graduate School of Medical and Dental SciencesNiigata UniversityNiigata 951-8122Japan Department of Gastroenterology and Hepatology Uonuma Institute of Community Medicine Niigata University HospitalMinami UonumaNiigata 949-7302Japan Department of Surgery Niigata Prefectural Tokamachi HospitalTokamachiNiigata 948-0065Japan Department of Pathology Uonuma Institute of Community Medicine Niigata University HospitalMinami UonumaNiigata 949-7302Japan Department of Internal Medicine Tokamachi Central ClinicTokamachiNiigata 948-0065Japan

BACKGROUND Immunosuppression is effective in treating a number of diseases,but adverse effects such as bone marrow suppression,infection,and oncogenesis are of concern.Methotrexate is a key immunosuppressant used to treat rheumatoid arthritis.Although it is effective for many patients,various side effects have been reported,one of the most serious being methotrexate-related lymphoproliferative disorder.While this may occur in various organs,liver involvement is rare.Information on these liver lesions,including clinical characteristics,course,and imaging studies,has not been summarized to date.CASE SUMMARY We present a case of 70-year-old woman presented with a 2-wk history of fever and abdominal pain.She had had rheumatoid arthritis for 5 years and was being treated with medication including methotrexate.Contrast-enhanced computed tomography revealed multiple low density tumors in the liver and the histological analyses showed significant proliferation of lymphocytes in masses that were positive on immunohistochemical staining for CD3,CD4,CD8,and CD79a but negative for CD20 and CD56.Staining for Epstein-Barr virus-encoded RNA was negative.And based on these findings,the liver tumors were diagnosed as Methotrexate-related lymphoproliferative disorders.A timedependent disappearance of the liver tumors after stopping methotrexate supported the diagnoses.CONCLUSION The information obtained from our case and a review of 9 additional cases reported thus far assist physicians who may face the challenge of diagnosing and managing this disorder.

关键词： Arthritis Rheumatoid Methotrexate Malignant lymphoma Case report

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Endobronchial metastasis from adenocarcinoma of gastric cardia 7 years after potentially curable resection

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World Journal of Gastrointestinal Surgery 2010年第8期2卷 270-274页

作者： Takaaki Hanyu Tatsuo Kanda Atsushi Matsuki go hasegawa Kazuhito Yajima Masanori Tsuchida Shin-ichi Kosugi Makoto Naito Katsuyoshi Hatakeyama Division of Digestive and General Surgery Niigata University Graduate School of Medical and Dental Sciences Division of Cellular and Molecular Pathology Niigata University Graduate School of Medical and Dental Sciences Division of Thoracic and Cardiovascular Surgery Niigata University Graduate School of Medical and Dental Sciences

Endobronchial metastasis(EBM) is a rare form of metas-tasis from extrapulmonary malignant tumors,although there are few reports of EBM from gastric cancer specifically.We report the case of a 51-year-old woman who had undergone gastrectomy for advanced gastric cancer seven years previously but was diagnosed with a solitary lung tumor by follow-up computed tomography.On diagnosis of primary lung cancer,she underwent pulmonary lobectomy,but immunohistochemical examination confirmed the resected tumor to be an EBM from the gastric cancer.Six months later,she was diagnosed with peritoneal metastases and underwent chemotherapy with gastric cancer regimen.She is still alive at 33 mo after the lobectomy.Generally,the prognosis for EBM is poor although multidisciplinary treatment can lead to long-term survival.Precise diagnosis on the basis of detailed pathological and immunohistochemical evaluation can contribute to deciding the most effective treatment and improving prognosis.

关键词： Endobronchial metastasis Immunohisto-chemistry Gastric cancer

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A Case Report of Synovial Osteochondromatosis of the Knee Joint with neither Calcification nor a Synovial Lesion on Imaging

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Open Journal of Orthopedics 2016年第12期6卷 351-356页

作者： Taihei go Hideyuki Aoki Sou Ikata Yoshiyasu Miyazaki Keiji hasegawa Takashi Nakamura Kazuaki Tsuchiya Department of Orthopedics Toho University Tokyo Japan

Synovial osteochondromatosis is a rare, benign condition of unknown etiology in which the synovium undergoes metaplasia, leading to cartilaginous nodules that ultimately break free, mineralize, and even ossify. The most commonly involved joint is the knee. Typically, radiographs can be diagnostic and mineralized nodules are pathognomonic. In as many as one-third of cases, however, no calcification or ossification of the cartilage occurs in the early stage of the disease because mineralization is time-dependent. In such cases, gadolinium-enhanced MRI can be useful. Unmineralized nodules are typically peripherally enhanced because they are attached to and derive a vascular supply from the synovium. We experienced an unmineralized case of synovial osteochondromatosis of the right knee joint, in which imaging diagnosis was difficult. Neither calcification nor ossification was observed, but all nodules were released from the synovium as loose bodies and there was no vascular supply. Therefore, MRI did not show a typical appearance. These findings suggest that synovial osteochondromatosis should be considered as a differential diagnosis in a case in which unmineralized loose bodies without a synovial lesion are found in an imaging examination.

关键词： Osteochondromatosis Knee Joint Calcification Synovial Lesion

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A Patient with Malignant Spinal Epidural Lymphoma with Initial Rapidly Aggravating Paraplegia

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Open Journal of Orthopedics 2017年第3期7卷 90-97页

作者： Taihei go Yasuaki Iida Hideyuki Aoki Shintaro Tsuge Keiji hasegawa Yuichiro Yokoyama Akihito Wada Yuri Akishima-Fukasawa Hiroshi Takahashi Department of Orthopedics Toho University Tokyo Japan

We report the case of a 51-year-old female with rapid neurological deterioration as an initial presentation of non-Hodgkin’s lymphoma. Paraplegia occurred suddenly after a 4-day history of weakness and numbness of the lower extremity. MRI revealed a dorsal epidural mass from T10 to T11 that compressed the spinal cord. There was neither bone destruction nor a paravertebral mass. Emergency decompressive laminectomy and tumor resection were performed. Histological analysis of the surgical specimen indicated diffuse large B cell lymphoma. The clinical stage was IV on CT and complete remission was achieved by subsequent chemotherapy. Spinal cord compression occurs in the course of non-Hodgkin’s lymphoma in 0.1% - 6.5% of cases, but this situation usually develops in the late phase with bone destruction and/or a paravertebral mass. Cord compression and especially the severe symptoms such as paraplegia are rare as the initial presentation of lymphoma.

关键词： Malignant Lymphoma Epidural Mass Paraplegia Thoracic Spine

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Associations among pain catastrophizing, muscle strength, and physical performance after total knee and hip arthroplasty

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World Journal of Orthopedics 2017年第4期8卷 336-341页

作者： Kazuhiro Hayashi Masato Kako Kentaro Suzuki Keiko Hattori Saori Fukuyasu Koji Sato Izumi Kadono Tadahiro Sakai Yukiharu hasegawa Yoshihiro Nishida Department of Rehabilitation Nagoya University Hospital Department of Orthopaedic Surgery Nagoya University Graduate School and School of Medicine

AIM To investigate whether reductions in pain catastrophizing associated with physical performance in the early period after total knee arthroplasty(TKA) or total hip arthroplasty(THA).METHODS The study group of 46 participants underwent TKA or THA. The participants were evaluated within 7d before the operation and at 14d afterwards. Physical performance was measured by the Timed Up and go(TUG) test, and 10-m gait time was measured at comfortable and maximum speeds. They rated their knee or hip pain using a visual analog scale(VAS) for daily life activities. Psychological characteristics were measured by the Pain Catastrophizing Scale(PCS). Physical characteristics were measured by isometric muscle strength of knee extensors and hip abductors on the operated side. The variables of percent changes between pre-and postoperation were calculated by dividing post-operation score by pre-operation score.RESULTS Postoperative VAS and PCS were better than preoperative for both TKA and THA. Postoperative physical performance and muscle strength were poorer than preoperative for both TKA and THA. The percent change in physical performance showed no correlation with preoperative variables. In TKA patients, the percent change of PCS showed correlation with percent change of TUG(P = 0.016), 10-m gait time at comfortable speeds(P = 0.003), and 10-m gait time at maximum speeds(P = 0.042). The percent change of muscle strength showed partial correlation with physical performances.The percent change of VAS showed no correlation with physical performances. On the other hand, in THA patients, the percent change of hip abductor strength showed correlation with percent change of TUG(P =0.047), 10-m gait time at comfortable speeds(P = 0.001),and 10-m gait time at maximum speeds(P = 0.021). The percent change of knee extensor strength showed partial correlation with physical performances. The percent change of VAS and PCS showed no correlation with physical performances.CONCLUSION Changes in pain catastrophizing significantly associated

关键词： Gait Hip arthroplasty Knee arthroplasty Osteoarthritis Pain Pain management Postoperative care

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Proposal and Analyses of Resonant Bilateral Converter Employing Simple Zero Current Switches

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Journal of Energy and Power Engineering 2012年第3期6卷 404-410页

作者： Keiju Matsui Masaru hasegawa Department of Electrical Engineering Chubu University Kasugai 487-8501 Japan

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Vitamin D3 Supplementation Improved Physical Performance in Healthy Older Adults in Japan: A Pilot Study

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Health 2018年第9期10卷 1200-1209页

作者： Noboru hasegawa Miyako Mochizuki Mayumi Kato Nobuko Shimizu Takako Yamada Department of Health and Medical Sciences Ishikawa Prefectural Nursing University Kahoku Japan Kyoto Bunkyo Junior College Uji Japan Aichi Medical College for Physical and Occupational Therapy Kiyosu Japan Bukkyo University Kyoto Japan

Japan has the highest proportion of older adults and so-called “Super-aged society” in the world. These results suggested that the prevalence of both cognitive and physical functional impairment increases with age. Therefore, the present study was designed to investigate the effect of vitamin D3 supplementation in cognitive and physical functional impairment in healthy older adults in Japan. We enrolled 7 Japanese male (age: 76.0 ± 8.7) and 5 female (age: 78.3 ± 9.3) in this study. The physical function of even a person getting on a wheelchair could be tested in all subjects. Treatment group (n = 7) consisted of a 500 IU/day vitamin D3 corresponding to twice of daily requirement for 6 months. Blood was collected by venipuncture and the serum 25-hydroxy vitamin D (25 OHD), 1,25-hydroxy vitamin D (1,25 OHD), Ca and PTH concentration were measured. The Mini-Mental State Examination and the Montreal Cognitive Assessment-Japanese version were used for the cognitive function test. Physical function was measured objectively using the Timed Up and go (TUG), 4-mgait speed test (4 MGS), 5-repetition sit-to-stand (5 STS), 30-second chair stand test (CS-30) and measurement of upper grip strength. Our results show that a 6-month intake of vitamin D3 increased serum 25 OHD within the insufficiency and sufficiency levels without changing 1,25 OHD, Ca and PTH concentration. And it significantly decreased 4 MGS without changing TUG, 5 STS, CS-30, upper grip strength and cognitive function. Serum 25 OHD cut-off values for skeletal muscle index, grip strength and 4 MGS in diagnosis of sarcopenia are 18.6 - 23.4 ng/mL. These findings suggest that serum 25 OHD levels (23.4 ng/mL) might improve moving capacity, lower limb muscle strength, and physical balance functional impairment.

关键词： Serum 25-Hydroxyvitamin D Cognitive Function Physical Function Aging Sarcopenia

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Serum 1, 25-Hydroxyvitamin D: A Useful Index of Cognitive and Physical Functional Impairment in Healthy Older Adults in Japan: A Pilot Study

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Health 2016年第15期8卷 1679-1686页

作者： Noboru hasegawa Miyako Mochizuki Mayumi Kato Takako Yamada Nobuko Shimizu Akihisa Torii Department of Health and Medical Sciences Ishikawa Prefectural Nursing University Kahoku Japan Kyoto Bunkyo Junior College Uji Japan Aichi Medical College for Physical and Occupational Therapy Kiyosu Japan

We enrolled 23 Japanese men (age: 76.0 ± 8.7) and 17 women (age: 78.3 ± 9.3) in this study. The physical function of even a person getting on a wheelchair could be tested in all subjects. Blood was collected by venipuncture and the serum 1, 25-hydroxy vitamin D (1, 25OHD) concentration was measured. The Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment-Japanese version (MoCA-J) was used for the cognitive function test. Physical function was measured objectively using the Timed UP and go (TUG) and 4-m walking test (4MWS). A significant positive correlation was found between serum 1, 25OHD and MMSE or MoCA-J. It is expected that an elderly person can maintain a mean serum 1, 25OHD level of about 100 pg/mL for preventing early cognitive disorder. In the present study, a significant positive correlation was found between urinary 25-hydroxy vitamin D (25OHD)/creatinine and MMSE or MoCA-J. Our results showed that urinary 25OHD might be a useful biomarker for predicting cognitive disorder. There was a significant negative correlation between serum 1, 25OHD and TUG or 4MWS. These findings suggest that serum 1, 25OHD levels might serve as a useful index to improve cognitive and physical functional impairment.

关键词： Serum 1 25-Hydroxyvitamin D Cognitive Function Physical Function Aging Urinary 25-Hydroxyvitamin D

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星野集团富士虹夕诺雅酒店:魅力露营胜地

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风景园林 2018年第12期25卷 54-58页

作者： [日]长谷川浩己不详

场地位于河口湖北部,其朝南的斜坡隔着湖水与富士山相对。这块斜坡原本被用作宿营地,松树林与草地等多种元素在此形成了镶嵌图案式景观。除了接待区,场地的最高点和最低点之间的高程差超过50m。当你攀登斜坡时,河口湖和富士山的壮丽景... 详细信息

场地位于河口湖北部,其朝南的斜坡隔着湖水与富士山相对。这块斜坡原本被用作宿营地,松树林与草地等多种元素在此形成了镶嵌图案式景观。除了接待区,场地的最高点和最低点之间的高程差超过50m。当你攀登斜坡时,河口湖和富士山的壮丽景色就会呈现在你的眼前。再往上,你可以看到茂密的松子杉(一种日本柳杉)林。设计布局的生成充分利用了这些景观特征。这些自然景观的独特场所性令设计师产生了将场地在大体上分为2个区域(上部和下部)的设计理念,游客可以在这2个区域来回走动,体验它们带来的完全不同的乐趣。设计师希望这2个分区的功能相辅相成,使参观者对每个区域都能留下持久而生动的印象。

关键词：富士山酒店景观特征设计师日本柳杉自然景观场地斜坡

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