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Using a novel hemostatic peptide solution to prevent bleeding after endoscopic submucosal dissection of a gastric tumor

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World Journal of Gastrointestinal Endoscopy 2024年第3期16卷 168-174页

作者： Kuniyo Gomi Yorimasa Yamamoto Erika yoshida Misako Tohata Masatsugu Nagahama Department of Gastroenterology Showa University Fujigaoka HospitalYokohama 227-8501KanagawaJapan

BACKGROUND Endoscopic mucosal dissection has become the standard treatment for early gastric ***,post-endoscopic submucosal dissection(ESD)ulcer occurs in 4.4%of *** study hypothesized whether applying PuraStat,a novel hemostatic peptide solution,prevents post-ESD *** To investigate the preventive potential of PuraStat,a hemostatic formulation,against bleeding in post-ESD gastric *** Between May 2022 and March 2023,101 patients(Group P)underwent ESD for gastric diseases at our hospital and received PuraStat(2 mL)for post-ESD *** retrospectively compared this group with a control group(Group C)com-prising 297 patients who underwent ESD for gastric diseases at our hospital between April 2017 and March 2021.P values<0.05 on two-sided tests indicated *** Post-ESD bleeding occurred in 6(5.9%)(95%CI:2.8-12.4)and 20(6.7%)(95%CI:4.4-10.2)patients in Groups P and C,respectively,with no significant between-group *** relative risk was 1.01(95%CI:0.95-1.07).The lesser curvature or anterior wall was the bleeding site in all 6 patients who experienced postoperative bleeding in Group *** multivariate analysis,the odds ratios for resection diameter≥50 mm and oral anticoagulant use were 6.63(95%CI:2.52-14.47;P=0.0001)and 4.04(1.26-0.69;P=0.0164),*** adjusted odds ratio of post-ESD bleeding and PuraStat was 1.28(95%CI:0.28-2.15).CONCLUSION PuraStat application is not associated with post-ESD ***,the study suggests that gravitational forces may affect the effectiveness of applied PuraStat.

关键词： Endoscopic submucosal dissection PuraStat Bleeding Gastric cancer hemostatic forceps Proton pump inhibitor hemostatic peptide solution

Himalayas as a global hot spot of springtime stratospheric intrusions:Insight from isotopic signatures in sulfate aerosols

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Research in Cold and Arid Regions 2024年第1期16卷 5-13页

作者： Kun Wang ShiChang Kang Mang Lin PengFei Chen ChaoLiu Li XiuFeng Yin Shohei Hattori Teresa L.Jackson JunHua Yang YiXi Liu Naohiro yoshida Mark HThiemens State Key Laboratory of Cryospheric Science Northwest Institute of Eco-Environment and ResourcesChinese Academy of Sciences(CAS)LanzhouGansu 730000China State Key Laboratory of Isotope Geochemistry Guangzhou Institute of GeochemistryCASGuangzhouGuangdong 510640China University of Chinese Academy of Sciences Beijing 100049China International Center for Isotope Effects Research(ICIER) School of Earth Sciences and EngineeringNanjing UniversityNanjingJiangsu 210023China Frontiers Science Center for Critical Earth Material Cycling State Key Laboratory for Mineral Deposits ResearchSchool of Earth Sciences and EngineeringNanjing UniversityNanjingJiangsu 210023China Department of Chemical Science and Engineering School of Materials and Chemical TechnologyTokyo Institute of Technology4259 Nagatsuta-choMidori-kuYokohamaKanagawa 226-8502Japan Department of Chemistry and Biochemistry University of California San DiegoLa JollaCA 92093-0021USA Earth-Life Science Institute Tokyo Institute of TechnologyMeguro-kuTokyo 152-8551Japan National Institute of Information and Communications Technology KoganeiTokyo 184-8795Japan

Downward transport of stratospheric air into the troposphere(identified as stratospheric intrusions)could potentially modify the radiation budget and chemical of the Earth's surface *** the highest and largest plateau on earth,the Tibetan Plateau including the Himalayas couples to global climate,and has attracted widespread attention due to rapid warming and cryospheric *** studies recognized strong stratospheric intrusions in the Himalayas but are poorly understood due to limited direct evidences and the complexity of the meteorological dynamics of the third ***^(35)S is a radioactive isotope predominately produced in the lower stratosphere and has been demonstrated as a sensitive chemical tracer to detect stratospherically sourced air mass in the planetary boundary ***,we report 6-month(April–September 2018)observation of^(35)S in atmospheric sulfate aerosols(^(35)SO_(4)^(2-))collected from a remote site in the Himalayas to reveal the stratospheric intrusion phenomenon as well as its potential impacts in this *** the sampling campaign,the^(35)SO_(4)^(2-)concentrations show an average of 1,070±980 atoms/m^(3).In springtime,the average is 1,620±730 atoms/m^(3),significantly higher than the global existing data measured so *** significant enrichments of^(35)SO_(4)^(2-)measured in this study verified the hypothesis that the Himalayas is a global hot spot of stratospheric intrusions,especially during the springtime as a consequence of its unique geology and atmospheric *** combined with the ancillary evidences,e.g.,oxygen-17 anomaly in sulfate and modeling results,we found that the stratospheric intrusions have a profound impact on the surface ozone concentrations over the study region,and potentially have the ability to constrain how the mechanisms of sulfate oxidation are affected by a change in plateau atmospheric properties and *** study provides new observational constraints on stra

关键词： Himalayas Stratospheric intrusions Cosmogenic^(35)SO_(4)^(2-) Ozone Atmospheric oxidation

Stresses in the Scapular Fossa Do Not Exceed the Yield Stress When Elevated up to 135 Degrees of Abduction after Reverse Shoulder Arthroplasty

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Journal of Biomedical Science and Engineering 2024年第2期17卷 35-40页

作者： Rina Sakai Tomonori Kenmoku Ryo Tazawa Kazuhiro yoshida Tomomi Mizuhashi Masanobu Ujihira Department of Medical Engineering and Technology Kitasato University School of Allied Health Sciences Sagamihara Japan Department of Orthopedic Surgery Kitasato University School of Medicine Sagamihara Japan Kitasato University Graduate School of Medical Sciences Sagamihara Japan

Reverse shoulder arthroplasty (RSA) is an effective treatment for rotator cuff tears. Despite its advantages, complications occur at a high rate. Complications requiring revision include a high rate of base plate failure, 38% of which are due to instability. The primary stability the base plate ensures is a crucial factor and, thus, is the subject of much debate in clinical studies and biomechanical research. This study is aimed to provide data that will contribute to the base plate’s pri-mary stability and glenoid longevity by clarifying the stresses at the scapular fossa and base plate interface associated with elevation after RSA. A 3D finite element model was created from the DICOM data for the scapulohumeral joint and SMR shoulder system. For loading conditions, 30 N was applied for each posi-tion with abduction angles of 0, 45, 90, and 135 degrees. A three-dimensional fi-nite element analysis was performed using the static implicit method with LS-DYNA. The von Mises stresses in the scapular fossa were found not to exceed the yield stress on the bone even after elevation to an abduction angle of 135 de-grees after RSA. It is rough to uniformly compare the yield stress and the von Mises stress, but it was inferred that the possibility of fracture is low unless a large external force is applied. A maximum von Mises stress showed 0 degrees of abduction, suggesting that the lowered position is in a more severe condition than the elevated position. If better improvement is desired, it may be necessary to devise ways to reduce the stress on the upper screw. .

关键词： Reverse Shoulder Arthroplasty Finite Element Analysis Yield Stress Glenoid

Flow Rate Measurement of Gravity Infusion Set and Functional Evaluation of Drop Counter: A Pilot Study

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Journal of Biomedical Science and Engineering 2024年第7期17卷 129-135页

作者： Rina Sakai Shuichi Tanaka Kaya Murakami Tomomi Mizuhashi Kazuhiro yoshida Masanobu Ujihira Department of Medical Engineering and Technology Kitasato University School of Allied Health Sciences Sagamihara Japan Faculty of Medical Engineering Gunma University of Health and Welfare Maebashi Japan Kitasato University Graduate School of Medical Sciences Sagamihara Japan

Developing a novel drop counter by introducing the Internet of Things concept has been vigorously conducted in recent years. Understanding the newly introduced drop counter’s flow rate control accuracy and flow rate count feature is essential for improving safety in infusion management. This study aimed to verify if the new drop counters could secure accurate flow rate and drip count by conducting actual flow rate measurements using gravimetry and functional evaluation. A drop counter was attached to each drip chamber of the infusion set, and an IV drip was conducted at the 100 ml/h flow rate. The weight of discharged physiological saline was measured to plot trumpet curves. Next, three different types of drop counters were evaluated to determine if they maintained drip count accuracy according to the changes in their position angles. The flow rate errors in all conditions indicated trumpet-like curves, exhibiting an overall error range within ±10% in all observation windows. Although every drop counter successfully detected and measured dripping, it was challenging in some counters to detect dripping when the drip chamber was tilted. In comparing adult and pediatric IV sets, the adult IV set was found to be less likely to detect dripping in the angled position. No significant differences in results were confirmed between high and low flow rates, suggesting that the drop count function would not be affected by the flow rate in the ranges of typical infusion practices. Doppler sensors have a wide range of measurements and high sensitivity;the dripping was detected successfully even when the drip chamber was tilted, probably due to the advantages of these sensors. In contrast, miscounts occurred in those equipped with infrared sensors, which could not detect light intensity changes in tilted positions. Understanding the tendencies in flow rate errors in infusion can be valuable information for infusion management.

关键词： Gravity Infusion Set Drop Counter IV Fluids Flow Rate Trumpet Curves

Utility of plasma D-dimer for diagnosis of venous thromboembolism after hepatectomy

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World Journal of Clinical Cases 2024年第2期12卷 276-284页

作者： Taiichiro Miyake Hiroaki Yanagimoto Daisuke Tsugawa Masayuki Akita Riki Asakura Keisuke Arai Toshihiko yoshida Shinichi So Jun Ishida Takeshi Urade Yoshihide Nanno Kenji Fukushima Hidetoshi Gon Shohei Komatsu Sadaki Asari Hirochika Toyama Masahiro Kido Tetsuo Ajiki Takumi Fukumoto Division of Hepato-Biliary-Pancreatic Surgery Department of SurgeryKobe University Graduate School of MedicineKobe 650-0017HyogoJapan

BACKGROUND Venous thromboembolism(VTE)is a potentially fatal complication of *** use of postoperative prophylactic anticoagulation in patients who have undergone hepatectomy is controversial because of the risk of postoperative ***,we hypothesized that monitoring plasma D-dimer could be useful in the early diagnosis of VTE after *** To evaluate the utility of monitoring plasma D-dimer levels in the early diagnosis of VTE after *** The medical records of patients who underwent hepatectomy at our institution between January 2017 and December 2020 were retrospectively *** were divided into two groups according to whether or not they developed VTE after hepatectomy,as diagnosed by contrast-enhanced computed tomography and/or ultrasonography of the lower *** factors,including demographic data and perioperative D-dimer values,were compared between the two *** operating characteristic curve analysis was performed to determine the D-dimer cutoff *** and multivariate analyses were performed using logistic regression analysis to identify significant *** In total,234 patients who underwent hepatectomy were,of whom(5.6%)were diagnosed with VTE following hepatectomy.A comparison between the two groups showed significant differences in operative time(529 vs 403 min,P=0.0274)and blood loss(530 vs 138 mL,P=0.0067).The D-dimer levels on postoperative days(POD)1,3,5,7 were significantly higher in the VTE group than in the non-VTE *** the multivariate analysis,intraoperative blood loss of>275 mL[odds ratio(OR)=5.32,95%confidence interval(CI):1.05-27.0,P=0.044]and plasma D-dimer levels on POD 5≥21μg/mL(OR=10.1,95%CI:2.04-50.1,P=0.0046)were independent risk factors for VTE after *** Monitoring of plasma D-dimer levels after hepatectomy is useful for early diagnosis of VTE and may avoid routine prophylactic anticoagulation in the

关键词： Hepatectomy Malignant tumor Postoperative complication D-dimer Early diagnosis Venous thromboembolism

Endoscopy-based Kyoto classification score of gastritis related to pathological topography of neutrophil activity

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World Journal of Gastroenterology 2020年第34期26卷 5146-5155页

作者： Osamu Toyoshima Toshihiro Nishizawa Shuntaro yoshida Yoshiki Sakaguchi Yousuke Nakai Hidenobu Watanabe hidekazu Suzuki Chizu Tanikawa Koichi Matsuda Kazuhiko Koike Department of Gastroenterology Toyoshima Endoscopy ClinicTokyo 157-0066Japan Department of Gastroenterology Graduate School of MedicineThe University of TokyoTokyo 113-8655Japan Department of Gastroenterology and Hepatology International University of Health and WelfareNarita HospitalChiba 286-8520Japan Department of Endoscopy and Endoscopic Surgery Graduate School of MedicineThe University of TokyoTokyo 113-8655Japan Department of Pathology Pathology and Cytology Laboratory JapanTokyo 166-0003Japan Department of Gastroenterology and Hepatology Tokai University School of MedicineKanagawa 259-1193Japan Laboratory of Molecular Medicine Human Genome CenterInstitute of Medical ScienceThe University of TokyoTokyo 108-8639Japan Department of Computational Biology and Medical Sciences Laboratory of Clinical Genome SequencingGraduate School of Frontier SciencesThe University of TokyoTokyo 108-8639Japan

BACKGROUND Endoscopy-based Kyoto classification for gastritis and pathological topographic distribution of neutrophil infiltration are correlated with gastric cancer *** To investigate the association between Kyoto classification and the topographic distribution of neutrophil *** Kyoto classification score,ranging from 0 to 8,consisted of atrophy,intestinal metaplasia,enlarged folds,nodularity,and diffuse *** activity was scored according to the updated Sydney System using biopsy samples obtained from the greater curvature of the corpus and the *** participants were divided into four categories,inactive stomach,antrumpredominant gastritis,pangastritis,and corpus-predominant gastritis,based on the topographic distribution of neutrophil *** of sex,age,body mass index,drinking habit,smoking habit,family history of gastric cancer,serum Helicobacter pylori(***)antibody,and Kyoto score on topography of neutrophil infiltration were *** A total of 327 patients(comprising 50.7%women,with an average age of 50.2 years)were enrolled in this *** infection rate was 82.9%with a mean Kyoto score of *** Kyoto score was associated with the topographic distribution of neutrophil *** scores were significantly higher in the order of inactive stomach,antrum-predominant gastritis,pangastritis,and corpuspredominant gastritis(3.05,4.57,5.21,and 5.96,respectively).Each individual score of endoscopic findings(i.e.,atrophy,intestinal metaplasia,enlarged folds,nodularity,and diffuse redness)was correlated with the topographic distribution of neutrophil *** multivariate analysis,the Kyoto score,age,and serum *** antibody were independently associated with the topographic distribution of neutrophil *** The Kyoto classification score was associated with the topographic distribution of neutrophil activity.

关键词： Kyoto classification Helicobacter pylori Neutrophil activity Updated Sydney System Gastritis Gastric cancer Endoscopy Pathology

Clinical features of cardiac nodularity-like appearance induced by Helicobacter pylori infection

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World Journal of Gastroenterology 2020年第35期26卷 5354-5361页

作者： Toshihiro Nishizawa Kosuke Sakitani hidekazu Suzuki Shuntaro yoshida Yosuke Kataoka Yousuke Nakai Hirotoshi Ebinuma Takanori Kanai Osamu Toyoshima Kazuhiko Koike Department of Gastroenterology Toyoshima Endoscopy ClinicTokyo 1570066Japan Department of Gastroenterology Narita HospitalInternational University of Health and WelfareChiba 2868520Japan Department of Gastroenterology Sakitani Endoscopy ClinicChiba 2740825Japan Department of Internal Medicine Tokai University School of MedicineKanagawa 2591193Japan Department of Gastroenterology Graduate School of MedicineThe University of TokyoTokyo 1138655Japan Department of Internal Medicine Keio University School of MedicineTokyo 1608582Japan

We have previously reported that Helicobacter pylori(***)-associated nodular gastritis could occur in both the antrum and the *** nodularity-like appearance(hereafter,called as cardiac nodularity)had a high predictive accuracy for the diagnosis of *** *** the previous study,we included only the patients who were evaluated for *** infection for therst time,and excluded patients with a history of ***,the prevalence and clinical features of cardiac nodularity remains *** To perform this cross-sectional study to explore the characteristics of cardiac *** Consecutive patients who underwent esophagogastroduodenoscopy betweenMay,2017 and August,2019 in the Toyoshima Endoscopy Clinic were enrolled in this *** included ***-negative,***-positive,and *** patients,and excluded patients with unclear *** status and eradication *** infection was diagnosed according to serum *** antibody and the urea breath test or *** nodularity was defined as a miliary nodular appearance or the presence of scattered whitish circular small colorations within 2 cm of the esophagogastric *** was visualized as whitish in the narrow-band imaging *** collected data on the patients’baseline *** A total of 1078 patients were finally *** ***-negative patients,cardiac nodularity and antral nodularity were recognized in 0.14%*** ***-positive patients,cardiac nodularity and antral nodularity were recognized in 54.5%and 29.5%,*** ***-eradicated patients,cardiac nodularity and antral nodularity were recognized in 4.5%and 0.6%,*** frequency of cardiac nodularity was significantly higher than that of antral nodularity in ***-positive and-eradicated *** frequencies of cardiac nodularity and antral nodularity in ***-eradicated patients were significa

关键词： Cardia Nodularity Helicobacter pylori Diagnosis Gastritis

Gastric cancer incidence based on endoscopic Kyoto classification of gastritis

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世界胃肠病学杂志:英文版 2023年第31期29卷 4763-4773页

作者： Osamu Toyoshima Toshihiro Nishizawa Shuntaro yoshida Tatsuya Matsuno Gota Fujisawa Akira Toyoshima Hirotoshi Ebinuma Mitsuhiro Fujishiro Yutaka Saito hidekazu Suzuki Department of Gastroenterology Toyoshima Endoscopy ClinicTokyo 157-0066Japan Department of Gastroenterology and Hepatology International University of Health and WelfareNarita HospitalNarita 286-8520Japan Department of Colorectal Surgery Japanese Red Cross Medical CenterTokyo 150-8935Japan Department of Gastroenterology Graduate School of MedicineThe University of TokyoTokyo 113-8655Japan Division of Endoscopy National Cancer Center HospitalTokyo 104-0045Japan Division of Gastroenterology and Hepatology Department of Internal MedicineTokai University School of MedicineIsehara 259-1193Japan

BACKGROUND Gastric cancer(GC)incidence based on the endoscopic Kyoto classification of gastritis has not been systematically investigated using time-to-event *** To examine GC incidence in an endoscopic surveillance *** This study was retrospectively conducted at the Toyoshima Endoscopy *** who underwent two or more esophagogastroduodenoscopies were *** incidence was based on Kyoto classification scores,such as atrophy,intestinal metaplasia(IM),enlarged folds(EFs),nodularity,diffuse redness(DR),and total Kyoto *** ratios(HRs)adjusted for age and sex were calculated using a Cox hazard *** A total of 6718 patients were enrolled(median age 54.0 years;men 44.2%).During the follow-up period(max 5.02 years;median 2.56 years),GC developed in 34 *** average frequency of GCs per year was 0.19%.Kyoto atrophy scores 1[HR with score 0 as reference:3.66,95%confidence interval(CI):1.06 to 12.61],2(11.60,3.82-35.27),IM score 2(9.92,4.37-22.54),EF score 1(4.03,1.63-9.96),DR scores 1(6.22,2.65-14.56),and 2(10.01,3.73-26.86)were associated with GC incidence,whereas nodularity scores were *** total Kyoto scores of 4(HR with total Kyoto scores 0-1 as reference:6.23,95%CI:1.93 to 20.13,P=0.002)and 5-8(16.45,6.29-43.03,P<0.001)were more likely to develop GC,whereas the total Kyoto scores 2-3 were *** HR of the total Kyoto score for developing GC per 1 rank was 1.75(95%CI:1.46 to 2.09,P<0.001).CONCLUSION A high total Kyoto score(≥4)was associated with GC *** endoscopy-based diagnosis of gastritis can stratify GC risk.

关键词： Gastric cancer Gastritis Endoscopy Atrophy Intestinal metaplasia Kyoto classification

Helicobacter pylori infection in subjects negative for high titer serum antibody

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World Journal of Gastroenterology 2018年第13期24卷 1419-1428页

作者： Osamu Toyoshima Toshihiro Nishizawa Masahide Arita Yosuke Kataoka Kosuke Sakitani Shuntaro yoshida Hiroharu Yamashita Keisuke Hata Hidenobu Watanabe hidekazu Suzuki Department of Gastroenterology Toyoshima Endoscopy Clinic Department of Pathology Pathology and Cytology Laboratory Japan Medical Education Center Keio University School of Medicine

AIM To investigate the clinicopathological features of the patients testing negative for high titer serum antiHelicobacter pylori(H. pylori) *** The antibody titers were measured using antigens derived from Japanese individuals. ^(13)C-urea breath test-positive individuals were defined as having H. pylori infection. We investigated the demographic characteristics, laboratory data, endoscopic findings including Kyoto classification of gastritis, and histology in negative-high titer patients without H. pylori eradication therapy. Kyoto classification consisted of scores for gastric atrophy, intestinal metaplasia, enlarged folds, nodularity, and *** Of the 136 subjects enrolled, 23(17%) had H. pylori infection. Kyoto classification had an excellent area under the receiver operating characteristics curve(0.886, 95% confidence interval: 0.803-0.968, P = 3.7 × 10^(-20)) for predicting H. pylori infection with a cutoff value of 2. Further, Kyoto classification, H. pylori density, and neutrophil activity had high accuracies(89.7%, 96.3%, and 94.1%, respectively). Kyoto classification was independent of the demographic and laboratory parameters in multivariate *** Endoscopic Kyoto classification of gastritis is a useful predictor of H. pylori infection in negative-high titer antibody patients.

关键词： Kyoto classification Gastritis Helicobacter pylori Antibody Endoscopy