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Gastroduodenal ulcer bleeding in elderly patients on low dose aspirin therapy

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World Journal of Gastroenterology 2018年第34期24卷 3908-3918页

作者： Koh Fukushi Keiichi Tominaga Kazunori Nagashima Akira Kanamori Naoya Izawa Mimari Kanazawa Takako Sasai hideyuki hiraishi Department of Gastroenterology Dokkyo Medical University Department of General Internal Medicine 2 Kawasaki Medical School General Medical Center

AIM To determine the clinical characteristics of elderly patients of hemorrhagic gastroduodenal ulcer on low-dose aspirin(LDA)therapy.METHODS A total of 1105 patients with hemorrhagic gastroduodenal ulcer treated in our hospital between January 2000 and March 2016 were grouped by age and drugs used,and these groups were compared in several factors.These groups were compared in terms of length of hospital stay,presence/absence of hemoglobin(Hb)decrease,presence/absence of blood transfusion,Forrest Ⅰ,percentage of Helicobacter pylori infection,presence/absence of underlying disease,and percentage of severe cases.RESULTS The percentage of blood transfusion(62.6%vs 47.7%,P<0.001),Hb decrease(53.8% vs 40.8%,P<0.001),and the length of hospital stay(23.5 d vs 16.7 d,P<0.001)were significantly greater in those on drug therapy.The percentage of blood transfusion(65.3%vs 47.8%,P<0.001),Hb decrease(54.2%vs 42.1%,P<0.001),and length of hospital stay(23.3 d vs 17.5 d,P<0.001)were significantly greater in the elderly.In comparison with the LDA monotherapy group,the percentage of severe cases was significantly higher in the LDA combination therapy group when elderly patients were concerned(16.1%vs34.0%,P=0.030).Meanwhile,among those on LDA monotherapy,there was no significant difference between elderly and non-elderly(16.1%vs 16.0%,P=0.985).CONCLUSION A combination of LDA with antithrombotic drugs or nonsteroidal anti-inflammatory drugs(NSAIDs)contributes to aggravation.And advanced age is not an aggravating factor when LDA monotherapy is used.

关键词： Hemorrhagic gastroduodenal ulcer Low-dose aspirin Antithrombotic drugs Elderly patients Proton pump inhibitor

Endoscopic ultrasonography can diagnose distal biliary strictures without a mass on computed tomography

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World Journal of Gastroenterology 2010年第2期16卷 237-244页

作者： Yasuyuki Saifuku Michiko Yamagata Takero Koike Genyo Hitomi Kazunari Kanke Hidetaka Watanabe Toshimitsu Murohisa Masaya Tamano Makoto Iijima Keiichi Kubota hideyuki hiraishi Department of Gastroenterology Dokkyo Medical University880 KitakobayashiMibuShimotsuga-gunTochigi 321-0293Japan Second Department of Surgery Dokkyo Medical UniversityTochigi 321-0293Japan

AIM:To assess the diagnostic ability of endoscopic ultrasonography(EUS)for evaluating causes of dista biliary strictures shown on endoscopic retrograde chol angiopancreatography(ERCP)or magnetic resonance cholangiopancreatography(MRCP),even without iden tifiable mass on computed tomography(CT). METHODS:The diagnostic ability of EUS was retro spectively analyzed and compared with that of routine cytology(RC)and tumor markers in 34 patients with distal biliary strictures detected by ERCP or MRCP a Dokkyo Medical School Hospital from December 2005 to December 2008,without any adjacent mass or ec centric thickening of the bile duct on CT that could cause biliary strictures.Findings considered as benign strictures on EUS included preservation of the normasonographic layers of the bile duct wall,irrespective of the presence of a mass lesion.Other strictures were considered malignant.Final diagnosis of underlying diseases was made by pathological examination in 18 cases after surgical removal of the samples,and by clinical follow-up for>10 mo in 16 cases. RESULTS:Seventeen patients(50%)were finally di- agnosed with benign conditions,including 6"normal" subjects,while 17 patients(50%)were diagnosed with malignant disease.In terms of diagnostic ability,EUS showed 94.1%sensitivity,82.3%specificity,84.2% positive predictive value,93.3%negative predictive value(NPV)and 88.2%accuracy for identifying ma- lignant and benign strictures.EUS was more sensi- tive than RC(94.1%vs 62.5%,P=0.039).NPV was also better for EUS than for RC(93.3%vs 57.5%,P= 0.035).In addition,EUS provided significantly higher sensitivity than tumor markers using 100 U/mL as the cutoff level of carbohydrate antigen 19-9(94.1%vs 53%,P=0.017).On EUS,biliary stricture that was fi- nally diagnosed as malignant showed as a hypoechoic, irregular mass,with obstruction of the biliary duct and invasion to surrounding tissues. CONCLUSION:EUS can diagnose biliary strictures caused by malignant tumors that are undetectable on CT.Earlier detection by EUS would provide m

关键词： Computed tomography Cytology Endoscopic retrograde cholangiopancreatography Endoscopic ultrasound Indeterminate biliary stricture Magnetic resonance cholangiopancreatography Tumor marker

Clinical importance of colonoscopy in patients with gastric neoplasm undergoing endoscopic submucosal dissection

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World Journal of Gastroenterology 2017年第23期23卷 4262-4269页

作者： Chieko Tsuchida Naoto Yoshitake Hitoshi Kino Yoshihito Kaneko Masakazu Nakano Kohei Tsuchida Keiichi Tominaga Takako Sasai Hironori Masuyama Hidetsugu Yamagishi Yasuo Imai hideyuki hiraishi Department of Gastroenterology Dokkyo Medical University Department of Diagnostic Pathology Dokkyo Medical University

AIM To evaluate the usefulness of total colonoscopy(TCS) for patients undergoing gastric endoscopic submucosal dissection(ESD) and to assess risk factors for colorectal neoplasms.METHODS Of the 263 patients who underwent ESD at our department between May 2010 and December 2013, 172 patients undergoing TCS during a one-year period before and after ESD were targeted. After excluding patients with a history of surgery or endoscopic therapy for colorectal neoplasms, 158 patients were analyzed. Of the 868 asymptomatic patients who underwent TCS during the same period because of positive fecal immunochemical test(FIT) results, 158 patients with no history of either surgery or endoscopic therapy for colorectal neoplasms who were matched for age and sex served as the control group for comparison.RESULTS TCS revealed adenoma less than 10 mm in 53 patients(33.6%), advanced adenoma in 17(10.8%), early colorectal cancer in 5(3.2%), and advanced colorectalcancer in 4(2.5%). When the presence or absence of adenoma less than 10 mm, advanced adenoma, and colorectal cancer and the number of adenomas were compared between patients undergoing ESD and FITpositive patients, there were no statistically significant differences in any of the parameters assessed. The patients undergoing ESD appeared to have the same risk of colorectal neoplasms as the FIT-positive patients. Colorectal neoplasms were clearly more common in men than in women(P = 0.031). Advanced adenoma and cancer were significantly more frequent in patients with at least two of the following conditions: hypertension, dyslipidemia, and diabetes mellitus(P = 0.019).CONCLUSION In patients undergoing gastric ESD, TCS appears to be important for detecting synchronous double neoplasms. Advanced adenoma and cancer were more common in patients with at least two of the following conditions: hypertension, dyslipidemia, and diabetes mellitus. Caution is therefore especially warranted in patients with these risk factors.

关键词： Colonoscopy Colorectal 瘤胃的瘤内视镜的 submucosal 解剖烘便的免疫化学的测试

Successful endoscopic procedures for intraductal papillary neoplasm of the bile duct:A case report

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World Journal of Gastroenterology 2010年第7期16卷 909-913页

作者： Kohei Tsuchida Michiko Yamagata Yasuyuki Saifuku Dan Ichikawa Kazunari Kanke Toshimitsu Murohisa Masaya Tamano Makoto Iijima Yukiko Nemoto Wataru Shimoda Toshiaki Komori Hirokazu Fukui Kazuhito Ichikawa Hitoshi Sugaya Kazuhito Miyachi Takahiro Fujimori hideyuki hiraishi Department of Gastroenterology Dokkyo Medical UniversityTochigi 321-0293Japan First Department of Surgery Dokkyo Medical UniversityTochigi 321-0293Japan Department of Surgical and Molecular Pathology Dokkyo Medical UniversityTochigi 321-0293Japan

Attention has recently been focused on biliary papillary tumors as the novel disease entity intraductal papillary neoplasm of the bile duct(IPNB),which consists of papillary proliferation of dysplastic biliary epithelium.As even benign papillary tumors are considered as premalignant,some investigators recommend aggressive surgical therapy for IPNB,although no guidelines are available to manage this disease.Few reports have described long-term follow-up of patients with benign IPNB without radical resection.If patients with IPNB who are treated only with endoscopic procedures are noted,clinical profiles and alternative therapies other than resection may be recommended.We report the case of a patient who experienced repetitive cholangitis for 10 years and was finally diagnosed with IPNB.Radical resection could not be recommended because of the age of the patient,therefore,endoscopic sphincterotomy was performed.Although an endoscopic retrograde biliary drainage catheter was placed several times for repetitive cholangitis,the patient has done well during follow-up.Our case may offer insights into the natural course and management decisions for the novel disease entity of IPNB.

关键词： Biliary tract neoplasms Papilloma Endoscopic sphincterotomy Endoscopic retrograde biliary drainage

Surgical treatment of HCC in a patient with lamivudine-resistant hepatitis B cirrhosis with adefovir dipivoxil

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World Journal of Hepatology 2010年第8期2卷 318-321页

作者： Takashi Akima Masaya Tamano Hidetsugu Yamagishi Keiichi Kubota Takahiro Fujimori hideyuki hiraishi Department of Gastroenterology Dokkyo Medical University Department of Gastroenterology Dokkyo Medical University Koshigaya Hospital Department of Surgical and Molecular Pathology Dokkyo Medical University Second Department of Surgery Dokkyo Medical University

We describe a 77-year-old woman with chronic hepatitis B who became resistant to lamivudine.She was started on adefovir(10 mg daily)while still continuing lamivudine therapy.Four mo later her liver function improved and serum Hepatitis B virus(HBV)-DNA level became undetectable.Three years after the start of additional adefovir treatment,hepatocellular carcinoma (HCC)was detected and the patient underwent a successful hepa-tectomy.Our findings suggest tha-t the addition of adefovir to ongoing lamivudine therapy cannot completely suppress hepatocarcinogenesis,but is useful for improving liver function in patients with lamivudine-resistant HBV-related cirrhosis,allowing HCC surgery.

关键词： Hepatitis B virus Hepatocellular carcinoma Hepatocarcinogenesis Lamivudine Adefovir dipivoxil

Regenerative medicine strategies for chronic complete spinal cord injury

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Neural Regeneration Research 2024年第4期19卷 818-824页

作者： Shogo Hashimoto Narihito Nagoshi Masaya Nakamura hideyuki Okano Department of Orthopedic Surgery Keio University School of Medicine Department of Physiology Keio University School of Medicine

Spinal cord injury is a condition in which the parenchyma of the spinal cord is damaged by trauma or various diseases.While rapid progress has been made in regenerative medicine for spinal cord injury that was previously untreatable,most research in this field has focused on the early phase of incomplete injury.However,the majority of patients have chronic severe injuries;therefore,treatments for these situations are of fundamental importance.The reason why the treatment of complete spinal cord injury has not been studied is that,unlike in the early stage of incomplete spinal cord injury,there are various inhibitors of neural regeneration.Thus,we assumed that it is difficult to address all conditions with a single treatment in chronic complete spinal cord injury and that a combination of several treatments is essential to target severe pathologies.First,we established a combination therapy of cell transplantation and drug-releasing scaffolds,which contributes to functional recovery after chronic complete transection spinal cord injury,but we found that functional recovery was limited and still needs further investigation.Here,for the further development of the treatment of chronic complete spinal cord injury,we review the necessary approaches to the different pathologies based on our findings and the many studies that have been accumulated to date and discuss,with reference to the literature,which combination of treatments is most effective in achieving functional recovery.

关键词： cell transplantation chronic phase complete transection regenerative medicine spinal cord injury

The deterministic condition for the ground reaction force acting point on the combined knee valgus and tibial internal rotation moments in early phase of cutting maneuvers in female athletes

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Journal of Sport and Health Science 2024年第3期13卷 376-386页

作者： Issei Ogasawara Ken Ohta Gajanan S.Revankar Shoji Konda Yohei Shimokochi hideyuki Koga Ken Nakata Department of Health and Sport Sciences Graduate School of MedicineOsaka UniversityToyonaka 560-0043Japan Sports Sensing Co. LTD.Fukuoka 815-0035Japan Department of Neurology Graduate School of MedicineOsaka UniversitySuita 565-0871Japan Department of Health and Sport Management Osaka University of Health and Sport SciencesSennan-gun 590-0496Japan Department of Joint Surgery and Sports Medicine Graduate School of Medical and Dental SciencesTokyo Medical and Dental UniversityBunkyo-ku 113-8519Japan

Background:Combined knee valgus and tibial internal rotation(VL+IR)moments have been shown to stress the anterior cruciate ligament(ACL)in several in vitro cadaveric studies.To utilize this knowledge for non-contact ACL injury prevention in sports,it is necessary to elucidate how the ground reaction force(GRF)acting point(center of pressure(CoP))in the stance foot produces combined knee VL+IR moments in risky maneuvers,such as cuttings.However,the effects of the GRF acting point on the development of the combined knee VL+IR moment in cutting are still unknown.Methods:We first established the deterministic mechanical condition that the CoP position relative to the tibial rotational axis differentiates the GRF vector’s directional probability for developing the combined knee VL+IR moment,and theoretically predicted that when the CoP is posterior to the tibial rotational axis,the GRF vector is more likely to produce the combined knee VL+IR moment than when the CoP is anterior to the tibial rotational axis.Then,we tested a stochastic aspect of our theory in a lab-controlled in vivo experiment.Fourteen females performed 60˚cutting under forefoot/rearfoot strike conditions(10 trials each).The positions of lower limb markers and GRF data were measured,and the knee moment due to GRF vector was calculated.The trials were divided into anterior-and posterior-CoP groups depending on the CoP position relative to the tibial rotational axis at each 10 ms interval from 0 to 100 ms after foot strike,and the occurrence rate of the combined knee VL+IR moment was compared between trial groups.Results:The posterior-CoP group showed significantly higher occurrence rates of the combined knee VL+IR moment(maximum of 82.8%)at every time point than those of the anterior-CoP trials,as theoretically predicted by the deterministic mechanical condition.Conclusion:The rearfoot strikes inducing the posterior CoP should be avoided to reduce the risk of non-contact ACL injury associated with the combined knee VL+IR stress.

关键词： Center of pressure Deterministic condition Foot strike pattern Injury mechanism Moment of ground reaction force

Dendritic Learning-Incorporated Vision Transformer for Image Recognition

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IEEE/CAA Journal of Automatica Sinica 2024年第2期11卷 539-541页

作者： Zhiming Zhang Zhenyu Lei Masaaki Omura hideyuki Hasegawa Shangce Gao Faculty of Engineering University of ToyamaToyama-shi 930-8555Japan IEEE

Dear Editor,This letter proposes to integrate dendritic learnable network architecture with Vision Transformer to improve the accuracy of image recognition.In this study,based on the theory of dendritic neurons in neuroscience,we design a network that is more practical for engineering to classify visual features.Based on this,we propose a dendritic learning-incorporated vision Transformer(DVT),which out-performs other state-of-the-art methods on three image recognition benchmarks.

关键词： Image network image

Complex-Valued Neural Networks:A Comprehensive Survey

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IEEE/CAA Journal of Automatica Sinica 2022年第8期9卷 1406-1426页

作者： ChiYan Lee hideyuki Hasegawa Shangce Gao Faculty of Engineering University of ToyamaToyama 930-8555Japan

Complex-valued neural networks(CVNNs)have shown their excellent efficiency compared to their real counterparts in speech enhancement,image and signal processing.Researchers throughout the years have made many efforts to improve the learning algorithms and activation functions of CVNNs.Since CVNNs have proven to have better performance in handling the naturally complex-valued data and signals,this area of study will grow and expect the arrival of some effective improvements in the future.Therefore,there exists an obvious reason to provide a comprehensive survey paper that systematically collects and categorizes the advancement of CVNNs.In this paper,we discuss and summarize the recent advances based on their learning algorithms,activation functions,which is the most challenging part of building a CVNN,and applications.Besides,we outline the structure and applications of complex-valued convolutional,residual and recurrent neural networks.Finally,we also present some challenges and future research directions to facilitate the exploration of the ability of CVNNs.

关键词： Complex activation function complex backpropagation algorithm complex-valued learning algorithm complex-valued neural network deep learning