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Long-term outcomes of postgastrectomy syndrome after total laparoscopic distal gastrectomy using the augmented rectangle technique

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World Journal of Gastrointestinal Surgery 2022年第2期14卷 120-131页

作者： Suguru Yamauchi Hajime Orita Jun Chen hiroki egawa Yutaro Yoshimoto Akira Kubota Ryota Matsui Yukinori Yube Sanae Kaji Shinichi Oka Malcolm V Brock Tetsu Fukunaga Department of Gastroenterology and Minimally Invasive Surgery Juntendo University HospitalTokyo 113-8431Japan Department of Surgery The Johns Hopkins University School of MedicineBaltimoreMD 21205-2196United States

BACKGROUND For total laparoscopic distal gastrectomies for gastric cancer,the reconstruction method is critical to the clinical outcome of the ***,which reconstruction technique is optimal remains *** originally reported the augmented rectangle technique(ART)as a reconstruction option for total laparoscopic Billroth I ***,little is known about its effect on long-term outcomes,specifically the incidence of postgastrectomy syndrome and its impact on quality of *** To analyze postgastrectomy syndrome and quality of life after ART using the Postgastrectomy Syndrome Assessment Scale-37(PGSAS-37)*** At Juntendo University,a total of 94 patients who underwent ART for Billroth I reconstruction with total laparoscopic distal gastrectomies for gastric cancer between July 2016 and March 2020 completed the PGSAS-37 *** analysis was performed,comparing those 94 ART cases from our institution(ART group)to 909 distal gastrectomy cases with a Billroth I reconstruction from other Japanese institutions who also completed the PGSAS-37 as part of a larger national database(PGSAS group).RESULTS Patients in the ART group had significantly better total symptom scores in all the symptom subscales(i.e.,esophageal reflux,abdominal pain,meal-related distress,indigestion,diarrhea,constipation,and dumping).The loss of body weight was marginally greater for those in the ART group than in the PGSAS group(-9.3%vs-7.9%,P=0.054).The ART group scored significantly lower in their dissatisfaction of ongoing symptoms,during meals,and with daily *** ART for Billroth I reconstruction provided beneficial long-term results for postgastrectomy syndrome and quality of life in patients undergoing total laparoscopic distal gastrectomies for gastric cancer.

关键词： Laparoscopic distal gastrectomy Postgastrectomy syndrome Augmented rectangle technique Billroth I Postgastrectomy Syndrome Assessment Scale-37

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Challenge to ABO blood type barrier in living donor liver transplantation

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Hepatobiliary & Pancreatic Diseases International 2020年第4期19卷 342-348页

作者： Hiroto egawa Department of Gastroenterology Tokyo Women’s Medical UniversityTokyoJapan

ABO incompatible living donor liver transplantation has the potential to expand the donor pool for patients with end stage liver diseases on the expense of challenges to overcome immunological barriers across blood *** is a profound impact of age on incidence and severity of antibody mediated rejection(AMR).Even children older than 1 year have chances of AMR;children aged 8 years or older have risks of hepatic necrosis similar to adult liver *** mechanism of AMR is based on circulatory disturbances secondary to inflammation and injury of the vascular endothelium caused by an antibody-antigen-complement *** strategy to overcome ABO blood type barrier is based on both pre-transplant desensitization and adequate treatment of this ***,rituximab is the standard means of desensitization but unfortunately an insufficient aid to treat *** of low incidence(less than 5%in the rituximab era),in practice of AMR only some case reports about the treatment of clinical AMR are available in the *** experiences revealed that the proteasome inhibitor,bortezomib might be a promising treatment based on its capacity to deplete plasma cell *** ABO blood type barrier has been counteracted in 95%of patients by applying“rituximab-desensitization”,many issues,such as prediction of high-risk patients of infection and AMR and secure treatment strategies for evoked AMR,remain to be resolved.

关键词： ABO blood type Living donor liver transplantation Antibody mediated rejection

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The Gaps Between Institutional and Practical Disaster Risk Management Measures on Coastal Flood Risks in South Korea’s Coastal Communities

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International Journal of Disaster Risk Science 2024年第4期15卷 594-607页

作者： Hyejeong Park Kihun Nam Shinichi egawa Disaster Medical Science Division International Research Institute of Disaster ScienceTohoku UniversitySendaiMiyagi 980-0845Japan Department of Fire and Disaster Prevention Engineering Changshin UniversityChangwonGyeongsangnam-do 51326Republic of Korea

Global warming and climate change significantly increase the frequency of coastal floods caused by sea level rise(SLR) as a permanent factor and hydrometeorological hazards as tentative factors. The combined risks will affect coastal *** Korea is gradually facing SLR risks, mainly in its southern coastal regions;however, disaster risk reduction(DRR)in coastal regions remains fragmented. This study aimed to investigate the status of DRR for coastal communities in South Korea by looking at government practices and testimonies from residents. This study reviewed DRR-related regulations and documents and collected data from interviews with local government officials, field visits, and informal conversations with residents in six coastal communities. The findings show that the coastal communities were less resilient to coastal floods than to other hazards, such as typhoons and heavy rains, and the potential consequences could be expanded due to demographic challenges, fragmented institutional systems, and low risk awareness. Moreover, this study emphasized the necessity of an integrated approach to reducing the impact of coastal floods caused by both SLR and other factors. It also highlighted the importance of coastal community engagement in local DRR activities through increasing risk awareness and adapting to environmental change based on appropriate risk information disclosure by the government. The impacts of coastal floods triggered by SLR and other hazard factors can be reduced by aligning practical regulatory measures with adaptive strategies and enhancing the disaster resilience of coastal communities.

关键词： Coastal community Coastal foods Disaster risk reduction Hydrometeorological hazards Sea level rise South Korea

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Clinical implications of accessory pancreatic duct

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World Journal of Gastroenterology 2010年第36期16卷 4499-4503页

作者： Terumi Kamisawa Kensuke Takuma Taku Tabata Naoto egawa Department of Internal Medicine Tokyo Metropolitan Komagome Hospital3-18-22 HonkomagomeBunkyo-kuTokyo 113-8677Japan

The accessory pancreatic duct (APD) is the main drainage duct of the dorsal pancreatic bud in the embryo,entering the duodenum at the minor duodenal papilla (MIP).With the growth,the duct of the dorsal bud undergoes varying degrees of atrophy at the duodenal *** of the APD in 291 control cases was 43% as determined by dye-injection endoscopic retrograde *** of the APD in 46 patients with acute pancreatitis was only 17%,which was significantly lower than in control cases (P < 0.01).The terminal shape of the APD was correlated with APD *** on the data about correlation between the terminal shape of the APD and its patency,the estimated APD patency in 167 patients with acute pancreatitis was 21%,which was signif icantly lower than in control cases (P < 0.01).A patent APD may function as a second drainage system for the main pancreatic duct to reduce the pressure in the main pancreatic duct and prevent acute *** f indings of 91 patients with pancreaticobiliary maljunction (PBM) were divided into a normal duct group (80 patients) and a dorsal pancreatic duct (DPD) dominant group (11 patients).While 48 patients (60%) with biliary carcinoma (gallbladder carcinoma,n=42;bile duct carcinoma,n=6) were identified in PBM with a normal pancreatic duct system,only two cases of gallbladder carcinoma (18%) occurred in DPD-dominant patients (P < 0.05).Concentration of amylase in the bile of DPD dominance was signifi cantly lower than that of normal pancreatic duct system (75 403.5 ± 82 015.4 IU/L vs 278 157.0 ± 207 395.0 IU/L,P < 0.05).In PBM with DPD dominance,most pancreatic juice in the upper DPD is drained into the duodenum via the MIP,and reflux of pancreatic juice to the biliary tract might be reduced,resulting in less frequency of associated biliary carcinoma.

关键词： Accessory pancreatic duct Minor duodenal papilla Pancreas divisum Main pancreatic duct Acute pancreatitis Pancreaticobiliary maljunction

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Relative importance of biological and human-associated factors for alien plant invasions in Hokkaido, Japan

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Journal of Plant Ecology 2019年第4期12卷 673-681页

作者： Chika egawa Takeshi Osawa Tomoko Nishida Yasuto Furukawa Institute for Agro-Environmental Sciences National Agriculture and Food Research Organization3-1-3 KannondaiTsukubaIbaraki 305-8604Japan Faculty of Urban Environmental Sciences Tokyo Metropolitan University1-1 Minami-OsawaHachiojiTokyo 192-0397Japan Headquarters National Agriculture and Food Research Organization3-1-1 KannondaiTsukubaIbaraki 305-4517Japan Rakuno Gakuen University 582 Bunkyodai-MidorimachiEbetsuHokkaido 069-8501Japan

Aims The invasion success of alien plants is strongly affected by both biological and human-associated *** of the rela-tive contribution of each factor is important not only for the further understanding of invasion processes but also for the better manage-ment of invasion risk,particularly in protected areas of high con-servation ***,we quantified the relative importance of species biological traits and association with a human activity,***,in explaining the invasion success of alien plants across the entire region and in protected areas in Hokkaido,*** As a quantitative measure of invasion success,the distribution ex-tent of naturalized populations across the entire prefecture and in protected areas was calculated for 63 alien species with equal residence time based on species occurrence records at a spatial resolution of 5-km mesh grid *** each species,we identi-fied seven biological traits(seed mass,dispersal mode,maximum plant height,capability of vegetative reproduction,flowering start time and period and life span)and two human-associated factors(introduction purpose and cultivation frequency for agricultural use).Cultivation frequency was determined based on the frequency of seed-sowing in pastures:(1)not sown,(2)accidentally sown as a seed contaminant and(3)intentionally sown for commercial *** importance of biological traits and human-associated factors in explaining the distribution extent was determined using an information-theoretic *** Findings In explaining the distribution extent across the entire prefecture,species biological traits and human-associated factors showed comparable importance;cultivation frequency exhibited the high-est importance value closely followed by seed mass,maximum height and flowering *** contrast,when focusing on pro-tected areas,human association was more important than bio-logical traits,as indicated by the greatest importance of cultiva

关键词： agricultural use biological invasion distribution nature reserve pasture plants

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Autoimmune pancreatitis metachronously associated with retroperitoneal fibrosis with IgG4-positive plasma cell infiltration

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World Journal of Gastroenterology 2006年第18期12卷 2955-2957页

作者： Terumi Kamisawa Pong Yui Chen Hitoshi Nakajima Naoto egawa Department of Internal Medicine Tokyo Metropolitan Komagome HospitalTokyoJapan

Retroperitoneal fibrosis is an uncommon disorder characterized by the formation of a dense plaque of fibrous tissue in the retroperitoneum, and its etiology remains unknown. Autoimmune pancreatitis is a rare type of chronic pancreatitis characterized by fibrosis with abundant infiltration of IgG4-positive plasma cells and lymphocytes and obliterative phlebitis in the pancreas. We present a case of autoimmune pancreatitis that developed 10 mo after the occurrence of retroperitoneal fibrosis. Histological findings of the resected retroperitoneal mass were marked periureteral fibrosis with abundant infiltration of IgG4-positive plasma cells and lymphocytes and obliterative phlebitis. These findings suggest a common pathophysiological mechanism for retroperitoneal fibrosis and autoimmune pancreatitis in this case. Some cases of retroperitoneal fibrosis might be a retroperitoneal lesion of IgG4-related sderosing disease.

关键词： Autoimmune pancreatitis Retroperitoneal fibrosis IgG4

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Utility of co-transplanting mesenchymal stem cells in islet transplantation

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World Journal of Gastroenterology 2011年第47期17卷 5150-5155页

作者： Naoaki Sakata Masafumi Goto Gumpei Yoshimatsu Shinichi egawa Michiaki Unno Division of Hepato-Biliary-Pancreatic Surgery Department of Surgery Tohoku University Graduate School of Medicine 1-1 Seiryo-machi Aoba-ku Sendai Miyagi 980-8574 Japan Division of Advanced Surgical Science and Technology Tohoku University Graduate School of Medicine 1-1 Seiryo-machi Aoba-ku Sendai Miyagi 980-8574 Japan New Industry Creation Hatchery Center Tohoku University Graduate School of Medicine 1-1 Seiryomachi Aoba-ku Sendai Miyagi 980-8574 Japan

Islet transplantation is characterized by the transplantation of isolated islets from donor pancreata into a diabetic recipient. Although it is a viable choice in the treatment of insulin dependent diabetes mellitus, most patients (approximately 90%) require insulin five years after transplantation. Recently, the co-transplantation of mesenchymal stem cells (MSCs) and islets in animal studies has revealed the effectiveness of MSCs co-transplantation for improving islet function. Themechanisms underlying the beneficial impact of MSCs include immunomodulation and the promotion of angiogenesis. In this review, we discuss MSCs and how they support improved graft survival and function.

关键词： Mesenchymal stem cell Islet transplanta-tion Bone marrow Immunomodulatory Regulatory Tcell Angiogenesis Vascular endothelial growth factor Diabetes mellitus

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The Sendai Framework for Disaster Risk Reduction: Renewing the Global Commitment to People’s Resilience, Health,and Well-being

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International Journal of Disaster Risk Science 2015年第2期6卷 164-176页

作者： Amina Aitsi-Selmi Shinichi egawa Hiroyuki Sasaki Chadia Wannous Virginia Murray Public Health Strategy Division Public Health England Research Department of Epidemiology and Public Health University College London Division of International Cooperation for Disaster Medicine International Research Institute of Disaster Science(IRIDeS)Tohoku University The United Nations Office for Disaster Risk Reduction(UNISDR) The United Nations Office for Disaster Risk Reduction(UNISDR)Scientific and Technical Advisory Group

The Sendai Framework for Disaster Risk Reduction 2015–2030(SFDRR) is the first global policy framework of the United Nations’ post-2015 agenda. It represents a step in the direction of global policy coherence with explicit reference to health, development, and climate change. To develop SFDRR, the United Nations Office for Disaster Risk Reduction(UNISDR) organized and facilitated several global, regional, national, and intergovernmental negotiations and technical meetings in the period preceding the World Conference on Disaster Risk Reduction(WCDRR) 2015 where SFDRR was adopted. UNISDR also worked with representatives of governments, UN agencies, and scientists to develop targets and indicators for SFDRR and proposed them to member states for negotiation and adoption as measures of progress and achievement in protecting lives and livelihoods. The multiple efforts of the health community in the policy development process, including campaigning for safe schools and hospitals, helped to put people’s mental and physicalhealth, resilience, and well-being higher up the disaster risk reduction(DRR) agenda compared with the Hyogo Framework for Action 2005–2015. This article reviews the historical and contemporary policy development process that led to the SFDRR with particular reference to the development of the health theme.

关键词： Disaster risk reduction Global health Health policy Public health Safe hospitals

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Utility of pancreatography for diagnosing autoimmune pancreatitis

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World Journal of Gastroenterology 2011年第18期17卷 2332-2337页

作者： Kensuke Takuma Terumi Kamisawa Taku Tabata Yoshihiko Inaba Naoto egawa Yoshinori Igarashi Department of Internal Medicine Tokyo Metropolitan Komagome Hospital Department of Gastroenterology and Hepatology Omori Medical Center Toho University School of Medicine

AIM: To identify pancreatographic findings that facilitate differentiating between autoimmune pancreatitis (AIP) and pancreatic cancer (PC) on endoscopic retrograde cholangiopancreatography (ERCP) and magnetic resonance cholangiopancreatography (MRCP). METHODS: ERCP findings of 48 AIP and 143 PC patients were compared. Diagnostic accuracies for AIP by ERCP and MRCP were compared in 30 AIP patients. RESULTS: The following ERCP findings suggested a diagnosis of AIP rather than PC. Obstruction of the main pancreatic duct (MPD) was more frequently detected in PC (P < 0.001). Skipped MPD lesions were detected only in AIP (P < 0.001). Side branch derivation from the narrowed MPD was more frequent in AIP (P < 0.001). The narrowed MPD was longer in AIP (P < 0.001), and a narrowed MPD longer than 3 cm was more frequent in AIP (P < 0.001). Maximal diameter of the upstream MPD was smaller in AIP (P < 0.001), and upstream dilatation of the MPD less than 5 mm was more frequent in AIP (P < 0.001). Stenosis of the lower bile duct was smooth in 87% of AIP and irregular in 65% of PC patients (P < 0.001). Stenosis of the intrahepatic or hilar bile duct was detected only in AIP (P = 0.001). On MRCP, diffuse narrowing of the MPD on ERCP was shown as a skipped non-visualized lesion in 50% and faint visualization in 19%, but segmental narrowing of the MPD was visualized faintly in only 14%. CONCLUSION: Several ERCP findings are useful for differentiating AIP from PC. Although MRCP cannot replace ERCP for the diagnostic evaluation of AIP, some MRCP findings support the diagnosis of AIP.

关键词： Autoimmune pancreatitis Pancreatic cancer Endoscopic retrograde cholangiopancreatography Magnetic resonance cholangiopancreatography

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Malignancies associated with intraductal papillary mucinous neoplasm of the pancreas

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World Journal of Gastroenterology 2005年第36期11卷 5688-5690页

作者： Terumi Kamisawa Yuyang Tu Naoto egawa Hitoshi Nakajima Kouji Tsuruta Atsutake Okamoto Department of Internal Medicine Tokyo Metropolitan Komagome Hospital Tokyo Japan Department of Surgery Tokyo Metropolitan Komagome Hospital Tokyo Japan

AIM： As intraductal papillary mucinous neoplasm （IPMN） has a favorable prognosis, associated malignancies have potential significance in these patients. We examined the incidence and characteristics of pre-existing, coexisting and subsequent malignancies in patients with IPMN. METHODS： Seventy-nine cases of IPMN were diagnosed by detection of mucous in the pancreatic duct during endoscopic retrograde pancreatography. Histological diagnosis was confirmed in 30 cases （adenoma （n = 19） and adenocarcinoma （n = 11）. Other primary malignancies associated with IPMN, occurring in the prediagnostic or postdiagnostic period, were investigated. Postdiagnostic follow-up period was 3.3±0.5 years （range, 0.2-20 years）. RESULTS： Other 40 malignancies occurred in 28 patients （35%）. They were found before （n = 15）, at （n = 19） and after （n = 6） the diagnosis of IPMT. Major associated malignancies were gastric cancer （n = 12）, colonic cancer （n = 7）, esophageal cancer （n = 4）, pulmonary cancer （n = 4）, and independent pancreatic cancer （n = 3）. Pancreatic cancer was synchronous with IPMN in two patients and metachronous in one （3 years after diagnosis of IPMN）. Thirty-one lesions were treated surgically or endoscopically. Fourteen patients died of associated cancers. Development of other malignancies was related to age （71.9±8.2 v566.8±9.3, P〈0.05）, but not to gender or site of the tumor. CONCLUSION： IPMN is associated with a high incidence of other malignancies, particularly gastric and colonic cancers. Common genetic mechanisms between IPMN and other associated malignancies might be present. Clinicians should pay attention to the possibility of associated malignancies in preoperative screening and follow-up of patients with IPMN. 2005 The WJG Press and Elsevier Inc. All rights reserved

关键词： Intraductal papillary mucinous neoplasms Pancreas Gastric cancer Colonic cancer

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