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Small invasive ductal carcinoma of the pancreas distinct from branch duct intraductal papillary mucinous neoplasm

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World Journal of Gastroenterology 2009年第43期15卷 5489-5492页

作者： hiroki sakamoto Masayuki Kitano Takamitsu Komaki Hajime Imai Ken Kamata Masatomo Kimura Yoshifumi Takeyama Masatoshi Kudo Division of Gastroenterology and Hepatology Department of Internal MedicineKinki University School of Medicine377-2Ohno-HigashiOsaka-Sayama 589-8511Japan Department of Pathology Kinki University School of Medicine377-2Ohno-HigashiOsaka-Sayama 589- 8511Japan Department of Surgery Kinki University School of Medicine377-2Ohno-HigashiOsaka-Sayama 589-8511Japan

Endoscopic ultrasonography （EUS） is a highly sensitive diagnostic method for the detection of small pancreatic carcinomas. Recently, there have been some reports describing the utility of contrast-enhanced harmonic EUS （CEH-EUS） which uses sonographic contrast agent for differentiation of a pancreatic mass. This report describes a case of small adenocarcinoma of the pancreas distinct from branch duct intraductal papillary mucinous neoplasm （IPMN） in which investigation by EUS took place every 6 mo and diagnosis was made accurately by additional CEH-EUS during the follow-up of the branch duct IPMN. A 68-year-old female was admitted to our hospital because of a branch duct IPMN in the pancreatic body. She had been followed-up by EUS every 6 too. However, after 2 years EUS demonstrated a low echoic area distinct from the branch duct IPMN which was vaguely discernible by EUS, and accurate sizing and differential diagnosis were considered difficult on the EUS imaging. CHEUS with Sonazoid revealed a hypovascular tumor and we suspected small pancreatic carcinoma. The histopathological diagnosis was adenocarcinoma （10 mm） in the pancreatic tail, distinct from the branch duct IPMN of the pancreatic body. EUS and CEH-EUS may play an important role in the correct diagnosis of small pancreatic tumors, including synchronous and metachronous occurrence of IPMN and ductal adenocarcinoma of the pancreas.

关键词： Intraductal papillary mucinous adenoma Small pancreatic cancer Endoscopic ultrasonography Contrast-enhanced harmonic endoscopic ultrasonography Pancreatic cancer Pancreas Contrast enhanced endoscopic ultrasonography

Diagnosis of subepithelial tumors in the upper gastrointestinal tract by endoscopic ultrasonography

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World Journal of Radiology 2010年第8期2卷 289-297页

作者： hiroki sakamoto Masayuki Kitano Masatoshi Kudo Division of Gastroenterology and Hepatology Department of Internal MedicineKinki University School of MedicineOsaka-Sayama 589-8511Japan

Endoscopic ultrasonography(EUS) is the most accurate procedure for detecting and diagnosing subepithelial tumors,due to its higher sensitivity and specificity than other imaging *** can characterize lesions by providing information on echogenic origin,size,borders,homogeneity,and the presence of echogenic or anechoic *** echoendoscopes,and recently also electronic radial echoendoscopes,can be used with color Doppler or power Doppler to assess the vascular signals from subepithelial masses,and thus permit the differentiation of vascular structures from cysts,as well as the assessment of the tumor blood ***,the diagnostic accuracy of EUS imaging alone has been shown to be low in subepithelial lesions with 3rd and 4th *** is also difficult to differentiate exactly between benign and malignant tumors and to gain an accurate picture of histology using *** the other hands,EUS guided fine needle aspiration(EUS-FNA) can provide samples for cytologic or histologic *** lesions of the 3rd and the 4th EUS layers,more than in 1 cm diameter are recommended,and histologic confirmation using endoscopic submucosal resection or EUSFNA should be obtained when ***,EUSFNA plays an important role in the clinical management of subepithelial *** improvements in endoscopic technology are expected to be more useful modalities in differential diagnosis and discrimination between benign and malignant subepithelial

关键词： Endoscopic ultrasonography Submucosal tumor Subepithelial tumor

Contrast-enhanced harmonic endoscopic ultrasonography for assessment of lymph node metastases in pancreatobiliary carcinoma

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World Journal of Gastroenterology 2016年第12期22卷 3381-3391页

作者： Takeshi Miyata Masayuki Kitano Shunsuke Omoto Kumpei Kadosaka Ken Kamata Hajime Imai hiroki sakamoto Naoshi Nisida Yogesh Harwani Takamichi Murakami Yoshifumi Takeyama Yasutaka Chiba Masatoshi Kudo Department of Gastroenterology and Hepatology Kinki University Faculty of Medicine Department of Radiology Kinki University Faculty of Medicine Department of Surgery Kinki University Faculty of Medicine Division of Biostatistics Clinical Research Center Kinki University Faculty of Medicine

AIM: To assess the usefulness of contrast-enhanced harmonic endoscopic ultrasonography (CH-EUS) for lymph node metastasis in pancreatobiliary ***: All patients suspected of pancreatobiliary carcinoma with visible lymph nodes after standard EUS between June, 2009 and January, 2012 were enrolled. In the primary analysis, patients with successful EUS-fine needle aspiration (FNA) were included. The lymph nodes were assessed by several standard EUS variables (short and long axis lengths, shape, edge characteristic and echogenicity), color Doppler EUS variable [central intranodal blood vessel (CIV) presence] and CH-EUS variable (heterogeneous/homogeneous enhancement patterns). The diagnostic accuracy relative to EUS-FNA was calculated. In the second analysis, N-stage diagnostic accuracy of CH-EUS was compared with EUS-FNA in patients who underwent surgical ***: One hundred and nine patients (143 lymph nodes) fulfilled the criteria. The short axis cut-off ≥ 13 mm predicted malignancy with a sensitivity and specificity of 72% and 85%, respectively. These values were 72% and 63% for the long axis cut-off ≥ 20 mm, 62% and 75% for the round shape variable, 81% and 30% for the sharp edge variable, 66% and 61% for the hypoechogenicity variable, 70% and 72% for the CIV-absent variable, and 83% and 91% for the heterogeneous CH-EUS-enhancement variable, respectively. CH-EUS was more accurate than standard and color Doppler EUS, except the short axis cut-off. Notably, three patients excluded because of EUS-FNA failure were correctly N-staged by ***: CH-EUS complements standard and color Doppler EUS and EUS-FNA for assessment of lymph node metastases.

关键词： Contrast-enhanced harmonic endoscopic ultrasonography Sensitivity and specificity Lymph node Pancreatobiliary carcinoma Endoscopic ultrasonography-fine needle aspiration

Diagnosis of pancreatic tumors by endoscopic ultrasonography

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World Journal of Radiology 2010年第4期2卷 122-134页

作者： hiroki sakamoto Masayuki Kitano Ken Kamata Muhammad El-Masry Masatoshi Kudo Division of Gastroenterology and Hepatology Department of Internal Medicine Kinki University School of Medicine Hepatogastroenterology and Endoscopy Unit Department of Internal Medicine Assiut University Hospitals

Pancreatic tumors are highly diverse, as they can be solid or cystic, and benign or malignant. Since their imaging features overlap considerably, it is often difficult to characterize these tumors. In addition, small pancreatic tumors, especially those less than 2 cm in diameter, are difficult to detect and diagnose. For characterizing pancreatic tumors and detecting small pancreatic tumors, endoscopic ultrasonography (EUS) is the most sensitive of the imaging procedures currently available. This technique also provides good results in terms of the preoperative staging of pancreatic tumors. EUS-guided fine needle aspiration (EUS-FNA) has also proved to be a safe and useful method for tissue sampling of pancreatic tumors. Despite these advantages, however, it is still difficult to differentiate between be-nign and malignant, solid or cystic pancreatic tumors, malignant neoplasms, and chronic pancreatitis using EUS, even when EUS-FNA is performed. Recently, contrast-enhanced EUS with Doppler mode (CE-EUS) employing ultrasound contrast agents, which indicate vascularization in pancreatic lesions, has been found to be useful in the differential diagnosis of pancreatic tumors, especially small pancreatic tumors. However, Doppler ultrasonography with contrast-enhancement has several limitations, including blooming artifacts, poor spatial resolution, and low sensitivity to slow flow. Consequently, an echoendoscope was developed recently that has a broad-band transducer and an imaging mode that was designed specifically for contrastenhanced harmonic EUS (CEH-EUS) with a secondgeneration ultrasound contrast agent. The CEH-EUS technique is expected to improve the differential diagnosis of pancreatic disease in the future. This review describes the EUS appearances of common solid and cystic pancreatic masses, the diagnostic accuracy of EUS-FNA, and the relative efficacies and advantages of CE-EUS and CEH-EUS along with their relative advantages and their complementary roles in

关键词： Contrast-enhanced endoscopic ultrasonography Endoscopic ultrasonography EUS-guided fine needle aspiration Pancreas Sonazoid

Effectiveness of Compatibilizer on Mechanical Properties of Recycled PET Blends with PE, PP, and PS

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Materials Sciences and Applications 2014年第8期5卷 548-555页

作者： Nobuyuki Imamura hiroki sakamoto Yuji Higuchi Hiroyuki Yamamoto Shinichi Kawasaki Kazushi Yamada Hiroyuki Nishimura Takahiro Nishino Advanced Fibro-Science Kyoto Institute of Technology Kyoto Japan Energy Technology Laboratories Osaka Gas Co. Osaka Japan Osaka Gas Chemicals Co. Konohana-ku Osaka Japan Osaka Resin Industry Co. Osaka Japan

Recycled PET (R-PET) is well known to exhibit brittle behavior in the presence of notches and indicated the low heat distortion temperature. In addition, it is hard to prevent some impurities such as cap or label of the bottle that mixed into R-PET during the recycling process. In this paper, the effect of the amounts and kinds of compatibilizers on the morphological characteristics and mechanical performance of recycled poly(ethylene terephthalate) (R-PET) compounded with polyethylene (PE), polypropylene (PP), and polystyrene (PS) was investigated. From the results, with an increase in the glycidyl methacrylate modified PE (EGMA) additive contents, in the increment of the Izod impact strength of Composite-G was obtained. In addition, it was found that the miscibility of Composite-G was improved with increasing the amount of EGMA, which indicated from the result of SEM images.

关键词： Component Recycled PET Recycled Polypropylene Recycled Polyethylene Compatibilizer

Bicuspidization Using the Open-Sleeve Technique for Congenital Aortic Stenosis during Infancy

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Congenital Heart Disease 2024年第2期19卷 177-183页

作者： Toshi Maeda hiroki Ito Keiichi Hirose Kisaburo sakamoto Departments of Cardiovascular Surgery Mt.Fuji Shizuoka Children’s HospitalShizuoka420-8660Japan

Congenital aortic stenosis(cAS)frequently requires intervention during the neonatal or infantile ***,surgical repair is challenging because of the narrow surgical *** performed bicuspidization using the open-sleeve technique for cAS with a unicuspid aortic valve in two ***,the patients were doing well without reintervention for the aortic valve for 8 and 6 years,*** aortic annular diameter increased along with somatic *** for neonates or infancy can be performed safely using the open-sleeve technique as its midterm results have been satisfactory.

关键词： Aortic valve repair infant bicuspidization open-sleeve technique

Review on acute pancreatitis attributed to COVID-19 infection

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World Journal of Gastroenterology 2022年第19期28卷 2034-2056页

作者： Takumi Onoyama hiroki Koda Wataru Hamamoto Shiho Kawahara Yuri sakamoto Taro Yamashita hiroki Kurumi Soichiro Kawata Yohei Takeda Kazuya Matsumoto Hajime Isomoto Division of Gastroenterology and Nephrology Department of Multidisciplinary Internal MedicineTottori University Faculty of MedicineYonago 683-8504Tottori PrefectureJapan Department of Internal Medicine Irisawa Medical ClinicMatsue 690-0025Shimane PrefectureJapan

The coronavirus disease 2019(COVID-19)is known to cause gastrointestinal *** studies have revealed COVID-19-attributed acute pancreatitis(AP).However,clinical characteristics of COVID-19-attributed AP remain *** performed a narrative review to elucidate relation between COVID-19 and AP using the PubMed *** basic and pathological reports revealed expression of angiotensin-converting enzyme 2 and transmembrane protease serine 2,key proteins that aid in the entry of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)into the *** experimental and pathological evaluation suggested that SARS-CoV-2 infects human endocrine and exocrine pancreas cells,and thus,SARS-CoV-2 may have a direct involvement in pancreatic ***,systemic inflammation,especially in children,may cause *** of immune mediators associated with AP,including interleukin(IL)-1β,IL-10,interferon-γ,monocyte chemotactic protein 1,and tumor necrosis factor-αare higher in the plasma of patients with COVID-19,that suggests an indirect involvement of the *** real-world settings,some clinical features of AP complicate COVID-19,such as a high complication rate of pancreatic necrosis,severe AP,and high ***,clinical features of COVID-19-attributed AP remain uncertain due to insufficient research on etiologies of ***,high-quality clinical studies and case reports that specify methods for differential diagnoses of other etiologies of AP are needed.

关键词： COVID-19 SARS-CoV-2 Pancreatitis Revised atlanta classification Prognosis Etiology

Mercury concentration in hair samples from Chinese people in coastal cities

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Journal of Environmental Sciences 2008年第10期20卷 1258-1262页

作者： sakamoto Mineshi National Institute for Minamata Disease Ministry of the Environment4058-18 Hama Minamata City Kumamoto 867-0008 Japan.

This investigation was made to estimate current normal concentrations of total mercury in the hair of Chinese coastal people. Hair samples were collected from 659 healthy inhabitants in the areas along the coast and the rivers (such as Shanghai, Ningbo, Dalian, Xiamen, and Zhoushan) of China from Feb. 2005 to June 2006. Total mercury concentrations in the samples were analyzed by the cold vapor atomic adsorption spectrometry method (CVAAS). The results showed the geometric mean concentration of total mercur...

关键词： hair mercury Chinese people coastal cities

Programmed cell death-1 inhibitor-related sclerosing cholangitis:A systematic review

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World Journal of Gastroenterology 2020年第3期26卷 353-365页

作者： Takumi Onoyama Yohei Takeda Taro Yamashita Wataru Hamamoto Yuri sakamoto hiroki Koda Soichiro Kawata Kazuya Matsumoto Hajime Isomoto Division of Medicine and Clinical Science Department of Multidisciplinary Internal MedicineFaculty of MedicineTottori UniversityTottori prefecture 683-8504Japan Internal Medicine Irisawa Medical ClinicShimane prefecture 690-0025Japan

BACKGROUND Programmed cell death-1(PD-1)inhibitor has been indicated for many types of ***,these inhibitors also cause immune-related adverse *** disorder is a phenotype of immune-related adverse event affecting 0%–4.5%of patients treated with PD-1 *** studies have reported PD-1 inhibitor-related sclerosing cholangitis(SC);however,the associated clinical and pathological features are *** To evaluate the clinical and pathological features of PD-1 inhibitor-related SC through a systematic review of the *** The review,conducted using electronic databases in PubMed,was restricted to the period from January 2014 to September 2019 and focused on case reports/series on PD-1 inhibitor-related SC published in *** scanned the references of the selected literature to identify any further relevant *** cases previously studied by us,including three that have not yet been published,were included in this *** Thirty-one PD-1 inhibitor-related SC cases were *** age of patients was 67 years(range,43–89),with a male to female ratio of 21:*** main disease requiring PD-1 inhibitor treatment was non-small cell lung *** that caused PD-1 inhibitor-related SC were nivolumab(19 cases),pembrolizumab(10 cases),avelumab(1 case),and durvalumab(1 case).The median number of cycles until PD-1 inhibitor-related SC onset was 5.5(range,1–27).Abdominal pain or discomfort(35.5%,11/31)was the most frequent *** serum tests identified liver dysfunction with a notable increase in biliary tract enzymes relative to hepatic enzymes,and a normal level of serum immunoglobulin *** dilation without obstruction(76.9%,20/26),diffuse hypertrophy of the extrahepatic biliary tract(90.5%,19/21),and multiple strictures of the intrahepatic biliary tract(30.4%,7/23)were *** 11/23(47.8%)cases,pathological examination indicated that CD8+T cells were the dominant inflammatory cells i

关键词： Nivolumab Pembrolizumab Avelumab Durvalumab Atezolizumab Programmed cell death-1 inhibitor Immune-related adverse events Cholangitis