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Strategies for gastric cancer in the modern era

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World Journal of Gastrointestinal Oncology 2010年第9期2卷 335-341页

作者： Satoru Takayama Takehiro Wakasugi Hitoshi Funahashi hiromitsu takeyama Department of Gastroenterological Surgery Nagoya City University Graduate School of Medical Sciences

Gastric cancer is one of the most common neoplasms in Japan, and it is also the second leading cause of cancer-related deaths worldwide. Nowadays, infection with Helicobacter pylori (H. pylori) is a known risk factor for the development of gastric cancer. Therefore, gastric cancer should be considered as an infectious disease, and in fact, prophylactic eradication of H. pylori may prevent the development of metachronous gastric carcinoma. Before the role of H. pylori was understood, a different approach was used. Recently even after the cancer has developed, some newer therapeutic approaches have been pursued. These newer treatments have been summarized as "minimally invasive therapies" and use endoscopic or laparoscopic techniques. In addition, robotic approaches are being developed that seem to hold a great potential to change the surgical approach. Since basic understanding and treatment of the disease have both changed signif icantly over the last decade, we present a review of current advances in gastric cancer research and therapy.

关键词： Helicobacter pylori Endoscopic submucosal dissection Laparoscopy-assisted distal gastrectomy Gastric cancer Robot

Hybrid natural orifice transluminal endoscopic surgery for ileocecal resection

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World Journal of Gastrointestinal Surgery 2012年第2期4卷 41-44页

作者： Satoru Takayama Masayasu Hara Mikinori Sato hiromitsu takeyama Department of Gastroenterological Surgery Nagoya City University Graduate School of Medical SciencesNagoya

Although laparoscopic colectomy is commonly performed around the world,an operative wound formed during the surgery is large but not sufficient enough to convert for the majority of open ***,a certain sized skin incision is required to remove the resected *** we report the case of a pure laparoscopic ileocecal resection which involves transanal specimen *** present a case characterized by a laterally spreading type of tumor of the *** performed a pure laparoscopic ileocecal resection and the resected specimen was removed transanally using *** functional anastomosis was then performed using a flexible linear stapling device under supporting barbed suture *** patient was discharged without complications on postoperative day *** colectomy performed with minimal incision could essentially increase the usage of this surgical *** our method is restricted to flat or small lesions,we think it is a feasible and realistic solution for minimization of operative invasion because it involves specimen extraction through a natural orifice.

关键词： Laparoscopic ileocecal resection Natural orifice transluminal endoscopic surgery Transanus Barbed suture

Use of barbed suture for peritoneal closure in transabdominal preperitoneal hernia repair

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World Journal of Gastrointestinal Surgery 2012年第7期4卷 177-179页

作者： Satoru Takayama Nozomu Nakai Midori Shiozaki Ryo Ogawa Masaki Sakamoto hiromitsu takeyama Department of Gastroenterological Surgery Nagoya City University Graduate School of Medical SciencesNagoya467-8601 AichiJapan

AIM:To investigate the use of the V-Loc wound closure device for transabdominal preperitoneal hernia repair. METHODS:We performed conventional transabdominal preperitoneal hernia repair in 19 patients, including one single incisional case using V-Loc. Except for the use of V-Loc for peritoneal closure, the procedures were the same as those used in conventional techniques. RESULTS:Although the operators included 2 residents who have no experience in laparoscopic herniorrhaphy and intracorporeal suture, the operations were completed. We believe that V-Loc is especially suitable for inexperienced surgeons and the use of V-Loc reduces the operative time by a small amount but reduces operator stress significantly. CONCLUSION:We conclude that V-Loc is the ideal peritoneal closure device for transabdominal preperitoneal hernia repair.

关键词： Transabdominal preperitoneal approach V-Loc Single incision laparoscopic surgery

Eosinophilic gastroenteritis with cytomegalovirus infection in an immunocompetent child

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World Journal of Gastroenterology 2007年第34期13卷 4653-4654页

作者： Junji takeyama Daiki Abukawa Katsushi Miura Department of Pathology Miyagi Children's Hospital Sendai 989-3126 Japan Department of General Pediatrics Miyagi Children's Hospital Sendai 989-3126 Japan

A 3-year-old boy developed transient protein-losing gastroenteropathy associated with cytomegalovirus (CMV) infection. Both IgG and IgM antibodies to CMV were positive in a serologic blood test. Upper gastrointestinal endoscopy showed multiple erosions throughout the body of the stomach, without enlarged gastric folds. Histological examination of the biopsy specimens indicated eosinophilic gastroenteritis and CMV infection. The patient had complete resolution without specific therapy for CMV in four weeks. An allergic reaction as well as CMV infection played important roles in the pathogenesis of this case.

关键词： Eosinophilic gastroenteritis Cytomegalovirus Protein-losing gastroenteropathy Allergy Menetrier'sdisease

A Probabilistic Liquefaction Hazard Assessment for Urban Regions Based on Dynamics Analysis Considering Soil Uncertainties

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Journal of Earth Science 2021年第5期32卷 1129-1138页

作者： Jian Chen Hideyuki O-tani Tomohide takeyama Satoru Oishi Muneo Hori Japan Agency for Marine-Earth Science and Technology Yokohama 236-0001Japan RIKEN Center for Computational Science Kobe 650-0047Japan Department of Civil Engineering Kobe UniversityKobe 657-8501Japaw

Earthquake induced liquefaction is one of the main geo-disasters threating urban regions, which not only causes direct damages to buildings, but also delays both real-time disaster relief actions and reconstruction activities. It is thus important to assess liquefaction hazard of urban regions effectively and efficiently for disaster prevention and mitigation. Conventional assessment approaches rely on engineering indices such as the factor of safety(FS) against liquefaction, which cannot take into account directly the uncertainties of soils. In contrast, a physics simulation-based approach, by solving soil dynamics problems coupled with excess pore water pressure(EPWP) it is possible to model the uncertainties directly via Monte Carlo simulations. In this study, we demonstrate the capability of such an approach for assessing an urban region with over 10 000 sites. The permeability parameters are assumed to follow a base-10-lognormal distribution among 100 model analyses for each site. A dynamic simulation is conducted for each model analysis to obtain the EPWP results. Based on over 1 million EPWP analysis models, we obtained a probabilistic liquefaction assessment. Empowered by high performance computing, we present for the first time a probabilistic liquefaction hazard assessment for urban regions based on dynamics analysis, which consider soil uncertainties.

关键词： liquefaction hazard assessment soil uncertainties soil dynamics analysis automatic modeling high performance computing

Control of Snow Falling Flow around NACA0015 Blade using a Plasma Electrode with Weather Resistant Design

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Journal of Thermal Science 2022年第1期31卷 72-81页

作者： MATSUDA Hisashi CHIBA Takahiro YAGAMI Masaki TAJIMA Yusuke WATANABE Nobuyoshi SATO Hideaki takeyama Masafumi Hokkaido University of Science Hokkaido 006-8585Japan Asahi Rubber Inc. Saitama 330-0801Japan

The plasma actuation (PA) effect on the snow falling flow was investigated using a plasma electrode with weather resistant design and the natural snow wind facility of the Hokkaido University of Science. NACA0015 test blade with chord length c of 300 mm was used. Wind tunnel tests were carried out under the angle of the attack of the blade was fixed at 15 degrees, and the main flow velocity is U=5 m/s. PIV (Particle image velocimetry) measurements were conducted on various PA conditions using natural dry snowflakes as a tracer. When the actuator was driven under the condition of the fundamental frequency of F=50 kHz, and the pulsed modulated frequency f of fc/U=1 and Duty ratio (Ratio of plasma ON time to pulse duration time) =1%, movement of snowflakes was controlled the most effectively tested. It was clarified that the fundamental frequency of PA also affects the control of snow flow. Under snowfall conditions, the weather resistant designed plasma electrode has suffered no damage and operated successfully.

关键词： plasma actuator weather resistant design snow falling flow control experiment PIV

Consensus of primary care in acute pancreatitis in Japan

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World Journal of Gastroenterology 2006年第21期12卷 3314-3323页

The incidence of acute pancreatitis in Japan is increasing and ranges from 187 to 347 cases per million populations. Case fatality was 0.2% for mild to moderate, and 9.0% for severe acute pancreatitis in Japan in 2003. Experts in pancreatitis in Japan made this document focusing on the practical aspects in the early management of patients with acute pancreatitis. The correct diagnosis of acute pancreatitis and severity stratification should be made in all patients using the criteria for the diagnosis of acute pancreatitis and the multifactor scoring system proposed by the Research Committee of Intractable Diseases of the Pancreas as early as possible. All patients diagnosed with acute pancreatitis should be managed in the hospital. Monitoring of blood pressure, pulse and respiratory rate, body temperature, hourly urinary volume, and blood oxygen saturation level is essential in the management of such patients. Early vigorous intravenous hydration is of foremost importance to stabilize circulatory dynamics. Adequate pain relief with opiates is also important. In severe acute pancreatitis, prophylactic intravenous administration of antibiotics at an early stage is recommended. Administration of protease inhibitors should be initiated as soon as thediagnosis of acute pancreatitis is confirmed. A combination of enteral feeding with parenteral nutrition from early stage is recommended if there are no clear signs and symptoms of ileus and gastrointestinal bleeding. Patients with severe acute pancreatitis should be transferred to ICU as early as possible to perform special measures such as continuous regional arterial infusion of protease inhibitors and antibiotics, and continuous hemodiafiltration. The Japanese Government covers medical care expense for severe acute pancreatitis as one of the projects of Research on Measures for Intractable Diseases.

关键词： Fluid resuscitation Protease inhibitor treatment Antibiotic treatment Continuous regional arterial infusion Contrast-enhanced computed tomography

Blockade of high mobility group box-1 protein attenuates experimental severe acute pancreatitis

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World Journal of Gastroenterology 2006年第47期12卷 7666-7670页

作者： Hidehiro Sawa Takashi Ueda Yoshifumi takeyama Takeo Yasuda Makoto Shinzeki Takahiro Nakajima Yoshikazu Kuroda Department of Gastroenterological Surgery Kobe University Graduate School of Medical Sciences Kobe 650-0017 Japan Department of Surgery Kinki University School of Medicine Osaka-sayama 589-8511 Japan

AIM： To examine the effects of anti-high mobility group box 1 （HIGB1） neutralizing antibody in experimental severe acute pancreatitis （SAP）. METHODS： SAP was induced by creating closed duodenal loop inC3H/HeN mice. SAP was induced immediately after intrapedtoneal injection of anti-HMGB1 neutralizing antibody （200 pg）. Sevedty of pancreatitis, organ injury （liver, kidney and lung）, and bacterial translocation to pancreas was examined 12 h after induction of SAP. RESULTS： Anti-HHGB1 neutralizing antibody significantly improved the elevation of the serum amylase level and the histological alterations of pancreas and lung in SAR Anti-HHGB1 antibody also significantly ameliorated the elevations of serum alanine aminotransferase and creatinine in SAR However, anti-HHGB1 antibody worsened the bacterial translocation to pancreas. CONCLUSION： Blockade of HHGB1 attenuated the development of SAP and associated organ dysfunction, suggesting that HHGB1 may act as a key mediator for inflammatory response and organ injury in SAR

关键词： Severe acute pancreatitis High mobility group box-l Neutralizing antibody Inflammatory response Organ dysfunction Bacterial translocation

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