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Gastric partitioning for the treatment of malignant gastric outlet obstruction

World Journal of Gastrointestinal Oncology 2019年第12期11卷 1161-1171页

作者： Marcus Fernando kodama Pertille Ramos Leandro Cardoso Barchi Rodrigo Jose de Oliveira Marina Alessandra Pereira Donato Roberto Mucerino Ulysses Ribeiro Jr Bruno Zilberstein Ivan Cecconello Department of Gastroenterology Hospital das Clinicas HCFMUSPFaculdade de MedicinaUniversidade de Sao Paulo

BACKGROUND Gastric outlet obstruction(GOO)is one of the main complications in stage IV gastric cancer *** condition is usually managed by gastrojejunostomy(GJ).However,gastric partitioning(GP)has been described as an alternative to overcoming possible drawbacks of GJ,such as delayed gastric emptying and tumor *** To compare the outcomes of patients who underwent GP and GJ for malignant *** We retrospectively analyzed 60 patients who underwent palliative gastric bypass for unresectable distal gastric cancer with GOO from 2009 to *** clinicopathological characteristics including age,nutritional status,body mass index,and performance status were *** symptoms were graded according to GOO score(GOOS).Surgical outcomes evaluated included duration of the procedure,surgical complications,mortality,and length of hospital *** of oral diet after the procedure,weight gain,and overall survival were the long-term outcomes *** GP was performed in 30 patients and conventional GJ in the other 30 *** mean follow-up was 9.2 ***-nine(81.6%)patients died during that *** variables were similar between groups,with the exception of worse performance status in GP *** mean operative time was higher in the GP group(161.2 vs 85.2 min,P<0.001).There were no differences in postoperative complications and surgical mortality between *** median overall survival was 7 and 8.4 mo for the GP and GJ groups,respectively(P=0.610).The oral acceptance of soft solids(GOOS 2)and low residue or full diet(GOOS 3)were reached by 28(93.3%)GP patients and 22(75.9%)GJ patients(P=0.080).Multivariate analysis demonstrated that GOOS 2 and GOOS 3 were the main prognostic factors for survival(hazard ratio:8.90,95%confidence interval:3.38-23.43,P<0.001).CONCLUSION GP is a safe and effective procedure to treat *** to GJ,it provides similar surgical outcomes with a trend to better solid diet accep

关键词： Stomach neoplasms Gastric outlet obstruction Palliative surgery Gastrojejunostomy Gastric cancer

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Introduction of Music Therapy Incorporated into Cognitive Remediation: A New Approach to Cognitive Dysfunction in Psychiatric Disorders and a Preliminary Report on Its Effects in Schizophrenia

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Open Journal of Psychiatry 2019年第1期9卷 23-38页

作者： Naoko Kosugi Chiaki Oshiyama Naoki kodama Shin-Ichi Niwa Division of Healthcare Informatics Faculty of Healthcare Tokyo Healthcare University Tokyo Japan National Institute of Advanced Industrial Science and Technology (AIST) Artificial Intelligence Research Center Tokyo Japan Department of Radiological Technology Faculty of Medical Technology Niigata University of Health and Welfare Niigata Japan Department of Psychiatry Aizu Medical Center Fukushima Medical University Fukushima Japan

Aim: Cognitive dysfunction and negative symptoms interfere social participation in patients with schizophrenia. Cognitive remediation has proven effective for cognitive deficits. While there are few effective treatments for the negative symptoms of schizophrenia, music therapy is expected to ameliorate negative symptoms. With the goal of improving both cognitive dysfunction and negative symptoms, we originally developed a program of Music Therapy incorporated into Cognitive Remediation (MTCR). We introduce the MTCR program and our preliminary results of conducting MTCR in patients with schizophrenia. Methods: The program was based on the NEAR (neuropsychological educational approach to cognitive remediation) program. The MTCR program uses instrumental performances and ensemble vocal performances to train cognitive functions, which consists of 30 sessions in total, with each session being 60 minutes long (45 minutes of music, 15 minutes of verbal session). The participants attended sessions semiweekly in groups of fewer than 12 members. We measured the participants’ symptoms twice, before the intervention and after the final session. For both measurements, we used the BACS and BPRS. Thirty-six individuals (26 men, 10 women;average age of 42.4 years) with schizophrenia participated in this study. They participated in an average of 28.2 sessions. Results: BACS total scores (p Conclusions: The present study demonstrated that MTCR program can improve both cognitive dysfunction and negative symptoms of patients with schizophrenia, which implies that it can also potentially facilitate the social participation of such patients.

关键词： Schizophrenia Cognitive Remediation Music Therapy Social Participation BACS BPRS

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FRAX and Exercise: Should Exercise Be Categorized as a Risk Factor in Osteoporotic Patients

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Open Journal of Orthopedics 2013年第2期3卷 133-136页

作者： Akira Horikawa Naohisa Miyakoshi Yoichi Shimada Hiroyuki kodama Department of Orthopedic Surgery Akita University Graduate School of Medicine Akita Japan. South Akita Orthopedic Clinic Katagami Japan

Although FRAX (WHO Fracture Risk assessment Tool), developed by the WHO, is a well-validated tool for determining the probability of a major osteoporotic fracture in the next 10 years, it doesn’t include a number of other impact factors such as exercise and nutrition. The purpose of this study was to compare the differences in FRAX between subjects with and without exercise habits or intake of calcium/coffee. A significant difference in FRAX was observed between the groups with respect to exercise (p < 0.001). There were no significant differences in FRAX, however, between the groups with and without intake of calcium/coffee. Although exercise habits are not included in FRAX, our findings suggest that exercise status influenced other factors included in FRAX. Since exercise is reported to prevent falls and fall-related osteoporotic fractures, including exercise status in FRAX may be more effective for estimating the possibility of future fractures. Further investigation should be conducted to determine whether exercise status is an important risk factor, independent of FRAX, for osteoporotic fractures.

关键词： FRAX Exercise Osteoporosis

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Using LiF crystals for high-performance neutron imaging with micron-scale resolution

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High Power Laser Science and Engineering 2015年第4期3卷 1-9页

作者： A.Faenov M.Matsubayashi T.Pikuz Y.Fukuda M.Kando R.Yasuda H.Iikura T.Nojima T.Sakai M.Shiozawa R.kodama Y.Kato Institute for Academic Initiatives Suita Osaka University Joint Institute for High Temperatures Russian Academy of Sciences Quantum Beam Science Center Japan Atomic Energy Agency PPC and Graduate School of Engineering Suita Osaka University Nippon SOKEN Inc. The Graduate School for the Creation of New Photonics Industries

This paper describes an overview of our recent discovery – clear demonstration that Li F crystals can be efficiently used as a high-performance neutron imaging detector based on optically stimulated luminescence of color centers generated by neutron irradiation. It is shown that the neutron images we have obtained are almost free from granular noise, have a spatial resolution of～5.4 μm and a linear response with a dynamic range of at least 103. The high contrast and good sensitivity of Li F crystals allow us to distinguish two holes with less than 2% transmittance difference. We propose to use such detectors in areas where high spatial resolution with high image gradation resolution is needed, including diagnostics of different plasma sources such as laser and z-pinch produced plasmas.

关键词： color centers Li F crystals neutron imaging neutrons plasma diagnostics

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Long-Term Outcome of 102 Cases of Lupus Nephritis: A Single-Center Cohort Study in Japan

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International Journal of Clinical Medicine 2017年第12期8卷 668-679页

作者： Mio kodama Keiko Uchida Kazunori Karasawa Takahito Moriyama Kosaku Nitta Department of Medicine Kidney Center Tokyo Women’s Medical University Tokyo Japan

Background: The mortality rate is higher in SLE patients with lupus nephritis (LN) than in those without nephropathy. Objectives: The aim of this study was to identify the factors affecting the long-term renal outcome in 102 patients with LN. Methods: This was a retrospective cohort study. Logistic regression analysis was used in a model to determine how independent variables predicted the outcome. The survival analysis was based on the Kaplan-Meier curve with subjects censored for death. Results: The 15-year survival rate was 93.5%, and the renal function non-deterioration rate was 78.3%. No influence of individual types of immunosuppressant drugs used was found on the renal function deterioration rate. In this study, the results of analysis identified only daily urinary protein excretion level as having any significant effect on the risk of progression of LN to renal failure. Conclusions: These results suggest that remission induction therapy and maintenance therapy focused on long-term preservation of renal function need to be selected for LN patients with a high daily urinary protein value at the start of treatment and for LN patients who fail to show any reduction of the daily urinary protein excretion level to 0.5 g or less at one year after the biopsy.

关键词： Lupus Nephritis Outcome Renal Function Proteinuria Mortality

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A novel negative regulatory mechanism of Smurf2 in BMP/Smad signaling in bone

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Bone Research 2020年第4期8卷 429-438页

作者： Junichi Kushioka Takashi Kaito Rintaro Okada Hiroyuki Ishiguro Zeynep Bal Joe kodama Ryota Chijimatsu Melanie Pye Masahiro Narimatsu Jeffrey LWrana Yasumichi Inoue Hiroko Ninomiya Shin Yamamoto Takashi Saitou Hideki Yoshikawa Takeshi Imamura Department of Orthopaedic Surgery Osaka University Graduate School of Medicine2-2 YamadaokaSuitaOsaka 565-0871Japan Bone and Cartilage Regenerative Medicine The University of Tokyo7-3-1HongoBunkyo-kuTokyo 113-8655Japan Centre for Systems Biology Lunenfeld-Tanenbaum Research InstituteMount Sinai Hospital600 University AveTorontoON M5G 1X5Canada Department of Cell Signaling Graduate School of Pharmaceutical SciencesNagoya City University3-1 Tanabe-doriMizuho-kuNagoyaAichi 467-8603Japan Department of Molecular Medicine for Pathogenesis Ehime University Graduate School of Medicine454 ShitsukawaToonEhime 791-0295Japan Department of Gastroenterology and Metabology Ehime University Graduate School of Medicine454 ShitsukawaToonEhime 791-0295Japan Translational Research Center Ehime University Hospital454 ShitsukawaToonEhime 791-0295Japan

Transforming growth factor-β(TGF-β)and bone morphogenetic protein(BMP)play important roles in bone *** ubiquitination regulatory factors(Smurfs)regulate TGF-β/BMP signaling via ubiquitination,resulting in degradation of signaling molecules to prevent excessive activation of TGF-β/BMP *** Smurf2 has been shown to negatively regulate TGF-β/Smad signaling,its involvement in BMP/Smad signaling in bone metabolism has not been thoroughly *** the present study,we sought to evaluate the role of Smurf2 in BMP/Smad signaling in bone *** collagen sponges containing 3μg of recombinant human BMP2(rhBMP2)were implanted in the dorsal muscle pouches of wild type(WT)and Smurf2−/−*** rhBMP2-induced ectopic bone in Smurf2−/−mice showed greater bone mass,higher mineral apposition and bone formation rates,and greater osteoblast numbers than the ectopic bone in WT *** WT mice,the ectopic bone consisted of a thin discontinuous outer cortical shell and scant inner trabecular *** contrast,in Smurf2−/−mice,the induced bone consisted of a thick,continuous outer cortical shell and abundant inner trabecular ***,rhBMP2-stimulated bone marrow stromal cells(BMSCs)from Smurf2−/−mice showed increased osteogenic ***2 induced the ubiquitination of Smad1/***/Smad signaling was enhanced in Smurf2−/−BMSCs stimulated with rhBMP2,and the inhibition of BMP/Smad signaling suppressed osteogenic differentiation of these *** findings demonstrate that Smurf2 negatively regulates BMP/Smad signaling,thereby identifying a new regulatory mechanism in bone metabolism.

关键词： Smurf2 metabolism involvement

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Remnant gastric cancer:An ordinary primary adenocarcinoma or a tumor with its own pattern?

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World Journal of Gastrointestinal Surgery 2021年第4期13卷 366-378页

作者： Marcus Fernando kodama Pertille Ramos Marina Alessandra Pereira Andre Roncon Dias Anna Carolina Batista Dantas Daniel Jose Szor Ulysses Ribeiro Jr Bruno Zilberstein Ivan Cecconello Department of Gastroenterology Instituto do CancerHospital das Clínicas da Faculdade de Medicina da Universidade de São PauloSão PauloSão Paulo 01249000Brazil

BACKGROUND Remnant gastric cancer(RGC)is defined as a tumor that develops in the stomach after a previous gastrectomy and is generally associated with a worse ***,there little information available regarding RGCs and their prognostic factors and *** To evaluate the clinicopathological characteristics and prognosis of RGC after previous gastrectomy for benign *** Patients who underwent curative resection for primary gastric cancer(GC)at our institute between 2009 and 2019 were retrospectively *** RGC resections with histological diagnosis of gastric adenocarcinoma were enrolled in this *** proximal GC(PGC)who underwent total gastrectomy was selected as the comparison *** and pathological data were collected from a prospective medical *** A total of 41 patients with RGC and 120 PGC were *** age(P=0.001),lower body mass index(P=0.006),hemoglobin level(P<0.001),and number of resected lymph nodes resected(LN)(P<0.001)were associated with the RGC *** type,pathological tumor-node-metastasis,and perioperative morbimortality were similar between RGC and *** was no difference in disease-free survival(P=0.592)and overall survival(P=0.930)between *** status was the only independent factor related to *** RGC had similar clinicopathological characteristics to *** the lower number of resected LN,RGC had a similar prognosis.

关键词： Stomach neoplasms Gastric remnant Gastric cancer Remnant gastric cancer Peptic ulcer Gastric stump

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Immunohistochemical expression of thymidylate synthase and prognosis in gastric cancer patients submitted to fluoropyrimidine-based chemotherapy

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Chinese Journal of Cancer Research 2018年第5期30卷 526-536页

作者： Marina Alessandra Pereira Marcus Fernando kodama Pertille Ramos ANDre Roncon Dias Sheila Friedrich Faraj Cinthya dos Santos Cirqueira EvANDro Sobroza de Mello Bruno Zilberstein Venancio Avancini Ferreira Alves Ulysses Ribeiro Jr Department of Gastroenterology Cancer InstituteUniversity of Sao Paulo Medical School Department of Pathology Cancer InstituteUniversity of Sao Paulo Medical School Department of Pathology Instituto Adolfo Lutz

Objective： Adjuvant chemotherapy with 5-fluorouracil （5-FU） has been widely used in gastric cancer （GC） patients to prevent relapse after curative resection. 5-FU acts by inhibiting thymidylate synthase （TS）, and high levels of TS correlate with resistance to treatment with fluoropyfimidines. The aim of this study was to evaluate the expression of TS in GC patients, and its relation with clinicopathological characteristics and prognosis in adjuvant chemotherapy with 5-FU. Methods： We retrospectively evaluated 285 patients who underwent D2-gastrectomy with curative intent. TS expression was determined by immunohistochemistry （IHC） in tumor cells by tissue microarray （TMA）. TS level was evaluated according to the intensity and percentage of cells marked by a score system. Patients were divided in three groups according to their TS-score： negative, low and high. Results： TS expression was positive in 92.3% of GC. TS-high, TS-low and TS-negative were observed in 46.3%, 46.0% and 7.7% of patients, respectively. High-TS GC were associated with older age （P=0.007）, high neutrophil/lymphocyte ratio （P=0.048）, well/moderately differentiated histology （P=0.001）, intestinal Lauren type （P〈0.001） and absence of perineural invasion （P=0.003）. Among 285 patients, 133 stage IUIII patients （46.7%） received chemotherapy with 5-FU. In survival analysis, TS-high was associated with worse disease-free survival （DFS） in stage III GC patients who received 5-FU-based chemotherapy （P=0.007）. Multivariate analysis revealed that total gastrectomy, poorly differentiated tumors and high TS-score were associated with worse DFS in stage III GC patients. Conclusions： High TS-score in stage III GC was associated with poor DFS in patients treated with fluoropyrimidine-based chemotherapy.

关键词： Gastric cancer adjuvant therapy thymidylate synthase 5-fluorouracil-based chemotherapy

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Poorly differentiated endocrine carcinoma of the pancreas responded to gemcitabine:Case report

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World Journal of Gastroenterology 2010年第30期16卷 3853-3856页

作者： Shoichi Nakazuru Toshiyuki Yoshio Shigeki Suemura Mari Itoh Manabu Araki Chiaki Yoshioka Makiyo Ohta Yuka Sueyoshi Takashi Ohta Hiroko Hasegawa Kaori Morita Takashi Toyama Noriyoshi Kuzushita Yoshinori kodama Masayuki Mano Eiji Mita Department of Gastroenterology and Hepatology National Hos- pital OrganizationOsaka National Hospital2-1-14 HouenzakaChuo-kuOsaka CityOsaka 540-0006Japan Department of Pathology National Hospital OrganizationOsaka National Hospital2-1-14 HouenzakaChuo-kuOsaka CityOsaka 540-0006Japan

Poorly differentiated endocrine carcinoma (PDEC) of the pancreas is a rare and aggressive tumor. First-line treatment is commonly a combination of etoposide and cisplatin, but there is no consensus regarding further treatment recommendations. In this report, we describe a case of pancreatic PDEC treated with gemcitabine as third-line chemotherapy. A 62-year-old man with pancreatic PDEC was administered etoposide plus cisplatin as first-line treatment; he then received irinotecan for tumor relapse. However, because irinotecan induced ileus in this patient, we chose gemcitabine as thirdline chemotherapy. After two cycles of gemcitabine (1000 mg/m2 on days 1, 8 and 15 every 4 wk), a partialtumor response was noted by computed tomography (approximately 68% reduction in tumor size). Our patient survived for 15 mo after diagnosis. This is a rare case of unresectable pancreatic PDEC, which showed a partial response to gemcitabine after the failure of two other regimens. Gemcitabine could be an effective treatment option for pancreatic PDEC that is resistant to other treatments.

关键词： Poorly differentiated endocrine carcinoma Pancreatic endocrine tumor Gemcitabine Chemotherapy

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Influence of the period between onset of IgA nephropathy and medical intervention on renal prognosis

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Health 2011年第8期3卷 518-523页

作者： Keiko Okazaki, Yusuke Suzuki Takashi Kobayashi Fumiko kodama Satoshi Horikoshi Yasuhiko Tomino 不详

Background. The clinical course of IgA nephropathy (IgAN) is highly variable. In order to verify the necessity of early medical intervention in IgAN patients, the present study investigated the clinical impact of the duration between disease onset and first medical intervention on renal prognosis. Methods. We enrolled 57 patients diagnosed with IgAN on the basis of biopsy performed at our hospital. The medical records of these patients were traceable to the last 10 years, during which they had not undergone dialysis or treatment at any other hospital. On the basis of histological assessment of prognosis, these patients were classified according to the Japanese guidelines into the following groups: groups I, good prognosis;group II, relatively good prognosis;group III, relatively poor prognosis;and group IV, poor prognosis. We investigated the correlation between the duration of disease onset and the first consultation with a nephrologist and the rate of increase in serum creatinine over a 10 year period. In addition to the abovementioned patients, 6 patients with IgAN who underwent dialysis within the 10 years were separately evaluated. These patients came under the poor prognosis category;i.e., they belonged to group IV. Results. The duration between disease onset and medical consultation was significantly longer in younger patients or in those with asymptomatic proteinuria at onset when compared to that in older patients or in those with other urinary abnormalities. There was a significant correla tion between this duration and renal prognosis, particularly in group III patients. Although the duration between onset and consultation was not correlated to the serum creatinine level at the time of first medical intervention, urinary protein level among group IV patients at the time of first consultation was significantly higher in patients with dialysis than that in those without dialysis. Conclusions. Early medical intervention may lead to a better renal prognosis,

关键词： IgA Nephropathy Medical Intervention Diagnosis Prognosis

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