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Dynamic ultrasonography for optimizing treatment position in superior mesenteric artery syndrome:Two case reports and review of literature

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World Journal of Gastroenterology 2024年第5期30卷 499-508页

作者： Nobuaki Hasegawa Akihiko oka Muyiwa Awoniyi Yuri Yoshida hiroshi Tobita Norihisa Ishimura Shunji Ishihara Department of Internal Medicine II Shimane University Faculty of MedicineIzumo 693-8501ShimaneJapan Department of Gastroenterology Hepatology and NutritionDigestive Disease and Surgery InstituteHepatology SectionCleveland ClinicClevelandOH 44195United States Clinical Laboratory Division Shimane University HospitalIzumo 693-8501ShimaneJapan Division of Hepatology Shimane University HospitalIzumo 693-8501Japan

BACKGROUND Superior mesenteric artery(SMA)syndrome is a rare cause of duodenal obstruction by extrinsic compression between the SMA and the aorta(SMA-Ao).Although the left lateral recumbent position is considered effective in the treatment of SMA syndrome,individual variations in the optimal patient position have been *** this report,we present two elderly cases of SMA syndrome that exhibited rapid recovery due to ultrasonographic dynamic evaluation of the optimal position for each *** SUMMARY Case 1:A 90-year-old man with nausea and *** diagnosis of SMA syndrome by computed tomography(CT),ultrasonography(US)revealed the SMA-Ao distance in the supine position(4 mm),which slightly improved in the lateral position(5.7–7.0 mm)without the passage of duodenal ***,in the sitting position,the SMA-Ao distance was increased to 15 mm accompanied by improved content ***,US indicated enhanced passage upon abdominal massage on the right *** day 2,the patient could eat comfortably with the optimal position and *** 2:An 87-year-old woman with *** the diagnosis of SMA syndrome and aspiration pneumonia by CT,dynamic US confirmed the optimal position(SMA-Ao distance was improved to 7 mm in forward-bent position,whereas it remained at 5 mm in the supine position).By day 7 when her pneumonia recovered,she could eat with the optimal *** The optimal position for SMA syndrome varies among *** US appears to be a valuable tool in improving patient outcomes.

关键词： Superior mesenteric artery syndrome Wilkie’s syndrome Cast syndrome Aorto-mesenteric compass syndrome Ultrasonography Case report

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Comparison of PPIs and H_2-receptor antagonists plus prokinetics for dysmotility-like dyspepsia

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World Journal of Gastroenterology 2012年第13期18卷 1517-1524页

作者： Masahiro Sakaguchi Miyuki Takao Yasuo Ohyama hiroshi oka hiroshi Yamashita Takumi Fukuchi Kiyoshi Ashida Masahiro Murotani Masuyo Murotani Kazuo Majima hiroshi Morikawa Takashi Hashimoto Keisuke Kiyota Hirohiko Esaki Kanji Amemoto Gouhei Isowa Fumiyuki Takao Department of Gastroenterology Moriguchi Keijinkai HospitalMoriguchiOsaka 570-0021Japan Department of Gastroenterology Osaka Saiseikai Nakatsu HospitalOsaka 530-0012Japan Murotani Clinic KadomaOsaka 571-0008Japan Majima Clinic NeyagawaOsaka 572-0084Japan Morikawa Clinic HirakataOsaka 573-0058Japan Hashimoto Clinic MoriguchiOsaka 570-0079Japan Kiyota Clinic MatsubaraOsaka 580-0004Japan Department of Gastroenterology Arisawa General HospitalHirakataOsaka 573-1195Japan Amemoto Clinic MoriguchiOsaka 570-0021Japan Isowa Clinic NeyagawaOsaka 572-0062Japan Mii Clinic NeyagawaOsaka 572-0019Japan

AIM:To compare efficacy of proton pump inhibitors(PPIs)with H2-receptor antagonists(H2RAs)plus prokinetics(Proks)for dysmotility-like symptoms in functional dyspepsia(FD).METHODS:Subjects were randomized to receive openlabel treatment with either rabeprazole 10 mg od(n= 57)or famotidine 10 mg bid plus mosapride 5 mg tid(n=57)for 4 *** primary efficacy endpoint was change(%)from baseline in total dysmotility-like dyspepsia symptom *** secondary efficacy endpoint was patient satisfaction with ***:The improvement in dysmotility-like dyspep-sia symptom score on day 28 was significantly greater in the rabeprazole group(22.5%±29.2%of baseline) than the famotidine+mosapride group(53.2%± 58.6%of baseline,P<0.0001).The superior benefit of rabeprazole treatment after 28 d was consistent regardless of Helicobacter pylori *** more subjects in the rabeprazole group were satisfied or very satisfied with treatment on day 28 than in the famotidine+mosapride group(87.7%vs 59.6%,P= 0.0012).Rabeprazole therapy was the only significant predictor of treatment response(P<0.0001),defined as a total symptom score improvement≥50%.CONCLUSION:PPI monotherapy improves dysmotility-like symptoms significantly better than H2RAs plus Proks,and should be the treatment of first choice for Japanese FD.

关键词： H2受体拮抗剂消化不良功能障碍指数和生产者配合治疗不良症状运动

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High-grade pancreatic intraepithelial neoplasia diagnosed based on changes in magnetic resonance cholangiopancreatography findings:A case report

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World Journal of Clinical Cases 2024年第8期12卷 1487-1496页

作者： Nao Furuya Atsushi Yamaguchi Naohiro Kato Syuhei Sugata Takuro Hamada Takeshi Mizumoto Yuzuru Tamaru Ryusaku Kusunoki Toshio Kuwai Hirotaka Kouno Kazuya Kuraoka Yoshiyuki Shibata Sho Tazuma Takeshi Sudo hiroshi Kohno Shiro oka Department of Gastroenterology National Hospital Organization Kure Medical Center and Chugoku Cancer CenterKure 737-0023HiroshimaJapan Department of Gastroenterology Hiroshima University HospitalHiroshima 734-8551HiroshimaJapan Department of Pathology National Hospital Organization Kure Medical Center and Chugoku Cancer CenterKure 737-0023HiroshimaJapan Department of Surgery National Hospital Organization Kure Medical Center and Chugoku Cancer CenterKure 737-0023HiroshimaJapan

BACKGROUND High-grade pancreatic intraepithelial neoplasia(PanIN)exhibits no mass and is not detected by any examination ***,it can be diagnosed by pancreatic juice cytology from indirect *** previous cases were diagnosed based on findings of a focal stricture of the main pancreatic duct(MPD)and caudal MPD dilatation and subsequent pancreatic juice cytology using endoscopic retrograde cholangiopancreatography(ERCP).We experienced a case of high-grade PanIN with an unclear MPD over a 20-mm range,but without caudal MPD dilatation on magnetic resonance cholangiopancreatography(MRCP).CASE SUMMARY A 60-year-old female patient underwent computed tomography for a follow-up of uterine cancer post-excision,which revealed pancreatic *** revealed an unclear MPD of the pancreatic body at a 20-mm length without caudal MPD ***,course observation was *** 24 mo,MRCP revealed an increased caudal MPD caliber and a larger pancreatic *** performed ERCP and detected atypical cells suspected of adenocarcinoma by serial pancreatic juice aspiration cytology *** performed a distal pancreatectomy and obtained a histopathological diagnosis of high-grade *** parenchyma invasion was not observed,and curative resection was *** High-grade Pan-IN may cause MPD narrowing in a long range without caudal MPD dilatation.

关键词： Pancreatic cancer Pancreatic intraepithelial neoplasm High-grade pancreatic intraepithelial neoplasm Magnetic resonance cholangiopancreatography Carcinoma in situ Case report

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Superior mesenteric artery syndrome:Diagnosis and management

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World Journal of Clinical Cases 2023年第15期11卷 3369-3384页

作者： Akihiko oka Muyiwa Awoniyi Nobuaki Hasegawa Yuri Yoshida hiroshi Tobita Norihisa Ishimura Shunji Ishihara Department of Internal Medicine Ⅱ Shimane University Faculty of MedicineIzumo 693-8501ShimaneJapan Department of Gastroenterology Hepatology and NutritionDigestive Disease and Surgery InstituteHepatology SectionCleveland ClinicClevelandOH 44195United States Clinical Laboratory Division Shimane University HospitalIzumo 693-8501ShimaneJapan Division of Hepatology Shimane University HospitalIzumo 693-8501ShimaneJapan

Superior mesenteric artery(SMA)syndrome(also known as Wilkie's syndrome,cast syndrome,or aorto-mesenteric compass syndrome)is an obstruction of the duodenum caused by extrinsic compression between the SMA and the *** median age of patients is 23 years old(range 0-91 years old)and predominant in females over males with a ratio of 3:*** symptoms are variable,consisting of postprandial abdominal pain,nausea and vomiting,early satiety,anorexia,and weight loss and can mimic anorexia nervosa or functional *** recurrent vomiting leads to aspiration pneumonia or respiratory depression via metabolic alkalosis,early diagnosis is *** useful diagnostic modalities are computed tomography as a standard tool and ultrasonography,which has advantages in safety and capability of real-time assessments of SMA mobility and duodenum *** initial treatment is usually conservative,including postural change,gastroduodenal decompression,and nutrient management(success rates:70%-80%).If conservative therapy fails,surgical treatment(i.e.,laparoscopic duodenojejunostomy)is recommended(success rates:80%-100%).

关键词： Superior mesenteric artery syndrome Wilkie’s syndrome Cast syndrome Aorto-mesenteric compass syndrome

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A Radiographic Evaluation of Short Monolithic Femoral Hip Stem (SMF) for Dysplastic Osteoarthritis: Does Stem Alignment Influence on the Stability?

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Open Journal of Orthopedics 2023年第4期13卷 182-193页

作者： Kentaro Kaneko hiroshi Sunami Atsushi oka Koji Kanzaki Akihiko Maeda Mariko Asahi Atsushi Kusaba Saiji Kondo Department of Orthopaedic Surgery Showa University Fujigaoka Hospital Yokohama Japan Institute of Joint Replacement Zama General Hospital Zama Japan Department of Orthopaedic Surgery Showa University Yokohama Northern Hospital Yokohama Japan

Background: There have been a few reports of SMFTM stem for dysplastic hips. The aim of this study is to evaluate the influence of stem alignment in dysplastic femurs on the stability of the implants and on the bone reaction by means of consecutive radiographical analysis. Methods: The preoperative diagnosis is dysplastic osteoarthritis in all patients. Twenty-nine hips in 28 patients after MIS-THA were followed up for two or more years (3.5 years in average). The average age at the surgery was 60. Those who belonged to Crowe’s classification I were 19 and those of II were 10 hips. The shape of the femur was classified as Dorr’s Type A in 5, B in 21, and C in 3 hips. Results: The varus alignment of the stem was 21 hips and non-varus was 8 hips. Crowe’s Grade did not have influence on the stem alignment. The ratio of non-varus alignment was more with Dorr’s Type C than with others. Achieving rate of mediolateral fixation was significantly higher in the varus alignment than in non-varus. The significant subsidence occurred in 3 hips (10.3%) although all stems became stable within 6 months. No revision was necessary. Conclusion: The varus insertion of the stem seemed more secure also in dysplastic femurs, but even non-varus ones seemed acceptable as they brought about no severe problem. Comprehensively evaluating the result, careful selection of the patient is essential to take the advantage of and to overcome the disadvantage of this short stem for dysplastic hips.

关键词： Total Hip Arthroplasty Short Stem MIS Hip Dysplasia

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The efficacy of ma-huang-tang (maoto) against influenza

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Health 2011年第5期3卷 300-303页

作者： Mizue Saita Toshio Naito Soushin Boku Yukiko Watanabe Mai Suzuki Fukuko oka Miki Takahashi Takako Sakurai Eiichiro Sogihara Tomomi Haniu Yuki Uehara Kazunori Mitsuhashi hiroshi Fukuda hiroshi Isonuma Keiko Lee Hiroyuki Kobayashi 不详

In this study, we compared Ma Huang Tang (maoto), a traditional Japanese medicine (Kampo), with antiviral drugs to evaluate their respective and combined effect on the duration of fever and other subjective symptoms of influenza. Forty-five patients enrolled in this randomized control trial had positive type A influenza on rapid influenza antigen test, provided written consent, and sought treatment at Juntendo University Hospital between November 2008 and March 2009. Using a computer-gen- erated list, patients were randomly assigned to one of the four intervention groups: 1): maoto (TJ-27), 9 subjects;2): Tamiflu (oseltamivir), 13 subjects;3): Relenza (zanamivir), 6 subjects;and 4): maoto/oseltamivir combination, 9 subjects. Six outcome measures were evaluated, including fever, myalgia, headache, arthralgia, fatigue, and cough. Statistical differences were determined by the Bonferroni-adjusted t-test for multiple comparisons. Our results showed that there were no significant differences among the four groups in the time-course profile of fever and the number of days until fever resolution since treatment was initiated. In addition, no significant intergroup differences were detected in the number of days until resolution of myalgia, headache, fatigue, and cough. However, the maoto group reported a more rapid improvement in joint pain than the oseltamivir group (P = 0.01). In conclusion, maoto showed comparable efficacy as antiviral medications in reducing fever and influenza symptoms. As serious concerns over the indiscriminate use, adverse reactions, and resistance to current antiviral drugs continue to grow, maoto may serve as an elegant option for the treatment of influenza.

关键词： Ma Huang Tang (Maoto) Influenza Joint Pain Oseltamivir and Zanamivir

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Novel risk markers for gastric cancer screening: Present status and future prospects

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World Journal of Gastrointestinal Endoscopy 2010年第12期2卷 381-387页

作者： Shotaro Enomoto Takao Maekita hiroshi Ohata Kimihiko Yanaoka Masashi oka Masao Ichinose Second Department of Internal Medicine Wakayama Medical University

Initial identification of populations at high risk of gastric cancer (GC) is important for endoscopic screening of GC. As serum pepsinogen (PG) test-positive subjects with progression of chronic atrophic gastritis (CAG) show a high likelihood of future cancer development, this population warrants careful follow-up observation as a high-risk GC group. By combining the PG test with Helicobacter pylori (HP) antibody titers, the HP-related chronic gastritis stage can be classified, thus identifying not only a GC high-risk group but also a low-risk group. Among PG test-negative patients without CAG, those with high serum PG Ⅱ levels and HP antibody titers are thought to have severe gastric mucosal inflammation and the risk of diffuse-type GC is also high. Meanwhile, in gastric mucosae obtained by endoscopic biopsy, HP infection induces aberrant DNA methylation in CpG islands in multiple gene regions and the extent of methylation clearly correlates with GC risk. By quantifying aberrant DNA methylation in suitable gene markers, we can determine the extent of the epigenetic field for cancerization. These novel concepts and risk markers will have many clinical applications in gastrointestinal endoscopy, including more efficient endoscopic GC screening and a strategic approach to metachronous multiple GCs after endoscopic treatment.

关键词： Gastric cancer Screening Risk Pepsinogen Helicobacter pylori DNA methylation

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<i>In Vitro</i>Evaluation System of Pharmacokinetics and Irradiation Effect in Boron Neutron Capture Therapy (BNCT) Using Three-Dimensional Artificial Human Tumor Tissue Model

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Journal of Cancer Therapy 2019年第10期10卷 835-845页

作者： Shintaro Ishiyama Yoshiya Asano Minoru Suzuki Mitsuru Akashi hiroshi Shimoda Faculty of Science and Technology Graduate School of Science and Technology Hirosaki University Bunkyo Hirosaki Aomori Japan Department of Neuroanatomy Cell Biology and Histology Graduate School of Medicine Hirosaki University Zaifu Hirosaki Aomori Japan Particle Radiation Oncology Research Center Institute for Integrated Radiation and Nuclear Science Kyoto University Asahiro-Nishi Kumamori Sennan Osaka Japan Building Block Science Graduate School of Frontier Biosciences Osaka University Yamada-Oka Osaka Japan Department of Anatomical Science Graduate School of Medicine Hirosaki University Hirosaki Zaifu Hirosaki Aomori Japan

Boron neutron capture therapy (BNCT) is based on the incorporation of boron-containing drugs to cancer cells and the nuclear reaction of 10B atoms by thermal neutron irradiation results in tumor degeneration. For the development of this therapy, currently, long time and high cost consuming experiments using many animals are required. In this study, we constructed a new in vitro evaluation system for BNCT by combination of an artificial tumor tissue model, comprised of normal human dermal-derived fibroblast (NHDF) and human pancreatic cancer cell line BxPC3, and the optical plastic material CR-39 as a solid state nuclear track detector. Administration of boronophenylalanine (10BPA) as a boron-containing drug and neutron irradiation up to 2.52 × 1012 n/cm2 to the control tissue constructed by NHDF (NHDF3D) and BxPC3 cell loaded tissue (NHDF3D/BxPC3) resulted in detection of 1.6 times higher number of α-ray/recoiled Li particle tracks in NHDF3D/BxPC3 in comparison to NHDF3D, demonstrating that putative irradiation damage to cancer cells can be evaluated by this system. On a cellular level, the hit number of α-ray/recoiled Li particle tracks per single BxPC3 cells and NHDF was evaluated as 5.46 and 1.71, respectively. The tumor and normal tissue ratio (T/N ratio) was 3.19, which was corresponded with those of BPA as 2 - 4 that reported in the previous studies. This new in vitro evaluation system may provide a useful tool for a low cost, labor-saving, and non-animal method for the development of new boron-containing drugs or improvement of BNCT conditions.

关键词： Boron Neutron Capture Therapy (BNCT) Boronophenylalanine (10BPA) Artificial Human Tumor Tissue Model Cell Accumulation Method

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Adiponectin deficiency enhances colorectal carcinogenesis and liver tumor formation induced by azoxymethane in mice

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World Journal of Gastroenterology 2008年第42期14卷 6473-6480页

作者： Tamao Nishihara Miyako Baba Morihiro Matsuda Masahiro Inoue Yasuko Nishizawa Atsunori Fukuhara hiroshi Araki Shinji Kihara Tohru Funahashi Shinji Tamura Norio Hayashi Hiroyasu Iishi Iichiro Shimomura Department of Gastroenterology and Hepatology Graduate School of Medicine Osaka University 2-2 Yamada-oka Suita Osaka 565-0871 Japan Department of Pathology Osaka Medical Center for Cancer and Cardiovascular Diseases Research Institute 1-3-2 Nakamichi Higashinari-ku Osaka 537-8511 Japan Department of Metabolic Medicine Graduate School of Medicine Osaka University 2-2 Yamada-oka Suita Osaka 565-0871 Japan Department of Biochemistry Osaka MedicaCenter for Cancer and Cardiovascular Diseases ResearchInstitute 1-3-2 Nakamichi Higashinari-ku Osaka 537-8511Japan Department of Gastrointestinal Oncology Osaka Medical Center for Cancer and Cardiovascular Diseases 1-3-3 Nakamichi Higashinari-ku Osaka 537-8511 Japan

AIM:To investigate the causal relationship between hypoadiponectinemia and colorectal carcinogenesis in in vivo experimental model,and to determine the con-tribution of adiponectin defi ciency to colorectal cancer development and ***:We examined the influence of adiponectin defi ciency on colorectal carcinogenesis induced by the administration of azoxymethane(AOM)(7.5 mg/kg,in-traperitoneal injection once a week for 8 wk),by using adiponectin-knockout(KO) ***:At 53 wk after the fi rst AOM treatment,KOmice developed larger and histologically more progres-sive colorectal tumors with greater frequency com-pared with wild-type(WT) mice,although the tumor incidence was not different between WT and KO *** mice showed increased cell proliferation of colorec-tal tumor cells,which correlated with the expression levels of cyclooxygenase-2(COX-2) in the colorectal *** addition,KO mice showed higher incidence and frequency of liver tumors after AOM *** percent of WT mice developed liver tumors,and these WT mice had only a single *** contrast,50% of KO mice developed liver tumors,and 58% of these KO mice had multiple ***:Adiponectin deficiency enhances colorectal carcinogenesis and liver tumor formation induced by AOM in *** study strongly suggests that hypoadiponectinemia could be involved in the pathogenesis for colorectal cancer and liver tumor in human subjects.

关键词：结肠直肠癌细胞增殖致癌作用肝癌

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Assessment of gastroesophageal reflux disease by serodiagnosis of Helicobacter pylori-related chronic gastritis stage

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World Journal of Gastrointestinal Endoscopy 2011年第4期3卷 71-77页

作者： Shotaro Enomoto Masashi oka hiroshi Ohata Chizu Mukoubayashi Mika Watanabe Kosaku Moribata Yosuke Muraki Naoki Shingaki Hisanobu Deguchi Kazuki Ueda Izumi Inoue Takao Maekita Mikitaka Iguchi Kimihiko Yanaoka Hideyuki Tamai Mitsuhiro Fujishiro Osamu Mohara Masao Ichinose Second Department of Internal Medicine Wakayama Medical UniversityWakayama641-0012Japan Wakayama Wellness Foundation Wakayama640-8404Japan Department of Endoscopy and Endoscopic Surgery Faculty of MedicineUniversity of TokyoTokyo113-8655Japan

AIM:To evaluate the association of Helicobacter pylori(***)-related chronic gastritis stage with upper gastro-intestinal symptoms and gastro-eso-phageal reflux disease(GERD).METHODS:Subjects underwent upper gastrointestinal endoscopy,a questionnaire using a frequency scale for symptoms of GERD(FSSG),and measurements of serum ***-antibody and pepsinogen(PG)*** were classified into the following 4 groups in terms of ***-related chronic gastritis stage:Group A(n = 219),***(-)PG(-);Group B(n = 310),***(+)PG(-);Group C(n = 279),***(+)PG(+);and Group D(n = 17),***(-)PG(+).RESULTS:Reflux esophagitis occurred in 30.6% of Group A,14.5% of Group B,6.8% of Group C,and 0% of Group D(P < 0.001).Scores for acid reflux sympto-ms decreased significantly with chro-nic gastritis stage(from Group A to D)(P < 0.05),while scores for dysmotility symptoms did no-t differ *** prevalence of nonerosive reflux disease(NERD)did not differ amo-ng ***,in subjects with GERD,the prevalence of NERD tended to increase with chronic gastritis stage(P = 0.081).CONCLUSION:Acid reflux sympto-ms and the prevalen-ce of reflux esophagitis can be assessed by measuring both serum ***-antibody and PG levels.

关键词： Gastro-eso-phageal reflux disease Helicobacter pylori Pepsinogen Screening and diagnosis

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