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Optimal resection of gastric bronchogenic cysts based on anatomical continuity with adherent gastric muscular layer: A case report

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World Journal of Gastrointestinal Surgery 2023年第6期15卷 1216-1223页

作者： Masayoshi Terayama Koshi Kumagai hiroshi kawachi Rie Makuuchi Masaru Hayami Satoshi Ida Manabu Ohashi Takeshi Sano Souya Nunobe Department of Gastroenterological Surgery Gastroenterological CenterCancer Institute HospitalJapanese Foundation for Cancer ResearchTokyo 135-8550Japan Department of Pathology Cancer Institute HospitalJapanese Foundation for Cancer ResearchTokyo 135-8550Japan

BACKGROUND Bronchogenic cysts are congenital lesions requiring radical resection because of malignant ***,a method for the optimal resection of these cysts has not been completely *** SUMMARY Herein,we presented three patients with bronchogenic cysts that were located adjacent to the gastric wall and resected *** cysts were detected incidentally with no symptoms and the preoperative diagnosis was challenging to obtain via radiological *** on laparoscopic findings,the cyst was attached firmly to the gastric wall and the boundary between the gastric and cyst walls was difficult to ***,resection of cysts alone caused cystic wall injury in Patient ***,the cyst was resected completely along with a part of the gastric wall in Patient *** examination revealed the final diagnosis of bronchogenic cyst and revealed that the cyst wall shared the muscular layer with the gastric wall in Patients 1 and *** Patient 3,the cyst was located adjacent to the gastric wall but histopathologically originated from diaphragm rather than *** the patients were free from *** The findings of this study state that a safe and complete resection of bronchogenic cysts required the adherent gastric muscular layer or full-thickness dissection,if bronchogenic cysts are suspected via pre-and/or intraoperative findings.

关键词： Bronchogenic cysts Laparoscopic resection Gastric wall Muscular layer Case report

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Therapeutic target for nephrotic syndrome: Identification of novel slit diaphragm associated molecules

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World Journal of Nephrology 2014年第3期3卷 77-84页

作者： Yoshiyasu Fukusumi Naoko Miyauchi Taeko Hashimoto Akira Saito hiroshi kawachi Department of Cell Biology Institute of Nephrology Niigata University Graduate School of Medical and Dental Sciences Niigata 951-8510 Japan

The slit diaphragm bridging the neighboring foot pro-cesses functions as a fnal barrier of glomerular capil-lary wall for preventing the leak of plasma proteins into primary urine. It is now accepted that the dysfunction of the sit diaphragm contributes to the development of proteinuria in several glomerular diseases. Neph-rin, a gene product of NPHS1, a gene for a congenital nephrotic syndrome of Finnish type, constitutes an ex-tracellular domain of the slit diaphragm. Podocin was identified as a gene product of NPHS2 , a gene for a familial steroid-resistant nephrotic syndrome of French. Podocin binds the cytoplasmic domain of nephrin. After then, CD2 associated protein, NEPH1 and transient re-ceptor potential-6 were also found as crucial molecules of the slit diaphragm. In order to explore other novel molecules contributing to the development of protein-uria, we performed a subtraction hybridization assay with a normal rat glomerular RNA and a glomerular RNA of rats with a puromycin aminonucleoside ne-phropathy, a mimic of a human minimal change type nephrotic syndrome. Then we have found that synaptic vesicle protein 2B, ephrin-B1 and neurexin were already downregulated at the early stage of puromycin aminonucleoside nephropathy, and that these molecules were localized close to nephrin. It is conceivable that these molecules are the slit diaphragm associated molecules, which participate in the regulation of the barrier func-tion. These molecules could be targets to establish a novel therapy for nephrotic syndrome.

关键词： Podocyte Slit diaphragm Synaptic vesicle protein 2B Ephrin-B1 Neurexin

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New application of endocytoscope for histopathological diagnosis of colorectal lesions

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World Journal of Gastrointestinal Endoscopy 2022年第8期14卷 495-501页

作者： Fumihiro Inoue Daizen Hirata Mineo Iwatate Santa Hattori Mikio Fujita Wataru Sano Tamotsu Sugai hiroshi kawachi Kazuhito Ichikawa Yasushi Sano Gastrointestinal Center and Institute of Minimally-invasive Endoscopic Care(i-MEC) Sano HospitalKobe 655-0031HyogoJapan Molecular Diagnostic Pathology Iwate Medical University School of MedicineShiwa-gun 028-3694IwateJapan Department of Pathology Cancer Institute Hospital of Japanese Foundation for Cancer ResearchKoto 135-8550TokyoJapan Department of Pathology Noda HospitalNoda 270-0237ChibaJapan

BACKGROUND The endocytoscope with ultra-high magnification(x 520)allows us to observe the cellular structure of the colon epithelium during colonoscopy,known as virtual *** hypothesized that the endocytoscope could directly observe colorectal histopathological specimens and store them as endocyto-pathological images by the endoscopists without a microscope,potentially saving the burden on *** To assess the feasibility of endocyto-pathological images taken by an endoscopist as adequate materials for histopathological *** Three gastrointestinal pathologists were invited and asked to diagnose 40 cases of endocyto-pathological images of colorectal *** case contained seven endocyto-pathological images taken by an endoscopist,consisting of one loupe image,three low-magnification images,and three ultra-high magnification *** participants chose hyperplastic polyp or low-grade adenoma for 20 cases of endocyto-pathological images(10 hyperplastic polyps,and 10 Low-grade adenomas in conventional histopathology)in study 1 and high-grade adenoma/shallow invasive cancer or deep invasive cancer for 20 cases[10 tumor in situ/T1a and 10 T1b]in study *** investigated the agreement between the histopathological diagnosis using the endocyto-pathological images and conventional histopathological *** Agreement between the endocyto-pathological and conventional histopathological diagnosis by the three gastrointestinal pathologists was 100%(95%CI:94.0%–100%)in studies 1 and *** interobserver agreement among the three gastrointestinal pathologists was 100%,and theκcoefficient was 1.00 in both *** Endocyto-pathological images were adequate and reliable materials for histopathological diagnosis.

关键词： Cancer Colon Endocytoscopy Histopathology Specimen

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Meta-analysis of lymph node metastasis in Siewert type Ⅰ and Ⅱ T1 adenocarcinomas

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World Journal of Meta-Analysis 2016年第6期4卷 118-123页

作者： Hiroki Osumi Junko Fujisaki Masami Omae Tomoki Shimizu Toshiyuki Yoshio Akiyoshi Ishiyama Toshiaki Hirasawa Tomohiro Tsuchida Yorimasa Yamamoto hiroshi kawachi Noriko Yamamoto Masahiro Igarashi Departments of Gastroenterology and Pathology Cancer Institute Hospital Japanese Foundation for Cancer Research Departments of Pathology Cancer Institute Hospital Japanese Foundation for Cancer Research

AIM To evaluate the incidence of lymph node metastasis （LNM） and its risk factors in patients with Siewert type Ⅰ and type Ⅱ pT1 *** We enrolled 85 patients [69 men, 16 women; median age （range）, 67 （38-84） years] who had undergone esophagectomy or proximal gastrectomy for Siewert type Ⅰ and type Ⅱ pT1 adenocarcinomas. Predictive risk factors of LNM included age, sex, location of the tumor center, confirmed Barrett’s esophageal adenocarcinoma, tumor size, macroscopic tumor type, pathology, invasion depth, presence of ulceration, and lymphovascular invasion. Multivariate logistic regression analysis was used to identify factors predicting LNM. We also evaluated the frequencies of LNM for Siewert type Ⅰ and type Ⅱ pT1 adenocarcinomas in meta-data *** were found in 11 out of 85 patients （12.9%, 95%CI： 5.8-20.0）. Only 1 of the 15 patients （6.6%, 95%CI： 0.0-19.2） who had a final diagnosis of pT1a adenocarcinoma had a positive LNM, whereas 10 of the 70 patients （14.2%, 95%CI： 6.0-22.4） with a final diagnosis of pT1b adenocarcinoma had positive LNM. Furthermore, only one of the 30 patients （3.3%, 95%CI： 0.0-9.7） with a tumor invasion depth within 500 μm from muscularis mucosae had positive LNM. Poor differentiation and lymphovascular invasion were independently associated with a risk of LNM. In meta-data analysis, 12 of the 355 patients （3.3%, 95%CI： 1.5-5.2） who had a final diagnosis of pT1a adenocarcinoma had a positive LNM, whereas 91 of the 438 patients （20.7%, 95%CI： 16.9-24.5） with a fnal diagnosis of pT1b adenocarcinoma had positive *** consider endoscopic submucosal dissection （ESD） is suitable for patients with Siewert type Ⅰ and type Ⅱ T1a adenocarcinomas. For patients with T1b adenocarcinoma, especially invasion depth is within 500 μm from muscularis mucosae with no other risk factor for LNM, diagnostic ESD could be a treatment option according to the overall status of patients and the presence of comorbiditi

关键词： Siewert type Ⅰ and type Ⅱ adenocarcinomas Lymph node metastasis

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雷公藤多苷对不可逆性肾小球硬化模型系膜损伤的抑制作用

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中国中药杂志 2005年第5期30卷 361-365页

作者：万毅刚孙伟清水不二雄顾刘宝铃木浩一唐泽环河内裕南京大学医学院附属鼓楼医院江苏南京210008 南京中医药大学附属医院肾科江苏南京210029 新潟大学大学院医歯学総合研究科附属肾研究施设分子病态学分野日本新潟9518510 江苏省老年医学研究所内分泌实验室江苏南京210008

目的观察雷公藤多苷(GTW)对不可逆性肾小球硬化模型系膜损伤的抑制作用,阐明其在体内延缓肾小球硬化的分子药理机制。方法运用2次注射单克隆抗体(mAb)1223的方法,建立大鼠不可逆性肾小球硬化模型,以经口灌胃GTW(50mg·kg-1BW)干预42d,... 详细信息

目的观察雷公藤多苷(GTW)对不可逆性肾小球硬化模型系膜损伤的抑制作用,阐明其在体内延缓肾小球硬化的分子药理机制。方法运用2次注射单克隆抗体(mAb)1223的方法,建立大鼠不可逆性肾小球硬化模型,以经口灌胃GTW(50mg·kg-1BW)干预42d,并设立对照组。比较24h尿蛋白排泄量(Upro)、肾功能(Scr,BUN)以及肾小球形态学(LM,IF)变化,并检测(RTPCR)模型鼠肾组织中I型胶原(collagentypeI)、转化生长因子(TGFβ)mRNA表达水平。结果GTW抑制肾小球硬化模型鼠Upro和系膜增殖。肾小球总细胞数GTW组(65.67±3.43),对照组(87.02±2.41),P<0.05;细胞外基质积分GTW组(1.20±0.06),对照组(2.77±0.23),P<0.05;α平滑肌肌动蛋白积分GTW组(1.75±0.33),对照组(2.62±0.15),P<0.05;I型胶原积分GTW组(1.68±0.31),对照组(2.06±0.24),P<0.05。GTW使肾小球硬化模型鼠肾组织中collagentypeI,TGFβmRNA表达水平下调53.5%和14.7%,与对照组比较,二者差异均有显著性(P<0.05)。结论GTW抑制肾小球硬化模型鼠Upro和系膜增殖的作用是通过减少细胞因子mRNA的表达来实现的。

关键词：肾小球硬化对照组雷公藤多苷 mRNA表达抑制作用 TGF-β Ⅰ型胶原模型不可逆性下调

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Neutrophil-mediated liver injury during hepatic ischemia-reperfusion in rats

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Hepatobiliary & Pancreatic Diseases International 2006年第3期5卷 436-442页

作者： Motomichi Sato Kanji kawachi Yuji Abe Department of Surgery Ⅱ Ehime University EhimeJapan

BACKGROUND: Neutrophil plays an important role in hepatic ischemia-reperfusion injury. We investigated neutrophil infiltration in liver tissue, Kupffer cells' role in neutrophil accumulation, and apoptosis and regeneration of hepatocytes in liver ischemia-reperfusion injury. METHODS: Vascular microclamps were placed across the pedicles of the median and left lateral lobes for 90 minutes after 30% hepatectomy with the resection of caudate, right lateral and quadrate lobes and papillary process. Gadolinium chloride (GdCl3) was used to destroy Kupffer cells. Neutrophil activity was inhibited with Urge-8, a monoclonal antibody against neutrophil produced in our laboratory. GdCl3 (10 mg/kg) and Urge-8 (50 mg/kg) were given intravenously in respective groups. Ischemia control, GdCl3 and Urge-8 groups were compared. RESULTS: Following hepatic reperfusion, serum interleukin-8 (IL-8) levels and hepatic neutrophil counts peaked at 3 hours, and peak concentrations of alanine aminotransferase (ALT) occurred at 6 hours. Animals of the control group showed increases in neutrophil infiltration in liver tissue, liver enzyme levels, and apoptosis index of hepatocytes and decreases in overall survival rate and proliferating cell nuclear antigen (PCNA) expression of hepatocytes. The survival rates and PCNA proportion of hepatocytes were higher and the levels of hepatic neutrophil infiltration, liver enzymes, and hepatocyte apoptosis after reperfusion were lower in the GdCl3 and Urge-8 groups than those in the ischemia control group. CONCLUSIONS: Blockades of Kupffer cells' activity and neutrophil infiltration by GdCl3 and Urge-8 eliminate neutrophil-mediated hepatic injury and enhance subsequent hepatic regeneration during liver ischemiareperfusion.

关键词： neutrophil liver ischemia-reper fusion injury

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Sigmoid colon endometriosis treated with laparoscopy-assisted sigmoidectomy:Significance of preoperative diagnosis

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World Journal of Gastroenterology 2007年第40期13卷 5400-5402页

作者： Motohira Yoshida Yuji Watanabe Atsushi Horiuchi Yuji Yamamoto Hiroki Sugishita Kanji kawachi Department of Organ Regenerative Surgery Ehime University Graduate School of MedicineShitsukawaToonEhime 791-0295Japan

We present a female patient with sigmoid colon endometriosis who was diagnosed correctly preoperatively and underwent minimally invasive surgery. She was admitted to our hospital with rectal bleeding and constipation. We performed several workups. Colonoscopy and endoscopic ultrasonography showed sigmoid colon stenosis caused by submucosal tumor, and magnetic resonance imaging revealed a sigmoid colon tumor displaying signal hy- pointensity on both T1- and T2-weighted imaging. However, colonoscopic ultrasonography-assisted needle aspiration biopsy could not specify tumor characteristics. From these examinations, the lesion was diagnosed as sigmoid colon endometriosis and laparoscopy-assisted sigmoidectomy was performed. Pathological diagnosis from the resected specimen was identical to preoperative diagnosis, i.e., colonic endometriosis. Since differential diagnosis of intestinal endometriosis seems difficult, a cautious preoperative diagnosis is required to select treatments including minimally invasive surgery.

关键词： Intestinal endometriosis Preoperative diagnosis Laparoscopy-assisted surgery

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Examination of in vivo mutagenicity of sodium arsenite and dimethylarsinic acid in gpt delta rats

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Journal of Environmental Sciences 2016年第11期28卷 125-130页

作者： Masaki Fujioka Min Gi Satoko kawachi Kumiko Tatsumi Naomi Ishii Kenichiro Doi Anna Kakehashi Hideki Wanibuchi Department of Molecular Pathology Osaka City University Graduate School of Medicine

Arsenic is a well-known human bladder and liver carcinogen, but its exact mechanism of carcinogenicity is not fully understood. Dimethylarsinic acid（DMAV） is a major urinary metabolite of sodium arsenite（i As~Ⅲ） and induces urinary bladder cancers in rats. DMAVand i As~Ⅲare negative in in vitro mutagenicity tests. However, their in vivo mutagenicities have not been determined. The purpose of present study is to evaluate the in vivo mutagenicities of DMAVand i As~Ⅲin rat urinary bladder epithelium and liver using gpt delta F344 ***-week old male gpt delta F344 rats were randomized into 3 groups and administered 0,92 mg/L DMAV, or 87 mg/L i As~Ⅲ（each 50 mg/L As） for 13 weeks in the drinking water. In the mutation assay, point mutations are detected in the gpt gene by 6-thioguanine selection（gpt assay） and deletion mutations are identified in the red/gam genes by Spi-selection（Spi-assay）. Results of the gpt and Spi-assays showed that DMAVand i As~Ⅲhad no effects on the mutant frequencies or mutation spectrum in urinary bladder epithelium or liver. These findings indicate that DMAVand i As~Ⅲare not mutagenic in urinary bladder epithelium or liver in rats.

关键词： Dimethylarsinic acid Sodium arsenite In vivo mutagenicity Urinary bladder epithelium gpt delta rat

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Expression of adhesion molecules on mature cholangiocytes in canal of Hering and bile ductules in wedge biopsy samples of primary biliary cirrhosis

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World Journal of Gastroenterology 2005年第28期11卷 4382-4389页

作者： Hiroaki Yokomori Masaya Oda Mariko Ogi Go Wakabayashi Shigeyuki kawachi Kazunori Yoshimura Toshihiro Nagai Masaki Kitajima Masahiko Nomura Toshifumi Hibi Department of Internal Medicine Kitasato Institute Medical Center Hospital Saitama 364-8501Japan Organized Center of Clinical Medicine International University of Health and Welfare Tokyo 107-0052Japan Laboratory of Pathology Kitasato Institute Medical Center Hospital Saitama 364-8501Japan Department of Surgery School of Medicine Keio UniversityTokyo 160-0016Japan Physiology Saitama Medical School Saitama 350-0495Japan Electron Microscopy Laboratory School of Medicine Keio UniversityTokyo 160-0016Japan Department of Internal Medicine School of Medicine Keio UniversityTokyo 160-0016Japan

AIM：To examine the expression of intercellular adhesion molecule-1 （ICAM-1） and lymphocyte function-associated antigen-1（LFA-1）expression on canals of Hering （COH）and bile ductules associated with the autoimmune process of bile duct destruction in primary biliary cirrhosis（PBC）．METHODS：Ten wedged liver biopsies of PBC（five cases each of stages 2 and 3）were studied. The liver specimens were processed for transmission electron microscopy. Immunohistochemistry was performed using anti-ICAM-1 and anti-LFA-1 mouse *** situ hybridization was done to examine the messenger RNA expression of ICAM-1 in ***-embedded sections using peptide nucleic acid probes and the catalyzed signal amplification （CSA）***-silver staining for electron microscopy was Derrormed using anti-ICAM and anti-LFA-1 mouse *** immunogold particles on epithelial cells of bileductules and cholangiocytes of CoH cells were counted and analyzed *** blotting was performed to confirm ICAM-1 protein expression．RESULTS：In liver tissues of PBC ***-stochemistry showed aberrant ICAM-1 expression on the plasma membrane of epithelial cells lining bile ductules，and also on mature cholangiocytes but not on hepatocytes in ***-1-positive lymphocytes were closely associated with epithelial cells in bile ***-1 expression at protein level was confirmed by Western *** situ hybridization demonstrated ICAM-1 mRNA expression in bile ductules and LFA-1 mRNA in lymphocytes infiltrating the *** immunoelectron microscopy，ICAM-1 was demonstrated on the basal suface of epithelial cells in bile ductules and on the luminal surfaces of cholangiocytes in damaged *** with intermediate morphology resembling progenitor cells in Coil were not labeled with ICAM-1 and LFA-1．CONCLUSION：De novo expression of ICAM-1 both on mature cholangiocytes in COH and epithelial cells in bile ductules in PBC implies that lymphocyte-indu

关键词： Primary biliary cirrhosis Canal of Hedng Small bile ductile ICAM-1 LFA-1 Immunohistochemistry Western blot Immunogold electron microscopyPrimary biliary cirrhosis Canal of Hedng Small bile ductile ICAM-1 LFA-1 Immunohistochemistry Western blot Immunogold electron microscopy

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Evaluation of prognostic factors and scoring system in colonic perforation

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World Journal of Gastroenterology 2007年第23期13卷 3228-3231页

作者： Atsushi Horiuchi Yuji Watanabe Takashi Doi Kouichi Sato Syungo Yukumi Motohira Yoshida Yuji Yamamoto Hiroki Sugishita Kanji kawachi Department of Surgery 2 Ehime University School of Medicine

AIM: To study the significance of scoring systems assessing severity and prognostic factors in patients with colonic perforation. METHODS: A total of 26 patients (9 men, 17 women; mean age 72.7 ± 11.6 years) underwent emergency operation for colorectal perforation in our institution between 1993 and 2005. Several clinical factors were measured preoperatively and 24 h postoperatively. Acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ), Mannheim peritonitis index (MPI) and peritonitis index of Altona (PIA Ⅱ) scores were calculated preoperatively. RESULTS: Overall postoperative mortality rate was 23.1% (6 patients). Compared with survivors, non- survivors displayed low blood pressure, low serum protein and high serum creatinine preoperatively, and low blood pressure, low white blood cell count, low pH, low PaO2/FiO2, and high serum creatinine postoperatively. APACHE Ⅱ score was significantly lower in survivors than in non-survivors (10.4 ± 3.84 vs 19.3 ± 2.87, P = 0.00003). Non-survivors tended to display high MPI score and low PIA Ⅱ score, but no signif icant difference was identif ied. CONCLUSION: Pre- and postoperative blood pressure and serum creatinine level appear related to prognosis of colonic perforation. APACHE Ⅱ score is most associated with prognosis and scores ≥ 20 are associated with signif icantly increased mortality rate.

关键词： Scoring system Colonic perforation Prognostic factor

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