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Case Report: Asymptomatic Osteosarcoma

Case Reports in Clinical Medicine 2015年第12期4卷 369-375页

作者： Reiko Yamaguchi Seiichi Matsumoto Keisuke Ae Taisuke Tanizawa Tabu Gokita Keiko Hayakawa Yuki Funauchi Munehisa Kito hirotada ishii Noriko Motoi Department of Orthopaedic Surgery Cancer Institute Hospital Tokyo Japan ishii Orthopaedic Clinic Tokyo Japan Division of Pathology Cancer Institute Hospital Tokyo Japan

Osteosarcomas are primary malignant tumors that are characterized by the production of osteoid or immature bone. However they are the most common primary malignant tumor of bone in adolescents and young adults, the diagnosis of osteosarcoma is often delayed. It is because of the rarity of population, the variety of findings, nonspecific symptoms and so on. A 46-year-old male patient had left knee pain for 3 months without any symptoms in his right knee. At a nearby clinic, X-ray of his healthy side was taken by chance. The irregular bone formation was however seen in the metaphysis of the distal femur with spreading into the soft tissues. No abnormal findings were pointed out at his left side knee. A diagnosis of pleomorphic sarcoma was made by incisional biopsy. Pulmonary CT showed multiple nodules which were considered as multiple lung metastases. He was diagnosed as right femoral sarcoma, clinical stage IV (T1N0M1a) by TNM classification. He underwent preoperative chemotherapy, followed by limb-saving operation. No preoperative complaints were found in his left knee. Final diagnosis of surgically resected specimen was osteoblastic osteosarcoma which showed neoplastic osteoid formation within pleomorphic malignant cells. However, osteosarcomas occurred in adult populations are sometimes occurred as a secondary neoplasms, he had a history of diabetes but no other medical history, such as radiation therapy for a solid cancer, Paget’s disease, other benign bone lesions or inherited conditions. As far as our knowledge, we believe that this is a first case report of asymptomatic incidental osteosarcoma.

关键词： Incidental Osteosarcoma Asymptomatic Osteosarcoma De Novo Osteosarcoma

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Novel strategies for the treatment of inflammatory bowel disease: Selective inhibition of cytokines and adhesion molecules

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World Journal of Gastroenterology 2006年第29期12卷 4628-4635页

作者： Kazuhiko Nakamura Kuniomi Honda Takahiro Mizutani hirotada Akiho Naohiko Harada Department of Medicine and Bioregulatory Science Graduate School of Medical Sciences Kyushu UniversityFukuoka 812-8582Japan Fukuoka-Higashi Medical Center Koga 811-3195 Japan

The etiology of inflammatory bowel disease （IBD） has not yet been clarified and immunosuppressive agents which non-specifically reduce inflammation and immunity have been used in the conventional therapies for IBD. Evidence indicates that a dysregulation of mucosal immunity in the gut of IBD causes an overproduction of inflammatory cytokines and trafficking of effector leukocytes into the bowel, thus leading to an uncontrolled intestinal inflammation. Such recent advances in the understanding of the pathogenesis of IBD created a recent trend of novel biological therapies which specifically inhibit the molecules involved in the inflammatory cascade. Major targets for such treatment are inflammatory cytokines and their receptors, and adhesion molecules. A chimeric anti-TNF-α monoclonal antibody, infiiximab, has become a standard therapy for CD and it is also likely to be beneficial for UC. Several anti-TNF reagents have been developed but most of them seem to not be as efficacious as infliximab. A humanized anti-TNF monoclonal antibody, adalimumab may be useful for the treatment of patients who lost responsiveness or developed intolerance to infliximab. Antibodies against IL-12 p40 and IL-6 receptor could be alternative new anti-cytokine therapies for IBD. Antiinterferon-γ and anti-CD25 therapies were developed, but the benefit of these agents has not yet been established. The selective blocking of migration of leukocytes into intestine seems to be a nice approach. Antibodies against α4 integrin and α4β7 integrin showed benefit for IBD. Antisense oligonucleotide of intercellular adhesion molecule 1 （ICAM-1） may be efficacious for IBD. Clinical trials of such compounds have been either recently reported or are currently underway. In this article, we review the efficacy and safety of such novel biological therapies for IBD.

关键词： Inflammatory bowel disease Cytokine Adhesion molecule Treatment

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Endoscopic submucosal dissection for superficial esophageal squamous cell neoplasms

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World Journal of Gastrointestinal Pathophysiology 2012年第2期3卷 44-50页

作者： Kuniomi Honda hirotada Akiho Department of Gastroenterology Kitakyushu Municipal Medical CenterKitakyushu 802-0077Japan

Endoscopic resection is an effective treatment for noninvasive esophageal squamous cell neoplasms(ESCNs).Endoscopic mucosal resection(EMR)has been developed for small localized ESCNs as an alternative to surgical therapy because it shows similar effectiveness and is less invasive than ***,EMR is limited in resection size and therefore piecemeal resection is performed for large lesions,resulting in an imprecise histological evaluation and a high frequency of local *** submucosal dissection(ESD)has been developed in Japan as one of the standard endoscopic resection techniques for *** enables esophageal lesions,regardless of their size,to be removed en bloc and thus has a lower local recurrence rate than *** development of new devices and the establishment of optimal strategies for esophageal ESD have resulted in fewer complications such as perforation than ***,esophageal stricture after ESD may occur when the resected area is larger than three-quarters of the esophageal lumen or particularly when it encompasses the entire circumference;such a stricture requires multiple sessions of endoscopic balloon ***,oral prednisolone has been reported to be useful in preventing post-ESD *** addition,a combination of chemoradiotherapy(CRT)and ESD might be an alternative therapy for submucosal esophageal cancer that has a risk of lymph node metastasis because esophagectomy is extremely invasive;CRT has a higher local recurrence rate than esophagectomy but is less *** is likely to play a central role in the treatment of superficial esophageal squamous cell neoplasms in the future.

关键词： Endoscopic submucosal dissection Esophageal cancer Esophageal neoplasm

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Usefulness of percutaneous endoscopic gastrostomy for supportive therapy of advanced aerodigestive cancer

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World Journal of Gastrointestinal Pathophysiology 2013年第4期4卷 119-125页

作者： Haruei Ogino hirotada Akiho Department of Gastroenterology Kitakyushu Municipal Medical Center

Aerodigestive cancer, like esophageal cancer or head and neck cancer, is well known to have a poor prognosis. It is often diagnosed in the late stages, with dysphagia being the major symptom. Insufficient nutrition and lack of stimulation of the intestinal mucosa may worsen immune compromise due to toxic side effects. A poor nutritional status is a significant prognostic factor for increased mortality. Therefore, it is most important to optimize enteral nutrition in patients with aerodigestive cancer before and during treatment, as well as during palliative treatment. Percutaneous endoscopic gastrostomy(PEG) may be useful for nutritional support. However, PEG tube placement is limited by digestive tract stenosis and is an invasive endoscopic procedure with a risk of complications. There are three PEG techniques. The pull/push and introducer methods have been established as standard techniques for PEG tube placement. The modified introducer method, namely the direct method, allows for direct placement of a larger button-bumper-type catheter device. PEG tube placement using the introducer method or the direct method may be a much safer alternative than the pull/push method. PEG may be recommended in patients with aerodigestive cancer because of the improved complication rate.

关键词： Aerodigestive cancer Percutaneous endoscopic gastrostomy Direct method Introducer method Pull/push method Complications

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Low-grade inflammation plays a pivotal role in gastrointestinal dysfunction in irritable bowel syndrome

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World Journal of Gastrointestinal Pathophysiology 2010年第3期1卷 97-105页

作者： hirotada Akiho Eikichi Ihara Kazuhiko Nakamura Department of Medicine and Bioregulatory Science Graduate School of Medical SciencesKyushu University

The pathogenesis of irritable bowel syndrome (IBS) is considered to be multifactorial and includes psychosocial factors, visceral hypersensitivity, infection, microbiota and immune activation. It is becoming increasingly clear that low-grade inflammation is present in IBS patients and a number of biomarkers have emerged. This review describes the evidence for low-grade inflammation in IBS and explores its mechanism with particular focus on gastrointestinal motor dysfunction. Understanding of the immunological basis of the altered gastrointestinal motor function in IBS may lead to new therapeutic stra- tegies for IBS.

关键词： Irritable bowel syndrome Serotonin Enteri-tis Gastrointestinal motility

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A gain-of-function mutation in Msl10 triggers cell death and wound-induced hyperaccumulation of jasmonic acid in Arabidopsis

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Journal of Integrative Plant Biology 2016年第6期58卷 600-609页

作者： Yan Zou Satya Chintamanani Ping He hirotada Fukushige Liping Yu Meiyu Shao Lihuang Zhu David F.Hildebrand Xiaoyan Tang Jian-Min Zhou School of Life Science and Technology Shanghai Tech University Syngenta Biotechnology Inc.Slater Department of Biochemistry and Biophysics Institute for Plant Genomics and Biotechnology Texas A&M University Department of Agronomy Agricultural Sciences Center-Noth University of Kentucky State Key Laboratory of Plant Genomics Institute of Genetics and Developmental Biology Chinese Academy of Sciences School of Life Sciences Capital Normal University

Jasmonates（JAs） are rapidly induced after wounding and act as key regulators for wound induced signaling pathway. However, what perceives the wound signal and how that triggers JA biosynthesis remains poorly understood. To identify components involved in Arabidopsis wound and JA signaling pathway, we screened for mutants with abnormal expression of a luciferase reporter, which is under the control of a wound-responsive promoter of an ethylene response factor（ERF） transcription factor gene, RAP2.6（Related to APetala 2.6）.The rea1（RAP2.6 expresser in shoot apex） mutant constitutively expressed the RAP2.6-LUC reporter gene in young *** with the typical JA phenotypes including shorter petioles,loss of apical dominance, accumulation of anthocyanin pigments and constitutive expression of JA response gene, rea1 plants also displayed cell death and accumulated high levels of JA in response to wounding. The phenotype of rea1 mutant is caused by a gain-of-function mutation in the C-terminus of a mechanosensitive ion channel MscS-like 10（MSL10）. MSL10 is localized in the plasma membrane and is expressed predominantly in root tip, shoot apex and vascular tissues. These results suggest that MSL10 is involved in the wound-triggered early signal transduction pathway and possibly in regulating the positive feedback synthesis of JA.

关键词： Arabidopsis cell death jasmonates mechanosensitive ion channel wound

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Cytokine-induced alterations of gastrointestinal motility in gastrointestinal disorders

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World Journal of Gastrointestinal Pathophysiology 2011年第5期2卷 72-81页

作者： hirotada Akiho Eikichi Ihara Yasuaki Motomura Kazuhiko Nakamura Department of Medicine and Bioregulatory Science Graduate School of Medical SciencesKyushu University

Inflammation and immune activation in the gut are usually accompanied by alteration of gastrointestinal(GI) *** infection,changes in motor function have been linked to host defense by enhancing the expulsion of the infectious *** this review,we describe the evidence for inflammation and immune activation in GI infection,inflammatory bowel disease,ileus,achalasia,eosinophilic esophagitis,microscopic colitis,celiac disease,pseudo-obstruction and functional GI disorders. We also describe the possible mechanisms by which inflammation and immune activation in the gut affect GI *** motility disorder is a broad spectrum disturbance of GI *** several systems including central nerves,enteric nerves,interstitial cells of Cajal and smooth muscles contribute to a coordinated regulation of GI motility,smooth muscle probably plays the most important ***,we focus on the relationship between activation of cytokines induced by adaptive immune response and alteration of GI smooth muscle *** evidence has shownthat Th1 and Th2 cytokines cause hypocontractility and hypercontractility of inflamed intestinal smooth muscle. Th1 cytokines downregulate CPI-17 and L-type Ca 2+ channels and upregulate regulators of G protein signaling 4,which contributes to hypocontractility of inflamed intestinal smooth ***,Th2 cytokines cause hypercontractilty via signal transducer and activator of transcription 6 or mitogen-activated protein kinase signaling ***1 and Th2 cytokines have opposing effects on intestinal smooth muscle contraction via 5-hydroxytryptamine *** the immunological basis of altered GI motor function could lead to new therapeutic strategies for GI functional and inflammatory disorders.

关键词： Cytokine Motility Inflammation Immunology

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Safety advantage of endocut mode over endoscopic sphincterotomy for choledocholithiasis

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World Journal of Gastroenterology 2006年第13期12卷 2086-2088页

作者： hirotada Akiho Yorinobu Sumida Kazuya Akahoshi Atsuhiko Murata Jiro Ouchi Yasuaki Motomura Taisuke Toyomasu Mitsuhide Kimura Masaru Kubokawa Masahiro Matsumoto Shingo Endo Kazuhiko Nakamura Division of Gastroenterology Aso Iizuka Hospital JapanDepartment of Medicine and Bioregulatory ScienceGraduate School of Medical SciencesKyushu UniversityJapan Division of Gastroenterology Aso Iizuka Hospital Japan Division of Surgery Aso Iizuka Hospital Japan Division of Qastroenterology Aso Iizuka Hospital Japan Department of Medicine and Bioregulatory Science Graduate School of Medical Sciences Kyushu UniversityJapan

AIM： To evaluate whether an automatically controlled cut system （endocut mode） could reduce the complication rate of endoscopic sphincterotomy （EST） and serum hyperamylasemia after EST compared to the conventional blended cut mode. METHODS： From January 2001 to October 2003, 134 patients with choledocholithiasis were assigned to either endocut mode group or conventional blended cut mode group at the time of sphincterotomy. The two groups were retrospectively compared for the complications after EST and serum amylase level before and 24 h after the procedure. RESULTS： Of the 134 patients treated, 79 were assigned to conventional blended cut mode group and 55 to endocut mode group. There was no significant difference in age, sex, and serum amylase level before EST between the two groups. Complications were found in 5 patients of the endocut mode group （9%）： hyperamylasemia （5 times higher than normal） in 4 and moderate pancreatitis in 1. Complications were found in 13 patients of the conventional blended cut mode group （16%）： hyperamylasemia in 12 and moderate pancreatitis in 1. Serum amylase levels were elevated in both groups 24 h after EST （P〈0.02）. The average serum amylase level 24 h after EST in the conventional blended cut mode group was significantly higher than that in the endocut mode group （P〈 0.05）. CONCLUSION： Endocut mode offers a safety advantage over conventional blended cut mode for pancreatitis after EST by reducing hyperamylasemia.

关键词： Endocut mode Endoscopic sphincterotomy Choledocholithiasis

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Hyper-Miniaturisation of Monodisperse Janus Hydrogel Beads with Magnetic Anisotropy Based on Coagulation of Fe<sub>3</sub>O<sub>4</sub>Nanoparticles

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Journal of Materials Science and Chemical Engineering 2013年第2期1卷 1-5页

作者： Kyouhei Aketagawa hirotada Hirama Toru Torii Department of Human and Engineered Environmental Studies Graduate School of Frontier Sciences The University of Tokyo Ka-shiwa-shi Japan

We describe a simple and robust technique for fabricating monodisperse Janus hydrogel beads with magnetic anisotropy smaller than the microchannel used to produce them.

关键词： Magnetic Janus Particles Microchannels Calcium Alginate Gel Monodisperse Osmotic Pressure Coagulation

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Acute pancreatitis associated with peroral double-balloon enteroscopy: A case report

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World Journal of Gastroenterology 2006年第11期12卷 1802-1804页

作者： Kuniomi Honda Takahiro Mizutani Kazuhiko Nakamura Naomi Higuchi Kenji Kanayama Yorinobu Sumida Shigetaka Yoshinaga Soichi Itaba hirotada Akiho Ken Kawabe Yoshiyuki Arita Tetsuhide Ito Department of Medicine and Bioregulatory Science Graduate School of Medical Sciences Kyushu UniversityFukuokaJapan

A 58-year-old Japanese man had tarry stool and severe anemia. Neither upper nor lower gastrointestinal （GI） endoscopy showed any localized lesions. Thus, the source of his GI bleeding was suspected to be in the small intestine, and he underwent peroral double-balloon enteroscopy （DBE） using EN-450T5 （Fujinon-Toshiba ES System Co., Tokyo, Japan）. There were no lesions considered to be the source of GI bleeding. After the procedure, the patient began to experience abdominal pain. Laboratory tests revealed hyperamylasemia and abdominal computed tomography revealed an inflammation of the pancreas and the peripancreas. He was thus diagnosed to have acute pancreatitis. Conservative treatments resulted in both clinical and laboratory amelioration. He had no history of alcohol ingestion, gallstone disease or pancreatitis. Magnetic resonance cholangiopancreatography demonstrated no structural alterations and no stones in the pancreatobiliary ductal system. As his abdominal pain started after the procedure, his acute pancreatitis was thus thought to have been related to the peroral DBE. This is the first reported case of acute pancreatitis probably associated with peroral DBE.

关键词： Enteroscopy Small intestine Pancreatitis complication

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