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Autofluorescence imaging endoscopy for identifi cation and assessment of inflammatory ulcerative colitis

World Journal of Gastroenterology 2011年第46期17卷 5110-5116页

作者： Taro Osada Atsushi Arakawa Naoto Sakamoto hiroya ueyama Tomoyoshi Shibuya Tatsuo Ogihara Takashi Yao Sumio Watanabe Department of Gastroenterology Juntendo University School of Medicine Department of Human Pathology Juntendo University School of Medicine

AIM:To validate the clinical relevance of autofluores-cence imaging(AFI)endoscopy for the assessment of inflammatory ulcerative colitis(UC).METHODS:A total of 572 endoscopic images were se-lected from 42 UC patients:286 taken with white light imaging(WLI)and 286 with AFI from the same *** images were assessed for overall mucosal inflammation according to Mayo endoscopic subscore(MES),and for seven characteristic endoscopic ***,AFI photographs were scored according to relative abundance of red,green and blue color com-ponents within each image based on an RGB additive color *** and AFI endoscopic scores from the same sites were *** evaluation of biopsies was according to the Riley ***:Relative to red(r=0.52,P<0.01)or blue(r=0.56,P<0.01)color component,the green color component of AFI(r=-0.62,P<0.01)corresponded more closely with mucosal inflammation *** were signif icant differences in green color components between MES-0(0.396±0.043)and MES-1(0.340± 0.035)(P<0.01),and between MES-1 and ≥ MES-2(0.318±0.037)(P<0.01).The WLI scores for "vascu-lar patterns"(r=-0.65,P<0.01),"edema"(r=-0.62,P<0.01),histology scores for "polymorphonuclear cells in the lamina propria"(r=-0.51,P<0.01)and "crypt architectural irregularities"(r=-0.51,P<0.01)showed correlation with the green color component of *** were significant differences in green color components between limited(0.399± 0.042)and extensive(0.375±0.044)(P=0.014)polymorpho-nuclear cell inf iltration within *** the severity of the mucosal inflammation increased,the green color component of AFI *** AFI green color com-ponent was well correlated with the characteristic en-doscopic and histological inflammatory features of ***:AFI has application in detecting inflammatory lesions,including microscopic activity in the co-lonic mucosa of UC patients,based on the green color component of images.

关键词： Autofluorescence imaging endoscopy En-doscopic activity Histological activity Microscopic in-flammation Green color component

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A white opaque substance-positive gastric hyperplastic polyp with dysplasia

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World Journal of Gastroenterology 2013年第26期19卷 4262-4266页

作者： hiroya ueyama Kenshi Matsumoto Akihito Nagahara Ryosuke Gushima Takuo Hayashi Takashi Yao Sumio Watanabe Department of Gastroenterology Juntendo University School of Medicine Department of Human Pathology Juntendo University School of Medicine

The endoscopic findings of gastric hyperplastic polyps (HPs) with dysplasia have not been well-defined, and the clinical significance of these lesions, including their malignant potential, is unclear. In this report, we describe a case of a white opaque substance (WOS)positive gastric HP with dysplasia. A 76-year-old woman was referred to our hospital for endoscopic resection of a gastric HP. Upper endoscopy revealed a 25-mm whitish and reddish polypoid lesion on the greater curvature in the lower third of the stomach. The whitish part was diagnosed as a WOS using conventional and magnifying endoscopy with narrow band imaging. An examination of the biopsy specimen indicated that the lesion was a typical gastric HP. However, because of its color and the presence of a WOS, we suspected that this lesion was an atypical gastric HP. Therefore, we performed a polypectomy. Histopathologically, diffuse lowto high-grade dysplasia was found on the surface of the polyp. We performed immunohistochemical staining using a monoclonal antibody specific for adipophilin as a marker of lipid droplets (LDs). LDs were detected in approximately all of the neoplastic cells, especially in the surface epithelium of the intervening apical parts and were located in the subnuclear cytoplasm of the neoplastic cells. According to endoscopic and histopathological findings, the WOS-positive epithelium indicated dysplasia of the gastrointestinal phenotype, which could absorb lipids. The presence of a WOS in a gastric HP may be considered an endoscopic finding that is predictive of the neoplastic transformation of a gastric HP. We suggest that a WOS-positive gastric HP should be resected endoscopically to investigate its neoplastic transformation.

关键词： Gastric hyperplastic polyp with dysplasia White opaque substance Adipophilin Lipid droplet Narrow band imaging

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Clinicopathological features of alpha-fetoprotein producing early gastric cancer with enteroblastic differentiation

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World Journal of Gastroenterology 2016年第36期22卷 8203-8210页

作者： Kohei Matsumoto hiroya ueyama Kenshi Matsumoto Yoichi Akazawa Hiroyuki Komori Tsutomu Takeda Takashi Murakami Daisuke Asaoka Mariko Hojo Natsumi Tomita Akihito Nagahara Yoshiaki Kajiyama Takashi Yao Sumio Watanabe Department of Gastroenterology Juntendo University School of Medicine Department of Esophageal and Gastroenterological Surgery Juntendo University School of Medicine Department of Gastroenterology Juntendo University Shizuoka Hospital Department of Pathology Juntendo University School of Medicine

AIM To investigate clinicopathological features of early stage gastric cancer with enteroblastic differentiation(GCED).METHODS We retrospectively investigated data on 6 cases of early stage GCED and 186 cases of early stage conventional gastric cancer(CGC: well or moderately differentiated adenocarcinoma) who underwent endoscopic submucosal dissection or endoscopic mucosal resection from September 2011 to February 2015 in our *** was defined as a tumor having a primitive intestine-like structure composed of cuboidal or columnar cells with clear cytoplasm and immunohistochemical positivity for either alpha-fetoprotein, Glypican 3 or SALL4. The following were compared between GCED and CGC: age, gender, location and size of tumor, macroscopic type, ulceration, depth of invasion, lymphatic and venous invasion, positive horizontal and vertical margin, curative resection *** Six cases(5 males, 1 female; mean age 75.7 years; 6 lesions) of early gastric cancer with a GCED component and 186 cases(139 males, 47 females; mean age 72.7 years; 209 lesions) of early stage CGC were investigated. Mean tumor diameters were similar but rates of submucosal invasion, lymphatic invasion, venous invasion, and non-curative resection were higher in GCED than CGC(66.6% vs 11.4%, 33.3% vs 2.3%, 66.6% vs 0.4%, 83.3% vs 11% respectively, P < 0.01). Deep submucosal invasion was not revealed endoscopically or by preoperative biopsy. Histologically, in GCED the superficial mucosal layer was covered with a CGC component. The GCED component tended to exist in the deeper part of the mucosa to the submucosa by lymphatic and/or venous invasion, without severe stromal reaction. In addition, Glypican 3 was the most sensitive marker for GCED(positivity, 83.3%), *** Even in the early stage GCED has high malignant potential, and preoperative diagnosis is considered difficult. Endoscopists and pathologists should know the clinicopathological features of this h

关键词： Alpha-fetoprotein-producing gastric cancer Gastric cancer with enteroblastic differentiation Early gastric cancer Glypican 3 SALL4

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Symptoms of Gastro-Esophageal Reflux Disease: A Comparative Study between Elderly and Younger Patients in Japan

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Health 2014年第14期6卷 1700-1705页

作者： Mariko Hojo Akihito Nagahara Daisuke Asaoka hiroya ueyama Yuji Shimada Kenshi Matsumoto Sumio Watanabe Department of Gastroenterology School of Medicine Juntendo University Tokyo Japan

The difference in gastro-esophageal reflux disease (GERD) symptoms between elderly and younger GERD patients has not been fully studied. Our aim was to examine if there was any difference in the degree of GERD symptoms between elderly and younger patients with reflux esophagitis. Patients who were diagnosed by endoscopic examination as having reflux esophagitis and who answered the questionnaire on the frequency scale for the symptoms of GERD (FSSG) were included. Elderly and younger adult patients were defined as patients aged 65 and over or less than 65, respectively. 596 subjects were included. 184 subjects (mean 71.1 years;114 males) were classified into the Elderly group, and 412 subjects (mean 51.2 years;307 males) into the Younger group. The mean FSSG score of the Elderly and Younger groups was 6.7 and 8.4, respectively (p = 0.0024). Among those with severe esophagitis, the mean FSSG score of the Elderly and Younger groups was 8.5 and 8.7, respectively (p = 0.58). Although elderly patients tended to have less degree of GERD symptoms than younger patients, these findings suggest that there may be no significant age-related difference in complaints of GERD symptoms among severe reflux esophagitis patients.

关键词： Gastro-Esophageal Reflux Disease Reflux Esophagitis Los Angeles Classification Elderly FSSG Questionnaire

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Mallory-Weiss tear during gastric endoscopic submucosal dissection

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World Journal of Gastrointestinal Endoscopy 2011年第7期3卷 151-153页

作者： Hiroki Hongou Kuangi Fu hiroya ueyama Taiji Takahashi Tsutomu Takeda Akihisa Miyazaki Sumio Watanabe Department of Gastroenterology Juntendo University Nerima Hospital Nerima Tokyo 177-0033 Japan Department of Gastroenterology Juntendo University School of Medicine Tokyo 113-8431 Japan

A 78-year-old woman was referred to our department for treatment of an early gastric cancer. Esophagogastroduodenoscopy (EGD) demonstrated a flat elevated lesion and a polypoid lesion on the greater curvature of the antrum. Histological analysis of, endoscopic biopsy samples taken from these lesions revealed an adenocarcinoma and a hyperplastic polyp, respectively. ESD was conducted for removal of the lesions. Carbon dioxide (CO2) in- stead of room air was used for insufflation, and the patient was adequately sedated without struggling or vomiting during the treatment. No significant bleeding from the lesion was observed during ESD, but fresh blood was identified endoscopically. Surprisingly, a Mallory- Weiss tear with active bleeding was detected on the lesser curvature of the gastric corpus. A total of eight hemoclips were applied for hemostasis. Both lesions were completely removed en bloc, and no bleeding or perforation developed after ESD. Histologically, the first lesion was apapillary carcinoma limited to the mucosal layer and without lymphovascular invasion or involvement of the surgical margins, while the second lesion was a benign hyperplastic polyp.

关键词： Mallory-Weiss tear Endoscopic submucosal dissection Early gastric cancer Hemostasis Hemoclip

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A case of neuroendocrine tumor G1 with unique histopathological growth progress

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World Journal of Gastrointestinal Endoscopy 2013年第12期5卷 605-609页

作者： Misuzu Hirai Kenshi Matsumoto hiroya ueyama Hirohumi Fukushima Takashi Murakami Hitoshi Sasaki Akihito Nagahara Takashi Yao Sumio Watanabe Department of Gastroenterology Juntendo University School of Medicine Department of Human Pathology Juntendo University School of Medicine

A gastric neuroendocrine tumor(NET)is generated from deep within the tissue mucosal *** many cases,NETs are discovered as submucosal tumor(SMT)-like structures by forming a tumor *** case has a clear mucosal demarcation line and developed like a polyp.A dilated blood vessel was found on the *** mass lacked the yellow color characteristic of NETs,and a SMT-like form was ***,a nonspecific epithelial lesion was suspected and we performed endoscopy with magnifying narrowband imaging(M-NBI).However,this approach did not lead to the diagnosis,as we diagnosed the lesion as a NET by biopsy *** lesion was excised by endoscopic submucosal *** histopathological examination proved that the lesion was a polypoid lesion although it was also a NET because the tumorcells extended upward through the normal gland ducts *** our knowledge,there is no previous report of NET G1 with such unique histopathological growth progress and macroscopic appearance shown by detailed examination using endoscopy with M-NBI.

关键词： Neuroendocrine tumor G1 Demarcation line Polypoid growth Magnifying narrow-band imag-ing Submucosal tumor

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Sustainability of Monetary-cum-Exchange Rate Policy in China

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Frontiers of Economics in China-Selected Publications from Chinese Universities 2019年第4期14卷 604-628页

作者： hiroya Akiba Waseda University ShinjukuTokyo 169-8050Japan

This paper theoretically considers the long-run sustainability of China's monetary-cum-exchange rate policy under the impossible *** different models are examined:One sterilizes current net foreign assets(NFAs)and the other focuses on NFAs realized in the previous *** the de facto opening of financial flows,sterilization yields a negative risk premium in uncovered interest parity(UIP)that triggers a feedback increase among capital ***,stability depends on the magnitudes and the combination of structural and policy *** is shown that if current capital inflows are sterilized,the monetary-cum-exchange rate policy in China offers a sustainable solution for exchange rates that are relatively stringently ***,such a solution can be obtained for relatively flexible or moderately managed rates if sterilization policy is implemented on the previous period's inflows.

关键词： sustainability monetary-cum-exchange rate policy impossible trinity sterilized intervention capital inflow

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Effectiveness of impedance monitoring during radiofrequency ablation for predicting popping

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World Journal of Gastroenterology 2012年第41期18卷 5870-5878页

作者： hiroya Iida Tsukasa Aihara Shinichi Ikuta Naoki Yamanaka Department of Surgery Meiwa Hospital4-31 Agenaruo-choNishinomiyaHyogo 663-8186Japan

AIM： To retrospectively evaluate the effectiveness of impedance monitoring for predicting popping during radiofrequency ablation （RFA） using internally cooled electrodes. METHODS： We reviewed 140 patients （94 males, 46 females; age range 73.0 ＋ 11.1 year） who underwent RFA between February 2006 and November 2008 with a modified protocol using a limited power delivery rather than a conventional one to avoid popping. All the patients provided their written informed consent, and the study was approved by the institutional review board. Intraprocedural impedances were measured for the study subjects, and the tumors were classified into three types according to the characteristics of their impedance curves： increasing, flat, or decreasing. The tumors were further sorted into seven subtypes （A-G） depending on the curvature of the impedance curve＇ s increase or decrease. Relative popping rates were determined for the three types and seven subtypes. A chi-square test was performed to estimate statistical ***： A total of 148 nodules treated by RFA were analyzed. The study samples included 132 nodules of hepatocellular carcinoma, 14 nodules of metastatic liver cancer, and two nodules of intrahepatic cholangio- carcinoma. The numbers of nodules with each imped- ance curve type were as follows： 37 increasing-type nodules, 43 fiat-type nodules, and 68 decreasing-type nodules. Popping occurrence rates were 24.3%, 46.5% and 64.7%, respectively. Flat-type nodules exhibited a significantly higher rate of popping compared to increasing-type nodules （P = 0.039）. Decreasing-type nodules exhibited a significantly higher rate of popping compared to increasing-type nodules （P 〈 0.0001）. No- tably, nodules that showed a sharp decrease in imped- ance in the latter ablation period （subtype E） exhibited a significantly higher rate of popping compared to other subtypes. CONCLUSION： Intraprocedural impedance monitoring can be a useful tool to predict the occurrence of pop- ping

关键词： Radiofrequency ablation Internally cooledelectrode Popping Liver Complication

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Roles of dopaminergic receptors in bladder and erectile function at the spinal level

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Asian Journal of Andrology 2002年第4期4卷 287-290页

作者： Osamu Ishizuka hiroya Mizusawa Osamu Nishizawa Department of Urology Shinshu University School of Medicine 3-1-1 Asahi Matsumoto 390-8621 JapanDepartment of Urology Shinshu University School of Medicine 3-1-1 Asahi Matsumoto 390-8621 JapanDepartment of Urology Shinshu University School of Medicine 3-1-1 Asahi Matsumoto 390-8621 Japan

1 Introduction At the spinal level, the dopaminergic, the α1adrenergic and the neurokinin receptors play definite roles in the micturition control. From the anatomical point of view, the spinal center of micturition is located close to the center of erectile function. Recently, apomorphine is used for the treatment of erectile dysfunction and its mechanism of action is considered to be mainly through the central nervous system. 2 Dopaminergic receptors and bladder function at the spinal level

关键词： apomorphine penile erection micturition spinal cord

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Study of Unsteady Flow Simulation of Backward Impeller with Non-uniform Casing

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Journal of Thermal Science 2017年第3期26卷 208-213页

作者： War War Min Swe hiroya MORIMATSU Hidechito HAYASHI Tetsuya OKUMURA Ippei ODA Nagasaki University 1-14 Bunkyo-machiNagasaki 852-8521Japan Panasonic Ecology Systems Co. Ltd.4017 Aza Shimonakata takaki-choKasugai486-8522Japan

The flow characteristics of the centrifugal fans with different blade outlet angles are basically discussed on steady and unsteady simulations for a rectangular casing fan. The blade outlet angles of the impellers are 35° and 25° respectively. The unsteady flow behavior in the passage of the impeller 35° is quite different from that in the steady flow behavior. The large flow separation occurs in the steady flow field and unsteady flow field of the impeller 35°, the flow distribution in the circumferential direction varies remarkably and the flow separation on the blade occurs only at the back region of the fan; but the steady flow behavior in the impeller 25° is almost consistent with the unsteady flow behavior, the flow distribution of the circumferential direction doesn't vary much and the flow separation on the blade hardly occurs. When the circumferential variation of the flow in the impeller is large, the steady flow simulation is not coincident to the unsteady flow simulation.

关键词： Centrifugal fan Impeller Blade outlet angles Steady and unsteady simulation Rectangular casing

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