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Identification of the layered morphology of the esophageal wall by optical coherence tomography

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World Journal of Gastroenterology 2009年第35期15卷 4402-4409页

作者： Satoshi Yokosawa Tomoyuki Koike Yasushi Kitagawa Waku Hatta kaname uno Yasuhiko Abe Katsunori Iijima Akira Imatani Shuichi Ohara Tooru Shimosegawa Division of Gastroenterology Tohoku University Graduate School of Medicine1-1Seiryo-machiAoba-kuSendai Miyagi 980-8574Japan

AIM:To assess each layer of the optical coherence tomography(OCT)image of the esophageal wall with reference to the histological structure. METHODS:Resected specimens of fresh pig esophagus was used as a model for the esophageal wall.We injected cyanoacrylate adhesive into the specimens to create a marker,and scanned them using a miniature OCT probe.The localization of these markers was assessed in the OCT images.Then we compared the OCT-imaged morphology with the corresponding histological section,guided by the cyanoacrylate adhesive markers.We prepared a second set of experiments using nylon sutures as markers. RESULTS:The OCT image of the esophageal specimen has a clear five-layered morphology. First,it consisted of a relatively less reflective layer; second,a more reflective layer;third,a less reflective layer;fourth,a more reflective layer;and fifth,a less reflective layer.Comparing the OCT images with marked histological sections showed that the first layer corresponded to stratified squamous epithelium; the second to lamina propria;the third to muscularis mucosa;fourth,submucosa;and fifth,muscularispropria with deeper structures of the esophageal wall.CONCLUSION:We demonstrated that the OCT image of the normal esophageal wall showed a five- layered morphology,which corresponds to histological esophageal wall components.

关键词：形态鉴定断层扫描光学相干氰基丙烯酸酯胶粘剂食道标记定位组织结构组织切片

Novel role of toll-like receptors in Helicobacter pylori-induced gastric malignancy

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World Journal of Gastroenterology 2014年第18期20卷 5244-5251页

作者： kaname uno Katsuaki Kato Tooru Shimosegawa Division of Gastroenterology Tohoku UniversityMiyagi 981-8574Japan Center of Cancer Screening Miyagi Cancer SocietyMiyagi 980-0011Japan

Helicobacter pylori(H.pylori)infects the human stomach during infancy and develops into chronic activeinflammation.The majority of H.pylori tend to colonize within the mucous gel layer of the stomach.Thestomach lacks its own immune function,thus innateimmunity as the first line of defense is vital for specificimmunity against H.pylori.We review recent discoveries in the pathophysiologic roles of toll-like receptors(TLRs),mainly TLR2 and TLR4,in H.pylori-induced inflammation.In addition,the TLR pathways activated byH.pylori-induced inflammation have been shown to beclosely associated not only with gastric carcinogenesis,but also with formation of the tumor microenvironmentthrough the production of pro-inflammatory cytokines,chemokines,and reactive oxygen species.Althoughthe correlation between single nucleotide polymorphisms of TLRs and gastric cancer risk remains unclear,a recent study demonstrated that STAT3-driven upregulation of TLR2 might promote gastric tumorigenesis independent of inflammation.Further research onthe regulation of TLRs in H.pylori-associated gastriccarcinogenesis will uncover diagnostic/predictive biomarkers and therapeutic targets for gastric cancer.

关键词： Toll like receptors Helicobacter pylori Gastric ca

Gastric cancer development after the successful eradication of Helicobacter pylori

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World Journal of Gastrointestinal Oncology 2016年第3期8卷 271-281页

作者： kaname uno Katsunori Iijima Tooru Shimosegawa Division of Gastroenterology Tohoku University Hospital

Gastric cancer(GC) develops as a result of inflammationassociated carcinogenesis due to Helicobacter pylori(H. pylori) infection and subsequent defects in genetic/epigenetic events. Although the indication for eradication therapy has become widespread, clinical studies have revealed its limited effects in decreasing the incidence of GC. Moreover, research on biopsy specimens obtained by conventional endoscopy has demonstrated the feasibility of the restoration of some genetic/epigenetic alterations in the gastric mucosa. Practically, the number of sporadic cases of primary/metachronous GC that emerge after successful eradication has increased, while on-going guidelines recommend eradication therapy for patients with chronic gastritis and those with background mucosa after endoscopic resection for GC. Accordingly, regular surveillance of numerous individuals who have received eradication therapy is recommended despite the lack of biomarkers. Recently, the focus has been on functional reversibility after successful eradication as another cue to elucidate the mechanisms of restoration as well as those of carcinogenesis in the gastric mucosa after H. pylori eradication. We demonstrated that Congo-red chromoendoscopy enabled the identification of the multifocal distribution of functionally irreversible mucosa compared with that of restored mucosa after successful eradication in individuals at extremely high risk for GC. Further research that uses functional imaging may provide new insights into the mechanisms of regeneration and carcinogenesis in the gastric mucosa post-eradication and may allow for the development of useful biomarkers.

关键词： Helicobacter pylori eradication Gastric cancer Congo-red chromoendoscopy Biomarker

Useful strategies to prevent severe stricture after endoscopic submucosal dissection for superficial esophageal neoplasm

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World Journal of Gastroenterology 2015年第23期21卷 7120-7133页

作者： kaname uno Katsunori Iijima Tomoyuki Koike Tooru Shimosegawa Division of Gastroenterology Tohoku University Hospital

The minimal invasiveness of endoscopic submucosal dissection(ESD) prompted us to apply this technique to large-size early esophageal squamous cell carcinoma and Barrett's adenocarcinoma, despite the limitationsin the study population and surveillance duration. A post-ESD ulceration of greater than three-fourths of esophageal circumference was advocated as an important risk factor for refractory strictures that require several sessions of dilation therapy. Most of the preoperative conditions are asymptomatic, but dilatation treatment for dysphagia associated with the stricture has potential risks of severe complications and a worsening of quality of life. Possible mechanisms of dysphasia were demonstrated based on dysmotility and pathological abnormalities at the site:(1) delayed mucosal healing;(2) severe inflammation and disorganized fibrosis with abundant extracellular matrices in the submucosa; and(3) atrophy in the muscularis proper. However, reports on the administration of anti-scarring agents, preventive dilation therapies, and regenerative medicine demonstrated limited success in stricture prevention, and there were discrepancies in the study designs and protocols of these reports. The development and consequent long-term assessments of new prophylactic technologies on the promotion of wound healing and control of the inflammatory/tumor microenvironment will require collaboration among various research fields because of the limited accuracy of preoperative staging and high-risk of local recurrence.

关键词： Esophageal stricture Dysphasia Endoscopicsubmucosal dissection

Characteristics of symptomatic reflux episodes in Japanese proton pump inhibitor-refractory non-erosive reflux disease patients

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World Journal of Gastroenterology 2015年第47期21卷 13352-13359页

作者： Kenichiro Nakagawa Tomoyuki Koike Katsunori Iijima Masahiro Saito Hiroki Kikuchi Waku Hatta Nobuyuki Ara kaname uno Naoki Asano Tooru Shimosegawa Division of Gastroenterology Tohoku University Graduate School of Medicine

AIM: To clarify the pathogenesis of gastroesophageal reflux disease symptoms in non-erosive reflux disease(NERD) patients.METHODS: Thirty-five NERD patients with persistent symptoms, despite taking rabeprazole 10 mg twice daily for at least 8 wk, were included in this study. All patients underwent 24 h combined impedance- p H on rabeprazole. The symptom index(SI) was considered to be positive if ≥ 50%, and proximal reflux episodes were determined when reflux reached 15 cm above the proximal margin of the lower esophageal sphincter.RESULTS: In 14(40%) SI-positive patients, with liquid weakly acid reflux, the occurrence rate of reflux symptoms was significantly more frequent in proximal reflux episodes(46.7%) than in distal ones(5.7%)(P < 0.001). With liquid acid reflux, there were no significant differences in the occurrence rate of reflux symptoms between proximal reflux episodes(38.5%) and distal ones(20.5%)(NS). With mixed liquid-gas weakly acid reflux, the occurrence rate of reflux symptoms in proximal reflux episodes was significantly more frequent(31.0%) than in distal reflux ones(3.3%)(P < 0.001). With mixed liquid-gas acid reflux, there were no significant differences in the occurrence rate of reflux symptoms between proximal reflux episodes(29.4%) and distal ones(14.3%)(NS).CONCLUSION: The proximal extent of weakly acidic liquid and mixed liquid-gas reflux is a major factor associated with reflux perception in SI-positive patients on proton pump inhibitor therapy.

关键词： Proton pump inhibitor Symptomatic refluxepisodes Proximal reflux Non-erosive reflux disease Impedance-pH monitoring

Recent development of optical coherence tomography for preoperative diagnosis of esophageal malignancies

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World Journal of Gastrointestinal Endoscopy 2015年第9期7卷 872-880页

作者： kaname uno Tomoyuki Koike Tooru Shimosegawa Division of Gastroenterology Tohoku University Hospital

Endoscopic diagnosis with histological evidence is necessary to decide the best strategy for treating esophageal squamous cell carcinoma and Barrett's-associated neoplasia, and the recent development of endoscopic technologies have made possible real-time information of malignant hallmarks. We focused on the development of optical coherence tomography(OCT), the only technology that can depict real-time cross-sectional images with high resolution. With the improvements in image resolution, acquisition rate and demonstrable area of three-dimensional devices with Doppler capability, OCT imaging was shown to enable visualization of structural/functional alterations in the mucosal/submucosal tissue of the esophagus, resulting in more accurate preoperative diagnosis of such malignancies. Moreover, it approved to be useful for targeting malignant areas for biopsy and treatment as well as for predicting the treatment effects. Therefore, further development of this technology is expected to overcome the current clinical issues in management strategies of esophageal malignancies.

关键词： Optical coherence tomography Barrett'sesophagus Esophageal squamous cell carcinoma

Role of nitric oxide in the pathogenesis of Barrett's-associated carcinogenesis

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World Journal of Gastrointestinal Pathophysiology 2016年第1期7卷 131-137页

作者： Gen Kusaka kaname uno Katsunori Iijima Tooru Shimosegawa Division of Gastroenterology Tohoku University Hospital

Barrett's esophagus(BE), a premalignant condition to Barrett's adenocarcinoma(BAC), is closely associated with chronic inflammation due to gastro-esophageal reflux. Caudal type homeobox 2(CDX2), a representative marker of BE, is increased during the metaplastic and neoplastic transformation of BE. Nitric oxide(NO) has been proposed to be a crucial mediator of Barrett's carcinogenesis. We previously demonstrated that CDX2 might be induced directly under stimulation of large amounts of NO generated around the gastroesophageal junction(GEJ) by activating epithelial growth factor receptor in a ligand-independent manner. Thus, we reviewed recent developments on the role of NO in Barrett's carcinogenesis. Notably, recent studies have reported that microbial communities in the distal esophagus are significantly different among groups with a normal esophagus, reflux esophagitis, BE or BAC, despite there being no difference in the bacterial quantity. Considering that microorganism components can be one of the major sources of large amounts of NO, these studies suggest that the bacterial composition in the distal esophagus might play an important role in regulating NO production during the carcinogenic process. Controlling an inflammatory reaction due to gastro-esophageal reflux or bacterial composition around the GEJ might help prevent the progression of Barrett's carcinogenesis by inhibiting NO production.

关键词： Barrett's esophagus Nitric oxide Epithelialgrowth factor receptor Caudal type homeobox 2 Microbiome

Evaluation of temperature dependent vortex pinning properties in strongly pinned YBa_(2)Cu_(3)O_(7-δ)thin films with Y_(2)BaCuO_(5)nanoinclusions

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Superconductivity 2024年第1期9卷 95-105页

作者： Alok K.Jha kaname Matsumoto Tomoya Horide Shrikant Saini Ataru Ichinose Paolo Mele Yutaka Yoshida Satoshi Awaji Department of Materials Science and Engineering Kyushu Institute of TechnologyTobata-kuKitakyushu 804-8550Japan Department of Mechanical and Control Engineering Kyushu Institute of TechnologyTobata-kuKitakyushu 804-8550Japan Central Research Institute of Electrical Power Industry YokosukaKanagawa 240-0196Japan College of Engineering-Innovative Global Program Shibaura Institute of TechnologyMinuma-kuSaitama 337-8570Japan Department of Energy Engineering and Science Nagoya UniversityChikusa-kuNagoya 464-8603Japan Institute for Materials Research Tohoku UniversityAoba-kuSendai 980-8577Japan

The pinning of quantized magnetic vortices in superconducting YBa_(2)Cu_(3)O_(7-δ)(YBCO or Y123)thin films with Y_(2)BaCuO_(5)(Y211)nanoinclusions have been investigated over wide temperature range(4.2-77 K).The concentration of Y211 nanoinclusions has been systematically varied inside YBCO thin films prepared by laser ablation technique using surface modified target approach.Large pinning force density values(Fp∼0.5 TNm^(−3)at 4.2 K,9 T)have been observed for the YBCO film with moderate concentration of Y211 nanoinclusions(3.6 area%on ablation target).In addition,uniform enhancement in critical current density(J_(c))was observed in the angular dependent J_(c)measurement of YBCO+Y211 nanocomposite films.Y211 nanoinclusions have been found to be very efficient in pinning the quantized vortices thereby enhancing the in‐field J_(c)values over a wide range of temperature.Increasing the concentration of Y211 secondary phase into Y123 film matrix results into agglomeration of Y211 phase and observed as increased Y211 nanoparticle size.These larger secondary phase nanoparticles are not as efficient pinning centers at lower temperatures as they are at higher temperatures due to substantial reduction of the coherence length at lower temperatures.Investigation of the temperature dependence of J_(c)for YBCO+Y211 nanocomposite films has been conducted and possible vortex pinning mechanism in these nanocomposite films has been discussed.

关键词： YBCO thin film Critical current Vortex pinning Nanoscale APCs

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MASONPRINCE——灵感办公基地

中国建筑装饰装修 2024年第7期 36-43页

作者：陈贤栋 TOMO東木筑造设计事务所

MASONPRINCE灵感基地复古经典与未来复现碰撞缠绕,空间言语,诉说时尚潮牌的叛逆基因,转换成不断移动变幻的美学感知。MASONPRINCE(MP)是中国本土的深圳品牌,秉持着“无阶时尚集体”的观念,阐述青年群体时装自由的宣言,希望以中国设计的... 详细信息

MASONPRINCE灵感基地复古经典与未来复现碰撞缠绕,空间言语,诉说时尚潮牌的叛逆基因,转换成不断移动变幻的美学感知。MASONPRINCE(MP)是中国本土的深圳品牌,秉持着“无阶时尚集体”的观念,阐述青年群体时装自由的宣言,希望以中国设计的力量,打破时装源于青年文化却归于主流与商业体系的循环。

关键词：商业体系青年群体时尚时装灵感基地