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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, muscularis propria with deeper structures of the esophageal wa 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： Optical coherence tomography Esophagus Muscularis mucosa Esophageal squamous cellcarcinoma Endoscopic ultrasonography

Brain activity following esophageal acid infusion using positron emission tomography

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World Journal of Gastroenterology 2010年第43期16卷 5481-5489页

作者： Shigeyuki Kobayashi Yasuhiko Abe Manabu Tashiro Tomoyuki Koike katsunori Iijima Akira Imatani Shuichi Ohara Satoshi Watanabe Shin Fukudo Tooru Shimosegawa Division of Gastroenterology Tohoku University Graduate School of Medicine Division of Cyclotron Nuclear Medicine Cyclotron and Radioisotope Center Tohoku University Division of Behavioral Medicine Tohoku University Graduate School of Medicine

AIM: To investigate symptoms and brain activity following esophageal acid infusion. METHODS: Fifteen healthy volunteers were recruited for the study. Hydrochloric acid (pH 1 and 2) and distilled water (pH 7) were randomly and repeatedly infused into the esophagus. The brain activity was evaluated by positron emission tomography. The severity of heartburn elicited by the infusion was rated on an auditory analog scale of ***: The severity of heartburn following each infusion showed a step-wise increase with increasing acidity of the perfusate. The heartburn scores were significantly higher in the second pH 1 infusion compared with the first infusion. Acid and distilled water infusion induced activation of various brain areas such as the anterior insula, temporal gyrus, and anterior/ posterior cingulate cortex. At pH 1 or 2, in particular, activation was observed in some emotion-related brain areas such as the more anterior part of the anterior cingulate cortex, parahippocampal gyrus, or the temporal pole. Strong activation of the orbitofrontal cortex was found by subtraction analysis of the two second pH 1 infusions, with a significant increase of heartburn symptoms. CONCLUSION: Emotion-related brain areas were activated by esophageal acid stimulation. The orbitofrontal area might be involved in symptom processing, with esophageal sensitization induced by repeated acid stimulation.

关键词： Esophageal acid infusion Brain imaging Positron emission tomography

Correlation between mood and heart rate variability indices during daily life

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Health 2011年第9期3卷 553-556页

作者： Kohzoh Yoshino katsunori Matsuoka 不详

We investigated the correlation between mood and heart rate variability (HRV) indices during daily life. The RR-interval and body acceleration of 40 normal male subjects were recorded using ambulatory device for 48 to 72 hours. Every hour that the subjects were awake they registered their current mood on a Visual Analogue Scale questionnaire. The questionnaire scales eight of the subjects’ current moods. Those are happiness, tension, fatigue, worry, depression, anger, vigor, and confusion. The following four HRV indices were calculated. Those are heart rate, root mean square of successive differences of RR-interval sequence, the normalized high-frequency (0.15 - 0.4 Hz) power of RR-in- terval variability, and mean frequency in the high-frequency band of RR-interval variability. The calculated HRV indices data and the mood data were normalized individually, the data with body acceleration exceeding 30 mG were excluded from the analysis to reduce the effect of exercise, and the differences from the first day (?mood and ?HRV-index) were taken to reduce the effect of circadian rhythm. The most three highly correlated combinations were ?vigor and ?HFnu (R = –0.24, p < 0.0001), ?vigor and ?RMSSD (R = –0.24, p < 0.0001), and ?vigor and ?HR (R = 0.22, p < 0.001). Vigor exhibited the most significant correlations with HRV indices of eight moods.

关键词： Mood Autonomic Nervous System Ambulatory Heart Rate Emotion

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日本地源热泵系统应用和市场发展

暖通空调 2015年第E12期45卷 40-43页

作者： katsunori Nagano 日本北海道大学工程学研究生院

自2011年3月11日福岛核泄漏危机以来，日本民众对能源问题产生了极大的关注，同时日本政府也采取了多项行动推动可再生能源系统的利用，其中包括地源热泵（GSHP）系统。GSHP市场的年增长达到20％，并在最近几年，GSHPs已经参与很多NZEB... 详细信息

自2011年3月11日福岛核泄漏危机以来，日本民众对能源问题产生了极大的关注，同时日本政府也采取了多项行动推动可再生能源系统的利用，其中包括地源热泵（GSHP）系统。GSHP市场的年增长达到20％，并在最近几年，GSHPs已经参与很多NZEB项目。本文介绍了当前日本GSHP市场的状况和一个NZEB整合可再生能源资源的案例，包括在寒冷地区利用GSHP进行地板供暖。

关键词：地源热泵系统日本政府市场发展可再生能源资源应用 GSHP 能源问题能源系统

Geographic differences in low-dose aspirin-associated gastroduodenal mucosal injury

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World Journal of Gastroenterology 2015年第25期21卷 7709-7717页

作者： katsunori Iijima Tooru Shimosegawa Division of Gastro- enterology Tohoku University Graduate School of Medicine

Aspirin, even at low doses, has been known to cause upper gastro-intestinal complications, such as gastroduodenal ulcers, despite the definite benefits from its antithrombotic effects. Helicobacter pylori(H. pylori) is major pathogen responsible for gastroduodenal ulcerformation. There have been conflicting results about the potential interaction between these two ulcerogenic factors and the geographic areas involved. In Western countries, the prevalence of gastroduodenal ulcers is consistently higher in H. pylori-positive low-dose aspirin(LDA) users than in H. pylori-negative ones, suggesting that H. pylori infection exacerbates LDA-induced gastroduodenal mucosal injury in these geographic areas. Meanwhile, previous studies from Japan have generally reported a similar prevalence of LDA-induced gastroduodenal mucosal injury regardless of the presence of H. pylori infection, indicating that the infection is not an overall exacerbating factor for drug-induced injury. H. pylori infection could have a synergistic or antagonistic interaction with LDA use in adverse gastroduodenal events depending on gastric acid secretion. It is wellrecognized that the net effect of H. pylori infection on gastric acid secretion shows considerable geographic variation at the population level. While gastric acid secretion levels were not decreased and were wellpreserved in most patients with H. pylori infection from Western countries, the majority of Japanese patients with H. pylori infection exhibited decreased gastric acid secretion. Such large geographic differences in the net effect of H. pylori infection on gastric acid secretion could be at least partly responsible for the geographically distinct interaction between LDA use and H. pylori infection on adverse gastroduodenal lesions.

关键词： Helicobacter pylori Low-dose aspirin Gastricacid secretion Gastroduodenal ulcers Geographicvariation

Diabetes Reflect Study: Redefining Fundamental Learning of SMBG through Educational Color Tools

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International Journal of Clinical Medicine 2015年第4期6卷 227-234页

作者： katsunori Suzuki Takaaki Sato Mariko Hatta Division of Endocrinology and Metabolism Saiseikai Niigata Daini Hospital Niigata Japan Department of Nutrition Saiseikai Niigata Daini Hospital Niigata Japan

Aims: To investigate the effects of a newly developed color-coded educational glucose control instruction (COLOR), combined with a color-displayed glucose meter on changes in type-2 diabetes patient’s behavior and their HbA1c levels. Material and Methods: Patients using a COLOR-self-monitoring of blood glucose (SMBG) method were instructed to record daily blood glucose levels with red (high glucose ≥ 180 mg/dL) or blue (low glucose ≤ 70 mg/dL) colored circles on their SMBG notebooks according to the colors displayed on the glucose meter. Results: COLOR-SMBG showed an improved the actual behavior modification scores by 14% compared to Conventional group at 1-month follow-up

关键词： Color-Coded Educational Glucose Control Instruction Education SMBG Type 2 Diabetes

Quantifying the Effect of Metformin 1000 mg/day in Japanese Patients with Type 2 Diabetes

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International Journal of Clinical Medicine 2014年第15期5卷 894-901页

作者： katsunori Suzuki Taishi Yoshioka Yoko Wakui Division of Endocrinology and Metabolism Saiseikai Niigata Daini Hospital Niigata Japan

Objective: To examine the effect of high-dose metformin on glucose metabolism in Japanese patients with type 2 diabetes. Method: A total of 144 patients with type 2 diabetes who could be followed up for 6 months after their dose of metformin was increased to 1000 mg/day (from 750 mg/day or less) were examined. The dose of metformin was increased from 750 mg/day in 70 subjects (250-mg dose increase) and from 500 mg/day in 74 subjects (500-mg dose increase). Results: After the dose increased to 1000 mg/day, HbA1c was significantly decreased by 0.65% ± 0.7%, 0.42% ± 0.5%, and 0.87% ± 0.7% in all subjects, the 250-mg dose increase group, and the 500-mg dose increase group, respectively. No significant change was observed in weight. Analysis by BMI (2 and ≥25 kg/m2) revealed a comparable significant decrease in HbA1c in all subjects, the 250-mg dose increase group, and the 500-mg dose increase group. Analysis by duration of diabetes showed a significant decrease in HbA1c regardless of the duration. Conclusion: Increasing the metformin dose to 1000 mg/day showed a significant antihyperglycemic effect over 6 months in Japanese patients with type 2 diabetes. Blood glucose improved regardless of the duration of diabetes or the presence or absence of obesity. Overall tolerability was favorable.

关键词： High-Dose Metformin Type 2 Diabetes HbA1c

Tongue-like Barrett's esophagus is associated with gastroesophageal reflux disease

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World Journal of Gastroenterology 2008年第26期14卷 4196-4203页

作者： Hatsushi Yamagishi Tomoyuki Koike Shuichi Ohara Shigeyuki Kobayashi Ken Ariizumi Yasuhiko Abe katsunori Iijima Akira Imatani Yoshifumi Inomata Katsuaki Kato Daisuke Shibuya Shigemitsu Aida Tooru Shimosegawa Division of Gastroenterology Tohoku University Graduate School of MedicineSendai 980-8574Japan Miyagi Cancer Society Sendai980-0011Japan Department of Gastroenterlogy Sendai City HospitalSendai 984-8501Japan

AIM:To test this hypothesis of barrett esophagus (BE) classified into two types and to further determine if there was any correlation between the shape of endoscopically suspected esophageal metaplasia (ESEM), prevalence of reflux esophagitis (RE) and heartburn. METHODS: A total of 6504 Japanese who underwent endoscopy for their annual stomach check-up were enrolled in this study. BE was detected without histological confirmation that is ESEM. We originally classified cases of ESEM into 3 types based on its shape: Tongue-like (T type), Dome-like (D type) and Wave-like (W type) ESEM. The respective subjects were prospectively asked to complete questionnaires concerning the symptoms of heartburn, dysphagia, and abdominal pain for a one-month period. RESULTS: ESEM was observed in 10.3% of 6504 subjects (ESEM < 1 cm, 9.4%; 1 cm ≤ ESEM < 3 cm, 1.7%; ESEM ≥ 3 cm, 0.5%). The frequency of ESEM was significantly higher in males compared with female subjects. Statistical analysis showed that the prevalence of heartburn and RE were significantly higher in the T type ESEM than in the W type ESEM (P < 0.05). CONCLUSION: The T type ESEM was strongly associated with reflux symptoms and RE whereas the W type ESEM was not associated with GERD.

关键词： Tongue-like endoscopically suspectedesophageal metaplasia Dome-like endoscopicallysuspected esophageal metaplasia Wave-likeendoscopically suspected esophageal metaplasia Gastroesophageal reflux disease

Pathogenesis and risk factors for gastric cancer after Helicobacter pylori eradication

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World Journal of Gastrointestinal Oncology 2016年第9期8卷 663-672页

作者： Reina Ohba katsunori Iijima Department of Gastroenterology Akita University Graduate School of Medicine

Helicobacter pylori(***) infection was thought to be the main cause of gastric cancer,and its eradication showed improvement in gastric inflammation and dec-reased the risk of gastric ***,a number of studies reported the occurrence of gastric cancer after successful *** infected with ***,even after eradication,have a higher risk for the occurrence of gastric cancer when compared with uninfected *** gastric cancer occurs frequently following the endoscopic removal of early gastric *** data indicate that metachronous cancer leads to the occurrence of gastric cancer even after successful eradication of *** pathogenesis of this metachronous cancer remains *** research is needed to identify biomarkers to predict the development of metachronous gastric cancer and methods for gastric cancer *** this article,we review the role of the *** in carcinogenesis and the histological and endoscopic characteristics and risk factors for metachronous gastric cancer after ***,we discuss recent risk predictions and possible approaches for reducing the risk of metachro-nous gastric cancer after eradication.

关键词： Helicobacter pylori Eradication Atrophic gastritis Intestinal metaplasia Metachronous gastric cancer