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World Journal of Gastroenterology 2011年第21期17卷 2652-2657页

作者： Kentaro Ishii Takao Itoi Atsushi Sofuni Fumihide Itokawa Takayoshi Tsuchiya Toshio Kurihara Shujiro Tsuji Nobuhito ikeuchi Junko Umeda Fuminori Moriyasu Akihiko Tsuchida Department of Gastroenterology and Hepatology Tokyo Medical University Third Department of Surgery Tokyo Medical University

AIM:To evaluate the efficacy and safety of endoscopic removal and trimming of self-expandable metallic stents(SEMS).METHODS:All SEMS had been placed for distal biliary ***-seven endoscopic procedures were performed in 19 patients in whom SEMS(one uncovered and 18 covered) removal had been attempted,and 8 patients in whom stent trimming using argon plasma coagulation(APC) had been attempted at Tokyo Medical University *** APC settings were:voltage 60-80 W and gas flow at 1.5 L/***:The mean stent indwelling period for all patients in whom stent removal had been attempted was 113.7 ± 77.6 d(range,8-280 d).Of the 19 patients in whom removal of the SEMS had been attempted,the procedure was successful in 14(73.7%) without procedure-related adverse *** indwelling period in the stent removable group was shorter than that in the unremovable group(94.9 ± 71.5 d vs 166.2 ± 76.2 d,P = 0.08).Stent trimming was successful for all patients with one minor adverse event consisting of self-limited *** time ranged from 11 to 16 ***:Although further investigations on larger numbers of cases are necessary to accumulate evidence,the present data suggested that stent removal and stent trimming is feasible and effective for stent-related complications.

关键词： Self-expandable metallic stent Endoscopic biliary stenting Endoscopic stent removal Endoscopic stent trimming

Diffuse gastroduodenitis and pouchitis associated with ulcerative colitis

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World Journal of Gastroenterology 2006年第36期12卷 5913-5915页

作者： Hiroki ikeuchi Kazutoshi Hori Takashi Nishigami Hiroki Nakano Motoi Uchino Mitsuhiro Nakamura Nobuaki Kaibe Masafumi Noda Hidenori Yanagi Takehira Yamamura Second Department of Surgery Hyogo College of Medicine Hyogo Japan Department of Gastroenterology Hyogo College of Medicine. Hyogo Japan Second Department of Pathology Hyogo College of Medicine. Hyogo Japan

We experienced a very rare case of ulcerative colitis (UC) accompanied with analogous lesions in the stomach, duodenum, and ileal J -pouch. Ileal J-pouch anal anastomosis was performed on a 29-year old woman in 1996. Six years later, she was admitted again to our hospital because of epigastralgia, nausea, watery diarrhea and low fever. Based on the results of endoscopic examination, we diagnosed it as pouchitis. Moreover, on hypotonic duodenography, expansion of the duodenal bulb and the descending portion were poor. Kerckring folds disappeared with typical lead-pipe appearance. The pathogenesis of the gastric and duodenal lesion in this patient was similar to that of the colonic lesions of UC. For the gastroduodenal lesions in this patient, symptomatic remission was obtained following administration of crushed mesalazine tablets (1500 mg/d) for 14 d with continuous administration of omeprazole. Firstly we used ciprofloxacin to treat pouchitis. On the fifth day, she got a fever because of catheter infection. In the catheter culture, methicillin-resistant Staphylococcus aureus (MRSA) was detected. Therefore we changed ciprofloxacin to vancomycin hydrochloride (Vancomycin?). Vancomycin was very effective, and the stool frequency dramatically improved in three days. Now she continues to take mesalazine, but her condition is stable and there has been no recurrence of pouchitis.

关键词： Ulcerative colitis Pouchitis Gastroduodenal lesions

Apoptosis-inducing activity of endocrine-disrupting chemicals in cultured PC12 cells

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Advances in Biological Chemistry 2012年第2期2卷 92-105页

作者： Harue Sasaya Kazuya Yasuzumi Hiroki Maruoka Ayumi Fujita Yuichi Kato Taiki Waki Koji Shimoke Toshihiko ikeuchi Department of Life Science and Biotechnology Faculty of Chemistry Materials and Bioengineering and Strategic Research Base Kansai University Osaka Japan Technology Research Laboratory Kurabo Industries Ltd. Osaka Japan

Endocrine-disrupting chemicals (EDCs) are known to exert estrogen-like effects that are similar to those made by naturally produced hormones or by inhibition of the receptors in the cell receiving the hormones. Recently, several reports have indicated that EDCs can affect the developing central nervous system. In our current study, we report that some EDCs induce apoptosis in cultured PC12 cells and can be classified into three groups. Bisphenol A (BPA), p-nonylphenol (NP) and tributyltin chloride (TBT) were found to induce endoplasmic reticulum (ER) stress-associated apoptosis and activate the unfolded protein response (UPR) system, whereas benomyl (beno) induced non-ER stress-associated apoptosis. The half-maximal apoptosis-inducing concentrations (IC50) of these EDCs were 160 μM for BPA, 25.6 μM for NP, 640 nM for TBT and 48 μM for beno. Although these concentrations are higher than those found in the environment, some EDCs may have apoptotic effects on various cells in the body, including neurons, through their accumulation in the body over time or condensation through the food chain. On the other hand, benzopyrene, fenvalerate, styrene monomer and bis(2-ethylhexyl)phthalate did not induce apoptosis in PC12 cells. We analyzed also whether apoptosis-inducing EDCs had an estrogen-like effect on cultured PC12 cells transfected with a luciferase reporter plasmid, the activity of which is dependent on estrogen receptor α. We found that BPA had an estrogen-like effect (EC50 = 5.9 μM) but that NP, TBT and beno did not in transfected PC12 cells. These results suggest that BPA may predomi-nantly exert estrogenic effects, but others may pre-dominantly have apoptosis-inducing effects on cells in the body exposed to a polluted environment.

关键词： Endocrine-Disrupting Chemicals ER Stress Apoptosis Estrogen Receptor PC12 Cells

Prognosis of cancer with branch duct type IPMN of the pancreas

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World Journal of Gastroenterology 2010年第15期16卷 1890-1895页

作者： Nobuhito ikeuchi Takao Itoi Atsushi Sofuni Fumihide Itokawa Takayoshi Tsuchiya Toshio Kurihara Kentaro Ishii Shujiro Tsuji Junko Umeda Fuminori Moriyasu Akihiko Tsuchida Kazuhiko Kasuya Department of Gastroenterology and Hepatology Tokyo Medical University Department of Surgery Tokyo Medical University

AIM:To examine the coexistence of metachronous and synchronous cancer in branch duct intraductal papillary mucinous neoplasms of the pancreas (IPMN).METHODS: We reviewed the records of 145 patients with branch duct IPMN between January 1991 and April 2008 and assessed the relationship between IPMN and intraor extra-pancreatic carcinoma and the outcome of ***: The mean observation period was 55.9 ± 45.3 mo. Among the 145 patients, the frequency of extra-pancreatic cancer was 29.0%. The frequency of gastric cancer, colon cancer, breast cancer, and pan-creatic cancer were 25.5%, 15.7%, 13.7%, and 9.8%, respectively. Twenty (13.8%) of the patients died. The cause of death was extra-pancreatic carcinoma in 40%,pancreatic cancer in 25%, IPMN per se in 20%, and benign disease in 15% of the ***: The prognosis for IPMN depends not on the IPMN per se, but on the presence of intraor extra-pancreatic cancer.

关键词： Intraductal papillary mucinous neoplasms of the pancreas Long-term follow-up Extra-pancreatic cancer Pancreatic cancer Prognosis

Evaluating “Cosmetic Therapy” by Using Near-Infrared Spectroscopy

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World Journal of Neuroscience 2014年第2期4卷 194-201页

作者： Mayumi ikeuchi Keishi Saruwatari Yumi Takada Mika Shimoda Ayako Nakashima Masao Inoue Takashige Oroguchi Naoaki Ishii Fumihito Yoshii Munetaka Haida Department of Neurology Tokai University School of Medicine Kanagawa Japan Department of Nursing Tokai University School of Health Sciences Kanagawa Japan Kanebo Cosmetics Inc. Beauty Research Laboratory Tokyo Japan Kanebo Cosmetics Inc. Innovative Beauty Science Laboratory Kanagawa Japan Life Care Center Tokai University School of Medicine Kanagawa Japan SHIMADZU CORPORATION Market Development Group Tokyo Japan Tokai University Junior College of Nursing and Medical Technology Kanagawa Japan

This study examined the effect of cosmetic therapy on frontal lobe activation as revealed by topographic near-infrared spectroscopy (NIRS). We evaluated emotional responses to a photograph of a face with/without makeup by 22 healthy female volunteers (mean age, 52 ± 10.5 years). The results of the first-round analysis showed a significant increase of oxy-Hb in the frontal lobe area when the subject looked at a photograph of herself made up as compared to not made up. In a later round of analysis, we divided the subjects into 2 groups having contrasting scores on the Profile of Mood States-Short Form Japanese version. One group was classed as “high vigor” (a common standard pattern) and the other as “low vigor” (depression-tendency pattern). The made-up/not made-up difference did not have any effect on the oxy-Hb level in the frontal lobe in the high vigor group. In contrast, makeup produced a significant increase in the oxy-Hb level over a wide frontal area in the low vigor group, which indicated widespread frontal lobe activation. This result indicates a beneficial effect of cosmetic therapy on the brain function of patients with depression and/ or dementia.

关键词： NIRS Frontal Lobe Cosmetic Therapy Depression Emotion POMS

Transnasal endoscopic biliary drainage as a rescue management for the treatment of acute cholangitis

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World Journal of Gastrointestinal Endoscopy 2010年第2期2卷 50-53页

作者： Takao Itoi Atushi Sofuni Fumihide Itokawa Takayoshi Tsuchiya Toshio Kurihara Kentaro Ishii Shujiro Tsuji Nobuhito ikeuchi Fuminori Moriyasu Department of Gastroenterology and Hepatology Tokyo Medical University

Endoscopic biliary drainage has been established to provide effective treatment for acute obstructive jaundice and cholangitis. A recently developed ultrathin transnasal videoendoscope (TNE) is minimally invasive even for critically ill patients and can be performed without conscious sedation. Transnasal endoscopic biliary drainage (TNE-BD) is performed using a frontviewing TNE with approximately 5 mm outer diameter and 2 mm working channel diameter. Finally, 5F nasobiliary tube or plastic stent are placed. Technical success rates are approximately 100% and 70% for postendoscopic sphincterotomy or placement of self-expandable metallic stent, and intact papilla, respectively. There are no serious complications. In conclusion, although further cases should be accumulated, TNEBD and in particular, one-step naso-biliary drainage using TNE may be a useful and novel technique for the treatment of acute cholangitis.

关键词： Transnasal endoscope Ultrathin endoscope Biliary drainage

PVA作为黏膜黏附口颊片中黏膜黏附聚合物的评价

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中国医药工业杂志 2017年第8期48卷 1154-1154页

作者： ikeuchi-Takahashi Y 王盈

评价了聚乙烯醇（PVA）作为黏膜黏附聚合物在直接压片法制备吲哚美辛黏膜黏附口颊片中的可用性。采用不同聚合度和粒径的PVA制备口颊片，并考察其拉伸强度、体外黏附力和吸水性。结果显示含中等黏度、小粒径PVA的片剂具有最大的拉伸强... 详细信息

评价了聚乙烯醇（PVA）作为黏膜黏附聚合物在直接压片法制备吲哚美辛黏膜黏附口颊片中的可用性。采用不同聚合度和粒径的PVA制备口颊片，并考察其拉伸强度、体外黏附力和吸水性。结果显示含中等黏度、小粒径PVA的片剂具有最大的拉伸强度。通过析因设计分析法优化得到了PVA的规格参数，用该优化PVA以直接压片法制备黏膜黏附口颊片，并与采用羧乙烯基聚合物和羟丙纤维素为黏膜黏附聚合物制备的口颊片进行比较。结果显示，含优化PVA的片剂黏附力最高、黏度较低、药物释放相对较快；含羧乙烯基聚合物的片剂拉伸强度最火，但崩解速度快；而含较高浓度羟丙纤维素的片剂黏附性能良好，但崩解时间很长。

关键词：聚合物制备黏附力 PVA 黏膜评价乙烯基聚合物拉伸强度崩解时间

Ⅰ期重建性结肠直肠切除术治疗溃疡性结肠炎的安全性

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世界核心医学期刊文摘（胃肠病学分册） 2005年第12期1卷 14-15页

作者： ikeuchi H. Nakano H. Uchino M. 赵萌 1- 1 Mukogawa- cyo Nisinomiya Hyogo 663- 8501 Japan Dr.

PURPOSE: The aim of this study was to compare clinical outcomes in patients with ulcerative colitis who underwent restorative proctocolectomy with and without diverting ileostomy. METHODS: A series of 245 consecutive patients who underwent ileal pouch anal anastomosis with mucosectomy with an ultrasonically activated scalpel (harmonic scalpel) was studied. Of these patients, 92 patients had a diverting ileostomy and 150 selected patients did not. The decision for or against an ileostomy was made at the end of the operation. RESULTS: Twelve patients (8 percent) in the group without ileostomy had pouch- related complications, which necessitated secondary ileostomy in five patients (3.3 percent). Intestinal obstruction developed in 17 patients (11.3 percent) who had no ileostomy and in 12 patients (13.0 percent) who underwent ileostomy. Two of 17 patients who had no ileostomy and 1 of 12 patients with ileostomy required laparotomy with division of adhesions, whereas the remaining patients responded to conservative measures. There were no significant differences in the incidence of postoperative complications after the initial operation between the two groups. In the group with ileostomy, the morbidity rate for ileostomy was 12.1 percent, and that for ileostomy closure was 18.7 percent. The total postoperative complication rate for the group with ileostomy was significant higher than that for the group without ileostomy. CONCLUSION: We conclude that restorative proctocolectomy with mucosectomy by use of an ultrasonically activated scalpel and without diversion is a superior therapeutic choice for selected patients.

关键词：结肠直肠切除术回肠造口术溃疡性结肠炎回肠贮袋肠梗阻病例粘连松解术超声刀道性并发症率剥除术

Prospective postsurgical capsule endoscopy in patients with Crohn's disease

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World Journal of Gastrointestinal Endoscopy 2014年第3期6卷 88-98页

作者： Tomoaki Kono Nobuyuki Hida Koji Nogami Masaki Iimuro Yoshio Ohda Yoko Yokoyama Koji Kamikozuru Katsuyuki Tozawa Mikio Kawai Tomohiro Ogawa Kazutoshi Hori Hiroki ikeuchi Hiroto Miwa Shiro Nakamura Takayuki Matsumoto Department of Lower Gastroenterology Hyogo College of Medicine Department of Surgery Hyogo College of Medicine Department of Upper Gastroenterology Hyogo College of Medicine

AIM: To clarify the usefulness of postsurgical capsule endoscopy(CE) in the diagnosis of recurrent small bowel lesions of Crohn's disease(CD). METHODS: This prospective study included 19 patients who underwent ileocolectomy or partial ileal resection for CD. CE was performed 2-3 wk after surgery to check for the presence/absence and severity of lesions remaining in the small bowel, and for any recurrence at the anastomosed area. CE was repeated 6-8 mo after surgery and the findings were compared with those obtained shortly after surgery. The Lewis score (LS) was used to evaluate any inflammatory changes of the small bowel. RESULTS: One patient was excluded from analysis because of insufficient endoscopy data at the initial CE. The total LS shortly after surgery was 428.3 on average(median, 174; range, 8-4264), and was ≥ 135(active stage) in 78%(14 of 18) of the patients. When the remaining unresected small bowel was divided into 3 equal portions according to the transition time(proximal, middle, and distal tertiles), the mean LS was 286.6, 83.0, and 146.7, respectively, without any significant difference. Ulcerous lesions in the anastomosed area were observed in 83% of all patients. In 38% of the 13 patients who could undergo CE again after 6-8 mo, the total LS was higher by ≥ 100 than that recorded shortly after surgery, thus indicating a diagnosis of endoscopic progressive recurrence. CONCLUSION: Our pilot study suggests that CE can be used to objectively evaluate the postoperative recurrence of small bowel lesions after surgery for CD.

关键词： Crohn’s disease Postoperative recurrence Capsule endoscopy Lewis score Small bowel