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Gastroduodenal ulcer bleeding in elderly patients on low dose aspirin therapy

World Journal of Gastroenterology 2018年第34期24卷 3908-3918页

作者： Koh Fukushi keiichi tominaga Kazunori Nagashima Akira Kanamori Naoya Izawa Mimari Kanazawa Takako Sasai Hideyuki Hiraishi Department of Gastroenterology Dokkyo Medical University Department of General Internal Medicine 2 Kawasaki Medical School General Medical Center

AIM To determine the clinical characteristics of elderly patients of hemorrhagic gastroduodenal ulcer on low-dose aspirin(LDA)*** A total of 1105 patients with hemorrhagic gastroduodenal ulcer treated in our hospital between January 2000 and March 2016 were grouped by age and drugs used,and these groups were compared in several *** groups were compared in terms of length of hospital stay,presence/absence of hemoglobin(Hb)decrease,presence/absence of blood transfusion,Forrest Ⅰ,percentage of Helicobacter pylori infection,presence/absence of underlying disease,and percentage of severe *** The percentage of blood transfusion(62.6%vs 47.7%,P<0.001),Hb decrease(53.8% vs 40.8%,P<0.001),and the length of hospital stay(23.5 d vs 16.7 d,P<0.001)were significantly greater in those on drug *** percentage of blood transfusion(65.3%vs 47.8%,P<0.001),Hb decrease(54.2%vs 42.1%,P<0.001),and length of hospital stay(23.3 d vs 17.5 d,P<0.001)were significantly greater in the *** comparison with the LDA monotherapy group,the percentage of severe cases was significantly higher in the LDA combination therapy group when elderly patients were concerned(16.1%vs34.0%,P=0.030).Meanwhile,among those on LDA monotherapy,there was no significant difference between elderly and non-elderly(16.1%vs 16.0%,P=0.985).CONCLUSION A combination of LDA with antithrombotic drugs or nonsteroidal anti-inflammatory drugs(NSAIDs)contributes to *** advanced age is not an aggravating factor when LDA monotherapy is used.

关键词： Hemorrhagic gastroduodenal ulcer Low-dose aspirin Antithrombotic drugs Elderly patients Proton pump inhibitor

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Clinical importance of colonoscopy in patients with gastric neoplasm undergoing endoscopic submucosal dissection

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World Journal of Gastroenterology 2017年第23期23卷 4262-4269页

作者： Chieko Tsuchida Naoto Yoshitake Hitoshi Kino Yoshihito Kaneko Masakazu Nakano Kohei Tsuchida keiichi tominaga Takako Sasai Hironori Masuyama Hidetsugu Yamagishi Yasuo Imai Hideyuki Hiraishi Department of Gastroenterology Dokkyo Medical University Department of Diagnostic Pathology Dokkyo Medical University

To evaluate the usefulness of total colonoscopy (TCS) for patients undergoing gastric endoscopic submucosal dissection (ESD) and to assess risk factors for colorectal *** the 263 patients who underwent ESD at our department between May 2010 and December 2013, 172 patients undergoing TCS during a one-year period before and after ESD were targeted. After excluding patients with a history of surgery or endoscopic therapy for colorectal neoplasms, 158 patients were analyzed. Of the 868 asymptomatic patients who underwent TCS during the same period because of positive fecal immunochemical test (FIT) results, 158 patients with no history of either surgery or endoscopic therapy for colorectal neoplasms who were matched for age and sex served as the control group for *** revealed adenoma less than 10 mm in 53 patients (33.6%), advanced adenoma in 17 (10.8%), early colorectal cancer in 5 (3.2%), and advanced colorectal cancer in 4 (2.5%). When the presence or absence of adenoma less than 10 mm, advanced adenoma, and colorectal cancer and the number of adenomas were compared between patients undergoing ESD and FIT-positive patients, there were no statistically significant differences in any of the parameters assessed. The patients undergoing ESD appeared to have the same risk of colorectal neoplasms as the FIT-positive patients. Colorectal neoplasms were clearly more common in men than in women (P = 0.031). Advanced adenoma and cancer were significantly more frequent in patients with at least two of the following conditions: hypertension, dyslipidemia, and diabetes mellitus (P = 0.019).CONCLUSIONIn patients undergoing gastric ESD, TCS appears to be important for detecting synchronous double neoplasms. Advanced adenoma and cancer were more common in patients with at least two of the following conditions: hypertension, dyslipidemia, and diabetes mellitus. Caution is therefore especially warranted in patients with these risk factors.

关键词： Colonoscopy Colorectal neoplasm Gastric neoplasm Endoscopic submucosal dissection Fecal immunochemical test

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Curative resection with endoscopic submucosal dissection of early gastric cancer in Helicobacter pylori-negative Ménétrier’s disease:A case report

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World Journal of Gastroenterology 2022年第5期28卷 594-601页

作者： Koh Fukushi Kenichi Goda Hitoshi Kino Masayuki Kondo Mimari Kanazawa Ken Kashima Akira Kanamori keiichiro Abe Tsunehiro Suzuki keiichi tominaga Hidetsugu Yamagishi Atsushi Irisawa Department of Gastroenterology Dokkyo Medical UniversityMibu 321-0293TochigiJapan Department of Diagnostic Pathology Dokkyo Medical UniversityMibu 321-0293TochigiJapan

BACKGROUND Adult-onset Ménétrier’s disease is strongly associated with Helicobacter pylori(***)infection and an elevated risk of *** of early-stage gastric cancer developed in ***-negative Ménétrier’s disease are extremely *** report a case of early gastric cancer in ***-negative Ménétrier’s disease that was curatively resected with endoscopic submucosal dissection(ESD).CASE SUMMARY A 60-year-old woman was referred to our hospital after her medical examination detected ***-enhanced upper gastrointestinal(UGI)radiography revealed translucency of the nodule-aggregating surface with giant *** tests showed hypoproteinemia and were negative for serum *** immunoglobulin G *** 99mTc-DTPA-human serum albumin scintigraphy showed protein loss from the *** endoscopy showed a 40-mm protruding erythematous lesion on giant rugae of the greater curvature of lower gastric body,suggesting early-stage gastric cancer due to Ménétrier’s *** bloc resection with ESD was performed for diagnosis and *** of ESD showed well-differentiated tubular *** cancer was confined to the mucosa,and complete curative resection was *** hyperplasia and atrophy of the gastric glands were observed in non-tumor areas,histologically corresponding to Ménétrier’s *** years after ESD,gastric cancer had not recurred,and Ménétrier’s disease remained in remission with spontaneous regression of giant gastric *** Complete curative resection was achieved through ESD in a patient with earlystage gastric cancer and ***-negative Ménétrier’s disease.

关键词： Ménétrier’s disease Helicobacter pylori Gastric cancer Endoscopic resection Endoscopic submucosal dissection Case report

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Whole circumferential endoscopic submucosal dissection of superficial adenocarcinoma in long-segment Barrett's esophagus:A case report

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World Journal of Gastrointestinal Surgery 2021年第10期13卷 1285-1292页

作者： keiichiro Abe Kenichi Goda Akira Kanamori Tsunehiro Suzuki Akira Yamamiya Yoichi Takimoto Takahiro Arisaka Koki Hoshi Takeshi Sugaya Yuichi Majima keiichi tominaga Makoto Iijima Shinichi Hirooka Hidetsugu Yamagishi Atsushi Irisawa Department of Gastroenterology Dokkyo Medical UniversityMibu 321-0293TochigiJapan Department of Pathology The Jikei University School of MedicineNishishimbashi 105-8471TokyoJapan Academic Institutional Research Center Dokkyo Medical UniversityMibu 321-0293TochigiJapan

BACKGROUND Esophageal adenocarcinoma(EAC)derived from long-segment Barrett’s esophagus(LSBE)is extremely rare in ***-related EAC is often difficult to diagnose in the horizontal *** the tumor has spread throughout the LSBE,whole circumferential endoscopic submucosal dissection(ESD)should be performed,which is difficult to complete ***,whole circumferential ESD can bring refractory postoperative *** hereby report a case of EAC involving the whole circumference of the LSBE,achieving complete endoscopic removal without *** SUMMARY An 85-year-old man with the chief complaint of dysphagia underwent *** suspected a flat-type cancerous lesion that extended the whole circumference of the LSBE(C 3.5,M 4.0)using narrow-band imaging magnification endoscopy(NBI-M).We achieved circumferential en bloc resection of the lesion safely with special ESD *** of the ESD specimens demonstrated that the superficial EAC extended the whole circumference of the LSBE,and papillary or well-differentiated tubular adenocarcinoma was confined in the lamina propria mucosa showing a vertical negative *** prevent post-ESD stenosis,we performed endoscopic local injection of steroids,followed by oral administration of *** was no evidence of esophageal refractory stenosis or tumor recurrence 30 mo after *** summary,we experienced a rare case of LSBE-related *** horizontal tumor extent was accurately diagnosed by ***,we achieve whole circumferential ESD safely without postoperative refractory *** NBI-M,ESD,and steroid therapy enabled the curative resection of superficial full circumferential LSBE-related EAC without refractory postoperative stenosis.

关键词： Endoscopic submucosal dissection Long-segment Barrett's esophagus Superficial esophageal adenocarcinoma Steroid Magnification endoscopy Case report

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tRNA cleavage: a new insight

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Neural Regeneration Research 2020年第1期15卷 47-52页

作者： Sherif Rashad Kuniyasu Niizuma Teiji tominaga Department of Neurosurgery Tohoku University Graduate School of MedicineSendaiJapan Department of Neurosurgical Engineering and Translational Neuroscience Tohoku University Graduate School of MedicineSendaiJapan Department of Neurosurgical Engineering and Translational Neuroscience Graduate School of Biomedical EngineeringTohoku UniversitySendaiJapan

Over the past decades,tRNA was found to be a rich hub of RNA modifications such as 1-methyladenosine and 5-methycytosine modifications and others,holding more than half of all modifications occurring in RNA ***,tRNA was discovered to be a source of various small noncoding RNA species,such as the stress induced angiogenin cleaved tRNA halves(tiRNA)or the miRNA like tRNA derived *** cleavage under stress was fist discovered in bacteria and later was found to be conserved across different species,including *** cellular stress conditions,tRNA undergoes conformational changes and angiogenin cleaves it into 3′and 5′halves.5′tiRNA halves were shown to repress protein *** cleavage is thought of to be a cytoprotective mechanism by which cells evade apoptosis,however some data hints to the opposite;that tiRNA are cytotoxic or at least related to apoptosis *** cleavage also was shown to be affected by tRNA modifications via different enzymes in the cytosol and *** this review,we will highlight the biology of tRNA cleavage,show the evidence of it being cytoprotective or a marker of cell death and shed a light on its role in disease models and human diseases as well as possible future directions in this field of RNA research.

关键词： angiogenin apoptosis cell stress RNA modification stress granules stroke tiRNA translation repression tRNA tRNA cleavage

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Vibrational dynamics of the CN stretching mode of [Ru(CN)_6]^(4-) in D_2O studied by nonlinear infrared spectroscopy

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Science China(Physics,Mechanics & Astronomy) 2010年第6期53卷 1013-1019页

作者： Jumpei TAYAMA Motohiro BANNO Kaoru OHTA Keisuke tominaga Graduate School of Science Kobe University Molecular Photoscience Research Center Kobe University PRESTO JST4-1-8 Honcho KawaguchiSaitamaJapan 332-0012Japan

We have studied vibrational dynamics of the T1u mode of the CN stretching mode of [Ru(CN)6 ]4- in D2O by infrared(IR) nonlinear spectroscopy such as an IR three-pulse photon echo experiment and polarization-sensitive IR pump-probe spectroscopy. The isotropic component of the pump-probe signal shows a bi-exponential decay with time constants of 0.8 ps and 20.8 ps. The fast and slow components correspond to the rapid equilibration between the T1u mode and the Raman active modes of the CN stretching mode and the vibrational population relaxation from the v=1 state of the T1u mode,respectively. Anisotropy of the pump-probe signal decays with a time constant of 3.1 ps,which is due to the time evolution of the superposition states of the triply degenerate T1u modes. Three pulse photon echo measurements showed that the time correlation function of the frequency fluctuation decays bi-exponentially with time constants of 80 fs and 1.4 ps. These time constants depend only on the solute and are independent of the solvent,whereas the amplitudes depend on both the solute and solvent.

关键词： nonlinear IR spectroscopy metal complex aqueous solution

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Diversion colitis and pouchitis: A mini-review

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World Journal of Gastroenterology 2018年第16期24卷 1734-1747页

作者： Kentaro tominaga Kenya Kamimura Kazuya Takahashi Junji Yokoyama Satoshi Yamagiwa Shuji Terai Division of Gastroenterology and Hepatology Graduate School of Medical and Dental Sciences Niigata University

Diversion colitis is characterized by inflammation of the mucosa in the defunctioned segment of the colon after colostomy or ileostomy. Similar to diversion colitis, diversion pouchitis is an inflammatory disorder occurring in the ileal pouch, resulting from the exclusion of the fecal stream and a subsequent lack of nutrients from luminal bacteria. Although the vast majority of patients with surgically-diverted gastrointestinal tracts remain asymptomatic, it has been reported that diversion colitis and pouchitis might occur in almost all patients with diversion. Surgical closure of the stoma, with reestablishment of gut continuity, is the only curative intervention available for patients with diversion disease. Pharmacologic treatments using short-chain fatty acids, mesalamine, or corticosteroids are reportedly effective for those who are not candidates for surgical reestablishment; however, there are no established assessment criteria for determining the severity of diversion colitis, and no management strategies to date. Therefore, in this mini-review, we summarize and review various recently-reported treatments for diversion disease. We are hopeful that the information summarized here will assist physicians who treat patients with diversion colitis and pouchitis, leading to better case management.

关键词： Diversion colitis Diversion pouchitis Ileitis Inflammatory bowel disease

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Safety and efficacy of transpapillary bridged bilateral side-by-side stenting for unresectable malignant hilar biliary obstruction

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Hepatobiliary & Pancreatic Diseases International 2017年第6期16卷 659-661页

作者： Hirotsugu Maruyama Kazunari tominaga Kunihiro Kato Satoshi Sugimori Masatsugu Shiba Toshio Watanabe Yasuhiro Fujiwara Department of Gastroenterology Osaka City University Graduate School of Medicine 1-4-3 Asahimachi Abeno-ku Osaka 545-8585 Japan

To the Editor:Biliary drainage is most frequently performed among endoscopic procedures using pancreatobiliary endoscopy.A large-diameter metallic stent can significantly extend the patency period rather than a plastic stent for extrahepatic biliary stricture.;However,the optimal drainage for the hilar biliary obstruction is still controversial.

关键词： Safety and efficacy of transpapillary bridged bilateral side-by-side stenting for unresectable malignant hilar biliary obstruction

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Transient receptor potential vanilloid 4-dependent calcium influx and ATP release in mouse and rat gastric epithelia

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World Journal of Gastroenterology 2016年第24期22卷 5512-5519页

作者： Hiroshi Mihara Nobuhiro Suzuki Ammar Abdullkader Boudaka Jibran Sualeh Muhammad Makoto tominaga Yoshiaki Tabuchi Toshiro Sugiyama Department of Gastroenterology Graduate School of Medicine and Pharmaceutical Sciences University of Toyama Division of Cell Signaling Okazaki Institute for Integrative Bioscience (National Institute for Physiological Sciences) National Institutes of Natural Sciences Department of Physiology College of Medicine and Health Sciences Sultan Qaboos University Life Science Research Center University of Toyama

AIM: To explore the expression of transient receptor potential vanilloid 4(TRPV4) and its physiological meaning in mouse and rat gastric epithelia. METHODS: RT-PCR and immunochemistry were used to detect TRPV4 m RNA and protein expression in mouse stomach and a rat normal gastric epithelial cell line(RGE1-01), while Ca2+-imaging and electrophysiology were used to evaluate TRPV4 channel activity. ATP release was measured by a luciferin-luciferase assay. Gastric emptying was also compared between WT and TRPV4 knockout mice. RESULTS: TRPV4 m RNA and protein were detected in mouse tissues and RGE1-01 cells. A TRPV4-specific agonist(GSK1016790A) increased intracellular Ca2+ concentrations and/or evoked TRPV4-like current activities in WT mouse gastric epithelial cells andRGE1-01 cells, but not TRPV4 KO cells. GSK1016790 A or mechanical stimuli induced ATP release from RGE1-01 cells while TRPV4 knockout mice displayed delayed gastric emptying in vivo. CONCLUSION: TRPV4 is expressed in mouse and rat gastric epithelium and contributes to ATP release and gastric emptying.

关键词： Transient receptor potential vanilloid 4 Stomach gastric emptying ATP

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Cytapheresis for pyoderma gangrenosum associated with inflammatory bowel disease:A review of current status

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World Journal of Clinical Cases 2020年第11期8卷 2092-2101页

作者： Kentaro tominaga Kenya Kamimura Hiroki Sato Masayoshi Ko Yuzo Kawata Takeshi Mizusawa Junji Yokoyama Shuji Terai Division of Gastroenterology and Hepatology Graduate School of Medical and Dental SciencesNiigata UniversityNiigata 951-8510Japan

Pyoderma gangrenosum(PG)is a neutrophilic dermatosis clinically characterized by the presence of painful skin ulcerations with *** it is frequently associated with inflammatory bowel diseases,including ulcerative colitis,gastroenterologists should be familiar with the disease including therapeutic ***,we have conducted a review focusing on the cytapheresis for PG in cases of inflammatory bowel diseases.A literature search was conducted to extract studies published in the last 20 years,with information on demographics,clinical symptoms,treatment,and the clinical course from a total of 22 cases reported and our recent *** most patients,cytapheresis was associated with improvement or resolution of PG after failure of conventional therapeutic options such as corticosteroids,antibiotics,immunosuppressive agents and *** on the information summarized,cytapheresis is helpful in the majority of patients with PG refractory to medical treatment associated with inflammatory bowel diseases and could be further studied in a multicenter,randomized trial.

关键词： Granulocytapheresis Leucocytapheresis Cytapheresis Inflammatory bowel diseases Pyoderma gangrenosum Complications

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