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Refractory ulcerative colitis accompanied with cytomegalovirus colitis and multiple liver abscesses: A case report

World Journal of Gastroenterology 2005年第33期11卷 5241-5244页

作者： Takuya Inoue Ichiro Hirata Yutaro Egashira Kumi Ishida ken kawakami Eijiro Morita Naoko Murano Shingo Yasumoto Mitsuyuki Murano ken Toshina Takashi Nishikawa Norihiro Hamamoto ken Nakagawa ken-Ichi Katsu The Second Department of Internal Medicine Osaka Medical College 2-7 DaigakuchoTakatsuki City Osaka 569-8686 Japan Department of Pathology Osaka Medical College Takatsuki City Osaka 569-8686 Japan The Second Department of Internal Medicine Osaka Medical College 2-7 Daigakucho Takatsuki City Osaka 569-8686 Japan

Various hepato-biliary complications are an increased incidence in patients with inflammatory bowel disease,and portal bacteremia is well documented in patients with ulcerative colitis (UC). However, few reports mention UC in association with liver abscesses. Recently, there are several reports describing cytomegalovirus (CMV) infection in association with disease exacerbation and steroid refractoriness in patients with UC. Here we present a case of refractory UC accompanied with multiple liver abscesses and CMV colitis. The patient, a 72-year-old male, with a five-year history of repeated admissions to our hospital for UC, presented with an exacerbation of his UC.Sigmoidoscopy performed on admission suggested that his UC was exacerbated, then he was given prednisolone and mesalazine orally, and betamethasone enemas.However, he had exacerbated symptoms. Repeat sigmoidoscopy revealed multiple longitudinal ulcers and pseudopolyps in the rectosigmoid colon. Although immunohistochemical staining of biopsy specimens and the serum testing for antigenemia were negative on admission and after the repeat sigmoidoscopy, they became histologically positive for CMV. Nonetheless, the patient developed spiking fevers, soon after ganciclovir was administered. Laboratory studies revealed an increased white cell count with left shift, and Enterococcus fecalis grew in blood cultures. An abdominal computed tomography (CT) scan was obtained and the diagnosis of liver abscesses associated with UC was made, based on CT results. The hepatic abscesses were successfully treated with intravenous meropenem for 6 wk, without further percutaneous drainage. To our knowledge, this is the first reported case of multiple liver abscesses that develop during UC exacerbation complicated by CMV colitis.

关键词：溃疡性肠炎细胞巨化病毒病毒性肠炎肝脓肿病例报告

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Effects of oral tacrolimus as a rapid induction therapy in ulcerative colitis

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World Journal of Gastroenterology 2015年第6期21卷 1880-1886页

作者： ken kawakami Takuya Inoue Mitsuyuki Murano ken Narabayashi Sadaharu Nouda Kumi Ishida Yosuke Abe Koji Nogami Nobuyuki Hida Hirokazu Yamagami kenji Watanabe Eiji Umegaki Shiro Nakamura Tetsuo Arakawa Kazuhide Higuchi Second Department of Internal Medicine Osaka Medical College Division of Lower Gastroenterology Department of Internal Medicine Hyogo College of Medicine Department of Gastroenterology Osaka City University Graduate School of Medicine

AIM:To determine the efficacy and safety of rapid induction therapy with oral tacrolimus without a meal in steroid-refractory ulcerative colitis(UC)patients.METHODS:This was a prospective,multicenter,observational study.Between May 2010 and August 2012,49 steroid-refractory UC patients(55 flare-ups)were consecutively enrolled.All patients were treated with oral tacrolimus without a meal at an initial dose of 0.1mg/kg per day.The dose was adjusted to maintain trough whole-blood levels of 10-15 ng/m L for the first 2 wk.Induction of remission at 2 and 4 wk after tacrolimus treatment initiation was evaluated using Lichtiger’s clinical activity index(CAI).RESULTS:The mean CAI was 12.6±3.6 at onset.Within the first 7 d,93.5%of patients maintained high trough levels(10-15 ng/m L).The CAI significantly decreased beginning 2 d after treatment initiation.At 2wk,73.1%of patients experienced clinical responses.After tacrolimus initiation,31.4%and 75.6%of patients achieved clinical remission at 2 and 4 wk,respectively.Treatment was well tolerated.CONCLUSION:Rapid induction therapy with oral tacrolimus shortened the time to achievement of appropriate trough levels and demonstrated a high remission rate 28 d after treatment initiation.Rapid induction therapy with oral tacrolimus appears to be a useful therapy for the treatment of refractory UC.

关键词： Ulcerative colitis Tacrolimus Rapid induction ther

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Clinical effects of adalimumab treatment with concomitant azathioprine in Japanese Crohn's disease patients

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World Journal of Gastroenterology 2013年第17期19卷 2676-2682页

作者： Kumi Ishida Takuya Inoue Kaori Fujiwara Taisuke Sakanaka ken Narabayashi Sadaharu Nouda Toshihiko Okada Kazuki Kakimoto Takanori Kuramoto ken kawakami Yosuke Abe Toshihisa Takeuchi Mitsuyuki Murano Satoshi Tokioka Eiji Umegaki Kazuhide Higuchi the Second Department of Internal Medicine Osaka Medical College Takatsuki City

AIM:To assess adalimumab's efficacy with concomitant azathioprine (AZA) for induction and maintenance of clinical remission in Japanese Crohn's disease (CD) patients. METHODS:This retrospective, observational, singlecenter study enrolled 28 consecutive CD patients treated with adalimumab (ADA). Mean age and mean disease duration were 38.1 ± 11.8 years and 11.8 ± 10.1 years, respectively. The baseline mean Crohn's disease activity index (CDAI) and C-reactive protein were 177.8 ± 82.0 and 0.70 ± 0.83 mg/dL, respectively. Twelve of these patients also received a concomitant stable dose of AZA. ADA was subcutaneously administered:160 mg at week 0, 80 mg at week 2, followed by 40 mg every other week. Clinical response and remission rates were assessed via CDAI and C-reactive protein for 24 wk. RESULTS:The mean CDAI at weeks 2, 4, 8, and 24 was 124.4, 120.2, 123.6, and 135.1, respectively. The CDAI was significantly decreased at weeks 2 and 4 with ADA and was significantly suppressed at 24 wk with ADA/AZA. Overall clinical remission rates at weeks 4 and 24 were 66.7% and 63.2%, respectively. Although no statistically significant difference in C-reactive protein was demonstrated, ADA with AZA resulted in a greater statistically significant improvement in CDAI at 24 wk, compared to ADA alone. CONCLUSION:Scheduled ADA with concomitant AZA may be more effective for clinical remission achievement at 24 wk in Japanese Crohn's disease patients.

关键词： Crohn’s disease Adalimumab Immunomodulator Azathioprine Inflammatory bowel disease

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Evaluation of Reactive Oxygen Species (ROS) Generated on the Surface of Copper Using Chemiluminesence

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Materials Sciences and Applications 2023年第10期14卷 482-499页

作者： ken Hirota Hiroya Tanaka Taika Maeda Kazuhiko Tsukagoshi Hiroshi kawakami Takashi Ozawa Masahiko Wada Research Center of Bio-Micro-Fluidic Science Doshisha University Kyoto Japan Department of Chemical Engineering and Materials Science Faculty of Science & Engineering Doshisha University Kyoto Japan Graduate School of Engineering College of Engineering Osaka Metropolitan University Osaka Japan Japan Copper Development Association Tokyo Japan

The antibacterial activity of copper is well-known from an ancient civilization, however, its biocidal mechanism has not been necessarily elucidated. Notwithstanding up to now, mainly 4 processes have been proposed. Among them, it is cleared that 4 kinds of reactive oxygen species (ROS): hydroxyl radical ·OH, hydrogen per oxide H2O2, superoxide anion ·O-2 and singlet oxygen 1O2, play an important role for contact-killing of bacteria, viruses and fungi. In this paper, generation of ROS on the surfaces of copper plates heated from room temperature to 673 K for 4.2 × 102 s in air, was investigated using the chemiluminescence. ROS have been evaluated by selecting the most suitable scavengers, such as 2-propanol for ·OH, sodium pyruvate for H2O2, nitro blue tetrazolium for ·O-2, and sodium azide NaN3 for 1O2. At the same time the outermost surface of copper, on which thin film of cuprous oxide Cu2O was first formed and then cupric oxide CuO was laminated on Cu2O, was examined by thin-film XRD and TEM analysis to estimate the amounts and kinds of copper oxides. It was found that the most amounts of ROS were obtained for the 573 K-heated Cu plate and they were composed of ·OH, H2O2, and ·O-2..

关键词： Copper Microbial Activity Reactive Oxygen Species Chemiluminescence Scavengers

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Diagnostic and therapeutic single-operator cholangiopancreatoscopy in biliopancreatic diseases:Prospective multicenter study in Japan

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World Journal of Gastroenterology 2016年第5期22卷 1891-1901页

作者： Toshio Kurihara Ichiro Yasuda Hiroyuki Isayama Toshio Tsuyuguchi Taketo Yamaguchi ken Kawabe Yoshinobu Okabe Keiji Hanada Tsuyoshi Hayashi Takao Ohtsuka Syuhei Oana Hiroshi kawakami Yoshinori Igarashi Kazuya Matsumoto Kiichi Tamada Shomei Ryozawa Hiroki Kawashima Yutaka Okamoto Iruru Maetani Hiroyuki Inoue Takao Itoi Department of Gastroenterology and Hepatology Tokyo Medical University6-7-1 NishishinjukuShinjuku-kuTokyo 160-0023Japan First Department of Internal Medicine Gifu University HospitalGifu 501-1194Japan Department of Gastroenterology Graduate School of MedicineThe University of TokyoTokyo 113-8655Japan Department of Gastroenterology and Nephrology Chiba University Graduate School of MedicineChiba 260-8677Japan Department of Gastroenterology Chiba Cancer CenterFunabashi Municipal HospitalChiba 260-8717Japan Department of Gastroenterology Clinical Research InstituteNational Hospital OrganizationKyushu Medical CenterFukuoka 810-8563Japan Division of Gastroenterology Department of MedicineKurume University School of MedicineKurume 830-0011Japan Department of Gastroenterology Onomichi General HospitalOnomichi 722-8508Japan Department of Medical Oncology and Hematology Sapporo Medical University School of MedicineSapporo 060-8543Japan Department of Surgery and Oncology Graduate School of Medical SciencesKyushu UniversityFukuoka 812-8582Japan Department of Gastroenterology Iwate Medical UniversityMorioka 020-0023Japan Department of Gastroenterology and Hepatology Graduate School of MedicineHokkaido UniversitySapporo 060-8648Japan Division of Gastroenterology and Hepatology Omori Medical CenterToho UniversityTokyo 143-0015Japan Department of Gastroenterology Tottori University HospitalYonago 683-8504Japan Department of Internal Medicine Division of GastroenterologyJichi Medical UniversityShimotsuke 329-0498Japan Department of Gastroenterology Digestive Disease CenterShowa UniversityNorthern Yokohama HospitalYokohama 224-0032Japan Department of Gastroenterology and Hepatology Graduate School of MedicineNagoya UniversityNagoya 466-8550Japan Department of Gastroenterology Mutsu General HospitalMutsu 035-0071Japan Division of Gastroenterology Department of Internal MedicineOhashi Medical CenterToho UniversityTokyo 153-0044Japan Department of Gastroenterology Mie University

AIM: To assess the utility and safety of single-operator cholangiopancreatoscopy(SOCPS) using the Spy Glass system in widespread clinical application for biliary and pancreatic diseases.METHODS: This study was a prospective case series conducted in 20 referral centers in Japan. There were 148 patients who underwent SOCPS; 124 for biliary diseases and 24 for pancreatic diseases. The attempted interventions were SOCPS examination, SOCPS-directed tissue sampling, and therapy for stone removal, among others. The main outcomes were related to the procedure success rate in terms of visualizing the target lesions, SOCPS-directed adequate tissue sampling, and complete stone removal. RESULTS: A total of 148 patients were enrolled for the diagnosis of indeterminate biliary and pancreatic lesions or treatment of biliary and pancreatic disease. The overall procedure success rate of visualizing the target lesions was 91.2%(135/148). The overall procedural success rates of visualizing the target lesions of diagnostic SOCPS in the bile duct and pancreatic duct were 95.5%(84/89) and 88.2%(15/17), respectively. Diagnosis: the overall adequate tissue for histologic examination was secured in 81.4% of the 86 patients who underwent biopsy under SOCPS(bile duct, 60/75, 80.0%; pancreatic duct, 10/11, 90.9%). The accuracy of histologic diagnosis using SOCPS-directed biopsies in indeterminate bile duct lesions was 70.7%(53/75). In the pancreatic duct, the accuracy of SOCPS visual impression of intraductal papillary mucinous neoplasm was 87.5%(14/16). Stone therapy: complete biliary and pancreatic stone clearance combined with SOCPS-directed stone therapy using electrohydraulic lithotripsy or laser lithotripsy was achieved in 74.2%(23/31) and 42.9%(3/7) of the patients, respectively. Others: SOCPS using the Spy Glass system was used in cannulation of the cystic duct in two patients and for passing across the obstructed self-expandable metallic stent for a malignant biliary stricture in two patients. All procedures were successful in both

关键词： Cholangioscopy Endoscopic retrogradecholangiopancreatography Pancreatoscopy Singleoperator SpyGlass

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Pole Assignment for Three-Dimensional Systems Using Two-Dimensional Dynamic Compensators

Pole Assignment for Three-Dimensional Systems Using Two-Dime...

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第二十二届中国控制会议

作者： Atsushi kawakami Mathematics and Sciences Core Kanazawa Institute of Technology7-1OugigaokaNonoichi-machiIshikawa-gunIshikawa-ken921-8501 Japan

＜正＞In this paper, we propose a method for assigning poles for three-dimensional systems described by the state-space model. In this method, we perform the state feedback and input transformation containing two-dimensional dynamic compensators on the given three-dimensional systems, so that we let the denominator polynomials of the transfer functions of the closed-loop systems coincide with the product of three one-dimensional polynomials whose roots are in the unit circle.

关键词： Pole assignment Three-dimensional systems Two-dimensional dynamic compensators. Feedback input transformation

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2007年新潟县中越近海地震期间柏崎刈羽核电站垂直阵观测的土的非线性行为

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世界地震译丛 2012年第2期43卷 62-76页

作者： H. Mogi S. S. Man H. kawakami S. Okamura 胡勐乾(译) 侯春林(校) 吕春来(复校) 不详环境保护部核与辐射安全中心

2007年新潟县中越近海地震期间柏崎刈羽核电站遭受到极强的震动。该核电站周围密集的地震检波器阵观测到的加速度记录目前已对公众开放,将会提供有价值的资料。基于在主震及前震、余震中观测到的垂直阵记录,利用归一化输入输出最小化(NI... 详细信息

2007年新潟县中越近海地震期间柏崎刈羽核电站遭受到极强的震动。该核电站周围密集的地震检波器阵观测到的加速度记录目前已对公众开放,将会提供有价值的资料。基于在主震及前震、余震中观测到的垂直阵记录,利用归一化输入输出最小化(NIOM)方法研究了S波速度随时间的变化。在地表下50m与50～100m的地层中,发现在主震的主运动期间S波速度显著降低,显示了非线性行为。然而在地表100m以下的基岩层中,观测到了近似线性的行为。并且发现在100m以内的地层中,主运动后不久S波速度增大,说明这些地层没有发生较大的液化。最后,基于得到的S波速度研究了剪切模量和剪应变之间的关系。地表层及中间层的归一化剪切模量(G/G0)降低到约0.2(应变水平1×10-3～1×10-2)和0.6(在应变水平1×10-3～2×10-3)。

关键词：非线性行为核电站垂直阵地震期观测近海 S波速度柏

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