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World Journal of Gastroenterology 2017年第28期23卷 5253-5256页

作者： Masaya Uesato Tsuguaki Kono Yasunori Akutsu kentarou murakami Akiko Kagaya Yorihiko Muto Akira Nakano Mizuho Aikawa Tomohide Tamachi Hiroyuki Amagai Takahiro Arasawa Yasuhide Muto Hisahiro Matsubara Department of Frontier Surgery Chiba University Graduate School of Medicine

A 65-year-old man with c T1 b N0M0 stage Ⅰ middle thoracic esophageal cancer underwent subtotal esophagectomy and gastric tube reconstruction through the posterior mediastinal route after preoperative carbon-ion radiotherapy and chemotherapy in a clinical trial. Anastomotic leakage occurred,but it spontaneously improved. At six months after the operation,he was rehospitalized with a cough and dysphagia. An esophago-bronchiole fistula and stenosis of the gastric tube were observed. He first underwent stent placement in the gastric tube. Two weeks later,the syringeal epithelium was burned by argon plasma coagulation after stent removal. Endoscopic occlusion was then performed for the fistula with two guidewire-assisted silicone spigots. Two weeks later,he was discharged on an oral diet,and he has not developed recurrence of the fistula or cancer for three years. This is the first report of endoscopic occlusion with a guidewire-assisted silicone spigot through the esophagus.

关键词： Endobronchial Watanabe 塞子 Guidewire 管漏 Esophagectomy 食道的癌症内视镜的吸藏

Gastric endoscopic submucosal dissection via gastrostoma before the second operation for esophageal perforation: A case report

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World Journal of Gastrointestinal Endoscopy 2018年第6期10卷 121-124页

作者： Takuma Sasaki Masaya Uesato Takumi Ohta kentarou murakami Akira Nakano Hisahiro Matsubara Department of Frontier Surgery Chiba University Graduate School of Medicine

A 69-year-old man with advanced esophageal cancer and 2 early gastric cancers received chemoradiotherapy and was scheduled to undergo subtotal esophagectomy after gastric endoscopic submucosal dissection(ESD). However, left lower esophageal perforation induced by vomiting suddenly occurred, and he urgently underwent esophago-proximal gastrectomy and gastrostomy without reconstruction. The resected specimen showed a complete response of pretreatment for the esophageal cancer and radical resection of one gastric cancer. Radical resection of the other gastric lesion was necessary before reconstruction. The fistula of gastrostoma was gradually dilated from 6.7 to 9.3 mm in order to pass the endoscope. At nine months after emergent operation, gastric ESD was performed via only the gastrostoma. A hemoclip with thread was attached to the specimen, and the thread was pulled out of the gastrostoma. The specimen was able to be removed en bloc, resulting in radical resection. Gastric tube reconstruction through the posterior sternal route was performed at six months after the ESD. He has not developed recurrence of the esophageal or gastric cancer in the two years since the emergent operation.

关键词： Gastric cancer Endoscopic submucosal dissection Gastrostomy Gastrostoma

Lymphoepithelioma-like esophageal carcinoma with macroscopic reduction

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World Journal of Gastrointestinal Endoscopy 2014年第8期6卷 385-389页

作者： Masaya Uesato Tuguaki Kono Tooru Shiratori Yasunori Akutsu Isamu Hoshino kentarou murakami Daisuke Horibe Tetsurou Maruyama Yoshihide Semba Ryuma Urahama Yukiko Ogura Takashi Oide Toru Tanizawa Hisahiro Matsubara Department of Frontier Surgery Chiba University Graduate School of Medicine Department of Diagnostic Pathology Chiba University Graduate School of Medicine

Esophageal lymphoepithelioma-like carcinoma(LELC) is extremely rare. We report the first case of esopha-geal LELC showing macroscopic reduction. A 67-year-old male presented with dysphagia and, by endoscopic examination, was found to have a significantly raised tumor of 10 mm in diameter in the thoracic esophagus. The biopsied material showed esophageal cancer. We performed endoscopic submucosal dissection. However, the tumor became flattened, similar to a scar, in only 2 mo. Histologically, the carcinoma cells had infiltrated the submucosal layer. Prominent infiltration of T lymphoid cells that stained positive for CD8 was observed aroundthe carcinoma cells. Therefore, this lesion was consid-ered to be an LELC with poorly differentiated squamous cells. Because the margin was positive, an esophagec-tomy was performed. Carcinoma cells were detected in the neck in one lymph node. The staging was T1N0M1 b. However, the patient has been well, without adjuvant therapy or recurrence, for more than 5 years.

关键词： Esophageal cancer Lymphoepithelioma-like carcinoma Lymphoid stroma Tumor-infiltrating lym-phocyte Cytotoxic T lymphocyte Reduction

Copper Accumulates in Hemosiderins in Livers of Patients with Iron Overload Syndromes

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Journal of Clinical and Translational Hepatology 2015年第2期3卷 85-92页

作者： Yukiya Ono Masatoshi Ishigami Kazuhiko Hayashi Shinya Wakusawa Hisao Hayashi Kotaro Kumagai Natsuko Morotomi Tetsuji Yamashita Miwa Kawanaka Minemori Watanabe Hiroaki Ozawa Mayumi Tai Hiroaki Miyajima kentarou Yoshioka Yoshiki Hirooka Hidemi Goto Department of Gastroenterology Nagoya University Graduate School of Medicine Nagoya Japan Department of Medical Laboratory Sciences Nagoya University Graduate School of Medicine Nagoya Japan Department of Medicine Aichi Gakuin University School of Pharmacy Nagoya Japan Digestive Disease and Lifestyle Related Disease Kagoshima University Graduate School of Medical and Dental Sciences Kagoshima Japan Department of Internal Medicine Moji Hospital Kitakyushu Japan Department of Medicine Yoshida Hospital Matsuyama Japan General Internal Medicine 2 Kawasaki Hospital Kawasaki Medical School Okayama Japan Department of Endocrinology and Diabetes Okazaki City Hospital Okazaki Japan Department of Pathology Okazaki City Hospital Okazaki Japan Department of Gastroenterology Fukushima Rohsai Hospital Fukushima Japan First Department of Medicine Hamamatsu University School of Medicine Hamamatsu Japan Department of Liver Biliary Tract and Pancreas Diseases Fujita Health University Toyoake Japan

In biology,redox reactions are essential and sometimes harmful,and therefore,iron metabolism is tightly regulated by *** the state of copper in iron overload syndromes remains unclear,we investigated whether copper metabolism is altered in these *** patients with iron overload syndromes participated in this *** clinical diagnoses were aceruloplasminemia (n=2),hemochromatosis (n=5),ferroportin disease (n=2),and receiving excess intravenous iron supplementation (n=2).Liver specimens were analyzed using a light microscope and transmission electron microscope equipped with an X-ray *** addition to a large amount of iron associated with oxygen and phosphorus,the iron-rich hemosiderins of hepatocytes and Kupffer cells contained small amounts of copper and sulfur,regardless of disease ***-dimensional imaging clearly showed that cuproproteins were distributed homogenously with iron complexes within *** stasis was unlikely in noncirrhotic *** enhanced induction of cuproproteins by excess iron may contribute to copper accumulation in *** conclusion,we have demonstrated that copper accumulates in hemosiderins in iron overload conditions,perhaps due to alterations in copper metabolism.

关键词： Aceruloplasminemia Cuproprotein induction Ferroportin disease Hemochromatosis Hemosiderin Iron copper interaction Iron overload syndromes

TEM Observation of Si0.99C0.01 Thin Films with Arsenic-Ion-, Boron-Ion-, and Silicon-Ion-Implantation Followed by Rapid Thermal Annealing

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Journal of Materials Science and Chemical Engineering 2017年第1期5卷 15-25页

作者： Junji Yamanaka Shigenori Inoue Keisuke Arimoto Kiyokazu Nakagawa kentarou Sawano Yasuhiro Shiraki Atsushi Moriya Yasuhiro Inokuchi Yasuo Kunii Center for Crystal Science and Technology University of Yamanashi Kofu Japan Advanced Research Laboratories Tokyo City University Tokyo Japan Hitachi Kokusai Electric Inc. Toyama Japan

Strained Si and its related materials, such as strained SiGe and strained silicon-carbon alloy (Si-C), are receiving tremendous interest due to their high carrier mobility. In this study we carry out a basic investigation of the change in microstructure of ion-implanted Si-C solid solution caused by rapid thermal annealing, because it is very important to realize a field-effect transistor made of this new material. The microstructures of arsenic-ion-, boron-ion-, and silicon-ion-implanted Si0.99C0.01 specimens upon thermal annealing are observed using transmission electron microscopy, and it is revealed that the rate of solid-state crystallization of ion-implanted Si-C is slower than that of the ion-implanted Si.

关键词： Strained Heterodevice Silicon-Carbon Alloy Ion Implantation Transmission Electron Microscopy

Maintenance for healed erosive esophagitis:PhaseⅢcomparison of vonoprazan with lansoprazole

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World Journal of Gastroenterology 2018年第14期24卷 1550-1561页

作者： Kiyoshi Ashida Katsuhiko Iwakiri Naoki Hiramatsu Yuuichi Sakurai Tetsuharu Hori kentarou Kudou Akira Nishimura Eiji Umegaki Department of Gastroenterology Rakuwakai Otowa HospitalKyoto 607-8062Japan Department of Gastroenterology Nippon Medical School Graduate School of MedicineTokyo 113-8603Japan Department of Gastroenterology and Hepatology Osaka Rosai HospitalSakaiOsaka 591-8025Japan Takeda Pharmaceutical Company Limited Osaka 540-8645Japan Department of Gastroenterology Kobe University Graduate School of MedicineKobeHyogo 650-0017Japan

AIM To compare vonoprazan 10 and 20 mg vs lansoprazole 15 mg as maintenance therapy in healed erosive esophagitis(EE).METHODS A total of 607 patients aged ≥ 20 years, with endoscopically-confirmed healed EE following 8 wk of treatment with vonoprazan 20 mg once daily, were randomized 1:1:1 to receive lansoprazole 15 mg(n = 201), vonoprazan 10 mg(n = 202), or vonoprazan 20 mg(n = 204), once daily. The primary endpoint of the study was the rate of endoscopically-confirmed EE recurrence during a 24-wk maintenance period. The secondary endpoint was the EE recurrence rate at Week 12 during maintenance treatment. Additional efficacy endpoints included the incidence of heartburn and acid reflux, and the EE healing rate 4 wk after the initiation of maintenance treatment. Safety endpoints comprised adverse events(AEs), vital signs, electrocardiogram findings, clinical laboratory results, serum gastrin and pepsinogen Ⅰ/Ⅱ levels, and gastric mucosa histopathology *** Rates of EE recurrence during the 24-wk maintenance period were 16.8%, 5.1%, and 2.0% with lansoprazole 15 mg, vonoprazan 10 mg, and vonoprazan 20 mg, respectively. Vonoprazan was shown to be non-inferior to lansoprazole 15 mg(P < 0.0001 for both doses). In a post-hoc analysis, EE recurrence at Week 24 was significantly reduced with vonoprazan at both the 10 mg and the 20 mg dose vs lansoprazole 15 mg(5.1% vs 16.8%, P = 0.0002, and 2.0% vs 16.8%, P < 0.0001, respectively); by contrast, the EE recurrence rate did not differ significantly between the two doses of vonoprazan(P = 0.1090). The safety profiles of vonoprazan 10 and 20 mg were similar to that of lansoprazole 15 mg in patients with healed EE. Treatment-related AEs were reported in 11.4%, 10.4%, and 10.3% of patients in the lansoprazole 15 mg, vonoprazan 10 mg, and vonoprazan 20 mg arms, *** Our findings confirm the non-inferiority of vonoprazan 10 and 20 mg to lansoprazole 15 mg as maintenance therapy for patients with heale

关键词： Gastroesophageal reflux disease Erosive esophagitis Lansoprazole Potassium-competitive acid blockers Vonoprazan Maintenance therapy