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World Journal of Cardiovascular Surgery 2019年第9期9卷 97-107页

作者： Koji furukawa Kosuke Mori Yukie Shirasaki Hirohito Ishii Kunihide Nakamura Department of Cardiovascular Surgery Faculty of Medicine University of Miyazaki Miyazaki Japan

Objectives: To investigate the influence of cold renal perfusion on renal function and clinical outcomes in cases where the renal ischemia time exceeded 30 min during pararenal and juxtarenal abdominal aortic aneurysm (P/JAAA) surgery. Methods and Results: Fifty-four patients who underwent open repair for P/JAAAs were retrospectively analyzed. Thirty-nine patients received renal perfusion with cold Ringer’s solution (perfusion group) and 15 patients did not receive renal perfusion (non-perfusion group). There were no significant differences in preoperative serum creatinine level (Cr) (1.08 ± 0.42 vs. 1.35 ± 0.71 mg/dL, p = 0.09), percentage of patients with Cr > 2 mg/dL [2/38 (5%) vs. 2/15 (13%), p = 0.8], and renal ischemia time during proximal aortic clamping (49 ± 21 vs. 47 ± 11 min;p = 0.8) between the groups. Postoperative Cr was significantly lower in the perfusion group than in the non-perfusion group (1.48 ± 0.76 vs. 2.23 ± 1.21 mg/dL, p 2 mg/dL was also significantly lower in the perfusion group than in the non-perfusion group [5 (13%) vs. 7 (47%), p < 0.01)]. At discharge, Cr returned to preoperative levels in both groups. All patients were discharged from the hospital without incidents. Conclusion: Renal artery perfusion with cold Ringer’s solution clearly reduced the deterioration of postoperative renal function compared to non-renal perfusion.

关键词： Cold Renal Perfusion Pararenal Abdominal Aortic Aneurysm Juxtarenal Abdominal Aortic Aneurysm Suprarenal Clamping Renal Function

The expression of histamine receptors in skin lesions of MRL/MP-lpr/lpr mice

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The expression of histamine receptors in skin lesions of MRL...

Utility of linked color imaging for endoscopic diagnosis of early gastric cancer

The 8th International Congress on SLE

作者： Fukumi furukawa Nobuo Kanazawa Takashi Yoshimasu Department of Dermatology Wakayama Medical UniversityJapan Department of Dermatology Wakayama Medical UniversityJapan Department of Dermatology Wakayama Medical UniversityJapan

＜正＞Systemic lupus erythematosus（SLE）is a chronic inflammatory disease accompanied with systemic organs disorder including skin changes,but the pathogenesis is not clearly understood, The skin lesion of MRL/MP-lpr...

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World Journal of Gastroenterology 2019年第10期25卷 1248-1257页

作者： Toshihisa Fujiyoshi Ryoji Miyahara Kohei Funasaka Kazuhiro furukawa Tsunaki Sawada Keiko Maeda Takeshi Yamamura Takuya Ishikawa Eizaburo Ohno Masanao Nakamura Hiroki Kawashima Masato Nakaguro Masahiro Nakatochi Yoshiki Hirooka Department of Gastroenterology and Hepatology Nagoya University Graduate School of Medicine Department of Endoscopy Nagoya University Hospital Department of Pathology and Laboratory Medicine Nagoya University Hospital Division of Data Science Data Coordinating CenterDepartment of Advanced MedicineNagoya University Hospital

BACKGROUND Linked color imaging(LCI) is a method of endoscopic imaging that emphasizes slight differences in red mucosal *** To evaluate LCI in diagnostic endoscopy of early gastric cancer and to compare LCI and pathological *** Endoscopic images were obtained for 39 patients(43 lesions) with early gastric cancer. Three endoscopists evaluated lesion recognition with white light imaging(WLI) and LCI. Color values in Commission Internationale de l'Eclairage(CIE)1976 L*a*b* color space were used to calculate the color difference(ΔE) between cancer lesions and non-cancer areas. After endoscopic submucosal dissection,blood vessel density in the surface layer of the gastric epithelium was evaluated pathologically. The identical region of interest was selected for analyses of endoscopic images(WLI and LCI) and pathological *** LCI was superior for lesion recognition(P < 0.0001), and ΔE between cancer and non-cancer areas was significantly greater with LCI than WLI(29.4 vs 18.6, P <0.0001). Blood vessel density was significantly higher in cancer lesions(5.96% vs4.15%, P = 0.0004). An a* cut-off of ≥ 24 in CIE 1976 L*a*b* color space identified a cancer lesion using LCI with sensitivity of 76.7%, specificity of 93.0%, and accuracy of 84.9%.CONCLUSION LCI is more effective for recognition of early gastric cancer compared to WLI as a result of improved visualization of changes in redness. Surface blood vessel density was significantly higher in cancer lesions, and this result is consistent with LCI image analysis.

关键词： Linked color imaging Early gastric cancer Endoscopic submucosal dissection Vessel density Color difference

Risk factors for internal anal sphincter dysfunction in Japanese adults

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Open Journal of Gastroenterology 2013年第1期3卷 25-34页

作者： Tatsuya Abe Toru Kono Yoshikazu Hachiro Masao Kunimoto Hiroyuki furukawa Department of Proctology Kunimoto Hospital Asahikawa Japan Division of Gastroenterologic and General Surgery Department of Surgery Asahikawa Medical University Asahikawa Japan

Purpose: The internal anal sphincter provides most of the resting anal tone and is the main muscle responseble for continence. This study was designed to estimate the prevalence of, and identify risk factors associated with, internal anal sphincter dysfunction in Japanese adults. Methods: Anorectal manometry was performed in 1193 women and 1124 men aged 20 years or older. The maximal resting pressure, measured by a rapid pull-through technique, was defined as the highest resting pressure recorded. Internal anal sphincter dysfunction was defined as a maximal resting pressure less than 30 mmHg. Potential risk factors were assessed through self-reports, interviews, physical examinations, and medical record reviews. Multivariate logistic regression analysis was used to identify independent risk factors for internal anal sphincter dysfunction. Results: Significant differences in maximal resting pressure were seen between women (58.1 ± 24.9 mmHg) and men (68.8 ± 23.5 mmHg, P < 0.001). Maximal resting pressure decreased significantly with increasing age in both sexes. The prevalence of internal anal sphincter dysfunction was 10.4% (15.5% in women, 5.1% in men). In a multivariate logistic regression model, age, mental disease, pelvic organ prolapse repair, and fecal incontinence were independently associated with a greater risk of internal anal sphincter dysfunction in women and men. Conclusions: Internal anal sphincter dysfunction is a common problem for women and men. Several of the identified risk factors are preventable or modifiable, and may direct future research in fecal incontinence therapy.

关键词： Fecal Incontinence Internal Anal Sphincter Anorectal Manometry Maximal Resting Pressure

Variation of blood vessels in the cranial-cervical legion

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Forensic Medicine and Anatomy Research 2013年第4期1卷 74-79页

作者： Satoshi furukawa Satomu Morita Hayato Okunaga Lisa Wingenfeld Katsuji Nishi Department of Legal Medicine Shiga University of Medical Science ōtsu Japan Institute of Legal Medicine Munich University Munich Germany

The blood vessels in the head and neck have several main roots for supplying blood to the brain and returning of blood to the heart. It was well known that each artery and vein in the head and neck has its variation. The variation of the vessels some times gives rise to unexpectable findings, which are not described in the textbook. In this study we like to show the morphological variations observed at routine autopsy cases and some forensic pathological findings caused by those variations.

关键词： Variation of the Vessels Forensic Pathology

Immunohistochemical Analysis of p16 Expression in Uterine Smooth Muscle Tumors

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Open Journal of Obstetrics and Gynecology 2015年第12期5卷 688-697页

作者： Seiji Kanayama Hidekazu Oi Ryuji Kawaguchi Naoto furukawa Hiroshi Kobayashi Department of Obstetrics and Gynecology Nara Hospital Faculty of Medicine Kinki University Nara Japan Department of Obstetrics and Gynecology Nara Medical University Nara Japan

Objective: Immunohistochemistry with p16 antibody is used as a diagnostic marker in several gynecologic pathologies. The purpose of the present study was to evaluate the diagnostic and prognostic significance of p16 immunohistochemistry in various uterine smooth muscle tumors. Methods: Tissue specimens, including 29 leiomyomas, 13 smooth muscle tumors of uncertain malignant potential (STUMP), and 17 leiomyosarcomas, were obtained from 59 patients with uterine smooth muscle tumors. The prevalence of p16 expression in various uterine smooth muscle tumors was examined using immunohistochemistry methods and we investigated the association between p16 expression and various clinicopathologic parameters, including prognosis of leiomyosarcomas. Results: The prevalence of p16 expression of leiomyomas, STUMP, and leiomyosarcomas tumors was 10.3%, 38.4%, and 76.4%, respectively. The prevalence and immunohistochemistry scores of p16 were significantly higher in the leiomyosarcomas group than in the leiomyomas or STUMP tumor groups. In the leiomyosarcomas groups, p16 immunohistochemistry scores were significantly higher in the groups with more advanced stage, higher mitotic activity, and recurrence. The relationship among p16 immunohistochemistry scores and age, tumor size, extent of necrosis, and degree of myometrial invasion was not significant. High expression of p16 in leiomyosarcomas was linked to shorter disease-free and overall survival. Conclusions: The use of p16 immunohisitochemistry is a useful marker in differential diagnosis in various uterine smooth muscle tumors. Moreover, p16 overexpression possibly plays an important role in tumor progression and we demonstrate that p16 may be a predictor of overall survival in patients with leiomyosarcoma tumors.

关键词： Leiomyoma Leiomyosarcomas p16 Smooth Muscle Tumors STUMP

Maintenance of High Blood Pressure and Early Establishment of Pulsatile Blood Flow to the Spinal Cord during Thoracoabdominal Aortic Repair

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World Journal of Cardiovascular Surgery 2018年第10期8卷 175-188页

作者： Koji furukawa Eisaku Nakamura Masanori Nishimura Hirohito Ishii Kunihide Nakamura Department of Cardiovascular Surgery Faculty of Medicine University of Miyazaki Miyazaki Japan Department of Cardiovascular Surgery Miyazaki Medical Association Hospital Miyazaki Japan

Objectives: Despite continuous advancements in the surgical treatments for thoracoabdominal aortic aneurysms (TAAA), paraplegia remains a devastating treatment-related complication. We aimed to summarize our experience with a novel surgical strategy involving maintenance of high blood pressure and early establishment of pulsatile blood flow to the spinal cord. Materials and Methods: Between August 2011 and October 2017, 29 patients (age, 67 ± 12 years) underwent open surgery for TAAA. According to the Crawford classification, two aneurysms were type I, eight were type II, 12 were type III, and seven were type IV. We used partial cardiopulmonary bypass under mild hypothermia in all patients except one. By maintaining distal aortic perfusion pressure at 60 - 80 mmHg and creating the distal aortic anastomosis before visceral branch reconstruction, we established early perfusion of the hypogastric arteries with native pulsatile flow. Intraoperative spinal monitoring and cerebrospinal fluid drainage were performed in 26 (90%) and 23 (79%) patients, respectively. Nineteen patients (66%) underwent reconstruction of the intercostal arteries. During perioperative management, the mean arterial pressure was kept >80 mmHg. Results: No in-hospital deaths or acute neurological complications occurred. One patient (3.4%) experienced delayed temporal paraplegia. During follow-up, aorta-related death occurred in only one patient, who developed prosthetic vascular graft infection but did not undergo repeat graft replacement. The 3-year freedom from aortic-related death was 95%. Conclusion: Our surgical strategy involving maintenance of high blood pressure and early establishment of pulsatile flow to the spinal cord was effective in preventing spinal cord injury following open surgery for TAAA.

关键词： Thoracoabdominal Aortic Aneurysm Open Surgery High-Blood-Pressure Maintenance Pulsatile Flow

Real-world local recurrence rate after cold polypectomy in colorectal polyps less than 10 mm using propensity score matching

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World Journal of Gastroenterology 2021年第47期27卷 8182-8193页

作者： Masashi Saito Takeshi Yamamura Masanao Nakamura Keiko Maeda Tsunaki Sawada Eri Ishikawa Yasuyuki Mizutani Takuya Ishikawa Naomi Kakushima Kazuhiro furukawa Eizaburo Ohno Hiroki Kawashima Masatoshi Ishigami Mitsuhiro Fujishiro Department of Gastroenterology and Hepatology Nagoya University Graduate School of MedicineNagoya 4668550Japan Department of Endoscopy Nagoya University HospitalNagoya 4668550Japan

BACKGROUND Cold polypectomy(CP)is a simple and safe procedure for polyps less than 10 mm in size;however,there is concern about local recurrence following CP because of unidentified margins of excised specimens and the lack of tumor suppression effect by *** clinical trials have evaluated local persistent recurrence;their results suggest that a higher rate of local recurrence has not been documented so *** were few reports that observed the course over long periods of time after CP in clinical *** To evaluate the presence of local recurrence following CP and hot polypectomy(HP)using propensity score *** We analyzed 275 patients who underwent polypectomy for non-pedunculated colorectal polyps less than 10 mm(959 Lesions)between October 2016 and 2017 and underwent follow-up endoscopy *** divided them into the CP group(706 Lesions),wherein CP was performed,and the HP group(253 Lesions),wherein HP was *** propensity score matching,we extracted 215 Lesions in each group and evaluated the local recurrence and content of CP in the real clinic and adverse events using medical *** After propensity score matching,there were no significant differences in the patients’and their endoscopic background(age,use of antithrombotics,indications,size,morphology,location of polyps,and polypectomy device)between the *** mean duration between colorectal polypectomy and the next follow-up colonoscopy was 17.5±7.1(range,6-39)mo in the CP group and 15.7±6.0(range,6-35)mo in the HP group,which was significantly longer in the CP group(P=0.005).The local recurrence rate was 0.93%in the CP group and 0.93%in the HP group,without a significant difference(P=0.688).Additionally,no differences were observed in the macroscopic en bloc resection rate,histopathological complete resection rate,and pathological results between the *** events did not occur in either *** Local recurrence after CP was

关键词： Cold polypectomy Colorectal polyp Hot polypectomy Local recurrence Safety Propensity score matching

Strangulated hernia through a defect of the broad ligament and mobile cecum: A case report

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World Journal of Gastroenterology 2006年第9期12卷 1479-1480页

作者： Kunihiko Hiraiwa Kyoei Morozumi Hiroshi Miyazaki Keiichi Sotome Akio furukawa Makoto Nakamaru Department of Surgery Hamamatsu Red Cross Hospital HamamatsuShizuokaJapan Department of Surgery Fussa Hospital FussaTokyoJapan

我们报导 28 岁的女人与小肠阻塞介绍的一个案例。她有既不优先的外科也不交货。笔直地腹的拍在中间的腹部和骨盆的洞在小肠揭示了几个空气液体层次。计算断层摄影术在道格拉斯的窝表明了一个扩大的小肠环，但是没有明确的诊断能被做。... 详细信息

我们报导 28 岁的女人与小肠阻塞介绍的一个案例。她有既不优先的外科也不交货。笔直地腹的拍在中间的腹部和骨盆的洞在小肠揭示了几个空气液体层次。计算断层摄影术在道格拉斯的窝表明了一个扩大的小肠环，但是没有明确的诊断能被做。有由一个长肠的试管排干肠的液体的支持的治疗没导致改进，它建议了绞窄性疝的可能性。探索剖腹术揭示了活动盲肠和回肠成疝的 20 厘米的长度进正确阔韧带的一个缺点。当一个坏疽的变化在监禁的肠被认出，它的切除术被执行，由阔韧带的缺点的端对端的吻合和闭合列在后面。手术后的功课是平静的。肠梗阻是为到一个紧急情况部门的表示的一个很普通的原因，当内疝是阻塞的一个稀罕原因时。在内疝之中，通过阔韧带的缺点的那些是极其稀罕的。阔韧带的缺点能对外科，骨盆的煽动性的疾病，和交货损伤先天或第二等。在结论，我们强调阔韧带的那脱肠应该为与肠梗阻介绍的女病人被加到鉴别诊断的表。从窒息的早诊断和外科的修理还原剂病态和死亡。

关键词：肠疝韧带可移动盲肠病例报告