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Factors associated with complicated erosive esophagitis: A Japanese multicenter, prospective, cross-sectional study

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World Journal of Gastroenterology 2017年第2期23卷 318-327页

作者： masahiro Sakaguchi Noriaki Manabe Nobuo Ueki Jun Miwa Tomoki Inaba Norimasa Yoshida Kouichi Sakurai masahiro nakagawa Hajime Yamada Michiya Saito Koji Nakada Katsuhiko Iwakiri Takashi Joh Ken Haruma Department of Gastroenterology Moriguchi Keijinkai Hospital Division of Endoscopy and Ultrasonography Department of Clinical Pathology and Laboratory MedicineKawasaki Medical School Department of Internal Gastroenterology and Hepatology Tokyo Rosai Hospital Department of Gastroenterology Toshiba General Hospital Department of Gastroenterology Kagawa Prefectural Central Hospital Department of Gastroenterology Japanese Red Cross Kyoto Daiichi Hospital Hattori Clinic Department of Endoscopy Hiroshima City Hospital Department of Gastroenterology and Hepatology Shinko Hospital1 Michiya Clinic1 Department of Laboratory Medicine Daisan Hospital Jikei University School of Medicine1 Department of Gastroenterology Nippon Medical School Graduate School of Medicine1 Department of Gastroenterology and Metabolism Nagoya City University Graduate School of Medical Sciences1 Department of General Internal Medicine 2 Kawasaki Medical School General Medical Center

AIM To assess the clinical characteristics of patients with complicated erosive esophagitis(EE) and their associated *** This prospective, cross-sectional study included patients diagnosed with EE by upper gastrointestinal endoscopy between October 2014 and March 2015 at 106 Japanese hospitals. Data on medical history, general condition, gastrointestinal symptoms, lifestyle habits, comorbidities, and endoscopic findings were collected using a standard form to create a dedicated database. Logistic regression analysis was used to calculate adjusted odds ratios(aO R) and 95%CI for the association with complicated *** During the study period, 1749 patients diagnosed with EE, 38.3% of whom were prescribed proton pump inhibitors(PPIs) were included. Of them, 143(8.2%) had EE complications. Esophageal bleeding occurred in 84(4.8%) patients, esophageal strictures in 45(2.6%) patients, and 14(0.8%) patients experienced both. Multivariate analysis showed that increased age(a OR: 1.05; 95%CI: 1.03-1.08), concomitant use of psychotropic agents(a OR: 6.51; 95%CI: 3.01-13.61), and Los Angeles grades B(a OR: 2.69; 95%CI: 1.48-4.96), C(aO R: 15.38; 95%CI: 8.62-28.37), and D(aO R: 71.49; 95%CI: 37.47-142.01) were significantly associated with complications, whereas alcohol consumption 2-4 d/wk was negatively associated(a OR: 0.23; 95%CI: 0.06-0.61). Analyzing associated factors with each EE complication separately showed esophageal ulcer bleeding were associated with increased age(a OR: 1.05; 95%CI: 1.02-1.07) and Los Angeles grades B(aO R: 3.60; 95%CI: 1.52-8.50), C(a OR: 27.61; 95%CI: 12.34-61.80), and D(a OR: 119.09; 95%CI: 51.15-277.29), while esophageal strictures were associated with increased age(a OR: 1.07; 95%CI: 1.04-1.10), gastroesophageal reflux symptom(aO R: 2.51; 95%CI: 1.39-4.51), concomitantuse of psychotropic agents(a OR: 11.79; 95%CI: 5.06-27.48), Los Angeles grades C(aO R: 7.35; 95%CI: 3.32-16.25), and D(a OR: 20.34; 95%CI: 8.36-49.53) and long-

关键词：复杂并发症腐蚀食道炎质子泵禁止者食道的溃疡流血食道的苛评

Management of gastric mucosa-associated lymphoid tissue lymphoma in patients with extra copies of the MALT1 gene

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World Journal of Gastroenterology 2017年第33期23卷 6155-6163页

作者： Masaya Iwamuro Ryuta Takenaka masahiro nakagawa Yuki Moritou Shunsuke Saito Shinichiro Hori Tomoki Inaba Yoshinari Kawai Tatsuya Toyokawa Takehiro Tanaka Tadashi Yoshino Hiroyuki Okada Department of Gastroen-terology and Hepatology Okayama University Graduate School of MedicineDentistryand Pharmaceutical Sciences Department of Internal Medicine Tsuyama Chuo Hospital Department of Internal Medicine Hiroshima City Hospital Department of Gastroenterology Mitoyo General Hospital Department of Internal Medicine Okayama Saiseikai General Hospital Department of Gastroenterology Shikoku Cancer Center Department of Gastroenterology Kagawa Prefectural Central Hospital Department of Gastroenterology Onomichi Municipal Hospital Department of Gastroenterology Fukuyama Medical Center Department of Pathology Okayama University Hospital Department of Pathology Okayama University Graduate School of MedicineDentistryand Pharmaceutical Sciences

AIM To identify the clinical features of gastric mucosaassociated lymphoid tissue(MALT) lymphoma with extra copies of *** This is a multi-centered,retrospective study. We reviewed 146 patients with MALT lymphoma in the stomach who underwent fluorescence in situ hybridization analysis for t(11;18) translocation. Patients were subdivided into patients without t(11;18) translocation or extra copies of MALT1(Group A,n = 88),patients with t(11;18) translocation(Group B,n = 27),and patients with extra copies of MALT1(Group C,n = 31). The clinical background,treatment,and outcomes of each group were *** Groups A and C showed slight female predominance,whereas Group B showed slight male predominance. Mean ages and clinical stages at lymphoma diagnosis were not different between groups. Complete response was obtained in 61 patients in Group A(69.3%),22 in Group B(81.5%),and 21 in Group C(67.7%). Helicobacter pylori(H. pylori) eradication alone resulted in complete remission in 44 patients in Group A and 13 in Group C. In Group B,14 patients underwent radiotherapy alone,which resulted in lymphoma disappearance. Although the difference was not statistically significant,event-free survival in Group C tended to be inferior to that in Group A(P = 0.10).CONCLUSION Patients with t(11;18) translocation should be treated differently from others. Patients with extra copies of MALT1 could be initially treated with H. pylori eradication,similar to patients without t(11;18) translocation or extra copies of MALT1.

关键词： Extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue Gastric neoplasms Esophagogastroduodenoscopy t(11 18) translocation Trisomy 18

Efficacy and safety of endoscopic submucosal dissection for gastric tube cancer:A multicenter retrospective study

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World Journal of Gastroenterology 2021年第11期27卷 1043-1054页

作者： Takuya Satomi Seiji Kawano Tomoki Inaba masahiro nakagawa Hirokazu Mouri Masao Yoshioka Shoichi Tanaka Tatsuya Toyokawa Sayo Kobayashi Takehiro Tanaka Hiromitsu Kanzaki Masaya Iwamuro Yoshiro Kawahara Hiroyuki OkadaDepartment of Gastroenterology and Hepatology Department of Gastroenterology and Hepatology Okayama University Graduate School of MedicineDentistryand Pharmaceutical SciencesOkayama 700-8558OkayamaJapan Department of Gastroenterology Kagawa Prefectural Central HospitalTakamatsu 760-8557KagawaJapan Department of Endoscopy Hiroshima City Hiroshima Citizens HospitalHiroshima 730-8518HiroshimaJapan Department of Gastroenterology and Hepatology Kurashiki Central HospitalKurashiki 710-8602OkayamaJapan Department of Gastroenterology and Hepatology Okayama Saiseikai General HospitalOkayama 700-8511OkayamaJapan Department of Gastroenterology National Hospital Organization Iwakuni Clinical CenterIwakuni 740-8510YamaguchiJapan Department of Gastroenterology National Hospital Organization Fukuyama Medical CenterFukuyama 720-8521HiroshimaJapan Department of Internal Medicine Fukuyama City HospitalFukuyama 721-8511HiroshimaJapan Department of Pathology Okayama University HospitalOkayama 700-8558OkayamaJapan Department of Practical Gastrointestinal Endoscopy Okayama University Graduate School of MedicineDentistry and Pharmaceutical SciencesOkayama 700-8558OkayamaJapan

BACKGROUND Recent improvements in the prognosis of patients with esophageal cancer have led to the increased occurrence of gastric tube cancer(GTC)in the reconstructed gastric ***,there are few reports on the treatment results of endoscopic submucosal dissection(ESD)for *** To evaluate the efficacy and safety of ESD for GTC after esophagectomy in a multicenter *** We retrospectively investigated 48 GTC lesions in 38 consecutive patients with GTC in the reconstructed gastric tube after esophagectomy who had undergone ESD between January 2005 and December 2019 at 8 institutions participating in the Okayama Gut Study *** clinical indications of ESD for early gastric cancer were similarly applied for GTC after *** specimens were evaluated in 2-mm slices according to the Japanese Classification of Gastric Carcinoma with curability assessments divided into curative and non-curative resection based on the Gastric Cancer Treatment *** characteristics,treatment results,clinical course,and treatment outcomes were *** The median age of patients was 71.5 years(range,57-84years),and there were 34 men and 4 *** median observation period after ESD was 884 d(range,8-4040 d).The median procedure time was 81 min(range,29-334 min),the en bloc resection rate was 91.7%(44/48),and the curative resection rate was 79%(38/48).Complications during ESD were seen in 4%(2/48)of case,and those after ESD were seen in 10%(5/48)of *** survival rate at 5 years was 59.5%.During the observation period after ESD,10 patients died of other *** there were differences in the procedure time between institutions,a multivariate analysis showed that tumor size was the only factor associated with prolonged procedure *** ESD for GTC after esophagectomy was shown to be safe and effective.

关键词： Endoscopic submucosal dissection Gastric tube Gastric cancer Esophagectomy Multicenter study Retrospective study

Regression of hepatocellular carcinoma during vitamin K administration

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World Journal of Gastroenterology 2005年第42期11卷 6722-6724页

作者： Kazuhiro Nouso Shuji Uematsu Kunihiro Shiraga Ryoichi Okamoto Ryo Harada Shoko Takayama Wakako Kawai Shigeru Kimura Toru Ueki Nobuaki Okano masahiro nakagawa Motowo Mizuno Yasuyuki Araki Yasushi Shiratori Department of Internal Medicine Hiroshima City Hospital Hiroshima 730-8518 Japan Department of Medicine and Medical Science Okayama University Graduate School of Medicine and Dentistry Okayama 700-8558 Japan

An 85-year-old man with HCV infection and diabetes mellitus was diagnosed as having hepatocellular carcinoma (HCC, 13 cm in diameter) based on high serum alpha-fetoprotein (AFP),AFP-L3,and des-γ-carboxy prothrombin levels as well as typical enhancement pattern on contrast-enhanced CT. The patient did not receive any interventional treatments because of advanced age and the advanced stage of *** chose to take vitamin K,which was reported to suppress the growth of HCC in vitro. Three months after starting vitamin K, all three tumor markers were normalized and HCC was markedly regressed, showing no enhancement in the early arterial phase on CT. Here we present the report describing the regression of HCC during the administration of vitamin K.

关键词：肝细胞癌维生素K 病理机制临床表现

A fate model of pathogenic viruses in a composting toilet based on coliphage inactivation

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Journal of Environmental Sciences 2011年第7期23卷 1194-1198页

作者： Shinobu Kazama Narue Tameike Naoko nakagawa masahiro Otaki Department of Human Environmental Science Ochanomizu University INAX Co. 1-23-6 Yoshino-cho Kita-ku Satiama 331-0811 Japan Department of Civil and Environmental Engineering Tokyo Metropolitan University 1-1 Minamiosawa Hachioji City Tokyo 192-0397 Japan

A composting toilet using sawdust as a matrix has the potential to trap pathogens that might occasionally be contained in human feces. Therefore, care should be taken when handling the sawdust. It should also be noted that pathogenic viruses tend to have stronger tolerance than pathogenic bacteria. The fates of several species of coliphages, T4, λ, Qβ and MS2, in sawdust were investigated as a viral model. The fates of coliphages were significantly different among them, and they changed in response to temperature and the water content of the sawdust. As the results, T4 coliphage had the strongest tolerance and Qβ had the weakest one in sawdust. It was estimated the days required to decrease virus to a safe level based on a risk assessment. According to the rates of Qβ and T4, 15 days and 167 days were required respectively for a safe level of infection risk based on actually operated composting toilet condition. Thus, it was significantly different depending on the species and sawdust conditions.

关键词： composting toilet viral indicator coliphage risk assessment

Field survey of a sustainable sanitation system in a residential house

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Journal of Environmental Sciences 2006年第6期18卷 1088-1093页

作者： Naoko nakagawa masahiro OTAKI Shinji MIURA Hironobu HAMASUNA Katsuyoshi ISHIZAKI Department of Human Environmental Sciences Ochanomizu University2-1-1OtsukaBunkyo-KuTokyo 112-8610Japan. City Maintenance Technical Research Center 2-9-23ShinjuShinjuku-KuTokyo 160-0023Japan Nagasaki Institute of Applied Science 536Abama-choNagasaki-shiNagasaki Pref.851-0123Japan Research Institute for a Sustainable Future Waseda University513 Tsurumaki-ChouWasedaShinjuku-KuTokyo 169-8050Japan

Sustainable sanitation is an approach for more ecological and sustainable water resources management. In this paper, we proposed one of the new integrated waste treatment systems： an ＂sustainable sanitation system＂ that includes separation of the black water from water system by a non-flushing toilet （bio-toilet）, and a gray water treatment based on a biological and ecological concept. Sustainable sanitation system also converts the domestic waste to soil conditioners and fertilizers, for farmland use. As one of the case studies, Environmentally Symbiotic Housing in which people actually live using the bio-toilet for the black water treatment and the household wastewater treatment facility for the gray water was introduced. The availability of this system was investigated by analyzing the sawdust used in the bio-toilet and the quality of the effluent in the household wastewater treatment facility. As the result, the water content of the sawdust did not exceed 60% in any of the sampling points and the BOD and COD of the effluent of the household wastewater treatment facility were below 10 and 20 mg/L respectively, due to the low loading. Compared to the pollution load on the water environment created by the conventional system, it was found that the effluent of the house has a lower load than the tertiary treatment and the volume of the water consumption is 75% of the conventional system.

关键词： bio-toilet pollution load sustainable sanitation system water consumption

Evaluation Method of the Gait Motion Based on Self-organizing Map Using the Gravity Center Fluctuation on the Sole

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International Journal of Automation and computing 2017年第5期14卷 603-614页

作者： Koji Makino masahiro Nakamura Hidenori Omori Yoshinobu Hanagata Shohei Ueda Kyosuke nakagawa Kazuyoshi Ishida Hidetsugu Terada Graduate School of Engineering University of YamanashiKofuYamanashi 400-8511Japan Kofu Municipal Hospital KofuYamanashi 400-0832Japan

This paper describes the evaluation method of the gait motion in walk rehabilitation. We assume that the evaluation consists of the classification of the measured data and the prediction of the feature of the gait motion. The method may enable a doctor and a physical therapist to recognize the condition of the patients more easily, and increase the motivation of patient further for rehabilitation. However, it is difficult to divide the gait motion into discrete categories, since the gait motion continuously changes and does not have the clear boundaries. Therefore, the self-organizing map （SOM） that is able to arrange the continuous data on the almost continuous map is employed in order to classify them. And, the feature of the gait motion is predicted by the classification. In this study, we adopt the gravity-center fluctuation （GCF） on the sole as the measured data. First, it is shown that the pattern of the CCF that is obtained by our developed measurement system includes the feature of the gait motion. Secondly, the relation between the pattern of the GCF and the feature of the gait motion that the doctor and the physical therapist evaluate by visual inspection is considered using the SOM. Next, we describe the prediction of following features measured by numerical values： the length of stride, the velocity of walk and the difference of steps that are important for the doctor and the physical therapist to make a diagnosis of the condition of the gait motion in walk rehabilitation. Finally, it is investigated that the position of a new test data that is arranged on the map accords with the prediction. As a consequence, we confirm that the method using the SOM is often useful to classify and predict the condition of the patient.

关键词： Gait motion self-organizing map (SOM) rehabilitation evaluation method gravity center fluctuation (GCF).

Indirect inguinal hernia containing portosystemic shunt vessel: A case report

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World Journal of Clinical Cases 2021年第2期9卷 509-515页

作者： masahiro Yura Kikuo Yo Asuka Hara Keita Hayashi Yuki Tajima Yasushi Kaneko Hiroto Fujisaki AkiraHirata Kiminori Takano Kumiko Hongo Kimiyasu Yoneyama Motohito nakagawa Department of Surgery Hiratsuka City HospitalHiratsuka 2540065KanagawaJapan

BACKGROUND Inguinal hernia repair is one of the most common general surgical operations *** present a case of indirect inguinal hernia containing an expanded portosystemic shunt *** SUMMARY We report a 72-year-old man who had a 4 cm×4 cm swelling in the right inguinal region,which disappeared with light manual ***-pelvic computed tomography(CT)revealed a right inguinal hernia containing an expanded portosystemic shunt vessel,which had been noted for 7 years due to liver *** performed Lichtenstein’s herniorrhaphy and identified the hernia sac as being indirect and the shunt vessel existing in the extraperitoneal cavity through the internal inguinal ***,we found two short branches between the expanded shunt vessel and testicular vein in the middle part of the inguinal canal and cut these branches to allow the shunt vessel to return to the extraperitoneal cavity of the *** hernia sac was returned as *** encountered no intraoperative *** discharge,groin seroma requiring puncture at the outpatient clinic was *** If an inguinal hernia patient has portal hypertension,ultrasound should be used to determine the contents of the *** atypical vessels are visualized,they may be shunt vessels and additional CT is recommended to ensure the selection of an adequate approach for safe hernia repair.

关键词： Inguinal hernia Lichtenstein’s herniorrhaphy Portosystemic shunt Portal hypertension Shunt vessel Case report

Unresectable esophageal cancer treated with multiple chemotherapies in combination with chemoradiotherapy:A case report

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World Journal of Clinical Cases 2021年第12期9卷 2801-2810页

作者： masahiro Yura Kazuo Koyanagi Asuka Hara Keita Hayashi Yuki Tajima Yasushi Kaneko Hiroto Fujisaki Akira Hirata Kiminori Takano Kumiko Hongo Kikuo Yo Kimiyasu Yoneyama Yoshifumi Tamai Reiko Dehari Motohito nakagawa Department of Surgery Hiratsuka City HospitalKanagawa 2540065Japan Department of Gastroenterological Surgery Tokai University School of MedicineIsehara 2591193Japan Department of Radiology Hiratsuka City HospitalKanagawa 2540065Japan Department of Surgical Pathology Hiratsuka City HospitalKanagawa 2540065Japan

BACKGROUND Definitive chemoradiotherapy(dCRT)using cisplatin plus 5fluorouracil(CF)with radiation is considered the standard treatment for unresectable locally advanced T4 esophageal squamous cell carcinoma(ESCC).Recently,induction chemotherapy has received attention as an effective treatment *** SUMMARY We report a successful case of a 59-year-old female with unresectable locally advanced T4 ESCC treated by two additional courses of chemotherapy with CF after induction chemotherapy with docetaxel,cisplatin and fluorouracil(DCF)followed by *** esophagogastroduodenoscopy(EGD)detected a type 2 advanced lesion located on the middle part of the esophagus,with *** tomography detected the primary tumor with suspected invasion of the left bronchus and 90°of direct contact with the aorta,and upper mediastinal lymph node *** findings from biopsy revealed squamous cell *** initially performed induction chemotherapy using three courses of DCF,but the lesion was still evaluated unresectable after DCF ***,we subsequently performed dCRT treatment(CF and radiation).After dCRT,prominent reduction of the primary tumor was recognized but a residual tumor with ulceration was detected by *** the patient had some surgical risk,we performed two additional courses of CF and achieved a clinically complete *** 14 mo from last administration of CF chemotherapy,recurrence has not been detected by computed tomography and EGD,and biopsy from the scar formation has revealed no cancer *** We report successful case with tumor remnants even after DCF and subsequent dCRT,for whom a complete response was finally achieved with two additional courses of CF *** CF chemotherapy could be one radical treatment option for residual ESCC after treatment with induction DCF followed by dCRT to avoid salvage surgery,especially for high-risk patients.

关键词： Unresectable esophageal cancer Induction docetaxel,cisplatin and fluorouracil Chemoradiotherapy Complete response Additional chemotherapy Case report