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Radiation exposure during image-guided endoscopic procedures: The next quality indicator for endoscopic retrograde cholangiopancreatography

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World Journal of Clinical Cases 2018年第16期6卷 1087-1093页

作者： Shiro hayashi Mamoru Takenaka Makoto Hosono Tsutomu Nishida Department of Gastroenterology and Internal Medicine Hayashi Clinic Department of Gastroenterology Toyonaka Municipal Hospital Department of Gastroenterology and Hepatology Kindai University Faculty of Medicine Department of Radiology Kindai University Faculty of Medicine

Endoscopic retrograde cholangiopancreatography(ERCP) is one of the most frequently used image-guided procedures in gastrointestinal endoscopy. Post-ERCP pancreatitis is an important concern, and prophylaxis, cannulation and other related technical procedures have been well documented by endoscopists. In addition, medical radiation exposure is of great concern in the general population because of its rapidly increasing frequency and its potential carcinogenic effects. International organizations and radiological societies have established diagnostic reference levels, which guide proper radiation use and serve as global standards for all procedures that use ionizing radiation. However, data on gastrointestinal fluoroscopic procedures are still lacking because the demand for these procedures has recently increased. In this review, we present the current status of quality indicators for ERCP and the methods for measuring radiation exposure in the clinical setting as the next quality indicator for ERCP. To reduce radiation exposure, knowledge of its adverse effects and the procedures for proper measurement and protection are essential. Additionally, further studies on the factors that affect radiation exposure, exposure management and diagnostic reference levels are necessary. Then, we can discuss how to manage medical radiation use inthese complex fluoroscopic procedures. This knowledge will help us to protect not only patients but also endoscopists and medical staff in the fluoroscopy unit.

关键词： Quality indicator Fluoroscopic procedures Endoscopic retrograde cholangiopancreatography Diagnostic reference levels Radiation exposure

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Importance of abdominal X-ray to confirm the position of levonorgestrel-releasing intrauterine system:A case report

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World Journal of Clinical Cases 2022年第15期10卷 4904-4910页

作者： Aki Maebayashi Kanoko Kato Nobuki hayashi Masaji Nagaishi Kei Kawana Obstetrics and Gynecology Nihon University HospitalTokyo 1018309Japan Obstetrics and Gynecology Nihon University School of MedicineTokyo 1738610Japan

BACKGROUND Levonorgestrel-releasing intrauterine systems(LNG-IUSs)gradually release levonorgestrel into the uterus and is effective against hypermenorrhoea and *** associated with the insertion include expulsion,displacement,and uterine *** identification of copper intrauterine devices(IUDs)is possible due to echogenicity from the copper ***,the barium sulfate coatings of LNG-IUSs do not always provide hyperechoic *** barium sulfate and copper are radiopaque and clearly identifiable on ***,X-ray imaging is required to locate *** SUMMARY A 46-year-old woman with hypermenorrhoea due to submucosal myomas was treated with LNG-IUS at another *** LNG-IUS insertions had apparently been followed by spontaneous expulsion,although objective confirmation using imaging was not *** patient was referred to our institution for *** the first visit,there appeared to be no device in the uterus,and none was observed on transvaginal ***,two LNGIUSs were observed in the pelvis on abdominal plain X-rays prior to *** myomectomy was performed,and the two LNG-IUSs were found to have perforated the *** devices were safely removed during surgery,and the submucosal myomas were also *** perforated section of the myometrium was minimal+ADs-therefore,a repair operation was not *** Plain abdominal X-rays facilitate the determination of whether an LNG-IUS is in the uterine ***,it is important to confirm a device’s location,regardless of whether spontaneous expulsion is suspected,prior to inserting another device.

关键词： Hysteroscope Intrauterine devices Levonorgestrel-releasing intrauterine system Submucosal myoma Uterine perforation Case report

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Management of thrombocytopenia due to liver cirrhosis:A review

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World Journal of Gastroenterology 2014年第10期20卷 2595-2605页

作者： Hiromitsu hayashi Toru Beppu Ken Shirabe Yoshihiko Maehara Hideo Baba Department of Gastroenterological Surgery Graduate School of Life Sciences Kumamoto University Kumamoto 860-8556 Japan Department of Surgery and Science Graduate School of Medical Sciences Kyushu University Fukuoka 812-8582 Japan

Thrombocytopenia is a common complication in liver disease and can adversely affect the treatment of liver cirrhosis,limiting the ability to administer therapy and delaying planned surgical/diagnostic procedures because of an increased risk of *** factors,including splenic sequestration,reduced activity of the hematopoietic growth factor thrombopoietin,bone marrow suppression by chronic hepatitis C virus infection and anti-cancer agents,and antiviral treatment with interferon-based therapy,can contribute to the development of thrombocytopenia in cirrhotic *** these factors,the major mechanisms for thrombocytopenia in liver cirrhosis are(1)platelet sequestration in the spleen;and(2)decreased production of thrombopoietin in the *** treatment options,including platelet transfusion,interventional partial splenic embolization,and surgical splenectomy,are now available for severe thrombocytopenia in cirrhotic *** thrombopoietin agonists and targeted agents are alternative tools for noninvasively treating thrombocytopenia due to liver cirrhosis,their ability to improve thrombocytopenia in cirrhotic patients is under investigation in clinical *** this review,we propose a treatment approach to thrombocytopenia according to our novel concept of splenic volume,and we describe the current management of thrombocytopenia due to liver cirrhosis.

关键词： Liver cirrhosis Thrombocytopenia Thrombopoietin Partial splenic embolization Splenectomy

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Quantitation of HBsAg predicts response to entecavir therapy in HBV genotype C patients

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World Journal of Gastroenterology 2012年第39期18卷 5570-5575页

作者： Etsuro Orito Kei Fujiwara Hiroshi Kanie Tesshin Ban Tomonori Yamada Katsumi hayashi Department of Gastroenterology Nagoya Daini Red Cross HospitalNagoya 466-8650Japan

AIM： To analysis the factors that predict the response to entecavir therapy in chronic hepatitis patients with hepatitis B virus （HBV） genotype C. METHODS： Fifty patients [hepatitis B e antigen （HBeAg）- negative：HBeAg-positive = 26：24] with HBV genotype C, who received nalve entecavir therapy for 〉 2 years, were analyzed. Patients who showed HBV DNA levels ≥ 3.0 log viral copies/mL after 2 years of entecavir ther- apy were designated as slow-responders, while those that showed 〈 3.0 log copies/mL were termed rapid- responders. Quantitative hepatitis B surface antigen （HBsAg） levels （qHBsAg） were determined by the Archi- tect HBsAg QT immunoassay. Hepatitis B core-related antigen was detected by enzyme immunoassay. Pre-C and Core promoter mutations were determined using by polymerase chain reaction （PCR）. Drug-resistance muta- tions were detected by the PCR-Invader method. RESULTS： At year 2, HBV DNA levels in all patients in the HBeAg-negative group were 〈 3.0 log copies/mL. In contrast, in the HBeAg-positive group, 41.7% were slow-responders, while 58.3% were rapid-responders. No entecavir-resistant mutants were detected in the slow-responders. When the pretreatment factors were compared between the slow- and rapid-responders; the median qHBsAg in the slow-responders was 4.57 log IU/mL, compared with 3.63 log IU/mL in the rapid- responders （P 〈 0.01）. When the pretreatment factors predictive of HBV DNA-negative status at year 2 in all 50 patients were analyzed, HBeAg-negative status, low HBV DNA levels, and low qHBsAg levels were signifi- cant （P 〈 0.01）. Multivariate analysis revealed that the low qHBsAg level was the most significant predictive factor （P = 0.03）. CONCLUSION： Quantitation of HBsAg could be a use- ful indicator to predict response to entecavir therapy.

关键词： Chronic hepatitis B Quantitation of hepa-titis B surface antigen Entecavir Hepatitis B virusgenotype C SIow-responders Hepatitis B core-relatedantigen Core promoter mutation Pre-C mutation

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Pyrochemical treatment of spent nitride fuels for MA transmutation

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Science China Chemistry 2014年第11期57卷 1427-1431页

作者： hayashi Hirokazu SATO Takumi SHIBATA Hiroki KURATA Masaki IWAI Takashi ARAI Yasuo Nuclear Science and Engineering Center Sector of Nuclear Science Research Japan Atomic Energy Agency2-4 Shirakata-shiraneTokai-muraNaka-gun Ibaraki-ken 319-1195 Japan

Nitride fuels have several advantages including high thermal conductivity and high metal density(like metallic fuels) and high melting point and isotropic crystal structure(like oxide fuels). Since the late 1990 s, the partitioning and transmutation of minor actinides(MA) has been studied to decrease the long-term radio-toxicity of high-level waste and to mitigate the burden of final disposal. Japan Atomic Energy Agency(JAEA) has proposed a dedicated transmutation cycle using an accelerator-driven system(ADS) with nitride fuels containing MA. The nitride fuel cycle we have developed includes a pyrochemical process. Our focus is on the electrolysis of nitride fuels and their refabrication from the recovered actinides; other processes are similar to the technology for metal fuel treatment and have been studied elsewhere. Here, we summarize our activity on the development of the pyrochemical treatment of spent nitride fuels.

关键词： nitride fuels minor actinides pyrochemical process

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A rice mutant displaying a heterochronically elongated internode carries a 100 kb deletion

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Journal of Genetics and Genomics 2011年第3期38卷 123-128页

作者： Mika hayashi-Tsugane Masahiko Maekawa Qian Qian Hirokazu Kobayashi Shigeru Iida Kazuo Tsugane National Institute for Basic Biology Okazaki 444-8585 Japan Graduate School of Nutritional and Environmental Sciences University of Shizuoka Shizuoka 422-8526 Japan Institute of Plant Science and Resources Okayama University Kurashiki 710-0046 Japan Global Center of Excellence Program University of Shizuoka Shizuoka 422-8526 Japan Graduate School of Pharmaceutical Sciences University of Shizuoka Shizuoka 422-8526 Japan The Graduate University for Advanced Studies (Sokendai) Okazaki 444-8585 Japan

We have isolated a recessive rice mutant, designated as indeterminate growth （ing）, which displays creeping and apparent heterochronic phenotypes in the vegetative period with lanky and winding culms. Rough mapping and subsequent molecular characterization revealed that the ing mutant carries a large deletion, which corresponds to a 103 kb region in the Nipponbare genome, containing nine annotated genes on chromosome 3. Of these annotated genes, the SLR1 gene encoding a DELLA protein is the only one that is well characterized in its function, and its null mutation, which is caused by a single base deletion in the middle of the intronless SLR1 gene, confers a slender phenotype that bears close resemblance to the ing mutant phenotype. The primary cause of the ing mutant phenotype is the deletion of the SLR1 gene, and the ing mutant appears to be the first characterized mutant having the entire SLR1 sequence deleted. Our results also suggest that the deleted region of 103 kb does not contain an indispensable gene, whose dysfunction must result in a lethal phenotype.

关键词： Heterochronic Elongated intemode Large deletion Map-based cloning Rice genome

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Left testicular artery arching over the ipsilateral renal vein

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Asian Journal of Andrology 2006年第1期8卷 107-110页

作者： Munekazu Naito Hayato Terayama Yoichi Nakamura Shogo hayashi Takayoshi Miyaki Masahiro Itoh Department of Anatomy Tokyo Medical UniversityTokyo 160-8402Japan

Aim： To report two cases of the left testicular artery arching over the left renal vein （LRV） before running downward to the testis. Methods： The subjects were obtained from two Japanese cadavers. During the student course of gross-anatomical dissection, the anatomical relationship between the testicular vessels and the renal vein was specifically observed. Results： The arching left testicular artery arose from the aorta below the LRV and made a loop around the LRV, which appeared to be mildly compressed between the arching artery and the psoas major muscle. Conclusion： Clinically, compression of the LRV between the abdominal aorta and the superior mesenteric artery occasionally induces LRV hypertension, resulting in varicocele, orthostatic protenuria and hematuria. Considering that the incidence of a left arching testicular artery is higher than that of a right one, an arching left artery could be an additional cause of LRV hypertension. （Asian J Androl 2006 Jan; 8： 107-110）

关键词： anatomy testis blood vessels

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Autoimmune pancreatitis complicated by gastric varices:A report of 3 cases

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World Journal of Gastroenterology 2012年第31期18卷 4228-4232页

作者： Norihiro Goto Jun Mimura Toshinao Itani Motohito hayashi Yukari Shimada Tomoaki Matsumori Department of Gastroenterology Nishi-Kobe Medical CenterHyogo 651-2273Japan

We present three cases of autoimmune pancreatitis(AIP) complicated by gastric *** 1:A 57-yearold man was diagnosed with AIP complicated by gastric varices and splenic vein *** was not detected at the time of the *** AIP improved using steroid therapy,the splenic vein was reperfused,and the gastric varices disappeared;case 2:A 55-year-old man was diagnosed with AIP complicated by gastric varices,splenic vein obstruction,and *** the AIP improved using steroid therapy,the gastric varices and splenic vein obstruction did not resolve;case 3:A 68-year-old man was diagnosed with AIP complicated by gastric varices,splenic vein obstruction,and *** gastric varices,splenic vein obstruction,and AIP did not improve using steroid *** three cases suggest that gastric varices or splenic vein obstruction without splenomegaly may be an indication for steroid therapy in patients with AIP because the complications will likely become irreversible over time.

关键词： Autoimmune Pancreatitis Gastric varices

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Small bowel anisakiosis: A report of two cases

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World Journal of Gastroenterology 2006年第25期12卷 4106-4108页

作者： Shigetoshi Matsuo Takashi Azuma Seiya Susumu Satoshi Yamaguchi Shirou Obata Tomayoshi hayashi Department of Surgery Nagasaki Prefectural Shimabara Hospital Japan Department of Radiology Nagasaki Prefectural Shimabara Hospital Japan Department of Pathology Nagasaki Prefectural Shimabara Hospital Japan

Small bowel stenosis is a serious complication of intestinal anisakiosis. The aim of this report is to investigate whether severe stenosis of the small intestine can be conservatively managed. We treated two patients with severe stenosis of the small intestine caused by anisakiosis. Surgical intervention was eventually performed on the 23^rd and 35^th in the hospital, respectively. Histopathological examination of the resected specimens revealed that the intestinal wall had been completely damaged by the inflammatory reaction of anisakiosis, and that the damage was irreversible, thereby suggesting that laparotomy is needed in cases of severe small bowel stenosis caused by intestinal anisakiosis, even if a long period of conservative treatment for the intestinal anisakiosis allowed the patient to pass successfully through the acute phase.

关键词： Anisakiosis Small intestine

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Broad-Spectrum Blast Resistance： Harnessing a Natural Allele of a Transcription Factor in Rice

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Molecular Plant 2017年第9期10卷 1144-1146页

作者： Hiroshi Takatsuji Institute of Agrobiological Sciences (NIAS) National Agriculture and Food Research Organization (NARO) 2-1-2 Kannondai Tsukuba Ibaraki 305-0051 Japan

Rice blast, which is caused by the fungus Magnaporthe oryzae, is a widespread and destructive plant disease that greatly reduces yield and grain quality worldwide. The use of host resistance is the most effective and economic way to control plant diseases. Many studies on blast resistance genes have focused on the nucleotide-binding site leucine-rich repeat （NB-LRR） resistance （called typical R） genes that mediate effector-triggered immunity. However, incorporating these R genes into rice varieties has not achieved durable blast resistance, because R-gene-mediated resistance is race-specific and often breaks down owing to the appearance of fungal variants that escape host recognition. Thus, the deployment of genes conferring non-race-specific du- rable resistance is highly desired by breeders. In plants, several genes conferring non-race-specific durable resistance genes have been isolated, but only a few of the molecular mechanisms responsible for resistance have been determined.

关键词： Broad-Spectrum Blast Resistance Harnessing a Natural Allele Transcription Factor in Rice

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