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Rare case of fecal impaction caused by a fecalith originating in a large colonic diverticulum: A case report

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World Journal of Clinical Cases 2021年第2期9卷 416-421页

作者： Hiroki Tanabe Kazuyuki Tanaka mitsuru Goto Tomonobu Sato Keisuke Sato Mikihiro Fujiya Toshikatsu Okumura Division of Gastroenterology and Hematology/Oncology Department of MedicineAsahikawa Medical UniversityAsahikawa 078-8510HokkaidoJapan Department of Gastroenterology Asahikawa Kousei HospitalAsahikawa 078-8211HokkaidoJapan Department of Pathology Asahikawa Kousei HospitalAsahikawa 078-8211HokkaidoJapan

BACKGROUND Fecal impaction is defined as a large mass of compacted feces in the colon and has the potential to induce a serious medical condition in elderly *** impaction is generally preventable,and early recognition of the typical radiological findings is important for making an early *** factors that lead to fecal impaction are usually similar to those causing *** cases with fecal impaction associated with a diverticulum have been *** SUMMARY We present the case of a 62-year-old woman who suffered from abdominal pain and vomiting,had a medical history of repeated acute abdomen and was diagnosed with fecal impaction in the descending colon based on X-ray and computed tomography(CT)*** examination by gastrografinenhanced colonography following colonoscopy and CT colonography,the fecalith was suspected to have been produced at the site of a large diverticulum in the transverse *** fecalith was surgically resected,and a histological diagnosis of pseudodiverticulum was *** was no recurrence during 33 mo of *** This case highlights the importance of accurate identification and treatment of a fecal *** case indicated that the endoscopic evacuation and subsequent colonography were effective for identifying a diverticulum that might have caused fecal impaction.A fecal impaction was associated with the ***,the planned diverticulectomy was *** emergency medical treatment and maintenance treatments should be selected in such cases to prevent recurrence.

关键词： Colonic ileus Constipation Acute abdomen Computed tomography colonography Case report Colonoscopy

Device-assisted traction methods in colorectal endoscopic submucosal dissection and options for difficult cases

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World Journal of Gastrointestinal Endoscopy 2023年第4期15卷 265-272页

作者： mitsuru Nagata Department of Endoscopy Shonan Fujisawa Tokushukai HospitalFujisawa 251-0041KanagawaJapan

Endoscopic submucosal dissection(ESD)procedure has a longer procedure time and higher perforation rate than endoscopic mucosal resection owing to technical complications,including a poor field of vision and inadequate tension for the submucosal dissection *** traction devices were developed to secure the visual field and provide adequate tension for the dissection *** randomized controlled trials demonstrated that traction devices reduce colorectal ESD procedure time compared with conventional ESD(C-ESD),but they had limitations,including a single-center *** CONNECT-C trial was the first multicenter randomized controlled trial comparing the C-ESD and traction device-assisted ESD(T-ESD)for colorectal *** the T-ESD,one of the device-assisted traction methods(S-O clip,clip-with-line,and clip pulley)was chosen according to the operator’s *** median ESD procedure time(primary endpoint)was not significantly different between C-ESD and *** lesions≥30 mm in diameter or in cases treated by nonexpert operators,the median ESD procedure time tended to be shorter in T-ESD than in *** T-ESD did not reduce ESD procedure time,the CONNECT-C trial results suggest that T-ESD is effective for larger lesions and nonexpert operators in colorectal *** with esophageal and gastric ESD,colorectal ESD has some difficulties,including poor endoscope maneuverability,which may be associated with prolonged ESD procedure time.T-ESD may not effectively improve these issues,but a balloon-assisted endoscope and underwater ESD may be promising options and these methods can be combined with T-ESD.

关键词： Endoscopic submucosal dissection Traction Traction direction Balloonassisted endoscope Underwater endoscopic submucosal dissection

Animal Model of Lung Metastasis of Hepatocellular Carcinoma: A Tool for the Development of Anti-Metastatic Therapeutics

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Journal of Cancer Therapy 2013年第2期4卷 420-425页

作者： mitsuru Futakuchi Department of Molecular Toxicology Graduate School of Medical Sciences Nagoya City University Nagoya Japan

We observed that N-nitrosomorpholine (NMOR) given after a multi-carcinogenic treatment induces liver carcinomas with 56% lung metastasis. An additional treatment with diethylnitrosamine (DEN) with NMOR further enhanced the incidence of hepatocellular carcinoma (HCC) with lung metastasis. We have further revised the duration of NMOR treatment to establish an animal model with a simple experimental protocol and an appropriate experimental duration to facilitate investigation exploring the mechanisms of HCC metastasis and development of anti-metastatic therapeutics. We observed that DEN exposure followed by a 16-week treatment with NMOR to be a most efficient protocol for the induction of HCC metastasizing to the lung. In this review, we will discuss about the usefulness of animal models for induction of highly metastatic HCC and the assessment of the efficacy of anti-metastatic therapeutics. Additionally, we will also discuss use of these models in analysis of individual steps in the metastatic process by using non-steroidal anti-inflammatory drugs, aspirin and indomethacin, two nuclear factor kappa B (NF-κB) inhibitors, pentoxifylline and N-acetyl-L-cysteine.

关键词： Lung Metastasis Hepatocellular Carcinoma NF-κB Inhibitor

Efficacy and safety of grasping forceps-assisted endoscopic resection for gastric neoplasms:A multi-centre retrospective study

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World Journal of Gastrointestinal Oncology 2021年第3期13卷 174-184页

作者： Ryoji Ichijima Sho Suzuki mitsuru Esaki Toshiki Horii Chika Kusano Hisatomo Ikehara Takuji Gotoda Division of Gastroenterology and Hepatology Department of MedicineNihon University School of MedicineChiyoda-ku 101-0062TokyoJapan Department of Medicine and Bioregulatory Sience Graduate School of Medical SciencesKyushu UniversityFukuoka 812-8582Japan Department of Gastroenterology Yuri Kumiai General HospitalYurihonjou City 015-8511AkitaJapan

BACKGROUND Endoscopic submucosal dissection(ESD)is widely accepted for early gastric cancer(EGC)without lymph node metastasis,although ESD is challenging,even for small lesions,in the greater curvature(GC)of the upper(U)and middle(M)thirds of the *** forceps-assisted endoscopic resection(GF-ER)is a type of endoscopic mucosal resection that is performed via a double-channel *** To investigate the safety and efficacy of GF-ER vs ESD in the GC of the stomach’s U and M *** We retrospectively reviewed the medical records of 506 patients who underwent ER of 522 EGC lesions in the stomach’s U and M regions in three institutions between January 2016 and May *** lesions from eight patients who underwent GF-ER for EGC(the GF-ER group)were compared to 63 lesions from 63 patients who underwent ESD(the ESD group).We also performed a subgroup analysis of small lesions(≤10 mm)in 6 patients(7 lesions)from the GF-ER group and 20 patients(20 lesions)from the ESD *** There were no statistically significant differences between the GF-ER and ESD groups in the en bloc resection rates(100%vs 100%)and the R0 resection rates(100%vs 98.4%).The median procedure time in the GF-ER group was shorter than that in the ESD group(4.0 min vs 55.0 min,P<0.01).There were no adverse events in the GF-ER group,although five perforations(8.0%)and 1 case of postoperative bleeding(1.6%)were observed in the ESD *** we only considered lesions that were≤10 mm,the median procedure time in the GF-ER group was still shorter than that in the ESD group(4.0 min vs 35.0 min,P<0.01).There were no adverse events in the GF-ER group,although 1 case of perforation(1.6%)were observed in the ESD *** These findings suggest that GF-ER may be an effective therapeutic option for small lesions in the GC of the stomach’s U and M regions.

关键词： Gastric cancer Endoscopic resection Endoscopic submucosal dissection Endoscopic mucosal resection Grasping forceps-assisted endoscopic resection

Two traction methods that can facilitate esophageal endoscopic submucosal dissection

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World Journal of Gastrointestinal Endoscopy 2023年第4期15卷 259-264页

作者： mitsuru Nagata Department of Endoscopy Shonan Fujisawa Tokushukai HospitalFujisawa 251-0041KanagawaJapan

Different traction devices that can provide a visual field and attain appropriate tension at the dissection plane during endoscopic submucosal dissection(ESD)have been ***-with-line(CWL)is a classic traction device that can offer per-oral traction toward the direction where the line is drawn.A multicenter randomized controlled trial(CONNECT-E trial)comparing the conventional ESD and CWL-assisted ESD(CWL-ESD)for large esophageal tumors was conducted in *** study showed that CWL-ESD was associated with a shorter procedure time(defined as the time from initiating submucosal injection to completing tumor removal)without increasing the risk of adverse *** analysis revealed that whole-circumferential lesion and abdominal esophageal lesion were independent risk factors for technical difficulties,which were defined as a procedure time of>120 min,perforation,piecemeal resection,inadvertent incision(any accidental incision caused by the electrosurgical knife within the marked area),or handover to another ***,techniques other than CWL should be considered for these *** studies have shown the usefulness of endoscopic submucosal tunnel dissection(ESTD)for such lesions.A randomized controlled trial conducted at five Chinese institutions showed that compared with the conventional ESD,ESTD had a significantly reduced median procedure time for lesions covering≥1/2 of the esophageal *** addition,a propensity score matching analysis conducted at a single Chinese institution showed that compared with the conventional ESD,ESTD had a shorter mean resection time for lesions at the esophagogastric *** the appropriate use of CWL-ESD and ESTD,esophageal ESD can be performed more efficiently and ***,the combination of these two methods may be effective.

关键词： Endoscopic submucosal dissection Traction Clip-with-line Endoscopic submucosal tunnel dissection

Effects of denosumab treatment in chronic liver disease patients with osteoporosis

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World Journal of Gastroenterology 2020年第33期26卷 4960-4971页

作者： Chisato Saeki mitsuru Saito Tsunekazu Oikawa Masanori Nakano Yuichi Torisu Masayuki Saruta Akihito Tsubota Division of Gastroenterology and Hepatology Department of Internal MedicineThe Jikei University School of MedicineTokyo 1058461Japan Department of Orthopaedic Surgery The Jikei University School of MedicineTokyo 1058461Japan Core Research Facilities Research Center for Medical ScienceThe Jikei University School of MedicineTokyo 1058461Japan

BACKGROUND Effective treatment of osteoporosis is essential for improving morbidity and health-related quality of life in chronic liver disease(CLD)*** has been shown to increase bone mineral density(BMD)and decrease the risk of osteoporotic fracture in the general ***,there are few reports evaluating the efficacy of denosumab in CLD *** To investigated the effects and safety of denosumab in CLD patients with *** Sixty CLD patients with osteoporosis were subcutaneously administered denosumab once every 6 *** study period for evaluating efficacy and safety was 12 *** from baseline in BMD at the lumbar spine,femoral neck,and total hip were evaluated at 12 mo of denosumab *** turnover and quality were assessed by measuring serum tartrate-resistant acid phosphatase-5b(bone resorption marker),serum total procollagen type I N-terminal propeptide(bone formation maker),and plasma pentosidine(bone quality marker).RESULTS Among the 405 CLD patients,138(34.1%)patients were diagnosed with osteoporosis;among these,78 patients met the exclusion criteria and thus 60 patients were finally included in the present *** median percentage changes from baseline to 12 mo of denosumab treatment in BMD at the lumbar spine,femoral neck,and total hip were+4.44%,+3.71%,and+4.03%,*** significantly improved BMD,regardless of sex,patient age,and presence of liver *** tartrate-resistant acid phosphatase-5b and procollagen type I N-terminal propeptide levels constantly and significantly declined after denosumab treatment(P<0.001).Plasma pentosidine levels were also significantly lower at 12 mo of treatment(P=0.010).No patients experienced fractures and moderate-to-severe adverse events,except for transient *** Denosumab treatment was safe and increased BMD,suppressed bone turnover,and improved bone quality marker levels in CLD patients with osteoporosis,irrespective

关键词： Chronic liver disease Denosumab Osteoporosis Bone mineral density Bone turnover Bone quality

Chemoprevention of colorectal cancer by targeting obesity-related metabolic abnormalities

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World Journal of Gastroenterology 2014年第27期20卷 8939-8946页

作者： Yohei Shirakami Masahito Shimizu Masaya Kubota Hiroshi Araki Takuji Tanaka Hisataka Moriwaki mitsuru Seishima Department of Informative Clinical Medicine Gifu University Graduate School of Medicine Department of Gastroenterology Gifu University Graduate School of Medicine Department of Tumor Pathology Gifu University Graduate School of Medicine

Obesity and its related metabolic disorders, including insulin resistance and chronic inflammation, increase the risk of colorectal cancer(CRC). This observation suggests that the metabolic abnormalities associated with obesity can be effective targets for preventing the development of CRC in obese individuals. In recent years, many studies using obese and diabetic animal models have been conducted to investigate the chemoprevention of CRC using pharmaceutical or nutritional interventions. Pitavastatin, a medicine used to treat hyperlipidemia, prevents the development of obesityrelated colorectal carcinogenesis by attenuating chronic inflammation. Anti-hypertensive medicines, such as captopril and telmisartan, also suppress the formation of colonic preneoplastic lesions in obese and diabetic mice. In addition, several phytochemicals, including green tea catechins, have been reported to improve metabolic disorders and prevent the development of various cancers, including CRC. Moreover, the administration of branched-chain amino acids, which improves protein malnutrition and prevents the progression of hepatic failure, is effective for suppressing obesityrelated colon carcinogenesis, which is thought to be associated with improvements in insulin resistance. In the present article, we summarize the detailed relationship between metabolic abnormalities and the development of CRC. This review also outlines recent evidence, in particular drawing from basic and clinical examinations using either pharmaceutical or nutritional intervention that suggests that targeting metabolic alterations may be an effective strategy for preventing the development of CRC in obese individuals.

关键词： Colorectal cancer Obesity Green tea catechin Branched-chain amino acid Chemoprevention

Implications of double-stranded DNA structure for development, cancer and evolution

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Open Journal of Genetics 2011年第3期1卷 78-87页

作者： mitsuru Furusawa 不详

Genomes consist of DNA and the genetic information is encoded in a linear form of DNA. According to the central dogma of molecular biology, the genetic information is transcribed into mRNA, and mRNA translated into a polypeptide. Gene expression should be precisely regulated in order to create progeny. Unlike RNA, DNA has double-stranded structure. Is there any specific biological reason why DNA has evolved to possess double-stranded structure? In this presentation, biological implications of the double-stranded structure of the DNA molecule will be reviewed. In eukaryotes, it has been reported that cells might have the machinery that distinguishes one DNA-strand from the other, and that the strand-recognition mechanism might control development, cancer and evolution. Three prominent models concerning biological implications of replication of double-stranded DNA will be discussed: 1) Klar’s “somatic strand-specific imprinting and selective chromatid segregation model” for differential gene regulation, 2) Cairns’ “immortal strand inheritance model” for cancer prohibition, and 3) the “disparity mutagenesis model” for the acceleration of evolution proposed by the present author.

关键词： Blast Graph Theory Redundant Sequences CD-HIT

Sound-Environment Monitoring Method Based on Computational Auditory Scene Analysis

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Journal of Signal and Information Processing 2017年第2期8卷 65-77页

作者： mitsuru Kawamoto Service Sensing Assimilation and Modeling Research Group Human Informatics Research Institute National Institute of Advanced Industrial Science and Technology (AIST) Tsukuba Japan

Monitoring techniques are a key technology for examining the conditions in various scenarios, e.g., structural conditions, weather conditions, and disasters. In order to understand such scenarios, the appropriate extraction of their features from observation data is important. This paper proposes a monitoring method that allows sound environments to be expressed as a sound pattern. To this end, the concept of synesthesia is exploited. That is, the keys, tones, and pitches of the monitored sound are expressed using the three elements of color, that is, the hue, saturation, and brightness, respectively. In this paper, it is assumed that the hue, saturation, and brightness can be detected from the chromagram, sonogram, and sound spectrogram, respectively, based on a previous synesthesia experiment. Then, the sound pattern can be drawn using color, yielding a “painted sound map.” The usefulness of the proposed monitoring technique is verified using environmental sound data observed at a galleria.

关键词： Sound-Environment Visualization Environmental Sounds Monitoring Painted Sound Patterns Synesthesia