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Difficulty in differentiating two cases of sigmoid stenosis by diverticulitis from cancer

World Journal of Gastroenterology 2012年第27期18卷 3623-3626页

作者： Noriko Nishiyama Hirohito Mori Hideki Kobara Kazi Rafiq Shintarou Fujihara mitsuyoshi kobayashi Tsutomu Masaki Department of Gastroenterology and Neurology Faculty of MedicineKagawa UniversityKagawa 761-0793Japan Department of Pharmacology Faculty of MedicineKagawa UniversityKagawa 761-0793Japan

The incidence of colonic diverticulosis with or without diverticulitis has increased in the Japanese population due to the modernization of food and aging.The rate of diverticulitis in colon diverticulosis ranges from 8.1% to 9.6%.However,few cases of stenosis due to diverticulitis have been reported.These reports suggest that the differentiation between sigmoid diverticulitis and colon cancer is difficult.This report describes two cases of colon stenosis due to diverticulitis that were difficult to differentiate from colon cancer.Case 1 was a 70-year-old woman with narrowed stools for 1 month who underwent colonofiberscopy (CFS).CFS revealed a diverticulum and circumferential stenosis in the sigmoid colon.Barium enema revealed a marked,hourglassshaped,2-cm circumferential stenosis in the sigmoid colon.Fluorodeoxyglucose (FDG)-positron emission tomography computed tomography (CT) revealed an increased FDG uptake at the affected portion of the sigmoid colon.Sigmoid colon cancer was suspected,and laparoscopic sigmoidectomy was performed.Pathological examination demonstrated active inflammation with no evidence of malignancy.Case 2 was a 50-yearold man who presented to a nearby clinic with reduced stool output despite the urge to defecate.CFS detected severe stenosis in the sigmoid colon approximately 25 cm from the dentate line.Contrast-enhanced abdominal CT revealed multiple diverticula,wall thickening,and swelling of the lymph nodes around the peritoneal aorta and the inferior mesenteric artery.A partial sigmoidectomy was performed.Pathological examination of the resected specimen revealed no changes in the mucosal epithelial surface,but a marked infiltration of inflammatory cells was observed.

关键词：结肠癌狭窄正电子发射断层扫描计算机断层扫描癌症食物安全病理检查脱氧葡萄糖

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Bleeding duodenal hemangioma: Morphological changes and endoscopic mucosal resection

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World Journal of Gastroenterology 2012年第22期18卷 2872-2876页

作者： Noriko Nishiyama Hirohito Mori Hideki Kobara Shintarou Fujihara Takako Nomura mitsuyoshi kobayashi Tsutomu Masaki Department of Gastroenterology and Neurology Faculty of Medicine Kagawa Medical University

Recently, the development of endoscopic procedures has increased the availability of minimally invasive treatments; however, there have been few case reports of duodenal hemangioma treated by endoscopic mucosal resection. The present report describes a case of duodenal hemangioma that showed various endoscopic changes over time and was treated by endoscopic mucosal resection. An 80-year-old woman presented with tarry stools and a loss of appetite. An examination of her blood revealed severe anemia, and her hemoglobin level was 4.2 g/dL. An emergency upper gastrointestinal endoscopy was performed. A red, protrusive, semipedunculated tumor (approximately 20 mm in diameter) with spontaneous bleeding on its surface was found in the superior duodenal angle. Given the semipedunculated appearance of the tumor, it was suspected to be an epithelial tumor with a differential diagnosis of hyperplastic polyp. The biopsy results suggested a telangiectatic hemangioma. Because this lesion was considered to be responsible for her anemia, endoscopic mucosal resection was performed for diagnostic and treatment purposes after informed consent was obtained. A histopathological examination of the resected specimen revealed dilated and proliferated capillary lumens of various sizes, which confirmed the final diagnosis of duodenal hemangioma. Neither anemia nor tumor recurrence has been observed since the endoscopic mucosal resection (approximately 1 year). Duodenal hemangiomas can be treated endoscopically provided that sufficient consideration is given to all of the possible treatment strategies. Interestingly, duodenal hemangiomas show morphological changes that are influenced by various factors, such as mechanical stimuli.

关键词：毛细血管扩张十二指肠形态学变化切除术内镜黏膜出血鉴别诊断

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Rectal perforations and fistulae secondary to a glycerin enema:Closure by over-the-scope-clip

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World Journal of Gastroenterology 2012年第24期18卷 3177-3180页

作者： Hirohito Mori Hideki Kobara Shintaro Fujihara Noriko Nishiyama mitsuyoshi kobayashi Tsutomu Masaki Kunihiko Izuishi Yasuyuki Suzuki Department of Gastroenterology and Neurology Kagawa Medical University School of MedicineKagawa 761-0793Japan Department of Gastroenterological Surgery Kagawa Medical University School of MedicineKagawa 761-0793Japan

Rectal perforations due to glycerin enemas(GE) typically occur when the patient is in a seated or lordotic standing position.Once the perforation occurs and peritonitis results,death is usually inevitable.We describe two cases of rectal perforation and fistula caused by a GE.An 88-year-old woman presented with a large rectal perforation and a fistula just after receiving a GE.Her case was further complicated by an abscess in the right rectal wall.The second patient was a 78-year-old woman who suffered from a rectovesical fistula after a GE.In both cases,we performed direct endoscopic abscess lavage with a saline solution and closed the fistula using an over-the-scope-clip(OTSC) procedure.These procedures resulted in dramatic improvement in both patients.Direct endoscopic lavage and OTSC closure are very useful for pararectal abscess lavage and fistula closure,respectively,in elderly patients who are in poor general condition.Our two cases are the first reports of the successful endoscopic closure of fistulae using double OTSCs after endoscopic lavage of the debris and an abscess of the rectum secondary to a GE.

关键词：直肠穿孔封闭剪辑灌肠甘油继发盐水溶液

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Efficacy and safety of over-the-scope clip: Including complications after endoscopic submucosal dissection

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World Journal of Gastroenterology 2013年第18期19卷 2752-2760页

作者： Noriko Nishiyama Hirohito Mori Hideki Kobara Kazi Rafiq Shintarou Fujihara mitsuyoshi kobayashi Makoto Oryu Tsutomu Masaki Department of Gastroenterology and Neurology Faculty of Medicine Kagawa University Kagawa 761-0796 Japan Department of Pharmacology Faculty of Medicine Kagawa University Kagawa 761-0796 Japan

AIM: To retrospectively review the results of over-thescope clip (OTSC) use in our hospital and to examine the feasibility of using the OTSC to treat perforations after endoscopic submucosal dissection (ESD). METHODS: We enrolled 23 patients who presented with gastrointestinal (GI) bleeding, fistulae and perforations and were treated with OTSCs (Ovesco Endoscopy GmbH, Tuebingen, Germany) between November 2011 and September 2012. Maximum lesion size was defined as lesion diameter. The number of OTSCs to be used per patient was not decided until the lesion was completely closed. We used a twin grasper (Ovesco Endoscopy GmbH, Tuebingen, Germany) as a grasping device for all the patients. A 9 mm OTSC was chosen for use in the esophagus and colon, and a 10 mm device was used for the stomach, duodenum and rectum. The overall success rate and complications were evaluated, with a particular emphasis on patients who had undergone ESD due to adenocarcinoma. In technical successful cases we included not only complete closing by using OTSCs, but also partial closing where complete closure with OTSCs is almost difficult. In overall clinical successful cases we included only complete closing by using only OTSCs perfectly. All the OTSCs were placed by 2 experienced endoscopists. The sites closed after ESD included not only the perforation site but also all defective ulcers sites.RESULTS: A total of 23 patients [mean age 77 years (range 64-98 years)] underwent OTSC placement during the study period. The indications for OTSC placement were GI bleeding (n = 9), perforation (n = 10), fistula (n = 4) and the prevention of post-ESD duodenal artificial ulcer perforation (n = 1). One patient had a perforation caused by a glycerin enema, after which a fistula formed. Lesion closure using the OTSC alone was successful in 19 out of 23 patients, and overall success rate was 82.6%. A large lesion size (greater than 20 mm) and a delayed diagnosis (more than 1 wk) were the major contributing factors for the overall unsuccessful clinical cases

关键词： Over-the-scope clip Gastrointestinal bleed-ing Endoscopic submucosal dissection complications Gastrointestinal fistulae Gastrointestinal perforation

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Successful treatment of hypovascular advanced hepatocellular carcinoma with lipiodol-targetting intervention radiology

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World Journal of Gastroenterology 2007年第32期13卷 4398-4400页

作者： Kazutaka Kurokohchi Akihiro Deguchi Tsutomu Masaki Takashi Himoto Hirohito Yoneyama mitsuyoshi kobayashi Tsuyoshi Maeta Takaaki Kiuchi Fumikazu Kohi Hisaaki Miyoshi Tomohiko Taminato Shigeki Kuriyama Department of Gastroenterology and Neurology Kagawa University School of Medicine1750-1 IkenobeMiki-choKita-gunKagawa 761-0793Japan Department of Laboratory MedicineKagawa University School of Medicine1750-1 IkenobeMiki-choKita-gunKagawa 761-0793Japan Department of Gastroenterology and Neurology Kagawa University School of Medicine1750-1 IkenobeMiki-choKita-gunKagawa 761-0793Japan Department of Gastroenterology KKR Takamatsu Hospital4-18 TenjinmaeTakamatsuKagawa 760-0018Japan Department of Radiology KKR Takamatsu Hospital4-18 TenjinmaeTakamatsuKagawa 760-0018Japan Department of Laboratory Medicine Kagawa University School of Medicine1750-1 IkenobeMiki-choKita-gunKagawa 761-0793Japan

We report a case of hypovascular advanced hepa-tocellular carcinoma (HCC) successfully treated with a novel combination therapy of percutaneous ethanol-lipiodol injection (PELI) and intervention radiology (IVR),lipiodol-targetting IVR (Lipi-IVR). The present case had a hypovascular HCC (3 cm in diameter) located in the S6 region of the liver. Although the tumor was not detectable at all by both of early and late phase of helical dynamic computed tomography (CT),it could be detected by ultrasonography (US) as a low echoic space occupying lesion (SOL) beside the gallbladder and right kidney. Serum levels of alpha fetoprotein (AFP) and AFP-L3 were extremely high. Combination therapy of PELI,firstly reported in our department,and IVR (PELI and IVR,lipiodol-targetting IVR) was performed twice for the treatment. PELI could effectively visualize the location of the tumor for IVR treatment and show the presence of a thin blood vessel branching from the right hepatic artery flowing into the lipiodol deposit. After treatment,the serum levels of AFP and AFP-L3 were rapidly decreased to normal and maintained for more than eight months. Thus,this case expressing the tremendous effect might give us insight into the effectiveness of the novel combination therapy of PELI and IVR for the treatment of hypovascular HCC.

关键词：肝细胞癌经皮乙醇注射治疗放射医学干涉超声波检查法

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Influence of percutaneous local therapy for hepatocellular carcinoma on gastric function

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World Journal of Gastroenterology 2013年第10期19卷 1618-1624页

作者： mitsuyoshi kobayashi Fumihiko Kinekawa Kazuya Matsuda Shintaro Fujihara Noriko Nishiyama Takako Nomura Joji Tani Hisaaki Miyoshi Hideki Kobara Akihiro Deguchi Hirohito Yoneyama Hirohito Mori Tsutomu Masaki Department of Gastroenterology and Neurology Faculty of MedicineKagawa UniversityMiki-choKita-gunKagawa 761-0793Japan Department of Internal Medicine Sanuki Municipal HospitalSanuki-cityKagawa 769-2393Japan Department of Internal Medicine Matsuda ClinicTakamatsu-cityKagawa 760-0071Japan

AIM:To investigate the influence of percutaneous local therapy on gastric myoelectrical activity in patients with hepatocellular carcinomas.METHODS:Forty-four patients with hepatocellular carcinoma(HCC) [27 males and 17 females,ranging in age from 49 to 81 years old(69.7 ± 8.01 years)] who were admitted for percutaneous local therapy were enrolled in this study.We examined clinical abdominal symptoms using the Gastrointestinal Symptom Rating Scale(GSRS) before and 3 d after percutaneous local therapy.We also measured cutaneous fasting and postprandial electrogastrography(EGG) recordings before and 3 d after percutaneous local therapy.RESULTS:We found that the percentage of normogastria in the fasting period was lower in the Child B group than in the Child A group(66.8% ± 8.6% vs 84.0% ± 3.8%).After percutaneous local therapy for HCC,the percentages of normogastria in the fasting period were significantly decreased(81.6% ± 3.5% vs 75.2% ± 4.5%).None of the postprandial EGG parameters changed significantly after percutaneous local therapy for HCC.Percutaneous local therapy for HCC reduced the power ratio(PR).In particular,the PR of tachygastria was significantly decreased after therapy(P < 0.01).However,no significant differences were found in the postprandial EGG parameters.Likewise,no significant differences were found in the calculated GSRS scores obtained from the questionnaire before and after therapy.CONCLUSION:Gastric slow-wave dysrhythmias were induced by percutaneous local therapy in HCC patients,even though the GSRS scores obtained from the questionnaire did not change significantly.

关键词： Gastric myoelectrical activity Electrogastrography Hepatocellular carcinoma Percutaneous ethanol injection Radiofrequency ablation

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Fundamental Study on Response Properties of Structures Constructed on Lunar Regolith

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Open Journal of Earthquake Research 2024年第1期13卷 27-40页

作者： Yuji Miyamoto Takaharu Nakano Toshio kobayashi Department of Architecture and Civil Engineering Fukui University of Technology Fukui Japan Graduate School of Engineering Osaka University Osaka Japan SANSEI Inc. Tokyo Japan

The Artemis Program, for constructing the lunar base, is in progress. How to design and construct architectural and civil engineering structures in the lunar environment has become an important issue. The lunar surface is covered with soft sand, called regolith, and it is required to protect lunar bases and structures, as well as internal precision equipment, against vibrational disturbances such as moonquakes and meteorite collisions. Therefore, in this study, the static and cyclic triaxial compression tests of the regolith simulant were conducted. The reference strain and equivalent damping factor of the regolith simulant were smaller compared to sandy soil on Earth. In addition, a shaking table test using model specimens was conducted on the response properties of regolith ground alone and structures set on regolith ground. The buried foundation and pile foundation notably suppressed the horizontal response attributed to the rocking component compared to a direct foundation.

关键词： Lunar Development Regolith Soil-Structure Interaction Triaxial Compression Test Shaking Table Test

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TiO₂-PES Fibrous Composite Material for Ammonia Removal Using UV-A Photocatalyst

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Journal of Materials Science and Chemical Engineering 2024年第1期12卷 1-19页

作者： Anh Phuong Le Thi Masaru Ohshiro Takaomi kobayashi Department of Science and Technology Innovation Nagaoka University of Technology Nagaoka Japan Kasai Corporation Niigata Japan

This study focused on the development and characterization of TiO2-PES composite fibers with varying TiO2 loading amounts using a phase inversion process. The resulting composite fibers exhibited a sponge-like structure with embedded TiO2 nanoparticles within a polymer matrix. Their photocatalytic performance for ammonia removal from aqueous solutions under UV-A light exposure was thoroughly investigated. The findings revealed that PeTi8 composite fibers displayed superior adsorption capacity compared to other samples. Moreover, the study explored the impact of pH, light intensity, and catalyst dosage on the photocatalytic degradation of ammonia. Adsorption equilibrium isotherms closely followed the Langmuir model, with the results indicating a correlation between qm values of 2.49 mg/g and the porous structure of the adsorbents. The research underscored the efficacy of TiO2 composite fibers in the photocatalytic removal of aqueous under UV-A light. Notably, increasing the distance between the photocatalyst and the light source resulted in de-creased hydroxyl radical concentration, influencing photocatalytic efficiency. These findings contribute to our understanding of TiO2 composite fibers as promising photocatalysts for ammonia removal in water treatment applications.

关键词： Ammonia Removal Photocatalyst TiO2-PES Composite Fiber Fibrous Material

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Unroofing Technique for Anomalous Origin of the Left Coronary Artery from the Right Sinus of Valsalva: Report of a Case

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World Journal of Cardiovascular Surgery 2024年第6期14卷 69-77页

作者： Keisuke Morimoto Futoshi kobayashi Hiromu Horie Yuki Sakaguchi Einosuke Mizuta Department of Cardiovascular Surgery Sanin Rosai Hospital Yonago Japan Department ofCardiology Sanin Rosai Hospital Yonago Japan

Anomalous origin of the left coronary artery (AOLCA) from the right sinus of Valsalva constitutes a rare congenital coronary artery anomaly. Patients with an anomalous left main coronary artery face a significantly higher risk of sudden cardiac death compared to those with an anomalous right coronary artery. The anomalous coronary artery traversing between the ascending aorta and the pulmonary artery markedly heightens the risk of myocardial ischemia, arrhythmia, and sudden death. Symptomatic patients often exhibit a longer intramural course of the coronary artery, which may necessitate earlier intervention or influence the choice of surgical repair method. Surgical intervention is advocated for patients with this anomaly, even in the absence of symptoms. For anomalous aortic origin of a coronary artery from the opposite sinus of Valsalva with an intramural course, coronary unroofing is the preferred revascularization procedure. This report presents a case of AOLCA originating from the right sinus of Valsalva, treated surgically using the unroofing technique for the aortic intramural segment of the anomalous coronary artery traversing between the great vessels. The unroofing technique is recommended for treating AOLCA with an extensive intramural course that does not involve the commissure.

关键词： Unroofing Technique Anomaly of Coronary Artery Anomalous Origin of Left Coronary Artery

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在中国简牍研究中应用日本木简研究成果的可能性——以马场基《日本古代木简论》为切入点

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敦煌学辑刊 2024年第1期1卷 25-38页

作者：小林文治南开大学历史学院天津300350

近年来,简牍研究的理论内容高速发展,并集中于“简牍学”的形成。在这样的大背景下,中国的简牍研究者开始着眼于国外的简牍研究成果也实属必然。日本木简的研究成果总量十分庞大,并且研究分类十分细致。马场基所著的《日本古代木简论》... 详细信息

近年来,简牍研究的理论内容高速发展,并集中于“简牍学”的形成。在这样的大背景下,中国的简牍研究者开始着眼于国外的简牍研究成果也实属必然。日本木简的研究成果总量十分庞大,并且研究分类十分细致。马场基所著的《日本古代木简论》着重展现、推进了东亚研究视野下的木简研究,充分体现了现阶段日本木简研究最前沿的成果。本文认为,马场氏的研究方式或许蕴含着能给中国的简牍研究带来全新的视角和研究方式的可能性。本文通过马场氏著作的相关讨论,对如何将日本木简研究中的方法应用至中国简牍研究进行探讨。

关键词：日本木简中国简牍简牍学

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