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Efficient hemostatic method for endoscopic submucosal dissection of colorectal tumors

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World Journal of Gastroenterology 2010年第33期16卷 4180-4186页

作者： naohisa yoshida Yuji Naito Munehiro Kugai Ken Inoue Naoki Wakabayashi Nobuaki Yagi Akio Yanagisawa Toshikazu Yoshikawa Department of Molecular Gastroenterology and Hepatology Kyoto Prefectural University of MedicineGraduate School of Medical Science Department of Surgical Pathology Kyoto Prefectural University of MedicineGraduate School of Medical Science

AIM:To evaluate a new hemostatic method using hemostatic forceps to prevent perforation and perioperative hemorrhage during colonic endoscopic submucosal dissection(ESD).METHODS:We studied 250 cases,in which ESD for colorectal tumors was performed at the Kyoto Prefectural University of Medicine or Nara City Hospital between 2005 and *** developed a new hemostatic method using hemostatic forceps in December 2008 for the efficient treatment of submucosal thick *** was performed on 126 cases after adoption of the new method(the adopted group)and the new method was performed on 102 of these *** was performed on 124 cases before the adoption of the new method (the unadopted group).The details of the new method are as follows:firstly,a vessel was coagulated using the hemostatic forceps in the soft coagulation mode according to the standard procedure,and the coagulated vessel was removed using the forceps in the"endocut" mode without perioperative ***,the partial surrounding submucosa was dissected using the forceps in the endocut *** the current study,we evaluated the efficacy of this ***:Coagulated vessels were successfully removed using the hemostatic forceps in all 102 cases without severe perioperative *** perioperative hemorrhage occurred in five cases(4.9%);however,it was stopped by immediately reuse of the hemostatic *** partial surrounding submucosa was dissected using the forceps in all 102 *** the adopted group,the median operation time was 105 *** proportion of endoscopic en bloc resection was 92.8%(P<0.01)compared to 80.6%in the unadopted *** postoperative hemorrhage and perforation rates were 2.3%and 2.3%.The rate of perforation was significantly lower than that in the unadopted group (9.6%,P<0.01).We evaluated the ease of use of this method by allowing our three trainees to performed ESD on 46 cases,which were accomplished without any severe ***:The new

关键词： Endoscopic submucosal dissection Colorectal tumor Hemostatic forceps Perforation Perioperative hemorrhage

Detection of BCL2-IGHrearrangement on paraffin-embedded tissue sections obtained from a small submucosal tumor of the rectum in a patient with recurrent follicular lymphoma

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World Journal of Gastroenterology 2004年第17期10卷 2602-2604页

作者： naohisa yoshida Kenichi Nomura Yosuke Matsumoto Kazuhiro Nishida Naoki Wakabayashi Hideyuki Konishi Shoji Mitsufuji Keisho Kataoka Takeshi Okanoue Masafumi Taniwaki Molecular Gastroenterology and Hepatology Kyoto Prefectural University of Medicine Graduate School of Medical ScienceKyoto 602-8566Japan Molecular Hematology and Oncology Kyoto Prefectural University of Medicine Graduate School of Medical ScienceKyoto 602-8566Japan Clinical Molecular Genetics and Laboratory Medicine Kyoto Prefectural University of Medicine Graduate School of Medical ScienceKyoto 602-8566Japan

A 59-year-old woman was admitted to our hospital because of recurrent follicular lymphoma(FL).Colonoscopic examination revealed a rectal submucosal tumor(SMT)without any erosions and *** this patient,it was difficult to distinguish non-Hodgkin's lymphoma(NHL)invasion from other disorders of the colon including carcinoid tumor merely based on endoscopic *** and immunohistochemical studies on biopsy specimens showed an infiltration of atypical lymphocytes that were positive for CD20 and BCL2 but negative for *** in situ hybridization on paraffin-embedded tissue sections (T-FISH)identified a translocation of BCL2 with IGHgene. Based on these findings,the tumor was defined as an invasion of FL.T-FISH method is useful for the detection of a monoclonality of atypical lymphocytes in an SMT of the gastrointestinal tract,and particularly for the detection of chromosomal translocations specific to lymphoma subtypes.

关键词： Gene Rearrangement Biopsy Female Humans Immunoglobulin Heavy Chains In Situ Hybridization, Fluorescence Lymphoma, Follicular Middle Aged Neoplasm Recurrence, Local Paraffin Embedding Proto-Oncogene Proteins c-bcl-2 Rectal Neoplasms

Trisomy 3 may predict a poor response of gastric MALT lymphoma to Helicobacter pylori eradication therapy

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World Journal of Gastroenterology 2005年第1期11卷 89-93页

作者： Sawako Taji Kenichi Nomura Yosuke Matsumoto Hideaki Sakabe naohisa yoshida Shoji Mitsufuji Kazuhiro Nishida Shigeo Horiike Shigeo Nakamura Masuji Morita Masafumi Taniwaki Molecular Gastroenterology and Hepatology Molecular Hematology and Oncology Department of Internal Medicine Department of Pathology and Clinical Laboratories School of Nursing Clinical Molecular Genetics and Laboratory Medicine

AIM: To investigate the relation of the response to Helicobacter pylori eradication therapy to the depth of tumor invasion and chromosome abnormalities in patients with mucosaassociated lymphoid tissue (MALT) lymphoma and to determine the clinical value of ***: We studied 13 patients with localized gastric MALT lymphoma of stage E1. Before eradication therapy,the depth of tumor invasion was assessed by endoscopic ultrasonography in 8 patients and by endoscopic examination and gastrointestinal series in the remaining patients. To detect chromosomal abnormalities, paraffin-embedded tissue sections of diagnostic biopsy specimens underwent tissuefluorescence in situ hybridization (FISH), using chromosomespecific α-satellite DNA probes for chromosomes 3,7,12,and 18 and YAC clones for t(11;18)(q21;q21).RESULTS: Seven of the 13 patients had complete regression(CR) in response to H pylori eradication therapy. No patient with CR had submucosal tumor invasion. Trisomy 18 was seen in 1 patient with CR, and both trisomies 12 and 18 were present in another patient with CR. All patients with no response or progressive disease had deep submucosal tumor invasion and showed t(11;18)(q21;q21) or trisomy 3. Trisomy 7 was not detected in this series of ***: The depth of tumor invasion is an accurate predictor of the response of stage E1 MALT lymphoma to H pylori eradication therapy and is closely associated with the presence of chromosomal abnormalities. Trisomy 3 may predict the aggressive development of MALT lymphoma.

关键词： Helicobacter pylori infection Gastric MALT lymphoma Trisomy 3

Successful endoscopic hemostasis for gastric arterial bleeding due to invasion of malignant lymphoma

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World Journal of Gastroenterology 2005年第27期11卷 4285-4286页

作者： Kenichi Nomura Shinya Yamada Daisuke Shimizu Takashi Okuda Yuri Kamitsuji naohisa yoshida Yosuke Matsumoto Naoki Wakabayashi Kazuya Mikami Shigeo Horiike Takeshi Okanoue Masafumi Taniwaki Masafumi Taniwaki Molecular Gastroenterology and Hepatology Department of Urology Clinical Molecular Genetics and Laboratory Medicine

A 75-year-old male with malignant lymphoma (ML) accompanied with gastric lesion was treated with combination chemotherapy. The patient produced tarry stool on the 4th d, and emergency gastroscopy showed arterial bleeding from the lesion. Hemostasis was achieved by injecting pure ethanol and using hemostatic clips. There is only one previous report on endoscopic hemostasis being effective for bleeding due to lymphoma. Since gastric bleeding causes significant mortality, endoscopic hemostasis should be considered as first-line treatment for ML patients who were treated with chemotherapy.

关键词： Malignant lymphoma Endoscopic hemostasis Pure ethanol injection Hemostatic clips

Pseudomembranous colitis presenting as acute colonic obstruction without diarrhea in a patient with gastric Burkitt lymphoma

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World Journal of Gastroenterology 2005年第17期11卷 2681-2683页

作者： Kenichi Nomura Kohei Fukumoto Daisuke Shimizu Takashi Okuda naohisa yoshida Yuri Kamitsuji Yosuke Matsumoto Hideyuki Konishi Yuji Ueda Shigeo Horiike Takeshi Okanoue Masafumi Taniwaki Department of Molecular Hematology and Oncology Kyoto Prefectural University of Medicine Graduate School of Medical ScienceKyotoJapan Department of Molecular Gastroenterology and Hepatology Kyoto Prefectural University of Medicine Graduate School of Medical ScienceKyotoJapan Department of Inflammation and Immunology Kyoto Prefectural University of Medicine Graduate School of Medical ScienceKyotoJapan Division of Digestive Surgery Kyoto Prefectural University of Medicine Graduate School of Medical ScienceKyotoJapan Department of Molecular Hematology and Oncology Kyoto Prefectural University of Medicine Graduate School of Medical ScienceKyotoJapan Department of Clinical Molecular Genetics and Laboratory MedicineKyoto Prefectural University of MedicineGraduate School of Medical ScienceKyotoJapan

Pseudomembranous colitis (PMC) usually manifests asfever and diarrhea in hospitalized patients treated withsystemic antibiotics. We described a case of PMC withintestinal obstruction but without diarrhea. A 60-yearold man was hospitalized for chemotherapy for the treatment of Burkitt lymphoma of the stomach. The patient became febrile and complained of crampy abdominal pain during the post-chemotherapy nadir. Plain abdominal radiography showed some intestinal gas and niveau. Because stool cytotoxin assay for clostridium difficile was positive and colon fiberscopic examination showed a pseudomembrane at the left side of the colon,and a diagnosis of PMC was made. Treatment with intracolonic vancomycin administration by colonoscopy and nasoileus tube was successful. Physicians should take into account the possibility of bowel obstruction due to PMC occurring in patients undergoing chemotherapy and perform emergency colonoscopy examination of suspected cases.

关键词： Pseudomembranous colitis Ileus Vancomycin Chemotherapy Lymphoma

Nonalcoholic fatty liver disease is a novel predictor of cardiovascular disease

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World Journal of Gastroenterology 2007年第10期13卷 1579-1584页

作者： Masahide Hamaguchi Takao Kojima Noriyuki Takeda Chisato Nagata Jun Takeda Hiroshi Sarui Yutaka Kawahito naohisa yoshida Atsushi Suetsugu Takahiro Kato Junichi Okuda Kazunori Ida Toshikazu Yoshikawa Inflammation and Immunology Graduate School of Medical ScienceKyoto Prefectural University of MedicineJapan Department of Gastroenterology Murakami Memorial HospitalAsahi UniversityJapan Department of Endocrinology and Metabolism Murakami Memorial HospitalAsahi UniversityJapan Department of Epidemiology & Preventive Medicine Graduate School of MedicineGifu UniversityJapan Department of Diabetes and Endocrinology Division of Molecule and StructureGraduate School of MedicineGifu UniversityJapan

AIM:To clarify whether nonalcoholic fatty liver disease(NAFLD)increases the risk of cardiovascular ***:We carried out a prospective observational study with a total of 1637 apparently healthy Japanese men and women who were recruited from a health check-up *** was diagnosed by abdominal *** metabolic syndrome(MS)was defined according to the modified National Cholesterol Education Program(NCEP)ATP Ⅲ *** years after the baseline evaluations,the incidence of cardiovascular disease was assessed by a self-administered ***:Among 1221 participants available for outcome analyses,the incidence of cardiovascular disease was higher in 231 subjects with NAFLD at baseline(5 coronary heart disease,6 ischemic stroke,and 1 cerebral hemorrhage)than 990 subjects without NAFLD(3 coronary heart disease,6 ischemic stroke,and 1 cerebral hemorrhage).Multivariate analyses indicated that NAFLD was a predictor of cardiovascular disease independent of conventional risk factors(odds ratio 4.12,95% CI,1.58 to 10.75,P = 0.004).MS was alsoindependently associated with cardiovascular *** simultaneous inclusion of NAFLD and MS in a multivariate model revealed that NAFLD but not MS retained a statistically significant correlation with cardiovascular ***:Although both of them were predictors of cardiovascular disease,NAFLD but not MS retained a statistically significant correlation with cardiovascular disease in a multivariate *** is a strong predictor of cardiovascular disease and may play a central role in the cardiovascular risk of MS.

关键词： Nonalcoholic fatty liver disease Metabolic syndrome Coronary heart disease Cardiovascular disease Risk factors

Importance of histological evaluation in endoscopic resection of early colorectal cancer

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World Journal of Gastrointestinal Pathophysiology 2012年第2期3卷 51-59页

作者： naohisa yoshida Yuji Naito Nobuaki Yagi Akio Yanagisawa Department of Molecular Gastroenterology and Hepatology Kyoto Prefectural University of MedicineGraduate School of Medical ScienceKyoto 602-8566Japan Department of Surgical Pathology Kyoto Prefectural University of MedicineGraduate School of Medical ScienceKyoto 602-8566Japan

The diagnostic criteria for colonic intraepithelial tumors vary from country to *** intramucosal adenocarcinoma is recognized in Japan,in Western countries adenocarcinoma is diagnosed only if the tumor invades to the submucosa and accesses the muscularis ***,endoscopic therapy,including endoscopic mucosal resection(EMR)and endoscopic submucosal dissection(ESD),is used worldwide to treat adenoma and early colorectal *** histopathological evaluation is important for the curativeness of these therapies as inappropriate endoscopic therapy causes local recurrence of the tumor that may develop into fatal ***,colorectal ESD and EMR are not indicated for cancers with massive submucosal ***,diagnosis of cancer with massive submucosal invasion by endoscopy is limited,even when magnifying endoscopy for pit pattern and narrow band imaging and flexible spectral imaging color of enhancement are ***,occasional cancers with massive submucosal invasion will be treated by ESD and *** histopathological evaluation of these lesions should be performed in order to determine the necessity of additional therapy,including surgical resection.

关键词： Endoscopic submucosal dissection Endoscopic mucosal resection Early colorectal cancer Histopathology

Successful treatment with rifampin for fulminant antibiotics-associated colitis in a patient with non-Hodgkin's lymphoma

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World Journal of Gastroenterology 2004年第5期10卷 765-766页

作者： Kenichi Nomura Yosuke Matsumoto naohisa yoshida Sawako Taji Naoki Wakabayashi Shoji Mitsufuji Shigeo Horiike Masuji Morita Takeshi Okanoue Masafumi Taniwaki Molecular Hematology and Oncology Kyoto Prefectural University of Medicine Graduate School of Medical ScienceKyotoJapan Molecular Gastroenterology and Hepatology Kyoto Prefectural University of Medicine Graduate School of Medical ScienceKyotoJapan School of Nursing Kyoto Prefectural University of Medicine Graduate School of Medical ScienceKyotoJapan Clinical Molecular Genetics and Laboratory Medicine Kyoto Prefectural University of Medicine Graduate School of Medical ScienceKyotoJapan

A 74-year-old man was admitted to the hospital because of chemotherapy for relapsed non-Hodgkin's lymphoma (NHL).The patient became febrile and experienced diarrhea after chemotherapy. Although ceftazidime and amikacin sulfate were administered as empiric therapy, diarrhea was *** several days, stool cytotoxin assay for clostridium difficile (C. difficile) was positive and he was diagnosed as having antibiotics-associated colitis (AAC). Although antibiotics were discontinued and both oral vancomycin and metronidazole were administrated, disease was not improved. To rule out the presence of an additional cause of diarrhea, colon fiberoscopic examination was performed. It revealed multiple deep ulcerative lesions at right side colon, surface erosive and minute erosive lesions in all continuous *** were not seen. These findings are compatible with AAC without pseudomembranes. There are no reports that the rifampin is effective on refractory ***, we administered oral rifampin for the current *** reasons are 1) conventional antibiotics were not effective,2) rifampin has excellent in vitro activity against C. difficile,and 3) the efficacy of rifampin on relapsing colitis due to *** is established. After administration of rifampin, fever alleviated and diarrhea was improved. Because AAC may result in significant mortality, patients with refractory or fulminant AAC should be treated with oral rifampin from outset.

关键词：暴发性抗生素相关性大肠炎利福平非何杰金氏淋巴瘤抗药性羧形菌病例报告

Analysis of deformation mechanisms in magnesium single crystals using a dedicated four-point bending tester

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Journal of Magnesium and Alloys 2024年第5期12卷 1911-1917页

作者： Yutaka yoshida Rikuto Izawa Kenji Ohkubo Faculty of Engineering Kitami Institute of TechnologyKoen-choKitamiHokkaido 090-8507Japan Graduate student Department of Mechanical and Electrical EngineeringKitami Institute of TechnologyKoen-choKitamiHokkaido 090-8507Japan Center for Advanced Research of Materials Faculty of EngineeringHokkaido UniversityKita-kuSapproHokkaido 060-8628Japan Kyokuto Kaihatsu Kogyo Co. Ltd.AwajiChuohuOosakaOosaka 541-0047Japan

In this study,we explored the deformation mechanisms of Mg single crystals using a combination of scanning electron microscopy and electron backscattered diffraction in conjunction with a dedicated four-point bending *** prepared two single-crystal samples,oriented along theanddirections,to assess the mechanisms of deformation when the initial basal slip was *** thesample,the primary{1012}twin(T1)was confirmed along thedirection of the sample on the compression side with an increase in bending *** thesample,T1 and the secondary twin(T2)were confirmed to be along thedirection,with an orientation of±60°with respect to the bending stress direction,and their direction matched with(0001)in T1 and *** result implies that crystallographically,the basal slip occurs *** addition,thesample showed the double twin in T1 on the compression side and the tertiary twin along thedirection on the tension *** results demonstrated that the maximum bending stress and displacement changed significantly under the bend loading because the deformation mechanisms were different for these single ***,the correlation between bending behavior and twin orientation was determined,which would be helpful for optimizing the bending properties of Mg-based materials.

关键词： Four-point bending Magnesium single crystal Twinning Basal slip Scanning electron microscopy Electron backscatter diffraction