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Fulminant gastrointestinal graft-versus-host disease concomitant with cytomegalovirus infection:Case report and literature review

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World Journal of Gastroenterology 2013年第4期19卷 597-603页

作者： Hidetaka Okubo naoyoshi Nagata Naomi Uemura Department of Gastroenterology and Hepatology National Center for Global Health and MedicineTokyo 162-8655Japan Department of Gastroenterology and Hepatology Kohnodai HospitalIchikawa 272-0827ChibaJapan

Here,we report a case of fulminant gastrointestinal graft-versus-host disease(GI-GVHD) with cytomegalovirus(CMV) infection in 44-year-old *** the difficulties associated with the treatment of GIGVHD and GI-CMV disease,the mucosal findings and the clinical course showed marked improvements during long-term clinical *** endoscopic findings were remarkable,with diffuse sloughing mucosa in the stomach and highly active inflammation and deep discrete ulcers throughout the *** in the CMV quantitative polymerase chain reaction results were correlated with the endoscopic mucosal findings and were useful for assessing the efficacy of the *** a definite diagnosis of GI-GVHD is generally made by endoscopy with biopsy,the gross appearance of this disease can vary depending on the *** this paper,we also conduct a literature review of patients with GI-GVHD.

关键词： Acute gastrointestinal graft-versus-host disease Allogenic stem-cell transplantation Cytomegalovirus gastrointestinal disease Cytomegaloviruspolymerase chain reaction Endoscopy

Colonoscopy can miss diverticula of the left colon identified by barium enema

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World Journal of Gastroenterology 2013年第15期19卷 2362-2367页

作者： Ryota Niikura naoyoshi Nagata Takuro Shimbo Junichi Akiyama Naomi Uemura Department of Gastroenterology and Hepatology National Center for Global Health and MedicineShinjukuTokyo 162-8655Japan Department of Clinical Research and Informatics National Center for Global Health and MedicineShinjukuTokyo 162-8655Japan Department of Gastroenterology and Hepatology Kohnodai HospitalNational Center for Global Health and MedicineIchikawaChiba 272-8516Japan

AIM: To identify the diagnostic value of colonoscopy for diverticulosis as determined by barium enema. METHODS: A total of 65 patients with hematochezia who underwent colonoscopy and barium enema were analyzed, and the diagnostic value of colonoscopy for diverticula was assessed. The receiver operating characteristic area under the curve was compared in relation to age (< 70 or ≥ 70 years), sex, and colon location. The number of diverticula was counted, and the detection ratio was calculated. RESULTS: Colonic diverticula were observed in 46 patients with barium enema. Colonoscopy had a sensitivity of 91% and specificity of 90%. No significant differences were found in the receiver operating characteristic area under the curve (ROC-AUC) for age group or sex. The ROC-AUC of the left colon was significantly lower than that of the right colon (0.81 vs 0.96, P=0.02). Colonoscopy identified 486 colonic diverticula, while barium enema identified 1186. The detection ratio for the entire colon was therefore 0.41 (486/1186). The detection ratio in the left colon (0.32, 189/588) was significantly lower than that of the right colon (0.50, 297/598) (P < 0.01). CONCLUSION: Compared with barium enema, only half the number of colonic diverticula can be detected by colonoscopy in the entire colon and even less in the left colon.

关键词： Colonoscopic diagnosis Colonic diverticulosis Colonic diverticular bleeding Barium enema Receiver operating characteristic area under the curve

Improvement of a Real Gas-Sensor for the Origin of Methane Selectivity Degradation by l-XAFS Investigation

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Nano-Micro Letters 2015年第3期7卷 255-260页

作者： Takahiro Wada naoyoshi Murata Takuya Suzuki Hiromitsu Uehara Hiroaki Nitani Yasuhiro Niwa Motohiro Uo Kiyotaka Asakura Graduate School of Medical and Dental Sciences Tokyo Medical and Dental University Corporate R&D Headquarters Fuji Electric Co. Ltd Catalysis Research Center Hokkaido University Photon Factory Institute of Materials Structure Science

We have directly investigated the chemical state of the Pd species in a real l-gas sensor device by examining the l-fluorescence X-ray absorption fine structure. The l-gas sensor device was heavily damaged by a heating process in which the temperature was ill-controlled, resulting in decrease of methane selectivity. We found that the Pd O in the fresh l-gas sensor was reduced to Pd metal particles as the methane selectivity decreased. Based on the investigation results, we modified the device structure so as to heat up homogeneously. The lifetime of the sensor was then successfully increased by more than 5 years.

关键词： Micro gas sensor Micro-XAFS Pd/Al2O3 Deactivation

Diagnostic value of antigenemia assay for cytomegalovirus gastrointestinal disease in immunocompromised patients

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World Journal of Gastroenterology 2011年第9期17卷 1185-1191页

作者： naoyoshi Nagata Masao Kobayakawa Takuro Shimbo Kazufusa Hoshimoto Tomoyuki Yada Takuji Gotoda Junichi Akiyama Shinichi Oka Naomi Uemura Department of Gastroenterology and Hepatology National Center for Global Health and Medicine Department of Clinical Research and Informatics International Clinical Research Center Research Institute National Center for Global Health and Medicine Department of Clinical Laboratory Pathological Division National Center for Global Health and Medicine Department of Gastroenterology and Hepatology National Center for Global Health and MedicineKohnodai Hospital Division of Aids Clinical Center National Center for Global Health and Medicine

AIM:To investigate the utility of the cytomegalovirus(CMV)antigenemia assay for the diagnosis of CMV gastrointestinal disease(GID). METHODS:One hundred and thirty immunocompromised patients were enrolled in this *** with a history of anti-CMV treatment and who had not undergone examination using the antigenemia assay were ***-GID was defined as the detection of large cells with intranuclear inclusions alone or associated with granular cytoplasmic inclusions by *** sections were stained with hematoxylin and eosin and immunohistochemically stained with *** evaluated the association between CMV-GID and patient characteristics(symptoms,underlying disease,medication,leukocyte counts,and antigenemia assay).All patients were checked with an human immunodeficiency virus(HIV)antibody test before endoscopic *** blood cell(WBC)counts were obtained from medical records within 1 wk of *** was defined as a total WBC count<5000 cells/mm 3 . For HIV patients,we also checked CD4+counts from medical records. RESULTS:A total of 99 patients were retrospectively selected for *** the immunocompromised patients,19 had malignant disease,18 had autoimmune disease,19 had disorders of biochemical homeostasis, three had undergone transplantation,and 45 had HIV infection.A total of 50 patients had received immunosuppressive *** patients had inflammatory bowel ***-five patients were diagnosed as having *** analysis indicated an association between HIV infection,leukopenia,and positive antigenemia and CMV-GID(P<0.05).Multivariate analysis using logistic regression revealed that HIV infection and positive antigenemia were the only independent factors related to CMV-GID(P<0.01).The sensitivity,specificity,positive predictive value,and negative predictive value of antigenemia for CMV-GID were 65.4%,93.6%, 91.9%,and 71.0%,*** a subgroup analy-sis,patients with leukopenia displayed

关键词： Cytomegalovirus Gastrointestinal disease Antigenemia assay Real-time polymerase chain reaction Human immunodeficiency virus infection

Swine-origin influenza-virus-induced acute lung injury:Novel or classical pathogenesis?

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World Journal of Biological Chemistry 2010年第5期1卷 85-94页

作者： naoyoshi Maeda Toshimitsu Uede Division of Molecular Immunology Institute for Genetic MedicineHokkaido UniversityKita-15Nishi-7Kita-kuSapporo 060-0815Japan Research Center for Infection-associated Cancer Institute for Genetic MedicineHokkaido University Kita-15Nishi-7Kita-kuSapporo 060-0815Japan

Influenza viruses are common respiratory pathogens in humans and can cause serious infection that leads to the development of *** to their hostrange diversity,genetic and antigenic diversity,and potential to reassort genetically in vivo,influenza A viruses are continual sources of novel influenza strains that lead to the emergence of periodic epidemics and outbreaks in ***,newly emerging viral diseases are always major threats to public *** March 2009,a novel influenza virus suddenly emerged and caused a worldwide *** novel pandemic influenza virus was genetically and antigenically distinct from previous seasonal human influenza A/H1N1 viruses;it was identified to have originated from pigs,and further genetic analysis revealed it as a subtype of A/H1N1,thus later called a swine-origin influenza virus A/*** the novel virus emerged,epidemiological surveys and research on experimental animal models have been conducted,and characteristics of the novel influenza virus have been determined but the exact mechanisms of pulmonary pathogenesis remain to be *** this editorial,we summa-rize and discuss the recent pandemic caused by the novel swine-origin influenza virus A/H1N1 with a focus on the mechanism of pathogenesis to obtain an insight into potential therapeutic strategies.

关键词： Acute lung injury Influenza virus A/H1N1pdm Pandemic Swine-origin influenza virus

Post-polypectomy bleeding and thromboembolism risks associated with warfarin vs direct oral anticoagulants

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World Journal of Gastroenterology 2018年第14期24卷 1540-1549页

作者： Naohiro Yanagisawa naoyoshi Nagata Kazuhiro Watanabe Tatsuhiro Iida Mariko Hamada Sakurako Kobayashi Takuro Shimbo Junichi Akiyama Naomi Uemura Department of Gastroenterology and Hepatology National Center for Global Health and MedicineTokyo 162-8655Japan Ohta Nishinouchi Hospital Fukushima 963-8022Japan Department of Gastroenterology and Hepatology National Center for Global Health and MedicineKohnodai HospitalChiba 272-8516Japan

AIM To verify the validity of the endoscopy guidelines for patients taking warfarin or direct oral anticoagulants(DOAC).METHODS We collected data from 218 patients receiving oral anticoagulants(73 DOAC users, 145 warfarin users) and 218 patients not receiving any antithrombotics(age-and sexmatched controls) who underwent polypectomy.(1) We evaluated post-polypectomy bleeding(PPB) risk in patients receiving warfarin or DOAC compared with controls;(2) we assessed the risks of PPB and thromboembolism between three AC management methods: Discontinuing AC with heparin bridge(HPB)(endoscopy guideline recommendation), continuing AC, and discontinuing AC without *** PPB rate was significantly higher in warfarin users and DOAC users compared with controls(13.7% and 13.7% vs 0.9%, P < 0.001), but was not significantly different between rivaroxaban(13.2%), dabigatran(11.1%), and apixaban(13.3%) users. Two thromboembolic events occurred in warfarin users, but none in DOAC users. Compared with the continuing anticoagulant group, the discontinuing anticoagulant with HPB group(guideline recommendation) had a higher PPB rate(10.8% vs 19.6%, P = 0.087). These findings were significantly evident in warfarin but not DOAC users. One thrombotic event occurred in the discontinuing anticoagulant with HPB group and the discontinuing anticoagulant without HPB group; none occurred in the continuing anticoagulant *** PPB risk was similar between patients taking warfarin and DOAC. Thromboembolism was observed in warfarin users only. The guideline recommendations for HPB should be re-considered.

关键词： High-risk endoscopic procedures Novel oral anticoagulants Endoscopic guideline validation Postprocedure gastrointestinal bleeding

Current status in remnant gastric cancer after distal gastrectomy

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World Journal of Gastroenterology 2016年第8期22卷 2424-2433页

作者： Masaichi Ohira Takahiro Toyokawa Katsunobu Sakurai Naoshi Kubo Hiroaki Tanaka Kazuya Muguruma Masakazu Yashiro naoyoshi Onoda Kosei Hirakawa Department of Surgical Oncology Osaka City University Graduate School of Medicine

Remnant gastric cancer(RGC) and gastric stump cancer after distal gastrectomy(DG) are recognized as the same clinical entity. In this review, the current knowledges as well as the non-settled issues of RGC are presented. Duodenogastric reflux and denervation of the gastric mucosa are considered as the two main factors responsible for the development of RGC after benign disease. On the other hand, some precancerous circumstances which already have existed at the time of initial surgery, such as atrophic gastritis and intestinal metaplasia, are the main factors associated with RGC after gastric cancer. Although eradication of Helicobacter pylori(H. pylori) in remnant stomach is promising, it is still uncertain whether it can reduce the risk of carcinogenesis. Periodic endoscopic surveillance after DG was reported useful in detecting RGC at an early stage, which offers a chance to undergo minimally invasive endoscopic treatment or laparoscopic surgery and leads to an improved prognosis in RGC patients. Future challenges may be expected to elucidate the benefit of eradication of H. pylori in the remnant stomach if it could reduce the risk for RGC, to build an optimal endoscopic surveillance strategy after DG by stratifying the risk for development of RGC, and to develop a specific staging system for RGC for the standardization of the treatment by prospecting the prognosis.

关键词： Remnant gastric cancer Helicobacter pylori endoscopic treatment Surveillance laparoscopic surgery

Evolution History of Gassan Volcano, Northeast Japan Arc

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Open Journal of Geology 2018年第7期8卷 647-661页

作者： Ryo Oizumi Masao Ban naoyoshi Iwata Graduate School of Science and Technology Yamagata University Yamagata Japan Faculty of Science Yamagata University Yamagata Japan

Evolution history of the volcano is essential not only to characterize the volcano, but also consider magma genesis beneath the volcano. Most of the stratovolcanoes in northeast Japan follow a general evolutional course: cone building, horse-shoe shaped caldera forming collapse, and post-caldera stages. However, the detailed history of each stage is not well investigated. We investigated evolution history of young edifice of Gassan volcano, representative stratovolcano in rear side of northeast Japan arc. Most of the products are lavas, which are divided into two groups by geomorphologic and geologic features. The former (Gassan lower lavas) is composed of relatively thin and fluidal lavas, whose original geomorphology remains a little, while the latter (Gassan upper lavas) is composed of relatively thick and viscous lavas, whose original geomorphology is moderately preserved. Based on geologic features, the upper lavas can be further divided into Gassan upper north lavas and upper summit lavas in ascending order. After the formation of the thick lavas, horse-shoe shaped caldera was formed by the instability of the edifice, probably triggered by fault activity. No evidence of post caldera activity inner part of it is observed. Based on K-Ar data, estimated age of Gassan lower lavas is ca. 0.75 to ca. 0.6 Ma, those of Gassan upper north and upper summit lavas are ca. 0.60 to ca. 0.55 Ma and ca. 0.55 to ca. 0.45 Ma. The eruption rate is estimated to be ca. 0.0004 km3/1000 years in Gassan lower lavas and ca. 0.02 km3/1000 years in Gassan upper summit lavas. These values are lower than the eruption rate of representative Japanese stratovolcanoes.

关键词： Stratovolcano Andesitic Lava Evolution History Gassan Volcano NE Japan K-Ar Age Dating

Constipation, hard stools, fecal urgency, and incomplete evacuation, but not diarrhea is associated with diabetes and its related factors

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World Journal of Gastroenterology 2016年第11期22卷 3252-3260页

作者： Noriko Ihana-Sugiyama naoyoshi Nagata Ritsuko Yamamoto-Honda Eiko Izawa Hiroshi Kajio Takuro Shimbo Masafumi Kakei Naomi Uemura Junichi Akiyama Mitsuhiko Noda Department of Diabetes Endocrinology and Metabolism National Center for Global Health and Medicine Tokyo 162-8655 Japan Division of General Medicine Jichi Medical University Graduate School of Medicine Tochigi 329-0498 Japan Department of Gastroenterology and Hepatology National Center for Global Health and Medicine Tokyo 162-8655 Japan Department of Endocrinology and Metabolism Toranomon Hospital Tokyo 105-0001 Japan Diabetes Research Diabetes Research Center National Center for Global Health and Medicine Tokyo 162-8655 Japan Center for Clinical Sciences National Center for Global Health and Medicine Tokyo 162-8655 Japan Ohta Nishinouchi Hospital Fukushima 963-8022 Japan First Department of Comprehensive Medicine Saitama Medical Center Jichi Medical University School of Medicine Saitama 330-0834 Japan Department of Gastroenterology and Hepatology Kohnodai Hospital National Center for Global Health and Medicine Chiba 272-8516 Japan Department of Endocrinology and Diabetes Saitama Medical University Saitama 350-0495 Japan

AIM: To determine the bowel symptoms associated with diabetes and diabetes-related factors after excluding gastrointestinal (GI) organic ***: Participants were 4738 (603 diabetic and 4135 non-diabetic) patients who underwent colonoscopy and completed a questionnaire. On the day of pre-colonoscopy, 9 symptoms (borborygmus, abdominal distension, increased flatus, constipation, diarrhea, loose stools, hard stools, fecal urgency, and incomplete evacuation) were prospectively evaluated on a 7-point Likert scale. The test-retest reliability of the bowel symptom scores from the baseline and second questionnaires was analyzed using kappa statistics. Associations between bowel symptom scores and diabetes or diabetes-related factors were analyzed by a rank-ordered logistic model adjusted for related confounders, and odds ratios (ORs) were ***: In multivariate analysis, constipation [adjusted odds ratio (AOR) = 1.57, CI: 1.33-1.85, P < 0.01] and hard stools (AOR = 1.56, CI: 1.33-1.84, P < 0.01) were associated with diabetes, and fecal urgency (AOR = 1.16, CI: 0.99-1.37, P = 0.07) and incomplete evacuation (AOR = 1.16, CI: 1.00-1.36, P = 0.06) were marginally associated with diabetes. These symptoms remained associated even after excluding organic GI diseases on colonoscopy. Test-retest reliability of symptom score with a mean duration of 3.2 mo was good (mean kappa, 0.69). Associations of symptoms with diabetes-related factors were found; constipation with HbA1c ≥ 8.0% (AOR = 2.11, CI: 1.19-3.73), body mass index (BMI) < 25 (AOR = 2.11, CI: 1.22-3.66), and insulin use (AOR = 1.90, CI: 1.08-3.36); hard stools with diabetes duration (AOR = 1.03, CI: 1.00-1.07); fecal urgency with BMI < 25 (AOR = 1.73, CI: 1.00-2.98); and incomplete evacuation with BMI < 25 (AOR = 2.60, CI: 1.52-4.43), serum creatinine level (AOR = 1.27, CI: 1.10-1.47), and insulin use (AOR = 1.92, CI: 1.09-3.38).CONCLUSION: Diabetes is as

关键词： Functional bowel disease Gastrointestinal symptom rating scale Decreased passage of stools Diabetic complications