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Garenoxacin Prophylaxis for Febrile Neutropenia after Chemotherapy in Hematological Malignancies

Open Journal of Internal Medicine 2016年第4期6卷 128-138页

作者： nobuhiko nakamura Takeshi Hara Soranobu Ninomiya Yuhei Shibata Takuro Matsumoto Hiroshi nakamura Junichi Kitagawa Yasuhito Nannya Masahito Shimizu Nobuo Murakami Hisashi Tsurumi Department of Hematology Gifu University Graduate School of Medicine Gifu Japan

Background: Febrile neutropenia is one of the most serious adverse events in patients with hematological malignancies and chemotherapy. The routine use of fluoroquinolone prophylaxis in patients with hematological malignancies is controversial. Therefore, we prospectively evaluated the efficacy and safety of prophylactic use of garenoxacin for febrile neutropenia. Patients and Methods: Consecutive adult patients with hematological malignancies who were at risk for chemotherapy-induced neutropenia lasting more than seven days were eligible for present study. They received oral garenoxacin (400 mg daily) from the neutrophil count decreased to less than 1000/μl and continued until the neutropenia had resolved. The primary endpoint was incidence of febrile neutropenia, and the secondary endpoints were the type and incidence of adverse events. Results: We enrolled 46 consecutive patients (median age, 59 years). The underlying diseases comprised acute myeloid leukemia (n = 17), acute lymphoblastic leukemia (n = 3), malignant lymphoma (n = 23), and multiple myeloma (n = 3). There were 23 febrile neutropenia episodes and 2 episodes of bacteremia. There were no grade 3 or 4 adverse events;however serum creatinine levels were significantly elevated after garenoxacin administration. The overall prophylactic efficacy of garenoxacin was 50%, and there were no infection-related deaths. Conclusions: Prophylactic use of garenoxacin is effective and safe in patients with hematological malignancies. (Clinical trial registration number: UMIN000004979).

关键词： Febrile Neutropenia Prophylaxis Garenoxacin Hematological Malignancies

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Endoscopic Examination for Patients with Diarrhea after Allogeneic Stem Cell Transplantation

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Open Journal of Internal Medicine 2017年第4期7卷 105-114页

作者： Junichi Kitagawa Takuro Matsumoto Yuhei Shibata nobuhiko nakamura Hiroshi nakamura Soranobu Ninomiya Yasuhito Nannya Masahito Shimizu Takeshi Hara Hiroshi Araki Hisashi Tsurumi Department of Hematology Graduate School of Medicine Gifu University Gifu Japan Department of Gastroenterology Graduate School of Medicine Gifu University Gifu Japan

Objective: Intestinal graft-versus-host disease (GVHD) represents one of the most serious complications of allogeneic stem cell transplantation (allo-SCT). Endoscopic and histological proof is required due to the number of differential diagnoses manifesting as diarrhea. We investigated the safety of endoscopic biopsies, and the role of conducting biopsies and inspections of the terminalileum. Patients: Thirty two colonoscopic examinations and 29 biopsies were performed for 19 patients after allo-SCT in our institute between October 2011 and May 2015. Results: Endoscopic examinations and biopsies were performed safely under the policy of transfusing platelets for thrombocytopenia (3/μL). For biopsied cases, the diagnostic consistency rate with endoscopic findings was 60%, with a tendency toward negative correlations with early examinations after diarrhea onset (25% for 0 - 1 days;62.5% for later) or low-grade GVHD according to Freiburg criteria (41.2% for grade 1, 66.7% for grade 2, 100% for higher). The terminal ileum was inspected with colonoscopy in 13 cases. Endoscopic diagnoses of the ileum were provided in 11 cases and histological diagnoses in 9 cases. Diagnostic consistency for diagnosis of the terminal ileum between endoscopy and histology was 77.8%. Conclusion: Because endoscopic and histopathological findings do not always match, caution is required when focusing on endoscopic findings alone, as there is a risk of misdiagnosis. Extensive inspection of the terminal ileum with biopsy appears useful to identify otherwise undetected lesions. Our data thus support invasive endoscopic examinations for gastrointestinal complications, including ileac inspection and biopsies under appropriate management.

关键词： Intestinal GVHD Endoscopic Evaluation Ileoscopy Colonoscopy

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Precision surgical approach with lymph-node dissection in early gastric cancer

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World Journal of Gastroenterology 2019年第14期25卷 1640-1652页

作者： Shinichi Kinami Naohiko nakamura Yasuto Tomita Takashi Miyata Hideto Fujita nobuhiko Ueda Takeo Kosaka Department of Surgical Oncology Kanazawa Medical University

The gravest prognostic factor in early gastric cancer is lymph-node metastasis,with an incidence of about 10% overall. About two-thirds of early gastric cancer patients can be diagnosed as node-negative prior to treatment based on clinicpathological data. Thus, the tumor can be resected by endoscopic submucosal dissection. In the remaining third, surgical resection is necessary because of the possibility of nodal metastasis. Nevertheless, almost all patients can be cured by gastrectomy with D1+ lymph-node dissection. Laparoscopic or robotic gastrectomy has become widespread in East Asia because perioperative and oncological safety are similar to open surgery. However, after D1+ gastrectomy,functional symptoms may still result. Physicians must strive to minimize postgastrectomy symptoms and optimize long-term quality of life after this *** on the location and size of the primary lesion, preservation of the pylorus or cardia should be considered. In addition, the extent of lymph-node dissection can be individualized, and significant gastric-volume preservation can be achieved if sentinel node biopsy is used to distinguish node-negative *** the surgical treatment for early gastric cancer may be less radical than in the past, the operative method itself seems to be still in transition.

关键词： Stomach neoplasms surgery Gastrectomy methods Recovery of function Sentinel lymph node surgery Gastric cancer

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Diagnostic ability of multi-detector spiral computed tomography for pathological lymph node metastasis of advanced gastric cancer

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World Journal of Gastrointestinal Oncology 2020年第4期12卷 435-446页

作者： Zhi-Yong Jiang Shinichi Kinami Naohiko nakamura Takashi Miyata Hideto Fujita Hiroyuki Takamura nobuhiko Ueda Takeo Kosaka Department of Surgical Oncology Kanazawa Medical University1-1 DaigakuUchinada-machiKahoku-gunIshikawa 920-0293Japan

BACKGROUND The reliability of preoperative nodal diagnosis of advanced gastric cancer by multi-detector spiral computed tomography(MDCT)is still *** To examine the diagnostic ability of MDCT more precisely by using data on intranodal pathological metastatic *** A total of 108 patients with advanced gastric cancer who underwent MDCT and curative gastrectomy at Kanazawa Medical University Hospital were enrolled in this *** nodal sizes measured on computed tomography(CT)images were compared with the pathology results.A receiver-operating characteristic curve was constructed,from which the critical value(CV)was calculated by using the data of the first 69 patients *** using the CV,sensitivity and specificity were calculated with prospectively collected data from 39 consecutive *** enabled a more precise one-to-one correspondence of lymph nodes between CT and pathological examination by using the size data of lymph node *** intranodal pathological metastatic patterns were classified into the following four types:Small nodular,peripheral,large nodular,and *** Although all the cases were clinically suspected as having metastasis,81 had lymph node metastasis and 27 had no *** number of dissected,detected on CT,and metastatic nodes were,4241,897,and 801,*** CV obtained from the receiver-operating characteristic was 7.6 mm for the long *** sensitivity was 91.4%and the specificity was 47.3%in the prospective *** large nodular and diffuse metastases were easy to diagnose becausemetastatic nodes with a large axis often exhibit these *** The ability of MDCT to contribute to a nodal diagnosis of advanced gastric cancer was examined prospectively with precise size data from node mapping,using a CV of 7.6 mm for the long axis that was calculated from the retrospectively collected *** sensitivity was as high as 91%,and would be improved when referring to the en

关键词： Advanced gastric cancer Lymph node metastasis Multi-detector spiral computed tomography Pathological diagnosis

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Placement of percutaneous transhepatic biliary stent using a silicone drain with channels

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World Journal of Gastroenterology 2009年第33期15卷 4201-4203页

作者： Hiroshi Yoshida Yasuhiro Mamada nobuhiko Taniai Sho Mineta Yoshiaki Mizuguchi Yoichi Kawano Junpei Sasaki Yoshiharu nakamura Takayuki Aimoto Takashi Tajiri Department of Surgery Nippon Medical School

This report describes a method for percutaneous transhepatic biliary stenting with a BLAKE Silicone Drain, and discusses the usefulness of placement of the drain connected to a J-VAC Suction Reservoir for the treatment of stenotic hepaticojejunostomy. Percutaneous transhepatic biliary drainage was performed under ultrasonographic guidance in a patient with stenotic hepaticojejunostomy after hepatectomy for hepatic hilum malignancy. The technique used was as follows. After dilatation of the drainage root, an 11-Fr tube with several side holes was passed through the stenosis of the hepaticojejunostomy. A 10-Fr BLAKE Silicone Drain is · exible, which precludes one-step insertion. One week after insertion of the 11-Fr tube, a 0.035-inch guidewire was inserted into the tube. After removal of the 11-Fr tube, the guidewire was put into the channel of a 10-Fr BLAKE Silicone Drain. The drain was inserted into the jejunal limb through the intrahepatic bile duct and was connected to a J-VAC Suction Reservoir. Low-pressure continued suction was applied. Patients can be discharged after insertion of the 10-Fr BLAKE Silicone Drain connected to the J-VAC Suction Reservoir. Placement of a percutaneous transhepatic biliary stent using a 10-Fr BLAKE Silicone Drain connected to a J-VAC Suction Reservoir is useful for the treatment of stenotic hepaticojejunostomy.

关键词：排水渠道支架胆道肝硅治疗作用恶性肿瘤狭窄

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Efficacy of the fat-dissociation method for nodal harvesting in gastric cancer

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World Journal of Gastrointestinal Surgery 2020年第6期12卷 277-286页

作者： Shinichi Kinami Toshio Ohnishi Naohiko nakamura Zhi Yong Jiang Takashi Miyata Hideto Fujita Hiroyuki Takamura nobuhiko Ueda Takeo Kosaka Department of Surgical Oncology Kanazawa Medical UniversityKahoku-gunIshikawa920-0293Japan

BACKGROUND There is an increased need for accurate staging for gastric cancer ***, it is necessary to carefully examine all dissected lymph nodes for precise staging. Recently, the fat-dissociation method has been developed as a quick and accurate method for harvesting dissected lymph nodes of colorectal cancer *** To investigate the usefulness of the fat-dissociation method for harvesting dissected lymph nodes of gastric cancer *** Fifty-six resected specimens from gastric cancer patients who underwent standard curative gastrectomy and lymph node dissection at our hospital were used. Group 2 lymph nodes were separated from each specimen, and the remaining adipose tissue containing the group 1 lymph nodes was used. Some resected specimens were subjected to the fat-dissociation method. One vial of Imofully~? was dissolved in 50 m L of saline and injected into the tissue. The tissue was incubated for 1 h and the dissolved fat was removed. Subsequently, the nodes were identified, picked up with scissors, and mapped. The number of nodes in each lymphatic compartment and duration of lymph node harvest and mapping were *** The fat-dissociation method was used for 24 samples, while the conventional dissection method was used for 32 samples. The total number of harvested lymph nodes was 45.9 in the fat dissociation group and 44.3 in the control group, and there was no significant difference between the two groups. There were also no significant differences in the number of lymph nodes between the two groups based on a comparison of the lymphatic compartments. However, the total median duration of the fat-dissociation method was 38.2 min, reflecting a reduced duration of approximately 60 min compared to the control *** Based on our results, the fat-dissociation method is effective in shortening the duration of lymph node harvest in gastric cancer surgery.

关键词： Gastric cancer Lymph node dissection Staging Lymph node mapping Fatdissociationmethod Efficacy

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-449 C>G polymorphism of NFKB1 gene,coding nuclear factor-kappa-B,is associated with the susceptibility to ulcerative colitis

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World Journal of Gastroenterology 2012年第47期18卷 6981-6986页

作者： Ranji Hayashi Tomomitsu Tahara Tsukasa Yamaaki Takashi Saito Kazuhiro Matsunaga nobuhiko Hayashi Atsushi Fukumura Kazuaki Ozaki Masakatsu nakamura Hisakazu Shiroeda Mikihiro Tsutsumi Tomoyuki Shibata Tomiyasu Arisawa Department of Gastroenterology Kanazawa Medical UniversityIshikawa 920-0293Japan Department of Gastroenterology Fujita Health University1-98 Dengakugakubo Katsukake-ChoToyoakeAichi 470-1192Japan

AIM:To clarify the association between a polymorphism-449 C>G(rs72696119) in 5'-UTR of NFKB1 with ulcerative colitis(UC).METHODS:The studied population comprised 639 subjects,including patients with UC(UC cases,n = 174) and subjects without UC(controls,n = 465).We employed polymerase chain reaction-single strand conformation polymorphism to detect the gene ***:The rs72696119 G allele frequencies in controls and UC cases were 33.4% and 38.5%,respectively(P = 0.10).Genotype frequency of the GG homozygote in UC cases was significantly higher than that in controls(P = 0.017),and the GG homozygote was significantly associated with susceptibility to UC [odds ratio(OR),1.88;95%CI,1.13-3.14].In male subjects,the GG homozygote was associated with an increased risk for UC(OR,3.10;95%CI,1.47-6.54;P = 0.0053),whereas this association was not found in female *** addition,the GG homozygote was significantly associated with the risk of non-continuous disease(OR,2.06;95%CI,1.12-3.79;P = 0.029),not having total colitis(OR,2.40;95%CI,1.09-3.80,P = 0.040),disease which developed before 20 years of age(OR,2.80;95%CI,1.07-7.32,P = 0.041),no hospitalization(OR,2.28;95%CI,1.29-4.05;P = 0.0090) and with a maximum of 8 or less on the UCDAI score(OR,2.45;95%CI,1.23-4.93;P = 0.022).CONCLUSION:Our results provide evidence that NFKB1 polymorphism rs72696119 was significantly associated with the development of *** polymorphism influences the susceptibility to and pathophysiological features of UC.

关键词：溃疡性结肠炎基因多态性遗传易感性核因子编码聚合酶链反应等位基因频率多态性检测

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Classification of archaic rice grains excavated at the Mojiaoshan site within the Liangzhu site complex reveals an Indica and Japonica chloroplast complex

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食物生产加工与营养(英文) 2020年第1期2卷 148-159页

作者： Katsunori Tanaka Chunfang Zhao Ningyuan Wang Shinji Kubota Masaaki Kanehara nobuhiko Kamijo Ryuji Ishikawa Hiroyuki Tasaki Minako Kanehara Bin Liu Minghui Chen Shin-ichi nakamura Tetsuro Udatsu Cailin Wang Faculty of Agriculture and Life Science Hirosaki University3 BunkyoHirosakiAomori 036-8561Japan Institute of Food Crops Jiangsu Academy of Agricultural SciencesXiaolingweiNanjing 210014Jiangsu ProvinceChina Zhejiang Provincial Institute of Cultural Relics and Archaeology Gongshuqu Jiashanxincun26Hangzhou 310014Zhejiang ProvinceChina Center for Cultural Resource Studies Kanazawa University Kanazawa UniversityKakumaKanazawaIshikawa 920-1192Japan Department of Teacher Training and School Education Nara University of EducationTakahataNaraNara 630-8528Japan Archaeological Research Center Ehime University10-13 Dogo-hi-mataMatsuyamaEhime 790-8577Japan Agricultural Museum Faculty of AgricultureMiyazaki University1-1 Gakuen-Kibana-dai-NishiMiyazakiMiyazaki 889-2192Japan

To understand rice types that were utilized during postdomestication and in the modern age and the potential of genetic research in aged rice materials,archaeogenetic analysis was conducted for two populations of archaic rice grains from the Mojiaoshan site during the Liangzhu Period in China(2940 to 2840 BC).Sequencing after the PCR amplification of three regions of the chloroplast genome and one region of the nuclear genome showed recovery rates that were comparable to those in previous studies except for one chloroplast genome region,suggesting that the materials used in this work were appropriate for recovering genetic information related to domestication traits by using advanced *** after sequencing in these regions proved the existence of Japonica and Indica chloroplasts in archaic grains from the west trench,which were subsequently classified into eight plastid groups(type I–VIII),and indicated that these rice grains derived from different maternal lineages were stored together in storage houses at the Mojiaohsan *** these plastid groups,type V exhibited the same sequences as two modern Indica accessions that are utilized in basic studies and rice *** was inferred that part of the chloroplast genome of archaic rice has been preserved in modern genetic resources in these two modern Indica accessions,and the results indicated that rice related to their maternal ancestor was present at the Mojiaoshan site during the Liangzhu Period in *** usefulness of archaeogenetic analysis can be demonstrated by our research data as well as previous studies,providing encouragement for the possibility that archaeogenetic analysis can be applied to older rice materials that were utilized in the rice-domesticated period.

关键词： Agriculture Archaeology Archaic DNA Diversity Mojiaoshan Rice

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Bacteremia in hemodialysis patients

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World Journal of Nephrology 2016年第6期5卷 489-496页

作者： Masashi Suzuki nobuhiko Satoh Motonobu nakamura Shoko Horita George Seki Kyoji Moriya Department of Internal Medicine the University of Tokyo HospitalBunkyo-kuTokyo 113-0033Japan Department of Infection Control and Prevention the University of Tokyo HospitalBunkyo-kuTokyo 113-0033Japan Yaizu City Hospital YaizuShizuoka 425-8505Japan

Infection is a common complication and is the second leading cause of death in hemodialysis patients. The risk of bacteremia in hemodialysis patients is 26-fold higher than in the general population, and 1/2-3/4 of the causative organisms of bacteremia in hemodialysis patients are Gram-positive bacteria. The ratio of resistant bacteria in hemodialysis patients compared to the general population is unclear. Several reports have indicated that hemodialysis patients have a higher risk of methicillin-resistant Staphylococcus aureus infection. The most common site of infection causing bacteremia is internal prostheses; the use of a hemodialysis catheter is the most important risk factor for bacteremia. Although antibiotic lock of hemodialysis catheters and topical antibiotic ointment can reduce catheter-related blood stream infection(CRBSI), their use should be limited to necessary cases because of the emergence of resistant organisms. Systemic antibiotic administration and catheter removal is recommended for treating CRBSI, although a study indicated the advantages of antibiotic lock and guidewire exchange of catheters over systemic antibiotic therapy. An infection control bundle recommended by the Center for Disease Control and Prevention succeeded in reducing bacteremia in hemodialysis patients with either a catheter or arteriovenous fistula. Appropriate infection control can reduce bacteremia in hemodialysis patients.

关键词：血液透析并发症治疗方法临床分析

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Functional coupling of V-ATPase and CLC-5

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World Journal of Nephrology 2017年第1期6卷 14-20页

作者： nobuhiko Satoh Masashi Suzuki Motonobu nakamura Atsushi Suzuki Shoko Horita George Seki Kyoji Moriya Department of Internal Medicine Faculty of Medicinethe University of Tokyo Hospital Department of Endocrinology and Nephrology Yaizu City Hospital Department of Infection Control and Prevention the University of Tokyo Hospital

Dent's disease is an X-linked renal tubulopathy characterized by low molecular weight proteinuria,hypercalciuria and progressive renal failure. Disease aetiology is associated with mutations in the CLCN5 gene coding for the electrogenic 2Cl^-/H^+ antiporter chloride channel 5(CLC-5),which is expressed in the apical endosomes of renal proximal tubules with the vacuolar type H^+-ATPase(V-ATPase). Initially identified as a member of the CLC family of Cl- channels,CLC-5 was presumed to provide Cl- shunt into the endosomal lumen to dissipate H^+ accumulation by V-ATPase,thereby facilitating efficient endosomal acidification. However,recent findings showing that CLC-5 is in fact not a Cl-channel but a 2Cl^-/H^+ antiporter challenged this classical shunt model,leading to a renewed and intense debate on its physiological roles. Cl- accumulation via CLC-5 is predicted to play a critical role in endocytosis,as illustrated in mice carrying an artificial Cl- channel mutation E211 A that developed defective endocytosis but normal endosomal acidification. Conversely,a recent functional analysis of a newly identified disease-causing Cl^- channel mutation E211 Q in a patient with typical Dent's disease confirmed the functional coupling between V-ATPase and CLC-5 in endosomal acidification,lending support to the classical shunt model. In this editorial,we will address the current recognition of the physiological role of CLC-5 with a specific focus on the functional coupling of V-ATPase and CLC-5.

关键词：登特病肾衰竭治疗方法临床分析

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