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World Journal of Gastroenterology 2018年第28期24卷 3155-3162页

作者： Masanori Ochi Toshiro Kamoshida Atsushi Ohkawara Haruka Ohkawara nobushige kakinoki Shinji Hirai Akinori Yanaka Department of Gastroenterology Hitachi General Hospital Hitachi Medical Education and Research Center University of Tsukuba

AIM To investigate the relationship between the onsets of multikinase inhibitor(MKI)-associated hand-foot skin reaction(HFSR) and prognosis under intervention by pharmacists after the introduction of sorafenib.METHODS We conducted a retrospective study involving 40 patients treated with sorafenib. Intervention by pharmacists began at the time of treatment introduction and continued until the appearance of symptomatic exacerbation or non-permissible adverse reactions. We examined the relationship between MKI-associated HFSR and overall survival(OS) after the initiation of treatment.RESULTS The median OS was 10.9 mo in the MKI-associated HFSR group and 3.4 mo in the no HFSR group, showing a significant difference in multivariate analysis. A multivariate analysis of the time to treatment failure indicated that the intervention by pharmacists and MKI-associated HFSR were significant factors. The median cumulative dose and the mean medication possession ratio were significantly higher in the intervention group than in the non-intervention group. A borderline significant difference was observed in terms of OS in this group.CONCLUSION Intervention by pharmacists increased drug adherence. Under increased adherence, MKI-associated HFSR was an advantageous surrogate marker. Intervention by healthcare providers needs to be performed for adequate sorafenib treatment.

关键词： Hepatocellular carcinoma Surrogate marker Multikinase inhibitor-associated hand-foot skin reaction Sorafenib Intervention by pharmacists

Early colonoscopy and urgent contrast enhanced computed tomography for colonic diverticular bleeding reduces risk of rebleeding

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World Journal of Clinical Cases 2021年第11期9卷 2446-2457页

作者： Masanori Ochi Toshiro Kamoshida Yukako Hamano Atsushi Ohkawara Haruka Ohkawara nobushige kakinoki Yuji Yamaguchi Shinji Hirai Akinori Yanaka Department of Gastroenterology Hitachi General HospitalIbaraki 317-0077Japan Hitachi Medical Education and Research Center University of TsukubaIbaraki 317-0077Japan

BACKGROUND Colonoscopy within 24 h of hospital admission for colonic diverticular bleeding(CDB)is recommended.However,little is known about rates of rebleeding within 30 d.We posited that a group of patients who underwent contrast-enhanced computed tomography(CT)within 4 h of the last hematochezia and colonoscopy within 24 h would experience fewer incidences of rebleeding.AIM To evaluate the outcomes of early colonoscopy for CDB among different groups of patients.METHODS Data from 182 patients with CDB who underwent contrast-enhanced CT and colonoscopy between January 2011 and December 2018 at the study site were retrospectively reviewed.Patients were divided into groups based on the timing of the CT imaging,within or at 4 h were defined as urgent CTs(n=100)and those performed after 4 h were defined as elective CTs(n=82).Main outcomes included rebleeding within 30 d and the identification of stigmata of recent hemorrhage(SRH)(i.e.,active bleeding,non-bleeding visible vessels,or adherent clots).RESULTS In total,182 patients(126 men and 56 women)with median ages of 68.6(range,37-92)and 73.7(range,48-93)years,respectively,underwent CT imaging and colonoscopy within 24 h of the last hematochezia.Patients for whom CT was performed within 4 h of the last hematochezia were included in the urgent CT group(n=100)and patients for whom CT was performed after 4 h were included in the elective CT group(n=82).SRH were identified in 35.0%(35/100)of the urgent CT cases and 7.3%(6/82)of the elective CT cases(P<0.01).Among all patients with extravasation-positive images on CT,SRH was identified in 31 out of 47 patients(66.0%)in the urgent CT group and 4 out of 20 patients(20.0%)in the elective CT group(P<0.01).Furthermore,rates of rebleeding within 30 d were significantly improved in the urgent CT and extravasation-positive cases(P<0.05).Results from the evaluation of early colonoscopy did not show a difference in the ability to detect SRH identification or rebleeding rates.Only cases by urgent CT reduced risk of rebleeding due to

关键词： Colonoscopy Gastrointestinal hemorrhage Colon Diverticular diseases Xray computed tomography

High total Joule heat increases the risk of post-endoscopic submucosal dissection electrocoagulation syndrome after colorectal endoscopic submucosal dissection

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World Journal of Gastroenterology 2021年第38期27卷 6442-6452页

作者： Masanori Ochi Ryosuke Kawagoe Toshiro Kamoshida Yukako Hamano Haruka Ohkawara Atsushi Ohkawara nobushige kakinoki Yuji Yamaguchi Shinji Hirai Akinori Yanaka Kiichiro Tsuchiya Department of Gastroenterology Hitachi General HospitalHitachi City 317-0077IbarakiJapan Department of Gastroenterology Faculty of MedicineUniversity of TsukubaTsukuba 305-8576IbarakiJapan

BACKGROUND We hypothesized that thermal damage accumulation during endoscopic submucosal dissection(ESD)causes the pathogenesis of post-ESD electrocoagulation syndrome(PECS).AIM To determine the association between Joule heat and the onset of PECS.METHODS We performed a retrospective cohort study in patients who underwent colorectal ESD from May 2013 to March 2021 in Japan.We developed a novel device that measures swift coagulation time with a sensor adjacent to the electrosurgical coagulation unit foot switch,which enabled us to calculate total Joule heat.PECS was defined as localized abdominal pain(visual analogue scale≥30 mm during hospitalization or increased by≥20 mm from the baseline)and fever(temperature≥37.5 degrees or white blood cell count≥10000μ/L).Patients exposed to more or less than the median Joule heat value were assigned to the high and low Joule heat groups,respectively.Statistical analyses included Mann-Whitney U and chisquare tests and logistic regression and receiver operating characteristic curve(ROC)analyses.RESULTS We evaluated 151 patients.The PECS incidence was 10.6%(16/151 cases),and all patients were followed conservatively and discharged without severe complications.In multivariate analysis,high Joule heat was an independent PECS risk factor.The area under the ROC curve showing the correlation between PECS and total Joule heat was high[0.788(95%confidence interval:0.666-0.909)].CONCLUSION Joule heat accumulation in the gastrointestinal wall is involved in the onset of PECS.ESD-related thermal damage to the peeled mucosal surface is probably a major component of the mechanism underlying PECS.

关键词： Post-endoscopic submucosal dissection electrocoagulation syndrome Joule heat Colorectal endoscopic submucosal dissection Colorectal neoplasms Electrocoagulation Gastrointestinal tract

Rationale and Study Protocol of the J-SAVER Study: A Phase II Study of S-1 on Alternate Days Combined with Bevacizumab in Patients Aged ≥75 Years with Metastatic Colorectal Cancer

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Journal of Cancer Therapy 2017年第11期8卷 1040-1048页

作者： Toshikazu Moriwaki Tetsuya Eto Akihito Tsuji nobushige kakinoki Mitsuo Shimada Takashi Maeba Hiroaki Hatano Ikuo Takahashi Hiroyasu Ishida Kazuho Ikeda Yoshiaki Bando Ichinosuke Hyodo Division of Gastroenterology Faculty of Medicine University of Tsukuba Tsukuba Japan Department of Gastroenterology Tsuchiura Kyodo General Hospital Tsuchiura Japan Department of Medical Oncology Kobe City Medical Center General Hospital Kobe Japan Department of Gastroenterology Hitachi General Hospital Hitachi Japan Department of Surgery Tokushima University Tokushima Japan Department of Surgery Japan Community Health Care Organization Ritsurin Hospital Takamatsu Japan Department of Surgery Matsuyama Shimin Hospital Matsuyam Japan Department of Surgery Matsuyama Red Cross Hospital Matsuyama Japan Department of Gastroenterology National Hospital Organization Mito Medical Center Higashi Ibaraki-Gun Japan Department of Gastroenterology Koyama Memorial Hospital Kashima Japan Department of Surgery Tokushima Prefecture Naruto Hospital Naruto Japan

Fluoropyrimidine combined with bevacizumab is commonly used in elderly patients with metastatic colorectal cancer worldwide. However, the proportion of elderly patients who discontinued treatment due to toxicities was higher than that of younger patients. The aim of this study is to develop a less toxic schedule of S-1, while maintaining the anti-tumor effect. This phase II study is aimed to evaluate an alternate-day administration of S-1 combined with bevacizumab in untreated elderly patients (aged ≥75 years) with metastatic colorectal cancer. The primary endpoint is progression-free survival, and the secondary endpoints are safety, response rate, and overall survival. The expected median progression-free survival is 8.5 months, and the minimum efficacy threshold is 5.0 months. The total required sample size is calculated as 50 patients, with a 2-sided type I error of 0.10 and a power of more than 80%. This study is ongoing, and fifty-four patients were enrolled until October 2016. We hope that S-1 on alternate days combined with bevacizumab for elderly patients with colorectal cancer is well tolerated and can maintain effectiveness. Trial registration: UMIN clinical trials UMIN000010402.

关键词： Alternate Days Bevacizumab Colorectal Cancer Fluoropyrimidine Elderly Older S-1

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昆虫保幼激素类似物作为昆虫生长调节剂

世界农药 1987年第6期 48-50页

作者： nobushige Itaya 冯惠林日本住友化学公司宝塚研究中心

昆虫生长调节剂(IGRs)由于具有和常规杀虫剂不同的独特作用方式而受到人们的重视.1972年,Schafer和Wilder将IGR分成昆虫发育抑制剂(IDI)和蜕皮抑制剂(MI)两类.前者包括下面讨论的昆虫激素类似化合物,后者则包括几丁质合成抑制剂.昆虫激... 详细信息

昆虫生长调节剂(IGRs)由于具有和常规杀虫剂不同的独特作用方式而受到人们的重视.1972年,Schafer和Wilder将IGR分成昆虫发育抑制剂(IDI)和蜕皮抑制剂(MI)两类.前者包括下面讨论的昆虫激素类似化合物,后者则包括几丁质合成抑制剂.昆虫激素在昆虫发育过程中起重要作用,其中已知的有脑激素、蜕皮激素和保幼激素.脑激素刺激前胸腺释放出蜕皮激素,蜕皮激素(α-蜕皮激素)转化为20-羟基蜕皮激素(β-蜕皮激素),刺激生成新的表皮,从而诱导蜕皮.

关键词：昆虫激素若虫同型幼虫昆虫生长调节剂滞育保幼激素咽侧体激素

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有机硅拟除虫菊酯的合成和杀虫活性

世界农药 1988年第4期 12-16+34页

作者： Yoshimi Yamada Toshihiko Yano nobushige Itaya 孙越日本住友化学公司宝塚研究中心农药研究室日本住友化学公司宝塚研究中心农药研究室日本住友化学公司宝塚研究中心农药研究室

有关硅取代物(含硅医药)的药用活性已有许多报道,但是,人们却很少了解硅取代的农用化学品的情况。合成拟除虫菊酯是一类由天然拟除虫菊酯发展而来的杀虫剂,它们的杀虫活性与它们的构型能力有很重要的关系:构型中,化合物要具备药效所必... 详细信息

有关硅取代物(含硅医药)的药用活性已有许多报道,但是,人们却很少了解硅取代的农用化学品的情况。合成拟除虫菊酯是一类由天然拟除虫菊酯发展而来的杀虫剂,它们的杀虫活性与它们的构型能力有很重要的关系:构型中,化合物要具备药效所必需的各个结构特点,其彼此之间是恰当地相对和互补的。Ethofenprox 与其一系列类似物(1a和1b,图1)是最近报道的一类新的拟除虫菊酯杀虫剂。1a和1b的结构特点是具有一个四元碳原子,在此

关键词：毫摩尔硅胶杀虫活性柱色谱分离剩余物化合物除虫菊宿根花卉

Restoration of visual function by ectopic expression of melanopsin in rd mice

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Restoration of visual function by ectopic expression of mela...