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Percutaneous endoscopic gastrostomy with Funada-style gastropexy greatly reduces the risk of peristomal infection

Gastroenterology Report 2015年第1期3卷 69-74页

作者： Naoki Okumura Naoko Tsuji nobuto ozaki Nozomu Matsumoto Takehisa Takaba Masanori Kawasaki Takafumi Tomita Yasuko Umehara Satoko Taniike Masashi Kono Masatoshi Kudo Department of Gastroenterology Sakai HospitalKinki University Faculty of MedicineSakaiJapan Department of Gastroenterology and Hepatology Kinki University Faculty of MedicineOsaka-sayamaJapan

Background and aims:Peristomal wound infections are common complications of percutaneous endoscopic gastrostomy(PEG).The Funada-style gastropexy device has two parallel needles with a wire loop and suture thread,and was developed about 20 years ago in *** kit has allowed us to perform dual gastropexy very easily;PEG with gastropexy has become a very popular technique in *** present study aimed to compare the advantages and disadvantages of PEG with the gastropexy technique with the standard‘pull’***:We retrospectively reviewed 182 consecutive,non-randomized patients undergoing PEG in our hospital,and a comparative analysis was made between the gastropexy(87 patients)and non-gastropexy(95 patients)***:The rates of patients having erythema(11.6%vs.47.9%;P<0.001),exudates(2.3%vs.14.9%;P<0.01)and infection(0%vs.6.4%;P紏0.01)in the peristomal area were lower in the gastropexy than in the non-gastropexy *** rate of minor bleeding from the peristomal area was higher in the gastropexy than in the non-gastropexy group(12.8%vs.2.1%;P<0.01),but no patient required a blood *** procedure time was longer in the gastropexy group than in the non-gastropexy group(31 vs.24 min;P<0.001).The 30-day mortality rates were 4.7%and 5.3%respectively,and these deaths were not related to the gastrostomy ***:PEG with gastropexy markedly reduces peristomal *** minor bleeding and a longer procedure time were disadvantages,there were no severe *** findings suggested that PEG with Funada-style gastropexy was a safe and feasible method for reducing early complications of PEG.

关键词： percutaneous endoscopic gastrostomy gastropexy peristomal infection

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Gastrointestinal stromal tumor of the ampulla of Vater:A case report

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World Journal of Gastroenterology 2014年第16期20卷 4817-4821页

作者： Masayoshi Kobayashi nobuto Hirata So Nakaji Toshiyasu Shiratori Hiroyuki Fujii Eiji Ishii Department of Gastroenterology Kameda Medical CenterChiba 296-0041Japan

Gastrointestinal stromal tumors (GISTs) usually develop in the stomach and small intestine and only rarely occur at the ampulla of Vater, with only 11 cases reported in the literature. We report a case of a GIST of the ampulla of Vater. A 36-year-old, previously healthy man presented with a loss of consciousness lasting a few minutes. A gastroduodenal endoscopy revealed a submucosal tumor with central ulceration at the ampulla of Vater. The enhanced computed tomography scan revealed a smooth-outlined hypervascular solid mass (24 mm × 30 mm) in the second part of the duodenum. Neither lymphadenopathy nor metastasis was observed. Magnetic resonance cholangiopancreatography and endoscopic retrograde cholangiopancreatography showed normal bile and pancreatic ducts. Biopsies were collected from the ulcerative lesion, and the tumor was diagnosed as a GIST. A submucosal tumor with central ulceration may be a characteristic form of GISTs of the ampulla of Vater, and biopsy studies are useful for the diagnosing such tumors. The patient underwent pancreatoduodenectomy, and the operative specimen revealed a 2.2-cm GIST with 1 mitosis per 50 high-power fields. The gold standard for treatment of GISTs is surgical resection without rupture of a capsule. If technically possible, local resection may be considered. However, when the location of the lesion presents challenges, a pancreatoduodenectomy should be performed for GIST of the ampulla of Vater.

关键词： Gastrointestinal stromal tumor Ampulla of Vater Submucosal tumor Bleeding Biopsy Pancreatoduodenectomy

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Granular cell tumor of the common bile duct: A Japanese case

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World Journal of Gastroenterology 2012年第43期18卷 6324-6327页

作者： Junko Saito Michiko Kitagawa Hiroshi Kusanagi Nobuyasu Kano Eiji Ishii So Nakaji nobuto Hirata Kazuei Hoshi Department of Gastroenterology Chikamori Hospital Kochi 780-8522 Japan Department of Surgery Kameda Medical Center Kamogawa 296-8602 Japan Department of Gastroenterology Kameda Medical Center Kamogawa 296-8602 Japan Department of Pathology Kameda Medical Center Kamogawa 296-8602 Japan

Granular cell tumor (GCT) of the biliary system is rare. It is reported that it occurs more commonly in young black women. We report here our seldom experience of a Japanese case in whom icterus was found as a first symptom just after a caesarean operation. A 36-year-old Japanese woman developed icterus after delivery by the Caesarean operation. A surgical operation was performed without can deny that there was a tumor-related change in a bile duct as a result of examination for various images. As a result of pathological evaluation, GCT was diagnosed. By the preoperative organization biomicroscopy result, it was not able to be attachd a right diagnosis. It was thought that this tumor, although rare, should be considered as one of the causes of biliary stenosis in the younger population.

关键词： Japanese Granular cell tumor Common bile duct Icterus Endoscopic retrograde cholangiopancreatography

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Fundamental Study on a Grout Penetration Model for a HLW Repository

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Journal of Energy and Power Engineering 2012年第8期6卷 1191-1203页

作者： Tomoo Fujita Fumiaki Shinkai Jun nobuto Geological Isolation Research and Development Directorate Japan Atomic Energy Agency Ibaraki 319-1194 Japan Civil Engineering Technology Division Shimizu Corporation Tokyo 105-8007 Japan

In both the construction and operation phases of a repository for high-level radioactive waste, it will be important to constrain groundwater inflow using grouting technology that will be effective under the high groundwater pressure conditions deep underground. In this research, a review of existing grout penetration models in Japan and foreign countries and a trial analysis are conducted with a goal of describing the gout penetration with accuracy on site. Specifically, the applicability of the model developed by Gustafson ＆ Stille to the laboratory penetration tests was studied. The results show that the calculated values from the Gustafson ＆ Stille model agree well with values of laboratory penetration tests.

关键词： Grout penetration model velocity viscosity yield value.

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Evaluation of the Production of Young Green Barley Plants Containing Functional Ingredients

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American Journal of Plant Sciences 2015年第2期6卷 323-333页

作者： Tianxiao Meng Chizuru Miura nobuto Irino Ryuichiro Kondo Faculty of Agriculture Kyushu University Fukuoka Japan Asahi Ryokuken Co. Ltd. Fukuoka Japan

We conducted experiments to establish the growing conditions of hydroponic young green barley plants in which functional ingredients were applied and absorbed during the cultivation period. No studies have conducted experiments on functional ingredients applied during the cultivation of young green barley. In this study, glucosamine (GlcN) and collagen (Cgn) were used, both of which are widely known as functional ingredients and are in high market demand. In the GlcN application experiment, young green barley plants were cultivated with only liquid fertilizer during the early growing period for 9 days, and then the plants were cultivated in 0.25% GlcN-water solution for the following 3 days. The plants used in this experiment absorbed 0.60% of GlcN. Furthermore, an experiment was conducted to test plant absorption of collagen. Collagen absorption was evaluated using hydroxyproline (Hyp) as an indicator ingredient. Under control conditions, the Hyp content was 0.04% after 14 days of cultivation. Meanwhile, in the application experiment of Cgn derived from pigs (average molecular weight is 3000), plants were cultivated in 1% Cgn-water solution for 14 days. As a result, the Hyp content increased to 0.28%. Thus, this study clarifies, for the first time, that barley plants can absorb exogenous functional ingredients applied from the outside. The nutrient component contents in young green barley plants were measured. The amino acid and vitamin C content in hydroponic young green barley significantly increased, as compared to those grown in organic soil. Furthermore, in 0.1% Cgn-water solution cultivation, glutamic acid and aspartic acid, both of which are a functional amino acids, increased approximately three folds as compared to the plant grown in organic soil under natural sunlight. Furthermore, K and Na, which are inorganic ingredients in young green barley, were measured. The K content in the plants grown in 1% Cgn-water solution cultivation for 14 days decreased by

关键词： Young Green Barley Hydroponic Glucosamine Collagen Kalium (K)

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Endoscopic lithotripsy with peroral direct cholangioscopy using a conventional endoscope

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World Journal of Gastrointestinal Endoscopy 2013年第3期5卷 132-134页

作者： So Nakaji nobuto Hirata Toshiyasu Shiratori Masayoshi Kobayashi Masami Inase Department of Gastroenterology Kameda Medical CenterKamogawa cityChiba 296-8602Japan

Recently,peroral direct cholangioscopy(PDCS) using an ultra-slim endoscope has come into the ***,the working channel is too small to use various devices for *** report a case of endoscopic lithotripsy with PDCS using a conventional endoscope as a *** tomography scan on an 80-year-old female who was admitted with acute cholangitis showed two large stones in the bile *** retrograde cholangiopancreatography was attempted ***,mechanical lithotripsy failed because the stone was too large for the basket ***,electric hydraulic lithotripsy with PDCS using a conventional endoscope was performed allowed the stones to be cleared *** conclusion,PDCS using a conventional endoscope can be an alternative solution for endoscopic lithotripsy for patients with large stones in the dilated bile duct.

关键词： Peroral direct cholangioscopy Electric hydraulic lithotripsy Conventional endoscope Bile duct stone Transpapillary lithotripsy

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Model Examination for the Effect of Treading Stress on Young Green Barley (<i>Hordeum vulgare</i>)

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American Journal of Plant Sciences 2013年第1期4卷 174-181页

作者： Ryota Koga Tianxiao Meng Eriko Nakamura Chizuru Miura nobuto Irino Shoji Yahara Ryuichiro Kondo Department of Agro-Environmental Science Faculty of Agriculture Kyushu University Fukuoka Japan Graduate School of Pharmaceutical Sciences Kumamoto University Kumamoto Japan

Treading barley (“Mugifumi” in Japanese) is a barley culturing process that is unique and indispensable in Japan. Generally, roller machines or human feet are used to tread young barley several times (Figure 1). As a model examination, a stainless steel instrument was used for treading barley in this study (Figure 2(a)). Treading damages plants and decreases growth, such as the height and weight of aerial parts, which then recover gradually. In our study, the total amino acid contents increased with the treading stress. The treading stress induced a 1.7-fold increase in aspartic acid contents and an approximately 1.6-fold increase in glutamic acid, proline, cystine, and methionine contents. Isolation and purification suggested that the main components of the methanol-eluted fraction from the young green barley were six known phenolic compounds. Saponarin and lutonarin were the main components. The saponarin content was about 160 mg/g (methanol-soluble fraction) at 10 days after germination. We found that the higher antioxidant activity was due to the increased lutonarin/saponarin ratio from 10% to 24%. Therefore, our results suggest that treading stress is useful for young green barley.

关键词： Hordeum vulgare Treading Stress Mugifumi Flavonoid Amino Acid Antioxidant Activity

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Effects of Irradiation with Light of Different Photon Densities on the Growth of Young Green Barley Plants

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Agricultural Sciences 2015年第2期6卷 208-216页

作者： Tianxiao Meng Eriko Nakamura nobuto Irino Khem Raj Joshi Hari Prasad Devkota Shoji Yahara Ryuichiro Kondo Faculty of Agriculture Kyushu University Fukuoka Japan Asahi Ryokuken Co. Ltd. Fukuoka Japan Graduate School of Pharmaceutical Sciences Kumamoto University Kumamoto Japan

In recent years, young green barley has been increasingly used as a functional food ingredient. Studies have shown that cultivated young green barley has different levels of amino acids, vitamin C, and polyphenol content depending on the harvest time. Furthermore, some studies have investigated the effect of the growing conditions on cultivated barley in particular the use of light-emitting diodes (LED). Young green barley was exposed to three light sources of different wavelengths (sun light [ASL], light-emitting diode[LED] - Red 9 + Blue 1 [LED-R9:B1], LED - Red 4 + Green 1+ Blue 1 [LED-R4: G1:B1]). Under light with photon densities of 200 μmolmL-2·s-1, the dry weight of young green barley was not affected, while the differences were observed in the morphology of the underground portion of the plant (roots) depending on the light source. The roots of the plant grown in ASL weighed twice as much as those that were grown under LED irradiation. Furthermore, LED irradiation caused an increase in the amino acid content in plants;the amino acid content of plants grown under LED-R9:B1 was twice as much as that grown under ASL irradiation. Four kinds of cyanogenicglucosides (CGs) were isolated, identified, and their levels were measured. The plant grown under LED-RGB irradiation, including LED-G, produced approximately 20% more CGs as compared to the plants grown under the other two light sources. Thus, it was inferred that young green barley exhibited a stress response under LED-G light and accumulated CGs in the stems and leaves with prepare for any damage that may occur on the leaf surface. The nitrogen (N) content in the root was the lowest, while the CG content was the highest in the plant grown under LED-RGB irradiation. It is inferred that the N content decreased because N was eliminated from the roots to allow for accumulation of CGs response to stress. In general, the growth experiments to use an irradiation condition in which the distance between the light sourc

关键词： Young Green Barley Light-Emitting Diode CyanogenicGlucosides Amino Acid Tocopherol

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The effect of photo-irradiation on the growth and ingredient composition of young green barley (<i>Hordeum vulgare</i>)

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Agricultural Sciences 2013年第4期4卷 185-194页

作者： Ryota Koga Tianxiao Meng Eriko Nakamura Chizuru Miura nobuto Irino Hari Prasad Devkota Shoji Yahara Ryuichiro Kondo Department of Agro-Environmental Science Faculty of Agriculture Kyushu University Fukuoka Japan Graduate School of Pharmaceutical Sciences Kumamoto University Kumamoto Japan

We clarified that photo-irradiation of young green barley from three different light sources, natural light, 100% red light-emitting diodes (R-LEDs), and a mixture of 90% red-LEDs + 10% blue-LEDs (RB-LEDs), had significantly different results in growth degree (weight and height) and in components of young green barley. Barley that has sprouted for 15 days after germination did not show any apparent difference in height in response to irradiation by the three tested light sources, but by the 20th day of sprouting the height showed a positive effect by R-LEDs irradiation. By 15 days of sprouting the barley had achieved the heaviest weight by natural light irradiation, while the barley irradiated by R-LEDs had made remarkable progress at 20 days of sprouting. On the other hand, the irradiation by RB-LEDs showed a suppressive tendency after 15 days or more. The amino acid content, as indicated by dry weight conversion, was greatest in the barley irradiated by RB-LEDs, followed by R-LEDs, and natural light, which showed that LEDs irradiation is effective. In addition, four cyanogenic glucosides were isolated, identified, and quantified, as they are components frequently assessed in barley research. With regard to vitamin E, R-LEDs irradiation increased γ-tocopherol. Our results indicate that irradiation by LEDs would be effective for the enhancement of the functionality of young green barley.

关键词： Hordeum Vulgare LEDs Cyanogenic Glucosides Amino Acid Tocopherol SEM

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Neuroendocrine carcinoma of the esophagus: Report of a case and review of the literature

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Open Journal of Gastroenterology 2012年第2期2卷 85-90页

作者： Keisuke Kubota Akihiro Okada Junko Kuroda Masashi Yoshida nobuto Origuchi Keiichiro Ohta Masayuki Itabashi Yoshiyuki Osamura Masaki Kitajima Department of Gastroenterological Surgery International University of Health and Welfare Mita Hospital Tokyo Japan Department of Pathology International University of Health and Welfare Mita Hospital Tokyo Japan

Esophageal neuroendocrine carcinomas are rare, aggressive and have a poor prognosis. Combined therapy using chemotherapy, radiotherapy and/or surgery appear effective for them. Upper gastrointestinal endoscope of a 65-year-old male revealed a localized ulcerative lesion in the middle esophagus. Histology of biopsy specimens indicated a neuroendocrine carcinoma. A computed tomography showed an esophageal tumor with enlarged mediastinal lymph nodes. The patient was administered neoadjuvant chemo-therapy consisting of 5-fluorouracil and cisplatin, which led to partial response. Subtotal esophagectomy with three-field lymphadenectomy was performed. Pathologically, the tumor was 25 mm and infiltrated the proper muscle layer. The tumor cells were arranged in microtubular structures, with small and round cells containing scanty cytoplasm, and exhibited intense mitosis 51/10 HPF. They were positive for synaptophysin and chromogranin A, and Ki-67 labeling index was 70% - 80%. These findings led to the diagnosis of neuroendocrine carcinoma of small cell type. The patient was administered adjuvant chemotherapy using cisplatin and CPT-11, and he is now alive disease-free at the time of this writing.

关键词： Esophagus Neuroendocrine Carcinoma Surgery Chemotherapy

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