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Tumor size discrepancy between endoscopic and pathological evaluations in colorectal endoscopic submucosal dissection

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World Journal of Gastrointestinal Endoscopy 2024年第3期16卷 136-147页

作者： Takeshi Onda osamu goto Toshiaki Otsuka Yoshiaki Hayasaka Shun Nakagome Tsugumi Habu Yumiko Ishikawa Kumiko Kirita Eriko Koizumi Hiroto Noda Kazutoshi Higuchi Jun Omori Naohiko Akimoto Katsuhiko Iwakiri Department of Gastroenterology Nippon Medical SchoolGraduate School of MedicineBunkyo-ku 113-8603TokyoJapan Endoscopy Center Nippon Medical School HospitalBunkyo-ku 113-8603TokyoJapan Department of Hygiene and Public Health Nippon Medical SchoolBunkyoku 113-8603TokyoJapan Center for Medical Education Nippon Medical SchoolBunkyo-ku 113-8603TokyoJapan

BACKGROUND Tumor size impacts the technical difficulty and histological curability of colorectal endoscopic submucosal dissection(ESD);however,the preoperative evaluation of tumor size is often different from histological assessment.Analyzing influential factors on failure to obtain an accurate tumor size evaluation could help prepare optimal conditions for safer and more reliable ESD.METHODS This was a retrospective study conducted at a single institution.A total of 377 lesions removed by colorectal ESD at our hospital between April 2018 and March 2022 were collected.We first assessed the difference in size with an absolute per-centage of the scaling discrepancy.Subsequently,we compared the clinicopatho-logical characteristics of the correct scaling group(>-33%and33%),which was further subdivided into the underscaling group(-33%or less of the discrepancy)and overscaling group(33%or more of the discrepancy),respectively.As secondary outcome measures,parameters on size estimation were compared between the underscaling and correct scaling groups,as well as between the overscaling and correct scaling groups.Finally,multivariate analysis was performed in terms of the following relevant parameters on size estimation:Pathological size,location,and possible influential factors(P<0.1)in the univariate analysis.RESULTS The mean of absolute percentage in the scaling discordance was 21%,and 91 lesions were considered to be incorrectly estimated in size.The incorrect scaling was significantly remarkable in larger lesions(40 mm vs 28 mm;P<0.001)and less experience(P<0.001),and these two factors were influential on the underscaling(75 lesions;P<0.001).Conversely,compared with the correct scaling group,16 lesions in the overscaling group were significantly small(20 mm vs 28 mm;P<0.001),and the small lesion size was influential on the overscaling(P=0.002).CONCLUSION Lesions indicated for colorectal ESD tended to be underestimated in large tumors,but overestimated in small one

关键词： Endoscopic submucosal dissection Colorectal tumor Tumor size Size estimation Size discrepancy

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Tetra-EDOT substituted 3D electrochromic polymers with lower band gaps

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Science China Chemistry 2017年第1期60卷 90-98页

作者： Jingjing Shi Imran Murtaza Shan Shao Xiaosi Zhu Yang Zhao Mengmeng Zhu osamu goto Hong Meng School of Advanced Materials Peking University Shenzhen Graduate School Key Laboratory of Flexible Electronics & Institute of Advanced Materials Jiangsu National Synergetic Innovation Center for Advanced MaterialsNanjing Tech University Department of Physics International Islamic University

A couple of novel electrochromic materials poly(2,3,4,5-tetrakis(2,3-hydrothieno[3,4-b]dixin-5-yl)-1-methyl-1H-pyrrole)(P(t-EDOT-mPy))and poly(5,5',5",5'"-(thiophene-2,3,4,5-tetrayl)tetrakis(2,3-dihydrothieno[3,4-b][1,4]dioxine))(P(t-EDOTTh))are electrodeposited via multi-position polymerization of their tetra-EDOT substituted monomers t-EDOT-mPy and t-EDOT-Th,respectively.Compared with the linear 2D structured poly(thiophene)(E_g=2.2 eV)and poly(2,5-bis(2,3-dihydrothieno[3,4-b][1,4]dioxin-5-yl)thiophene)(E_g=1.7eV),P(t-EDOT-Th)(E_g=1.62eV)has the lowest band gap.Hence,we speculate that the band gaps of the two polymers,having 3D structures,are decreased in contrast to non-substituted polymers or bi-EDOT substituted polymers,thiophene and 1-methyl-1H-pyrrole.The results indicated that P(t-EDOT-Th)thin films are more stable and show higher transmittance amid two polymers,which may find their utilization in organic optoelectronics.

关键词：变色聚合物带隙 3d 电致变色材料 TETRA 二维结构三维结构光电子学

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Curative ESD for intraepithelial esophageal carcinoma with leiomyoma mimicking submucosal invasive carcinoma

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World Journal of Gastrointestinal Endoscopy 2009年第1期1卷 68-71页

作者： Keiko Niimi Shinya Kodashima Satoshi Ono osamu goto Nobutake Yamamichi Mitsuhiro Fujishiro Department of Gastroenterology Graduate School of MedicineUniversity of TokyoTokyo 113-8655Japan

This case report presents a 65-year-old man who developed early esophageal cancer with leiomyoma treated by endoscopic submucosal dissection(ESD).There have been several reports of co-existing superficial esophageal cancer and leiomyoma treated by endoscopic mucosal resection.However,there is no previous report describing the co-existing lesion treated by ESD.In order to determine treatment strategies for esophageal cancer,accurate endoscopic evaluation of the cancerous depth is essential.In the present case,the combination of endoscopic ultrasonography and narrow-band imaging system with magnifying endoscopy was extremely useful to evaluate the superficial esophageal cancer with leiomyoma,which lead to the appropriate treatment,ESD.

关键词： Endoscopic submucosal dissection Submucosal tumor Esophageal neoplasms Narrow-band imaging magnifying endoscopy Endoscopic ultrasonography

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Cutting edge of endoscopic full-thickness resection for gastric tumor

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World Journal of Gastrointestinal Endoscopy 2015年第16期7卷 1208-1215页

作者： Tadateru Maehata osamu goto Hiroya Takeuchi Yuko Kitagawa Naohisa Yahagi Division of Research and Development for Minimally Invasive Treatment Cancer CenterKeio UniversitySchool of Medicine Department of Surgery Keio UniversitySchool of Medicine

Recently,several studies have reported local full-thickness resection techniques using flexible endoscopy for gastric tumors,such as gastrointestinal stromal tumors,gastric carcinoid tumors,and early gastric cancer(EGC). These techniques have the advantage of allowing precise resection lines to be determined using intraluminal endoscopy. Thus,it is possible to minimize the resection area and subsequent deformity. Some of these methods include:(1) classical laparoscopic and endoscopic cooperative surgery(LECS);(2) inverted LECS;(3) combination of laparoscopic and endoscopic approaches to neoplasia with non-exposure technique; and(4) non-exposed endoscopic wall-inversion surgery. Furthermore,a recent prospective multicenter trial of the sentinel node navigation surgery(SNNS) for EGC has shown acceptable results in terms of sentinel node detection rate and the accuracy of nodal metastasis. Endoscopic full-thickness resection with SNNS is expected to become a treatment option that bridges the gap between endoscopic submucosal dissection and standard surgery for EGC. In the future,the indications for these procedures for gastric tumors could be expanded.

关键词： Gastrointestinal stromal tumor Early gastric cance

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Subserosal injection of hyaluronic acid may prevent perforation after endoscopic resection

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World Journal of Gastrointestinal Endoscopy 2009年第1期1卷 61-64页

作者： Keiko Niimi Mitsuhiro Fujishiro Shinya Kodashima Satoshi Ono osamu goto Nobutake Yamamichi Kazuhiko Koike Department of Gastroenterology Graduate School of MedicineUniversity of TokyoTokyo 113-8655Japan

AIM:To investigate the protective effect of subserosal injection of hyaluronic acid(HA) after endoscopic resection(ER) using ex vivo and in vivo studies.METHODS:As the first examination,technical application of subserosal injection was tested 10 times using resected porcine stomachs.As the second examination,ER was applied to make six mucosal defects per stomach in three live minipigs and thermal damage was given on the proper muscle layer by using hemostatic forceps.Following the thermocoagulation,1 mL of normal saline and HA,respectively,was injected targeting the subserosal layer in two mucosal defects each and the rest kept no injection as the control.The minipigs were recovered from the anesthesia and kept fasting until euthanasia which was carried out around 24 h after the procedures.RESULTS:Ex vivo study revealed that complete and partial subserosal injection was possible two(20%) and four(40%) times,respectively.In vivo study revealed that no postoperative perforation occurred at any point of the thermocoagulation.Apparent retention of hyaluronic acid was identified at only two(33%) points where HA was injected.CONCLUSION:This study failed to show preventative effects of subserosal injection of HA on postoperative perforation due to technical faults.However,this concept has a possibility to change strategy of ER with further technical innovation.

关键词： Subserosal injection Endoscopic submucosal dissection Endoscopic mucosal resection Animal model Thermal injury Perforation

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Topic highlight on texture and color enhancement imaging in gastrointestinal diseases

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World Journal of Gastroenterology 2024年第14期30卷 1934-1940页

作者： osamu Toyoshima Toshihiro Nishizawa Keisuke Hata Department of Gastroenterology Toyoshima Endoscopy ClinicTokyo 157-0066Japan Department of Gastroenterology and Hepatology International University of Health and WelfareNarita HospitalNarita 286-8520Japan Department of Gastroenterology Nihonbashi Muromachi Mitsui Tower Midtown ClinicTokyo 103-0022Japan

Olympus Corporation developed texture and color enhancement imaging(TXI)as a novel image-enhancing endoscopic technique.This topic highlights a series of hot-topic articles that investigated the efficacy of TXI for gastrointestinal disease identification in the clinical setting.A randomized controlled trial demonstrated improvements in the colorectal adenoma detection rate(ADR)and the mean number of adenomas per procedure(MAP)of TXI compared with those of white-light imaging(WLI)observation(58.7%vs 42.7%,adjusted relative risk 1.35,95%CI:1.17-1.56;1.36 vs 0.89,adjusted incident risk ratio 1.48,95%CI:1.22-1.80,respectively).A cross-over study also showed that the colorectal MAP and ADR in TXI were higher than those in WLI(1.5 vs 1.0,adjusted odds ratio 1.4,95%CI:1.2-1.6;58.2%vs 46.8%,1.5,1.0-2.3,respectively).A randomized controlled trial demonstrated non-inferiority of TXI to narrow-band imaging in the colorectal mean number of adenomas and sessile serrated lesions per procedure(0.29 vs 0.30,difference for non-inferiority-0.01,95%CI:-0.10 to 0.08).A cohort study found that scoring for ulcerative colitis severity using TXI could predict relapse of ulcerative colitis.A cross-sectional study found that TXI improved the gastric cancer detection rate compared to WLI(0.71%vs 0.29%).A cross-sectional study revealed that the sensitivity and accuracy for active Helicobacter pylori gastritis in TXI were higher than those of WLI(69.2%vs 52.5%and 85.3%vs 78.7%,res-pectively).In conclusion,TXI can improve gastrointestinal lesion detection and qualitative diagnosis.Therefore,further studies on the efficacy of TXI in clinical practice are required.

关键词： Endoscopy Texture and color enhancement imaging White-light imaging Narrow-band imaging Colorectal neoplasm Gastric cancer Adenoma Ulcerative colitis Helicobacter infections Colonoscopy

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Machine learning algorithm partially reconfigured on FPGA for an image edge detection system

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Journal of Electronic Science and Technology 2024年第2期22卷 48-68页

作者： Gracieth Cavalcanti Batista Johnny Oberg osamu Saotome Haroldo F.de Campos Velho Elcio Hideiti Shiguemori Ingemar Soderquist Division of Electronic and Embedded Systems KTH Royal Institute of TechnologyStockholm 16440Sweden Electronic Engineering Division Aeronautics Institute of TechnologySao Josédos Campos SP 12228-900Brazil Laboratory of Applied Computing and Mathematics National Institute for Space ResearchSao Josédos Campos SP 12227-900Brazil Department of C4ISR Institute of Advanced StudiesSao Josédos Campos SP 12228-001Brazil Saab AB Linkoping 58188Sweden

Unmanned aerial vehicles(UAVs)have been widely used in military,medical,wireless communications,aerial surveillance,etc.One key topic involving UAVs is pose estimation in autonomous navigation.A standard procedure for this process is to combine inertial navigation system sensor information with the global navigation satellite system(GNSS)signal.However,some factors can interfere with the GNSS signal,such as ionospheric scintillation,jamming,or spoofing.One alternative method to avoid using the GNSS signal is to apply an image processing approach by matching UAV images with georeferenced images.But a high effort is required for image edge extraction.Here a support vector regression(SVR)model is proposed to reduce this computational load and processing time.The dynamic partial reconfiguration(DPR)of part of the SVR datapath is implemented to accelerate the process,reduce the area,and analyze its granularity by increasing the grain size of the reconfigurable region.Results show that the implementation in hardware is 68 times faster than that in software.This architecture with DPR also facilitates the low power consumption of 4 mW,leading to a reduction of 57%than that without DPR.This is also the lowest power consumption in current machine learning hardware implementations.Besides,the circuitry area is 41 times smaller.SVR with Gaussian kernel shows a success rate of 99.18%and minimum square error of 0.0146 for testing with the planning trajectory.This system is useful for adaptive applications where the user/designer can modify/reconfigure the hardware layout during its application,thus contributing to lower power consumption,smaller hardware area,and shorter execution time.

关键词： Dynamic partial reconfiguration(DPR) Field programmable gate array(FPGA)implementation Image edge detection Support vector regression(SVR) Unmanned aerial vehicle(UAV) pose estimation

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Glutathione-depleted cyclodextrin pseudo-polyrotaxane nanoparticles for anti-inflammatory oxaliplatin(Ⅳ) prodrug delivery and enhanced colorectal cancer therapy

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Chinese Chemical Letters 2024年第4期35卷 280-286页

作者： Wenjia Wang Xingyue He Xiaojie Wang Tiantian Zhao osamu Muraoka Genzoh Tanabe Weijia Xie Tianjiao Zhou Lei Xing Qingri Jin Hulin Jiang State Key Laboratory of Natural Medicines China Pharmaceutical UniversityNanjing 210009China Faculty of Pharmacy Kinki University HigashiosakaOsaka 577-8502Japan State Key Laboratory of Natural Medicines(SKLNM)and Department of Medicinal Chemistry School of PharmacyChina Pharmaceutical UniversityNanjing 210009China School of Pharmacy Hangzhou Medical CollegeHangzhou 311399China College of Pharmacy Yanbian UniversityYanji 133002China

Oxaliplatin(Oxa) is the first-line chemotherapeutic drug for the treatment of colorectal cancer(CRC). However, long-term Oxa chemotherapy can induce inflammation and increase the levels of cyclooxygenase-2(COX-2) and prostaglandin E2(PGE2), which can promote tumor metastasis. Moreover,high glutathione(GSH) levels in CRC cells significantly reduce Oxa sensitivity and seriously restrict the clinical application of Oxa. Herein, an Oxa(Ⅳ) prodrug with anti-inflammatory properties(desmethyl naproxe, DN) and GSH-depleting cyclodextrin pseudo-polyrotaxane carriers were prepared and further self-assembled into micellar nanoparticles(designated DNPt@PPRI). The relesae of DN from DNPt@PPRI can reduce the level of PGE2 to inhibit inflammation and tumor metastasis by decreasing COX-2 protein,and also synergize with Oxa to inhibit tumor. More importantly, GSH depletion can reduce the detoxification of Oxa and further enhance chemotherapy-induced apoptosis. DNPt@PPRI have a good GSH depletion ability to enhance the sensitivity of Oxa, indicating a potential in the synergistic chemotherapy and chemo-sensitization of colorectal cancer.

关键词： Oxaliplatin Glutathione depletion Tetravalent platinum prodrug Synergistic therapy Colorectal cancer

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Preoperative albumin-bilirubin score and liver resection percentage determine postoperative liver regeneration after partial hepatectomy

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World Journal of Gastroenterology 2024年第14期30卷 2006-2017页

作者： Kazuhiro Takahashi Masahiko Gosho Yoshihiro Miyazaki Hiromitsu Nakahashi osamu Shimomura Kinji Furuya Manami Doi Yohei Owada Koichi Ogawa Yusuke Ohara Yoshimasa Akashi Tsuyoshi Enomoto Shinji Hashimoto Tatsuya Oda Department of Gastrointestinal and Hepatobiliary-Pancreatic Surgery University of TsukubaTsukuba 3058-575IbarakiJapan Department of Biostatistics University of TsukubaTsukuba 3058-575IbarakiJapan

BACKGROUND The success of liver resection relies on the ability of the remnant liver to regenerate.Most of the knowledge regarding the pathophysiological basis of liver regeneration comes from rodent studies,and data on humans are scarce.Additionally,there is limited knowledge about the preoperative factors that influence postoperative regeneration.AIM To quantify postoperative remnant liver volume by the latest volumetric software and investigate perioperative factors that affect posthepatectomy liver regenera-tion.METHODS A total of 268 patients who received partial hepatectomy were enrolled.Patients were grouped into right hepatectomy/trisegmentectomy(RH/Tri),left hepa-tectomy(LH),segmentectomy(Seg),and subsegmentectomy/nonanatomical hepatectomy(Sub/Non)groups.The regeneration index(RI)and late rege-neration rate were defined as(postoperative liver volume)/[total functional liver volume(TFLV)]×100 and(RI at 6-months-RI at 3-months)/RI at 6-months,respectively.The lower 25th percentile of RI and the higher 25th percentile of late regeneration rate in each group were defined as“low regeneration”and“delayed regeneration”.“Restoration to the original size”was defined as regeneration of the liver volume by more than 90%of the TFLV at 12 months postsurgery.RESULTS The numbers of patients in the RH/Tri,LH,Seg,and Sub/Non groups were 41,53,99 and 75,respectively.The RI plateaued at 3 months in the LH,Seg,and Sub/Non groups,whereas the RI increased until 12 months in the RH/Tri group.According to our multivariate analysis,the preoperative albumin-bilirubin(ALBI)score was an independent factor for low regeneration at 3 months[odds ratio(OR)95%CI=2.80(1.17-6.69),P=0.02;per 1.0 up]and 12 months[OR=2.27(1.01-5.09),P=0.04;per 1.0 up].Multivariate analysis revealed that only liver resection percentage[OR=1.03(1.00-1.05),P=0.04]was associated with delayed regeneration.Furthermore,multivariate analysis demonstrated that the preoperative ALBI score[OR=2.63(1.00-1.05),P=0.02;per 1.0 up]and liver resection percentage[OR=1.02(1.00

关键词： Liver regeneration Albumin-bilirubin score Liver resection percentage Partial hepatectomy Human Regeneration index

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Inverse relationship between platelet Akt activity and hippocampal atrophy:A pilot case-control study in patients with diabetes mellitus

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World Journal of Clinical Cases 2024年第2期12卷 302-313页

作者： Haruhiko Tokuda Takamitsu Hori Daisuke Mizutani Tomoyuki Hioki Kumi Kojima Takashi Onuma Yukiko Enomoto Tomoaki Doi Rie Matsushima-Nishiwaki Shinji Ogura Hiroki Iida Toru Iwama Takashi Sakurai osamu Kozawa Department of Metabolic Research Research InstituteNational Center for Geriatrics and GerontologyObu 474-8511Japan Department of Clinical Laboratory National Center for Geriatrics and GerontologyObu 474-8511Japan Department of Pharmacology Gifu University Graduate School of MedicineGifu 501-1194Japan Department of Neurosurgery Gifu University Graduate School of MedicineGifu 501-1194Japan Department of Dermatology Central Japan International Medical CenterMinokamo 505-8510Japan Department of Anesthesiology and Pain Medicine Gifu University Graduate School of MedicineGifu 501-1194Japan Department of Emergency Medicine Faculty of MedicineUniversity of ToyamaToyama 930-0194Japan Department of Emergency and Disaster Medicine Gifu University Graduate School of MedicineGifu 501-1194Japan Research Institute National Center for Geriatrics and GerontologyObu 474-8511Japan

BACKGROUND Akt plays diverse roles in humans.It is involved in the pathogenesis of type 2 diabetes mellitus(T2DM),which is caused by insulin resistance.Akt also plays a vital role in human platelet activation.Furthermore,the hippocampus is closely associated with memory and learning,and a decrease in hippocampal volume is reportedly associated with an insulin-resistant phenotype in T2DM patients without dementia.AIM To investigate the relationship between Akt phosphorylation in unstimulated platelets and the hippocampal volume in T2DM patients.METHODS Platelet-rich plasma(PRP)was prepared from the venous blood of patients with T2DM or age-matched controls.The pellet lysate of the centrifuged PRP was subjected to western blotting to analyse the phosphorylation of Akt,p38 mitogen-activated protein(MAP)kinase and glyceraldehyde 3-phosphate dehydrogenase(GAPDH).Phosphorylation levels were quantified by densitometric analysis.Hippocampal volume was analysed using a voxel-based specific regional analysis system for Alzheimer’s disease on magnetic resonance imaging,which proposes the Z-score as a parameter that reflects hippocampal volume.RESULTS The levels of phosphorylated Akt corrected with phosphorylated p38 MAP kinase were inversely correlated with the Z-scores in the T2DM subjects,whereas the levels of phosphorylated Akt corrected with GAPDH were not.However,this relationship was not observed in the control patients.CONCLUSION These results suggest that an inverse relationship may exist between platelet Akt activation and hippocampal atrophy in T2DM patients.Our findings provide insight into the molecular mechanisms underlying T2DM hippocampal atrophy.

关键词： Akt Platelet Hippocampal atrophy Magnetic resonance imaging Diabetes mellitus

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