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Clinical significance of hypoechoic submandibular gland lesions in type 1 autoimmune pancreatitis

World Journal of Gastroenterology 2017年第18期23卷 3295-3300页

作者： Shinichi Takano Mitsuharu Fukasawa Makoto Kadokura Hiroko Shindo Ei Takahashi Sumio Hirose Yoshimitsu Fukasawa satoshi kawakami Tadashi Sato Nobuyuki Enomoto First Department of Internal Medicine Faculty of Medicine University of Yamanashi

AIM To assess the role of ultrasonography of submandibular glands(SGs) in the diagnosis of type 1 autoimmune pancreatitis(AIP). METHODS Thirty-seven patients who were definitively diagnosed with type 1 AIP according to the international consensus diagnostic criteria(ICDC) for AIP at our institution between December 1990 and April 2016 were retrospectively reviewed. Findings by physical examination, ultrasonography, and scintigraphy of SGs were analyzed to reach a diagnosis based on the ICDC for AIP. The efficacy of corticosteroid treatment in the resolution of hypoechoic lesions in SGs was also evaluated by assessment with ultrasonography before and after treatment in 18 cases.RESULTS The sensitivity of multiple hypoechoic lesions in SGs by ultrasonography for the diagnosis of sialadenitis in type 1 AIP(84%) was higher than that of physical examination(46%), scintigraphy(28%), and SGs thickness(49%). Ultrasonographic evidence of hypoechoic lesions in SGs improved the definitive diagnosis of sialadenitis and type 1 AIP by the ICDCcriteria in 11(30%) and 2(5.4%) cases, respectively. Multiple hypoechoic lesions in SGs were resolved or disappear by corticosteroid administration in 14 of 16 cases with hypoechoic lesions in SGs, whereas the ultrasonographic findings in the remaining 2 cases with hypoechoic lesions in SGs and the 2 cases with homogenous SG parenchyma remained unchanged after corticosteroid administration.CONCLUSION SG ultrasonography to detect multiple hypoechoic lesions might be useful for type 1 AIP diagnosis by improving diagnostic accuracy together with the ICDC sialadenitis criteria.

关键词：自体免疫的胰腺炎 Ultrasonography Submandibular 腺国际一致诊断标准 Sialadenitis

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Risk factors for perforation during endoscopic retrograde cholangiopancreatography in post-reconstruction intestinal tract

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World Journal of Clinical Cases 2019年第1期7卷 10-18页

作者： Shinichi Takano Mitsuharu Fukasawa Hiroko Shindo Ei Takahashi Sumio Hirose Yoshimitsu Fukasawa satoshi kawakami Hiroshi Hayakawa Hiroshi Yokomichi Makoto Kadokura Tadashi Sato Nobuyuki Enomoto First Department of Internal Medicine Faculty of Medicine University of Yamanashi Yamanashi 409-3898 Japan Department of Health Sciences Interdisciplinary Graduate School and Engineering University of Yamanashi Yamanashi 409-3898 Japan

BACKGROUND Endoscopic retrograde cholangiopancreatography(ERCP) in patients with surgically altered anatomy has been a major challenge to gastrointestinal endoscopists with low success rates for reaching the target site as well as high complication rates. The knowledge of ERCP-related risk factors is important for reducing unexpected complications.AIM To identify ERCP-related risk factors for perforation in patients with surgically altered anatomy.METHODS The medical records of 187 patients with surgically altered anatomy who underwent ERCP at our institution between April 2009 and December 2017 were retrospectively reviewed. An analysis of patient data, including age, sex, type of reconstruction, cause of surgery, aim of ERCP, success rate of reaching target site,success rate of procedure, adverse events, type of scope, time to reach the target site, and duration of procedure, was performed. In patients with Billroth-Ⅱ reconstruction, additional potential risk factors were the shape of the inserted scope and whether the anastomosis was antecolic or retrocolic.RESULTS All patients(n = 187) had surgical anatomy, such as Billroth-Ⅰ(n = 22), Billroth-Ⅱ(n = 33), Roux-en-Y(n = 54), Child, or Whipple reconstruction(n = 75). ERCP was performed for biliary drainage in 43 cases(23%), stone removal in 29 cases(16%),and stricture dilation of anastomosis in 59 cases(32%). The scope was unable to reach the target site in 17 cases(9%), and an aimed procedure could not be accomplished in 54 cases(29%). Adverse events were pancreatitis(3%),hyperamylasemia(10%), cholangitis(6%), cholestasis(4%), excessive sedation(1%), perforation(2%), and others(3%). Perforation occurred in three cases, all of which were in patients with Billroth-Ⅱ reconstruction; in these patients, further analysis revealed loop-shaped insertion of the scope to be a significant risk for perforation(P = 0.01).CONCLUSION Risk factors for perforation during ERCP in patients with surgically altered anatomy were Billroth-Ⅱ reconstruction and looping of the scope dur

关键词： Surgically altered anatomy Billroth-Ⅱ Endoscopic retrograde cholangiopancreatography Perforation

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Neurorehabilitation using a voluntary driven exoskeletal robot improves trunk function in patients with chronic spinal cord injury: a single-arm study

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Neural Regeneration Research 2022年第2期17卷 427-432页

作者： Hiroki Okawara Syoichi Tashiro Tomonori Sawada Keiko Sugai Kohei Matsubayashi Michiyuki kawakami satoshi Nori Osahiko Tsuji Narihito Nagoshi Morio Matsumoto Masaya Nakamura Department of Orthopaedic Surgery Keio University School of MedicineTokyoJapan Department of Rehabilitation Medicine Keio University School of MedicineTokyoJapan Department of Orthopedic Surgery National Hospital OrganizationMurayama Medical CenterTokyoJapan

Body weight-supported treadmill training with the voluntary driven exoskeleton(VDE-BWSTT) has been shown to improve the gait function of patients with chronic spinal cord injury. However, little is known whether VDE-BWSTT can effectively improve the trunk function of patients with chronic spinal cord injury. In this open-label, single-arm study, nine patients with chronic spinal cord injury at the cervical or thoracic level(six males and three females, aged 37.8 ± 15.6 years, and time since injury 51.1 ± 31.8 months) who underwent outpatient VDE-BWSTT training program at Keio University Hospital, Japan from September 2017 to March 2019 were included. All patients underwent twenty 60-minute gait training sessions using VDE. Trunk muscular strength, i.e., the maximum force against which patient could maintain a sitting posture without any support, was evaluated in four directions: anterior, posterior, and lateral(right and left) after 10 and 20 training sessions. After intervention, lateral muscular strength significantly improved. In addition, a significant positive correlation was detected between the change in lateral trunk muscular strength after 20 training sessions relative to baseline and gait speed. The change in trunk muscular strength after 20 training sessions relative to baseline was greatly correlated with patient age. This suggests that older adult patients with chronic spinal cord injury achieved a greater improvement in trunk muscle strength following VDE-BWSTT. All these findings suggest that VDE-BWSTT can improve the trunk function of patients with chronic spinal cord injury and the effect might be greater in older adult patients. The study was approved by the Keio University of Medicine Ethics Committee(IRB No. 20150355-3) on September 26, 2017.

关键词： body weight-supported treadmill training gait disorders hybrid assistive limb neurologic neurophysiotherapy postural balance precision medicine robot-assisted gait training robotics spinal cord injury trunk

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The neck burn scar contracture:a concept of effective treatment

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Burns & Trauma 2017年第3期5卷 140-147页

作者： Sadanori Akita Kenji Hayashida satoshi Takaki Yoshihisa kawakami Takuto Oyama Hiroyuki Ohjimi Department of Plastic Surgery Wound Repair and Regeneration School of Medicine Fukuoka University 7-45-1 Nanakuma Jonan ku Fukuoka 8140180 Japan Section of Plastic Surgery School of Medicine Shimane University Shimane Japan Department of Plastic Surgery School of Medicine Fukuoka University Fukuoka Japan

A neck scar contracture can severely and negatively affect the function of mastication, phonic, or breathing and result in neck pain and issues with esthetics. The best way is of course to avoid such contracture by means of non-surgical treatment such as use of a growth factor. The basic fibroblastic growth factor is clinically well proven in decreasing scar formation and improving healing. There are numerous reconstructive methods for neck contracture, especially when the lesions are relatively limited in part of the neck. However, a very severe and full circumferential scar contracture requires extensive reconstruction. The thin groin flap is one of the answers and well matches with the tissue texture and maintains the flexibility. Even with extensive burns and delayed reconstructions due to resuscitation first, the groin area is well preserved and can be safely harvested by dual vasculature systems of the superficial circumflex iliac artery and superficial epigastric artery, which warrant more reliability compared to the perforator flaps in this area. More demanding and stringent forms of the neck burn scar contracture are the sequelae of radiation. A radiation burn or radiation injury can be progressing and hard to heal. Adipose-derived stem cells can reverse the scar contracture as the surrounding tissue is softened and can accelerate wound healing. In this review, different types of neck burn scar contracture and reconstructive methods are summarized, including innovative use of bFGF and ADSCs in the management of difficult wound healing and scar contracture.

关键词： Neck scar contracture Anatomical locations Prophylaxis Severe scar contracture Thin groin flap Radiation injury Adipose-derived stem cell

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应用葫芦藓液体培养和金属资源回收技术(英文)

应用葫芦藓液体培养和金属资源回收技术(英文)

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2010全国地衣与苔藓系统学研讨会

作者： Misao Itouga Yoshihiro Honma Seiji Nakatsuka Yukari Komatsu satoshi kawakami Hitoshi Sakakibara Riken Plant Science Center 1-7-22 Suehiro-cho Tsurumi-kuYokohamaKanagawa 230-0045Japan

Water contamination from human activities is recently one of the most serious environmental issues.We discovered a novel ability in the moss Funaria hygrometrica obtained from an industrial waste area.The protonemal c... 详细信息

关键词： Funaria hygrometrica protonemal cell culture device wastewater gold lead

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Development of highly sensitive and rapid antigen detection assay for diagnosis of COVID-19 utilizing optical waveguide immunosensor

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Journal of Molecular Cell Biology 2021年第10期13卷 763-766页

作者： Rikako Funabashi Kei Miyakawa Yutaro Yamaoka Seiko Yoshimura satoshi Yamane Sundararaj Stanleyraj Jeremiah Kohei Shimizu Hiroki Ozawa Chiharu kawakami Shuzo Usuku Nobuko Tanaka Etsuko Yamazaki Hirokazu Kimura Hideki Hasegawa Akihide Ryo Department of Microbiology Yokohama City University Graduate School of MedicineKanagawajapan Life Science Laboratory Technology and Development DivisionKanto Chemical Co.Inc.KanagawaJapan Primary Care Testing Solution Development Department Canon Medical Systems CorporationTochigiJapan Yokohama City Institute of Public Health KanagawaJapan Clinical Laboratory Department Yokohama City University HospitalKanagawaJapan Department of Health Science Gunma Paz University Graduate SchoolGunmajapan Center for Influenza and Respiratory Virus Research National Institute of Infectious DiseasesMusashimurayamaTokyoJapan

Ever since its outbreak,the COVID-19 pandemic caused by SARS-CoV-2 has been spreading rapidly causing a global health crisis.Accurate diagnosis and instituting appropriate intervention to relevant individuals are essential not only to slow down the spread of this pandemic but also to manage our resources efficiently.To date,testing for SARS-CoV-2 infection mostly relies on reverse transcription-quantitative polymerase chain reaction(RT-qPCR)on a nasopharyngeal or saliva specimen and remains the gold standard for diagnosis as it exhibits high sensitivity and specificity.

关键词： diagnosis specificity nasopharyngeal

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Clinical effects of adalimumab treatment with concomitant azathioprine in Japanese Crohn's disease patients

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World Journal of Gastroenterology 2013年第17期19卷 2676-2682页

作者： Kumi Ishida Takuya Inoue Kaori Fujiwara Taisuke Sakanaka Ken Narabayashi Sadaharu Nouda Toshihiko Okada Kazuki Kakimoto Takanori Kuramoto Ken kawakami Yosuke Abe Toshihisa Takeuchi Mitsuyuki Murano satoshi Tokioka Eiji Umegaki Kazuhide Higuchi the Second Department of Internal Medicine Osaka Medical College Takatsuki City

AIM:To assess adalimumab's efficacy with concomitant azathioprine (AZA) for induction and maintenance of clinical remission in Japanese Crohn's disease (CD) patients. METHODS:This retrospective, observational, singlecenter study enrolled 28 consecutive CD patients treated with adalimumab (ADA). Mean age and mean disease duration were 38.1 ± 11.8 years and 11.8 ± 10.1 years, respectively. The baseline mean Crohn's disease activity index (CDAI) and C-reactive protein were 177.8 ± 82.0 and 0.70 ± 0.83 mg/dL, respectively. Twelve of these patients also received a concomitant stable dose of AZA. ADA was subcutaneously administered:160 mg at week 0, 80 mg at week 2, followed by 40 mg every other week. Clinical response and remission rates were assessed via CDAI and C-reactive protein for 24 wk. RESULTS:The mean CDAI at weeks 2, 4, 8, and 24 was 124.4, 120.2, 123.6, and 135.1, respectively. The CDAI was significantly decreased at weeks 2 and 4 with ADA and was significantly suppressed at 24 wk with ADA/AZA. Overall clinical remission rates at weeks 4 and 24 were 66.7% and 63.2%, respectively. Although no statistically significant difference in C-reactive protein was demonstrated, ADA with AZA resulted in a greater statistically significant improvement in CDAI at 24 wk, compared to ADA alone. CONCLUSION:Scheduled ADA with concomitant AZA may be more effective for clinical remission achievement at 24 wk in Japanese Crohn's disease patients.

关键词： Crohn’s disease Adalimumab Immunomodulator Azathioprine Inflammatory bowel disease

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