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Recent trends in the prevalence and distribution of colonic diverticula in Japan evaluated using computed tomography colonography

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World Journal of Gastroenterology 2021年第27期27卷 4441-4452页

作者： Noriyuki Isohata Koichi Nagata Kenichi Utano Ryoichi Nozaki satoshi Nozu Takashi Kato Shigeyoshi kijima Hiroshi Matsumoto Kenichiro Majima Yasuji Ryu Michiaki Hirayama Shungo Endo Department of Coloproctology Fukushima Medical UniversityAizu Medical CenterAizuwakamatsu 969-3492FukushimaJapan Department of Gastroenterology Fukushima Medical UniversityFukushima 960-1295FukushimaJapan Department of Radiology Fukushima Medical UniversityAizu Medical CenterAizuwakamatsu 969-3492FukushimaJapan Department of Gastroenterology Takano HospitalColoproctology CenterKumamoto 862-0971KumamotoJapan Department of Radiology Saitama Cancer CenterIna 362-0806SaitamaJapan Department of Gastroenterology National Hospital Organization Hokkaido Medical CenterSapporo 063-0005HokkaidoJapan Department of Radiology Jichi Medical UniversityShimotsuke 329-0498TochigiJapan Division of Gastroenterology Kawasaki Medical School HospitalKurashiki 701-0192OkayamaJapan Department of Health Management Kameda Medical CenterKamogawa 296-8602ChibaJapan Department of Radiology Tonami General HospitalTonami 939-1395ToyamaJapan Department of Gastroenterology Tonan HospitalSapporo 060-0004HokkaidoJapan

BACKGROUND Computed tomography colonography(CTC)may be superior to colonoscopy and barium enema for detecting ***,few studies have used CTC to diagnose *** To evaluate the current prevalence and distribution of colonic diverticula in Japan using *** This study was conducted as part of the Japanese National Computed Tomographic Colonography Trial,which included 1181 participants from 14 hospitals in *** analyzed the prevalence and distribution of colonic diverticula and their relationships with age and *** relationship between the diverticula and the length of the large intestine was also *** Diverticulosis was present in 48.1%of the *** prevalence of diverticulosis was higher in the older participants(P<0.001 for trend).The diverticula seen in younger participants were predominantly located in the right-sided *** participants had a higher frequency of bilateral type(located in the rightand left-sided colon)diverticulosis(P<0.001 for trend).The length of the large intestine with multiple diverticula in the sigmoid colon was significantly shorter in those without diverticula(P<0.001).CONCLUSION The prevalence of colonic diverticulosis in Japan is higher than that previously *** prevalence was higher,and the distribution tended to be bilateral in older participants.

关键词： Computed tomography colonography Diverticulosis Diverticular disease Colon

Glioblastoma without Remarkable Contrast Enhancement on Magnetic Resonance Imaging

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International Journal of Clinical Medicine 2012年第6期3卷 439-445页

作者： satoshi Utsuki Hidehiro Oka Yoshiteru Miyajima Chihiro kijima Yoshie Yasui Kiyotaka Fujii Department of Neurosurgery Kitasato University School of Medicine Sagamihara Japan

This is the report of a histological and clinical investigation of 4 cases of glioblastoma, a rare tumor, in whom poor contrast enhancement of the tumor was visualized on magnetic resonance imaging (MRI). Among the 94 patients with first-occurrence glioblastoma treated between January 2000 and August 2011, 4 were enrolled in this retrospective study. There were 2 men and 2 women, ranging in age from 41 to 70 years (mean, 57 years). All the patients underwent tumor resection, postoperative irradiation, and chemotherapy. One died of local tumor recurrence after 36 months;the remaining three remain alive as of 25 to 72 months after the initial treatment. The histopathology was glioblastoma with nuclear pleomorphism and pseudopalisading necrosis in all cases. However, the typical vascular endothelial proliferation was not found in 3 cases. All glioblastomas were immunopositive for p53 and immunonegative for epidermal growth factor receptor (EGFR) and isocitrate dehydrogenase 1 (IDH1). These glioblastomas showing unclear contrast enhancement on MRI had similar clinical and pathological characteristics, but differed in characteristics from glioblastoma patients showing marked contrast enhancement of the tumor on MRI.

关键词： Enhancement Effect Glioblastoma EGFR IDH1 p53 Secondary Glioblastoma

Outcome of Vision Impairment and Diabetes Insipidus in Suprasellar Region Germinoma

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International Journal of Clinical Medicine 2011年第2期2卷 82-85页

作者： satoshi Utsuki Hidehiro Oka Yoshiteru Miyajima Chihiro kijima Kiyotaka Fujii Shinichi Kan 不详

Aim: Many cases of suprasellar region germinoma occurs in diabetes insipidus (DI), but a patient initially may come to the hospital for the chief complaint of visual impairment. The aim of this study is to determine the etiology of initial symptom presentation and the outcomes of visual impairment and DI in suprasellar region germinoma. Methods: We investigated eleven cases of single lesion suprasellar germinomas that were diagnosed and treated in our hospital. For each, a magnetic resonance imaging (MRI) was performed. Results: At the hospital visit, decreased visual acuity was found in 5/11 cases, while DI was found in all cases. The decreased visual acuity was improved in 4/5 cases by treatment, but DI improved in only 2/11 cases. In 10 cases, DI occurred earlier than visual impairment. As the initial symptom, visual impairment occurred earlier than DI in only one case and did not improve by treatment. In this case, a pituitary stalk of the normal thickness could be identified by MRI, and the optic nerve was swollen. In ten cases except this case, no significant enlargement of optic nerve was detected, and a swollen pituitary stalk was confirmed. Conclusions: In suprasellar germinomas, it is rare, but the optic nerve can significantly swell at onset, while the pituitary stalk may be intact. In such cases, visual impairment occurs earlier than DI, and visual impairment may not be improved.

关键词： Diabetes Insipidus Neurohypophyseal Germinoma Optic Nerve Germinoma Visual Function

Preoperative Prediction of Whether Intraoperative Fluorescence of Protoporphyrin IX Can Be Achieved by 5-Aminolevulinic Acid Administration

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International Journal of Clinical Medicine 2012年第2期3卷 132-135页

作者： satoshi Utsuki Hidehiro Oka Chihiro kijima Madoka Inukai Kiyotaka Fujii Masahiro Ishizuka Kiwamu Takahashi Katsushi Inoue Department of Neurosurgery Kitasato University School of Medicine Sagamihara Japan SBI ALApromo Co. Ltd. Tokyo Japan

Protoporphyrin IX (PPIX) fluorescence-guided brain tumor resection, using 5-aminolevulinic acid (5-ALA), is among the most valuable tools for determining tumor removal area. However, PPIX fluorescence is not necessarily achieved during an operation visually even when 5-ALA is used, and we do not know until tumor exposure to the excitation light of the ultraviolet region whether PPIX fluorescence has been achieved. When a particular biopsy and frozen section diagnosis is made, the reason for lack of PPIX fluorescence in the tissue cannot be judged. We do not know whether the tumor fails to fluoresce or no fluorescence is seen because it is not the main body of the tumor. We investigated whether the presence or absence of tumor fluorescence could be predicted by examining urinary porphyrin before surgery, at the time of intraoperative fluorescence diagnosis using 5-ALA. The urine of brain tumor patients 2 hours after 5-ALA administration was irradiated with a 405 ± 1 nm laser light. The patients were divided into a fluorescent urine group and negative fluorescent urine group. Red fluorescence was observed in response to the 405 ± 1 nm laser beam for all tumors in the fluorescent urine group. Clear red fluorescence was not observed even with 405 ± 1 nm laser beam irradiation in any tumors in the negative fluorescent urine group. Preoperative prediction of the intraoperative fluorescence of PPIX can be achieved by observation of urine 2 hours after 5-ALA administration with exposure to a 405 ± 1 nm laser light.

关键词： 5-Aminolevulinic Acid Intraoperative Fluorescence Coproporphyrin Protoporphyrin IX Urinary Porphyrin

Effect of Postoperative Administration of Saireito for Bilateral Chronic Subdural Hematomas

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International Journal of Clinical Medicine 2011年第3期2卷 285-288页

作者： satoshi Utsuki Hidehiro Oka Chihiro kijima Madoka Inukai Katsutoshi Abe Kimitoshi Sato Sachio Suzuki Kiyotaka Fujii 不详

The aim of this retrospective study was to investigate the efficacy of saireito for bilateral chronic subdural hematomas (B-CSDH). Between April 2006 and March 2010, a total of 18 patients undergoing unilateral burr hole drainage for B-CSDH took part in a controlled clinical study. Postoperative status of the nonsurgical side was subsequently evaluated, with (n = 10) and without (n = 8) saireito administration. Two in the saireito-treated group patients and four in the control group patients ultimately required contralateral surgical intervention. The remainder, including eight saireito-treated hematomas, resolved without further surgery, generally within eight weeks of the surgical side procedure. However, two of the four resolving control lesions took longer to regress. The hydragogue and anti-inflammatory/steroid-evoking properties ascribed to saireito may facilitate hematoma resolution. After unilateral surgery for B-CSDH, saireito administration may prevent symptomatic deterioration of a contralateral low-density CSDH, preempting subsequent surgery.

关键词： Bilateral Chronic Subdural Hematomas Contralateral Hematoma Medical Treatment Saireito Steroid-Like Effect

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胆道肿瘤临床实践指南(英文第三版)

中华消化外科杂志 2021年第4期20卷 359-375页

作者： Masato Nagino satoshi Hirano Hideyuki Yoshitomi Taku Aoki Katsuhiko Uesaka Michiaki Unno Tomoki Ebata Masaru Konishi Keiji Sano Kazuaki Shimada Hiroaki Shimizu Ryota Higuchi Toshifumi Wakai Hiroyuki Isayama Takuji Okusaka Toshio Tsuyuguchi Yoshiki Hirooka Junji Furuse Hiroyuki Maguchi Kojiro Suzuki Hideya Yamazaki Hiroshi kijima Akio Yanagisawa Masahiro Yoshida Yukihiro Yokoyama Takashi Mizuno Itaru Endo 杨翼飞(译) 仇毓东(译) 赵梦珂(译) 伏旭(译) 蔡正华(译) 毛凉(审校) 爱知癌症中心日本名古屋北海道大学医学院胃肠外二科日本札幌独协医科大学琦玉医学中心普通外科日本越谷独协医科大学普通外二科日本米布静冈癌症中心肝胆胰外科日本长崎东北大学医学院外科系日本仙台名古屋大学医学院外科系日本名古屋国立癌症中心医院东院区肝胆胰外科日本柏市京都大学医学院外科系日本东京国立癌症中心医院日本东京帝京大学千叶医学中心外科系日本市原东京女子医科大学胃肠病研究所普通外科日本东京新泻大学医学与牙科研究生院消化与普通外科日本新泻均天道大学医学研究生院消化内科日本东京国立癌症中心医院肝胆胰肿瘤科日本东京千叶县锯原医院消化内科日本锯原藤田医科大学消化内科及消化肿瘤科日本丰明杏林大学医学院肿瘤内科日本三鹰泰恩金凯医院教育研究中心日本札幌爱知医科大学放射科日本长谷京都府立医科大学医学研究生院放射科日本京都广崎大学医学研究部病理学与生物科学系日本广崎日本红十字会京都第二医院病理科日本京都国际医疗福利大学肝胆胰胃肠外科日本一川横滨市立大学医学研究生院消化外科日本横滨南京大学医学院附属鼓楼医院肝胆胰中心

日本肝胆胰外科学会(JSHBPS)于2007年出版第一版胆道肿瘤(胆管癌、胆囊癌及壶腹癌)临床实践指南,于2014年更新第二版,2021年英文第三版胆道肿瘤临床实践指南围绕6个主题提出若干临床问题,基于相关循证医学证据并组织专家讨论后,最终确... 详细信息

日本肝胆胰外科学会(JSHBPS)于2007年出版第一版胆道肿瘤(胆管癌、胆囊癌及壶腹癌)临床实践指南,于2014年更新第二版,2021年英文第三版胆道肿瘤临床实践指南围绕6个主题提出若干临床问题,基于相关循证医学证据并组织专家讨论后,最终确定推荐意见、推荐强度以及推荐说明。根据证据推荐分级的评估、制订与评价(GRADE)系统,推荐强度被分为1级(强)或者2级(弱)。英文第三版胆道肿瘤临床实践指南中提出的31个临床问题涵盖:(1)预防性治疗;(2)诊断;(3)胆道引流;(4)外科治疗;(5)化疗;(6)放疗。31个临床问题中,14个问题给予推荐强度为强的推荐意见,14个问题给予推荐强度为弱的推荐意见,剩余的3个问题未给予推荐意见。每条推荐意见都进行推荐强度说明。最新版指南基于循证医学证据,为临床提供了重要建议。未来与癌症登记数据库协作将是评估指南和建立新证据的关键。

关键词：胆道肿瘤临床实践指南预防性治疗循证医学证据肝胆胰外科胆道引流推荐意见壶腹癌