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World Journal of Gastroenterology 2015年第14期21卷 4385-4390页

作者： Akinori Shirahige Haruhisa Suzuki Ichiro Oda Masau Sekiguchi Genki Mori seiichiro Abe Satoru Nonaka Shigetaka Yoshinaga Shigeki Sekine Ryoji Kushima Yutaka Saito Takeo Fukagawa Hitoshi Katai Endoscopy Division National Cancer Center Hospital Pathology Division National Cancer Center Hospital Department of Clinical Laboratory Medicine and Diagnostic Pathology Shiga University of Medical Science Gastric Surgery Division National Cancer Center Hospital

An 80-year-old man was under annual surveillance esophagogastroduodenoscopy after endoscopic submucosal dissection(ESD) for early gastric cancer(EGC).Two years after the initial ESD, a 0-Ⅱc type metachronous EGC lesion, 8 mm in size, without an ulcer scar, was found in the gastric *** estimated tumor depth was up to the mucosa, and biopsy revealed well and poorly differentiated *** was performed for this lesion and en bloc resection with negative margins was *** examination revealed an adenosquamous carcinoma 8 mm in size invading the deep submucosal layer(1600 μm), with lymphovascular invasion, consistent with the diagnosis of non-curative *** gastrectomy was recommended for this patient; however, two months after the ESD, preoperative computed tomography revealed multiple liver metastases, and the patient was considered as an unsuitable candidate for surgical *** chemotherapy was therefore started; however, the patient died of gastric cancer 27 mo after the second *** gastric adenosquamous carcinoma localized to the mucosa and submucosa is extremely rare and its clinical behavior is not well *** present report is very significant in that it underscores the distinct possibility of gastric adenosquamous carcinoma being very aggressive and fatal even when detected at an early cancer.

关键词： Early gastric cancer Endoscopic submucosal dissect

Endoscopic characteristics of small intestinal malignant tumors observed by balloon-assisted enteroscopy

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World Journal of Gastrointestinal Endoscopy 2019年第5期11卷 373-382页

作者： Tomofumi Horie Naoki Hosoe Kaoru Takabayashi Yukie Hayashi Kenji JL Limpias Kamiya Ryoichi Miyanaga Shinta Mizuno Kayoko Fukuhara seiichiro Fukuhara Makoto Naganuma Masayuki Shimoda Haruhiko Ogata Takanori Kanai Division of Gastroenterology and Hepatology Department of Internal MedicineSchool of MedicineKeio University Center for Diagnostic and Therapeutic Endoscopy School of MedicineKeio University Department of Pathology School of MedicineKeio University

BACKGROUND Capsule endoscopy and balloon-assisted enteroscopy(BAE) enable visualization of rare small bowel conditions such as small intestinal malignant ***,details of the endoscopic characteristics of small intestinal malignant tumors are still *** To elucidate the endoscopic characteristics of small intestinal malignant *** From March 2005 to February 2017,1329 BAE procedures were performed at Keio University Hospital. Of these procedures,malignant tumors were classified into three groups,Group 1: epithelial tumors including primary small intestinal cancer,metastatic small intestinal cancer,and direct small intestinal invasion by an adjacent organ cancer; Group 2: small intestinal malignant lymphoma; and Group 3,small intestinal gastrointestinal stromal tumors. We systematically collected clinical and endoscopic data from patients' medical records to determine the endoscopic characteristics for each *** The number of patients in each group was 16(Group 1),23(Group 2),and 6(Group 3),and the percentage of solitary tumors was 100%,43.5%,and 100%,respectively(P < 0.001). Patients' clinical background parameters including age,symptoms,and laboratory data were not significantly different between the groups. Seventy-five percent of epithelial tumors(Group 1) were located in the upper small intestine(duodenum and ileum),and approximately 70% of gastrointestinal stromal tumors(Group 3) were located in the jejunum. Solitary protruding or mass-type tumors were not seen in malignant lymphoma(Group2)(P < 0.001). Stenosis was seen more often in Group 1,(68.8%,27.3%,and 0%;Group 1,2,and 3,respectively; P = 0.004). Enlarged white villi inside and/or surrounding the tumor were seen in 12.5%,54.5%,and 0% in Group 1,2,and 3,respectively(P = 0.001).CONCLUSION The differential diagnosis of small intestinal malignant tumors could be tentatively made based on BAE findings.

关键词： Small intestine Malignant Tumor Double balloon enteroscopy Balloon enteroscopy Video capsule endoscopy Endoscopy

Leukemogenic Fusion Gene (p190 BCR-ABL) Transduction into Hematopoietic Stem/Progenitor Cells in the Common Marmoset

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Open Journal of Blood Diseases 2012年第1期2卷 1-10页

作者： Yan Dong seiichiro Kobayashi Yamin Tian Manabu Ozawa Takafumi Hiramoto Kiyoko Izawa Yuansong Bai Yasushi Soda Erika Sasaki Toshio Itoh Yoshiro Maru Satoshi Takahashi Kaoru Uchimaru Naoki Oyaizu Arinobu Tojo Chieko Kai Kenzaburo Tani Central Institute for Experimental Animals Kawasaki Japan Department of Laboratory Medicine Research Hospital Institute of Medical Science the University of Tokyo Tokyo Japan Department of Molecular Genetics Medical Institute of Bioregulation Kyushu University Fukuoka Japan Department of Pharmacology Tokyo Woman’s Medical University Japan Division of Molecular Therapy Institute of Medical Science the University of Tokyo Tokyo Japan Laboratory Animal Research Center Institute of Medical Science the University of Tokyo Tokyo Japan.

Patients with Philadelphia chromosome (p190 BCR-ABL fusion gene)-positive acute lymphoblastic leukemia have a poor prognosis despite intensive therapeutic *** this study, we attempted to develop a leukemia nonhuman primate model that mimics various human systems. Hematopoietic stem/progenitor cells in the common marmoset were transduced with a lentiviral vector containing the p190 BCR-ABL fusion gene by ex vivo transduction or in vivo direct bone marrow injection. In the latter model, BCR-ABL gene expression was maintained for more than one and a half years. One marmoset unexpectedly developed myelofibrosis-like disease. However, none of the marmosets have developed leukemia to date. In conclusion, we successfully achieved sustained p190 BCR-ABL gene expression in vivo. However, a genetic mutation in addition to p190 BCR-ABL may be required for the malignant transformation of hematopoietic stem/progenitor cells in the common marmoset during the short observation period. This novel in vivo approach will help develop a marmoset leukemia model in the future.

关键词： Leukemia Lentiviral Vector Myelofibrosis Common Marmoset

Endoscopic removal of foreign bodies:A retrospective study in Japan

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World Journal of Gastrointestinal Endoscopy 2020年第1期12卷 33-41页

作者： Kenji JL Limpias Kamiya Naoki Hosoe Kaoru Takabayashi Yukie Hayashi Xi Sun Ryoichi Miyanaga Kayoko Fukuhara seiichiro Fukuhara Makoto Naganuma Atsushi Nakayama Motohiko Kato Tadateru Maehata Rieko Nakamura Koichi Ueno Junichi Sasaki Yuko Kitagawa Naohisa Yahagi Haruhiko Ogata Takanori Kanai Division of Gastroenterology and Hepatology Department of Internal MedicineKeio University School of MedicineTokyo 160-8582Japan Center for Diagnostic and Therapeutic Endoscopy Keio University School of MedicineTokyo 160-8582Japan Department of Gastroenterology and Hepatology Chinese PLA General HospitalBeijing 100853China Division of Research and Development for Minimally Invasive Treatment Cancer CenterKeio University School of MedicineTokyo 160-8582Japan Department of Surgery Keio University School of MedicineTokyo 160-8582Japan Department of Emergency and Critical Care Medicine Keio University School of MedicineTokyo 160-8582Japan

BACKGROUND The ingestion of foreign bodies(FBs)and food bolus impaction(FBI)in the digestive tract are commonly encountered clinical *** to handle such problems continue to evolve offering advantages,such as the avoidance of surgery,reduced cost,improved visualization,reduced morbidity,and high removal success ***,to date,no studies have evaluated the endoscopic management of FBs in *** To elucidate level of safety and efficacy in the endoscopic management of FBs and *** A total of 215 procedures were performed at Keio University Hospital between November 2007 and August *** were collected from medical charts,and endoscopic details were collected from an endoscopic reporting *** performed with a flexible gastrointestinal endoscope were only taken into *** who underwent a technique involving FB or FBI from the digestive tract were only *** on patient sex,patient age,outpatient,inpatient,FB type,FB location,procedure time,procedure type,removal device type,success,and technical complications were reviewed and analyzed *** Among the 215 procedures,136(63.3%)were performed in old adults(≥60 years),180(83.7%)procedures were performed in *** most common type of FBs were press-through-pack(PTP)medications[72(33.5%)cases],FBI[47(21.9%)],Anisakis parasite(AP)[41(19.1%)cases].Most FBs were located in the esophagus[130(60.5%)cases]followed by the stomach[68(31.6%)cases].AP was commonly found in the stomach[39(57.4%)cases],and it was removed using biopsy forceps in 97.5%of the *** most common FBs according to anatomical location were PTP medications(40%)and dental prostheses(DP)(40%)in the laryngopharynx,PTP(48.5%)in the esophagus,AP(57.4%)in the stomach,DP(37.5%)in the small intestine and video capsule endoscopy device(75%)in the colon.A transparent cap with grasping forceps was the most commonly used device[82(38.1%)cases].The success rate of the procedure was

关键词： Anisakis parasite Endoscopic removal Food bolus impaction Foreign body Grasping forceps

Evaluation of the margins of differentiated early gastric cancer by using conventional endoscopy

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World Journal of Gastrointestinal Endoscopy 2015年第6期7卷 659-664页

作者： Shigetaka Yoshinaga Ichiro Oda seiichiro Abe Satoru Nonaka Haruhisa Suzuki Hajime Takisawa Hirokazu Taniguchi Yutaka Saito Endoscopy Division National Cancer Center Hospital Pathology Division National Cancer Center Hospital

AIM: To evaluate the determination of the margin of differentiated-type early gastric cancers by using conventional ***: We retrospectively evaluated 364 differentiated early gastric cancers that were endoscopically resected as en-bloc specimens and diagnosed pathologically in detail between November 2007 and October 2008. All procedures were done with conventional endoscopes and all endoscopic samples, before and after indigo carmine dye, were re-evaluated using a digital filing system by one endoscopist. We analyzed the incidence of lesions with unclear margins and the relationship between unclear margins and relevant clinicopathological findings. RESULTS: The rate of lesions with unclear margins was 20.6%(75/364). Multivariate regression analysis suggested that the factors that make the determination of the margin difficult were normal color, presence of components of flat area(0-IIb), a diameter ≥ 21 mm, ulceration, and components of poorly differentiated adenocarcinoma in the mucosal ***: As many as 20% of differentiated early gastric cancers show unclear margins. Consideration of the factors associated with unclear margins may help endoscopists to accurately determine the margins of the lesion.

关键词： Early gastric cancer Conventional endoscopy Determination of the margin

Efficacy and safety of endoscopic submucosal dissection under general anesthesia

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World Journal of Gastrointestinal Endoscopy 2016年第13期8卷 466-471页

作者： Kanefumi Yamashita Hironari Shiwaku Toshihiro Ohmiya Hideki Shimaoka Hiroki Okada Ryo Nakashima Richiko Beppu Daisuke Kato Takamitsu Sasaki seiichiro Hoshino Satoshi Nimura Ken Yamaura Yuichi Yamashita Department of Gastroenterological Surgery Fukuoka University Faculty of Medicine Department of Pathology Fukuoka University Faculty of Medicine Department of Anesthesiology Fukuoka University Faculty of Medicine

AIM: To evaluate the efficacy and safety of endoscopic submucosal dissection(ESD) under general ***: From January 2011 to July 2014, 206 consecutive patients had undergone ESD under general anesthesia for neoplasms of the stomach, esophagus, and colorectum were enrolled in this retrospective study. The efficacy and safety of ESD under general anesthesia were ***: The en bloc resection rate of esophageal, gastric, and colorectal lesions was 100.0%, 98.3%, and 96.1%, respectively. The complication rate of perforationand bleeding were 0.0% and 0.0% in esophageal ESD, 1.7% and 1.7% in gastric ESD, and 3.9% and 2.0% in colorectal ESD, respectively. No cases of aspiration pneumonia were observed. All complications were managed by conservative treatment, with no surgical intervention ***: With the cooperation of an anesthesiologist, ESD under general anesthesia appears to be a useful method, decreasing the risk of complications.

关键词： Complication Endoscopic submucosal dissection General anesthesia Conscious sedation

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压力容器对接焊缝焊趾应力集中系数预测研究

电力科技与环保 2023年第3期39卷 256-261页

作者：李博堤成一郎宋学伟柏源韦飞郑贵荣张玉华顾文浩钟潇潇国电环境保护研究院有限公司江苏南京210031 大阪大学工学研究科大阪吹田565-0871 国能浙江宁海发电有限公司浙江宁波315612

为有效预测压力容器对接焊缝焊趾应力集中系数(stress concentration factor,SCF),以双V型对接焊缝(geometrically symmetric butt joint,BJ-S)和带垫板的对接焊缝(butt joint with backing plate,BJ-BP)为研究对象,通过建立有限元模型,对每组200个、共10组以上的不同影响参数组合下的对接焊缝焊趾有限元SCF数据进行回归分析。回归分析中考察了8种不同几何参数以及名义应力对SCF的影响,对BJ-S已有的SCF公式进行修正,提高了不同名义应力下SCF预测公式的准确性;并在此基础上,提出了BJ-BP焊趾的SCF预测公式。结果表明:基于已有角变形的BJ-S公式,对名义应力修正之后,拟合数据和验证数据显示R^(2)由修正前的0.8538提升到0.98以上,且预测公式结果和有限元结果的误差在11%以内。对于BJ-BP焊趾处SCF,将提出的BJ-S的SCF公式应用于BJ-BP时,R^(2)为0.9144,效果不佳。BJ-S公式计算值和BJ-BP有限元结果具有线性关系,通过引入减小率常数进行修正,所得的BJ-BP总SCF公式的R^(2)在0.98以上,且误差小于8.5%,提高了SCF预测的精度,可为不同名义应力水平下的疲劳强度评估提供支撑。

关键词：对接焊缝焊趾应力集中系数有限元