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Relationship between arterial stiffness and cognitive function in outpatients with dementia and mild cognitive impairment compared with community residents without dementia

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Journal of Geriatric Cardiology 2022年第8期19卷 594-602页

作者： Ai Hirasawa Kumiko Nagai Taiki Miyazawa Hitomi Koshiba Mami Tamada shigeki shibata Koichi Kozaki Department of Health and Welfare Faculty of Health SciencesKyorin UniversityTokyoJapan Department of Geriatric Medicine Faculty of MedicineKyorin UniversityTokyoJapan Department of Health and Sports Science Faculty of WellnessShigakkan UniversityAichiJapan

BACKGROUND It is unclear whether the dementia patients with Alzheimer’s disease(AD)and vascular dementia(VaD)and mixed dementia(MIX,including AD and VaD)would have more developed arterial stiffness as compared with local residents without dementia.The aim of this study was to assess arterial stiffness and cognitive function in different types of dementia pa-tients[AD,VaD,MIX and mild cognitive impairment(MCI)]and community residents without dementia.METHODS This was a single-center,cross-sectional observational study.We studied a cohort of 600 elderly outpatients with a complaint of memory loss,who were divided into four groups(AD,VaD,MIX and MCI).In addition,they were compared with 55 age-matched local residents without dementia(Controls).We assessed arterial stiffness by brachial-ankle pulse wave velocity(baPWV)and the global cognitive function by the Mini-Mental State Examination(MMSE).RESULTS The baPWV was higher in AD,VaD and MIX than in MCI and in Controls(P<0.05).The baPWV was higher in MCI than in Controls(P=0.021),while MMSE were compatible between them(P=0.119).The higher baPWV predicted the presence of AD,VaD,MIX and MCI with the odds ratio of 6.46,8.74,6.16 and 6.19,respectively.In contrast,there were no difference in baPWV among three different types of dementia(P=0.191).The linear relationship between baPWV and MMSE was observed in the elderly with MMSE≥23(R=0.452,P=0.033),while it was not in dementia patients(MMSE<23).CONCLUSIONS The findings suggest that MCI and dementia patients have stiffer arteries as compared with age-matched local residents,although global cognitive function may be comparable between MCI and the local residents.

关键词： arterial impairment stiffness

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Background diseases and the number of previous intravitreal aflibercept injections on immediate intraocular pressure increase and vitreous reflux rate in phakic eyes

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International Journal of Ophthalmology(English edition) 2024年第3期17卷 545-550页

作者： Tetsuya Muto shigeki Machida Shinichiro Imaizumi Department of Ophthalmology Dokkyo Medical University Saitama Medical CenterKoshigaya 343-8555Japan Imaizumi Eye Hospital Koriyama 963-8877Japan Fukushima Medical University Fukushima 960-1295Japan

●AIM:To evaluate the effect of background diseases and number of previous intravitreal aflibercept injections(IVAIs)on immediate intraocular pressure(IOP)increase and vitreous reflux(VR)rate and to evaluate the correlation of both age and axial length with immediate IOP increase and VR rate.●METHODS:This study included 105 patients with cystoid macular edema secondary to retinal vein occlusion,35 patients with diabetic macular edema,69 patients with neovascular age-related macular degeneration(nAMD),and 12 patients with myopic choroidal neovascularization,which underwent first-time IVAI.The correlation of immediate IOP increase and VR rates with the four background diseases was investigated.Moreover,the correlation of age with immediate IOP increase and VR rate as well as correlation of axial length with immediate IOP increase and VR rate were evaluated.Further,54 patients with nAMD were treated with IVAI>10 times(multiple IVAIs).Moreover,the correlation of immediate IOP increase and VR rates with first-time and multiple IVAIs in nAMD was determined.●RESULTS:The immediate IOP increase(P=0.16)and VR rates(P=0.50)were almost similar among the four background diseases.The immediate postinjection IOP and age,VR rate and age,immediate postinjection IOP and axial length,or VR rate and axial length were not correlated in the four background diseases.The immediate IOP increase(P=0.66)and VR rates(P=0.28)did not significantly differ between first-time and multiple IVAIs in nAMD.●CONCLUSION:Background diseases and number of previous IVAIs have no effect on immediate IOP increase and VR rate.Further,age and axial length have no correlation on immediate IOP increase and VR rate.

关键词： aflibercept intraocular pressure vitreous reflux intravitreal injection

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Low skeletal muscle mass and high visceral adiposity are associated with recurrence of acute cholecystitis after conservative management:A propensity score-matched cohort study

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Hepatobiliary & Pancreatic Diseases International 2024年第1期23卷 64-70页

作者： Yudai Koya Michihiko shibata Yuki Maruno Yoshitaka Sakamoto Shinji Oe Koichiro Miyagawa Yuichi Honma Masaru Harada Department of Gastroenterology Kyushu Rosai HospitalMoji Medical Center3-1 HigashiminatomachiMoji-kuKitakyushu 801-8502Japan Third Department of Internal Medicine School of MedicineUniversity of Occupational and Environmental HealthKitakyushu 807-8555Japan Department of Surgery Kyushu Rosai Hospital Moji Medical CenterKitakyushu 801-8502Japan

Background:Recurrent acute cholecystitis(RAC)can occur after non-surgical treatment for acute cholecystitis(AC),and can be more severe in comparison to the first episode of AC.Low skeletal muscle mass or adiposity have various effects in several diseases.We aimed to clarify the relationship between RAC and body parameters.Methods:Patients with AC who were treated at our hospital between January 2011 and March 2022 were enrolled.The psoas muscle mass and adipose tissue area at the third lumbar level were measured using computed tomography at the first episode of AC.The areas were divided by height to obtain the psoas muscle mass index(PMI)and subcutaneous/visceral adipose tissue index(SATI/VATI).According to median VATI,SATI and PMI values by sex,patients were divided into the high and low PMI groups.We performed propensity score matching to eliminate the baseline differences between the high PMI and low PMI groups and analyzed the cumulative incidence and predictors of RAC.Results:The entire cohort was divided into the high PMI(n=81)and low PMI(n=80)groups.In the propensity score-matched cohort there were 57 patients in each group.In Kaplan-Meier analysis,the low PMI group and the high VATI group had a significantly higher cumulative incidence of RAC than their counterparts(log-rank P=0.001 and 0.015,respectively).In a multivariate Cox regression analysis,the hazard ratios of low PMI and low VATI for RAC were 5.250(95%confidence interval 1.083-25.450,P=0.039)and 0.158(95%confidence interval:0.026-0.937,P=0.042),respectively.Conclusions:Low skeletal muscle mass and high visceral adiposity were independent risk factors for RAC.

关键词： Acute cholecystitis Low skeletal muscle mass Recurrent acute cholecystitis Sarcopenia Visceral adiposity

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Myocardial metastasis from ZEB1-and TWIST-positive spindle cell carcinoma of the esophagus:A case report

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World Journal of Gastroenterology 2024年第11期30卷 1636-1643页

作者： Yoshihiro shibata Hirofumi Ohmura Kazuki Komatsu Kosuke Sagara Atsuji Matsuyama Ryuji Nakano Eishi Baba Department of Medical Oncology Fukuoka Wajiro HospitalFukuoka 811-0213Japan Department of Oncology and Social Medicine Kyushu University Graduate School of Medical SciencesFukuoka 812-8582Japan Department of Pathology and Oncology University of Occupational and Environmental HealthKitakyushu 807-8555Japan Department of Diagnostic Pathology Fukuoka Wajiro HospitalFukuoka 811-0213Japan

BACKGROUND Metastatic cardiac tumors are known to occur more frequently than primary cardiac tumors,however,they often remain asymptomatic and are commonly dis-covered on autopsy.Malignant tumors with a relatively high frequency of cardiac metastasis include mesothelioma,melanoma,lung cancer,and breast cancer,whereas reports of esophageal cancer with cardiac metastasis are rare.CASE SUMMARY The case of a 60-year-old man who complained of dysphagia is presented.Upper gastrointestinal endoscopy showed a submucosal tumor-like elevated lesion in the esophagus causing stenosis.Contrast-enhanced computed tomography showed left atrial compression due to the esophageal tumor,multiple liver and lung metastases,and a left pleural effusion.Pathological examination of a biopsy speci-men from the esophageal tumor showed spindle-shaped cells,raising suspicion of esophageal sarcoma.The disease progressed rapidly,and systemic chemotherapy was deemed necessary,however,due to his poor general condition,adminis-tration of cytotoxic agents was considered difficult.Given his high Combined Positive Score,nivolumab was administered,however,the patient soon died from the disease.The autopsy confirmed spindle cell carcinoma(SCC)of the esophagus and cardiac metastasis with similar histological features.Cancer stem cell markers,ZEB1 and TWIST,were positive in both the primary tumor and the cardiac metastasis.CONCLUSION To the best of our knowledge,there have been no prior reports of cardiac metastasis of esophageal SCC.This case highlights our experience with a patient with esophageal SCC who progressed rapidly and died from the disease,with the autopsy examination showing cardiac metastasis.

关键词： Spindle cell carcinoma Esophagus Myocardial metastasis Epithelial-mesenchymal transition Case report

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Recent trends in bone metastasis treatments:A historical comparison using the new Katagiri score system

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World Journal of Clinical Cases 2024年第15期12卷 2499-2505页

作者： Kenji Matsuda Kazuhiro Shimazu Hanae Shinozaki Koji Fukuda Taichi Yoshida Daiki Taguchi Kyoko Nomura Hiroyuki shibata Department of Clinical Oncology Akita University Graduate School of MedicineAkita 010-8543Japan Department of Environmental Health Science and Public Health Akita University Graduate School of MedicineAkita 010-8543Japan Department of Comprehensive Cancer Control Akita University Graduate School of MedicineAkita 010-8543Japan

BACKGROUND Bone metastasis has various negative impacts.Activities of daily living(ADL)and quality of life(QOL)can be significantly decreased,survival may be impacted,and medical expenses may increase.It is estimated that at least 5%cancer patients might be suffering from bone metastases.In 2016,we published the Comprehensive Guidelines for the Diagnosis and Treatment of Bone Metastasis.Since then,the therapeutic outcomes for patients have gradually improved.As life expectancy is a major determinant of surgical intervention,the strategy should be modified if the prolongation of survival is to be achieved.AIM To monitor how bone metastasis treatment has changed before and after launch of our guidelines for bone metastasis.METHODS For advanced cancer patients with bone metastasis who visited the Department of Clinical Oncology at Akita University hospital between 2012 and 2023,parameters including the site and number of bone metastases,laboratory data,and survival time,were extracted from electronic medical records and the Katagiri score was calculated.The association with survival was determined for each factor.RESULTS Data from 136 patients were obtained.The 1-year survival rate for the poor prognosis group with a higher Katagiri score was 20.0%in this study,which was 6%and an apparent improvement from 2014 when the scoring system was developed.Other factors significantly affecting survival included five or more bone metastases than less(P=0.0080),and treatment with chemotherapy(P<0.001),bone modifying agents(P=0.0175)and immune checkpoint inhibitors(P=0.0128).In recent years,advances in various treatment methods have extended the survival period for patients with advanced cancer.It is necessary not only to simply extend survival time,but also to maintain ADL and improve QOL.CONCLUSION Various therapeutic interventions including surgical approach for bone metastasis,which is a disorder of locomotor organs,are increasingly required.Guidelines and scoring system for prognosis need to be revised promptly.

关键词： Bone metastasis New Katagiri scoring system Prognosis Immune check point inhibitors Survival

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High-grade pancreatic intraepithelial neoplasia diagnosed based on changes in magnetic resonance cholangiopancreatography findings:A case report

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World Journal of Clinical Cases 2024年第8期12卷 1487-1496页

作者： Nao Furuya Atsushi Yamaguchi Naohiro Kato Syuhei Sugata Takuro Hamada Takeshi Mizumoto Yuzuru Tamaru Ryusaku Kusunoki Toshio Kuwai Hirotaka Kouno Kazuya Kuraoka Yoshiyuki shibata Sho Tazuma Takeshi Sudo Hiroshi Kohno Shiro Oka Department of Gastroenterology National Hospital Organization Kure Medical Center and Chugoku Cancer CenterKure 737-0023HiroshimaJapan Department of Gastroenterology Hiroshima University HospitalHiroshima 734-8551HiroshimaJapan Department of Pathology National Hospital Organization Kure Medical Center and Chugoku Cancer CenterKure 737-0023HiroshimaJapan Department of Surgery National Hospital Organization Kure Medical Center and Chugoku Cancer CenterKure 737-0023HiroshimaJapan

BACKGROUND High-grade pancreatic intraepithelial neoplasia(PanIN)exhibits no mass and is not detected by any examination modalities.However,it can be diagnosed by pancreatic juice cytology from indirect findings.Most previous cases were diagnosed based on findings of a focal stricture of the main pancreatic duct(MPD)and caudal MPD dilatation and subsequent pancreatic juice cytology using endoscopic retrograde cholangiopancreatography(ERCP).We experienced a case of high-grade PanIN with an unclear MPD over a 20-mm range,but without caudal MPD dilatation on magnetic resonance cholangiopancreatography(MRCP).CASE SUMMARY A 60-year-old female patient underwent computed tomography for a follow-up of uterine cancer post-excision,which revealed pancreatic cysts.MRCP revealed an unclear MPD of the pancreatic body at a 20-mm length without caudal MPD dilatation.Thus,course observation was performed.After 24 mo,MRCP revealed an increased caudal MPD caliber and a larger pancreatic cyst.We performed ERCP and detected atypical cells suspected of adenocarcinoma by serial pancreatic juice aspiration cytology examination.We performed a distal pancreatectomy and obtained a histopathological diagnosis of high-grade PanIN.Pancreatic parenchyma invasion was not observed,and curative resection was achieved.CONCLUSION High-grade Pan-IN may cause MPD narrowing in a long range without caudal MPD dilatation.

关键词： Pancreatic cancer Pancreatic intraepithelial neoplasm High-grade pancreatic intraepithelial neoplasm Magnetic resonance cholangiopancreatography Carcinoma in situ Case report

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多边框架下新兴市场国家面临的困境及其破解——对日本式经济增长的经验借鉴

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日本研究 2017年第2期 22-32页

作者：柴田茂纪张磊日本大分大学经济学部辽宁大学日本研究所

当前新兴市场国家的发展势头迅猛,已经成为世界经济发展的主要驱动力量。然而新兴市场国家面临普遍的困境,如何在参与度越来越高的国际经济活动中妥善处理与发达国家之间的贸易摩擦,同时提高自身的国际地位和影响力以实现合作共赢,是几... 详细信息

当前新兴市场国家的发展势头迅猛,已经成为世界经济发展的主要驱动力量。然而新兴市场国家面临普遍的困境,如何在参与度越来越高的国际经济活动中妥善处理与发达国家之间的贸易摩擦,同时提高自身的国际地位和影响力以实现合作共赢,是几乎所有新兴市场国家所面对的一项重要课题。直至20世纪60年代,日本尚且处于赶超阶段,日本通过实现贸易自由化以减少西方国家对日本出口产品的限制,实施对外经济援助以维护亚洲地区的稳定,以及两种方式相结合的手段促进国际贸易并提高国际地位。日本在经济高速发展阶段所面临的困境和成功的经验为当前新兴市场国家提供了一个极其有益的范式。

关键词：新兴市场国家贸易自由化变迁路径自动出口限制成本竞争

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血液稀释引起的高血容量会损害动态脑血流自主调控能力

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麻醉与镇痛 2008年第6期4卷 79-87页

作者： Yojiro Ogawa, DDS, PhD Ken-ichi Iwasaki, MD, PhD Ken Aoki, PhD shigeki shibata, MD, PhD Jitsu Kato, MD, PhD Setsuro Ogawa, MD, PhD 唐亮(译) 李士通(校) Departments of Hygiene and Space Medicineand Anesthesiology Nihon University School of Medicine Tokyo Japan 不详

背景手术期间频繁改变血容量会影响脑血流的自主调控功能，主要是通过改变交感神经活性、心输出量、血液粘度和脑血管张力来实现的。然而对于在急性的大幅度血容量变化中的动态脑血流自主调控效应还没有人进行过研究，特别是由于血液稀... 详细信息

背景手术期间频繁改变血容量会影响脑血流的自主调控功能，主要是通过改变交感神经活性、心输出量、血液粘度和脑血管张力来实现的。然而对于在急性的大幅度血容量变化中的动态脑血流自主调控效应还没有人进行过研究，特别是由于血液稀释引起的中心高血容量。方法我们用频谱及转换函数方法分析12例个体在血液稀释、中心低血容量和高血容量时的平均动脉压（MBP）和脑血流（CBF）流速变异性的变化，从而评估他们的动态脑血流自主调控能力。通过不同水平的下肢负压（-15和-30mmHg）和输注不同量的生理盐水（15ml／kg和30ml／kg）来实现中心血容量的快速改变。然后我们用阻抗心动图法测出中心静脉压（CVP）和（或）心输出量，据此评估中心血容量的变化。结果下肢负压为-30mmHg时稳态CBF流速和心输出量下降（CVP变化接近-4mmHg），上述指标在每种生理盐水输注时都增加（CVP变化在4-6mmHg），MBP没有显著性变化。然而MBP和CBF流速变异性的转换函数增益（转换强度）只有在输注生理盐水之后才有显著性增加，提示在血液稀释引起的中心高血容量是由MBP的波动导致CBF起伏的转换强度增加。结论我们的研究提示，虽然稳态CBF流速在中心低血容量与高血容量时都发生改变，但是只有血液稀释引起的中心高血容量才会损害动态脑血流的自主调控能力。

关键词：高血容量血液稀释脑血流调控能力损害生理盐水交感神经活性

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A dispersed vegetative cover contributes to urban biodiversity:plant diversity across land use types and scale in an Asian city

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Journal of Forestry Research 2023年第2期34卷 539-551页

作者： Jiefeng Kang Shozo shibata Laboratory of Landscape Ecology and Planning Graduate School of Global Environmental StudiesKyoto UniversityKyotoJapan

Urbanization provides both challenges and opportunities for biodiversity conservation,but patterns of urban plant diversity across land uses,especially in Asian countries,remains unclear.To determine these patterns of diversity,woody plants in 174 sample quadrats across various land use types in Kyoto City were investigated.Richness,abundance,and evenness were evaluated at city,land use,and quadrat scales,and biodiversity of different land use types was compared.At the city level,223 species in 77 families were recorded.At the land use level,residential areas had the highest total biological richness,with moderate to low evenness,while commercial areas exhibited low richness.At the quadrat level,the low-rise residential area had higher species richness than the other land uses.Species abundance and evenness in quadrats were significantly different across land use types for the canopy layer but not for the understory.The results provide insights into urban biodiversity design and management by identifying prior land uses for biodiversity improvement and by highlighting the contribution of residential private yards.Urban heterogeneity,scale,and multidimensionality should be considered when measuring urban biodiversity.

关键词： Urban biodiversity Woody plants Land uses Residential areas Japan

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Obstructive and secretory complications of diverting ileostomy

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World Journal of Gastroenterology 2022年第47期28卷 6732-6742页

作者： Shingo Tsujinaka Hideyuki Suzuki Tomoya Miura Yoshihiro Sato Chikashi shibata Department of Gastroenterological Surgery Tohoku Medical and Pharmaceutical UniversitySendai 983-8536MiyagiJapan

This review aimed to highlight the etiology,diagnosis,treatment,and prevention of obstructive and secretory complications associated with diverting ileostomy(DI).Obstructive complications at the stoma site are termed stoma outlet obstruction(SOO)or stoma-related obstruction(SRO).The incidence of SOO/SRO is 5.4%-27.3%,and the risk factors are multifactorial;however,the configuration of the stoma limb and the thickness of the rectus abdominis muscle(RAM)may be of particular concern.Trans-stomal tube decompression is initially attempted with a success rate of 33%-86%.A thick RAM may carry the risk of recurrence.Surgical refinement,including a wider incision of the anterior sheath and adequate stoma limb length,avoids tension and immobility and may decrease SOO/SRO.Secretory complications of DI are termed high output stoma(HOS).Persistent HOS lead to water and sodium depletion,and secondary hyperaldosteronism,resulting in electrolyte imbalances,such as hypomagnesemia.The incidence of HOS is 14%-24%,with an output of 1000-2000 mL/d lasting up to three days.Treatment of HOS is commenced after excluding postoperative complications or enteritis and includes fluid intake restriction,antimotility and antisecretory drug therapies,and magnesium supplementation.Intensive monitoring and surveillance programs have been successful in decreasing readmissions for dehydration.

关键词： Small bowel obstruction Stoma outlet obstruction Stoma-related obstruction High output stoma High output syndrome Dehydration

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