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Management of acute pancreatitis in Japan: analysis of nationwide epidemiological survey

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World Journal of Gastroenterology 2016年第28期22卷 6335-6344页

作者： shin hamada Atsushi Masamune Tooru Shimosegawa Division of Gastroenterology Tohoku University Graduate School of Medicine

Acute pancreatitis(AP) is an acute inflammatory disease of the exocrine pancreas. In Japan, nationwide epidemiological surveys have been conducted every 4 to 5 years by the Research Committee of Intractable Pancreatic Diseases, under the support of the Ministry of Health, Labour, and Welfare of Japan. We reviewed the results of the nationwide surveys focusing on the severity assessment and changes in the therapeutic strategy for walled-off necrosis. The severity assessment system currently used in Japan consists of 9 prognostic factors and the imaging grade on contrastenhanced computed tomography. By univariate analysis, all of the 9 prognostic factors were associated with AP-related death. A multivariate analysis identified 4 out of the 9 prognostic factors(base excess or shock, renal failure, systemic inflammatory response syndrome criteria, and age) that were associated with AP-related death. Receiver-operating characteristics curve analysis showed that the area under the curve was 0.82 for these 4 prognostic factors and 0.84 for the 9 prognostic factors, suggesting the comparable utility of these 4 factors in the severity assessment. We also examined the temporal changes in treatment strategy for walled-off necrosis in Japan according to the 2003, 2007, and 2011 surveys. Step-up approaches and lessinvasive endoscopic therapies were uncommon in 2003 and 2007, but became popular in 2011. Mortality has been decreasing in patients who require intervention for walled-off necrosis. In conclusion, the nationwide survey revealed the comparable utility of 4 prognostic factors in the severity assessment and the increased use of less-invasive, step-up approaches with improved clinical outcomes in the management of walled-off necrosis.

关键词： Endoscopic necrosectomy Diagnostic criteria Epidemiology Pancreatic pseudocyst Systemic inflammatory response syndrome Step-up approach Walled-off necrosis

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World Journal of Gastroenterology 2015年第33期21卷 9808-9816页

作者： Eriko Nakano Atsushi Kanno Atsushi Masamune Naoki Yoshida Seiji Hongo shin Miura Tetsuya Takikawa shin hamada Kiyoshi Kume Kazuhiro Kikuta Morihisa Hirota Keisuke Nakayama Fumiyoshi Fujishima Tooru Shimosegawa Division of Gastroenterology Tohoku University Graduate School of Medicine Division of Nephrology Endocrinology and Vascular MedicineTohoku University Graduate School of Medicine Department of Pathology Tohoku University Graduate School of Medicine

A 50-year-old male was referred to our hospital for the evaluation of *** positron emission tomography revealed high fluorodeoxyglucose uptake in the pancreas,bilateral lacrimal glands,submandibular glands,parotid glands,bilateral pulmonary hilar lymph nodes,and *** data showed an elevation of hepatobiliary enzymes,renal dysfunction,and remarkably high immunoglobulin(Ig) G levels,without elevated serum *** computed tomography revealed swelling of the pancreatic head and bilateral *** retrograde cholangiopancreatography showed an irregular narrowing of the main pancreatic duct in the pancreatic head and stricture of the lower common bile *** examination by endoscopic ultrasonography-guided fine-needle aspiration revealed findings of lymphoplasmacytic sclerosing pancreatitis without IgG4-positive plasma *** laboratory values and the swelling of several organs were improved by the treatment with *** patient was diagnosed as having type 1 autoimmune pancreatitis(AIP) based on the International Consensus Diagnostic ***,we encountered a case of compatible type 1 AIP without elevated levels of serum IgG4 or IgG4-positive plasma *** case suggests that AIP phenotypes are not always associated with IgG4.

关键词： IgG4-related disease Steroid Intestinal nephritis

Pancreatic duct drainage using EUS-guided rendezvous technique for stenotic pancreaticojejunostomy

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World Journal of Gastroenterology 2013年第31期19卷 5182-5186页

作者： Tetsuya Takikawa Atsushi Kanno Atsushi Masamune shin hamada Eriko Nakano shin Miura Hiroyuki Ariga Jun Unno Kiyoshi Kume Kazuhiro Kikuta Morihisa Hirota Hiroshi Yoshida Yu Katayose Michiaki Unno Tooru Shimosegawa Division of Gastroenterology Tohoku University Graduate School of Medicine Miyagi 980-8574 Japan Division of Hepato-biliary-Pancreatic Surgery Tohoku University Graduate School of Medicine Miyagi 980-8574 Japan

The patient was a 30-year-old female who had undergone excision of the extrahepatic bile duct and Rouxen-Y hepaticojejunostomy for congenital biliary dilatation at the age of ***,she suffered from recurrent acute pancreatitis due to pancreaticobiliary maljunction and received subtotal stomach-preserving *** developed a pancreatic fistula and an intra-abdominal abscess after the *** complications were improved by percutaneous abscess drainage and antibiotic *** ever,upper abdominal discomfort and the elevation of serum pancreatic enzymes persisted due to stenosis from the *** we could not accomplish dilation of the stenosis by endoscopic retrograde cholangiopancreatography,we tried an endoscopic ultrasonography(EUS) guided rendezvous technique for pancreatic duct *** transgastric puncture of the pancreatic duct using an EUS-fine needle aspiration needle,the guidewire was inserted into the pancreatic duct and finally reached to the jejunum through the stenotic *** changed the echoendoscope to an oblique-viewing endoscope,then grasped the guidewire and withdrew it through the *** stenosis of the pancreaticojejunostomy was dilated up to 4 mm,and a pancreatic stent was put in *** the pancreatic stent was removed after three months,the patient remained *** duct drainage using an EUS-guided rendezvous technique was useful for the treatment of a stenotic pancreaticojejunostomy after pancreaticoduodenectomy.

关键词： Balloon dilatation Endoscopic ultrasoundguided fine needle aspiration Pancreaticobiliary maljunction Pancreaticoduodenectomy Pancreatitis Postoperative complication

MSX2 overexpression inhibits gemcitabine-induced caspase-3 activity in pancreatic cancer cells

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World Journal of Gastroenterology 2005年第43期11卷 6867-6870页

作者： shin hamada Kennichi Satoh Kenji Kimura Atsushi Kanno Atsushi Masamune Tooru Shimosegawa Division of Gastroenterology

AIM： To evaluate the effect of MSX2 on gemcitabineinduced caspase-3 activation in pancreatic cancer cell line Panc-1. METHODS： Using V5-tagged MSX2 expression vector, stable transfectant of MSX2 was generated from Panc-i cells （Px14 cells）. Cell viability under gemcitabine administration was determined by MTF assay relative to control cell line （empty-vector transfected Panc-1 cells; P-3EV cells）. Hoechst staining was used for the detection of apoptotic cell. Activation of caspase-3 was assessed using Western blotting analysis and direct measurement of caspase-3 specific activities. RESULTS： MSX2 overexpression in Panc-1 cells resulted in decreased gemcitabine-induced caspase-3 activation and increased cell viability under gemcitabine treatment in Px14 cells. CONCLUSION： MSX2 exerts repressive effects on gemcitabine-induced apoptotic pathway. This novel apoptosis-regulating function of MSX2 may provide a new therapeutic target for pancreatic cancer.

关键词： MSX2 Caspase-3 Gemcitabine

Micro RNA-320 family is downregulated in colorectal adenoma and affects tumor proliferation by targeting CDK6

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World Journal of Gastrointestinal Oncology 2016年第7期8卷 532-542页

作者： Toshihiro Tadano Yoichi Kakuta shin hamada Yosuke Shimodaira Masatake Kuroha Yoko Kawakami Tomoya Kimura Hisashi Shiga Katsuya Endo Atsushi Masamune Seiichi Takahashi Yoshitaka Kinouchi Tooru Shimosegawa Division of Gastroenterology Tohoku University Graduate School of Medicine Community Gastroenterology (Iwaki Kyoritsu Hospital) Tohoku University Graduate School of Medicine Health Administration Center Center for the Advancement of Higher Education Tohoku University

AIM: To investigate the microR NA(miR NA) expression during histological progression from colorectal normal mucosa through adenoma to carcinoma within a lesion. METHODS: Using microarray, the sequential changes in miR NA expression profiles were compared in colonic lesions from matched samples; histologically, nonneoplastic mucosa, adenoma, and submucosal invasive carcinoma were microdissected from a tissue sample. Cell proliferation assay was performed to observe the effect of miR NA, and its target genes were predicted using bioinformatics approaches and the expression profile of SW480 transfected with the miR NA mimics. mR NA and protein levels of the target gene in colon cancer cell lines with a mimic control or miR NA mimics were measured using qR TPCR and Western blotting. The expression levels of miR NA and target gene in colorectal tissue samples were also ***: Microarray analysis identified that the miR-320 family, including miR-320 a, miR-320 b, miR-320 c, miR-320 d and miR-320 e, were differentially expressed in adenomaand submucosal invasive carcinoma. The mi R-320 family, which inhibits cell proliferation, is frequently downregulated in colorectal adenoma and submucosal invasive carcinoma tissues. Seven genes including CDK6 were identified to be common in the results of gene expression array and bioinformatics analyses performed to find the target gene of the miR-320 family. We confirmed that mR NA and protein levels of CDK6 were significantly suppressed in colon cancer cell lines with miR-320 family mimics. CDK6 expression was found to increase from non-neoplastic mucosa through adenoma to submucosal invasive carcinoma tissues and showed an inverse correlation with miR-320 family ***: MiR-320 family affects colorectal tumor proliferation by targeting CDK6, plays important role in its growth, and is considered to be a biomarker for its early detection.

关键词： CDK6 Colorectal cancer Mi R-320 family Colorectal adenoma Laterally spreading type

Granular cell tumor of the pancreas:A case report and review of literature

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World Journal of Gastrointestinal Oncology 2010年第2期2卷 121-124页

作者： Atsushi Kanno Kennichi Satoh Morihisa Hirota shin hamada Jun Umino Hiromichi Itoh Atsushi Masamune shinichi Egawa Fuyuhiko Motoi Michiaki Unno Kazuyuki Ishida Tooru Shimosegawa Division of Gastroenterology Tohoku University Graduate School of Medicine Department of Hepatobiliary-pancreatic surgery Tohoku University Graduate School of Medicine Department of Pathology Tohoku University Graduate School of Medicine

Granular cell tumors,also called Abrikossof's tumors,were originally described by Abrikossof A in *** f irst case of a pancreatic granular cell tumor was described in 1975 and only 6 cases have been *** describe a case of granular cell tumor in the pancreas showing pancreatic duct *** imaging studies showed f indings compatible with those of pancreatic carcinoma,the patient underwent distal *** examination showed that the tumor consisted of a nested growth of large tumor cells with ample granular cytoplasm and small round *** tumor cells expressed S-100 protein and were stained with neuron-specific enolase and periodic acid-Schiff,but were negative for desmin,vimentin,and *** resected tumor was diagnosed as a granular cell *** our knowledge,this is the seventh case of Granular cell tumor of the pancreas to be reported.

关键词： Granular cell tumor Pancreas Diagnosis Distal pancreatectomy

AI powered, automated discovery of polymer membranes for carbon capture

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npj Computational Materials 2023年第1期9卷 966-976页

作者： Ronaldo Giro Hsianghan Hsu Akihiro Kishimoto Toshiyuki Hama Rodrigo F.Neumann Binquan Luan Seiji Takeda Lisa hamada Mathias B.Steiner IBM Research Av.República do Chile330CEP 20031-170 Rio de JaneiroRJBrazil IBM Research 7-7Shin-KawasakiSaiwai-KuKawasakiKanagawa 212-0032Japan IBM Research 1101 Kitchawan Road PO Box 218Yorktown HeightsNY 10598-0218USA

The generation of molecules with artificial intelligence(AI)or,more specifically,machine learning(ML),is poised to revolutionize materials *** applications range from development of potent drugs to efficient carbon capture and separation ***,existing computational discovery frameworks for polymer membranes lack automated training data creation,generative design,and physical performance validation at meso-scale where complex properties of amorphous materials *** methodological gaps are less relevant to the ML design of individual molecules such as the monomers which constitute the building blocks of ***,we report automated discovery of complex materials through inverse molecular design which is informed by meso-scale target features and process *** have explored the multi-scale discovery regime by computationally generating and validating hundreds of polymer candidates designed for application in post-combustion carbon dioxide ***,we have validated each discovery step,from training dataset creation,via graph-based generative design of optimized monomer units,to molecular dynamics simulation of gas permeation through the polymer *** the latter,we have devised a representative elementary volume(REV)enabling permeability simulations at about 1000×the volume of an individual,ML-generated monomer,obtaining quantitative *** discovery-to-validation time per polymer candidate is on the order of 100 h using one CPU and one GPU,offering a computational screening alternative prior to lab validation.

关键词： monomer latter elementary

Efficacy of long-term rifaximin treatment for hepatic encephalopathy in the Japanese

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World Journal of Hepatology 2019年第6期11卷 531-541页

作者： shinya Nishida Koichi hamada Noriyuki Nishino Daizo Fukushima Ryota Koyanagi Yoshinori Horikawa Yoshiki Shiwa Satoshi Saitoh Department of Gastroenterology Shin-Yurigaoka General HospitalKawasaki 215-0026Japan Department of Gastroenterology Southern-Tohoku General HospitalKoriyama 963-8563Japan Department of Minimally Invasive Surgical and Medical Oncology Fukushima Medical UniversityFukushima 960-1295Japan Department of Hepatology Toranomon HospitalTokyo 105-8470Japan

BACKGROUND Hepatic encephalopathy(HE)is a complication of liver cirrhosis and can result in neuropsychological and neuromuscular dysfunctions in ***,an antibiotic,has been reported to decrease the occurrence of overt HE and also improve cognitive function in studies from Europe and the United States of *** is not enough evidence of the relationship between the long-term use of rifaximin and its clinical effects in the *** To determine the clinical effects of long-term rifaximin therapy in decompensated liver cirrhosis patients,with overt HE or *** In this single-center retrospective observational cohort study,we reviewed the data of 38 patients who had taken rifaximin at the dose of 1200 mg/d for more than 24 *** primary outcome measured was the efficacy of long-term rifaximin use,and secondary outcome measured was the safety of its long-term use as determined by its influence on portosystemic shunts as well as Escherichia coli-related ***,we compared the prognosis between the rifaximin group and control cases,matched for hepatic elasticity assessed by magnetic resonance ela-stography,age,and Child-Pugh *** Of the 38 patients included in the study,12(31.6%)had overt HE,27(71.1%)had complications of esophageal varices,and 9(23.7%)had hepatocellular carcinoma(HCC).The control group was matched for age,Child-Pugh classification,liver stiffness,and presence of *** median of serum ammonia level before treatment was 104μg/dL(59-297),and 2 wk after treatment,it significantly decreased to 85μg/dL(34-153)(P=0.002).A significantly low value of 80.5μg/dL(44-150)was maintained 24 wk after *** long-term use of rifaximin did not cause a decline in liver *** occurred in 2 patients,who improved with the administration of probiotics,and there were no cases of aborted rifaximin therapy owing to adverse *** patients with Child C,the survival was short,but there

关键词： Hepatic encephalopathy Rifaximin Hepatic cirrhosis Spontaneous portosystemic shunt Magnetic resonance elastography Child-Pugh classification

Virtual Core based Synthesis of SoC Architectures

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Virtual Core based Synthesis of SoC Architectures