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Risk factors for postoperative stoma outlet obstruction in ulcerativecolitis

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World Journal of Gastrointestinal Surgery 2020年第12期12卷 507-519页

作者： Tomoaki Kitahara Yu Sato Takashi Oshiro Rie Matsunaga Makoto Nagashima shinichi Okazumi Department of Surgery Toho University Sakura Medical CenterSakura 285-8741ChibaJapan

BACKGROUND Current medical treatments can achieve remission of ulcerative colitis (UC).Surgery is required when potent drug treatment is ineffective or when coloncancer or high-grade dysplasia develops. The standard procedure is restorativeproctocolectomy (RPC) with ileal pouch-anal anastomosis, commonly performedas two- or three-stage RPC with diverting ileostomy. Postoperative stoma outletobstruction (SOO) is frequent, but the causes are not well *** To identify the risk factors for SOO after stoma surgery in patients with *** We retrospectively reviewed the files of 148 consecutive UC patients whounderwent surgery with stoma construction. SOO was defined as small bowelobstruction symptoms and intestinal dilatation just below the penetrating part ofthe stoma on computed tomography. Patients were divided into two groups:Those who developed SOO within 30 d after surgery and those who did *** characteristics, intraoperative parameters, the stoma site, and rectusabdominis muscle thickness were collected. Moreover, we identified the patientswho repeatedly developed SOO. Univariate and multivariate analyses wereperformed to identify risk factors for SOO and recurring *** Eighty-nine patients who underwent two-stage RPC were included betweenJanuary 2008 and March 2020. Postoperatively, SOO occurred in 25 (16.9%)patients after a median time of 9 d (range 2-26). Compared to patients withoutSOO, patients with SOO had a significantly higher rate of malignant tumors ordysplasia (36.0% vs 17.1%, P = 0.032), lower total glucocorticoid dose one monthbefore surgery (0 mg vs 0 mg, P = 0.026), higher preoperative total protein level(6.8 g/dL vs 6.3 g/dL, P = 0.048), higher rate of loop ileostomy (88.0% vs 55.3%, P= 0.002), and higher maximum stoma drainage volume (2300 mL vs 1690 mL, P =0.004). Loop ileostomy (OR = 6.361;95%CI 1.322–30.611;P = 0.021) and maximumstoma drainage volume (OR = 1.000;95%CI 1.000–1.001;P = 0.015) wereconfirmed as independent r

关键词： Ileal pouch anal anastomosis Ileostomy Loop ileostomy Proctocolectomy and restorative Surgical stomas Total proctocolectomy Ulcerative colitis

Knee locking caused by osteochondroma of the proximal tibia adjacent to the pes anserinus:A case report

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世界临床病例杂志 2023年第23期11卷 5595-5601页

作者： Tatsuru Sonobe Michiyuki Hakozaki Yohei Matsuo Yojiro Takahashi Katsuhiro Yoshida shinichi Konno Department of Orthopaedic Surgery Fukushima Medical University School of MedicineFukushima 960-1295Japan Department of Orthopaedic Surgery Fukushima General Health and Welfare CentreFukushima 963-8041Japan Higashi-Shirakawa Orthopaedic Academy Fukushima Medical University School of MedicineFukushima 960-1295Japan Department of Orthopaedic Surgery Fujita General HospitalFukushima 969-1793Japan

BACKGROUND Osteochondroma is one of the most common benign bone tumors,and it may cause bone and joint deformities and limited range of motion of an adjacent *** pes anserinus region is one of the most frequent sites of osteochondroma,but knee locking caused by osteochondromas in the pes anserinus region is extremely *** SUMMARY We describe a 13-year-old Japanese girl’s extra-articular knee locking that occurred when the semitendinosus tendon got caught in osteochondroma that had developed in the pes anserinus *** osteochondroma was surgically *** postoperative outcome has been excellent,with no recurrence of knee locking or tumor one-year *** When a young person develops knee locking,the possibility of extra-articular as well as intra-articular locking should be ***,one of the causes of extra-articular locking,can be treated with surgery with good postoperative results.

关键词： Extra-articular knee locking Impingement Osteochondroma Pes anserinus Tibia Surgery Case report

Numerical analysis of plasma arc physical characteristics under additional constraint of keyhole

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Chinese Physics B 2018年第3期27卷 306-313页

作者： Bin Xu Fan Jiang Shujun Chen Manabu Tanaka shinichi Tashiro Nguyen Van Anh Engineering Research Center of Advanced Manufacturing Technology for Automotive Components Ministry of EducationBeijing 100124China joining and Welding Research Institute Osaka UniversityOsaka 567-0047Japan

The physical characteristics of a plasma arc affect the stability of the keyhole and weld pool directly during keyhole plasma arc welding(KPAW).There will be significant change for these characteristics because of the interaction between the keyhole weld pool and plasma arc after ***,in order to obtain the temperature field,flow field,and arc pressure of a plasma arc under the reaction of the keyhole,the physical model of a plasma arc with a pre-set keyhole was *** addition,the tungsten and base metal were established into the calculated domain,which can reflect the effect of plasma arc to weld pool *** on magneto hydrodynamics and Maxwell equations,a twoSdimensional steady state mathematical model was *** the heat production of anode and cathode,the distribution of temperature field,flow field,welding current density,and plasma arc pressure were solved out by the finite difference *** the calculated results,it is found that the plasma arc was compressed a second time by the *** additional constraint results in an obvious rise of the plasma arc pressure and flow velocity at the minimum diameter place of the keyhole,while the temperature field is impacted ***,the observational and metallographic experiments are conducted,and the shapes of plasma arc and fusion line agree with the simulated results generally.

关键词： characteristics of plasma arc interaction of keyhole and plasma arc pre-set keyhole model nu-merical analysis

Diagnostic value of antigenemia assay for cytomegalovirus gastrointestinal disease in immunocompromised patients

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World Journal of Gastroenterology 2011年第9期17卷 1185-1191页

作者： Naoyoshi Nagata Masao Kobayakawa Takuro Shimbo Kazufusa Hoshimoto Tomoyuki Yada Takuji Gotoda Junichi Akiyama shinichi Oka Naomi Uemura Department of Gastroenterology and Hepatology National Center for Global Health and Medicine Department of Clinical Research and Informatics International Clinical Research Center Research Institute National Center for Global Health and Medicine Department of Clinical Laboratory Pathological Division National Center for Global Health and Medicine Department of Gastroenterology and Hepatology National Center for Global Health and MedicineKohnodai Hospital Division of Aids Clinical Center National Center for Global Health and Medicine

AIM:To investigate the utility of the cytomegalovirus(CMV)antigenemia assay for the diagnosis of CMV gastrointestinal disease(GID). METHODS:One hundred and thirty immunocompromised patients were enrolled in this *** with a history of anti-CMV treatment and who had not undergone examination using the antigenemia assay were ***-GID was defined as the detection of large cells with intranuclear inclusions alone or associated with granular cytoplasmic inclusions by *** sections were stained with hematoxylin and eosin and immunohistochemically stained with *** evaluated the association between CMV-GID and patient characteristics(symptoms,underlying disease,medication,leukocyte counts,and antigenemia assay).All patients were checked with an human immunodeficiency virus(HIV)antibody test before endoscopic *** blood cell(WBC)counts were obtained from medical records within 1 wk of *** was defined as a total WBC count<5000 cells/mm 3 . For HIV patients,we also checked CD4+counts from medical records. RESULTS:A total of 99 patients were retrospectively selected for *** the immunocompromised patients,19 had malignant disease,18 had autoimmune disease,19 had disorders of biochemical homeostasis, three had undergone transplantation,and 45 had HIV infection.A total of 50 patients had received immunosuppressive *** patients had inflammatory bowel ***-five patients were diagnosed as having *** analysis indicated an association between HIV infection,leukopenia,and positive antigenemia and CMV-GID(P<0.05).Multivariate analysis using logistic regression revealed that HIV infection and positive antigenemia were the only independent factors related to CMV-GID(P<0.01).The sensitivity,specificity,positive predictive value,and negative predictive value of antigenemia for CMV-GID were 65.4%,93.6%, 91.9%,and 71.0%,*** a subgroup analy-sis,patients with leukopenia displayed

关键词： Cytomegalovirus Gastrointestinal disease Antigenemia assay Real-time polymerase chain reaction Human immunodeficiency virus infection

Investigating drivers of active nitrification in organic horizons of tropical forest soils

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Soil Ecology Letters 2023年第3期5卷 89-99页

作者： shinichi Watanabe Makoto Shibata Yoshiko Kosugi Lion Marryanna Keitaro Fukushima Arief Hartono Shinya Funakawa Graduate School of Global Environmental Studies Kyoto UniversityKitashirakawa Oiwake-choSakyo-kuKyoto606-8502Japan Graduate School of Agriculture Kyoto UniversityKitashirakawa Oiwake-choSakyo-kuKyoto606-8502Japan Forest Research Institute Malaysia 52109 KepongSelangorMalaysia Center for Ecological Research Kyoto University509-3Hirano 2-chomeOtsu-shiShiga520-2113Japan Faculty of Agriculture Bogor Agricultural UniversityJalan MerantiKampus IPB Darmaga 16680BogorIndonesia

High nitrate leaching has been observed from the O horizons of some tropical forests;however,the drivers of high nitrate production(active nitrification)in these O horizons have not yet been *** study investigated the drivers of active nitrification in the O horizon of tropical forest soils by focusing on two of the most widely recognized controlling factors of nitrification,total N,and *** collected mineral and O horizons from eight tropical forests in Cameroon,Indonesia,and Malaysia and measured gross nitrification *** O horizons showed significantly higher gross nitrification rates than mineral horizons,indicating that these O horizons have a high potential for *** nitrification rates in the O horizons were positively correlated with both total N and pH,and the chemical properties(e.g.,total content of N,P,and base cations)were *** correlations suggested that the underlying driver of nitrification in the O horizon was nutrient richness in the *** also indicated a threshold of gross nitrification rates around pH values of 5.5–*** elucidate that active nitrification and subsequent high nitrate leaching from the O horizon could be driven by nutrient-rich litter,possibly derived from soil fertility and tree species.

关键词： nitrogen dynamics gross nitrification rate organic horizon forest floor acidic soil leguminous trees

Does laparoscopic liver resection for colorectal liver metastases provide a true survival benefit compared with open liver resection?

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Hepatobiliary Surgery and Nutrition 2020年第5期9卷 657-660页

作者： shinichi Akahoshi Toru Beppu Yasuhisa Mori Koichi Kinoshita Nobutaka Sato Ken Kikuchi Department of Surgery Yamaga City Medical CenterKumamotoJapan Department of Surgery and Oncology Graduate School of Medical SciencesKyushu UniversityFukuokaJapan Adviser Sakurajuji HospitalKumamotoJapan

The recent Southampton consensus guideline and two previous international consensus meetings held in Louisville and Morioka in 2008 and 2014,respectively have recommended laparoscopic liver resection(LLR)as a standard procedure for selected patients with colorectal liver metastases(CRLM)(1-3).The Oslo-CoMet and LapOpHuva studies are the only two randomized controlled trials(RCTs)that have provided solid evidence showing that LLR is a safer,less invasive,and more cost-effective approach with higher health-related quality of life and oncological outcomes equivalent to those of open liver resection(OLR)for patients with CRLM(4-6).

关键词： resection colorectal metastases

Intramanchette transport during primate spermiogenesis： expression of dynein, myosin Va, motor recruiter myosin Va, VIIa-Rab27a/b interacting protein, and Rab27b in the manchette during human and monkey spermiogenesis

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Asian Journal of Andrology 2008年第4期10卷 561-568页

作者： shinichi Hayasaka Yukihiro Terada Kichiya Suzuki Haruo Murakawa Ikuo Tachibana Tadashi Sankai Takashi Murakami Nobuo Yaegashi Kunihiro Okamura Department of Obstetrics and Gynecology Tohoku University School of Medicine Sendai Miyagi 980-8574 Japan Suzuki Memorial Hospital lwanuma Miyagi 989-2481 Japan Tsukuba Primate Research Center National Institute of Biomedical Innovation Tukuba Ibaraki 305-0843 Japan

Aim： To show whether molecular motor dynein on a microtubule track, molecular motor myosin Va, motor recruiter myosin Va, VIIa-Rab27a/b interacting protein （MyRIP）, and vesicle receptor Rab27b on an F-actin track were present during human and monkey spermiogenesis involving intramanchette transport （IMT）. Methods： Spermiogenic cells were obtained from three men with obstructive azoospermia and normal adult cynomolgus monkey （Macacafascieularis）. Immunocytochemical detection and reverse transcription-polymerase chain reaction （RT-PCR） analysis of the proteins were carried out. Samples were analyzed by light microscope. Results： Using RT-PCR, we found that dynein, myosin Va, MyRIP and Rab27b were expressed in monkey testis. These proteins were localized to the manchette, as shown by immunofluorescence, particularly during human and monkey spermiogenesis. Conclusion： We speculate that during primate spermiogenesis, those proteins that compose microtubule-based and actin-based vesicle transport systems are actually present in the manchette and might possibly be involved in intramanchette transport.

关键词： intramanchette transport manchette spermiogenesis

Prognostic factors of minimally invasive surgery for gastric cancer: Does robotic gastrectomy bring oncological benefit?

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World Journal of Gastroenterology 2021年第39期27卷 6659-6672页

作者： Masaya Nakauchi Koichi Suda Susumu Shibasaki Kenichi Nakamura shinichi Kadoya Kenji Kikuchi Kazuki Inaba Ichiro Uyama Department of Gastroenterological Surgery Fujita Health UniversityToyoake 470-1192AichiJapan Department of Gastroenterological Surgery Ishikawa Prefectural Central HospitalKanazawa 920-8535IshikawaJapan

BACKGROUND Gastric cancer is the third leading cause of cancer-related death worldwide and surgical resection remains the sole curative treatment for gastric *** invasive gastrectomy including laparoscopic and robotic approaches has been increasingly used in a few *** far,only a few reports have investigated the oncological outcomes following minimally invasive *** To determine the 5-year survival following minimally invasive gastrectomy for gastric cancer and identify prognostic *** This retrospective cohort study identified 939 patients who underwent gastrectomy for gastric cancer during the study *** excluding 125 patients with non-curative surgery(n=77),other synchronous cancer(n=2),remnant gastric cancer(n=25),insufficient physical function(n=13),and open gastrectomy(n=8),a total of 814 consecutive patients with primary gastric cancer who underwent minimally invasive R0 gastrectomy at our institution between 2009 and 2014 were retrospectively ***,5-year overall and recurrence-free survival were analyzed using the Kaplan–Meier method with the log-rank test and Cox regression analyses,while factors associated with survival were determined using multivariate *** Our analysis showed that age>65 years,American Society of Anesthesiologists(ASA)physical status 3,total or proximal gastrectomy,and pathological T4 and N positive status were independent predictors of both 5-year overall and recurrencefree ***,the included patients had a 5-year overall and recurrence-free survival of 80.3%and 78.2%,*** the 814 patients,157(19.3%)underwent robotic gastrectomy,while 308(37.2%)were diagnosed with pathological stage II or III ***,our findings showed that robotic gastrectomy was an independent positive predictor for recurrence-free survival in patients with pathological stage II/III[hazard ratio:0.56(0.33-0.96),P=0.035].Comparison of recurrence-fre

关键词： Laparoscopy Gastric cancer Minimally invasive surgery Prognostic factor Stomach neoplasms

Advances in endoscopic therapy using grasping-type scissors forceps(with video)

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World Journal of Gastrointestinal Surgery 2021年第8期13卷 772-787页

作者： Kazuya Akahoshi Keishi Komori Kazuaki Akahoshi shinichi Tamura Shigeki Osada Yuki Shiratsuchi Masaru Kubokawa Endoscopy Center Aso Iizuka HospitalIizuka 820-8505Japan Department of Gastroenterology Aso Iizuka HospitalIizuka 820-8505Japan

Endoscopic submucosal dissection(ESD)is a globally accepted minimally invasive therapy for early-stage gastrointestinal tract *** numerous electrosurgical knives have been developed for ESD,technical difficulties and high complication rates(bleeding and perforation)have limited their use *** grasping-type scissors forceps[clutch cutter(CC)]is the first forceps-type resection device developed with reference to hemostatic *** aim was to allow easy and safe ESD throughout the gastro-intestinal tract,as a biopsy technique,using one *** CC can grasp the target tissue accurately and pull it away from the underlying muscle layer prior to energizing the tissue,for safe and effective incision and hemostasis during *** clinical studies showed that ESD using the CC(ESD-CC)is a safe(perforation rate:0%-3.6%;delayed bleeding rate:0%-4.2%),technically efficient(en-bloc resection rate:88.9%-100%),and single-device method for dissecting early-stage gastrointestinal tract *** ESD-CC technique is simple and easy to learn because it can be completed simply by repeating the grasp,pull,and coagulate and/or incise actions using an electrosurgical *** reported self-completion rate by nonexperts was significantly better with the CC than with conventional knives(61.7%vs 24.5%,respectively;P<0.001).Furthermore,the CC is used for other endoscopic therapies,such as endoscopic polypectomy for large pedunculated polyps,endoscopic myotomy for Zenker’s diverticulum,endoscopic treatment of buried bumper syndrome,and endoscopic necrosectomy for wall-off pancreatic *** initial reports using CC for these therapies have shown favorable *** this review,we describe the structural features of the CC,how to use the instrument,efficacies of ESD-CC,and other unique endoscopic therapies using the CC.

关键词： Grasping-type scissors forceps Clutch cutter Endoscopic submucosal dissection Endoscopic polypectomy Zenker’s diverticulum Buried bumper syndrome