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Risk factors for adverse in-hospital outcomes in acute colonic diverticular hemorrhage

World Journal of Gastroenterology 2015年第37期21卷 10697-10703页

作者： Naoyoshi Nagata Ryota Niikura Tomonori Aoki shiori moriyasu Toshiyuki Sakurai Takuro Shimbo Katsunori Sekine Hidetaka Okubo Kazuhiro Watanabe Chizu Yokoi Junichi Akiyama Mikio Yanase Masashi Mizokami Kazuma Fujimoto Naomi Uemura Department of Gastroenterology and Hepatology National Center for Global Health and Medicine Department of Clinical Research and Informatics National Center for Global Health and Medicine Department of Gastroenterology and Hepatology National Center for Global Health and Medicine Kohnodai Hospital Kohnodai Department of Internal Medicine and Gastrointestinal Endoscopy Saga Medical School

AIM: To investigate the factors associated with transfusion, further bleeding, and prolonged length of stay.METHODS: In total, 153 patients emergently hospitalized for diverticular bleeding who were examined by colonoscopy were prospectively enrolled. Patients in whom the bleeding source was identified received endoscopic treatment such as clipping or endoscopic ligation. After spontaneous cessation of bleeding withconservative treatment or hemostasis with endoscopic treatment, all patients were started on a liquid food diet and gradually progressed to a solid diet over 3d, and were discharged. At enrollment, we assessed smoking, alcohol, medications [non-steroidal antiinflammatory drugs(NSAIDs)], low-dose aspirin, and other antiplatelets, warfarin, acetaminophen, and oral corticosteroids), and co-morbidities [hypertension,diabetes mellitus, dyslipidemia, cerebro-cardiovascular disease, chronic liver disease, and chronic kidney disease(CKD)]. The in-hospital outcomes were need for transfusion, further bleeding after spontaneous cessation of hemorrhage, and length of hospital stay.The odds ratio(OR) for transfusion need, further bleeding, and prolonged length of stay were estimated by logistic regression analysis.RESULTS: No patients required angiographic embolization or surgery. Stigmata of bleeding occurred in 18% of patients(27/153) and was treated by endoscopic procedures. During hospitalization, 40patients(26%) received a median of 6 units of packed red blood cells. Multivariate analysis revealed that female sex(OR = 2.5, P = 0.02), warfarin use(OR= 9.3, P 70years(OR = 2.1, P = 0.04) and NSAID use(OR = 2.7,P = 0.03) were independent risk factors for prolonged hospital

关键词： In-hospital adverse clinical outcomes Antithrombot

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Decreased accumulation of ultrasound contrast in the liver of nonalcoholic steatohepatitis rat model

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World Journal of Gastroenterology 2011年第37期17卷 4191-4198页

作者： Yuki Miyata Takeo Miyahara Fuminori moriyasu Department of Gastroenterology and Hepatology Tokyo Medical University

AIM:To investigate the diagnosis of nonalcoholic steatohepatitis(NASH) using contrast ultrasonography in the NASH rat model.METHODS:The liver in methionine choline-deficient diet(MCDD) rats,a NASH model constructed by feeding an MCDD,was examined by contrast ultrasonography at weeks 2,4,8,12 and 16,with late phase images of contrast ultrasonography(Kupffer imaging) in which contrast enhancement was achieved by incorporation of a contrast agent by Kupffer cells(KCs),and images were compared to those in rats taking a regular chow.RESULTS:Decrease in contrast enhancement was observed first in MCDD rats at week 2.KCs were counted based on immunohistochemistry,but their numbers were not reduced and it was assumed that attenuation of contrast enhancement was attributable to reduced phagocytic activity of the KCs.CONCLUSION:It is suggested that clinical application of contrast ultrasonography may be valuable for noninvasive diagnosis of NASH.

关键词：大鼠模型超声检查酒精性造影剂肝炎脂肪对比度增强积累

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A predictive factor for the response to S-1 plus cisplatin in gastric cancer

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World Journal of Gastroenterology 2010年第36期16卷 4575-4582页

作者： Ikuko Miyazaki Takashi Kawai Youji Harada Fuminori moriyasu Department of Gastroenterology and Hepatology Tokyo Medical University Hospital6-7-1 Nishi-ShinjukuShinjuku-kuTokyo 160-0023Japan Endoscope Center Tokyo Medical University Hospital6-7-1 Nishi-ShinjukuShinjuku-kuTokyo 160-0023Japan Department of Gastroenterology Toda Chuo General Hospital1-19-3 HonchoToda-shiSaitama 335-1132Japan

AIM:To prove that the protein expression level of thymidylate synthase is a predictive factor for the response to S-1/cisplatin(CDDP)chemotherapy in gastric cancer.METHODS:We measured the protein expression levels of thymidylate synthase(TS),dihydropyrimidine dehydrogenase(DPD),and orotate phosphoribosyltrans-ferase(OPRT)in advanced gastric cancer.Before S-1/CDDP chemotherapy,tumor specimens from primary sites were obtained by endoscopic biopsy and analyzed by enzyme-linked immunosorbent assay.The chemo-therapeutic effects on the primary sites were evaluated by endoscopic biopsy performed more than once after S-1/CDDP chemotherapy.The effects are a predictive factor for the response to S-1/CDDP chemotherapy inpatients with advanced gastric cancer,as evaluated by endoscopic biopsy over time.RESULTS:The protein expression level of TS was significantly higher(P40 ng/mg protein.CONCLUSION:We have confirmed that the protein expression level of TS is a predictive factor for the response to S-1/CDDP chemotherapy in patients with advanced gastric cancer.

关键词： Gastric cancer Thymidylate synthase Dihy-dropyrimidine dehydrogenase Orotate phosphoribosyl-transferase Biopsy

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Arterial-phase contrast-enhanced ultrasonography for evaluating anti-angiogenesis treatment: A pilot study

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World Journal of Gastroenterology 2011年第8期17卷 1045-1050页

作者： Keiko Yoshida Tomihiko Hirokawa Fuminori moriyasu Masahiko Yamada Yasuharu Imai Department of Gastroenterology and Hepatology Tokyo Medical University

AIM:To verify whether arterial-phase contrast-enhanced ultrasonography(CEUS) of tumor parenchymal tissue is useful for evaluation of anti-angiogenesis agents.METHODS:Rabbits with liver tumor were subjected to CEUS,and images of the nodular maximal diameter in vascular phase were recorded.Image analysis was performed to plot the time intensity curve(TIC) at the tumor parenchyma,which set the diameter of the region of interest of intensity measurement.The TIC was calculated to obtain the time to peak intensity(TPI) and the magnitude of PI.Rabbits were randomly assigned to a treatment group with sorafenib and a control group.Two weeks later,the same ultrasound examination was repeated followed by pathological testing to assess the effect of sorafenib on the liver tumor.RESULTS:In four rabbits in the treatment group,the rate of change of tumor size was decreased comparedwith that of the control(the rate 2.3 vs 7.9,P = 0.02).The TPI of the treatment group elongated significantly(the rate 3.1 vs 1.1,P = 0.07 for SonoVue,2.0 vs 0.88,P = 0.09 for Sonazoid).The magnitude of PI showed no significant changes.In pathological examination,capillary diameters in the treatment group were significantly smaller than those in the control group(26.4 vs 42.8 μm,P = 0.013).CONCLUSION:Analysis of the TIC in the arterial phase of tumor tissue could evaluate the efficacy of antiangiogenesis drug treatment in liver tumor.

关键词：抗血管生成药物治疗超声检查造影动脉评价试验最大直径

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Effectiveness of narrow-band imaging magnification for invasion depth in early colorectal cancer

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World Journal of Gastroenterology 2010年第14期16卷 1727-1734页

作者： Masakatsu Fukuzawa Yutaka Saito Takahisa Matsuda Toshio Uraoka Takao Itoi Fuminori moriyasu Division of Endoscopy National Cancer Center Hospital Tokyo 1040045 Japan Division of Gastroenterology and Hepatology Tokyo Medical University Tokyo 1600023 Japan Department of Endoscopy Okayama University Hospital Okayama 7008558 Japan Microvasculature

AIM: To evaluate the surface microvascular patterns of early colorectal cancer (ECC) using narrow-band imaging (NBI) with magnification and its effectiveness for invasion depth diagnosis. METHODS: We studied 112 ECC lesions [mucosal/ submucosal superficial (m/sm-s), 69; sm-deep (sm-d), 43] ≥ 10 mm that subsequently underwent endoscopic or surgical treatment at our hospital. We compared microvascular architecture revealed by NBI with magnification to histological findings and then to magnifi- cation colonoscopy pit pattern diagnosis. RESULTS: Univariate analysis indicated vessel density: non-dense (P < 0.0001); vessel regularity: negative (P < 0.0001); caliber regularity: negative (P < 0.0001); vessel length: short (P < 0.0001); and vessel meandering: positive (P = 0.002) occurred significantly more often with sm-d invasion than m/sm-s invasion. Multivariate analysis showed sm-d invasion was independently associated with vessel density: non-dense[odds ratio (OR) = 402.5, 95% confidence interval (CI): 12.4-13 133.1] and vessel regularity: negative (OR = 15.9, 95% CI: 1.2-219.1). Both of these findings when combined were an indicator of sm-d invasion with sensitivity, specificity and accuracy of 81.4%, 100% and 92.9%, respectively. Pit pattern diagnosis sensitivity, specificity and accuracy, meanwhile, were 86.0%, 98.6% and 93.8%, respectively, thus, the NBI with magnification findings of non-dense vessel density and negative vessel regularity when combined together were comparable to pit pattern diagnosis. CONCLUSION: Non-dense vessel density and/or negative vessel regularity observed by NBI with magnification could be indicators of ECC sm-d invasion.

关键词： Colorectal neoplasms Narrow-band imaging Microvasculature

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Clinical Trial Protocol: Randomized Controlled Trial of Cancer Pain Monitoring System (CAPAMOS) in Patients with Advanced Cancer

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Open Journal of Nursing 2022年第2期12卷 113-124页

作者： shiori Yoshida Fumiko Sato Keita Tagami Shin Takahashi Department of Oncology Nursing Tohoku University Graduate School of Medicine Sendai Japan Department of Palliative Medicine Tohoku University Graduate School of Medicine Sendai Japan Department of Medical Oncology Tohoku University Hospital Sendai Japan

Purpose: This randomized controlled trial (RCT) protocol was designed to evaluate the effectiveness of the Cancer Pain Monitoring System (CAPAMOS), a telenursing system designed to alleviate pain in ambulatory patients with advanced cancer. Methods: The study design involved a randomized controlled trial consisting of an intervention group using CAPAMOS and a control group that received usual care. At the time of enrollment, both groups will be given a questionnaire regarding issues, such as concerns related to cancer pain and self-management of opioid medication. Patients will then receive pain relief education based on the results of the questionnaire. Subjects in the control group will receive a pain diary and pain-relief pamphlet that acts as an educational tool. They could also call the outpatient clinic if they wanted to ask for a nursing consultation. The intervention group will be able to use CAPAMOS to manage their pain and receive video consultation with a telenurse, who is an oncology nursing specialist. Educational tools will be built into CAPAMOS. The study will be conducted for one month. The primary endpoint of this study was to calculate the Japanese Brief Pain Inventory score. The secondary endpoints were to assess the opioid medication self-management, Barriers Questionnaire, Japanese EuroQol 5-dimensions 5-level, and economic evaluation. Assessment items will be evaluated at registration and 2 and 4 weeks after registration. Conclusions: A RCT based on this protocol is expected to validate the efficacy of telenursing using CAPAMOS in patients with advanced cancer and pain.

关键词： Telenursing Cancer Pain Advanced Cancer Patients Symptom Management Patient Care Randomized Controlled Trial

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Gallbladder Burkitt's lymphoma mimicking gallbladder cancer:A case report

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World Journal of Gastroenterology 2022年第6期28卷 675-682页

作者： Kiyotaka Hosoda Akira Shimizu Koji Kubota Tsuyoshi Notake Hikaru Hayashi Koya Yasukawa Kentaro Umemura Atsushi Kamachi Takamune Goto Hidenori Tomida shiori Yamazaki Yuri Narusawa Naoko Asano Takeshi Uehara Yuji Soejima Division of Gastroenterological Hepato-Biliary-PancreaticTransplantation and Pediatric SurgeryDepartment of SurgeryShinshu University School of MedicineMatsumoto 390-8621Japan Department of Laboratory Medicine Shinshu University School of MedicineMatsumoto 390-8621Japan

BACKGROUND Malignant lymphoma is a rare form of gallbladder malignancy.Most of these malignancies are diffuse large B-cell lymphomas or mucosa-associated lymphoid tissue-type lymphomas;however,Burkitt’s lymphoma of the gallbladder is extremely rare,and only two previous reports are available in the literature.Herein,we report a rare case of Burkitt’s lymphoma of the gallbladder mimicking gallbladder adenocarcinoma.CASE SUMMARY An 83-year-old man with no abdominal complaints was found to have a gallbladder tumor and periportal lymph node enlargement on computed tomography(CT)performed for hypertension screening.His laboratory data revealed slightly elevated serum levels of carcinoembryonic antigen and soluble interleukin 2 receptor.Imaging examinations revealed two irregular and contrastenhanced masses extending into the gallbladder lumen,but these did not infiltrate the serosa.Moreover,a periportal lymph node had enlarged to 30 mm.Based on these findings,we diagnosed the patient as having gallbladder adenocarcinoma with lymph node metastasis,which was treated using bile duct resection with gallbladder bed resection and periportal lymph node dissection.However,the patient was finally diagnosed as having Burkitt’s lymphoma.Although the surgical margin was pathologically negative,recurrence was noted at the hepatic radical margin and superior pancreaticoduodenal lymph nodes on positron emission tomography/CT soon after discharge.Thus,he was referred to a hematologist and started receiving treatment with reduced-dose cyclophosphamide,doxorubicin,vincristine,and prednisone.CONCLUSION Burkitt’s lymphoma can occur in the gallbladder.Biopsy can be useful in cases with findings suggestive of gallbladder malignant lymphoma.

关键词： Gallbladder Malignant lymphoma Burkitt’s lymphoma Gallbladder cancer Lymphadenopathy Case report

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The Impact of Footwear on Posture, Gait and Balance

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Health 2022年第2期14卷 209-218页

作者： Saori Karasawa Munetaka Yamamoto Junko Sakurai shiori Kawasaki Hiroyuki Kobayashi Department of Hospital Administration Juntendo Graduate School of Medicine Tokyo Japan Patient Safety Management Section Juntendo University Hospital Tokyo Japan Faculty of Health and Nursing Juntendo University Chiba Japan

Background: The objective of this study was to investigate the effects of footwear on posture and balance while walking. The types of footwear investigated in this study were open back shoes, commonly worn by hospitalized patients, and closed back shoes. Previous studies have shown that open back shoes, or slippers, increase the risk of falling (among elderly). We hypothesized that our findings would suggest that open back shoes negatively affect gait mechanics in healthy individuals. Methods: Healthy individuals (n = 12) participated in a walking test while wearing closed back shoes and open back shoes. The explanatory variables in this study were the analysis of gait, posture, and balance before and after walking. The objective variable was footwear (closed back shoes vs. open back shoes). A paired t-test was performed to detect significant differences between the two conditions. Results: Among the test items measured, we found a significant difference in minimum wide tilt angle and left-right differences in step length and intensity while walking between the conditions of closed back shoes and open back shoes. These results suggest that open back shoes could negatively impact posture and balance while walking, even in healthy subjects. Conclusion: It is imperative to improve patient awareness of the risk of falling. We believe that the inclusion of our findings in educational pamphlets and in-house notices could help improve patient awareness and more effectively prevent falls among patients.

关键词： Footwear Posture Walking Test Health Fall

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Gene expression of CCL8 and CXCL10 in peripheral blood leukocytes during early pregnancy in cows

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Journal of Animal Science and Biotechnology 2018年第4期9卷 813-823页

作者： Ryosuke Sakumoto Kosuke Iga Ken-Go Hayashi shiori Fujii Hiroko Kanahara Misa Hosoe Tadashi Furusawa Division of Animal Breeding and Reproduction Research Institute of Livestock and Grassland Science National Agriculture and Food Research Organization (NARO) Division of Livestock and Forage Research Tohoku Agricultural Research CenterNARO Division of Animal Sciences Institute of Agrobiological SciencesNARO

Background: The aim of the present study was to evaluate CCL8 and CXCL10 expression and its regulatory mechanism in peripheral blood leukocytes(PBLs) at the time of maternal recognition in cows. Blood samples were collected on 14, 15, 16, 17 and 18 d after artificial insemination(AI). Based on the day of return of estrus, cows were divided into three groups, pregnant(n = 5), early embryonic mortality(EEM; n = 5) and late embryonic mortality(LEM; n = 5). The gene expression levels in PBLs were assessed with quantitative real-time reverse transcription PCR.Results: The expression of CCL8 and CXCL10 mRNA in PBLs gradually increased from 14 to 18 d of pregnant cows and significant differences were observed on 18 d(P < 0.05), whereas no significant changes were observed both in EEM and LEM cows. Interferon-stimulated protein 15 k Da(ISG15), myxovirus-resistance gene(MX) 1 and MX2 mRNA expression in PBLs increased from 14 to 18 d which was significant on 18 d of pregnant cows as well as in LEM cows(P < 0.05), but no changes were observed in EEM cows. To determine whether the expression of CCL8 and CXCL10 in PBLs was regulated by pregnancy-related substances or not, expression level was assessed after exposure to interferon-τ(IFNT) and CCL16. Monocytes, granulocytes and lymphocytes were obtained using density-gradient centrifugation and flow cytometry. The addition of IFNT(100 ng/mL) and CCL16(100 ng/mL) to cultured PBLs increased the expression of CCL8 and CXCL10 mRNA(P < 0.05). The expression of ISG15, MX1 and MX2 mRNA in PBLs was also stimulated by IFNT and CCL16(P < 0.05).Conclusions: The expression of CCL8 and CXCL10 genes increased in PBLs during early pregnancy. Since IFNT stimulated CCL8 and CXCL10 expression in cultured PBLs, the increase of CCL8 and CXCL10 might be pregnancy-dependent events.The expression of both CCL8 and CXCL10 in PBLs was stimulated by CCL16 as wel as IFNT, suggesting a chemokine interaction that at least includes CCL8, CXCL10 and CCL16, and may play a role in regulating maternal recognitio

关键词： CCL8 Cow CXCL10 Leukocytes Pregnancy

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Long-term prognosis of focal segmental glomerulosclerosis treated with therapeutic low-density lipoprotein-apheresis in patients with severe kidney dysfunction and proteinuria

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Rheumatology & Autoimmunity 2023年第1期3卷 35-42页

作者： Shinji Kitajima Megumi Osima Hisayuki Ogura shiori Nakagawa Yuta Yamamura Taito Miyake Taro Miyagawa Tadashi Toyama Akinori Hara Norihiko Sakai Miho Shimizu Takashi Wada Yasunori Iwata Department of Nephrology and Laboratory Medicine Faculty of MedicineInstitute of MedicalPharmaceutical and Health SciencesGraduate School of Medical SciencesKanazawa UniversityKanazawaJapan Division of Blood Purification Kanazawa University HospitalKanazawaJapan

Background:The prognosis of focal segmental glomerulosclerosis patients with nephrotic syndrome is estimated to be 10%-20%in 5 years and 30%-50%in 10 years,leading to end-stage kidney disease.The response rate with steroid therapy is 40%-60%.Therapeutic low-density lipoprotein-apheresis(LDL-A)may be effective in patients with steroid resistance.Information regarding the long-term prognosis of patients with focal segmental glomerulosclerosis receiving this therapy is scarce.Methods:We investigated the effectiveness of treatment in 50 patients with primary focal segmental glomerulosclerosis diagnosed between 1961 and 2017 at Kanazawa University Hospital and related facilities.The patients were observed at least 12 months after biopsy or until end-stage kidney disease occurrence or death.Results:LDL-A was performed in four patients who presented with steroidresistant nephrotic syndrome(two patients had concurrent acute renal failure for which hemodialysis was performed).In comparison with 17 patients who did not receive LDL-A after 1989,the LDL-A group had higher urinary protein excretion(13.7 vs.5.2 g/day,P=0.053)and serum creatinine(4.11 vs.1.65 mg/dL)levels at onset,and a numerically higher remission rate(75.0%vs.58.7%)compared with the nonlipoprotein-apheresis group.Conclusion:Therapeutic LDL-A can be performed for critical cases and may improve the remission rate.

关键词： apheresis end-stage kidney disease focal segmental glomerulosclerosis LDL prognosis

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