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Clinical differentiation of acute appendicitis and right colonic diverticulitis: A case-control study

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World Journal of Clinical Cases 2019年第12期7卷 1393-1402页

作者： Yosuke Sasaki Fumiya Komatsu Naoyasu Kashima Takahiro Sato Ikutaka Takemoto Sho Kijima Tadashi Maeda Takamasa Ishii taito miyazaki Yoshiko Honda Nagato Shimada Yoshihisa Urita Department of General Medicine and Emergency Care Toho University School of Medicine

BACKGROUND Acute right colonic diverticulitis (ARCD) is an important differential diagnosis of acute appendicitis (AA) in Asian countries because of the unusually high prevalence of right colonic diverticula. Due to qualitative improvement and the high penetration rate of computed tomography (CT) scanning in Japan, differentiation of ARCD and AA mainly depends on this modality. But cost, limited availability, and concern for radiation exposure make CT scanning problematic. Differential findings of ARCD from AA are based on several small studies that used univariate comparisons from Korea and Taiwan. Previous studies on clinical and laboratory differences between AA and ARCD are limited. AIM To determine clinical differences between AA and ARCD for differentiation of these two diagnoses by creating a logistic regression model. METHODS We performed an exploratory single-center retrospective case-control study evaluating 369 Japanese patients (age ≥ 16 years), 236 (64.0%) with AA and 133 (36.0%) with ARCD, who were hospitalized between 2012 and 2016. Diagnoses were confirmed by CT images. We compared age, sex, onset-to-visit interval, epigastric/periumbilical pain, right lower quadrant (RLQ) pain, nausea/vomiting, diarrhea, anorexia, medical history, body temperature, blood pressure, heart rate, RLQ tenderness, peritoneal signs, leukocyte count, and levels of serum creatinine, serum C-reactive protein (CRP), and serum alanine aminotrans-ferase. We subsequently performed logistic regression analysis for differentiating AA from ARCD based on the results of the univariate *** In the AA and ARCD groups, median ages were 35.5 and 41.0 years, respectively (p=0.011);median onset-to-visit intervals were 1 [interquartile range (IQR): 0-1] and 2 (IQR: 1-3) days, respectively (P < 0.001);median leukocyte counts were 12600 and 11500/mm3, respectively (P = 0.002);and median CRP levels were 1.1 (IQR: 0.2-4.1) and 4.9 (IQR: 2.9-8.5) mg/dL, respectively (P < 0.001). In th

关键词： Abdominal pain Acute abdomen Appendicitis Clinical difference Creactive protein Diverticulitis Right lower quadrant pain

Clinical prediction of complicated appendicitis:A case-control study utilizing logistic regression

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World Journal of Clinical Cases 2020年第11期8卷 2127-2136页

作者： Yosuke Sasaki Fumiya Komatsu Naoyasu Kashima Takeshi Suzuki Ikutaka Takemoto Sho Kijima Tadashi Maeda taito miyazaki Yoshiko Honda Hiroaki Zai Nagato Shimada Kimihiko Funahashi Yoshihisa Urita Department of General Medicine and Emergency Care Toho University School of MedicineOta-kuTokyo 143-8541Japan Department of General and Gastroenterological Surgery Toho University Omori Medical CenterOtakuTokyo 143-8541Japan

BACKGROUND Since high-quality evidence on conservative treatment of acute appendicitis using antibiotics has increased,differentiation of patients with complicated appendicitis(CA)from those with simple appendicitis(SA)has become increasingly *** studies have revealed that male gender,advanced age,comorbid conditions,prehospital delay,fever,and anorexia are risk factors of perforated *** serum C-reactive protein(CRP)level and hyponatremia have also been reported as predictive biomarkers of ***,confounding between various factors is problematic because most previous studies were limited to univariate *** To evaluate non-laboratory and laboratory predictive factors of CA using logistic regression *** We performed an exploratory,single-center,retrospective case-control study that evaluated 198 patients(83.9%)with SA and 38 patients(16.1%)with *** were confirmed by computed tomography images for all *** compared age,sex,onset-to-visit interval,epigastric/periumbilical pain,right lower quadrant pain,nausea/vomiting,diarrhea,anorexia,medical history(of previous non-surgically treated appendicitis,diabetes,hypertension,dyslipidemia,liver cirrhosis,hemodialysis,chronic lung diseases,malignant tumors,immunosuppressant use,and antiplatelet use),vital signs,physical findings,and laboratory data to select the explanatory variates for logistic *** on the univariate comparisons,we performed logistic regression for clinical differentiation between CA and SA using only nonlaboratory factors and also including both non-laboratory and laboratory *** The 236 eligible patients consisted of 198 patients(83.9%)with SA and 38 patients(16.1%)with *** median ages were 34 years old[interquartile ranges(IR),24-45 years]in the SA group and 49 years old(IR,35-63 years)in the CA group(P<0.001).The median onset-to-visit interval was 1 d(IR,0-1)and 1 d(IR,1-2)in the SA and CA groups,respectively

关键词： Acute abdomen Abscess Appendicitis C-reactive protein Forecasting Intestinal perforation

In vivo direct reprogramming as a therapeutic strategy for brain and retina repair

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Neural Regeneration Research 2021年第10期16卷 1998-1999页

作者： Haruka Sekiryu taito Matsuda Department of Stem Cell Biology and Medicine Graduate School of Medical SciencesKyushu UniversityFukuokaJapan

Once neurons are lost because of injury or degeneration,they hardly ever regenerate in most mammalian central nervous system(CNS)*** adult rodents,some brain regions,such as the subventricular zone of the lateral ventricle and the subgranular zone of the dentate gyrus,retain neural stem cells(NSCs)and generate new *** a small population of new neurons derived from NSCs migrate toward lesion sites after brain injury,they are insufficient to completely restore neuronal *** transplantation using induced pluripotent stem cells(iPSCs)or embryonic stem cells(ESCs)has become an attractive therapeutic strategy for nerve injury or degeneration(Barker et al.,2015;Huang and Zhang,2019).For Parkinson’s disease,transplantation of dopaminergic neurons from human ESCs or iPSCs is emerging as a therapeutic approach(Li and Chen,2016).However,the risks of immune rejection and tumorigenesis remain substantial drawbacks of this therapeutic approach.

关键词： therapeutic degeneration programming

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 *** response rate with steroid therapy is 40%-60%.Therapeutic low-density lipoprotein-apheresis(LDL-A)may be effective in patients with steroid *** regarding the long-term prognosis of patients with focal segmental glomerulosclerosis receiving this therapy is ***: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 *** patients were observed at least 12 months after biopsy or until end-stage kidney disease occurrence or ***: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 ***: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

Peak Detection Implementation for Real-Time Signal Analysis Based on FPGA

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Circuits and Systems 2018年第10期9卷 148-167页

作者： Alperen Mustafa Colak taito Manabe Yuichiro Shibata Fujio Kurokawa Graduate School of Engineering Nagasaki University Nagasaki Japan Nagasaki Institute of Applied Science Nagasaki Japan

In this paper a real-time peak detection method based on modified Automatic Multiscale Field Detection (AMPD) algorithm and Field Programmable Gate Arrays (FPGA) technologies of a time series data is studied, and optimum scaling is highlighted after testing several scales. To validate the results obtained from modified algorithm, they are compared with the results of original AMPD method. As data of this study, three-phase voltage values of a power station are used. A detail detective sensitivity analysis of phase-to-phase voltage values is tried at different scales. Moreover, the original algorithm is tested regarding the off-line mode to obtain optimum scaling for real-time peak point detection. It is concluded that the peak detection of minimum and maximum points of data series achieved by modified algorithm is very close to the results of original AMPD algorithm.

关键词： AMPD Algorithm Off-Line Method FPGA Peak Detection

Postoperative recurrence of an IPMN of the pancreas with a fistula to the stomach

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World Journal of Gastrointestinal Endoscopy 2010年第10期2卷 349-351页

作者： Masaya Uesato Yoshihiro Nabeya Shinichi miyazaki taito Aoki Takashi Akai Kiyohiko Shuto Tohru Tanizawa Masaru miyazaki Hisahiro Matsubara Department of Frontier Surgery Chiba University Graduate School of MedicineChiba 260-8677Japan Makuhari Gastrointestinal Clinic Chiba 262-0033Japan Department of Pathology Chiba University HospitalChiba 260-8677Japan Department of General Surgery Chiba University Graduate School of MedicineChiba 260-8677Japan

We report on a case of a 74 year old man who was diagnosed with a recurrence of non-invasive carcinoma of intraductal papillary mucinous neoplasm (non-invasive IPMN) by postoperative gastroscopy (GS). A pylorus preserving pancreatico duodenectomy for IPMN in the pancreatic head was performed. A histopathological study revealed non-invasive adenocarcinoma. At first,the local recurrence of the tumor around the superior mesenteric artery circumference was diagnosed and disappeared with gemcitabine. Later,the GS showed the elevated lesion with mucin hypersecretion in the remnant stomach. The lesion had a central dip and a fistula common to the pancreas was confirmed on fisterography. We diagnosed a recurrence of IPMN and administered chemotherapy again. However,he died of his original illness. There are no reports of postoperative recurrence of IPMN checked by GS. It should be remembered that the elevated lesion of the remnant stomach is considered as one of the recurrent patterns of IPMN.

关键词： Intraductal papillary mucinous neoplasm Recurrence Fistula Stomach Endoscopy

Prospace融合器结合关节突融合在单节段经后路腰椎间融合术中的初步应用(英文)

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中国修复重建外科杂志 2007年第11期21卷 1155-1159页

作者：龙厚清植山和正刘少喻三户明夫板桥泰斗中山大学附属第一医院脊柱外科广州510070 日本弘前大学弘前纪念病院整形外科

目的评价Prospace融合器结合自体骨关节突融合技术应用于单节段经后路腰椎间融合术（posterior lumbar interbody fusion，PLIF）中的效果。方法2002年5月～2004年12月，收治76例脊柱疾患。其中男52例，女24例；年龄23～81岁，平均53．... 详细信息

目的评价Prospace融合器结合自体骨关节突融合技术应用于单节段经后路腰椎间融合术（posterior lumbar interbody fusion，PLIF）中的效果。方法2002年5月～2004年12月，收治76例脊柱疾患。其中男52例，女24例；年龄23～81岁，平均53．2岁。退变性腰椎间盘病60例，腰椎峡部裂9例，翻修手术7例。病程1．2～8．7年，平均3．6年。实施PLIF的节段：L2.3例，L3.4例，L4,5 54例，L5～S1 10例，L4～S1 1例，L5.6 2例。减压后双侧植入Prospace融合器，并将椎板减压所得自体骨填塞于融合器之间及其周围椎间隙内，结合椎弓根螺钉系统，将剩余自体骨填塞在双侧关节突关节。JOA评分评估临床疗效，腰椎侧位X线片测量椎间隙高度比和腰椎前凸角，CT扫描示有骨小梁通过椎间隙、关节突关节、腰椎动态侧位X线片无椎间活动、内植物周围无透亮间隙则评定为融合。结果平均手术出血量和手术时间分别为384ml和178min。获随访24～43个月，平均32个月。随访末期JOA评分为26·1±2．7，高于术前评分（14．5±4．0），且差异有统计学意义（P〈0．05）；平均JOA恢复率为81．1％（37．5％～100．0％）；椎体融合率为97．4％（74／76）。平均椎间隙高度比和融合节段腰椎前凸角分别由术前的0．27±0．07、5．8±2．2^o，改善为随访末期的0．33±0．06、11．3±2．0^o，差异均有统计学意义（P〈0．05）。无明显与内植物相关的并发症发生。结论若手术指征选择恰当，Prospace应用于单节段PLIF可获得满意的临床和影像学效果，且安全有效。

关键词：经后路腰椎间融合术 Prospace 关节突融合自体骨移植

Analysis of a Questionnaire Survey regarding Current Conditions against Exposure to Anticancer Drugs and Reports of Cancer Chemotherapy at Outpatient Departments in Japan

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Pharmacology & Pharmacy 2017年第5期8卷 140-152页

作者： Tsuyoshi Shirakawa Tomoko Hara Kojiro Hata Kojiro Hata Kimitaka Suetsugu Hideki Kakimoto Kentaro Ogata Yousuke Ikari Hidenori Sasaki Makoto Takahashi Masaru Fukahori Miyuki Uoi taito Esaki Mikako Hiraike Toshinobu Hayashi Akira Tokunaga Norio Ureshino Tsuneo Kuwamura Hitoshi Kusaba Kenji Mitsugi Eishi Baba Department of Pharmacy National Hospital Organization Kyushu Medical Center Fukuoka Japan Department of Oncology Miyazaki Prefectural Miyazaki Hospital Miyazaki Japan Department of Internal Medicine Fukuoka Wajiro Hospital Fukuoka Japan Department of Pharmacy Hamanomachi Hospital Fukuoka Japan Department of Pharmacy Kyushu University Hospital Fukuoka Japan Department of Pharmacy Fukuoka University Hospital Fukuoka Japan Department of Practical Pharmaceutical Science Faculty of Pharmaceutical Sciences Fukuoka University Fukuoka Japan Division of Medical Oncology Hematology and Infection Diseases Fukuoka University Hospital Fukuoka Japan Department of Pharmacy Kurume University Hospital Fukuoka Japan Division of Gastroenterology Kurume University Department of Medicine Fukuoka Japan Department of Pharmacy National Kyushu Cancer Center Fukuoka Japan Department of Gastrointestinal and Medical Oncology National Kyushu Cancer Center Fukuoka Japan Department of Pharmacy National Hospital Organization Kyushu Medical Center Fukuoka Japan Department of Pharmacy Saga-Ken Medical Centre Koseikan Saga Japan Department of Medical Oncology Saga-Ken Medical Centre Koseikan Saga Japan Department of Pharmacy Japan Community Healthcare Organization Kyushu Hospital Fukuoka Japan Department of Medicine and Comprehensive Biosystemic Science Kyushu University Graduate School of Medical Sciences Fukuoka Japan Department of Medical Oncology Hamanomachi Hospital Fukuoka Japan Department of Comprehensive Clinical Oncology Faculty of Medical Sciences Kyushu University Fukuoka Japan

[Background] Medical staff have many occasions to be exposed to anticancer drugs (ACDs) in the process of performing cancer chemotherapy. Although guidelines for the safe handling of ACDs have been published, actual measures against exposure to ACDs differ between hospitals, and no surveillance data regarding the conditions of each hospital in relation to performing chemotherapy in Japan are available. [Methods] To understand current measures against exposure to ACDs and problems related to cancer chemotherapy at outpatient departments, we conducted a questionnaire survey on doctors, pharmacists, and nurses in 10 leading hospitals for cancer chemotherapy in Japan. [Results] Responses were received from all 10 institutions. The hospital pharmacists prepared all ACDs for outpatients in each institution. All hospitals took basic measures against ACD exposure, such as using personal protective equipment and penetration-resistant waste containers. Conditions against exposure to ACDs generally improved between 2012 and 2015, especially in terms of conveyance of ACDs and use of a closed-system drug transfer device. However, no measures linking ACDs with administration routes or injection sites were commonly taken in any of the hospitals in 2015. [Conclusions] Conditions against ACD exposure improved between 2012 and 2015, possibly because new guidelines were issued. To improve measures for ACD exposure in Japan, preparing more appropriate manuals and offering more opportunities to medical staff for continuing education are considered important.

关键词： Exposure Anticancer Drugs Measurement Personal Protective Equipment Outpatient Service