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Inferior mesenteric arteriovenous fistula during treatment with bevacizumab in colorectal cancer patient: A case report

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World Journal of Gastrointestinal Oncology 2020年第11期12卷 1364-1371页

作者： Ayako Doi Hiroyuki Takeda Kumiko Umemoto Ryosuke Oumi Shinji Wada Shingo Hamaguchi Hidefumi Mimura Hiroyuki Arai Yoshiki Horie Takuro Mizukami Naoki Izawa takashi ogura Takako EguchiNakajima Yu Sunakawa Department of Clinical Oncology St.Marianna University School of MedicineKanagawa 216-8511Japan Department of Gastroenterology St.Marianna University School of MedicineKanagawa 216-8511Japan Department of Radiology St.Marianna University School of MedicineKanagawa 216-8511Japan Innovation Center for Next Generation Clinical Trials and iPS Cell Therapy Kyoto University HospitalKyoto 606-8507Japan

BACKGROUND Fistula formation is a severe adverse event related to antiangiogenetic agents such as bevacizumab and inferior mesenteric arteriovenous fistula(IMAVF) is a result of acquired factor, especially colon surgery. However, IMAVF occurs very rarely and there are few reports in patients during chemotherapy. We report a case of a patient who developed IMAVF during treatment with bevacizumab in metastatic colorectal cancer(mCRC) after colon *** SUMMARY An 81-year-old man was diagnosed with descending colon cancer and underwent left hemicolectomy without any complications. He was definitely diagnosed with high-risk stage 2 and received tegafur-uracil plus leucovorin as adjuvant chemotherapy. Three years and 6 mo after the operation, the cancer relapsed with peritoneal dissemination. The patient underwent CyberKnife radiosurgery targeting the recurrent tumor and received chemotherapy with S-1 plus bevacizumab. At 1 year after chemotherapy, he complained of severe diarrhea, which is suspected drug-induced colitis. As diarrhea worsened despite the termination of treatment, he underwent colonoscopy and computed tomography (CT) scans that revealed edematous change from sigmoid to rectosigmoid colon. CT scans also revealed an aneurysm adjacent to the inferior mesenteric vein and multidetector CT angiography showed the IMAVF. Elective angiography confirmed the diagnosis of an IMAVF and it was successfully treated by arterial embolization. The patient resumed chemotherapy with only S-1 6 mo after *** Clinicians should keep in mind the probability of severe diarrhea arose from IMAVF in mCRC patients treated with bevacizumab.

关键词： Metastatic cancer Colon surgery Chemotherapy Fistula formation Inferior mesenteric artery Interventional radiology Case report

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Improvement of thermal environment and reduction of energy consumption for coolin8 and heating by retrofitting windows

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Frontiers of Architectural Research 2013年第1期2卷 1-10页

作者： Mochidome takashi Hokoi Shuichi ogura Daisuke Takamura Masahiko Suzuki Jun Kyoto University Kyoto 606-8501 Japan VEC Japan LIXIL Japan

Various techniques for creating a comfortable thermal environment and saving energy have been proposed and employed in residential buildings in many countries, including Japan. For these techniques to be introduced, existing houses should be renovated. Among the techniques available, installation of additional inner windows is effective in creating a comfortable and energy-efficient living environment. In the present research, the effect of additional inner windows on the thermal environment and energy saving was investigated by measuring indoor climates. Windows were renovated in two rooms on the fourth floor of a four-story reinforced concrete building. Air temperatures, the humidity, the global solar radiation on horizontal and vertical surfaces, radiant temperatures, and the electricity consumption of air-conditioners were measured. A comparison of these vatues before and after the installation of inner- windows showed that the thermal environment and energy saving had improved. Results obtained from a thermal model agreed well with measured results by changing the value of solar transmittance and heat transmission coefficient of the glazing forlowing renovation. Furthermore, in a questionnaire survey conducted in summer, more than half of the occupants answered ＂cornfortabte＂ to a question on the overall thermal comfort.

关键词： Double-skin windows Retrofitting windows Thermat environ-ment Energy saving

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Comparative study on pharmacokinetics and toxicity of intravitreal and sub-Tenon injection of triamcinolone acetonide in ocular tissues

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International Journal of Ophthalmology(English edition) 2020年第12期13卷 1864-1871页

作者： Yuko Arie Hiroko Miyai Ayako Suzuki Takeshi Okabe Mitsuyo takashima Mayumi Takata takashi Kurasawa Masaki Ito Reijiro Arakawa Yuichiro ogura Akira Naito Sagami Research Laboratories Wakamoto Pharmaceutical Corporation Ltd.Kanagawa 2580018Japan Department of Ophthalmology and Visual Science Nagoya City University Graduate School of Medical SciencesNagoya 4678601Japan

AIM:To compare the differences in kinetics,distribution,and toxicity of triamcinolone acetonide(TA)between the injection methods,sub-Tenon and intravitreal injections in rabbit ocular ***:TA was injected into the vitreous or the sub-Tenon in *** pharmacokinetic study,rabbits were sacrificed periodically and then TA in blood and ocular tissues(retina/choroids,vitreous,and aqueous humor)were measured over 91 *** toxicological study,clinical signs,slit-lamp microscopic examination,ophthalmological test were *** eyeballs and surrounding tissues were collected and fixed with glutaraldehyde-formalin solution,and then paraffin embedded for histological ***:Higher levels of TA were distributed in the intraocular tissues when injected into the vitreous compared to the ***,TA level was remarkably lower in the rabbits which received intravitreal TA injections than those treated with sub-Tenon injection throughout the study period in *** discharge probably caused by systemic circulation of TA was observed by receiving sub-Tenon TA ***,technicassociated toxicological ocular symptoms and findings were more frequently observed in intravitreal injection than in sub-Tenon ***:There are significant differences in kinetics and distribution of TA in vitreous body,aqueous humor and plasma,between the two injection *** further study is needed to explain the species difference between human and rabbit,it is assumed that the difference in the frequency of intraocular pressure elevation and cataract formation by TA between the two injection methods are directly related to the TA concentrations in aqueous humor and vitreous body in each injection *** toxicity and technic-associated toxicity are also closely related to kinetics of TA in plasma and each injection method itself,respectively.

关键词： corticosteroid(s) pharmacokinetics injection ophthalmic drug delivery toxicity

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Recurrent colorectal cancer after endoscopic resectionwhen additional surgery was recommended

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World Journal of Gastroenterology 2016年第7期22卷 2336-2341页

作者： Yukiko Takatsu Yosuke Fukunaga Shunsuke Hamasaki Atsushi ogura Jun Nagata Toshiya Nagasaki,takashi Akiyoshi Tsuyoshi Konishi Yoshiya Fujimoto Satoshi Nagayama Masashi Ueno Department of Gastroenterological Surgery Cancer Institute HospitalJapanese Foundation for Cancer ResearchTokyo 135-8550Japan

AIM: To evaluate the type of recurrence after endoscopic resection in colorectal cancer patients and whether rescue was possible by salvage ***: Among 4972 patients who underwent surgical resection at our institution for primary or recurrent colorectal cancers from January 2005 to February 2015, we experienced eight recurrent colorectal cancers after endoscopic resection when additional surgical resection was ***: The recurrence patterns were: intramural local recurrence(five cases), regional lymph node recurrence(three cases), and associated with simultaneous distant metastasis(three cases). Among five cases with lymphatic invasion observed histologically in endoscopic resected specimens, four cases recurred with lymph node metastasis or distant metastasis. All cases were treated laparoscopically and curative surgery was achieved in six cases. Among four cases located in the rectum, three cases achieved preservation of the anus. Postoperative complications occurred in two cases(enteritis).CONCLUSION: For high-risk submucosal invasive colorectal cancers after endoscopic resection, additional surgical resection with lymphadenectomy is recommended, particularly in cases with lymphovascular invasion.

关键词： Colorectal neoplasms Colorectal surgery Laparoscopy Endoscopy Recurrence

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Volvulus of the gall bladder diagnosed by ultrasonography,computed tomography,coronal magnetic resonance imaging and magnetic resonance cholangio-pancreatography

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World Journal of Gastroenterology 2006年第28期12卷 4599-4601页

作者： Nobuhisa Matsuhashi Shinichi Satake Kazunori Yawata Eri Asakawa takashi Mizoguchi Masayuki Kanematsu Hiroshi Kondo Ichiro Yasuda Kenichi Nonaka Chihiro Tanaka Atsushi Misao Shinji ogura Department of Emergency and Disaster Medicine Gifu University1-1 Yanagido501-1194Gifu CityJapan Department of Radiology Gifu University1-1 Yanagido501-1194Gifu CityJapan Department of Gastroenterology Gifu University1-1 Yanagido501-1194Gifu CityJapan Department of Surgical Oncology Gifu University1-1 Yanagido501-1194Gifu CityJapan Department of Surgery Misao HospitalYotsuyachou500-8088Gifu CityJapan

A 54-year-old woman was admitted to our hospital with the complaint of right upper quadrant pain. Upon physical examination the vital signs of the patient were within normal ranges. Ultrasonography and computed tomography （CT） examination of the abdomen was obtained, which demonstrated a large dilatated cystic structure, measuring approximately 68.6 mm × 48.6 mm, with marked distension and inflammation. Additionally, the enhanced CT was characterized by the non-enhanced wall of the gallbladder. As the third examination in this study, magnetic resonance imaging （MRI）, namely coronal MRI and magnetic resonance cholangio-pancreatography （MRCP）, were performed. The MRCP demonstrated a dilatation of the gallbladder but detected no neck of the gallbladder. Simple cholecystectomy was performed. Macroscopic findings included a distended and gangrenous gallbladder, and closer examination revealed a counterclockwise torsion of 360 degrees on the gallbladder mesentery. Coronal MRI and MRCP showing characteristic radiography may be useful in making a definitive diagnosis.

关键词： Volvulus of the gallbladder Computed tomography Magnetic resonance imaging Magnetic resonance cholangio-pa ncreatography

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Inverse relationship between platelet Akt activity and hippocampal atrophy:A pilot case-control study in patients with diabetes mellitus

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World Journal of Clinical Cases 2024年第2期12卷 302-313页

作者： Haruhiko Tokuda Takamitsu Hori Daisuke Mizutani Tomoyuki Hioki Kumi Kojima takashi Onuma Yukiko Enomoto Tomoaki Doi Rie Matsushima-Nishiwaki Shinji ogura Hiroki Iida Toru Iwama takashi Sakurai Osamu Kozawa Department of Metabolic Research Research InstituteNational Center for Geriatrics and GerontologyObu 474-8511Japan Department of Clinical Laboratory National Center for Geriatrics and GerontologyObu 474-8511Japan Department of Pharmacology Gifu University Graduate School of MedicineGifu 501-1194Japan Department of Neurosurgery Gifu University Graduate School of MedicineGifu 501-1194Japan Department of Dermatology Central Japan International Medical CenterMinokamo 505-8510Japan Department of Anesthesiology and Pain Medicine Gifu University Graduate School of MedicineGifu 501-1194Japan Department of Emergency Medicine Faculty of MedicineUniversity of ToyamaToyama 930-0194Japan Department of Emergency and Disaster Medicine Gifu University Graduate School of MedicineGifu 501-1194Japan Research Institute National Center for Geriatrics and GerontologyObu 474-8511Japan

BACKGROUND Akt plays diverse roles in *** is involved in the pathogenesis of type 2 diabetes mellitus(T2DM),which is caused by insulin *** also plays a vital role in human platelet ***,the hippocampus is closely associated with memory and learning,and a decrease in hippocampal volume is reportedly associated with an insulin-resistant phenotype in T2DM patients without *** To investigate the relationship between Akt phosphorylation in unstimulated platelets and the hippocampal volume in T2DM *** Platelet-rich plasma(PRP)was prepared from the venous blood of patients with T2DM or age-matched *** pellet lysate of the centrifuged PRP was subjected to western blotting to analyse the phosphorylation of Akt,p38 mitogen-activated protein(MAP)kinase and glyceraldehyde 3-phosphate dehydrogenase(GAPDH).Phosphorylation levels were quantified by densitometric *** volume was analysed using a voxel-based specific regional analysis system for Alzheimer’s disease on magnetic resonance imaging,which proposes the Z-score as a parameter that reflects hippocampal *** The levels of phosphorylated Akt corrected with phosphorylated p38 MAP kinase were inversely correlated with the Z-scores in the T2DM subjects,whereas the levels of phosphorylated Akt corrected with GAPDH were ***,this relationship was not observed in the control *** These results suggest that an inverse relationship may exist between platelet Akt activation and hippocampal atrophy in T2DM *** findings provide insight into the molecular mechanisms underlying T2DM hippocampal atrophy.

关键词： Akt Platelet Hippocampal atrophy Magnetic resonance imaging Diabetes mellitus

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Peeling a giant ileal lipoma with endoscopic unroofing and submucosal dissection

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World Journal of Gastroenterology 2010年第13期16卷 1676-1679页

作者： takashi Morimoto Kuang-I Fu Hironori Konuma Yuko Izumi Syujirou Matsuyama Kanako ogura Akihisa Miyazaki Sumio Watanabe Department of Gastroenterology Juntendo University Nerima Hospital Department of Pathology Juntendo University Nerima Hospital Department of Gastroenterology Juntendo University School of Medicine

Lipoma is relatively common in the colon but is less often in the small intestine. Most lipomas are incidentally detected at endoscopy and are usually small and asymptomatic. However, some of them can present with obstruction and/or intussusceptions. Surgical resection is commonly recommended to remove such significant lipomas with a limited pedicle and larger than 2 cm in size, as endoscopic resection may result in unfavorable complications such as intestinal perforations. We report a case of 62-year-old man presenting with hematochezia. Colonoscopy showed a submucosal tumor, about 50 mm in size, in the terminal ileum. A clinical diagnosis of lipoma was established based on the findings of colonoscopy and abdominal computed tomography (CT). As the patient complained of hematochezia and mild iron deficiency anemia associated with repeated tumor prolapse, we decided to remove his lipoma. Consequently, the lesion was completely removed en bloc . Although abdominal CT immediately after removal of the lesion showed a small amount of free air, conservative treatment was successfully carried out for the perforation. Histologically, the removed lesion was a lipoma.

关键词： Lipoma Endoscopic submucosal dissection Endoscopic unroofing Perforation

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Risk of alcohol use relapse after liver transplantation for alcoholic liver disease

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World Journal of Gastroenterology 2017年第5期23卷 869-875页

作者： Yasuharu Onishi Hiroyuki Kimura Tomohide Hori Shinichi Kishi Hideya Kamei Nobuhiko Kurata Chisato Tsuboi Naoko Yamaguchi Mayu Takahashi Saki Sunada Mitsuaki Hirano Hiroshige Fujishiro takashi Okada Masatoshi Ishigami Hidemi Goto Norio Ozaki Yasuhiro ogura Department of Transplantation Surgery Nagoya University Hospital Department of Psychiatry Nagoya University Hospital Transplant Coordination Service Nagoya University Hospital Department of Gastro-enterology and Hepatology Nagoya University Graduate School of Medicine

AIMTo investigate factors, including psychosocial factors, associated with alcoholic use relapse after liver transplantation (LT) for alcoholic liver disease (ALD).METHODSThe clinical records of 102 patients with ALD who were referred to Nagoya University Hospital for LT between May 2003 and March 2015 were retrospectively evaluated. History of alcohol intake was obtained from their clinical records and scored according to the High-Risk Alcoholism Relapse scale, which includes duration of heavy drinking, types and amount of alcohol usually consumed, and previous inpatient treatment history for alcoholism. All patients were assessed for eligibility for LT according to comprehensive criteria, including Child-Pugh score, Model for End-Stage Liver Disease score, and psychosocial *** the 102 patients with ALD referred for LT, seven (6.9%) underwent LT. One (14.3%) of these seven patients returned to heavy drinking, but that patient was able to successfully quit drinking following an immediate intervention, consisting of psychotherapeutic education and supportive psychotherapy, by a psychiatrist. A comparison between the transplantation/registration (T/R) group, consisting of the seven patients who underwent LT and 10 patients listed for deceased donor LT, and 50 patients who did not undergo LT and were not listed for deceased donor LT (non-T/R group), showed statistically significant differences in duration of abstinence period (P < 0.01), duration of heavy drinking (P < 0.05), adherence to medical treatment (P < 0.01), and declaration of abstinence (P < 0.05).CONCLUSIONPatients with ALD referred for LT require comprehensive evaluation, including evaluation of psychosocial criteria, to prevent alcoholic recidivism.

关键词： Liver transplantation Risk assessment Alcoholic liver disease Psychosocial evaluation criteria Liaison psychiatry Alcohol use relapse

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Systemic hemodynamics in advanced cirrhosis: Concerns during perioperative period of liver transplantation

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World Journal of Hepatology 2016年第25期8卷 1047-1060页

作者： Tomohide Hori Yasuhiro ogura Yasuharu Onishi Hideya Kamei Nobuhiko Kurata Motoshi Kainuma Hideo Takahashi Shogo Suzuki takashi Ichikawa Shoko Mizuno Tadashi Aoyama Yuki Ishida Takahiro Hirai Tomoko Hayashi Kazuko Hasegawa Hiromu Takeichi Atsunobu Ota Yasuhiro Kodera Hiroyuki Sugimoto Taku Iida Shintaro Yagi Kentaro Taniguchi Shinji Uemoto Department of Transplant Surgery Nagoya University Hospital Department of Intensive Care Unit Nagoya University Hospital Second Department of Surgery Nagoya University Hospital Department of Transplant Surgery Kyoto University Hospital First Department of Surgery Mie University Hospital

Advanced liver cirrhosis is usually accompanied by portal hypertension. Long-term portal hypertension results in various vascular alterations. The systemic hemodynamic state in patients with cirrhosis is termed a hyperdynamic state. This peculiar hemodynamic state is characterized by an expanded blood volume, high cardiac output, and low total peripheral resistance. Vascular alterations do not disappear even long after liver transplantation(LT), and recipients with cirrhosis exhibit a persistent systemic hyperdynamic state even after LT. Stability of optimal systemic hemodynamics is indispensable for adequate portal venous flow(PVF) and successful LT, and reliable parameters for optimal systemic hemodynamics and adequate PVF are required. Even a subtle disorder in systemic hemodynamics is precisely indicated by the balance between cardiac output and blood volume. The indocyanine green(ICG) kinetics reflect the patient's functional hepatocytes and effective PVF, and PVF is a major determinant of the ICG elimination constant(kICG) in the well-preserved allograft. The kICG value is useful to set the optimal PVF during living-donor LT and to evaluate adequate PVF after LT. Perioperative management has a large influence on the postoperative course and outcome; therefore, key points and unexpected pitfalls for intensive management are herein summarized. Transplant physicians should fully understand the peculiar systemic hemodynamic behavior in LT recipients with cirrhosis and recognize the critical importance of PVF after LT.

关键词： Liver cirrhosis Portal hypertension Liver transplantation Indocyanine green Hyperdynamic

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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 *** 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

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