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Clinicopathological features of minute pharyngeal lesions diagnosed by narrow-band imaging endoscopy and biopsy

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World Journal of Gastroenterology 2012年第44期18卷 6468-6474页

作者： takashi Kumamoto Kazuhiro Sentani Shiro Oka Shinji tanaka Wataru Yasui Kumamoto Gastrointestinal Clinic Hiroshima 730-0051Japan Department of Molecular Pathology Hiroshima University Graduate School of Biomedical SciencesHiroshima 734-8551Japan Department of Endoscopy Hiroshima University HospitalHiroshima 734-8551Japan

AIM:To evaluate the utility of magnified narrow-band imaging(NBI) endoscopy for diagnosing and treating minute pharyngeal ***:Magnified NBI gastrointestinal examinations were performed by the first author.A magnification hood was attached to the tip of the endoscope for quick *** of the examinations were performed under *** NBI examinations were performed for all of the pharyngeal lesions that had noticeable brownish areas under unmagnified NBI observation,and an intrapapillary capillary loop(IPCL) classification was made.A total of 93 consecutive pharyngeal lesions were diagnosed as IPCL type Ⅳ and were suspected to represent ***-two lesions of approximately 1 mm in diameter were biopsied in the clinic,and 17 lesions with larger diameters were resected by endoscopic submucosal dissection(ESD) at the Hiroshima University *** addition to the histological diagnoses,the lesion diameters were microscopically measured in 45 of the 62 *** of the 62 biopsied patients received endoscopic follow ***:Minute pharyngeal lesions were diagnosed in 93 of approximately 3000 patients receiving magnified NBI examinations at the *** the 93 patients with IPCL type Ⅳ lesions,80 were men,and 13 were ***-six were drinkers,and 57 were *** had esophageal ***-one lesions were located on the posterior hypopharyngeal wall,and 72 lesions were located on the posterior oropharyngeal *** 93 lesions were flat and showed similar findings in the magnified and unmagnified NBI *** almost all of the IPCL type Ⅳ lesions showed faint redness when examined under white light,it was difficult to diagnose the lesions using only this technique because the contrast was weaker than that achieved in the NBI *** the 93 lesions,only 3 had diameters greater than 2.1 ***-two lesions of approximately 1 mm were biopsied in the clinic,whereas 17 larger lesions were tre

关键词： Biopsy Minute pharyngeal lesions Narrow-band imaging

Predictive factors for body weight loss and its impact on quality of life following gastrectomy

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World Journal of Gastroenterology 2017年第26期23卷 4823-4830页

作者： Kazuaki Tanabe Masazumi Takahashi takashi Urushihara Yoichi Nakamura Makoto Yamada Sang-Woong Lee Shinnosuke tanaka Akira Miki Masami Ikeda Koji Nakada Department of Gastroenterological Surgery Hiroshima University Hospital Division of Gastroenterological Surgery Yokohama Municipal Citizen’s Hospital Department of Gastroenterological Breast and Transplant SurgeryHiroshima Prefectural Hospital Department of Surgery Toho University Ohashi Medical Center Department of Surgery Gifu Municipal Hospital Department of General and Gastroentero-logical Surgery Osaka Medical College Department of Gastroenterological Surgery Fukuoka University School of Medicine Department of Surgery Kobe City Medical Center General Hospital Department of Surgery Asama General Hospital Department of Laboratory Medicine the Jikei University School of Medicine

To determine the predictive factors and impact of body weight loss on postgastrectomy quality of life (QOL). METHODSWe applied the newly developed integrated questionnaire postgastrectomy syndrome assessment scale-45, which consists of 45 items including those from the Short Form-8 and Gastrointestinal Symptom Rating Scale instruments, in addition to 22 newly selected items. Between July 2009 and December 2010, completed questionnaires were received from 2520 patients with curative resection at 1 year or more after having undergone one of six types of gastrectomy for Stage I gastric cancer at one of 52 participating institutions. Of those, we analyzed 1777 eligible questionnaires from patients who underwent total gastrectomy with Roux-en-Y procedure (TGRY) or distal gastrectomy with Billroth-I (DGBI) or Roux-en-Y (DGRY) procedures. RESULTSA total of 393, 475 and 909 patients underwent TGRY, DGRY, and DGBI, respectively. The mean age of patients was 62.1 ± 9.2 years. The mean time interval between surgery and retrieval of the questionnaires was 37.0 ± 26.8 mo. On multiple regression analysis, higher preoperative body mass index, total gastrectomy, and female sex, in that order, were independent predictors of greater body weight loss after gastrectomy. There was a significant difference in the degree of weight loss (P 25 kg/m2). Multiple linear regression analysis identified lower postoperative body mass index, rather than greater body weight loss postoperatively, as a certain factor for worse QOL (P 2, 0.028-0.080). CONCLUSIONWhile it is certainly important to maintain adequate body weight after gastrectomy, the impact of body weight loss on QOL is unexpectedly small.

关键词： Quality of life Gastrectomy Weight loss Postgastrectomy syndrome assessment scale-45

Usefulness of a novel slim type Flush Knife-BT over conventional Flush Knife-BT in esophageal endoscopic submucosal dissection

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World Journal of Gastroenterology 2017年第9期23卷 1657-1665页

作者： Yoshiko Ohara takashi Toyonaga Namiko Hoshi Shinwa tanaka Shinichi Baba Hiroshi Takihara Fumiaki Kawara Tsukasa Ishida Yoshinori Morita Eiji Umegaki Takeshi Azuma Division of Gastroenterology Department of Internal MedicineGraduate School of MedicineKobe University Department of Endoscopy Kobe University Hospital Department of Endoscopy Kishiwada Tokushukai Hospital

To investigated the usefulness of a novel slim type ball-tipped FlushKnife (FlushKnife-BTS) over ball-tipped FlushKnife (FlushKnife-BT) in functional experiments and clinical *** order to evaluate the functionality of FlushKnife-BTS, water aspiration speed, resistance to knife insertion through the scope, and waterjet flushing speed were compared between FlushKnife-BTS and BT. In clinical practice, esophageal endoscopic submucosal dissection (ESD) performed using FlushKnife-BTS or BT by an experienced endoscopist between October 2015 and January 2016 were retrospectively reviewed. The treatment speed and frequency of removing and reinserting the knife to aspirate fluid and air during ESD sessions were *** experiments revealed that water aspiration speed by the endoscope equipped with a 2.8-mm working channel with FlushKnife-BTS was 7.7-fold faster than that with conventional FlushKnife-BT. Resistance to knife insertion inside the scope with a 2.8-mm working channel was reduced by 40% with FlushKnife-BTS. The waterjet flushing speed was faster with the use of FlushKnife-BT. In clinical practice, a comparison of 6 and 7 ESD using FlushKnife-BT and BTS, respectively, revealed that the median treatment speed was 25.5 mm2/min (range 19.6-30.3) in the BT group and 44.2 mm2/min (range 15.5-55.4) in the BTS group (P = 0.0633). However, the median treatment speed was significantly faster with FlushKnife-BTS when the resection size was larger than 1000 m2 (n = 4, median 24.2 mm2/min, range 19.6-27.7 vs n = 4, median 47.4 mm2/min, range 44.2-55.4, P = 0.0209). The frequency of knife replacement was less in the BTS group (median 1.76 times in one hour, range 0-5.45) than in the BT group (7.02 times in one hour, range 4.23-15) (P = 0.0065).CONCLUSIONOur results indicate that FlushKnife-BTS enhances the performance of ESD, particularly for large lesions, by improving air and fluid aspirat

关键词： Endoscopic submucosal dissection Novel slim type ball-tipped FlushKnife Ball-tipped FlushKnife Resistance to knife insertion Water aspiration speed

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

White-opaque Switching in Different Mating Type-like Locus Gene Types of Clinical Candida albicans Isolates

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Chinese Medical Journal 2016年第22期129卷 2725-2732页

作者： Hou-Min Li Yumi Shimizu-Imanishi Reiko tanaka Ruo-Yu Li takashi Yaguchi Department of Dermatology Peking University People's Hospital Beijing 100044 China Medical Mycology Research Center Chiba University Chiba 260-8673 Japan Department of Dermatology Peking University First Hospital Beijing 100034 China

Background：Candida albicans （***） can become a pathogen causing superficial as well as life-threatening systemic infections,especially in immunocompromised *** phenotypic attributes contribute to its capacity to colonize human *** our study,93 *** isolates from patients of various candidiasis in a hospital of China were *** aimed to investigate the white-opaque （WO） switching competence,drug sensitivity,and virulence of mating type-like （MTL） a/α ***：Internal transcribed spacer （ITS） gene and the MTL configuration were detected in all the isolates by reverse transcription-polymerase chain ***/opaque phenotype and doubling time of cell growth were *** minimum inhibitory concentrations of antifungal agent were measured using broth microdilution ***：Sixty-four isolates （69.6%） were classified to serotype A,19 （20.6%） to serotype B,and 9 （9.8%） to serotype ***,phylogenetic analysis showed that these isolates were divided into four different subgroups of ITS *** of our clinical isolates were MTLa/α type,while 6.8% remained MTLa or MTLα *** frequency of opaque phenotype was 71.0% （66 isolates）.Following the guidelines of Clinical and Laboratory Standards Institute M27-A3,all isolates were susceptible to caspofungin and a few （0.6-3.2%） of them showed resistance against amphotericin B,flucytosine,fluconazole,itraconazole,and ***：From these analyses,there were comparatively more *** strains classified into serotype B,and the frequency of opaque phase strains was significant in the clinical isolates from ***,phenotypic,or drug susceptibility patterns were not significantly different from previous ***/α isolates could also undergo WO switching which facilitates their survival.

关键词： Candida albicans Drug Susceptibility Genotype Mating Type-like White-opaque

Temperature Management of Red Blood Cell Solution Transported by Car for Transfusion at Home

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Open Journal of Blood Diseases 2020年第2期10卷 37-40页

作者： Hiroshi Fujita Yoshiharu Tojo takashi Mine Asashi tanaka Department of Transfusion Medicine Tokyo Metropolitan Bokutoh Hospital Sumida-ku Tokyo City Japan Donated Blood Distribution Foundation Shinjuku-ku Tokyo City Japan Department of Transfusion Medicine Tokyo Medical University Hachioji Medical Center Hachioji-shi Tokyo City Japan

Objective: In Japan, red blood cell (RBC) solution is usually transported by car from a medical institution to the patient’s house for home transfusion. However, there are no regulations for transporting blood by car in the medical setting. Therefore, we assessed and compared the methods (containers) used for transporting the RBC solution by car. Materials and Methods: Irradiated RBC solution samples (280 mL) supplied by the Japan Red Cross Society were each divided into two bags. The quality of blood transported by car (1 - 2 hours) in an active transport refrigerator (ATR) (control group) was compared with that transported in a cooler, or styrofoam box (study group). We tested the hemolytic effects of transportation by car, storage, and filtration through a transfusion set on the lactate dehydrogenase (LD) levels in the RBC solutions. Results: Post-filtered LD levels were significantly higher in the RBC solutions transported in a cooler-box with inadequate temperature control when compared to those transported in an ATR with optimal temperature control. However, under conditions of optimal temperature control, the post-filtered LD levels were comparable in the control and study (both cooler and styrofoam boxes) group RBC solutions. Conclusion: Temperature management is critical for the maintenance of the quality of the RBC solution transported by car.

关键词： Car Transport Red Blood Cell Solution Hemolysis

Novel serum tumor marker, RCASl, in pancreatic diseases

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World Journal of Gastroenterology 2005年第33期11卷 5199-5202页

作者： Koji Yamaguchi Munechika Enjoji Manabu Nakashima Makoto Nakamuta takashi Watanabe Masao tanaka Department of Surgery and Oncology Graduate School of Medicine Kyushu University Japan Medicine Bioregulatory Sciences Graduate School of Medical Sciences Kyushu University Japan Department of Molecular Immunology Medical Institute of Bioregulation Faculty of MedicineKyushu UniversityJapan Department of Molecular Immunology Medical Institute of Bioregulation Faculty of Medicine Kyushu University Japan

AIM： As tumor markers for pancreatic carcinoma, carcinoembryonic antigen （CEA） and carbohydrate antigen （CA） 19-9 have been used, but the sensitivity and specificity are not enough for the diagnosis of pancreatic carcinoma. METHODS： A novel serum tumor marker, RCAS1, was compared with two conventional serum tumor markers, CEA （highly specific for pancreatic cancer） and CA 19-9 （highly sensitive for pancreatic cancer）, in 48 patients with pancreatic exocrine tumors. RESULTS： When the diagnosis of benign or malignant conditions was examined by one tumor marker, the sensitivity of RCAS1 alone （55%） was higher than that of CEA alone （27%） and the specificity of RCAS1 alone （92%） was greater than that of CA19-9 alone （78%）. When examined by a combination of two markers, the sensitivity of a combination of RCAS1 and CA19-9 （95%） was superior to those of CA19-9 alone （78%）, RCAS1 alone （55%, P = 0.002）, CEA alone （27%）（P〈0.001）, RCAS1 and CEA （59%） and CA19-9 and CEA （82%）. CONCLUSION： These results suggest that the combination of RCAS1 and CA19-9 is highly sensitive for pancreatic carcinoma.

关键词： RCASi CEA CA19-9 Pancreatic diseases

Clinical outcomes of ampullary neoplasms in resected margin positive or uncertain cases after endoscopic papillectomy

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World Journal of Gastroenterology 2019年第11期25卷 1387-1397页

作者： Arata Sakai Masahiro Tsujimae Atsuhiro Masuda Takao Iemoto Shigeto Ashina Kohei Yamakawa Takeshi tanaka Shunta tanaka Yasutaka Yamada Ryota Nakano Yu Sato Manabu Kurosawa Takuya Ikegawa Seiji Fujigaki takashi Kobayashi Hideyuki Shiomi Yoshifumi Arisaka Tomoo Itoh Yuzo Kodama Division of Gastroenterology Department of Internal MedicineKobe University Graduate School of Medicine Department of Gastroenterology Kita-Harima Medical Center Department of Gastroenterology Nippon Life Hospital Department of Diagnostic Pathology Kobe University Graduate School of Medicine

BACKGROUND Endoscopic papillectomy(EP) for benign ampullary neoplasms could be a lessinvasive alternative to pancreatoduodenectomy(PD). There are some problems and limitations with EP. The post-EP resection margins of ampullary tumors are often positive or uncertain because of the burning effect of EP. The clinical outcomes of resected margin positive or uncertain cases after EP remain *** To investigate the clinical outcomes of resected margin positive or uncertain cases after *** Between January 2007 and October 2018, all patients with ampullary tumors who underwent EP at Kobe University Hospital were included in this study. The indications for EP were as follows: adenoma, as determined by preoperative endoscopic biopsy, without bile/pancreatic duct extension, according to endoscopic ultrasound or intraductal ultrasound. The clinical outcomes of resected margin positive or uncertain cases after EP were retrospectively *** Of the 45 patients, 29 were male, and 16 were female. The mean age of the patients was 65 years old. Forty-one patients(89.5%) underwent en bloc resection,and 4 patients(10.5%) underwent piecemeal resection. After EP, 33 tumors were histopathologically diagnosed as adenoma, and 12 were diagnosed as adenocarcinoma. The resected margins were positive or uncertain in 24 patients(53.3%). Of these cases, 15 and 9 were diagnosed as adenoma and adenocarcinoma, respectively. Follow-up observation was selected for all adenomas and 5 adenocarcinomas. In the remaining 4 adenocarcinoma cases,additional PD was performed. Additional PD was performed in 4 cases, and residual carcinoma was found after the additional PD in 1 of these cases. In the follow-up period, local tumor recurrence was detected in 3 cases. Two of these cases involved primary EP-diagnosed adenoma. The recurrent tumors were also adenomas detected by biopsy. The remaining case involved primary EPdiagnosed adenocarcinoma. The recurrent tumor was also an adenocarc

关键词： Ampullary neoplasm Endoscopic papillectomy Resected margin Clinical outcome

Smoking increases risk of tooth loss: A meta-analysis of the literature

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World Journal of Meta-Analysis 2013年第1期1卷 16-26页

作者： Fumihito Sato Masashi Sawamura Miki Ojima Keiko tanaka takashi Hanioka Hideo tanaka Keitaro Matsuo Division of Epidemiology and Prevention Aichi Cancer Center Research Institute Nagoya Aichi 464-8618 Japan Department of Preventive Dentistry Graduate School of Dentistry Osaka University Suita Osaka 565-0871 Japan Department of Public Health Faculty of Medicine Fukuoka University Fukuoka 814-0180 Japan Department of Preventive and Public Health Dentistry Fukuoka Dental College Fukuoka 814-0193 Japan Department of Epidemiology Nagoya University Graduate School of Medicine Nagoya Aichi 464-8601 Japan

AIM: To quantitatively evaluate the impact of smoking on tooth ***: We performed a Pub Med search to identify published articles that investigated the risk of tooth loss by smoking, from which RRs and their variance with characteristics of each study were extracted. The random-effects models were used to derive a pooled effect across studies. Potential sources of heterogeneity on the characteristics of the study and their influence on the pooled effect size were investigated using metaregression models. RESULTS: We identified 24 studies containing a total of 95973 participants for analysis. The pooled RR of ever-smokers compared with never- smokers was 1.73(95%CI: 1.60-1.86, P < 0.001). In meta-regression analysis, only the mean age of participants alone was identified as a statistically significant source of heterogeneity. The effect of smoking on tooth loss was stronger when the mean age of study participants was higher, indicating possible enhancement of tooth loss due to aging by smoking. RR was significantly lower in former smokers(1.49, 95%CI: 1.32-1.69, P < 0.001) than in current smokers(2.10, 95%CI: 1.87-2.35, P < 0.001), indicating the substantial benefit of smoking cessation for reducing the risk of tooth ***: Smoking is an independent risk factor for tooth loss regardless of many other confounders. Smoking cessation may attenuate this effect.

关键词： Meta-analysis Oral health Relative risk Smoking Tooth loss