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Endoscopic submucosal dissection for early esophageal neoplasms using the stag beetle knife

World Journal of Gastroenterology 2018年第15期24卷 1632-1640页

作者： Toshio Kuwai Toshiki Yamaguchi Hiroki Imagawa Ryoichi Miura Yuki Sumida Takeshi Takasago Yuki Miyasako tomoyuki Nishimura Sumio Iio Atsushi Yamaguchi Hirotaka Kouno Hiroshi Kohno Sauid Ishaq Department of Gastroenterology National Hospital Organization Kure Medical Center and Chugoku Cancer Center Department of Gastroenterology DGH SGU WI Birmingham City University

AIM To determine short-and long-term outcomes of endoscopic submucosal dissection(ESD) using the stag beetle(SB) knife, a scissor-shaped *** Seventy consecutive patients with 96 early esophageal neoplasms, who underwent ESD using a SB knife at Kure Medical Center and Chugoku Cancer Center, Japan, between April 2010 and August 2016, were retrospectively evaluated. Clinicopathological characteristics of lesions and procedural adverse events were assessed. Therapeutic success was evaluated on the basis of en bloc, histologically complete, and curative or non-curative resection rates. Overall and tumor-specific survival, local or distant recurrence, and 3-and 5-year cumulative overall metachronous cancer rates were also *** Eligible patients had dysplasia/intraepithelial neoplasia(22%) or early cancers(squamous cell carcinoma, 78%). The median procedural time was 60 min and on average, the lesions measured 24 mm in diameter, yielding 33-mm tissue defects. The en bloc resection rate was 100%, with 95% and 81% of dissections deemed histologically complete and curative, respectively. All procedures were completed without accidental incisions/perforations or delayed bleeding. During follow-up(mean, 35 ± 23 mo), no local recurrences or metastases were observed. The 3-and 5-year survival rates were 83% and 70%, respectively, with corresponding rates of 85% and 75% for curative resections and 74% and 49% for noncurative resections. The 3-and 5-year cumulative rates of metachronous cancer in the patients with curative resections were 14% and 26%, *** ESD procedures using the SB knife are feasible, safe, and effective for treating early esophageal neoplasms, yielding favorable short-and long-term outcomes.

关键词： Neoplasms Stag beetle knife Esophageal Endoscopic submucosal dissection Outcome measures

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Risk factors for intraoperative perforation during endoscopic submucosal dissection of superficial esophageal squamous cell carcinoma

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World Journal of Gastroenterology 2017年第3期23卷 478-485页

作者： Masaaki Noguchi Tomonori Yano Tomoji Kato Tomohiro Kadota Maomi Imajoh Hiroyuki Morimoto Shozo Osera Atsushi Yagishita tomoyuki Odagaki Yusuke Yoda Yasuhiro Oono Hiroaki Ikematsu Kazuhiro Kaneko Department of Gastroenterology Endoscopy division National Cancer Center Hospital East Division of Gastroenterology and Hepatology Department of Internal Medicine The Jikei University School of Medicine

AIM To identify the risk factors and clarify the subsequent clinical *** This study retrospectively analyzed consecutive patients with esophageal squamous cell carcinoma( ESCC) treated using endoscopic submucosal dissection(ESD) between April 2008 and October 2012. We divided the ESCC lesions into perforation cases and non-perforation cases, and compared characteristics and endoscopic findings between the two groups. "Intraoperative perforation" was defined as the detection of a perforation site during ESD and the presence of mediastinal *** In total, 147 patients with 156 ESCC lesions were treated by ESD. Intraoperative perforation was recorded for nine lesions(5.8%) from nine patients. Multivariate analysis identified mucosal deficiency larger than 75% of the circumference of the esophagus as an independent risk factor for intraoperative perforation(OR = 7.37, 95%CI: 1.45-37.4, P = 0.016). The predominant site of perforation was the left wall [6/9(67%)]. Six of nine perforation sites were successfully closed by clips during the procedures. Two of nine cases required drainage for pleural effusions; however, all nine cases recovered with conservative treatment and without surgical intervention. At the median follow up of 42 mo after ESD, no cases of local recurrence or distant organ metastasis had been *** This study suggests that mucosal deficiency larger than 75% of the luminal circumference is a risk factor for intraoperative perforation during ESD for ESCC.

关键词： Endoscopic submucosal dissection Risk factor Esophageal carcinoma Perforation

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Risk factors for local recurrence and appropriate surveillance interval after endoscopic resection

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World Journal of Gastroenterology 2019年第12期25卷 1502-1512页

作者： Yoriaki Komeda Tomohiro Watanabe Toshiharu Sakurai Masashi Kono Kazuki Okamoto tomoyuki Nagai Mamoru Takenaka Satoru Hagiwara Shigenaga Matsui Naoshi Nishida Naoko Tsuji Hiroshi Kashida Masatoshi Kudo Department of Gastroenterology and Hepatology Kindai University Faculty of Medicine

BACKGROUND Risk factors for local recurrence after polypectomy, endoscopic mucosal resection(EMR), and endoscopic submucosal dissection(ESD) have not been ***, the appropriate interval for endoscopic surveillance of colorectal tumors at high-risk of local recurrence has not been *** To clarify the clinicopathological characteristics of recurrent lesions after endoscopic colorectal tumor resection and determine the appropriate *** Three hundred and sixty patients(1412 colorectal tumors) who underwent polypectomy, EMR, or ESD and received endoscopic surveillance subsequently for more than one year to detect local recurrence were enrolled in this study. The clinicopathological factors associated with local recurrence were determined via univariate and multivariate *** Local recurrence was observed in 31 of 360(8.6%) patients [31 of 1412(2.2%)lesions] after colorectal tumor resection. Piecemeal resection, tumor size of more than 2 cm, and the presence of villous components were associated with colorectal tumor recurrence after endoscopic resection. Of these three factors, the piecemeal resection procedure was identified as an independent risk factor for recurrence. Colorectal tumors resected into more than five pieces were associated with a high risk of recurrence since the average period from resection torecurrence in these cases was approximately 3 mo. The period to recurrence in cases resected into more than 5 pieces was much shorter than that in those resected into less than 4 pieces(3.8 ± 1.9 mo vs 7.9 ± 5.0 mo, P < 0.05).CONCLUSION Local recurrence of endoscopically treated colorectal tumors depends upon the outcome of first endoscopic procedure. Piecemeal resection was the only significant risk factor associated with local recurrence after endoscopic resection.

关键词： Local recurrence Colorectal tumor Endoscopic surveillance Piecemeal resection Risk factors

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Helicobacter pylori-negative,non-steroidal anti-inflammatory drug:Negative idiopathic ulcers in Asia

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World Journal of Gastroenterology 2014年第3期20卷 706-713页

作者： Katsunori Iijima Takeshi Kanno tomoyuki Koike Tooru Shimosegawa Division of Gastroenterology Tohoku University Graduate School of Medicine

Since the discovery of Helicobacter pylori(***)infection in the stomach,the bacteria infection and non-steroidal anti-inflammatory drugs(NSAIDs)use had been considered to be the 2 main causes of peptic ***,there have been recent reports of an increase in the proportion of peptic ulcers without these known risk factors;these are termed idiopathic peptic *** trend was firstly indicated in 1990s from some reports in North *** Asia,numerous studies reported that idiopathic ulcers accounted for a small percentage of all ulcers in the 1990s,but in the2000s,multiple studies reported that the proportion of idiopathic ulcers had reached 10%-30%,indicating that the incidence of idiopathic ulcers in Asia has also been rising in recent *** a decline in *** infection rates of general population in Asia is seen as the main reason for the increased incidence of idiopathic ulcers,it is also possible that the absolute number of idiopathic ulcer cases has *** age,serious systemic complication,and psychological stress are considered to be the potential risk factors for idiopathic *** of idiopathic ulcers is challenging,at present,because there is no effective preventative measure against recurrence in contrast with cases of ***-positive ulcers and NSAIDs-induced *** it is expected that *** infection rates in Asia will decline further in the future,measures to treat idiopathic ulcers will also likely become more important.

关键词： Helicobacter pylori Non-steroidal antiinflammatory

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Long-lasting responses after discontinuation of nivolumab treatment for reasons other than tumor progression in patients with previously treated,advanced non-small cell lung cancer

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Cancer Communications 2019年第1期39卷 665-669页

作者： Hideharu Kimura tomoyuki Araya Taro Yoneda Hiroki Shirasaki Koji Kurokawa Tamami Sakai Hayato Koba Yuichi Tambo Shingo Nishikawa Takashi Sone Kazuo Kasahara Respiratory Medicine Kanazawa University HospitalTakara-machi 13-1KanazawaIshikawa 920-8641Japan Respiratory Medicine National Hospital Organization Kanazawa Medical CenterKanazawaIshikawa 920-8650Japan Respiratory Medicine Komatsu Municipal HospitalKomatsuIshikawa 923-8560Japan Respiratory Medicine Fukui-ken Saiseikai HospitalFukuiFukui 918-8503Japan Respiratory Medicine Ishikawa Prefectural Central HospitalKanazawaIshikawa 920-8530Japan Internal Medicine Keiju Medical CenterNanaoIshikawa 926-8605Japan Regional Respiratory Symptomatology Kanazawa University Graduate School of Medical ScienceKanazawaIshikawa 920-8641Japan

Dear Editor,Nivolumab,an inhibitor of programmed cell death 1(PD-1),is an immune checkpoint inhibitor(ICI)that enhances T cell functions by preventing negative regulation of cancer immunity,and it has shown clinically significant efficacy and tolerability in various types of *** on the results of randomized phase III trials comparing nivolumab with docetaxel[1,2],nivolumab is now used in clinical practice for patients with previously treated advanced non-small cell lung cancer(NSCLC).Fur-thermore,the most recent Japan Lung Cancer Society guidelines include nivolumab monotherapy in the sys-temic treatment strategy for previously treated,locally advanced or metastatic NSCLC[3].However,ICIs induce characteristic immune-related adverse events(irAEs),which are not seen with conventional cytotoxic agents or molecular targeted *** can occur in any organ system,most typically the skin,lung,and gastrointesti-nal,hepatic,and endocrine systems.

关键词： nivolumab patients lung

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Useful strategies to prevent severe stricture after endoscopic submucosal dissection for superficial esophageal neoplasm

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World Journal of Gastroenterology 2015年第23期21卷 7120-7133页

作者： Kaname Uno Katsunori Iijima tomoyuki Koike Tooru Shimosegawa Division of Gastroenterology Tohoku University Hospital

The minimal invasiveness of endoscopic submucosal dissection(ESD) prompted us to apply this technique to large-size early esophageal squamous cell carcinoma and Barrett's adenocarcinoma, despite the limitationsin the study population and surveillance duration. A post-ESD ulceration of greater than three-fourths of esophageal circumference was advocated as an important risk factor for refractory strictures that require several sessions of dilation therapy. Most of the preoperative conditions are asymptomatic, but dilatation treatment for dysphagia associated with the stricture has potential risks of severe complications and a worsening of quality of life. Possible mechanisms of dysphasia were demonstrated based on dysmotility and pathological abnormalities at the site:(1) delayed mucosal healing;(2) severe inflammation and disorganized fibrosis with abundant extracellular matrices in the submucosa; and(3) atrophy in the muscularis proper. However, reports on the administration of anti-scarring agents, preventive dilation therapies, and regenerative medicine demonstrated limited success in stricture prevention, and there were discrepancies in the study designs and protocols of these reports. The development and consequent long-term assessments of new prophylactic technologies on the promotion of wound healing and control of the inflammatory/tumor microenvironment will require collaboration among various research fields because of the limited accuracy of preoperative staging and high-risk of local recurrence.

关键词： Esophageal stricture Dysphasia Endoscopicsubmucosal dissection

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有机/无机杂化材料的热机械性能和相结构

有机/无机杂化材料的热机械性能和相结构

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2004北京国际粘接技术研讨会

作者： Mitsukazu Ochi tomoyuki Matsumura Hidenori Ishikawa Kansai Univ. Faculty of Engineering3-1-5Yamate-choSuita-shiOsaka564Japan

由三官能团的烷基氧硅烷通过溶胶一凝胶反应合成了主链中含有线性硅氧烷链的环氧接枝硅氧烷低聚物（ESO）。在环氧树脂的固化过程中加入作为无机原料的硅氧烷低聚物,制各出了一种新型的环氧/硅杂化材料。在杂化材料中可以观察到,细小的... 详细信息

由三官能团的烷基氧硅烷通过溶胶一凝胶反应合成了主链中含有线性硅氧烷链的环氧接枝硅氧烷低聚物（ESO）。在环氧树脂的固化过程中加入作为无机原料的硅氧烷低聚物,制各出了一种新型的环氧/硅杂化材料。在杂化材料中可以观察到,细小的富硅区的直径大约为5nm。这些富硅区均匀地分散在固化的环氧基体中。同时我们也对杂化材料的热机械性能做了研究。随着硅网络的杂化,材料粘弹态的储能模量升高,而玻璃态的tgnδ曲线的峰面积减少。杂化材料的热膨胀系数较未经改性的环氧树脂低。而且,在高温下杂化材料的机械强度也较环氧树脂高。这些应该是由硅网的杂化抑制了网链的移动所造成的。

关键词：环氧树脂硅氧烷低聚物杂化硅

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Attenuated defense response induced by stimulation of amygdala and bed nucleus of stria terminalis in orexin neuron-ablated mice

Attenuated defense response induced by stimulation of amygda...

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第十五届国际药理学大会

作者： Sakurai Takeshi Fukuda Yasuichiro Kuwaki tomoyuki Dept Pharmacol Univ TsukubaJapan. Dept Autonom Physiol Chiba Univ Grad Sch MedJapan. Dept Molec Integ Physiol Chiba Univ Grad Sch MedJapan.

＜正＞ We have previously shown that the defense response against stressor was attenuated in prepro - orexin knockout mice and orexin neuron - ablated mice and proposed that orexin plays as a master switch to elicit multiple efferent pathways of the defense response. It is still open question,however,how information of stressor activates the orexinergic neurons. In this study,we examined possible contribution of the amygdala and bed nucleus of stria terminalis （BNST） as one of the afferent nuclei to activate orexinergic neurons. In urethane - anesthetized mice,a GABA- A receptor antagonist,bicuculline. was microinjected into the amygdala or BNST. of which electrical stimulation induced simultaneous increases in blood pressure,heart rate,and respiratory frequency. Bicuculline dose - de-pendently induced cardiorespiratory excitation in both orexin neuron - ablated mice and wild - type controls. However,dose - response curve was rightward shifted in the orexin neuron- ablated mice. We conclude that the amygdala and BNST constitute one of the afferent pathways to the orexinergic neurons that involved in the defense response against stressor.

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DEVELOPMENT AND DEMONSTRATION OF ATR-MOX FUEL

DEVELOPMENT AND DEMONSTRATION OF ATR-MOX FUEL

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第十三届国际核工程大会

作者： tomoyuki Abe Seiichiro Maeda Hiroaki Nakazawa Japan Nuclear Cycle Development Institute Japan Nuclear Cycle Development Institute Japan Nuclear Cycle Development Institute

＜正＞ Advanced thermal reactor （ATR） is a heavy-water-moderated, boiling-light-water-cooled, pressure-tube-type reactor developed by Japan Nuclear Cycle Development Institute （JNC）. And the prototype ATR "FUGEN" is the world first thermal neutron power reactor to utilize uranium and plutonium mixed oxide （MOX） fuel practically and the operation of FUGEN ended in 2003 after 25 years of pioneering works. JNC developed MOX fuels for ATR to provide a flexible utilization of plutonium. The

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日本和中国台湾岛毛耳苔属的研究(英文)

日本和中国台湾岛毛耳苔属的研究(英文)

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2010全国地衣与苔藓系统学研讨会

作者： tomoyuki Katagiri Tomio Yamaguchi Hironori Deguchi Department of Biological Science Graduate School of ScienceHiroshima UniversityKagamiyama 1-3-1Higashi-hiroshima-shiHiroshima739-8526Japan

Three species of the genus Jubula *** confirmed to occur in Japan and Taiwan:***(Hook.) Dumort.,*** Steph.(*** ***), and *** Steph.,where two species have been so far known to be distributed:*** and *** ***(2004) showed that most Japanese plants reported as *** *** were identical with *** *** on the basis of morphology of male *** present investigation aims to clarify the entity of the Japanese and Taiwanese plants previously reported as *** ***,and we also revised the species of Jubula for Japan and Taiwan.

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