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Acute pancreatitis and cholangitis: A complication caused by a migrated gastrostomy tube

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World Journal of Gastroenterology 2007年第39期13卷 5285-5287页

作者： Hiroshi Imamura toshihiro Konagaya Takashi Hashimoto Kunio Kasugai Division of Gastroenterology Department of Internal Medicine Aichi Medical University School of Medicine 21 Karimata Yazako Nagakute-cho Aichi-gun Aichi-ken 480-1195 Japan

Percutaneous endoscopic gastrostomy (PEG) is generally considered safe with a low rate of serious complications. However, dislocation of the PEG-tube into the duodenum can lead to serious complications. An 86-year old Japanese woman with PEG-tube feeding sometimes vomited after her family doctor replaced the PEG-tube without radiologic confirmation. At her hospitalization, she complained of severe tenderness at the epigastric region and the PEG-tube was drawn into the stomach. Imaging studies showed that the tip of PEG-tube with the infl ated balloon was migrated into the second portion of the duodenum, suggesting that it might have obstructed the bile and pancreatic ducts, inducing cholangitis and pancreatitis. After the PEG- tube was replaced at the appropriate position, vomiting and abdominal tenderness improved dramatically and laboratory studies became normal immediately. Our case suggests that it is important to secure PEG-tube at the level of skin, especially after replacement.

关键词： Percutaneous endoscopic gastrostomy Complications Tube migration Pancreatitis Cholangitis

Solvent Composition Effect on PDMS Composite Dielectric Elastomer Actuator

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Materials Sciences and Applications 2021年第11期12卷 504-518页

作者： Satoshi Tamura Ryotaro Kiyono toshihiro Hirai Graduate School of Medicine Science and Technology Shinshu University Nagano Japan Shin-Etsu Polymer Co. Ltd. Tokyo Japan Faculty of Engineering Shinshu University Nagano Japan Fiber Innovation Incubator Faculty of Textile Science and Technology Shinshu University Ueda Japan

Polydimethylsiloxane (PDMS) is inactive to electric fields, but when combined with ferroelectric cyanoethyl sucrose (CR-U), it becomes an electrically active actuator material. The PDMS/CR-U composites were prepared by casting method using tetrahydrofuran (THF) and acetone (ACT) as solvents. The effect of a mixed solvent composition was investigated. The viscosity of the PDMS/CR-U/solvent solution decreased as the THF composition increased. The composite film obtained by evaporation of the solvent and cross-linkage of PDMS showed a phase-separated structure. Spherical CR-U dispersed in the PDMS matrix with a skin layer on one surface side. Electrical resistance, dielectric constant, space-charge distribution, and electrically induced bending deformation behavior were investigated for these composite films. The composite films prepared from a THF-rich solvent exhibited lower surface resistivity than those prepared from a THF-poor solvent. Applying an electric field to the composite film resulted in an asymmetric space-charge distribution with charge accumulation in the skin layer. THF content decreased the viscosity of the solution, meaning the decrease of the apparent size of PDMS chain aggregates. It allows the dispersion of CR-U in the PDMS matrix and also results in the decline of resistivity, the increase of permittivity, and the increase of charge injection. The results explained the structure formation of the composite film and the electric field response as an actuator. A casting solvent of THF content of 87.5 wt% or more is essential for the function of the PDMS/CR-U composite.

关键词： Dielectric Actuator Polydimethylsiloxane Composite Solvent Composition Morphology Charge Accumulation

Application of Thermodynamic Databases to Evaluation of Surface Properties of Alloys and Ionic Mixtures

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Application of Thermodynamic Databases to Evaluation of Surf...

Whole-exome sequencing for a more accurate diagnosis of intraductal papillary neoplasms of the bile duct

第十二届全国相图学术会议

作者： toshihiro Tanaka Department of Materials Science and Processing Graduate School of Engineering Osaka University2-1 YamadaokaSuitaOsaka 565-0871Japan

＜正＞The authors have applied thermodynamic databases, which are usually used for the calculation of phase diagrams and chemical reactions and so on, to the evaluation of the surface tension of liquid alloys, molten ionic mixtures and molten slags. The thermodynamic calculation procedure has been also described to evaluate the interfacial tension between liquid steels and molten slags from the thermodynamic databases. In addition the thermodynamic evaluation of nano-particle alloy phase diagrams is presented as one of the examples of the application of the surface tension obtained above.

关键词： thermodynamic databases surface tension nano-particle

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Gastroenterology Report 2022年第1期10卷 618-621页

作者： Tomoaki Matsumori Norimitsu Uza Nobuyuki Kakiuchi toshihiro Morita Yoshihiro Nishikawa Masahiro Shiokawa Kojiro Taura Yuzo Kodama Hiroshi Seno Department of Gastroenterology and Hepatology Graduate School of MedicineKyoto UniversityKyotoJapan Department of Phathology and Tumor Biology Kyoto UniversityKyotoJapan Department of Hepato-Biliary-Pancreatic Surgery Graduate school of MedicineKyoto UniversityKyotoJapan Department of Gastroenterology Kobe UniversityKobeJapan

Introduction According to the World Health Organization(WHO,2018),intraductal papillary neoplasms of the bile duct(IPNB)are characterized as polypoid masses in dilated bile ducts;additionally,invasive IPNB occasionally presents with a nodular surface or mass formation[1,2].The IPNB diagnostic criteria are,however,often ambiguous,*** IPNB is considered a type of cancer and whether it must have mucus production are debatable[3].Therefore,establishing new IPNB diagnostic criteria based on an alternative approach,such as whole-exome sequencing,is ***,we present a case of IPNB with atypical features on which we performed a detailed genetic analysis to determine the genetic,morphological,and histological features of IPNB in this case.

关键词： neoplasms bile diagnosis

利用直接原子化原子吸收光谱法测定硅酸盐岩石中的Li、Be、Co、Ni、Cu、Rb、Cs、Pb和Bi

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地质地球化学 1993年第4期21卷 64-68页

作者： toshihiro Nakamura 汪彤芸地矿部矿产综合利用研究所

研究了通过固体硅酸盐试样的直接原子化进行Li、Be、Co、Ni、Cu、Rb、Cs、Pb和Bi的原子吸收光谱法测定的最佳实验条件。一份1.0mg粉末试样(粒度0.3～25μm)与等量石墨粉末混合。按已制定的加热程序使置于石墨炉内的微型石墨杯内的混合... 详细信息

研究了通过固体硅酸盐试样的直接原子化进行Li、Be、Co、Ni、Cu、Rb、Cs、Pb和Bi的原子吸收光谱法测定的最佳实验条件。一份1.0mg粉末试样(粒度0.3～25μm)与等量石墨粉末混合。按已制定的加热程序使置于石墨炉内的微型石墨杯内的混合样原子化。利用加入含500ngK的水标准溶液作为测定Rb和Cs的离子化缓冲剂来进行校正。9个地球化学标准参考岩石试样的分析结果与推荐值极为吻合。测得值与推荐值的相关系数为0.0993;相对标准偏差(n=5)低于10％。

关键词：硅酸盐岩岩石锂铍光谱法

Endoscopic diagnosis for colorectal sessile serrated lesions

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World Journal of Gastroenterology 2021年第13期27卷 1321-1329页

作者： toshihiro Nishizawa Shuntaro Yoshida Akira Toyoshima Tomoharu Yamada Yoshiki Sakaguchi Taiga Irako Hirotoshi Ebinuma Takanori Kanai Kazuhiko Koike Osamu Toyoshima Department of Gastroenterology and Hepatology International University of Health and Welfare Narita HospitalNarita 2868520Japan Department of Gastroenterology Toyoshima Endoscopy ClinicTokyo 1570066Japan Department of Colorectal Surgery Japanese Red Cross Medical CenterTokyo 1508935Japan Department of Gastroenterology The University of TokyoTokyo 1138655Japan Department of Gastroenterology Graduate School of MedicineThe University of TokyoTokyo 1138655Japan Department of Internal Medicine Irako ClinicTokyo 1560052Japan Division of Gastroenterology and Hepatology Department of Internal MedicineKeio University School of MedicineShinjuku-ku 1608582TokyoJapan

BACKGROUND Hyperplastic polyps are considered non-neoplastic, whereas sessile serrated lesions(SSLs) are precursors of cancer via the ‘‘serrated neoplastic pathway’’. The clinical features of SSLs are tumor size(> 5 mm), location in the proximal colon, coverage with abundant mucus called the ‘‘mucus cap’’, indistinct borders, and a cloud-like surface. The features in magnifying narrow-band imaging are varicose microvascular vessels and expanded crypt openings. However, accurate diagnosis is often *** To develop a diagnostic score system for *** We retrospectively reviewed consecutive patients who underwent endoscopic resection during colonoscopy at the Toyoshima endoscopy clinic. We collected data on serrated polyps diagnosed by endoscopic or pathological examination. The significant factors for the diagnosis of SSLs were assessed using logistic regression analysis. Each item that was significant in multivariate analysis was assigned 1 point, with the sum of these points defined as the endoscopic SSL diagnosis score. The optimal cut-off value of the endoscopic SSL diagnosis score was determined by receiver-operating characteristic curve *** Among 1288 polyps that were endoscopically removed, we analyzed 232 diagnosed as serrated polyps by endoscopic or pathological examination. In the univariate analysis, the location(proximal colon), size(> 5 mm), mucus cap, indistinct borders, cloud-like surface, and varicose microvascular vessels were significantly associated with the diagnosis of SSLs. In the multivariate analysis, size(> 5 mm;P = 0.033), mucus cap(P = 0.005), and indistinct borders(P = 0.033) were independently associated with the diagnosis of SSLs. Size > 5 mm, mucus cap, and indistinct borders were assigned 1 point each and the sum of these points was defined as the endoscopic SSL diagnosis score. The receiver-operating characteristic curve analysis showed an optimal cut-off score of 3, which predicted pathological SSLs with 75

关键词： Sessile serrated lesion Mucus cap Indistinct borders Hyperplastic polyp Endoscopic features Size

Efficacy of neoadjuvant chemotherapy for initially resectable colorectal liver metastases:A retrospective cohort study

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World Journal of Gastrointestinal Oncology 2022年第7期14卷 1281-1294页

作者： Kazuhisa Takeda Yu Sawada Yasuhiro Yabushita Yuki Honma Takafumi Kumamoto Jun Watanabe Ryusei Matsuyama Chikara Kunisaki toshihiro Misumi Itaru Endo Gastroenterological Center Yokohama City University Medical CenterYokohama 232-0024Japan Department of Gastroenterological Surgery Yokohama City University Graduate School of MedicineYokohama 236-0004Jordan Department of Biostatistics Yokohama City University Graduate School of MedicineYokohama 236-0004Japan

BACKGROUND The liver is the most common metastatic site of colorectal *** is the mainstay of treatment for patients with colorectal liver metastases(CRLMs).However,there are cases of early recurrence after upfront hepatectomy *** selected high-risk patients,neoadjuvant chemotherapy(NAC)may improve longterm *** To determine the efficacy of NAC for initially resectable *** Among 644 patients who underwent their first hepatectomy for CRLMs at our institution,297 resectable cases were stratified into an upfront hepatectomy group(238 patients)and a NAC group(59 patients).Poor prognostic factors for upfront hepatectomy were identified using multivariate logistic regression *** score matching was used to compare clinical outcomes between the upfront hepatectomy and NAC groups,according to the number of poor prognostic *** curves were estimated using the Kaplan-Meier method and compared using the log-rank *** Preoperative carcinoembryonic antigen levels(≥10 ng/mL)(P=0.003),primary histological type(other than well/moderately differentiated)(P=0.04),and primary lymph node metastases(≥1)(P=0.04)were identified as independent poor prognostic factors for overall survival(OS)in the upfront hepatectomy ***-risk status was defined as the presence of two or more risk *** propensity score matching,50 patients were matched in each *** high-risk patients,the 5-year OS rate was significantly higher in the NAC group(13 patients)than in the upfront hepatectomy group(18 patients)(100%vs 34%;P=0.02).CONCLUSION NAC may improve the prognosis of high-risk patients with resectable CRLMs who have two or more risk factors.

关键词： Colorectal neoplasms Neoadjuvant therapy Neoplasm metastasis Prognosis Risk factors Survival

Gastric cancer incidence based on endoscopic Kyoto classification of gastritis

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World Journal of Gastroenterology 2023年第31期29卷 4763-4773页

作者： Osamu Toyoshima toshihiro Nishizawa Shuntaro Yoshida Tatsuya Matsuno Gota Fujisawa Akira Toyoshima Hirotoshi Ebinuma Mitsuhiro Fujishiro Yutaka Saito Hidekazu Suzuki Department of Gastroenterology Toyoshima Endoscopy ClinicTokyo 157-0066Japan Department of Gastroenterology and Hepatology International University of Health and WelfareNarita HospitalNarita 286-8520Japan Department of Colorectal Surgery Japanese Red Cross Medical CenterTokyo 150-8935Japan Department of Gastroenterology Graduate School of MedicineThe University of TokyoTokyo 113-8655Japan Division of Endoscopy National Cancer Center HospitalTokyo 104-0045Japan Division of Gastroenterology and Hepatology Department of Internal MedicineTokai University School of MedicineIsehara 259-1193Japan

BACKGROUND Gastric cancer(GC)incidence based on the endoscopic Kyoto classification of gastritis has not been systematically investigated using time-to-event *** To examine GC incidence in an endoscopic surveillance *** This study was retrospectively conducted at the Toyoshima Endoscopy *** who underwent two or more esophagogastroduodenoscopies were *** incidence was based on Kyoto classification scores,such as atrophy,intestinal metaplasia(IM),enlarged folds(EFs),nodularity,diffuse redness(DR),and total Kyoto *** ratios(HRs)adjusted for age and sex were calculated using a Cox hazard *** A total of 6718 patients were enrolled(median age 54.0 years;men 44.2%).During the follow-up period(max 5.02 years;median 2.56 years),GC developed in 34 *** average frequency of GCs per year was 0.19%.Kyoto atrophy scores 1[HR with score 0 as reference:3.66,95%confidence interval(CI):1.06 to 12.61],2(11.60,3.82-35.27),IM score 2(9.92,4.37-22.54),EF score 1(4.03,1.63-9.96),DR scores 1(6.22,2.65-14.56),and 2(10.01,3.73-26.86)were associated with GC incidence,whereas nodularity scores were *** total Kyoto scores of 4(HR with total Kyoto scores 0-1 as reference:6.23,95%CI:1.93 to 20.13,P=0.002)and 5-8(16.45,6.29-43.03,P<0.001)were more likely to develop GC,whereas the total Kyoto scores 2-3 were *** HR of the total Kyoto score for developing GC per 1 rank was 1.75(95%CI:1.46 to 2.09,P<0.001).CONCLUSION A high total Kyoto score(≥4)was associated with GC *** endoscopy-based diagnosis of gastritis can stratify GC risk.

关键词： Gastric cancer Gastritis Endoscopy Atrophy Intestinal metaplasia Kyoto classification

Endoscopy-based Kyoto classification score of gastritis related to pathological topography of neutrophil activity

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World Journal of Gastroenterology 2020年第34期26卷 5146-5155页

作者： Osamu Toyoshima toshihiro Nishizawa Shuntaro Yoshida Yoshiki Sakaguchi Yousuke Nakai Hidenobu Watanabe Hidekazu Suzuki Chizu Tanikawa Koichi Matsuda Kazuhiko Koike Department of Gastroenterology Toyoshima Endoscopy ClinicTokyo 157-0066Japan Department of Gastroenterology Graduate School of MedicineThe University of TokyoTokyo 113-8655Japan Department of Gastroenterology and Hepatology International University of Health and WelfareNarita HospitalChiba 286-8520Japan Department of Endoscopy and Endoscopic Surgery Graduate School of MedicineThe University of TokyoTokyo 113-8655Japan Department of Pathology Pathology and Cytology Laboratory JapanTokyo 166-0003Japan Department of Gastroenterology and Hepatology Tokai University School of MedicineKanagawa 259-1193Japan Laboratory of Molecular Medicine Human Genome CenterInstitute of Medical ScienceThe University of TokyoTokyo 108-8639Japan Department of Computational Biology and Medical Sciences Laboratory of Clinical Genome SequencingGraduate School of Frontier SciencesThe University of TokyoTokyo 108-8639Japan

BACKGROUND Endoscopy-based Kyoto classification for gastritis and pathological topographic distribution of neutrophil infiltration are correlated with gastric cancer *** To investigate the association between Kyoto classification and the topographic distribution of neutrophil *** Kyoto classification score,ranging from 0 to 8,consisted of atrophy,intestinal metaplasia,enlarged folds,nodularity,and diffuse *** activity was scored according to the updated Sydney System using biopsy samples obtained from the greater curvature of the corpus and the *** participants were divided into four categories,inactive stomach,antrumpredominant gastritis,pangastritis,and corpus-predominant gastritis,based on the topographic distribution of neutrophil *** of sex,age,body mass index,drinking habit,smoking habit,family history of gastric cancer,serum Helicobacter pylori(***)antibody,and Kyoto score on topography of neutrophil infiltration were *** A total of 327 patients(comprising 50.7%women,with an average age of 50.2 years)were enrolled in this *** infection rate was 82.9%with a mean Kyoto score of *** Kyoto score was associated with the topographic distribution of neutrophil *** scores were significantly higher in the order of inactive stomach,antrum-predominant gastritis,pangastritis,and corpuspredominant gastritis(3.05,4.57,5.21,and 5.96,respectively).Each individual score of endoscopic findings(i.e.,atrophy,intestinal metaplasia,enlarged folds,nodularity,and diffuse redness)was correlated with the topographic distribution of neutrophil *** multivariate analysis,the Kyoto score,age,and serum *** antibody were independently associated with the topographic distribution of neutrophil *** The Kyoto classification score was associated with the topographic distribution of neutrophil activity.

关键词： Kyoto classification Helicobacter pylori Neutrophil activity Updated Sydney System Gastritis Gastric cancer Endoscopy Pathology