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Efficient hemostatic method for endoscopic submucosal dissection of colorectal tumors

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World Journal of Gastroenterology 2010年第33期16卷 4180-4186页

作者： Naohisa Yoshida Yuji Naito Munehiro Kugai Ken Inoue Naoki Wakabayashi Nobuaki Yagi Akio Yanagisawa toshikazu yoshikawa Department of Molecular Gastroenterology and Hepatology Kyoto Prefectural University of MedicineGraduate School of Medical Science Department of Surgical Pathology Kyoto Prefectural University of MedicineGraduate School of Medical Science

AIM:To evaluate a new hemostatic method using hemostatic forceps to prevent perforation and perioperative hemorrhage during colonic endoscopic submucosal dissection(ESD).METHODS:We studied 250 cases,in which ESD for colorectal tumors was performed at the Kyoto Prefectural University of Medicine or Nara City Hospital between 2005 and 2010.We developed a new hemostatic method using hemostatic forceps in December 2008 for the efficient treatment of submucosal thick vessels.ESD was performed on 126 cases after adoption of the new method(the adopted group)and the new method was performed on 102 of these cases.ESD was performed on 124 cases before the adoption of the new method (the unadopted group).The details of the new method are as follows:firstly,a vessel was coagulated using the hemostatic forceps in the soft coagulation mode according to the standard procedure,and the coagulated vessel was removed using the forceps in the"endocut" mode without perioperative hemorrhage.Secondly,the partial surrounding submucosa was dissected using the forceps in the endocut mode.In the current study,we evaluated the efficacy of this method.RESULTS:Coagulated vessels were successfully removed using the hemostatic forceps in all 102 cases without severe perioperative hemorrhage.Moderate perioperative hemorrhage occurred in five cases(4.9%);however,it was stopped by immediately reuse of the hemostatic forceps.The partial surrounding submucosa was dissected using the forceps in all 102 cases.In the adopted group,the median operation time was 105 min.The proportion of endoscopic en bloc resection was 92.8%(P<0.01)compared to 80.6%in the unadopted group.The postoperative hemorrhage and perforation rates were 2.3%and 2.3%.The rate of perforation was significantly lower than that in the unadopted group (9.6%,P<0.01).We evaluated the ease of use of this method by allowing our three trainees to performed ESD on 46 cases,which were accomplished without any severe hemorrhage.CONCLUSION:The new method effectively treated submucosal thick vess

关键词： Endoscopic submucosal dissection Colorectal tumor Hemostatic forceps Perforation Perioperative hemorrhage

Direct cholangioscopy combined with doubleballoon enteroscope-assisted endoscopic retrograde cholangiopancreatography

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World Journal of Gastroenterology 2012年第28期18卷 3765-3769页

作者： Tatsuya Koshitani Shogo Matsuda Koji Takai Takayuki Motoyoshi Makoto Nishikata Yasuhide Yamashita Toshihiko Kirishima Naomi Yoshinami Hiroyuki Shintani toshikazu yoshikawa Department of Gastroenterology Kyoto City Hospital Kyoto 6048845 Japan Department of Molecular Gastroenterology and Hepatology Kyoto Prefectural University of Medicine Graduate School of Medical Science Kyoto 6028566 Japan

Double-balloon enteroscope (DBE)-assisted endoscopic retrograde cholangiopancreatography (ERCP) is an effective endoscopic approach for pancreatobiliary disorders in patients with altered gastrointestinal anatomy. Endoscopic interventions via DBE in these postoperative settings remain difficult because of the lack of an elevator and the use of extra-long ERCP accessories. Here, we report the usefulness of direct cholangioscopy with an ultra-slim gastroscope during DBE-assisted ERCP. Three patients with choledocholithiasis in postoperative settings (two patients after Billroth Ⅱ gastrojejunostomy and one patient after Roux-en-Y gastrojejunostomy) were treated. DBE was used to gain access to the papilla under carbon dioxide insufflation, and endoscopic sphincterotomy was performed with a conventional sphincterotome. For direct cholangioscopy, the enteroscope was exchanged for an ultra-slim gastroscope through an incision in the overtube, which was inserted directly into the bile duct. Direct cholangioscopy was used to extract retained bile duct stones in two cases and to confirm the complete clearance of stones in one case. Bile duct stones were eliminated with a 5-Fr basket catheter under direct visual control. No adverse events were noted in any of the three cases. Direct cholangioscopy with an ultra-slim gastroscope facilitates subsequent treatment within the bile duct. This procedure represents another potential option during DBE-assisted ERCP.

关键词：胃肠道胆管胆道内镜造影电子胃镜肠吻合术二氧化碳气

Rebamipide promotes healing of colonic ulceration through enhanced epithelial restitution

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World Journal of Gastroenterology 2011年第33期17卷 3802-3809页

作者： Tomohisa Takagi Yuji Naito Kazuhiko Uchiyama Toshimitsu Okuda Katsura Mizushima Takahiro Suzuki Osamu Handa Takeshi Ishikawa Nobuaki Yagi Satoshi Kokura Hiroshi Ichikawa toshikazu yoshikawa Department of Molecular Gastroenterology and Hepatology Graduate School of Medical ScienceKyoto Prefectural University of Medicine6028566 KyotoJapan

AIM:To investigate the efficacy of rebamipide in a rat model of colitis and restitution of intestinal epithelial cells in vitro.METHODS:Acute colitis was induced with trinitrobenzene sulfonic acid(TNBS)in male Wistar rats.Rats received intrarectal rebamipide treatment daily starting on day 7 and were sacrificed on day 14 after TNBS administration.The distal colon was removed to evaluate the various parameters of inflammation.Moreover,wound healing assays were used to determine the enhanced restitution of rat intestinal epithelial(RIE)cells treated with rebamipide.RESULTS:Intracolonic administration of rebamipide accelerated TNBSinduced ulcer healing.Increases in the wet weight of the colon after TNBS administration were significantly inhibited by rebamipide.The wound assay revealed that rebamipide enhanced the migration of RIE cells through phosphorylation of extracellular signalregulated kinase(ERK)and activation of Rho kinase.CONCLUSION:Rebamipide enema healed intestinal injury by enhancing restitution of RIE cells,via ERK activation.Rebamipide might be a novel therapeutic approach for inflammatory bowel disease.

关键词：肠上皮细胞伤口愈合结肠炎复原溃疡 Wistar大鼠灌肠治疗大鼠模型

Rosuvastatin reduces rat intestinal ischemia-reperfusion injury associated with the preservation of endothelial nitric oxide synthase protein

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World Journal of Gastroenterology 2006年第13期12卷 2024-2030页

作者： Yuji Naito Kazuhiro Katada Tomohisa Takagi Hisato Tsuboi Masaaki Kuroda Osamu Handa Satoshi Kokura Norimasa Yoshida Hiroshi Ichikawa toshikazu yoshikawa Department of Medical Proteomics Kyoto Prefectural University of Medicine Kyoto 602-8566Japan Inflammation and Immunology Graduate School of Medical Science Kyoto Prefectural University of MedicineKyoto 602-8566Japan Department of Biomedical Safety Science Kyoto Prefectural University of Medicine Kyoto 602-8566Japan Molecular Gastroenterology and Hepatology Graduate School of Medical Science Kyoto Prefectural University of MedicineKyoto 602-8566Japan Department of Food Sciences and Nutritional Health The Faculty of Human Environment Kyoto Prefectural UniversityKyoto 606-8522Japan

瞄准：为了在 ischemia-reperfusion (红外) 上调查 rosuvastatin 的保护的效果，并且在内皮的氮的氧化物 synthase (eNOS ) 的表示上决定这个代理人的效果，在老鼠导致了小肠的损害和发炎蛋白质。方法：肠的损坏被为 30 min 夹钳优异 m... 详细信息

瞄准：为了在 ischemia-reperfusion (红外) 上调查 rosuvastatin 的保护的效果，并且在内皮的氮的氧化物 synthase (eNOS ) 的表示上决定这个代理人的效果，在老鼠导致了小肠的损害和发炎蛋白质。方法：肠的损坏被为 30 min 夹钳优异 mes 伤寒动脉和腹的箱子在男 Sprague-Dawley 老鼠导致，为 60 min 由灌注列在后面。在生理盐水溶解的 Rosuvastatin intraperitoneally 被管理在局部缺血前的 60 min。肠的粘膜损害和发炎的严厉被几个生物化学的标记，以及由组织检查所见评估。eNOS 的蛋白质层次被西方的污点决定。结果：当粘膜的索引损坏，管腔内血红素和蛋白质的层次显著地在假冒操作组与那些相比在红外组被增加。然而，这些增加被处理显著地以一种剂量依赖者方式与 rosuvastatin 禁止。rosuvastatin 的保护的效果被组织检查所见也证实。到红外的小肠的暴露导致了 thiobarbituric 的重要增加描绘的粘膜发炎酸反应的物质，联系织物的 myeloperoxidase 活动，和老鼠的粘膜内容导致 cytokine 的嗜中性的 chemoattractant-1 (CINC-1 ) 和肿瘤坏死 factor-alpha (TNF-alpha ) 。在红外以后的煽动性的参数的这些增加被预告的处理显著地在 10 mg/kg 的剂量与 rosuvastatin 禁止。而且， CINC-1 和 TNF-alpha 的 mRNA 表示在红外以后被增加，并且这增加被 rosuvastatin 也禁止。eNOS 的粘膜蛋白质层次在红外期间减少了，但是在与 rosuvastatin 对待的老鼠被保存。结论：Rosuvastatin 禁止老鼠红外导致的肠的损害和发炎，和它的保护与 eNOS 的保藏被联系蛋白质。

关键词：肠疾病缺血再灌注损伤内皮氧化酶蛋白基因

Lansoprazole ameliorates intestinal mucosal damage induced by ischemia-reperfusion in rats

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World Journal of Gastroenterology 2004年第19期10卷 2814-2817页

作者： Hiroshi Ichikawa Norimasa Yoshida Tomohisa Takagi Naoya Tomatsuri Kazuhiro Katada Yutaka Isozaki Kazuhiko Uchiyama Yuji Naito Takeshi Okanoue toshikazu yoshikawa Department of Food Sciences and Nutritional Health Faculty of Human EnvironmentKyoto Prefectural University606-8522Japan Department of Molecular Gastroenterology and Hepatology Graduate School of Medical SciencesKyoto Prefectural University of Medicine606-8522Japan Department of Inflammation and Immunology Graduate School of Medical SciencesKyoto Prefectural University of Medicine606-8522Japan

AIM: To investigate the protective effect of lansoprazoleon ischemia and reperfusion (I/R)-induced rat intestinalmucosal injury in vivo.METHODS: Intestinal damage was induced by clampingboth the superior mesenteric artery and the celiac trunkfor 30 rain followed by reperfusion in male Sprague-Dawleyrats. lansoprazole was given to rats intraperitoneally 1 hbefore vascular clamping.RESULTS: Both the intraluminal hemoglobin and proteinlevels, as indices of mucosal damage, significantlyincreased in I/R-groups comparion with those of sham-operation groups. These increases in intraluminal hemoglobinand protein levels were significantly inhibited by the treatmentwith lansoprazole at a dose of 1 mg/kg. Small intestineexposed to I/R resulted in mucosal inflammation that wascharacterized by significant increases in thiobarbituric acid-reactive substances (TBARS), tissue-associatedmyeloperoxidase activity (MPO), and mucosal content of ratcytokine-induced neutrophil chemoattractant-1 (CINC-1).These increases in TBARS, MPO activities and CINC-1 contentin the intestinal mucosa after I/R were all inhibited bypretreatment with lansoprazole at a dose of 1 mg/kg.Furthermore, the CINC-1 mRNA expression was increasedduring intestinal I/R, and this increase in mRNA expressionwas inhibited by treatment with lansoprazole.CONCLUSION: Lansoprazole inhibits lipid peroxidation andreduces development of intestinal mucosal inflammationinduced by I/R in rats, suggesting that lansoprazole mayhave a therapeutic potential for I/R injury.

关键词：羊毛二烯肠道黏膜病多次灌注液老鼠血色素

Bowel preparation for colonoscopy using standard vs reduced doses of sodium phosphate: A single-blind randomized controlled study

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World Journal of Gastrointestinal Endoscopy 2014年第8期6卷 379-384页

作者： Tatsuya Koshitani Mayumi Kawada toshikazu yoshikawa Division of Gastroenterology Yamato Kenshin Center Kyoto Prefectural University of Medicine Graduate School of Medical Science

AIM: To evaluate the efficacy of a colonoscopy prepa-ration that utilizes a reduced dose of sodium phosphate(NaP) and an adjunct.METHODS: Sixty-two patients requiring screening colonoscopies were studied. Each patient was randomly allocated to receive either 50 NaP tablets(50 g) or 30 NaP tablets(30 g) with 10 mL of 0.75% sodium pico-sulfate for bowel preparation. NaP was administered at a rate of five tablets(5 g) or three tablets(3 g) every 15 min with 200 mL of water, beginning five to six hours before colonoscopy. The sodium picosulfate was administered with 200 mL of water on the night before the procedure. Both groups were compared in term of the efficacies of colonic cleansing, the time required for completion of the bowel preparation, and acceptability of the preparation.RESULTS: Sixty patients(n = 30 for each group) were analyzed. The cleansing efficacy tended to be higher in the 30 g NaP plus sodium picosulfate group as as-sessed by the mean total Ottawa scale score(50 g NaP6.70 ± 1. 42 vs 30 g NaP plus sodium picosulfate 6.17 ± 1.18 P = 0.072). The mean time for bowel prepara-tion tended to be shorter in the 30 g NaP plus sodium picosulfate group(50 g NaP 189.9 ± 64.0 min vs 30 g NaP plus sodium picosulfate 161.8 ± 57.6 min, P = 0.065). There were no significant differences between the two groups in the acceptability of the preparations(50 g NaP 83.3% vs 30 g NaP plus sodium picosulfate 86.7%, P = 0.500). There were no adverse events re-lated to bowel preparation in either of the groups.CONCLUSION: The colonoscopy preparation that uti-lized 30 g NaP with sodium picosulfate was comparable to that utilizing 50 g NaP. This novel bowel preparation might be useful before colonoscopy.

关键词： Bowel preparation Colonoscopy Colonoscopy preparation Sodium phosphate Sodium picosulfate

Nonalcoholic fatty liver disease is a novel predictor of cardiovascular disease

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World Journal of Gastroenterology 2007年第10期13卷 1579-1584页

作者： Masahide Hamaguchi Takao Kojima Noriyuki Takeda Chisato Nagata Jun Takeda Hiroshi Sarui Yutaka Kawahito Naohisa Yoshida Atsushi Suetsugu Takahiro Kato Junichi Okuda Kazunori Ida toshikazu yoshikawa Inflammation and Immunology Graduate School of Medical ScienceKyoto Prefectural University of MedicineJapan Department of Gastroenterology Murakami Memorial HospitalAsahi UniversityJapan Department of Endocrinology and Metabolism Murakami Memorial HospitalAsahi UniversityJapan Department of Epidemiology & Preventive Medicine Graduate School of MedicineGifu UniversityJapan Department of Diabetes and Endocrinology Division of Molecule and StructureGraduate School of MedicineGifu UniversityJapan

AIM:To clarify whether nonalcoholic fatty liver disease(NAFLD)increases the risk of cardiovascular disease.METHODS:We carried out a prospective observational study with a total of 1637 apparently healthy Japanese men and women who were recruited from a health check-up program.NAFLD was diagnosed by abdominal ultrasonography.The metabolic syndrome(MS)was defined according to the modified National Cholesterol Education Program(NCEP)ATP Ⅲ criteria.Five years after the baseline evaluations,the incidence of cardiovascular disease was assessed by a self-administered questionnaire.RESULTS:Among 1221 participants available for outcome analyses,the incidence of cardiovascular disease was higher in 231 subjects with NAFLD at baseline(5 coronary heart disease,6 ischemic stroke,and 1 cerebral hemorrhage)than 990 subjects without NAFLD(3 coronary heart disease,6 ischemic stroke,and 1 cerebral hemorrhage).Multivariate analyses indicated that NAFLD was a predictor of cardiovascular disease independent of conventional risk factors(odds ratio 4.12,95% CI,1.58 to 10.75,P = 0.004).MS was alsoindependently associated with cardiovascular events.But simultaneous inclusion of NAFLD and MS in a multivariate model revealed that NAFLD but not MS retained a statistically significant correlation with cardiovascular disease.CONCLUSION:Although both of them were predictors of cardiovascular disease,NAFLD but not MS retained a statistically significant correlation with cardiovascular disease in a multivariate model.NAFLD is a strong predictor of cardiovascular disease and may play a central role in the cardiovascular risk of MS.

关键词：非酒精性脂肪肝心血管疾病风险因子预测指标冠心病

Microarray Profiling of Gene Expression Patterns in Giomerular Celis of Astaxanthin-Treated Diabetic Mice: An Approach on Nutrigenomics

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Microarray Profiling of Gene Expression Patterns in Giomerul...

Freeze-thaw cycles and associated geomorphology in a post-glacial environment:current glacial,paraglacial,periglacial and proglacial scenarios at Pico de Orizaba volcano,Mexico

The International Meeting of the Society for Free Radical Research(SFRR)-Asia & the Third International Symposium on Natural Antioxidants-Molecular Mechanisms and Health Effects(ISNA)

作者： Yuji Naito Satomi Akagiri Masaaki Kuroda Tomohisa Takagi Osamu Handa Satoshi Kokura Hiroshi Ichikawa Norimasa Yoshida toshikazu yoshikawa Graduate School of Medical Science Kyoto Prefectural University of Medicine Kyoto Graduate School of Medical Science Kyoto Prefectural University of Medicine Kyoto Graduate School of Medical Science Kyoto Prefectural University of Medicine Kyoto Graduate School of Medical Science Kyoto Prefectural University of Medicine Kyoto Graduate School of Medical Science Kyoto Prefectural University of Medicine Kyoto Graduate School of Medical Science Kyoto Prefectural University of Medicine Kyoto Graduate School of Medical Science Kyoto Prefectural University of Medicine Kyoto Graduate School of Medical Science Kyoto Prefectural University of Medicine Kyoto Graduate School of Medical Science Kyoto Prefectural University of Medicine Kyoto

Diabetic nephropathy is characterized by the proliferation of glomerular mesangium cells and the accumulation of extra-cellular matrix. In the previous study, we demonstrated that astaxanmin reduced glomerular oxidative stress as well as inhibited the increase of urinary albumin in diabetic db/db mice. High-density DNA microarrays that examine expression of many genes simultaneously not only can provide new information about gene function, but also generate insights into transcriptional processes, and identify new mechanism of pathogenesis. The aim of the present study is to determine the gene expression patterns in glomerular cells of astaxanthin-treated mice by using a microarray technique.

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Journal of Mountain Science 2024年第6期21卷 1954-1977页

作者： Víctor SOTO Carlos M.WELSH R. Kenji yoshikawa Hugo DELGADO GRANADOS Centro de Ciencias de la Tierra Universidad VeracruzanaCircuito Gonzalo Aguirre BeltránS/NZona Universitaria91090XalapaMéxico Water and Environmental Research Center University of Alaska FairbanksFairbanksAlaska 99775USA Instituto de Geofísica Universidad Nacional Autónoma de MéxicoCiudad de México 04150México Department of Earth and Environmental Sciences Ludwig Maximilians UniversitätMunich 80333Germany

The glacial history of Pico de Orizaba indicates that during the Last Glacial Maximum,its icecap covered up to~3000 m asl;due to the air temperature increasing,its main glacier has retreated to 5050 m asl.The retraction of the glacier has left behind an intense climatic instability that causes a high frequency of freeze-thaw cycles of great intensity;the resulting geomorphological processes are represented by the fragmentation of the bedrock that occupies the upper parts of the mountain.There is a notable lack of studies regarding the fragmentation and erosion occurring in tropical high mountains,and the associated geomorphological risks;for this reason,as a first stage of future continuous research,this study analyzes the freezing and thawing cycles that occur above 4000 m asl,through continuous monitoring of surface ground temperature.The results allow us to identify and characterize four zones:glacial,paraglacial,periglacial and proglacial.It was found that the paraglacial zone presents an intense drop of temperature,of up to~9℃ in only sixty minutes.The rock fatigue and intense freeze-thaw cycles that occur in this area are responsible for the high rate of rock disintegration and represent the main factor of the constant slope dynamics that occur at the site.This activity decreases,both in frequency and intensity,according to the distance to the glacier,which is where the temperature presents a certain degree of stability,until reaching the proglacial zone,where cycles are almost non-existent,and therefore there is no gelifraction activity.The geomorphological processes have resulted in significant alterations to the mountain slopes,which can have severe consequences in terms of risk and water.

关键词： Freeze-Thaw Gelifraction Mountain mechanical erosion Periglacial geomorphology Postglacial scenarios