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MR Differentiation of Endometriomas Complicated with and without Malignancy: Comparison with Pathological Findings

Open Journal of Medical Imaging 2014年第3期4卷 142-153页

作者： Mari Kohno Tsuyoshi Tajima Kazunori Hashimoto Hideo Matsui toshio nishikawa Shuji Sakai Department of Diagnostic Imaging and Nuclear Medicine Tokyo Women’s Medical University Tokyo Japan Department of Radiology National Center for Global Health and Medicine Tokyo Japan Department of Obstetrics and Gynecology Tokyo Women’s Medical University Tokyo Japan Department of Molecular Pathology School of Medicine Yokohama City University Yokohama Japan

Introduction: The purposes were to clarify the magnetic resonance imaging (MRI) findings of malignant ovarian lesions arising from endometriomas, and to compare the lesions’ histopathology and MRI characteristics. Materials and Methods: Between May 2004 and December 2012, 140 patients, all of whom were diagnosed as having an endometrioma by using MR imaging, underwent surgery. We compared the MR characteristics including size and signal intensity of the tumor and mural nodules, the thickness of the septum, and the thickness of the wall with the pathological diagnoses. The attached angles of the mural nodules to the cyst wall were also evaluated. Results: Among the 179 lesions, preoperative MR imaging diagnosed 153 benign and 26 malignant. Based on the pathological results, 169 were diagnosed as benign and 10 were diagnosed as malignant. Finally, preoperative MR imaging correctly diagnosed 152 benign (group 1) and nine malignant (group 2), misdiagnosed 17 benign as malignant (group 3) and misdiagnosed one malignant as benign (group 4). As for mural nodules, there was a significant difference between groups 1 and 2 in the mean maximum diameter of the mural nodules. An acute attached angle was shown in 1 of 7 in group 1, in 11 of 16 in group 2, and in 14 of 22 in group 3. We also compared benign group with malignant group on the final pathological findings. As for mural nodules, there was a significant difference between groups 1 + 3 and group 2 in the mean maximum diameter of the mural nodules. On dynamic study, there were 22 enhanced mural nodules (75.9%) on group 1 + 3. Conclusion: Most of endometriomas preoperatively diagnosed as benign were pathological benign lesions. Endometriomas that contain many enhanced mural nodules with papillary shape, larger size, showing hypointense on T1WI, hyperintense on T2WI and showing an acute attached angle may have malignant potential.

关键词： MR Imaging Endometrioma Malignancy Mural Nodule Subtraction Image

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Evaluation of the Palatability of Dry Syrups and the Bitterness Intensities of Dry Syrups Mixed with Various Beverages

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Pharmacology & Pharmacy 2021年第2期12卷 43-54页

作者： toshio Kurihara Honami Kojima Miyako Yoshida Mizuho Oshio Rino Kunikata Haruka nishikawa Takahiro Uchida Faculty of Pharmaceutical Sciences Mukogawa Women’s University Nishinomiya Japan

The purpose of this study was to evaluate the palatability of dry syrups for pediatric use by human gustatory sensation testing and the artificial taste sensor. The bitterness intensities of dry syrups mixed with various beverages were also evaluated using the taste sensor. Twenty dry-syrup formulations of antibacterial and anti-allergic drugs containing bitter active ingredients, frequently used in pediatric medicine in Japan, were selected for testing. The main factors influencing palatability were determined by factor analysis of data from human gustatory sensation testing using the semantic differential method. It was shown that the bitterness intensity of dry syrups in water could be predicted by the artificial taste sensor. The influence of different beverages (orange juice, milk or cocoa) mixed with the dry syrups was evaluated using the artificial taste sensor. Taste and texture were found to be the principal factors influencing the palatability of dry syrups. While the bitterness intensities of some dry syrups were increased by mixing with orange juice, the bitterness intensities of most dry syrups were decreased by mixing with milk or cocoa. This suggests that one or more constituents of milk or cocoa may reduce the bitterness intensities of dry syrups.

关键词： Palatability Semantic Differential Method Dry Syrup Taste Sensor

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Endoscopic management of unresectable malignant gastroduodenal obstruction with a nitinol uncovered metal stent: a prospective Japanese multicenter study

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World Journal of Gastroenterology 2016年第14期22卷 3837-3844页

作者： Reina Sasaki Yuji Sakai toshio Tsuyuguchi Takao nishikawa Tatsuya Fujimoto Shigeru Mikami Harutoshi Sugiyama Osamu Yokosuka Department of Gastroenterology and Nephrology Graduate School of Medicine Chiba University Department of Gastroenterology Kimitsu Chuo Hospital Department of Gastroenterology Kikkoman General Hospital

AIM: To determine the safety and efficacy of endoscopic duodenal stent placement in patients with malignant gastric outlet ***: This prospective, observational, multicenter study included 39 consecutive patients with malignant gastric outlet obstruction. All patients underwent endoscopic placement of a nitinol, uncovered, selfexpandable metal stent. The primary outcome was clinical success at 2 wk after stent placement that was defined as improvement in the Gastric Outlet Obstruction Scoring System score relative to the ***: Technical success was achieved in all duodenal stent procedures. Procedure-related complications occurred in 4 patients(10.3%) in the form of mild pneumonitis. No other morbidities or mortalitieswere observed. The clinical success rate was 92.3%. The mean survival period after stent placement was 103 d. The mean period of stent patency was 149 d and the patency remained acceptable for the survival period. Stent dysfunction occurred in 3 patients(7.7%) on account of tumor ***: Endoscopic management using duodenal stents for patients with incurable malignant gastric outlet obstruction is safe and improved patients' quality of life.

关键词： Duodenal stenosis Gastrointestinal stent Gastric stenosis Malignant tumors Metallic stent

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Clinical utility of 0.025-inch guidewire VisiGlide2TM in the endoscopic retrograde cholangiopancreatography-related procedures

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World Journal of Gastrointestinal Endoscopy 2017年第2期9卷 77-84页

作者： Yuji Sakai toshio Tsuyuguchi Nobuto Hirata So Nakaji Kenji Shimura Takao nishikawa Tatsuya Fujimoto Tetsuya Hamano Takayoshi Nishino Osamu Yokosuka Department of Gastroenterology and Nephrology Graduate School of MedicineChiba University Department of Gastroenterology Kameda Medical Center Department of Gastroenterology Asahi Central Hospital Department of Gastroenterology Kimitsu Central Hospital Department of Gastroenterology Tokyo Women’s Medical University Yachiyo Medical Center

AIM To examine the result of the use of 0.025-inch guidewire(GW) Visi Glide2 TM as the first choice in the endoscopic retrograde cholangiopancreatography(ERCP)-related procedures without selecting the patient in a multicenter prospective study. METHODS ERCP using 0.025-inch GW VisiGlide2^(TM) as the first choice was conducted in patients who have needed ERCP, and its accomplishment rate of procedure, procedural time, incidence of accidental symptoms were compared with those of ERCP using 0.025-inch GW VisiG *** The accomplishment rate of procedure was 97.5%(197/202), and procedural time was 23.930 ± 16.207 min. The accomplishment rate of procedure using 0.025-inch GW Visi GlideTM was 92.3%(183/195), and procedural time was 31.285 ± 19.122 min, thus the accomplishment rate of procedure was significantly improved and procedural time was significantly shortened(P < 0.05). Accidental symptoms by ERCPrelated procedures were observed in 3.0%(6/202), and all were conservatively alleviated. CONCLUSION When 0.025-inch GW VisiG lide2 TM was used for ERCPrelated procedure as the first choice, it showed high accomplishment rate of procedure and low incidence of accidental symptoms, suggesting it can be used as the universal GW. Clinical Trial Registry(UMIN0000016042).

关键词： Endoscopic sphincterotomy Endoscopic retrograde cholangiopancreatography 0.025-inch guidewire

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Current state of practice for colonic diverticular bleeding in 37 hospitals in Japan: A multicenter questionnaire study

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World Journal of Gastrointestinal Endoscopy 2016年第20期8卷 785-794页

作者： Ryota Niikura Naoyoshi Nagata Hisashi Doyama Ryosuke Ota Naoki Ishii Katsuhiro Mabe Tsutomu Nishida Takuto Hikichi Kazuki Sumiyama Jun nishikawa toshio Uraoka Shu Kiyotoki Mitsuhiro Fujishiro Kazuhiko Koike Department of Gastroenterology Graduate School of Medicinethe University of Tokyo Bunkyo-ku Tokyo 113-8655 Japan Department of Gastroenterology and Hepatology National Center for Global Health and MedicineShinjuku-ku Tokyo 162-8655 Japan Department of Gastroenterology Ishikawa Prefectural Central Hospital Kanazawa-shiIshikawa 920-8201 Japan Department of Gastroenterology St. Luke’s International Hospital Chuo-ku Tokyo 104-8560 Japan Division of Endoscopy Hokkaido University Hospital Kita-ku Sapporo 060-0808 Hokkaido Japan Department of Gastroenterology National Hospital Organization Hakodate Hospital KawaharachouHakodate-shi 041-0844 Hokkaido Japan Department of Gastroenterology Toyonaka Municipal Hospital Toyonaka-shi Osaka 560-0055 Japan Department of Endoscopy Fukushima Medical University Hospital Fukushima-shi Fukushima 960-1295 Japan Department of Endoscopy the Jikei University School of Medicine Minato-ku Tokyo 105-8471Japan Department of Clinical Laboratory Science Yamaguchi University Graduate School of Medicine Ube-shiYamaguchi 755-0046 Japan Department of Gastroenterology National Hospital Organization Tokyo Medical Center Meguro-ku Tokyo 150-0021 Japan Department of Gastroenterology Shuto General Hospital Yanai-shi Yamaguchi 742-0032 Japan Endoscopy and Endoscopic Surgery the University of Tokyo Hospital Bunkyo-ku Tokyo 113-8655 Japan

AIM To clarify the current state of practice for colonic diverticular bleeding(CDB) in *** We conducted multicenter questionnaire surveys of the practice for CDB including clinical settings(8 questions),diagnoses(8 questions),treatments(7 questions),and outcomes(4 questions) in 37 hospitals across *** answers were compared between hospitals with high and low number of inpatient beds to investigate which factor influenced the *** Endoscopists at all 37 hospitals answered the questions,and the mean number of endoscopists at these hospitals was *** all the hospitals,computed tomography was performed before colonoscopy in 67% of the *** rate of bowel preparation was 46.0%.Early colonoscopy was performed within 24 h in 43.2% of the *** the hospitals,83.8% performed clipping as first-line endoscopic *** than half of the hospitals experienced less than 20% rebleeding events after endoscopic *** significant difference was observed in the annual number of patients hospitalized for CDB between high-(≥700 beds) and low-volume *** emergency visits(P=0.012) and endoscopists(P=0.015),and less frequent participation of nursing staff in early colonoscopy(P=0.045) were observed in the high-volume *** Some practices unique to Japan were found,such as performing computed tomography before colonoscopy,no bowel preparation,and clipping as first-line ***,the number of staff differed,the practices for CDB were common irrespective of hospital size.

关键词： colonic diverticular hemorrhage lower gastrointestinal bleeding computed tomography endoscopy bowel preparation

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New tapered metallic stent for unresectable malignant hilar bile duct obstruction

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World Journal of Clinical Cases 2015年第10期3卷 887-893页

作者： Yuji Sakai toshio Tsuyuguchi Takao nishikawa Harutoshi Sugiyama Reina Sasaki Dai Sakamoto Yuto Watanabe Masato Nakamura Shin Yasui Rintaro Mikata Osamu Yokosuka Department of Gastroenterology and Nephrology Graduate School of Medicine Chiba University

AIM: To examine the usefulness of a new tapered metallic stent(MS) in patients with unresectable malignant hilar bile duct ***: This new tapered MS was placed in 11 patients with Bismuth Ⅱ or severer unresectable malignant hilar bile duct obstruction, as a prospective study. The subjects were six patients with bile duct carcinoma, three with gallbladder cancer, and two with metastatic bile duct obstruction. Stenosis morphology was Bismuth Ⅱ: 7, Ⅲa: 3, and Ⅳ: 1. UMIN Clinical Trial Registry(UMIN000004758).RESULTS: MS placement was 100%(11/11) successful. There were no procedural accidents. The mean patency period was 208.401 d, the median survival period was 142.000 d, and the mean survival period was 193.273 d. Occlusion rate was 36.4%(4/11); the causes of occlusion were ingrowth and overgrowth in 2 patients each, 18.2%, respectively. Patients with occlusion underwent endoscopic treatment one more time and all were treatable. CONCLUSION: The tapered MS proved useful in patients with unresectable malignant hilar bile duct obstruction because it provided a long patency period, enabled re-treatment by re-intervention, and no procedural accidents occurred.

关键词： Malignant hilar bile duct obstruction Metallic stent Tapered metallic stent

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Endoscopic papillary large balloon dilation for bile duct stones in elderly patients

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World Journal of Clinical Cases 2015年第4期3卷 353-359页

作者： Yuji Sakai toshio Tsuyuguchi Harutoshi Sugiyama Reina Sasaki Dai Sakamoto Masato Nakamura Yuuto Watanabe Takao nishikawa Shin Yasui Rintaro Mikata Osamu Yokosuka Department of Gastroenterology and Nephrology Graduate School of Medicine Chiba University

AIM: To investigate whether endoscopic papillary large balloon dilation(EPLBD) can be safety and effectively performed in patients aged ≥ 80 years. METHODS: Lithotomy by EPLBD was conducted in 106 patients with bile duct stones ≥ 13 mm in size or with three or more bile duct stones ≥ 10 mm. The patients were divided into group A(< 80 years) and group B(≥ 80 years). Procedure success rate, number of endoscopic retrograde cholangiopancreatographies(ERCP), and incidence of complications were examined in both ***: Group B tended to include significantly more patients with peripapillary diverticulum, hypertension, hyperlipemia, cerebrovascular disease/dementia, respiratory disease/cardiac disease, and patients administered an anticoagulant or antiplatelet agent(P < 0.05). The success rate of the initial lithotomy was 88.7(94/106)%. The final lithotomy rate was 100(106/106)%. Complications due to treatment procedure occurred in 4.72(5/106)% of the patients. There was no significant difference in procedure success rate, number of ERCP, or incidence of complications between group A and group ***: EPLBD can be safely performed in elderly patients, the same as in younger patients.

关键词： Elderly patients Endoscopic papillary large balloon dilation Endoscopic sphincterotomy Large bile duct stones Choledocholithiasis

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钢制防屈曲约束支撑的开发

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施工技术(中英文) 2011年第6期40卷 88-90页

作者：牧野俊雄西川宏之一戸康生福田浩司住金关西工业株式会社住友金属工业株式会社

作为消能减震部件,要求防屈曲约束支撑的滞回曲线稳定。开发了两块腹板式钢制防屈曲约束支撑SUB-H和螺栓组装式钢制防屈曲约束支撑SUB-X。结合开发试验,提出了SUB的结构设计公式。静态和动态荷载试验证明,SUB具有较高的安全性和精度,大... 详细信息

作为消能减震部件,要求防屈曲约束支撑的滞回曲线稳定。开发了两块腹板式钢制防屈曲约束支撑SUB-H和螺栓组装式钢制防屈曲约束支撑SUB-X。结合开发试验,提出了SUB的结构设计公式。静态和动态荷载试验证明,SUB具有较高的安全性和精度,大型试验证明SUB在高轴力状态下也具有良好的滞回性能。

关键词：钢制防屈曲约束支撑累积塑性变形屈服强度循环荷载

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Endoscopic papillary large balloon dilation for removal of bile duct stones

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World Journal of Gastroenterology 2014年第45期20卷 17148-17154页

作者： Yuji Sakai toshio Tsuyuguchi Yoshiaki Kawaguchi Nobuto Hirata So Nakaji Katsuya Kitamura Shigeru Mikami Tatsuya Fujimoto Masashi Ijima Eishin Kurihara Shuhei Oana Takayoshi Nishino Ryo Tamura Dai Sakamoto Masato Nakamura Takao nishikawa Harutoshi Sugiyama Hitoshi Yoshida Tetsuya Mine Osamu Yokosuka Department of Gastroenterology and Nephrology Graduate School of Medicine Chiba University Department of Gastroenterology Tokai University Hospital Department of Gastroenterology Kameda Medical Center Division of Gastroenterology Department of Medicine Showa University School of Medicine Department of Internal Medicine Kikkoman General Hospital Department of Gastroenterology Kimitsu Central Hospital Department of Gastroenterology Isesaki Municipal Hospital Department of Gastroenterology Iwate Medical University Hospital Department of Gastroenterology Tokyo Women’s Medical University Yachiyo Medical Center

AIM:To investigate the efficacy and outcomes of endoscopic papillary large balloon dilation(EPLBD)for bile duct stones in a multicenter prospective ***:Lithotomy by EPLBD was conducted in 124patients with bile duct stones≥13 mm in size or with three or more bile duct stones≥10 *** endoscopic sphincterotomy,the papilla was dilated using balloons 12-20 mm in diameter fitting the bile duct ***:The success rate of first-time lithotomy was 86.3%(107/124)and the final lithotomy success rate was 100%(124/124).Lithotripsy was needed in10 of the 124(13.6%)*** events due to the treatment procedure occurred in 6(4.8%)patients,all of which were *** large balloon dilation after endoscopic sphincterotomy in patients with large stones or multiple stones in the bile duct is considered to ensure the safety of treatment and to reduce the need for ***:It is suggested that treatment by EPLBD for large bile duct stones may be safe and useful.

关键词： Endoscopic retrograde cholangiopancrea-tography En

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