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Hepatobiliary & Pancreatic Diseases International 2022年第2期21卷 196-198页

作者： Yuki Ishikawa-Kakiya Hirotsugu Maruyama Kojiro Tanoue Shusei Fukunaga Yasuaki Nagami yasuhiro fujiwara Department of Gastroenterology Osaka City University Graduate School of Medicine1-4-3AsahimachiAbeno-kuOsaka 545-8585Japan

To the Editor:Malignant pleural mesothelioma is a rare and aggressive form of cancer with a poor prognosis [1].Its progression is mainly a direct invasion from the primary lesion,and metastasis to distant regions rarely *** was found that metastasis of malignant pleural mesothelioma may occur in the liver,adrenal glands,and kidneys in autopsy cases [2].

关键词： metastasis pleural needle

Safety and efficacy of transpapillary bridged bilateral side-by-side stenting for unresectable malignant hilar biliary obstruction

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Hepatobiliary & Pancreatic Diseases International 2017年第6期16卷 659-661页

作者： Hirotsugu Maruyama Kazunari Tominaga Kunihiro Kato Satoshi Sugimori Masatsugu Shiba Toshio Watanabe yasuhiro fujiwara Department of Gastroenterology Osaka City University Graduate School of Medicine 1-4-3 Asahimachi Abeno-ku Osaka 545-8585 Japan

To the Editor:Biliary drainage is most frequently performed among endoscopic procedures using pancreatobiliary endoscopy.A large-diameter metallic stent can significantly extend the patency period rather than a plastic stent for extrahepatic biliary stricture.;However,the optimal drainage for the hilar biliary obstruction is still controversial.

关键词： Safety and efficacy of transpapillary bridged bilateral side-by-side stenting for unresectable malignant hilar biliary obstruction

Biodegradation of synthetic surfactants by river microorganisms

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Journal of Environmental Sciences 1996年第3期8卷 275-284页

作者： Hideaki Maki Kenrou Tokuhiro yasuhiro fujiwara Michihiko Ike Kenji Furukawa Masanori Fujita(Department of Environmental Engineering, Faculty of Engineering, Osaka University, 2-1 Yamadaoka,Suita, Osaka 565, Japan) Dept. of Environmental Engineering Faculty of Engineering Osaka University 2-1 Yamadaoka Suita Osaka 565 Japan

Four kinds of widely used synthetic surfactants and polyethylene glycol (PEG) which corresponds to the hydrophilic moieties of polyoxyethylene-type nonionic surfactants were subjected to a complete biodegradation test using microorganisms from relatively unpolluted river waters (the TOC-Handai method). Sodium dodecyl sulfate (SDS), alcohol ethoxylate (AE) and PEG were mineralized by most of the microorganisms used as inocula, irrespective of differences in their degradation rates, which is in agreement with their biodegradabilities confirmed so far by other *** degradable surfactants were, however, not completely degraded by some river microorganisms. Among the surfactants tested, SDS was degraded most rapidly by microorganisms of each river in the same manner but the degradation rates of AE and PEG differed considerably according to the inoculum sampling station. Sodium linear alkylbenzensulfonate (LAS) and nonylphenol ethoxylate (NPE). which are known to be recalcitrant molecules, were not degraded completely by microorganisms of any of the river waters within the testing period; degradation of the former rarely proceeded , while that of the latter ceased leaving the well-known intermediates. The residual metabolites of NPE generated by biodegradation, which were analyzed by high-performance liquid chromatography and gas chromatography/mass spectrometry, revealed that this surfactant was transformed to carboxylated metabolites, nonylphenoxy acetic acid (NP1EC)and [(nonylphenoxy)ethoxy] acetic acid (NP2EC) exclusively.

关键词： biodegradation surfactants river microorganisms TOC

Quality of ulcer healing in gastrointestinal tract:Its pathophysiology and clinical relevance

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World Journal of Gastroenterology 2012年第35期18卷 4811-4822页

作者： Tetsuo Arakawa Toshio Watanabe Tetsuya Tanigawa Kazunari Tominaga yasuhiro fujiwara Kenichi Morimoto Department of Gastroenterology Osaka City University Graduate School of Medicine

In this paper, we review the concept of quality of ulcer healing （QOUH） in the gastrointestinal tract and its role in the ulcer recurrence. In the past, peptic ulcer disease （PUD） has been a chronic disease with a cycle of repeated healing/remission and recurrence. The main etiological factor of PUD is Helicobacter pylori （H. pylorl~, which is also the cause of ulcer recur- rence. However, H. pylori-negative ulcers are pres- ent in 12%-20% of patients; they also recur and are on occasion intractable. QOUH focuses on the fact that mucosal and submucosal structures within ulcer scars are incompletely regenerated. Within the scars of healed ulcers, regenerated tissue is immature and with distorted architecture, suggesting poor QOUH. The abnormalities in mucosal regeneration can be the basis for ulcer recurrence. Our studies have shown that persistence of macrophages in the regenerated area plays a key role in ulcer recurrence. Our studies in a rat model of ulcer recurrence have indicated that proinflammatory cytokines trigger activation of macro- phages, which in turn produce increased amounts of cytokines and chemokines, which attract neutrophils to the regenerated area. Neutrophils release proteolytic enzymes that destroy the tissue, resulting in ulcer re- currence. Another important factor in poor QOUH can be deficiency of endogenous prostaglandins and a defi- ciency and/or an imbalance of endogenous growth fac- tors. Topically active mucosal protective and antiulcer drugs promote high QOUH and reduce inflammatory cell infiltration in the ulcer scar. In addition to PUD, the concept of QOUH is likely applicable to inflammatory bowel diseases including Crohn＇s disease and ulcer- ative colitis.

关键词： Quality of ulcer healing Peptic ulcer dis-ease Recurrence Prostaglandin Cytokines Growthfactors

Glutamine depletion induces murine neonatal melena with increased apoptosis of the intestinal epithelium

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World Journal of Gastroenterology 2011年第6期17卷 717-726页

作者： Takayuki Motoki Yoshio Naomoto Junji Hoshiba yasuhiro Shirakawa Tomoki Yamatsuji Junji Matsuoka Munenori Takaoka Yasuko Tomono yasuhiro fujiwara Hiroshi Tsuchita Mehmet Gunduz Hitoshi Nagatsuka Noriaki Tanaka Toshiyoshi fujiwara Department of Gastroenterological Surgery Transplantand Surgical OncologyGraduate School of MedicineDentistryand Pharmaceutical SciencesOkayama University Department of General Surgery Kawasaki Medical School Kawasaki Hospital Division of Molecular and Cell Biology Shigei Medical Research Institute Department of Animal Resources Advanced Science Research CenterOkayama University Food Technology Research Institute Meiji Dairies Corporation Department of Oral Pathology and Medicine Graduate School of MedicineDentistryand Pharmaceutical SciencesOkayama University

AIM:To investigate the possible biological outcome and effect of glutamine depletion in neonatal mice and rodent intestinal epithelial ***:We developed three kinds of artificial milk with different amounts of glutamine;Complete amino acid milk (CAM),which is based on maternal mouse milk,glutamine-depleted milk (GDM),and glutaminerich milk (GRM).GRM contains three-fold more glutamine than ***-seven newborn mice were divided into three groups and were fed with either of CAM,GDM,or GRM via a recently improved nipple-bottle system for seven *** the feeding period,the mice were subjected to macroscopic and microscopic observations by immunohistochemistry for 5-bromo-2'deoxyuridine (BrdU) and Ki-67 as markers of cell proliferation,and for cleaved-caspase-3 as a marker of ***,IEC6 rat intestinal epithelial cells were cultured in different concentrations of glutamine and were subject to a 4-[3-(4-iodophenyl)-2-(4-nitrophenyl)2H-5-tetrazolio]-1,3-benzene disulfonate cell proliferation assay,flow cytometry,and western blotting to examine the biological effect of glutamine on cell growth and ***:During the feeding period,we found colonic hemorrhage in six of 28 GDM-fed mice (21.4%),but not in the GRM-fed mice,with no differences in body weight gain between each *** examination showed destruction of microvilli and the disappearance of glycocalyx of the intestinal wall in the colon epithelial tissues taken from GDM-fed *** of GDM reduced BrdU incorporation (the average percentage of BrdU-positive staining;GRM:13.8%,CAM:10.7%,GDM:1.14%,GRM vs GDM:P < 0.001,CAM vs GDM:P < 0.001) and Ki-67 labeling index (the average percentage of Ki67-positive staining;GRM:24.5%,CAM:22.4% GDM:19.4%,GRM vs GDM:P=0.001,CAM vs GDM:P =0.049),suggesting that glutamine depletion inhibited cell proliferation of intestinal epithelial *** deprivation further caused the deformation of the nuclear membrane and the plasma m

关键词： Glutamine Newborn mice Artificial milk Melena Intestinal epithelial cells Apoptosis

Management of gastric fundal varices without gastro-renal shunt in 15 patients

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World Journal of Gastroenterology 2008年第3期14卷 448-453页

作者： Natsuhiko Kameda Kazuhide Higuchi Masatsugu Shiba Kaori Kadouchi Hirohisa Machida Hirotoshi Okazaki Tetsuya Tanigawa Toshio Watanabe Kazunari Tominaga yasuhiro fujiwara Kenji Nakamura Tetsuo Arakawa Department of Gastroenterology Graduate School of Medicine Osaka City University Osaka 569-8686 Japan Second Department of Internal Medicine Osaka Medical College Osaka 569-8686 Japan Department of Radiology Graduate School of Medicine Osaka City University Osaka 569-8686 Japan

AIM:To examine the portal hemodynamics of gastric fundal varices (GV) without gastro-renal shunt (GRS), and to retrospectively investigate the effects of various kinds of treatment on eradication. METHODS: Ninety-four liver cirrhosis patients at high- risk of GV were treated in our hospital and enrolled in this study. We retrospectively examined their characteristics, liver function, and portal hemodynamics of GV. We performed balloon-occluded retrograde transvenous obliteration (BRTO) at first. If it was not technically possible to perform BRTO, endoscopic injection sclerotherapy using α-cyanoacrylate glue (CA) or percutaneous transhepatic obliteration (PTO) was performed. RESULTS: Among the 94 patients, a GRS was present in 79 (84.0%), and absent in the remaining 15 (16.0%). The subphrenic vein was connected to the inferior vena cava as the drainage vein in 13 (86.7%) out of the 15 cases without GRS. We performed BRTO in 6 patients, CA in 4 patients and PTO in 5 patients. The eradication rate was 100% for each procedure, but the rate of early recurrence within 6 mo was 16.7% for BRTO, 50.0% for CA and 40.0% for PTO, respectively. CONCLUSION: We should examine the hemodynamics before treatment of GV irrespective of the existence of GRS. If this hemodynamic examination reveals that the drainage vein connects directly to the inferior vena cava in GV without GRS, BRTO may be an effective treatment for GV with GRS.

关键词： Gastric fundal varices Gastro-renal shunt Balloon-occluded retrograde transvenous obliteration

Angle of covered self-expandable metallic stents after placement is a risk factor for recurrent biliary obstruction

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World Journal of Hepatology 2022年第5期14卷 992-1005页

作者： Kojiro Tanoue Hirotsugu Maruyama Yuki Ishikawa-Kakiya Yosuke Kinoshita Kappei Hayashi Masafumi Yamamura Masaki Ominami Yuji Nadatani Shusei Fukunaga Koji Otani Shuhei Hosomi Fumio Tanaka Noriko Kamata Yasuaki Nagami Koichi Taira Toshio Watanabe yasuhiro fujiwara Department of Gastroenterology Osaka City University Graduate School of MedicineOsaka 545-8585Japan

BACKGROUND Studies have shown that covered self-expandable metallic stents(CSEMS)with a low axial forces after placement can cause early recurrent biliary obstruction(RBO)due to precipitating sludge *** To ascertain whether the angle of CSEMS after placement is a risk factor for RBO in unresectable distal malignant biliary obstruction(MBO).METHODS Between January 2010 and March 2019,261 consecutive patients underwent selfexpandable metallic stent insertion by endoscopic retrograde cholangiopancreatography at our facility,and 87 patients were included in this *** evaluated the risk factors for RBO,including the angle of CSEMS after placement as the primary *** measured the obtuse angle of CSEMS after placement on an abdominal radiograph using the SYNAPSE PACS *** also evaluated technical and functional success,adverse events,time to RBO(TRBO),non-RBO rate,survival time,cause of RBO,and reintervention procedure as secondary *** We divided the patients into two cohorts based on the presence or absence of *** angle of CSEMS after placement(per 1°and per 10°)was evaluated using the multivariate Cox proportional hazard analysis,which was an independent risk factor for RBO in unresectable distal MBO[hazard ratio,0.97 and 0.71;95%confidence interval(CI):0.94-0.99 and 0.54-0.92;P=0.01 and 0.01,respectively].For early diagnosis of RBO,the cut-off value of the angle of CSEMS after placement using the receiver operating characteristic curve was 130°[sensitivity,50.0%;specificity 85.5%;area under the curve 0.70(95%CI:0.57-0.84)].TRBO in the<130°angle group was significantly shorter than that in the≥130°angle group(P<0.01).CONCLUSION This study suggests that the angle of the CSEMS after placement for unresectable distal MBO is a risk factor for *** novel results provide pertinent information for future stent management.

关键词： Covered self-expandable metallic stents Recurrent biliary obstruction Malignant biliary obstruction Endoscopic retrograde cholangiopancreatography Angle Axial force

A case of mucosa-associated lymphoid tissue lymphoma forming multiple lymphomatous polyposis in the small intestine

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World Journal of Gastroenterology 2007年第9期13卷 1453-1457页

作者： Naoto Hirata Kazunari Tominaga Kensuke Ohta Kaori Kadouchi Hirotoshi Okazaki Tetsuya Tanigawa Masatsugu Shiba Toshio Watanabe yasuhiro fujiwara Shiro Nakamura Nobuhide Oshitani Kazuhide Higuchi Tetsuo Arakawa Department of Gastroenterology Osaka City University Graduate School of Medicine 1-4-3 Asahimachi Abeno-ku Osaka 545-8585 Japan Department of Hematology Osaka City University Graduate School of Medicine1-4-3 Asahimachi Abeno-kuOsaka 545-8585 Japan Department of Gastroenterology Rinku General Medical Center 2-3 Rinkuouraikita Izumisano Osaka 598-0048Japan

A 50-year old woman suffering from diabetes had a CT scan that revealed a diffuse thickening of small intestinal wall and swollen paraaortic lymph nodes. An esophago gastroduodenoscopy (EGD) confirmed multiple polypoid lesions in the duodenum and small intestine, and conventional histological testing revealed non-specific inflammatory changes. Further examinations including the immunohistochemical profiles of the biopsied specimens led us to diagnose the lesion as a marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue type, forming multiple lymphomatous polyposis sequentially spreading from duodenal bulb to terminal ileum. According to Lugano’s classification, its staging was clinically diagnosed as stage Ⅱ. Two courses of a standard CHOP (cyclophosphamide, doxorubicin hydrochloride, vincristine sulfate, and predonisolone) regimen with rituximab reduced the lesion and the patient had a almost complete response. A 5-year follow- up EGD and histological examinations detected no recurrence of the disease.

关键词： Intestinal lymphoma Hucosa-associated lymphoid tissue lymphoma Hultiple lymphomatous polyposis

Successful treatment of giant rectal varices by modified percutaneous transhepatic obliteration with sclerosant:Report of a case

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World Journal of Gastroenterology 2006年第33期12卷 5408-5411页

作者： Hirotoshi Okazaki Kazuhide Higuchi Masatsugu Shiba Shirou Nakamura Tomoko Wada Kazuki Yamamori Ai Machida Kaori Kadouchi Akihiro Tamori Kazunari Tominaga Toshio Watanabe yasuhiro fujiwara Kenji Nakamura Tetsuo Arakawa Department of Gastroenterology Osaka City University Graduate School of Medicine Osaka Japan Department of Gastroenterology Osaka City University Graduate School of Medicine Osaka Japan Department of Radiology Osaka City University Graduate School of Medicine Osaka Japan

We present a female patient with continuous melena, diagnosed with rectal variceal bleeding. She had a history of esophageal varices, which were treated with endoscopic therapy. Five years after the treatment of esophageal varices, continuous melena occurred. Since colonoscopy showed that the melena was caused by giant rectal varices, we thought that they were not suitable to receive endoscopic treatment. We chose the modified percutaneous transhepatic obliteration with sclerosant, which is one of the interventional radiology techniques but a new clinical procedure for rectal varices. After the patient received this therapy, her condition of rectal varices was markedly improved.

关键词： Rectal varices Modified percutaneoustranshepatic obliteration with sclerosant

Molecular diagnosis and therapy for occult peritoneal metastasis in gastric cancer patients

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World Journal of Gastroenterology 2014年第47期20卷 17796-17803页

作者： Shunsuke Kagawa Kunitoshi Shigeyasu Michihiro Ishida Megumi Watanabe Hiroshi Tazawa Takeshi Nagasaka yasuhiro Shirakawa Toshiyoshi fujiwara Department of Gastroenterological Surgery Okayama University Graduate School of MedicineDentistry and Pharmaceutical SciencesOkayama 700-8558Japan

To apply an individualized oncological approach to gastric cancer patients,the accurate diagnosis of disease entities is *** metastasis is the most frequent mode of metastasis in gastric cancer,and the tumor-node-metastasis classification includes cytological detection of intraperitoneal cancer cells as part of the staging process,denoting metastatic *** accuracy of cytological diagnosis leaves room for improvement;therefore,highly sensitive molecular diagnostics,such as an enzyme immunoassay,reverse transcription polymerase chain reaction,and virusguided imaging,have been developed to detect minute cancer cells in the peritoneal *** targeting therapy has also been spun off from basic research in the past *** conventional cytologyis still the mainstay,novel approaches could serve as practical complementary diagnostics to cytology in near future.

关键词： Gastric cancer Peritoneal lavage Cytology Molecular diagnostic techniques Reverse transcriptase polymerase chain reaction Carcinoembryonic antigen