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Risk factors for perforation during endoscopic retrograde cholangiopancreatography in post-reconstruction intestinal tract

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World Journal of Clinical Cases 2019年第1期7卷 10-18页

作者： Shinichi Takano Mitsuharu Fukasawa Hiroko Shindo Ei Takahashi Sumio Hirose Yoshimitsu Fukasawa Satoshi kawakami Hiroshi Hayakawa Hiroshi yokomichi Makoto Kadokura Tadashi Sato Nobuyuki Enomoto First Department of Internal Medicine Faculty of Medicine University of Yamanashi Yamanashi 409-3898 Japan Department of Health Sciences Interdisciplinary Graduate School and Engineering University of Yamanashi Yamanashi 409-3898 Japan

BACKGROUND Endoscopic retrograde cholangiopancreatography(ERCP) in patients with surgically altered anatomy has been a major challenge to gastrointestinal endoscopists with low success rates for reaching the target site as well as high complication rates. The knowledge of ERCP-related risk factors is important for reducing unexpected *** To identify ERCP-related risk factors for perforation in patients with surgically altered *** The medical records of 187 patients with surgically altered anatomy who underwent ERCP at our institution between April 2009 and December 2017 were retrospectively reviewed. An analysis of patient data, including age, sex, type of reconstruction, cause of surgery, aim of ERCP, success rate of reaching target site,success rate of procedure, adverse events, type of scope, time to reach the target site, and duration of procedure, was performed. In patients with Billroth-Ⅱ reconstruction, additional potential risk factors were the shape of the inserted scope and whether the anastomosis was antecolic or *** All patients(n = 187) had surgical anatomy, such as Billroth-Ⅰ(n = 22), Billroth-Ⅱ(n = 33), Roux-en-Y(n = 54), Child, or Whipple reconstruction(n = 75). ERCP was performed for biliary drainage in 43 cases(23%), stone removal in 29 cases(16%),and stricture dilation of anastomosis in 59 cases(32%). The scope was unable to reach the target site in 17 cases(9%), and an aimed procedure could not be accomplished in 54 cases(29%). Adverse events were pancreatitis(3%),hyperamylasemia(10%), cholangitis(6%), cholestasis(4%), excessive sedation(1%), perforation(2%), and others(3%). Perforation occurred in three cases, all of which were in patients with Billroth-Ⅱ reconstruction; in these patients, further analysis revealed loop-shaped insertion of the scope to be a significant risk for perforation(P = 0.01).CONCLUSION Risk factors for perforation during ERCP in patients with surgically altered anatomy were Billro

关键词： Surgically altered anatomy Billroth-Ⅱ Endoscopic retrograde cholangiopancreatography Perforation

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Gross domestic product and dietary pattern among 49 western countries with a focus on polyamine intake

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Health 2010年第11期2卷 1327-1334页

作者： Phan Nguyen Thanh Binh Kuniyasu Soda Masanobu kawakami 不详

Socioeconomic status is known to affect dietary profile, and differences in food habits and choice may affect polyamine intake due to significant variations in the concentrations of the polyamines spermine, spermidine, and putrescine present in different foods. The relationship between gross domestic product (GDP) and dietary profile, with a focus on polyamine intake, was investigated for 49 different European and other Western countries. The data for food supply and GDP were collected from the database of the United Nations and the International Monetary Fund, respectively, and the amount of polyamine intake from food was estimated using polyamine concentrations listed in published sources. Countries were divided equally according to GDP values into two categories, higher and lower, and the amount and composition of food polyamines as well as dietary profile were compared. Higher GDP countries supply animal products and seafood in greater amounts than lower GDP countries;however, whole milk supply per calorie was higher in lower GDP than higher GDP countries. While crops supply was relatively higher in lower GDP countries, fruit supply was greater in higher GDP countries. Higher GDP was associated with increased amount of spermine and putrescine per total calorie, although spermidine amount per calorie was similar between higher and lower GDP countries. GDP, as an indicator of countries’ socioeconomic status, is associated with the amount and the composition of polyamines as well as dietary pattern.

关键词： GDP Dietary Pattern Polyamine Intake Western Countries

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Dietary characteristics of the Malayan Night Heron (Gorsachius melanolophus) in the Yaeyama Islands,southern Japan

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Chinese Birds 2011年第2期02卷 87-93页

作者： Kazuto kawakami Masaki FUJITA Motohiro HASEGAWA Hiroshi MAKIHARA Forestry and Forest Products Research Institute Okinawa Prefectural Museum and Art Museum

The Malayan Night Heron (Gorsachius melanolophus) inhabits a range of tropical and subtropical zones in South,Southeast and East *** this heron breeds singularly in dense forests,its detailed ecology is not well known and only piecemeal information on its diet is ***,we quantitatively estimated its diet menu with an analysis of pellets and stomach contents in the subtropical Yaeyama Islands of southern *** results showed that the heron frequently foraged on land snails,arachnids,freshwater crabs and insects;no fish were *** the earthworm was believed to be a primary dietary source of this species,it was not detected in our results,as it does not remain in pellets due to its high *** indicated that this bird dominantly depends on soil animals that inhabit humid forest *** the heron does not directly utilize aquatic habitats,they likely prefer moist forests caused by watery environments such as streams and *** forests should be conserved for maintaining populations of this heron species.

关键词： diet Gorsachius melanolophus pellet analysis soil animal

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Refractory ulcerative colitis accompanied with cytomegalovirus colitis and multiple liver abscesses: A case report

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World Journal of Gastroenterology 2005年第33期11卷 5241-5244页

作者： Takuya Inoue Ichiro Hirata Yutaro Egashira Kumi Ishida Ken kawakami Eijiro Morita Naoko Murano Shingo Yasumoto Mitsuyuki Murano Ken Toshina Takashi Nishikawa Norihiro Hamamoto Ken Nakagawa Ken-Ichi Katsu The Second Department of Internal Medicine Osaka Medical College 2-7 DaigakuchoTakatsuki City Osaka 569-8686 Japan Department of Pathology Osaka Medical College Takatsuki City Osaka 569-8686 Japan The Second Department of Internal Medicine Osaka Medical College 2-7 Daigakucho Takatsuki City Osaka 569-8686 Japan

Various hepato-biliary complications are an increased incidence in patients with inflammatory bowel disease,and portal bacteremia is well documented in patients with ulcerative colitis (UC). However, few reports mention UC in association with liver abscesses. Recently, there are several reports describing cytomegalovirus (CMV) infection in association with disease exacerbation and steroid refractoriness in patients with UC. Here we present a case of refractory UC accompanied with multiple liver abscesses and CMV colitis. The patient, a 72-year-old male, with a five-year history of repeated admissions to our hospital for UC, presented with an exacerbation of his *** performed on admission suggested that his UC was exacerbated, then he was given prednisolone and mesalazine orally, and betamethasone ***, he had exacerbated symptoms. Repeat sigmoidoscopy revealed multiple longitudinal ulcers and pseudopolyps in the rectosigmoid colon. Although immunohistochemical staining of biopsy specimens and the serum testing for antigenemia were negative on admission and after the repeat sigmoidoscopy, they became histologically positive for CMV. Nonetheless, the patient developed spiking fevers, soon after ganciclovir was administered. Laboratory studies revealed an increased white cell count with left shift, and Enterococcus fecalis grew in blood cultures. An abdominal computed tomography (CT) scan was obtained and the diagnosis of liver abscesses associated with UC was made, based on CT results. The hepatic abscesses were successfully treated with intravenous meropenem for 6 wk, without further percutaneous drainage. To our knowledge, this is the first reported case of multiple liver abscesses that develop during UC exacerbation complicated by CMV colitis.

关键词： Uver abscess Ulcerative colitis Cytomegalovirusinfection Inflammatory bowel disease

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Influence of substrate misorientation on the emission and waveguiding properties of a blue (In,Al,Ga)N laser-like structure studied by synchrotron radiation microbeam X-ray diffraction

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Photonics Research 2021年第3期9卷 299-307页

作者： A.Kafar A.Sakaki R.Ishii S.Stanczyk K.Gibasiewicz Y.Matsuda D.Schiavon S.Grzanka T.Suski P.Perlin M.Funato Y.kawakami Department of Electronic Science and Engineering Kyoto UniversityKyoto 615-8510Japan Institute of High Pressure Physics PAS Sokolowska 29/3701-142 WarsawPoland Nichia Corporation AnanTokushima 774-8601Japan TopGaN Ltd. Sokolowska 29/3701-142 WarsawPoland

In this work, we study how an epitaxial laser-like(or superluminescent diode-like) structure is modified by intentional changes of the substrate misorientation in the range of 0.5°–2.6°. The 40 μm × 40 μm test structure with misorientation profiling was fabricated using multilevel photolithography and dry-etching. The local structural parameters were measured by synchrotron radiation microbeam X-ray diffraction, with the sampling area of below 1 μm × 1 μm. We directly obtained the relation between the misorientation and indium content in the quantum well, changing from 9% to 18%, with a high resolution(small misorientation step). We also show a good agreement of local photoluminescence emission wavelength with simulation of transition energy based on synchrotron radiation microbeam X-ray diffraction(SR-XRD) data and estimated Stokes shift. We observe that the substrate misorientation influences also the In Ga N waveguide and Al Ga N cladding composition. Still, we showed through simulation of the optical confinement factor of a full laser diode structure that good light guiding properties should be preserved in the whole misorientation range studied here. This proves the usefulness of misorientation modification in applications like broadband superluminescent diodes or multicolor laser arrays.

关键词： structure microbeam blue

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Improvement of the resolution of Photosystem Ⅱ crystals from a thermophilic cyanobacterium Thermosynechococcus vulcanus

Improvement of the resolution of Photosystem Ⅱ crystals fro...

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The 3rd Asian and Oceanian Conference on Photobiology

作者： Keisuke kawakami Akio Okuma Nobuo Kamiya Graduate School of Natural Science and Technology Okayama UniversityTsushima-nakaOkayama 700-8530 Graduate School of Natural Science and Technology Okayama UniversityTsushima-nakaOkayama 700-8530 Division of Molecular Materials Science Graduate School of ScienceOsaka City University 3-3-138 SugimotoSumiyoshi-kuOsaka 558-8585Japan

＜正＞Photosystem Ⅱ （PSⅡ） is a supramolecular complex consisting of 14-16 membrane-spanning subunits, 3 hydrophilic, peripheral subunits, and over 40 cofactors, including chlorophylls, carotenoids, Mn, Ca, Fe, and plastoquinones, with a total molecular mass of 350 kDa for a monomer. PSⅡ exists in thylakoid membranes of oxygenic photosynthetic organisms, and performs light-induced electron transfer and water-splitting reactions, leading to the formation of molecular oxygen. The crystal structure of PSⅡ has been reported at 3.0-3.8 A resolutions by three groups independently （1-3）, which provided important information concerning the position and arrangement of protein subunits as well as various cofactors within this complex. However, the current resolution obtained is not high enough to reveal the full structure of PSⅡ at atomic level, as represented by the most recent structure of PSⅡ at 3.0 A resolution in which, there are three transmembrane helices whose identities were not yet determined （3）.

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Promotive Effects of Yokukansan, a Traditional Japanese Medicine, on Proliferation and Differentiation of Cultured Mouse Cortical Oligodendrocytes

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Pharmacology & Pharmacy 2014年第7期5卷 670-680页

作者： Toshiyuki Ueki Yasushi Ikarashi Zenji kawakami Kazushige Mizoguchi Yoshio Kase Tsumura Research Laboratories Kampo Scientific Strategies Division Tsumura & Co. Ami-machi Japan

Effects of yokukansan, a traditional Japanese medicine, on proliferation and differentiation of oligodendrocytes were examined using purified mouse cortical oligodendrocyte precursor cells (OPCs). OPCs were cultured for four days, and proliferation was evaluated by counting A2B5 (a specific antibody to OPC)-reactive cells on the second day of cell culture. Differentiation from OPC to oligodendrocyte was evaluated by counting O4 (a specific antibody to detect differentiated cells in various stages)-reactive cells on the fourth day of culture. The effects of yokukansan (final concentration: 100 or 200 μg/ml) on proliferation and differentiation were examined by adding it to the medium for four days. Yokukansan increased not only the number of A2B5-positive cells on the second day but also the number of O4-positive cells on the fourth day compared to those in the corresponding controls. A WST-8 assay was used to identify active components from seven components of Uncaria Hook (UH), one of the constituent galenicals of yokukansan. Geissoschizine methyl ether (GM: 0.1 - 3.0 μM) was identified by this screening assay and increased the number of A2B5-positive cells on the second day and O4-positive cells on the fourth day as yokukansan did. These results suggest that yokukansan promotes the proliferation and differentiation of oligodendrocytes, and also that GM contained in UH is one of active components responsible for this effect of yokukansan.

关键词： Yokukansan Oligodendrocyte Proliferation Differentiation Geissoschizine Methyl Ether

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Relationship between food polyamines and gross domestic product in association with longevity in Asian countries

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Health 2010年第12期2卷 1390-1396页

作者： Phan Nguyen Thanh Binh Kuniyasu Soda Chizuko Maruyama Masanobu kawakami 不详

The relationship between gross domestic pro- duct (GDP) and dietary profile, with a focus on polyamine intake, was investigated in 35 Asian countries. Data on food supply, GDP, and health condition were collected from databases of the United Nations, the International Monetary Fund, and the World Health Organization, respectively. The amount of polyamine intake from food was estimated using polyamine concentrations listed in published sources. The amounts of putrescine, spermidine, spermine, and total polyamines in 1000 kcal of food in Asian countries were 39.07 ± 17.98, 33.74 ± 14.35, 14.05 ± 6.60 and 86.85 ± 33.96 μmol/1000 kcal, respectively. Putrescine, spermidine, and spermine constituted 44, 39, and 17% of total polyamine, respectively. Vegetables contributed the largest amount of both putrescine and spermidine and the second largest amount of spermine (45.5%, 62.2% and 27.2% of total putrescine, spermidine, and spermine, respectively). Meat was the richest source of spermine and contributed the greatest amount (50%) of this polyamine. We showed a significant positive association between GDP and the amount of polyamine per 1000 kcal of food. Lifespan was associated with both GDP and the amount of polyamine per energy quotient of food. As several basic research studies have shown that polyamines help prolong longevity, it follows that polyamines may have a role in determining the lifespan of humans.

关键词： Polyamine GDP Longevity Cardiovascular Diseases Food

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Lignan Glycosides and Phenolic Compound Glycosides from the Branches of <i>Tabebuia chrysotricha</i>

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American Journal of Plant Sciences 2015年第5期6卷 676-684页

作者： Shinji Takahashi Susumu kawakami Sachiko Sugimoto Katsuyoshi Matsunami Hideaki Otsuka Graduate School of Biomedical and Health Sciences Hiroshima University Hiroshima Japan Faculty of Pharmacy Yasuda Women’s University Hiroshima Japan

From the branches of Tabebuia chrysotricha (Bignoniaceae), two lignan glycosides (1, 2) and two phenolic compound glycosides (3, 4) were isolated, along with 15 known compounds (5 - 19). The structures of the new compounds were elucidated on the basis of spectroscopic evidence and those of the known compounds were identified by comparison of spectroscopic data with those reported in the literature. The DPPH radical-scavenging activity was assayed for the compounds isolated, the aryltetralin-type lignans showing moderate activity.

关键词： Tabebuia chrysotricha Bignoniaceae Lignan Glycoside Phenolic Glycoside DPPH Radical-Scavenging Activity

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Low-dose intermittent interferon-alpha therapy for HCV-related liver cirrhosis after curative treatment of hepatocellular carcinoma

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World Journal of Gastroenterology 2007年第39期13卷 5188-5195页

作者： Soocheol Jeong Hiroshi Aikata Yoshio Katamura Takahiro Azakami Tomokazu Kawaoka Hiromi Saneto Kiminori Uka Nami Mori Shintaro Takaki Hideaki Kodama Koji Waki Michio Imamura Hiroo Shirakawa Yoshiiku kawakami Shoichi Takahashi Kazuaki Chayama Department of Medicine and Molecular Science Division of Frontier Medical Science Programs for Biomedical Research Graduate School of Biomedical Sciences Hiroshima University Hiroshima 734-8551 Japan

AIM: To assess the efficacy of low-dose intermittent interferon (IFN) therapy in patients with hepatitis C virus (HCV)-related compensated cirrhosis who had received curative treatment for primary hepatocellular carcinoma (HCC). METHODS: We performed a prospective case controlled study. Sixteen patients received 3 MIU of natural IFN- alpha intramuscularly 3 times weekly for at least 48 wk (IFN group). They were compared with 16 matched historical controls (non-IFN group). RESULTS: The cumulative rate of first recurrence of HCC was not significantly different between the IFN group and the non-IFN group (0% vs 6.7% and 68.6% vs 80% at 1- and 3-year, P = 0.157, respectively). The cumulative rate of second recurrence was not also significantly different between the IFN group and the non-IFN group (0% vs 6.7% and 35.9% vs 67% at 1- and 3-year, P = 0.056, respectively). Although the difference in the Child-Pugh classification score between the groups at initial treatment of HCC was not signifi cant, the score was signifi cantly worse at the time of data analysis in the non-IFN group than IFN group (7.19 ± 1.42 vs 5.81 ± 0.75, P = 0.0008). The cumulative rate of deviation from objects of any treatment for recurrentHCC was also higher in the non-IFN group than IFN group (6.7% and 27% vs 0 and 0% at 1- and 3-year, P = 0.048, respectively). CONCLUSION: Low-dose intermittent IFN-alpha therapy for patients with HCV-related compensated cirrhosis after curative HCC treatment was effective by making patients tolerant to medical or surgical treatment for recurrent HCC in the later period of observation.

关键词： Hepatitis C virus Hepatocellular carcinoma Interferon therapy Liver cirrhosis Liver function Recurrence Survival

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