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Low-molecular-weight dextran for optical coherence tomography may not be protective against kidney injury in patients with renal insufficiency

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World Journal of Nephrology 2021年第2期10卷 8-20页

作者： Toru Misawa Tomoyo Sugiyama yoshihisa kanaji Masahiro Hoshino Masao Yamaguchi Masahiro Hada Tatsuhiro Nagamine Kai Nogami Yumi Yasui Eisuke Usui Tetsumin Lee Taishi Yonetsu Tetsuo Sasano Tsunekazu Kakuta Department of Cardiovascular Medicine Tsuchiura Kyodo General HospitalIbaraki 300-0028Japan Department of Interventional Cardiology Tokyo Medical and Dental UniversityTokyo 113-8519Japan Department of Cardiovascular Medicine Tokyo Medical and Dental UniversityTokyo 113-8519Japan

BACKGROUND Low-molecular-weight dextran(LMWD)is considered a safe alternative to contrast media for blood displacement during optical coherence tomography(OCT)*** To investigate whether the use of LMWD for OCT is protective against kidney injury in patients with advanced renal *** In this retrospective cohort study,we identified 421 patients with advanced renal insufficiency(estimated glomerular filtration rate<45 mL/min/1.73 m2)who underwent coronary angiography or percutaneous coronary intervention;79 patients who used additional LMWD for OCT imaging(LMWD group)and 342 patients who used contrast medium exclusively(control group).We evaluated the differences between these two groups and performed a propensity score-matched subgroup *** The median total volume of contrast medium was 133.0 mL in the control group vs 140.0 mL in the LMWD *** baseline renal function was not statistically different between these two groups,the LMWD group demonstrated a strong trend toward the progression of renal insufficiency as indicated by the greater change in serum creatinine level during the 1-year follow-up compared with the control *** in the LMWD group experienced worsening renal function more frequently than patients in the control *** score matching adjusted for total contrast media volume consistently indicated a trend toward worsening renal function in the LMWD group at the 1-year *** serum creatinine at 1-year follow-up was significantly greater in the LMWD group than that in the control group[0.06(-0.06,0.29)vs-0.04(-0.23,0.08)mg/dL,P=0.001],despite using similar contrast *** OCT using LMWD may not be protective against worsening renal function in patients with advanced renal insufficiency.

关键词： Coronary artery disease Kidney injury Contrast media Dextran Optical coherence tomography Renal insufficiency

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Characteristics of multiple nodules in a patient with pulmonary Langerhans cell histiocytosis: A case report

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World Journal of Clinical Cases 2019年第17期7卷 2519-2525页

作者： Nobuhiro kanaji Yoshimasa Tokunaga Ryou Ishikawa Naoki Watanabe Norimitsu Kadowaki Department of Internal Medicine Division of HematologyRheumatology and Respiratory MedicineFaculty of MedicineKagawa UniversityKagawa 761-0793Japan Department of General Thoracic Surgery Breast and Endocrinological SurgeryFaculty of MedicineKagawa UniversityKagawa 761-0793Japan Department of Diagnostic Pathology Faculty of MedicineKagawa UniversityKagawa 761-0793Japan

BACKGROUND The common computed tomography findings of pulmonary Langerhans cell histiocytosis (PLCH) are multiple cysts and micronodules predominantly in middle to upper lung ***-cystic nodules and large nodules are atypical findings of *** SUMMARY The patient was a 48-year-old Japanese man with a smoking history (20 cigarettes/d,28 years) and no *** nodules existed in all lung lobes,predominantly in the right lower *** nodules seemed to be distributed randomly,and others were adjacent to *** nodules were solid;some small ones were *** largest nodule was 22 mm in *** metastatic lung tumors were suspected,thoracoscopic lung biopsy led to the diagnosis of *** 6 months after he quit smoking,all nodules had almost *** investigated the characteristics of nodules at diagnosis in *** 349 nodules in total,116 were in upper and 199 were in lower ***-six (27.5%) were cystic;the remaining 253 (72.5%) were *** prevalence of cystic nodules was higher in upper lobes than in lower lobes (right upper 37.5% vs lower 18.2%,P = 0.0068;left upper 48.1% vs lower 24.4%,P = 0.0078).The average size (dia.) of cystic nodules was smaller than that of noncystic nodules (5.03 mm vs 7.40 mm,respectively,P < 0.0001).CONCLUSION Although multiple non-cystic nodules including large nodules (over 20 mm) are atypical,PLCH should be included in differential *** presence of small cystic nodules predominantly in upper lobes and asymptomatic situation are also important for differential diagnoses to distinguish from metastatic cancers.

关键词： Langerhans cell histiocytosis Multiple Non-cystic Nodule Distribution Size Case report

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Paraneoplastic syndromes associated with lung cancer

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World Journal of Clinical Oncology 2014年第3期5卷 197-223页

作者： Nobuhiro kanaji Naoki Watanabe Nobuyuki Kita Shuji Bandoh Akira Tadokoro Tomoya Ishii Hiroaki Dobashi Takuya Matsunaga Department of Internal Medicine Division of Endocrinology and Metabolism Hematology Rheumatology and Respiratory MedicineFaculty of MedicineKagawa University

Paraneoplastic syndromes are signs or symptoms that occur as a result of organ or tissue damage at locations remote from the site of the primary tumor or metastases. Paraneoplastic syndromes associated with lung cancer can impair various organ functions and include neurologic, endocrine, dermatologic, rheumatologic, hematologic, and ophthalmological syndromes, as well as glomerulopathy and coagulopathy(Trousseau's syndrome). The histological type of lung cancer is generally dependent on the associated syndrome, the two most common of which are humoral hypercalcemia of malignancy in squamous cell carcinoma and the syndrome of inappropriate antidiuretic hormone secretion in small cell lung cancer. The symptoms often precede the diagnosis of the associated lung cancer, especially when the symptoms are neurologic or dermatologic. The proposed mechanisms of paraneoplastic processes include the aberrant release of humoral mediators, such as hormones and hormone-like peptides, cyto-kines, and antibodies. Treating the underlying cancer is generally the most effective therapy for paraneoplastic syndromes, and treatment soon after symptom onset appears to offer the best potential for symptom improvement. In this article, we review the diagnosis, potential mechanisms, and treatments of a wide variety of paraneoplastic syndromes associated with lung cancer.

关键词： Paraneoplastic syndrome Small cell lung cancer Non-small cell lung cancer Symptom Diagnosis Treatment Endocrine Neurologic Hematologic Trousseau’s syndrome

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Appendicitis with psoas abscess successfully treated by laparoscopic surgery

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World Journal of Gastroenterology 2014年第25期20卷 8317-8319页

作者： Yasunori Otowa Yasuo Sumi Shingo kanaji Kiyonori Kanemitsu Kimihiro Yamashita Tatsuya Imanishi Tetsu Nakamura Satoshi Suzuki Kenichi Tanaka Yoshihiro Kakeji Division of Gastrointestinal Surgery Department of SurgeryKobe University Graduate School of Medicine 7-5-2 Kusunokichou Chuo-ku Kobe Hyogo Prefecture 650-0017 Japan Division of Gastrointestinal Surgery Department of SurgeryKobe University Graduate School of Medicine7-5-2 KusunokichouChuo-ku KobeHyogo Prefecture 650-0017Japan

Although acute appendicitis is a common disease, retroperitoneal abscesses are rarely observed. Here, we report a case consisting of a psoas abscess and cutaneous fistula caused by appendicitis. The patient was a 56-year-old male who was introduced to our institution due to an intractable right psoas abscess. Imaging tests had been performed over the previous 3 years; however, clinicians could not find the origin of the abscess and failed to resolve the problem. A successful operation was performed via a laparoscopic approach, and 17 mo have passed without recurrence. The advantage of laparoscopic surgery is well understood in cases of appendicitis with abscesses. However, the indication for laparoscopic approach is not clear for retroperitoneal abscesses. From our experience, we can conclude that appendicitis with retroperitonealabscesses can be managed and treated using a laparoscopic approach.

关键词： Appendicitis Laparoscopic surgery Psoas abscess Retroperitoneal abscess Right leg pain

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Laparoscopic partial resection for hemangioma in the third portion of the duodenum

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World Journal of Gastroenterology 2014年第34期20卷 12341-12345页

作者： Shingo kanaji Tetsu Nakamura Masayasu Nishi Masashi Yamamoto Kiyonori Kanemitu Kimihiro Yamashiita Tatsuya Imanishi Yasuo Sumi Satoshi Suzuki Kenichi Tanaka Yoshihiro Kakeji Department of Gastrointestinal Surgery Faculty of MedicineHyogo 650-0017Japan

Benign duodenal tumors are rare and less commonthan malignant ***,vascular lesionsof the duodenum,including hemangiomas,are rarecauses of gastrointestinal *** report describes a case with bleeding hemangiomas in the thirdportion of the duodenum and jejunum and their successful treatment using a laparoscopic *** no report of totally laparoscopic resection for tumorin the third portion of *** performinga laparoscopic Kocher maneuver,the location of theduodenal hemangioma was confirmed by endoscopicand laparoscopic *** lesion was excisedusing ultrasonic coagulating shears and the defect inthe duodenal wall was sutured *** of the jejunum was treated extracorporeally through a 3.0 cm umbilical *** operatingtime was 241 min and blood loss was *** course was *** benign duodenal tumors in the third portion,if endoscopic resection is not adapted,this less invasive technique may be a standard treatment.

关键词： Hemangioma Third portion Duodenum Total laparoscopic resection

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Space Charge Effects in CSL Gauge——with previously assumed charge distribution

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真空科学与技术学报 1992年第Z1期23卷 83-86页

作者： T.kanaji T.Urano S.Hongo Eaculty of Engineermg Kobe University Rokko Nada Kobe Japan-657Eaculty of Engineermg Kobe University Rokko Nada Kobe Japan-657Eaculty of Engineermg Kobe University Rokko Nada Kobe Japan-657

The "cascade static lens （CSL） gauge" has a high sensitivity（S） because the emitted electrons repeat the go and back oscillation before they are received by the electrodes. (S=18.6 Pa-1 (2480 Torr-1 in a

关键词： CSL with previously assumed charge distribution Space Charge Effects in CSL Gauge

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Local advanced rectal cancer perforation in the midst of preoperative chemoradiotherapy:A case report and literature review

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World Journal of Clinical Cases 2017年第1期5卷 18-23页

作者： Nobuhisa Takase Kimihiro Yamashita Yasuo Sumi Hiroshi Hasegawa Masashi Yamamoto Shingo kanaji Yoshiko Matsuda Takeru Matsuda Taro Oshikiri Tetsu Nakamura Satoshi Suzuki Yu-Ichiro Koma Masato Komatsu Ryohei Sasaki Yoshihiro Kakeji Division of Gastrointestinal Surgery Department of Surgery Kobe University Graduate School of Medicine Division of Pathology Department of Pathology Kobe University Graduate School of Medicine Division of Diagnostic Pathology Department of Pathology Kobe University Graduate School of Medicine Department of Surgery Hyogo Cancer Center Department of Radiation Oncology Kobe University Graduate School of Medicine

Standard chemoradiotherapy(CRT) for local advanced rectal cancer(LARC) rarely induce rectal perforation. Here we report a rare case of rectal perforation in a patient with LARC in the midst of preoperative CRT. A 56-year-old male was conveyed to our hospital exhibiting general malaise. Colonoscopy and imaging tests resulted in a clinical diagnosis of LARC with direct invasion to adjacent organs and regional lymphadenopathy. Preoperative 5-fluorouracil-based CRT was started. At 25 d after the start of CRT, the patient developed a typical fever. Computed tomography revealed rectal perforation, and he underwent emergency sigmoid colostomy. At 12 d after the surgery, the remaining CRT was completed according to the original plan. The histopathological findings after radical operation revealed a wide field of tumor necrosis and fibrosis without lymph node metastasis. We share this case as important evidence for the treatment of LARC perforation in the midst of preoperative CRT.

关键词： Local advanced rectal cancer Preoperative chemoradiotherapy Rectal perforation 5-fluorouracil Tumor necrosis

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Effects of Subcutaneous Closed Suction Drain for the Prevention of Incisional SSI in Patients with Colorectal Perforation

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Surgical Science 2014年第3期5卷 122-127页

作者： Yasuo Sumi Kimihiro Yamashita Kiyonori Kanemitsu Shingo kanaji Masashi Yamamoto Tatsuya Imanishi Tetsu Nakamura Satoshi Suzuki Kenichi Tanaka Yoshihiro Kakeji Division of Gastrointestinal Surgery department of SURGERY Kobe University Graduate School of Medicine Kobe Japan

Objective: To determine if a subcutaneous closed suction drain decreases the incidence of wound complications in patients undergoing emergency surgery for colorectal perforation. Materials and Methods: Data on 47 patients who underwent emergency operations for colorectal perforation were examined retrospectively. The clinical features of these cases with or without the use of the J-VACTM Drainage System were examined, and statistical analysis was performed. Results: In these high-risk cases, the overall incidence of incisional surgical site infection (SSI) was 36.2%. The incidence of incisional SSI in these cases with and without the J-VACTM Drainage System was 16.7% and 56.5%, respectively. Conclusion: Our results suggest that a subcutaneous closed suction drain is effective for preventing incisional SSI in patients who have undergone emergency operations for colorectal perforation.

关键词： Surgical Wound Infection Intestinal Perforation Closed Suction Drainage Emergency Operation

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EGFR mutation identifies distant squamous cell carcinoma as metastasis from lung adenocarcinoma

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World Journal of Respirology 2013年第2期3卷 38-43页

作者： Nobuhiro kanaji Shuji Bandoh Toshitetsu Hayashi Reiji Haba Naoki Watanabe Tomoya Ishii Asako Kunitomo Takayuki Takahama Akira Tadokoro Osamu Imataki Hiroaki Dobashi Takuya Matsunaga Division of Endocrinology and Metabolism Hematology Rheumatology and Respiratory Medicine Department of Internal Medicine Faculty of Medicine Kagawa University Kagawa 761-0793 Japan Department of Diagnostic Pathology Faculty of Medicine Kagawa University Kagawa 761-0793 Japan

Lung cancer metastasis is typically determined by histologic similarity between distant and primary lesions. Herein, we present a 70-year-old Japanese woman with an adenocarcinoma in her lung and a squamous cell carcinoma in her femur; both tumors had an identical epidermal growth factor receptor mutation, G719 S. This indicated that both tumors had a common origin, despite their histologic dissimilarity. The tumor in the femur was thus identified genetically as a lung cancer metastasis. This case suggests that genetic analysis can determine whether a distant lesion is a lung cancermetastasis, particularly when the histology differs from that of the primary lesion.

关键词： Non-small cell lung cancer Adenocarcinoma Squamous cell carcinoma Epidermal growth factor receptor mutation G719 Metastasis

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冠状动脉中度狭窄病人在冠状动脉CT血管成像上微血管功能障碍的特征性表现

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国际医学放射学杂志 2022年第1期 122-123页

作者： M.Hoshino S.Yang T.Sugiyama J.Zhang Y.kanaji R.Hamaya 汤若薇

摘要目的评估冠状动脉中度狭窄病人并发冠状动脉微血管功能障碍（CMD）的患病率，并分析冠状动脉CT血管成像（CCTA）上病灶、血管及心包脂肪与CMD相关的特征性

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