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Early colonoscopy and urgent contrast enhanced computed tomography for colonic diverticular bleeding reduces risk of rebleeding

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World Journal of Clinical Cases 2021年第11期9卷 2446-2457页

作者： Masanori Ochi Toshiro Kamoshida Yukako Hamano Atsushi Ohkawara Haruka Ohkawara Nobushige Kakinoki yuji yamaguchi Shinji Hirai Akinori Yanaka Department of Gastroenterology Hitachi General HospitalIbaraki 317-0077Japan Hitachi Medical Education and Research Center University of TsukubaIbaraki 317-0077Japan

BACKGROUND Colonoscopy within 24 h of hospital admission for colonic diverticular bleeding(CDB)is ***,little is known about rates of rebleeding within 30 *** posited that a group of patients who underwent contrast-enhanced computed tomography(CT)within 4 h of the last hematochezia and colonoscopy within 24 h would experience fewer incidences of *** To evaluate the outcomes of early colonoscopy for CDB among different groups of *** Data from 182 patients with CDB who underwent contrast-enhanced CT and colonoscopy between January 2011 and December 2018 at the study site were retrospectively *** were divided into groups based on the timing of the CT imaging,within or at 4 h were defined as urgent CTs(n=100)and those performed after 4 h were defined as elective CTs(n=82).Main outcomes included rebleeding within 30 d and the identification of stigmata of recent hemorrhage(SRH)(i.e.,active bleeding,non-bleeding visible vessels,or adherent clots).RESULTS In total,182 patients(126 men and 56 women)with median ages of 68.6(range,37-92)and 73.7(range,48-93)years,respectively,underwent CT imaging and colonoscopy within 24 h of the last *** for whom CT was performed within 4 h of the last hematochezia were included in the urgent CT group(n=100)and patients for whom CT was performed after 4 h were included in the elective CT group(n=82).SRH were identified in 35.0%(35/100)of the urgent CT cases and 7.3%(6/82)of the elective CT cases(P<0.01).Among all patients with extravasation-positive images on CT,SRH was identified in 31 out of 47 patients(66.0%)in the urgent CT group and 4 out of 20 patients(20.0%)in the elective CT group(P<0.01).Furthermore,rates of rebleeding within 30 d were significantly improved in the urgent CT and extravasation-positive cases(P<0.05).Results from the evaluation of early colonoscopy did not show a difference in the ability to detect SRH identification or rebleeding *** case

关键词： Colonoscopy Gastrointestinal hemorrhage Colon Diverticular diseases Xray computed tomography

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High total Joule heat increases the risk of post-endoscopic submucosal dissection electrocoagulation syndrome after colorectal endoscopic submucosal dissection

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World Journal of Gastroenterology 2021年第38期27卷 6442-6452页

作者： Masanori Ochi Ryosuke Kawagoe Toshiro Kamoshida Yukako Hamano Haruka Ohkawara Atsushi Ohkawara Nobushige Kakinoki yuji yamaguchi Shinji Hirai Akinori Yanaka Kiichiro Tsuchiya Department of Gastroenterology Hitachi General HospitalHitachi City 317-0077IbarakiJapan Department of Gastroenterology Faculty of MedicineUniversity of TsukubaTsukuba 305-8576IbarakiJapan

BACKGROUND We hypothesized that thermal damage accumulation during endoscopic submucosal dissection(ESD)causes the pathogenesis of post-ESD electrocoagulation syndrome(PECS).AIM To determine the association between Joule heat and the onset of *** We performed a retrospective cohort study in patients who underwent colorectal ESD from May 2013 to March 2021 in *** developed a novel device that measures swift coagulation time with a sensor adjacent to the electrosurgical coagulation unit foot switch,which enabled us to calculate total Joule *** was defined as localized abdominal pain(visual analogue scale≥30 mm during hospitalization or increased by≥20 mm from the baseline)and fever(temperature≥37.5 degrees or white blood cell count≥10000μ/L).Patients exposed to more or less than the median Joule heat value were assigned to the high and low Joule heat groups,*** analyses included Mann-Whitney U and chisquare tests and logistic regression and receiver operating characteristic curve(ROC)*** We evaluated 151 *** PECS incidence was 10.6%(16/151 cases),and all patients were followed conservatively and discharged without severe *** multivariate analysis,high Joule heat was an independent PECS risk *** area under the ROC curve showing the correlation between PECS and total Joule heat was high[0.788(95%confidence interval:0.666-0.909)].CONCLUSION Joule heat accumulation in the gastrointestinal wall is involved in the onset of ***-related thermal damage to the peeled mucosal surface is probably a major component of the mechanism underlying PECS.

关键词： Post-endoscopic submucosal dissection electrocoagulation syndrome Joule heat Colorectal endoscopic submucosal dissection Colorectal neoplasms Electrocoagulation Gastrointestinal tract

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Therapeutic Comparison between Sun Irradiation vs. Narrowband UVB Phototherapy along with Concomitant Topical Tacalcitol for Vitiligo Vulgaris

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Journal of Cosmetics, Dermatological Sciences and Applications 2012年第2期2卷 88-91页

作者： Atsushi Tanemura Aya Takahashi Yuriko Ueki Hiroyuki Murota yuji yamaguchi Ichiro Katayama Department of Dermatology Graduate School of Medicine Osaka University Osaka Japan Department of Geriatric and Environmental Dermatology Nagoya City University Graduate School of Medical Sciences Nagoya Japan

In addition to therapeutic options such as steroid ointment, immunosuppressive drug and ultraviolet phototherapy, recent reports have demonstrated the clinical efficacy of topical vitamin D3 for vitiligo vulgaris. However, there seems to be little clinical effect of vitamin D3 without UV exposure. In the present study, we evaluated the clinical difference of sun irradiation vs. narrowband UVB in combination with tacalcitol assessing the change of lesion size and color tone by a spectrophotometer. Thirty-three vitiligo patients were composed of 19 treated with sun illumination and 14 treated with narrowband UVB in combination with topical use of tacalcitol. The mean % size reduction was higher in the group of sunbathing than narrowband UVB (29% vs. 23%). Delta L score, which represented the difference of whiteness between lesional and perilesional skin, was significantly improved after treatment in the group of sun irradiation instead of narrowband UVB (p = 0.0023). Therefore, we consider that sun illumination along with tacalcitol may be able to induce natural repigmentation and be an alternative therapeutic option for vitiligo vulgaris.

关键词： Vitiligo Tacalcitol [1α24(OH)2D3] Sun Irradiation Narrowband UVB

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Characterization of Corrinoid Compounds in the Edible Cyanobacterium <i>Nostoc flagelliforme</i>the Hair Vegetable

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Food and Nutrition Sciences 2014年第4期5卷 334-340页

作者： Fei Teng Tomohiro Bito Shigeo Takenaka Hiroyuki Takenaka yuji yamaguchi Yukinori Yabuta Fumio Watanabe Department of Veterinary Science Graduate School of Life and Environmental Sciences Osaka Prefecture University Osaka Japan Division of Applied Bioresources Chemistry The United Graduate School of Agricultural Sciences Tottori University Tottori Japan MAC Gifu Research Institute MicroAlgae Corporation Gifu Japan.

Vitamin B12 contents in the edible cyanobacterium Nostoc flagelliforme, also known as hair vegetable, were assayed using a microbiological method. We detected high vitamin B12 contents in samples of naturally grown cells (109.2 ± 18.5 μg/100g dry weight) and cultured cells (120.2 ± 53.6 μg/100g dry weight). However, commercially available hair vegetable samples, which comprised fake substitutes and Nostoc, had variable contents (4.8 - 101.6 μg/100g dry weight) because concomitant fake items contain very low vitamin B12 contents. To evaluate whether natural and cultured N. flagelliforme samples contained vitamin B12 or pseudovitamin B12, corrinoid compounds were purified and identified as pseudovitamin B12 (approximately 72%) and vitamin B12 (approximately 28%) using silica gel 60 TLC bioautography and LC/MS. The results suggested that N. flagelliforme contains substantial amounts of pseudovitamin B12, which is inactive in humans.

关键词： Edible Cyanobacteria Hair Vegetable Nostoc flagelliforme Pseudovitamin B12 Vitamin B12

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Evaluation of the Tokyo Cognitive Assessment for Predicting Cognitive Impairment in Rehabilitation Users

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Open Journal of Therapy and Rehabilitation 2022年第2期10卷 54-61页

作者： Hiroya Miyabara Seigo Koura Moemi Matsuo Makoto Uchinoura Yuki Kishikawa yuji yamaguchi Youhei Komatsu Seijiro Nishimura Shinichi Shibata Hajime Shibata Faculty of Rehabilitation Nishikyusyu University Kanzaki City Japan Kurume Rehabilitation Hospital Kurume City Japan

[Purpose] This study aimed to evaluation of the Tokyo cognitive assessment (Toca) for predicting cognitive impairment in rehabilitation users. [Method] The variables of age, BMI, educational background, Toca for 36 rehabilitation users and 22 healthy elder were assessed. We compared cognitive functions in rehabilitation users who need support and healthy elders. [Results] Of the Toca 1 to 11 trials, there was a significant difference other than 9, 10 rials. The Toca scores with 8 points higher were significantly higher in healthy elders than in rehabilitation users. The area under the receiver-operator curve (AUC) for predicting mild cognitive impairment (MCI) by the Toca was 0.874. Using a cut-off point of 19/20, the Toca demonstrated a sensitivity of 83.9% and a sensitivity of 85.0% in diagnosing MCI. [Conclusion] The Toca is a brief cognitive screening tool with high sensitivity and specificity for detecting MCI as currently conceptualized in rehabilitation users.

关键词： Tokyo Cognitive Assessment Mild Cognitive Impairment Rehabilitation Users

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Correlations between Motor Ability with Gait Speed and Cognitive Functions in Rehabilitation Users

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Open Journal of Therapy and Rehabilitation 2022年第1期10卷 1-8页

Purpose: To compare and examine motor and cognitive functions in people who require support, and in healthy elders. Method: The variables of age, BMI, educational background, blood pressure, grip strength, knee extension, gait speed, MMSE, and subjective health feeling for 36 rehabilitation users and 22 healthy elders were assessed. We compared and examined motor and cognitive functions in rehabilitation users who need support and healthy elders. Results: The percentage of MMSE scores with 27 points or higher and that of subjective health feeling with 3 points or higher were significantly higher in healthy elders than in rehabilitation users. Systolic and diastolic blood pressure were significantly higher in rehabilitation users than in healthy elders. Gait speed and MMSE scores were significantly higher in healthy elders than rehabilitation users. Conclusion: Gait speed could be used for physical fitness in elders. Gait speed was the best physical fitness measurement for elders. Gait speed of rehabilitation users was strongly related to MMSE scores. Gait speed could be a determinant of MMSE scores.

关键词： Elderly Gait Speed Motor Ability Rehabilitation Users The Long-Term Care Insurance

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A new approach to transfect NF-κB decoy oligodeoxynucleotides into the periodontal tissue using the ultrasound-microbubble method

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International Journal of Oral Science 2017年第2期9卷 80-86页

作者： Hiroyuki yamaguchi yuji Ishida Jun Hosomichi Jun-ichi Suzuki Risa Usumi-Fujita Yasuhiro Shimizu Sawa Kaneko Takashi Ono Department of Orthodontic Science Graduate School of Medical and Dental SciencesTokyo Medical and Dental UniversityTokyoJapan Department of Advanced Clinical Science and Therapeutics Graduate School of MedicineThe University of TokyoTokyoJapan

The objective of this study is to investigate the effect of the ultrasound-microbubble technique in nuclear factor kappa B(NF-κB) decoy oligodeoxynucleotide(ODN) transfection in the gingival tissue in mice. The 6-FAM-labeled scrambled decoy ODN with microbubbles was applied to the periodontal tissue in 8-week-old male C57BL/6J mice by ultrasound radiation at low(LUM-Sc) and high(HUM-Sc) intensities to optimize the transfection condition of the ultrasound-microbubble *** inspections were performed two hours after transfection to compare the expression with that in the sham-operated group without ultrasound radiation(A-Sc). Then, an NF-κB decoy was transfected into the periodontal tissue using the highintensity ultrasound-microbubble(HUM-NF) technique to examine the anti-inflammatory effects of the decoy ODN. Western blot analysis was performed to investigate the expression of interleukin(IL)-1β, IL-6 and intercellular adhesion molecule-1(ICAM-1)in the gingival tissues in the HUM-Sc, the HUM-NF and control groups. The fluorescence microscopy results showed that the fluorescent intensity in the periodontal tissues in the LUM-Sc and HUM-Sc groups was significantly higher than that in the A-Sc and the control groups. The fluorescent intensity in the HUM-Sc group, especially in the gingival connective tissue,was the highest of all groups. Western blot analysis indicated that the protein expression levels of IL-1β, IL-6 and ICAM-1 in the HUM-NF group were significantly lower than those in the HUM-Sc and the control groups. These findings suggest that the high-intensity ultrasound-microbubble technique is an effective tool for decoy transfection into the periodontal tissue.

关键词： decoy oligodeoxynucleotide gene therapy periodontal tissue ultrasound

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Lateral pelvic lymph nodes for rectal cancer:A review of diagnosis and management

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World Journal of Gastrointestinal Oncology 2021年第10期13卷 1412-1424页

作者： Shimpei Ogawa Michio Itabashi yuji Inoue Takeshi Ohki Yoshiko Bamba Kurodo Koshino Ryosuke Nakagawa Kimitaka Tani Hisako Aihara Hiroka Kondo Shigeki yamaguchi Masakazu Yamamoto Department of Surgery Institute of GastroenterologyTokyo Women's Medical UniversityTokyo 162-8666Japan

The current status and future prospects for diagnosis and treatment of lateral pelvic lymph node(LPLN)metastasis of rectal cancer are described in this *** resonance imaging(MRI)is recommended for the diagnosis of LPLN metastasis.A LPLN-positive status on MRI is a strong risk factor for metastasis,and evaluation by MRI is important for deciding treatment *** dissection(LPLD)has an advantage of reducing recurrence in the lateral pelvis but also has a disadvantage of complications;therefore,LPLD may not be appropriate for cases that are less likely to have LPLN *** therapy(RT)and chemoradiation therapy(CRT)have limited effects in cases with suspected LPLN metastasis,but a combination of preoperative CRT and LPLD may improve the treatment ***,RT and CRT plus selective LPLD may be a rational strategy to omit unnecessary LPLD and produce a favorable treatment outcome.

关键词： Diagnosis Treatment Rectal cancer Lateral pelvic lymph node metastasis Lateral pelvic lymph node dissection Radiotherapy

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Successful treatment of conversion chemotherapy for initially unresectable synchronous colorectal liver metastasis

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World Journal of Gastroenterology 2015年第6期21卷 1982-1988页

作者： Kenta Baba Akihiko Oshita Mohei Kohyama Satoshi Inoue Yuta Kuroo Takuro yamaguchi Hiroyuki Nakamura Yoichi Sugiyama Tatsuya Tazaki Masaru Sasaki yuji Imamura Yutaka Daimaru Hideki Ohdan Atsushi Nakamitsu Department of Surgery JA Hiroshima General Hospital Department of Gastroenterological and Transplant Surgery Applied Life Sciences Institute of Biomedical and Health Sciences Hiroshima University Department of Pathology JA Hiroshima General Hospital

A 72-year-old woman with a sigmoid colon cancer and a synchronous colorectal liver metastasis(CRLM),which involved the right hepatic vein(RHV)and the inferior vena cava(IVC),was referred to our *** metastatic lesion was diagnosed as initially unresectable because of its invasion into the confluence of the RHV and *** she had undergone laparoscopic sigmoidectomy for the original tumor,she consequently had 3 courses of modified 5-fluorouracil,leucovorin,and oxaliplatin(m FOLFOX6)plus *** tomography revealed a partial response,and the confluence of the RHV and IVC got free from cancer *** 3 additional courses of m FOLFOX6 plus cetuximab,preoperative percutaneous transhepatic portal vein embolization(PTPE)was performed to secure the future remnant liver ***,a right hemihepatectomy was *** postoperative course was *** patient was discharged from the hospital on postoperative day *** had neither local recurrence nor distant metastasis 18 mo after the last surgical *** multidisciplinary strategy,consisting of conversion chemotherapy using FOLFOX plus cetuximab and PTPE,could contribute in facilitating curative hepatic resection for initially unresectable CRLM.

关键词： Initial y unresectable Colorectal liver metastasis

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Genetic Characterization of Streptococcus pyogenes emm89 Strains Isolated in Japan From 2011 to 2019

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Infectious Microbes & Diseases 2020年第4期2卷 160-166页

作者： yujiro Hirose Masaya yamaguchi Norihiko Takemoto Tohru Miyoshi-Akiyama Tomoko Sumitomo Masanobu Nakata Tadayoshi Ikebe Tomoki Hanada Takahiro yamaguchi Ryuji Kawahara Rumi Okuno Hitoshi Otsuka Yuko Matsumoto yuji Terashima Yu Kazawa Noriko Nakanishi Kaoru Uchida Yumi Akiyama Kaori Iwabuchi Chikara Nakagawa Kazunari Yamamoto Victor Nizet Shigetada Kawabata Department of Oral and Molecular Microbiology Osaka University Graduate School of DentistrySuitaOsakaJapan Department of Pediatrics University of California at San Diego School of MedicineLa JollaCAUSA Department of Infectious Diseases Research InstituteNational Center for Global Health and MedicineTokyoJapan Department of Oral Microbiology Kagoshima University Graduate School of Medical and Dental SciencesKagoshimaJapan Department of Bacteriology I National Institute of Infectious DiseasesTokyoJapan Division of Microbiology Osaka Institute of Public HealthOsaka CityOsakaJapan Department of Microbiology Tokyo Metropolitan Institute of Public HealthTokyoJapan Department of Public Health Sciences Yamaguchi Prefectural Institute of Public Health and Environment Yamaguchi CityYamaguchiJapan Microbiological Testing and Research Division Yokohama City Institute of Public HealthYokohamaKanagawaJapan Department of Microbiology Fukushima Prefectural Institute of Public HealthFukushima CityFukushimaJapan Department of Infectious Diseases Kobe Institute of HealthKobeHyogoJapan Department of Bacteriology Toyama Institute of HealthImizuToyamaJapan Infectious Disease Research Division Hyogo Prefectural Institute of Public Health ScienceKakogawaHyogoJapan Department of Health Science Iwate Prefectural Research Institute for Environmental Sciences and Public HealthMoriokaIwateJapan Division of Microbiology Kyoto City Institute of Health and Environmental SciencesKyoto CityKyotoJapan Niigata City Institute of Public Health and the Environment Niigata CityNiigataJapan Skaggs School of Pharmaceutical Sciences University of California at San DiegoLa JollaCAUSA.

Invasive infection caused by Streptococcus pyogenes emm89 strains has been increasing in several countries linked to a recently emergent clade of emm89 strains,designated clade *** Japan,the features of emm89 *** strains,such as clade classification,remains *** this study,we collected emm89 strains isolated from both streptococcal toxic shock syndrome(STSS)(89 STSS isolates)and noninvasive infections(72 non-STSS isolates)in Japan from 2011 to 2019,and conducted wholegenome sequencing and comparative analysis,which resulted in classification of a large majority into clade 3 regardless of disease *** addition,invasive disease-associated factors were found among emm89 strains,including mutations of control of virulence sensor,and absence of the hylP1 gene encoding *** findings provide new insights into genetic features of emm89 strains.

关键词： clade 3 emm89 streptococcal toxic shock syndrome Streptococcus pyogenes

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