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High doses of dextromethorphan induced shock and convulsions in a 19-year-old female:A case report

World Journal of Clinical Cases 2023年第16期11卷 3870-3876页

作者： Shintaro Shimozawa Daisuke Usuda Toru Sasaki Shiho Tsuge Riki Sakurai Kenji Kawai Shun Matsubara Risa Tanaka Makoto suzuki yuta Hotchi Shungo Tokunaga Ippei Osugi Risa Katou Sakurako Ito Suguru Asako Kentaro Mishima Akihiko Kondo Keiko Mizuno Hiroki Takami Takayuki Komatsu Jiro Oba Tomohisa Nomura Manabu Sugita Department of Emergency and Critical Care Medicine Juntendo University Nerima HospitalNerima-city 177-8521TokyoJapan Clinical Training Center Juntendo University Nerima HospitalNerima-city 177-8521TokyoJapan Department of Sports Medicine Faculty of MedicineJuntendo UniversityBunkyo-city 113-8421TokyoJapan

BACKGROUND Dextromethorphan is a prevalent antitussive agent that can be easily obtained as an over-the-counter *** has been a growing number of reported cases of toxicity in recent ***,there are numerous instances of mild symptoms,with only a limited number of reports of severe cases necessitating intensive *** presented the case of a female who ingested 111 tablets of dextromethorphan,leading to shock and convulsions and requiring intensive care that ultimately saved her *** SUMMARY A 19-year-old female was admitted to our hospital via ambulance,having overdosed on 111 tablets of dextromethorphan(15 mg)obtained through an online importer in a suicide *** patient had a history of drug abuse and multiple self-inflicted *** the time of admission,she exhibited symptoms of shock and altered ***,upon arrival at the hospital,the patient experienced recurrent generalized clonic convulsions and status epilepticus,necessitating tracheal *** convulsions were determined to have been caused by decreased cerebral perfusion pressure secondary to shock,and noradrenaline was administered as a *** lavage and activated charcoal were also administered after *** systemic management in the intensive care unit,the patient’s condition stabilized,and the need for vasopressors *** patient regained consciousness and was *** patient was subsequently transferred to a psychiatric facility,as suicidal ideation *** We report the first case of shock caused by an overdose of dextromethorphan.

关键词： Dextromethorphan Drug overdose Shock Symptom Treatment Case report

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Carotenoid productivity in human intestinal bacteria Eubacterium limosum and Leuconostoc mesenteroides with functional analysis of their carotenoid biosynthesis genes

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Engineering Microbiology 2024年第2期4卷 1-11页

作者： Wataru Matsumoto Miho Takemura Haruka Nanaura yuta Ami Takashi Maoka Kazutoshi Shindo Shin Kurihara Norihiko Misawa Research Institute for Bioresources and Biotechnology Ishikawa Prefectural University1-308SuematsuNonoich-shi 921-8836Japan Department of Science and Technology on Food Safety Kinki University930 NishimitaniKinokawaWakayama 649-6493Japan Research Institute for Production Development Shimogamo-morimotochoSakyo-kuKyoto 606-0805Japan Department of Food and Nutrition Japan Women’s UniversityMejirodaiBunkyo-kuTokyo 112-8681Japan

The human intestinal microbiota that comprise over 1,000 species thrive in dark and anaerobic *** are recognized for the production of diverse low-molecular-weight metabolites crucial to human health and ***,low-molecular-weight pigments known for their antioxidative activity,are delivered to humans through oral ***,it remains unclear whether human intestinal bacteria biosynthesize carotenoids as part of the in-situ *** this study,we investigated carotenoid synthesis genes in vari-ous human gut and probiotic *** a result,novel candidates,the crtM and crtN genes,were identified in the carbon monoxide-utilizing gut anaerobe Eubacterium limosum and the lactic acid bacterium Leuconostoc mesenteroides *** gene candidates were isolated,introduced into Escherichia coli,which synthesized a carotenoid substrate,and cultured *** analysis of the resulting carotenoids re-vealed that the crtM and crtN gene candidates of *** and *** mediate the production of 4,4′-diaponeurosporene through 15-cis-4,4′-*** of the crtE-homologous genes in these bacteria indicated their non-functionality for C40-carotenoid *** and ***,along with the known carotenogenic lactic acid bacterium Lactiplantibacillus plantarum,were observed to produce no carotenoids under strictly anaerobic *** two lactic acid bacteria synthesized detectable levels of 4,4′-diaponeurosporene under semi-aerobic *** findings highlight that the obligate anaerobe ***-sum retains aerobically functional C30-carotenoid biosynthesis genes,potentially with no immediate self-utility,suggesting an evolutionary direction in carotenoid biosynthesis.(229 words)

关键词： C_(30)carotenoid biosynthesis Obligate anaerobe Human gut bacterium Eubacterium limosum Leuconostoc mesenteroides Lactiplantibacillus plantarum

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Allergic reaction to anisakis-contaminated fish after the first administration of BNT162b2 mRNA vaccine:a case report

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Gastroenterology Report 2022年第1期10卷 650-652页

作者： Fumiue Harada Kana Yamamoto Tomoki Matsuda Chika Yamamoto yuta Tani Mutsuko Ohnishi Morihito Takita Tetsuya Tanimoto Masahiro Kami Ryusaburo Shineha Department of Internal Medicine Soma Central HospitalSomaFukushimaJapan Department of Disaster and Comprehensive Medicine Fukushima Medical UniversityFukushimaFukushimaJapan Department of Radiation Health Management Fukushima Medical UniversityFukushimaFukushimaJapan Research Division Medical Governance Research InstituteMinatoTokyoJapan

Introduction SARS-CoV-2 vaccination is an effective means to prevent severe illness and death due to SARS-CoV-2 infection[1].Vaccine safety has been carefully monitored to be sure that the benefit outweighs the risk of adverse events(AEs).Common AEs of the BNT162b2 mRNA vaccine,for example,include fatigue(45%),headache(40%),and chills(28%)after the first administration in accordance with the adult phase Ⅲ clinical trial[1].

关键词： headache death administration

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Pre-hepatectomy type Ⅳ collagen 7S predicts post-hepatectomy liver failure and recovery

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World Journal of Gastroenterology 2020年第7期26卷 725-739页

作者： Masatsugu Ishii Osamu Itano Masahiro Shinoda Minoru Kitago yuta Abe Taizo Hibi Hiroshi Yagi Ayano Takeuchi Hanako Tsujikawa Tokiya Abe Yuko Kitagawa Department of Surgery Keio University School of MedicineTokyo 160-8582Japan Department of Hepato-Biliary-Pancreatic and Gastrointestinal Surgery International University of Health and Welfare School of MedicineChiba 286-8686Japan Department of Pediatric Surgery and Transplantation Kumamoto UniversityKumamoto 860-8556Japan Department of Public Health Keio University School of MedicineTokyo 160-8582Japan Department of Pathology Keio University School of MedicineTokyo 160-8582Japan

BACKGROUND Liver resection is an effective treatment for benign and malignant liver ***,a method for preoperative evaluation of hepatic reserve has not yet been *** reported assessments of preoperative hepatic reserve focused only on liver failure in the early postoperative period and did not consider the long-term recovery of hepatic *** determining eligibility for hepatectomy,the underlying pathophysiology needs to be considered to determine if the functional hepatic reserve can withstand both surgery and any postoperative *** To identify pre-hepatectomy factors associated with both early postoperative liver failure and long-term postoperative liver function *** This study was a retrospective cohort *** retrospectively investigated 215 patients who underwent hepatectomy at our hospital between May 2013 and December *** post-hepatectomy liver failure(PHLF)was defined using the International Study Group of Liver Surgery’s definition of ***-term postoperative recovery of liver function was defined as the time taken for serum total bilirubin and albumin levels to return to levels of2.8 g/dL,respectively,and the time taken for Child-Pugh score to return to Child-Pugh class *** Preoperative type IV collagen 7S was identified as a significant independent factor associated with both PHLF and postoperative long-term recovery of liver *** analysis revealed that the time taken for the recovery of Child-Pugh scores and serum total bilirubin and albumin levels was significantly shorter in patients with type IV collagen 7S≤6 ng/mL than in those with type IV collagen 7S>6 ng/*** additional analyses,similar results were observed in patients without chronic viral hepatitis associated with *** Preoperative type IV collagen 7S is a preoperative predictor of PHLF and longterm postoperative liver function *** can also be used in patients without chron

关键词： Hepatectomy Liver failure Type Ⅳ collagen 7S Liver fibrosis Postoperative complications Long-term postoperative liver function recovery

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Interferon-λ3 polymorphisms in pegylated-interferon-α plus ribavirin therapy for genotype-2 chronic hepatitis C

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World Journal of Gastroenterology 2015年第13期21卷 3904-3911页

作者： Haruya Ishiguro Hiroshi Abe Nobuyoshi Seki Tomonori Sugita yuta Aida Munenori Itagaki Satoshi Sutoh Noritomo Shimada Tomomi Furihata Akihito Tsubota Yoshio Aizawa Division of Gastroenterology and Hepatology Department of Internal MedicineJikei University School of Medicine Katsushika Medical CenterTokyo 125-8506Japan Department of Gastroenterology and Hepatology Shinmatsudo Central General HospitalChiba 270-0034Japan Laboratory of Pharmacology and Toxicology Graduate School of Pharmaceutical SciencesChiba UniversityChiba 260-8675Japan Core Research Facilities for Basic Science Research Center for Medical ScienceJikei University School of MedicineTokyo 105-8461Japan

AIM: To evaluate interferon-λ3(IFNL3) polymorphisms in response-guided pegylated interferon-α plus ribavirin(Peg-IFNα/RBV) therapy for genotype 2(G2) chronic hepatitis ***: Between January 2006 and June 2012, a total of 180 patients with chronic infections of G2 hepatitis C virus(HCV) were treated with responseguided Peg-IFNα/RBV therapy. The treatment duration was 24 wk for patients who achieved rapid virologic response(RVR), and 36 or 48 wk for patients who did not. Then, the impact of the IFNL3 single nucleotide polymorphism genotype(TT/non-TT at rs8099917) on treatment outcomes was evaluated in the 180 patients, and between patients infected with either HCV subgenotype 2a or ***: Of the 180 patients evaluated, 111 achieved RVR, while the remaining 69 patients did not. In RVR patients, the sustained virologic response(SVR) rate was 96.4%, and the IFNL3 genotype did not influence the SVR rate(96.6% vs 95.8% in IFNL3 genotype TT vs non-TT). However, in non-RVR patients, the SVR rate decreased to 72.5%(P < 0.0001), and this rate was significantly different between the IFNL3 genotype TT and non-TT groups(80.0% vs 42.9%, P = 0.0146). Multivariate regression analysis in non-RVR patients identified the IFNL3 genotype TT as the only baseline-significant factor associated with SVR(OR = 5.39, 95%CI: 1.29-22.62; P = 0.0189). In analysis according to HCV sub-genotype, no significant difference in the SVR rate was found between HCV sub-genotypes 2a and ***: In response-guided Peg-IFNα/RBV combination therapy for chronically HCV G2-infected patients, the impact of the IFNL3 genotype on SVR was limited to non-RVR patients.

关键词： Hepatitis C virus genotype 2 Interferon-λ3 single

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Rescue case of low birth weight infant with acute hepatic failure

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World Journal of Gastroenterology 2017年第40期23卷 7337-7342页

作者： Noriki Okada Yukihiro Sanada Taizen Urahashi Yoshiyuki Ihara Naoya Yamada yuta Hirata Takumi Katano Kentaro Ushijima Shinya Otomo Shujiro Fujita Koichi Mizuta Department of Transplant Surgery Jichi Medical University Department of Clinical Pharmacology Jichi Medical University Department of Pharmacy Jichi Medical University Department of Pediatrics Yokohama City University School of Medicine

We report a case involving a rescued low birth weight infant(LBWI) with acute liver failure. Case: The patient was 1594 g and 32^(3/7) gestational wk at birth. At the age of 11 d, she developed acute liver failure due to gestational alloimmune liver disease. Exchange transfusion and high-dose gamma globulin therapy were initiated, and body weight increased with enteral nutrition. Exchange transfusion was performed a total of 33 times prior to living donor liver transplantation(LDLT). Her liver dysfunction could not be treated by medications alone. At 55 d old and a body weight of 2946 g, she underwent LDLT using an S2 monosegment graft from her mother. Three years have passed with no reports of intellectual disability or liver dysfunction. LBWIs with acute liver failure may be rescued by LDLT after body weight has increased to over 2500 g.

关键词： Liver transplantation Acute liver failure Low birth weight infant Transplantable body weight Monosegment graft

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A force measurement platform for a vitreoretinal surgical simulator using an artificial eye module integrated with a quartz crystal resonator

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Microsystems & Nanoengineering 2022年第4期8卷 137-149页

作者： yuta Taniguchi Hirotaka Sugiura Toshiro Yamanaka Shiro Watanabe Seiji Omata Kanako Harada Mamoru Mitsuishi Tomoyasu Shiraya Koichiro Sugimoto Takashi Ueta Kiyohito Totsuka Fumiyuki Araki Muneyuki Takao Makoto Aihara Fumihito Arai Department of Mechanical Engineering The University of Tokyo7-3-1 HongoBunkyo-kuTokyo 113-8656Japan Faculty of Advanced Science and Technology Kumamoto University2-39-1 KurokamiChuo-kuKumamoto-shiKumamoto 860-8555Japan Center for Disease Biology and Integrative Medicine The University of Tokyo7-3-1 HongoBunkyo-kuTokyo 113-0033Japan Department of Ophthalmology The University of Tokyo7-3-1 HongoBunkyo-kuTokyo 113-8655Japan

To provide quantitative feedback on surgical progress to ophthalmologists practicing inner limiting membrane(ILM)peeling,we developed an artificial eye module comprising a quartz crystal resonator(QCR)force sensor and a strain body that serves as a uniform force transmitter beneath a retinal *** a sufficiently large initial force must be loaded onto the QCR force sensor assembly to achieve stable contact with the strain body,the highly sensitive and wide dynamic-range property of this sensor enables the eye module to detect the slight forceps contact force.A parallel-plate strain body is used to achieve a uniform force sensitivity over the 4-mm-diameter ILM peeling *** these two components allowed for a measurable force range of 0.22 mN to 29.6 N with a sensitivity error within−11.3 to 4.2%over the ILM peeling *** this eye module,we measured the applied force during a simulation involving artificial ILM peeling by an untrained individual and compensated for the long-term drift of the obtained force data using a newly developed *** compensated force data clearly captured the characteristics of several types of motion sequences observed from video recordings of the eye bottom using an ophthalmological *** a result,we succeeded in extracting feature values that can be potentially related to trainee skill level,such as the mean and standard deviation of the pushing and peeling forces,corresponding,in the case of an untrained operator,to 122.6±95.2 and 20.4±13.2 mN,respectively.

关键词： artificial quartz resonator

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How to maintain nutritional status after esophagectomy via the Tanaka method

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Journal of Cancer Metastasis and Treatment 2021年第1期7卷 785-793页

作者： Yoshihiro Tanaka yuta Sato Tomonari Suetsugu Junichi Mase Ritsuki Takaha Naoki Okumura Nobuhisa Matsuhashi Takao Takahashi Kazuhiro Yoshida Department of Surgical Oncology Graduate School of MedicineGifu UniversityGifu 501-1194Japan.

Aim:Many therapeutic means have emerged to treat esophageal *** relating to nutritional status such as body weight maintenance are important to the continuation of these *** this study,we investigated methods to extend the administration of diversified treatments for patients with esophageal cancer,especially regarding measures to suppress body weight loss after ***:We retrospectively evaluated a strategy for preventing postoperative body weight loss which can hinder the continuation of treatment via a reconstruction method aimed at safety and comfort combined with postoperative dietary intake and nutritional support for esophageal cancer ***:The subjects comprised 386 patients who underwent subtotal stomach reconstruction during esophageal cancer surgery performed from January 2008 to January 2021 at Gifu University *** anastomotic leakage rate was 0.5%.By administering oral nutritional supplementation under strict rules using ENSURE®H during the perioperative period,the percentage of body weight loss after 5 years could be limited to 4.78%compared to that before *** assessing early feeling of fullness measured using the EORTC QLQ-OES18 at postoperative months 3,12,24,36,48,and 60 were 1.7±0.3,2.0±0.2,1.2±0.3,1.3±0.2,1.5±0.2,and 1.4±0.1,***:Considering methods to eliminate the factors that prevent continuation of treatment may lead to sustainable treatment against esophageal *** surgical reconstruction and nutritional management will allow maintenance of body weight and good quality of life.

关键词： Esophageal cancer nutrition reconstruction oral nutritional supplementation

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Two cases of pancreatic ductal adenocarcinoma with intrapancreatic metastasis

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World Journal of Gastroenterology 2016年第41期22卷 9222-9228页

作者： Yusuke Fujita Minoru Kitago Yohei Masugi Osamu Itano Masahiro Shinoda yuta Abe Taizo Hibi Hiroshi Yagi Yoko Fujii-Nishimura Michiie Sakamoto Yuko Kitagawa Department of Surgery Keio University School of Medicine Department of Pathology Keio University School of Medicine

There are no standardized diagnostic criteria for intrapancreatic metastasis of pancreatic ductal adenocarcinoma(PDAC). Here, we report two cases of patients with PDAC who were pathologically diagnosed as harboring intrapancreatic metastasis. In both cases, the main lesions were located in the pancreatic body, and no other lesion was detected preoperatively. The patients were diagnosed with pancreatic body cancers and distal pancreatectomy was performed. Pathological findings revealed microscopic cancer nests, which had connections to neither the main lesion nor the premalignant lesion in the pancreatic tail parenchyma. In both cases, the histological type of the daughter lesion was quite similar to that of the main lesion. Hence, we diagnosed the daughter lesions as metastatic foci in the pancreas. Although intrapancreatic metastasis of PDAC has been regarded as a poor prognostic factor, few reports of intrapancreatic metastasis are available. This article reports two such cases and provides a review of the literature.

关键词： Carcinoma Pancreatic ductal Neoplasm micrometastasis Recurrence Carcinogenesis

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Current perspectives of viral hepatitis

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World Journal of Gastroenterology 2024年第18期30卷 2402-2417页

作者： Daisuke Usuda Yuki Kaneoka Rikuo Ono Masashi Kato Yuto Sugawara Runa Shimizu Tomotari Inami Eri Nakajima Shiho Tsuge Riki Sakurai Kenji Kawai Shun Matsubara Risa Tanaka Makoto suzuki Shintaro Shimozawa yuta Hotchi Ippei Osugi Risa Katou Sakurako Ito Kentaro Mishima Akihiko Kondo Keiko Mizuno Hiroki Takami Takayuki Komatsu Tomohisa Nomura Manabu Sugita Department of Emergency and Critical Care Medicine Juntendo University Nerima HospitalNerima 177-8521TokyoJapan Department of Sports Medicine Faculty of MedicineJuntendo UniversityBunkyo 113-8421TokyoJapan

Viral hepatitis represents a major danger to public health,and is a globally leading cause of *** five liver-specific viruses:Hepatitis A virus,hepatitis B virus,hepatitis C virus,hepatitis D virus,and hepatitis E virus,each have their own unique epidemiology,structural biology,transmission,endemic patterns,risk of liver complications,and response to antiviral *** remain few options for treatment,in spite of the increasing prevalence of viral-hepatitiscaused liver ***,chronic viral hepatitis is a leading worldwide cause of both liver-related morbidity and mortality,even though effective treatments are available that could reduce or prevent most patients’*** 2016,the World Health Organization released its plan to eliminate viral hepatitis as a public health threat by the year 2030,along with a discussion of current gaps and prospects for both regional and global eradication of viral ***,treatment is sufficiently able to prevent the disease from reaching advanced ***,future therapies must be extremely safe,and should ideally limit the period of treatment necessary.A better understanding of pathogenesis will prove beneficial in the development of potential treatment strategies targeting infections by viral *** review aims to summarize the current state of knowledge on each type of viral hepatitis,together with major innovations.

关键词： Hepatitis A virus Hepatitis B virus Hepatitis C virus Hepatitis D virus Hepatitis E virus Current perspectives

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