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A novel endoscopic ablation of gastric antral vascular ectasia

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World Journal of Gastrointestinal Endoscopy 2010年第8期2卷 298-300页

作者： Masae Komiyama Kuangi Fu Takashi Morimoto Hironori Konuma Toshifumi Yamagata Yuko Izumi akihisa miyazaki Sumio Watanabe Department of Gastroenterology Juntendo Univerity Nerima Hospital Department of Gastroenterology Juntendo University School of Medicine

An 80-year-old woman was admitted to our hospital because of tarry stool with iron deficiency anemia. Her past history included autoimmune hepatitis. Esophagogastroduodenal endoscopy was performed to investigate the bleeding source and revealed multiple linear gastric vascular malformations in the antrum and cardia, compatible with Gastric antral vascular ectasia (GAVE). Endoscopic ablation was carried out with the tip of the hot biopsy forceps without opening at soft coagulation mode of 80W. The patient tolerated the procedure well and there were no complications associated with endoscopic therapies. After two sessions of endoscopic ablation her anemia improved to around 10 g/dL, an increase of 3.6 g/dL. Various endoscopic treatments have been described to manage GAVE. The most popular is argon plasma coagulation (APC), although APC is associated with over-distension induced by the argon plasma gas. To avoid over-distension and to reduce the abdominal discomfort/pain of this patient,we have used hot biopsy forceps instead of APC. Our case suggests that this procedure is effective, easy and convenient,as no special equipment or skill is necessary.

关键词： Hot biopsy forceps Endoscopic ablation Gastric antral vascular ectasia

Youngest case of an early gastric cancer after successful eradication therapy

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World Journal of Gastrointestinal Endoscopy 2013年第6期5卷 300-303页

作者： Hironori Konuma Ichiro Konuma Kuangi Fu Satoshi Yamada Yutaka Suzuki akihisa miyazaki Department of Gastroenterology Juntendo Univerity Nerima Hospital Konuma Clinic Yamada Clinic Department of Surgery International University of Health and Welfare Hospital

A 28-year-old woman visited our clinic with a chief complaint of epigastralgia. She had received successful Helicobacter pylori (H. pylori ) eradication therapy 5 years before. We repeated esophagogastroduodenoscopy, and a discolored depressed area with reddish spots and converging folds, 20 mm in size, was detected. No atrophic change including intestinal metaplasia or nodular gastritis was seen endoscopically. Two endoscopic biopsies revealed undifferentiated adenocarcinoma. No H. pylori was found, and the 13 C-urea breath test was also negative. Abdominal computed tomography demonstrated no nodal involvement, distant metastasis or fluid collection. She underwent a laparoscopyassisted distal gastrectomy. Histologically, the resected specimen revealed an early undifferentiated gastric cancer that had invaded deeply into the submucosal layer. Nodal involvement was histologically confirmed.No atrophic change or H. pylori infection was evident histologically. This is the youngest patient ever reported to have developed a node-positive early gastric cancer after eradication of H. pylori .

关键词： Early gastric cancer Helicobacter pylori Eradication therapy Undifferentiated adenocarcinoma Intestinal-type adenocarcinoma Point of no return theory

Mallory-Weiss tear during gastric endoscopic submucosal dissection

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World Journal of Gastrointestinal Endoscopy 2011年第7期3卷 151-153页

作者： Hiroki Hongou Kuangi Fu Hiroya Ueyama Taiji Takahashi Tsutomu Takeda akihisa miyazaki Sumio Watanabe Department of Gastroenterology Juntendo University Nerima Hospital Nerima Tokyo 177-0033 Japan Department of Gastroenterology Juntendo University School of Medicine Tokyo 113-8431 Japan

A 78-year-old woman was referred to our department for treatment of an early gastric cancer. Esophagogastroduodenoscopy (EGD) demonstrated a flat elevated lesion and a polypoid lesion on the greater curvature of the antrum. Histological analysis of, endoscopic biopsy samples taken from these lesions revealed an adenocarcinoma and a hyperplastic polyp, respectively. ESD was conducted for removal of the lesions. Carbon dioxide (CO2) in- stead of room air was used for insufflation, and the patient was adequately sedated without struggling or vomiting during the treatment. No significant bleeding from the lesion was observed during ESD, but fresh blood was identified endoscopically. Surprisingly, a Mallory- Weiss tear with active bleeding was detected on the lesser curvature of the gastric corpus. A total of eight hemoclips were applied for hemostasis. Both lesions were completely removed en bloc, and no bleeding or perforation developed after ESD. Histologically, the first lesion was apapillary carcinoma limited to the mucosal layer and without lymphovascular invasion or involvement of the surgical margins, while the second lesion was a benign hyperplastic polyp.

关键词： Mallory-Weiss tear Endoscopic submucosal dissection Early gastric cancer Hemostasis Hemoclip

Endoscopic retrieval of a gastric trichobezoar

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World Journal of Gastrointestinal Endoscopy 2011年第1期3卷 20-22页

作者： Hironori Konuma Kuangi Fu Takashi Morimoto Takayoshi Shimizu Yuko Izumi Satoko Shiyanagi Masahiko Urao akihisa miyazaki Sumio Watanabe Department of Gastroenterology Juntendo Univerity Nerima Hospital Department of Pediatric Surgery Juntendo Univerity Nerima Hospital Department of Gastroenterology Juntendo University School of Medicine

A 9-year-old girl presented with a chief complaint of abdominal pain. Esophagogastroduodenal endoscopy (EGD) identifi ed a long and large gastric trichobezoar extending into the duodenum. We attempted endoscopic retrieval after informed consent was obtained from the patient's mother. Initially, a gasper with 5-prolongs, com monly used for retrieval of endoscopically excised poly ps, failed to remove the whole trichobezoar. When a net was used instead, it proved impossible to remove the trichobezoar completely. Therefore, we withdrew the scope from the mouth, leaving the net grasping the tri co bezoar firmly in the stomach. Subsequently, we were able to retrieve about 70% of the trichobezoar manually by grasping the snare part of the net directly. A second pass found no deep laceration or perforation endoscopically. The remaining trichobezoar was completely retrieved with the net. The procedure was completed within 15 min. The retrieved specimens were34 cm in length and 100 g in weight. The patient was discharged uneventfully 5 d thereafter. She was advised to visit a psychiatrist to avoid suffering from a relapse. Follow-up EGD showed no trichobezoar, and the patient' s frontal hair grew back.

关键词： Gastric bezoar Trichobezoar Endoscopic retrieval Grasper Retrieval net

Preoperative albumin-bilirubin score and liver resection percentage determine postoperative liver regeneration after partial hepatectomy

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World Journal of Gastroenterology 2024年第14期30卷 2006-2017页

作者： Kazuhiro Takahashi Masahiko Gosho Yoshihiro miyazaki Hiromitsu Nakahashi Osamu Shimomura Kinji Furuya Manami Doi Yohei Owada Koichi Ogawa Yusuke Ohara Yoshimasa Akashi Tsuyoshi Enomoto Shinji Hashimoto Tatsuya Oda Department of Gastrointestinal and Hepatobiliary-Pancreatic Surgery University of TsukubaTsukuba 3058-575IbarakiJapan Department of Biostatistics University of TsukubaTsukuba 3058-575IbarakiJapan

BACKGROUND The success of liver resection relies on the ability of the remnant liver to regenerate.Most of the knowledge regarding the pathophysiological basis of liver regeneration comes from rodent studies,and data on humans are scarce.Additionally,there is limited knowledge about the preoperative factors that influence postoperative regeneration.AIM To quantify postoperative remnant liver volume by the latest volumetric software and investigate perioperative factors that affect posthepatectomy liver regenera-tion.METHODS A total of 268 patients who received partial hepatectomy were enrolled.Patients were grouped into right hepatectomy/trisegmentectomy(RH/Tri),left hepa-tectomy(LH),segmentectomy(Seg),and subsegmentectomy/nonanatomical hepatectomy(Sub/Non)groups.The regeneration index(RI)and late rege-neration rate were defined as(postoperative liver volume)/[total functional liver volume(TFLV)]×100 and(RI at 6-months-RI at 3-months)/RI at 6-months,respectively.The lower 25th percentile of RI and the higher 25th percentile of late regeneration rate in each group were defined as“low regeneration”and“delayed regeneration”.“Restoration to the original size”was defined as regeneration of the liver volume by more than 90%of the TFLV at 12 months postsurgery.RESULTS The numbers of patients in the RH/Tri,LH,Seg,and Sub/Non groups were 41,53,99 and 75,respectively.The RI plateaued at 3 months in the LH,Seg,and Sub/Non groups,whereas the RI increased until 12 months in the RH/Tri group.According to our multivariate analysis,the preoperative albumin-bilirubin(ALBI)score was an independent factor for low regeneration at 3 months[odds ratio(OR)95%CI=2.80(1.17-6.69),P=0.02;per 1.0 up]and 12 months[OR=2.27(1.01-5.09),P=0.04;per 1.0 up].Multivariate analysis revealed that only liver resection percentage[OR=1.03(1.00-1.05),P=0.04]was associated with delayed regeneration.Furthermore,multivariate analysis demonstrated that the preoperative ALBI score[OR=2.63(1.00-1.05),P=0.02;per 1.0 up]and liver resection percentage[OR=1.02(1.00

关键词： Liver regeneration Albumin-bilirubin score Liver resection percentage Partial hepatectomy Human Regeneration index

Malnutrition and Its Association with the Mortality of Patients with Femoral Intertrochanteric Fractures: A Retrospective Analysis of Japanese Patients

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Open Journal of Orthopedics 2024年第1期14卷 22-31页

作者： Taizo Kaneko Kyoko Matsudaira Kentaro Hayakawa Fumiaki Tokimura Tsuyoshi miyazaki Department of Orthopaedic Surgery Tokyo Metropolitan Institute for Geriatrics and Gerontology Tokyo Japan

Background: The incidence of femoral intertrochanteric fractures in older adults is higher than that of femoral neck fractures;however, both conditions are often analyzed together as proximal femoral fractures. Considering the difference in treatment, postoperative complication, and mortality risk, these two fractures should be analyzed separately. This study aimed to analyze 1-year mortality and its risk factors in patients with surgically treated femoral intertrochanteric fractures. Methods: Consecutive patients with intertrochanteric fractures who underwent surgical interventions at our institution between January 2017 and December 2021 were retrospectively reviewed. A total of 238 patients were eligible for inclusion in this study. Patients’ demographic and clinical information were retrospectively collected. Patients were divided into the 1-year mortality (n = 16) and survival (n = 222) groups. The incidence of 1-year mortality and its independent risk factors were investigated using univariate and multivariate logistic regression analyses. Results: The mean age of patients was 85.6 ± 8.5 years. The 1-year mortality rate was 6.7% (16/238). Preoperative albumin level, the Geriatric Nutritional Risk Index (GNRI), and malnutrition status (GNRI p = 0.02, p = 0.02, and p = 0.0011, respectively). Multivariate analysis showed that malnutrition status (GNRI p = 0.035) was an independent risk factor for 1-year mortality. Conclusion: Malnutrition status assessed using GNRI (GNRI < 92) was an independent risk factor for 1-year mortality. Our findings suggest that GNRI may be an effective screening tool for predicting postoperative 1-year mortality of patients with surgically treated femoral intertrochanteric fractures.

关键词： Intertrochanteric Fracture Mortality Geriatric Nutritional Risk Index Malnutrition Risk Factor

Preliminary Investigation of Copper(II) Ion Binding or Complex Coordination in Lysozeme Molecules

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Journal of Materials Science and Chemical Engineering 2024年第4期12卷 98-103页

作者： Kou Takahashi Ryotaro miyazaki Daisuke Nakane Temitayo O. Aiyelabola Takashiro Akitsu Department of Chemistry Faculty of Science Tokyo University of Science Tokyo Japan Department of Chemistry Faculty of Science Obafemi Awolowo University Ile-Ife Nigeria

Hydrophobic Val derivative Schiff base copper(II) complexes and dipeptide (AlaAla, GlyGly) derivative Schiff base copper(II) complexes were introduced into egg white lysozyme. X-ray crystal structure analysis revealed amino acid derivative Schiff base copper(II) complexes were obtained. Herein we discuss primarily on the binding mode of copper(II) of the complexes obtained with egg white lysozyme. The electron density of copper(II) ions was confirmed by X-ray crystal structure analysis. The Val derivative Schiff base copper(II) complex was weakly bound at Arg114 of egg white lysozyme. In other copper(II) complexes, binding of copper(II) ions with dissociated ligands to various residues was observed. The binding sites of copper(II) ions were compared with computational scientific predictions.

关键词： Copper Schiff Base Lysozyme Metal-Protein Binding Computational Methods

Impact of Socioeconomic Status and Demographic Composition on Disaster Mortality: Community‑Level Analysis for the 2011 Tohoku Tsunami

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International Journal of Disaster Risk Science 2022年第6期13卷 913-924页

作者： Takeshi miyazaki School of Economics Kyushu UniversityFukuoka 819-0395Japan

On 11 March 2011, the Tohoku tsunami hit the northeastern region of Japan, causing massive damage to people and property. The tsunami was bigger than any other in Japan’s recorded history, but the damage varied by community. This research addressed the effects of socioeconomic status and demographic composition on mortality in the 2011 Tohoku tsunami using community-level data.These effects were estimated using regression analysis, taking into account a variety of potential contributing aspects at the community level, including strength of the tsunami,population characteristics, gender, age, education, household composition, evacuation methods, and occupation. It was found that the height of the tsunami and the shares of threegeneration households and employees in the manufacturing industry are all positively correlated with tsunami mortality.The impacts of these factors on mortality are particularly large for the older adults.

关键词： 2011 Tohoku tsunami Community-level analysis Demographic composition Disaster risk reduction Mortality Socioeconomic status

Synthesis,structure and mechanical properties of Zr-Cu-based bulk metallic glass composites

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International Journal of Minerals,Metallurgy and Materials 2010年第2期17卷 208-213页

作者： akihisa Inoue Institute for Materials Research Tohoku University

The unusual glass-forming ability（GFA） of the Zr48Cu36Ag8Al8 alloy and the high ductility of the Zr48Cu36Ag8Al8 metallic glass-matrix composites containing Ta powder were reported.The bulk metallic glass rod with a diameter of 25 mm was successfully synthesized using copper mold casting for the Zr48Cu36Ag8Al8 alloy.High GFA of this alloy was found to be related to a large supercooled liquid region and a quaternary eutectic point with low melting temperature.The bulk metallic glass matrix composites were prepared by introducing extra Ta particles into the Zr48Cu36Ag8Al8 melt.The composites consist of Ta particles homogenously distributed in the Zr48Cu36Ag8Al8 metallic glass matrix.The optimum content of Ta powder is 10at%for the composite with the highest plasticity,which shows a plastic strain of 31%.

关键词： bulk metallic glass composites glass forming ability Zr-Cu-based alloy plastic strain