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Endoscopic submucosal dissection for early esophageal neoplasms using the stag beetle knife

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World Journal of Gastroenterology 2018年第15期24卷 1632-1640页

作者： Toshio Kuwai Toshiki Yamaguchi Hiroki Imagawa Ryoichi Miura Yuki Sumida Takeshi Takasago Yuki Miyasako Tomoyuki Nishimura Sumio Iio Atsushi Yamaguchi hirotaka kouno Hiroshi Kohno Sauid Ishaq Department of Gastroenterology National Hospital Organization Kure Medical Center and Chugoku Cancer Center Department of Gastroenterology DGH SGU WI Birmingham City University

AIM To determine short-and long-term outcomes of endoscopic submucosal dissection(ESD) using the stag beetle(SB) knife, a scissor-shaped *** Seventy consecutive patients with 96 early esophageal neoplasms, who underwent ESD using a SB knife at Kure Medical Center and Chugoku Cancer Center, Japan, between April 2010 and August 2016, were retrospectively evaluated. Clinicopathological characteristics of lesions and procedural adverse events were assessed. Therapeutic success was evaluated on the basis of en bloc, histologically complete, and curative or non-curative resection rates. Overall and tumor-specific survival, local or distant recurrence, and 3-and 5-year cumulative overall metachronous cancer rates were also *** Eligible patients had dysplasia/intraepithelial neoplasia(22%) or early cancers(squamous cell carcinoma, 78%). The median procedural time was 60 min and on average, the lesions measured 24 mm in diameter, yielding 33-mm tissue defects. The en bloc resection rate was 100%, with 95% and 81% of dissections deemed histologically complete and curative, respectively. All procedures were completed without accidental incisions/perforations or delayed bleeding. During follow-up(mean, 35 ± 23 mo), no local recurrences or metastases were observed. The 3-and 5-year survival rates were 83% and 70%, respectively, with corresponding rates of 85% and 75% for curative resections and 74% and 49% for noncurative resections. The 3-and 5-year cumulative rates of metachronous cancer in the patients with curative resections were 14% and 26%, *** ESD procedures using the SB knife are feasible, safe, and effective for treating early esophageal neoplasms, yielding favorable short-and long-term outcomes.

关键词： Neoplasms Stag beetle knife Esophageal Endoscopic submucosal dissection Outcome measures

Newly developed self-expandable Niti-S MD colonic metal stent for malignant colonic obstruction

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World Journal of Gastrointestinal Surgery 2020年第4期12卷 138-148页

作者： Yuki Miyasako Toshio Kuwai Sauid Ishaq Kanae Tao Hirona Konishi Ryoichi Miura Yuki Sumida Kazutaka Kuroki Yuzuru Tamaru Ryusaku Kusunoki Atsushi Yamaguchi hirotaka kouno Hiroshi Kohno Department of Gastroenterology National Hospital OrganizationKure Medical Center and Chugoku Cancer CenterKure 737-0023Japan Gastroenterology Department Russells Hall HospitalBirmingham City UniversityBirmingham B179BEUnited Kingdom St George’s University University Centre GrenadaWest IndiesGrenada

BACKGROUND Colonic stents are increasingly used to treat acute malignant colonic *** Wall Flex and Niti-S D type stents are the commonly used self-expandable metallic stents available in Japan since *** Flex stent has a risk of stentrelated perforation because of its axial force,while the Niti-S D type stent has a risk of obstructive colitis because of its weaker radial ***-S MD type stents not only overcome these limitations but also permit delivery through highly flexible-tipped smaller-caliber *** To compare the efficacy and safety of the newly developed Niti-S MD type colonic *** This single-center retrospective observational study included 110 patients with endoscopic self-expandable metallic stents placed between November 2011 and December 2018:Wall Flex(Group W,n=37),Niti-S D type(Group N,n=53),and Niti-S MD type(Group MD,n=20).The primary outcome was clinical success,defined as a resolution of obstructive colonic symptoms,confirmed by clinical and radiological assessment within 48 *** secondary outcome was technical success,defined as accurate stent placement with adequate stricture coverage on the first attempt without *** The technical success rate was 100%in Groups W,N,and MD,and the overall clinical success rate was 89.2%(33/37),96.2%(51/53),and 100%(20/20)in Groups W,N,and MD,*** adverse events included pain(3/37,8.1%),poor expansion(1/37,2.7%),and fever(1/37,2.6%)in Group W and perforation due to obstructive colitis(2/53,3.8%)in Group N(likely due to poor expansion).Late adverse events(after 7 d)included stent-related perforations(4/36,11.1%)and stent occlusion(1/36,2.8%)in Group W and stent occlusion(2/51,3.9%)in Group *** stent-related perforation rate in Group W was significantly higher than that in Group N(P<0.05).No adverse event was observed in Group *** In our early and limited experience,the newly developed Niti-S MD type colonic stent was effective

关键词： Colonic stenting New endoscopic colonic stent Malignant colonic obstruction Niti-S WallFlex

High-grade pancreatic intraepithelial neoplasia diagnosed based on changes in magnetic resonance cholangiopancreatography findings:A case report

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World Journal of Clinical Cases 2024年第8期12卷 1487-1496页

作者： Nao Furuya Atsushi Yamaguchi Naohiro Kato Syuhei Sugata Takuro Hamada Takeshi Mizumoto Yuzuru Tamaru Ryusaku Kusunoki Toshio Kuwai hirotaka kouno Kazuya Kuraoka Yoshiyuki Shibata Sho Tazuma Takeshi Sudo Hiroshi Kohno Shiro Oka Department of Gastroenterology National Hospital Organization Kure Medical Center and Chugoku Cancer CenterKure 737-0023HiroshimaJapan Department of Gastroenterology Hiroshima University HospitalHiroshima 734-8551HiroshimaJapan Department of Pathology National Hospital Organization Kure Medical Center and Chugoku Cancer CenterKure 737-0023HiroshimaJapan Department of Surgery National Hospital Organization Kure Medical Center and Chugoku Cancer CenterKure 737-0023HiroshimaJapan

BACKGROUND High-grade pancreatic intraepithelial neoplasia(PanIN)exhibits no mass and is not detected by any examination ***,it can be diagnosed by pancreatic juice cytology from indirect *** previous cases were diagnosed based on findings of a focal stricture of the main pancreatic duct(MPD)and caudal MPD dilatation and subsequent pancreatic juice cytology using endoscopic retrograde cholangiopancreatography(ERCP).We experienced a case of high-grade PanIN with an unclear MPD over a 20-mm range,but without caudal MPD dilatation on magnetic resonance cholangiopancreatography(MRCP).CASE SUMMARY A 60-year-old female patient underwent computed tomography for a follow-up of uterine cancer post-excision,which revealed pancreatic *** revealed an unclear MPD of the pancreatic body at a 20-mm length without caudal MPD ***,course observation was *** 24 mo,MRCP revealed an increased caudal MPD caliber and a larger pancreatic *** performed ERCP and detected atypical cells suspected of adenocarcinoma by serial pancreatic juice aspiration cytology *** performed a distal pancreatectomy and obtained a histopathological diagnosis of high-grade *** parenchyma invasion was not observed,and curative resection was *** High-grade Pan-IN may cause MPD narrowing in a long range without caudal MPD dilatation.

关键词： Pancreatic cancer Pancreatic intraepithelial neoplasm High-grade pancreatic intraepithelial neoplasm Magnetic resonance cholangiopancreatography Carcinoma in situ Case report

Gastric and enteric anisakiasis successfully treated with Gastrografin therapy: A case report

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World Journal of Gastrointestinal Endoscopy 2018年第3期10卷 69-73页

作者： Hiroki Fujikawa Toshio Kuwai Toshiki Yamaguchi Ryoichi Miura Yuki Sumida Takeshi Takasago Yuki Miyasako Tomoyuki Nishimura Sumio Iio Hiroki Imagawa Atsushi Yamaguchi hirotaka kouno Hiroshi Kohno Department of Gastroenterology National Hospital OrganizationKure Medical Center and Chugoku Cancer Center

We report a case of a 59-year-old woman who was diagnosed with gastric and small intestinal anisakiasis, which was successfully treated with endoscopic extraction and Gastrografin therapy. She was admitted to our hospital with epigastric pain and vomiting one day after eating raw fish. She exhibited tenderness in the epigastrium without obvious rebound tenderness or guarding. Computed tomography (CT) demonstrated segmental edema of the intestinal wall with proximal dilatation and a small number of ascites. Because enteric anisakiasis was suspected based on the patient's history of recent raw fish consumption and abdominal CT, we performed gastroscopy and confirmed that nine Anisakis larvae were attached to the gastric mucosa. All of the Anisakis larvae were extracted via endoscopy, and the patient was diagnosed with gastric and enteric anisakiasis. Additionally, in the hospital, we performed ileography twice using Gastrografin, which led to shortened hospital stay. Based on the clinical results of this case, we suggest that Gastrografin therapy is a safe, convenient, and useful method to extract enteric Anisakis larvae.

关键词： Enteric anisakiasis Gastrografin Ileus Endoscopic extraction Anisakis larvae

A rare presentation of appendiceal diverticulitis associated with pelvic pseudocyst

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World Journal of Gastroenterology 2008年第8期14卷 1293-1295页

作者： hirotaka Niwa Takeyuki Hiramatsu Department of Surgery Yaizu City Hospital Yaizu-City Shizuoka Japan

We report a case of a 32-year-old woman with episodic right lower quadrant abdominal pain. With the diagnosis of either acute appendicitis or tubo-ovarian abscess, she was treated with antibiotics, which successfully relieved the pain and the inflammatory findings. She repeated the clinical condition a few times and antibiotics worked each time. In a year, her subjective symptoms became milder, however, a giant pelvic cyst appeared. She had an exploratory laparotomy to confirm this diagnosis. Histopathological studies revealed herniated appendiceal mucosa through the muscular layer associated with chronic inflammation and marked fibrosis. Gynecological disorders such as endometriosis or lutein cyst rupture was denied. These findings represent appendiceal diverticulitis. We discuss the clinical features of the disease and its relation with the pelvic pseudocyst.

关键词： Appendiceal diverticulitis Perforation Pelvic pseudocyst

Structural Health Monitoring by Using Fiber-Optic Distributed Strain Sensors With High Spatial Resolution

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Photonic Sensors 2013年第4期3卷 355-376页

作者： Hideaki MURAYAMA Daichi WADA hirotaka IGAWA School of Engineering The University of Tokyo 7-3-1 Hongo Bunkyo-ku Tokyo 113-8656 Japan Japan Aerospace Exploration Agency 6-13-10hsawa Mitaka Tokyo 181-0015 Japan

In this paper, we review our researches on the topics of the structural health monitoring （SHM） with the fiber-optic distributed strain sensor. Highly-dense information on strains in a structure can be useful to identify some kind of existing damages or applied loads in implementation of SHM. The fiber-optic distributed sensors developed by the authors have been applied to the damage detection of a single-lap joint and load identification of a beam simply supported. We confirmed that the applicability of the distributed sensor to SHM could be improved as making the spatial resolution higher. In addition, we showed that the simulation technique considering both structural and optical effects seamlessly in strain measurement could be powerful tools to evaluate the performance of a sensing system and design it for SHM. Finally, the technique for simultaneous distributed strain and temperature measurement using the PANDA-fiber Bragg grating （FBG） is shown in this paper, because problems caused by the cross-sensitivity toward strain and temperature would be always inevitable in strain measurement for SHM.

关键词： Structural health monitoring fiber-optic distributed sensor strain monitoring damage detection load identification

Synthesis strategies of covalent organic frameworks: An overview from nonconventional heating methods and reaction media

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Green Energy & Environment 2023年第6期8卷 1596-1618页

作者： Jing Xiao Jia Chen Juewen Liu hirotaka Ihara Hongdeng Qiu CAS Key Laboratory of Chemistry of Northwestern Plant Resources and Key Laboratory for Natural Medicine of Gansu Province Lanzhou Institute of Chemical PhysicsChinese Academy of SciencesLanzhou 730000China University of Chinese Academy of Sciences Beijing 100049China Department of Chemistry Waterloo Institute for NanotechnologyUniversity of WaterlooWaterlooOntario N2L 3G1Canada Department of Applied Chemistry and Biochemistry Kumamoto University2-39-1 KurokamiChuo-ku Kumamoto 860-8555Japan College of Chemistry Zhengzhou UniversityZhengzhou 450001China

Covalent organic frameworks(COFs), as an emerging class of porous crystalline materials constructed by covalent links between the building monomers, have gained tremendous attention. Over the past 15 years, COFs have made rapid progress and substantial development in the chemistry and materials fields. However, the synthesis of COFs has been dominated by solvothermal methods for a long time and it usually involves high temperature, high pressure and toxic organic solvents, which created many challenges for environmental considerations. Recently,the exploration of new approaches for facile fabrication of COFs has aroused extensive interest. Hence, in this review, we comprehensively describe the synthetic strategies of COFs from the aspects of nonconventional heating methods and reaction media. In addition, the advantages,limitations and properties of the preparation methods are compared. Finally, we outline the main challenges and development prospects of the synthesis of COFs in the future and propose some possible solutions.

关键词： Covalent organic frameworks Heating methods Reaction media Synthesis strategy Formation mechanism

Valproic acid as a micro RNA modulator to promote neurite outgrowth

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Neural Regeneration Research 2016年第10期11卷 1564-1565页

作者： hirotaka Oikawa Judy C.G.Sng Neuroepigenetics Laboratory Singapore Institute for Clinical Sciences Agency for Science and Technology (A*STAR) Department of Pharmacology Yong Loo Lin School of Medicine National University of Singapore

Valproic acid （VPA） has been a first-choice drug for clinical treatment of epilepsy and manic disorder. For decades, its phar- macological action was believed to act on inhibition of gam- ma-aminobutyric acid （GABA） transaminase, in turn, increas- ing GABA in inhibitory synapses. However, in recent years, VPA has been investigated on other therapeutic actions. Those investigations demonstrate that VPA shows neuroprotective ef- fects by promoting neurogenesis, neuronal differentiation, and neuroregeneration （Foti et al., 2013）.

关键词： VPA RNA Valproic acid as a micro RNA modulator to promote neurite outgrowth acid

Efficacy of balloon-occluded retrograde transvenous obliteration, percutaneous transhepatic obliteration and combined techniques for the management of gastric fundal varices

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World Journal of Gastroenterology 2006年第24期12卷 3866-3873页

作者： hirotaka Arai Takehiko Abe Hitoshi Takagi Masatomo Mori Department of Gastroenterology Maebashi Red Cross Hospital 3-20-14 Asahi-choMaebashi 371-0014Japan Department of Medicine and Molecular Science Gunma University Graduate School of Medicine (previously known as the First Department of Internal Medicine Gunma University School of Medicine)MaebashiGunma 371-8511Japan

AIM： To evaluate the effect of three interventional treatments involving transvenous obliteration for the treatment of gastric varices, and to compare the efficacy and adverse effects of these methods, METHODS： From 1995 to 2004, 93 patients with gastric fundal varices underwent interventional radiologic embolotherapy at our hospital. Of the 93 patients, 75 were treated with the balloon-occluded retrograde transvenous obliteration （BRTO） procedure; 8 were with the percutaneous transhepatic obliteration （PTO） procedure; and 10 were with the combined BRTO and PTO therapy. A follow-up evaluation examined the rates of survival, recurrence and rebleeding of the gastric varices, worsening of esophageal varices and complications in each group. RESULTS： The BRTO, PTO, and combined therapy were technically successful in 81% （75/93）, 44% （8/18）, and 100% （10/10） patients, respectively. Recurrence of gastric varices was found in 3 patients in the BRTO group and in 3 patients in the PTO group. Rebleeding was observed in 1 patient in the BRTO group and in 1 patient in the PTO group. The 1- and 3-year survival rates were 98% and 87% in the patients without hepatocellular carcinoma （HCC） in the BRTO group, 100% and 100% in the PTO group, and 90% and 75% in the combined therapy group, respectively. CONCLUSION： Combined BRTO and PTO therapy may rescue cases with uncontrollable gastric fundal varices that remained even after treatment with BRTO and/or PTO, though there were limitations of our study, including retrospective nature and discrepancy in sample size between the BRTO, PTO and combined therapy groups.

关键词： Gastric varices Balloon-occluded retrogradetransvenous obliteration Percutaneous transhepaticobliteration Combined therapy