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Long-term growth of intrahepatic papillary neoplasms: A case report

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World Journal of Gastroenterology 2019年第36期25卷 5569-5577页

作者： Takumu Hasebe koji sawada Hidemi Hayashi Shunsuke Nakajima Hiroyuki Takahashi Masahiro Hagiwara koji Imai Sayaka Yuzawa Mikihiro Fujiya Hiroyuki Furukawa Toshikatsu Okumura Department of Medicine Division of Gastroenterology and Hematology/Oncology Asahikawa Medical University Asahikawa 0788510 Hokkaido Japan Department of Surgery Division of Gastroenterological and General Surgery Asahikawa Medical University Asahikawa 0788510 Hokkaido Japan Department of Diagnostic Pathology Asahikawa Medical University Hospital Asahikawa 0788510 Hokkaido Japan

BACKGROUND Intraductal papillary neoplasm of the bile duct (IPNB) is a type of tumor that presents in the intra- or extrahepatic bile ducts. Cystic-type intrahepatic IPNB often mimics simple liver cysts, making the diagnosis difficult. Because the growth of IPNB is slow, careful follow-up and timely therapeutic intervention is recommended. There are few reports with a follow-up period longer than a decade;thus, we report the case of a patient with an IPNB that grew for over 13 years. CASE SUMMARY A 65-year-old man was diagnosed, 13 years prior with a cystic hepatic tumor with abnormal imaging findings. The targeted tumor biopsy results showed no malignancy. Biannual follow-up examinations were performed because of the potential for malignancy. The cystic lesions showed gradual enlargement over 11 years and a 4 mm papillary proliferation appeared on the cyst wall, which is compatible with IPNB. The tumor was observed for another 2 years because of the patient’s wishes. The imaging findings showed enlargement to 8 mm and a new 9 mm papillary proliferation of the cystic tumor. Contrast-enhanced ultrasonography showed hyperenhancement during the arterial phase in both cyst walls, indicating intraductal tumor progression in both tumors. Thus, liver segment 8 subsegmentectomy was performed. The pathological findings indicated that the tumors contained mucin, and high-grade atypia was observed in the papillary lesions, showing IPNB.CONCLUSION The development of IPNB should be monitored in patients with cystic lesions and ultrasonography are useful tool for the evaluation.

关键词： Bile duct neoplasm Mucin Disease progression Ultrasonography Perfluorobutane Case report

Risk and Protective Factors Associated with Depression and Anxiety among Pregnant Women during the COVID-19 Pandemic

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Health 2024年第1期16卷 37-51页

作者： Maiko Manaka Miyako Tsuda Moe Fujitani Ai sawada Nanae Akatsuka Ayako Sasaki Faculty of Nursing Osaka Medical and Pharmaceutical University Takatsuki Japan Osaka City Juso Hospital Osaka Japan Osaka City General Hospital Osaka Japan

Background: The coronavirus disease (COVID-19) pandemic has impacted perinatal women’s mental health. However, protective factors associated with depression among pregnant Japanese women during the pandemic have not been reported. Purpose: The present study investigated the risk and protective factors associated with depression and anxiety among pregnant women during the COVID-19 pandemic. Methods: An online questionnaire was administered to 157 pregnant women between October 2022 and May 2023 at two general hospitals in Japan. The Japanese versions of the Patient Health Questionnaire-9 (PHQ-9) and General Anxiety Disorder-7 (GAD-7) were used to assess symptoms of depression and anxiety. The χ2 test or Fisher’s exact test and multivariate logistic regression model were used to examine factors associated with depression and anxiety among pregnant women. Results: Overall, 47.1% and 35.7% of the pregnant women reported depressive and anxiety symptoms, respectively. A “history of mental illness” was a risk factor for depression and anxiety among pregnant women during the COVID-19 pandemic. Additionally, unmarried status was a risk factor for anxiety among pregnant women, whereas outdoor and indoor exercises were protective factors against depression and anxiety, respectively. Conclusions: Exercise may have protected pregnant women from depression and anxiety during the COVID-19 pandemic. Encouraging exercise may help maintain the mental health of pregnant women who do not have exercise restrictions.

关键词： Depression Anxiety Factors Pregnancy COVID-19 Pandemic

Elevated plasma cryofibrinogen in patients with active inflammatory bowel disease is morbigenous

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World Journal of Gastroenterology 2006年第10期12卷 1621-1625页

作者： koji sawada Ryouki Takahashi Abbi R Saniabadi Maiko Ohdo Takashi Shimoyama Department of Gastroenterology Fujimoto Hospital MedicineOsaka and Department of GastroenterologyHyogo College of MedicineNishinomiyaJapan Wakamoto Pharmaceuticals Sagami Laboratory KanagawaJapan Japan Immunoresearch Laboratories.Takasaki Japan Department of Gastroenterology Hyogo College of Medicine NishinomiyaJapan

瞄准：在活跃的煽动性的肠疾病(IBD ) 调查冷沉纤维蛋白(CF ) 的角色。方法：CF 是在 284 个题目的 assayed：61 与活跃并且 63 与不活跃的 ulcerative (UC ) ， 45 有 proctocolectomy， 35 与活跃并且 20 与不活跃的 Crohn 的疾病(CD... 详细信息

瞄准：在活跃的煽动性的肠疾病(IBD ) 调查冷沉纤维蛋白(CF ) 的角色。方法：CF 是在 284 个题目的 assayed：61 与活跃并且 63 与不活跃的 ulcerative (UC ) ， 45 有 proctocolectomy， 35 与活跃并且 20 与不活跃的 Crohn 的疾病(CD ) ， 40 与另外的疾病和 20 健康控制。胰岛素禁止者(TI ) 和 TI 抗体(TI-Ab ) 被 ELISA 在血浆和 CF 建筑群测量。结果：在活跃 UC 的 CF 与所有另外的组(c2<0.001 ) 相比惊人地高。同样， CF 比在不活跃的 CD 或在控制(c2<0.01 ) 在活跃 CD 是显著地更高的。在 UC，高 CF 和 TI-Ab 与对操作的需要被联系。进一步，在血浆的高 CF， CF/fibrinogen 比率，低 TI 和高 TI-Ab 与疾病活动或倔强被联系到药。提高的 CF 没与相似 C 反应的蛋白质和白血房间除了红细胞沉降率数的尖锐反应物被联系，建议那提高的 CF 不是急性炎的后果。结论：在活跃 IBD 的提高的 CF 看起来是致病。CF 经由二主要机制支持 IBD， TI (一种反煽动性的物质) 熄灭并且损害由形成蛋白质总数的微脉管的灌注。CF 可以也用作长期的 IBD 的一个简历标记。另外的研究被保证充分在 IBD 评估 CF 的角色，结果应该贡献 IBD 的致病的更好的理解。

关键词：等离子体冷纤维蛋白原疾病炎症药物抗体

Treating inflammatory bowel disease by adsorptive leucocytapheresis:A desire to treat without drugs

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World Journal of Gastroenterology 2014年第29期20卷 9699-9715页

作者： Abbi R Saniabadi Tomotaka Tanaka Toshihide Ohmori koji sawada Takayuki Yamamoto Hiroyuki Hanai Department of Pharmacology Hamamatsu University School of Medicine Department of Gastroenterology Akitsu Prefectural Hospital Ohmori Gastrointestinal Clinic Ikoma General and Gastroenterological Clinic Inflammatory Bowel Disease Centre Yokkaichi Social Insurance Hospital Hamamatsu South Hospital

Ulcerative colitis and Crohn’s disease are the major phenotypes of the idiopathic inflammatory bowel disease(IBD),which afflicts millions of individuals throughout the world with debilitating symptoms,impairing function and quality of life.Current medications are aimed at reducing the symptoms or suppressing exacerbations.However,patients require life-long medications,and this can lead to drug dependency,loss of response together with adverse side effects.Indeed,drug side effects become additional morbidity factor in many patients on long-term medications.Nonetheless,the efficacy of anti-tumour necrosis factors(TNF)-αbiologics has validated the role of inflammatory cytokines notably TNF-αin the exacerbation of IBD.However,inflammatory cytokines are released by patients’own cellular elements including myeloid lineage leucocytes,which in patients with IBD are elevated with activation behaviour and prolonged survival.Accordingly,these leucocytes appear logical targets of therapy and can be depleted by adsorptive granulocyte/monocyte apheresis(GMA)with an Adacolumn.Based on this background,recently GMA has been applied to treat patients with IBD in Japan and in the European Union countries.Efficacy rates have been impressive as well as disappointing.In fact the clinical response to GMA seems to define the patients’disease course,response to medications,duration of active disease,and severity at entry.The best responders have been first episode cases(up to 100%)followed by steroid nave and patients with a short duration of active disease prior to GMA.Patients with deep ulcers together with extensive loss of the mucosal tissue and cases with a long duration of IBD refractory to existing medications are not likely to benefit from GMA.It is clinically interesting that patients who respond to GMA have a good long-term disease course by avoiding drugs including corticosteroids in the early stage of their IBD.Additionally,GMA is very much favoured by patients for its good safety profile.GMA in 21st century reminds us of ph

关键词： Inflammatory bowel disease Myeloid lineage leucocy

日本百年石质文物保护:从技术演进到大遗址保护的全景探析

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华夏考古 2024年第3期 125-129页

作者： [日]泽田正昭雷欣怡(译) 日本奈良文化财研究所成都博物馆四川成都市610015

人类创造并传承至今的历史,启示着人类社会的理想状态和前进方向。此中,文化遗产更被誉为人类社会的指南针,是历史的重要物证。尤其近年来,政府极力主张它们应作为旅游资源被有效利用,许多地方率先加强行政效能到地方文化的振兴中,依托... 详细信息

人类创造并传承至今的历史,启示着人类社会的理想状态和前进方向。此中,文化遗产更被誉为人类社会的指南针,是历史的重要物证。尤其近年来,政府极力主张它们应作为旅游资源被有效利用,许多地方率先加强行政效能到地方文化的振兴中,依托当地历史文化,通过世界遗产名录活动的开展和文化遗产的认定,达到地方振兴的目的。像这样将文化遗产作为媒介,举办地域认同感的文化活动也成为近年的趋势。

关键词：世界遗产名录文化遗产石质文物保护日本百年大遗址保护技术演进重要物证指南针

Ultrasound-guided rectus sheath block for anterior cutaneous nerve entrapment syndrome after laparoscopic surgery:A case report

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World Journal of Clinical Cases 2022年第7期10卷 2357-2362页

作者： Ryuji sawada Kunitaro Watanabe Joho Tokumine Alan Kawarai Lefor Tadao Ando Tomoko Yorozu Department of Pain Clinic NTT Medical Center TokyoHigashigotanda 141-8625TokyoJapan Department of Anesthesiology Hino Municipal HospitalTamadaira 191-0062TokyoJapan Department of Anesthesiology Kyorin University School of MedicineMitaka 181-8611TokyoJapan Department of Surgery Jichi Medical UniversityShimotsuke 329-0498TochigiJapan

BACKGROUND Anterior cutaneous nerve entrapment syndrome is defined as abdominal pain due to entrapped intercostal nerves.This is the first report of a patient successfully treated for anterior cutaneous nerve entrapment syndrome after laparoscopic surgery with an ultrasound-guided rectus sheath block.The rectus sheath block physically lysed adhesions and relieved pain from anterior cutaneous nerve entrapment syndrome.CASE SUMMARY The patient is a 44-year-old man who presented with severe left upper abdominal pain at an operative scar one month after laparoscopic ulcer repair.Diagnosis and treatment were performed using an ultrasound-guided rectus sheath block with 0.1%lidocaine 20 mL.The pain was relieved after the block.The diagnosis was anterior cutaneous nerve entrapment syndrome.Rectus sheath block may be effective for patients with anterior cutaneous nerve entrapment syndrome.CONCLUSION Ultrasound-guided rectus sheath block is a promising treatment modality for patients with postoperative anterior cutaneous nerve entrapment syndrome due to adhesions.

关键词： Anterior cutaneous nerve entrapment syndrome Rectus sheath block Hydrodissection Laparoscopic surgery Case report

Neurorehabilitation using a voluntary driven exoskeletal robot improves trunk function in patients with chronic spinal cord injury: a single-arm study

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Neural Regeneration Research 2022年第2期17卷 427-432页

作者： Hiroki Okawara Syoichi Tashiro Tomonori sawada Keiko Sugai Kohei Matsubayashi Michiyuki Kawakami Satoshi Nori Osahiko Tsuji Narihito Nagoshi Morio Matsumoto Masaya Nakamura Department of Orthopaedic Surgery Keio University School of MedicineTokyoJapan Department of Rehabilitation Medicine Keio University School of MedicineTokyoJapan Department of Orthopedic Surgery National Hospital OrganizationMurayama Medical CenterTokyoJapan

Body weight-supported treadmill training with the voluntary driven exoskeleton(VDE-BWSTT) has been shown to improve the gait function of patients with chronic spinal cord injury. However, little is known whether VDE-BWSTT can effectively improve the trunk function of patients with chronic spinal cord injury. In this open-label, single-arm study, nine patients with chronic spinal cord injury at the cervical or thoracic level(six males and three females, aged 37.8 ± 15.6 years, and time since injury 51.1 ± 31.8 months) who underwent outpatient VDE-BWSTT training program at Keio University Hospital, Japan from September 2017 to March 2019 were included. All patients underwent twenty 60-minute gait training sessions using VDE. Trunk muscular strength, i.e., the maximum force against which patient could maintain a sitting posture without any support, was evaluated in four directions: anterior, posterior, and lateral(right and left) after 10 and 20 training sessions. After intervention, lateral muscular strength significantly improved. In addition, a significant positive correlation was detected between the change in lateral trunk muscular strength after 20 training sessions relative to baseline and gait speed. The change in trunk muscular strength after 20 training sessions relative to baseline was greatly correlated with patient age. This suggests that older adult patients with chronic spinal cord injury achieved a greater improvement in trunk muscle strength following VDE-BWSTT. All these findings suggest that VDE-BWSTT can improve the trunk function of patients with chronic spinal cord injury and the effect might be greater in older adult patients. The study was approved by the Keio University of Medicine Ethics Committee(IRB No. 20150355-3) on September 26, 2017.

关键词： body weight-supported treadmill training gait disorders hybrid assistive limb neurologic neurophysiotherapy postural balance precision medicine robot-assisted gait training robotics spinal cord injury trunk

Efficacy of neoadjuvant chemotherapy for initially resectable colorectal liver metastases:A retrospective cohort study

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World Journal of Gastrointestinal Oncology 2022年第7期14卷 1281-1294页

作者： Kazuhisa Takeda Yu sawada Yasuhiro Yabushita Yuki Honma Takafumi Kumamoto Jun Watanabe Ryusei Matsuyama Chikara Kunisaki Toshihiro Misumi Itaru Endo Gastroenterological Center Yokohama City University Medical CenterYokohama 232-0024Japan Department of Gastroenterological Surgery Yokohama City University Graduate School of MedicineYokohama 236-0004Jordan Department of Biostatistics Yokohama City University Graduate School of MedicineYokohama 236-0004Japan

BACKGROUND The liver is the most common metastatic site of colorectal cancer.Hepatectomy is the mainstay of treatment for patients with colorectal liver metastases(CRLMs).However,there are cases of early recurrence after upfront hepatectomy alone.In selected high-risk patients,neoadjuvant chemotherapy(NAC)may improve longterm survival.AIM To determine the efficacy of NAC for initially resectable CRLMs.METHODS Among 644 patients who underwent their first hepatectomy for CRLMs at our institution,297 resectable cases were stratified into an upfront hepatectomy group(238 patients)and a NAC group(59 patients).Poor prognostic factors for upfront hepatectomy were identified using multivariate logistic regression analysis.Propensity score matching was used to compare clinical outcomes between the upfront hepatectomy and NAC groups,according to the number of poor prognostic factors.Survival curves were estimated using the Kaplan-Meier method and compared using the log-rank test.RESULTS Preoperative carcinoembryonic antigen levels(≥10 ng/mL)(P=0.003),primary histological type(other than well/moderately differentiated)(P=0.04),and primary lymph node metastases(≥1)(P=0.04)were identified as independent poor prognostic factors for overall survival(OS)in the upfront hepatectomy group.High-risk status was defined as the presence of two or more risk factors.After propensity score matching,50 patients were matched in each group.Among high-risk patients,the 5-year OS rate was significantly higher in the NAC group(13 patients)than in the upfront hepatectomy group(18 patients)(100%vs 34%;P=0.02).CONCLUSION NAC may improve the prognosis of high-risk patients with resectable CRLMs who have two or more risk factors.

关键词： Colorectal neoplasms Neoadjuvant therapy Neoplasm metastasis Prognosis Risk factors Survival

NF-κB Regulates B-Cell-Derived Nerve Growth Factor Expression

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Cellular & Molecular Immunology 2006年第1期3卷 63-66页

作者： Klaus Heese Noriko Inoue Tohru sawada Department of Molecular and Cell Biology School of Biological SciencesNanyang Technological University60 Nanyang DriveSingapore 637551Singapore BF Research Institute Inc.Itoyoshi Building 2012-5-9 DoshomachiChuo-kuOsaka 541-0045Japan BF Research Institute Inc. Itoyoshi Building 2012-5-9 DoshomachiChuo-kuOsaka 541-0045Japan

In the mammalian brain, four neurotrophins have been identified： nerve growth factor （NGF）, brain-derived neurotrophic factor （BDNF）, neurotrophin-3 （NT-3） and neurotrophin-4/5 （NT-4/5）. NGF exerts an important role in the development and functions of the central and peripheral nervous system. However, it has recently been documented that several types of immune cells, such as mast ceils, iymphocytes, basophils and eosinophils, produce, store and release NGF. Accumulating preclinical and clinical data indicate that dysfunctions of NGF and the other neurotrophins may contribute to impaired immune responses and concentration of NGF frequently correlates with disease severity. Thus, the aim of this study was to elucidate the potential signaling mechanisms of cytokineneurotrophins interactions contributing to increased NGF levels. Our data show that the transcription factor NF-κB plays a pivotal role in regulating B-cell-derived NGF expression.

关键词： immune system inflammation interleukin NGF neurotrophin