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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)-α biologics has validated the role of inflammatory cytokines notably TNF-α in 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 naïve 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 st

关键词： Inflammatory bowel disease Myeloid lineage leucocytes Adsorptive granulocytes/monocytes apheresis Corticosteroid sparing effect Complement activation fragments Treating inflammatory bowel disease without drugs

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 *** 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

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

AIM： To investigate the role of cryofibrinogen （CF） in active inflammatory bowel disease （IBD）. METHODS： CF was assayed in 284 subjects： 61 with active and 63 with inactive ulcerative colitis （UC）, 45 who had proctocolectomy, 35 with active and 20 with inactive Crohn＇s disease （CD）, 40 with other diseases and 20 healthy controls. Trypsin inhibitor （TI） and TI antibody （TI-Ab） were measured in plasma and CF complex by ELISA. RESULTS： CF in active UC was strikingly high compared with all other groups （x^2〈0.001）. Similarly, CF was significantly higher in active CD than in inactive CD or in controls （x^2〈0.01）. In UC, high CF and TI-Ab were associated with the need for operations. Further, high CF, CF/fibrinogen ratio, low TI and high TI-Ab in plasma were associated with disease activity or refractoriness to medication. Elevated CF was not associated with acute reactants like C-reactive protein and white blood cell counts except for erythrocyte sedimentation rate, suggesting that elevated CF was not a consequence of acute inflammation. CONCLUSION： Elevated CF in active IBD appears to be morbigenous. CF promotes IBD via two main mechanisms, quenching of TI （an anti-inflammatory substance） and impairing microvascular perfusion by forming protein aggregates. CF may also serve as a biomarker of chronic IBD. Additional studies are warranted to fully evaluate the role of CF in IBD and the outcome should contribute to a better understanding of the pathogenesis of IBD.

关键词： Inflammatory bowel disease Cryofibrinogen Trypsin inhibitor Trypsin inhibitor antibody Acute colitis

A case study of seismic response of earth embankment foundation on liquefiable soils

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Journal of Central South University 2009年第6期16卷 994-1000页

作者：黄雨 YASHIMA A sawada K 张锋 Department of Geotechnical Engineering Tongji University Key Laboratory of Geotechnical and Underground Engineering Ministry of EducationTongji University Department of Civil Engineering Gifu University Department of Civil Engineering Nagoya Institute of Technology

A case study of seismic response of an earth embankment foundation on liquefiable soils in Kansai area,western Japan was presented. Based on a calibrated cyclic elasto-plastic constitutive model for liquefiable sand and Biot dynamic coupled theory,the seismic analysis was carried out by using a dynamic effective stress finite element method under plane strain condition. A recent design study was illustrated in detail for a river earth embankment subjected to seismic excitation on the saturated deposits with liquefiable sands. Simulated results of the embankment foundation during liquefaction were obtained for acceleration,displacement,and excess pore water pressures,which were considered to yield useful results for earthquake geotechnical design. The results show that the foundation soil reaches a fully liquefied state with high excess pore pressure ratios approaching to 1.0 due to the earthquake shaking. At the end of the earthquake,the extensive liquefaction causes about 1.0 m lateral spreading at the toe and 60 cm settlement at the crest of the earth embankment.

关键词： earth embankment earthquake liquefaction cyclic plasticity finite element method case study

Full polarimetric PALSAR-based land cover monitoring in Cambodia for implementation of REDD policies

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International Journal of Digital Earth 2013年第3期6卷 255-275页

作者： Ram Avtar Wataru Takeuchi Haruo sawada Institute of Industrial Science The University of TokyoTokyoJapan

Forest cover monitoring plays an important role in the implementation of climate change mitigation policies such as Kyoto protocol and Reducing Emissions from Deforestation and Forest Degradation(REDD).In this study,we have monitored land cover using the PALSAR(Phased Array type L-band Synthetic Aperture Radar)full polarimetric data based on incoherent target *** classification technique has been applied on CloudePottier decomposition,FreemanDurden three component,and Yamaguchi four component decomposition for accurate mapping of different types of land cover *** on confusion matrix derived from the predicted and defined pixels,the evergreen and sparsely deciduous forests have shown high producer’s accuracy by FreemanDurden three component and Yamaguchi four component classifica*** overall accuracy of Maximum Likelihood Classification by Yamaguchi four component is 94.1%with 0.93 kappa coefficient as compared to the 90.3%with 0.88 kappa coefficient by FreemanDurden three component and 89.7%with 0.88 kappa coefficient by CloudePottier *** accuracy of classification in a forested area using full polarimetric PALSAR data may have been because of high penetration of L-band *** content of this study could be useful for the forest cover mapping during cloudy days needed for proper implementation of REDD policies in Cambodia.

关键词： global climate change REDD PALSAR forest cover mapping

Dynamic pressure change in a rotating, laterally oscillating cylindrical container

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Journal of Ocean Engineering and Science 2018年第2期3卷 91-95页

作者： Yusuke Saito Tatsuo sawada Department of Mechanical Engineering Keio University3-14-1 HiyoshiKohoku-kuYokohama 223-8522Japan

We examined wave phenomena pertinent to water in a rotating,laterally oscillating cylindrical *** particular,we measured the time-dependent dynamic water pressure and pressure change by fast Fourier transform *** swirling of water in the container had three frequency components;the frequency responses of each frequency component are reported *** swirling occurs in a rotating cylindrical container,it was found that the wave rotating in the same direction as the rotation of the cylindrical container and the wave rotating in the opposite direction to the cylindrical container exist at the same *** swirling direction was determined by the relationship of these magnitude.

关键词： Sloshing Dynamic pressure Cylindrical container Rotation Oscillation Swirling

Synchrotron X-ray diagnostics of cutoff shape of nonthermal electron spectrum at young supernova remnants

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Research in Astronomy and Astrophysics 2014年第2期14卷 165-178页

作者： Ryo Yamazaki Yutaka Ohira Makoto sawada Aya Bamba Department of Physics and Mathematics Aoyama Gakuin University5-10-1 FuchinobeSagamihara 252-5258Japan

Synchrotron X-rays can be a useful tool to investigate electron accelera- tion at young supemova remnants （SNRs）. At present, since the magnetic field con- figuration around the shocks of SNRs is uncertain, it is not clear whether electron acceleration is limited by SNR age, synchrotron cooling, or even escape from the ac- celeration region. We study whether the acceleration mechanism can be constrained by the cutoff shape of the electron spectrum around the maximum energy. We derive analytical formulae of the cutoff shape in each case where the maximum electron en- ergy is determined by SNR age, synchrotron cooling and escape from the shock. They are related to the energy dependence of the electron diffusion coefficient. Next, we discuss whether information on the cutoff shape can be provided by observations in the near future which will simply give the photon indices and the flux ratios in the soft and hard X-ray bands. We find that if the power-law index of the electron spectrum is independently determined by other observations, then we can constrain the cutoff shape by comparing theoretical predictions of the photon indices and/or the flux ratios with observed data which will be measured by NuSTAR and/or ASTRO-H. Such study is helpful in understanding the acceleration mechanism. In particular, it will supply another independent constraint on the magnetic field strength around the shocks of SNRs.

关键词： acceleration of particles -- ISM: cosmic rays -- ISM: supernova rem-nants -- turbulence -- X-rays: ISM

Implicit Discontinuous Galerkin Method for RANS Simulation Utilizing Pointwise Relaxation Algorithm

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Communications in Computational Physics 2010年第3期7卷 510-533页

作者： Kanako Yasue Michiko Furudate Naofumi Ohnishi Keisuke sawada Department of Aerospace Engineering Graduate School of EngineeringTohoku UniversitySendai 980-8579Japan

An efficient implicit procedure for the Discontinuous Galerkin (DG) methodis developed utilizing a pointwise relaxation algorithm. In the pointwise relaxation,those contributions from the degrees of freedom in own computational cell are accounted for in the implicit matrix inversion. The resulting scheme is shown to be stablewith very large CFL numbers for both the Euler and the Navier-Stokes equations fortypical test problems. In order to achieve a faster convergence, efforts are also madeto reduce computing time of the present method by utilizing a p-multigrid schemeand also by solving a simplified matrix instead of a fully loaded dense matrix in theimplicit matrix inversion. A superior performance of the present implicit DG methodon the parallel computer using up to 128 PEs is shown in terms of readily achievablescalability and high parallel efficiency. The RANS simulation of turbulent flowfieldover AGARD-B model is carried out to show the convergence property and numericalstability of the present implicit DG method for engineering applications.

关键词： Discontinuous Galerkin method pointwise relaxation implicit scheme viscous compressible flow

An Implicit LU-SGS Scheme for the Spectral Volume Method on Unstructured Tetrahedral Grids

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Communications in Computational Physics 2009年第10期6卷 978-996页

作者： Takanori Haga Keisuke sawada Z.J.Wang Department of Aerospace Engineering Tohoku UniversitySendai 980-8579Japan Department of Aerospace Engineering Iowa State UniversityAmesIA 50011USA

An efficient implicit lower-upper symmetric Gauss-Seidel(LU-SGS)solution approach has been applied to a high order spectral volume(SV)method for unstructured tetrahedral *** LU-SGS solver is preconditioned by the block element matrix,and the system of equations is then solved with a LU *** compact feature of SV reconstruction facilitates the efficient solution algorithm even for high order *** developed implicit solver has shown more than an order of magnitude of speed-up relative to the Runge-Kutta explicit scheme for typical inviscid and viscous problems.A convergence to a high order solution for high Reynolds number transonic flow over a 3D wing with a one equation turbulence model is also indicated.

关键词： High-order unstructured grid spectral volume implicit method