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Initial experience with robot-assisted adrenalectomy for giant adrenal tumors

Asian Journal of Urology 2024年第3期11卷 507-508页

作者： Takayuki Ohzeki Hiroyuki Kita Remon Kunishige Taiji Hayashi Tsukasa Nishioka Koichi Sugimoto takafumi minami Kazutoshi Fujita Department of Urology Izumi City General Hospital4-5-1 WakechoIzumiOsaka 594-0073Japan Department of Urology Kaizuka City Hospital10-20 Hori 3-chomeKaizukaOsaka 594-0073Japan Department of Urology Kindai University Faculty of Medicine377-2 Ohno-HigashiOsaka-SayamaOsaka 589-8511Japan

Dear Editor,Adrenocortical carcinomas and adrenal cysts,including pseudocysts,are uncommon tumors[1,2].No consistent approach to surgery for large adrenal tumors including cysts,has been established,and especially when malignancy is suspected,consideration is still given to the option of *** robot-assisted surgery,we successfully performed the resection of a giant adrenal pseudocyst and a giant adrenocortical carcinoma,as reported previously[3],underlining the advantages of robot-assisted surgery for large adrenal tumors.

关键词： adrenal tumors surgery

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Cytomegalovirus infection in severe ulcerative colitis patients undergoing continuous intravenous cyclosporine treatment in Japan

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World Journal of Gastroenterology 2007年第5期13卷 754-760页

作者： Masaaki minami Michio Ohta Teruko Ohkura takafumi Ando Naoki Ohmiya Yasumasa Niwa Hidemi Goto Department of Gastroenterology Nagoya University Graduate School of Medicine 65 Tsurumai-cho Showa-ku Nagoya 466-8550 Japan Department of Bacteriology Nagoya University Graduate School of Medicine 65 Tsurumai-cho Showa-ku Nagoya 466-8550 Japan

AIM： TO investigate active cytomegalovirus （CMV） infection following the cydosporine A （CyA） treatment of steroid-refractory ulcerative colitis （UC）. METHODS： Twenty-three patients with severe UC not responding to steroid therapy （male 14, and female 9） enrolled at Nagoya University Hospital from 1999 to 2005. They received continuous intravenous infusion of CyA （average 4 mg/kg per day） for 1 mo. Serum and colonic biopsy samples were collected before CyA treatment and 4 d, 10 d, 20 d, and 30 d after treatment. Patients were evaluated for CMV by using serology （IgM antibody by ELISA）, quantitative real-time PCR for CMV DNA, and histopathological assessment of hematoxylin and eosin （HE）-stained colonic biopsies. CMV infection was indicated by positive results in any test. RESULTS： No patients had active CMV infection before CyA treatment. Eighteen of 23 UC patients treated with CyA were infected with active CMV （IgM antibody in 16/23 patients, 69.6%; CMV DNA in 18/23 patients, 78.2%; and inclusion bodies in 4/23 patients, 17.3%）. There was no difference in the active CMV-infection rate between males and females. Active CMV infection was observed after approximately 8 d of CyA treatment, leading to an exacerbation of colitis. Fifteen of these 18 patients with active CMV infection （83.3%） required surgical treatment because of severe deteriorating colitis. Treatment with ganciclovir rendered surgery avoidable in three patients. CONCLUSION： Our results suggest that active CMV infection in severe UC patients treated with CyA is associated with poor outcome. Further, ganciclovir is useful for treatment of CMV-associated UC after immunosuppressive therapy.

关键词： Cytomegalovirus Cyclosporine Ulcerative colitis Ganciclovir

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Interleukin-17 levels in Helicobacter pylori-infected gastric mucosa and pathologic sequelae of colonization

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World Journal of Gastroenterology 2005年第40期11卷 6305-6311页

作者： Tomokazu Mizuno takafumi Ando Kazuo Nobata Tomoyuki Tsuzuki Osamu Maeda Osamu Watanabe Masaaki minami Kenji Ina Kazuo Kusugami Richard M. Peek Hidemi Goto Department of Gastroenterology Division of Gastroenterology

AIM： To determine the role of interleukin （IL）-17 in gastric ulcerogenesis. METHODS： Thirty-six gastric ulcer （GU） patients and 29 non-ulcer （NU） patients were enrolled in this study. Mucosal biopsy samples were obtained from the gastric antrum and GU site during endoscopy. Samples were used in in situ stimulation for 48 h in the presence of 10 ug/mL phytohemagglutinin-P （PHA）, histological examination, and Helicobacter pylori（Hpylon） culture. IL-17 and IL-8 protein levels in culture supematants were assayed by ELISA. IL- 17 mRNA expression was analyzed by reverse transcriptasepolymerase chain reaction （RT-PCR）. Hpylori cagA and vacA status was assessed by reverse hybridization using a line probe assay （UPA）. IL-8 levels in culture supematants were assayed after AGS cells were co-cultured with Hpylori strain 26 695 or recombinant human （rh） IL-17. RESULTS： All 36 GU patients and 15 of 29 NU patients were found to be Hpy/or/-positive, while 14 NU patients were Hpylori-nogative. All 51 H pylori strains from both GU and NU patients were cagA- and vacAsl/ml-positive. Antral mucosal tissues from H pylori-positive patients contained significantly （H pylori-positive NU patients： median 467 pg/mg/protein, range 53-2 499; Hpylori negative NU patients： median 104 pg/mg/protein, range 16-312, P〈0.0005） higher levels of IL-17 than those from uninfected patients. IL-17 levels at the ulcer site were significantly （ulcer site： median 1 356 pcj/mg/protein, range 121-1 3730; antrum： median 761 pg/mg/protein, range 24-7 620, P〈0.005） higher than those at distant sites in the antrum. Biopsies from H pylori-positive GU and NU patients showed IL-17 mRNA expression in all samples whereas those from the antrum of the Hpylori-negativecontrols showed no detectable expression. A significant correlation was seen between IL-17 and IL-8 levels at each biopsy site （ulcer： r = 0.62,P〈0.0001; antrum： r = 0.61, P〈0.0001） in GU patients. RhIL-17 and Hpylori strain 26 695 each stimulated IL-8 product

关键词： Helicobacter pylori Gastric ulcer Histologicalgastritis Interleukin-17 Interleukin-8

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Prospective controlled study on the effects of polyethylene glycol in capsule endoscopy

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World Journal of Gastroenterology 2012年第15期18卷 1789-1792页

作者： takafumi Ito Ken Ohata Akiko Ono Hideyuki Chiba Yosuke Tsuji Hajime Sato Nobuyuki Matsuhashi Department of Gastroenterology Kanto Medical CenterNTT EastTokyo 1418625Japan Department of Health Policy and Technology Assessment National Institute of Public Health2-3-6 MinamiWako-shi 3293147Japan

AIM:To prospectively confirm whether a small amount of polyethylene glycol(PEG)ingested after swallowing endoscopy capsule improves image quality and completion ***:Forty-four consecutive patients referred to us for capsule endoscopy(CE)were randomized to two *** patients were restricted to clear fluids for 12 h before the *** in group A(22 cases)received no additional preparation,while those in group B(20 cases)ingested 500 mL of PEG within a 2 h period starting 30 min after swallowing the *** fluids and meals were allowed 2 h and 4 h after capsule ingestion,*** quality was assessed as the percentage of visualized bowel surface area as follows:1:90%.The small bowel record was divided into five segments by time,and the score for each segment was *** CE examinations were performed with the Pillcam SB capsule endoscopy sys-tem(Given Imaging ***.,Yoqnem).RESULTS:This study ended in December 2009,because sample size was considered large enough.A total of 44 patients were *** patients in group B were excluded from the analysis because small bowel images could not be obtained from these patients;one had a full stomach,while the other presented with a massive gastric ***,22 patients from group A and 20 patients from group B completed the *** was no significant difference in age(P=0.22),sex(P=0.31),and indication for *** significant adverse events occurred in any of the study *** group A,image quality deteriorated as the capsule progressed ***,in group B,image quality was maintained to the distal small *** each of the five segments,the visibility score was significantly higher in group B than in group A(segment 1:4.3± 0.7vs 4.7±0.5,P=0.03;segment 2:4.2±0.9vs 4.8 ±0.4,P=0.01;segment 3:4.0±1.0 vs 4.6±0.7,P =0.04;segment 4:3.6±1.1 vs 4.5±0.6,P=0.003;segment 5:2.7±1.0vs 4.4±0.8,P=0.00004).Thus,the use of PEG during CE e

关键词： Capsule endoscopy Completion rate Image quality Polyethylene glycol Preparation

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