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Evaluation of preferable insertion routes for esophagogastroduodenoscopy using ultrathin endoscopes

World Journal of Gastroenterology 2014年第17期20卷 5045-5050页

作者： satoshi Ono Keiko Niimi Mitsuhiro Fujishiro Yu takahashi Yoshiki Sakaguchi Chiemi Nakayama Chihiro Minatsuki Rie Matsuda Itsuko Hirayama-Asada Yosuke Tsuji satoshi Mochizuki Shinya Kodashima Nobutake Yamamichi Atsuko Ozeki Lumine Matsumoto Yumiko Ohike Tsutomu Yamazaki Kazuhiko Koike Center for Epidemiology and Preventive Medicine Graduate School of MedicineUniversity of TokyoTokyo 113-8655Japan Department of Gastroenterology Graduate School of MedicineUniversity of TokyoTokyo 113-8655Japan Department of Endoscopy and Endoscopic Surgery Graduate School of MedicineUniversity of TokyoTokyo 113-8655Japan

AIM:To evaluate the discomfort associated with esophagogastroduodenoscopy(EGD)using an ultrathin endoscope through different insertion routes.METHODS:This study(January 2012-March 2013)included 1971 consecutive patients[male/female(M/F),1158/813,57.5±11.9 years]who visited a single institute for annual health checkups.Transnasal EGD was performed in 1394 patients and transoral EGD in 577.EGD-associated discomfort was assessed using a visual analog scale score(VAS score:0-10).RESULTS:Multivariate analysis revealed gender(M vs F:4.02±2.15 vs 5.06±2.43)as the only independent predictor of the VAS score in 180 patients who underwent EGD for the first time;whereas it revealed gender(M vs F 3.60±2.20 vs 4.84±2.37),operator,age group(A:70 years;A/B/C/D/E:4.99±2.32/4.34±2.49/4.19±2.31/3.99±2.27/3.63±2.31),and type of insertion as independent predictors in the remaining patients.Subanalysis for gender,age group,and insertion route revealed that the VAS score decreased with age regardless of gender and insertion route,was high in female patients regardless of age and insertion route,and was low in males aged over60 years who underwent transoral insertion.CONCLUSION:Although comprehensive analysis revealed that the insertion route may not be an independent predictor of the VAS score,transoral insertion may reduce EGD-associated discomfort in elderly patients.

关键词： Esophagogastroduodenoscopy Ultrathin endoscope Vis

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Review of novel therapeutic medicines targeting androgen signaling in castration-resistant prostate cancer

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World Journal of Clinical Urology 2014年第3期3卷 264-271页

作者： Daisuke Obinata Kyoko Fujiwara Kenya Yamaguchi Ken-ichi Takayama Tomohiko Urano Hiroki Nagase satoshi Inoue Satoru takahashi Noboru Fukuda Department of Urology Nihon University School of MedicineTokyo 173-8610 Japan Division of General Medicine Department of Medicine Nihon University School of MedicineTokyo 173-8610 Japan Department of Anti-Aging Medicine Graduate School of Medicine The University of TokyoTokyo 113-8655 Japan Chiba Cancer Center Research Institute Chiba 260-8717 Japan Division of Life Science Advanced Research Institute of Sciences and Humanities Nihon UniversityTokyo 173-8610 Japan

Prostate cancer is the most common male malignant neoplasm.Androgens and the androgen receptor(AR)play a key role in the onset and progression of prostate cancer.The expression of the AR is still preserved in the majority of patients with castration-resistant prostate cancer(CRPC).CRPC is considered to be induced by the following mechanisms:(1)sustained AR activation by enhancing intracellular conversion of adrenal androgens to dehydrotestosterone via a de novo route;(2)AR hypersensitivity;(3)promiscuous activation of AR signaling;and(4)outlaw pathways.Recent advances in the treatment of CRPC include novel medicinestargeting AR signaling pathways.In addition,functional molecular studies have shown that some of the ARregulated genes and AR coregulators are prognostic markers and potential therapeutic targets for prostate cancer,particularly in the castration-resistant state.Therefore,identification of the AR signaling pathways responsible for establishment of CRPC is critical for developing new strategies for the treatment of CRPC.

关键词： Androgen receptor Prostate cancer Pyrrole-imidazole polyamide

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Cochlear Implantation in Patients with Eosinophilic Otitis Media

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International Journal of Otolaryngology and Head & Neck Surgery 2015年第1期4卷 32-37页

作者： Masahiro takahashi Yasuhiro Arai Naoko Sakuma Daisuke Sano Goshi Nishimura Takahide Taguchi Nobuhiko Oridate satoshi Iwasaki Shin-Ichi Usami Department of Otorhinolaryngology Head and Neck Surgery Yokohama City University School of Medicine Yokohama Japan Department of Otorhinolaryngology International University of Health and Welfare Mita Hospital Tokyo Japan Department of Otorhinolaryngology Shinshu University School of Medicine Nagano Japan

It is known that cochlear implantation for deaf patients with eosinophilic otitis media (EOM) is safe and can provide good speech perception. However, the best timing of implant surgery in patients with EOM is not yet known. The aim of this case report is to suggest the appropriate timing of the surgery in EOM patients with deaf. Cochlear implantation was indicated in two patients with EOM. One underwent cochlear implantation in the absence of any ear discharge. In the other case, implant surgery was delayed for three years due to persistent ear discharge. No complications related to implant device or skin flap were observed in either case. The speech recognition score after implantation was good in the first case and poor in the second case. Perioperative complications were manageable even in the patient with persistent ear discharge. However, the delay in implant surgery due to the persistent ear discharge resulted in a poor speech recognition score. Early implantation should be considered even in EOM patients with ear discharge, although the presence of active middle ear inflammation is regarded as one of the contraindications for implantation according to the current Japanese guidelines.

关键词： Eosinophilic Otitis Media Cochlear Implantation Speech Recognition

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Recovery from Out-of-Hospital Cardiopulmonary Arrest Due to Type A Acute Aortic Dissection: A Case Report

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Case Reports in Clinical Medicine 2016年第11期5卷 505-510页

作者： Yoko Sugawara Tomohiro Kurihara satoshi Ohtsubo Masanori Takamatsu Kenichiro Sasao Motojiro Takebe Shiho Irino Mirai takahashi Takashi Hirotani Kazuhiko Sekine Department of Emergency and Critical Care Medicine Tokyo Saiseikai Central Hospital Tokyo Japan Department of Cardiovascular Surgery Tokyo Saiseikai Central Hospital Tokyo Japan

Case: A 55-year-old man without past medical histories suffering from back pain for two weeks was successfully resuscitated from an 8-min cardiopulmonary arrest (CPA) and was brought to our hospital by ambulance. Computed tomography demonstrated type A acute aortic dissection (AAAD) with brachiocephalic artery occlusion. After admission, Glasgow Coma Scale score improved to E1VTM4, and voluntary movement was noted only in the right limbs. Outcome: The patient underwent emergency grafting of the ascending aorta and innominate artery under deep hypothermic circulatory arrest. After surgery, the patient recovered with mild disorientation and left hemiplegia. Magnetic resonance imaging of the head revealed no large infarction but revealed multiple acute ischemic changes. One year later, the patient demonstrated independent walk and successfully returned to work life. Conclusions: Immediate resuscitation and surgery resulted in good recovery from CPA after AAAD.

关键词： Aortic Branch Artery Occlusion Cerebral Ischemia Malperfusion Prognosis Surgical Indication

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OPTIMUM DESIGN OF CARS TO CONSIDER COMPATIBILITY

OPTIMUM DESIGN OF CARS TO CONSIDER COMPATIBILITY

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The Fourth China-Japan-Korea Joint symposium on Optimization of Structural and Mechanical Systems

作者： Hiroshi Yamakawa satoshi takahashi Professor Dept.of Mechanical Engineering School of Science ＆ EngineeringWaseda UniversityTokyoJapan Graduate student Dept.of Mechanical Engineering School of Science ＆ EngineeringWaseda UniversityTokyoJapan

＜正＞Optimum designs of car structures to consider compatibility are studied here which may make the damage on a smaller size car less when it collides with a bigger sized one. To avoid the tedious computation of nonlinear crash analysis the car is modeled here by lumped masses and nonlinear springs to express nonlinear dynamic behaviors which are identified from the results of FEM analysis and SISAME models Then crash analysis is carried out making use of the developed model. Based on the crash analysis ,the mass distributions and characteristics of nonlinear springs are determined optimally to minimize the maximum deceleration and the deformation at driver’s position in the smaller size car. Numerical results show the effectiveness of the proposed method. A basic optimum way of design to consider compatibility at an initial design stage is made available by the proposed method.

关键词： Car design Crash analysis Compatibility Lumped parameter model Structural optimization

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Resected tumor seeding in stomach wall due to endoscopic ultrasonography-guided fine needle aspiration of pancreatic adenocarcinoma

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World Journal of Gastroenterology 2015年第27期21卷 8458-8461页

作者： Akiko Tomonari Akio Katanuma Tomoaki Matsumori Hajime Yamazaki Itsuki Sano Ryuki Minami Manabu Sen-yo satoshi Ikarashi Toshifumi Kin Kei Yane Kuniyuki takahashi Toshiya Shinohara Hiroyuki Maguchi Center for Gastroenterology Teine-Keijinkai Hospital Department of Gastroenterology and Hepatology Kyoto University Graduate School of Medicine Department of Pathology Teine-Keijinkai Hospital

Endoscopic ultrasonography-guided fine needle aspiration(EUS-FNA) is a useful and relatively safe tool for the diagnosis and staging of pancreatic cancer. However, there have recently been several reports of tumor seeding after EUS-FNA of adenocarcinomas. A 78-year-old man was admitted to our hospital due to upper gastric pain. Examinations revealed a 20 mm mass in the pancreatic body, for which EUS-FNA was performed. The cytology of the lesion was adenocarcinoma, and the stage of the cancer was T3N0M0. The patient underwent surgery with curative intent, followed by adjuvant chemotherapy with S-1. An enlarging gastric submucosal tumor was found on gastroscopy at 28 mo after surgery accompanied by a rising level of CA19-9. Biopsy result was adenocarcinoma, consistent with a pancreatic primary tumor. Tumor seeding after EUS-FNA was strongly suspected. The patient underwent surgical resection of the gastric tumor with curative intent. The pathological result of the resected gastric specimen was adenocarcinoma with a perfectly matched mucin special stain result with the previously resected pancreatic cancer. This is the first case report of tumor seeding after EUS-FNA which was surgically resected and inspected pathologically.

关键词： Endoscopic ultrasonography-guided fine needle aspiration Tumor seeding Pancreatic cancer

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Investigation of Patients with Spontaneous Rupture of the Urinary Bladder

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Open Journal of Clinical Diagnostics 2015年第4期5卷 141-144页

作者： Yoshihiro Inoue Yasuhisa Fujino Makoto Onodera satoshi Kikuchi Masayuki Sato Hisaho Sato Masahiro Kojika Yasushi Suzuki Gaku takahashi Shigehiro Shibata Department of Critical Care Medicine School of Medicine Iwate Medical University Morioka Japan

Non-traumatic rupture of the urinary bladder is termed “spontaneous rupture of the urinary bladder”. Although this disorder is relatively rare, when the bladder ruptures into the abdominal cavity, urine leaking into the abdominal cavity leads to the development of urinary peritonitis. We encountered seven patients with spontaneous rupture of the urinary bladder at our institution between 1987 and 2012. Six of these patients were women, all of whom had undergone surgery and radiotherapy to treat malignant uterine tumor. All seven patients suddenly developed abdominal pain and ascites. Urea nitrogen (UN) and creatinine (Cre) levels were greater in ascites than in the blood in all patients. Although all patients were treated conservatively, recurrence was identified in three patients. Recurrence was observed in only one of the four patients who received hyperbaric oxygen therapy. Conclusion: Hyperbaric oxygen therapy may be effective for recurrence of spontaneous rupture of the urinary bladder.

关键词： Spontaneous Rupture of the Urinary Bladder Hyperbaric Oxygen Therapy (HBO)

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A Greater Association of Hyperuricemia than of Metabolic Syndrome with the New Incidence of Chronic Kidney Disease

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Open Journal of Nephrology 2016年第1期6卷 17-27页

作者： Satoru Kuriyama Shinichiro Nishio satoshi Kidoguchi Kosuke Honda Yasuhito takahashi Naoki Sugano Yukio Maruyama Tatsuo Hosoya Tomoko Nakano Tomoko Tanabe Edward Stim Takashi Yokoo Division of Nephrology & Hypertension Department of Medicine Jikei University Tokyo Japan Health Management Center & Tokyo Regional Taxation Bureu Clinic Tokyo Japan Department of Pathophysiology & Therapy in Chronic Kidney Disease Jikei University School of Medicine Tokyo Japan Emergency Assistance Japan Tokyo

Background: To what extent uric acid (UA) levels and/or metabolic syndrome (Mets) contribute to the onset of chronic kidney disease (CKD) is largely unknown. The present study explores how these two factors have an association with the new incidence of CKD. Methods: Study design is a cohort study. A total of 14,485 participants were eligible for the cross-sectional analysis on UA levels and the prevalence of Mets. Among those individuals, 8,223 participants without CKD and 4,839 without Mets were eligible for the longitudinal analysis of the new incidence of CKD. Parameters monitored were body mass index, systolic and diastolic blood pressure, serum creatinine concentration, estimated glolerular filtration rate, lipid profiles, plasma glucose, HbA1c. The primary predictor was the level of UA and Mets to explain the newly-developed CKD. The observation period was 4 years. Results: In a cross-sectional analysis, higher UA levels were associated with the greater prevalence of Mets. In addition, UA levels were associated with the numbers of the Mets constituents in both genders. In a longitudinal analysis, higher UA levels were associated with the greater rate of CKD and the greater incidence of Mets. In addition, the incidence of CKD at year 4 was influenced by the presence of hyperuricemia, but not by that of the Mets. The odd ratio (OR) to predict the CKD incidence was 1.42 (95% confidence intervals (CI), 0.52 to 3.78) in the presence of Mets alone, 2.10 (95% CI, 1.36 to 3.23) in the presence of hyperuricemia alone, and 3.56 (95% CI, 1.55 to 8.21) in the presence of both. Conclusion: Hyperuricemia has a greater association with the incidence of CKD than Mets does. Hyperuricemia complicated by Mets is additionally detrimental.

关键词： Uric Acid Hypertension CKD Estimated Glomerular Filtration Rate

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Importance of virological response in the early stage of telaprevir-based triple therapy for hepatitis C

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World Journal of Hepatology 2015年第26期7卷 2688-2695页

作者： satoshi Hiramine Norihiro Furusyo Eiichi Ogawa Makoto Nakamuta Eiji Kajiwara Hideyuki Nomura Kazufumi Dohmen Kazuhiro takahashi Takeaki Satoh Koichi Azuma Akira Kawano Toshimasa Koyanagi Kazuhiro Kotoh Shinji Shimoda Jun Hayashi Depart- ment of General Internal Medicine Kyushu University Hospital Department of Gastroenterology Kyushu Medical CenterNational Hospital Organization Department of Hepatology Steel Memorial Yahata Hospital the Center for Liver Disease Shin-Kokura Hospital Department of Internal Medicine Chihaya Hospital Department of Medicine Hamanomachi Hospital Center for Liver Disease National Hospital Organization Kokura Medical Center Department of Medicine Kyushu Central Hospital Department of Medicine Kitakyushu Municipal Medical Center Department of Medicine Fukuoka City Hospital Department of Medicine and Bioregulatory Science Graduate School of Medical Sciences Kyushu University Kyushu General Internal Medicine Center Hara- Doi Hospital

AIM: To investigate the efficacy of virological response(VR) to telaprevir(TVR)-based triple therapy in predicting treatment outcome of hepatitis C.METHODS: This prospective, multicenter study consisted of 253 Japanese patients infected with hepatitis C virus(HCV) genotype 1b. All received 12 wk of TVR in combination with 24 wk of pegylatedinterferon-α(IFN-α) and ribavirin. Serum HCV RNA was tested at weeks 1, 2, 3, 4, 6, 8, 12, 16, 20, and 24. VR was defined as undetectable serum HCV RNA. Sustained virological response(SVR) was VR at 24 wk after the end of treatment and was regarded as a successful outcome.RESULTS: Of 253 patients, 207(81.8%) achieved SVR. The positive predictive value of VR for SVR was 100% at week 2, after which it gradually decreased, and was over 85% to week 12. The negative predictive value(NPV) gradually increased, reaching 100% at week 12. The upslope of the NPV showed a large increase from week 4(40.6%) to week 6(82.4%). There was a moderate concordance between the SVR and VR at week 6(kappa coefficient = 0.44), although other VRs had poor concordance to SVR. Multiple logistic regression analysis extracted VR at week 6(P < 0.0001, OR = 63.8) as an independent factor contributing to SVR. In addition, the interleukin-28 B single nucleotide polymorphism and response to previous pegylated-IFN-α and ribavirin therapy were identified as independent factors for SVR.CONCLUSION: VR at week 6, but not at week 4, is an efficient predictor of both SVR and non-SVR to TVRbased triple therapy.

关键词： Chronic hepatitis C Direct-acting antiviral agent

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One-Step Multiplex PCR for Simultaneous Detection and Identification of Eight Medically Important <i>Candida</i>Species

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Open Journal of Stomatology 2021年第1期11卷 14-24页

作者： Akira Fukatsu Osamu Tsuzukibashi Hidenori Suzuk Katsuhiro Asaka Yoshinori Ono Mana Fuchigami Taira Kobayashi satoshi Uchibori Yuji takahashi Chiaki Komine Yoshimi Konishi Yuki Ogura Hiroko Omori Masanobu Wakami Hiroshi Murakami Masahiko Fukumoto Division of Laboratory Medicine for Dentistry Department of Oral Health Science Nihon University School of Dentistry at Matsudo Chiba Japan Laboratory Medicine for Dentistry Nihon University Graduate School of Dentistry at Matsudo Chiba Japan Department of Fixed Prosthodontics and Oral Implantology Nihon University School of Dentistry at Matsudo Chiba Japan Division of Oral Function and Rehabilitation Department of Oral Health Science Nihon University School of Dentistry at Matsudo Chiba Japan

Recently, the incidence of Candida infections has substantially increased. Conventional identification methods for Candida species are technically difficult to conduct and cannot accurately distinguish each species. The purpose of the present study was to design primers to identify and detect simultaneously eight medically important Candida species using one-step multiplex PCR. PCR primers were designed based on partial sequences of intergenic spacer (IGS) and internal transcribed spacer (ITS) genes of eight medically important Candida species. These primers were able to distinguish each Candida species and did not display cross-reactivity with representative Candida species other than the eight Candida species. Moreover, our developed one-step multiplex PCR method is accurate, specific, cost-effective, time-saving, and worked without requiring DNA extraction.

关键词： Candida Candida albicans One-Step Multiplex PCR PCR Method

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