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World Journal of Gastroenterology 2014年第33期20卷 11850-11855页

作者： Katsutoshi Sugimoto Hisashi Oshiro Saori Ogawa Mitsuyoshi Honjo takeshi hara Fuminori Moriyasu Department of Gastroenterology and Hepatology Tokyo Medical University Tokyo 160-0023 Japan Department of Pathology Tokyo Medical University Tokyo 160-0023 Japan Department of Intelligent Image Information Gifu University Graduate School of Medicine Gifu 501-1193 Japan

AIM: To evaluate the usefulness of three-dimensional (3D) shear-wave elastography (SWE) in assessing the liver ablation volume after radiofrequency (RF) ablation.

关键词： Radiofrequency ablation Liver Ultrasound Shear-wave elastography Three-dimensional

Natural history of inferior mesenteric arteriovenous malformation that led to ischemic colitis: A case report

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World Journal of Clinical Cases 2021年第2期9卷 396-402页

作者： Yushi Kimura takeshi hara Ryotaro Nagao Takayuki Nakanishi Junji Kawaguchi Atsushi Tagami Tsuneko Ikeda Hiroshi Araki Hisashi Tsurumi Department of Gastroenterology Matsunami General HospitalHashima-gun 501-6062Japan Department of Hematology Matsunami General HospitalHashima-gun 501-6062Japan Department of Pathology Matsunami General HospitalHashima-gun 501-6062Japan

BACKGROUND Ischemic colitis with inferior mesenteric arteriovenous malformation(AVM)is a rare *** a few reports have been published,no report has described the natural history of idiopathic mesenteric *** SUMMARY A 50-year-old male was admitted to our hospital due to abdominal pain that had persisted for 3 mo and bloody *** had no history of trauma or abdominal *** had undergone two colonoscopies 6 mo and 2 years ago,and they showed only a *** was diagnosed with ischemic colitis with inferior mesenteric AVM following contrast-enhanced abdominal computed tomography(CT)and underwent rectal low anterior *** has not had a recurrence of symptoms for 3 *** history showed that he had undergone non-enhanced abdominal CT 2,5,and 8 years ago when he had attacks of urinary ***,dilation of blood vessels around the rectosigmoid colon could have been detected 5 years ago,and these findings gradually became more *** This is the first report of the natural history of inferior mesenteric AVM.

关键词： Inferior mesenteric arteriovenous malformation Ischemic colitis Natural history Case report Arteriovenous malformation

Sofosbuvir plus ribavirin is tolerable and effective even in elderly patients 75-years-old and over

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World Journal of Hepatology 2020年第9期12卷 672-684页

作者： Hideyuki Tamai Naoki Shingaki Yoshiyuki Ida Ryo Shimizu Shuya Maeshima Junpei Okamura Akira Kawashima Taisei Nakao takeshi hara Hiroyoshi Matsutani Izumi Nishikawa Katsuhiko Higashi Department of Hepatology Wakayama Rosai HospitalWakayama 6408505Japan Second Department of Internal Medicine Wakayama Medical UniversityWakayama 6418509Japan Department of Internal Medicine Naga Municipal HospitalWakayama 6496414Japan Department of Gastroenterology Wakayama Rosai HospitalWakayama 6408505Japan Department of Internal Medicine Hidaka General HospitalWakayama 6440002Japan

BACKGROUND Although clinical use of sofosbuvir plus ribavirin has been approved for patients infected with genotype 2 hepatitis C virus,patients≥75-years-old have not been included in previous clinical *** To evaluate the real-world safety and efficacy of sofosbuvir plus ribavirin for elderly patients(≥75-years-old)compared to nonelderly patients,we conducted a post-marketing prospective cohort *** We treated 265 patients with genotype 2 hepatitis C virus using standard approved doses of sofosbuvir(400 mg/d)plus ribavirin adjusted by body weight,administered orally for 12 *** Sustained virological response rates for the overall cohort,patients<65-years-old,≥65-years-old but<75-years-old,and≥75-years-old were 97%(258/265),98%(93/95),97%(84/87),and 98%(81/83),respectively(P=0.842).Logistic regression analyses identified history of hepatocellular carcinoma treatment and alpha-fetoprotein as factors significantly associated with sustained virological ***-fetoprotein was the only independent factor *** virological response rate was significantly lower for patients with hepatocellular carcinoma treatment(91%)than for patients without history of hepatocellular carcinoma treatment(98%,P=0.004).One patient(0.4%)discontinued treatment due to drug-induced *** reduction or interruption of ribavirin was required for 12.1%(32/265)of patients because of anemia,including 7.7%(14/182)of patients<75-years-old and 21.7%(18/83)of patients≥75-years-old(P=0.002).CONCLUSION Although ribavirin dose reduction or interruption was required with advanced age,sofosbuvir plus ribavirin appears tolerable and highly effective even in patients≥75-years-old.

关键词： Hepatitis C virus Genotype 2 Sofosbuvir Ribavirin Elderly patients Cirrhosis

Garenoxacin Prophylaxis for Febrile Neutropenia after Chemotherapy in Hematological Malignancies

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Open Journal of Internal Medicine 2016年第4期6卷 128-138页

作者： Nobuhiko Nakamura takeshi hara Soranobu Ninomiya Yuhei Shibata Takuro Matsumoto Hiroshi Nakamura Junichi Kitagawa Yasuhito Nannya Masahito Shimizu Nobuo Murakami Hisashi Tsurumi Department of Hematology Gifu University Graduate School of Medicine Gifu Japan

Background: Febrile neutropenia is one of the most serious adverse events in patients with hematological malignancies and chemotherapy. The routine use of fluoroquinolone prophylaxis in patients with hematological malignancies is controversial. Therefore, we prospectively evaluated the efficacy and safety of prophylactic use of garenoxacin for febrile neutropenia. Patients and Methods: Consecutive adult patients with hematological malignancies who were at risk for chemotherapy-induced neutropenia lasting more than seven days were eligible for present study. They received oral garenoxacin (400 mg daily) from the neutrophil count decreased to less than 1000/μl and continued until the neutropenia had resolved. The primary endpoint was incidence of febrile neutropenia, and the secondary endpoints were the type and incidence of adverse events. Results: We enrolled 46 consecutive patients (median age, 59 years). The underlying diseases comprised acute myeloid leukemia (n = 17), acute lymphoblastic leukemia (n = 3), malignant lymphoma (n = 23), and multiple myeloma (n = 3). There were 23 febrile neutropenia episodes and 2 episodes of bacteremia. There were no grade 3 or 4 adverse events;however serum creatinine levels were significantly elevated after garenoxacin administration. The overall prophylactic efficacy of garenoxacin was 50%, and there were no infection-related deaths. Conclusions: Prophylactic use of garenoxacin is effective and safe in patients with hematological malignancies. (Clinical trial registration number: UMIN000004979).

关键词： Febrile Neutropenia Prophylaxis Garenoxacin Hematological Malignancies

Endoscopic Examination for Patients with Diarrhea after Allogeneic Stem Cell Transplantation

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Open Journal of Internal Medicine 2017年第4期7卷 105-114页

作者： Junichi Kitagawa Takuro Matsumoto Yuhei Shibata Nobuhiko Nakamura Hiroshi Nakamura Soranobu Ninomiya Yasuhito Nannya Masahito Shimizu takeshi hara Hiroshi Araki Hisashi Tsurumi Department of Hematology Graduate School of Medicine Gifu University Gifu Japan Department of Gastroenterology Graduate School of Medicine Gifu University Gifu Japan

Objective: Intestinal graft-versus-host disease (GVHD) represents one of the most serious complications of allogeneic stem cell transplantation (allo-SCT). Endoscopic and histological proof is required due to the number of differential diagnoses manifesting as diarrhea. We investigated the safety of endoscopic biopsies, and the role of conducting biopsies and inspections of the terminalileum. Patients: Thirty two colonoscopic examinations and 29 biopsies were performed for 19 patients after allo-SCT in our institute between October 2011 and May 2015. Results: Endoscopic examinations and biopsies were performed safely under the policy of transfusing platelets for thrombocytopenia (3/μL). For biopsied cases, the diagnostic consistency rate with endoscopic findings was 60%, with a tendency toward negative correlations with early examinations after diarrhea onset (25% for 0 - 1 days;62.5% for later) or low-grade GVHD according to Freiburg criteria (41.2% for grade 1, 66.7% for grade 2, 100% for higher). The terminal ileum was inspected with colonoscopy in 13 cases. Endoscopic diagnoses of the ileum were provided in 11 cases and histological diagnoses in 9 cases. Diagnostic consistency for diagnosis of the terminal ileum between endoscopy and histology was 77.8%. Conclusion: Because endoscopic and histopathological findings do not always match, caution is required when focusing on endoscopic findings alone, as there is a risk of misdiagnosis. Extensive inspection of the terminal ileum with biopsy appears useful to identify otherwise undetected lesions. Our data thus support invasive endoscopic examinations for gastrointestinal complications, including ileac inspection and biopsies under appropriate management.

关键词： Intestinal GVHD Endoscopic Evaluation Ileoscopy Colonoscopy

Diagnosis of the jejunoileal lymphoma by double-balloon endoscopy

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World Journal of Gastrointestinal Endoscopy 2013年第3期5卷 111-116页

作者： Takashi Ibuka Hiroshi Araki Tomohiko Sugiyama Takayuki Nakanishi Fumito Onogi Masahito Shimizu takeshi hara Tsuyoshi Takami Hisashi Tsurumi Hisataka Moriwaki First Department of Internal Medicine Gifu University Graduate School of MedicineGifu 501-1194Japan Department of Gastroenterology Gifu University School of MedicineGifu 501-1194Japan Department of Immunopathology Gifu University Graduate School of MedicineGifu 501-1194Japan

AIM:To investigate the feasibility of double-balloon endoscopy(DBE) to detect jejunoileal lymphoma,compared with fluorodeoxyglucose positron emission tomography(FDG-PET).METHODS:Between March 2004 and January 2011,we histologically confirmed involvement of malignant lymphoma of the jejunoileum in 31 patients by DBE and *** 20 patients of them,we performed with *** retrospectively reviewed the records of these 20 *** median age was 64 years(range 50-81).In the 20 patients,the pathological diagnosis of underlying non-Hodgkin's lymphoma(NHL) comprised follicular lymphoma(FL,n = 12),diffuse large B cell lymphoma(DLBCL,n = 4),mantle cell lymphoma(MCL,n = 2),enteropathy associated T cell lymphoma(ETL,n = 1) and anaplastic large cell lymphoma(ALCL,n = 1).RESULTS:Ten cases showed accumulation by FDGPET(50%).FDG-PET was positive in 3 of 12 FL cases(25%) while in 7 of 8 non-FL cases(88%,P < 0.05).Intestinal FL showed a significantly lower rate of positive FDG-PET,in comparison with other types of *** with endoscopically elevated lesions(n = 10) showed positive FDG-PET in 2(20%),but those with other type NHL did in 8 of 10(80%,P < 0.05).When the cases having elevated type was compared with those not having elevated type lesion,the number of cases that showed accumulation of FDG was significantly smaller in the former than in the ***:In a significant proportion,small intestinal involvement cannot be pointed out by ***,FL is difficult to evaluate by FDG-PET but essentially requires DBE.

关键词： Double-balloon endoscopy Non-Hodgkin’s lymphoma Jejunoileum Fluorodeoxyglucose positron emission tomography Follicular lymphoma

Does a combined intervention program of repetitive transcranial magnetic stimulation and intensive occupational therapy affect cognitive function in patients with post-stroke upper limb hemiparesis?

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Neural Regeneration Research 2016年第12期11卷 1932-1939页

作者： Takatoshi hara Masahiro Abo Kiyohito Kakita takeshi Masuda Ryunosuke Yamazaki Department of Rehabilitation Medicine The Jikei University School of Medicine Department of Rehabilitation Medicine Kyoto Ohara Memorial Hospital

Low-frequency repetitive transcranial magnetic stimulation（LF-r TMS） to the contralesional hemisphere and intensive occupational therapy（i OT） have been shown to contribute to a significant improvement in upper limb hemiparesis in patients with chronic stroke. However, the effect of the combined intervention program of LF-r TMS and i OT on cognitive function is unknown. We retrospectively investigated whether the combined treatment influence patient＇s Trail-Making Test part B（TMT-B） performance, which is a group of easy and inexpensive neuropsychological tests that evaluate several cognitive functions. Twenty-five patients received 11 sessions of LF-r TMS to the contralesional hemisphere and 2 sessions of i OT per day over 15 successive days. Patients with right- and left-sided hemiparesis demonstrated significant improvements in upper limb motor function following the combined intervention program. Only patients with right-sided hemiparesis exhibited improved TMT-B performance following the combined intervention program, and there was a significant negative correlation between Fugl-Meyer Assessment scale total score change and TMT-B performance. The results indicate the possibility that LF-r TMS to the contralesional hemisphere combined with i OT improves the upper limb motor function and cognitive function of patients with right-sided hemiparesis. However, further studies are necessary to elucidate the mechanism of improved cognitive function.

关键词： nerve regeneration stroke repetitive transcranial magnetic stimulation Trail-Making Test cognitive function occupational therapy neural regeneration

Autophagy is involved in oral rAAV/Aβ vaccine-induced Aβ clearance in APP/PS1 transgenic mice

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Neuroscience Bulletin 2015年第4期31卷 491-504页

作者： He-Cheng Wang Tao Zhang Bolati Kuerban Ying-Lan Jin Weidong Le Hideo hara Dong-Sheng Fan Yan-Jiang Wang takeshi Tabira De-Hua Chui Neuroscience Research Institute & Department of Neurobiology School of Basic Medical SciencesPeking University Health Science Center Center for Translational Research of Neurology Disease First Affiliated HospitalDalian Medical University Division of Neurology Department of Internal MedicineSaga University Faculty of Medicine Department of Neurology Peking University Third Hospital Department of Neurology Daping HospitalThird Military Medical University Department of Neurology Graduate School of MedicineJuntendo University

The imbalance between β-amyloid （Aβ） generation and clearance plays a fundamental role in the pathogenesis of Alzheimer＇s disease （AD）. The sporadic form of AD is characterized by an overall impairment in Aβ clearance. Immunotherapy targeting Aβ clearance is believed to be a promising approach and is under active clinical investigation. Autophagy is a conserved pathway for degrading abnormal protein aggregates and is crucial for Aβ clearance. We previously reported that oral vaccination with a recombinant AAV/Aβ vaccine increased the clearance of Aβ from the brain and improved cognitive ability in AD animal models, while the underlying mechanisms were not well understood. In this study, we first demonstrated that oral vaccination with rAAV/Aβ decreased the p62 level and up-regulated the LC3B- II/LC3B-I ratio in APP/PS1 mouse brain, suggesting enhanced autophagy. Further, inhibition of the Akt/mTOR pathway may account for autophagy enhancement. We also found increased anti-Aβ antibodies in the sera of APP/PS1 mice with oral vaccination, accompanied by elevation of complement factors C1q and C3 levels in the brain. Our results indicate that autophagy is closely involved in oral vaccination-induced Aβ clearance, and modulating the autophagy pathway may be an important strategy for AD prevention and intervention.

关键词： oral vaccination autophagy Akt/mTOR pathway Aβ clearance Alzheimer's disease

A Study on Relationship among Blade Camber Direction and Pitch Angle and Performance of a Small Straight-Blade Darrieus Wind Turbine by Using Scale Test Model and Gurney Flap

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Journal of Flow Control, Measurement & Visualization 2021年第2期9卷 28-44页

作者： Tadakazu Tanino Keisuke hara Ryo Yoshihara takeshi Miyaguni Advanced Engineering School National Institute of Technology Kurume College Fukuoka Japan Department of Mechanical Systems Engineering University of Kitakyushu Fukuoka Japan

Straight-blade Darrieus vertical axis wind turbines are used as medium and small size wind turbine because of higher power output in vertical axis wind turbine (VAWT). In our previous study, the relationship between the performance and Reynolds number based on airfoil chord length had been investigated by using small-scale test models of lift-type VAWT, and the results showed that the performance of tested wind turbine models with small diameter was clearly lower than that of the large-scale field test machine, and its performance also varies significantly with the blade pitch angle. In this study, we focused on the performance of a small-scale straight-blade Darrieus VAWT, the relationship among the blade airfoil camber direction and the pitch angle, and the performance of the small-scale VAWT was examined experimentally by using a small-scale VAWT test model with Gurney flap which was a small flat plate. Gurney flaps with its height h, as a ratio to the blade chord length c, h/c = 0.036 to 0.055, were attached to the blades of the VAWT test model, in addition, the attaching direction of the Gurney flap on the blade was examined for both inward and outward of the rotor, and the pitch angle was also examined for a range of −5 to 10 degrees. These results are discussed comparing with the result of the VAWT without Gurney flap and considering the numerical results for the single blade with/without the Gurney flap. The results showed that the performance of the tested VAWT was reversed between the inward and outward Gurney flaps around a pitch angle of 10 degrees. That is, the inward Gurney flap was superior at a pitch angle of less than 10 degrees, while the outward Gurney flap was effective at a pitch angle of more than 10 degrees. Furthermore, for the tested small-scale VAWT model, the optimum pitch angle was about 5 degrees, and the inward and shorter Gurney flap showed higher power performance of the VAWT und

关键词： Darrieus VAWT Gurney Flap Camber Direction Pitch Angle Power Performance

Supercritical Fluid Impregnation of Essential Bark Oil in Copolymers of L-Lactide with 7-Membered Cyclic Compounds

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Journal of Biomaterials and Nanobiotechnology 2014年第3期5卷 159-172页

作者： Chikara Tsutsumi Teruyuki hara Yuka Ueno Yuushou Nakayama takeshi Shiono Department of Applied Chemistry and Biotechnology Niihama National College of Technology NiihamaJapan Department of Applied Chemistry Graduate School of Engineering Hiroshima University Higashi-Hiroshima Japan

In order to develop a novel controlled-release material, we previously attempted to impregnate poly(L-lactide) (poly(L-LA)), poly(L-LA-ran-CL) (CL: ε-caprolactone) or poly(L-LA-ran-TEMC) (TEMC: tetramethylene carbonate) with low boiling point, organic useful compounds using supercritical carbon dioxide (scCO2) as the solvent. In this work, the factors influencing impregnation of poly (L-LA) random copolymers with useful compounds were investigated under scCO2 using the copolymers previously used. The influence of temperature, pressure, and time on the impregnation contents of the useful compounds on the copolymers was evaluated. The polymer used, which is a base of this material, was poly(L-LA-ran-CL), poly(L-LA-ran-TEMC), or poly(L-LA-ran-DXO) (DXO: 1,5-dioxepan-2-one). Statistical random copolymers of L-LA with CL, TEMC, or DXO were synthesized using Sn(oct)2 as a catalyst at 150°C for 24 h without solvent. Preparation of the controlled-release materials was carried out using essential bark oil from Thujopsis dolabrata var. hondae and synthetic L-LA random copolymers as a base material under scCO2. The impregnation experiment, which investigated the influence of pressure, was conducted in the range of 10 to 20 MPa. The influence of temperature on impregnation was carried out at 40°C to 100°C. Impregnation time was varied from 1 to 5 h. The pressure of essential oil impregnated into poly(L-LA) random copolymers was the highest at 14 MPa. In the influence of temperature on impregnation, the amount of essential oil increased with increasing temperature.

关键词： Biodegradable Polyester L-Lactide Copolymer Supercritical Carbon Dioxide Impregnation