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Quality of ulcer healing in gastrointestinal tract:Its pathophysiology and clinical relevance

World Journal of Gastroenterology 2012年第35期18卷 4811-4822页

作者： Tetsuo Arakawa Toshio Watanabe tetsuya tanigawa Kazunari Tominaga Yasuhiro Fujiwara Kenichi Morimoto Department of Gastroenterology Osaka City University Graduate School of Medicine

In this paper, we review the concept of quality of ulcer healing （QOUH） in the gastrointestinal tract and its role in the ulcer recurrence. In the past, peptic ulcer disease （PUD） has been a chronic disease with a cycle of repeated healing/remission and recurrence. The main etiological factor of PUD is Helicobacter pylori （H. pylorl~, which is also the cause of ulcer recur- rence. However, H. pylori-negative ulcers are pres- ent in 12%-20% of patients; they also recur and are on occasion intractable. QOUH focuses on the fact that mucosal and submucosal structures within ulcer scars are incompletely regenerated. Within the scars of healed ulcers, regenerated tissue is immature and with distorted architecture, suggesting poor QOUH. The abnormalities in mucosal regeneration can be the basis for ulcer recurrence. Our studies have shown that persistence of macrophages in the regenerated area plays a key role in ulcer recurrence. Our studies in a rat model of ulcer recurrence have indicated that proinflammatory cytokines trigger activation of macro- phages, which in turn produce increased amounts of cytokines and chemokines, which attract neutrophils to the regenerated area. Neutrophils release proteolytic enzymes that destroy the tissue, resulting in ulcer re- currence. Another important factor in poor QOUH can be deficiency of endogenous prostaglandins and a defi- ciency and/or an imbalance of endogenous growth fac- tors. Topically active mucosal protective and antiulcer drugs promote high QOUH and reduce inflammatory cell infiltration in the ulcer scar. In addition to PUD, the concept of QOUH is likely applicable to inflammatory bowel diseases including Crohn＇s disease and ulcer- ative colitis.

关键词： Quality of ulcer healing Peptic ulcer dis-ease Recurrence Prostaglandin Cytokines Growthfactors

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Management of gastric fundal varices without gastro-renal shunt in 15 patients

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World Journal of Gastroenterology 2008年第3期14卷 448-453页

作者： Natsuhiko Kameda Kazuhide Higuchi Masatsugu Shiba Kaori Kadouchi Hirohisa Machida Hirotoshi Okazaki tetsuya tanigawa Toshio Watanabe Kazunari Tominaga Yasuhiro Fujiwara Kenji Nakamura Tetsuo Arakawa Department of Gastroenterology Graduate School of Medicine Osaka City University Osaka 569-8686 Japan Second Department of Internal Medicine Osaka Medical College Osaka 569-8686 Japan Department of Radiology Graduate School of Medicine Osaka City University Osaka 569-8686 Japan

AIM:To examine the portal hemodynamics of gastric fundal varices (GV) without gastro-renal shunt (GRS), and to retrospectively investigate the effects of various kinds of treatment on eradication. METHODS: Ninety-four liver cirrhosis patients at high- risk of GV were treated in our hospital and enrolled in this study. We retrospectively examined their characteristics, liver function, and portal hemodynamics of GV. We performed balloon-occluded retrograde transvenous obliteration (BRTO) at first. If it was not technically possible to perform BRTO, endoscopic injection sclerotherapy using α-cyanoacrylate glue (CA) or percutaneous transhepatic obliteration (PTO) was performed. RESULTS: Among the 94 patients, a GRS was present in 79 (84.0%), and absent in the remaining 15 (16.0%). The subphrenic vein was connected to the inferior vena cava as the drainage vein in 13 (86.7%) out of the 15 cases without GRS. We performed BRTO in 6 patients, CA in 4 patients and PTO in 5 patients. The eradication rate was 100% for each procedure, but the rate of early recurrence within 6 mo was 16.7% for BRTO, 50.0% for CA and 40.0% for PTO, respectively. CONCLUSION: We should examine the hemodynamics before treatment of GV irrespective of the existence of GRS. If this hemodynamic examination reveals that the drainage vein connects directly to the inferior vena cava in GV without GRS, BRTO may be an effective treatment for GV with GRS.

关键词： Gastric fundal varices Gastro-renal shunt Balloon-occluded retrograde transvenous obliteration

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A case of mucosa-associated lymphoid tissue lymphoma forming multiple lymphomatous polyposis in the small intestine

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World Journal of Gastroenterology 2007年第9期13卷 1453-1457页

作者： Naoto Hirata Kazunari Tominaga Kensuke Ohta Kaori Kadouchi Hirotoshi Okazaki tetsuya tanigawa Masatsugu Shiba Toshio Watanabe Yasuhiro Fujiwara Shiro Nakamura Nobuhide Oshitani Kazuhide Higuchi Tetsuo Arakawa Department of Gastroenterology Osaka City University Graduate School of Medicine 1-4-3 Asahimachi Abeno-ku Osaka 545-8585 Japan Department of Hematology Osaka City University Graduate School of Medicine1-4-3 Asahimachi Abeno-kuOsaka 545-8585 Japan Department of Gastroenterology Rinku General Medical Center 2-3 Rinkuouraikita Izumisano Osaka 598-0048Japan

A 50-year old woman suffering from diabetes had a CT scan that revealed a diffuse thickening of small intestinal wall and swollen paraaortic lymph nodes. An esophago gastroduodenoscopy (EGD) confirmed multiple polypoid lesions in the duodenum and small intestine, and conventional histological testing revealed non-specific inflammatory changes. Further examinations including the immunohistochemical profiles of the biopsied specimens led us to diagnose the lesion as a marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue type, forming multiple lymphomatous polyposis sequentially spreading from duodenal bulb to terminal ileum. According to Lugano’s classification, its staging was clinically diagnosed as stage Ⅱ. Two courses of a standard CHOP (cyclophosphamide, doxorubicin hydrochloride, vincristine sulfate, and predonisolone) regimen with rituximab reduced the lesion and the patient had a almost complete response. A 5-year follow- up EGD and histological examinations detected no recurrence of the disease.

关键词： Intestinal lymphoma Hucosa-associated lymphoid tissue lymphoma Hultiple lymphomatous polyposis

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Anti-aquaporin-4 antibody(AQP4-IgG)and anti-myelin oligodendrocyte glycoprotein antibody(MOG-IgG)in the cerebrospinal fluid

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Neural Regeneration Research 2024年第5期19卷 949-950页

作者： tetsuya Akaishi Tatsuro Misu Department of Neurology Tohoku UniversitySendaiJapan

In the last decade,a new neurological disease concept known as anti-myelin oligodendrocyte glycoprotein antibody(MOG-IgG)-associated disease(MOGAD)has emerged and is currently one of the most focused research areas in the field of *** is a membrane protein mainly expressed on the surface of oligodendrocytes(Zhou et al.,2006).The exact pathogenic role of MOG-IgG in patients with MOGAD remains unclear;however,MOG-IgG has been suggested to cause tissue alterations and damage MOG-expressing cells(Zhou et al.,2006).The pathogenicity of MOG-IgG is further supported by the observation that only a few patients with acquired central nervous system(CNS)demyelinating syndromes exhibit both anti-aquaporin-4 antibody(AQP4-IgG)and MOG-IgG simultaneously,particularly with clear positivity levels of these antibodies as indicated by a cell-based assay result with a titer≥1:100(Sechi et al.,2021;Banwell et al.,2023).

关键词： AQP4 myelin

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Statistical evaluation of cluster formation of relapse in neuromyelitis optica spectrum disorder

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Neural Regeneration Research 2024年第9期19卷 1888-1889页

作者： tetsuya Akaishi Ichiro Nakashima Department of Neurology Tohoku UniversitySendaiJapan Department of Neurology Tohoku Medical and Pharmaceutical UniversitySendaiJapan

Evaluating the cluster formation of clinical attacks in chronic relapsing diseases is an important statistical issue because the presence of attack clusters may influence therapeutic strategies for relapse *** recently reported the occurrence of unevenly clustered attacks in patients with anti-aquaporin-4(AQP4)antibody-positive neuromyelitis optica spectrum disorder(NMOSD)(Akaishi et al.,2020a).

关键词： AQP4 relapse

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Background diseases and the number of previous intravitreal aflibercept injections on immediate intraocular pressure increase and vitreous reflux rate in phakic eyes

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International Journal of Ophthalmology(English edition) 2024年第3期17卷 545-550页

作者： tetsuya Muto Shigeki Machida Shinichiro Imaizumi Department of Ophthalmology Dokkyo Medical University Saitama Medical CenterKoshigaya 343-8555Japan Imaizumi Eye Hospital Koriyama 963-8877Japan Fukushima Medical University Fukushima 960-1295Japan

●AIM:To evaluate the effect of background diseases and number of previous intravitreal aflibercept injections(IVAIs)on immediate intraocular pressure(IOP)increase and vitreous reflux(VR)rate and to evaluate the correlation of both age and axial length with immediate IOP increase and VR rate.●METHODS:This study included 105 patients with cystoid macular edema secondary to retinal vein occlusion,35 patients with diabetic macular edema,69 patients with neovascular age-related macular degeneration(nAMD),and 12 patients with myopic choroidal neovascularization,which underwent first-time *** correlation of immediate IOP increase and VR rates with the four background diseases was ***,the correlation of age with immediate IOP increase and VR rate as well as correlation of axial length with immediate IOP increase and VR rate were ***,54 patients with nAMD were treated with IVAI>10 times(multiple IVAIs).Moreover,the correlation of immediate IOP increase and VR rates with first-time and multiple IVAIs in nAMD was determined.●RESULTS:The immediate IOP increase(P=0.16)and VR rates(P=0.50)were almost similar among the four background *** immediate postinjection IOP and age,VR rate and age,immediate postinjection IOP and axial length,or VR rate and axial length were not correlated in the four background *** immediate IOP increase(P=0.66)and VR rates(P=0.28)did not significantly differ between first-time and multiple IVAIs in nAMD.●CONCLUSION:Background diseases and number of previous IVAIs have no effect on immediate IOP increase and VR ***,age and axial length have no correlation on immediate IOP increase and VR rate.

关键词： aflibercept intraocular pressure vitreous reflux intravitreal injection

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The Development of the “Monitoring Application for Inappropriate Expressions in Nursing Records”for PsyNACS^©

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Journal of Computer and Communications 2024年第5期12卷 42-52页

作者： Hirokazu Ito Yuko Yasuhara tetsuya Tanioka Department of Nursing Institute of Biomedical Sciences Tokushima University Graduate School Tokushima Japan

Lengthening periods of hospitalization, increasing numbers of patients with age-related complications, and a shortage of nursing staff have been of great concern in medical psychiatry in Japan. Under these circumstances, countries such as Japan that face a super-aging society and a decline in the working-age population, have been recommended for use of advanced information and communications technology (ICT) to improve the efficiency of medical treatment and care. This study aims to develop the “Monitoring Application for Inappropriate Expressions in Nursing Records” for using PsyNACS©, which will enable psychiatric nursing plans to harness the advantages of ICT. The functions considered necessary are as follows: 1) identification of users who enter information;2) a necessary database for lists of inappropriate expressions;3) development of a matching function to recommend proper writing input and a warning function;and 4) a management function for an inappropriate expression list database. A demonstration experiment for developing the application in this study was conducted at a specialized psychiatric hospital. To introduce them to the application, nurses and nurse managers were informed about the system developed in this study, and a survey regarding their opinions on the functions of the application was conducted with ten nurse managers. The results were evaluated in terms of usefulness for nursing care, documentation, and the education of nurses from an ethical perspective. This study suggests that matching their input with an inappropriate expression database will allow nurses to record more appropriate expressions. From an ethical perspective, the ability to use appropriate expressions makes records more likely to withstand disclosure requests from patients and their families.

关键词： PsyNACS© Monitoring Application Inappropriate Expressions Nursing Records

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Real-world efficacy and safety of tofacitinib treatment in Asian patients with ulcerative colitis

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World Journal of Gastroenterology 2024年第13期30卷 1871-1886页

作者： Kentaro Kojima Kenji Watanabe Mikio Kawai Soichi Yagi Koji Kaku Maiko Ikenouchi Toshiyuki Sato Koji Kamikozuru Yoko Yokoyama tetsuya Takagawa Masahito Shimizu Shinichiro Shinzaki Department of Gastroenterology Hyogo Medical UniversityNishinomiya 663-8501Japan Department of Gastroenterology Gifu University Graduate School of MedicineGifu 501-1194Japan Department of Internal Medicine for Inflammatory Bowel Disease The University of ToyamaToyama 930-0194Japan Center for Clinical Research and Education Hyogo Medical UniversityNishinomiya 663-8501Japan

BACKGROUND Real-world data on tofacitinib(TOF)covering a period of more than 1 year for a sufficient number of Asian patients with ulcerative colitis(UC)are *** To investigate the long-term efficacy and safety of TOF treatment for UC,including clinical *** We performed a retrospective single-center observational analysis of 111 UC patients administered TOF at Hyogo Medical University as a tertiary inflammatory bowel disease *** consecutive UC patients who received TOF between May 2018 and February 2020 were *** were followed up until August *** primary outcome was the clinical response rate at week *** outcomes included clinical remission at week 8,cumulative persistence rate of TOF administration,colectomy-free survival,relapse after tapering of TOF and predictors of clinical response at week 8 and week *** The clinical response and remission rates were 66.3%and 50.5%at week 8,and 47.1%and 43.5%at week 48,*** overall cumulative clinical remission rate was 61.7%at week 48 and history of anti-tumor necrosis factor-alpha(TNF-α)agents use had no influence(P=0.25).The cumulative TOF persistence rate at week 48 was significantly lower in patients without clinical remission than in those with remission at week 8(30.9%vs 88.1%;P<0.001).Baseline partial Mayo Score was significantly lower in responders vs non-responders at week 8(odds ratio:0.61,95%confidence interval:0.45-0.82,P=0.001).Relapse occurred in 45.7%of patients after TOF tapering,and 85.7%of patients responded within 4 wk after *** 6 patients with herpes zoster(HZ)developed the infection after achieving remission by *** TOF was more effective in UC patients with mild activity at baseline and its efficacy was not affected by previous treatment with anti-TNF-α*** relapsed patients responded again after re-increase of TOF and nearly half relapsed after tapering off *** attention is needed for tapering and H

关键词： Ulcerative colitis Tofacitinib Janus kinase inhibitor Real-world Biologics

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From bench to bedside:Opportunities and challenges for iLABMED

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iLABMED 2024年第1期2卷 1-5页

作者： tetsuya Asakawa Yi‐Wei Tang Hongzhou Lu Institute of Neurology National Clinical Research Center for Infectious Diseasesthe Third People's Hospital of ShenzhenShenzhenGuangdongChina Medical Affairs Danaher Corporation/CepheidNew YorkNew YorkUSA Department of Infectious Disease National Clinical Research Center for Infectious Diseasesthe Third People's Hospital of ShenzhenShenzhenGuangdongChina

Since the new iLABMED was founded in June 2023,it has published three issues with 21 articles(till Dec 2023).As a journal majored in laboratory medicine,iLABMED also has to face many opportunities and challenges of laboratory *** editorial summarized the main opportunities and challenges faced by *** future prospects of laboratory medicine,which must be highlighted by iLABMED were also discussed based on a brief review of the current advances in laboratory *** will continue to provide a useful platform for general‐interested,insightful,and informative articles with high quality.

关键词： journal summarized challenges

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A Revised Classification of Primary Iron Overload Syndromes

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Journal of Clinical and Translational Hepatology 2024年第4期12卷 346-356页

作者： Yasuaki Tatsumi Motoyoshi Yano Shinya Wakusawa Hiroaki Miyajima tetsuya Ishikawa Shinsaku Imashuku Atsuko Takano Wataru Nihei Ayako Kato Koichi Kato Hisao Hayashi Kentaro Yoshioka Kazuhiko Hayashi Department of Medical Biochemistry Faculty of Pharmaceutical SciencesToho UniversityFunabashiJapan Department of Gastroenterology Yokkaichi Municipal HospitalYokkaichiJapan Department of Medical Technology Shubun UniversityIchinomiyaJapan Department of Medicine and Neurology Tenryu Kohseikai ClinicHamamatsuJapan Department of Gastroenterology and Hepatology Nagoya University Graduate School of MedicineNagoyaJapan Department of Laboratory Medicine Uji-Tokushukai Medical CenterUjiJapan Department of Medicine Saiseikai Takaoka HospitalTakaokaJapan Department of Medicine Aichi-Gakuin University School of PharmacyNagoyaJapan Department of Gastroenterology FNPS Meijo HospitalNagoyaJapan

Background and Aims:The clinical introduction of hepcidin25(Hep25)has led to a more detailed understanding of its relationship with ferroportin(FP)and divalent metal transporter1 in primary iron overload syndromes(PIOSs).In 2012,we proposed a classification of PIOSs based on the Hep25/FP system,which consists of prehepatic aceruloplasminemia,hepatic hemochromatosis(HC),and posthepatic FP disease(FP-D).However,in consideration of accumulated evidence on PIOSs,we aimed to renew the ***:We reviewed the 2012 classification and retrospectively renewed it according to new information on ***:Iron-loading anemia was included in PIOSs as a prehepatic form because of the newly discovered erythroferrone-induced suppression of Hep25,and the state of traditional FP-D was remodeled as the BIOIRON *** key molecules responsible for prehepatic PIOSs are low transferrin saturation in aceruloplasminemia and increased erythroferrone production by erythroblasts in iron-loading *** PIOSs comprise four genotypes of HC,in each of which the synthesis of Hep25 is inappropriately reduced in the *** Hep25 synthesis is adequate in posthepatic PIOSs;however,two mutant FP molecules may resist Hep25 differently,resulting in SLC40A1-HC and FP-D,*** phenotypes are diagnosed using laboratory tests,including circulating Hep25,followed by suitable *** sequencing of the candidate genes may be outsourced to gene centers when *** kits for the prevalent mutations,such as C282Y,may be the first choice for a genetic analysis of HC in ***:The revised classification may be useful worldwide.

关键词： Ethnicity Ferroportin Hemochromatosis Hepcidin25 Iron overload syndrome

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