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How Effective Is Cervical Ripening Using the Controlled-Release Dinoprostone Vaginal Delivery System for Primiparas with Unruptured Membranes?

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Open Journal of Obstetrics and Gynecology 2024年第8期14卷 1185-1196页

作者： Yoshino Kinjyo Yukiko Chinen Tadatsugu kinjo Shuko Chinen Keiko Mekaru Department of Obstetrics and Gynecology Graduate School of Medicine University of the Ryukyus Okinawa Japan

Background: Labor induction has a low success rate, especially in primiparas with unruptured membranes. Previous studies focused on pregnant women with unruptured membranes, but none specifically targeted primiparas. Aims: To compare the effectiveness of a controlled-release dinoprostone vaginal delivery system for cervical dilatation (PROPESS) with that of mechanical dilation for labor induction in primiparous women with unruptured membranes. Materials and Methods: We retrospectively analyzed the data of 90 primiparas with unruptured membranes (41 and 49 in the PROPESS and mechanical dilation groups, respectively). The primary outcome was the cesarean section (CS) rate. The secondary outcomes were the prevalence of vaginal delivery within 12 or 24 h after the initial insertion, oxytocin usage rate, chorioamnionitis, additional use of mechanical dilation in the PROPESS group, and neonatal outcomes. Results: The CS rate was significantly lower in the PROPESS group than in the mechanical dilation group (p = 0.02). A total of 13 patients (31.7%) delivered within 24 h with PROPESS alone, indicating a significantly higher rate of delivery within 24 h in the PROPESS group (p = 0.02). Fewer patients required additional oxytocin in the PROPESS group than in the mechanical dilation group (p = 0.001). However, 14 (34%) patients in the PROPESS group required additional mechanical cervical dilation, resulting in a longer time to delivery than mechanical dilation. Conclusions: PROPESS significantly reduced CS rates and increased delivery rates 24 h after the initial insertion in primiparas with unruptured membranes compared to mechanical dilatation. However, failure to respond to PROPESS resulted in an overall longer delivery time than that of the conventional mechanical dilation group;therefore, identifying predictors of response to PROPESS is necessary.

关键词： PROPESS Labor Induction Primiparas Cervical Ripening Unruptured Membranes

Perinatal Morbidity, Mortality, and Neurodevelopmental Outcomes of Neonates with Fetal Growth Restriction

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Open Journal of Obstetrics and Gynecology 2024年第3期14卷 321-333页

作者： Natsuki Tamashiro Shuko Chinen Yoshino Kinjyo Yukiko Chinen Tadatsugu kinjo Keiko Mekaru Department of Obstetrics and Gynecology Graduate School of Medicine University of the Ryukyus Nishihara Japan

Objective: This study aimed to assess perinatal morbidity, mortality rates, and neurodevelopmental outcomes in the management of fetal growth restriction (FGR) at a single tertiary institute. Methods: Among 2465 deliveries between 2013 and 2019, 109 cases of FGR were reviewed retrospectively for causes, indications for pregnancy termination, perinatal death, overall neonatal outcomes, and long-term prognosis. Results: Excluding FGR due to congenital anomalies (n = 17), the mortality rate was 3.3% (3/92). One neonate delivered at 23 weeks developed cerebral palsy (1.1%). Retinopathy of prematurity occurred in four neonates (4.3%). Neurodevelopmental disorders were present in six neonates (6.5%), all of whom were delivered at 32 - 38 weeks. Significantly lower gestational age at delivery, lower birth weight, and higher umbilical artery resistance indices were observed in neonates with neurodevelopmental disorders. Conclusions: Intact survival before 27 weeks of gestation at delivery with FGR is uncommon. Neurodevelopmental disorders may still develop after delivery at 32 - 38 weeks;consideration should be given to the timing of delivery usingfetal ductus venosus Doppler waveforms measurements to reduce neurodevelopmental disorders.

关键词： Fetal Death Fetal Growth Retardation Neurodevelopmental Disorders Perinatal Mortality Umbilical Artery Doppler Velocimetry

Flow Characteristics of Rectangular Underexpanded Impinging Jets

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Journal of Thermal Science 2006年第1期15卷 59-64,30页

作者： Minoru YAGA Yoshio kinjo Masumi TAMASHIRO Kenyu OYAKAWA Dept. of Mechanical System Engineering University of the Ryukyus Okinawa 903-0213 Japan Mazda Motor Corporation Hiroshima 730-8670 Japan

In this paper, the flow fields of underexpanded impinging jet issued from rectangular nozzles of aspect ratio 1, 3 and 5 are numerically and experimentally studied. Two dimensional temperature and pressure distributions are measured by using infrared camera and the combination of a pressure scanning device and a stepping motor, respectively. The variation of the stagnation pressure on the impinging plate reveals that a hysteretic phenomenon exists during the increasing and decreasing of the pressure ratio for the aspect ratio of 3.0 and 5.0. It is also found that the nozzle of aspect ratio 1.0 caused the largest total pressure loss Pc /p0= 0.27 at the pressure ratio of Po /p0 = 6.5, where Pc is the stagnation center pressure on the wall, P0 the upstream stagnation pressure, Pb the ambient pressure. The other two nozzles showed that the pressure loss Pc / P0 =0.52 and 0.55 were achieved by the nozzles of the aspect ratio 3,0 and 5.0, respectively. The comparison between the calculations and experiments is fairly good, showing the three dimensional streamlines and structures of the shock waves in the jets. However, the hysteresis of the pressure variations observed in the experiments between the pressure ratio of 3.5 and 4.5 cannot be confirmed in the calculations.

关键词： compressible flow shock wave under-expanded rectangular impinging jet CFD.

Endoscopic and histopathological study on the duodenum of Strongyloides stercoralis hyperinfection

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World Journal of Gastroenterology 2008年第11期14卷 1768-1773页

作者： Kazuto Kishimoto Akira Hokama Tetsuo Hirata Yasushi Ihama Manabu Nakamoto Nagisa kinjo Fukunori kinjo Jiro Fujita Department of Endoscopy Ryukyu University HospitalOkinawa 903-0215Japan Department of Medicine and Therapeutics(First Department of Internal Medicine) Control and Prevention of Infectious DiseaseFaculty of Medicine University of the RyukyusOkinawa 903-0215Japan

AIM:To investigate endoscopic and histopathological findings in the duodenum of patients with Strongyloides stercoralis(***)hyperinfection. METHODS:Over a period of 23 years(1984-2006),we investigated 25 patients *** hyperinfection who had had an esophagogastroduodenoscopy before undergoing treatment for *** clinical and endoscopic findings were analyzed retrospectively. RESULTS:Twenty-four(96%)of the patients investigated were under immunocompromised condition which was mainly due to a human T lymphotropic virus type 1(HTLV-1)*** abnormal endoscopic findings,mainly edematous mucosa,white villi and erythematous mucosa,were observed in 23(92%) *** degree of duodenitis including villous atrophy/destruction and inflammatory cell infiltration corresponded to the severity of the endoscopic findings. The histopathologic yield for identifying larvae was 71.4% by duodenal *** endoscopic findings of duodenitis were more severe in patients whose biopsies were positive for larvae than those whose biopsies were negative(Endoscopic severity score:4.86±2.47vs 2.71 ±1.38,P<0.05). CONCLUSION:Our study clearly demonstrates that,in addition to stool analysis,endoscopic observation and biopsies are very *** also emphasize that *** and HTLV-1 infections should be ruled out before immunosuppressive therapy is administered in endemic regions.

关键词： Strongyloides stercoralis Strongyloidiasis Hyperinfection Endoscopy Histopathology Duodenum

Association between colonic polyps and diverticular disease

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World Journal of Gastroenterology 2008年第15期14卷 2411-2413页

作者： Tetsuo Hirata Yuko Kawakami Nagisa kinjo Susumu Arakaki Tetsu Arakaki Akira Hokama Fukunori kinjo Jiro Fujita Department of Medicine and Therapeutics Control and Prevention of Infectious Diseases Faculty of Medicine University of the Ryukyus Okinawa 903-0215 Japan Department of Internal Medicine Nishinjo Hospital Okinawa 900-0034 Japan Department of Endoscopy Ryukyu University Hospital Okinawa 903-0215 Japan Department of Coloproctology Nishinjo Hospital Okinawa 900-0034 Japan

AIM: To evaluate the association between colonic polyps and diverticular disease in Japan. METHODS: We retrospectively reviewed the medical records of 672 consecutive patients who underwent total colonoscopy between August 2006 and April 2007 at Nishinjo Hospital, Okinawa, Japan. Patients with a history of any of the following were excluded from the study: previous polypectomy, colonic resection, and inflammatory bowel diseases. The association between colonic polyps and diverticular disease was analyzed by logistic regression analysis, adjusted for age and sex. RESULTS: Prevalence of colonic polyps in all patients with diverticular disease was significantly higher than that in those without diverticular disease (adjusted odds ratio 1.7). CONCLUSION: Our data showed that patients with diverticular disease have a higher risk of colonic polyps compared to those without.

关键词： Colonic polyps Colonic neoplasm Diverticular disease Proximal diverticular disease Colonoscopy

Diagnosis of intestinal tuberculosis using a monoclonal antibody to Mycobacterium tuberculosis

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World Journal of Gastroenterology 2012年第47期18卷 6974-6980页

作者： Yasushi Ihama Akira Hokama Kenji Hibiya Kazuto Kishimoto Manabu Nakamoto Tetsuo Hirata Nagisa kinjo Haley L Cash Futoshi Higa Masao Tateyama Fukunori kinjo Jiro Fujita Department of Infectious Respiratoryand Digestive MedicineFaculty of MedicineUniversity of the RyukyusOkinawa 903-0215Japan Department of Endoscopy Ryukyu University HospitalOkinawa 903-0215Japan

AIM:To investigate the utility of immunohistochemical(IHC) staining with an antibody to Mycobacterium tuberculosis(***) for the diagnosis of intestinal tuberculosis(TB).METHODS:We retrospectively identified 10 patients(4 males and 6 females;mean age = 65.1 ± 13.6 years) with intestinal *** characteristics,including age,gender,underlying disease,and symptoms were *** radiograph and laboratory tests,including sputum Ziehl-Neelsen(ZN) staining,*** culture,and sputum polymerase chain reaction(PCR) for tubercle bacilli DNA,as well as Tuberculin skin test(TST) and QuantiFERON-TB gold test(QFT),were *** records recorded on the basis of Sato's classification were also reviewed,in addition to data from intestinal biopsies examined for histopathological findings,including hematoxylin and eosin staining,and ZN staining,as well as *** culture,and PCR for tubercle bacilli *** the present study,archived formalin-fixed paraffin-embedded(FFPE) intestinal tissue samples were immunohistochemically stained using a commercially available species-specific monoclonal antibody to the 38-kDa antigen of the *** *** sections were also stained with the pan-macrophage marker CD68 ***:From the clinical data,we found that no patients were immunocompromised,and that the main symptoms were diarrhea and weight *** patients displayed active pulmonary TB,six patients(60%) had a positive TST,and 4 patients(40%) had a positive *** findings revealed that all patients had type 1 findings(linear ulcers in a circumferential arrangement or linear ulcers arranged circumferentially with mucosa showing multiple nodules),all of which were located in the right hemicolon and/or terminal *** patients(70%) had concomitant healed lesions in the ileocecal *** acid-fast bacilli were detected with ZN staining of the intestinal tissue samples,and both *** culture and PCR

关键词： Colonoscopy Intestinal tuberculosis Immunohistochemistry Monoclonal antibody Mycobacterium tuberculosis

An autopsy case of a primary aortoenteric fistula: A pitfall of the endoscopic diagnosis

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World Journal of Gastroenterology 2008年第29期14卷 4701-4704页

作者： Yoko Ihama Tetsuji Miyazaki Chiaki Fuke Yasushi Ihama Ryoji Matayoshi Hiroshi Kohatsu Fukunori kinjo Department of Legal Medicine School of Medicine University of the RyukyusOkinawa 903-0215 Japan Department of Endoscopy University Hospital University of the Ryukyus Okinawa 903-0215 Japan Department of Internal Medicine Okinawa Red Cross HospitalOkinawa 900-8611 Japan

A primary aortoenteric fistula (PAEF), defined as a communication between the native aorta and the gastrointestinal tract, is a rare cause of gastrointes-tinal bleeding. The preoperative diagnosis of PAEF is extremely difficult. Consequently, PAEF may cause sudden and unexpected death. We present an autopsy case of a 68-year-old man who died of massive gastro-intestinal bleeding due to a PAEF. Autopsy revealed a pinhole rupture located on the third part of the duode-nal mucosa and fistulized into the adjacent abdominal aortic aneurysm (AAA). Our case indicates that the aortoenteric fistula can result in fatal gastrointestinal bleeding. Consequently, a PAEF should be included in the differential diagnosis of gastrointestinal bleeding.

关键词： Primary aortoenteric fistula Gastrointestinal bleeding Herald bleeding Misleading Medico-legalautopsy

An unusual enteropathy-associated T-cell lymphoma with MYC translocation arising in a Japanese patient:A case report

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World Journal of Gastroenterology 2012年第19期18卷 2434-2437页

作者： Kenji Okumura Masahiko Ikebe Tatsuro Shimokama Morishige Takeshita Nao kinjo Keishi Sugimachi Hidefumi Higashi Department of Surgery Nippon Steel Yawata Memorial HospitalKitakyushu 805-8508Japan Department of Pathology Nippon Steel Yawata Memorial HospitalKitakyushu 805-8508Japan Department of Pathology School of MedicineFukuoka UniversityFukuoka 814-0180Japan

Enteropathy-associated T-cell lymphoma （EATL） is a rare peripheral T-cell lymphoma classified into 2 types, with or without celiac disease, based on histology. Type 2 EATL is less commonly associated with celiac disease, in which cells are characterized by being monomorphic and small- to medium-sized. Cells are characterized by CD8 and CD56 expression and c-MYC oncogene locus gain. We present an atypical case of type 2 EATL in the jejunum, with human T-lymphotropic virus-1 that was CD4- CDS＋ CD56- CD30- CD25- TIA-I＋ and granzyme B＋ on immunohistological staining. It also displayed translocation of chromosome 8p24 （c-MYC）, as de- termined by fluorescent/n situ hybridization. Mucosalspreading and intraepithelial invasion by lymphoma with villous atrophy were detected adjacent to the mucosal layer. The lymphoma may be derived from in- traepithelial CD8＋ T cells, similar to celiac disease.

关键词： Enteropathy-associated T-cell lymphoma Celiac disease Human T-lymphotropic virus-l Fluores-cent in situ hybridization Chromosome 8p24

Furanocembranoid from the Okinawan soft coral Sinularia sp.

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Natural Products and Bioprospecting 2022年第1期12卷 71-77页

作者： Misaki Nagasaka Kazuki Tani Keisuke Nishikawa Riri kinjo Takahiro Ishii Department of Biosciences and Biotechnology Faculty of AgricultureUniversity of the RyukyusSenbaru 1NishiharaOkinawa 903-0213Japan Department of Chemistry Graduate School of ScienceOsaka City UniversityOsaka 558-8585Japan

One new furanocembranoid diterpene,11-hydroxy-Δ^(12(13))-pukalide(1),along with six known secondary metabolites,11-acetoxy-Δ^(12(13))-pukalide(2),13α-acetoxypukalide(3),pukalide(4),3α-methoxyfuranocembranoid(5),Δ9(15)-africanene(6),and methyl(5′E)-5-(2′,6′-dimethylocta-5′,7′-dienyl)furan-3-carboxylate(7)were isolated from the Okinawan soft coral Sinularia *** chemical structures were elucidated based on spectroscopic analysis(FTIR,NMR,and HRESIMS),and the relative stereochemistry of 1 was determined by NOESY experiments and acetylation,which yielded derivative *** addition,compounds 1 and 7 exhibited toxicity in the brine shrimp lethality test.

关键词： Soft coral Sinularia sp. Furanocembranoid Diterpene