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Evaluation of magnifying colonoscopy in the diagnosis of serrated polyps

World Journal of Gastroenterology 2012年第32期18卷 4308-4316页

作者： Shinya Ishigooka Masahito Nomoto Nobuyuki Obinata Yoshichika Oishi yoshinori sato satoko Nakatsu Midori Suzuki Yoshiko Ikeda Tadateru Maehata Tomoaki Kimura Yoshiyuki Watanabe Takashi Nakajima Hiro-o Yamano Hiroshi Yasuda Fumio Itoh Department of Internal Medicine Division of Gastroenterology and HepatologySt.Marianna University School of MedicineKawasaki 216-8511Japan Center of Gastroenterology St.Marianna Toyoko HospitalKawasaki 211-0063Japan Department of Gastroenterology Akita Red Cross HospitalAkita 010-1495Japan

AIM:To elucidate the colonoscopic features of serrated lesions of the colorectum using magnifying ***:Broad division of serrated lesions of the colorectum into hyperplastic polyps(HPs),traditional serrated adenomas(TSAs),and sessile serrated adenomas/polyps(SSA/Ps) has been proposed on the basis of recent molecular biological ***,few reports have examined the colonoscopic features of these divisions,including magnified colonoscopic *** study examined 118 lesions excised in our hospital as suspected serrated lesions after magnified observation between January 2008 and September *** characteristics(sex,age),conventional colonoscopic findings(location,size,morphology,color,mucin) and magnified colonoscopic findings(pit pattern diagnosis) were interpreted by five colonoscopists with experience in over 1000 colonoscopies,and were compared with histopathological *** pit patterns were categorized according to Kudo's classification,but a more detailed investigation was also performed using the subclassification [type Ⅱ-Open(type Ⅱ-O),type Ⅱ-Long(type Ⅱ-L),or type Ⅳ-Serrated(type Ⅳ-S)] proposed by Kimura T and Yamano ***:Lesions comprised 23 HPs(23/118:19.5%),39 TSAs(39/118:33.1%:with cancer in one case),50 SSA/Ps(50/118:42.4%:complicated with cancer in three cases),and six others(6/118:5.1%).We excluded six others,including three regular adenomas,one hamartoma,one inflammatory polyp,and one juvenile polyp for further *** colonoscopy showed that SSA/Ps were characterized as larger in diameter than TSAs and HPs(SSA/P vs HP,13.62 ± 8.62 mm vs 7.74 ± 3.24 mm,P < 0.001;SSA/Ps vs TSA,13.62 ± 8.62 mm vs 9.89 ± 5.73 mm,P < 0.01);common in the right side of the colon [HPs,30.4%(7/23):TSAs,20.5%(8/39):SSA/P,84.0%(42/50),P < 0.001];flat-elevated lesion [HPs,30.4%(7/23):TSAs,5.1%(2/39):SSA/Ps,90.0%(45/50),P < 0.001];normal-colored or pale imucosa [HPs,34.8%(8/23):TSAs,10.3%(4/39):SSA/Ps,80%(40/50),P < 0.00

关键词： Serrated adenoma Sessile serrated adenoma/polyp Hyperplastic polyps Traditional serrated adenomas Conventional colonoscopy Magnifying colonoscopy Pit patterns Serrated lesions

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利用钢铁生产吹氧法的垃圾气化与熔融系统

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钢铁 2003年第Z1期38卷 109-111页

作者： Takaku Yamamoto Hirotaka sato yoshinori Matsukura Yutaka Ujisawa Sumitomo Metal Industries LTD住友金属 Sumitomo Metal IndustriesLTD住友金属 Sumitomo Metal IndustriesLTD住友金属 Sumitomo Metal IndustriesLTD住友金属

利用高温冶金炼铁、炼钢技术,开发了一种新型的垃圾气化与熔融系统.住友金属开发的这种体系具有下列基本概念:用顶吹和侧吹氧枪实现稳态生产,产生无二恶英的高热值净化气和高质量的炉渣.系统的基本概念用一台规模为2 t/d的城市垃圾处理... 详细信息

利用高温冶金炼铁、炼钢技术,开发了一种新型的垃圾气化与熔融系统.住友金属开发的这种体系具有下列基本概念:用顶吹和侧吹氧枪实现稳态生产,产生无二恶英的高热值净化气和高质量的炉渣.系统的基本概念用一台规模为2 t/d的城市垃圾处理小型炉得到澄清.利用顶吹氧枪,由于在炉子上部产生均匀气流,从而可稳定炉子顶气的成分.顶吹氧枪的使用可防止粗粉尘(尺寸＞0.1 mm)的飞散,使熔化的粉尘均匀沉积在炉子内壁上.内壁上形成的粉尘沉积层不但可防止粉尘飞散,而且能保护炉子内壁.在2t/d规模小型炉试验结果的基础上,进一步启动了一台20 t/d规模的示范炉.示范炉和小型炉一样不用焦炭,能稳定地气化和熔化城市垃圾.由于在高温还原气氛下气化和快速冷却,结果可产生无二恶英的高热值净化气.垃圾中的灰分在高温还原气氛下熔融,得到不含重金属的高质量炉渣.

关键词：垃圾气化与熔融系统二恶英重金属高热值气体

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Successful endoscopic fragmentation of large hardened fecaloma using jumbo forceps

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World Journal of Gastrointestinal Endoscopy 2017年第2期9卷 91-94页

作者： Yasumasa Matsuo Hiroshi Yasuda Hiroyasu Nakano Miki Hattori Midori Ozawa yoshinori sato Yoshiko Ikeda Shun-Ichiro Ozawa Masaki Yamashita Hiroyuki Yamamoto Fumio Itoh Division of Gastroenterology and Hepatology Department of Internal MedicineSt.Marianna University School of MedicineKanagawa 216-8511Japan

We present a rare case of fecaloma, 7 cm in size, in the setting of systemic scleroderma. A colonoscopy revealed a giant brown fecaloma occupying the lumen of the colon and a colonic ulcer that was caused by the fecaloma. The surface of the fecaloma was hard, large and slippery, and fragmentation was not possible despite the use of various devices, including standard biopsy forceps, an injection needle, and a snare. However, jumbo forceps were able to shave the surface of the fecaloma and break it successfully by repeated biting for 6 h over 2 d. The ability of the jumbo forceps to collect large mucosal samples was also appropriate for achieving fragmentation of the giant fecaloma.

关键词： Fecaloma Jumbo biopsy forceps Systemic scleroderma Mixed connective tissue disease

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Treatment and prevention of gastrointestinal bleeding in patients receiving antiplatelet therapy

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World Journal of Critical Care Medicine 2015年第1期4卷 40-46页

作者： Hiroshi Yasuda Yasumasa Matsuo yoshinori sato Sun-ichiro Ozawa Shinya Ishigooka Masaki Yamashita Hiroyuki Yamamoto Fumio Itoh Division of Gastroenterology and Hepatology St. Marianna University School of Medicine

Antiplatelet therapy is the standard of care for the secondary prevention of acute coronary syndrome and ischemic stroke, especially after coronary intervention. However, this therapy is associated with bleeding complications such as gastrointestinal bleeding, which is one of the most common life-threatening complications. Early endoscopy is recommended for most patients with acute upper gastrointestinal bleeding. After successful endoscopic hemostasis, immediate resumption of antiplatelet therapy with proton-pump inhibitors(PPIs) is recommended to prevent further ischemic events. PPI prophylaxis during antiplatelet therapy reduces the risk of upper gastrointestinal bleeding. The potential negative metabolic interaction between PPIs and clopidogrel is still unclear.

关键词： Antiplatelet therapy Aspirin Clopidogrel Gastrointestinal bleeding Endoscopy Proton-pump inhibitor

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Factors Relevant to Knee Pain among Independent Community-Dwelling Older Adults: A Complete Cross-Sectional Study

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Open Journal of Preventive Medicine 2020年第11期10卷 277-287页

作者： Shinichiro sato Yuta Nemoto Noriko Takeda yoshinori Kitabatake Kazushi Maruo Takashi Arao Faculty of Health Sciences University of Human Arts and Sciences Saitama Japan Research Team for Social Participation and Community Health Tokyo Metropolitan Institute of Gerontology Tokyo Japan Division of Liberal Arts Kogakuin University Tokyo Japan Department of Health Sciences Saitama Prefectural University Saitama Japan Faculty of Medicine University of Tsukuba Ibaraki Japan Meiji Yasuda Life Foundation of Health and Welfare Tokyo Japan

Objective: Knee pain is commonly observed among older adults. Therefore, the prevention of knee pain in older adults is a major public health issue. This study aimed to clarify factors relevant to knee pain among older adults. Methods: This study targeted all independent older adults (N = 6661) living in a local municipality in Japan. Participants’ health status and lifestyle habits were surveyed using a questionnaire. The survey was conducted from 15 January to 14 February 2016. Relationships between knee pain and physical activity, sitting time, nutrition, drinking, smoking, or body mass index (BMI) were examined using logistic regression analysis. Odds ratios (OR) and 95% confidence intervals (CI) adjusted for several confounding factors were calculated. Results: Older adults of 5311 responded to the questionnaire and 1843 reported knee pain. The prevalence of knee pain was 34.8%. Knee pain was significantly associated with BMI (OR: 0.60, 95% CI: 0.51 - 0.69, P P P P = 0.001). Conclusions: This study suggests that one in three independently-living older adults experiences chronic knee pain and that physical activity, BMI, and nutritional status are associated with knee pain.

关键词： Complete Survey Physical Activity Prevalence Rate Sitting Time

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Efficacy of an Abduction Brace in Preventing Initial Dislocation in the Early Postoperative Period after Primary Total Hip Arthroplasty

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Surgical Science 2012年第3期3卷 131-135页

作者： yoshinori Ishii Hideo Noguchi Mitsuhiro Takeda Junko sato Yoichiro Domae Department of Orthopaedic Surgery Shibata Prefectural Hospital Niigata Japan Ishii Orthopaedic and Rehabilitation Clinic Saitama Japan

We hypothesized that a hip brace may prevent the initial dislocation in the early postoperative period after total hip arthroplasty (THA). We performed a prospective evaluation of the efficacy of a brace in preventing dislocation in 54 primary THAs in 43 patients. All of the patients wore braces for 3 weeks postoperatively. The occurrence of dislocation was evaluated six months postoperatively. There were no cases of dislocation while wearing a brace, while two posterior dislocations occurred 8 and 12 days postoperatively while picking something up from the floor without a brace in so-called provocative positions. The results of this study suggest that a hip brace helps patients to recognize careless provocative positions and prevents the initial hip dislocation in this period instead of usual postoperative management for an average of 6 weeks after discharge, such as a high toilet seat, restricted hip flexion in the activities of daily living, use of a reacher or grabber, an abduction pillow, and a high chair.

关键词： Hip Brace Dislocation Total Hip Arthroplasty

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Mineral and Sea-Salt Aerosol Fluxes over the Last 340 kyr Reconstructed from the Total Concentration of Al and Na in the Dome Fuji Ice Core

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Atmospheric and Climate Sciences 2013年第2期3卷 186-192页

作者： Hironori sato Toshitaka Suzuki Motohiro Hirabayashi yoshinori Iizuka Hideaki Motoyama Yoshiyuki Fujii Department of Earth and Environmental Sciences Faculty of Science Yamagata University Yamagata Japan Institute of Low Temperature Science Hokkaido University Sapporo Japan National Institute of Polar Research Tokyo Japan

A quantitative analysis of the total concentrations of Al and Na in the Antarctic ice sheet during the past 340 kyr was performed by applying the acid digestion method to the Dome Fuji ice core. Atmospheric fluxes of mineral and sea-salt aerosol to Dome Fuji were calculated from the total concentration. The average fluxes of mineral aerosol to Dome Fuji in the periods of glacial maximum, 18.6 ± 10.1 mg·m–2·yr–1, were larger than the value in the interglacial periods, 3.77 ± 2.20 mg·m–2·yr–1. Conversely, the fluxes of sea-salt have no significant difference between the average value of glacial maximum, 130 ± 55 mg·m–2·yr–1, and that of interglacial, 111 ± 54 mg·m–2·yr–1. The results obtained in this study suggest that the variation of mineral aerosol flux in Dome Fuji, together with climate change, was much larger than that of sea-salt aerosol flux. This result may have occurred because the variety in the intensity of the source and transport during the glacial-interglacial cycle is more significant for mineral aerosol than that for sea-salt aerosol.

关键词： Ice Core Antarctica Dome Fuji Climate Change Aerosol Flux Full Digestion

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Biliary metal stents should be placed near the hilar duct in distal malignant biliary stricture patients

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World Journal of Gastroenterology 2022年第17期28卷 1860-1870页

作者： Mitsuru Sugimoto Tadayuki Takagi Rei Suzuki Naoki Konno Hiroyuki Asama Yuki sato Hiroki Irie yoshinori Okubo Jun Nakamura Mika Takasumi Minami Hashimoto Tsunetaka Kato Ryoichiro Kobashi Takumi Yanagita Takuto Hikichi Hiromasa Ohira Department of Gastroenterology Fukushima Medical UniversityFukushima 9601295Japan Department of Endoscopy Fukushima Medical University HospitalFukushima 9601295Japan

BACKGROUND Endoscopic biliary drainage using a self-expandable metallic stent(SEMS)has been widely performed to treat distal malignant biliary obstruction(DMBO).However,the optimal position of the stent remains *** To determine the ideal position for SEMS *** In total,135 DMBO patients underwent SEMS(uncovered or covered)placement over a ten-year period.A total of 127 patients with biliary obstruction between the junction of the cystic duct and Vater’s papilla were *** SEMS was placed through the upper common bile duct 2 cm from the biliary hilar duct in 83 patients(Hilar group)or near the top of the biliary obstruction in 44 patients(Lower group).Technical and functional success,adverse events,and risk factors for SEMS dysfunction were *** The stent patency period was significantly longer in the Hilar group than in the Lower group(P value<0.01).In multivariate analysis,the only statistically significant risk factor for SEMS dysfunction was being in the Lower group(hazard ratio:9.94,95%confidence interval:2.25–44.0,P<0.01).CONCLUSION A longer patency period was achieved by positioning the SEMS near the biliary hilar duct.

关键词： Endoscopic biliary drainage Malignant biliary obstruction Uncovered self-expandable metallic stent Covered self-expandable metallic stent Biliary hilar duct Patency period

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Evaluation of Fever and Its Related Factors during 4 Weeks after Primary Total Hip Arthroplasty

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Surgical Science 2013年第1期4卷 1-6页

作者： yoshinori Ishii Hideo Noguchi Mitsuhiro Takeda Junko sato Takeshi Yamamoto Yo-Ichiro Domae Department of Orthopaedic Surgery Shibata Prefectural Hospital Shibata Japan Ishii Orthopaedic and Rehabilitation Clinic Gyoda Japan

The purpose of this study was to describe the incidence and characteristics of postoperative fever (POF;≥38℃) and clarify the correlation between POF and febrile-related factors during 4 weeks after primary total hip arthroplasty (THA). A total of 56 patients were included in the study (67 THAs). The preoperative diagnosis for all patients was osteoarthritis. The average follow-up period was 90 months. No patients developed deep infection during the follow-up period. The maximum mean peak daily temperature was 37.7℃ on the day of the surgery and the next day. Fifty-two percent of patients experienced POF, with most developing a maximum temperature (MT) on the day of surgery and the latest occurring by postoperative day (POD) 3. Only C-reactive protein (R = 0.384, p = 0.001) among the febrile-related factors had a weak correlation with MT. Four hips showed a POF of >38℃ later than POD 7;all four of these patients were diagnosed with a urinary tract infection. POF is common and may be part of a normal inflammatory response to tissue injury after THA. More than half of patients may develop POF within 1 week, with most developing MT on POD 0 and the latest occurring by POD 3. In addition, urinary tract infections might be an initial reason for POF in the subsequent 3 weeks.

关键词： Total Hip Arthroplasty Post-Operative Fever Maximum Temperature C-Reactive Protein Urinary Tract Infection

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Detection of the <i>PIK3CA</i>Mutation in Circulating Tumor DNA as a Possible Predictive Indicator for Poor Prognosis of Early-Stage Breast Cancer

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Journal of Cancer Therapy 2018年第1期9卷 42-54页

作者： Ayaka sato Masahiko Tanabe Yumi Tsuboi Masako Ikemura Keiichiro Tada Yasuyuki Seto yoshinori Murakami Division of Molecular Pathology Institute of Medical Science The University of Tokyo Tokyo Japan Department of Breast and Endocrine Surgery Graduate School of Medicine The University of Tokyo Tokyo Japan Department of Pathology Graduate School of Medicine The University of Tokyo Tokyo Japan

Objectives: Circulating tumor DNA (ctDNA) is shown to provide the real-time genomic information of metastatic breast cancer. This study elucidates the clinico-pathological significance of ctDNA in early-stage breast cancer using the PIK3CA mutation as an indicator. Materials and Methods: Twenty-seven primary breast cancers without metastasis were surgically resected and pathologically diagnosed at the University of Tokyo Hospital, Japan. Genomic DNA of primary tumor was extracted from formalin-fixed and paraffin-embedded specimens. ctDNA was extracted from fresh-frozen plasma from patients. The PIK3CA mutations at E542K, E545K and H1047R were examined by Sanger sequencing or droplet digital PCR in 27 tumors and pre- and post-surgery plasma. Results: The PIK3CA mutations were detected in 13 (48%) of 27 primary tumors. These mutations did not significantly correlate with specific clinico-pathological characteristics of tumors. When ctDNA was examined, 4 (33%) of 12 cases carrying the mutated PIK3CA showed the identical mutation in pre-surgery plasma and 2 (50%) of them showed the identical mutations in post-surgery plasma. Interestingly, in these 2 cases in pathological stages IIIA and IA, fractional abundance of the mutated PIK3CA alleles to the total alleles in pre-surgery ctDNA was around 1% or more and was higher than that of the other two cases without PIK3CA mutations in post-surgery ctDNA. Conclusions: The PIK3CA mutation in ctDNA is detectable even in a subset of early-stage breast cancer. Furthermore, fractional abundance of the mutated PIK3CA in pre-surgery ctDNA could provide a possible predictive indicator for tumor burden and for choosing the appropriate adjuvant treatment of breast cancer.

关键词： Early-Stage Breast Cancer PIK3CA Circulating Tumor DNA Plasma Droplet Digital PCR

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