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The optimal stent pusher position to achieve successful ureteral stent insertion under fluoroscopic guidance

Asian Journal of Urology 2024年第2期11卷 311-315页

作者： Makoto Taguchi Kaneki Yasuda Hidefumi Kinoshita Department of Urology Osaka Saiseikai Izuo Hospital Based on Social Welfare Organization“Saiseikai”Imperial Gift Foundation Inc.OsakaJapan Department of Urology and Andrology Kansai Medical UniversityHirakataOsakaJapan

Objective: To examine factors to predict the optimal stent pusher position when inserting ureteral stents under ***: We retrospectively reviewed 327 patients who underwent ureteral stent insertion. We considered the pubic bone as a useful anatomical landmark to insert ureteral stents under fluoroscopic guidance. Thus, we categorized patients into three groups (proximal, middle, and distal groups) according to the position of the radiopaque tip of the push catheter when inserting the ureteral stent. Success was defined as a completely curled ureteral stent tail. We compared stent insertion success rates among the three groups. A multivariate analysis was performed to identify the factors affecting stent insertion ***: In men, 36 (63.2%) cases were deemed successful in the proximal group compared with 40 (80.0%) cases in the middle group and 12 (20.7%) cases in the distal group (p<0.001). In women, 26 (45.6%) cases were deemed successful in the proximal group compared with 54 (98.2%) cases in the middle group and 38 (76.0%) cases in the distal group (p<0.001). With the multivariate analysis, the stent pusher position was the most significant factor influencing successful stent insertion (men: odds ratio 6.00, 95% confidence interval 2.66-13.51, p<0.001;women: odds ratio 37.80, 95% confidence interval 4.94-289.22, p<0.001).Conclusion: The position of the stent pusher affects stent insertion success. The middle of the pubic symphysis is the optimal position for the radiopaque tip of the pusher when inserting ureteral stents under fluoroscopic guidance.

关键词： Stent Cystoscopy Fluoroscopy Ureter

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Liver biopsy in the post-hepatitis C virus era in japan

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World Journal of Gastroenterology 2024年第14期30卷 1949-1957页

作者： Yoshihiro Ikura Takako Okubo Yasuhiro Sakai Department of Pathology Takatsuki General HospitalTakatsuki 569-1192Osaka PrefectureJapan Department of Pathology Kansai Medical University Medical CenterMoriguchi 570-8507Japan

In japan,liver biopsies were previously crucial in evaluating the severity of hepatitis caused by the hepatitis C virus(HCV)and diagnosing HCV-related hepatocellular carcinoma(HCC).However,due to the development of effective antiviral treatments and advanced imaging,the necessity for biopsies has significantly *** change has resulted in fewer chances for diagnosing liver disease,causing many general pathologists to feel less confident in making liver biopsy *** article provides a comprehensive overview of the challenges and potential solutions related to liver biopsies in ***,it highlights the importance of considering steatotic liver diseases as independent conditions that can coexist with other liver diseases due to their increasing ***,it emphasizes the need to avoid hasty assumptions of HCC in nodular lesions,because clinically diagnosable HCCs are not targets for ***,the importance of diagnosing hepatic immune-related adverse events caused by immune checkpoint inhibitors is increasing due to the anticipated widespread use of these *** conclusion,pathologists should be attuned to the changing landscape of liver diseases and approach liver biopsies with care and attention to detail.

关键词： Liver biopsy Alteration Post-hepatitis C virus era Steatotic liver disease Hepatic tumors Immune checkpoint inhibitors

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Evaluation of Delivery Analysis to Detect Intrafractional Motion during Tomotherapy

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International Journal of Medical Physics, Clinical Engineering and Radiation Oncology 2019年第4期8卷 225-235页

作者： Kazuo Tarutani Masao Tanooka Keisuke Sano Okada Wataru Masayuki Fujiwara Koichiro Yamakado Department of Radiology Hyogo College of Medicine Nishinomiya Japan japan organization of occupational health and safety kansai rousai hospital Amagasaki Japan Department of Radiotherapy Takarazuka City Hospital Takarazuka Japan

The purpose of this study was to investigate the ability of a management system (Delivery Analysis: DA) to detect intrafractional motion during intensity-modulated radiation therapy (IMRT) in tomotherapy mode. Tomotherapy has made it possible to manage internal movements during treatment using software DA, which quantifies using the information of the passing dose obtained during the radiation treatment of patients. First, three treatment plans for the test were created (lumbar spine, prostate, and femur). Second, a pelvis phantom was moved in the X, Y, and Z directions, and a sinogram was acquired. The magnitudes of the movements were 3 mm, 5 mm, and 10 mm, respectively. Finally, the ability of DA to detect the motion was evaluated by comparing the sinogram obtained by moving the phantom with a reference sinogram obtained without movement. The sensitivity of DA could be detected with a shift amount of 3 mm (gamma analysis tolerance 0.3 mm/0.3%). The average gamma analysis of each direction at 0.3 mm/0.3% tolerance at each treatment site was 96.1% for the prostate, 93.5% for the lumbar spine, and 94.4% for the femur. Additionally, the average gamma pass rate results for the pelvic phantom in the X, Y, Z directions for a 10 mm shift were 96.2%, 96.3%, and 95.9%, respectively. DA is a powerful tool with high detection sensitivity and ability to detect body movement during treatment.

关键词： Delivery Analysis (DA) Tomotherapy Sinogram Intra-Fraction Motion Quality Assurance (QA)

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Diagnostic criteria for autoimmune pancreatitis in japan

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World Journal of Gastroenterology 2008年第32期14卷 4992-4994页

作者： Terumi Kamisawa Kazuichi Okazaki Shigeyuki Kawa Department of Internal Medicine Tokyo Metropolitan Komagome Hospital Third Department of Internal Medicine Kansai Medical University Center for health Safety and Environmental Management Shinshu University

Autoimmune pancreatitis （AIP） is a particular type of pancreatitis of presumed autoimmune etiology. Currently, AIP should be diagnosed based on combination of clinical, serological, morphological, and histopathological features. When diagnosing AIP, it is most important to differentiate it from pancreatic cancer. Diagnostic criteria for AIP, proposed by the japan Pancreas Society in 2002 first in the world, were revised in 2006. The criteria are based on the minimum consensus of AIP and aim to avoid misdiagnosing pancreatic cancer as far as possible, but not for screening AIR The criteria consist of the following radiological, serological, and histopathological items：（1） radiological imaging showing narrowing of the main pancreatic duct and enlargement of the pancreas, which are characteristic of the disease; （2） laboratory data showing abnormally elevated levels of serum y-globulin, IgG or IgG4, or the presence of autoantibodies; （3） histopathological examination of the pancreas demonstrating marked fibrosis and prominent infiltration of lymphocytes and plasma cells, which is called lymphoplasmacytic sclerosing pancreatitis （LPSP）. For a diagnosis of AIP, criterion 1 must be present, together with criterion 2 and/ or criterion 3. However, it is necessary to exclude malignant diseases such as pancreatic or biliary cancer.

关键词： Autoimmune pancreatitis Diagnostic criteria IgG4 Lymphoplasmacytic sclerosing pancreatitis

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Recent standardization of treatment strategy for pancreatic neuroendocrine tumors

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World Journal of Gastroenterology 2010年第36期16卷 4519-4525页

作者： Masayuki Imamura Department of Surgey Kansai Denryoku Hospital2-1-7FukushimaFukushima-KuOsaka 553-0003Japan

Recent advances in localization techniques,such as the selective arterial secretagogue injection test(SASI test) and somatostatin receptor scintigraphy have promoted curative resection surgery for patients with pancreatic neuroendocrine tumors(PNET).For patients with sporadic functioning PNET,curative resection surgery has been established by localization with the SASI test using secretin or *** curative resection of functioning PNET associated with multiple endocrine neoplasia type 1(MEN 1) which are usually multiple and sometimes numerous,resection surgery of the pancreas and/or the duodenum has to be performed based on localization by the SASI *** resection surgery of PNET has increased,several important pathological features of PNET have been *** example,in patients with Zollinger-Ellison syndrome(ZES),duodenal gastrinoma has been detected more frequently than pancreatic gastrinoma,and in patients with MEN 1 and ZES,gastrinomas have been located mostly in the duodenum,and pancreatic gastrinoma has been found to co-exist in 13% of *** PNET in patients with MEN 1 becomes metastatic to the liver when it is more than 1 cm in diameter and should be resected after careful *** most important prognos-tic factor in patients with PNET is the development of hepatic *** treatment strategy for hepatic metastases of PNET has not been established and aggressive resection with chemotherapy and trans-arterial chemoembolization have been performed with significant *** usefulness of octreotide treatment and other molecular targeting agents are currently being assessed.

关键词： Gastrinoma Glucagonoma Insulinoma Multiple endocrine neoplasia type 1 Octreotide Pancreas preserving total duodenectomy Pancreatic neuroendocrine tumors Selective arterial secretagogue injection test Somatostatin receptor scintigraphy

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Determination of symptoms associated with hiesho among young females using hie rating surveys

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Journal of Integrative Medicine 2018年第1期16卷 34-38页

作者： Hidetoshi Mori Hiroshi Kuge Shunji Sakaguchi Tim Hideaki Tanaka Junji Miyazaki Faculty of health Sciences Course of Acupuncture and Moxibustion Tsukuba University of Technology Tsukuba 305-8521 Japan Department of Anesthesiology Osaka Medical College Hospital Osaka 569-8686 Japan Research Division of Acupuncture and Moxibustion Kansai University of Health Sciences Osaka 590-0482 Japan Takarazuka University of Medical and health Care Takarazuka 666-0162 Japan

Objective： Hie （cold sensation） is one of the most well-known health complaints in japan and elsewhere in East Asia. Those who suffer from severe hie are considered to have hiesho （cold disorder）. This study was conducted to determine symptoms associated with hie in young females using a survey consisting of the hie scale and hie diary. Methods： Two hundred and seventy-one participants were included for the analysis. Survey forms were distributed to the participants. Diagnosis of hiesho was determined by using the hie scale. A discriminant score of over -0.38 was considered hiesho. The Short Form-8 health Survey Standard Version （SF-8） was used to measure health-related quality of life （QOL）. The participants were also asked to respond to the questionnaire evaluating 14 physical and emotional symptoms, utilizing a six-level Likert scale item. Results： The 1st factor （hie factor） was correlated with hie （r= 0.546）, dry mouth （r= 0.332）, lower- extremity edema （r = 0.450）, headrushes （r=0.470）, shoulder stiffness （r = 0.311 ）, headrushes with chills （r = 0.726）, and fatigue （r= 0.359）. Cronbach＇s α of the 1st factor was 0.748, which indicated reliability between the items. When hie factor was the dependent variable, standardized partial regression coefficient was β=-0.387 for physical component score （P 〈 0.001） and β=-0.243 for mental component score （P 〈 0.001 ）. Conclusion： This study indicated that hiesho symptoms among young female adults were associated with bodily pain and general health perceptions of the SF-8 QOL survey.

关键词： Cold l:ypersensitivity Questionnaires health surveys Quality of life Regression analysis Reproducibility of results

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Phase Ⅱ study of protracted irinotecan infusion and a low-dose cisplatin for metastatic gastric cancer

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World Journal of Gastroenterology 2006年第40期12卷 6522-6526页

作者： Hiroshi Imamura Masataka Ikeda Hiroshi Furukawa Toshimasa Tsujinaka Kazumasa Fujitani Kenji Kobayashi Hiroyuki Narahara Michio Kato Haruhiko Imamoto Arimichi Takabayashi Hideaki Tsukuma Department of Surgery Sakai Municipal Hospital Osaka Japan Department of Surgery Osaka National Hospital Osaka Japan Department of Surgery Kinki Central Hospital Hyogo Japan Department of Internal Medicine Osaka Medical Center for Cancer and Cardiovascular Diseases Osaka Japan Department of Surgery Kinki University School of Medicine Osaka Japan Department of Surgery Kansai Rosai Hospital Hyogo Japan Department of Surgery Kitano Hospital & Research Institute Osaka Japan

AIM: To test protracted irinotecan infusion plus a low-dose cisplatin in this Phase Ⅱ trial to decrease its toxic-ity. METHODS: The eligibility criteria were: (1) histologi-cally proven measurable gastric cancer; (2) performance status of 0 or 1; (3) no prior chemotherapy or comple-tion of prior therapy at least 4 wk before enrollment; (4) adequate function of major organs; (5) no other active malignancy; and (6) written informed consent. The regi-men consisted of irinotecan (60 mg/m2) on d 1 and 15 by 24-h infusion and cisplatin (10 mg/m2) on d 1, 2, 3, 15, 16, and 17. Treatment was repeated every 4 wk. RESULTS: Thirty-one patients were registered between April 2000 and January 2001. The response rate for all 31 patients, 20 patients without prior chemotherapy, and 11 patients with prior chemotherapy was 52% (16/31), 60% (12/20), and 36% (4/11), respectively. The median survival time was 378 d. The median number of courses given to all patients was 2. Grade 4 neutropenia oc-curred in 11 (35%) patients, while grade 3 to 4 diarrhea or nausea occurred in 1 (3%) and 3 (10%) patients, respectively. Fatigue was minimal as grade 1 fatigue was found only in 3 (10%) patients. Other adverse events were mild and no treatment-related deaths ***: This regimen showed a high level of ac-tivity and acceptable toxicity in patients with metastatic gastric cancer.

关键词： Gastric cancer CPT-11 CDDP Protracted Irinotecan Chemotherapy

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Consensus of primary care in acute pancreatitis in japan

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World Journal of Gastroenterology 2006年第21期12卷 3314-3323页

The incidence of acute pancreatitis in japan is increasing and ranges from 187 to 347 cases per million populations. Case fatality was 0.2% for mild to moderate, and 9.0% for severe acute pancreatitis in japan in 2003. Experts in pancreatitis in japan made this document focusing on the practical aspects in the early management of patients with acute pancreatitis. The correct diagnosis of acute pancreatitis and severity stratification should be made in all patients using the criteria for the diagnosis of acute pancreatitis and the multifactor scoring system proposed by the Research Committee of Intractable Diseases of the Pancreas as early as possible. All patients diagnosed with acute pancreatitis should be managed in the hospital. Monitoring of blood pressure, pulse and respiratory rate, body temperature, hourly urinary volume, and blood oxygen saturation level is essential in the management of such patients. Early vigorous intravenous hydration is of foremost importance to stabilize circulatory dynamics. Adequate pain relief with opiates is also important. In severe acute pancreatitis, prophylactic intravenous administration of antibiotics at an early stage is recommended. Administration of protease inhibitors should be initiated as soon as thediagnosis of acute pancreatitis is confirmed. A combination of enteral feeding with parenteral nutrition from early stage is recommended if there are no clear signs and symptoms of ileus and gastrointestinal bleeding. Patients with severe acute pancreatitis should be transferred to ICU as early as possible to perform special measures such as continuous regional arterial infusion of protease inhibitors and antibiotics, and continuous hemodiafiltration. The japanese Government covers medical care expense for severe acute pancreatitis as one of the projects of Research on Measures for Intractable Diseases.

关键词： Fluid resuscitation Protease inhibitor treatment Antibiotic treatment Continuous regional arterial infusion Contrast-enhanced computed tomography

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Helicobacter pylori eradication to prevent gastric cancer: underlying molecular and cellular mechanisms

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World Journal of Gastroenterology 2006年第11期12卷 1671-1680页

作者： Shingo Tsuji Masahiko Tsujii Hiroaki Murata Tsutomu Nishida Masato Komori Masakazu Yasumaru Shuji Ishii Yoshiaki Sasayama Sunao Kawano Norio Hayashi Department of Gastroenterology and Hepatology Osaka University Graduate School of Medicine (Kl) YamadaokaSuita565-0871 Japan Department of Internal Medicine kansai Rohsai hospital Amagasaki660-0064 Japan Department of Internal Medicine Kashiwara Muncipal hospital Kashiwara582-0002 Japan Department of Clinical Laboratory Science Osaka University Graduate School of Medicine Suita565-0871 Japan

Numerous cellular and molecular events have been described in development of gastric cancer. In this artide, we overviewed roles of Helicobacter pylori （H pylori） infection on some of the important events in gastric carcinogenesis and discussed whether these cellular and molecular events are reversible after cure of the infection. There are several bacterial components affecting gastric epithelial kinetics and promotion of gastric carcinogenesis. The bacterium also increases risks of genetic instability and mutations due to NO and other reactive oxygen species. Epigenetic silencing of tumor suppressor genes such as RUNX3 may alter the frequency of phenotype change of gastric glands to those with intestinal metaplasia. Host factors such as increased expression of growth factors, cytokines and COX-2 have been also reported in non-cancerous tissue in Hpylori-positive subjects. It is noteworthy that most of the above phenomena are reversed after the cure of the infection. However, some of them including overexpression of COX-2 continue to exist and may increase risks for carcinogenesis in metaplastic or dysplastic mucosa even after successful H pylori eradication. Thus, H pylori eradication may not completely abolish the risk for gastric carcinogenesis. Efficiency of the cure of the infection in suppressing gastric cancer depends on the timing and the target population, and warrant further investigation.

关键词： Helicobacter Cancer Gastric acid p53 Inflammation Gastric atrophy Intestinal metaplasia

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Morphology and gene expression of sex‐determining region Y‐box 9 and runt‐related transcription factor 2 in centrifugally compressed cell collagen‐combined constructs (C^(6))

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Biosurface and Biotribology 2023年第3期9卷 78-83页

作者： Xu Ye Masashi Yamazaki Wataru Ando Norimasa Nakamura Hiromichi Fujie Faculty of System Design Tokyo Metropolitan UniversityTokyoJapan Research Center for Medicine‐Engineering Collaboration TokyoJapan Department of Orthopaedic Surgery Kansai Rosai HospitalAmagasakiJapan Department of Orthopaedic Surgery Osaka University Graduate School of MedicineSuitaJapan Institute for Medical Science in Sports Osaka Health Science UniversityOsakaJapan Center for Advanced Medical Engineering and Informatics Osaka UniversitySuitaJapan

The authors previously developed a scaffold‐free tissue‐engineered construct(TEC)from mesenchymal stem cells(MSCs).Although the TEC exhibited even cell distribution and was successfully applied for cartilage repair in animal models,it is unsuitable for relatively large‐scale cartilage defects due to its small *** solve the problem,the authors recently developed a novel biomaterial,a centrifugally compressed cell‐collagen combined construct(C^(6))from a mixture of MSCs and atelocollagen,both of which are subjected to *** results of the previous study indicated that C^(6) exhibited high cell viability(70%)and sufficient cell distribution similar to that of the *** the present study,the morphology and gene expression of C^(6) were *** ex-amination indicated that C6 is six times thicker(approximately 1 mm)than the TEC after a 7‐day *** C^(6) remained unchanged in scale with increased cell density after a 21‐day *** electron microscopic observation indicated that C^(6) exhibited interconnected and porous microstructures,while the TEC had close‐knit *** transcriptase‐polymerase chain reaction analysis indicated that the expression of sex‐determining region Y‐box 9 and runt‐related transcription factor 2 was significantly higher in C^(6) than that in TEC.

关键词： biomaterials cartilage microstructures

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