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Removal of diminutive colorectal polyps: A prospective randomized clinical trial between cold snare polypectomy and hot forceps biopsy

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World Journal of Gastroenterology 2017年第2期23卷 328-335页

作者： Yoriaki Komeda Hiroshi Kashida Toshiharu Sakurai George Tribonias Kazuki Okamoto Masashi Kono Mitsunari Yamada Teppei Adachi Hiromasa Mine Tomoyuki Nagai Yutaka Asakuma Satoru Hagiwara Shigenaga Matsui Tomohiro Watanabe Masayuki Kitano Takaaki Chikugo Yasutaka Chiba Masatoshi Kudo Department of Gastroenterology and Hepatology Kindai University Faculty of Medicine Department of Pathology Kindai University Faculty of Medicine Clinical Research Center Kindai University Hospital

AIMTo compare the efficacy and safety of cold snare polypectomy (CSP) and hot forceps biopsy (HFB) for diminutive colorectal *** prospective, randomized single-center clinical trial included consecutive patients ≥ 20 years of age with diminutive colorectal polyps 3-5 mm from December 2014 to October 2015. The primary outcome measures were en-bloc resection (endoscopic evaluation) and complete resection rates (pathological evaluation). The secondary outcome measures were the immediate bleeding or immediate perforation rate after polypectomy, delayed bleeding or delayed perforation rate after polypectomy, use of clipping for bleeding or perforation, and polyp retrieval rate. Prophylactic clipping after polyp removal wasn’t routinely *** hundred eight patients were randomized into the CSP (102), HFB (106) and 283 polyps were evaluated (CSP: 148, HFB: 135). The en-bloc resection rate was significantly higher with CSP than with HFB [99.3% (147/148) vs 80.0% (108/135), P < 0.0001]. The complete resection rate was significantly higher with CSP than with HFB [80.4% (119/148) vs 47.4% (64/135), P < 0.0001]. The immediate bleeding rate was similar between the groups [8.6% (13/148) vs 8.1% (11/135), P = 1.000], and endoscopic hemostasis with hemoclips was successful in all cases. No cases of perforation or delayed bleeding occurred. The rate of severe tissue injury to the pathological specimen was higher HFB than CSP [52.6% (71/135) vs 1.3% (2/148), P < 0.0001]. Polyp retrieval failure was encountered CSP (7), HFB (2).CONCLUSIONCSP is more effective than HFB for resecting diminutive polyps. Further long-term follow-up study is required.

关键词： Cold snare polypectomy Colonoscopy Polypectomy Colorectal diminutive polyps Hot forceps biopsy

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Effects of duration of phenytoin administration on mRNA expression of cytochrome P450 and P-glycoprotein in the liver and small intestine of rats

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Asian Journal of Pharmaceutical Sciences 2016年第5期11卷 662-667页

作者： Atsushi Kawase Hiroyuki Tanaka Toru Otori Kenji Matsuyama Masahiro Iwaki Department of Pharmacy Faculty of PharmacyKindai University

Phenytoin(5,5-diphenylhydantoin;DPH) induces expression of cytochromes P450(CYPs). Interactions between DPH and tacrolimus suggested that the persistence of CYP induction after discontinuation of DPH is dependent on the history of administration and dosing period of DPH. However, the relationship between the duration of DPH administration and expression of CYPs in the liver and small intestine of rats is not known. Alterations in levels of P-glycoprotein(P-gp;MDR1;ABCB1) as well as CYPs cause drug interactions in the small intestine. We examined the effects of the duration of DPH administration on expression of CYPs and P-gp in the liver and small intestine of rats. Rats were treated with DPH(100 mg/kg,peroral(p.o.) twice a day(b.d.)) for 2, 4, 8, and 16 d. mRNA levels of CYPs and P-gp were examined using the total RNA extracted from the liver and duodenum 2 h and 24 h after the final administration of DPH. CYP3 A activities were determined using microsomes. DPH administration for 2 d and 4 d markedly increased m RNA levels of CYPs such as CYP3 A1, CYP3 A2,CYP2 B1, and CYP2 B2 in the liver. A relatively long duration of DPH administration(8 d and16 d) resulted in abolition of the induction of hepatic CYP but increased CYP3 A activities were maintained. These results suggest that the duration of DPH administration could be an important determinant of hepatic CYP induction.

关键词： Phenytoin Cytochromes P450 Microsomes mRNA Liver

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Evaluation of anti-migration properties of biliary covered self-expandable metal stents

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World Journal of Gastroenterology 2016年第30期22卷 6917-6924页

作者： Kosuke Minaga Masayuki Kitano Hajime Imai Yogesh Harwani Kentaro Yamao Ken Kamata Takeshi Miyata Shunsuke Omoto Kumpei Kadosaka Toshiharu Sakurai Naoshi Nishida Masatoshi Kudo Department of Gastroenterology and Hepatology Kindai University Faculty of Medicine

AIM: To assess anti-migration potential of six biliary covered self-expandable metal stents(C-SEMSs) by using a newly designed phantom model. METHODS: In the phantom model, the stent was placed in differently sized holes in a silicone wall and retracted with a retraction robot. Resistance force to migration(RFM) was measured by a force gauge on the stent end. Radial force(RF) was measured with a RF measurement machine. Measured flare structure variables were the outer diameter, height, and taper angle of the flare(ODF, HF, and TAF, respectively). Correlations between RFM and RF or flare variables were analyzed using a linear correlated ***: Out of the six stents, five stents were braided, the other was laser-cut. The RF and RFM of each stent were expressed as the average of five replicate measurements. For all six stents, RFM and RF decreased as the hole diameter increased. For all six stents, RFM and RF correlated strongly when the stent had not fully expanded. This correlation was not observed in the five braided stents excluding the laser cut stent. For all six stents, there was a strong correlation between RFM and TAF when the stent fully expanded. For the five braided stents, RFM after full stent expansion correlated strongly with all three stent flare structure variables(ODF, HF, and TAF). The laser-cut C-SEMS had higher RFMs than the braided C-SEMSs regardless of expansion ***: RF was an important anti-migration property when the C-SEMS did not fully expand. Once fully expanded, stent flare structure variables plays an important role in anti-migration.

关键词： Biliary stricture Self-expandable metal stent Radial force Resistance force to migration Anti-migration property

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Root pruning is effective in alleviating the inhibition of soybean growth caused by anaerobic stress for a short period

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Journal of Integrative Agriculture 2023年第4期22卷 1035-1044页

作者： Koji YAMANE Miki MARIYAMA Yoshihiro HIROOKA Morio IIJIMA Graduate School of Agriculture Kindai UniversityNara 631-8505Japan

Soybean is an important upland crop,but its productivity is often limited by anaerobic stress caused by *** ability to adjust root growth under environmental constraints is an important physiological trait for adapting to an everchanging environment,and root pruning is an artificial technique for regenerating the root *** the present study,we investigated whether root pruning in soybean can effectively alleviate the inhibitory effects of anaerobic *** plants were affected by anaerobic stress at the germination,vegetative stage 1(V1),and reproductive stage 1(R1)stages,and then the plants were treated with root pruning just after the stress *** plants at the germination stage were treated with root cap and tip removals after hypoxia(N_(2)treatment).Root cap removal was more effective in suppressing the inhibitory effects of hypoxia than root tip removal(5 mm from the tip).The shoot dry weights of the soybean plants with and without root cap removal after hypoxia were 51.2 and 73.8%of the control,respectively,while the root dry weights of plants with and without root cap removal after hypoxia were 43.2 and 62.8%of the control,*** root cap removal effectively enhanced soybean growth after anaerobic stress,the root cap may be the candidate tissue for the stress memory *** soybean plants at the V1 stage of growth were affected by anaerobic stress,the branch number,pod weight in the main stem,root length,and root surface area of the soybean plants treated with anaerobic stress at the R1 stage significantly decreased compared with those of the *** contrast,root pruning(2 mm from the tip)immediately after the stress treatment enhanced root growth,branch number,and pod *** branch number,pod weight,root length,and root surface area of the plants treated with root pruning were 1.13,1.14,1.12,and 1.13 times higher than those of plants treated with anaerobic *** was observed in the roo

关键词： crack fertilization nodulation control root cap removal stress memory waterlogging

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Impacts of invasive Iris pseudacorus L.(yellow flag) establishing in an abandoned urban pond on native semi-wetland vegetation

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Journal of Integrative Agriculture 2018年第8期17卷 1881-1887页

作者： Daisuke Hayasaka Shingo Fujiwara Taizo Uchida Graduate School of Agriculture KINDAI University Faculty of Engineering Kyushu Sangyo University

Iris pseudacorus L., intentionally introduced in Japan as an ornamental plant and to improve aquatic environments, has been declared a noxious species in the Invasive Alien Species Act of Japan due to the suspected high ecological risks to the local species and ecosystems. Although prompt responses to I. pseudacorus have been sought to conserve local biodiversity, knowledge about its invasiveness is lacking. Here, we report the relationship between the establishment of I. pseudacorus and floristic changes in semi-wetland vegetation of an abandoned urban pond(Aoike), Nara City, Nara Prepecture, Japan. In total, 64 vascular plants were recorded in the pond, of which 50 were native species, seven were naturalized non-native, and seven were invasive species. On the other hand, most of these vascular plants(42 species) were grassland species and only several aquatic plants(10 species) were found in this study pond. The number of vascular plant species decreased significantly at quadrats with a coverage of I. pseudacorus above 50%. In addition, tendencies of lower number of native species and concomitant higher number of invasive species were found with increasing coverage of I. pseudacorus. From these results, we suggest that it is important to preferentially manage sites where the coverage of I. pseudacorus is above 50%, in order to preserve the local biodiversity. Additionally, as recommended in the literature, it is essential that the cut reproductive organs are kept submerged under deep water for an effective control of I. pseudacorus.

关键词： biodiversity conservation biological invasions ecological impacts exotic species hydrophytes species traits

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Targeted and immune therapies for hepatocellular carcinoma:Predictions for 2019 and beyond

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World Journal of Gastroenterology 2019年第7期25卷 789-807页

作者： Masatoshi Kudo Department of Gastroenterology and Hepatology Kindai University Faculty of Medicine

Systemic therapy for hepatocellular carcinoma(HCC) has markedly advanced since the survival benefit of a molecular targeted agent, sorafenib, were demonstrated in the SHARP and Asia Pacific trials in 2007. Treatment options for patients with advanced HCC increased by sorafenib, and long-term survival for patients with advanced stage HCC has become possible to some extent. However,development of a more potent first-line novel molecular targeted agent replacing sorafenib and a potent second-line agent after disease progression on or intolerant to sorafenib has been warranted because sorafenib lacks tumor shrinking/necrotizing effects and induces relatively severe adverse events such as hand foot skin reaction. Many agents in the 1 st line and 2 nd line setting were attempted to develop between 2007 and 2016, but all of these clinical trials *** the other hand, clinical trials of 4 agents(regorafenib, lenvatinib,cabozantinib, and ramucirumab) succeeded in succession in 2017 and 2018, and their use in clinical practice is possible(regorafenib and lenvatinib) or underway(cabozantinib and ramucirumab). Furthermore, all of 5 clinical trials of combination therapy with transcatheter chemoembolization(TACE) plus a molecular targeted agent failed to date, however, the combination of TACE and sorafenib(TACTICS trials) was reported to be successful and presented at ASCO in 2018. Phase 3 clinical trials of immune checkpoint inhibitors and a combination therapy of immune checkpoint inhibitors and molecular targeted agents are also ongoing, which suggests treatment paradigm of HCC in all stages from early,intermediate and advanced stage, is expected to be changed drastically in the very near future.

关键词： Hepatocellular carcinoma Molecular targeted agent Immune checkpoint inhibitor Sorafenib Lenvatinib

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Risk factors for local recurrence and appropriate surveillance interval after endoscopic resection

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World Journal of Gastroenterology 2019年第12期25卷 1502-1512页

作者： Yoriaki Komeda Tomohiro Watanabe Toshiharu Sakurai Masashi Kono Kazuki Okamoto Tomoyuki Nagai Mamoru Takenaka Satoru Hagiwara Shigenaga Matsui Naoshi Nishida Naoko Tsuji Hiroshi Kashida Masatoshi Kudo Department of Gastroenterology and Hepatology Kindai University Faculty of Medicine

BACKGROUND Risk factors for local recurrence after polypectomy, endoscopic mucosal resection(EMR), and endoscopic submucosal dissection(ESD) have not been ***, the appropriate interval for endoscopic surveillance of colorectal tumors at high-risk of local recurrence has not been *** To clarify the clinicopathological characteristics of recurrent lesions after endoscopic colorectal tumor resection and determine the appropriate *** Three hundred and sixty patients(1412 colorectal tumors) who underwent polypectomy, EMR, or ESD and received endoscopic surveillance subsequently for more than one year to detect local recurrence were enrolled in this study. The clinicopathological factors associated with local recurrence were determined via univariate and multivariate *** Local recurrence was observed in 31 of 360(8.6%) patients [31 of 1412(2.2%)lesions] after colorectal tumor resection. Piecemeal resection, tumor size of more than 2 cm, and the presence of villous components were associated with colorectal tumor recurrence after endoscopic resection. Of these three factors, the piecemeal resection procedure was identified as an independent risk factor for recurrence. Colorectal tumors resected into more than five pieces were associated with a high risk of recurrence since the average period from resection torecurrence in these cases was approximately 3 mo. The period to recurrence in cases resected into more than 5 pieces was much shorter than that in those resected into less than 4 pieces(3.8 ± 1.9 mo vs 7.9 ± 5.0 mo, P < 0.05).CONCLUSION Local recurrence of endoscopically treated colorectal tumors depends upon the outcome of first endoscopic procedure. Piecemeal resection was the only significant risk factor associated with local recurrence after endoscopic resection.

关键词： Local recurrence Colorectal tumor Endoscopic surveillance Piecemeal resection Risk factors

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Comparative Analysis of Tsunami Casualty Estimation Approaches: Agent-Based Modeling versus Simplified Approach in Japanese Coastal Cities

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International Journal of Disaster Risk Science 2024年第5期15卷 719-737页

作者： Tomoyuki Takabatake Nanami Hasegawa Keita Yamaguchi Miguel Esteban Department of Civil and Environmental Engineering Kindai University Department of Civil and Environmental Engineering Waseda University

Estimating potential casualties from a significant earthquake and tsunami event is crucial to enhance disaster preparedness and response. Although various approaches exist to assess potential casualties, few studies have made direct comparisons between them. The present study aimed to clarify the diff erences in the estimation of casualties between an agent-based model(ABM), which can capture detailed evacuation behavior but demands significant computational resources, and a simplified approach at less computational cost by assuming that evacuees would move along a straight line from their initial location to the closest evacuation destination. These diff erent approaches were applied to three coastal cities in Japan—Mihama,Kushimoto, and Shingu in Wakayama Prefecture—revealing significant diff erences in the estimated results between the ABM and the simplified approach. Notably, when the eff ects of building collapse due to an earthquake were considered, the mortality rates estimated by the ABM were higher than those estimated by the simplified approach in the three cities. There were also significant diff erences in the spatial distribution of the estimated mortality rates between the ABM and the simplified approach. The findings suggest that while the simplified approach can yield results more quickly, casualty estimates derived from such models should be interpreted with caution.

关键词： Agent-based modeling Building collapse Casualty estimation Evacuation Japan, Tsunami

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Clinical utility of treatment method conversion during single-session endoscopic ultrasound-guided biliary drainage

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World Journal of Gastroenterology 2020年第9期26卷 947-959页

作者： Kosuke Minaga Mamoru Takenaka Kentaro Yamao Ken Kamata Shunsuke Omoto Atsushi Nakai Tomohiro Yamazaki Ayana Okamoto Rei Ishikawa Tomoe Yoshikawa Yasutaka Chiba Tomohiro Watanabe Masatoshi Kudo Department of Gastroenterology and Hepatology Kindai University Faculty of MedicineOsaka-Sayama 589-8511Japan Clinical Research Center Kindai University HospitalOsaka-Sayama 589-8511Japan

BACKGROUND Although several techniques for endoscopic ultrasound-guided biliary drainage(EUS-BD)are available at present,an optimal treatment algorithm of EUS-BD has not yet been *** To evaluate the clinical utility of treatment method conversion during single endoscopic sessions for difficult cases in initially planned *** This was a single-center retrospective analysis using a prospectively accumulated *** with biliary obstruction undergoing EUS-BD between May 2008 and April 2016 were *** primary outcome was to evaluate the improvement in EUS-BD success rates by converting the treatment methods during a single endoscopic *** outcomes were clarification of the factors leading to the conversion from the initial EUS-BD and the assessment of efficacy and safety of the conversion as judged by technical success,clinical success,and adverse events(AEs).RESULTS A total of 208 patients underwent EUS-BD during the study *** 18.8%(39/208)of the patients,the treatment methods were converted to another EUSBD technique from the initial *** obstruction was caused by pancreatobiliary malignancies,other malignant lesions,biliary stones,and other benign lesions in 22,11,4,and 2 patients,*** reasons for the difficulty with the initial EUS-BD were classified into the following 3 procedures:Target puncture(n=13),guidewire manipulation(n=18),and puncture tract dilation(n=8).Technical success was achieved in 97.4%(38/39)of the cases and clinical success was achieved in 89.5%of patients(34/38).AEs occurred in 10.3%of patients,including bile leakage(n=2),bleeding(n=1),and cholecystitis(n=1).The puncture target and drainage technique were altered in subsequent EUSBD procedures in 25 and 14 patients,*** final technical success rate with 95%CI for all 208 cases was 97.1%(95%CI:93.8%-98.9%),while that of the initially planned EUS-BD was 78.8%(95%CI:72.6%-84.2%).CONCLUSION Among multi-step pro

关键词： Endoscopic ultrasound Endoscopic ultrasound-guided biliary drainage Interventional endoscopic ultrasound Biliary drainage Biliary obstruction

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Refractory case of ulcerative colitis with idiopathic thrombocytopenic purpura successfully treated by Janus kinase inhibitor tofacitinib:A case report

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World Journal of Clinical Cases 2020年第24期8卷 6389-6395页

作者： Yoriaki Komeda Toshiharu Sakurai Arito Hashimoto Tomoyuki Nagai Satoru Hagiwara Masatoshi Kudo Kazuko Sakai Kazuto Nishio Yasuyoshi Morita Itaru Matsumura Department of Gastroenterology and Hepatology Kindai University Faculty of MedicineOsaka 589-8511Japan Department of Genome Biology Kindai University Faculty of MedicineOsaka 589-8511Japan Department of Hematology and Rheumatology Kindai University Faculty of MedicineOsaka 589-8511Japan

BACKGROUND Concomitant ulcerative colitis (UC) and idiopathic thrombocytopenic purpura(ITP) is a rare phenomenon. The management of UC with ITP can be challenging,since a decreased platelet count augments *** SUMMARY A 24-year-old man with UC and steroid-resistant ITP experienced UC *** continuous infusion of cyclosporine was initiated, UC did not *** administration of tofacitinib subsequently led to the induction of *** patient has maintained remission of UC and ITP for over one year ontofacitinib treatment. Whole transcriptomic sequencing was performed forinflamed rectal mucosae obtained before and after the initiation of Janus kinase(JAK) inhibitor, suggesting that distinct molecular signatures seemed to beregulated by JAK inhibitors and other conventional therapies including tumornecrosis factor *** Tofacitinib should be considered in refractory cases of UC with ITP.

关键词： Ulcerative colitis Idiopathic thrombocytopenic purpura Tofacitinib Whole transcriptome analysis Case report Predictive biomarker

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