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World Journal of Clinical Cases 2025年第1期13卷 56-61页

作者： Saori Kondo Takashi Suzuki Kanato Yoshiike Sakura Yamanaka Kenta Sonehara Hiroshi Nabeshima Osamu Oguchi Department of Obstetrics and Gynecology Saku Central Hospital Advanced Care CenterSaku City 385-0051NaganoJapan

BACKGROUND Malignant transformation(MT)of mature cystic teratoma(MCT)has a poor prognosis,especially in advanced *** chemoradiotherapy(CCRT)has an inhibitory effect on *** SUMMARY Herein,we present a case in which CCRT had a reduction effect preoperatively.A 73-year-old woman with pyelonephritis was referred to our *** tomography revealed right hydronephrosis and a 6-cm pelvic *** ultrasound-guided fine-needle biopsy(EUS-FNB)revealed squamous cell *** patient was diagnosed with MT of *** to her poor general con-dition and renal malfunction,we selected CCRT,expecting fewer adverse *** CCRT,her performance status improved,and the tumor size was reduced;surgery was *** months postoperatively,the patient developed dis-semination and lymph node *** chemotherapy was *** died 18 months after treatment *** EUS-FNB was useful in the diagnosis of MT of MCT;CCRT suppressed the disea-se and improved quality of life.

关键词： Mature cystic teratoma Malignant transformation Squamous cell carcinoma Concurrent chemoradiotherapy Endoscopic ultrasound-guided fine-needle biopsy Case report

A Case of Low-Grade Appendiceal Mucinous Neoplasm of Its Difficultly to Distinguish from a Right Ovarian Tumor Due to Postmenopause

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Open Journal of Obstetrics and Gynecology 2022年第11期12卷 1140-1146页

作者： Tsutomu Muramoto Kyosuke Kamijo Megumi Sano Yuki Ibuki Atushi Mori Yaeko Kobayashi nagano municipal hospital Department of Obstetrics and Gynecology Nagano Japan

We here present a rare case of appendiceal tumor mimicking ovarian tumor in menopause woman. The patient was a 56-year-old woman, G1P1, who presented to our hospital with a right adnexal cyst diagnosed at another hospital. Transvaginal echocardiography showed a cyst in the right adnexal region, and pelvic contrast-enhanced MRI revealed a small cyst in the same region. The left ovary was atrophic and identifiable. It was unclear whether the cyst was contiguous with the gastrointestinal tract. Blood tests showed no elevation of tumor markers. We considered its possibility of a gastrointestinal origin, but since right normal ovary was not found, we thought the tumor was of ovarian origin and decided on a laparoscopic resection of the right adnexa. Intraoperatively, we observed atrophied bilateral normal ovaries, and the pelvic tumor was contiguous to the appendix. Surgeons performed a laparoscopic appendectomy after consultation with us. After resection we searched the abdominal and pelvic cavities, but found no obvious disseminated lesions. The histological diagnosis was low-grade appendiceal mucinous neoplasm (LAMN), a rare benign tumor of the appendix. Appendiceal tumors can be difficult to differentiate from right ovarian tumors due to their close anatomic location in the pelvis. It is possible to determine whether the tumor is of ovarian or appendiceal origin by identifying normal ovaries and the location of the feeding vessels into the tumors. In our case, there were no lesions other than the appendix, but LAMN can metastasize to the ovary, cause pseudomyoxoma peritonei, or be an overlapping tumor with an ovarian tumor. If an appendiceal tumor is diagnosed after surgery for ovarian tumor, the intra-abdominal cavity should be searched for metastasis or dissemination, and a thorough search for ovarian lesions should be performed with the possibility of an overlapping tumor in mind.

关键词： Low-Grade Appendiceal Mucinous Neoplasm Ovarian Tumor Menopause Woman

Use of transabdominal (external) ultrasound during balloon dilatation to diagnose tracheobronchial remnant in congenital esophageal stenosis

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World Journal of Pediatric Surgery 2018年第1期1卷 9-11页

作者： Kengo Hattori Shigeru Takamizawa Yuichiro Miyake Tomoko Hatata Katsumi Yoshizawa Tomoko Furukawa Yoshiaki Kondo Department of Surgery Nagano Children's HospitalNaganoJapan Department of Radiology Nagano Children's HospitalNaganoJapan

Preoperativedifferential diagnosis between tracheobronchial remnant(TBR)and other typesof congenital esophageal stenosis(CES)is challenging,even when usingendoscopic ultrasonography(EUS).This report is the first to demonstrate theuse of transabdominal(external)ultrasound during balloon dilatation todiagnose TBR in *** simple technique is a promising diagnostic tool forTBR as an alternative to EUS.

关键词： balloon esophageal congenital

Disseminated carcinomatosis of the bone marrow caused by granulocyte colony-stimulating factor:A case report and review of literature

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World Journal of Gastrointestinal Oncology 2022年第10期14卷 2077-2084页

作者： Kengo Fujita Ayaka Okubo Toshitsugu Nakamura Nobumichi Takeuchi Department of Medical Oncology Ina Central HospitalNagano 396-8555Japan Department of Diagnostic Pathology Ina Central HospitalNagano 396-8555Japan

BACKGROUND Disseminated carcinomatosis of the bone marrow(DCBM)is a widespread metastasis with a hematologic disorder that is mainly caused by gastric *** it commonly occurs as a manifestation of recurrence long after curative treatment,the precise mechanism of relapse from dormant status remains *** colony-stimulating factor(G-CSF)can promote cancer progression and invasion in various ***,the potential of G-CSF to trigger recurrence from a cured malignancy has not been *** SUMMARY A 55-year-old Japanese woman was diagnosed with Ewing sarcoma localized on the fifth lumbar vertebrae 6 years after curative gastrectomy for T1 gastric *** palliative surgery to release nerve compression,pathological diagnosis of the resected specimen was followed by curative radiation and *** treatment,G-CSF was administered 32 times for severe neutropenia *** months after completing definitive treatment,she complained of severe back pain and was diagnosed as multiple bone metastases with DCBM from gastric *** palliative chemotherapy,she died of disseminated intravascular coagulation 13 d after the *** examination of the autopsied bone marrow confirmed a diffuse positive staining for the G-CSF receptor(G-CSFR)in the relapsed gastric cancer cell cytoplasm,whereas the primary lesion cancer cells showed negative staining for *** this case,G-CSF administration may have been the key trigger for the disseminated relapse of a dormant gastric *** administering G-CSF to cancer survivors,recurrence of a preceding cancer should be monitored even after curative treatment.

关键词： Disseminated bone marrow carcinomatosis Gastric cancer Granulocyte colony-stimulating factor Cancer survivor Immunostaining Case report

Helicobacter heilmannii sensu stricto-related gastric ulcers:A case report

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World Journal of Gastroenterology 2014年第12期20卷 3376-3382页

作者： Takehisa Matsumoto Masatomo Kawakubo Taiji Akamatsu Naohiko Koide Naoko Ogiwara Seiko Kubota Mitsutoshi Sugano Yoshiyuki Kawakami Tsutomu Katsuyama Hiroyoshi Ota Departments of Laboratory Medicine Shinshu University Hospital Endoscopy Center Suzaka HospitalNagano Prefectural Hospital Organization Department of Surgery Nagano Prefectural Kiso Hospital Department of Health and Medical Sciences Shinshu University Graduate School of Medicine Maruko Central hospital

A spiral bacterium (SH9), morphologically different from Helicobacter pylori (H. pylori), was found in a 62-year-old woman’s gastric mucosa. Gastroscopic examination revealed multiple gastric ulcers near the pyloric ring; mapping gastric biopsy showed mild mononuclear infiltration with large lymphoid follicles in the antrum, without corpus atrophy. Urea breath test and H. pylori culture were negative, but Giemsa staining of biopsies revealed tightly coiled bacteria that immunostained with anti-H. pylori antibody. Sequencing of SH9 16S rRNA and the partial urease A and B subunit genes showed that the former sequence had highest similarity (99%; 1302/1315 bp) to Helicobacter heilmannii (H. heilmannii) sensu stricto (H. heilmannii s.s.) BC1 obtained from a bobcat, while the latter sequence confirmed highest similarity (98.3%; 1467/1493 bp) to H. heilmannii s.s. HU2 obtained from a human. The patient was diagnosed with multiple gastric ulcers associated with H. heilmannii s.s. infection. After triple therapy (amoxicillin, clarithromycin, and lansoprazole) with regimen for eradicating H. pylori, gastroscopy showed ulcer improvement and no H. heilmannii s.s. upon biopsy.

关键词： Helicobacter heilmannii sensu stricto, “ Helicobacter heilmannii” type 2, Gastric ulcers, Urease gene, Non-Helicobacter pylori helicobacters

Usefulness of Detailed Analysis with Operative Procedure of Total Laparoscopic Hysterectomy (TLH) Done a Single Surgeon, to Master the Surgical Technique of TLH and Gain Higher Proficiency

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Open Journal of Obstetrics and Gynecology 2022年第11期12卷 1183-1190页

作者： Tsutomu Muramoto Shin Takenaka Ryo Koike Megumi Sano Kyosuke Kamijo Reproductive Center Nagano Municipal Hospital Nagano Japan Department of Obstetrics and Gynecology Showa University Fujigaoka Hospital Yokohama Japan

Objective: To analyze the relationship between the numbers of cases experienced and the operation time for a single surgeon aiming to master the TLH surgical technique. Material and Methods: Retrospective data analysis of women who underwent TLH for benign diseases between April, 2014 and March, 2016 was conducted by a single surgeon in a single hospital (Showa University of Fujigaoka hospital). We divided the main procedures of the TLH operation into five sections, and measured the time required for each section. These cases were divided into three groups, group 1, 2, and 3. Results: There were 54 cases of TLH over two years for a single surgeon, and 21 cases that included essential operative procedures were divided into three groups of seven cases each. The average duration of the surgery (min.) was 178.3 ± 48.2 in the group 1, 128.3 ± 15.6 in the group 2, and 111.3 ± 15.9 in the group 3. A significant reduction in the required time was observed between group 1, 2, and 3 groups. As the number of cases increased, the operation time became statistically significantly shorter for every section except B and D. The skill growth rate was different at each section. Conclusion: For a single surgeon, as the number of surgical cases increased, we recognized the increased skill with the procedure in every section and the rate of skill growth differed for different sections. The difference of growth rate for each section implied that the number of operative cases required for a surgeon in each section was different.

关键词： Total Laparoscopic Hysterectomy on the Job Training Learning Curve Surgical Technique of TLH

Growth process of small pancreatic carcinoma: A case report with imaging observation for 22 months

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World Journal of Gastroenterology 2008年第12期14卷 1958-1960页

作者： Takeshi Hisa Hiroki Ohkubo Satoshi Shiozawa Hiroki Ishigame Masato Takamatsu Masayuki Furutake Bunsei Nobukawa Koichi Suda Department of Internal Medicine Saku Central Hospital Nagano 384-0301 Japan Department of Surgery Saku Central Hospital Nagano 384-0301 Japan Department of Clinical Pathology Saku Central Hospital Nagano 384-0301 Japan Department of Human Pathology Juntendo University School of Medicine Tokyo Japan Department of Pathology Tokyo-West Tokusyukai Hospital Tokyo Japan

This report describes serial observations of the growth process of a small invasive ductal carcinoma (IDC) of the pancreas from imaging studies. Histopathological studies showed IDC with macroscopic retention cysts proximal to an intraductal papillary-mucinous adenoma with mild atypia of the branch duct type in the pancreatic body, with no relation between the two lesions. IDC was demonstrated as an extremely low-echoic mass resembling a cyst with an unclear margin on the initial endoscopic ultrasonography. We misinterpreted the low-echoic mass as a benign intraductal mucinous-papillary neoplasm (IPMN) based on findings of other imaging studies, and the patient was followed-up. The mass increased from 7 mm to 13 mm in diameter over 22 mo, and remained smaller than 10 mm in diameter for about 420 d. The tumor volume doubling time was 252 d. The Ki67 labeling index was 15.9%, similar to that described in previous reports. Hence, IDC may grow slowly while remaining small.

关键词： Invasive ductal carcinoma Pancreas Intraductal papillary-mucinous neoplasm Endoscopicultrasonography Tumor volume doubling time

Gastrointestinal stromal tumor of the stomach with axillary lymph node metastasis: A case report

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World Journal of Gastroenterology 2017年第9期23卷 1720-1724页

作者： Naoki Kubo Nobumichi Takeuchi Department of Surgery Ina central HospitalInashiNagano 396-8555Japan

Gastrointestinal stromal tumors (GISTs) are the most common type of gastrointestinal mesenchymal tumors, although metastasis to the perigastric lymph nodes is relatively rare, compared with liver or peritoneal metastasis. In this report, we describe a case of stomach GIST with a solitary simultaneous metastasis in the left axillary lymph node. A 68-year-old man was diagnosed with a large upper-stomach GIST, and computed tomography and positron emission tomography revealed masses in the left axilla and right mediastinum. We did not detect evidence of metastases to the liver, or other sites including the perigastric lymph nodes, although findings from the surgically resected axillary lymph nodes were compatible with GIST metastasis. Treatment using imatinib markedly reduced the gastric and mediastinal lesions, and this response persisted for 3 years. The patient subsequently experienced rapid growth of the gastric lesion without mediastinal or axilla recurrence, which required palliative surgery. Despite continuing medical treatment(sunitinib and regorafenib), the patient died of liver metastases 23 mo after the surgery. Based on our findings, it appears that the axillary lymph nodes can be a potential metastatic site for GIST metastasis.

关键词： Gastrointestinal stromal tumor Axillary Lymph node Metastasis Imatinib

Effect of a traditional Chinese medicine theory-based mobile app on improving symptoms in patients with type 2 diabetes mellitus:A randomized controlled trial

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Journal of Integrative Nursing 2021年第3期3卷 97-105页

作者： Huiwen XU Yuan YUAN Li YANG En TAKASHI Akio KITAYAMA Department of Medical Nursing School of NursingYangzhou UniversityYangzhouJiangsuChina Division of Basic and Clinical Medicine Nagano College of NursingKomaganeNaganoJapan Department of Endocrinology Jiangsu Province Hospital of Chinese MedicineNanjingJiangsuChina Division of Health Science Nagano College of NursingKomaganeNaganoJapan

Objective:The aim of this study was to evaluate the effect of the Traditional Chinese Medicine(TCM)theory-based mobile app on improving symptoms in patients with type 2 diabetes mellitus(T2DM)in *** and Methods:A randomized controlled trial was ***-seven patients with T2DM were enrolled and they were randomized into the control group and the experimental *** control group was given usual diabetes education and follow-up with telephone call,while the experimental group was followed up by using the TCM theory-based mobile *** 6-month intervention,the diabetic symptom scores,the blood glucose levels,and self-management ability of the two groups were ***:Compared with intervention before,the levels of fasting blood glucose(FBG),2-h postprandial blood glucose(2hPG),and glycated hemoglobin(HbA1c)decreased in the control group(9.28±3.05 vs.8.26±2.73 mmol/L,12.65±4.18 vs.10.65±3.79 mmol/L,and 8.78%±1.76%vs.7.96%±1.47%,respectively,all P<0.05)and also decreased in the experimental group(8.36±2.64 vs.7.35±2.45 mmol/L,11.50±4.29 vs.9.85±2.71 mmol/L,and 8.64%±2.04%vs.7.29%±1.56%,respectively,all P<0.05)after 6-month intervention,while the summary of diabetes self-care activities(SDSCAs)scale scores after 6-month intervention increased significantly in the control group(35.20±14.68 vs.44.78±10.21,P<0.05)and the experimental group(32.16±13.21 vs.50.37±10.06,P<0.05).After 6-month intervention,the diabetic symptom scores(18.16±2.74 vs.22.18±4.77)and HbA1c(7.29±1.56%vs.7.96%±1.47%)were lower,and SDSCA scale scores(50.37±10.06 vs.44.78±10.21)were higher in the experimental group than the control group(all P<0.05).Conclusion:The mobile app based on TCM theory can effectively improve diabetes-related symptoms in patients with T2DM and help control their blood glucose as well as enhance their self-management ability.

关键词： App chronic disease management diabetes mellitus traditional Chinese medicine

A lightweight mainstream capnometer with very low dead space volume is useful monitor for neonates with spontanous and mechanical ventilation: Pilot study

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Open Journal of Pediatrics 2012年第2期2卷 127-132页

作者： Daijiro Takahashi Miyu Matsui Takehiko Hiroma Tomohiko Nakamura Division of Neonatology Nagano Children’s Hospital Nagano Japan

Objects: The purpose of this study was to observe a correlation between PETCO2 and PaCO2 in intubated neonates under intermittent mandatory ventilation with spontaneous breathing. Material and methods: A total of 55 paired PETCO2 measured by mainstream capnometry and PaCO2 values were obtained from 4 intubated neonates in our neonatal intensive care units at nagano Children’s hospital, nagano, Japan. Results: PETCO2 and PaCO2 were significantly correlated (r2 = 0.928, p ETCO2 and mean PETCO2 correlated strongly with PaCO2 (maximum PETCO2: r2 = 0.9401, p ETCO2: r2 = 0.8587, p 2 also correlated with minimum PETCO2 (r2 = 0.2884, p ETCO2 (p ETCO2 (p 2 and PETCO2. Conclusion: Present study showed that a good correlation exists between PETCO2 and PaCO2 in intubated neonates under intermittent mandatory ventilation with spontaneous breathing. Lightweight with low amounts of dead space mainstream capnometry can be used as noninvasive monitor in incubated neonates with spontaneous breathing.

关键词： Capnography Neonate