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Ōsaka, Japan

Ezoe Y.,Kyoto University | Muto M.,Kyoto University | Uedo N.,Osaka Medical Cancer for Cancer and Cardiovascular Diseases | Doyama H.,Ishikawa Prefectural Central Hospital | And 10 more authors.
Gastroenterology | Year: 2011

Background & Aims: It is difficult to accurately diagnose patients with depressed gastric mucosal cancer based on conventional white-light imaging (C-WLI) endoscopy. We compared the real-time diagnostic yield of C-WLI for small, depressed gastric mucosal cancers with that of magnifying narrow-band imaging (M-NBI). Methods: We performed a multicenter, prospective, randomized, controlled trial of patients with undiagnosed depressed lesions ≤10 mm in diameter identified by esophagogastroduodenoscopy. Patients were randomly assigned to groups that were analyzed by C-WLI (n = 176) or M-NBI (n = 177) immediately after detection; the C-WLI group received M-NBI after C-WLI. We compared the diagnostic accuracy, sensitivity, and specificity between C-WLI and M-NBI and assessed the diagnostic yield of M-NBI conducted in conjunction with C-WLI. Results: Overall, 40 gastric cancers (20 in each group) were identified. The median diagnostic values for M-NBI and C-WLI were as follows: accuracy, 90.4% and 64.8%; sensitivity, 60.0% and 40.0%; and specificity, 94.3% and 67.9%, respectively. The accuracy and specificity of M-NBI were greater than those of C-WLI (P <.001); the difference in sensitivity was not significant (P =.34). The combination of M-NBI with C-WLI significantly enhanced performance compared with C-WLI alone; accuracy increased from (median) 64.8% to 96.6% (P <.001), sensitivity increased from 40.0% to 95.0% (P <.001), and specificity increased from 67.9% to 96.8% (P <.001). Conclusions: M-NBI, in conjunction with C-WLI, identifies small, depressed gastric mucosal cancers with 96.6% accuracy, 95.0% sensitivity, and 96.8% specificity. These values are better than for C-WLI or M-NBI alone. © 2011 AGA Institute.

Nakamura T.,Kyoto University | Ohmori K.,Fukushima Medical University | Kanemaru S.-I.,Kitano Hospital
General Thoracic and Cardiovascular Surgery | Year: 2011

Since the 1980s, tissue engineering has become one of the major areas of endeavor in medical research, applying the principles of biology and engineering to the development of functional substitutes for damaged tissue. Using this technology, various attempts have been made to create and apply a tissue-engineered prosthetic trachea, or airway. In addition to the conventional tissue engineering approach, a new substantially different concept has been advocated in Japan since 2000. This is "in situ tissue engineering," where a tissue is created not in vitro but in vivo, exploiting the potential of the living body for wound healing. An artifi cial trachea created by in situ tissue engineering has already been applied in human patients for reconstruction of airway defects, and promising results have been obtained. This article reviews recent progress in the relatively new fi eld of airway reconstruction employing tissue engineering. © The Japanese Association for Thoracic Surgery 2011.

Kohno S.,Kitano Hospital
Japanese Journal of Clinical Radiology | Year: 2015

We present two cases of fulminant amebic colitis. CT demonstrated thick-walled cystic masses in the ascending colon and cecum in both patients. The first patient died due to complications following multiple necrosis and perforations in the colon. CT findings of the second patient were correctly interpreted as suspicious of amebic colitis, leading to an appropriate treatment. There are several diseases that may involve the ascending colon and cecum and show similar findings on CT. Amebic colitis should be considered in the differential for some of the patients.

Kitamura T.,Kyoto University | Fujishita T.,Kyoto University | Loetscher P.,Novartis | Revesz L.,Novartis | And 4 more authors.
Proceedings of the National Academy of Sciences of the United States of America | Year: 2010

Recent reports have suggested critical roles of myeloid cells in tumor invasion and metastasis, although these findings have not led to therapeutics. Using a mouse model for liver dissemination, we show that mouse and human colon cancer cells secrete CC-chemokine ligands CCL9 and CCL15, respectively, and recruit CD34+ Gr-1- immature myeloid cells (iMCs). They express CCL9/15 receptor CCR1 and produce matrix metalloproteinases MMP2 and MMP9. Lack of the Ccr1, Mmp2, or Mmp9 gene in the host dramatically suppresses outgrowths of disseminated tumors in the liver. Importantly, CCR1 antagonist BL5923 blocks the iMC accumulation and metastatic colonization and significantly prolongs the survival of tumor-bearing mice. These results suggest that CCR1 antagonists can provide antimetastatic therapies for patients with disseminated colon cancer in the liver.

Kaneko K.,Nagasaki University | Kanai R.,Kitano Hospital
Journal of Craniofacial Surgery | Year: 2011

We report a rare case of a hemangioma arising from the accessory parotid gland. The patient, a 45-year-old woman, complained of a right midcheek mass. Magnetic resonance imaging showed a well-defined mass located in the right buccal space, anterior to the masseter muscle, and adjacent to the Stensen duct. The mass had high T2-weighted signal intensity and showed strong patchy enhancement with gadolinium. This mass was surrounded by a common capsule with the accessory parotid gland. These findings indicated a hemangioma originating from the accessory parotid gland. The mass was completely removed by an intraoral approach without postoperative facial palsy, skin deformity, and difficulty in secreting saliva. Histologic examination of the tumor revealed multiple, thin-walled, and dilated blood vessels, confirming the diagnosis of a cavernous hemangioma. Magnetic resonance imaging was extremely useful in diagnosing the mass as a hemangioma before surgery, clarifying relationships between the mass and adjacent structures and determining the surgical approach to the mass. Copyright © 2011 by Mutaz B. Habal, MD.

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