33 results on '"Tomita, Yuri"'
Search Results
2. Prevalence of colonoscopy in Japan using a large-scale health claims data compared to esophagogastroduodenoscopy
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Yoshida, Naohisa, Maeda-Minami, Ayako, Ishikawa, Hideki, Mutoh, Michihiro, Tomita, Yuri, Kobayashi, Reo, Hashimoto, Hikaru, Inoue, Ken, Hirose, Ryohei, Dohi, Osamu, Itoh, Yoshito, and Mano, Yasunari
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- 2024
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3. Analysis of the development of gastric cancer after resecting colorectal lesions using large-scale health insurance claims data
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Yoshida, Naohisa, Maeda-Minami, Ayako, Ishikawa, Hideki, Mutoh, Michihiro, Kanno, Yui, Tomita, Yuri, Hirose, Ryohei, Dohi, Osamu, Itoh, Yoshito, and Mano, Yasunari
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- 2023
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4. Comparison of LED and LASER Colonoscopy About Linked Color Imaging and Blue Laser/Light Imaging of Colorectal Tumors in a Multinational Study
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Yoshida, Naohisa, Draganov, Peter V., John, Sneha, Neumann, Helmut, Rani, Rafiz Abdul, Hsu, Wen-Hsin, Fernandopulle, Nilesh, Siah, Kewin Tien Ho, Morgenstern, Ricardo, Tomita, Yuri, Inoue, Ken, Dohi, Osamu, Hirose, Ryohei, Itoh, Yoshito, Murakami, Takaaki, Inagaki, Yoshikazu, Inada, Yutaka, and Arantes, Vitor
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- 2023
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5. Standard Endoscopic Mucosal Resection vs Precutting Endoscopic Mucosal Resection Using Novel Disk-Tip Snare for Colorectal Lesions
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Yoshida, Naohisa, Inoue, Ken, Hashimoto, Hikaru, Kobayashi, Reo, Tomita, Yuri, Sugino, Satoshi, Hirose, Ryohei, Dohi, Osamu, Morinaga, Yukiko, Inada, Yutaka, Murakami, Takaaki, and Itoh, Yoshito
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- 2023
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6. Analysis of Texture and Color Enhancement Imaging for Improving the Visibility of Non-polypoid Colorectal Lesions
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Yoshida, Naohisa, Inoue, Ken, Dohi, Osamu, Kobayashi, Reo, Tomita, Yuri, Hashimoto, Hikaru, Sugino, Satoshi, Hirose, Ryohei, Murakami, Takaaki, Inada, Yutaka, Morinaga, Yukiko, and Itoh, Yoshito
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- 2022
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7. Repeat Cold Snare Polypectomy Can Be Performed for Recurrent Benign Lesions After Cold Snare Polypectomy
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Yoshida, Naohisa, Hashimoto, Hikaru, Inoue, Ken, Kobayashi, Reo, Tomita, Yuri, Sugino, Satoshi, Hirose, Ryohei, Dohi, Osamu, Morinaga, Yukiko, Inada, Yutaka, Murakami, Takaaki, and Itoh, Yoshito
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- 2022
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8. The usefulness of combining the pocket-creation method with a traction device using a scissor-type knife for colorectal endoscopic submucosal dissection
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Tomita, Yuri, Yoshida, Naohisa, Inoue, Ken, Hashimoto, Hikaru, Sugino, Satoshi, Yasuda, Ritsu, Hirose, Ryohei, Dohi, Osamu, Naito, Yuji, Murakami, Takaaki, Inada, Yutaka, Morinaga, Yukiko, Kishimoto, Mitsuo, and Itoh, Yoshito
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- 2022
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9. An analysis about the function of a new artificial intelligence, CAD EYE with the lesion recognition and diagnosis for colorectal polyps in clinical practice
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Yoshida, Naohisa, Inoue, Ken, Tomita, Yuri, Kobayashi, Reo, Hashimoto, Hikaru, Sugino, Satoshi, Hirose, Ryohei, Dohi, Osamu, Yasuda, Hiroaki, Morinaga, Yukiko, Inada, Yutaka, Murakami, Takaaki, Zhu, Xin, and Itoh, Yoshito
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- 2021
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10. Efficacy of hemostatic gel for perioperative bleeding and prevention of delayed bleeding of cold snare polypectomy under anticoagulant.
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Yoshida, Naohisa, Dohi, Osamu, Inagaki, Yoshikazu, Tomita, Yuri, Hashimoto, Hikaru, Kobayashi, Reo, Inoue, Ken, Hirose, Ryohei, Morimoto, Yasutaka, Inada, Yutaka, Murakami, Takaaki, and Itoh, Yoshito
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POLYPECTOMY ,HEMORRHAGE ,PROPENSITY score matching ,ORAL medication ,ANTICOAGULANTS - Abstract
Background and Aim: A hemostatic gel, PuraStat (3‐D Matrix, Tokyo, Japan), is used for various gastrointestinal hemostasis. In this study, we analyzed the efficacy of PuraStat for perioperative bleeding (POB) and prevention of delayed bleeding (DB) to colorectal cold snare polypectomy (CSP) with continuous anticoagulant. Methods: This was a single‐center, retrospective study. Subjects were lesions of 2–9 mm under continuous anticoagulant from 2021 to 2023 and treated with PuraStat for POB. The definition of POB was bleeding which did not stop spontaneously by 1.0–1.5 min after resection and needed hemostasis. Successful hemostasis was defined as cessation of bleeding within 1.0–1.5 min after spraying PuraStat and the rate of it and risk factors of POB were analyzed. For comparison, cases receiving previous CSP without PuraStat were extracted from all cases with CSP (2018‐2021), and POB and DB rate (DBR) were analyzed after propensity score matching. Results: One hundred twenty‐two lesions (91: direct oral anticoagulant (DOAC), 31: warfarin) with anticoagulant were analyzed and the rate of successful hemostasis with PuraStat was 92.6% (DOAC/warfarin: 93.4%/80.6%, P = 0.01). The rate of DB was 0.0%. Multivariate analysis showed that significant risk factors about unsuccessful hemostasis for POB with PuraStat were lesion size 8–9 mm (P < 0.01), warfarin (P = 0.01), and combination of antiplatelet (P = 0.01). Regarding the comparison about CSP with/without PuraStat, the clipping rate and DBR were 8.5%/94.9% (P < 0.01) and 0%/1.7% (P = 1.0). Conclusion: The effects of PuraStat for POB and DB in colorectal CSP with continuous anticoagulant were acceptable. [ABSTRACT FROM AUTHOR]
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- 2024
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11. The Efficacy of 480 ml Oral Sodium Sulfate for Improving Insufficient Bowel Preparation of Colonoscopy with High-Concentrated Polyethylene Glycol.
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Yoshida, Naohisa, Inagaki, Yoshikazu, Hasegawa, Daisuke, Kobayashi, Reo, Tomita, Yuri, Hashimoto, Hikaru, Hirose, Ryohei, Dohi, Osamu, Inoue, Ken, Morimoto, Yasutaka, Inada, Yutaka, Murakami, Takaaki, and Itoh, Yoshito
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SULFATES ,DRUG efficacy ,RESEARCH ,COLONOSCOPY ,DRUG tolerance ,BOWEL preparation (Procedure) ,SODIUM compounds ,TIME ,RETROSPECTIVE studies ,DIET ,ADENOMA ,PATIENTS' attitudes ,POLYETHYLENE glycol ,DESCRIPTIVE statistics ,DRUG side effects ,TASTE ,EVALUATION - Abstract
Objectives. Oral sulfate solution (OSS) is used for bowel preparation (BP) during colonoscopy. The way of taking this agent can be used a same-day regimen (only on the day of colonoscopy) and split regimen (the day before and on the day of colonoscopy) for receiving it. In this study, we analyzed the efficacy of a same-day regimen of 480 ml OSS for insufficient bowel preparation (BP) with high-concentrated polyethylene glycol (H-PEG). Materials and Methods. This multicenter retrospective study was conducted from December 2021 to December 2022 at three related institutions on patients aged ≥ 20 years with a fair or poor Aronchick score of BP with 1 l H-PEG in previous colonoscopy. All patients received a low-residual diet and 10 ml of 0.75% picosulfate sodium a day before the colonoscopy and 480 ml of OSS and ≥1 l of water 3 hours before the colonoscopy. We analyzed the rate of improvement with OSS compared to H-PEG and other efficacies, and adverse events (AE). Results. We evaluated 125 cases (77 males) with an average age of 72.1 ± 8.8 years. The completion rate of 480 ml of OSS was 97.6% (122/125). The improvement rate of BP showing good or excellent score with OSS was 70.4% (88/125). Compared OSS with previous H-PEG, the insertion time (min) was 7.0 ± 4.8 vs. 8.1 ± 6.0 (p = 0.01), and the adenoma detection rates were 67.2% vs. 63.2% (p = 0.05). The cleansing time (min) was 131 ± 46 vs. 165 ± 53 (p < 0.01). The rate of AE with OSS was 10.4% (13/125). There were no significant differences about AE in age and gender. The tolerance of OSS compared with H-PEG (good/similar/bad) was 72.0%/24.8%/3.2% (amounts), 26.4%/39.2%/34.4% (taste), and 76.8%/10.4%/12.8% (overall preference), respectively. Conclusions. The same-day regimen of 480 ml OSS effectively improved the insufficient BP of 1 l H-PEG. [ABSTRACT FROM AUTHOR]
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- 2023
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12. Association between the person-centered maternity care experience and mental health after delivery in urban and rural Dhading, Nepal: a cross-sectional study.
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Tomita, Yuri, Kiriya, Junko, Silwal, Ram Chandra, Ong, Ken Ing Cherng, Shibanuma, Akira, and Jimba, Masamine
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MENTAL health services , *PATIENT-centered care , *MATERNAL health services , *MATERNITY nursing , *MENTAL health facilities , *HEALTH facilities , *MENTAL health - Abstract
Background: Person-centered maternity care is a component of quality care, which includes effective communication, respect, and dignity. Supportive care has a positive effect on mothers' perinatal experience. In contrast, negative childbirth experiences can cause psychological problems. However, the impact of person-centered maternity care experience on mothers' mental health after delivery remains unknown. Therefore, in this study, we examined the association between person-centered maternity care experience at healthcare facilities and maternal mental health after delivery among Nepali women. Methods: We conducted a cross-sectional study in urban and rural areas in Dhading District, Nepal. Participants were women who gave birth at public healthcare facilities, and their baby's age was between 1 and 12 months. After purposively selecting the target areas, we recruited the women from July to August 2019 and interviewed them using questionnaires. We conducted multiple regression analyses to analyze the association between delivery care experience and depressive symptoms and the association between delivery care experience and mental well-being. Results: In total, 595 women were included in the data analysis. The experience of better person-centered maternity care was associated with lower depressive symptom scores in urban (unstandardized coefficient [B]= − 0.09, p < 0.001) and rural areas (B= − 0.10, p < 0.001). Moreover, the experience of better person-centered maternity care was associated with higher mental well-being scores in both urban (B= 0.30, p < 0.001) and rural areas (B= 0.15, p = 0.017). Conclusions: Person-centered maternity care was associated with lower depressive symptom scores and higher mental well-being, regardless of the setting in Nepal. Person-centered maternity care during childbirth can potentially improve mental health after delivery. Maternity care should be improved with more attention to person-centered maternity care aspects. [ABSTRACT FROM AUTHOR]
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- 2023
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13. Images of laser and light‐emitting diode colonoscopy for comparing large colorectal lesion visibility with linked color imaging and white‐light imaging.
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Yoshida, Naohisa, Hayashi, Yoshikazu, Kashida, Hiroshi, Tomita, Yuri, Dohi, Osamu, Inoue, Ken, Hirose, Ryohei, Itoh, Yoshito, Okada, Masahiro, Yoshimoto, Shiori, Fujinuma, Toshihiro, Sakamoto, Hirotsugu, Sunada, Keijiro, Komeda, Yoriaki, Sekai, Ikue, Okai, Natsuki, and Yamamoto, Hironori
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LIGHT emitting diodes ,COLONOSCOPY - Abstract
Objectives: In light‐emitting diode (LED) and laser colonoscopy, linked color imaging (LCI) superiority to white‐light imaging (WLI) for polyp detection is shown separately. We analyzed the noninferiority of LCI between LED and laser colonoscopy and that of WLI (LECOL study). Methods: We prospectively collected nonpolypoid lesions with WLI and LCI using LED and laser colonoscopy from January 2021 to August 2021. All images were evaluated randomly by 12 endoscopists (six nonexperts and six experts in three institutions) using the polyp visibility score: 4, excellent; 3, good; 2, fair; and 1, poor. The comparison score (LED better/similar/laser better) for redness and brightness was evaluated for WLI and LCI pictures of each lesion. Results: Finally, 63 nonpolypoid lesions were evaluated, and the mean polyp size was 24.5 ± 13.4 mm. Histopathology revealed 13 serrated lesions and 50 adenomatous/cancerous lesions. The mean polyp visibility scores of LCI pictures were significantly higher than those of WLI in the LED (3.35 ± 0.85 vs. 3.08 ± 0.91, P < 0.001) and the laser (3.40 ± 1.71 vs. 3.05 ± 0.97, P < 0.001) group, and the noninferiority of LCI pictures between LED and laser was significant (P < 0.001). The comparison scores revealed that the evaluation of redness and brightness (LED better/similar/laser better) were 26.8%/40.1%/33.1% and 43.5%/43.5%/13.0% for LCI pictures (P < 0.001) and 20.6%/44.3%/35.1% and 60.3%/31.7%/8.0% for WLI pictures (P < 0.001), respectively. Conclusion: The noninferiority of polyp visibility with WLI and LCI in LED and laser colonoscopy was shown. WLI and LCI of LED tended to be brighter and less reddish than those of laser. [ABSTRACT FROM AUTHOR]
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- 2022
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14. ANALYSIS OF CASES WITH LONG PROCEDURE TIME OR INTERRUPTION OF COLORECTAL ESD AND THEIR RISK FACTORS.
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Inoue, Ken, Yoshida, Naohisa, Kobayashi, Reo, Tomita, Yuri, Inada, Yutaka, Murakami, Takaaki, Morimoto, Yasutaka, and Itoh, Yoshito
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- 2024
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15. The Efficacy of Tumor Characterization for Colorectal Lesions with Blue Light Imaging of a Compact Light-Emitting Diode Endoscopic System Compared to a Laser Endoscopic System: A Pilot Study.
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Inoue, Ken, Yoshida, Naohisa, Kobayashi, Reo, Tomita, Yuri, Hashimoto, Hikaru, Sugino, Satoshi, Hirose, Ryohei, Dohi, Osamu, Yasuda, Hiroaki, Yasuda, Ritsu, Murakami, Takaaki, Inada, Yutaka, and Itoh, Yoshito
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LIGHT emitting diodes ,BLUE light ,COLON tumors ,BLUE lasers ,LASERS - Abstract
Background: A compact and cost-effective light source-processor combined 3-color light-emitting diode (LED) endoscopic system (ELUXEO-Lite: EP-6000, Fujifilm Co., Tokyo) with a magnified colonoscope (EC-6600ZP, Fujifilm Co.) has been released. Aims: In this study, we analyzed the efficacy of this system for colorectal tumor characterization with magnified blue light imaging (BLI-LED) and image's subjective and objective evaluations, compared to a magnified blue laser imaging (BLI-LASER) using a standard LASER endoscopic system. Methods: We retrospectively reviewed 37 lesions observed with both BLI-LED and BLI-LASER systems from 2019 using the Japanese narrow band imaging classification. Two representative magnified images, one BLI-LED and one BLI-LASER, of the same area of a lesion were evaluated for diagnostic accuracy and visualization quality by three experts and three non-experts. Their color difference values (CDVs) and brightness values (BVs) were also calculated as objective indicators. Results: Among 37 lesions, mean tumor size was 18.9 ± 13.1 mm, and 21 lesions were nonpolypoid. Histopathology revealed 14 sessile serrated lesions, 7 adenomas, 12 high-grade dysplasias and T1a cancers, and 4 T1b cancers. The diagnostic accuracy rates of BLI-LED/BLI-LASER of experts and non-experts were 90.1% and 87.4% (p = 0.52) and 89.2% and 89.2% (p = 0.99). The percentages of instances where BLI-LED images were better, the two imaging types were equivalent, or BLI-LASER images were better were 16%/83%/1% for experts and 19%/58%/23% for non-experts (p < 0.001). CDVs and BVs between BLI-LED and BLI-LASER were not significantly different (CDVs: p = 0.653 , BVs: p = 0.518). Conclusions: BLI-LED using the compact system was noninferior to BLI-LASER for colorectal tumor characterization and image quality. [ABSTRACT FROM AUTHOR]
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- 2022
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16. A Case of Fifteen Simultaneous Rectal Neuroendocrine Tumors and Endocrine Cell Micronests Resected by Both Endoscopic Treatments and Surgery.
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Hashimoto, Hikaru, Yoshida, Naohisa, Inoue, Ken, Kobayashi, Reo, Tomita, Yuri, Sugino, Satoshi, Dohi, Osamu, Hirose, Ryohei, Inada, Yutaka, Murakami, Takaaki, Morinaga, Yukiko, Kishimoto, Mitsuo, and Itoh, Yoshito
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RECTUM tumors ,NEUROENDOCRINE tumors ,ENDOSCOPIC surgery ,POLYPECTOMY ,RECTAL cancer ,LYMPHATIC metastasis ,EARLY detection of cancer - Abstract
Case Report:A 65-year-old man without any symptoms received colonoscopy for cancer screening and underwent cold snare polypectomy (CSP) for a 3-mm rectal lesion at a local clinic. A histopathological examination revealed neuroendocrine tumor (NET) G1 with a positive margin. The patient was referred to our hospital for further treatment. Then, the post-CSP scar was removed by endoscopic submucosal dissection (ESD), with a sufficient endoscopically normal margin. Histopathology showed 4 NETs and endocrine cell micronests (ECMs) distant from the post-CSP scar, with a positive lateral margin. We considered that the possibility of other NETs was high. Additional surgery was performed. After a histopathological examination, 11 NETs and ECMs were found in the whole rectum, without lymph node metastasis. The patient had no recurrence at 24 months after surgery. In the past 10 years, we have experienced 4 cases (including the present case) of multiple rectal NETs among 56 cases of rectal NETs of ≤10 mm (7.1%). None of our 4 cases showed any recurrence (follow-up period: 12–32 months).Conclusions:We herein report a case involving a patient with 15 rectal NETs and ECMs. We reviewed our experience with multiple rectal NETs, and the rate of multiple rectal NETs was 7.1%. Endoscopists should consider that multiple lesions may be present in cases of rectal NET and be aware that some cannot be detected endoscopically. [ABSTRACT FROM AUTHOR]
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- 2022
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17. The Efficacy of Short-Duration Polyethylene Glycol plus Electrolytes for Improving Bowel Preparation of Colonoscopy in Patients with Chronic Constipation.
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Yoshida, Naohisa, Inagaki, Yoshikazu, Fukumoto, Kohei, Yoriki, Hiroyuki, Inada, Yutaka, Murakami, Takaaki, Tomita, Yuri, Hashimoto, Hikaru, Sugino, Satoshi, Hirose, Ryohei, Dohi, Osamu, Inoue, Ken, and Itoh, Yoshito
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POLYETHYLENE glycol ,CONSTIPATION ,OLDER people ,ELECTROLYTES ,COLONOSCOPY - Abstract
Backgrounds and Aims. Sachets of polyethylene glycol plus electrolytes (PEG+E: Movicol: EA Pharma, Tokyo, Japan) are used for chronic constipation, and its efficacy is reported only for female and nonelderly people. Chronic constipation is one of the reasons of poor colonoscopic bowel preparation (BP). We analyzed its efficacy in improving chronic constipation and poor colonoscopic BP related to it, including male and elderly people. Materials and Methods. This multicenter retrospective study was conducted from September 2019 to September 2020 at 5 related institutions among patients ≥ 20 years old diagnosed with chronic constipation whose previous colonoscopic BP had had a fair or poor Aronchick score. Two or four sachets of PEG+E (13.7 or 27.4 g/day) were prescribed for 1 week before colonoscopy. We analyzed the rate of improvement in BP, effect-related factors, spontaneous bowel movements (SBMs), stool consistency, improvement of constipation symptoms, and adverse events. Results. We evaluated 106 cases (56 males) with an average age of 69.5 ± 9.4 years old (≤74 years old: 68 cases, ≥75 years old: 38 cases). The improvement rate of BP was 72.6%, and the insertion time and pain score also improved. A performance status of 1 or 2 was associated with poor BP. SBMs (times/week) increased from 4.0 ± 1.9 to 6.1 ± 2.6 (p < 0.001). The overall improvement rates of SBMs, stool consistency, symptoms of constipation, and rate of adverse events were 58.5%, 90.6%, 59.4%, and 6.6%, respectively, showing no significant differences with regard to age or gender. Conclusions. Short-duration PEG+E was effective for improving poor BP and chronic constipation. [ABSTRACT FROM AUTHOR]
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- 2020
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18. Video-assisted thoracic surgery for primary myelolipoma of the posterior mediastinum.
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Naoya Himuro, Takao Minakata, Yutaka Oshima, Yuri Tomita, Daisuke Kataoka, Shigeru Yamamoto, Mitsutaka Kadokura, Himuro, Naoya, Minakata, Takao, Oshima, Yutaka, Tomita, Yuri, Kataoka, Daisuke, Yamamoto, Shigeru, and Kadokura, Mitsutaka
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VIDEO-assisted thoracic surgery ,ADIPOSE tissue tumors ,MEDIASTINAL tumors ,HEMATOPOIESIS ,COMPUTED tomography ,HISTOPATHOLOGY ,SURGICAL excision - Abstract
Background: Myelolipoma is an uncommon tumor comprising adipose tissue and normal hematopoietic cells and mainly occurs in the adrenal cortex. Mediastinal myelolipoma is very rare; we report a case of posterior mediastinal myelolipoma that required surgical resection.Case Presentation: A 56-year-old male was diagnosed with a posterior mediastinal tumor by computed tomography. The tumor was originally noted in 2005, and during follow-up in March 2014, it was found to have increased in size. During consultation at our hospital, on magnetic resonance imaging (MRI), we considered the possibility that the tumor was malignant. Consequently, we resected the tumor by video-assisted thoracic surgery (VATS). The histopathological findings revealed that the tumor had undergone intrathoracic extramedullary hematopoiesis. However, after considering the patient's background and histopathological findings, we diagnosed the tumor as a thoracic extra-adrenal myelolipoma.Conclusions: Pathological analysis was instrumental in clarifying the diagnosis. We recommend surgery as a treatment option for posterior mediastinal tumors. [ABSTRACT FROM AUTHOR]- Published
- 2016
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19. Development of high‐quality artificial intelligence for computer‐aided diagnosis in determining subtypes of colorectal cancer.
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Weng, Weihao, Yoshida, Naohisa, Morinaga, Yukiko, Sugino, Satoshi, Tomita, Yuri, Kobayashi, Reo, Inoue, Ken, Hirose, Ryohei, Dohi, Osamu, Itoh, Yoshito, and Zhu, Xin
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Background and Aim Methods Results Conclusion There are no previous studies in which computer‐aided diagnosis (CAD) diagnosed colorectal cancer (CRC) subtypes correctly. In this study, we developed an original CAD for the diagnosis of CRC subtypes.Pretraining for the CAD based on ResNet was performed using ImageNet and five open histopathological pretraining image datasets (HiPreD) containing 3 million images. In addition, sparse attention was introduced to improve the CAD compared to other attention networks. One thousand and seventy‐two histopathological images from 29 early CRC cases at Kyoto Prefectural University of Medicine from 2019 to 2022 were collected (857 images for training and validation, 215 images for test). All images were annotated by a qualified histopathologist for segmentation of normal mucosa, adenoma, pure well‐differentiated adenocarcinoma (PWDA), and moderately/poorly differentiated adenocarcinoma (MPDA). Diagnostic ability including dice sufficient coefficient (DSC) and diagnostic accuracy were evaluated.Our original CAD, named Colon‐seg, with the pretraining of both HiPreD and ImageNET showed a better DSC (88.4%) compared to CAD without both pretraining (76.8%). Regarding the attentional mechanism, Colon‐seg with sparse attention showed a better DSC (88.4%) compared to other attentional mechanisms (dual: 79.7%, ECA: 80.7%, shuffle: 84.7%, SK: 86.9%). In addition, the DSC of Colon‐seg (88.4%) was better than other types of CADs (TransUNet: 84.7%, MultiResUnet: 86.1%, Unet++: 86.7%). The diagnostic accuracy of Colon‐seg for each histopathological type was 94.3% for adenoma, 91.8% for PWDA, and 92.8% for MPDA.A deep learning‐based CAD for CRC subtype differentiation was developed with pretraining and fine‐tuning of abundant histopathological images. [ABSTRACT FROM AUTHOR]
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- 2024
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20. The Comparison of Diagnostic Ability between Blue Laser/Light Imaging and Narrowband Imaging for Sessile Serrated Lesions with or without Dysplasia.
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Kobayashi R, Yoshida N, Morinaga Y, Hashimoto H, Tomita Y, Sugino S, Inoue K, Hirose R, Dohi O, Murakami T, Inada Y, Morimoto Y, and Itoh Y
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Objectives: Diagnostic ability of sessile serrated lesions (SSL) and SSL with dysplasia (SSLD) using blue laser/light imaging (BLI) has not been well examined. We analyzed the diagnostic accuracy of BLI for SSL and SSLD using several endoscopic findings compared to those of narrow band imaging (NBI)., Materials and Methods: This was a subgroup analysis of prospective studies. 476 suspiciously serrated lesions of ≥2 mm on the proximal colon showing serrated change with magnified NBI or BLI in our institution between 2014 and 2021 were examined histopathologically. After propensity score matching, we evaluated the diagnostic ability of SSL and SSLD of the NBI and BLI groups regarding various endoscopic findings. For WLI findings, granule, depression, and reddish were examined for diagnosing SSLD. For NBI/BLI findings, expanded crypt opening (ECO) or thick and branched vessels (TBV) were examined for diagnosing SSL. Network vessels (NV) and white dendritic change (WDC) defined originally were examined for diagnosing SSLD., Results: Among matched 176 lesions, the sensitivity of lesions with either ECO or TBV for SSL in the NBI/BLI group was 97.5%/98.5% ( p = 0.668). Those with either WDC or NV for diagnosing SSLD in the groups were 81.0%/88.9% ( p = 0.667). Regarding the rates of endoscopic findings among 30 SSLD and 290 SSL, there were significant differences in WDC (66.4% vs. 8.6%, p < 0.001), NV (55.3% vs. 1.4%, p < 0.001), and either WDC or NV (86.8% vs. 9.0%, p < 0.001)., Conclusions: The diagnostic ability of BLI for SSL and SSLD was not different from NBI. NV and WDC were useful for diagnosing SSLD., Competing Interests: Yoshida N is an editor of Gastroenterology Research and Practice. Yoshida N and Dohi O received a research grant from Fujifilm Co. Yoshida N received payment for lectures from Fujifilm Co. The other authors declare no conflicts of interest., (Copyright © 2024 Reo Kobayashi et al.)
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- 2024
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21. Detailed Superiority of the CAD EYE Artificial Intelligence System over Endoscopists for Lesion Detection and Characterization Using Unique Movie Sets.
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Kobayashi R, Yoshida N, Tomita Y, Hashimoto H, Inoue K, Hirose R, Dohi O, Inada Y, Murakami T, Morimoto Y, Zhu X, and Itoh Y
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Objectives: Detailed superiority of CAD EYE (Fujifilm, Tokyo, Japan), an artificial intelligence for polyp detection/diagnosis, compared to endoscopists is not well examined. We examined endoscopist's ability using movie sets of colorectal lesions which were detected and diagnosed by CAD EYE accurately., Methods: Consecutive lesions of ≤10 mm were examined live by CAD EYE from March-June 2022 in our institution. Short unique movie sets of each lesion with and without CAD EYE were recorded simultaneously using two recorders for detection under white light imaging (WLI) and linked color imaging (LCI) and diagnosis under blue laser/light imaging (BLI). Excluding inappropriate movies, 100 lesions detected and diagnosed with CAD EYE accurately were evaluated. Movies without CAD EYE were evaluated first by three trainees and three experts. Subsequently, movies with CAD EYE were examined. The rates of accurate detection and diagnosis were evaluated for both movie sets., Results: Among 100 lesions (mean size: 4.7±2.6 mm; 67 neoplastic/33 hyperplastic), mean accurate detection rates of movies without or with CAD EYE were 78.7%/96.7% under WLI (p<0.01) and 91.3%/97.3% under LCI (p<0.01) for trainees and 85.3%/99.0% under WLI (p<0.01) and 92.6%/99.3% under LCI (p<0.01) for experts. Mean accurate diagnosis rates of movies without or with CAD EYE for BLI were 85.3%/100% for trainees (p<0.01) and 92.3%/100% for experts (p<0.01), respectively. The significant risk factors of not-detected lesions for trainees were right-sided, hyperplastic, not-reddish, in the corner, halation, and inadequate bowel preparation., Conclusions: Unique movie sets with and without CAD EYE could suggest it's efficacy for lesion detection/diagnosis., Competing Interests: Conflicts of Interest The LED and LASER endoscopes, CAD EYE, and endoscopic LED systems were lent by Fujifilm for this study. Osamu Dohi and Naohisa Yoshida received the grants for research from Fujifilm Yoshida. Other authors did not have any conflict of interest. No funding was received for this study., (Copyright © 2024 The Japan Society of Coloproctology.)
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- 2024
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22. Additional 30-Second Observation of the Right-Sided Colon for Missed Polyp Detection With Texture and Color Enhancement Imaging Compared with Narrow Band Imaging: A Randomized Trial.
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Yoshida N, Inagaki Y, Inada Y, Kobayashi R, Tomita Y, Hashimoto H, Dohi O, Hirose R, Inoue K, Murakami T, Morimoto Y, Okuyama Y, Morinaga Y, and Itoh Y
- Subjects
- Humans, Male, Middle Aged, Female, Aged, Missed Diagnosis, Adult, Colonic Neoplasms diagnostic imaging, Colonic Neoplasms pathology, Colon, Ascending diagnostic imaging, Colon, Ascending pathology, Image Enhancement methods, Colonic Polyps diagnostic imaging, Colonic Polyps diagnosis, Colonic Polyps pathology, Narrow Band Imaging methods, Colonoscopy methods, Adenoma diagnostic imaging, Adenoma diagnosis, Adenoma pathology
- Abstract
Introduction: The efficacy of texture and color enhancement imaging (TXI) in the novel light-emitting diode endoscopic system for polyp detection has not been examined. We aimed to evaluate the noninferiority of the additional 30-second (Add-30-s) observation of the right-sided colon (cecum/ascending colon) with TXI compared with narrow band imaging (NBI) for detecting missed polyps., Methods: We enrolled 381 patients ≥40 years old who underwent colonoscopy from September 2021 to June 2022 in 3 institutions and randomly assigned them to either the TXI or NBI groups. The right-sided colon was first observed with white light imaging in both groups. Second, after reinsertion from hepatic flexure to the cecum, the right-sided colon was observed with Add-30-s observation of either TXI or NBI. The primary endpoint was to examine the noninferiority of TXI to NBI using the mean number of adenomas and sessile serrated lesions per patient. The secondary ones were to examine adenoma detection rate, adenoma and sessile serrated lesions detection rates, and polyp detection rates in both groups., Results: The TXI and NBI groups consisted of 177 and 181 patients, respectively, and the noninferiorities of the mean number of adenomas and sessile serrated lesions per patients in the second observation were significant (TXI 0.29 [51/177] vs NBI 0.30 [54/181], P < 0.01). The change in adenoma detection rate, adenoma and sessile serrated lesions detection rate, and polyp detection rate for the right-sided colon between the TXI and NBI groups were not different (10.2%/10.5% [ P = 0.81], 13.0%/12.7% [ P = 0.71], and 15.3%/13.8% [ P = 0.71]), respectively., Discussion: Regarding Add-30-s observation of the right-sided colon, TXI was noninferior to NBI., (Copyright © 2023 by The American College of Gastroenterology.)
- Published
- 2024
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23. Comparison of blue laser imaging and light-emitting diode-blue light imaging for the characterization of colorectal polyps using the Japan narrow-band imaging expert team classification: The LASEREO and ELUXEO COLonoscopic study.
- Author
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Okada M, Yoshida N, Kashida H, Hayashi Y, Shinozaki S, Yoshimoto S, Fujinuma T, Sakamoto H, Sunada K, Tomita Y, Dohi O, Inoue K, Hirose R, Itoh Y, Komeda Y, Sekai I, Okai N, Lefor AK, and Yamamoto H
- Abstract
Objectives: Although the laser light is optically ideal for producing narrow-band light, it has not been used in some areas of the world. Endoscopic light sources using light-emitting diodes (LEDs) are used worldwide. The purpose of this study was to compare blue laser imaging (laser-BLI) and LED-blue light imaging (LED-BLI) for the characterization of colorectal polyps using the Japan narrow band imaging expert team (JNET) classification., Methods: Colorectal lesions were prospectively examined using magnifying narrow-band light generated by a laser (laser-BLI) or LEDs (LED-BLI). Twelve endoscopists (six non-experts and six experts from three institutions) evaluated each still-magnified image of lesions using the JNET classification., Results: Seven hundred and fifty-six images from 63 lesions were reviewed. The mean polyp size was 24.5 ± 13.4 mm. Histopathology included 13 serrated lesions and 50 neoplasms. The rate of agreement between laser-BLI and LED-BLI using the JNET classification was 92.5% (699/756). The weighted κ-statistic was 0.99. The percentages of "almost similar" comparing scores of surface patterns, vessel patterns, and brightness among all endoscopists were 95.4%, 95.9%, and 95.0%, respectively., Conclusions: This multicenter study demonstrates that the rate of agreement between laser-BLI and LED-BLI using the JNET Classification is very high. The surface patterns, vessel patterns, and brightness are almost similar., Competing Interests: H.S. has received grants from Fujifilm Co. Ltd. H.Y. has consultant relationships with Fujifilm Co. Ltd. and received honoraria, grants, and royalties from the company. N.Y is an editor of Digestive Endoscopy. N.Y. and O.D. received a research grant from Fujifilm Co. Ltd. (J162001222). Y.I. is an executive councilor of the Japanese Society of Gastroenterology. The other authors declare no conflicts of interest., (© 2023 The Authors. DEN Open published by John Wiley & Sons Australia, Ltd on behalf of Japan Gastroenterological Endoscopy Society.)
- Published
- 2023
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24. Two cases of colonic tumors observed by linked color imaging and texture and color enhancement imaging with the tablet-image comparison method.
- Author
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Tomita Y, Yoshida N, Inoue K, Hashimoto H, Sugino S, Hirose R, Dohi O, and Itoh Y
- Abstract
An endoscope system using 5-color light-emitting diodes (LEDs) (EVIS X1: CV-1500, Olympus Co., Tokyo, Japan) was released worldwide in July 2020. In addition to the improvement of narrow band imaging (NBI), this system enables texture and color enhancement imaging (TXI). TXI makes the lesion reddish and supports better visibility of colorectal lesions in comparison to white light imaging for improving lesion detection. On the other hand, another 4-color LED endoscope system (ELUXEO: BL-7000; Fujifilm, Tokyo, Japan) has been on the market in the West since 2017. This system enables blue light imaging (BLI) and linked color imaging (LCI). Generally, the accurate comparison between two images obtained by two different endoscope systems is difficult. To resolve this problem, we developed a method named the tablet-image comparison (TIC) method. TIC is a simple, easy, and paperless method to get images under similar conditions of two endoscope systems for an accurate comparison. We herein report two colorectal lesions in which accurate comparisons of images between TXI and LCI and between improved NBI and BLI obtained in the EVIS X1 and ELUXEO systems were performed using the TIC method. One was IIa 30 mm (high-grade dysplasia) and the other was IIa 25 mm (low-grade adenoma). A detailed comparison between TXI and LCI could be performed by TIC. In these two cases, with a distant view, TXI showed greater redness than LCI. LCI showed slightly higher brightness than TXI. In magnified TXI and LCI, the irregularities observed were similar to NBI and BLI, respectively., Competing Interests: Naohisa Yoshida and Osamu Dohi received a research grant from Fujifilm. All other authors declare no conflict of interest.The author Naohisa Yoshida and Osamu Dohi were supported by a research grant from Fujifilm (J162001222)., (© 2021 The Authors. DEN Open published by John Wiley & Sons Australia, Ltd on behalf of Japan Gastroenterological Endoscopy Society.)
- Published
- 2021
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25. Cold snare polypectomy for large sessile serrated lesions is safe but follow-up is needed: a single-centre retrospective study.
- Author
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Yoshida N, Inoue K, Tomita Y, Hashimoto H, Sugino S, Hirose R, Dohi O, Naito Y, Morinaga Y, Kishimoto M, Inada Y, Murakami T, and Itoh Y
- Subjects
- Adult, Aged, Aged, 80 and over, Colonic Polyps diagnostic imaging, Colonic Polyps pathology, Colonoscopy adverse effects, Colonoscopy methods, Feasibility Studies, Female, Follow-Up Studies, Humans, Intestinal Perforation epidemiology, Intraoperative Complications epidemiology, Male, Middle Aged, Narrow Band Imaging, Postoperative Hemorrhage epidemiology, Recurrence, Retrospective Studies, Risk Factors, Colonic Polyps surgery
- Abstract
Background and Aim: Cold snare polypectomy (CSP) is growing in popularity due to its safety and convenience. Its indication is benign tumours such as adenoma and sessile serrated lesions (SSLs) <10 mm in size. CSP for SSLs ≥10 mm in size has not been well examined. In this study, we aimed the feasibility of this treatment regarding therapeutic results and local recurrence., Methods: This was a single-centre retrospective cohort study. We reviewed SSLs with or without dysplasia of 10-20 mm that were resected by CSP from 2014 to 2020. All tumours were diagnosed endoscopically as SSLs without dysplasia before CSP with the help of magnifying narrow band imaging or blue laser imaging. We analysed the lesion characteristics, en bloc resection, histopathological diagnosis, adverse events and local recurrence. We analysed risk factors for recurrence, comparing recurrent lesions to non-recurrent lesions. We also compared risk factors for lesions 10-14 mm in size to those for lesions 15-20 mm in size., Results: We analysed 160 lesions in 100 patients (M
age ± SD = 67.7 ± 10.1 years). The polyp size (M ± SD) was 11.8 ± 2.8 mm, and the en bloc resection rate was 60.0% (96 cases). The rates of massive perioperative haemorrhage, postoperative haemorrhage and perforation were 1.3%, 0% and 0%, respectively. Regarding histopathological diagnosis, two (1.2%) cases showed SSLs with high-grade dysplasia. The recurrence rate in 101 lesions with a median follow-up period of 18 months (interquartile range 12-24 months) was 5.0%. There were no significant risk factors such as tumour size, location, morphology and so on in terms of recurrence. All recurrent cases could be resected by repeat CSP. The recurrence rates of lesions 10-14 mm in size and 15-20 mm in size were 4.7% and 6.3%, respectively (p = 0.713)., Conclusion: CSP of SSLs ≥10 mm in size according to magnifying endoscopic diagnosis was safe and promising, but the rate of recurrence was slightly high, meaning that close follow-up is required., (© 2020 The Authors. United European Gastroenterology Journal published by Wiley Periodicals LLC. on behalf of United European Gastroenterology.)- Published
- 2021
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26. Mental well-being of international migrants to Japan: a systematic review.
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Miller R, Tomita Y, Ong KIC, Shibanuma A, and Jimba M
- Subjects
- Acculturation, China ethnology, Humans, Japan epidemiology, Philippines ethnology, Sex Factors, Social Support, Ethnicity psychology, Mental Disorders epidemiology, Mental Disorders psychology, Transients and Migrants psychology
- Abstract
Background: Migration is a stressful process of resettlement and acculturation that can often negatively impact the mental health of migrants. International migration to Japan, a country with dominant ethnic homogeneity, is growing steadily amid an ageing domestic population and severe labour shortages., Objectives: To identify the contemporary barriers to, and facilitators of, mental well-being among the migrant population in Japan., Design: Systematic review DATA SOURCES: PubMed, ProQuest, Web of Science, Ichushi and J-Stage ELIGIBILITY CRITERIA: Research articles examining the mental well-being of international migrants in Japan that were published in English or Japanese between January 2000 and September 2018 were included., Data Extraction and Synthesis: Full texts of relevant articles were screened and references of the included studies were hand-searched for further admissible articles. Study characteristics, mental well-being facilitators and barriers, as well as policy recommendations were synthesised into categorical observations and were then thematically analysed., Results: Fifty-five studies (23 published in English), surveying a total of 8649 migrants, were identified. The most commonly studied migrant nationalities were Brazilian (36%), followed by Chinese (27%) and Filipino (8%). Thematic analysis of barriers to mental well-being among migrants chiefly identified 'language difficulties', 'being female' and 'lack of social support', whereas the primary facilitators were 'social networks' followed by 'cultural identity'. Policy recommendations for authorities generally described more migrant support services and cross-cultural awareness among the Japanese public., Conclusion: Access to social support networks of various types appears to be an influential factor affecting the mental well-being of international migrants in Japan. More research is necessary on how to promote such connections to foster a more inclusive and multicultural Japanese society amid rapid demographic change., Prospero Registration Number: CRD42018108421., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
- Published
- 2019
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27. [Lung Cancer Associated with Hamartoma;Report of a Case].
- Author
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Oshima Y, Niiya Y, Minakata T, Himuro N, Tomita Y, Kataoka D, Yamamoto S, and Kadokura M
- Subjects
- Aged, Hamartoma diagnostic imaging, Humans, Lung Neoplasms diagnostic imaging, Lung Neoplasms pathology, Lymph Node Excision, Male, Pneumonectomy, Tomography, X-Ray Computed, Hamartoma surgery, Lung Neoplasms surgery
- Abstract
A 65-year-old male was admitted to our hospital for evaluation of an abnormal shadow in the left lung field of chest roentgenogram. A chest computed tomography scan revealed an ill-defined nodule in the superior lingular segment of left lung and a calcified nodule in the left pulmonary apex region. A diagnosis of lung adenocarcinoma in the left lingular was made by transbronchial cytology and the left upper lobectomy with lymph node dissection was performed. Pathological diagnosis was primary lung adenocarcinoma in the superior lingular segment of left lung (pT1aN0M0, stage I A) and hamartoma in the left pulmonary apex region. It was considered to be important to discriminate a hamartoma from a metastasic lesion in order to conduct correct treatment.
- Published
- 2018
28. [Descending Necrotizing Mediastinitis Survived by Two Operations;Report of a Case].
- Author
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Minakata T, Niiya Y, Oshima Y, Himuro N, Tomita Y, Kataoka D, Tanio N, Yamamoto S, Suzuki T, and Kadokura M
- Subjects
- Aged, Female, Humans, Necrosis, Mediastinitis surgery
- Abstract
The patient, a 65-year-old woman, visited at her local doctor's office with the chief complaint of pharyngeal pain. After being administered antibacterial drugs, hyperthermia persisted and the pharyngeal pain became exacerbated. She was referred to our hospital and diagnosed as a retropharyngeal abscess and descending necrotizing mediastinitis (DNM). She was urgently hospitalized and surgery was performed. The mediastinal pleura was incised with thoracoscopic guidance and curettage, irrigation, and drainage were performed. Additional drainage was determined to be necessary based on findings from subsequent chest computed tomography and a prolonged inflammatory reaction. Therefore, on hospital day 7, 2nd surgery were performed, and tracheotomy was additionally performed with curettage of the neck abscess. The patient was taken off mechanical ventilation on hospital day 18, and discharged on hospital day 55.
- Published
- 2017
29. Video-assisted thoracic surgery for primary myelolipoma of the posterior mediastinum.
- Author
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Himuro N, Minakata T, Oshima Y, Tomita Y, Kataoka D, Yamamoto S, and Kadokura M
- Subjects
- Humans, Male, Middle Aged, Mediastinal Neoplasms surgery, Myelolipoma surgery, Thoracic Surgery, Video-Assisted
- Abstract
Background: Myelolipoma is an uncommon tumor comprising adipose tissue and normal hematopoietic cells and mainly occurs in the adrenal cortex. Mediastinal myelolipoma is very rare; we report a case of posterior mediastinal myelolipoma that required surgical resection., Case Presentation: A 56-year-old male was diagnosed with a posterior mediastinal tumor by computed tomography. The tumor was originally noted in 2005, and during follow-up in March 2014, it was found to have increased in size. During consultation at our hospital, on magnetic resonance imaging (MRI), we considered the possibility that the tumor was malignant. Consequently, we resected the tumor by video-assisted thoracic surgery (VATS). The histopathological findings revealed that the tumor had undergone intrathoracic extramedullary hematopoiesis. However, after considering the patient's background and histopathological findings, we diagnosed the tumor as a thoracic extra-adrenal myelolipoma., Conclusions: Pathological analysis was instrumental in clarifying the diagnosis. We recommend surgery as a treatment option for posterior mediastinal tumors.
- Published
- 2016
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30. [Thymoma with extensive coagulative necrosis and high serum level of CYFRA 21-1; report of a case].
- Author
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Himuro N, Minakata T, Oshima Y, Tomita Y, Kataoka D, and Kadokura M
- Subjects
- Aged, Female, Humans, Necrosis, Thymoma blood, Thymoma pathology, Thymus Neoplasms blood, Thymus Neoplasms pathology, Tomography, X-Ray Computed, Antigens, Neoplasm blood, Keratin-19 blood, Thymoma surgery, Thymus Neoplasms surgery
- Abstract
A 73-year-old woman complained of right chest discomfort. Chest X-ray during the follow-up for rheumatoid arthritis showed a mediastinal tumor. Chest computed tomography (CT) and magnetic resonance imaging (MRI) showed a 65-mm tumor in the right anterior mediastinum. A blood test showed high serum levels of CYFRA 21-1(29.8 ng/ml), white blood cells( WBC 10,800/µl), and C-reactive protein(CRP 16.1 mg/dl). Subsequently, inflammatory reactions improved, and the thymic tumor was resected. Histopathologically, the tumor was a type B2 thymoma with extensive coagulative necrosis. After resection, the serum CYFRA 21-1 level returned to the normal range.
- Published
- 2014
31. Two cases of thymoma with pulmonary metastasis: a case report.
- Author
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Hirono M, Nonaka M, Himuro N, Tomita Y, Kataoka D, and Kadokura M
- Subjects
- Aged, Humans, Lung Neoplasms surgery, Male, Prognosis, Thymectomy, Thymoma surgery, Thymus Neoplasms surgery, Tomography, X-Ray Computed, Lung Neoplasms secondary, Thymoma pathology, Thymus Neoplasms pathology
- Abstract
Background: Pulmonary metastases of thymomas are relatively rare. We report on two patients who underwent surgery for resection of pulmonary metastases., Methods and Results: One patient was a 74-year-old man. A chest CT scan showed a mediastinal mass and a hilar nodule in the left lung. The patient underwent surgical resection of both of these lesions. The histological diagnosis was type A thymoma with intrapulmonary metastasis, classified as stage IVb. He did not receive any adjuvant therapy following the operation because the resection was complete. There has been no evidence of recurrence in four years.The other patient was a 68-year-old man with myasthenia gravis. At the age of 61 years, he underwent extended thymectomy with combined resection of the surrounding involved structures. The histological diagnosis was type B3 thymoma, stage III. Adjuvant radiation (40 Gy) was administered postoperatively; however, a pulmonary nodule occurred seven years following the initial operation (patient age, 68 years). He subsequently underwent right lower lobectomy and a diagnosis of intrapulmonary metastasis of thymoma was made. There has been no evidence of recurrence in two years., Conclusions: Long-term follow-up is important to detect recurrence in any cases of thymoma. Lung metastases should be operated upon if they appear to be completely resectable and this can achieve long-term survival.
- Published
- 2014
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32. [Surgically treated desmoid tumor of the chest wall which located at the previous thoracotomy site].
- Author
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Tomita Y, Nonaka M, Ohshima Y, Himuro N, Kataoka D, Kamio Y, Kunimura T, and Kadokura M
- Subjects
- Aged, Female, Humans, Pneumonectomy, Postoperative Complications, Thoracotomy, Adenocarcinoma surgery, Fibromatosis, Aggressive surgery, Lung Neoplasms surgery, Thoracic Neoplasms surgery, Thoracic Wall
- Abstract
Desmoid tumor is a soft-tissue tumor of unknown cause. Since recurrence sometimes occurs even with complete resection, careful consideration of which portions to resect and close postoperative followup are recommended. Seventeen months after undergoing a right upper lobectomy for primary lung adenocarcinoma, a 65-year-old female patient experienced pleural tumor which located at the previous thoracotomy site, as revealed by chest X-ray and computed tomography (CT). While needle aspiration biopsy revealed no malignancy, recurrence of the cancer could not be ruled out clinically. The tumor was resected with chest wall and lung and the histopathological diagnosis was desmoid tumor. This case demonstrates the importance of conducting differential diagnosis with recurrence or desmoid tumor after operation to treat lung cancer. Five years after resection of the desmoid tumor, no recurrence is observed.
- Published
- 2014
33. Epidural pneumatosis associated with pneumomediastinum occurring at rest.
- Author
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Nonaka M, Hatakeyama T, Okada I, Sakuraba K, Tomita Y, Sato S, Oga J, Ishida Y, and Hataya K
- Subjects
- Adolescent, Anti-Bacterial Agents therapeutic use, Dyspnea etiology, Epidural Space, Humans, Male, Mediastinal Emphysema diagnostic imaging, Mediastinal Emphysema therapy, Oxygen Inhalation Therapy, Subcutaneous Emphysema diagnostic imaging, Subcutaneous Emphysema therapy, Tomography, X-Ray Computed, Treatment Outcome, Mediastinal Emphysema complications, Subcutaneous Emphysema etiology
- Abstract
We report a rare case of epidural pneumatosis associated with pneumomediastinum that occurred at rest. A 17-year-old male had spontaneously felt shortness of breath while attending class during the day. Chest and neck CT revealed interstitial free air collection along the right pulmonary vascular sheath. It was speculated that some cough or strain-induced increase in intra-alveolar pressure in the alveoli along the right upper lobe caused free air leaks from the ruptured alveoli, which accumulated along the bronchovascular tissue sheath and moved into the mediastinum and subcutaneous area, especially in the right neck, right anterior chest wall, and right axillary region. CT also demonstrated subcutaneous emphysema extended into the epidural space through the intervertebral foramen. He exhibited a benign self-limited course.
- Published
- 2009
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