Intralesional steroid infusion using a spray tube to prevent stenosis after endoscopic submucosal dissection of esophageal cancer

Atsushi Goto,Takeshi Okamoto,Ryo Ogawa,Kouichi Hamabe,Shinichi Hashimoto,Jun Nishikawa,Taro Takami 대한소화기내시경학회 2022 Clinical Endoscopy Vol.55 No.4

Background/Aims: Intralesional steroid injections have been administered as prophylaxis for stenosis after esophageal endoscopicsubmucosal dissection. However, this method carries a risk of potential complications such as perforation because a fine needle is usedto directly puncture the postoperative ulcer. We devised a new method of steroid intralesional infusion using a spray tube and evaluatedits efficacy and safety. Methods: Intralesional steroid infusion using a spray tube was performed on 27 patients who underwent endoscopic submucosal dissectionfor superficial esophageal cancer with three-quarters or more of the lumen circumference resected. The presence or absence ofstenosis, complications, and the number of endoscopic balloon dilations (EBDs) performed were evaluated after treatment. Results: Although stenosis was not observed in 22 of the 27 patients, five patients had stenosis and dysphagia requiring EBD. The stenosisin these five patients was relieved after four EBDs. No complications related to intralesional steroid infusion using the spray tubewere observed. Conclusions: Intralesional steroid infusion using a spray tube is a simple and safe technique that is adequately effective in preventingstenosis (clinical trial number, UMIN000037567).

Another dividend puzzle : Why do dividend-paying firms pay dividends quarterly?

Suk Hi kim,Kenneth A. Kim,Takeshi Nishikawa 한국재무학회 2009 한국재무학회 학술대회 Vol.2009 No.05

In the U.S., dividends are paid quarterly, semiannually, or annually. Why do most dividendpaying firms pay dividends quarterly? We test explanations related to information signaling and agency costs, but neither explanations pan out. We also test whether managers are catering to shareholder demand for frequent dividends, but find no evidence of it. We then conduct an event study to see how the market reacts to dividend frequency-change announcements. When a firm announces an increase in its dividend-payout frequency, we find positive abnormal announcement returns. Further analysis suggests dividend frequency-increasing announcements signal an increase in future dividends, but not future earnings.

Invite Review : Brain Activation via Exercise: Exercise conditions Leading to neuronal activation & hippocampal neurogenesis

( Hideaki Soya ),( Masahiro Okamoto ),( Takashi Matsui ),( Min Chul Lee ),( Koshiro Inoue ),( Shimpei Nishikawa ),( Shingo Soya ),( Takahiko Fujikawa ),( Rakwal Randeep ),( Hyuk Ki Chang ),( Takeshi N 한국운동영양학회 2011 Physical Activity and Nutrition (Phys Act Nutr) Vol.15 No.1

The brain is considered to be an organ which can be affected by conditioning or exercise, just like muscles. Exercise activates the brain and enhances several neuronal functions and may lead to several neuronal plastic changes. Neuronal c-Fos accumulation in any hypothalamic nuclei increased only with supra-LT exercise, revealing a LT-like activation pattern. In the brain stem, both supra-LT and below-LT exercise activated the VLM and NTS. In case of hippocampus, its activation was induced by under-LT exercise, which increased regional blood flow through neurovascular coupling. Thus, we found that regions of brain activation were determined differently based on exercise intensity. In the further, more research on exercise intensive is indispensable. In this paper, we reviewed: (1) Hippocampal plasticity through exercise (2) Brain region-specific differential activation patterns with exercise below and above the lactate threshold (3) Hippocampal neuronal activity induced by mild exercise below the lactate threshold: regional blood flow monitoring in the hippocampus (4) Acute mild exercise induces BDNF and short-term training causes AHN (5) Why below-LT exercise is sufficient for hippocampal plasticity (6) Hippocampal activation mechanism during exercise. In particular, based on our recent findings, our focus was directed upon exercise-induced brain activation and neurogenesis.

Perianal and Vulvar Extramammary Paget Disease: A Report of Six Cases and Mapping Biopsy of the Anal Canal

( Yuzo Nagai ),( Sinsuke Kazama ),( Daisuke Yamada ),( Takuya Miyagawa ),( Koji Murono ),( Koji Yasuda ),( Takeshi Nishikawa ),( Toshiaki Tanaka ),( Tomomichi Kiyomatsu ),( Keisuke Hata ),( Kazushige 대한피부과학회 2016 Annals of Dermatology Vol.28 No.5

Treatment of perianal and vulvar extramammary Paget disease (EMPD), rare intraepithelial malignancies, is often challenging because of its potential to spread into the anal canal. However, there is still no consensus regarding the optimal resection margin within the anal canal. Between 2004 and 2014, six patients (three with perianal EMPD and three with vulvar EMPD) in which the spread of Paget cells into the anal canal was highly suspected were referred to our department. To evaluate the disease extent within the anal canal, preoperative mapping biopsy of the anal canal was performed in five out of six patients. Two patients were positive for Paget cells within the anal canal (one at the dentate line and the other at 0.5 cm above the dentate line), whereas in three patients, Paget cell were present only in the skin of the anal verge. Using 1 cm margin within the anal canal from the positive biopsy sites, we performed anal-preserving wide local excision (WLE), and negative resection margins within the anal canal were confirmed in all five patients. The remaining one patient with perianal EMPD did not undergo mapping biopsy of the anal canal because preoperative colonoscopy revealed that the Paget cells had spread into the lower rectum. Therefore, WLE with abdominoperineal resection was performed. During the median follow-up period of 37.3 months, no local recurrence was observed in all patients. Our small case series suggest the usefulness of mapping biopsy of the anal canal for the treatment of perianal and vulvar EMPD. (Ann Dermatol 28(5) 624∼628, 2016)

Risk factors for non-reaching of ileal pouch to the anus in laparoscopic restorative proctocolectomy with handsewn anastomosis for ulcerative colitis

Shigenobu Emoto,Keisuke Hata,Hiroaki Nozawa,Kazushige Kawai,Toshiaki Tanaka,Takeshi Nishikawa,Yasutaka Shuno,Kazuhito Sasaki,Manabu Kaneko,Koji Murono,Yuuki Iida,Hiroaki Ishii,Yuichiro Yokoyama,Hiroyu 대한장연구학회 2022 Intestinal Research Vol.20 No.3

Background/Aims: Restorative proctocolectomy (RPC) with ileal pouch-anal anastomosis and handsewn anastomosis for ulcerative colitis requires pulling down of the ileal pouch into the pelvis, which can be technically challenging. We examined risk factors for the pouch not reaching the anus.Methods: Clinical records of 62 consecutive patients who were scheduled to undergo RPC with handsewn anastomosis at the University of Tokyo Hospital during 1989–2019 were reviewed. Risk factors for non-reaching were analyzed in patients in whom hand sewing was abandoned for stapled anastomosis because of nonreaching. Risk factors for non-reaching in laparoscopic RPC were separately analyzed. Anatomical indicators obtained from presurgical computed tomography (CT) were also evaluated.Results: Thirty-seven of 62 cases underwent laparoscopic procedures. In 6 cases (9.7%), handsewn anastomosis was changed to stapled anastomosis because of non-reaching. Male sex and a laparoscopic approach were independent risk factors of non-reaching. Distance between the terminal of the superior mesenteric artery (SMA) ileal branch and the anus > 11 cm was a risk factor for non-reaching.Conclusions: Laparoscopic RPC with handsewn anastomosis may limit extension and induction of the ileal pouch into the anus. Preoperative CT measurement from the terminal SMA to the anus may be useful for predicting non-reaching.

Synthesis and characterization of conductive flexible cellulose carbon nanohorn sheets for human tissue applications

Karthik Paneer Selvam,Taichi Nagahata,Kosuke Kato,Mayuko Koreishi,Toshiyuki Nakamura,Yoshimasa Nakamura,Takeshi Nishikawa,Ayano Satoh,Yasuhiko Hayashi 한국생체재료학회 2020 생체재료학회지 Vol.24 No.4

Background: Conductive sheets of cellulose and carbon nanomaterials and its human skin applications are an interesting research aspect as they have potential for applications for skin compatibility. Hence it is needed to explore the effects and shed light on these applications. Method: To fabricate wearable, portable, flexible, lightweight, inexpensive, and biocompatible composite materials, carbon nanohorns (CNHs) and hydroxyethylcellulose (HEC) were used as precursors to prepare CNH-HEC (Cnh-cel) composite sheets. Cnh-cel sheets were prepared with different loading concentrations of CNHs (10, 20 50,100 mg) in 200 mg cellulose. To fabricate the bio-compatible sheets, a pristine composite of CNHs and HEC was prepared without any pretreatment of the materials. Results: The obtained sheets possess a conductivity of 1.83 × 10− 10 S/m and bio-compatible with human skin. Analysis for skin-compatibility was performed for Cnh-cel sheets by h-CLAT in vitro skin sensitization tests to evaluate the activation of THP-1 cells. It was found that THP-1 cells were not activated by Cnh-cel; hence Cnh-cel is a safe biomaterial for human skin. It was also found that the composite allowed only a maximum loading of 100 mg to retain the consistent geometry of free-standing sheets of < 100 μm thickness. Since CNHs have a unique arrangement of aggregates (dahlia structure), the composite is homogeneous, as verified by transmission electron microscopy (TEM) and, scanning electron microscopy (SEM), and other functional properties investigated by Raman spectroscopy, Fourier transform infrared spectroscopy (FT-IR), conductivity measurement, tensile strength measurement, and skin sensitization. Conclusion: It can be concluded that cellulose and CNHs sheets are conductive and compatible to human skin applications.