Reflux-related Extraesophageal Symptoms Until Proven Otherwise: A Direct Measurement of Abnormal Proximal Exposure Based on Hypopharyngeal Multichannel Intraluminal Impedance as a Reliable Indicator for Successful Treatment Outcomes

( Takeshi Suzuki ),( Yosuke Seki ),( Tomoaki Matsumura ),( Makoto Arai ),( Toyoyuki Hanazawa ),( Yoshitaka Okamoto ),( Haruhiko Suzuki ),( Kazunori Kasama ),( Akiko Umezawa ),( Yoshimoti Kurokawa ),( 대한소화기기능성질환·운동학회 2022 Journal of Neurogastroenterology and Motility (JNM Vol.28 No.1

Background/Aims The Lyon Consensus defined parameters based on upper endoscopy and 24-hour combined multichannel intraluminal impedancepH (MII-pH), that conclusively establish the presence of gastroesophageal reflux disease (GERD). However, the true role of upper endoscopy and MII-pH to evaluate patients with extraesophageal symptoms (EES) has not been well established. Hypopharyngeal MII (HMII), which directly measures laryngopharyngeal reflux (LPR) events, has been utilized to evaluate patients with EES suggestive of LPR. Methods This was a retrospective study involving patients with EES for > 12 weeks despite proton pump inhibitor therapy, and had no endoscopic confirmatory evidence for GERD and negative MII-pH. All patients were subsequently referred for further evaluation of EES with “unknown” etiology and underwent laryngoscopy and HMII. Based on HMII, abnormal proximal exposure (APE) was defined as LPR ≥ 1/day and/or full column reflux (reflux 2 cm distal to the upper esophageal sphincter) > 4/day. Patients with APE were offered antireflux surgery (ARS) and the outcome of ARS was objectively assessed using Reflux Symptom Index. Results Of 21 patients with EES which was thought to be GERD-unrelated based on endoscopy and MII-pH, 17 patients (81%) had APE. Eight patients with APE who had undergone ARS had significant symptomatic improvement in the Reflux Symptom Index score (19.6 ± 4.9 pre-ARS to 5.8 ± 1.4 post-ARS, P = 0.008). Conclusions A conventional diagnostic approach using endoscopy and MII-pH may not be sufficient to evaluate patients with EES suggestive of LPR. HMII is essential to evaluate patients with EES, and APE could be a reliable indicator for successful treatment outcomes. (J Neurogastroenterol Motil 2022;28:69-77)

Resistance to UV radiation in the two-spotted spider mite, Tetranychus urticae

Takeshi Suzuki,Makio Takeda 한국응용곤충학회 2008 한국응용곤충학회 학술대회논문집 Vol.2008 No.10

Why do two-spotted spider mites (Tetranychus urticae) inhabit on the underside of leaves? Why are diapause females orange? A possible key to answering these questions is ultraviolet (UV) radiation. UV radiation directly damages DNA and produces reactive oxygen species (ROS). ROS also damages DNA, dissociates proteins, and oxidizes lipids. Because mites are small, the UV/ROS-induced damage would be lethal to mites. In non-diapause females, mortalities under UV-C (250 nm) at 0.6 W m–2 and UV-B (300 nm) at 2.4 W m–2 were significantly higher than those under continuous darkness (DD; control). Oviposition rates in such treatments were significantly lower than those under DD. No significant effects for mortality and oviposition rate were observed under UV-A (350 nm) even when the intensity was as high as 2.4 W m–2. In diapause females, the differences in mortalities between all types of UV radiation and DD were not significant. Interestingly, more than half of diapause females escaped from leaf disks under all types of UV radiation, and the escape rates were significantly higher than those under DD and those for non-diapause females. This suggests that diapause females exhibit negative phototaxis. Mites inhabit the underside of leaves in summer with dense vegetation. Most of UV radiation is absorbed and reflected by leaves. Therefore, the underside of leaves is considered a suitable environment for mites to avoid UV radiation, particularly UV-B (UV-C is completely absorbed by the ozone layer). In autumn, leaves start turning yellow and red as winter approaches and finally, fall. During this phenological event, the UV-B level in the plant canopy would increases dramatically while female mites enter diapause with a change in their body color from yellow-green to orange. It is known that the orange color is mainly due to the accumulation of β-carotene, which plays a role as a scavenger of ROS. Therefore, low mortalities observed in diapause females under UV-C and UV-B may be a result of β-carotene accumulation or merely due to the increase in the escape rate. Therefore, whether the escaped diapause females are resistant to UV-C and UV-B damage needs to be confirmed. Our findings suggest that UV radiation is utilized as an effective non-chemical measure to reduce the mite population and that the selection of habitat and change in body color is the mite’s strategy to reduce the deleterious effects of UV-B.

AN ANALYSIS OF THE 1987 TOSHIBA APOLOGY OF COCOM VIOLATION

Takeshi Suzuki 한국수사학회 2005 수사학 Vol.0 No.3

Complications of endoscopic resection in the upper gastrointestinal tract

Takeshi Uozumi,Seiichiro Abe,Mai Ego Makiguchi,Satoru Nonaka,Haruhisa Suzuki,Shigetaka Yoshinaga,Yutaka Saito 대한소화기내시경학회 2023 Clinical Endoscopy Vol.56 No.4

Endoscopic resection (ER) is widely utilized as a minimally invasive treatment for upper gastrointestinal tumors; however, complications could occur during and after the procedure. Post-ER mucosal defect leads to delayed perforation and bleeding; therefore, endoscopic closure methods (endoscopic hand-suturing, the endoloop and endoclip closure method, and over-the-scope clip method) and tissue shielding methods (polyglycolic acid sheets and fibrin glue) are developed to prevent these complications. During duodenal ER, complete closure of the mucosal defect significantly reduces delayed bleeding and should be performed. An extensive mucosal defect that comprises three-quarters of the circumference in the esophagus, gastric antrum, or cardia is a significant risk factor for post-ER stricture. Steroid therapy is considered the first-line option for the prevention of esophageal stricture, but its efficacy for gastric stricture remains unclear. Methods for the prevention and management of ER-related complications in the esophagus, stomach, and duodenum differ according to the organ; therefore, endoscopists should be familiar with ways of preventing and managing organ-specific complications.

Antioxidant Properties of Enzymatic Hydrolysates from Royal Jelly

Takeshi Nagai,Reiji Inoue,Nobutaka Suzuki,Toshio Nagashima 한국식품영양과학회 2006 Journal of medicinal food Vol.9 No.3

Enzymatic hydrolysates were prepared from royal jelly using three enzymes (pepsin, trypsin, and papain), andtheir antioxidative properties were evaluated. The yield of these hydrolysates was very high, about 2026% on a raw weightbasis. In comparison with the antioxidative activities of water extract and alkaline extract of royal jelly, the antioxidative ac-tivities and scavenging activities against active oxygen species such as superoxide anion radical and hydroxyl radical of eachhydrolysate were high in the sample with a low protein concentration. These results suggest that once royal jelly is hydrolyzedusing enzyme, the hydrolysate possesses much higher antioxidative activity and scavenging activity against active oxygenspecies. Royal jelly will act as a medicinal food in the human body.

Rapid Changes in Serum Lipid Profiles during Combination Therapy with Daclatasvir and Asunaprevir in Patients Infected with Hepatitis C Virus Genotype 1b

Takeshi Chida,Kazuhito Kawata,Kazuyoshi Ohta,Erika Matsunaga,Jun Ito,Shin Shimoyama,Satoru Yamazaki,Hidenao Noritake,Tetsuro Suzuki,Takafumi Suda,Yoshimasa Kobayashi 거트앤리버 소화기연관학회협의회 2018 Gut and Liver Vol.12 No.2

Background/Aims: Changes in lipid profiles in patients infected with hepatitis C virus (HCV) during direct-acting antiviral therapy have been reported in recent years. However, the clinical aspects of disturbed lipid metabolism in chronic HCV infection have not been fully elucidated. Methods: Dynamic changes in serum total, low-density lipoprotein (LDL), and high-density lipoprotein (HDL) cholesterol and apolipoprotein levels in patients infected with HCV genotype 1b were examined during combination therapy with daclatasvir (DCV) and asunaprevir (ASV). Results: Total, LDL-, and HDL-cholesterol levels increased rapidly and persistently after week 4. Apolipoprotein (apo) A-I, apo B, apo C-II, and apo C-III levels were significantly higher at week 4 than at week 0. In contrast, apo A-II and apo E levels were significantly lower. The differences in LDL- and HDL-cholesterol levels were positively correlated with those of apo B and apo A-I, respectively. Interestingly, in patients with non-sustained virological response, these cholesterol levels decreased rapidly after viral breakthrough or viral relapse. Furthermore, similar changes were observed for apo A-I, apo B and apo C-III levels. Conclusions: Clearance of HCV using combination therapy with DCV and ASV results in rapid changes in serum lipid profiles, suggesting an influence of HCV infection on disturbed lipid metabolism.

Indocyanine green fluorescence videoangiography for reliable variations of supraclavicular artery flaps

Suzuki, Yushi,Shimizu, Yusuke,Kasai, Shogo,Yamazaki, Shun,Takemaru, Masashi,Kitamura, Takuya,Kawakami, Saori,Tamura, Takeshi Korean Society of Plastic and Reconstructive Surge 2019 Archives of Plastic Surgery Vol.46 No.4

Background Pedicled flaps are useful for reconstructive surgery. Previously, we often used vascularized supraclavicular flaps, especially for head and neck reconstruction, but then shifted to using thoracic branch of the supraclavicular artery (TBSA) flaps. However, limited research exists on the anatomy of TBSA flaps and on the use of indocyanine green (ICG) fluorescence videoangiography for supraclavicular artery flaps. We utilized ICG fluorescence videoangiography to harvest reliable flaps in reconstructive operations, and describe the results herein. Methods Data were retrospectively reviewed from six patients (five men and one woman: average age, 54 years; range, 48-60 years) for whom ICG videoangiography was performed to observe the skin perfusion of a supraclavicular flap after it was raised. Areas where the flap showed good enhancement were considered to be favorable for flap survival. The observation of ICG dye indicated good skin perfusion, which is predictive of flap survival; therefore, we trimmed any areas without dye filling and used the remaining viable part of the flap. Results The flaps ranged in size from $13{\times}5.5cm$ to $17{\times}6.5cm$. One patient received a conventional supraclavicular flap, four patients received a TBSA flap, and one patient received a flap that was considered to be intermediate between a supraclavicular flap and a TBSA flap. The flaps completely survived in all cases, and no flap necrosis was observed. Conclusions The TBSA flap is very useful in reconstructive surgery, and reliable flaps could be obtained by using ICG fluorescence videoangiography intraoperatively.

CROSS-BORDER GATEKEEPER OF FOREIGN CREATIVE INDUSTRY PRODUCTS : THE CASE OF MANGA (JAPANESE COMICS) AND SUSHI IN FRENCH MARKET

Takeshi Matsui,Satoko Suzuki,Yuichi Washida 글로벌지식마케팅경영학회 2014 Global Marketing Conference Vol.2014 No.1

Correlation among Inflammatory Cytokine Expression Levels, Degree of Disk Degeneration, and Predominant Clinical Symptoms in Patients with Degenerated Intervertebral Discs

Takeshi Sainoh,Kazuhide Inage,Sumihisa Orita,Masao Koda,Takeo Furuya,Kazuyo Yamauchi,Miyako Suzuki,Yoshihiro Sakuma,Go Kubota,Yasuhiro Oikawa,Jun Sato,Kazuki Fujimoto,Yasuhiro Shiga,Koki Abe,Hirohito 대한척추외과학회 2017 Asian Spine Journal Vol.11 No.3

Study Design: Observational study. Purpose: To assess the correlation among inflammatory cytokine expression levels, degree of intervertebral disk (IVD) degeneration, and predominant clinical symptoms observed in degenerative disk disease (DDD). Overview of Literature: Low back pain (LBP) is associated with inflammatory cytokine expression levels, including those of tumor necrosis factor-alpha (TNF-α), interleukin 6 (IL-6), and nerve growth factor (NGF). However, the association between cytokine expression levels and the physiological mechanisms of disk degeneration and clinical pain remain controversial. Methods: Using the enzyme-linked immunosorbent assay, TNF-α, IL-6, and NGF expression levels were analyzed in 58 IVD samples that were harvested from patients with lumbar DDD. Patient samples were grouped according to the degree of IVD degeneration using the Pfirrmann grading system and magnetic resonance imaging, and the correlations between the disease groups and each cytokine expression level were assessed. In addition, on the basis of their predominant preoperative symptoms, the patients were assigned to either an LBP or leg pain group to determine the correlation among these disease manifestations and individual cytokine expression levels. Results: A gradual increase in TNF-α (R=0.391) and IL-6 (R=0.388) expression levels correlated with the degree of IVD degeneration, whereas NGF (R=0.164) expression levels exhibited a minimal decrease with disease progression. Regarding the predominant clinical manifestation, only the LBP group exhibited a significant increase in TNF-α expression levels (p =0.002). Conclusions: These results suggested that TNF-α and IL-6 play an important role in the pathophysiology of IVD degeneration at any stage, whereas NGF plays an important role during the early disease stages. Moreover, because TNF-α expression levels were significantly high in the LBP group, we propose that they are involved in LBP onset or progression.

Colonic dysmotility and morphological abnormality frequently detected in Japanese patients with irritable bowel syndrome

( Takeshi Mizukami ),( Shinya Sugimoto ),( Tatsuhiro Masaoka ),( Hidekazu Suzuki ),( Takanori Kanai ) 대한장연구학회 2017 Intestinal Research Vol.15 No.2

Background/Aims: Colonoscopy and computed tomography (CT) are used primarily to exclude organic diseases in patients with irritable bowel syndrome (IBS), rather than to assess the pathophysiology of IBS. We aimed to evaluate colonic dysmotility and morphology in Japanese patients with IBS. Methods: One hundred eighty-four patients with IBS and 49 asymptomatic controls who underwent colonoscopy in combination with CT colonography or barium enema were retrospectively reviewed between 2008 and 2012. Water-aided colonoscopy was performed without sedation by a single endoscopist. The duration and pattern of colonic movement and cecal intubation time were recorded. To assess colonic morphology, barium enema or CT colonography were performed immediately after colonoscopy. Results: Colonic dysmotility was more frequent in the IBS group (28.8% vs. 2.0% in controls, P <0.001), especially in cases of IBS with diarrhea (IBS-D) (IBS with constipation [IBS-C] 28.8% vs. IBS-D 60.0% vs. mixed IBS [IBS-M] 5.1%, P <0.001). Colonic morphological abnormality was more frequent in the IBS group than in the control group (77.7% vs. 24.5%, P <0.001), especially in IBS-M and IBS-C groups (IBS-C 77.5% vs. IBS-D 48.9% vs. IBS-M 100%, P <0.001). Most patients with IBS with colonic dysmotility had experienced stress related to their symptoms. Cecal intubation time was significantly longer in the IBS group than in the control group (12.1±6.9 minutes vs. 4.6±1.9 minutes, P <0.001). Conclusions: Unsedated colonoscopy, combined with radiographic findings, can detect colonic dysmotility and morphological abnormality. Technical difficulties observed during cecal intubation may partially explain the pathophysiology of IBS. (Intest Res 2017;15:236-243)