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Retrocaval liver lifting maneuver and modifications of total hepatic vascular exclusion for liver tumor resection

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World Journal of Hepatology 2016年第8期8卷 411-420页

作者： Saiho Ko Yuuki Kirihatayfa Yayoi Matsumoto Tadataka Takagi Masanori Matsusaka Tomohide Mukogawa Hirofumi Ishikawa akihiko Watanabe Department of Surgery Nara Prefecture General Medical Center

AIM: To evaluate the efficacy of technical modifications of total hepatic vascular exclusion(THVE) for hepatectomy involving inferior vena cava(IVC).METHODS: Of 301 patients who underwent hepatectomy during the immediate previous 5-year period, 8(2.7%) required THVE or modified methods of IVC cross-clamping for resection of liver tumors with massive involvement of the IVC. Seven of the patients had diagnosis of colorectal liver metastases and 1 had diagnosis of hepatocellular carcinoma. All tumors involved the IVC, and THVE was unavoidable for combined resection of the IVC in all 8 of the patients. Technical modifications of THVE were applied to minimize the extent and duration of vascular occlusion, thereby reducing the risk of ***: Broad dissection of the space behind the IVC coupled with lifting up of the liver from the retrocaval space was effective for controlling bleeding around the IVC before and during THVE. The procedures facilitate modification of the positioning of the cranial IVC cross-clamp. Switching the cranial IVC cross-clamp from supra- to retrohepatic IVC or to the confluence of hepatic vein decreased duration of the THVE while restoring hepatic blood flow or systemic circulation via the IVC. Oblique cranial IVC cross-clamping avoided ischemia of the remnant hemi-liver. With these technicalmodifications, the mean duration of THVE was 13.4 ± 8.4 min, which was extremely shorter than that previously reported in the literature. Recovery of liver function was smooth and uneventful for all 8 patients. There was no case of mortality, re-operation, or severe complication(i.e., Clavien-Dindo grade of Ⅲ or more).CONCLUSION: The retrocaval liver lifting maneuver and modifications of cranial cross-clamping were useful for minimizing duration of THVE.

关键词： Total hepatic vascular exclusion Retrocaval liver lifting maneuver Oblique clamping Switching the clamp Hepatectomy

Preoperative detection and localization of small bowel hemangioma: Two case reports

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World Journal of Gastroenterology 2017年第20期23卷 3752-3757页

作者： Nobuhisa Takase Keisuke Fukui Takafumi Tani Tohru Nishimura Tomohiro Tanaka Naoki Harada Kimihiko Ueno Manabu Takamatsu akihiko Nishizawa Akiharu Okamura Kunihiko Kaneda Department of Surgery Kakogawa Central City Hospital Department of Internal Medicine Kakogawa Central City Hospital Department of Diagnostic Pathology Kakogawa Central City Hospital

Among the various diagnostic modalities for small bowel hemangioma, video capsule endoscopy (VCE) and double-balloon enteroscopy (DBE) can be recommended as part of the work-up in patients with obscure gastrointestinal bleeding (OGIB). DBE is superior to VCE in the accuracy of diagnosis and therapeutic potential, while in most cases total enteroscopy cannot be achieved through only the antegrade or retrograde DBE procedures. As treatment for small bowel bleeding, especially spout bleeding, localization of the lesion for the decision of DBE insertion facilitates early treatment, such as endoscopic hemostatic clipping, allowing patients to avoid useless transfusion and the worsening of their disease into life-threatening status. Applying endoscopic India ink marking prior to laparoscopic surgical resection is a particularly useful technique for more minimally invasive treatment. We report two cases of small bowel hemangioma found in examinations for OGIB that were treated with combination of laparoscopic and endoscopic modalities.

关键词： Laparoscopic surgery India ink marking Small bowel hemangioma Obscure gastrointestinal bleeding Minimally invasive

Relationship between ghrelin, Helicobacter pylori and gastric mucosal atrophy in hemodialysis patients

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World Journal of Gastroenterology 2016年第47期22卷 10440-10449页

作者： Hitomi Ichikawa Mitsushige Sugimoto Yukitoshi Sakao Shu Sahara Naro Ohashi akihiko Kato Ken Sugimoto Takahisa Furuta Akira Andoh Tadashi Sakao Hideo Yasuda First Department of Medicine Hamamatsu University School of Medicine Hamamastsu Shizuoka 431-3192 Japan Division of Digestive Endoscopy Shiga University of Medical Science Hospital Otsu Shiga 520-2192 Japan Hamana Clinic Hamana Clinic Hamamatsu Shizuoka 434-0037 Japan Blood Purification Unit Hamamatsu University School of Medicine Hamamastsu Shizuoka 431-3192 Japan Center for Clinical Research Hamamatsu University School of Medicine Hamamastsu Shizuoka 431-3192 Japan Department of Gastroenterology Shiga University of Medical Science HospitalOtsu Shiga 520-2192 Japan

AIM To investigate the relationship between plasma ghrelin level, Helicobacter pylori(H. pylori) infection status and the severity of atrophy in hemodialysis *** One hundred eights patients who received hemodialysis and 13 non-hemodialysis H. pylori-negative controlsunderwent gastroduodenoscopy to evaluate the severity of gastric atrophy. Serum levels of pepsinogen(PG) were measured as serum markers of gastric atrophy. H. pylori infection was evaluated by anti-H. pylori IgG antibody, rapid urease test and culture test. We classified H. pylori infection status as non-infection, present infection and past infection. In addition, plasma acyl-ghrelin and desacyl-ghrelin levels were measured by enzyme-linked immunosorbent assay. RESULTS Infection rate of H. pylori was 45.4%(49/108). Acylghrelin level in the non-infection group(39.4 ± 23.0 fmol/ml) was significantly higher than in the past(23.4 ± 19.9 fmol/ml, P = 0.005) and present infection groups(19.5 ± 14.0 fmol/ml, P < 0.001). Furthermore, desacyl-ghrelin level in the non-infection group(353.2 ± 190.2 fmol/ml) was significantly higher than those in the past(234.9 ± 137.5 fmol/ml, P = 0.008) and present infection groups(211.8 ± 124.2 fmol/ml, P < 0.001). Acyl-ghrelin was positively correlated with the PG Ⅰ level and PG Ⅰ/Ⅱ ratio(|R| = 0.484, P < 0.001 and |R| = 0.403, P < 0.001, respectively). Both ghrelins were significantly decreased in accordance with the progress of endoscopic atrophy(both P < 0.001) and acyl-ghrelin was significantly lower in patients with mild, moderate and severe atrophy(24.5 ± 23.1 fmol/ml, 20.2 ± 14.9 fmol/ml and 18.3 ± 11.8 fmol/ml) than in those with non-atrophy(39.4 ± 22.2 fmol/ml, P = 0.039, P = 0.002 and P < 0.001, respectively).CONCLUSION In hemodialysis patients, plasma ghrelin level was associated with the endoscopic and serological severity of atrophy related to H. pylori infection.

关键词： Acyl-ghrelin Desacyl-ghrelin Helicobacter pylori Hemodialysis Pepsinogen

A single nucleotide polymorphism in SPA TA17 may be a genetic risk factor for Japanese patients with meiotic arrest

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Asian Journal of Andrology 2009年第5期11卷 623-628,I0004,I0005页

作者： Toshinobu Miyamoto[日本] Akira Tsujimura[日本] Yasushi Miyagawa[日本] Eitetsu Koh[日本] Naoko Sakugawa[日本] Hiroe Miyakawa[日本] Hisashi Sato[日本] Mikio Namiki[日本] akihiko Okuyama[日本] Kazuo Sengoku[日本] Department of Obstetrics and Gynecology Asahikawa Medical College Asahikawa Hokkaido 078-851 O Japan＂ Department of Urology Graduate School of Medicine Osaka University Suita 565-0871 Japan＂ Department of Integrated Cancer Therapy and Urology Kanazawa University Graduate School of Medical Science Kanazawa920-8641 Japan

Genetic mechanisms have been implicated as a cause of some cases of male infertility. Recently, 10 novel genes involved in human spermatogenesis were identified by microarray analysis of human testicular tissue. One of these is spermatogenesis-associated 17 （SPATA17）. To investigate whether defects in the SPATA17 gene are associated with azoospermia due to meiotic arrest, a mutational analysis was conducted, in which the SPATA17 coding regions of 18 Japanese patients with this condition were sequenced. A statistical analysis was carried out that included 18 patients with meiotic arrest, 20 patients with Sertoli-cell-only syndrome （SCOS） and 96 healthy control men. No mutations were found in SPA TA17. However, three coding single nucleotide polymorphisms （cSNPs： SNP 1-SNP3） were detected in the patients with meiotic arrest. No significant differences in the genotype or allele frequencies of SNP1 and SNP2 were found between patients with meiotic arrest and the others. However, the frequency of the SNP3 allele was significantly elevated in the meiotic arrest group （P 〈 0.05）. This study suggests that SPATA17 may play a critical role in human spermatogenesis, especially in meiosis.

关键词： azoospermia meiosis polymorphism SNP SPATA17

Bacteremia or pseudobacteremia?Review of pseudomonas fluorescens infections

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World Journal of Emergency Medicine 2017年第2期8卷 151-154页

作者： Takeshi Nishimura Kenji Hattori akihiko Inoue Taiji Ishii Tctsuya Yumoto Kohei Tsukahara Astunori Nakao Satoshi Ishihara Shinichi Nakayama Hyogo Emergency Medical Center 1-3-1 Wakinohamakaigando-riChuo-kuKobeHyogo 651-0073Japan Department of Emergency and Critical Care Medicine Okayama University Graduate School of MedicineDentistry and Pharmaceutical Sciences2-5-1 ShikatachoKitakuOkayama CityOkayama700-8558Japan

INTRODUCTION *** is an aerobic,Gram-negative bacillus related to Pseudomonas *** other species of Pseudomonas,the organism is widespread in nature and is found in water,moist soil,and *** to its low virulence,*** is an infrequent cause of infections except for catheter-related bloodstream infections in cancer *** August 1,2003 to May 31,2016,Hyogo Emergency Medical Center and the Kobe Red Cross Hospital treated three cases of bloodstream infection

关键词： Bacteremia pseudobacteremia pseudomonas fluorescens infections

Metabolism for cyclosporin A during liver regeneration after partial hepatectomy in rats

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World Journal of Gastroenterology 2008年第41期14卷 6355-6359页

作者： Shigeki Nagayoshi Yujo Kawashita Susumu Eguchi Yukio Kamohara Mitsuhisa Takatsuki Shungo Miyamoto Satoshi Mochizuki akihiko Soyama Hirotaka Tokai Masaaki Hidaka Yoshitsugu Tajima Takashi Kanematsu Department of Transplantation and Digestive Surgery Graduate School of Biomedical Sciences Nagasaki University School of Medicine

AIM： To elucidate the metabolism and the effect of the cyclosporin A （CyA） as a representative immuno- suppressive drug used in transplantation in a partially hepatectomized rat model. METHODS： CyA was administered to rats that underwent a 70% hepatectomy. These rats were randomly assigned into three groups according to the dose of CyA administration as follows; （group I） water, （group 2） 5 mg/kg CyA, （group 3） 10 mg/kg CyA. On postoperative days-1, 3, 7 and 14, the rats were killed to analyze the serum concentration of CyA, the liver regeneration ratio, biochemical or histological markers, and mRNA expression using reverse transcriptase-poly- merase chain reaction method to determine albumin and cytochrome p450 expression. RESULTS： The serum concentration of CyA in group 3 was significantly higher than group 2 during liver regeneration. CyA enhanced the liver regeneration in a dose dependent manner. The mRNA expression associated with CyA metabolism was significantly decreased on day 14, while preserving the albumin producing activity. CONCLUSION： These data indicate that the p-450 activity required to metabolize the CyA may be reduced during regeneration of the remnant liver after a hepatectomy, which may, therefore, be linked to difficulty in controlling the optimal dose of CyA during early period of LDLT.

关键词： Cyclosporin A Liver regeneration Partial hepatectomy Rat

Movement of Dislocations in the Sub-Surface of a Polycrystalline Metal by Cavitation Peening Observed by Transmission Electron Microscopy

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Materials Sciences and Applications 2015年第2期6卷 140-144页

作者： Osamu Takakuwa akihiko Chiba Hitoshi Soyama Department of Nanomechanics Graduate School of Engineering Tohoku University Sendai Japan Institute for Materials Research Tohoku University Sendai Japan

The impact produced when cavitation bubbles collapse can be utilized to modify surfaces in the same way as shot peening and it is called cavitation peening (CP). CP is one of a number of surface modification techniques used to improve the fatigue strength of metallic materials by introducing compressive residual stress. Although it has been shown by an X-ray diffraction method that CP decreases the micro-strain related to dislocations in the sub-surface of a polycrystalline material, the mechanism for this decrease is unclear. In this paper, the movement of dislocations by CP was observed using transmission electron microscopy (TEM).

关键词： Microstructure Transmission Electron Microscopy Dislocation Surface Modification Cavitation

Using GIS-Based Weighted Linear Combination Analysis and Remote Sensing Techniques to Select Optimum Solid Waste Disposal Sites within Mafraq City, Jordan

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Journal of Geographic Information System 2011年第4期3卷 267-278页

作者： Ahmad Al-Hanbali Bayan Alsaaideh akihiko Kondoh 不详

Landfill siting was determined within Mafraq City, Jordan, through the integration of geographic information system (GIS), weighted linear combination (WLC) analysis, and remote sensing techniques. Several parameters were collected from various sources in vector and raster GIS formats, and then, used within the GIS-based WLC analysis to select optimum solid waste disposal sites. Namely, urban areas, agricultural lands, access roads, surface aquifers, groundwater table, fault system, water wells, streams, and land slope were considered in this research. Also, the trend of urban expansion within the study area was monitored using the Landsat data of 1989, 1999, and 2009 to support the selection process of disposal sites. It is found that about 84% of the study area was within “most suitable” to “moderately suitable” classes for landfill sites, while the rest of the study area was within “poorly suitable” and “unsuitable” classes. Based on the analysis of Landsat satellite data the urban area was expanded of more than 240% during the last three decades, mainly toward south, and southwest, except the villages near the existing disposal site, where the trend was toward east and northeast. Finally, three sites were suggested as alternatives to the existing disposal site taking into the consideration the environmental, biophysical, and economical variables applied in the GIS-based WLC analysis.

关键词： Solid Waste Weighted Linear Combination GIS Remote Sensing Jordan

Carcinogenesis and chemoprevention of biliary tract cancer in pancreaticobiliary maljunction

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World Journal of Gastrointestinal Oncology 2010年第3期2卷 130-135页

作者： akihiko Tsuchida Takao Itoi the third Department of Surgery Tokyo Medical University the fourth Department of Internal Medicine Tokyo Medical University

Pancreaticobiliary maljunction (PBM) is a high risk factor for biliary tract cancer. In PBM, since the pancreatic duct and bile duct converge outside the duodenal wall beyond the influence of the sphincter of Oddi, pancreatic juice and bile are constantly mixed, producing a variety of harmful substances. Because of this, the biliary mucosa is repeatedly damaged and repaired, which causes an acceleration of cell proliferative activity and multiple gene mutations. Histological changes such as hyperplasia, metaplasia, and dysplasia ultimately result in a high incidence of carcinogenesis. In a nationwide survey by the Japanese Study Group on PBM, coexisting biliary tract cancer was detected in 278 of the 1627 registered cases of PBM (17.1%). Of these cases, in those with dilatation of the extrahepatic bile duct, cancer was often detected not only in the gallbladder but also in the bile ducts. More than 90% of cancer cases without dilatation of the extrahepatic bile duct develop in the gallbladder. Standard treatment for PBM is a cholecystectomy and resection of the extrahepatic bile duct. However, cholecystectomy alone is performed at nearly half of institutions in Japan. Conversely, reports of carcinogenesis in the remnant bile duct or pancreas after diversion surgery are steadily increasing. One of the causes for this is believed to be an accumulation of gene mutations which were present before surgery. Anticancer drugs are ineffective in preventing such carcinogenesis following surgery, thus the postoperative administration of chemopreventive agents may be necessary.

关键词： Chemoprevention Gallbladder cancer Bile duct cancer Carcinogenesis Pancreaticobiliary maljunction