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World Journal of Gastroenterology 2011年第44期17卷 4890-4898页

作者： Tsutomu Tamai Hirofumi Uto Yoichiro Takami Kouhei Oda Akiko Saishoji Masashi Hashiguchi Kotaro Kumagai Takeshi Kure Seiichi Mawatari Akihiro moriuchi Makoto Oketani Akio Ido hirohito Tsubouchi Department of Digestive and Lifestyle Related Diseases Human and Environmental SciencesHealth ResearchKagoshima University Graduate School of Medical and Dental Sciences

AIM:To evaluate the clinical significance of oxidative stress markers in patients with hepatitis C virus(HCV)related hepatocellular carcinoma(HCC).METHODS:Sixty-four consecutive patients who were admitted to Kagoshima University Medical and Dental Hospital were enrolled in this retrospective *** patients had chronic liver disease(CLD) due to infection with *** patients with HCV-related HCC,34 with HCV-related CLD without HCC(non-HCC),and 20 healthy volunteers(HVs) were *** associations between serum manganese superoxide dismutase(MnSOD) and thioredoxin(TRX) levels and clinical parameters or patient prognosis were analyzed over a mean follow-up period of 31.7 ***:The serum MnSOD levels were significantly higher in patients with HCV-related HCC than in patients without HCC(P = 0.03) or HVs(P < 0.001).Similarly,serum TRX levels were also significantly higher in patients with HCV-related HCC than in patients without HCC(P = 0.04) or HVs(P < 0.01).However,serum levels of MnSOD and TRX were not correlated in patients with *** patients with HCC,the overall survival rate(OSR) was lower in patients with MnSOD levels ≥ 110 ng/mL than in patients with levels < 110 ng/mL(P = 0.01),and the OSR tended to be lower in patients with TRX levels < 80 ng/mL(P = 0.05).In addition,patient prognosis with HCC was poorest with serum MnSOD levels ≥ 110 ng/mL and serum TRX levels < 80 ng/***,a multivariate analysis using a Cox proportional hazard model and serum levels of five factors(MnSOD,prothrombin time,serum albumin,serum α-fetoprotein(AFP),and serum des-γ-carboxy prothrombin) revealed that MnSOD levels ≥ 110 ng/mL(risk ratio:4.12,95% confidential interval:1.22-13.88,P = 0.02) and AFP levels ≥ 40 ng/mL(risk ratio:6.75;95% confidential interval:1.70-26.85,P < 0.01) were independent risk factors associated with a poor patient ***:Serum MnSOD and TRX levels are potential clinical biomarkers that predict patient prognosis in

关键词：锰超氧化物歧化酶血清白蛋白丙型肝炎病毒硫氧还蛋白肝癌预后凝血酶原时间 MnSOD

Inverse Estimation on Trigger Factors of Simultaneous Slope Failures with Purification of Training Data Sets

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Journal of Earth Science and Engineering 2013年第9期3卷 594-602页

作者： hirohito Kojima Ryo Sekine Tomoya Yoshida Ryo Nozaki Department of Civil Engineering Faculty of Science & Technology Tokyo University of Science Chiba 278-8510 Japan Bureau of Waterworks Tokyo Metropolitan Government Tokyo 163-8001 Japan

This paper presents an procedure for purifying training data sets (i. e., past occurrences of slope failures) for inverse estimation on unobserved trigger factors of "different types of simultaneous slope failures". Due to difficulties in pixel-by-pixel observations of trigger factors, as one of the measures, the authors had proposed an inverse analysis algorithm on trigger factors based on SEM (structural equation modeling). Through a measurement equation, the trigger factor is inversely estimated, and a TFI (trigger factor influence) map can be also produced. As a subsequence subject, a purification procedure of training data set should be constructed to improve the accuracy of TFI map which depends on the representativeness of given training data sets of different types of slope failures. The proposed procedure resamples the matched pixels between original groups of past slope failures (i. e., surface slope failures, deep-seated slope failures, landslides) and classified three groups by K-means clustering for all pixels corresponding to those slope failures. For all cases of three types of slope failures, the improvement of success rates with respect to resampled training data sets was confirmed. As a final outcome, the differences between TFI maps produced by using original and resampled training data sets, respectively, are delineated on a DIF map (difference map) which is useful for analyzing trigger factor influence in terms of "risky- and safe-side assessment" sub-areas with respect to "different types of simultaneous slope failures".

关键词：触发因素数据集逆估计训练故障斜率同步净化

Treatment with dimethyl fumarate ameliorates liver ischemia/reperfusion injury

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World Journal of Gastroenterology 2017年第25期23卷 4508-4516页

作者： Chie Takasu Nosratola D Vaziri Shiri Li Lourdes Robles Kelly Vo Mizuki Takasu Christine Pham Seyed H Farzaneh Mitsuo Shimada Michael J Stamos hirohito Ichii Department of Surgery Medicine University of California Departments of Surgery Institute of Health Biosciences the University of Tokushima

AIM To investigate the hypothesis that treatment with dimethyl fumarate(D MF) mayame liorate liver ischemia/reperfusion injury(I/RI).METHODS Rats were divided into 3 groups: sham, control(CTL), and DMF. DMF(25 mg/kg, twice/d) was orally administered for 2 d before the procedure. The CTL and DMF rats were subjected to ischemia for 1 h and reperfusion for 2 h. The serum alanine aminotransferase(ALT) and malondialdehyde(MDA) levels, adenosine triphosphate(ATP), NO × metabolites, anti-oxidant enzyme expression level, antiinflammatory effect, and anti-apoptotic effect were *** Histological tissue damage was significantly reduced in the DMF group(Suzuki scores: sham: 0 ± 0; CTL: 9.3± 0.5; DMF: 2.5 ± 1.2; sham vs CTL, P < 0.0001; CTL vs DMF, P < 0.0001). This effect was associated with significantly lower serum ALT(DMF 5026 ± 2305 U/L vs CTL 10592 ± 1152 U/L, P = 0.04) and MDA(DMF 18.2 ± 1.4 μmol/L vs CTL 26.0 ± 1.0 μmol/L, P = 0.0009). DMF effectively improved the ATP content(DMF 20.3 ± 0.4 nmol/mg vs CTL 18.3 ± 0.6 nmol/mg, P = 0.02), myeloperoxidase activity(DMF 7.8 ± 0.4 m U/m L vs CTL 6.0 ± 0.5 m U/m L, P = 0.01) and level of endothelial nitric oxide synthase expression(DMF 0.38 ± 0.05-fold vs 0.17 ± 0.06-fold, P = 0.02). The higher expression levels of anti-oxidant enzymes(catalase and glutamatecysteine ligase modifier subunit and lower levels of key inflammatory mediators(nuclear factor-kappa B and cyclooxygenase-2 were confirmed in the DMF *** DMF improved the liver function and the anti-oxidant and inflammation status following I/RI. Treatment with DMF could be a promising strategy in patients with liver I/RI.

关键词：发炎反应氧化应力 Nrf2 局部缺血 Dimethyl fumarate 肝

Investigation of Antibiotic Use at a Dental Teaching Hospital in Yogyakarta, Indonesia: A Review from Guidelines

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Pharmacology & Pharmacy 2014年第5期5卷 524-531页

作者： Mayu Winnie Rachmawati Naoko Yoshida hirohito Tsuboi Kazuko Kimura Department of Drug Management and Policy Graduate School of Natural Science and Technology Kanazawa University Kanazawa Japan

Objective: To investigate prescription of antibiotics by dental practitioners at a dental teaching hospital in Yogyakarta, Indonesia, and to establish whether it conforms to major guidelines. Methods: A cross-sectional study of adult outpatients’ medical records was conducted in order to scrutinize antibiotic prescriptions. The results were compared with recommendations in four published guidelines. Results: Dental practitioners prescribed a wide range of antibiotics to treat 121 diagnoses. Amoxicillin (78.8%) was most commonly prescribed, followed by clindamycin (9.9%), metronidazole (5.0%), and lincomycin (2.1%). Among all prescriptions, 79.5% were for generic antibiotics. The most common diagnoses were dental pulp gangrene followed by dental pulp necrosis (26.7% and 8.8%, respectively). According to guidelines-1 through-4, the percentages of antibiotic prescriptions that were evaluated as appropriate for the reported diagnosis were 15.1%, 7.2%, 7.5%, and 16.3%, respectively. However, 9.9%, 84.0%, 83.7% and 67.8% of prescriptions could not be classified as appropriate or inappropriate because the respective guidelines neither listed the antibiotic nor gave statement regarding appropriate indications. Conclusion: Our results suggest that significant inappropriate antibiotic prescribing occurred at a dental teaching hospital in Yogyakarta, Indonesia, according to major antibiotics guidelines. However, the four guidelines failed to list some antibiotics, failed to list indications for prescription in some cases, and were inconsistent in their recommendations. There is a need to introduce specific institutional guidelines. Our findings should be helpful for developing public health policy guidelines to minimize inappropriate antibiotic prescribing at dental hospitals.

关键词： Appropriateness Antibiotics Prescriptions Dental Teaching Hospital Guidelines

Maintenance of High Blood Pressure and Early Establishment of Pulsatile Blood Flow to the Spinal Cord during Thoracoabdominal Aortic Repair

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World Journal of Cardiovascular Surgery 2018年第10期8卷 175-188页

作者： Koji Furukawa Eisaku Nakamura Masanori Nishimura hirohito Ishii Kunihide Nakamura Department of Cardiovascular Surgery Faculty of Medicine University of Miyazaki Miyazaki Japan Department of Cardiovascular Surgery Miyazaki Medical Association Hospital Miyazaki Japan

Objectives: Despite continuous advancements in the surgical treatments for thoracoabdominal aortic aneurysms (TAAA), paraplegia remains a devastating treatment-related complication. We aimed to summarize our experience with a novel surgical strategy involving maintenance of high blood pressure and early establishment of pulsatile blood flow to the spinal cord. Materials and Methods: Between August 2011 and October 2017, 29 patients (age, 67 ± 12 years) underwent open surgery for TAAA. According to the Crawford classification, two aneurysms were type I, eight were type II, 12 were type III, and seven were type IV. We used partial cardiopulmonary bypass under mild hypothermia in all patients except one. By maintaining distal aortic perfusion pressure at 60 - 80 mmHg and creating the distal aortic anastomosis before visceral branch reconstruction, we established early perfusion of the hypogastric arteries with native pulsatile flow. Intraoperative spinal monitoring and cerebrospinal fluid drainage were performed in 26 (90%) and 23 (79%) patients, respectively. Nineteen patients (66%) underwent reconstruction of the intercostal arteries. During perioperative management, the mean arterial pressure was kept >80 mmHg. Results: No in-hospital deaths or acute neurological complications occurred. One patient (3.4%) experienced delayed temporal paraplegia. During follow-up, aorta-related death occurred in only one patient, who developed prosthetic vascular graft infection but did not undergo repeat graft replacement. The 3-year freedom from aortic-related death was 95%. Conclusion: Our surgical strategy involving maintenance of high blood pressure and early establishment of pulsatile flow to the spinal cord was effective in preventing spinal cord injury following open surgery for TAAA.

关键词： Thoracoabdominal Aortic Aneurysm Open Surgery High-Blood-Pressure Maintenance Pulsatile Flow

Feasibility of gastric endoscopic submucosal dissection in elderly patients aged≥80 years

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World Journal of Gastrointestinal Endoscopy 2022年第1期14卷 49-62页

作者： Yasuhiro Inokuchi Ayaka Ishida Kei Hayashi Yoshihiro Kaneta Hayato Watanabe Kazuki Kano Mitsuhiro Furuta Kosuke Takahashi hirohito Fujikawa Takanobu Yamada Kouji Yamamoto Nozomu Machida Takashi Ogata Takashi Oshima Shin Maeda Department of Gastroenterology Kanagawa Cancer CenterYokohama 241-8515KanagawaJapan Department of Gastrointestinal Surgery Kanagawa Cancer CenterYokohama 241-8515KanagawaJapan Department of Biostatics Yokohama City University School of Medicine.Yokohama 236-0004KanagawaJapan Department of Gastroenterology Yokohama City UniversityYokohama 236-0004KanagawaJapan

BACKGROUND Endoscopic resection,especially endoscopic submucosal dissection(ESD),is increasingly performed in elderly patients with early gastric cancer,and lesions beyond the expanded indications are also resected endoscopically in some *** is essential to assess whether gastric ESD is safe and suitable for elderly patients and investigate what type of lesions carry an increased risk of ESD-related *** To assess the efficacy and feasibility of gastric ESD for elderly patients,and define high-risk lesions and prognostic *** Among a total of 1169 sessions of gastric ESD performed in Kanagawa Cancer Center Hospital from 2006 to 2014,179 sessions(15.3%)were performed in patients aged≥80 years,and 172 of these sessions were done in patients with a final diagnosis of gastric *** patients were studied retrospectively to evaluate short-term outcomes and *** short-term outcomes included the rates of en bloc resection and curative resection,complications,and procedurerelated *** was assessed according to the Japanese Gastric Cancer Treatment Guidelines ***’s exact test was used to statistically analyze risk *** characteristics of each group were compared using Fisher’s exact test and Mann-Whitney U *** rates at each time point were based on Kaplan-Meier *** survival rates were compared between patients with gastric cancer in each group with use of the log-rank *** identify prognostic factors that jointly predict the hazard of death while controlling for model overfitting,we used the least absolute shrinkage and selection operator(LASSO)Cox regression model including factors curative/noncurative,age,gender,body mass index,prognostic nutritional index,Charlson comorbidity index(CCI),Glasgow prognostic score,neutrophil-to-lymphocyte ratio,and antithrombotic agent *** selected the LASSO Cox regression model that resulted in minimal prediction error in 10-f

关键词： Endoscopic submucosal dissection Elderly Charlson comorbidity index Early gastric cancer Complications Prognostic indicators

A Case of Acute Renal Failure Associated with IgG4-Related Disease Presenting Both Tubulointerstitial Nephritis and Retroperitoneal Fibrosis

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Open Journal of Nephrology 2016年第3期6卷 86-92页

作者： hirohito Sugawara Hideki Takizawa Norihito Moniwa Naoki Takamatsu Yusuke Ohashi Yayoi Ogawa Department of Nephrology Teine-Keijinkai Hospital Sapporo Japan Department of General Internal Medicine Teine-Keijinkai Hospital Sapporo Japan Hokkaido Renal Pathology Center Sapporo Japan

We report a case of IgG4-related disease presenting both tubulointerstitial nephritis and retroperitoneal fibrosis causing acute renal failure in a 63-year-old male. He was admitted to our hospital because of acute renal failure requiring emergent hemodialysis. Computed tomography showed a soft-tissue density mass with an irregular border in the retroperitoneum. The mass involved bilateral ureters and had caused acute renal failure by bilateral hydronephrosis. Because of a history of uveitis and high IgG4 levels, we considered a diagnosis of retroperitoneal fibrosis, IgG4-related disease. Kidney biopsy revealed IgG4-related kidney disease with interstitial nephritis. After relief of urinary obstruction by inserting ureteral catheters into the bilateral ureters, renal function recovered.

关键词： IgG4 Related Disease IgG4 Related Tubulointerstitial Nephritis Retroperitoneal Fibrosis Acute Renal Failure

Surgical strategy in case with co-existence of malignant oligodendroglioma and arteriovenous malformation: A case report

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Case Reports in Clinical Medicine 2013年第8期2卷 473-478页

作者： hirohito Yano Noriyuki Nakayama Naoyuki Ohe Toshinori Takagi Jun Shinoda Toru Iwama Chubu Medical Center for Prolonged Traumatic Brain Dysfunction Department of Neurosurgery Kizawa Memorial Hospital Minokamo Japan Department of Neurosurgery Gifu University Graduate School of Medicine Gifu Japan Department of Neurosurgery Gifu University Graduate School of Medicine Gifu Japan

A brain tumor associated with an arteriovenous malformation (AVM) is very rare. A 42-year-old female presented with two separate lesions in her right frontal lobe on MRI. An angiogram diagnosed one of the lesions as an AVM. The second lesion appeared to be a tumor. Tumor removal was difficult due to bleeding from the nearby AVM, necessitating removal of the AVM and allowing complete excision of the tumor. Histopathological analysis revealed the tumor was an anaplastic oligodendroglioma. There was no recurrence of the tumor 5 year after completion of therapy. We discuss the operative strategy in case of synchronous diseases and provide a review of the literature.

关键词： Oligodendroglioma Arteriovenous Malformation Co-Existence

Prevalence of Non-Communicable Diseases and Number of Comorbidities According to Differences in Household Income Levels in Japan: Analysis from National Health and Nutrition Survey

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Food and Nutrition Sciences 2017年第1期8卷 19-30页

作者： Chika Horikawa Nobuko Murayama Asami Ota Megumi Tsuruta Satoshi Matsunaga Kazuya Fujihara Osamu Hanyu hirohito Sone Department of Health and Nutrition Faculty of Human Life Studies University of Niigata Prefecture Niigata Japan Department of Hematology Endocrinology and Metabolism Faculty of Medicine Niigata University Niigata Japan

Though it has been reported that in Western developed countries socioeconomic status is associated with non-communicable diseases (NCD), there are sparse evidence from Japan, midst an income gap that has been pointed out in recent years. Therefore, we examined the presence or absence of NCD and the number of comorbidities according to household income in Japanese, using data from the National Health and Nutrition Survey of 2010. 1287 men and 1659 women aged 20 - 79 years from households at 3 income levels (<2, 2 - 5.9, ≥6 million yen) were analyzed. Participants completed questionnaires regarding whether they had been diagnosed with NCD, as well as undergoing clinical laboratory tests. Logistic regression analyses were used for statistical analysis with adjustment for age, gender, household size, and population of municipalities. The prevalences of participants with high, medium, and low income were 22.3%, 57.6%, and 20.2%, respectively. Participants with the lowest income had the highest odds of hypertension (OR [95% confidence interval (CI)] = 1.71 [1.29 - 2.26], p p = 0.041), and stroke (5.07 [2.04 - 12.60] p < 0.001). Additionally, prevalences of participants with 2 or 3 NCD (hypertension, diabetes, and hypercholesterolemia) were 15.0% and 33.0% in high and low income levels, respectively. A low income could contribute to a high prevalence of NCD and large number of comorbidities among Japanese. Establishing a health policy in Japan is needed to enable an optimal health condition and lifestyle regardless of socioeconomic disparities.

关键词： Non-Communicable Diseases Comorbidities Household Income National Health and Nutrition Survey Japan