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World Journal of Gastroenterology 2007年第35期13卷 4699-4706页

作者： Yutaka Kohgo Katsuya Ikuta Takaaki Ohtake Yoshihiro Torimoto junji kato Division of Gastroenterology and Hematology/Oncology Department of MedicineAsahikawa Medical CollegeMidorigaoka-higashi 2-1Asahikawa 078-8510Japan Fourth Department of Internal Medicine Sapporo Medical UniversitySouth-1West-14ChuokuSapporo 060-0030Japan

There are several cofactors which affect body iron metabolism and accelerate iron overload. Alcohol and hepatic viral infections are the most typical examples for clarifying the role of cofactors in iron overload. In these conditions, iron is deposited in hepatocytes and Kupffer cells and reactive oxygen species （ROS） produced through Fenton reaction have key role to facilitate cellular uptake of transferrin-bound iron. Furthermore, hepcidin, antimicrobial peptide produced mainly in the liver is also responsible for intestinal iron absorption and reticuloendothelial iron release. In patients with ceruloplasmin deficiency, anemia and secondary iron overload in liver and neurodegeneration are reported. Furthermore, there is accumulating evidence that fatty acid accumulation without alcohol and obesity itself modifies iron overload states. Ineffective erythropoiesis is also an important factor to accelerate iron overload, which is associated with diseases such as thalassemia and myelodysplastic syndrome. When this condition persists, the dietary iron absorption is increased due to the increment of bone marrow erythropoiesis and tissue iron overload will thereafter occurs. In porphyria cutanea tarda, iron is secondarily accumulated in the liver.

关键词： Iron overload Cofactors Alcohol Chronic hepatic C Non-alcoholic steatohepatitis Insulin resistance Hepatocellular carcinoma

Prevention of hepatocellular carcinoma: Focusing on antioxidant therapy

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World Journal of Hepatology 2015年第3期7卷 593-599页

作者： Koji Miyanishi Toshifumi Hoki Shingo Tanaka junji kato Department of Medical Oncology and Hematology Sapporo Medical University School of Medicine

Oxidative stress has been investigated in the context of alcoholic liver injury for many years and shown to be a causal factor of chronic hepatitis C(CHC), nonalcoholic steatohepatitis(NASH), drug-induced liver injury, Wilson's disease, and hemochromatosis. In CHC, it has been demonstrated that oxidative stress plays an important role in hepatocarcinogenesis. In cases with persistent hepatitis due to failure of hepatitis C virus eradication,or chronic liver disease, such as NASH, the treatment of which remains unestablished, it is important to reduce serum alanine aminotransferase levels and prevent liver fibrosis and development of hepatocellular carcinoma. This also suggests the importance of antioxidant therapy. Among treatment options where it would be expected that anti-inflammatory activity plays a role in their confirmed efficacy for chronic hepatitis, iron depletion therapy, glycyrrhizin, ursodeoxycholic acid, Sho-Saiko-To, and vitamin E can all be considered antioxidant therapies. To date, however, the ability of these treatments to prevent cancer has been confirmed only in CHC. Nevertheless, anti-inflammatory and antifibrotic effects have been demonstrated in other liver diseases and these therapies may potentially be effective for cancer prevention.

关键词： Chronic hepatitis Antioxidant therapy Hepatocellular carcinoma Prevention Iron depletiontherapy

Phenol-based endoscopic ultrasound-guided celiac plexus neurolysis for East Asian alcohol-intolerant upper gastrointestinal cancer patients:A pilot study

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World Journal of Gastroenterology 2014年第30期20卷 10512-10517页

作者： Hirotoshi Ishiwatari Tsuyoshi Hayashi Makoto Yoshida Michihiro Ono Hiroyuki Masuko Tsutomu Sato Koji Miyanishi Yasushi Sato Rishu Takimoto Masayoshi Kobune Atsushi Miyamoto Tomoko Sonoda junji kato Department of Medical Oncology and Hematology Sapporo Medical University School of MedicineSapporo 0600061Japan Department of Hospital Pharmacy Sapporo Medical University School of MedicineSapporo 0600061Japan Department of Public Health Sapporo Medical University School of MedicineSapporo 0600061Japan

AIM: To investigate the effectiveness of phenol for the relief of cancer pain by endoscopic ultrasound-guided celiac plexus neurolysis (EUS-CPN).

关键词： Celiac plexus neurolysis Celiac plexus blockade Endoscopic ultrasound Phenol Pain management Upper gastrointestinal cancer

Case series of three patients with hereditary diffuse gastric cancer in a single family:Three case reports and review of literature

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World Journal of Gastroenterology 2020年第42期26卷 6689-6697页

作者： Masahiro Hirakawa Kohichi Takada Masanori Sato Chisa Fujita Naotaka Hayasaka Takayuki Nobuoka Shintaro Sugita Aki Ishikawa Miyako Mizukami Hiroyuki Ohnuma Kazuyuki Murase Koji Miyanishi Masayoshi Kobune Ichiro Takemasa Tadashi Hasegawa Akihiro Sakurai junji kato Department of Medical Oncology Sapporo Medical University School of MedicineSapporo 060-8556HokkaidoJapan Department of Gastroenterology National Hospital Organization Hokkaido Cancer CenterSapporo 003-0804HokkaidoJapan Department of Surgery Surgical Oncology and ScienceSapporo Medical University School of MedicineSapporo 060-8556HokkaidoJapan Department of Surgical Pathology Sapporo Medical University School of MedicineSapporo 060-8556HokkaidoJapan Department of Medical Genetics Sapporo Medical University School of MedicineSapporo 060-8556HokkaidoJapan Department of Hematology Sapporo Medical University School of MedicineSapporo 060-8556HokkaidoJapan

BACKGROUND Hereditary diffuse gastric cancer(HDGC)is a familial cancer syndrome often associated with germline mutations in the CDH1 ***,the frequency of CDH1 mutations is low in patients with HDGC in East Asian ***,we report three cases of HDGC harboring a missense CDH1 variant,c.1679C>G,from a single Japanese *** SUMMARY A 26-year-old female(Case 1)and a 51-year-old male(father of Case 1),who had a strong family history of gastric cancer,were diagnosed with advanced diffuse gastric *** genetic counselling,a 25-year-old younger brother of Case 1 underwent surveillance esophagogastroduodenoscopy that detected small signet ring cell carcinoma foci as multiple pale lesions in the gastric *** analysis revealed a CDH1 c.1679C>G variant in all three *** It is important for individuals suspected of having HDGC to be actively offered genetics *** report will contribute to an increased awareness of HDGC.

关键词： Hereditary diffuse gastric cancer Signet ring cell carcinoma CDH1 Ecadherin Endoscopic findings Case report

Scoring criteria for determining the safety of liver resection for malignant liver tumors

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World Journal of Meta-Analysis 2019年第5期7卷 234-248页

作者： Kohei Harada Minoru Nagayama Yoshiya Ohashi Ayaka Chiba Kanako Numasawa Makoto Meguro Yasutoshi Kimura Hiroshi Yamaguchi Masahiro Kobayashi Koji Miyanishi junji kato Toru Mizuguchi Departments of Surgery Surgical Scienceand OncologySapporo Medical UniversitySapporoHokkaido 060-8556Japan Division of Radiology Sapporo Medical University HospitalSapporoHokkaido 060-8556Japan Sapporo Medical University Postgraduate School of Health Science and Medicine Sapporo Medical UniversitySapporoHokkaido 060-8556Japan Research and Education Center for Clinical Pharmacy Kitasato University School of PharmacyTokyo 108-8641Japan Department of Internal Medicine IV Sapporo Medical UniversitySapporoHokkaido 060-8556Japan Department of Nursing and Surgical Science Sapporo Medical UniversitySapporo 0608543Japan

BACKGROUND Liver resection has become safer as it has become less ***,the minimum residual liver volume(RLV)required to maintain homeostasis is ***,the formulae used to calculate standard liver volume(SLV)are *** To review previously reported SLV formulae and the methods used to evaluate the minimum RLV,and explore the association between liver volume and *** A systematic review of Medline,PubMed,and grey literature was *** in the retrieved articles were cross-checked manually to obtain further *** last search was conducted on January 20,*** developed an SLV formula using data for 86 consecutive patients who underwent hepatectomy at our institution between July 2009 and August *** Linear regression analysis revealed the following formula:SLV(mL)=822.7×body surface area(BSA)?183.2(R2=0.419 and R=0.644,P<0.001).We retrieved 25 studies relating to SLV formulae and 12 studies about the RLV required for safe liver *** the previously reported formulae included various coefficient and constant values,a simplified version of the SLV,the common SLV(cSLV),can be calculated as follows:cSLV(mL)=710 or 770×*** minimum RLV for normal and damaged livers ranged from 20%-40%and 30%-50%,*** Sapporo score indicated that the minimum RLV ranges from 35%-95%depending on liver *** We reviewed SLV formulae and the minimum RLV required for safe liver *** Sapporo score is the only liver function-based method for determining the minimum RLV.

关键词： Standard liver volume Residual liver volume Hepatectomy Mortality Liver failure Liver function

Erythropoietin ameliorates early ischemia-reperfusion injury following the Pringle maneuver

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World Journal of Gastroenterology 2010年第38期16卷 4838-4845页

作者： Masato kato Tokihiko Sawada junji Kita Mitsugi Shimoda Keiichi Kubota Second Department of Surgery Dokkyo Medical UniversityKitakobayash 880

AIM:To investigate the protective effect of erythropoietin (Epo) against ischemia-reperfusion injury (IR/I) following the Pringle maneuver (PM),in comparison with conventional steroid administration in a prospective randomized trial. METHODS:Patients were randomized by age, sex, diagnosis, and surgical method, and assigned to three groups:(1) A steroid group (STRD, n= 9) who received 100 mg of hydrocortisone before PM, and on postoperative days 1, 2 and 3, followed by tapering until postoperative day 7; (2) An EPO1 group (n=10) who received 30 000 U of Epo before the PM and at the end of surgery; and (3) An EPO2 group (n=8) who received 60 000 U of Epo before the PM. Hemoglobin (Hb), hematocrit (Ht), aspartate aminotransferase (AST), alanine transaminase (ALT),lactate dehydrogenase (LDH), lactate, interleukin-6 (IL-6),and tumor necrosis factor(TNF)-α were measured before and just after (Day 0) surgery, and on postoperative days 1, 3, 7 and 14. RESULTS: There were no increases in Hb and Ht in the EPO1 and EPO2 groups. AST was signif icantly lower in EPO1 than in STRD on Day 0 (P=0.041), and lower in EPO1 than in STRD and EPO2 on Day 1 (P=0.018). ALT was signif icantly lower in EPO1 than in STRD and EPO2 on Day 0 (P=0.020) and Day 1 (P=0.004). There were no signif icant inter-group differences in the levels of LDH and lactate. IL-6 was signif icantly lower in EPO1 than in STRD and EPO2 on Day 0 (P=0.0036) and Day 1 (P=0.0451). TNF-α was signif icantly lower in EPO1 than in STRD and EPO2 on Day 0 (P=0.0006) and Day 1 (P<0.0001). Furthermore, hospitalization was signif icantly shorter in EPO1 and EPO2 than in ***:Epo has greater potential than steroids to ameliorate IR/I after the PM. Epo at a dose of 30000 U, administered before PM and just after surgery, yields better results.

关键词： Erythropoietin Hepatic resection Pringle maneuver Steroid Prospective randomized study

Hepatocellular carcinoma with chronic B-type hepatitis complicated by autoimmune hemolytic anemia:A case report

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World Journal of Gastroenterology 2007年第32期13卷 4401-4404页

作者： Toshie Okada Keiichi Kubota junji Kita Masato kato Tokihiko Sawada Department of Gastro-enterological Surgery Dokkyo University School of MedicineTochigiJapan

A 57-year-old man consulted a local hospital because of a persistent slight fever. At the age of 37 years he was diagnosed having B-type hepatitis, but left the liver dysfunction untreated. Twenty years later, he was diagnosed having chronic hepatitis B, hepatocellular carcinoma （HCC） and macrocytic anemia, and referred to our hospital for further investigation. A HCC with a maximum diameter of 5.2 cm was detected in segment 8. Results of blood tests included 1.8 mg/dL serum total bilirubin, 0.9 mg/dL bilirubin, less than 10 mg/dL haptoglobin, 7.9 g/dL hemoglobin, 130 fL MCV, and 14.5% reticuloo/tes. A bone marrow sample showed erythroid hyperplasia. The direct Coombs test gave a positive result. We diagnosed the anemia as autoimmmune hemolytic anemia （AIHA）, for which prednisolone could not be administered due to positivity for HBsAg and HBeAg. After preparation of washed blood cells for later transfusion, the patient underwent systematic resection of segment 8. The cut surface of the resected specimen demonstrated an encapsulated yellow-brownish tumor measuring 52 mmx 40 mm which was diagnosed pathologicaly as moderately differentiated HCC. On the 9th postoperative day, the patient＇s temperature rose to 38℃, and exacerbated hemolysis was observed. The maximum total bilirubin value was 5.8 mg/dL and minimum hemoglobin level was 4.6 g/dL. He tolerated this period without blood transfusion. Currently he is being followed up as an outpatient, and shows no signs of HCC recurrence or symptoms of anemia. AIHA associated with HBV infection has been described in only three previous cases, and the present case is the first in which surgery was performed for accompanying HCC.

关键词： Hepatocellular carcinoma B-type hepatitis Auto-immune hemolytic anemia

Familial occurrence of congenital bile duct dilatation

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World Journal of Gastroenterology 2008年第6期14卷 941-943页

作者： junji Iwasaki Yoshifumi Ogura Shunichi Nakagawa Kenji kato Akinobu Kondo Katsuya Shiraki Department of Surgery Matsusaka City Hospital 1550 Tono-machi Matsusaka Mie 515-8544 Japan First Department of Internal Medicine Mie University School of Medicine 2-174 Edobashi Tsu Mie 514-8507 Japan

Congenital bile duct dilatation (CBD) that developed in a parent and son is presented. Familial occurrence of CBD is rare, with only a few male cases having been reported. Since the initial report of CBD occurring in siblings in 1981, a total of 20 cases (10 pairs) have been published as of 2007. Clinical and genetic features of CBD are discussed.

关键词： Congenital bile duct dilatation Familial occurrence Choledochal cyst Choledochocele Anomalous pancreaticobiliary duct junction