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Impact of continuous positive airway pressure therapy for nonalcoholic fatty liver disease in patients with obstructive sleep apnea

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World Journal of Clinical Cases 2021年第19期9卷 5112-5125页

作者： Haruka Hirono kazuhiko watanabe Katsuhiko Hasegawa Masaki Kohno Shuji Terai Shogo Ohkoshi Department of Internal Medicine The Nippon Dental University School of Life Dentistry at NiigataNiigata 951-8580Japan The Center for Dental Sleep Medicine The Nippon Dental University Niigata HospitalNiigata 951-8580Japan Division of Gastroenterology and Hepatology Graduate School of Medical and Dental SciencesNiigata UniversityNiigata 951-8510Japan

BACKGROUND Obstructive sleep apnea(OSA)has been suggested as an independent risk factor for nonalcoholic fatty liver disease(NAFLD),and continuous positive airway pressure(CPAP)is the first-line therapy for *** To clarify the efficacy of effective CPAP therapy on NAFLD of OSA patients by serum markers and transient elastography(TE)using FibroScan®(Echosens,Paris,France).METHODS We prospectively enrolled 123 consecutive patients with OSA who met the indications for *** fibrosis and steatosis were assessed using *** and after 6 mo of CPAP therapy,serum markers and TE were assessed for all *** mean usage rate of CPAP therapy for 6 mo was arbitrarily calculated in each patient and expressed as“mean compliance index”(m-CI).RESULTS In 50 OSA patients with NAFLD,both aspartate aminotransferase(AST)and alanine aminotransferase(ALT)levels were significantly decreased after 6 mo of CPAP *** analysis showed that decreased body weight(BW),decreased body mass index(BMI),decreased AST level,decreased hemoglobin A1c,and high m-CI were significantly related with improved ALT *** multivariate regression model adjusted for quantities of BW change during 6 mo of CPAP therapy,high m-CI tended to improve ALT level(P=0.051).All 17 OSA patients with NAFLD,high m-CI and no BMI changes showed significant improvements in AST and ALT ***,no significant changes in TE data or serum fibrosis markers were *** Some NAFLD could be associated with chronic intermittent hypoxia due to OSA independent of BW *** those cases,adequate reoxygenation from effective CPAP therapy may improve NAFLD.

关键词： Nonalcoholic fatty liver disease Obstructive sleep apnea Continuous positive airway pressure Chronic intermittent hypoxia Transient elastography

Natural regression of fibrosis in chronic hepatitis B

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World Journal of Gastroenterology 2016年第24期22卷 5459-5466页

作者： Shogo Ohkoshi Haruka Hirono kazuhiko watanabe Katsuhiko Hasegawa Kenya Kamimura Masahiko Yano Department of Internal Medicine School of Life Dentistry at Niigata The Nippon Dental University Division of Gastroenterology and Hepatology Graduate School of Medical and Dental Sciences Niigata University

The fibrosis of liver cirrhosis was considered to be irreversible before the anti-viral drugs showed that it is reversible when they lead to continuous suppression of viral replication and inflammation. However, several reports previously showed that fibrosis of type B liver cirrhosis was almost completely absorbed after the natural remission of chronic inflammation. This phenomenon might not be limited to exceptional patients, but rather occur commonly, considering the dynamic clinical features of chronic hepatitis B(CHB), where inactive carrier stage normally follows aggravation of hepatitis and progression of fibrosis at the time of HBe Ag seroconversion. Thus, fibrosis levels of CHB as a hepatocellular carcinoma(HCC)-surveillance marker, particularly those of the inactive stage, could be underestimated, because some of them might have been(pre)cirrhotic in the past and recovered with the natural regression of fibrosis. We argue that cirrhosisinduced HCC mechanisms, rather than direct action of viral genome, may be more common than generally considered in CHB patients. This may have some impact on reconsidering the surveillance rationale for HCC in CHB, from where advanced HCCs tended to be missed. In addition, a molecular marker to assess the cancer-prone characteristics of the liver will definitely be needed to resolve the issue.

关键词： Chronic hepatitis B Cirrhosis Spontaneous remission Regression of fibrosis Occult hepatitis B infection Hepatocellular carcinoma surveillance of hepatitis B virus

Contributions of transgenic mouse studies on the research of hepatitis B virus and hepatitis C virus-induced hepatocarcinogenesis

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World Journal of Hepatology 2015年第28期7卷 2834-2840页

作者： Shogo Ohkoshi Haruka Hirono kazuhiko watanabe Katsuhiko Hasegawa Masahiko Yano Department of Internal Medicine School of Life Dentistry at Niigata the Nippon Dental University Division of Gastroenterology and Hepatology Graduate School of Medical and Dental Sciences Niigata University

Transgenic mouse technology has enabled the investigation of the pathogenic effects, including those on development, immunological reactions and carcinogenesis, of viral genes directly in living organism in a real-time manner. Although viral hepatocarcinogenesis comprises multiple sequences of pathological events, that is, chronic necroinflammation and the subsequent regeneration of hepatocytes that induces the accumulation of genetic alterations and hepatocellular carcinoma(HCC), the direct action of viral proteins also play significant roles. The pathogenesis of hepatitis B virus X and hepatitis C virus(HCV) core genes has been extensively studied by virtue of their functions as a transactivator and a steatosis inducer, respectively. In particular, the mechanism of steatosis in HCV infection and its possible association with HCC has been well studied using HCV core gene transgenic mouse models. Although transgenic mouse models have remarkable advantages, they are intrinsically accompanied by some drawbacks when used to study human diseases. Therefore, the results obtained from transgenic mouse studies should be carefully interpreted in the context of whether or not they are well associated with human pathogenesis.

关键词： Transgenic mouse Hepatocarcinogenesis Hepatitis C virus Hepatitis B virus X Hepatitis B virus Hepatitis C virus core protein Steatosis

Regenerative medicine using dental pulp stem cells for liver diseases

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World Journal of Gastrointestinal Pharmacology and Therapeutics 2017年第1期8卷 1-6页

作者： Shogo Ohkoshi Hajime Hara Haruka Hirono kazuhiko watanabe Katsuhiko Hasegawa Department of Internal Medicine School of Life Dentistry at NiigataNippon Dental UniversityChuo-ku 951-8580Japan

Acute liver failure is a refractory disease and its pro-gnosis, if not treated using liver transplantation, is extremely poor. It is a good candidate for regenerative medicine, where stem cell-based therapies play a central role. Mesenchymal stem cells(MSCs) are known to differentiate into multiple cell lineages including hepatocytes. Autologous cell transplant without any foreign gene induction is feasible using MSCs, thereby avoiding possible risks of tumorigenesis and immune rejection. Dental pulp also contains an MSC population that differentiates into hepatocytes. A point worthy of special mention is that dental pulp can be obtained from deciduous teeth during childhood and can be subsequently harvested when necessary after deposition in a tooth bank. MSCs have not only a regenerative capacity but also act in an anti--inflammatory manner via paracrine mechanisms. Promising efficacies and difficulties with the use of MSC derived from teeth are summarized in this review.

关键词： Dental pulp Mesenchymal stem cell Regenerative medicine Liver disease Tooth bank

老年人的身体平衡能力与“外部干扰适应理论”

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体育科学 2014年第2期34卷 54-59页

作者：渡部和彦王芸体育健康科学研究所天津体育学院运动生理与运动医学重点实验室天津3003811

保持与提高老年人健康及运动能力是现代体育学中的重要研究课题。老年人的体力和运动能力随着年龄的增加而降低，其中身体平衡能力的下降尤为显著。与20岁时相比，70岁时的平衡能力下降率达到了70％～80％。着眼于提高身体平衡能力和步... 详细信息

保持与提高老年人健康及运动能力是现代体育学中的重要研究课题。老年人的体力和运动能力随着年龄的增加而降低，其中身体平衡能力的下降尤为显著。与20岁时相比，70岁时的平衡能力下降率达到了70％～80％。着眼于提高身体平衡能力和步行机能的同时，避免老年人跌倒的运动指导原理，提出了“外部干扰一身体平衡适应理论”。当人体站立突然受到外部干扰时（如水平方向的位移），拮抗肌群出现同时收缩（Co—contraction）现象，关节被一时性固定，使迈步动作（Step-strategy）受到限制，从而产生了跌倒的危险。在这种情况下，为了防止跌倒的发生，迅速地将肌肉收缩形式转换为相反收缩（Reciprocal—contrac—tion）是非常重要的。因此，为了提高身体平衡能力和避免跌倒，介绍了一种特殊的训练装置——“人体移动装置”。作为“自我不稳定干扰”的应用，还涉及了多种步行运动和太极拳等训练方法及其效果。

关键词：老年人平衡能力外部干扰适应理论

直立姿势控制中头部动摇与足压中心移动的区别

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中国运动医学杂志 2011年第1期30卷 32-35,41页

作者：任杰渡部和彦上海体育学院运动科学学院上海200438 广岛大学教育学研究科

目的：探讨直立姿势控制中足压中心（COP）和头部动摇的区别和联系。方法：11名健康成年被试（7男4女,年龄28.0±5.6岁,身高1.68±0.09m）分别在闭眼和睁眼条件下各保持直立姿势1分钟。分别用测力台和数码摄像机同步记录被试在直立姿势... 详细信息

目的：探讨直立姿势控制中足压中心（COP）和头部动摇的区别和联系。方法：11名健康成年被试（7男4女,年龄28.0±5.6岁,身高1.68±0.09m）分别在闭眼和睁眼条件下各保持直立姿势1分钟。分别用测力台和数码摄像机同步记录被试在直立姿势状态下的COP和头部动摇轨迹。选用误差均方根（RMS）、平均速度（MV）和平均功率频率（MPF）作为评价COP和头部动摇的指标。结果：在RMS指标上COP与头部动摇之间有很高的相关性（r=0.75~0.97,P〈0.01）,但在MV和MPF这两个指标上,两者相关性较低。头部动摇MV的Romberg商数显著大于COP。结果提示头部测定法和COP法不能互相取代。在研究视觉对直立姿势控制的影响时,头部测定法比COP法更有效。

关键词：直立姿势视觉足压中心头部动摇 Romberg商数

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认知任务对直立姿势的视觉控制的影响

心理学报 2010年第3期42卷 360-366页

作者：任杰渡部和彦宫谷真人上海体育学院运动科学学院上海200438 广岛大学教育学研究科

为揭示认知任务对直立姿势的视觉控制的影响,本研究采用双重任务的方法,要求18名健康的成年被试在4种条件(2认知条件×2视觉条件)下尽力保持直立姿势的稳定。姿势动摇的测量采用头顶拍摄的方法并计算误差均方根、平均速度以及Romberg商... 详细信息

为揭示认知任务对直立姿势的视觉控制的影响,本研究采用双重任务的方法,要求18名健康的成年被试在4种条件(2认知条件×2视觉条件)下尽力保持直立姿势的稳定。姿势动摇的测量采用头顶拍摄的方法并计算误差均方根、平均速度以及Romberg商数。研究结果显示认知任务和视觉条件之间的交互作用显著,而且当有认知任务时姿势动摇的Romberg商数显著降低。这些结果说明认知任务抑制了直立姿势控制过程中的视觉加工。

关键词：双重任务姿势控制注意认知任务视觉控制

Comparative assessment of primary and secondary infection risks in a norovirus outbreak using a household model simulation

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Journal of Environmental Sciences 2016年第12期28卷 13-20页

作者： Fuminari Miura Toru watanabe Kozo watanabe kazuhiko Takemoto Kensuke Fukushi Department of Urban Engineering Graduate School of Engineering the University of Tokyo Department of Food Life and Environmental Sciences Faculty of Agriculture Yamagata University Department of Civil and Environmental Engineering Ehime University Institute for the Advanced Study of Sustainability the United Nations University Todai Institutes for Advanced Study(TODIAS) Integrated Research System for Sustainability Science(IR3S) The University of Tokyo

Diarrheal diseases can be transmitted via both primary infection due to exposures to contaminated materials from the environment and secondary infection due to person- to-person contacts. Usually, the importance of secondary infection is empirically assessed by fitting mathematical models to the epidemic curves. However, these empirical models may not be applicable to other epidemic cases because they are developed only for the target epidemics and they don＇t consider the detail routes of infection. In our previous study, we developed a theoretical model taking into account the various routes of infection that commonly occur in households （e.g., shaking hands, food handling, and changing diapers）. This model was made flexible and applicable to any epidemics by means of adjusting model parameters. In this study, we proposed a new index ＂Vulnerability indicator to secondary infection （VISI）＂, which expressed a ratio of secondary infection to primary infection risks and calculated this index in a simulated norouirus （NOV） epidemic that involved I0,000 households. The results demonstrated that households composed of more than three members including infant（s） had much higher levels of VlSl （5-45） than two-member-households with VlSI （0.1-4）. These results concluded that the infants were likely to be a hub of secondary infections in highly dense families and therefore careful handling of diapers was deemed indispensible in such families to effectively control the secondary infections.

关键词： Norovirus Quantitative microbial riskassessment Secondary infection

Efficacy and safety of distal radial approach for cardiac catheterization: A systematic review and meta-analysis

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World Journal of Cardiology 2021年第5期13卷 144-154页

作者： Toshihide Izumida Jun watanabe Ryo Yoshida kazuhiko Kotani Division of Community Medicine Kanazawa Medical University Himi Municipal HospitalHimi 935-8531ToyamaJapan Center for Community Medicine Jichi Medical UniversityShimotsuke-City 329-0498TochigiJapan Department of Internal Medicine Iwami HospitalIwami-Town 681-0003TottoriJapan

BACKGROUND The traditional radial approach(RA)is recommended as the standard method for coronary angiography(CAG),while a distal RA(DRA)has been recently used for *** To assess the efficacy and safety of the DRA vs RA during *** The following databases were searched through December 2020:MEDLINE,the Cochrane Central Register of Controlled Trials,EMBASE,the World Health Organization International Clinical Trials Platform Search Portal,and *** randomized-controlled trials for adult patients undergoing cardiac catheterization were *** primary outcomes were the successful cannulation rate and the incidence of radial artery spasm(RAS)and radial artery occlusion(RAO).Study selection,data abstraction and quality assessment were independently performed using the Grading of Recommendations,Assessment,Development,and Evaluation *** Three randomized control trials and 13 registered trials were *** two approaches showed similar successful cannulation rates[risk ratio(RR)0.90,95%confidence interval(CI):0.72-1.13].The DRA did not decrease RAS(RR 0.43,95%CI:0.08-2.49)and RAO(RR 0.48,95%CI:0.18-1.29).Patients with the DRA had a shorter hemostasis time in comparison to those with the RA(mean difference-6.64,95%CI:-10.37 to-2.90).The evidence of certainty was *** For CAG,the DRA would be safer than the RA with comparable cannulation *** the limited data,additional research,including studies with standard protocols,is necessary.

关键词： Radial artery Cardiac catheterization Coronary angiography Snuff box Systematic review Meta-analysis