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Gravity assistance enables liver stiffness measurements to detect liver fibrosis under congestive circumstances

World Journal of Hepatology 2022年第4期14卷 778-790页

作者： Takeshi Suda Ai Sugimoto Tsutomu Kanefuji Atsushi Abe Takeshi Yokoo Takahiro Hoshi Satoshi Abe Shinichi Morita kazuyoshi yagi Masashi Takahashi Shuji Terai Department of Gastroenterology and Hepatology Uonuma Institute of Community MedicineNiigata University Medical and Dental HospitalMinami Uonuma 949-7302NiigataJapan Division of Thoracic and Cardiovascular Surgery Graduate School of Medical and Dental SciencesNiigata UniversityNiigata 951-8122Japan Department of Gastroenterology and Hepatology Tsubame Rosai HospitalTsubame 959-1228NiigataJapan Department of Administration Joetsu-Area General Health Care CenterJoetsu 943-0803NiigataJapan Department of Preemptive Medicine for Digestive Diseases and Healthy Active Life Niigata University School of MedicineNiigata 951-8122Japan Division of Gastroenterology and Hepatology School of Medical and Dental SciencesNiigata UniversityNiigata 951-8122Japan

BACKGROUND As survival has been prolonged owing to surgical and medical improvements,liver failure has become a prognostic determinant in patients with congestive heart diseases.Congestive hepatopathy,an abnormal state of the liver as a result of congestion,insidiously proceed toward end-stage liver disease without effective biomarkers evaluating pathological progression.Regular measurements of shear wave elastography cannot qualify liver fibrosis,which is a prognosticator in any type of chronic liver disease,in cases of congestion because congestion makes the liver stiff without fibrosis.We hypothesized that the effects of congestion and fibrosis on liver stiffness can be dissociated by inducing architectural deformation of the liver to expose structural rigidity.To establish a strategy measuring liver stiffness as a reflection of architectural rigidity under congestion.METHODS Two-dimensional shear wave elastography(2dSWE)was measured in the supine(Sp)and left decubitus(Ld)positions in 298 consecutive cases as they were subjected to an ultrasound study for various liver diseases.Regions of interest were placed at twelve sites,and the median and robust coefficient of variation were calculated.Numerical data were compared using the Mann-Whitney U or Kruskal-Wallis test followed by Dunn's post-hoc multiple comparisons.The inferior vena cava(IVC)diameters at different body positions were compared using the Wilcoxon matched pairs signed rank test.The number of cases with cardiothoracic ratios greater than or not greater than 50%was compared using Fisher’s exact test.A correlation of 2dSWE between different body positions was evaluated by calculating Spearman correlation coefficients.RESULTS The IVC diameter was significantly reduced in Ld in subjects with higher 2dSWE values in Ld(LdSWE)than in Sp(SpSWE)(P=0.007,(average±SD)13.9±3.6 vs 13.1±3.4 mm)but not in those with lower LdSWE values(P=0.32,13.3±3.5 vs 13.0±3.5 mm).In 81 subjects,SpSWE was increased or decreased in Ld beyond the magnitude of robust coefficient o

关键词： Shear wave elastography Inferior vena cava diameter Congestive hepatopathy Liver fibrosis Body positions Fibrosis-4 index

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Rational arrangement of measuring shear wave speed in the liver

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World Journal of Gastroenterology 2019年第20期25卷 2503-2513页

作者： Takeshi Yokoo Tsutomu Kanefuji Takeshi Suda Itsuo Nagayama Takahiro Hoshi Satoshi Abe Shinichi Morita Hiroteru Kamimura Kenya Kamimura Atsunori Tsuchiya Masaaki Takamura kazuyoshi yagi Shuji Terai Department of Preemptive Medicine for Digestive Diseases and Healthy Active Life Niigata University School of MedicineNiigataNiigata 951-8122Japan Division of Gastroenterology and Hepatology Niigata Tokamachi HospitalTokamachiNiigata 948-0065Japan Department of Gastroenterology and Hepatology Uonuma Institute of Community MedicineNiigata University Medical and Dental HospitalMinami UonumaNiigata 949-7302Japan Division of Gastroenterology and Hepatology Graduate School of Medical and Dental SciencesNiigata UniversityNiigata 951-8122Japan

BACKGROUND Shear wave speed has been widely applied to quantify a degree of liver fibrosis. However, there is no standardized procedure, which makes it difficult to utilize the speed universally. AIM To provide procedural standardization of shear wave speed measurement. METHODS Point shear wave elastography (pSWE) was measured in 781 patients, and twodimensional shear wave elastography (2dSWE) was measured on the same day in 18 cases. Regions-of-interest were placed at 12 sites, and the median and robust coefficient-of-variation (CVR) were calculated. A residual sum-of-square (Σdi2) was computed for bootstrap values of 1000 iterations in 18 cases with each assumption of 1 to 12 measurements. The proportion of the Σdi2 (%Σdi2) was calculated as the ratio of Σdi2 to pSWE after converting it based on the correlation between pSWE and 2dSWE. RESULTS The CVR showed a significantly broader distribution in the left lobe (P < 0.0001),and the smallest CVR in the right anterior segment that covered 95% cases was 40.4%. pSWE was significantly higher in the left lobe than in the right lobe (1.63 ± 0.78 m/s vs 1.61 ± 0.78 m/s, P = 0.0004), and the difference between the lobes became further discrete when the subjects were limited to the cases with a CVR less than 40.4% in any segment (1.76 ± 0.80 m/s vs 1.70 ± 0.82 m/s, P < 0.0001). The highest values of the CVR in every 0.1 m/s interval were plotted in convex upward along pSWE and peaked at 1.93 m/s. pSWE and 2dSWE were significantly correlated (P < 0.0001, r = 0.95). In 216000 resamples from 18 cases, the %Σdi2 of 12 sites was 8.0% and gradually increased as the acquisition sites decreased to reach a significant difference with a %Σdi2 of 7 sites (P = 0.027). CONCLUSION These data suggest that shear wave speed should be measured at 8 or more sites of spreading in both lobes.

关键词： Liver stiffness Ultrasound Shear wave elastography Acoustic radiation force impulse Heterogeneity

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幽门腺化生可能通过CDX2表达引起肠上皮化生甚至直接进展为胃癌

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Gastroenterology Report 2021年第4期9卷 370-373,I0003页

作者： kazuyoshi yagi Atsunori Tsuchiya Satoru Hashimoto Taisuke Kato Osamu Onodera Shuji Terai Department of Gastroenterology and Hepatology Uonuma Institute of Community MedicineNiigata University Medical and Dental HospitalNiigataJapan Division of Gastroenterology and Hepatology Graduate School of Medical and Dental SciencesNiigata UniversityNiigataJapan Department of System Pathology for Neurological Disorders Brain Science BranchBrain Research InstituteNiigata UniversityNiigataJapan Department of Neurology Brain Research InstituteNiigata UniversityNiigataJapan

Introduction The majority of cases of gastric cancer are thought to develop due to chronic inflammation from Helicobacter pylori(H.pylori)infection leading to intestinal metaplasia,termed the intestinal metaplasia–dysplasia–cancer sequence[1].Chronic inflammation from H.pylori infection causes mucin core protein 6-positive(MUC6t)pyloric-gland metaplasia;however,its origin is controversial.This MUC6t pyloric-gland metaplasia is similar to spasmolytic polypeptide-expressing metaplasia in mouse studies[2–4].

关键词：肠上皮化生幽门腺 Helicobacter CDX2

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Hierarchically porous monoliths based on low-valence transition metal (Cu, Co, Mn) oxides:gelation and phase separation

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National Science Review 2020年第11期7卷 1656-1666页

作者： Xuanming Lu kazuyoshi Kanamori Kazuki Nakanishi Department of Chemistry Graduate School of ScienceKyoto University Institute for Integrated Cell-Material Sciences Kyoto University Institute for Advanced StudyKyoto University Division aof Materials Research Institute of Materials and Systems for Sustainability Nagoya University

Hierarchically porous monoliths based on copper (Cu), cobalt (Co) and manganese (Mn) oxides with three-dimensionally (3D) interconnected macropores and open nanopores were prepared using metal bromides as precursors via a sol–gel process accompanied by phase separation. The difficulty of gelation for low-valence metal cation was overcome by introducing a highly electronegative Br atom near to the metal atom to control the rates of hydrolysis and polycondensation. The 3D interconnected macropores were obtained using appropriate polymers to induce phase separation. The domain sizes of macropores and skeletons can be controlled by reaction parameters such as concentration and/or average molecular weight of polymers, and the amount of hydrochloric acid. The crystalline metal oxide monoliths with their 3D interconnected macroporous structure preserved were obtained after heat treatment in air.

关键词： hierarchically porous monolith low-valence transition metal oxide 3D interconnected macropore sol–gel process phase separation

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Epithelial Cell Apoptosis and Lung Remodeling

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Cellular & Molecular Immunology 2007年第6期4卷 419-429页

作者： kazuyoshi Kuwano Division of Respiratory Diseases Department of Internal MedicineJikeiUniversity School of Medicine

Lung epithelium is the primary site of lung damage in various lung diseases. Epithelial cell apoptosis has been considered to be initial event in various lung diseases. Apoptosis signaling is classically composed of two principle pathways. One is a direct pathway from death receptor ligation to caspase cascade activation and cell death. The other pathway triggered by stresses such as drugs, radiation, infectious agents and reactive oxygen species is mediated by mitochondria. Endoplasmic reticulum has also been shown to be the organeile to mediate apoptosis. Epithelial cell death is followed by remodeling processes, which consist of epithelial and fibroblast activation, cytokine production, activation of coagulation pathway, neoangiogenesis, re-epithelialization and fibrosis. Epithelial and mesenchymai interaction plays important roles in these processes. Further understanding of apoptosis signaling and its regulation by novel strategies may lead to effective treatments against various lung diseases. We review the recent advances in the understanding of apoptosis signaling and discuss the involvement of apoptosis in lung remodeling. Cellular ＆ Molecular Immunology.

关键词： apoptosis lung injury pulmonary fibrosis COPD remodeling

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Numerical Simulation of Deflecting Flow in a Symmetric Enlarged Channel

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Journal of Thermal Science 2007年第4期16卷 353-359页

作者： HiroyukiYOSHIKAWA MizueMUNEKATA HidekiOHBA kazuyoshi ICHINOMIYA Department of Mechanical System Engineering Kumamoto University2-39-1 KurokamiKumamoto860-8555 Japan Graduate School of Science and Technology Kumamoto University2-39-1 KurokamiKumamoto860-8555 Japan

在有突然的扩大的一条矩形的隧道的三维的分开的流动和热转移的数字结果在这份报纸被介绍。海军司烧和精力方程的数字模拟用有限差别方法被执行。三维的计算的结果与二维的相比，并且在流动之上的隧道的方面比率的效果被显示出。转变从... 详细信息

在有突然的扩大的一条矩形的隧道的三维的分开的流动和热转移的数字结果在这份报纸被介绍。海军司烧和精力方程的数字模拟用有限差别方法被执行。三维的计算的结果与二维的相比，并且在流动之上的隧道的方面比率的效果被显示出。转变从对不对称的流动对称作为增加方面比率出现在更低的雷纳兹数字。在二面下游的墙上的二个不同分开的流动区域的本地热转移特征的细节被澄清。流动和热二维数转移几乎为考虑的方面比率消失。

关键词：偏转流对称性空隙热传输热学

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Uncertainty in solid precipitation and snow depth prediction for Siberia using the Noah and Noah-MP land surface models

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Frontiers of Earth Science 2018年第4期12卷 672-682页

作者： kazuyoshi SUZUKI Milija ZUPANSKI Institute of Arctic Climate and Environment Change Research (IACE) Japan Agency for Marine-Earth Science and Technology (JAMSTEC)Yokohama236-0001Japan Cooperative Institute for Research in the Atmosphere Colorado State UniversityFort CollinsCO 80523-1375USA

In this study, we investigate the uncertainties associated with land surface processes in an ensemble predication context. Specifically, we compare the uncertainties produced by a coupled atmosphere–land modeling system with two different land surface models, the Noah- MP land surface model (LSM) and the Noah LSM, by using the Maximum Likelihood Ensemble Filter (MLEF) data assimilation system as a platform for ensemble prediction. We carried out 24-hour prediction simulations in Siberia with 32 ensemble members beginning at 00:00 UTC on 5 March 2013. We then compared the model prediction uncertainty of snow depth and solid precipitation with observation-based research products and evaluated the standard deviation of the ensemble spread. The prediction skill and ensemble spread exhibited high positive correlation for both LSMs, indicating a realistic uncertainty estimation. The inclusion of a multiple snowlayer model in the Noah-MP LSM was beneficial for reducing the uncertainties of snow depth and snow depth change compared to the Noah LSM, but the uncertainty in daily solid precipitation showed minimal difference between the two LSMs. The impact of LSM choice in reducing temperature uncertainty was limited to surface layers of the atmosphere. In summary, we found that the more sophisticated Noah-MP LSM reduces uncertainties associated with land surface processes compared to the Noah LSM. Thus, using prediction models with improved skill implies improved predictability and greater certainty of prediction.

关键词： ensemble simulation land-atmosphere interaction ensemble spread vertical temperature snow prediction

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Numerical Analysis of Thermal Convections in a Three-dimensional Cavity: Influence of Difference in Approximation Models on Numerical Solutions

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Journal of Thermal Science 2004年第3期13卷 283-288页

作者： kazuyoshi MATSUZAKI Hideki OHBA Mizue MUNEKATA Mechanical Engineering and Materials Science Kumamoto University 2-39-1 Kurokami Kumamoto 860-8555 JapanMechanical Engineering and Materials Science Kumamoto University 2-39-1 Kurokami Kumamoto 860-8555 JapanMechanical Engineering and Materials Science Kumamoto University 2-39-1 Kurokami Kumamoto 860-8555 Japan

In order to develop the practical approximation models suitable to flow fields at low Mach number with large temperature difference, the influence of difference in approximation models on numerical solutions was investigated by solving the natural convection in the 3-D enclosures with vertical sidewalls differentially heated and the heated bottom wall using 3 approximation models, that is Boussinesq approximation, low Mach Number approximation and approximation model proposed by Mlaouah. As results of the simulation, the effects of the differences in the three approximation models on the numerical solutions become clear.

关键词： thermal convection approximation model numerical analysis 3-D cavity.

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Prevention of aspiration of gastric contents during attempt in tracheal intubation in the semi-lateral and lateral positions

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World Journal of Emergency Medicine 2016年第4期7卷 285-289页

作者： Ichiro Takenaka kazuyoshi Aoyama Department of Anesthesia Kyushu Rosai Hospital Department of Anesthesia Kitakyushu General Hospital

BACKGROUND:Pulmonary aspiration of gastric contents during tracheal intubation is a lifethreatening complication in emergency patients.Rapid sequence intubation is commonly performed to prevent aspiration but is not associated with low risk of intubation related complications.Although it has been considered that aspiration can be prevented in the lateral position,few studies have evaluated the ability to prevent aspiration.Moreover,this position is not always a favorable position for tracheal intubation.If aspiration can be prevented in a clinically relevant semi-lateral position,it may be advantageous.We assessed the ability to prevent aspiration in the lateral position and various degrees of the semi-lateral position using a vomiting-regurgitation manikin model.METHODS:A manikin's head was placed in the neutral,simple extension,or sniffing position.The amount of aspirated saline into the bronchi during simulated vomiting was measured at semilateral position angles of 0°to 90° in 10° increments.The difference in the vertical height between the mouth corner and the inferior border of the vocal cord was measured radiologically at each semilateral position in the three head-neck positions.RESULTS:Pulmonary aspiration was prevented at the ≥70°,≥80°,and 90° semi-lateral positions in the neutral,simple extension,and sniffing positions,respectively.The mouth was lower than the vocal cord in the semi-lateral position in which aspiration was prevented.CONCLUSION:The lateral or excessive semi-lateral position was necessary to protect the lung from aspiration in the head-neck positions commonly used for tracheal intubation.Prevention of aspiration was difficult within clinically relevant semi-lateral positions.

关键词： Pulmonary aspiration Lateral position Semi-lateral position

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Necessity of neutrophil-to-lymphocyte ratio monitoring for hypothyroidism using nivolumab in patients with cancer

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World Journal of Clinical Oncology 2022年第7期13卷 641-651页

作者： Ako Gannichida Yusuke Nakazawa Akira Kageyama Hirofumi Utsumi kazuyoshi Kuwano Takashi Kawakubo Department of Pharmacy The Jikei University HospitalTokyo 105-8471Japan Division of Respiratory Diseases Department of Internal MedicineThe Jikei University School of MedicineTokyo 105-8461Japan

BACKGROUND Low neutrophil-to-lymphocyte ratio(NLR)has been shown to be associated with a favorable therapeutic response to nivolumab.The activation of immunocompetent cells such as lymphocytes exhibits an antitumor effect;however,the development of excessive immune responses in autologous organs along with the breakdown of self-tolerance causes immune-related adverse events,including hypothyroidism.Therefore,the possibility that NLR is associated with immune response shows that NLR can be not only a predictive factor for good response to nivolumab but also a predictive factor for the development of hypothyroidism.AIM To evaluate whether continuous NLR monitoring during nivolumab treatment is useful for predicting the incidence and onset period of hypothyroidism.METHODS This retrospective study comprised patients who received nivolumab for treating all types of cancer at our hospital between January 2015 and December 2019.The NLRs of patients were measured before each administration,and the patients were followed up till the administration of 12 doses.NLR at treatment initiation was compared between patients with and without hypothyroidism.Patients who developed hypothyroidism were categorized into three groups:those with NLR<3.5,3.5 to<5,and≥5 according to their maximum NLR from treatment initiation to hypothyroidism development.Further,the onset periods of hypothyroidism were compared between the groups.RESULTS Overall,104 patients were included in the analysis.Twenty-one patients developed hypothyroidism throughout the observation period.NLR at treatment initiation was significantly lower(2.54±1.21 vs 4.58±4.03;P=0.017)in patients with hypothyroidism than in those without hypothyroidism,and patients with NLR<5 had a significantly higher incidence of hypothyroidism than those with NLR≥5(26%:20 of 78 patients vs 4%:1 of 26 patients;P=0.022).Additionally,treatment continuity in patients with hypothyroidism was significantly longer than in those without hypothyroidism(median not reached vs 7 times administration,P=

关键词： Nivolumab Hypothyroidism Immune checkpoint inhibitors Immune-related adverse event Neutrophil-to-lymphocyte ratio

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