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Associations of body mass index and hospital-acquired disability with post-discharge mortality in older patients with acute heart failure

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Journal of Geriatric Cardiology 2022年第3期19卷 209-217页

作者： Akihiro Sakuyama Masakazu Saitoh kentaro hori Yuichi Adachi Keigo Iwai Masatoshi Nagayama Department of Physical Therapy Faculty of Health ScienceJuntendo UniversityTokyoJapan Department of Rehabilitation Sakakibara Heart InstituteTokyoJapan Department of Cardiology Sakakibara Heart InstituteTokyoJapan

OBJECTIVES To investigate the effect of hospital-acquired disability(HAD)on all-cause mortality after discharge according to the body mass index(BMI)in older patients with acute decompensated heart *** We included 408 patients aged≥65 years who were hospitalized for acute decompensated heart failure and had undergone an acute phase of cardiac rehabilitation at the Sakakibara Heart Institute between April 2013 and September 2015(me-dian age:82 years,interquartile range(IQR):76-86;52%male).Patients were divided into three groups based on BMI at hospital admission:underweight(<18.5 kg/m^(2)),normal weight(18.5 to 25 kg/m^(2)),and overweight(≥25 kg/m^(2)).HAD was defined as a decrease of at least five points at discharge compared to before hospitalization according to the Barthel *** The median follow-up period was 475(IQR:292-730)days,and all-cause mortality during the follow-up period was 84 deaths(21%).According to multivariate Cox regression analysis,being underweight(HR:1.941,95%CI:1.134−3.321,P=0.016)or overweight(HR:0.371,95%CI:0.171−0.803,P=0.012),with normal BMI as the reference,and HAD(HR:1.857,95%CI:1.062−3.250,P=0.030)were independently associated with all-cause *** with HAD exhibited a significantly lower cumulative survival rate in the underweight group(P=0.001)and tended to have a lower cumulative survival rate in the normal weight group(P=0.072).HAD was not significantly associated with cumulative survival in the overweight group(P=0.392).CONCLUSIONS BMI and HAD independently predicted all-cause mortality after discharge in older patients with acute de-compensated heart ***,HAD was significantly associated with higher all-cause mortality after discharge,espe-cially in the underweight group.

关键词： patients acute index

In vitro identification of nonalcoholic fatty liver diseaserelated protein hnRNPM

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World Journal of Gastroenterology 2015年第6期21卷 1784-1793页

作者： Jun-ichi Takino kentaro Nagamine Masayoshi Takeuchi Takamitsu hori Department of Biochemistry Faculty of Pharmaceutical Sciences Hiroshima International University Department of Advanced Medicine Medical Research Institute Kanazawa Medical University

AIM:To study the formation of intracellular glyceraldehyde-derived advanced glycation end products(Glycer-AGEs)in the presence of high concentrations of ***:Cells of the human hepatocyte cell line Hep3B were incubated with or without fructose for five days,and the corresponding cell lysates were separated by two-dimensional gradient sodium dodecyl sulfate-polyacrylamide gel ***-AGEs were detected with the anti-Glycer-AGEs ***,the identification of the proteins that are modified by glyceraldehyde in the presence of high concentrations of fructose was conducted using matrixassisted laser desorption/ionization time-of-flight mass spectrometry(MALDI-TOF-MS).The protein and m RNA levels were determined by Western blotting and realtime reverse transcription PCR,***:The results of the two-dimensional gradient sodium dodecyl sulfate-polyacrylamide gel electrophoresis indicated a greater amount of GlycerAGEs in the sample exposed to high concentrations of fructose than in the *** detected GlycerAGEs showed isoelectric points in the range of 8.0-9.0and molecular weights in the range of 60-80 k *** heterogeneous nuclear ribonucleoprotein M(hn RNPM),which plays an important role in regulating gene expression by processing heterogeneous nuclear RNAs to form mature m RNAs,was identified as a modified protein using *** the concentration of fructose in the medium induced a concentration-dependent increase in the generated ***,in an experiment using glyceraldehyde,which is a precursor of Glycer-AGEs,hn RNPM was found to be more easily glycated than the other ***:The results suggest that glyceraldehyde-modified hn RNPM alters gene *** change may cause adverse effects in hepatocytes and may serve as a target for therapeutic intervention.

关键词： Advanced glycation end-products Fructose Glycation

Assessment of cardiac output in liver transplantation recipients

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Hepatobiliary & Pancreatic Diseases International 2008年第4期7卷 362-366页

作者： Tomohide hori Chiduru Yamamoto Shintaro Yagi Taku Iida kentaro Taniguchi Takashi Hasegawa Koichiro Yamakado Yukinobu hori Kan Takeda Kazuo Maruyama Shinji Uemoto Department of Hepato-Pancreato-Biliary Surgery and Transplantation Kyoto University Hospital54 Shogoinkawara- choSakyo-kuKyoto606-8507Japan Department of Hepatobiliary Pancreatic Surgery Mie University Hospital2-174 EdobashiTsu CityMie Prefecture514-8507 Japan Department of Anesthesiology and Critical Care Medicine Mie University Graduate School of Medicine2-174 EdobashiTsu CityMie Prefecture514-8507Japan Department of Radiology Mie University Graduate School of Medicine2-174 EdobashiTsu CityMie Prefecture514-8507Japan Nagoya Economic University Graduate School of Law 61-1 UchikuboInuyama City Aichi Prefecture 484-8504Japan

BACKGROUND:Liver cirrhosis causes peculiar systemic hemodynamics,and accurate evaluation of systemic hemodynamic state is important for cirrhotic recipients who underwent living donor liver transplantation(LDLT). We investigated the clinical advantages of a novel non- invasive method for measuring systemic hemodynamic parameters using indocyanine green(ICG). METHODS:Twenty-eight LDLT recipients were evaluated. Simultaneous measurements of cardiac output(CO)using Swan-Ganz catheters and pulse dye densitometry(PDD) were performed every 12 hours after LDLT.A total of 155 sets of simultaneous CO measurements were obtained. RESULTS:The CO values obtained by PDD correlated well with those obtained by the invasive catheter *** addition,none of the recipients developed any side-effects, and we verified the safety of repeated ICG *** is safe,even for repeated use over time in the same recipient. Moreover,PDD can measure the blood volume(BV).CONCLUSIONS:Since the cirrhotic systemic hemody- namics characterized by high CO and large BV remains, even after LDLT,the ability to measure CO and BV in a non-invasive,simple and real-time manner using PDD has advantages for cirrhotic LDLT recipients.

关键词： liver transplantation indocyanine green pulse dye densitometry blood volume cardiac output liver cirrhosis

Contribution of the toxic advanced glycation end-productsreceptor axis in nonalcoholic steatohepatitis-related hepatocellular carcinoma

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World Journal of Hepatology 2015年第23期7卷 2459-2469页

作者： Jun-ichi Takino kentaro Nagamine Takamitsu hori Akiko Sakasai-Sakai Masayoshi Takeuchi Department of Biochemistry Faculty of Pharmaceutical Sciences Hiroshima International University Department of Advanced Medicine Medical Research Institute Kanazawa Medical University

Hepatocellular carcinoma(HCC) is one of the most common malignancies worldwide. The main etiologies of HCC are hepatitis B virus and hepatitis C virus(HCV), and non-hepatitis B/non-hepatitis C HCC(NBNCHCC) has also been identified as an etiological factor. Although the incidence of HCV-related HCC in Japan has decreased slightly in recent years, that of NBNC-HCC has increased. The onset mechanism of NBNC-HCC, which has various etiologies, remains unclear; however, nonalcoholic steatohepatitis(NASH), a severe form of nonalcoholic fatty liver disease, is known to be an important risk factor for NBNC-HCC. Among the different advanced glycation end-products(AGEs) formed by the Maillard reaction, glyceraldehyde-derived AGEs, the predominant components of toxic AGEs(TAGE), have been associated with NASH and NBNC-HCC, including NASH-related HCC. Furthermore, the expression of the receptor for AGEs(RAGE) has been correlated with the malignant progression of HCC. Therefore, TAGE induce oxidative stress by binding with RAGE may, in turn, lead to adverse effects, such as fibrosis and malignant transformation, in hepatic stellate cells and tumor cells during NASH or NASH-related HCC progression. The aim of this review was to examine the contribution of the TAGE-RAGE axis in NASH-related HCC.

关键词： Hepatocellular carcinoma Nonalcoholic steatohepati

Laparoscopic approach for choledochojejunostomy

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Hepatobiliary & Pancreatic Diseases International 2019年第3期18卷 285-288页

作者： Tomohide hori Yuki Aisu Michihiro Yamamoto Daiki Yasukawa Taku Iida Shintaro Yagi kentaro Taniguchi Shinji Uemoto Department of Surgery Shiga General Hospital Moriyama 524-8524 Japan Department of Digestive Surgery Tenriyorodusoudanjyo Hospital Tenri 632-8552 Japan Department of Hepato-Biliary-Pancreatic and Surgery and Transplantation Kyoto University Hospital Kyoto 606-8507 Japan First Department of Surgery Mie University Hospital Tsu 514-8507 Japan

Laparoscopic hepatobiliary and pancreatic (HBP) surgery has been developed slowly because of technical challenges and a protracted learning curve with the exception of laparoscopic cholecystectomy [1]. Surgical treatments for benign diseases of the extrahepatic bile duct (EHBD) are classified according to their therapeutic purpose as lithotomy (i.e., choledocholithotomy) or diversion (i.e., choledochojejunostomy)[2].

关键词： HBP EHBD Laparoscopic

Impact of lymph node micrometastasis in hilar bile duct carcinoma patients

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World Journal of Gastroenterology 2006年第16期12卷 2549-2555页

作者： kentaro Taniguchi Taku Iida Tomohide hori Shintaro Yagi Hiroshi Imai Taizo Shiraishi Shinji Uemoto First Department of Surgery Mie University School of Medicine2-174EdobashiTsu CityMie Prefecture514-8507Japan Second Department of Pathology Mie University School of Medicine2-174EdobashiTsu CityMie Prefecture514-8507Japan

AIM- To immunohistochemicaUy examine micrometastasis and VEGF-C expression in hilar bile duct carcinoma （HBDC） and to evaluate the clinical significance of the results. METHODS： A total of 361 regional lymph nodes from 25 patients with node-negative HBDC were immunostained with an antibody against cytokeratins 8 and 18 （CAM 5.2）, and immunohistochemical staining of VEGF-C was performed in 34 primary resected tumors. RESULTS： Lymph node micrometastasis was detected in 6 （24%） of the 25 patients and 10 （2.8%） of the 361 lymph nodes. Patients with micrometastasis showed significantly poorer survival rates than those without （P= 0.025）. VEGF-C expression was positive in 17 （50%） of 34 HBDC, and significantly correlated with lymph node metastasis （P=0.042） and microscopic venous invasion （P=0.035）. CONCLUSIONS： It is suggested that immunohistochemically detected lymph node micrometastasis has an impact on the outcome of HBDC. VEGF-C expression is highly correlated with lymph node metastasis in HBDC and might therefore be a useful predictor.

关键词： Hilar bile duct carcinoma Lymph node metastasis Micrometastasis Vascular endothelial growth factor-C

Stability of cirrhotic systemic hemodynamics ensures sufficient splanchnic blood flow after living-donor liver transplantation in adult recipients with liver cirrhosis

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World Journal of Gastroenterology 2007年第44期13卷 5918-5925页

作者： Tomohide hori Shintaro Yagi Taku Iida kentaro Taniguchi kentaro Yamagiwa Chiduru Yamamoto Takashi Hasegawa Koichiro Yamakado Takuma Kato Kanako Saito Linan Wang Mie Torii Yukinobu hori Kan Takeda Kazuo Maruyama Shinji Uemoto Departments of Hepatobiliary Pancreatic Surgery Mie University Hospital 2-174 Edobashi Tsu City Mie Prefecture 514-8507 Japan Department of Cellular and Molecular Immunology Mie University Graduate School of Medicine 2-174 Edobashi Tsu City Mie Prefecture 514-8507 Japan Department of Hepatobiliary Pancreatic and Transplant Surgery Kyoto University Hospital 54 Kawahara-cho Shogoin Sakyo-ku Kyoto 606-8507 Japan Department of Anesthesiology and Critical Care Medicine Mie University Hospital 2-174 Edobashi Tsu City Mie Prefecture 514-8507 Japan Department of Radiology Mie University Hospital 2-174 Edobashi Tsu City Mie Prefecture 514-8507 Japan Department of Medical Oncology and Immunology Mie University Graduate School of Medicine 2-174 Edobashi Tsu City Mie Prefecture 514-8507 Japan Nagoya Economic University Graduate School of Law 61-1 Uchikubo Inuyama City Aichi Prefecture 484-8504 Japan

AIM： To investigate the correlation between systemic hemodynamics and splanchnic circulation in recipients with cirrhosis undergoing living-donor liver transplantation （LDLT）, and to clarify how systemic hemodynamics impact on local graft circulation after LDLT.METHODS： Systemic hemodynamics, indocyanine green （ICG） elimination rate （K,cG） and splanchnic circulation were simultaneously and non-invasively investigated by pulse dye densitometry （PDD） and ultrasound. Accurate estimators of optimal systemic hyperdynamics after LDLT [i.e., balance of cardiac output （CO） to blood volume （BV） and mean transit time （MTT）, defined as the time required for half the administered ICG to pass through an attached PDD sensor in the first circulation] were also measured. Thirty recipients with cirrhosis were divided into two groups based on clinical outcomes corresponding to postoperative graft function.RESULTS： Cirrhotic systemic hyperdynamics characterized by high CO, expanded BV and low total peripheral resistance （TPR） were observed before LDLT. TPR reflecting cirrhotic vascular alterations was slowly restored after LDLT in both groups. Although no significant temporal differences in TPR were detected between the two groups, CO/BV and M＇IT differed significantly. Recipients with good outcomes showed persistent cirrhotic systemic hyperdynamics after LDLT, whereas recipients with poor outcomes presented with unstable cirrhotic systemic hyperdynamics and severely decreased KICG. Systemic hyperdynamic disorders after LDLT impacted on portal venous flow but not hepatic arterial flow.CONCLUSION： We conclude that subtle systemic hyperdynamics disorders impact on splanchnic circulation, and that an imbalance between CO and BV decreases portal venous flow, which results in critical outcomes.

关键词： Cirrhosis Hyperdynamic Portal hypertension Splanchnic Indocyanine green

Malignant pheochromocytoma:Hepatectomy for liver metastases

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World Journal of Gastrointestinal Surgery 2013年第11期5卷 309-313页

作者： Tomohide hori kentaro Yamagiwa Tadataka Hayashi Shintaro Yagi Taku Iida kentaro Taniguchi Yoshifumi Kawarada Shinji Uemoto Divisions of Hepato-Pancreato-Biliary Transplant and Pediatric SurgeryDepartment of SurgeryKyoto University HospitalKyoto 606-8507Japan First Department of Surgery Mie University HospitalTsuMie Prefecture514-8507Japan Second Department of Surgery Hamamatsu University HospitalHamamatsuShizuoka431-3192Japan

Malignant pheochromocytoma accounts for approximately 10% of pheochromocytoma cases. The main site of distant metastasis is the liver. Hypertensive crisis due to catecholamine oversecretion is potentially fatal. We present a case of malignant pheochromocytoma with multiple liver metastases. A 60-year-old female with repeated hypertensive episodes was diagnosed with malignant pheochromocytoma. She underwent a left adrenalectomy and partial hepatectomy with resection of segment 6. Catecholamine levels remained high after surgery and she received repeated cycles of chemotherapy. Four months after surgery, multiple liver metastases were detected. In spite of ongoing chemotherapy, catecholamine levels eventually became uncontrollable. Serum and urine noradrenaline andvanillylmandelic acid levels increased, but adrenaline and dopamine levels stayed within the normal range. Preoperative liver imaging revealed multiple metastases in all segments except segment 4. Percutaneous transhepatic portal vein embolization(PTPE) of the right and lateral branches of the portal vein was performed. The functional liver volume of segment 4 increased after PTPE. Right hepatectomy, lateral segmentectomy and partial resection of segment 1 were performed 10 mo after the initial surgery. Intraoperative ultrasonography detected two small tumors in segment 4, which were treated with intraoperative microwave coagulation therapy. Noradrenaline levels normalized immediately after the second hepatectomy. As there was increased telomerase activity in the resected specimen, she received adjuvant chemotherapy. She remained in good health for 2 years. However, further metastases eventually occurred and she subsequently died due to a brain hemorrhage. Hepatectomy may be a therapeutic option for reduction of tumor mass in pheochromocytoma with liver metastases.

关键词： Malignant pheochromocytoma Liver metastasis Mass reduction Percutaneous transhepatic portal vein embolization Hepatectomy

Gene Expression Changes Associated with the Loss of Heterogeneous Nuclear Ribonucleoprotein M Function

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American Journal of Molecular Biology 2017年第2期7卷 87-98页

作者： Jun-ichi Takino kentaro Nagamine Mikoto Suzuki Akiko Sakasai-Sakai Masayoshi Takeuchi Takamitsu hori Department of Biochemistry Hiroshima International University Hiroshima Japan Department of Advanced Medicine Kanazawa Medical University Ishikawa Japan

Advanced glycation endproducts (AGEs) are formed by the nonenzymatic reaction of sugars with proteins. Glycation may adversely affect proteins, such as by inducing a loss of function. It has been shown that glyceraldehyde-derived AGEs (Glycer-AGEs) accumulate in the liver of patients with nonalcoholic steatohepatitis (NASH). Previously, we showed the formation of intracellular Glycer-AGEs upon exposure of hepatocytes to fructose in vitro, and identified an RNA-binding protein, heterogeneous nuclear ribonucleoprotein M (HNRNPM), as a target for glycation. However, the impact of glycated HNRNPM in NASH remains poorly understood. In this study, we examined gene expression changes caused by HNRNPM knockdown, and investigated the up- and down-regulated genes as noninvasive biomarker candidates for NASH. Microarray analysis after HNRNPM knockdown showed that the levels of 138 transcripts were increased, while those of 100 transcripts were decreased as compared with those in the control. Gene Ontology-based functional analysis showed that 14 upregulated and 9 downregulated genes were associated with the extracellular space, which may enable their detection using blood tests. Among these, six of the up- and down-regulated genes were associated with the extracellular exosome. These results suggest that the loss of HNRNPM function by glycation is reflected extracellularly. Therefore, the identified genes may serve as noninvasive biomarkers for Glycer-AGEs-related NASH.

关键词： Glycation Nonalcoholic Steatohepatitis Heterogeneous Nuclear Ribonucleoprotein M Biomarkers