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Transcatheter arterial infusion for advanced hepatocellular carcinoma: Who are candidates?

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World Journal of Gastroenterology 2015年第29期21卷 8888-8893页

作者： Eiichiro Suzuki Tetsuhiro Chiba Yoshihiko Ooka Sadahisa Ogasawara Akinobu Tawada Tenyu Motoyama Naoya Kanogawa Tomoko Saito masaharu yoshikawa Osamu Yokosuka Department of Gastroenterology and Nephrology Graduate School of Medicine Chiba University

AIM: To elucidate anticancer effects of transcatheter arterial infusion chemotherapy(TAI) in patients with hepatocellular carcinoma(HCC). METHODS: Data from a total of 95 patients with HCC who received TAI were analyzed retrospectively. The efficacy of TAI was evaluated according to the Response Evaluation Criteria in Cancer of the Liver. Overall survival was calculated from the date of initial treatment to the date of death or last follow-up. Survival curves were calculated by the Kaplan-Meier method, and differences in survival were evaluated by the log rank test. Clinical variables that were identified as statistically different by a univariate analysis were included into the Cox proportional hazard regression model for multivariate analysis. A prognostic index based on the regression coefficients derived from variables identified by the multivariate analysis was constructed. Stratification of the patients was conducted using this prognostic index. RESULTS: The patient group was comprised of 76 men and 19 women with an average age of 68 years(range: 37-82 years). Six patients(6.3%) showedcomplete response and 18 patients(18.9%) showed partial response, for an overall response rate of 25.2%. The median overall survival was 27.6 mo, and the proportions of survivors at 1, 2, and 5 years were 67.4%, 54.0%, and 17.4%, respectively. Multivariate analysis demonstrated that no prior transcatheter arterial chemoembolization, lactate dehydrogenase < 230 IU/L, and performance status of 0 were the independent favorable prognostic factors. The development of a 0-3-point prognostic score index was based on the sum of these three prognostic factors. Subsequently, the patients were categorized into three groups: those with a good(prognostic index = 0-1; n = 54), intermediate(prognostic index = 2; n = 26), or poor(prognostic index = 3; n = 15) prognosis. The median survival times in these three groups were 41.0, 21.2, and 6.8 mo, respectively(P < 0.01). CONCLUSION: Our simple pro

关键词： Hepatocellular carcinoma Interventionalradiology Prognostic factor Survival Transcatheterarterial infusion

The Usefulness of Ryusei<sup>®</sup>Perfusion Balloon for Treating Acute Coronary Syndrome with Vulnerable Plaque

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World Journal of Cardiovascular Diseases 2019年第2期9卷 69-80页

作者： Fumitsugu yoshikawa Tetsu Nakajima masaharu Hanada Kazuo Hirata Ryuichi Aikawa Kuwana City Medical Center Mie Prefecture Japan JCHO Sakuragaoka Hospital Shizuoka Japan

Background: Intracoronary thrombus followed by a rupture of unstable vulnerable plaque is a well-known cause of acute coronary syndrome (ACS). The no reflow/slow flow phenomenon is sometimes observed during a primary percutaneous coronary intervention (PCI) against ACS. It has already been shown that long inflation using a perfusion balloon (PB) is useful to remediate a coronary perforation. Thus, we investigated the usefulness of a PB for treating ACS. Methods: This study was a retrospective, single-center, observational study. One hundred-seven patients with ACS underwent PCI from January 2015 to December 2017 in our hospital. Fifty patients were treated by PB directly (PB group) and the remaining 57 patients were treated by another conventional balloon (C group). We used the Ryuseiò balloon (Kaneka, Japan) as a PB. The clinical outcome was the incidence of the no reflow or slow flow phenomenon, the incidence of using IABP. Results: One patient in the PB group demonstrated slow flow phenomenon temporarily, and the coronary flow was quickly restored by thromboaspiration. In contrast, nine patients in the C group had occurrences of no reflow/slow flow phenomenon. Although all patients in the C group required stenting, some patients (24%) of the PB group did not require stenting. Conclusion: We found that the use of PB had a favorable effect on the treatment of ACS. Some patients completed PCI without a need for stenting.

关键词： A Perfusion Balloon Vulnerable Plaque Acute Coronary Syndrome

The Shift of the Ischial Region during Maneuvering the Standard Wheelchair and the Electric Wheelchair in Healthy Adults

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International Journal of Clinical Medicine 2021年第7期12卷 297-305页

作者： Mikiko Uemura masaharu Sugimoto Ryoko Shimizu Noriaki Maeshige Yoshiyuki yoshikawa Hidemi Fujino Faculty of Health Science Department of Rehabilitation Kansai University of Welfare Sciences Kashiwara Japan Department of Rehabilitation Science Graduate School of Health Sciences Kobe University Kobe Japan Toyama Rehabilitation Medical Health and Welfare College Toyama Japan Department of Rehabilitation Kansai Medical University Hospital Hirakata Japan Faculty of Health Sciences Department of Rehabilitation Naragakuen University Nara Japan

Pressure injuries are frequent secondary complications that occur in patients with Spinal Cord Injury (SCI), and the recurrence rate of ischial pressure injury is highest in SCI patients. Most SCI patients use wheelchairs, and some studies have shown a relationship between buttock pressure and sitting posture. However, the pressure distribution during wheelchair maneuvering is unclear. We measured and compared the shift of the ischial region when maneuvering a standard wheelchair or electric wheelchair in healthy adults. The subjects drove wheelchairs on a flat ground of 10 m and the shift of ischial region was measured with a pressure distribution-measuring device. The ischial region shifted forward or backward while maneuvering both the standard wheelchair and the electric wheelchair, and the shift rate of the ischial region was not significantly different between the standard wheelchair and the electric wheelchair. The ischial region shift occurred when the forward head moved by the video while maneuvering both a standard wheelchair and an electric wheelchair. Therefore, the shift might occurred because the pelvis shifted forward in conjunction with head movement during maneuvering of both the standard wheelchair and the electric wheelchair. This result showed that it is important to reduce head and trunk movements when maneuvering a wheelchair to reduce the shear force on the buttocks and prevent pressure injuries.

关键词： Spinal Cord Injury Pressure Ulcer Wheelchair Buttock Pressure

Eosinophilic cholecystitis along with pericarditis caused by Ascaris lumbricoides: A case report

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World Journal of Gastroenterology 2007年第27期13卷 3760-3762页

作者： Kosuke Kaji Hitoshi Yoshiji Masahide yoshikawa masaharu Yamazaki Yasuhide Ikenaka Ryuichi Noguchi Masayoshi Sawai Masatoshi Ishikawa Tsuyoshi Mashitani Mitsuteru Kitade Hideto Kawaratani Masahito Uemura Junichi Yamao Masao Fujimoto Akira Mitoro Masahisa Toyohara Motoyuki Yoshida Hiroshi Fukui Third Department of Internal Medicine Nara Medical University Nara Japan Department of Parasitology Nara Medical University Nara Japan

Although the etiology of eosinophilic cholecystitis is still obscure, the postulated causes include allergies, parasites, hypereosinophilic syndrome, and eosinophilic gastroenteritis. It is sometimes accompanied by several complications, but a simultaneous onset with pericarditis is very rares. A 28-year-old woman complained of acute right hypocondrial pain and dyspnea associated with systemic eruption. Several imaging modalities revealed acute cholecystitis and pericarditis with massive pericardial effusion. A marked peripheral blood eosinophilia was observed, and the eruption was diagnosed as urticaria. Her serum had a high titer of antibody against Ascaris lumbricoides . Treatment with albendazole drastically improved all clinical manifestations along with normalization of the imaging features and eosinophilia. We report herein a rare case of simultaneous onset of acute cholecystitis and pericarditis associated with a marked eosinophilia caused by parasitic infection.

关键词： Cholecystitis Pericardititis Ascaris Parasite Eosinophilia Albendazole