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Criteria for the diagnosis and severity stratification of acute pancreatitis

World Journal of Gastroenterology 2013年第35期19卷 5798-5805页

作者： Makoto Otsuki Kazunori Takeda Seiki Matsuno Yasuyuki Kihara Masaru Koizumi masahiko hirota Tetsuhide Ito Keisho Kataoka Motoji Kitagawa Kazuo Inui Yoshifumi Takeyama Kitasuma Hospital University of Occupational and Environmental Health Japan School of Medicine Department of Surgery National Hospital Organization Sendai Medical Center Towada Shiritsu Central Hospital Department of Gastroenterology Kitakyushu Central Hospital Kurihara Central Hospital Kumamoto Regional Medical Center Health Care Center Department of Medicine and Bioregulatory Science Graduate School of Medical Sciences Kyushu University Otsu Municipal Hospital Department of Nutritional Science Nagoya University of Arts and Sciences Department of Internal Medicine Second Teaching HospitalFujita Health University School of Medicine Department of Surgery Kinki University School of Medicine

Recent diagnostic and therapeutic progress for severe acute pancreatitis(SAP)remarkably decreased the casemortality *** further decrease the mortality rate of SAP,it is important to precisely evaluate the severity at an early stage,and initiate appropriate treatment as early as *** Committee of Intractable Diseases of the Pancreas in Japan developed simpler criteria combining routinely available data with clinical *** can be evaluated by laboratory examinations or by clinical signs,reducing the defect values of the severity ***,the severity criteria considered laboratory/clinical severity scores and contrastenhanced computed tomography(CE-CT)findings as independent risk ***,CE-CT scans are not necessarily required to evaluate the severity of acute *** was no fatal case in mild AP diagnosed by the CE-CT severity score,whereas case-mortality rate in those with SAP was 14.8%.Case-mortality of SAP that fulfilled both the laboratory/clinical and the CE-CT severity criteria was 30.8%.It is recommended,therefore,to perform CE-CT examination to clarify the prognosis in those patients who were diagnosed as SAP by laboratory/clinical severity *** the mortality rate of these patients with SAP is high,such patients should be transferred to advanced medical units.

关键词： Severe acute pancreatitis Severity score Scoring system Prognostic factors Case-mortality

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Optimized Lymphadenectomy for Early Gastric Cancer Based on the Analysis of 1141 Cases from a Single Institution

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International Journal of Clinical Medicine 2015年第3期6卷 186-192页

作者： Shinji Ishikawa Shinjirou Tomiyasu Hiroshi Tanaka Hiroki Sugita Tetsumasa Arita Yasushi Yagi masahiko hirota Department of Surgery Kumamoto Regional Medical Center Kumamoto Japan

Background: According to the treatment guidelines for gastric cancer in Japan (3rd edition), D1 lymphadenectomy is recommended for T1a cancer (out of indication for endoscopic resection) and a group of T1b cancer (differentiated type, not larger than 1.5cm and clinically N0). D1+ lymphadenectomy is recommended for T1b cancer other than above group. D2 lymphadenectomy is for clinically N+ early gastric cancer (EGC). Methods: Consecutive 1141 resected EGC cases in our institution from January 1991 to December 2013 were analyzed. The size, depth of wall invasion, presence of ulcer, histological type and distribution of metastasis positive lymph node were evaluated. Results: There were 678 T1a and 463 T1b cancers. Lymph node metastasis positive T1a were 11 cases. All of them were undifferentiated type and the metastasis positive lymph nodes were all confined to the D1 area. Lymph node metastasis positive T1b cancer was 82 cases. Among them, 70 cases were within D1 area, 77 cases were within D1+ area and 79 cases were within D2 area. The other 3 cases had metastasis positive lymph node in beyond the D2 area. Conclusion: D1 lymphadenectomy is enough for T1a EGC that is out of indication of endoscopic resection and D1+ lymphadenectomy is reasonable for T1b EGC. These cases are good indication of laparoscopic surgery. D2 lymphadenectomy is required for T1b undifferentiated cancers which size is larger than 4 cm.

关键词： Early Gastric Cancer Lymphadenectomy Laparoscopic Surgery

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Consensus of primary care in acute pancreatitis in Japan

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World Journal of Gastroenterology 2006年第21期12卷 3314-3323页

The incidence of acute pancreatitis in Japan is increasing and ranges from 187 to 347 cases per million populations. Case fatality was 0.2% for mild to moderate, and 9.0% for severe acute pancreatitis in Japan in 2003. Experts in pancreatitis in Japan made this document focusing on the practical aspects in the early management of patients with acute pancreatitis. The correct diagnosis of acute pancreatitis and severity stratification should be made in all patients using the criteria for the diagnosis of acute pancreatitis and the multifactor scoring system proposed by the Research Committee of Intractable Diseases of the Pancreas as early as possible. All patients diagnosed with acute pancreatitis should be managed in the hospital. Monitoring of blood pressure, pulse and respiratory rate, body temperature, hourly urinary volume, and blood oxygen saturation level is essential in the management of such patients. Early vigorous intravenous hydration is of foremost importance to stabilize circulatory dynamics. Adequate pain relief with opiates is also important. In severe acute pancreatitis, prophylactic intravenous administration of antibiotics at an early stage is recommended. Administration of protease inhibitors should be initiated as soon as thediagnosis of acute pancreatitis is confirmed. A combination of enteral feeding with parenteral nutrition from early stage is recommended if there are no clear signs and symptoms of ileus and gastrointestinal bleeding. Patients with severe acute pancreatitis should be transferred to ICU as early as possible to perform special measures such as continuous regional arterial infusion of protease inhibitors and antibiotics, and continuous hemodiafiltration. The Japanese Government covers medical care expense for severe acute pancreatitis as one of the projects of Research on Measures for Intractable Diseases.

关键词： Fluid resuscitation Protease inhibitor treatment Antibiotic treatment Continuous regional arterial infusion Contrast-enhanced computed tomography

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Local records of long-term dynamics of bamboo gregarious flowering in northern Laos and regional synchronicity of Dendrocalamus membranaceus in two flowering sites

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Journal of Mountain Science 2017年第6期14卷 1058-1064页

作者： hirota Isao Gifu University - Faculty of Applied Biological Sciences Yanagido 1-2 Gifu 501-1193 JAPAN Gifu 501-1193 Japan

Bamboos are widely distributed in mainland Southeast Asia and have abundant biomass. They are characterized by prolonged vegetative growth and semelparity. Where bamboos are dominant, their synchronous flowering and death has a major impact on forest vegetation. Although the small-scale dynamics of this process have become clearer in recent years, the history, geographical scale and synchronicity of bamboo flowering over broad areas remains unknown. This study focused on the flowering history of six bamboo species, Bambusa tulda, Cephalostachyum virgatum, Dendrocalamus hamiltonii, Dendrocalamus membranaceus, Indosasa sinica and Oxytenanthera parvifolia, over 40 years across a broad area of northern Laos. We also examined the synchronicity of flowering in D. membranaceus. We visited 49 villages in northern Laos and surveyed knowledgeable inhabitants about bamboo flowering history. The timing, scale and synchronicity of gregarious flowering varied among species. D. hamiltonii and D. membranaceus showed higher flowering synchronicity than other species. All the species except I. sinica had both sporadic and gregarious flowering traits, and showed conspicuous variability in their flowering scale. The flowering bamboo population at two gregarious flowering sites for D. membranaceus was surveyed. While thisspecies had the highest synchronicity in this study, its synchronicity was lower than other species in previous studies worldwide. We found that the gregarious flowering of bamboos in northern Laos over the last 40 years showed lower synchronicity than bamboo flowering reported in other areas of the world. The historical dynamics and scale of bamboo flowering must be further clarified to understand the vegetation composition of this area.

关键词： Fallow forest Sporadic flowering Shifting cultivation Synchronicity Southeast Asia

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Energetics of Resistive Wall Modes in Flowing Plasmas

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Plasma Science and Technology 2009年第4期11卷 409-412页

作者： M.hirota Japan Atomic Energy Agency

Stabilization/destabilization of magnetohydrodynamic （MHD） waves are formulated in terms of wave energy, where the waves are subject to Alfven and sound resonances and also influenced by small resistivity at conductive wall. Negative energy wave, which may exist in the presence of mean flow, is shown to be destabilized by the resistive wall, where its growth rate is characterized by the energy dissipation rate. The effect of resonance is examined as well based on a recent knowledge of wave energy for Alfv4n and sound continuum modes. Resonant coupling between an eigenmode and a continuum mode having the same sign of energy results in phase mixing （or continuum） damping. In contrast, if their signs are opposite, such resonance triggers an instability.

关键词： MHD stability resitive wall mode flowing plasma wave energy

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Copper and Nitrogen Co-Doping Effect on Visible-Light Responsive Photocatalysis of Plasma-Nitrided Copper-Doped Titanium Oxide Film

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Journal of Materials Science and Chemical Engineering 2017年第12期5卷 52-62页

作者： Ken-Ichi hirota masahiko Maeda College of Engineering Kanazawa Institute of Technology Ishikawa Japan

In order to clarify the visible-light responsive photocatalysis of TiO2 co-doped with Cu and N atoms, plasma-nitridation was taken place to Cu-doped TiO2 film. Cu-doped TiO2 films were prepared by dip-coating method and they were nitrided by nitrogen plasma in the plasma-enhanced CVD system. Cu-doped TiO2 films before and after plasma-nitridation show similar X-ray diffraction peaks of anatase TiO2. XPS analysis reveals that the ionic states of Ti and Cu in the Cu-doped TiO2 films are Ti4+ and Cu+, respectively. After nitrogen plasma treatment, oxygen atoms are released by substitution of nitrogen atoms in the TiO2 matrix, so that Cu+ is oxidized to generate Cu2+ and at the same time oxygen vacancy is formed. The absorption edge of both Cu-doped and plasma-nitrided Cu-doped TiO2 did red shift. Visible-light responsive photocatalytic activity of the Cu-doped TiO2 film degraded after nitrogen plasma treatment.

关键词： Sol-Gel Cu-Doped Titania Plasma-Nitridation Photocatalysis

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Livelihood Factors and Household Strategies for an Unexpected Climate Event in Upland Northern Laos

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Journal of Mountain Science 2015年第2期12卷 483-500页

作者： Phanxay INGXAY Satoshi YOKOYAMA Isao hirota Department of Geography Graduate School of Environmental Studies Nagoya University Graduate School of Bioagricultural Sciences Nagoya University

Climate events pose major challenges to food production and the livelihoods of rural inhabitants in northern Laos, where upland rice using swidden production is an important crop. The onset of the rainy season in this area is one such climate event, and it has occurred earlier and with less regularity in recent years. Not all households are able to cope with these changes. This study examines the ability of local farmers to cope with rice insufficiency. This investigation also clarifies household strategies in dealing with the climate event. We randomly interviewed 63 of 95 household heads, and performed a paired sample t test to examine the significance of differences in three household groups between the 2010 normal climate and the 2011 climate event. The groups were categorized according to rice selfsufficiency in 2011: groups I are households with rice self-sufficiency, group II are those facing a rice shortage of up to 3 months, and group III are those with insufficient rice for over 3 months. We also conducted a one-way ANOVA to examine the significance of differences in livelihood strategies among the three groups. We found that the household labor force was the most important factor in enhancing the villagers' ability to deal with the climate event and that the level of impact of that event shaped their coping strategies. Households with substantial labor force had more options for coping strategies than those with smaller ones. The villagers faced different levels of impact and adopted differentcoping strategies accordingly. Non-timber forest product collection was the principle livelihood strategy in response to non-climate factors such as education, access to health services, provision of equipment and clothing, and overcoming the impact of the climate event. Households heavily affected by the early rainy season onset tended to engage in intensive activities such as off-farm activity and outside work, rather than their major livelihood activities in the v

关键词： Climate events Livelihood factors Livelihood change Household strategy Swidden

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Sub-classification of intermediate-stage(Barcelona Clinic Liver Cancer stage-B) hepatocellular carcinomas

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World Journal of Gastroenterology 2015年第37期21卷 10604-10608页

作者： Koichiro Yamakado Shozo hirota Department of Radiology Hyogo College of Medicine

Hepatocellular carcinoma(HCC), the fifth most common cancer in the world, shows increasing incidence worldwide. Curative treatments such as hepatectomy,liver transplantation, and radiofrequency ablation are applied in only 30%-60% of cases. Most remaining patients receive transarterial chemoembolization(TACE).Patients with intermediate-stage HCCs are regarded as good candidates for TACE. However, the intermediate stage includes non-homogeneous patients. Some movements are underway to stratify patients using prognostic factors to identify patient groups exhibiting greater benefit from TACE than other patient *** review describes two substaging systems that subclassify intermediate-stage HCCs and discusses the importance of dividing intermediate-stage patients.

关键词： Hepatocellular carcinoma Intermediatestage Chemoem

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Strategy for quantum image stabilization

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Science China(Information Sciences) 2016年第5期59卷 39-48页

作者： Fei YAN Abdullah M.ILIYASU Huamin YANG Kaoru hirota School of Computer Science and Technology Changchun University of Science and Technology College of Engineering Prince Sattam Bin Abdulaziz University Department of Computational Intelligence and Systems Science Tokyo Institute of Technology

Image stabilization is a process to smooth the unstable motion vector of video sequences to achieve its stabilization. Even though the classical image stabilization techniques seem already very mature so far, similar advances have not been extended to the quantum computing domain. In this study, we explore a novel quantum video framework and make a modest attempt to perform the image stabilization based on it by utilizing the quantum comparator and quantum image translation operations. The proposed method is capable of estimating the camera motion during exposure and compensating for the video jitter caused by the motion. In addition, the quantum properties, i.e., entanglement and parallelism, ensure that the quantum image stabilization is feasible and effective. Finally, a simple experiment to stabilize a four-frame jittered quantum video is implemented using Matlab based on linear algebra with complex vectors as quantum states and unitary matrices as unitary transforms to show the feasibility and merits of this proposal.

关键词： quantum computation image stabilization quantum video image translation quantum measurement

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Activation of hypoxia-inducible factor 1 attenuates periapical inflammation and bone loss

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International Journal of Oral Science 2018年第2期10卷 92-101页

作者： Kimito Hirai Hisako Furusho Kiichi hirota Hajime Sasaki Department of Cariology Restorative Sciences & Endodontics University of Michigan School of Dentistry Department of Immunology and Infectious Diseases The Forsyth Institute Department of Oral and Maxillofacial Pathobiology Hiroshima University Department of Human Stress Response Science Institute of Biomedical Science Kansai Medical University

Hypoxia（low oxygen level） is an important feature during infections and affects the host defence mechanisms. The host has evolved specific responses to address hypoxia, which are strongly dependent on the activation of hypoxia-inducible factor 1（HIF-1）.Hypoxia interferes degradation of HIF-1 alpha subunit（HIF-1α）, leading to stabilisation of HIF-1α, heterodimerization with HIF-1 beta subunit（HIF-1β） and subsequent activation of HIF-1 pathway. Apical periodontitis（periapical lesion） is a consequence of endodontic infection and ultimately results in destruction of tooth-supporting tissue, including alveolar bone. Thus far, the role of HIF-1 in periapical lesions has not been systematically examined. In the present study, we determined the role of HIF-1 in a wellcharacterised mouse periapical lesion model using two HIF-1α-activating strategies, dimethyloxalylglycine（DMOG） and adenovirusinduced constitutively active HIF-1α（CA-HIF1 A）. Both DMOG and CA-HIF1 A attenuated periapical inflammation and tissue destruction. The attenuation in vivo was associated with downregulation of nuclear factor-κappa B（NF-κB） and osteoclastic gene expressions. These two agents also suppressed NF-κB activation and subsequent production of proinflammatory cytokines by macrophages. Furthermore, activation of HIF-1α by DMOG specifically suppressed lipopolysaccharide-stimulated macrophage differentiation into M1 cells, increasing the ratio of M2 macrophages against M1 cells. Taken together, our data indicated that activation of HIF-1 plays a protective role in the development of apical periodontitis via downregulation of NF-κB, proinflammatory cytokines, M1 macrophages and osteoclastogenesis.

关键词： CA Activation hypoxia-inducible factor attenuates periapical inflammation bone loss HIF

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