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Liver disease epidemiology and burden in patients with alterations in plasma protein metabolism:German retrospective insurance claims analysis

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World Journal of Hepatology 2023年第10期15卷 1127-1139页

作者： Nils Picker may hagiwara Severin Baumann Ed G Marins Thomas Wilke Kaili Ren Ulf maywald ChitraKarki Pavel Strnad Real-World Evidence Cytel Inc.Ingress-Health HWM GmbHWismar 23966Germany R&D Global Evidence and OutcomesTakeda Development Center AmericasInc.CambridgeMA 02139United States Global Medical Affairs Takeda Development Center AmericasInc.CambridgeMA 02139United States IPAM Institute IPAM E.V.Wismar 23966Germany Statistics and Quantitative Sciences Data Science InstituteTakeda Development Center AmericasInc.CambridgeMA 02139United States Drug Department AOK PLUSDresden 01058Germany Medical Clinic III GastroenterologyMetabolic Diseases and Intensive CareUniversity Hospital RWTH AachenAachen 52074Germany

BACKGROUND Alpha-1 antitrypsin deficiency is a rare genetic disease and a leading cause of inherited alterations in plasma protein metabolism(APPM).AIM To understand the prevalence,burden and progression of liver disease in patients with APPM including alpha-1 antitrypsin *** We conducted a retrospective analysis of anonymized patient-level claims data from a German health insurance provider(AOK PLUS).The APPM cohort comprised patients with APPM(identified using the German Modification of the International Classification of Diseases-10th Revision[ICD-10-GM]code E88.0 between 01/01/2010-30/09/2020)and incident liver disease(ICD-10-GM codes K74,K70.2-3 and K71.7 between 01/01/2012-30/09/2020).The control cohort comprised patients without APPM but with incident liver *** were incidence/prevalence of liver disease in patients with APPM,demographics/baseline characteristics,diagnostic procedures,progression-free survival(PFS),disease progression and *** Overall,2680 and 26299 patients were included in the APPM(fibrosis,96;cirrhosis,2584)and control(fibrosis,1444;cirrhosis,24855)cohorts,*** 100000 individuals,annual incidence and prevalence of APPM and liver disease was 10-15 and 36-51,*** the APPM cohort,median survival was 4.7 years[95%confidence interval(CI):3.5-7.0]and 2.5 years(95%CI:2.3-2.8)in patients with fibrosis and cirrhosis,respectively.A higher proportion of patients in the APPM cohort experienced disease progression(92.0%)compared with the control cohort(67.2%).Median PFS was shorter in the APPM cohort(0.9 years,95%CI:0.7-1.1)compared with the control cohort(3.7 years,95%CI:3.6-3.8;P<0.001).Patients with cirrhosis in the control cohort had longer event-free survival for ascites,hepatic encephalopathy,hepatic failure and esophageal/gastric varices than patients with cirrhosis in the APPM cohort(P<0.001).Patients with fibrosis in the control cohort had longer event-free survival for ascites,cir

关键词： Alpha-1 antitrypsin deficiency Epidemiology Germany Liver diseases Retrospective study

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Correlation between dose-volume parameters and rectal bleeding after 12 fractions of carbon ion radiotherapy for prostate cancer

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World Journal of Radiology 2024年第7期16卷 256-264页

作者： Takashi Ono Hiraku Sato Yuya Miyasaka Yasuhito hagiwara Natsuko Yano Hiroko Akamatsu mayumi Harada mayumi Ichikawa Department of Radiation Oncology Faculty of MedicineYamagata UniversityYamagata 990-9585Japan Department of Heavy Particle Medical Science Yamagata University Graduate School of Medical ScienceYamagata 990-9585Japan

BACKGROUND Carbon ion radiotherapy(CIRT)is currently used to treat prostate *** bleeding is a major cause of toxicity even with ***,to date,a correlation between the dose and volume parameters of the 12 fractions of CIRT for prostate cancer and rectal bleeding has not been ***,the clinical risk factors for rectal bleeding were absent after 12 fractions of *** To identify the risk factors for rectal bleeding in 12 fractions of CIRT for prostate *** Among 259 patients who received 51.6 Gy[relative biological effectiveness(RBE)],in 12 fractions of CIRT,15 had grade 1(5.8%)and nine had grade 2 rectal bleeding(3.5%).The dose-volume parameters included the volume(cc)of the rectum irradiated with at least x Gy(RBE)(Vx)and the minimum dose in the most irradiated x cc normal rectal volume(Dx).RESULTS The mean values of D6cc,D2cc,V10 Gy(RBE),V20 Gy(RBE),V30 Gy(RBE),and V40 Gy(RBE)were significantly higher in the patients with rectal bleeding than in those *** cutoff values were D6cc=34.34 Gy(RBE),D2cc=46.46 Gy(RBE),V10 Gy(RBE)=9.85 cc,V20 Gy(RBE)=7.00 cc,V30 Gy(RBE)=6.91 cc,and V40 Gy(RBE)=4.26 *** D2cc,V10 Gy(RBE),and V20 Gy(RBE)cutoff values were significant predictors of grade 2 rectal *** The above dose-volume parameters may serve as guidelines for preventing rectal bleeding after 12 fractions of CIRT for prostate cancer.

关键词： Carbon ion radiotherapy Prostate cancer Rectal bleeding Dose volume parameters Prevention

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Modified simultaneous integrated boost radiotherapy for an unresectable huge refractory pelvic tumor diagnosed as a rectal adenocarcinoma

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World Journal of Gastroenterology 2014年第48期20卷 18480-18486页

作者： Takuma Nomiya Hiroko Akamatsu mayumi Harada Ibuki Ota Yasuhito hagiwara mayumi Ichikawa Misako Miwa Shouhei Kawashiro Motohisa hagiwara Masahiro Chin Eiji Hashizume Kenji Nemoto Department of Radiation Oncology National Institute of Radiological Sciences Chiba 263-8555 Japan Department of Radiation Oncology Yamagata University Hospital Yamagata 990-8560 Japan Department of Surgery Nihonkai General Hospital Yamagata 990-8560 Japan

A clinical trial of radiotherapy with modified simultaneous integrated boost(SIB)technique against huge tumors was conducted.A 58-year-old male patient who had a huge pelvic tumor diagnosed as a rectal adenocarcinoma due to familial adenomatous polyposis was enrolled in this *** total dose of 77 Gy(equivalent dose in 2Gy/fraction)and 64.5 Gy was delivered to the center of the tumor and the surrounding area respectively,andapproximately 20%dose escalation was achieved with the modified SIB *** tumor with an initial maximum size of 15 cm disappeared 120 d after the start of the *** status of the patient improved from 4 to *** with modified SIB may be effective for patients with a huge tumor in terms of tumor shrinkage/disappearance,improvement of QOL,and prolongation of survival.

关键词： Clinical trial Image-guided radiotherapy Rectal neoplasms Quality of life Neoplasm recurrence

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Gastric cancer mortality related to direct radiographic and endoscopic screening:A retrospective study

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World Journal of Gastroenterology 2021年第33期27卷 5595-5609页

作者： Hiroaki hagiwara Fumitaka Moki Yukiko Yamashita Kazuki Saji Keigo Iesaki Hiromitsu Suda Department of Internal Medicine Hagiwara ClinicMaebashi 379-2106GunmaJapan Maebashi Medical Association Maebashi 371-0035GunmaJapan Gunma Health Foundation Maebashi 371-0005GunmaJapan Department of Internal Medicine and Surgery Yamashita ClinicMaebashi 371-0016GunmaJapan Department of Internal Medicine Saji ClinicMaebashi 371-0133GunmaJapan Department of Internal Medicine Iesaki ClinicMaebashi 371-0805GunmaJapan Department of Pediatrics Suda Kids ClinicMaebashi 371-0813GunmaJapan

BACKGROUND Despite its decreased incidence in Japan,gastric cancer continues among the leading causes of cancer-related deaths in both men and ***,efforts are still required to lower the mortality rate of gastric cancer in *** City introduced endoscopic gastric cancer screening in 2004,and participants are able to choose between direct radiography and ***,we expected to see a decrease in mortality rate from gastric cancer after introducing endoscopic screening and a difference in mortality rate reduction between screening *** To evaluate the impact on gastric cancer mortality rate of two types of gastric cancer screening in Maebashi City,*** Participants aged 40 to 79 years of the Maebashi City gastric cancer screening program in 2006 who were screened by direct radiography(n=11155)or endoscopy(n=10747)were *** were followed until March 31,2012,by cross-referencing their data against the Gunma Prefecture cancer registry *** compared the detection rate of gastric ***,we compared the mortality rate between the two *** Cox proportional hazards model was used to estimate the hazard ratio(HR)of gastric cancer ***,the reduction in gastric cancer mortality rate associated with each screening method was *** Gastric cancer was detected in 22 participants undergoing direct radiography(detection rate,0.20%)and in 52 participants undergoing endoscopy(detection rate,0.48%).However,most gastric cancers detected by endoscopic screening were early cancers that may not have resulted in *** found no significant difference in gastric cancer mortality rate between participants receiving annual screening and those who do *** the number of gastric cancer deaths in the direct radiography group was set as 1 in the Cox proportional hazard analysis,the HR of gastric cancer death was 1.368(95%CI:0.7308-2.562)in the overall group of *** results showed no s

关键词： Gastric cancer Radiography Endoscopy Population-based cancer screening Mortality reduction

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Potential mechanism of corpus-predominant gastritis after PPI therapy in Helicobacter pylori-positive patients with GERD

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World Journal of Gastroenterology 2014年第34期20卷 11962-11965页

作者： Ken-ichi Mukaisho Tadashi hagiwara Takahisa Nakayama Takanori Hattori Hiroyuki Sugihara Department of Pathology Division of Molecular Diagnostic PathologyShiga University of Medical ScienceSeta-tsukinowa-choOtsuShiga 520-2192Japan

The long-term use of proton pump inhibitors(PPIs)exacerbates corpus atrophic gastritis in patients with Helicobacter pylori(***)*** identify a potential mechanism for this change,we discuss interactions between pH,bile acids,and *** reflux,which includes bile,occurs in healthy individuals,and bile reflux is increased in patients with gastroesophageal reflux disease(GERD).Diluted human plasma and bile acids have been found to be significant chemoattractants and chemorepellents,respectively,for the bacillus *** only taurine conjugates,with a pKa of 1.8-1.9,are soluble in an acidic environment,glycine conjugates,with a pKa of 4.3-5.2,as well as taurine-conjugated bile acids are soluble in the presence of PPI ***,the soluble bile acid concentrations in the gastric contents of patients with GERD after continuous PPI therapy are considerably higher than that in those with intact acid *** the distal stomach,the high concentration of soluble bile acids is likely to act as a bactericide or chemorepellent for *** contrast,the mucous layer in the proximal stomach has an optimal bile concentration that forms chemotactic gradients with plasma components required to direct *** to the epithelial *** may then colonize in the stomach body rather than in the pyloric antrum,which may explain the occurrence of corpus-predominant gastritis after PPI therapy in ***-positive patients with GERD.

关键词： Helicobacter pylori Proton pump inhibitor Corpus-predominant gastritis Bile acids Gastroesophageal reflux disease Chemotactic gradient

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Successful hepatic resection for recurrent hepatocellular carcinoma after lenvatinib treatment:A case report

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World Journal of Hepatology 2020年第12期12卷 1349-1357页

作者： Hideki Yokoo Hiroyuki Takahashi Masahiro hagiwara Hiroyoshi Iwata Koji Imai Yoshinori Saito NaotoMatsuno Hiroyuki Furukawa Division of Hepato-Biliary-Pancreatic Surgery and Transplant Surgery Department of SurgeryAsahikawa Medical UniversityAsahikawa 078-8510HokkaidoJapan Department of Gastroenterology Asahikawa-Kosei General HospitalAsahikawa 078-8211HokkaidoJapan

BACKGROUND Lenvatinib has been shown to be noninferior to sorafenib regarding prognosis and recurrence rate in patients with unresectable hepatocellular carcinoma(HCC)who have not received prior systemic *** patients treated with lenvatinib,40%of cases achieved sufficient tumor reduction to make potential surgery ***,the outcomes of such surgery are *** report a successful case of hepatic resection for recurrent HCC after lenvatinib *** SUMMARY A 69-year-old man underwent right anterior sectionectomy for HCC in segment 8 of the *** months later,he was found to have an intrahepatic HCC recurrence that grew rapidly to 10 cm in diameter with sternal bone *** confirming partial response to lenvatinib administration for 2 mo,a second hepatectomy was *** examination showed that 80%of the tumor was *** patient did not develop any adverse effects under lenvatinib *** was discharged at 25 d after *** therapy for bone metastases continued to be given under lenvatinib,and the patient has remained alive for 1 year after the second *** The prognosis of patients with recurrent HCC may be improved by liver resection combined with prior lenvatinib therapy.

关键词： Conversion to surgery Lenvatinib Recurrent hepatocellular carcinoma Case report Neoadjuvant therapy Molecular targeted therapy

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Prolonged Intermittent Running Induces Inspiratory-Muscle Fatigue in Female Runners

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Journal of Sports Science 2016年第5期4卷 265-271页

作者： Toshiyuki Ohya Masahiro hagiwara Marie Oriishi Yasuhiro Suzuki Department of Sports Science Japan Institute of Sports Sciences 3-15-1 Nishigaoka Kita-ku Tokyo 115-0056 Japan Graduate School of Physical Education National Institute of Fitness and Sports in Kanoya Kagoshima Japan

Inspiratory-muscle fatigue （IMF） may occur after long-duration or continuous short-duration exercise and may limit exercise performance. Daily athletics training is often intermittent, but it is unclear if intermittent running induces IMF. We investigated IMF after a maximal anaerobic running test （MART） and maximal intermittent graded exercise test. Nine female middle-distance （400 or 800 m） runners performed MART and maximal intermittent graded exercise tests. Maximal inspiratory pressure （MIP） was measured before and after each test using a portable autospirometer. There was no significant difference in mean MIPs before （105 ± 24 cm H2O） and after （104 ± 28 cm H2O） the MART （P = 0.95, effect size [ES] as partial η2 = 0.01）. Mean M IP after the maximal intermittent graded exercise test （97 ± 26 cm H2O） was lower than before exercise （105 ± 27 cm H2O）（P = 0.01, 1]2 = 0.83） Mean IMF was higher for the maximal intermittent graded exercise test （8.5 ± 4.2 cm H2O） than for the MART （0.8 ± 4.1 cm H2O）（P = 0.01, ES as Cohen＇s d = 1.88）. IMF occurs after relatively long-duration intermittent running exercise. Coaches may consider recommending inspiratory-muscle training or warm-up to reduce IMF resulting from relatively long-duration intermittent running exercise.

关键词： Respiratory muscle diaphragm maximal inspiratory pressure track and field MART.

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Leadless cardiac pacemaker implantations after infected pacemaker system removals in octogenarians

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Journal of Geriatric Cardiology 2021年第7期18卷 505-513页

作者： Satoshi Higuchi Ayako Okada Morio Shoda Daigo Yagishita Satoshi Saito Miwa Kanai Shohei Kataoka Kyoichiro Yazaki Hiroaki Tabata Hideki Kobayashi Wataru Shoin Takahiro Okano Koji Yoshie Koichiro Ejima Koichiro Kuwahara Nobuhisa hagiwara Department of Cardiology Tokyo Women’s Medical UniversityKawada-choShinjuku-ku 8-1Tokyo 162-8666Japan Department of Cardiovascular Medicine Shinshu UniversitySchool of Medicine3-1-1 AsahiMatsumotoNagano 390-8621Japan Department of Cardiovascular Surgery Tokyo Women’s Medical UniversityKawada-cho 8-1Shinjuku-kuTokyo 162-8666Japan

Background Management of pacemaker(PM)infections among advanced aged patients possesses particular clinical challenges due to higher rates of concurrent cardiovascular disease and medical *** leadless cardiac pacemakers(LCPs)may provide new opportunities for better management options in this population,however,there is limited data especially in Asian populations to guide the decision *** We reviewed 11 octogenarians(median age:86[minimum 82–maximum 90]years;male:73%;median body mass index(BMI):20.1 kg/m^(2))who received Micra Transcatheter Pacing System(Medtronic Inc,Minneapolis,MN)implantations following transvenous lead extractions(TLEs)for PM *** All patients had more than two medical comorbidities(average 3.7 comorbidities).The indications for LCP implantations were atrioventricular block in four patients,atrial fibrillation bradycardia in five,and sinus node dysfunction in *** patients(73%)were bridged with temporary pacing using active fixation leads(median interval of 14.0 days),while one with severe dementia underwent a concomitant LCP implantation and TLE during the same *** TLEs and LCP implantations were successfully accomplished in all without any *** median time from the TLE procedure to discharge was 22 days(minimum 7–maximum 136).All patients remained free of infections during a mean follow-up period of 17.2±6.5 *** LCP implantations were safe and effective after removing the entire infectious PM system in all *** novel LCP technology may offer an alternative option for considering a re-implantation strategy after transvenous PM infections in elderly patients,particularly those with severe frailty and PM dependency.

关键词： implantation cardiac removing

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Solitary Bone Cyst of the Proximal Humerus with a Concomitant Stiff Shoulder Treated with both Arthroscopic Capsular Release and Arthroscope-Assisted Resection of the Bone Cyst: A Case Report

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Open Journal of Orthopedics 2018年第3期8卷 77-84页

作者： Akira Ando Masashi Koide Yoshihiro hagiwara Michimasa Matsuda Eiji Itoi Department of Orthopaedic Surgery Matsuda Hospital Sendai Japan Department of Orthopaedic Surgery Tohoku University School of Medicine Sendai Japan

Solitary bone cysts are benign bone lesions that usually occur in the humerus, calcaneus, and femur of children and adolescents. When present in adults, they are usually diagnosed as incidental findings. In this report, we present an adult case of a solitary bone cyst of the proximal humerus with concomitant refractory stiff shoulder treated with both arthroscopic capsular release and arthroscope-assisted resection of the bone cyst. A 73-year-old woman was referred with a complaint of persistent left shoulder pain and limited range of motion. Magnetic resonance imaging showed an approximately 4.5-cm long diameter cystic bone lesion from the humeral neck to the shaft. At first, arthroscopic synovectomy and pan-capsular release were performed. Next, two 1-cm skin incisions and 8-mm drill holes into the lateral wall of the cyst were created with fluoroscopic guidance. After insertion of the arthroscope through the holes, the white membranous cyst wall was resected with a shaver until bone marrow was observed. Finally, an 8-mm cannulated hydroxyapatite pin was inserted. This is a simple technique that allows direct visualization and complete resection of the cyst wall with two small incisions. Such a technique may be superior to conventional open procedures or those under image guidance.

关键词： Solitary Bone Cyst Humerus Adult Arthroscope-Assisted Resection Hydroxyapatite Pin

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Both Diet and Exercise Are Necessary for Obese CKD Patients: A Pilot Prospective Randomized Controlled Study

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Open Journal of Nephrology 2016年第2期6卷 43-54页

作者： Kazuyuki Noguchi Hirayasu Kai Hirofumi Zempo Fumio Mizuno Masahiro hagiwara Naoki Morito Joichi Usui Chie Saito Shinya Kuno Kunihiro Yamagata Department of Nephrology Faculty of Medicine University of Tsukuba Tsukuba Ibaraki Japan Graduate School of Comprehensive Human Sciences University of Tsukuba Tsukuba Ibaraki Japan

Aim: This study aimed to examine the effects of exercise training on kidney function and nutrition status in obese Chronic Kidney Disease (CKD) patients. Methods: This is a prospective randomized controlled trial. Twelve adult obese CKD patients were randomly assigned to dietary instruction alone group (Group-D) or to both dietary instruction and exercise training group (Group-E). All patients received supervised dietary advice including calorie, protein, and salt intake for a period of 12 weeks. In addition, patients in Group-E underwent a fitness-training program. A change in glomerular filtration rate (GFR) was the main outcome. Secondary outcomes were changes in body mass index, serum creatinine-based estimated-GFR, serum albumin, and albuminuria. Results: Changes in GFR and all secondary outcomes were not statistically significant in either of the two groups. Although exercise training did not appear to significantly affect serum albumin levels in either group, it did present with a large sized effect. Conclusion: Exercise training might not have any effect on kidney function;however, the combination of exercise training along with dietary advice may prove to be more effective in maintaining the nutrition status when compared with dietary instructions alone in obese CKD patients. These results suggest that appropriate exercise training with dietary instructions is recommended for the treatment of obese CKD patients.

关键词： CKD Obesity GFR Diet Exercise Training

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