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Local recurrence is an important prognostic factor of hepatocellular carcinoma

World Journal of Gastroenterology 2005年第36期11卷 5601-5606页

作者： Eiichirou Arimura Kazuhiro Kotoh Makoto nakamuta Shusuke Morizono Munechika Enjoji Hajime Nawata Department of Medicine and Bioregulatory Science Graduate School of Medical Sciences Kyushu University Fukuoka 812-8582 Japan

AIM: To clarify the importance of complete treatment by ***: A total of 140 previously untreated cases of HCC were enrolled in this study from 1988 to 2002. The inclusion criteria were: a solitary tumor less than 4 cm in diameter or multiple tumors, fewer than four in number and less than 3 cm in diameter, without extrahepatic metastasis or vessel invasion. As general principles for the treatment of HCC, the patients underwent transcatheter arterial chemoembolization (TACE) prior to PEIT. After the initial treatment of the patients,ultrasonography and computed tomography were performed, and measurement of serum levels of α-fetoprotein (AFP) was determined. When tumor recurrences were detected, PEIT and/or TACE were repeated whenever the hepatic functional reserve of the patient permitted. We then analyzed the variables that could influence prognosis, including tumor size and number, the serum levels of AFP, the parameters of hepatic function (albumin, bilirubin, ALT, hepaplastin test,platelet number, and indocyanine green retention at 15min [ICG-R15]), combined therapy with TACE, distant recurrence, and local ***: Univariate analysis identified the ICG test,serum levels of AFP and albumin, tumor size and number,and local recurrence, but not distant recurrence, as significant prognostic variables. In multivariate analysis using those five parameters, the ICG test, tumor size, tumor number,and local recurrence were identified as significant prognostic factors. In both univariate and multivariate analyses, the relative risk for the ICG test was the highest, followed by local ***: We found that local recurrence is an independent prognostic factor of HCC, indicating that achieving complete treatment for HCC on first treatment is important for improving the prognosis of patients with HCC.

关键词：肝细胞癌血液循环临床表现超声检查

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Scattered and rapid intrahepatic recurrences after radio frequency ablation for hepatocellular carcinoma

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World Journal of Gastroenterology 2005年第43期11卷 6828-6832页

作者： Kazuhiro Kotoh Munechika Enjoji Eiichirou Arimura Shusuke Morizono Motoyuki Kohjima Hironori Sakai Makoto nakamuta Department of Medicine and Bioregulatory Science Department of Gastroenterology

AIM: To evaluate a series of patients with hepatocellular carcinoma (HCC) treated with several different protocols and ***: We treated 138 patients [chronic hepatitis/liver cirrhosis (Child-Pugh A/B/C), 3/135 (107/25/3)]with two different devices and protocols: cool-tip needle [initial ablation at 60 W (standard method) (n=37)or at 40 W (modified method) (n = 28)] or; ablation with a LeVeen needle using a standard single-step, full expansion (single-step) method (n = 39) or a multi-step,incremental expansion (multi-step) ***: Eleven patients experienced rapid and scattered recurrences 1 to 7 mo after the ablation. Nine patients were treated by the cool-tip original protocol (60 W) (9/37=24%) and the other two by the LeVeen single-step method (2/39=5%). The location of the recurrence was surrounding and limited to the site of ablation segment in three cases, and spread over one lobule or both lobules in the other eight cases. There was no recurrence in the patients treated with the modified cool-tip modified method (40 W) or the LeVeen multi-step ***: There is a risk of rapid and scattered recurrence after RFA, especially when the standard cooltip procedure is used. Because such recurrence would worsen the prognosis, we recommend that modified protocols for the cool-tip and LeVeen needle methods should be used in clinical practice.

关键词：肝内循环放射治疗肝细胞癌照射频率

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High relative fat-free mass is important for maintaining serum albumin levels in patients with compensated liver cirrhosis

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World Journal of Gastroenterology 2005年第9期11卷 1356-1360页

作者： Kazuhiro Kotoh Makoto nakamuta Marie Fukushima Chitose Matsuzaki Munechika Enjoji Hironori Sakai Hajime Nawata Department of Medicine and Bioregulatory Science Department of Gastroenterology

AIM: In patients with liver cirrhosis, hypoalbuminemia causes edema and ascites, and a reduction in the quality of life. Since musculature is catabolized to supply amino acids for albumin synthesis in malnutritional cirrhotic patients, muscular volume is hypothesized to play an important role in albumin production. Therefore, we investigated the correlation between serum albumin levels and the fat-free mass (FFM) in cirrhotic ***: Fifty-seven patients (26 males and 31 females)with compensated liver cirrhosis were evaluated. Patients with edema or ascites were excluded from the *** volunteers (n = 104; 48 males and 56 females)were also evaluated as controls. FFM was measured using 5-500 kHz multifrequency bioelectric impedance *** minimize the difference in FFM distribution between males and females, we introduced a new marker, relative FFM (rFFM), which represents the ratio of FFM in a patient relative to that in a volunteer of the same height. Following FFM measurement, the serum albumin levels of patients were assayed ***: In patients with active cirrhosis (alanine aminotransaminase [ALT] ＞50 U/L), both albumin (the difference between maximum and minimum levels) and the standard deviation of albumin levels (SD-albumin) during the observation period showed a significant correlation with rFFM. Multiple linear regression analysis using variables such as rFFM, platelet number, and serum cholesterol levels,choline esterase, albumin, bilirubin, and ALT revealed that rFFM and ALT were significant and independent factors that influenced albumin or SD-albumin in cirrhotic ***: Our results indicate that cirrhotic patients with high rFFM showed less of a decrease in albumin levels, and that the muscle volume is one of the most important factors for maintaining serum albumins level in active cirrhosis. Exercise and protein-rich nutrition at the early stage of liver cirrhosis may be advisable for maintaining or increas

关键词：免疫白蛋白代偿性肝硬化营养学肥胖肌肉

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Dietary habits and behaviors associated with nonalcoholic fatty liver disease

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World Journal of Gastroenterology 2014年第7期20卷 1756-1767页

作者： Kenichiro Yasutake Motoyuki Kohjima Kazuhiro Kotoh Manabu Nakashima Makoto nakamuta Munechika Enjoji Department of Health and Nutrition Sciences Faculty of Health and Social Welfare SciencesNishikyushu UniversityKanzaki 842-8585Japan Department of Gastroenterology and Clinical Research Center Kyushu Medical CenterNational Hospital OrganizationFukuoka 810-8563Japan Department of Hepatology and Pancreatology Kyushu University HospitalFukuoka 812-8582Japan Faculty of Pharmaceutical Sciences Fukuoka UniversityFukuoka 814-0180Japan Health Care Center Fukuoka UniversityFukuoka 814-0180Japan

Nonalcoholic fatty liver disease(NAFLD)is one of the most frequent causes of health problems in Western(industrialized)***,the incidence of infantile NAFLD is increasing,with some of these patients progressing to nonalcoholic *** trends depend on dietary habits and *** particular,overeating and its associated obesity affect the development of *** problems in patients with NAFLD include excess intake of energy,carbohydrates,and lipids,and shortages of polyunsaturated fatty acids,vitamins,and *** nutritional therapeutic approaches are required for prophylaxis and treatment of NAFLD,continuous nutrition therapy is difficult for many patients because of their dietary habits and lifestyle,and because the motivation for treatment differs among ***,it is necessary to assess the nutritional background and to identify nutritional problems in each patient with *** assessing dietary habits,it is important to individually evaluate those that are consumed excessively or insufficiently,as well as inappropriate eating *** nutrition therapy requires patient education,based on assessments of individual nutrients,and continuing the *** this article,we update knowledge about NAFLD,review the important aspects of nutritional assessment targeting treatment success,and present some concrete nutritional care plans which can be applied generally.

关键词： Nonalcoholic fatty liver disease Nutritional thera

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Metastatic hepatocellular carcinoma of the external auditory canal

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World Journal of Gastroenterology 2007年第47期13卷 6436-6438页

作者： Ryuji Yasumatsu Kenji Okura Yumiko Sakiyama Makoto nakamuta Taisei Matsumura Satoru Uehara Tomoya Yamamoto Shizuo Komune Department of Otorhinolaryngology Graduate School of Medical SciencesKyushu University and Department of Otorhinolaryngology and Clinical Research InstituteNational Hospital Organization Kyushu Medical CenterFukuoka 812-8582Japan Department of Otorhino-laryngology and Clinical Research Institute National Hospital Organization Kyushu Medical CenterFukuoka 812-8582Japan Department of Gastro-enterology and Clinical Research Institute National Hospital Organization Kyushu Medical CenterFukuoka 812-8582Japan Department of Radiology and Clinical Research Institute National Hospital Organization Kyushu Medical CenterFukuoka 812-8582Japan Department of Otorhinolaryngology Graduate School of Medical SciencesKyushu UniversityJapan

This report describes a rare case of metastatic hepatocellular carcinoma (HCC) presenting a huge mass in the left external auditory canal (EAC). The patient was a 55-year-old man with hepatitis B virus-related HCC. He presented to our department with a three-month history of increasing left otalgia,and hearing loss with recent fresh aural bleeding. Histopathologic examination indicated that the tumor was secondary to HCC. Although external irradiation was not effective,the tumor was treated with surgical debulking and high dose rate 192 Ir remote afterloading system (RALS) for postoperative intracavitary irradiation. A review of the literature revealed only five other cases of HCC metastasis to the temporal bone,all of which mainly metastasized in the internal acoustic meatus. The present case is the first report of HCC metastasis to the EAC.

关键词：肝细胞癌肿瘤转移听觉肝炎

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Clinical significance of serum levels of vascular endothelial growth factor and its receptor in biliary disease and carcinoma

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World Journal of Gastroenterology 2005年第8期11卷 1167-1171页

作者： Munechika Enjoji Makoto nakamuta Koji Yamaguchi Satoshi Ohta Kazuhiro Kotoh Marie Fukushima Masami Kuniyoshi Tomomi Yamada Masao Tanaka Hajime Nawata Department of Medicine and Bioregulatory Science Department of Surgery and Oncology Medical Information Science

AIM: To investigate the clinical significance of serum vascular endothelial growth factor (VEGF) and soluble VEGF receptor-1 (VEGFR1/Flt-1) (sVEGFR1) levels in biliary ***: We analyzed the serum levels of these proteins in patients with acute cholangitis (group 1), biliary malignancies (group 2), and primary biliary cirrhosis or primary sclerosing cholangitis (group 3), and in healthy donors (group 4). The influence of inflammation was also analyzed. Serum VEGF levels were expressed as VEGF per platelet (VEGF/PLT, pg/106) in order to exclude the influence of platelet ***: sVEGFR1 levels were significantly higher in groups 1 and 2 than in the control group, but did not correlate with inflammatory markers. VEGF/PLT levels were generally higher in patients with active inflammation than in those with carcinoma. C-reactive protein strongly correlated with the levels of serum VEGF independently of platelet and leukocyte counts, even in cancer patients. In cancer patients, VEGF/PLT and sVEGFR1 levels might be indicators for evaluating the effect of medical treatment or the disease ***: Serum VEGF and VEGFR1 might be useful markers for gauging the clinical effect of various treatments on patients.

关键词：免疫血清胆囊疾病胆囊肿瘤血管生长因子

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Male Sex Pheromone of Hepialid Moth,Endoclita excrescens （Lepidoptera:Hepialidae）

Male Sex Pheromone of Hepialid Moth,Endoclita excrescens （L...

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The First Asia—Pacific Conference on Chemical Ecology

作者： T.NAKASHIMA H.KITAJIMA T SATO M.TOKORO K.nakamuta Forestry ＆ Forest Products Research Institute TsukubaIbaraki 305-3687JAPAN

＜正＞The hexane extract of hindlegs of male adults of Hepialid moth,Endoclita excrescens（Lepidoptera:Hepialidae）, induced the electrophysiological response on an antnna of the female moth but not on that of male *** GC/MS data suggested that the structure of the active compound is l,3,8-trimethy1-2,9-dioxabicyclo[3.3.1]non- *** has reported as one of the minor components of the hindleg extract of Hepialus hecta(Schulz et al.,

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Exenatide improves hepatic steatosis by enhancing lipid use in adipose tissue in nondiabetic rats

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World Journal of Gastroenterology 2014年第10期20卷 2653-2663页

作者： Kosuke Tanaka Yuko Masaki Masatake Tanaka Masayuki Miyazaki Munechika Enjoji Makoto nakamuta Masaki Kato Masatoshi Nomura Toyoshi Inoguchi Kazuhiro Kotoh Ryoichi Takayanagi Department of Medicine and Bioregulatory Science Graduate School of Medical Sciences Kyushu University Fukuoka 812-8582 Japan Department of Clinical Pharmacology Faculty of Pharmaceutical Science Fukuoka University Fukuoka 814-0180 Japan Department of Gastroenterology Kyushu Medical Center National Hospital Organization Fukuoka 810-8563 Japan Innovation Center for Medical Redox Navigation Kyushu University Fukuoka 812-8582 Japan

AIM:To investigate the metabolic changes in skeletal muscle and/or adipose tissue in glucagon-like peptide-1-induced improvement of nonalcoholic fatty liver disease(NAFLD).METHODS:Male Wistar rats were fed either a control diet(control group)or a high-fat diet(HFD).After 4wk,the HFD-fed rats were subdivided into two groups;one group was injected with exenatide[HFD-Ex(+)group]and the other with saline[HFD-Ex(-)group]every day for 12 *** control group received saline and were fed a control *** in weight gain,energy intake,and oxygen consumption were *** tolerance tests were performed after 8 wk of *** assessments were performed in liver and adipose *** expression levels of lipid metabolism related genes were evaluated in liver,skeletal muscle,and adipose ***:Exenatide attenuated weight gain[HFDEx(-)vs HFD-Ex(+)]and reduced energy intake,which was accompanied by an increase in oxygen consumption and a decrease in the respiratory exchange ratio[HFD-Ex(-)vs HFD-Ex(+)].However,exenatide did not affect glucose *** reduced lipid content in the liver and adipose *** did not affect the expression of lipid metabolism-related genes in the liver or skeletal *** adipose tissue,exenatide significantly upregulated lipolytic genes,including hormone-sensitive lipase,carnitine palmitoyltransferase-1,long-chain acyl-CoA dehydrogenase,and acyl-CoA oxidase 1[HFD-Ex(-)vs HFD-Ex(+)].Exenatide also upregulated catalase and superoxide dismutase 2[HFD-Ex(-)vs HFD-Ex(+)].CONCLUSION:In addition to reducing appetite,enhanced lipid use by exenatide in adipose tissue may reduce hepatic lipid content in NAFLD,most likely by decreasing lipid influx into the liver.

关键词： Adipose tissue Energy expenditure Exenatide Glucag

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Arterial steroid injection therapy can inhibit the progression of severe acute hepatic failure toward fulminant liver failure

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World Journal of Gastroenterology 2006年第41期12卷 6678-6682页

作者： Kazuhiro Kotoh Munechika Enjoji Makoto nakamuta Tsuyoshi Yoshimoto Motoyuki Kohjima Shusuke Morizono Shinsaku Yamashita Yuki Horikawa Kengo Yoshimitsu Tsuyoshi Tajima Yoshiki Asayama Kousei Ishigami Masakazu Hirakawa Department of Medicine and Bioregulatory Science Graduate School of Medical Science Kyushu University3-1-1 MaidashiHigashi-kuFukuoka 812-8582Japan Department of Clinical Radiology Graduate School of Medical ScienceKyushu University3-1-1 MaidashiHigashi-kuFukuoka 812-8582Japan

AIM: To utilize transcatheter arterial steroid injection therapy (TASIT) via the hepatic artery to reduce hepatic macrophage activity in patients with severe acute hepatic ***: Thirty-four patients with severe acute hepatic failure were admitted to our hospital between June 2002 to June 2006 providing for the possibility of liver transplantation (LT). Seventeen patients were treated using traditional liver supportive procedures, and the other 17 patients additionally underwent TASIT with 1000 mg methylprednisolone per day for 3 continuous days. RESULTS: Of the 17 patients who received TASIT, 13 were cured without any complications, 2 died, and 2 underwent LT. Of the 17 patients who did not receive TASIT, 4 were self-limiting, 7 died, and 6 underwent LT. Univariate logistic analysis revealed that ascites, serum albumin, prothrombin time, platelet count, and TASIT were significant variables for predicating the prognosis. Multivariate logistic regression analysis using stepwise variable selection showed that prothrombin time, platelet count, and TASIT were independent predictive factors. CONCLUSION: TASIT might effectively prevent the progression of severe acute hepatic failure to a fatal stage of fulminant liver failure.

关键词：动脉疾病病理治疗临床肝疾病

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Novel serum tumor marker, RCASl, in pancreatic diseases

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World Journal of Gastroenterology 2005年第33期11卷 5199-5202页

作者： Koji Yamaguchi Munechika Enjoji Manabu Nakashima Makoto nakamuta Takashi Watanabe Masao Tanaka Department of Surgery and Oncology Graduate School of Medicine Kyushu University Japan Medicine Bioregulatory Sciences Graduate School of Medical Sciences Kyushu University Japan Department of Molecular Immunology Medical Institute of Bioregulation Faculty of MedicineKyushu UniversityJapan Department of Molecular Immunology Medical Institute of Bioregulation Faculty of Medicine Kyushu University Japan

AIM: As tumor markers for pancreatic carcinoma,carcinoembryonic antigen (CEA) and carbohydrate antigen (CA) 19-9 have been used, but the sensitivity and specificity are not enough for the diagnosis of pancreatic ***: A novel serum tumor marker, RCAS1, was compared with two conventional serum tumor markers,CEA (highly specific for pancreatic cancer) and CA 19-9 (highly sensitive for pancreatic cancer), in 48 patients with pancreatic exocrine ***: When the diagnosis of benign or malignant conditions was examined by one tumor marker, the sensitivity of RCAS1 alone (55%) was higher than that of CEA alone (27%) and the specificity of RCAS1 alone (92%) was greater than that of CA19-9 alone (78%). When examined by a combination of two markers, the sensitivity of a combination of RCAS1 and CA19-9 (95%) was superior to those of CA19-9 alone (78%), RCAS1 alone (55%, P = 0.002),CEA alone (27%) (P＜0.001), RCAS1 and CEA (59%) and CA19-9 and CEA (82%).CONCLUSION: These results suggest that the combination of RCASL and CA19-9 is highly sensitive for pancreatic carcinoma.

关键词：血浆肿瘤标记物 RCAS1 胰腺癌病理机制抗原

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