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Case Study on Focal Retrograde Amnesia due to Limbic Encephalitis

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World Journal of Neuroscience 2020年第2期10卷 91-100页

作者： nobuhiro takahashi Mimpei Kawamura Naoki Tanihara Mamiko Sato Yasutaka Kobayashi Department of Rehabilitation Speech-Language-Hearing Therapy Fukui Health Science University Fukui Japan Fukui Higher Brain Dysfunction Support Center Fukui Japan Department of Rehabilitation Speech-Language-Hearing Therapy Fukui General Hospital Fukui Japan Department of Rehabilitation Medicine Fukui General Hospital Fukui Japan

This case study addresses episodic memory impairment or focal retrograde amnesia related to limbic encephalitis. The patient in question was a right-handed man in his 60s who developed focal retrograde amnesia due to limbic encephalitis. An abnormal MRI signal was observed in the right medial temporal lobe. Immediately after the encephalitis onset, mental symptoms—including impaired consciousness, disorientation, hallucinations, and delusions—appeared;however, his condition improved with medical treatment. After transfer to a convalescent and rehabilitation hospital, various neuropsychological tests were conducted but no apparent functional decline was observed in intellectual function, attention, memorization, or retention. However, the patient exhibited impairments related to autobiographical memory and memory of events 4?-?5 years before the onset of limbic encephalitis. Based on these observations, the patient was considered to exhibit focal retrograde amnesia due to limbic encephalitis. Despite exhibiting retrograde amnesia, he had no difficulty in his daily life in the ward. Moreover, after discharge from hospital, smooth work reinstatement was possible. This case demonstrates that, even after exhibiting retrograde amnesia, if its duration is relatively short and physical function and other higher-order brain functions are sustained, social rehabilitation—including work reinstatement—is feasible.

关键词： Limbic Encephalitis Focal Retrograde Amnesia Medial Temporal Lobe Topographic Disorientation Social Rehabilitation

Human platelets inhibit liver fibrosis in severe combined immunodeficiency mice

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World Journal of Gastroenterology 2013年第32期19卷 5250-5260页

作者： Kazuhiro takahashi Soichiro Murata Kiyoshi Fukunaga nobuhiro Ohkohchi Department of Surgery University of Tsukuba

AIM:To investigate the role of human platelets in liver ***:Severe combined immunodeficiency(SCID)mice were administered CCl4and either phosphate-buffered saline(PBS group)or human platelet transfusions(hPLT group).Concentrations of hepatocyte growth factor(HGF),matrix metallopeptidases(MMP)-9,and transforming growth factor-β(TGF-β)in the liver tissue were compared between the PBS and the hPLT groups by enzyme-linked immunosorbent assay(ELISA)and Western *** effects of a human platelet transfusion on liver fibrosis included the fibrotic area,hydroxyproline content,and-smooth muscle actin(α-SMA)expression,which were evaluated by picrosirius red staining,ELISA,and immunohistochemical staining using an anti-mouse-SMA antibody,*** of mesenchymal-epithelial transition factor(Met)and SMAD3,downstream signals of HGF and TGF-β,were compared between the two groups by Western blotting and were quantified using *** apoptosis was evaluated by terminal deoxynucleotidyl transferase dUTP nick end ***,the accumulation of human platelets in the liver 2 h after platelet transfusion was compared between normal and fibrotic livers by immunohistochemical staining using an anti-human CD41 ***:The fibrotic area and hydroxyproline content in the liver were both significantly lower in the hPLT group when compared to the PBS group(fibrotic area,1.7%±0.6%vs 2.5%±0.6%,P=0.03;hydroxyproline content,121±26 ng/g liver vs 156±47 ng/g liver,P=0.04).There was less α-smooth muscle actin staining in the hPLT group than in the PBS group(0.5%±0.1%vs 0.8%±0.3%,P=0.02).Hepatic expression levels of mouse HGF and MMP-9were significantly higher in the hPLT group than in the PBS group(HGF,109±13 ng/g liver vs 88±22 ng/g liver,P=0.03;MMP-9,113%±7%/GAPDH vs 92%±11%/GAPDH,P=0.04).In contrast,the concentration of mouse TGF-β in the liver tissue was significantly lower in the hPLT group than in the PBS group(22±5ng/g

关键词： Human platelet Liver fibrosis Hepatocyte apoptosis Hepatocyte growth factor Transforming growth factor-β Matrix metallopeptidases

Thrombocytopenia after liver transplantation:should we care?

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World Journal of Gastroenterology 2018年第13期24卷 1386-1397页

作者： Kazuhiro takahashi Shunji Nagai Mohamed Safwan Chen Liang nobuhiro Ohkohchi Department of Surgery Division of Gastroenterological and Hepatobiliary Surgery and Organ Transplantation University of TsukubaTsukubaIbaraki 3058575Japan Transplant and Hepatobiliary Surgery Henry Ford HospitalDetroitMl 48202United States

Transient thrombocytopenia is a common phenomenon after liver transplantation. After liver transplantation(LT), platelet count decreases and reaches a nadir on postoperative days 3-5, with an average reduction in platelet counts of 60%; platelet count recovers to preoperative levels approximately two weeks after LT. The putative mechanisms include haemodilution, decreased platelet production, increased sequestration, medications, infections, thrombosis, or combination of these processes. However, the precise mechanisms remain unclear. The role of platelets in liver transplantation has been highlighted in recent years, and particular attention has been given to their effects beyond hemostasis and thrombosis. Previous studies have demonstrated that perioperative thrombocytopenia causes poor graft regeneration, increases the incidence of postoperative morbidity, and deteriorates the graft and decreases patient survival in both the short and long term after liver transplantation. Platelet therapies to increase perioperative platelet counts, such as thrombopoietin, thrombopoietin receptor agonist, platelet transfusion, splenectomy, and intravenous immunoglobulin treatment might have a potential for improving graft survival, however clinical trials are lacking. Further studies are warranted to detect direct evidence on whether thrombocytopenia is the cause or result of poor-graft function and postoperative complications, and to determine who needs platelet therapies in order to prevent postoperative complications and thus improve post-transplant outcomes.

关键词： Thrombocytopenia Liver regeneration Platelet therapy Platelet Thrombopoietin receptor agonist Intravenous immunoglobulin treatment Liver transplantation

Complete response to multidisciplinary therapy in a patient with primary gastric choriocarcinoma

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World Journal of Gastroenterology 2013年第31期19卷 5187-5194页

作者： Kazuhiro takahashi Shigeki Tsukamoto Ken Saito nobuhiro Ohkohchi Katsu Hirayama Division of Gastro-enterological and Hepatobiliary Surgery and Organ Transplantation Department of Surgery University of Tsukuba Tsukuba 3058575 Japan Department of Surgery Hiraka General Hospital Yokote 0138610 Japan

Primary gastric choriocarcinoma is a rapidly growing neoplasm with an average survival of several months in untreated *** with lymph node dissection followed by chemotherapy is the treatment of *** used for gastric adenocarcinoma are usually ***,median survival remains less than six *** this case report,we describe a case of primary gastric choriocarcinoma with a clinical complete response to multidisciplinary treatment including surgery,chemotherapy,and radiofrequency ablation(RFA).The patient was originally referred for general *** demonstrated a large tumor occupying the fornix,and total gastrectomy with lymph node dissection was *** days later,multiple liver metastatic recurrences with high serum levels of beta-human chorionic gonadotropin(β-hCG) were *** with a gonadal choriocarcinoma regimen consisting of etoposide,methotrexate,actinomycin D,cyclophosphamide,and vincristine(EMA/CO),was *** three cycles,serum β-hCG decreased markedly and the tumors *** months later,multiple lung metastatic recurrences were *** one cycle of EMA/CO,only one nodule *** tomography-guided RFA was performed for this oligometastatic *** patient has been alive with no evidence of disease for 10 years after the initial *** the best of our knowledge,this patient with recurrent primary gastric choriocarcinoma has achieved the longest *** present case is the first report of choriocarcinoma metastatic to the lung successfully treated with *** our retrospective analysis of recurrent or unresectable primary gastric choriocarcinoma,we propose that gonadal choriocarcinoma regimens can be considered as first-line for primary gastric choriocarcinoma.

关键词： Primary gastric choriocarcinoma Betahuman chorionic gonadotropin Etoposide,methotrexate,actinomycin D,cyclophosphamide,and vincristine Oligometastatic Radiofrequency ablation

Dualistic role of platelets in living donor liver transplantation: Are they harmful?

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World Journal of Gastroenterology 2022年第9期28卷 897-908页

作者： Chen Liang Kazuhiro takahashi Kinji Furuya nobuhiro Ohkohchi Tatsuya Oda Gastrointestinal and Hepatobiliary-Pancreatic Surgery University of TsukubaTsukuba 3058575IbarakiJapan

Platelets are anucleate fragments mainly involved in hemostasis and thrombosis,and there is emerging evidence that platelets have other nonhemostatic potentials in inflammation,angiogenesis,regeneration and ischemia/reperfusion injury(I/R injury),which are involved in the physiological and pathological processes during living donor liver transplantation(LDLT).LDLT is sometimes associated with impaired regeneration and severe I/R injury,leading to postoperative complications and decreased patient *** studies have suggested that perioperative thrombocytopenia is associated with poor graft regeneration and postoperative morbidity in the short and long term after *** it is not fully understood whether thrombocytopenia is the cause or result,increasing platelet counts are frequently suggested to improve posttransplant outcomes in clinical *** on rodent experiments,previous studies have identified that platelets stimulate liver regeneration after partial ***,the role of platelets in LDLT is controversial,as platelets are supposed to aggravate I/R injury in the ***,a rat model of partial liver transplantation(LT)was used to demonstrate that thrombopoietin-induced thrombocytosis prior to surgery accelerated graft regeneration and improved the survival rate after *** was clarified that platelet-derived liver regeneration outweighed the associated risk of I/R injury after partial *** strategies to increase perioperative platelet counts,such as thrombopoietin,thrombopoietin receptor agonist and platelet transfusion,may improve graft regeneration and survival after LDLT.

关键词： Platelet Liver transplantation Regeneration Ischemia/reperfusion injury Kupffer cell Oxidative stress

Recurrent renal cell carcinoma leading to a misdiagnosis of polycystic liver disease: A case report

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World Journal of Gastroenterology 2019年第18期25卷 2264-2270页

作者： Chen Liang Kazuhiro takahashi Masanao Kurata Shingo Sakashita Tatsuya Oda nobuhiro Ohkohchi Department of Surgery University of Tsukuba Department of Diagnostic Pathology University of Tsukuba

BACKGROUND Polycystic liver disease(PCLD) with a large cystic volume deteriorates the quality of life of patients through substantial effects on the adjacent organs,recurrent cyst infections, cyst rupture, and hemorrhage. Surgical or radiological intervention is usually needed to alleviate these symptoms. We report a rare case of the cystic metastasis of renal cell carcinoma(RCC), which was misdiagnosed as PCLD, as a result of the clinical and radiological similarity between these *** SUMMARY A 74-year-old female who had undergone nephrectomy for papillary-type RCC(PRCC) was suffering from abdominal pain and the recurrent intracystic hemorrhage of multiple cysts in the liver. Imaging studies and aspiration cytology of the cysts showed no evidence of malignancy. With a diagnosis of autosomal dominant polycystic liver disease, the patient received hepatectomy for the purpose of mass reduction and infectious cyst removal. Surgery was performed without complications, and the patient was discharged on postoperative day 14. Postoperatively, the pathology revealed a diagnosis of recurrent PRCC with cystic *** This case demonstrates the importance of excluding the cystic metastasis of a cancer when liver cysts are observed.

关键词： Polycystic liver disease Polycystic kidney disease Cystic metastasis Renal cell carcinoma Case report

Voltammetric response of ferroceneboronic acid to diol and phenolic compounds as possible pollutants

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Journal of Environmental Sciences 2011年第6期23卷 1027-1032页

作者： Shigehiro takahashi Naoyuki Abiko nobuhiro Haraguchi Hiroyuki Fujita Eriko Seki Tetsuya Ono Kentaro Yoshida Jun-ichi Anzai Graduate School of Pharmaceutical Sciences Tohoku UniversityAramakiAoba-kuSendai 980-8578Japan School of Pharmaceutical Sciences Ohu University31-1 MisumidoTomita-machiKoriyamaFukushima 963-8611Japan

A voltammetric determination of possible organic pollutants such as diol and phenolic compounds in water was studied using ferroceneboronic acid（FBA） as a redox-active marker.A cyclic voltammogram of FBA exhibited a pair of oxidation and reduction peaks at 230 and 170 mV at pH 7.0,respectively,while another pair of redox peaks was observed in the presence of diol or phenolic compounds *** results were rationalized based on the formation of boronate esters of FBA with the added *** changes in the redox peak currents were dependent on the concentration of the additives,suggesting a usefulness of FBA in the electrochemical determination of these compounds in water.

关键词： ferroceneboronic acid sugar phenolic compound cyclic voltammetry pollutants in water electrochemical determination

Adjuvant surgery for advanced extrahepatic cholangiocarcinoma

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World Journal of Gastroenterology 2013年第40期19卷 6934-6938页

作者： Yukio Oshiro Kazuhiro takahashi Ryoko Sasaki Tadashi Kondo Shingo Sakashita nobuhiro Ohkohchi Department of Surgery Division of Gastroenterological and Hepatobiliary Surgeryand Organ TransplantationUniversity of TsukubaTsukuba 305-8575Japan Department of Pathology Faculty of MedicineUniversity of TsukubaTsukuba 305-8575Japan

Patients with StageⅣcholangiocarcinoma are currently not considered to be surgical candidates and are typically offered systemic ***,several novel systemic chemotherapy regimens have allowed an initially unresectable cholangiocarcinoma to be *** aim of this article is to present the usefulness of adjuvant surgery in a case of advanced cholangiocarcinoma that was successfully treated with gemcitabine.A 72-year-old man was diagnosed with distal cholangiocarcinoma with liver metastases(cT2N0M1,StageⅣ).He underwent metal stent placement in the duodenum to alleviate *** 18courses of chemotherapy using gemcitabine without severe drug toxicities,a computed tomography scan showed that the liver metastases in S6 and S7 had *** patient underwent subtotal stomachpreserving pancreaticoduodenectomy and lymph node *** pathological stage was pT2N0M0,StageⅠ*** patient underwent 6 cycles of adjuvant chemotherapy using *** patient is alive and well 6 years and 9 mo after the diagnosis.

关键词： Extrahepatic cholangiocarcinoma Adjuvant surgery Conversion surgery Chemotherapy Gemcitabine

Platelet therapy:A novel strategy for liver regeneration,anti-fibrosis,and anti-apoptosis

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World Journal of Surgical Procedures 2013年第3期3卷 29-36页

作者： Kazuhiro takahashi Soichiro Murata nobuhiro Ohkohchi Department of Surgery Division of Gastroenterological and Hepatobiliary Surgery and Organ TransplantationUniversity of TsukubaIbaraki 305-8575Japan

Platelets contain bio-physiological substances, including insulin-like growth factor-1, vascular endothelial growth factor, platelet-derived growth factor,hepatocyte growth factor, serotonin, transforming growth factor-β, adenosine diphosphate, adenosine tri-phosphate, and epidermal growth factor. Platelets have conventionally been considered to exacerbate the inflammatory response and liver injury. Recently,platelets were discovered to have a positive impact on the liver. In this review, we present experimenta and clinical evidence indicating that platelets accelerate liver regeneration and have anti-fibrosis and antiapoptosis activity, and we detail the mechanisms of action. Platelets accelerate liver regeneration by three different mechanisms:(1) a direct effect on hepatocytes,(2) a cooperative effect with liver sinusoidal endothelial cells, and(3) a collaborative effect with Kupffer cells. Platelets exert anti-fibrotic activity by deactivating hepatic stellate cells via the adenosinecyclic adenosine 5'-monophosphate signaling *** prevent hepatocyte apoptosis by activating the Akt pathway and up-regulating Bcl-x L, which sup-presses caspase-3 activation. Platelet therapy with thrombopoietin, thrombopoietin receptor agonists, and platelet transfusion has the advantages of convenience and cost-efficiency over other treatments. We propose that in the future, platelet therapy will play a promising role in the treatment of the various liver disorders that currently challenge the surgical field, such as liver failure after a massive hepatectomy, hepatectomy of a cirrhotic liver, and small grafts in liver transplantation.

关键词： Platelet therapy Liver regeneration Liver fibrosis Hepatocyte apoptosis Growth factor