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World Journal of Gastroenterology 2007年第41期13卷 5465-5470页

作者： Toru Ishikawa Michitaka Imai Hiroteru Kamimura Atsunori Tsuchiya tadayuki togashi Kouji Watanabe Kei-ichi Seki Hironobu Ohta Toshiaki Yoshida Tomoteru Kamimura Department of Gastroenterology and Hepatology Saiseikai Niigata Second HospitalNiigata 950-1104Japan

AIM： To investigate the poor prognosis of HCC with PVTT, we evaluated the efficacy by a new combination chemotherapy for advanced hepatocellular carcinoma （HCC） with portal vein tumor thrombus （PVTT）. METHODS： From 2002 to 2007, a total of 10 consecutive patients with Stage IVA HCC accompanied by PVTT were studied prospectively to examine the efficacy of treatment by intra-arterial infusion of a chemotherapeutic agents consisting of etoposide, carboplatin, epirubicin and pharmacokinetic modulating chemotherapy by 5-FU and enteric-coated tegafur/uracil. RESULTS： The mean course of chemotherapy was 14.4 （range, 9-21） too. One patient showed complete response （CR） with disappearance of HCC and PVI-F after treatment, and the two patients showed partial response （PR）, response rate （CR ＋ PR/All cases 30%）. The median survival time after the therapy was 457.2 d. The one-year survival rate was 70%. Adverse reactions were tolerable.CONCLUSION： Although the prognosis of most patients with Stage IVA HCC by PVTT is poor, our combination chemotherapy may induces long-term survival and is an effective treatment and produced anti-tumor activity with tolerable adverse effects in patients for advanced Stage IVA HCC accompanied by PVTT.

关键词： Hepatocellular carcinoma Portal vein tumor thrombus Intra-arterial regional chemotherapy

Comparison of a new aspiration needle device and the Quick-Core biopsy needle for transjugular liver biopsy

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World Journal of Gastroenterology 2006年第39期12卷 6339-6342页

作者： Toru Ishikawa Hiroteru Kamimura Atsunori Tsuchiya tadayuki togashi Kouji Watanabe Kei-ichi Seki Hironobu Ohta Toshiaki Yoshida Noriko Ishihara Tomoteru Kamimura Deptartments of Gastroenterology Saiseikai Niigata Second Hospital Niigata Japan Deptartments of Pathology Saiseikai Niigata Second Hospital Niigata Japan

AIM: To evaluate sample adequacy, safety, and needle passes of a new biopsy needle device compared to the Quick-Core biopsy needle for transjugular liver biopsy in patients affected by liver disease. METHODS: Thirty consecutive liver-disease patients who had major coagulation abnormalities and/or relevant ascites underwent transjugular liver biopsy using either a new needle device (18 patients) or the Quick-Core biopsy needle (12 patients). The length of the specimens was measured before fixation. A pathologist reviewed the histological slides for sample adequacy and pathologic diagnoses. The two methods’ specimen adequacy and complication rates were assessed. RESULTS: Liver biopsies were technically successful in all 30 (100%) patients, with diagnostic histological core specimens obtained in 30 of 30 (100%) patients, for an overall success rate of 100%. With the new device, 18 specimens were obtained, with an average of 1.1 passes per patient. Using the Quick-Core biopsy needle, 12 specimens were obtained, with an average of 1.8 passes per patient. Specimen length was significantly longer with the new needle device than with the Quick- Core biopsy needle (P < 0.05). The biopsy tissue was not fragmented in any of the specimens with the new aspiration needle device, but tissue was fragmented in 3 of 12 (25.0%) specimens obtained using the Quick-Core biopsy needle. Complications included cardiac arrhythmia in 3 (10.0%) patients, and transient abdominal pain in 4 (13.3%) patients. There were no cases of subcapsular hematoma, hemoperitoneum, or sepsis, and there was no death secondary to the procedure. In particular, no early or delayed major procedure-related complications were observed in any ***: Transjugular liver biopsy is a safe and effective procedure, and there was significant difference in the adequacy of the specimens obtained using the new needle device compared to the Quick- Core biopsy needle. Using the new biopsy needle device, the specimens

关键词： Liver disease Biopsy-interventional procedures Transjugular biopsy

Successful treatment of multiple lung metastases of hepatocellular carcinoma by combined chemotherapy with docetaxel, cisplatin and tegafur/uracil

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World Journal of Gastroenterology 2009年第14期15卷 1779-1781页

作者： Atsunori Tsuchiya Michitaka Imai Hiroteru Kamimura tadayuki togashi Kouji Watanabe Kei-ichi Seki Toru Ishikawa Hironobu Ohta Toshiaki Yoshida Tomoteru Kamimura Department of Gastroenterology Saiseikai Niigata Second Hospital NishiKu Teraji 280-7 Niigata 950-1104 Japan Division of Gastroenterology and Hepatology Graduate School of Medical and Dental Science Niigata University 1-757 Asahimachi-dori Chuo-ku Niigata 951-8510 Japan

We report the successful treatment of multiple lung metastases after hepatic resection for hepatocellular carcinoma (HCC) with combined docetaxel, cisplatin (CDDP), and enteric-coated tegafur/uracil (UFT-E). A 68-year-old man was diagnosed with multiple lung metastases of HCC 7 mo after partial hepatectomy for HCC. Oral UFT-E was given daily and docetaxel and CDDP were given intra-arterially (administered just before the bronchial arteries) every 2 wk via a subcutaneous injection port. One month after starting chemotherapy, levels of tumor marker, protein induced by vitamin K absence(PIVKA--), decreased rapidly,and after a further month, chest X-ray and computed tomography revealed the complete disappearance of multiple liver metastases. Two years after the combined chemotherapy, HCC recurred in the liver and was treated but no pulmonary recurrence occurred. In the absence of a standardized highly effective therapy, this combined chemotherapy with docetaxel, CDDP and UFT-E may be an attractive option for multiple lung metastases of HCC.

关键词： Hepatocellular carcinoma Docetaxel Lungmetastasis Cisplatin

CT-maximum intensity projection is a clinically useful modality for the detection of gastric varices

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World Journal of Gastroenterology 2005年第47期11卷 7515-7519页

作者： Toru Ishikawa Takashi Ushiki Ken-ichi Mizuno tadayuki togashi Kouji Watanabe Kei-ichi Seki Hironobu Ohta Toshiaki Yoshida Keiko Takeda Tomoteru Kamimura Department of Gastroenterology Saiseikai Niigata Second HospitalNiigataJapan Department of Radiology Saiseikai Niigata Second HospitalNiigataJapan

AIM： To evaluate the efficacy of CT-maximum intensity projection （CT-MIP） in the detection of gastric varices and their infiowing and outflowing vessels in patients with gastric varices scheduled to undergo balloonoccluded retrograde transvenous obliteration （B-RTO）. METHODS： Sixteen patients with endoscopically confirmed gastric varices were included in this study. All patients were evaluated with CT-MIP using threedimensional reconstructions, before and after B-RTO. RESULTS： CT-MIP clearly depicted gastric varices in 16 patients （100%）, the left gastric vein in 6 （32.5%）, the posterior gastric vein in 12 （75.0%）, the short gastric veins in 13 （81.3%）, gastrorenal shunts in 16 （100%）, the hemiazygos vein （HAZV） in 4 （25.0%）, the pericardiophrenic vein （PCPV） in 9 （56.3%）, and the left inferior phrenic vein in 9 patients （56.3%）. Although flow direction itself cannot be determined from CT-MIP, this modality provided clear images of the inflowing and the outflowing vessels. Moreover, in one patient, short gastric veins were not seen on conventional angiographic portography images of the spleen, but were clearly revealed on CT-MIP. CONCLUSION： We suggest that CT-MIP should be considered as a routine method for detecting and diagnosing collateral veins in patients with gastric varices scheduled for B-RTO. Furthermore, CT-MIP is more useful than endoscopy in verifying the early therapeutic effects of B-RTO.

关键词： Gastric varices CT-MIP, Portal hypertension

Angiotensin-Ⅱ administration is useful for the detection of liver metastasis from pancreatic cancer during pharmacoangiographic computed tomography

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World Journal of Gastroenterology 2007年第22期13卷 3080-3083页

作者： Toru Ishikawa Takashi Ushiki Hiroteru Kamimura tadayuki togashi Atsunori Tsuchiya Kouji Watanabe Kei-ichi Seki Hironobu Ohta Toshiaki Yoshida Keiko Takeda Tomoteru Kamimura Department of Gastroenterology and Hepatology Saiseikai Niigata Second Hospital Niigata Japan Department of Radiology Saiseikai Niigata Second Hospital Niigata Japan

AIM: To improve the preoperative diagnosis of liver metastasis from pancreatic cancer, we estimated computed tomography during arterial angiography (CTA) with/without administration of angiotensin-Ⅱ (AT-Ⅱ). METHODS: Thirty-fi ve patients with pancreatic cancer were examined in this study. After conventional CTA was performed, pharmacoangiographic CTA was performed with a 1-3 microgram/5 mL solution of angiotensin Ⅱ injected through a catheter into the celiac artery during spiral computed tomography. We prospectively analyzed the relative region of interest (ROI) ratio of tumor to liver with/without AT-Ⅱ. RESULTS: In all patients, the relative ratio of each computed tomography (CT) number in the ROI was larger at pharmacoangiographic CT than at conventional angiographic CT. Administration of angiotensin-Ⅱ enhanced the metastatic liver tumor as compared with normal tissue. Intratumoral blood flow increased in all patients with malignant tumors due to the pressure effect of AT-Ⅱ. Furthermore, the metastatic lesions in the liver of three patients were represented by only pharmacoangiographic CT, not by conventional CT and conventional CT angiography. In even peripheral and central areas of metastatic liver tumor, the lesions were enhanced after administration of AT-Ⅱ. CONCLUSION: These results support that high detection rate of liver metastasis revealed by pharmacoangiographic CT suggests the improvement of diagnosis on preoperative staging. Moreover, chemotherapy under AT-Ⅱ induced hypertension may have a better effect on the treatment of metastatic liver tumors.

关键词： Angiotensin Ⅱ Phamacoangiographic CT Pancreatic cancer

Equal Sex Ratios of a Marine Green Alga, Bryopsis plumosa

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Journal of Integrative Plant Biology 2008年第6期50卷 648-652页

作者： Tatsuya togashi Paul Alan Cox Marine Biosystems Research Center Chiba University Institute for Ethnomedicine Box 3464 Jackson Hole Wyoming 83001 USA Institute for Ethnomedicine Box 3464 Jackson Hole

By finding some important culture conditions as below, we succeeded in experimentally controlling the whole life history of a dioecious marine green alga, Bryopsis plumosa （Hudson） C. Agardh. In this study, we focused on the primary and secondary sex ratios （i.e. at inception and maturity） using these culture techniques. Gametogenesis was induced by culturing haploid gametophytes with Provasoli＇s enriched seawater （PES） medium under a 14：10 h light： dark cycle at 14 ℃. Formed zygotes grew into diploid sporophytes, which were cultured for 3 months with PES medium under a 14：10 h light ： nbsp;dark cycle at 18℃. Then they were transferred into Schreiber medium and cultured under a 10：14 h light： dark cycle at 22℃. Within 1 week, zoosporogenesis was observed. Zoospores were released within a couple of days. Each zoospore soon germinated and grew into a unisexual gametophyte. The primary sex ratio was examined in gametophytes that originated from a single sporophyte. The secondary sex ratio was studied in the field. Both were estimated as 1：1. Synchronized meiotic cell divisions might occur during zoosporogenesis dividing each sex-determining factor evenly among zoospores. Given the equal sex ratio at maturity, there seems to be no environmental factor that differentially affects the survival of male or female gametophytes in nature.

关键词： algal culture Bryopsis green algae life history sex ratio.

Synthesis of Novel Metal Ion Sensors Based on DNA-Metal Interactions

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复旦学报(自然科学版) 2005年第5期 215-216页

作者： Akira Ono,Humika togashi,Yoko Miyake Department of Applied Chemistry Faculty of Engineering Kanagawa University 3-27-1 Rokkakubashi Kanagawa-ku Yokohama-shi Kanagawa-ken 221-8686 Japan Department of Chemistry Faculty of Science Tokyo Metropolitan University 1-1 Minami-ohsawa Hachioji Tokyo 192-0397 Japan Department of Chemistry Faculty of Science Tokyo Metropolitan University 1-1 Minami-ohsawa Hachioji Tokyo 192-0397 Japan

Synthesis of Novel Metal Ion Sensors Based on DNA-Metal Interactions

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复旦学报（自然科学版） 2005年第5期44卷 825-826页

作者： Akira Ono Shiqi Cao Hurnika togashi Yoko Miyake Department of Applied Chemistry Faculty of Engineering-Kanagar.oa University 3-27-1 RokkakubashiiKanagazoa-ku Yokohama-shi Kanagazoa-ken 221-8686Japan Department of Chemistry Faculty of ScienceTokyo Metropolitan University 1-1 Minami-ohsawa Hachioji Tokyo 192-0397Japan

The interactions of metal ions with nucleic acids, nucleosides, and nucleo-bases have been extensively investigated[1,2]. We have reported that thymine-thymine (T-T) and cytosine-cytosine (C- C) miss base pairs in DNA duplexes highly selectively capture HgⅡ ion and Ag Ⅰ ion, which result in formations of metal-mediated base pairs, T-HgⅡ -T and C-AgⅠ -C, in duplexes[3]. The phenomenon is expected to be useful for a variety of studies such as synthesis of nano-wires containing metal ions, developing metal-ion sensing methods, ***, we report novel oligodeoxyribonucleotide (ODN)-based sensors that detect HgⅡ ions and AgⅠ ions in aqueous solutions.

关键词：金属离子传感器 DNA 交感作用核酸核苷

Clostridium difficile-associated diarrhea after living donor liver transplantation

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World Journal of Gastroenterology 2007年第14期13卷 2072-2076页

作者： Masao Hashimoto Yasuhiko Sugawara Sumihito Tamura Junichi Kaneko Yuichi Matsui Junichi togashi Masatoshi Makuuchi Artificial Organ and Transplantation Division Department of Surgery Graduate School of MedicineUniversity of Tokyo7-3-1 HongoBunkyo-kuTokyo 113-8655Japan

AIM： To assess the incidence and analyze the risk factors for Clostridium difficile-associated diarrhea （CDAD）after living donor liver transplantation （LDLT） in adult.METHODS： The micobiological data and medical records of 242 adult recipients that underwent LDLT at the Tokyo University Hospital were analyzed retrospectively. The independent risk factors for postoperative CDAD were identified.RESULTS： Postoperative CDAD occurred in 11 （5%）patients. Median onset of CDAD was postoperative d 19（range, 5-54）. In the multivariate analyses, male gender （odds ratio, 4.56） and serum creatinine （≥ 1.5 mg/dL,odds ratio, 16.0） independently predicted postoperative CDAD.CONCLUSION： CDAD should be considered in the differential diagnosis of patients with postoperative diarrhea after LDLT.

关键词： Living donor liver transplantation Clostridiumdifficile Diarrhea

Percutaneous endoscopic necrosectomy for walled-off necrosis in the retroperitoneal space of the elderly:A case report

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世界临床病例杂志 2023年第24期11卷 5736-5741页

作者： Kentaro Sato Goro Shibukawa Kenta Ueda Yuki Nakajima Kazutomo togashi Hiromasa Ohira Department of Gastroenterology Aizu Medical Center Fukushima Medical UniversityAizuwakamatsu 969-3492FukushimaJapan Department of Gastroenterology Fukushima Medical University School of MedicineFukushima 960-1295FukushimaJapan

BACKGROUND Walled-off necrosis(WON)is a late complication of acute pancreatitis possibly with a fatal *** for WON spreading to the retroperitoneal space,percutaneous endoscopic necrosectomy(PEN)can be an alternate approach to surgical necrosectomy,particularly for the older individuals or patients with poor condition because of *** SUMMARY An 88-year-old man was admitted to our hospital with a *** retrograde cholangiopancreatography(ERCP)was performed to improve jaundice;however,post-ERCP pancreatitis *** inflammation of pancreatitis spread widely from the right retroperitoneal cavity to the pelvis,and WON was formed 4 wk later.A percutaneous drainage tube was placed into the WON under computed tomography ***,the drainage did not ameliorate clinical symptoms including fever,which assured less invasive necrosectomy.A metallic stent for the upper gastrointestinal(GI)tract was placed from the percutaneous drainage *** upper GI endoscope was inserted into the inside of the WON through the metallic stent,and the necrotic tissues were bluntly removed with a snare *** times of these necrosectomies resulted in the near-complete removal of necrotic *** procedures consequently abated his fever and remarkable improvement in blood *** PEN for WON occurring in the retroperitoneal space was safe and effective for very old individuals.

关键词： Walled-off necrosis Percutaneous drainage Endoscopic necrosectomy Post endoscopic retrograde cholangiopancreatography pancreatitis Elderly Case report