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Thyroid hormone alterations in trauma patients requiring massive transfusion: An observational study

World Journal of Emergency Medicine 2014年第4期5卷 270-274页

作者： Toru Hifumi Ichiro Okada Nobuaki Kiriu Eiju Hasegawa tomoko ogasawara Hiroshi Kato Yuichi Koido Junichi Inoue Yuko Abe Kenya Kawakita Masanobu Hagiike Yasuhiro Kuroda Emergency Medical Center Kagawa University Hospital Division of Critical Care Medicine and Trauma National Hospital Organization Disaster Medical Center Division of Critical Care Medicine and Trauma Yamanashi Prefectural Central Hospital

BACKGROUND: Although non-thyroidal illness syndrome(NTIS) is considered a negative prognostic factor, the alterations in free triiodothyronine(f T3) levels in trauma patients requiring massive transfusion have not been ***: A prospective observational study comparing 2 groups of trauma patients was conducted. Group M comprised trauma patients requiring massive transfusions(>10 units of packed red blood cells) within 24 hours of emergency admission. Group C comprised patients with an injury severity score >9 but not requiring massive transfusions. Levels of f T3, free thyroxine(f T4), and thyroidstimulating hormone(TSH) were evaluated on admission and on days 1, 2, and 7 after admission. The clinical backgrounds and variables measured including total transfusion amounts were compared and the inter-group prognosis was evaluated. Results are presented as mean±standard ***: Nineteen patients were enrolled in each group. In both groups, 32 were men, and the mean age was 50±24 years. In group C one patient died from respiratory failure. The initial f T3 levels in group M(1.95±0.37 pg/m L) were signifi cantly lower than those in group C(2.49±0.72 pg/m L; P<0.01) and remained low until 1 week after admission. Initial inter-group f T4 and TSH levels were not significantly different. TSH levels at 1 week(1.99±1.64 μIU/m L) were higher than at admission(1.48±0.5 μIU/m L) in group C(P<0.05).CONCLUSION: Typical NTIS was observed in trauma patients requiring massive transfusions. When initial resuscitation achieved circulatory stabilization, prognosis was not strongly associated with NTIS.

关键词： Non-thyroidal illness syndrome Massive transfusion Trauma Freetriiodothyronine Thyroid hormone

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Transcatheter arterial infusion for advanced hepatocellular carcinoma: Who are candidates?

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World Journal of Gastroenterology 2015年第29期21卷 8888-8893页

作者： Eiichiro Suzuki Tetsuhiro Chiba Yoshihiko Ooka Sadahisa ogasawara Akinobu Tawada Tenyu Motoyama Naoya Kanogawa tomoko Saito Masaharu Yoshikawa Osamu Yokosuka Department of Gastroenterology and Nephrology Graduate School of Medicine Chiba University

AIM: To elucidate anticancer effects of transcatheter arterial infusion chemotherapy(TAI) in patients with hepatocellular carcinoma(HCC). METHODS: Data from a total of 95 patients with HCC who received TAI were analyzed retrospectively. The efficacy of TAI was evaluated according to the Response Evaluation Criteria in Cancer of the Liver. Overall survival was calculated from the date of initial treatment to the date of death or last follow-up. Survival curves were calculated by the Kaplan-Meier method, and differences in survival were evaluated by the log rank test. Clinical variables that were identified as statistically different by a univariate analysis were included into the Cox proportional hazard regression model for multivariate analysis. A prognostic index based on the regression coefficients derived from variables identified by the multivariate analysis was constructed. Stratification of the patients was conducted using this prognostic index. RESULTS: The patient group was comprised of 76 men and 19 women with an average age of 68 years(range: 37-82 years). Six patients(6.3%) showedcomplete response and 18 patients(18.9%) showed partial response, for an overall response rate of 25.2%. The median overall survival was 27.6 mo, and the proportions of survivors at 1, 2, and 5 years were 67.4%, 54.0%, and 17.4%, respectively. Multivariate analysis demonstrated that no prior transcatheter arterial chemoembolization, lactate dehydrogenase < 230 IU/L, and performance status of 0 were the independent favorable prognostic factors. The development of a 0-3-point prognostic score index was based on the sum of these three prognostic factors. Subsequently, the patients were categorized into three groups: those with a good(prognostic index = 0-1; n = 54), intermediate(prognostic index = 2; n = 26), or poor(prognostic index = 3; n = 15) prognosis. The median survival times in these three groups were 41.0, 21.2, and 6.8 mo, respectively(P < 0.01). CONCLUSION: Our simple pro

关键词： Hepatocellular carcinoma Interventionalradiology Prognostic factor Survival Transcatheterarterial infusion

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Biological features and biomarkers in hepatocellular carcinoma

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世界肝病学杂志：英文版（电子版） 2015年第16期7卷 2020-2028页

作者： Tetsuhiro Chiba Eiichiro Suzuki tomoko Saito Sadahisa ogasawara Yoshihiko Ooka Akinobu Tawada Atsushi Iwama Osamu Yokosuka Department of Gastroenterology and Nephrology Graduate School of Medicine Chiba University Department of Cellular and Molecular Medicine Graduate School of Medicine Chiba University

Similar to other cancers, a multistep process of carcinogenesis is observed in hepatocellular carcinoma(HCC). Although the mechanisms underlying the development of HCC have been investigated in terms of oncology, virology, and stem cell biology, the whole picture of hepatocarcinogenesis remains to be elucidated. Recent progress in molecular biology has provided clues to the underlying cause of various diseases. In particular, sequencing technologies, such as whole genome and exome sequencing analyses, have made an impact on genomic research on a variety of cancers including HCC. Comprehensive genomic analyses have detected numerous abnormal genetic alterations, such as mutations and copy number alterations. Based on these findings, signaling pathways and cancer-related genes involved in hepatocarcinogenesis could be analyzed in detail. Simultaneously, a number of novel biomarkers, both from tissue and blood samples, have been recently reported. These biomarkers have been successfully applied to early diagnosis and prognostic prediction of patients with HCC. In this review, we focus on the recent developments in molecular cancer research on HCC and explain the biological features and novel biomarkers.

关键词： Hepatocellular carcinoma Heterogenity Molecular biology Oncology Sorafenib

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