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Branched-chain amino acid treatment before transcatheter arterial chemoembolization for hepatocellular carcinoma

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World Journal of Gastroenterology 2012年第12期18卷 1379-1384页

作者： Hiroki Nishikawa Yukio Osaki Tadashi Inuzuka Haruhiko Takeda Jun Nakajima Fumihiro Matsuda Shinichiro Henmi Azusa Sakamoto Tetsuro Ishikawa Sumio Saito Ryuichi Kita toru kimura Department of Gastroenterology and Hepatology Osaka Red Cross Hospital

AIM： To examine the significance of branched-chain amino acid （BCAA） treatment before transcatheter arterial chemoembolization （rACE） for hepatocellular carcinoma （HCC）.METHODS： This study included 99 patients who underwent TACE therapy for HCC at our hospital and were followed up without treatment for at least 6 mo between January 2004 and January 2010. They were divided into 2 groups： those receiving BCAA granules （/7 = 40） or regular diet （n = 59, control）. Data obtained were retrospectively analyzed （prior to TACE, and 1 wk, 1, 3, and 6 mo after TACE） in terms of nutritional condition and clinical laboratory parameters （serum albumin level and Child-Pugh score）, both of which are determinants of hepatic functional reserve.RESULTS： The BCAA group comprised 27 males and 13 females with a mean age of 69,9 ：E 8,8 years, The patients of the BCAA group were classified as follows： Child-Pugh A/B/C in 22/15/3 patients, and Stage Ⅱ/Ⅲ/ /IVA HCC in 12/23/5 patients, respectively. The controlgroup comprised 32 males and 27 females with a mean age of 73.2 ± 10.1 years. In the control group, 9 patients had chronic hepatitis, Child-Pugh A/B/C in 39/10/1 patients, and Stage Ⅰ/Ⅱ/Ⅲ/IVA HCC in 1/11/35/12 patients, respectively. Overall, both serum albumin level and Child-Pugh score improved significantly in the BCAA group as compared with the control 3 and 6 mo after TACE （P 〈 0.05）. Further analysis was performed by the following categorization：（1） child-Pugh classification; （2） liver cirrhosis subgroup with a serum albumin level 〉 3.5 g/dL; and （3） epirubicin dose. A similar trend indicating a significant improvement of all variables in the BCAA group was noted （P 〈 0.05）.CONCLUSION： Treatment with BCAA granules in patients who have undergone TACE for HCC is considered useful to maintain their hepatic functional reserve.

关键词： Hepatocellular carcinoma Branched-chainamino acid granules Transcatheter arterial chemoembo-lization Liver function Improvement Cirrhosis Protein-energy malnutrition

A Study on Diagnostic Assist Systems of Chronic Obstructive Pulmonary Disease from Medical Images by Deep Learning

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Journal of Computer and Communications 2018年第1期6卷 21-31页

作者： toru kimura Takashi Kawakami Akihiro Kikuchi Ryosuke Ooev Masaki Akiyama Hiroyuki Horikoshi Faculty of Engineering Hokkaido University of Science Sapporo Japan Department of Radiology Gunma Prefecture Cancer Center Gunma Japan

In this paper, we propose new diagnostic assist systems of medical images using deep learning algorithms. Specifically, we aim to develop a diagnostic support system for the very early stage of chronic obstructive pulmonary disease (COPD) based on the CT images. It is said that COPD is a disease that develops due to long-term smoking, and it is said that there are a large number of latent onset reserve forces. By discovering this COPD in the very early period 0 and improving the living conditions, subsequent severity can be avoided in many cases, so a system that will help diagnosis by professional radiologists is needed. We show the some experimental results examined by the constructed system.

关键词： Deep Learning CT Images Diagnostic Assist Systems Chronic Obstructive Pulmonary Disease

Vascular endothelial growth factor 165b expression in stromal cells and colorectal cancer

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World Journal of Gastroenterology 2011年第44期17卷 4867-4874页

作者： Makoto Tayama Tomohisa Furuhata Yoshiko Inafuku Kenji Okita Toshihiko Nishidate toru Mizuguchi Yasutoshi kimura Koichi Hirata the First Department of Surgery Sapporo Medical University

AIM:To characterize the implications of vascular endothelial growth factor(VEGF)-A in stromal cells and colorectal cancer and the expression of VEGF-A splice ***:VEGF-A expression in tumor and stromal cells from 165 consecutive patients with colorectal cancer was examined by *** association between VEGF-A expression status and clinicopathological factors was *** freshfrozen samples were obtained for laser capture microdissection to analyze the splice variants of ***:VEGF-A was expressed in 53.9% and 42.4% of tumor and stromal cells,***-A expression in tumor cells(t-VEGF-A) was associated with advanced clinical stage(stage 0,1/9;stage 1,2/16;stage 2,32/55;stage 3,38/66;stage 4,16/19,P < 0.0001).VEGF-A expression in stromal cells(s-VEGF-A) increased in the earlier clinical stage(stage 0,7/9;stage 1,6/16;stage 2,33/55;stage 3,22/66;stage 4,5/19;P = 0.004).Multivariate analyses for risk factors of recurrence showed that only s-VEGF-A expression was an independent risk factor for recurrence(relative risk 0.309,95% confidence interval 0.141-0.676,P = 0.0033).The five-year disease-free survival(DFS) rates of t-VEGF-A-positive and-negative cases were 51.4% and 62.9%,*** was no significant difference in t-VEGF-A expression *** five-year DFS rates of s-VEGF-A-positive and-negative cases were 73.8% and 39.9%,respectively.s-VEGFA-positive cases had significantly better survival than s-VEGF-A-negative cases(P = 0.0005).Splice variant analysis revealed that t-VEGF-A was mainly composed of VEGF165 and that s-VEGF-A included both VEGF165 and *** cases with no venous invasion(v0),the level of VEGF165b mRNA was significantly higher(v0 204.5 ± 122.7,v1 32.5 ± 36.7,v2 2.1 ± 1.7,P = 0.03).The microvessel density tended to be lower in cases with higher VEGF165b mRNA ***:s-VEGF-A appears be a good prognostic factor for colorectal cancer and includes VEGF165 and VEGF165b.

关键词： Colorectal cancer Vascular endothelial growth factor-A Vascular endothelial growth factor 165 Microvascular density Stromal cell

Assessment of liver fibrosis by a noninvasive method of transient elastography and biochemical markers

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World Journal of Gastroenterology 2006年第27期12卷 4325-4330页

作者： Masaki Kawamoto toru Mizuguchi Tadashi Katsuramaki Minoru Nagayama Hideki Oshima Hiroyuki Kawasaki Takayuki Nobuoka Yasutoshi kimura Koichi Hirata Department of Surgery Ⅰ Sapporo Medical University HospitalSapporo Medical University School of MedicineS-1W-16Chuo-KuSapporoHokkaido 060-8543Japan

AIM： To assess the correlation between the fibrotic area （FA） as calculated by a digital image analysis （DIA）, and to compare the diagnostic accuracy of FibroScan to the other existing Liver fibrosis （LF） markers using the receiver operating curve analysis.METHODS： We recruited 30 patients who underwent a liver resection for three different etiologies including normal liver, hepatitis B, and hepatitis C. Liver stiffness was measured by using a FibroScan. The FA was then calculated by DIA to evaluate LF in order to avoid any sampling bias. RESULTS： The FA negatively correlated with Prothrombin time （PT）, platelet count, lecithin-cholesterol acyltransferase （LCAT）, and pre-albumin （ALB）. On the other hand, the findings of FibroScan correlated with similar markers. The FA positively correlated with FibroScan, serum hyaluronate level, and type Ⅳ collagen level, and aspartate transaminase to platelet ratio index （APRI）. The area under the receiver operating curve for FibroScan was higher than that for the other markers, even though the statistical significance was minimal. CONCLUSION： Our findings suggest that FibroScan can initially be used to assess LF as an alternative to a liver biopsy （LB） and serum diagnosis, because it is a safe method with comparable diagnostic accuracy regarding the existing LF markers.

关键词： Cirrhosis Digital image analysis Fibro-Scan Fibrotic area Hyaluronate Lecithin-cholesterol acyltransferase Liver fibrosis Pre-albumin

Propensity score analysis demonstrated the prognostic advantage of anatomical liver resection in hepatocellular carcinoma

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World Journal of Gastroenterology 2014年第12期20卷 3335-3342页

作者： Masayuki Ishii toru Mizuguchi Masaki Kawamoto Makoto Meguro Shigenori Ota Toshihiko Nishidate Kenji Okita Yasutohsi kimura Thomas T Hui Koichi Hirata Department of Surgery Surgical Oncology and ScienceSapporo Medical University Hospital Sapporo Medical University Department of Surgery Children’s Hospital and Research Center Oakland

AIM: To compare the prognoses of hepatocellular carcinoma (HCC) patients that underwent anatomic liver resection (AR) or non-anatomic liver resection (NAR) using propensity score-matched populations.

关键词： Anatomical liver resection Propensity score analysis Hepatocellular carcinoma

Electrohydraulic lithotripsy and rendezvous nasal endoscopic cholangiography for common bile duct stone: A case report

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World Journal of Clinical Cases 2019年第10期7卷 1149-1154页

作者： Koichi kimura Kensuke Kudo Tomoharu Yoshizumi Takeshi Kurihara Shohei Yoshiya Yohei Mano Kazuki Takeishi Shinji Itoh Noboru Harada toru Ikegami Tetsuo Ikeda Department of Endoscopy and Endoscopic Surgery Fukuoka Dental CollegeFukuoka 814-0175Japan Department of Surgery and Science Graduate School of Medical SciencesKyushu UniversityFukuoka 812-8582Japan

BACKGROUND In patients with large stones in the common bile duct(CBD),advanced treatment modalities are generally ***,we present an interesting case of a huge CBD stone treated with electrohydraulic lithotripsy(EHL)by the percutaneous approach and rendezvous endoscopic retrograde cholangiography(ERC)using a nasal *** SUMMARY A 91-year-old woman underwent ERC for a symptomatic large CBD stone with a diameter of 50 *** was referred to our institution after the failure of lithotomy by ERC,and after undergoing percutaneous transhepatic biliary *** attempted to fragment the stone by transhepatic cholangioscopy using ***,the stones were too large and partly soft clay-like for ***,we attempted lithotomy with ERC and cholangioscopy by the rendezvous technique using a nasal endoscope and achieved complete *** complication was observed at the end of this *** Cholangioscopy by rendezvous technique using a nasal endoscope is a feasible and safe endoscopic method for removing huge CBD stones.

关键词： Common bile duct stone Electrohydraulic lithotripsy Rendezvous technique Endoscopic retrograde cholangiography Nasal endoscop Case report

Gallbladder cancer harboring ERBB2 mutation on the primary and metastatic site: A case report

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World Journal of Gastrointestinal Oncology 2019年第9期11卷 761-767页

作者： Chiaki Inagaki Daichi Maeda Akie kimura toru Otsuru Yoshifumi Iwagami Naohiro Nishida Daisuke Sakai Ryo Shitotsuki Shinichi Yachida Yuichiro Doki Taroh Satoh Department of Frontier Science for Cancer and Chemotherapy Osaka University Graduate School of MedicineSuita 5650871OsakaJapan Department of Clinical Genomics Osaka University Graduate School of MedicineSuita 5650871OsakaJapan Gastroenterological Surgery Osaka University Graduate School of MedicineSuita 5650871OsakaJapan Center for Cancer Genomics and Personalized Medicine Osaka University Graduate School of MedicineSuita 5650871OsakaJapan Department of Cancer Genome Informatics Osaka University Graduate School of MedicineSuita 5650871OsakaJapan

BACKGROUND Bile duct cancer constitutes gallbladder cancer(GBC),intrahepatic cholangiocarcinoma(ICA),and extrahepatic cholangiocarcinoma(ECA).These three entities show morphological and immunohistochemical resemblance so that it is difficult to differentiate between primary ICA and liver metastasis of GBC,which sometimes becomes a point of discussion in clinical *** these cancers demonstrate significant differences in their mutational landscape,several reports demonstrated shared genomic alteration in paired primary and metastatic site aids in distinguishing metastatic recurrence from second primary *** SUMMARY We present a 73-year-old female patient who underwent curative resection for GBC harboring epidermal growth factor receptor 2(ERBB2)activating mutation on next-generation sequencing(NGS)-based genomic *** year later,a hepatic lesion was observed on follow-up imaging and she underwent surgical resection for a pathological *** histological findings of the hepatic lesion were similar to those of the primary ***,using NGS panel testing,the hepatic lesion was found to have ERBB2 activating mutation,which is the identical mutation detected in the sequencing result of the primary ***2 activating mutation occurs more frequently in GBC than ICA and ***,in the present case,we think this molecular finding potentiated the diagnosis of the liver mass toward a metastatic ***,this patient underwent HER2-targeted treatment with lapatinib in combination with capecitabin and obtained clinical *** This case illustrated NGS panel usefulness in distinguishing GBC recurrence from second primary cancer and HER2-targeted agent efficacy on ERBB2 mutated GBC.

关键词： Gall bladder cancer Bile duct cancer ERBB2 mutation Precision medicine Mutation-driven targeted treatment Case report

Nuclear heat shock protein 110 expression is associated with poor prognosis and hyperthermo-chemotherapy resistance in gastric cancer patients with peritoneal metastasis

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World Journal of Gastroenterology 2017年第42期23卷 7541-7550页

作者： Akiharu kimura Kyoichi Ogata Bolag Altan Takehiko Yokobori Erito Mochiki Mitsuhiro Yanai Norimichi Kogure toru Yanoma Masaki Suzuki Tuya Bai Hiroyuki Kuwano Department of General Surgical Science Gunma University Graduate School of Medicine Department of Oncology Clinical Development Gunma University Graduate School of Medicine Department of Molecular Pharmacology and Oncology Gunma University Graduate School of Medicine Department of Digestive Tract and General Surgery Saitama Medical CenterSaitama Medical University

AIM To investigate the significance of heat shock protein 110(HSP110) in gastric cancer(GC) patients with peritoneal metastasis undergoing *** Primary GC patients(n = 14) with peritoneal metastasis or positive peritoneal lavage cytology who underwent distal or total gastrectomy between April 2000 and December 2011 were enrolled in this study. The patients underwent postoperative intraperitoneal hyperthermo-chemotherapy using a Thermotron RF-8 heating device two weeks after surgery. We analyzed nuclear HSP110 expression in surgically resected tumors using immunohistochemistry. Additionally, the effect of HSP110 suppression on hyptherthermochemosensitivity was assessed in vitro in the MKN45 GC cell line using the HSP inhibitor KNK437. RESULTS HSP110 immnohistochemical staining in 14 GC patients showed that five(35.7%) samples belonged to the low expression group, and nine(64.3%) samples belonged to the high expression group. Progression-free survival was significantly shorter in the HSP110 high-expression group than in the low-expression group(P = 0.0313). However, no significant relationships were identified between HSP110 expression and the clinicopathological characteristics of patients. Furthermore, high HSP110 expression was not an independent prognostic factor in GC patients with peritoneal metastasis(P = 0.0625). HSP110 expression in MKN45 cells was suppressed by KNK437 at the hyperthermic temperature of 43 ℃ in vitro. Comparison of MKN45 cell proliferation in the presence and absence of KNK437 at 43 ℃, revealed that proliferation was significantly decreased when HSP110 was inhibited by KNK437. Additionally, HSP110 suppression via HSP inhibitor treatment increased cellular sensitivity to hyperthermo-chemotherapy in *** The expression of nuclear HSP110 in GC patients might be a new marker of chemosensitivity and a therapeutic target for patients who are tolerant to existing hyperthermo-chemotherapies.

关键词： Peritoneal metastasis Hyperthermia Hyperthermo-chemotherapy Heat shock protein 110 Gastric cancer Drug resistance

Regression of hepatocellular carcinoma during vitamin K administration

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World Journal of Gastroenterology 2005年第42期11卷 6722-6724页

作者： Kazuhiro Nouso Shuji Uematsu Kunihiro Shiraga Ryoichi Okamoto Ryo Harada Shoko Takayama Wakako Kawai Shigeru kimura toru Ueki Nobuaki Okano Masahiro Nakagawa Motowo Mizuno Yasuyuki Araki Yasushi Shiratori Department of Internal Medicine Hiroshima City Hospital Hiroshima 730-8518 Japan Department of Medicine and Medical Science Okayama University Graduate School of Medicine and Dentistry Okayama 700-8558 Japan

An 85-year-old man with HCV infection and diabetes mellitus was diagnosed as having hepatocellular carcinoma （HCC, 13 cm in diameter） based on high serum alpha-fetoprotein （AFP）, AFP-L3, and des-y-carboxy prothrombin levels as well as typical enhancement pattern on contrast-enhanced CT. The patient did not receive any interventional treatments because of advanced age and the advanced stage of HCC. He chose to take vitamin K, which was reported to suppress the growth of HCC in vitro. Three months after starting vitamin K, all three tumor markers were normalized and HCC was markedly regressed, showing no enhancement in the early arterial phase on CT. Here we present the report describing the regression of HCC during the administration of vitamin K.

关键词： Hepatocellular carcinoma Vitamin K Regression