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Hyperglycemia is a significant prognostic factor of hepatocellular carcinoma after curative therapy

World Journal of Gastroenterology 2013年第2期19卷 249-257页

作者： Takanori Hosokawa Masayuki Kurosaki Kaoru Tsuchiya Shuya Matsuda Masaru Muraoka Yuichiro Suzuki Nobuharu Tamaki Yutaka Yasui toru nakata Takashi Nishimura Shoko Suzuki Ken Ueda Hiroyuki Nakanishi Jun Itakura Yuka Takahashi Namiki Izumi Division of Gastroenterology and Hepatology Musashino Red Cross HospitalTokyo 180-8610Japan

AIM:To evaluate whether metabolic factors are related to distant recurrence of hepatocellular carcinoma(HCC) and survival after curative ***:This retrospective study included 344 patients whose HCC was treated curatively by radiofrequency ablation(RFA) *** mean age was 67.6 years and the mean observation period was 4.04 *** etiological background of liver disease was hepatitis B virus infection in 30,hepatitis C virus infection in 278,excessive alcohol drinking in 9,and other in 27 *** Child-Pugh classification grade was A(n = 307) or B(n = 37).The number of HCC nodules was one in 260,two in 61,and three in 23 *** surveillance of HCC recurrence after curative therapy with RFA,patients were radiologically evaluated every 3 *** associated with distant recurrence of HCC or survival were ***:Inadequate maintenance of blood glucose in diabetic patients was associated with higher incidence of distant *** 1-,2-,and 3-year recurrence rates were significantly higher in diabetic patients with inadequate maintenance of blood glucose compared with the others:50.6% vs 26.8%,83.5% vs 54.4%,and 93.8% vs 73.0%,respectively(P = 0.0001).Inadequate maintenance of blood glucose was an independent predictor of distant recurrence [adjusted relative risk 1.97(95%CI,1.33-2.91),(P = 0.0007)] after adjustment for other risk factors,such as number of HCC nodules [2.03(95%CI,1.51-2.73),P < 0.0001] and initial level of serum alpha fetoprotein(AFP) [1.43(95%CI,1.04-1.97),P = 0.028].Obesity was not an independent predictor of *** incidence of distant recurrence did not differ between diabetic patients with adequate maintenance of blood glucose and non-diabetic *** 232 patients who had HCC recurrence,138 had a second *** 1-,2-,and 3-year rates of second recurrence were significantly higher in diabetic patients with inadequate maintenance of blood glucose than in the others:9.0% vs 5.9%,53.1

关键词： Hyperglycemia Hepatocellular carcinoma Recurrence Radio frequency ablation Survival

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Neurodegenerative changes initiated by presynaptic dysfunction

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Translational Neurodegeneration 2013年第1期2卷 108-112页

作者： toru Yasuda Yasuto nakata Chi-Jing Choong Hideki Mochizuki Department of Neurology Osaka University Graduate School of MedicineSuitaOsakaJapan Present address:Department of Genetics National Center for Child Health and DevelopmentSetagaya-kuTokyoJapan

α-Synucleinopathies are a subgroup of neurodegenerative diseases including dementia with Lewy bodies(DLB)and Parkinson’s disease(PD).Pathologically,these disorders can be characterized by the presence of intraneuronal aggregates composed mainly of α-synuclein(αSyn),which are called Lewy bodies and Lewy *** report showed that more than 90% of αSyn aggregates are present in the form of very small deposits in presynaptic terminals of the affected neurons in ***,the mechanisms responsible for presynaptic accumulation of abnormal αSyn remain *** this article,we review recent findings on the involvement of presynaptic dysfunction in the initiation of neuronal dysfunctional *** review highlights that the presynaptic failure can be a potential trigger of the dying-back neuronal death in neurodegenerative diseases.

关键词： degenerative dysfunction involvement

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Branched-chain amino acids to tyrosine ratio value as a potential prognostic factor for hepatocellular carcinoma

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World Journal of Gastroenterology 2012年第17期18卷 2005-2008页

作者： toru Ishikawa Department of Gastroenterology and Hepatology Saiseikai Niigata Daini Hospital280-7 TerajiNiigata 950-1104Japan

The prognosis of hepatocellular carcinoma(HCC) depends on tumor extension as well as hepatic *** functional reserve is recognized as a factor affecting survival in the treatment of HCC;the ChildPugh classif ication system is the most extensively used method for assessing hepatic functional reserve in patients with chronic liver disease,using serum albumin level to achieve accurate assessment of the status of protein ***,insuff icient attention has been given to the status of amino acid(AA) metabolism in chronic liver disease and ***'s ratio is the molar ratio of branched-chain AAs(BCAAs:leucine,valine,isoleucine) to aromatic AAs(phenylalanine,tyrosine) and is important for assessing liver metabolism,hepatic functional reserve and the severity of liver *** this ratio is diff icult to determine in clinical situations,BCAAs/tyrosine molar concentration ratio(BTR) has been proposed as a simpler *** correlates with various liver function examinations,including markers of hepatic f ibrosis,hepatic blood flow and hepatocyte function,and can thus be considered as reflecting the degree of hepatic *** manuscript examines the literature to clarify whether BTR can serve as a prognostic factor for treatment of HCC.

关键词： Branched-chain amino acids to tyrosine ratio Fischer's ratio Prognostic factor Hepatocellular carcinoma

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Clinical features of hepatitis B virus-related hepatocellular carcinoma

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World Journal of Gastroenterology 2010年第20期16卷 2463-2467页

作者： toru Ishikawa Department of Gastroenterology and Hepatology Saiseikai Niigata Second HospitalNiigata 950-1104Japan

Hepatocellular carcinoma (HCC) is a major cause of cancer death,and chronic hepatitis B is a serious worldwide *** epidemiology of HCC is *** B virus (HBV) plays a major role in *** of HBV-related HCC is a key issue in current *** paper describes the prevention and clinical features of HBVrelated HCC,along with a short review of the disease.

关键词： Hepatocellular carcinoma Hepatitis B virus

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Early administration of branched-chain amino acid granules

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World Journal of Gastroenterology 2012年第33期18卷 4486-4490页

作者： toru Ishikawa Department of Gastroenterology and Hepatology Saiseikai Niigata Daini Hospital Niigata 950-1104 Japan

The effect of malnutrition on survival in patients with decompensated liver cirrhosis has not been well defined. Nutritional intervention with branched-chain amino acid (BCAA) can increase serum albumin concentration in patients with decompensated cirrhosis but its effects on survival are unclear. The BCAA to tyrosine ratio (BTR) is a surrogate marker (the normal range of BTR is between 4.41 and 10.05, and a Fischer's ratio of 1.8 corresponds to a BTR of 3.5) in patients with decompensated liver cirrhosis, and BCAA inhibits hepatic carcinogenesis in patients with compensated cirrhosis. This review discusses data regarding the effect of early administration of BCAA granules based on the ratio of BCAA to BTR on prognosis in patients with cirrhosis.

关键词： Branched-chain amino acid to tyrosine ratio Branched-chain amino acid granules Liver cirrhosis Nutritional intervention Malnutrition Quality of life Albumin Cancer onset

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Can zinc enhance response interferon therapy for patients with HCV-related liver disease?

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World Journal of Gastroenterology 2012年第25期18卷 3196-3200页

作者： toru Ishikawa Department of Gastroenterology and Hepatology Saiseikai Niigata Daini HospitalNiigata 950-1104Japan

Patients with liver disease may be at risk of zinc deple- tion. Zinc supplementation has been shown to contrib- ute to inhibition of liver fibrosis and improvement in hepatic encephalopathy. However, little is known about the anti-inflammatory effect of zinc on hepatitis C vi- rus （HCV）-related chronic liver disease. The standard of care for chronic HCV has improved markedly since the approval of interferon （IFN） therapy more than a decade ago. Over the past 20 years, IFN therapy has improved to more effectively eliminate the virus, pro- gressing from single IFN therapy to c（~mbination ther- apy with ribavirin （RBV） and finally to pegylated IFN （PEG-IFN） therapy. However, even combined therapy with PEG-IFN and RBV for 48 wk is unable to eliminate the virus in some 40% of hepatitis C cases, particularly those with genotype lb and high viral load. Treatment options for patients who have relapsed or are refrac- tory to treatment with PEG-IFN and RBV therefore need to be critically assessed. This paper overviews the relationship between chronic liver disease and zinc metabolism.

关键词： Chronic hepatitis C, Zinc Interferon therapy

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Chemotherapy with enteric-coated tegafur/uracil for advanced hepatocellular carcinoma

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World Journal of Gastroenterology 2008年第18期14卷 2797-2801页

作者： toru Ishikawa Department of Gastroenterology and Hepatology Saiseikai Niigata Second Hospital Teraji 280-7 Niigata 950-1104 Japan

Hepatocellular carcinoma (HCC) is one of the most common malignancies worldwide, including Japan. Although the development of imaging modalities has made the early diagnosis of HCC possible, surgically resectable cases are relatively uncommon because of hepatic function reserve and/or an advanced stage at presentation. Several modalities, such as transcatheter arterial chemoembolization, percutaneous ethanol injection, microwave coagulation therapy and radiofrequency ablation are reportedly useful in treating patients with non-resectable disease. However, unfortunately, many HCC patients have tumor recurrence. The overall prognosis of patients with HCC is very poor, and treatment of the advanced form is still problematic. In this article, we review the clinical efficacy and toxicity of enteric-coated tegafur/uracil in the treatment of patients with advanced non-resectable HCC.

关键词： Advanced hepatocellular carcinoma Tumor dormancy Enteric-coated tegafur/uracil Chemotherapy Portal vein tumor thrombus Lung metastasis

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Secondary prevention of recurrence by interferon therapy after ablation therapy for hepatocellular carcinoma in chronic hepatitis C patients

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World Journal of Gastroenterology 2008年第40期14卷 6140-6144页

作者： toru Ishikawa Department of Gastroenterology and Hepatology Saiseikai Niigata Second Hospital

Chronic hepatitis C is a leading cause of hepatocellular carcinoma (HCC) *** (IFN) ther-apy decreases the incidence of HCC in patients with chronic hepatitis *** of chronic-hepatitis-C-related HCC is one of the most important issues in current *** have previously reported that male gender and high titer of hepatitis C virus (HCV) RNA are predictive factors for the development of HCC in HCV-related *** efforts at eradicat-ing or reducing the viral load may reduce the risk for ***,because HCC often recurs after ablation therapy,we performed a trial of IFN in pa-tients with chronic liver disease caused by HCV to see whether IFN therapy decreases recurrence after abla-tion therapy of HCV-related *** using IFN therapy as a secondary prevention,patients with HCC who had received complete tumor ablation showed better sur-vival,primarily as a result of the preservation of liver function and also probably prevention of *** IFN therapy appears to decrease recur-rence after ablation therapy such as radiofrequency ablation (RFA) therapy of HCV-related *** believe that there is a survival benefit in secondary prevention using IFN ***,a controlled study is es-sential to obtain conclusive evidence of the efficacy of this strategy.

关键词： Hepatocellular carcinoma Radiofrequency ablation Interferon Secondary prevention

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Experimental Study of the Flow in Helical Circular Pipes:Torsion Effect on the Flow Velocity and Turbulence

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Journal of Thermal Science 2008年第3期17卷 193-198页

作者： Yasutaka HAYAMIZU Kyoji YAMAMOTO ShinichiroYANASE toru HYAKUTAKE toru SHINOHARA Shinichi MORITA Department of Mechanical Engineering Yonago National College of Technology Graduate School of Natural Science and Technology Okayama University

An objective of the present paper is to experimentally clarify the torsion effect on the flow in helical circular pipes. We have made six helical circular pipes having different pitches and common non-dimensional curvature δ of about 0.1. The torsion parameter β0, which is defined by β0 = τ/（2δ）1/2 with non-dimensional torsion r, are taken to be 0.02, 0.45, 0.69, 1.01, 1.38 and 1.89 covering from small to very large pitch. The velocity distributions and the turbulence of the flow are measured using an X-type hot-wire anemometer in the range of the Reynolds number from 200 to 20000. The results obtained are summarized as follows： The mean secondary flow pattern in a cross section of the pipe changes from an ordinary twin-vortex type as is seen in a curved pipe without torsion （toroidal pipe） to a single vortex type after one of the twin-vortex gradually disappears as β0 increases. The circulation direction of the single vortex is the same as the direction of torsion of the pipe. The mean velocity distribution of the axial flow is similar to that of the toroidal pipe at small β0, but changes its shape as β0 increases, and attains the shape similar to that in a straight circular pipe when ,β0 = 1.89. It is also found that the critical Reynolds number, at which the flow shows a marginal behavior to turbulence, decreases as ,β0 increases for small ,β0, and then increases after taking a minimum at ,β0 ≈ 1.4 as ,β0 increases. The minimum of the critical Reynolds number experimentally obtained is about 400 at ,β0 ≈ 1.4.

关键词： Helical Circular Pipe Torsion Effect Critical Reynolds Number Turbulence

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Anti-viral therapy to reduce recurrence and improve survival in hepatitis B virus-related hepatocellular carcinoma

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World Journal of Gastroenterology 2013年第47期19卷 8861-8866页

作者： toru Ishikawa Department of Gastroenterology and Hepatology Saiseikai Niigata Daini HospitalNiigata 950-1104Japan

Hepatocellular carcinoma(HCC)is the most common malignancy and the third leading cause of cancer death *** infection with hepatitis B virus(HBV)and hepatitis C virus accounts for approximately75%-80%of HCC cases *** particular,chronic HBV infection is a predominant risk factor for HCC in Asia and *** resection and radiofrequency ablation are increasingly used for the curative treatment of HCC,and good local control can be ***,the high rate of recurrence is a major obstacle to improving prognosis.A high viral load of HBV DNA is the most important correctable risk factor for ***,interferon and/or nucleotide analogues may decrease HBV ***,these drugs may decrease *** this article,treatment strategies for HBV-related HCC are described in order to reduce recurrence and improve survival.

关键词： Hepatocellular carcinoma Hepatitis B virus Recurrence Nucleotide analogues Interferon

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