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Invasive group B streptococcal infection in a patient with post splenectomy for hypersplenism secondary to liver cirrhosis and portal hypertension

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World Journal of Emergency Medicine 2016年第1期7卷 68-70页

作者： Tomoya Okazaki Toru Hifumi Arisa Manabe Hikari Matsumura Satoshi Egawa Hideyuki Hamaya Nastuyo Shinohara Koshiro Takano Hajime Shishido Yuko Abe Kenya Kawakita Masanobu Hagiike yasuhiro kuroda Emergency Medical Center Kagawa University Hospital Kita Kagawa 761-0793 Japan

BACKGROUND:Splenectomy in patients with liver cirrhosis(LC)is expected to become more common owing to its efficacy on portal hemodynamics.In this report we describe an alarming case of group B streptococcus(GBS)infection after splenectomy in a patient with LC.METHODS:A 72-year-old woman with a history of LC was admitted to our emergency department because of respiratory failure.The patient had received left lateral segmentectomy of the liver and splenectomy three months before admission.Pulmonary examination revealed significant wheezing during inspiration and expiration,but no crackles and stridor.Chest radiography and CT showed no infiltrates.A presumptive diagnosis of bronchial asthma caused by upper respiratory infection was made.Four days after admission,GBS infection was confirmed by blood culture and penicillin G was administered.Antibiotics were given intravenously for a total of 12 days.RESULTS:The patient was discharged on the 12th day after admission.CONCLUSIONS:Although efficacy of splenectomy in patients with LC has been reported,immune status should be evaluated for a longer period.Patients who have undergone splenectomy are highly susceptible to bacteria;moreover,LC itself is an independent risk factor for mortality in patients with sepsis.Since prophylaxis against GBS has not been established,immediate action should be taken.Emergency physicians should be aware of invasive GBS infection in the context of the critical risk factors related to splenectomy and LC,particularly the expected increase of splenectomy performed in LC patients.

关键词： Group B streptococcal infection Splenectomy Liver cirrhosis

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Survival from cardiac arrest due to sushi suffocation

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World Journal of Emergency Medicine 2014年第2期5卷 154-156页

作者： Toru Hifumi Nobuaki Kiriu Hiroshi Kato Yuichi Koido yasuhiro kuroda Emergency Medical Center Kagawa University Hospital Division of Critical Care Medicine and Trauma National Hospital Organization Disaster Medical Center

BACKGROUND: Sushi suffocation is relatively uncommon, and it is an unignorable cause of sudden death; however, no reports on sushi suffocation have been published.METHODS: A 60-year-old man was referred to our hospital for post resuscitative intensive care. He had choked on sushi and collapsed in the dining room of a mental hospital. A nursing assistant summoned a physician who attempted to extract the sushi. External cardiac massage was initiated after 7 minutes had elapsed and followed by endotracheal intubation. Return of spontaneous circulation was achieved after 7 minutes of resuscitation. A bronchoscopy demonstrated a large amount of shari in the trachea and right bronchus, which was removed with alligator forceps and a wire basket.RESULTS: Neurological recovery was evident on day 2 of admission. He was transferred back to the mental hospital with no neurological complications.CONCLUSION: Emergency physicians should consider sushi suffocation, including its clinical features and management.

关键词： Food suffocation Sushi Cardiopulmonary arrest

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Liver biopsy in the post-hepatitis C virus era in Japan

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World Journal of Gastroenterology 2024年第14期30卷 1949-1957页

作者： Yoshihiro Ikura Takako Okubo yasuhiro Sakai Department of Pathology Takatsuki General HospitalTakatsuki 569-1192Osaka PrefectureJapan Department of Pathology Kansai Medical University Medical CenterMoriguchi 570-8507Japan

In Japan,liver biopsies were previously crucial in evaluating the severity of hepatitis caused by the hepatitis C virus(HCV)and diagnosing HCV-related hepatocellular carcinoma(HCC).However,due to the development of effective antiviral treatments and advanced imaging,the necessity for biopsies has significantly decreased.This change has resulted in fewer chances for diagnosing liver disease,causing many general pathologists to feel less confident in making liver biopsy diagnoses.This article provides a comprehensive overview of the challenges and potential solutions related to liver biopsies in Japan.First,it highlights the importance of considering steatotic liver diseases as independent conditions that can coexist with other liver diseases due to their increasing prevalence.Second,it emphasizes the need to avoid hasty assumptions of HCC in nodular lesions,because clinically diagnosable HCCs are not targets for biopsy.Third,the importance of diagnosing hepatic immune-related adverse events caused by immune checkpoint inhibitors is increasing due to the anticipated widespread use of these drugs.In conclusion,pathologists should be attuned to the changing landscape of liver diseases and approach liver biopsies with care and attention to detail.

关键词： Liver biopsy Alteration Post-hepatitis C virus era Steatotic liver disease Hepatic tumors Immune checkpoint inhibitors

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

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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 reported.METHODS: 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 deviation.RESULTS: 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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How are multiple satellites seen from the ground? Relative apparent motion and formation stabilization

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Astrodynamics 2024年第1期8卷 121-134页

作者： Kenta Nakajima yasuhiro Yoshimura Hongru Chen Toshiya Hanada Department of Aeronautics and Astronautics Kyushu University744 Motooka Nishi-kuFukuoka819-0395Japan

This paper answers how multiple satellites are seen from the ground. This question is inspired by space-advertising, a public exhibition in the night sky using a dot matrix of satellites that are bright enough to be seen by the naked eye. Thus, it is important for space advertisement that the specific dot matrix is seen. Moreover, the stability of the dot matrix during a visible span is very valuable. To stabilize the dot matrix, this study formulates an apparent position of a dot from a representative dot seen from the ground. The formulation, linear functions of a set of relative orbital elements, reveals the appearance of the dot matrix. The proposed relative variable in the formulation drives the instability of the dot matrix, thereby revealing an initial stable configuration of deputies from a chief. The arbitrary dot matrix designed using the configuration is stable even at low elevations without orbital control during the visible span.

关键词： formation flying relative motion stabilization astrodynamics multi-apparent motions space advertisement

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A minimally invasive multiple percutaneous drainage technique for acute necrotizing pancreatitis

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World Journal of Emergency Medicine 2014年第4期5卷 310-312页

作者： Takero Terayama Toru Hifumi Nobuaki Kiriu Hiroshi Kato Yuichi Koido Yoshiaki Ichinose Kohei Morimoto kuroda yasuhiro Division of Critical Care Medicine and Trauma National Hospital Organization Disaster Medical Center Emergency Medical Center Kagawa University Hospital Division of Radiology National Hospital Organization Disaster Medical Center

BACKGROUND: In approximately 20% of patients, necrotizing pancreatitis is complicated with severe acute pancreatitis, with high morbidity and mortality rates. Minimally invasive step-up approach is both safe and effective, but sometimes requires multiple access sites.METHODS: A 62-year-old woman was admitted with diabetic ketoacidosis, and initial computed tomography(CT) revealed no evidence of acute pancreatitis. She was clinically improved with insulin therapy, fl uid administration, and electrolyte replacement. However, on the 14 th day of admission, she developed a high-grade fever, and CT demonstrated evidence of acute necrotizing pancreatitis with a large collection of peripancreatic fl uid. Percutaneous transgastric drainage was performed and a 14 French gauge(Fr) pigtail catheter was placed 1 week later, which drained copious pus. Because of persistent high-grade fever and poor clinical improvement, multiple 8 and 10 Fr pigtail catheters were placed via the initial drainage route, allowing the safe and effective drainage of the extensive necrotic tissue that was occupying the bilateral anterior pararenal space.RESULTS: After drainage, the patient recovered well and the last catheter was removed on day 123 of admission.CONCLUSIONS: Multiple percutaneous drainage requires both careful judgment and specialist skills. The perforation of the colon and small bowel as well as the injury of the kidney and major vessels can occur. The current technique appears to be safe and minimally invasive compared with other drainage methods in patients with extended, infected necrotic pancreatic pseudocysts.

关键词： Percutaneous drainage Acute necrotizing pancreatitis Minimally invasive technique

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SPERA Hydrogen System^(TM)by LOHC-MCH Method for Massive Hydrogen Storage and Transportation

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Journal of Environmental Science and Engineering(A) 2024年第2期13卷 50-60页

作者： Yoshimi Okada Kaji Naohiro Osamu Ikeda Kenichi Imagawa Hironori Kawai Masashi Nagai yasuhiro Inoue Frontier Business Division Chiyoda Corporation4-6-2 Minatomirai Nishi-kuYokohama 2208765Japan Hydrogen Business Department Chiyoda Corporation4-6-2 Minatomirai Nishi-kuYokohama 2208765Japan R&D Center Chiyoda Corporation3-13 Moriya-cho Kanagawa-kuYokohama 2208765Japan Technology Development Department Chiyoda Corporation4-6-2 Minatomirai Nishi-kuYokohama 2208765Japan

Expanding the hydrogen energy utilization is essential for decarbonization,and the commercialization of hydrogen energy carrier systems that can“store”and“transport”hydrogen in a large scale is necessary.The organic chemical hydride method incorporates hydrogen atoms into the molecular structure of a LOHC(Liquid Organic Hydrogen Carrier)to store and transport hydrogen in a liquid state under normal temperature and pressure,and is a highly safe method with low business risk.Chiyoda has been developing the technology since 2002,completed a pilot demonstration in 2014 and named it the SPERA Hydrogen^(TM) System,and successfully completed an international supply chain demonstration that transports hydrogen from Brunei to Japan in a large scale in 2020,moving to the commercialization stage.Currently,Chiyoda is conducting feasibility studies with a number of domestic and foreign companies with the aim of commercializing the system as soon as possible.In this paper,outline,features,development status and our efforts in commercialization of SPERA HydrogenTM System are introduced.

关键词： Hydrogen carrier LOHC Methylcyclohexane MCH toluene

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Microbiota in the stomach and application of probiotics to gastroduodenal diseases

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World Journal of Gastroenterology 2022年第47期28卷 6702-6715页

作者： yasuhiro Koga Japanese Society for Probiotic Science Isehara 259-1143Japan

The stomach is a hostile environment for most microbes because strong gastric acid kills indigenous microorganisms.Thus,the mass of indigenous microbes detected by traditional culturing method in a highly acidic stomach is reported to be very small.However,in a stomach with less acidity due to atrophic changes of the gastric mucosa,the number of live gastric microbiota dramatically increases and their composition changes.A probiotic is defined as a live microorganism that,when administered in adequate amounts,confers a health benefit on the host.The administration of probiotics to the stomach has thus far been considered impractical,mainly due to the strong acidity in the stomach.The identification of candidate probiotic strains with sufficient resistance to acidity and the ability to achieve close proximity to the gastric mucosa could enable the application of probiotics to the stomach.The utilization of probiotics alone for Helicobacter pylori(H.pylori)infection significantly improves gastric mucosal inflammation and decreases the density of H.pylori on the mucosa,although complete eradication of H.pylori has not yet been demonstrated.The use of probiotics in combination with antimicrobial agents significantly increases the H.pylori eradication rate,especially when the H.pylori strains are resistant to antimicrobial agents.While H.pylori has been considered the most important pathogenic bacterium for the development of gastric cancer,bacteria other than H.pylori are also suggested to be causative pathogens that promote the development of gastric cancer,even after the eradication of H.pylori.Increased non-H.pylori Gram-negative bacteria in the stomach with weak acidity accompanying atrophic gastritis may perpetuate gastric mucosal inflammation and accelerate carcinogenic progression,even after H.pylori eradication.Probiotics restore the acidity in this stomach environment and may therefore prevent the development of gastric cancer by termination of Gram-negative bacteria-induced inflammation.Functional dyspepsia

关键词： Stomach Microbiota Probiotics Helicobacter pylori Post-eradication gastric cancers Functional dyspepsia

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Coordinated control between a grid forming inverter and grid following inverters suppling power in a standalone microgrid

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Global Energy Interconnection 2022年第3期5卷 259-265页

作者： Junichi Arai yasuhiro Taguchi Kogakuin University 1-24-2 Nishi-ShinjukuShinjukuTokyo 163-8677Japan Energy and Environment Technology Research Institute 1-22-2 Nishi-Waseda ShinjukuNishi-Waseda East Wing 106Tokyo 169-0051Japan

Battery energy storage systems,fuel cells,and photovoltaic generators are being adopted in distribution networks to achieve CO;emission reduction.These power sources require inverters to connect to AC networks.However,sub-networks,such as a microgrids containing inverter power sources,may be disconnected from the utility network and operated in a standalone mode during extended blackouts.This study focuses on a standalone microgrid supplied by inverter power sources without a synchronous generator and proposes a new microgrid inverter control.In this inverter control,a single grid forming inverter is operated as a master power source to determine frequency and voltage,and other inverters,called grid following inverters,are operated as subordinate power sources with active and reactive power control.The necessary functions in the energy management system are examined,and the coordinated operation of all inverters in the microgrid is demonstrated via simulation.

关键词： Inverter control Microgrid Standalone operation Energy management system Grid forming inverter Grid following inverter

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Transcatheter arterial chemoembolization with a fine-powder formulation of cisplatin for hepatocellular carcinoma

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World Journal of Gastroenterology 2010年第27期16卷 3437-3444页

作者： Kazuhiro Kasai Akira Ushio Kei Sawara yasuhiro Miyamoto Yukiho Kasai Kanta Oikawa Hidekatsu kuroda yasuhiro Takikawa Kazuyuki Suzuki Division of Gastroenterology and Hepatology Department of Internal MedicineIwate Medical University

AIM:To evaluate the efficacy of transcatheter arterial chemoembolization(TACE) using a suspension of a fine-powder formulation of cisplatin(DDPH) for hepatocellular carcinoma(HCC).METHODS:The study population was comprised of 164 patients who were treated by TACE alone.Of these patients,76 underwent TACE using a suspension of DDPH in lipiodol(LPD)(DDPH group),and the remaining 88 underwent TACE with an emulsion of doxorubicin(ADM) with LPD(ADM group).We compared the DDPH group with the ADM group in terms of the objective early response rate,progression free survival(PFS) and overall survival(OS).RESULTS:The objective early response rate in the DDPH group was significantly higher than that in the ADM group(54% vs 24%,P < 0.001).The PFS rate in the DDPH group was also significantly higher than that in the ADM group(P < 0.001).Moreover,the OS in the DDPH group was significantly longer than that in the ADM group(P = 0.002).Although the incidence rate of nausea or vomiting in the DDPH group was higher than that in the ADM group,the ADM group showed a higher incidence rate of the adverse events of hepatic arterial damage and leucopenia.No other serious complications were observed in either group.CONCLUSION:We conclude that TACE using a suspension of DDPH in LPD could be a useful treatment for HCC.

关键词： Hepatocellular carcinoma DDPH Transcatheter arterial chemoembolization Cisplatin Doxorubicin

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