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Clearance of the liver remnant predicts short-term outcome in patients undergoing resection of hepatocellular carcinoma

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World Journal of Gastroenterology 2022年第38期28卷 5614-5625页

作者： Atsushi Miki Yasunaru Sakuma Hideyuki Ohzawa Akira Saito yoshiyuki meguro Jun Watanabe Kazue Morishima Kazuhiro Endo Hideki Sasanuma Atsushi Shimizu Alan Kawarai Lefor Yoshikazu Yasuda Naohiro Sata Department of Surgery Jichi Medical UniversityShimotsuke 329-0498TochigiJapan

BACKGROUND Estimation of the functional reserve of the remnant liver is important to reduce morbidity and mortality.AIM To estimate the functional reserve of the remnant liver in patients with hepatocellular carcinoma(HCC).METHODS We reviewed the medical records of 199 patients who underwent resection of HCC.Hepatic clearance of the remnant liver was calculated using fusion images of 99mTc-labelled galactosyl-human serum albumin liver scintigraphy and computed tomography.Posthepatectomy liver failure(PHLF)was classified according to the International Study Group of Liver Surgery.Complications was classified according to Clavien–Dindo classification.We analyzed by the risk factors for PHLF,morbidity and mortality with multivariate analysis.RESULTS Twenty-seven(30%)patients had major complications and 23(12%)developed PHLF.The incidence of major complications increased with increasing albumin–bilirubin(ALBI)grade.The area under the curve values for hepatic clearance of the remnant liver,liver to heart-plus-liver radioactivity at 15 min(LHL15),and ALBI score predicting PHLF were 0.868,0.629,and 0.655,respectively.The area under the curve for hepatic clearance of the remnant liver,LHL15,and ALBI score predicting major complications were 0.758,0.594,and 0.647,respectively.The risk factors for PHLF and major complications were hepatic clearance of the remnant liver and intraoperative bleeding.CONCLUSION The measurement of hepatic clearance may predict PHLF and major complications for patients undergoing resection of HCC.

关键词： Liver function Hepatectomy Cirrhosis Fusion image Complication Mortality

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Primary hepatic choriocarcinoma in a 49-year-old man:Report of a case

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World Journal of Gastroenterology 2013年第48期19卷 9485-9489页

作者： Ryosuke Sekine Masanobu Hyodo Masayuki Kojima yoshiyuki meguro Akifumi Suzuki Taku Yokoyama Alan T Lefor Norio Hirota Department of Emergency Medicine Ibaraki Prefectural Central Hospital Ibaraki 309-1793 Japan Department of Surgery Hitachiomiya Saiseikai Hospital Ibaraki 319-2256 Japan Department of Surgery Jichi Medical University Tochigi 329-0498 Japan Department of Pathology Hirota Institute for Surgical Pathology Tochigi 329-0403 Japan

We report a case of hepatic choriocarcinoma in a man diagnosed at autopsy after a rapid downhill clinical course.The patient was a 49-year-old man who presented with acute right-sided abdominal pain.There were no masses palpable on physical examination.Radiographic findings showed large multi-nodular tumors mainly in the right lobe of the liver.Fludeoxyglucosepositron emission tomography scan showed uptake only in the liver,and no uptake in the testes.We initially planned to perform a liver resection for the presumed diagnosis of intra-hepatic cholangiocarcinoma.However,the tumors grew rapidly and ruptured.Multiple lung metastases rapidly developed resulting in respiratory failure,preventing liver resection or even biopsy.He died 60 d after initial presentation with no pathological diagnosis.Postmortem studies included histopathological and immunohistological examinations which diagnosed a primary choriocarcinoma of the liver.Primary hepatic choriocarcinoma is very rare but should be considered in the differential diagnosis of a liver tumor in a middle aged man.Establishing this diagnosis may enable treatment of the choriocarcinoma.Liver biopsy and evaluation of serum human chorionic gonadotropin are recommended in these patients.

关键词： Hepatic choriocarcinoma Male Human chorionic gonadotropin Liver biopsy Fludeoxyglucosepositron emission tomography

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Nondestructive and active interrogation system for special nuclear material:proof of principle and initial results

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Nuclear Science and Techniques 2024年第5期35卷 216-225页

作者： Mahmoud Bakr Kai Masuda yoshiyuki Takahashi Tsuyoshi Misawa Norio Yamakawa Tomas Scott Institute of Advanced Energy Kyoto UniversityGokashoUjiKyoto 611‑0011Japan School of Physics University of BristolBs81TL Tyndall AvenueBristolUK Physics Department Faculty of ScienceAssiut UniversityAssiut 71516Egypt Research Reactor Institute Kyoto University2 Asashiro‑NishiKumatoriOsaka 590‑0494Japan Pony Industry Co.Ltd. 2‑3‑6 Kitakyuhoji‑MachiChuo‑KuOsaka 541‑0057Japan Astral Neutronics LTD Unit H5HallenBristol BS107SBUK

Herein,we employ the threshold energy neutron analysis(TENA)technique to introduce the world's first active interrogation system to detect special nuclear materials(SNMs),including U-235 and Pu-239.The system utilizes a DD neutron generator based on inertial electrostatic confinement(IEC)to interrogate suspicious objects.To detect secondary neutrons produced during fission reactions induced in SNMs,a tensioned metastable fluid detector(TMFD)is employed.The current status of the system's development is reported in this paper,accompanied by the results from experiments conducted to detect 10 g of highly enriched uranium(HEU).Notably,the experimental findings demonstrate a distinct difference in the count rates of measurements with and without HEU.This difference in count rates surpasses two times the standard deviation,indicating a confidence level of more than 96% for identifying the presence of HEU.The paper presents and extensively discusses the proof-of-principle experimental results,along with the system's planned trajectory.

关键词： Special nuclear materials Uranium detection Inertial electrostatic confinement fusion TENA HEU CTMFD

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A preliminary study on rectal dose reduction associated with hyaluronic acid implantation in brachytherapy for prostate cancer

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Asian Journal of Urology 2024年第2期11卷 286-293页

作者： Tairo Kashihara Yuka Urago Hiroyuki Okamoto Mihiro Takemori Hiroki Nakayama Shohei Mikasa Tetsu Nakaichi Kotaro Iijima Takahito Chiba Junichi Kuwahara Satoshi Nakamura Weishan Chang yoshiyuki Matsui Hiroshi Igaki Department of Radiation Oncology National Cancer Center Hospital5-1-1 TsukijiChuo-kuTokyoJapan Radiation Safety and Quality Assurance Division National Cancer Center Hospital5-1-1 TsukijiChuo-kuTokyoJapan Department of Radiological Sciences Graduate School of Human Health SciencesTokyo Metropolitan University7-2-10 Higashi-OguArakawa-kuTokyoJapan Department of Radiological Technology National Cancer Center Hospital5-1-1 TsukijiChuo-kuTokyoJapan Department of Urological Oncology National Cancer Center Hospital5-1-1 TsukijiChuo-kuTokyoJapan

Objectives: Hydrogel spacer (HS) was developed to reduce rectal toxicities caused by radiotherapy, but has been reported to cause major adverse events. Our institute has attempted to introduce a hyaluronic acid (HA) as an alternative spacer. This study aimed to compare rectal doses and geometric distributions between the HS and HA implantation in prostate cancer.Methods: HS and HA were inserted in 20 and 18 patients undergoing high-dose brachytherapy, respectively. The rectum spacer volumes injected were 10 mL and 22 mL, respectively. In the treatment planning system, 13.5 Gy was administered with common catheter positions. The rectal dose indices were assessed between the spacer groups for dosimetry evaluation. Distances between the prostate and rectum and configurations of the spacers were compared.Results: The mean doses irradiated to 0.1 and 2 mL of the rectum were 10.45 Gy and 6.71 Gy for HS, and 6.73 Gy and 4.90 Gy for HA (p<0.001). The mean minimum distances between the prostate and rectum were 1.23 cm and 1.79 cm for HS and HA, respectively (p<0.05). Geometrical configuration comparisons revealed that HA has a higher ability to expand the space than HS.Conclusion: The rectal dose reduction ability of HA is significantly greater than that of HS, suggesting its potential as a new spacer.

关键词： Brachytherapy Hyaluronicacid Hydrogel Prostaticneoplasm Radiotherapy

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High-grade pancreatic intraepithelial neoplasia diagnosed based on changes in magnetic resonance cholangiopancreatography findings:A case report

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World Journal of Clinical Cases 2024年第8期12卷 1487-1496页

作者： Nao Furuya Atsushi Yamaguchi Naohiro Kato Syuhei Sugata Takuro Hamada Takeshi Mizumoto Yuzuru Tamaru Ryusaku Kusunoki Toshio Kuwai Hirotaka Kouno Kazuya Kuraoka yoshiyuki Shibata Sho Tazuma Takeshi Sudo Hiroshi Kohno Shiro Oka Department of Gastroenterology National Hospital Organization Kure Medical Center and Chugoku Cancer CenterKure 737-0023HiroshimaJapan Department of Gastroenterology Hiroshima University HospitalHiroshima 734-8551HiroshimaJapan Department of Pathology National Hospital Organization Kure Medical Center and Chugoku Cancer CenterKure 737-0023HiroshimaJapan Department of Surgery National Hospital Organization Kure Medical Center and Chugoku Cancer CenterKure 737-0023HiroshimaJapan

BACKGROUND High-grade pancreatic intraepithelial neoplasia(PanIN)exhibits no mass and is not detected by any examination modalities.However,it can be diagnosed by pancreatic juice cytology from indirect findings.Most previous cases were diagnosed based on findings of a focal stricture of the main pancreatic duct(MPD)and caudal MPD dilatation and subsequent pancreatic juice cytology using endoscopic retrograde cholangiopancreatography(ERCP).We experienced a case of high-grade PanIN with an unclear MPD over a 20-mm range,but without caudal MPD dilatation on magnetic resonance cholangiopancreatography(MRCP).CASE SUMMARY A 60-year-old female patient underwent computed tomography for a follow-up of uterine cancer post-excision,which revealed pancreatic cysts.MRCP revealed an unclear MPD of the pancreatic body at a 20-mm length without caudal MPD dilatation.Thus,course observation was performed.After 24 mo,MRCP revealed an increased caudal MPD caliber and a larger pancreatic cyst.We performed ERCP and detected atypical cells suspected of adenocarcinoma by serial pancreatic juice aspiration cytology examination.We performed a distal pancreatectomy and obtained a histopathological diagnosis of high-grade PanIN.Pancreatic parenchyma invasion was not observed,and curative resection was achieved.CONCLUSION High-grade Pan-IN may cause MPD narrowing in a long range without caudal MPD dilatation.

关键词： Pancreatic cancer Pancreatic intraepithelial neoplasm High-grade pancreatic intraepithelial neoplasm Magnetic resonance cholangiopancreatography Carcinoma in situ Case report

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Development of a Method for Assessing Country-Based Flood Risk at the Global Scale

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International Journal of Disaster Risk Science 2022年第1期13卷 87-99页

作者： yoshiyuki Imamura Department of Civil and Environmental Engineering Tokyo Metropolitan University192-0397 HachiojiTokyoJapan

International frameworks such as the Sustainable Development Goals and the Sendai Framework for Disaster Risk Reduction 2015-2030 require the quantification of country-based flood risk.However,few approaches at the global scale include the three necessary components(hazard,exposure,and vulnerability)for determining disaster risk and are country-based assessments,owing to major challenges such as limited data availability and vulnerability proxy selection.Therefore,in this study,a method was developed with the following features:Incorporating the hazard,exposure,and vulnerability components;Applicable to the vast majority of countries in the world;Visualizing priority countries and illustrating effective measures and strategies;Clear and easy to understand by leaders and decision makers of international organizations,governments,and other stakeholders;Identifying each country’s challenges and providing guidance on specific issues for more detailed investigation and policy creation;Including more extensive factors compared with past studies.In Asia and the Pacific,the Flood Risk Index computed by the developed method is compared with the fatality ratio,and the results show that improving flood resilience secures people and society regardless of the magnitude and frequency of floods.Analysis at the global scale visualizes regional tendencies and indicates that countries closer to the equator have higher flood risk.Analysis of country-based flood risk based on five indicators demonstrates that the developed method can assist international organizations,governments,and other stakeholders to further examine country-specific conditions and establish and implement policies and strategies toward building a resilient society and achieving international targets.

关键词： Asia and the Pacific Country-based analysis Flood risk index Global scale Vulnerability proxy

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A combination of tides and nontidal variations in ocean bottom pressure may generate interannual slip fluctuations in the transition zone along a subduction plate interface

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Geodesy and Geodynamics 2023年第1期14卷 43-51页

作者： yoshiyuki Tanaka Hiromu Sakaue Masayuki Kano Suguru Yabe Department of Earth and Planetary Science The University of Tokyo7-3-1 HongoBunkyo-kuTokyo 113-0033Japan Graduate School of Science Tohoku University6-3Aramaki-aza-aobaAoba-kuSendai980-8578Japan Geological Survey of Japan National Institute of Advanced Industrial Science and Technology(AIST)Tsukuba Central 71-1-1 HigashiTsukubaIbaraki 305-8567Japan

The tidal triggering of earthquakes has been studied for many years.The discovery of slow earthquakes in the early 2000s,including slow slip,has urged scientists to investigate the tidal responses of these earthquakes due to their sensitivity to weak stress perturbations.Previous studies have shown that slow earthquakes correlate with diurnal and semidiurnal tides and seasonal variations in surface loads more clearly than ordinary earthquakes.However,little is known about long-term responses to external stresses.In this paper,based on a widely accepted frictional law for faults,a mechanism is proposed by which nontidal variations in ocean bottom pressure,when combined with tides,pro mote the occurrence of slow earthquakes.Because slow earthquakes accompany a slip on the plate interface,this mechanism allows one to estimate slip modulations.A one-degree-of-freedom slip model is constructed and applied to Ise Bay in the Tonankai region of southwestern Japan,where large-scale ocean mass redistributions have occurred.The model calculated with parameters determined from the observation of tectonic tremors is quantitatively consistent with the slip during 1997-2013 inferred from GNSS data,suggesting that the decrease in the sea-level change in approximately 2006 could cause the accele ration of a slip observed after that.This result implies that the decreases in sea level in approximately 1996 and 2014 could also cause subsequent slip accelerations.These three slip acceleration periods temporally coincide with the increases in background seismicity in a shallower portion of the plate interface.These changes in seismicity are common to shallow earthquakes in the Tokai area,and a similar model can reproduce them.Further studies are expected to reveal causality between shallow earthquakes and long-term slip fluctuations based on modeling that considers changes in the frictional property along the plate interface.

关键词： Tides Ocean bottom pressure Slow earthquake Seismicity Kuroshio current

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Importance of an appropriate number of examined lymph nodes in patients with pancreatic cancer-the more the better?

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Hepatobiliary Surgery and Nutrition 2022年第4期11卷 605-607页

作者： Toshiro Ogura Hiroyuki Ishida Amane Takahashi yoshiyuki Kawashima Department of Gastroenterological Surgery Saitama Cancer CenterSaitamaJapan

Pancreatic cancer is a highly aggressive malignant cancer with a 5-year survival rate of approximately 10%.The outcome of patients diagnosed with resectable pancreatic cancer as per the National Comprehensive Cancer Network(NCCN)classification and those who underwent resection was not satisfactory.Similar to other abdominal malignant tumors,the stages of pancreatic cancer are defined by local extension,lymph node metastasis,and distant metastasis.The presence or absence of lymph node metastasis is diagnosed by pathological examination of the retrieved lymph,the quality of the diagnosis based on lymph node(N)staging depends on the surgical and pathological aspects(1).

关键词： lymph metastasis patients

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Media Preference, Information Needs, and the Language Proficiency of Foreigners in Japan after the 2011 Great East Japan Earthquake

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International Journal of Disaster Risk Science 2018年第1期9卷 1-15页

作者： Akiyuki Kawasaki Michael Henry Kimiro meguro Department of Civil Engineering The University of Tokyo Division of Field Engineering for the Environment Faculty of Engineering Hokkaido University International Center for Urban Safety Engineering Institute of Industrial Science The University of Tokyo

After the 2011 Great East Japan Earthquake, the Japanese government identified the lack of proficiency in the Japanese language as one characteristic of foreigners that should be considered in disaster prevention planning.This article seeks to understand how proficiency in a local language affects disaster information gathering behavior by using the results of a questionnaire survey conducted after the 2011 Great East Japan Earthquake. Respondents were categorized based on their Japanese and English language abilities. Their media mode, language preferences, information importance, and information-gathering difficulties also were examined. It was found that foreigners skilled in Japanese demonstrated similar information gathering behavior as Japanese respondents, but foreigners unskilled in Japanese showed little usage of Japanese-language media. This group also encountered difficulties due to a lack of Japanese proficiency, but many members were able to acquire some level of Japanese-language information through Internet-based methods. To address language proficiency in disaster prevention planning, information provision in languages other than Japanese should be increased, and Japanese information should be shared in a way that facilitates translation. Although this survey wassignificant in its scope, the results should be considered within the limitations of the Internet-based response collection and focus only on the less-affected area of Japan.

关键词： 2011 Great East Japan Earthquake Disaster information Foreign population Internet-based media Language proficiency

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Non-prosthetic treatment using segmental osteotomy and bone grafting in a patient with cleft lip and palate

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Plastic and Aesthetic Research 2022年第1期9卷 654-660页

作者： Atsuhiro Inoue Michiko Tsuji yoshiyuki Baba Keiji Moriyama Department of Maxillofacial Orthognathics Graduate School of Medical and Dental SciencesTokyo Medical and Dental University1-5-45 YushimaBunkyo-kuTokyo 113-8549Japan Division of Pedodontics and Orthodontics Department of Surgical SpecialtiesNational Center for Child Health and Development2-10-1 OkuraSetagaya-kuTokyo 157-8535Japan

This case report aimed to present the course of surgically combined comprehensive orthodontic treatment of a male adult with cleft lip and palate,showing a left alveolar cleft,lateral deviation of the major segment of the maxilla,and palatal transposition of the lateral incisor.Preoperatively,the midline of the upper central incisors was shifted by 7.0 mm to the right,the right lateral incisor showed palatal transposition,and the residual alveolar cleft was 6.5 mm.Segmental Le Fort I osteotomy of the major segment,and simultaneous bone grafting into the extended alveolar bone and former cleft region were performed at 18 years and 4 months of age.Thus,midline correction,alignment of the right lateral incisor,and cleft closure were achieved;no further prosthetic treatment was required.

关键词： Cleft lip and palate palatal transposition segmental Le Fort I osteotomy bone grafting

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