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Combined preoperative platelet-to-lymphocyte ratio and serum carbohydrate antigen 19–9 level as a prognostic factor in patients with resected pancreatic cancer

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Hepatobiliary & Pancreatic Diseases International 2019年第3期18卷 278-284页

作者： Teruhisa Sakamoto Hiroaki Saito Masataka Amisaki Naruo Tokuyasu Soichiro Honjo yoshiyuki fujiwara Division of Surgical Oncology Department of Surgery School of Medicine Tottori University Faculty of Medicine

Background: Carbohydrate antigen 19–9(CA19-9) is the most frequently used tumor marker and serves as a prognostic indicator in patients with pancreatic cancer(PC). The platelet-to-lymphocyte ratio(PLR) is thought to be an inflammation-related serum marker. An elevated PLR represents increased inflammatory status and is associated with poor prognosis in patients with various cancers including PC. Methods: This study involved 103 patients with a histopathological diagnosis of pancreatic ductal adenocarcinoma who underwent pancreatectomy. The patients were assessed to determine the prognostic significance of the combination of the PLR and CA19-9 level. Results: Based on the receiver operating characteristic analysis results, the patients were divided into PLR H igh(PLR ≥ 129.1) andPLRLow(PLR < 129.1) groups and into CA19-9High(CA19-9 ≥ 74.0 U/mL) and CA19-9Low(CA19-9 < 74.0 U/mL) groups. The cumulative 5-year overall survival(OS) and disease-specific survival(DSS) rates significantly differed by both the PLR(PLR H igh group: 19.5% and 22.9%;PLRLow group: 39.1% and 45.9%) and CA19-9(CA19-9 H igh group: 19.1% and 25.6%;CA19-9Low group: 41.0% and 41.0%). We then divided the patients into Groups A(PLR L ow/CA19-9Low), B(PLR Low/CA19-9High or PLRHigh/CA19-9Low), and C(PLR H igh/CA19-9High). The cumulative 5-year OS rates in Groups A, B, and C were 44.0%, 31.9%, and 11.9%, respectively( P = 0.002). The cumulative 5-year DSS rates in Groups A, B, and C were 47.7%, 36.4%, and 16.8%, respectively( P = 0.002). Multivariate analysis revealed that the combination of the PLR and CA19-9 was an independent prognostic factor in patients with resected PC. Conclusions: The combination of the PLR and CA19-9 is useful for predicting the prognosis of patients with resected PC.

关键词： CA19-9 Pancreatic cancer Platelet-to-lymphocyte ratio Prognosis

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Prognostic value of postoperative complication for early recurrence after curative resection of hepatocellular carcinoma

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Hepatobiliary & Pancreatic Diseases International 2018年第4期17卷 323-329页

作者： Masataka Amisaki Hiroaki Saito Naruo Tokuyasu Teruhisa Sakamoto Soichiro Honjo yoshiyuki fujiwara Division of Surgical Oncology Department of SurgerySchool of MedicineTottori University Faculty of Medicine

Background: Postoperative complications may adversely affect oncological outcomes. The aim of this study was to evaluate the impact of postoperative complications on early-phase recurrence after curative resection for hepatocellular carcinoma(HCC).Methods: We included 145 HCC patients who underwent initial and curative resection between January2004 and December 2013. Postoperative complications of grade III or higher based on Clavien–Dindo classification were defined as clinically relevant postoperative complications. Recurrence within two years after hepatectomy was defined as early-phase ***: Thirty-eight patients(26%) developed postoperative complications. The only predictive factor for postoperative complication was longer operative duration(P = 0.037). The disease-specific survival rate of patients with complication was lower than that of patients without complications(P = 0.015). Earlyphase recurrence was observed in 20/38(53%) patients who suffered postoperative complications and36/107(34%) patients with no complications, which was statistically significant(P = 0.039). Multivariate analysis identified four factors contributing to early-phase recurrence: high serum AFP level(P = 0.042),multiple tumors(P < 0.001), poor differentiation(P = 0.036) and presence of postoperative complication(P = 0.039).Conclusions: Postoperative complication is an independent prognostic factor for early-phase recurrence after curative resection of HCC. Close observation of patients with postoperative complications may be a necessary treatment strategy for HCC.

关键词： Neoplasm metastasis Complications Risk factors Hepatocellular carcinoma

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Post-operative albumin-bilirubin grade predicts long-term outcomes among Child–Pugh grade A patients with hepatocellular carcinoma after curative resection

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Hepatobiliary & Pancreatic Diseases International 2018年第6期17卷 502-509页

作者： Masataka Amisaki Ei Uchinaka Masaki Morimoto Naruo Tokuyasu Teruhisa Sakamoto Soichiro Honjo Hiroaki Saito yoshiyuki fujiwara Division of Surgical Oncology Department of Surgery School of Medicine Tottori University Faculty of Medicine

Background: Although Child–Pugh grade A patients with hepatocellular carcinoma(HCC) are candidates for curative resection, some may have a poor prognosis. The albumin-bilirubin(ALBI) grade, a measure of liver function based on albumin and bilirubin, has the potential to detect Child–Pugh grade A HCC patients with poor prognosis. Because components of the ALBI grade can be measured easily even after surgery, we explored the predictive values of ALBI in patient prognosis after HCC resection. Methods: In this retrospective case-control study, we included 136 HCC patients who underwent curative resection between January 2004 and December 2013 at our hospital. ALBI grade was calculated from laboratory data recorded the day before surgery and at post-operative day 5. Results: Pre-and post-operative ALBI grade predicted patients’ long-term outcomes( P = 0.020 and P < 0.001, respectively, for overall survival, and P = 0.012 and P = 0.015, respectively, for recurrence-free survival). Post-operative ALBI grade was associated with patients’ surgical factors of repeated hepatic resection( P = 0.012), intra-operative bleeding( P = 0.006), and surgery duration( P = 0.033). Furthermore, post-operative ALBI grade, rather than pre-operative ALBI grade, was an independent predictive factor of long-term outcome of Child–Pugh grade A patients with HCC. Conclusions: Post-operative ALBI grade is useful to predict the prognosis in patients after HCC resection.

关键词： Prognosis Hepatic resection Albumin Bilirubin

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Influence of the water jet system vs cavitron ultrasonic surgical aspirator for liver resection on the remnant liver

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World Journal of Clinical Cases 2022年第20期10卷 6855-6864页

作者： Takehiko Hanaki Ayumi Tsuda Teppei Sunaguchi Keisuke Goto Masaki Morimoto Yuki Murakami Kyoichi Kihara Tomoyuki Matsunaga Manabu Yamamoto Naruo Tokuyasu Teruhisa Sakamoto Toshimichi Hasegawa yoshiyuki fujiwara Division of Gastrointestinal and Pediatric Surgery Department of SurgeryTottori University Faculty of MedicineYonago 683-8504TottoriJapan

BACKGROUND Several methods,such as finger fracture,Pean crush,cavitron ultrasonic surgical aspirator(CUSA),and water jet(WJ),are used for hepatic parenchymal dissection in liver *** is the conventional method in *** is a relatively novel method for parenchymal *** it has several advantages,such as lower volume of blood loss and shorter operative time,the effect of the WJ system for hepatic dissection on the remnant liver has not yet been *** To investigate and compare the effect of the WJ method vs CUSA on the remnant liver cut *** This observational study compared the two types of parenchymal transection methods(WJ vs CUSA)in liver *** total,24 and 40 patients who underwent hepatectomy using the WJ method and CUSA,respectively,were included in the ***,the clinicopathological characteristics and clinical outcomes of 24 and 40 patients were ***,postoperative contrast-enhanced computed tomography(CT)scan was performed to assess the cut surface length of the remnant liver and the degenerative thickness of the areas with a reduced contrast effect in the dissected ***,the two groups were *** On CT scan,the median areas of denaturation in the liver dissection planes were 522(range:109.5-1242)mm^(2) in the CUSA group and 324(range:93.6-1529)mm^(2) in the WJ *** area did not significantly differ between the two groups;however,the denaturation thickness of the WJ group was significantly lower than that of the CUSA group[5.8(range:0.7-11.1)mm vs 3.3(range:1.7-10.4)mm,P<0.001].CONCLUSION The WJ group had significantly thinner contrast-enhanced areas in the post hepatectomy detached section than the CUSA group.

关键词： Water jet Cavitron ultrasonic surgical aspirator Energy device Hepatic parenchymal dissection Liver resection

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Solitary mediastinal lymph node recurrence after curative resection of colon cancer

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World Journal of Gastrointestinal Surgery 2014年第8期6卷 164-168页

作者： Yasuhiro Matsuda Masahiko Yano Norikatsu Miyoshi Shingo Noura Masayuki Ohue Keijiro Sugimura Masaaki Motoori Kentaro Kishi yoshiyuki fujiwara Kunihito Gotoh Shigeru Marubashi Hirofumi Akita Hidenori Takahashi Masato Sakon Department of Surgery Osaka Medical Center for Cancer and Cardiovascular Disease

We report two cases of solitary mediastinal lymph node recurrence after colon cancer resection. Both cases had para-aortic lymph node metastasis at the time of initial surgery and received adjuvant chemotherapy for 4 years in case 1 and 18 mo in case 2. The time to recurrence was more than 8 years in both cases. After resection of the recurrent tumor, the patient is doing well with no recurrence for 6 years in case 1 and 4 mo in case 2. Patients should be followed up after colon cancer surgery considering the possibility of solitary mediastinal lymph node recurrence if they had para-aortic node metastasis at the time of initial surgery.

关键词： Solitary mediastinal lymph node recurrence Colon cance

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Standardized technique for single-incision laparoscopicassisted stoma creation

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World Journal of Gastrointestinal Endoscopy 2016年第15期8卷 541-545页

作者： Norikatsu Miyoshi Shiki Fujino Masayuki Ohue Masayoshi Yasui Shingo Noura Yuma Wada Ryuichiro Kimura Keijiro Sugimura Akira Tomokuni Hirofumi Akita Shogo Kobayashi Hidenori Takahashi Takeshi Omori yoshiyuki fujiwara Masahiko Yano Department of Surgery Osaka Medical Center for Cancer and Cardiovascular Diseases Department of Surgery Osaka Rosai Hospital

To describe the procedure, efficacy, and utility of singleincision laparoscopic-assisted stoma creation(SILStoma) for transverse colostomy. Using single-incision laparoscopic surgery, we developed a standardized technique for SILStoma. Twelve consecutive patients underwent SILStoma for transverse colostomy at Osaka Medical Center for Cancer and Cardiovascular Diseases from April 2013 to March 2016. A single, intended stoma site was created with a 2.5-3.5 cm skin incision for primary access to the intra-abdominal space, and it functioned as the main port through which multi-trocars were placed. Clinical and operative factors and postoperative outcomes were evaluated. Patient demographics, including age, gender, body mass index, and surgical indications for intestinal diversion were evaluated. SILStoma was performed in nine cases without the requirement of additional ports. In the remaining three cases, 1-2 additional 5-mm ports were required for mobilization of the transverse colon and safe dissection of abdominal adhesions. No cases required conversion to open surgery. In all cases, SILStoma was completed at the initial stoma site marked preoperatively. No intraoperative or postoperative complications greater than Grade Ⅱ(the Clavien-Dindo classification) were reported in the complication survey. Surgical site infection at stoma sites was observed in four cases; however, surgical interventions were not required and all infectionswere cured completely. In all cases, the resumption of bowel movements was observed between postoperative days 1 and 2. SILStoma for transverse loop colostomy represents a feasible surgical procedure that allows the creation of a stoma at the preoperatively marked site without any additional large skin incisions.

关键词： Laparoscopic surgery Colostomy Stoma Postoperative complications Cosmetic outcomes

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Impacts of invasive Iris pseudacorus L.(yellow flag) establishing in an abandoned urban pond on native semi-wetland vegetation

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Journal of Integrative Agriculture 2018年第8期17卷 1881-1887页

作者： Daisuke Hayasaka Shingo fujiwara Taizo Uchida Graduate School of Agriculture KINDAI University Faculty of Engineering Kyushu Sangyo University

Iris pseudacorus L., intentionally introduced in Japan as an ornamental plant and to improve aquatic environments, has been declared a noxious species in the Invasive Alien Species Act of Japan due to the suspected high ecological risks to the local species and ecosystems. Although prompt responses to I. pseudacorus have been sought to conserve local biodiversity, knowledge about its invasiveness is lacking. Here, we report the relationship between the establishment of I. pseudacorus and floristic changes in semi-wetland vegetation of an abandoned urban pond(Aoike), Nara City, Nara Prepecture, Japan. In total, 64 vascular plants were recorded in the pond, of which 50 were native species, seven were naturalized non-native, and seven were invasive species. On the other hand, most of these vascular plants(42 species) were grassland species and only several aquatic plants(10 species) were found in this study pond. The number of vascular plant species decreased significantly at quadrats with a coverage of I. pseudacorus above 50%. In addition, tendencies of lower number of native species and concomitant higher number of invasive species were found with increasing coverage of I. pseudacorus. From these results, we suggest that it is important to preferentially manage sites where the coverage of I. pseudacorus is above 50%, in order to preserve the local biodiversity. Additionally, as recommended in the literature, it is essential that the cut reproductive organs are kept submerged under deep water for an effective control of I. pseudacorus.

关键词： biodiversity conservation biological invasions ecological impacts exotic species hydrophytes species traits

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ANALYSIS ON PSEUDO-STEADY INDENTATION CREEP

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Acta Mechanica Solida Sinica 2008年第4期21卷 283-288页

作者： Hidenari Takagi Ming Dao Masami fujiwara Division of Applied Physics College of Engineering Nihon University Fukushima Japan Department of Materials Science and Engineering School of Engineering Massachusetts Institute of Technology Massachusetts USA

Theoretical analysis and finite element （FE） simulation have been carried out for a constant specific load rate （CSLR） indentation creep test. Analytical results indicate that both the representative stress and the indentation strain rate become constant after a transient period. Moreover, the FE simulation reveals that both the contours of equivalent stress and equivalent plastic strain rate underneath the indenter evolve with geometrical self-similarity. This suggests that pseudo-steady indentation creep occurs in the region beneath the indenter. The representative points in the region are defined as the ones with the equivalent stress equal to the representative stress. In addition, it is revealed that the proportionality between indentation strain rate and equivalent plastic strain rate holds at the representative points during the pseudo-steady indentation creep of a power law material. A control volume （CV） beneath the indenter, which governs the indenter velocity, is identified. The size of the CV at the indented surface is approximately 2.5 times the size of the impression. The stress exponent for creep can be obtained from the pseudosteady indentation creep data. These results demonstrate that the CSLR testing technique can be used to evaluate creep parameters with the same accuracy as conventional uniaxial creep tests.

关键词： indentation creep finite element method conical indenter geometrical self-similarity,pseudo-steady state control volume stress exponent

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Preparation of High Performance Foamed Concrete from Cement,Sand and Mineral Admixtures

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Journal of Wuhan University of Technology(Materials Science) 2007年第2期22卷 295-298页

作者：潘志华 fujiwara Hiromi Wee Tionghuan College of Materials Science & Engineering Nanjing University of Technology Faculty of Engineering Utsunomiya University7-1-2YotoUtsunomiyacity Department of Civil Engineering National University of Singapore

The titled high performance foamed concrete was developed from Portland cement, ultra fine granulated blast-furnace slag, pulverized fly ash and condensed silica fume by means of pre-foaming process. The resultant foamed concrete presents its thermal conductivity of about 0.16-0.75 W/（m·℃） and 28 d compressive strength of about 1.1-23.7 MPa when its mix proportion varies in the range of cement content 280 kg-650 kg/m^3, fly ash 42-97 kg/m^3, slag 64-146 kg/m^3, silica fume 34-78 kg/m^3, and sand 0-920 kg/m^3. The compressive strength of the foamed concrete with oven dried bulk density of 1500 kg/m^3 in appropriate mix proportion and with small amount of superplasticizer reached as high as 44.1 MPa. Meanwhile, the flesh foamed concrete behaves like an excellent flow-ability, therefore, is especially suitable for the application in case of massive foamed concrete casting in situ and in the case of filling casting into large volume underground irregular voids, except for pre-casting of building components like blocks, bricks, and wall panels.

关键词： foamed concrete density compressive strength thermal conductivity

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Study of photoexcited-carrier dynamics in GaAs photoconductive switches using dynamic terahertz emission microscopy

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Photonics Research 2016年第3期4卷 9-15页

作者： Hironaru Murakami Shogo fujiwara Iwao Kawayama Masayoshi Tonouchi Institute of Laser Engineering Osaka University

We propose dynamic terahertz(THz) emission microscopy(DTEM) to visualize temporal–spatial dynamics of photoexcited carriers in electronic materials. DTEM utilizes THz pulses emitted from a sample by probe pulses irradiated after pump pulse irradiation to perform time-resolved two-dimensional mapping of the THz pulse emission, reflecting various carrier dynamics. Using this microscopy, we investigated carrier dynamics in the gap region of low-temperature-grown Ga As and semi-insulating Ga As photoconductive switches of the identical-dipole type. The observed DTEM images are well explained by the change in the electric potential distribution between the electrodes caused by the screening effect of the photoexcited electron-hole pairs.

关键词： Ga Study of photoexcited-carrier dynamics in GaAs photoconductive switches using dynamic terahertz emission microscopy As THz

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