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Successful laparoscopic splenectomy after living-donor liver transplantation for thrombocytopenia caused by antiviral therapy

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World Journal of Gastroenterology 2008年第26期14卷 4245-4248页

作者： h.royuki Kato Masanobu Usui Yoshinori Azumi Ichiro Ohsawa Masashi Kishiwada h.royuki sakurai Masami Tabata Shuji Isaji Department of hepatobiliary Pancreatic Surgery Mie University Graduate School of Medicine Tsu Mie 514-8507 Japan

Although interferon (IFN) based therapy for recurrent hepatitis C virus (hCV) infection after liver transplantation has been widely accepted, it induces various adverse effects such as thrombocytopenia, resulting in its interruption. Recently, concomitant splenectomy at the time of living donor liver transplantation (LDLT) has been tried to overcome this problem, but this procedure leads to several complications such as excessive intraoperative bleeding and serious infection. A 60-year-old female received LDLT using a left lobe graft from her second son for liver failure caused by hepatitis C-related cirrhosis. Six months after LDLT, she was diagnosed as recurrent hCV infection by liver biopsy. IFN monotherapy was started from 7 mo after LDLT and her platelet count decreased to less than 50 000/μL, which thus made it necessary to discontinue the treatment. We decided to attempt laparoscopic splenectomy (LS) under general anesthesia. Since intra-abdominal findings did not show any adhesion formations around the spleen, LS could be successfully performed. After LS, since her platelet count immediately increased to 225 000/μL 14 d after operation, IFN therapy was restarted and we could convert the combination therapy of IFN and ribavirin, resulting in no detectable viral marker. Inconclusion, LS can be performed safely even after LDLT, and LS after LDLT is a feasible and less invasive modality for thrombocytopenia caused by antiviral therapy.

关键词： Concomitant splenectomy Portal veinthrombosis Ribavirin

Pneumatosis cystoides intestinalis associated with massive free air mimicking perforated diffuse peritonitis

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World Journal of Gastroenterology 2008年第43期14卷 6753-6756页

作者： Yoichi sakurai Masahiro hikichi Jun Isogaki Shinpei Furuta Risaburo Sunagawa Kazuki Inaba Yoshiyuki Komori Ichiro Uyama Department of Surgery Fujita Health University School of MedicineToyoake Aichi 470-1192Japan

While pneumatosis cystoides intestinalis （PCI） is a rare disease entity associated with a wide variety of gastrointestinal and non-gastrointestinal disorders, PCI associated with massive intra- and retroperitoneal free air is extremely uncommon, and is difficult to diagnose differentially from perforated peritonitis. We present two cases of PCI associated with massive peritoneal free air and/or retroperitoneal air that mimicked perforated peritonitis. These cases highlight the clinical importance of PCI that mimics perforated peritonitis, which requires emergency surgery. Preoperative imaging modalities and diagnostic laparoscopy are useful to make an accurate diagnosis.

关键词： Pneumatosis cystoides intestinalis Perforated peritonitis Corticosteroid therapy Peritonealfree air

Formation of ceramic-metal composite layers on die steels by electron beam irradiation

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材料与冶金学报 2015年第2期14卷 152-158页

作者： Takahiro Akao Yuki sakurai Tetsuhiko Onda Kazutake Uehara Zhongchun Chen Department of Mechanical and Aerospace Engineering Graduate School of EngineeringTottori University Koyama - minami d - 101 Tottori 680 - 8552 Japan Next Generation Advanced Medical Promotion Center Tottori University Hospital Nishi - cho 36 - 1 Yonago Tottori 683 - 8504 Japan

Surface modifications,which result in formation of a hard layer such as CrN,TiN,TiCN etc. on tool surfaces,have been widely utilized in machining tools. how ever,the hard layer has clear interface with the matrix,thereby the delamination between the hard layer and matrix often occurs because of a mismatch of the thermal expansion coefficients. A composite layer with complicated interfaces between hard material and matrix is desired to avoid such a delamination due to a complicated interface existed between workpiece and coating materials. In this study,the formation of ceramic- metal composite layers on the surfaces of die steels by an electron beam( EB) irradiation technique has been investigated. When WC- Co powder was embrocated onto the substrate surfaces,a composite layer of WC- Co and matrix was formed through solidification after the irradiation-induced melting. The composite layer shows a marble- like texture with WC- rich regions. The hardness of the layer reaches up to 1000 hV. For other ceramic pow ders such as TiN and SiC,only small amount of particles has been incorporated into the composite layer,resulting in a relatively low hardness enhancement after the EB irradiation.

关键词： surface modification die steel composite layer electron beam irradiation

Advanced Control Scenario of high-Performance Steady-State Operation for JT-60 Superconducting Tokamak

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Plasma Science and Technology 2004年第3期6卷 2281-2285页

作者： h.Tamai G.Kurita M.Matsukawa K.Urata S.sakurai K.Tsuchiya A.Morioka Y.M.Miura K.Kizu Y.Kamada A.Sakasai S.Ishida Japan Atomic Energy Research Institute Naka Ibaraki 311-0193 Japan

Plasma control on high-β_N steady-state operation for JT-60 superconductingmodification is discussed. Accessibility to high-β_N exceeding the free-boundary limit isinvestigated with the stabilising wall of reduced-activated ferritic steel and the active feedbackcontrol of the ill-vessel non-axisymmetric field coils. Taking the merit of superconducting magnet,advanced plasma control for steady-state high performance operation could be expected.

关键词： plasma control superconducting tokamak JT-60

Relationship between urinary cadmium and mortality in habitants of a cadmium-polluted area： a 22-year follow-up study in Japan

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Chinese Medical Journal 2011年第21期124卷 3504-3509页

作者： LI Qian Muneko Nishijo hideaki Nakagawa Yuko Morikawa Masaru sakurai Koshi Nakarnura Teruhiko Kido Koji Nogawa DAI Min National Office of Cancer Prevention and Control Cancer Institute ＆ Hospital Cancer Institute Chinese Academy of Medical Sciences Beijing 100021 China Department of Epidemiology and Public health Kanazawa Medical University Ishikawa 920-0293 Japan Faculty of Medicine School of Health Science Kanazawa University Kanazawa Ishikawa 920-0293 Japan Chiba Occupational health Promotion Center Tonya Chuo-ku Chiba Japan

Background Several studies have suggested that the exposure to cadmium （Cd） increased mortalities from renal diseases, cardiovascular diseases and malignant neoplasm, including lung cancer and prostate cancer among inhabitants living in Cd-polluted areas and factory workers. This study aimed to assess the influence of environmental exposure to Cd on long term outcome of inhabitants living in an area polluted by Cd. Methods A 22-year follow-up study was conducted with 3119 inhabitants （1403 men and 1716 women） living in the Cd polluted Kakehashi River basin in Japan. The subjects were divided into 4 groups according to the amount of urinary Cd level （〈3.0 μg/g creatinine （Cr）, 3.0-4.9 μg/g Cr, 5.0-9.9 μg/g Cr, and -〉10.0 μg/g Cr）. Mortality was calculated by the person-years method. hazards ratios （hR） and 95% confidence intervals （CI） were assessed by the Cox＇s proportional hazard model. Results Compared with urinary Cd 〈3.0 μg/g Cr group, the hR of 5.0-9.9μg/g Cr and 〉10.0 μg/g Cr groups were significantly increased after adjustment for age in both sexes： 1.24 （95% Cl 1.01-1.51） and 1.48 （95% CI 1.17-1.90） for men; 1.64 （95% CI 1.17-2.28） and 1.78 （95% Cl 1.27-2.50） for women. The most frequent cause of death was malignant neoplasm in men and cardiovascular diseases in women. The significant increase in mortality risk for cardiovascular diseases was observed in the subjects with 〉10 μg/g Cr in both sexes： 1.79 for men （95% Cl 1.02-3.12） and 2.38 for women （95% Cl 1.11-5.07）. When the subjects were divided into 2 categories （〈20μg/g Cr and 〉20 μg/g Cr）, the hR of the urinary Cd 〉20 μg/g Cr group for nephritis and nephrosis were 4.82 （95% Cl 1.07-21.61） in men and 7.92 （95% Cl 1.77-35.33） in women, respectively. The significant increase was not observed for malignant neoplasm. Conclusion These results suggest a dose-response relationship between Cd body burden and mortality for cardiovascular diseases, cerebrovascular diseases and nephritis and nephrosis.

关键词： urinary cadmium mortality special causes of death environmental exposure

Early-Stage Juvenile Fibromyalgia in a 12-Year-Old Girl

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Open Journal of Pediatrics 2015年第4期5卷 353-357页

作者： Yoshihiko sakurai Department of Pediatrics Matsubara Tokushukai Hospital Matsubara Japan

Juvenile fibromyalgia (JFM) is often diagnosed at a later stage. Therefore, little is known about its early phase. A 12-year-old girl with persistent lumbago without fever consulted an orthopedist, but imaging studies showed no abnormalities and analgesics were ineffective. She therefore visited our pediatric clinic. On digital palpation, she had pain in 13 of the 18 tender point sites of fibromyalgia. The blood test results were unremarkable. A medical interview revealed character tendencies often seen in patients with JFM;she was serious-minded, uncompromising, and showed excessive concern for others. Furthermore, psychological stress for the approaching annual sports day might have built up. All factors considered, early-stage JFM was the probable diagnosis. The patient accepted the diagnosis and understood that the disease may be psychogenic. Getting through the sports day cured her symptoms. This case highlights the importance of initial care, including a detailed explanation, in those with JFM.

关键词： Juvenile Fibromyalgia Early Stage Character Tendency Psychological Stress Initial Care

Nutritional Management of Cancer Patients Undergoing Chemotherapy and Chemoradiation Therapy

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肿瘤营养学杂志（英文） 2016年第1期1卷 10-14页

作者： Yoichi sakurai Department of Ecology Wayo Women’s University Graduate School Chiba 272-8533 Japan Department of Surgery Chiba-ken Saiseikai Narashino Hospital Chiba 275-8580 Japan

Although chemotherapy and chemoradiation therapy improve the clinical outcomes and decrease locoregional failure in patients with advanced cancer, they may lead to an increased risk of malnutrition in these patients due to their gastrointestinal side effects. Many cancer patients are already malnourished as a result of their cancer-bearing status. Consequently, these patients experience poor clinical outcomes due to various infectious and noninfectious complications. Nutritional management that is based on frequent monitoring of the nutritional status of patients can ensure that they receive adequate calories and certain nutrients, which is vital to improve their clinical outcomes and quality of life.

关键词： Nutrition Cancer patients Chemotherapy Chemoradiation therapy

Transient Macroamylasemia in a Severely Multiple-handicapped Child Following the Development of Acute Bronchitis

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Open Journal of Pediatrics 2015年第3期5卷 232-235页

作者： Yoshihiko sakurai Department of Pediatrics Matsubara Tokushukai Hospital Matsubara Japan

Macroamylasemia is a condition of elevated serum amylase levels in which normal serum amylase form a complex with high molecular weight proteins such as immunoglobulins. This is a case report on a patient with macroamylasemia following acute asthmatic bronchitis. A 5-year-old male with cerebral palsy and developmental retardation was admitted to our hospital because of high fever and severe cough. Treatment of the respiratory symptoms provided symptomatic improvement, but the serum amylase levels became suddenly elevated. Although acute pancreatitis associated with respiratory infection was initially suspected, a predominant salivary isoamylase, normal serum lipase level, low urine amylase level, and low amylase-creatinine clearance ratio (ACCR) (0.58%) indicated macroamylasemia. The serum amylase level decreased, and the ACCR increased within normal range 2 weeks after discharge. Both of these indicators have been within normal range over the past year. Transient macroamylasemia can be misdiagnosed as acute pancreatitis, especially in a severely multiple-handicapped child who is unable to complain. The ACCR is useful in the diagnosis of macroamylasemia.

关键词： Acute Respiratory Infections Amylase-Creatinine Clearance Ratio (ACCR) Macroamylasemia Multiple-handicapped Child

Mitochondrial Respiration Is Associated with Alloxan-Induced Mitochondrial Permeability Transition

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Journal of Biophysical Chemistry 2016年第4期7卷 87-97页

作者： Koichi sakurai Mika Itoh Department of Life Science Hokkaido Pharmaceutical University School of Pharmacy Sapporo Japan

We previously showed that increased mitochondrial inner membrane permeability which is known as mitochondrial permeability transition (MPT) is triggered by adding succinate in the presence of the diabetogenic agent alloxan. here, our aim was to investigate whether mitochondrial respiration is associated with alloxan-induced MPT. After mitochondria isolated from rat liver were incubated with alloxan at 37°C for 5 min, the addition of succinate immediately triggered the MPT in the presence of rotenone. however, little or no induction occurred at incubation temperatures below 25°C. Malate/glutamate also triggered MPT by alloxan in the absence of rotenone. In mitochondrial suspensions containing alloxan, succinate accelerated oxygen consumption that was completely inhibited by cyanide. These results suggest that mitochondrial respiration is associated with the alloxan-induced MPT. Alloxan radical production was investigated using ESR spectroscopy. Mitochondria incubated with succinate and alloxan elicited low signal intensity (radical formation) that increased significantly in the presence of cyanide. When the incubation of alloxan with mitochondria after the addition of succinate, a little intensity of the signal was observed, but it was remarkably increased after the addition of cyanide. Ubiquinone analogues inhibited the MPT induction. These results suggest that the initiation of MPT is associated with alloxan redox cycling via an electron transfer process at a quinone-binding site in respiratory mitochondria.

关键词： Mitochondria Permeability Respiration Alloxan Redox Cycle Radical