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Patients with early recurrence of hepatocellular carcinoma have poor prognosis

Hepatobiliary & Pancreatic Diseases International 2017年第3期16卷 279-288页

作者： Tomoki Kobayashi hiroshi aikata Tsuyoshi Kobayashi Hideki Ohdan Koji Arihiro Kazuaki Chayama Department of Gastroenterology and Metabolism hiroshima University Hospital Hiroshima Japan Department of Anatomical Pathology hiroshima University Hospital Hiroshima Japan Department of Gastroenterological and Transplant Surgery Applied Life Sciences Institute of Biomedical and Health Sciences Hiroshima University Hiroshima Japan Liver Research Project Center hiroshima University Hiroshima Japan

BACKGROUND： Early recurrence （ER） after hepatic resection （HR） is a poor prognostic factor for patients with hepatocellular carcinoma （HCC）. This study aimed to identify the clinico- pathological features, outcomes, and risk factors for ER after HR for small HCC in order to clarify the reasons why ER is a worse recurrence pattern. METHODS： We retrospectively examined 130 patients who underwent HR for small HCC （___30 mm）. Recurrence was clas- sifted into ER （〈2 years） and late recurrence （LR）（_〉2 years）. The clinicopathological features, outcomes, and risk factors for ER were analyzed by multivariate analysis. RESULTS： ER was observed in 39 patients （30.0%）. The sur- vival rate of the ER group was significantly lower than that of the LR group （P〈0.005）, and ER was an independent prognos- tic factor for poor survival （P=0.0001）. The ER group had a significantly higher frequency （P=0.0039） and shorter interval （P=0.027） of development to carcinoma beyond the Milan criteria （DBMC） compared with the LR group, and ER was an independent risk factor for DBMC （P〈0.0001）. Multi-nodularity, non-simple nodular type, and microvascular invasion were independent predictors for ER （P=0.012, 0.010, and 0.019, respectively）.CONCLUSIONS： ER was a highly malignant recurrence pattern associated with DBMC and subsequent poor survival after HR for small HCC. Multi-nodularity, non-simple nodular type, and microvascular invasion predict ER, and taking these factors into consideration may be useful for the decision of the treatment strategy for small HCC after HR.

关键词： early recurrence small hepatocellular carcinoma risk factors beyond the Milan criteria

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Systemic gemcitabine combined with intra-arterial low-dose cisplatin and 5-fluorouracil for advanced hepatocellular carcinoma: Seven cases

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World Journal of Gastroenterology 2008年第16期14卷 2602-2608页

作者： Kiminori Uka hiroshi aikata Shintaro Takaki Tomokazu Kawaoka Hiromi Saneto Daiki Miki Shoichi Takahashi Naoyuki Toyota Katsuhide Ito Kazuaki Chayama Department of Medicine and Molecular Science Division of Frontier Medical Science Programs for Biomedical Research Graduate School of Biomedical Sciences Hiroshima University Department of Radiology Hiroshima University Hospital

The combination of intra-arterial low-dose cisplatin and 5-fluorouracil (5-FU) is effective against advanced hepatocellular carcinoma (HCC). Systemic gemcitabine chemotherapy seems effective in many cancers. We report the results of combination therapy with systemic gemcitabine, intra-arterial low-dose cisplatin and 5-FU (GEMFP). Seven patients with non-resectable advanced HCC were treated with GEMFP. One course of chemotherapy consisted of daily intra-arterial cisplatin (20 mg/body weight/hour on d 1, 10 mg/body weight per 0.5 h on d 2-5 and 8-12), followed by 5-FU (250 mg/body weight per 5 h on d 1-5 and 8-12) via an injection port. Gemcitabine at 1000 mg/m2 was administered intravenously at 0.5 h on d 1 and 8. The objective response was 57%. The response to GEMFP was as follows: complete response (no patients), partial response (four patients), stable disease (three patients), and progressive disease (no patients). The median survival period was 8 mo (range, 5-55). With regard to the National Cancer Institute Common Toxicity Criteria (NCI-CTC) grade 3 or 4 adverse reactions, seven (100%), seven, six (86%) and one (14%) patients developed leukopenia, neutropenia, thrombocytopenia and anemia, respectively. GEMFP may potentially be effective for non- resectable advanced HCC, but it has severe hematologic toxicity.

关键词： 5-fluorouracil Cisplatin Gemcitabine Hepatocellular carcinoma

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Clinical features and prognosis of patients with extrahepatic metastases from hepatocellular carcinoma

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World Journal of Gastroenterology 2007年第3期13卷 414-420页

作者： Kiminori Uka hiroshi aikata Shintaro Takaki Hiroo Shirakawa Soo Cheol Jeong Keitaro Yamashina Akira Hiramatsu Hideaki Kodama Shoichi Takahashi Kazuaki Chayama Department of Medicine and Molecular Science Division of Frontier Medical Science Programs for Biomedical Research Graduate School of Biomedical Sciences Hiroshima University Hiroshima Japan

AIM: To assess the clinical features and prognosis of 151 patients with extrahepatic metastases from primary hepatocellular carcinoma (HCC), and describe the treatment strategy for such patients. METHODS: After the diagnosis of HCC, all 995 consecutive HCC patients were followed up at regular intervals and 151 (15.2%) patients were found to have extrahepatic metastases at the initial diagnosis of primary HCC or developed such tumors during the follow-up period. We assessed their clinical features, prognosis, and treatment strategies. RESULTS: The most frequent site of extrahepatic metastases was the lungs (47%), followed by lymph nodes (45%), bones (37%), and adrenal glands (12%). The cumulative survival rates after the initial diagnosis of extrahepatic metastases at 6, 12, 24, and 36 mo were 44.1%, 21.7%, 14.2%, 7.1%, respectively. The median survival time was 4.9 mo (range, 0-37 mo). Fourteen patients (11%) died of extrahepatic HCC, others died of primary HCC or liver failure. CONCLUSION: The prognosis of HCC patients with extrahepatic metastases is poor. With regard to the cause of death, many patients would die of intrahepatic HCC and few of extrahepatic metastases. Although most of HCC patients with extrahepatic metastases should undergo treatment for the primary HCC mainly, treatment of extrahepatic metastases in selected HCC patients who have good hepatic reserve, intrahepatictumor stage (T0-T2), and are free of portal venous invasion may improve survival.

关键词： Hepatocellular carcinoma Extrahepatic metastases Prognosis Causes of death

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Effects of a 24-week course of interferon-αtherapy after curative treatment of hepatitis C virus-associated hepatocellular carcinoma

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World Journal of Gastroenterology 2007年第40期13卷 5343-5350页

作者： Soo Cheol Jeong hiroshi aikata Yoshio Katamura Takahiro Azakami Tomokazu Kawaoka Hiromi Saneto Kiminori Uka Nami Mori Shintaro Takaki Hideaki Kodama Koji Waki Michio Imamura Hiroo Shirakawa Yoshiiku Kawakami Shoichi Takahashi Kazuaki Chayama Department of Medicine and Molecular Science Division of Frontier Medical SciencePrograms for Biomedical ResearchGraduate School of Biomedical SciencesHiroshima UniversityHiroshima 734-8551Japan

AIM： To assess whether a 24-wk course of interferon （IFN） could prevent hepatocellular carcinoma （HCC） recurrence and worsening of liver function in patients with hepatitis C virus （HCV）-infected patients after receiving curative treatment for primary HCC.METHODS： Outcomes in 42 patients with HCV infection treated with IFN-α, after curative treatment for primary HCC （IFN group）, were compared with 42 matched curatively treated historical controls not given IFN （non- IFN group）.RESULTS： Although the rate of initial recurrence did not differ significantly between ]FN group and non-IFN group （0%, 44%, 61~, and 67% ys 4.8%, 53~, 81%, and 87% at 1, 3, 5, and 7 years, P = 0.153, respectively）, ]FN group showed a lower rate than the non-IFN group for second recurrence （0%, 10.4%, 28%, and 350/0 ys 0%, 30~ , 59%, and 66% at 1, 3, 5 and 7 years, P = 0.022, respectively）. Among the ]FN group, patients with sustained virologic response （SVR） were less likely to have a second HCC recurrence than ]FN patients without an SVR, or non-IFN patients. Multivariate analysis identified the lack of SVR as the only independent risk factor for a second recurrence, while SVR and Child-Pugh class A independently favored overall survival.CONCLUSION： Most intrahepatic recurrences of HCV-related HCC occurred during persistent viral infection. Eradication of HCV is essential for the prevention of HCC recurrence and improvement of survival.

关键词： Hepatitis C virus Hepatocellular carcinoma Recurrence Survival Sustained virological response

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Low-dose intermittent interferon-alpha therapy for HCV-related liver cirrhosis after curative treatment of hepatocellular carcinoma

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World Journal of Gastroenterology 2007年第39期13卷 5188-5195页

作者： Soocheol Jeong hiroshi aikata Yoshio Katamura Takahiro Azakami Tomokazu Kawaoka Hiromi Saneto Kiminori Uka Nami Mori Shintaro Takaki Hideaki Kodama Koji Waki Michio Imamura Hiroo Shirakawa Yoshiiku Kawakami Shoichi Takahashi Kazuaki Chayama Department of Medicine and Molecular Science Division of Frontier Medical Science Programs for Biomedical Research Graduate School of Biomedical Sciences Hiroshima University Hiroshima 734-8551 Japan

AIM: To assess the efficacy of low-dose intermittent interferon (IFN) therapy in patients with hepatitis C virus (HCV)-related compensated cirrhosis who had received curative treatment for primary hepatocellular carcinoma (HCC). METHODS: We performed a prospective case controlled study. Sixteen patients received 3 MIU of natural IFN- alpha intramuscularly 3 times weekly for at least 48 wk (IFN group). They were compared with 16 matched historical controls (non-IFN group). RESULTS: The cumulative rate of first recurrence of HCC was not significantly different between the IFN group and the non-IFN group (0% vs 6.7% and 68.6% vs 80% at 1- and 3-year, P = 0.157, respectively). The cumulative rate of second recurrence was not also significantly different between the IFN group and the non-IFN group (0% vs 6.7% and 35.9% vs 67% at 1- and 3-year, P = 0.056, respectively). Although the difference in the Child-Pugh classification score between the groups at initial treatment of HCC was not signifi cant, the score was signifi cantly worse at the time of data analysis in the non-IFN group than IFN group (7.19 ± 1.42 vs 5.81 ± 0.75, P = 0.0008). The cumulative rate of deviation from objects of any treatment for recurrentHCC was also higher in the non-IFN group than IFN group (6.7% and 27% vs 0 and 0% at 1- and 3-year, P = 0.048, respectively). CONCLUSION: Low-dose intermittent IFN-alpha therapy for patients with HCV-related compensated cirrhosis after curative HCC treatment was effective by making patients tolerant to medical or surgical treatment for recurrent HCC in the later period of observation.

关键词： Hepatitis C virus Hepatocellular carcinoma Interferon therapy Liver cirrhosis Liver function Recurrence Survival

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Estimating the effective reproduction number of COVID-19 from population-wide wastewater data:An application in Kagawa,Japan

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Infectious Disease Modelling 2024年第3期9卷 645-656页

作者： Yuta Okada hiroshi Nishiura Kyoto University School of Public Health Yoshida-KonoeSakyoKyoto606-8601Japan

Although epidemiological surveillance of COVID-19 has been gradually downgraded globally,the transmission of COVID-19 *** is critical to quantify the transmission dynamics of COVID-19 using multiple datasets including wastewater virus concentration ***,we propose a comprehensive method for estimating the effective reproduction number using wastewater *** wastewater virus concentration data,which were collected twice a week,were analyzed using daily COVID-19 incidence data obtained from Takamatsu,Japan between January 2022 and September *** estimated the shedding load distribution(SLD)as a function of time since the date of infection,using a model employing the delay distribution,which is assumed to follow a gamma distribution,multiplied by a scaling *** also examined models that accounted for the temporal smoothness of viral load measurement *** model that smoothed temporal patterns of viral load was the best fit model(WAIC=2795.8),which yielded a mean estimated distribution of SLD of 3.46 days(95%CrI:3.01–3.95 days).Using this SLD,we reconstructed the daily incidence,which enabled computation of the effective reproduction *** the best fit posterior draws of parameters directly,or as a prior distribution for subsequent analyses,we first used a model that assumed temporal smoothness of viral load concentrations in wastewater,as well as infection counts by date of *** the subsequent approach,we examined models that also incorporated weekly reported case counts as a proxy for weekly incidence *** approaches enabled estimations of the epidemic curve as well as the effective reproduction number from twice-weekly wastewater viral load *** weekly case count data reduced the uncertainty of the effective reproduction *** conclude that wastewater data are still a valuable source of information for inferring the transmission dynamics of COVID-19,and that inferential performance is enhanced when tho

关键词： Severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) Wastewater-based epidemiology Shedding load distribution'Mathematical model

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The design and engineering strategies of metal tellurides for advanced metal-ion batteries

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Journal of Energy Chemistry 2024年第2期89卷 579-598,I0013页

作者： Wenmiao Zhao Xiaoyuan Shi Bo Liu hiroshi Ueno Ting Deng Weitao Zheng Key Laboratory of Automobile Materials of MOE School of Materials Science and EngineeringJilin Provincial International Cooperation Key Laboratory of High-Efficiency Clean Energy MaterialsJilin UniversityChangchun 130012JilinChina Key Laboratory of Polyoxometalate Science of Ministry of Education Northeast Normal UniversityChangchun 130024JilinChina Key Laboratory of Preparation and Application of Environmental Friendly Materials(Jilin Normal University) Ministry of EducationChangchun 130103JilinChina Creative Interdisciplinary Research Division The Frontier Research Institute for Interdisciplinary Sciences(FRIS)Department of ChemistryGraduate School of ScienceTohoku UniversitySendai 980-8578Japan

Owning various crystal structures and high theoretical capacity,metal tellurides are emerging as promising electrode materials for high-performance metal-ion batteries(MBs).Since metal telluride-based MBs are quite new,fundamental issues raise regarding the energy storage mechanism and other aspects affecting electrochemical *** volume expansion,low intrinsic conductivity and slow ion diffusion kinetics jeopardize the performance of metal tellurides,so that rational design and engineering are crucial to circumvent these ***,this review provides an in-depth discussion of recent investigations and progresses of metal tellurides,beginning with a critical discussion on the energy storage mechanisms of metal tellurides in various *** the following,recent design and engineering strategies of metal tellurides,including morphology engineering,compositing,defect engineering and heterostructure construction,for high-performance MBs are *** primary focus is to present a comprehensive understanding of the structural evolution based on the mechanism and corresponding effects of dimension control,composition,electron configuration and structural complexity on the electrochemical *** closing,outlooks and prospects for future development of metal tellurides are *** work also highlights the promising directions of design and engineering strategies of metal tellurides with high performance and low cost.

关键词： Metal tellurides Metal-ion battery Energy storage mechanism Material design and engineering

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Epidemiological impact of revoking mask-wearing recommendation on COVID-19 transmission in Tokyo,Japan

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Infectious Disease Modelling 2024年第4期9卷 1289-1300页

作者： Mayu Nagata Yuta Okada hiroshi Nishiura Kyoto University School of Public Health Yoshida-KonoeSakyoKyoto606-8601Japan

Despite the global implementation of COVID-19 mitigation measures,the disease continues to maintain *** mask wearing became one of the key measures for preventing the transmission of COVID-19 early in the pandemic period,many countries have relaxed the mandatory or recommended wearing of *** objective of the present study was to estimate the epidemiological impact of removing the mask-wearing recommendation in *** developed a model to assess the consequences of declining mask-wearing coverage after the government revoked its recommendation in February *** declining mask-wearing coverage was estimated using serial cross-sectional data,and a mathematical model was devised to determine the age-specific incidence of COVID-19 using the observed case count in Tokyo from week of October 3,2022 to October 30,*** explored model-based counterfactual scenarios to measure hypothetical situations in which the mask-wearing coverage decreases or increases relative to the observed *** results show that mask-wearing coverage declined from 97%to 69%by the week of October 30,2023,and that if the mask-wearing recommendation had continued,427 lives could have been saved in *** the mask-wearing coverage had declined to 25%of the observed level,the model suggests there might have been 1587 additional ***,revoking the mask-wearing recommendation had a substantial epidemiological *** future pandemics,our proposed approach could provide a realtime quantification of the effects of relaxing countermeasures.

关键词： COVID-19 Mask wearing recommendation Health policy Counterfactual Mathematical model

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Caspase-11 mediated inflammasome activation in macrophages by systemic infection of *** exacerbates arthritis

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International Journal of Oral Science 2024年第3期16卷 499-514页

作者： Tokuju Okano hiroshi Ashida Noriko Komatsu Masayuki Tsukasaki Tamako Iida Marie Iwasawa Yuto Takahashi Yasuo Takeuchi Takanori Iwata Miwa Sasai Masahiro Yamamoto hiroshi Takayanagi Toshihiko Suzuki Department of Bacterial Pathogenesis Infection and Host ResponseGraduate School of Medical and Dental SciencesTokyo Medical and Dental UniversityTokyoJapan Department of Immunology Graduate School of Medicine and Faculty of MedicineThe University of TokyoTokyoJapan Department of Osteoimmunology Graduate School of Medicine and Faculty of MedicineThe University of TokyoTokyoJapan Department of Lifetime Oral Health Care Science Graduate School of Medical and Dental SciencesTokyo Medical and Dental UniversityTokyoJapan Department of Periodontology Graduate School of Medical and Dental SciencesTokyo Medical and Dental UniversityTokyoJapan Department of Immunoparasitology Research Institute for Microbial DiseasesOsaka UniversityOsakaJapan

Clinical studies have shown that Aggregatibacter actinomycetemcomitans(***)is associated with aggressive periodontitis and can potentially trigger or exacerbate rheumatoid arthritis(RA).However,the mechanism is poorly ***,we show that systemic infection with *** triggers the progression of arthritis in mice anti-collagen antibody-induced arthritis(CAIA)model following IL-1βsecretion and cell infiltration in paws in a manner that is dependent on caspase-11-mediated inflammasome activation in *** administration of polymyxin B(PMB),chloroquine,and anti-CD11b antibody suppressed inflammasome activation in macrophages and arthritis in mice,suggesting that the recognition of lipopolysaccharide(LPS)in the cytosol after bacterial degradation by lysosomes and invasion via CD11b are needed to trigger arthritis following inflammasome activation in *** data reveal that the inhibition of caspase-11-mediated inflammasome activation potentiates aggravation of RA induced by infection with *** work highlights how RA can be progressed by inflammasome activation as a result of periodontitis-associated bacterial infection and discusses the mechanism of inflammasome activation in response to infection with ***.

关键词： CD11b inflam infection

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Dynamic ultrasonography for optimizing treatment position in superior mesenteric artery syndrome:Two case reports and review of literature

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World Journal of Gastroenterology 2024年第5期30卷 499-508页

作者： Nobuaki Hasegawa Akihiko Oka Muyiwa Awoniyi Yuri Yoshida hiroshi Tobita Norihisa Ishimura Shunji Ishihara Department of Internal Medicine II Shimane University Faculty of MedicineIzumo 693-8501ShimaneJapan Department of Gastroenterology Hepatology and NutritionDigestive Disease and Surgery InstituteHepatology SectionCleveland ClinicClevelandOH 44195United States Clinical Laboratory Division Shimane University HospitalIzumo 693-8501ShimaneJapan Division of Hepatology Shimane University HospitalIzumo 693-8501Japan

BACKGROUND Superior mesenteric artery(SMA)syndrome is a rare cause of duodenal obstruction by extrinsic compression between the SMA and the aorta(SMA-Ao).Although the left lateral recumbent position is considered effective in the treatment of SMA syndrome,individual variations in the optimal patient position have been *** this report,we present two elderly cases of SMA syndrome that exhibited rapid recovery due to ultrasonographic dynamic evaluation of the optimal position for each *** SUMMARY Case 1:A 90-year-old man with nausea and *** diagnosis of SMA syndrome by computed tomography(CT),ultrasonography(US)revealed the SMA-Ao distance in the supine position(4 mm),which slightly improved in the lateral position(5.7–7.0 mm)without the passage of duodenal ***,in the sitting position,the SMA-Ao distance was increased to 15 mm accompanied by improved content ***,US indicated enhanced passage upon abdominal massage on the right *** day 2,the patient could eat comfortably with the optimal position and *** 2:An 87-year-old woman with *** the diagnosis of SMA syndrome and aspiration pneumonia by CT,dynamic US confirmed the optimal position(SMA-Ao distance was improved to 7 mm in forward-bent position,whereas it remained at 5 mm in the supine position).By day 7 when her pneumonia recovered,she could eat with the optimal *** The optimal position for SMA syndrome varies among *** US appears to be a valuable tool in improving patient outcomes.

关键词： Superior mesenteric artery syndrome Wilkie’s syndrome Cast syndrome Aorto-mesenteric compass syndrome Ultrasonography Case report

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