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CD14 upregulation as a distinct feature of non-alcoholic fatty liver disease after pancreatoduodenectomy

World Journal of Hepatology 2013年第4期5卷 189-195页

作者： Daisuke Satoh Takahito Yagi Takeshi Nagasaka Susumu Shinoura Yuzo Umeda Ryuichi Yoshida Masashi Utsumi Takehiro Tanaka hiroshi Sadamori Toshiyoshi fujiwara Department of Gastroenterological Surgery Transplantand Surgical OncologyOkayama University Graduate School of MedicineDentistry and Pharmaceutical SciencesOkayama 700-8558Japan Department of Pathology Okayama University Graduate School of MedicineDentistry and Pharmaceutical SciencesOkayama 700-8558Japan

AIM:To investigate the pathogenesis of non-alcoholic fatty liver disease(NAFLD)after pancreatoduodenectomy(PD).METHODS:A cohort of 82 patients who underwent PD at Okayama University Hospital between 2003 and 2009 was enrolled and the clinicopathological features were compared between patients with and without NAFLD after *** tomography(CT)images were evaluated every 6 mo after PD for *** steatosis was diagnosed on CT when hepatic attenuation values were 40 Hounsfield *** biopsy was performed for 4 of 30 patients with NAFLD after PD who consented to undergo *** compare NAFLD after PD with NAFLD associated with metabolic syndrome,liver samples were obtained from 10 patients with NAFLD associated with metabolic syndrome [fatty liver,n = 5;non-alcoholic steatohepatitis(NASH),n = 5] by percutaneous ultrasonography-guided liver ***-fluorescence immunohistochemistry was applied to examine CD14 expression as a marker of lipopolysaccharide(LPS)-sensitized macrophage cells(Kupffer cells)in liver biopsy ***:The incidence of postoperative NAFLD was 36.6%(30/82).Univariate analysis identified cancer of the pancreatic head,sex,diameter of the main pancreatic duct,and dissection of the nerve plexus as factors associated with the development of NAFLD after *** patients who developed NAFLD after PD demonstrated significantly decreased levels of serum albumin,total protein,cholesterol and triglycerides compared to patients without NAFLD after PD,but no glucose intolerance or insulin *** biopsy was performed in four patients with NAFLD after *** four patients showed moderate-to-severe steatosis and NASH was diagnosed in *** of cells positive for CD68(a marker of Kupffer cells)and CD14(a marker of LPSsensitized Kupffer cells)were counted in all biopsy *** number of CD68+ cells in specimens of NAFLD after PD was significantly increased from that in specimens of NAFLD associated with meta

关键词： Non-alcoholic fatty liver disease Pancreatoduodenectomy CD14 Endotoxin Kupffer cells

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The Efficacy and Safety of Continuous Popliteal Sciatic Nerve Block for the Relief of Pain Associated with Critical Limb Ischemia: A Retrospective Study

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Open Journal of Anesthesiology 2013年第10期3卷 433-437页

作者： Atsushi Hashimoto hiroshi Ito Yuko Sato Yoshihiro fujiwara Department of Anesthesiology Aichi Medical University Nagakute Japan

Background: Patients with critical limb ischemia (CLI) often suffer from severe pain. A continuous peripheral nerve block has been shown to provide effective analgesia for patients having lower limb surgery. We have been administering continuous sciatic nerve block (CSNB) for patients with CLI whose pain could not be relieved by other analgesic tools. The aim of this retrospective study was to investigate the efficacy and safety of CSNB for patients with CLI. Method: We retrospectively investigated 99 patients who received CSNB for the relief of severe pain in the lower limb associated with CLI. Patient demographics, neurological history, complications, and subjective evaluation of the effectiveness of CSNB were investigated from their clinical records. The distal tips of 108 catheters were cultured. Result: One hundred and seventy-two catheters were placed in 99 patients. More than 90% of the patients enjoyed considerable relief of severe pain. The analgesic effect of CSNB was greater in patients with older age and hemodialysis. Thirty-one catheters had positive bacterial colonization. However, no severe infectious complication was found. There was no relationship between the co-existence of diabetes and positive bacterial colonization. We encountered a patient with ASO and diabetes who suffered from persistent motor weakness and hypesthesia even after 3 months of CSNB placement. Conclusions: CSNB provided good pain control for patients with severe pain caused by CLI. Although catheters were frequently found to be colonized, infection at the catheter site was self-limiting even in patients with diabetes.

关键词： Critical Limb Ischemia Continuous Sciatic Nerve Block Pain Control

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Postprandial hyperglycemia and postprandial hypertriglyceridemia in type 2 diabetes

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The Journal of Biomedical Research 2019年第1期33卷 1-16页

作者： Toru Hiyoshi Mutsunori fujiwara Zemin Yao Division of Diabetes and Endocrinology Department of Internal Medicine Japanese Red Cross Medical Center Department of Laboratory Medicine Japanese Red Cross Medical Center Department of Biochemistry Microbiology and Immunology Ottawa Institute of Systems BiologyUniversity of Ottawa

Postprandial glucose level is an independent risk factor for cardiovascular disease that exerts effects greater than glucose levels at fasting state, whereas increase in serum triglyceride level, under both fasting and postprandial conditions, contributes to the development of arteriosclerosis. Insulin resistance is a prevailing cause of abnormalities in postabsorptive excursion of blood glucose and postprandial lipid profile. Excess fat deposition renders a vicious cycle of hyperglycemia and hypertriglyceridemia in the postprandial state, and both of which are contributors to atherosclerotic change of vessels especially in patients with type 2 diabetes mellitus. Several therapeutic approaches for ameliorating each of these abnormalities have been attempted, including various antidiabetic agents or new compounds targeting lipid metabolism.

关键词： postprandial hyperglycemia postprandial hypertriglyceridemia Type 2 diabetes mellitus atherosclerosis

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Development of sequential type iron salt-catalyzed Nazarov/Michael reaction in an ionic liquid solvent system

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Science China Chemistry 2012年第8期55卷 1627-1632页

作者： IBARA Chie fujiwara Masamune HAYASE Shuichi KAWATSURA Motoi ITOH Toshiyuki Department of Chemistry and Biotechnology Graduate School of Engineering Tottori University 4-101 Koyama-minami Tottori 680-8552 Japan

Sequential type one pot Nazarov/Michael reaction of pyrrole derivatives has been demonstrated using 5 tool% Fe（C104）3· A120 as catalyst in an ionic liquid as solvent. We succeeded in obtaining 4,5-dihydrocyclopenta[b]pyrrol-6（1H）-one derivative in good yield for five repetitions of the reactions without any addition of the catalyst using an ionic liquid, [bmim][NTf2], as sol- vent system.

关键词： Nazarov cyclization Michael reaction green synthesis iron catalyst ionic liquids

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Structural effect of fluorophore on phenylboronic acid fluorophore/cyclodextrin complex for selective glucose recognition

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Frontiers of Chemical Science and Engineering 2020年第1期14卷 53-60页

作者： Takeshi Hashimoto Mio Kumai Mariko Maeda Koji Miyoshi Yuji Tsuchido Shoji fujiwara Takashi Hayashita Department of Materials and Life Sciences Faculty of Science and TechnologySophia UniversityTokyo102-8554Japan Department of Life Science and Medical Bioscience Graduate School of Advanced Science and EngineeringWaseda University(TWIns)Tokyo162-8480Japan Department of Current Legal Studies Faculty of LawMeiji Gakuin UniversityKanagawa244-8539Japan

Based on the design of the fluorescent site of a fluorescent probe,we have created a unique system that changes its twisting response to *** probes were synthesized,in which phenylboronic acid and two kinds of aromatic fluorescent site(pyrene or anthracene)were conjugated by an amide *** the fluorescence measurement of pyrene-type probe 1,dimer fluorescence was observed at high *** induced circular dichroism(ICD)experiments,a response was observed only in the presence of glucose and γ-cyclodextrin,and no response was seen with *** the other hand,in the fluorescence measurement of anthracene-type probe 2,dimer fluorescence was observed in the presence of both glucose and galactose,and the fluorescence was different from the case of *** the ICD spectra of these inclusion complexes were measured,an inversion of the Cotton effect,which indicates a change in the twisted structure,was observed in galactose and *** differences in response to monosaccharides may originate in the interaction between the fluorescent site and the cyclodextrin cavity.

关键词： sugar recognition phenylboronic acid cyclodextrin fluorescence response induced circular dichroism

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Questionnaire survey regarding the current status of superextended lymph node dissection in Japan

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World Journal of Gastrointestinal Oncology 2016年第9期8卷 707-714页

作者： Shinji Morita Takeo Fukagawa Hisataka fujiwara Hitoshi Katai Department of Surgical Oncology National Cancer Center HospitalChuo-kuTokyo

AIM To verify the current status of super-extended lymph node dissection for advanced gastric cancer according to a questionnaire *** One-hundred and five institutions responded to the *** survey included the following items: Number of experiences,whether performed prophylactically and/or therapeutically,whether preoperative chemotherapy was provided,number of preoperative chemotherapy rounds,and therapeutic options after *** Eighty-seven of the 105 institutions(83%) had performed D3 gastrectomy in the past or continued to perform D3 gastrectomy at ***,D3 gastrectomy was rarely performed prophylactically in clinical ***-eight institutions(74%) indicated that preoperative chemotherapy with curative intent was required for patients suspected of having para-aortic node(PAN) *** chemotherapy,a D3 gastrectomy was scheduled for patients with a complete or partial response,stable disease,and progressive disease at 36(46%),28(36%),and 13(17%) of the institutions,*** For patients with apparent PAN metastasis,a D3 gastrectomy is typically planned if a few courses of preoperative chemotherapy yield at least a stable disease condition.

关键词： Questionnaire survey Advanced gastric cancer Radical surgery Para-aortic nodal dissection Preoperative chemotherapy

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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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Sensorineural hearing dysfunction after discharge from critical care in adults:A retrospective observational study

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Journal of Otology 2021年第3期16卷 144-149页

作者： Takashi fujiwara Mizuki Sato Shin-ichi Sato Toshio Fukuoka Department of Public Health Research Kurashiki Clinical Research InstituteMiwa 1-1-1Kurashiki CityOkayama Prefecture710-8602Japan Department of Otolaryngology Head and Neck Surgery Kurashiki Central HospitalMiwa 1-1-1Kurashiki CityOkayama Prefecture710-8602Japan Department of Critical Care and Emergency Medicine Kurashiki Central HospitalMiwa 1-1-1Kurashiki CityOkayama Prefecture710-8602Japan Emergency and Critical Care Center Kurashiki Central HospitalMiwa 1-1-1Kurashiki CityOkayama Prefecture710-8602Japan

Background Patients undergoing intensive care are exposed to risk factors for hearing *** study assessed the worse changes in pure tone average(PTA)thresholds after intensive care and identified the factors associated with worse hearing *** We conducted a single-centre retrospective study,and included adult patients admitted to the intensive care unit(ICU)of Kurashiki Central Hospital between January 2014 and September 2019,who had regular pure tone audiometry performed before and after ICU *** between changes in PTA threshold and patient characteristics,were *** included ears were classified as those with worse hearing(>10 dB increase in the PTA threshold)and those without worse hearing,and the baseline characteristics were *** During the study period,125 ears of 71 patients(male:female ratio,35:36;mean age,72.5±12.3 years)met the eligibility ***,sex,and the use of furosemide were not correlated with changes in PTA *** analysis showed that ears with worse hearing were associated with a lower serum platelet count than ears without worse hearing(153±85×10^(9)/L vs.206±85×10^(9)/L,respectively;P=0.010),and the rate of planned ICU admission(elective surgery)was higher in the worse hearing group(57.1% vs.28.8%,respectively;p=0.011).Conclusions Age,sex,and the use of furosemide did not have adversely affect hearing *** serum platelet count and planned admission appear to be risk factors for worse hearing.

关键词： Hearing loss Critical care Intensive care Adverse effects Observational study

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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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Glutamine depletion induces murine neonatal melena with increased apoptosis of the intestinal epithelium

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World Journal of Gastroenterology 2011年第6期17卷 717-726页

作者： Takayuki Motoki Yoshio Naomoto Junji Hoshiba Yasuhiro Shirakawa Tomoki Yamatsuji Junji Matsuoka Munenori Takaoka Yasuko Tomono Yasuhiro fujiwara hiroshi Tsuchita Mehmet Gunduz Hitoshi Nagatsuka Noriaki Tanaka Toshiyoshi fujiwara Department of Gastroenterological Surgery Transplantand Surgical OncologyGraduate School of MedicineDentistryand Pharmaceutical SciencesOkayama University Department of General Surgery Kawasaki Medical School Kawasaki Hospital Division of Molecular and Cell Biology Shigei Medical Research Institute Department of Animal Resources Advanced Science Research CenterOkayama University Food Technology Research Institute Meiji Dairies Corporation Department of Oral Pathology and Medicine Graduate School of MedicineDentistryand Pharmaceutical SciencesOkayama University

AIM:To investigate the possible biological outcome and effect of glutamine depletion in neonatal mice and rodent intestinal epithelial ***:We developed three kinds of artificial milk with different amounts of glutamine;Complete amino acid milk (CAM),which is based on maternal mouse milk,glutamine-depleted milk (GDM),and glutaminerich milk (GRM).GRM contains three-fold more glutamine than ***-seven newborn mice were divided into three groups and were fed with either of CAM,GDM,or GRM via a recently improved nipple-bottle system for seven *** the feeding period,the mice were subjected to macroscopic and microscopic observations by immunohistochemistry for 5-bromo-2'deoxyuridine (BrdU) and Ki-67 as markers of cell proliferation,and for cleaved-caspase-3 as a marker of ***,IEC6 rat intestinal epithelial cells were cultured in different concentrations of glutamine and were subject to a 4-[3-(4-iodophenyl)-2-(4-nitrophenyl)2H-5-tetrazolio]-1,3-benzene disulfonate cell proliferation assay,flow cytometry,and western blotting to examine the biological effect of glutamine on cell growth and ***:During the feeding period,we found colonic hemorrhage in six of 28 GDM-fed mice (21.4%),but not in the GRM-fed mice,with no differences in body weight gain between each *** examination showed destruction of microvilli and the disappearance of glycocalyx of the intestinal wall in the colon epithelial tissues taken from GDM-fed *** of GDM reduced BrdU incorporation (the average percentage of BrdU-positive staining;GRM:13.8%,CAM:10.7%,GDM:1.14%,GRM vs GDM:P < 0.001,CAM vs GDM:P < 0.001) and Ki-67 labeling index (the average percentage of Ki67-positive staining;GRM:24.5%,CAM:22.4% GDM:19.4%,GRM vs GDM:P=0.001,CAM vs GDM:P =0.049),suggesting that glutamine depletion inhibited cell proliferation of intestinal epithelial *** deprivation further caused the deformation of the nuclear membrane and the plasma m

关键词： Glutamine Newborn mice Artificial milk Melena Intestinal epithelial cells Apoptosis

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