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Visceral Fat Accumulation Is Associated with Increased Mortality Rate after Transcatheter Arterial Chemoembolization in Patients with Hepatocellular Carcinoma

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Journal of Cancer Therapy 2015年第13期6卷 1124-1136页

作者： Masaya Saito Yoshihiko Yano hirotaka Hirano Kenji Momose Yuki Kawano Masaru Yoshida Takeshi Azuma Division of Gastroenterology Department of Internal Medicine Graduate School of Medicine Kobe University Kobe Japan Center for Infectious Diseases Graduate School of Medicine Kobe University Kobe Japan Division of Metabolomics Research Department of Internal Medicine Graduate School of Medicine Kobe University Kobe Japan

Aim: Transcatheter arterial chemoembolization (TACE) is thought to be a safe and effective treatment for hepatocellular carcinoma (HCC). However, in some HCC patients, it potentially shortens survival due to liver damage. We aimed to identify independent factors to predict overall survival of HCC after TACE. Methods: We included a total of 96 consecutive HCC patients who underwent TACE at Kobe University Hospital. Areas of skeletal muscle and fat tissue were measured by computed tomography (CT) scan before TACE. We divided the patients into two groups in terms of the presence or absence of 1-year mortality after TACE. Factors associated with 1-year mortality after TACE were assessed by multivariate analyses, and the optimal cut-off values were evaluated using a propensity score. Results: Multivariate analyses showed that visceral fat accumulation on CT was an independent factor associated with 1-year mortality after TACE (p = 0.033). There were no differences in skeletal muscle area and subcutaneous and intermuscular fat area between the two groups. Cut-off values for visceral fat area associated with 1-year mortality after TACE were defined as 33.3 cm2/m2 for males and 24.4 cm2/m2 for females. Conclusions: High visceral fat area was a prognostic factor associated with increased mortality rate in HCC patients undergoing TACE. Using this value, 1-year mortality risk after TACE would be better estimated before the day TACE was performed.

关键词： Glucose Metabolism Liver Cirrhosis Obesity Overall Survival Sarcopenia

Successful Extracorporeal Membranous Oxygenation with Possible Transfusion-Related Acute Lung Injury after Pulmonary Endarterectomy

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Open Journal of Thoracic Surgery 2018年第3期8卷 57-62页

作者： Kayo Sugiyama hirotaka Watanuki Masaho Okada Yasuhiro Futamura Atomu Tajima Rokuki Kiyosawa Katsuhiko Matsuyama Department of Cardiac Surgery Aichi Medical University Hospital Nagakute Japan

Transfusion-related acute lung injury (TRALI) is characterized by acute severe hypoxemia with bilateral noncardiogenic pulmonary edema after transfusion of a plasma-containing blood component. In patients undergoing cardiac surgery, the incidence of TRALI is high;however, the detailed clinical course is unknown. Here, we report a case of life-threatening TRALI following pulmonary thrombectomy, which was successfully treated with extracorporeal membranous oxygenation (ECMO).

关键词： Transfusion-Related Acute Lung Injury Extracorporeal Membrane Oxygenation Acute Pulmonary Emboli

Evaluation of a New Formula for Calculating Heparin Dose for Cardiopulmonary Bypass Patients

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Open Journal of Thoracic Surgery 2014年第2期4卷 32-38页

作者： Aya Nakasuji Satoshi Matsushita hirotaka Inaba Taira Yamamoto Kenji Kuwaki Eiichi Inada Atsushi Amano Department of Anesthesiology and Pain Medicine Faculty of Medicine Juntendo University Tokyo Japan Department of Cardiovascular Surgery Faculty of Medicine Juntendo University Tokyo Japan

Introduction: Anticoagulation is essential during CPB in cardiac surgery. It is generally performed using heparin;however the widely used formula for its dosing is based solely on body weight. Although the formula assumes activated clotting time (ACT) to be within normal range, baseline ACT varies in each patient. Thus, we developed an original formula, which takes into account baseline ACT in addition to body weight to calculate a more proper dose for initial administration of heparin. In this study, we monitored the ACT to examine if the dose of heparin calculated using our formula can prolong the ACT to the target range, and we determined the factors which interfere with the prolongation of ACT. Methods: Between October 2010 and April 2011, 141 consecutive patients underwent cardiac surgery requiring cardiopulmonary bypass at our hospital. We measured ACT 3 minutes after the initial administration of heparin and considered ACT values >400 seconds as appropriate for safe initiation of CPB. Results: Using the proposed formula, administered heparin dose was 241 ± 27 IU/kg and target ACT was achieved in 86.4% of patients. Multivariate analysis was performed to determine the effect of patient background factors on target ACT achievement. Body weight, age, and preoperative heparin therapy, which showed significant differences, were further analyzed. Conclusions: This study demonstrated that our newly developed formula could be used to properly calculate the optimal initial dose of heparin.

关键词： Anesthesia Cardiac Surgery Cardio Pulmonary Bypass

Results of aortic valve replacement for aortic stenosis in patients aged 80 years and older

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World Journal of Cardiovascular Diseases 2012年第3期2卷 220-226页

作者： Kenji Kuwaki Atsushi Amano hirotaka Inaba Taira Yamamoto Shizuyuki Dohi Takeshi Matsumura Satoshi Matsushita Department of Cardiovascular Surgery Juntendo University Tokyo Japan

Purpose: The aim of this study was to investigate our clinical experience in a contemporary series of aortic valve replacement (AVR) for aortic stenosis (AS) with or without coronary artery bypass grafting (CABG), and compare the early and mid-term results between patients aged more than 80 years and those aged less than 80 years. Methods: A retrospective review was performed of 258 consecutive patients with aortic stenosis (AS) who underwent AVR between August 2002 and December 2010 at Juntendo University Hospital. Results: Operative mortality was 7.3% in patients aged 80 years and older, compared with 3.6% in younger patients. Thus, operative mortality was higher in the older patients compared with the younger patients, but was not statistically significant between the two groups. Age more than 80 years was not a predictor of operative mortality. Advanced NYHA class (p = 0.03;odds ratio [OR], 9.5) was found to be a multivariate independent predictor of operative mortality. Patients aged 80 years and older were significantly more likely to suffer from respiratory failure after surgery than younger patients, but there were no significant differences in any other complications between the two age groups. Non-home discharge rate was significantly higher in the patients aged 80 years and older (21.9%) than in the younger patients (5.5%). Three-year survival was 84% in patients aged more than 80 years, and 83% of these elderly patients were living at home at the last follow-up. Conclusions: Patients aged 80 years and older have acceptable results of AVR with slightly increased risk of early mortality and morbidity compared with younger patients.

关键词： Aortic Valve Replacement Octogenarians

Endovascular Repair for Abdominal Aortic Aneurysm Reduces Postoperative Blood Endotoxin Levels Assayed by the EAA Method Compared with Open Abdominal Surgery

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World Journal of Cardiovascular Surgery 2014年第6期4卷 87-94页

作者： Atsumi Ohishi Satoshi Matsushita Shizuyuki Dohi Taira Yamamoto hirotaka Inaba Kenji Kuwaki Atsushi Amano Department of Cardiovascular Surgery Faculty of Medicine Juntendo University Tokyo Japan

Introduction: We hypothesized to demonstrate whether there are significant differences in blood endotoxin (Et) levels after abdominal aortic surgery between endovascular aortic repair (EVAR) and open abdominal surgery. Methods: The patients who underwent the surgical treatment for abdominal aortic aneurysm were divided into two groups according to the procedures: open abdomen surgery (OP) and EVAR (SG). The value of Endotoxin Activity Assay (EAA) was compared between groups. Results: After surgery, Et level was significantly higher in the OP group than in the SG group on postoperative day 3. Neutrophil count was significantly higher in the OP group immediately after treatment, but no significant difference was seen thereafter. There were no differences between the groups in other inflammatory markers. Conclusions: This study indicated that EVAR was less invasive compared to an open abdominal surgery from the standpoint of assessing postoperative endotoxin activity (EA) levels measured by EAA.

关键词： Inflammation Infection Stents Endovascular Aortic Repair

Successful Management of Pulmonary Tumor Embolism from Renal Cell Carcinoma

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Open Journal of Thoracic Surgery 2018年第2期8卷 19-25页

作者： Kayo Sugiyama hirotaka Watanuki Masaho Okada Yasuhiro Futamura Ikuo Sugimoto Kogenta Nakamura Katsuhiko Matsuyama Department of Cardiac Surgery Aichi Medical University Hospital Nagakute Japan Department of Vascular Surgery Aichi Medical University Hospital Nagakute Japan Department of Urology Surgery Aichi Medical University Hospital Nagakute Japan

Although invasion of renal cell carcinoma (RCC) into the inferior vena cava is common, pulmonary tumor embolism is rare. We present a case of a pulmonary tumor embolism from type II papillary renal cell carcinoma successfully treated using a staged approach. Such staged procedures are particularly effective in cases of massive renal tumors. Pulmonary tumor embolectomy using normothermic cardiopulmonary bypass is considerably less invasive than under deep hypothermic circulatory arrest.

关键词： Pulmonary Tumor Embolism Renal Cell Carcinoma Papillary Cell Carcinoma

浅层包气带水汽昼夜运移规律及其数值模拟研究

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地学前缘 2008年第5期15卷 330-343页

作者：曾亦键万力苏中波 hirotaka aito 王旭升曹文炳中国地质大学(北京)水资源与环境学院北京100083 国际地理信息科学及地球观测学院荷兰恩斯赫德7500AA 东京农工大学共生科学技术研究院日本东京183-8509

西北干旱、半干旱地区，浅层包气带水分通量主要由水汽组成，而水汽在运移过程中产生的能量转换和质量迁移是地表质能平衡计算不可缺少的重要源汇项。在野外进行一个沙坑实验，发现土壤水在中午（12：00～15：00）达到最大值（10cm深度... 详细信息

西北干旱、半干旱地区，浅层包气带水分通量主要由水汽组成，而水汽在运移过程中产生的能量转换和质量迁移是地表质能平衡计算不可缺少的重要源汇项。在野外进行一个沙坑实验，发现土壤水在中午（12：00～15：00）达到最大值（10cm深度，5．9～6．1cm^3／cm^3；30cm深度，11．9～13．1cm^3／cm^3），而在凌晨（02：00～05：00）出现最小值（10cm深度，4．4～4．5cm^3／cm^3；30cm深度，10．4～10．8cm^3／cm^3）。为进一步验证该实验条件下的土壤水运移及分布规律，考虑了土壤水、汽、热耦合运移的HYDRUS-ID模型被用来对实验过程进行模拟，模拟结果与实测结果吻合较好。为描述土壤水分昼夜运移模式，笔者将土壤水耦合运移的时间信息和空间信息进行同步分析；并根据土壤水运移的不同驱动力，分别对温度梯度、基质势梯度作用下的液态水及汽态水通量进行了分析。

关键词：包气带土壤水机制水汽热耦合运移

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日本储能系统现状

电器工业 2018年第7期 50-53页

作者： hirotaka Tsunoda 张爽日本电机工业会重电部中国电器工业协会国际合作部

一、日本储能系统概况（一）背景1）2011年日本东北部（Tohoku）太平洋海域发生Mw9.0特大地震引发了电力问题;2）可再生能源得到了进一步关注;3）电力储存设备需求大幅上升;4）政府补贴促进了储能的应用。（二）应用现状储能在各个环节... 详细信息

一、日本储能系统概况（一）背景1）2011年日本东北部（Tohoku）太平洋海域发生Mw9.0特大地震引发了电力问题;2）可再生能源得到了进一步关注;3）电力储存设备需求大幅上升;4）政府补贴促进了储能的应用。（二）应用现状储能在各个环节的应用如图1所示。1）发电如煤电、核电等：储能为配电系统提供稳定的电力;2）输配电：储能应用于输配电网络;3）终端用户：商用与住宅小区,储能用于峰谷调节、备用等。

关键词：储能系统日本输配电网络太平洋海域可再生能源特大地震设备需求政府补贴

Hepatocellular carcinoma in extremely elderly patients:An analysis of clinical characteristics,prognosis and patient survival

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World Journal of Gastroenterology 2006年第1期12卷 48-53页

作者： Gengo Tsukioka Satoru Kakizaki Naondo Sohara Ken Sato Hitoshi Takagi hirotaka Arai Takehiko Abe Mitsuo Toyoda Kenji Katakai Akira Kojima Yuichi Yamazaki Toshiyuki Otsuka Yutaka Matsuzaki Fujio Makita Daisuke Kanda Katsuhiko Horiuchi Tetsuya Hamada Mieko Kaneko Hideyuki Suzuki Masatomo Mori Department of Medicine and Molecular Science Gunma University Graduate School of MedicineMaebashiGunma 371-8511Japan Department of Gastroenterology Maebashi Red Cross HospitalMaebashiGunma 371-0014Japan Department of Internal Medicine Isesaki Municipal HospitalIsesakiGunma 372-0817Japan Department of Internal Medicine Kiryu Kousei General HospitalKiryuGunma 376-0024Japan Department of Internal Medicine Tone Chuo HospitalNuraataGunma 378-0053Japan Department of Gastroenterology National Nishigunma HospitalShibukawaGumna 377-0027Japan Department of Gastroenterology Saiseikai Maebashi HospitalMaebashiGunma 371-0821Japan Department of Gastroenterology Public Tomioka General HospitalTomiokaGunma 370-2361Japan Department of Internal Medicine Fuji Heavy Industries Ltd.Health Insurance Society General Ota HospitalOtaGunma 373-0056Japan Department of Gastroenterology Shimada Memorial HospitalFujiokaGunma 375-0024Japan

瞄准：80 年或更多与肝细胞癌(HCC ) 识别病人的临床、预示的特征。方法：有 HCC 的 1310 个病人的一个总数在这研究被包括。80 年或更多的 91 个病人在 HCC 的诊断的时候被定义为极其老的组。> 或 = 的 234 个病人 50 年但是不到 60 ... 详细信息

瞄准：80 年或更多与肝细胞癌(HCC ) 识别病人的临床、预示的特征。方法：有 HCC 的 1310 个病人的一个总数在这研究被包括。80 年或更多的 91 个病人在 HCC 的诊断的时候被定义为极其老的组。> 或 = 的 234 个病人 50 年但是不到 60 年被认为是非老的组。结果：两性比率(到女性的男性) 比在非老的组在极其老的组(0.90:1 ) 是显著地更低的(3.9:1， P < 0.001 ) 。为 HBsAg 的积极的率在极其老的组和为显然在极其老的组增加的 HBsAg 和 HCVAb 否定的病人的比例是显著地更低的(P < 0.001 ) 。在下列参数没有有效差量：肿瘤，分级的孩子呸，肿瘤阶段，门静脉血栓形成或腹水的存在，和为 HCVAb 的积极的率的直径和数字。极其老的病人经常没收到外科疗法(P < 0.001 ) 并且他们是更可能的收到保守疗法(P < 0.01 ) 。基于与在二个组之间的全面病人比较的 Kaplan-Meier 方法在幸存曲线没有有效差量。然而，幸存曲线在有阶段 I/II 的极其老的病人是显著地更坏的，上演 I/II，孩子呸分级与非老的组比较的肝硬化。死亡的原因没在病人之中不同，并且大多数盒子甚至在极其老的病人死于肝相关的疾病。结论：在有好肝功能和好表演地位的病人，为 HCC 的好攻击的治疗可能改进幸存率，甚至在极其老的病人。

关键词：肝细胞癌临床表现疾病预防生存质量