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Local recurrence is an important prognostic factor of hepatocellular carcinoma

World Journal of Gastroenterology 2005年第36期11卷 5601-5606页

作者： Eiichirou Arimura kazuhiro Kotoh Makoto Nakamuta Shusuke Morizono Munechika Enjoji Hajime Nawata Department of Medicine and Bioregulatory Science Graduate School of Medical Sciences Kyushu University Fukuoka 812-8582 Japan

AIM： To clarify the importance of complete treatment by PELT. METHODS： A total of 140 previously untreated cases of HCC were enrolled in this study from 1988 to 2002. The inclusion criteria were： a solitary tumor less than 4 cm in diameter or multiple tumors, fewer than four in number and less than 3 cm in diameter, without extrahepatic metastasis or vessel invasion. As general principles for the treatment of HCC, the patients underwent transcatheter arterial chemoembolization （TACE） prior to PEIT. After the initial treatment of the patients, ultrasonography and computed tomography were performed, and measurement of serum levels of α- fetoprotein （AFP） was determined. When tumor recurrences were detected, PEIT and/or TACE were repeated whenever the hepatic functional reserve of the patient permitted. We then analyzed the variables that could influence prognosis, including tumor size and number, the serum levels of AFP, the parameters of hepatic function （albumin, bilirubin, ALT, hepaplastin test, platelet number, and indocyanine green retention at 15 rain [ICG-R15]）, combined therapy with TACE, distant recurrence, and local recurrence. RESULTS： Univariate analysis identified the ICG test, serum levels of AFP and albumin, tumor size and number, and local recurrence, but not distant recurrence, as significant prognostic variables. In multivariate analysis using those five parameters, the ICG test, tumor size, tumor number, and local recurrence were identified as significant prognostic factors. In both univariate and multivariate analyses, the relative risk for the ICG test was the highest, followed by local recurrence. CONCLUSION： We found that local recurrence is an independent prognostic factor of HCC, indicating that achieving complete treatment for HCC on first treatment is important for improving the prognosis of patients with HCC. 2005 The WJG Press and Elsevier Inc. All rights reserved.

关键词： Hepatocellular carcinoma Local recurrence Percutaneous ethanol injection therapy Transcatheterarterial chemoembolization

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Endothelin-1 stimulates contraction and migration of rat pancreatic stellate cells

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World Journal of Gastroenterology 2005年第39期11卷 6144-6151页

作者： Atsushi Masamune Masahiro Satoh kazuhiro Kikuta Noriaki Suzuki Kennichi Satoh Tooru Shimosegawa Division of Gastroenterology Tohoku University Graduate School of Medicine SendaiJapan

AIM： To examine the ability of FT-1 to affect the cell functions of PSCs and the underlying molecular mechanisms. METHODS： PSCs were isolated from the pancreas of male Wistar rats after perfusion with collagenase, and cells between passages two and five were used. Expression of ET-1 and FT receptors was assessed by reverse transcription-PCR and immunostaining. Phosphorylation of myosin regulatory light chain （MLC）, extracellular-signal regulated kinase （FRK）, and Akt was examined by Western blotting. Contraction of PSCs was assessed on hydrated collagen lattices. Cell migration was examined using modified Boyden chambers. Ceil proliferation was assessed by measuring the incorporation of 5-bromo-2＇- deoxyuridine. RESULTS： Culture-activated PSCs expressed ETA and ETB receptors, and ET-1. ET-1 induced phosphorylation of NLC and FRK, but not Akt. ET-1 induced contraction and migration, but did not alter proliferation of PSCs. FT-1-induced contraction was inhibited by an ETA receptor antagonist BQ-123 and an ETB receptor antagonist BQ-788, whereas migration was inhibited by BQ-788 but not by BQ-123. A Rho kinase inhibitor Y-27632 abolished both contraction and migration. CONCLUSION： ET-1 induced contraction and migration of PSCs through El receptors and activation of Rho-Rho kinase. ETA and FTB receptors play different roles in the regulation of these cellular functions in response to ET-1.

关键词： Pancreatitis Pancreatic fibrosis Pancreatic stellate cells Endothelin-1 Rho kinase

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Dualistic role of platelets in living donor liver transplantation: Are they harmful?

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World Journal of Gastroenterology 2022年第9期28卷 897-908页

作者： Chen Liang kazuhiro Takahashi Kinji Furuya Nobuhiro Ohkohchi Tatsuya Oda Gastrointestinal and Hepatobiliary-Pancreatic Surgery University of TsukubaTsukuba 3058575IbarakiJapan

Platelets are anucleate fragments mainly involved in hemostasis and thrombosis,and there is emerging evidence that platelets have other nonhemostatic potentials in inflammation,angiogenesis,regeneration and ischemia/reperfusion injury(I/R injury),which are involved in the physiological and pathological processes during living donor liver transplantation(LDLT).LDLT is sometimes associated with impaired regeneration and severe I/R injury,leading to postoperative complications and decreased patient *** studies have suggested that perioperative thrombocytopenia is associated with poor graft regeneration and postoperative morbidity in the short and long term after *** it is not fully understood whether thrombocytopenia is the cause or result,increasing platelet counts are frequently suggested to improve posttransplant outcomes in clinical *** on rodent experiments,previous studies have identified that platelets stimulate liver regeneration after partial ***,the role of platelets in LDLT is controversial,as platelets are supposed to aggravate I/R injury in the ***,a rat model of partial liver transplantation(LT)was used to demonstrate that thrombopoietin-induced thrombocytosis prior to surgery accelerated graft regeneration and improved the survival rate after *** was clarified that platelet-derived liver regeneration outweighed the associated risk of I/R injury after partial *** strategies to increase perioperative platelet counts,such as thrombopoietin,thrombopoietin receptor agonist and platelet transfusion,may improve graft regeneration and survival after LDLT.

关键词： Platelet Liver transplantation Regeneration Ischemia/reperfusion injury Kupffer cell Oxidative stress

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Thrombocytopenia after liver transplantation:should we care?

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World Journal of Gastroenterology 2018年第13期24卷 1386-1397页

作者： kazuhiro Takahashi Shunji Nagai Mohamed Safwan Chen Liang Nobuhiro Ohkohchi Department of Surgery Division of Gastroenterological and Hepatobiliary Surgery and Organ Transplantation University of TsukubaTsukubaIbaraki 3058575Japan Transplant and Hepatobiliary Surgery Henry Ford HospitalDetroitMl 48202United States

Transient thrombocytopenia is a common phenomenon after liver transplantation. After liver transplantation(LT), platelet count decreases and reaches a nadir on postoperative days 3-5, with an average reduction in platelet counts of 60%; platelet count recovers to preoperative levels approximately two weeks after LT. The putative mechanisms include haemodilution, decreased platelet production, increased sequestration, medications, infections, thrombosis, or combination of these processes. However, the precise mechanisms remain unclear. The role of platelets in liver transplantation has been highlighted in recent years, and particular attention has been given to their effects beyond hemostasis and thrombosis. Previous studies have demonstrated that perioperative thrombocytopenia causes poor graft regeneration, increases the incidence of postoperative morbidity, and deteriorates the graft and decreases patient survival in both the short and long term after liver transplantation. Platelet therapies to increase perioperative platelet counts, such as thrombopoietin, thrombopoietin receptor agonist, platelet transfusion, splenectomy, and intravenous immunoglobulin treatment might have a potential for improving graft survival, however clinical trials are lacking. Further studies are warranted to detect direct evidence on whether thrombocytopenia is the cause or result of poor-graft function and postoperative complications, and to determine who needs platelet therapies in order to prevent postoperative complications and thus improve post-transplant outcomes.

关键词： Thrombocytopenia Liver regeneration Platelet therapy Platelet Thrombopoietin receptor agonist Intravenous immunoglobulin treatment Liver transplantation

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Assessing mixing uniformity in microreactors via in-line spectroscopy

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Chinese Journal of Chemical Engineering 2024年第2期66卷 119-124页

作者： Shusaku Asano Shinji Kudo Taisuke Maki Yosuke Muranaka kazuhiro Mae Jun-ichiro Hayashi Institute for Materials Chemistry and Engineering Kyushu UniversityKasuga 816-8580Japan Department of Chemical Engineering Graduate School of EngineeringKyoto UniversityJapan

Mixing behavior is critical for enhancing the selectivity of fast chemical reactions in microreactors.A high Reynolds number(Re)improves the mixing rate and selectivity of the reactions,but some exceptions of increasing side product yield with the higher Re have been *** study investigated the mixing uniformity in microreactors with in-line UV-vis spectroscopy to clarify the relationship between reaction selectivity and chaotic mixing with the higher Re.A colorization experiment of thymolphthalein in an acidic solution was conducted with an excess acid amount to the base to indicate a non-uniformly mixed ***-uniformity significantly increased with *** the same time,the degree of mixing,which was measured by a usual decolorization experiment,showed that the mixing rate increased with *** in-line analysis of the Villermaux-Dushman reaction during the mixing clarified that side product yield significantly increased with Re at around 300 and then decreased at around *** results suggest the compensation effect between the mixing uniformity and mixing rate on the selectivity of the mixing-sensitive *** mixing,characterized by a larger Re,can disturb mixing uniformity and,in some cases,decrease reaction selectivity.

关键词： Microreactor Villermaux-Dushman reaction In-line analysis Mixing Mass transfer Uniformity

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The advantages of radical distribution control and independent dual frequency on etch/ash

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半导体技术 2004年第8期29卷 41-46页

作者： Tanaka Hideaki Kubota kazuhiro Shin Okamoto Tokyo Electron Ltd. Tokyo Electron Ltd.Tokyo Electron Ltd.

The transition to 65 nm beyond and 300 mm wafers posed many challenges on etch depth and critical dimension (CD) uniformity within wafer. In this paper, we introduce a radical distribution con- trol (RDC) system for an excellent uniformity control. Etch depth and CD uniformity within wafer are well controlled by adding RDC function to SCCMTM. For increasing productivity, an all-in-one process, that is, etch/ash at the same chamber continuously is proposed here. By utilizing the advantage of inde- pendent dual frequency, a bias-controlled two-step ash “hybrid ash” is combined in the all-in-one process. Hybrid ash uses bias control and low pres- sure to minimize liner loss and the damage of low-k materials, which is targeting 65nm and beyond.

关键词：蚀刻分布控制独立双频 RDC SCCM

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Pegylated interferon α-2b plus ribavirin for older patients with chronic hepatitis C

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World Journal of Gastroenterology 2010年第35期16卷 4400-4409页

作者： Mosaburo Kainuma Norihiro Furusyo Eiji Kajiwara kazuhiro Takahashi Hideyuki Nomura Yuichi Tanabe Takeaki Satoh Toshihiro Maruyama Makoto Nakamuta kazuhiro Kotoh Koichi Azuma Junya Shimono Shinji Shimoda Jun Hayashi Department of General Internal Medicine Kyushu University Hospital Department of Internal Medicine Nippon Steel Yawata Memorial Hospital Department of Medicine Hamanomachi Hospital The Center for Liver Disease Shin-Kokura Hospital Department of Medicine Fukuoka City HospitalYoshiduka-honmachi Center for Liver Disease National Hospital Organization Kokura Medical Center Department of Medicine Kitakyushu Municipal Medical Center Department of Gastroenterology Kyushu Medical CenterNational Hospital Organization Department of Medicine and Bioregulatory Science Graduate School of Medical ScienceKyushu University Department of Medicine and Clinical Science Graduate School of Medical SciencesKyushu University Saiseikai Yahata General Hospital Harunomachi Department of Medicine and Biosystemic Science Graduate School of Medical ScienceKyushu University

AIM:To analyze the efficacy and safety of a combination therapy of pegylated interferon(PEG-IFN) α-2b plus ribavirin(RBV) in older Japanese patients(65 years or older) infected with hepatitis C virus(HCV).METHODS:This multicenter study included 938 patients with HCV genotype 1 who received 1.5 μg/kg per week PEG-IFN α-2b plus RBV 600-1000 mg/d for 48 wk and 313 HCV genotype 2 patients who received this treatment for 24 ***:At 24 wk after the end of combination therapy,the overall sustained virological response(SVR) for genotypes 1 and 2 were 40.7% and 79.6%,*** SVR rate decreased signif icantly with age in each genotype,and was markedly reduced in genotype 1(P<0.001).Moreover,the SVR was significantly higher in patients with genotype 1 who were less than 65 years(47.3% of 685) than in those 65 years or older(22.9% of 253)(P<0.001) and was higher in patients with genotype 2 who were less than 65 years(82.9% of 252) than in those 65 years or older(65.6% of 61)(P=0.004).When patients received a dosage at least 80% or more of the target dosage of PEG-IFN α-2b and 60% or more of the target dosage of RBV,the SVR rate significantly increased to 66.5% in patients less than 65 years and to 45.2% in those 65 years or older(P<0.001).Adverse effects resulted in treatment discontinuation more often in patients with genotype 1(14.4%) than in patients with genotype 2(7.3%),especially by patients 65 years or older(24.1%).CONCLUSION:PEG-IFN α-2b plus RBV treatment was effective in chronic hepatitis C patients 65 years or older who completed treatment with at least the minimum acceptable treatment dosage.

关键词： Hepatitis C virus Gerontology Pegylated interferon Ribavirin

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Perioperative insulin therapy using a closed-loop artificial endocrine pancreas after hepatic resection

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World Journal of Gastroenterology 2009年第33期15卷 4116-4121页

作者： Takehiro Okabayashi Hiromichi Maeda Zhao-Li Sun Robert A Montgomery Isao Nishimori kazuhiro Hanazaki Department of Surgery Kochi Medical School Kohasu- Okocho Nankoku-City Kochi 783-8505 Japan Department of Surgery Johns Hopkins University School of Medicine 720 Rutland Ave. Ross 771E Baltimore MD 21205 United States Department of Gastroenterology and Hepatology at Kochi Medical School Kohasu-Okocho Nankoku- City Kochi 783-8505 Japan

Postoperative hyperglycemia is common in critically ill patients, even in those without a prior history of diabetes mellitus. It is well known that hyperglycemia induced by surgical stress often results in dysregulation of liver metabolism and immune function, impairing postoperative recovery. Current evidence suggests that maintaining normoglycemia postoperatively improves surgical outcome and reduces the mortality and morbidity of critically ill patients. On the basis of these observations, several large randomized controlled studies were designed to evaluate the benefit of postoperative tight glycemic control with intensive insulin therapy. However, intensive insulin therapy carries the risk of hypoglycemia, which is linked to serious neurological events. Recently, we demonstrated that perioperative tight glycemic control in surgical patients could be achieved safely using a closed-loop glycemic control system and that this decreased both the incidence of infection at the site of the surgical incision, without the appearance of hypoglycemia, and actual hospital costs. Here, we review the benefits and requirements of perioperative intensive insulin therapy using a dosed-loop artificial endocrine pancreas system in hepatectomized patients. This novel intensive insulin therapy is safe and effectively improves surgical outcome after hepatic resection.

关键词： Artificial pancreas Hepatic resection Hyperglycemia Intensive insulin therapy Surgical site infection

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Effect of ageing on friction of human fingers

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Biosurface and Biotribology 2018年第4期4卷 117-121页

作者： Kiyoshi Mabuchi Rina Sakai kazuhiro Yoshida Masanobu Ujihira Department of Biomedical Engineering School of Allied Health SciencesKitasato University1-15-1KitasatoMinamikuSagamihara252-0373Japan

Friction is an essential property of human *** studies have repoted factors influencing *** on metal and plastic surfaces was measured because slipping of fingers could significantly affectindustrial machine *** contrast,office workers may complain of fingers slipping on a paper surface,andlament that ageing reduces the friction of their *** effect of ageing on finger friction against paper has not yetbeen *** clarify the effect of ageing,the authors measured finger friction on paper sheets,and discussed skinmoisture as an important factor.

关键词： friction Friction ageing

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Low preoperative platelet counts predict a high mortality after partial hepatectomy in patients with hepatocellular carcinoma

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World Journal of Gastroenterology 2005年第37期11卷 5888-5892页

作者： kazuhiro Kaneko Yoshio Shirai Toshifumi Wakai Naoyuki Yokoyama Kohei Akazawa Katsuyoshi Hatakeyama Division of Digestive and General Surgery Niigata University Graduate School of Medical and Dental Sciences Niigata Japan Department of Medical Informatics Niigata University Medical and Dental Hospital Niigata Japan

AIM： To assess the validity of our selection criteria for hepatectomy procedures based on indocyanine green disappearance rate （KICG）, and to unveil the factors affecting posthepatectomy mortality in patients with hepatocellular carcinoma （HCC）. METHODS： A retrospective analysis of 198 consecutive patients with HCC who underwent partial hepatectomies in the past 14 years was conducted. The selection criteria for hepatectomy procedures during the study period were KICG≥0.12 for hemihepatectomy, KICG≥0.10 for bisegmentectomy, KCG≥0.08 for monosegmentectomy, and KICG≥ 0.06 for nonanatomic hepatectomy. The hepatectomies were categorized into three types： major hepatectomy （hemihepatectomy or a more extensive procedure）, bisegmentectomy, and limited hepatectomy. Univariate （Fishers exact test） and multivariate （the logistic regression model） analyses were used. RESULTS： Postoperative mortality was 5% after major hepatectomy, 3% after bisegmentectomy, and 3% after limited hepatectomy. The bhree percentages were comparable （P = 0.876）. The platelet count of ≤ 10× 10^4/μL was the strongest independent factor for postoperative mortality on univariate （P = 0.001） and multivariate （risk ratio, 12.5; P= 0.029） analyses. No patient with a platelet count of 〉7.3× 10^4/μL died of postoperative morbidity, whereas 25% （6/24 patients） of patients with a platelet count of ≤7.3×10^4/μL died （P〈0.001）. CONCLUSION： The selection criteria for hepatectomy procedures based on KICG are generally considered valid, because of the acceptable morbidity and mortality with these criteria. The preoperative platelet count independently affects morbidity and mortality after hepatectomy, suggesting that a combination of KICG and platelet count would further reduce postoperative mortality.

关键词： Hepatocellular carcinoma Hepatectomy Morbidity Mortality Indocyanine green clearance test Blood platelet count

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