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Acquired hemophilia A in solid cancer: Two case reports and review of the literature

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World Journal of Clinical Cases 2018年第14期6卷 781-785页

作者： Makoto Saito Reiki Ogasawara Koh Izumiyama Akio Mori Takeshi Kondo masanori Tanaka Masanobu Morioka Masahiro Ieko Department of Internal Medicine and Hematology Aiiku Hospital Department of Internal Medicine Health Sciences University of Hokkaido

Acquired hemophilia A （AHA） is a rare, hemorrhagic autoimmune disease, whose pathogenesis involves reduced coagulation factor Ⅷ （FⅧ） activity related to the appearance of inhibitors against FⅧ. Common etiological factors include autoimmune diseases, ma-lignancy, and pregnancy. We report two cases of AHA in solid cancer. The first case is a 63-year-old man who developed peritoneal and intestinal bleeding after gastrectomy for gastric cancer. He was diagnosed with AHA, and was treated with prednisone, followed by cyclophosphamide. In the second case, a 68-year-old man developed a subcutaneous hemorrhage. He was diagnosed with AHA in hepatocellular carcinoma on CT imaging, and treated with rituximab alone. Hemostasis was achieved for both patients without bypassing agents as the amount of inhibitors was reduced and eradicated. However, both patients died within 1 yeardue to cancer progression. Successful treatment for AHA in solid cancer can be diffcult because treatment of the underlying malignancy is also required.

关键词： Acquired hemophilia A Coagulation factor Ⅷ Solid cancer Gastric cancer Hepatocellular carcinoma Case report

Mechanical properties of Fe-rich Si alloy from Hamiltonian

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npj Computational Materials 2017年第1期3卷 391-404页

作者： Tetsuo Mohri Ying Chen masanori Kohyama Shigenobu Ogata Arkapol Saengdeejing Somesh Kumar Bhattacharya Masato Wakeda Shuhei Shinzato Hajime Kimizuka Institute for Materials Research Tohoku UniversitySendai 980-8577Japan Fracture and Reliability Research Institute School of EngineeringTohoku UniversitySendai 980-8579Japan Research Institute of Electrochemical Energy Department of Energy and EnvironmentNational Institute of Advanced Industrial Science and TechnologyIkedaOsaka 563-8577Japan Department of Mechanical Science and Bioengineering Osaka UniversityOsaka 560-8531Japan Center for Elements Strategy Initiative for Structural Materials Kyoto UniversityKyoto 606-8501Japan Computational Structural Materials Design Group Research Center for Structural MaterialsNational Institute for Materials ScienceTsukuba 305-0047Japan

The physical origins of the mechanical properties of Fe-rich Si alloys are investigated by combining electronic structure calculations with statistical mechanics means such as the cluster variation method,molecular dynamics simulation,etc,applied to homogeneous and heterogeneous ***,we examined the elastic properties based on electronic structure calculations in a homogeneous system and attributed the physical origin of the loss of ductility with increasing Si content to the combined effects of magneto-volume and D03 *** a typical example of a heterogeneity forming a microstructure,we focus on grain boundaries,and segregation behavior of Si atoms is studied through high-precision electronic structure *** kinds of segregation sites are identified:looser and tighter *** on the site,different segregation mechanisms are ***,the dislocation behavior in the Fe-Si alloy is investigated mainly by molecular dynamics simulations combined with electronic structure *** solid-solution hardening and softening are interpreted in terms of two kinds of energy barriers for kink nucleation and migration on a screw dislocation ***,the clue to the peculiar work hardening behavior is discussed based on kinetic Monte Carlo simulations by focusing on the preferential selection of slip planes triggered by kink nucleation.

关键词： alloy softening microstructure

Elucidation of the relationship of BNIP3 expression to gemcitabine chemosensitivity and prognosis

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World Journal of Gastroenterology 2007年第34期13卷 4593-4597页

作者： Masaharu Ishida Makoto Sunamura Toru Furukawa masanori Akada Hiroko Fujimura Emiko Shibuya Shinichi Egawa Michiaki Unno Akira Horii Departments of Molecular Pathology Tohoku University School of Medicine 2-1 Seiryo-machi Aoba-ku Sendai 980-8575 Japan Department of Gastroenterological Surgery Tohoku University School of Medicine 1-1 Seiryo-machi Aoba-ku Sendai 980-8574 Japan Department of Gastroenterological Surgery Tohoku University School of Medicine 1-1 Seiryo-machi Aoba-ku Sendai 980-8574 Japan Cancer Surgery Section Hammersmith Hospital Imperial College Du Cane Road London W12 0NN United Kingdom Departments of Molecular Pathology Tohoku University School of Medicine 2-1 Seiryo-machi Aoba-ku Sendai 980-8575 Japan Department of Gastroenterological Surgery Tohoku University School of Medicine 1-1 Seiryo-machi Aoba-ku Sendai 980-8574 Japan

AIM: To evaluate the significance of BNIP3 in the pathogenesis of pancreatic cancer, we analyzed the relationship between the expression of BNIP3 and survival rate of the patients with pancreatic cancer, or chemosensitivities in pancreatic cancer cell lines, particularly for gemcitabine, the first-line anti-tumor drug for pancreatic cancer. METHODS: To compare the expression level of BNIP3 with the resistance to gemcitabine, eight pancreatic cancer cell lines were subjected to gemcitabine treatment and the quantitative real-time RT-PCR method was used to evaluate BNIP3 expression. Immunohistochemical analysis was also performed using 22 pancreatic cancer specimens to study relationship between BNIP3 expression and survival rate. RESULTS: Although no significantly positive association between BNIP3 mRNA level and gemcitabine chemosensitivity was observed, pancreatic cancer cell lines that were sensitive to gemcitabine treatment tended to show high levels of BNIP3 expression. The converse, an absence of BNIP3 expression, was not correlated with gemcitabine resistance. We further compared the BNIP3 expression profiles of resected primary pancreaticcancer specimens with the prognosis of the patients, and found a tendency of favorable prognosis and low BNIP3 expression. CONCLUSION: High levels of BNIP3 expression cannot be used as one of the predicting factors for gemcitabine chemosensitivity, and some yet to be known factors will have to fill the gap for the accurate prediction of pancreatic cancer chemosensitivity to gemcitabine. However, BNIP3 expression may have an impact on prediction of prognosis of patients with pancreatic cancer.

关键词： BNIP3 Chemosensitivity Gemcitabine Pancreatic cancer Prognosis

Sensitivity Numerical Analysis of Human Body Exergy Balance under an Unsteady-State Thermal Environment —Behavioral Adaptation Induced by Undesirable Cold Storage by Building Envelope in Winter

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Health 2016年第8期8卷 737-748页

作者： Koichi Isawa masanori Shukuya Department of Architecture Faculty of Engineering Fukuyama University Fukuyama Japan Department of Restoration Ecology and Built Environment Tokyo City University Yokohama Japan

We analyzed the relationships between the human body exergy balance and behavioral adaptations induced by undesirable cold storage by a building envelope under an unsteady-state thermal environment in winter. The complex interaction of the warm exergy production by shivering, lifting of the shell ratio, and reduction of the blood flow rate was considered to constitute the physiological adaptation necessary for maintaining the constant core temperature, which was an important aspect in living organisms. In the case of intermittent use room, it was suggested that better thermal comfort and desirable behavioral adaptations, which decreased the consumption of fossil fuels, could be achieved if interior wooden cladding was used in constructions with building envelopes that had a comparatively large heat capacity, or in cases of wooden constructions in which the building envelope heat capacity was comparatively small.

关键词： Passive System Exergy Human Body Adaptive Comfort Unsteady State

Recurrence of autoimmune hepatitis after liver transplantation without elevation of alanine aminotransferase

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World Journal of Gastroenterology 2007年第10期13卷 1618-1621页

作者： Huaiqi Yao Kojiro Michitaka Yoshio Tokumoto Yosuke Murata Toshie Mashiba masanori Abe Yoichi Hiasa Norio Horiike Morikazu Onji Department of Gastroenterology and Metabology Ehime University Graduate School of Medicine Shitsukawa Toon-city Ehime-ken 791-0295 Japan Department of Medicine Ehime University Graduate School of Medicine Shitsukawa Toon-city Ehime-ken 791-0295 Japan

It is controversial whether steroid therapy should be continued to prevent the recurrence of autoimmune hepatitis （AIH） in patients who have undergone liver transplantation （LTx） due to AIH. We report a case of recurrent autoimmune hepatitis after LTx despite a persistently normal range of alanine aminotransferase （ALT）. A S0-year-old woman was admitted to our hospital because of jaundice and severe liver dysfunction, where she was diagnosed with liver failure due to AIH. Steroid therapy was not effective enough and the patient received living-donor LTx in 1999. Following the operation, the level of ALT was maintained within a normal range and anti-nuclear antibody （ANA） became negative, however, the serum level of IgG gradually elevated and ANA became positive, while platelets decreased. A liver biopsy performed 6 years after LTx showed histological findings of AIH and she was diagnosed with recurrent AIH. A recurrence of AIH may occur after LTx even if the level of ALT remains within a normal range. We consider that a protocol liver biopsy should be performed in patients who undergo LTx due to AIH to decide the indication for steroid therapy.

关键词： Autoimmune hepatitis Liver transplantation Recurrence Steroid Protocol liver biopsy

Effect of an extract of Ganoderma lucidum in men with lower urinary tract symptoms： a double-blind, placebo-controlled randomized and dose-ranging study

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Asian Journal of Andrology 2008年第4期10卷 651-658页

作者： masanori Noguchi Tatsuyuki Kakuma Katsuro Tomiyasu Yoshiko Kurita Hiroko Kukihara Fumiko Konishi Shoichiro Kumamoto Kuniyoshi Shimizu Ryuichiro Kondo Kei Matsuoka Departments of Urology Kurume University School of Medicine Kurume 830-0011 Japan Departments of Bio-statistics Kurume University School of Medicine Kurume 830-0011 Japan Research Laboratories Chlorella Industry Chikugo 833-0056 Japan Department of Forest and Forest Products Science Faculty of Agriculture Kyushu University Fukuoka 812-8582 Japan

Aim： To conduct a double-blind, placebo-controlled randomized and dose-ranging study to evaluate the safety and efficacy of the extract of Ganoderma lucidum （G. lucidum） in men with lower urinary tract symptoms （LUTS）. Methods： We enrolled male volunteers （〉 50 years） with an International Prostate Symptom Score （IPSS; questions 1-7）〉 5 and a prostate-specific antigen （PSA） value 〈 4 ng/mL. Volunteers were randomized into groups of placebo （n = 12）, G. lucidum of 0.6 mg （n = 12）, 6 mg （n = 12） or 60 mg （n = 14）, administered once daily. Efficacy was measured as a change from baseline in IPSS and the peak urine flow rate （Qmax）. Prostate volume and residual urine were estimated by ultrasonography, and blood tests, including PSA levels, were measured at baseline and at the end of the treatment. Results： The overall administration was well tolerated, with no major adverse effects. Statistical significances in the magnitude of changes between the experimental groups were observed at weeks 4 and 8. No changes were observed with respect to Qmax, residual urine, prostate volume or PSA levels. Conclusion： The extract of G. lucidum was well tolerated and an improvement in IPSS was observed. The recommended dose of the extract of G. lucidum is 6 mg in men with LUTS.

关键词： lower urinary tract symptoms phytotherapy outcome randomized trial

Tumor differentiation phenotype in gastric differentiated-type tumors and its relation to tumor invasion and genetic alterations

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World Journal of Gastroenterology 2006年第24期12卷 3803-3809页

作者： Kimiyasu Yamazaki Yusuke Tajima Reiko Makino Nobukazu Nishino Shigeo Aoki masanori Kato Masaaki Sakamoto Koji Morohara Tsutomu Kaetsu Mitsuo Kusano Department of Surgery Division of General and Gastroenterological Surgery Showa UniversitySchool of Medicine1-5-8HatanodaiShina-gawa-kuTokyo 142-8666Japan Department of Surgery Division of General and Gastroenterological Surgery Showa UniversitySchool of Medicine1-5-8HatanodaiShina-gawa-kuTokyo 142-8666Japan Clinical Research LaboratoryShowa UniversitySchool of Medicine1-5-8HatanodaiShinagawa-kuTokyo 142-8666Japan

AIM： To clarify the relations between tumor differentiation phenotype and tumor invasion or genetic alterations in gastric differentiated-type tumors. METHODS： We examined the tumor differentiation phenotype, the presence of mutations in APC and p53, and the microsatellite instability （MSI） status in 48 gastric adenomas and 171 differentiated-type carcinomas, The tumor differentiation phenotype was determined by examining the expression of human gastric mucin （HGM）, NUC6, MUC2 and CD10, The tumors were then classified into gastric- （G-）, gastric and intestinal mixed （GI-）, or intestinal- （I-） phenotypes, according to the immunopositivity of the above markers, The presence of mutations in APC and p53 and the MSI status were also investigated in all the tumors, RESULTS： Gastric adenomas were significantly associated with CDIO expression, I-phenotype tumors and the presence of APC mutations, compared with carcinomas （66.7% vs 25.1%, P 〈 0.0001; 56.3% vs 14.6%, P 〈 0.0001; 39.6% vs 14.0%, P 〈 0.0001, respectively） and inversely associated with expressions of HGM and MUC6 and the presence of p53 mutations （10.4% vs 62.6%, P 〈 0.0001; 39.6% vs 64.3%, P = 0.003; 2.0% vs 26.3%, P = 0.001, respectively）. The frequency of APC mutations was significantly higher in HGM-negative tumors, MUC6-negative tumors, CD10-positive tumors and I-phenotype tumors than in HGM-positive tumors, MUC6- positive tumors, CD10-negative tumors and G-phenotype tumors （32.7% vs 7.1%, P 〈 0.0001; 27.8% vs 14.0%, P = 0.0182; 37.3% vs 10.4%, P 〈 0.0001; and 38.5% vs 9.5%, P = 0.0017, respectively）. The frequency of MSI was significantly higher in MUC6-positive tumors, CD10- negative tumors and G-phenotype tumors than in MUC6- negative tumors, CD10-positive tumors and I-phenotype tumors （24.8% vs 6.7%, P = 0.0009; 22.2% vs 8.0%, P = 0.0143; and 28.6% vs 9.6%, P = 0.0353, respectively）. CONCLUSION： The tumor differentiation phenotype is closely related to tumor invasion and genetic alterations in gastric d

关键词： Gastric carcinoma Tumor differentiation phe-notype APC p53 Microsatellite instability

Randomized clinical trial of an ethanol extract of Ganoderma lucidum in men with lower urinary tract symptoms

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Asian Journal of Andrology 2008年第5期10卷 777-785页

作者： masanori Noguchi Tatsuyuki Kakuma Katsuro Tomiyasu Akira Yamada Kyogo Itoh Fumiko Konishi Shoichiro Kumamoto Kuniyoshi Shimizu Ryuichiro Kondo Kei Matsuoka Departments of Urology Kurume University School of Medicine Kurume 830-0011 Japan Departments of Bio-statistics Kurume University School of Medicine Kurume 830-0011 Japan Departments of Immunology Kurume University School of Medicine Kurume 830-0011 Japan Research Laboratories Chlorella Industry Co Ltd Chikugo 833-0056 Japan Department of Forest and Forest Products Science Faculty of Agriculture Kyushu University Fukuoka 812-8582 Japan

Aim： To evaluate the safety and efficacy of an extract of Ganoderma lucidum that shows the strongest 5α-reductase inhibitory activity among the extracts of 19 edible and medicinal mushrooms by a double-blind, placebo-controlled, randomized and dose-ranging study in men with lower urinary tract symptoms （LUTS）. Methods： In this trial, we randomly assigned 88 men over the age of 49 years who had slight-to-moderate LUTS to 12 weeks of treatment with G. lucidum extract （6 mg once a day） or placebo. The primary outcome measures were changes in the International Prostate Symptom Score （IPSS） and variables of uroflowmetry. Secondary outcome measures included changes in prostate size, residual urinary volume after voiding, laboratory values and the reported adverse effects. Results： G. lucidum was effective and significantly superior to placebo for improving total IPSS with 2.1 points decreasing at the end of treatment （mean difference, -1.18 points; 95% confidence interval, -1.74 to -0.62; P 〈 0.0001）. No changes were observed with respect to quality of life scores, peak urinary flow, mean urinary flow, residual urine, prostate volume, serum prostate-specific antigen or testosterone levels. Overall treatment was well tolerated with no severe adverse effects. Conclusion： The extract of G. lucidum was well tolerated and improved IPSS scores. These results encouraged a further, large-scale evaluation of phytotherapy for a long duration using the extract of G. lucidum on men with LUTS.

关键词： lower urinary tract symptoms phytotherapy outcome randomized trial Ganoderma lucidum

Usefulness of portal vein pressure for predicting the effects of tolvaptan in cirrhotic patients

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World Journal of Gastroenterology 2016年第21期22卷 5104-5113页

作者： Ai Nakagawa masanori Atsukawa Akihito Tsubota Chisa Kondo Tomomi Okubo Taeang Arai Norio Itokawa Yoshiyuki Narahara Katsuhiko Iwakiri Division of Gastroenterology Department of Internal Medicine Nippon Medical School Chiba Hokusoh Hospital Core Research Facilities for Basic Science Research Center for Medical Sciences Jikei University School of Medicine Division of Gastroenterology Department of Internal Medicine Nippon Medical School

AIM: To elucidate influencing factors of treatment response, then tolvaptan has been approved in Japan for liquid ***: We herein conducted this study to clarify the influencing factors in 40 patients with decompensated liver cirrhosis complicated by liquid retention. Tolvaptan was administered at a dosage of 7.5 mg once a day for patients with conventional diuretic-resistant hepatic edema for 7 d. At the initiation of tolvaptan, the estimated hepatic venous pressure gradient (HVPG) value which was estimated portal vein pressure was measured using hepatic venous catheterization. We analyzed the effects of tolvaptan and influencing factors associated with treatment ***: Subjects comprised patients with a median age of 65 (range, 40-82) years. According to the Child-Pugh classification, class A was 3 patients, class B was 19, and class C was 18. Changes from the baseline in body weight were -1.0 kg (P = 2.04 × 10-6) and -1.3 kg (P = 1.83 × 10-5), respectively. The median HVPG value was 240 (range, 105-580) mmH2O. HVPG was only significant influencing factor of the weight loss effect. When patients with body weight loss of 2 kg or greater from the baseline was defined as responders, receiver operating characteristic curve analysis showed that the optimal HVPG cutoff value was 190 mmH2O in predicting treatment response. The response rate was 87.5% (7/8) in patients with HVPG of 190 mmH2O or less, whereas it was only 12.5% (2/16) in those with HVPG of greater than 190 mmH2O (P = 7.46 × 10-4). We compared each characteristics factors between responders and non-responders. As a result, HVPG (P = 0.045) and serum hyaluronic acid (P = 0.017) were detected as useful ***: The present study suggests that tolvaptan in the treatment of liquid retention could be more effective for patients with lower portal vein pressure.

关键词： Tolvaptan V2 receptor antagonist Portal vein pressure Hepatic venous pressure gradient Decompensated chirrosis