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The impact of standardized methods of hepatic vein reconstruction with an external iliac vein graft

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Hepatobiliary Surgery and Nutrition 2021年第2期10卷 163-171页

作者： Fumihiro Terasaki Yuji Kaneoka Atsuyuki Maeda Yuichi Takayama Yasuyuki Fukami Takamasa Takahashi Masahito Uji Department of Surgery Ogaki Municipal HospitalOgakiJapan

Background:Liver tumors that invade the hepatic vein are surgically challenging,especially in patients with liver *** of as much of the parenchyma as possible is important;thus,when feasible,we perform hepatectomy with hepatic vein reconstruction(HVR)using an external iliac vein(EIV)*** conducted a retrospective study to investigate the benefit of HVR and to evaluate our ***:The study included patients treated by hepatectomy with HVR using EIV grafts and vascular *** reviewed the surgical outcomes,including total operation and HVR times,postoperative complications,and postoperative liver ***:The surgeries included right HVR(n=13),left HVR(n=3),and middle HVR(n=1).The total operation time was 277±72 minutes(155-400 minutes),and the HVR time was 27±5 minutes(19-40 minutes).Graft patency was confirmed in 14(82%)of the *** patient who underwent HVR with running sutures required emergency surgery due to graft ***-Dindo>grade IIIa postoperative complications occurred in 4(23.5%)patients,but there were no treatment-related ***:In conclusion,our hepatic resections with HVR using the same techniques and graft materials showed acceptable surgical *** our experience,we believe that preparatory hepatic resection with HVR is an effective treatment,especially for patients with decreased liver function or with a small residual liver parenchyma.

关键词： Hepatectomy hepatic vein reconstruction(HVR) external iliac vein graft

Usefulness of Newly Devised Clomiphene Citrate Administration Method Compared with the Conventional Method in Ovulation and Pregnancy

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Open Journal of Obstetrics and Gynecology 2024年第4期14卷 637-649页

作者： Makoto Kawamura Misaki Akiyama Remi Nakajima Eri Satoi Yoko ogaki Rieko Kanda Department of Obstetrics and Gynecology Kohseichuo General Hospital Tokyo Japan

Objective: Since not all women wish to conceive a child through aggressive treatment, we investigated the usefulness of modified repeated intracyclic clomiphene citrate (CC) therapy (repeated CC therapy) as a newly devised administration method. Methods: We evaluated the effects of CC administration on menstrual cycle length and retrospectively compared ovulation and pregnancy in 220 women who received CC at our hospital. Patients in the conventional method group received 50 mg per day for five days, starting on the fifth day of menstruation (withdrawal bleeding). Groups with and without menstrual cycle shortening after conventional CC administration were compared. The repeated CC therapy group was also compared with the non-shortened group. Repeated CC therapy was administered for the first five days as in the conventional method, and a second five-day repeat treatment was administered after an interval of five to seven days. Pregnancy rates, including indirect pregnancies, were evaluated by three different methods. Results: Ovulation and pregnancy rates were significantly better in the shortened group than in the non-shortened group (P < 0.001 and P = 0.010, respectively). Even in the non-shortened group, ovulation and pregnancy rates including indirect pregnancies were significantly improved when ovulation was observed with repeated CC therapy (P < 0.001 and P = 0.022, respectively). Conclusions: For patients whose menstrual cycle was not improved or shortened, repeated CC therapy as the newly devised CC administration method is useful as the next step after the conventional CC administration method.

关键词： Clomiphene Citrate Infertility Menstrual Cycle Ovulation Induction

Endoscopic papillectomy of minor papillar adenoma associated with pancreas divisum

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World Journal of Gastroenterology 2009年第9期15卷 1138-1140页

作者： Akira Kanamori Takashi Kumada Seiki Kiriyama Yasuhiro Sone Makoto Tanikawa Yasuhiro Hisanaga Hidenori Toyoda Hiroki Kawashima Akihiro Itoh Yoshiki Hirooka Hidemi Goto Department of Gastroenterology Ogaki Municipal HospitalOgaki 503-8502Japan Department of Gastroenterology Nagoya University Graduate School ofMedicineNagoya 466-8560Japan Department of Gastroenterology Nagoya University Graduate School of MedicineNagoya 466-8560Japan Department of Endoscopy Nagoya University HospitalNagoya 466-8560Japan

Tumors of the minor papilla of the duodenum are quite *** successfully and safely treated an 18-mm adenoma of the minor papilla associated with pancreas divisum using endoscopic papillectomy.A 64-year-old man was admitted to our hospital for treatment of an asymptomatic mass in the minor papilla detected by upper gastrointestinal *** analysis showed an 18-mm,whitish,sessile mass,located in the duodenum proximal to a normal-appearing major *** retrograde pancreatography did not reveal the pancreatic *** resonance cholangiopancreatography showed a lack of the ventral pancreatic *** suspected this case was associated with pancreatic divisum;therefore,we performed endoscopic papillectomy of the minor papilla ***,endoscopic pancreatic stent placement in the minor papilla was done to prevent drainage *** patient has been asymptomatic without recurrence of tumor or stenosis of the Santorini orifice upon endoscopic examination for the past 2 years.

关键词：胰腺分裂症内镜逆行腺瘤消化道内窥镜磁共振胰胆管十二指肠未成年人复发肿瘤

Conserved balance of hepatocyte nuclear DNA content in mononuclear and binuclear hepatocyte populations during the course of chronic viral hepatitis

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World Journal of Gastroenterology 2006年第28期12卷 4546-4548页

作者： Hidenori Toyoda Takashi Kumada Olivier Bregerie Christian Brechot Chantal Desdouets Department of Gastroenterology Ogaki Municipal HospitalOgakiJapan Inserm U370-Pasteur Institute CHU NeckerParisFrance

瞄准：到有增加的原子 DNA 的 hepatocytes 的百分比满足的分析，即，四倍的(4n ) 和 octoploid (8n ) 原子核，然后比较单音原子并且双性人原子 hepatocyte 人口。方法：百分比单音原子双( 2n )，双性人的 4n ，和 8n hepatocytes 和... 详细信息

瞄准：到有增加的原子 DNA 的 hepatocytes 的百分比满足的分析，即，四倍的(4n ) 和 octoploid (8n ) 原子核，然后比较单音原子并且双性人原子 hepatocyte 人口。方法：百分比单音原子双( 2n )，双性人的 4n ，和 8n hepatocytes 和那些原子 2 x 2n ， 2 x 4n ，并且 2 x 8n hepatocytes 与一个方法被决定能同时与长期的肝炎 B 或 C 在 62 个病人测量原子 DNA 满足的 hepatocyte 和 binuclearity 。在单音的原子 hepatocyte 人口的 4n 和 8n hepatocytes 的百分比在双性人与 2 x 4n 和 2 x 8n hepatocytes 的百分比相比原子 hepatocyte 人口。结果：在双性人的在单音的原子 hepatocytes 的 4n 和 2 x 4n 和 2 x 8n hepatocytes 的百分比原子 hepatocytes 是类似的，不管这项活动或长期的肝炎并且不管感染的病毒的纤维变性等级。结论：在内的原子 DNA 内容的分发单音原子并且双性人原子 hepatocyte 人口在长期的病毒的肝炎的功课期间被保存。

关键词：保存方法细胞核双核肝细胞慢性病毒肝炎

Proposal of the term “gallstone cholangiopancreatitis” to specify gallstone pancreatitis that needs urgent endoscopic retrograde cholangiopancreatography

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World Journal of Gastrointestinal Endoscopy 2021年第10期13卷 451-459页

作者： Masatoshi Isogai Department of Surgery Nawa HospitalOgaki 503-0852GifuJapan

Opie’s“pancreatic duct obstruction”and“common channel”theories are generally accepted as explanations of the mechanisms involved in gallstone acute pancreatitis(AP).Common channel elucidates the mechanism of necrotizing pancreatitis due to *** pancreatic duct obstruction,the clinical picture of most patients with ampullary stone impaction accompanied by biliopancreatic obstruction is dominated by life-threatening acute cholangitis rather than by AP,which clouds the understanding of the severity of gallstone *** to the revised Atlanta classification,it is difficult to consider these clinical features as indications of severe ***,the term“gallstone cholangiopancreatitis”is suggested to define severe disease complicated by acute cholangitis due to persistent ampullary stone *** incorporates the terms“cholangitis”and“gallstone pancreatitis.”“Cholangitis”refers to acute cholangitis due to cholangiovenous reflux through the foci of extensive hepatocyte necrosis reflexed by marked elevation in transaminase levels caused by persistent ampullary obstruction.“Gallstone pancreatitis”refers to elevated pancreatic enzyme levels consequent to pancreatic duct *** pancreatic lesion is characterized by minimal or mild *** cholangiopancreatitis may be valuable in clinical practice for specifying gallstone AP that needs urgent endoscopic retrograde cholangiopancreatography with endoscopic sphincterotomy.

关键词： Gallstone pancreatitis Gallstone hepatitis Acute cholangitis Necrotizing pancreatitis Pathophysiology Endoscopic retrograde cholangiopancreatography

Serum Mac-2 binding protein is a novel biomarker for chronic pancreatitis

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World Journal of Gastroenterology 2016年第17期22卷 4403-4410页

作者： Tomohiro Maekawa Yoshihiro Kamada Yusuke Ebisutani Makiko Ueda Tomoki Hata Koichi Kawamoto Shinji Takamatsu Kayo Mizutani Mayuka Shimomura Tomoaki Sobajima Hironobu Fujii Kotarosumitomo Nakayama Kimihiro Nishino Makoto Yamada Takashi Kumada Toshifumi Ito Hidetoshi Eguchi Hiroaki Nagano Eiji Miyoshi Department of Molecular Biochemistry and Clinical Investigation Osaka University Graduate School of Medicine Suita Osaka 565-0871 Japan Department of Surgery Osaka University Graduate School of Medicine Suita Suita Osaka 565-0871 Japan aMs New Otani Clinic Osaka Osaka 540-8570 Japan Department of Gastroenterology Ogaki Municipal Hospital Ogaki Gifu 503-8502 Japan Department of Gastroenterology and Hepatology Japan Community Health Care Organization Osaka Hospital Osaka Osaka 540-8570 Japan Department of Surgery Yamaguchi University Graduate School of Medicine Ube Yamaguchi 755-8505 Japan

AIM: To determine the efficacy of Mac-2 binding protein(Mac-2bp) for diagnosis of chronic ***: Fifty-nine healthy volunteers(HV), 162 patients with chronic pancreatitis(CP), and 94 patients with pancreatic ductal adenocarcinoma(PDAC) were enrolled in this study. We measured serum Mac-2bp using our developed enzyme-linked immunosorbent assay kit. Additional biochemical variables were measured using an automated analyzer(including aminotransferase, alanine aminotransferase, γ-glutamyltransferase, alkaline phosphatase, triglyceride, C-reactive protein, and amylase levels) or chemiluminescent enzyme immunoassay(carbohydrate antigen 19-9 and carcinoembryonic antigen). The ability of Mac-2bp to predict CP diagnosis accurately was assessed using receiver operating characteristic(ROC) ***: Serum Mac-2bp levels were significantly increased in CP patients compared to HV(P < 0.0001) and PDAC patients(P < 0.0001). Area under the ROC curve values of Mac-2bp for the discrimination of CP from HV and PDAC were 0.727 and 0.784, respectively. Multivariate analyses demonstrated that serum Mac-2bp levels were independent determinants for CP diagnosis from HV and PDAC patients. Immunohistological staining showed that Mac-2bp was expressed faintly in the pancreas tissues of both CP and PDAC patients. Serum aspartate aminotransferase, alanine aminotransferase, γ-glutamyltransferase, alkaline phosphatase, and triglyceride levels were significantly higher in patients with CP or PDAC. Serum Mac-2bp levels were highly correlated with protein levels of alanine aminotransferase, γ-glutamyltransferase, and C-reactive protein, but not amylase, suggesting that the damaged liver produces Mac-2bp. CONCLUSION: Measurement of serum Mac-2bp may be a novel and useful biomarker for CP diagnosis as well as liver fibrosis in the general population.

关键词： Pancreatic ductal adenocarcinoma Chronic pancreatitis Biomarker Steatopancreatitis Mac-2 binding pro

Integrating Psychiatric Services into Comprehensive Dementia Care in the Community

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Open Journal of Psychiatry 2015年第2期5卷 129-136页

作者： Hiroto Ito Hideyuki Hattori Hiroaki Kazui Masamoto Taguchi Manabu Ikeda Department of Social Psychiatry National Institute of Mental Health National Center of Neurology and Psychiatry Tokyo Japan National Center for Geriatrics and Gerontology Aichi Japan Department of Psychiatry Osaka University Graduate School of Medicine Osaka Japan ogaki hospital Gifu Japan Department of Neuropsychiatry Faculty of Life Sciences Kumamoto University Kumamoto Japan

Purpose: This study was conducted to clarify the utility of patient-held records as an integrated care approach for patients with dementia in the community. Method: We analyzed the family-held/patient-held records of patients with dementia in the community. The inclusion criteria in the study were as follows: 1) patient-held/family member-held records of patients with dementia in the community;2) patient-held records designed to share information across different professionals, direct-care staff members, and local government staff;and 3) the continuous participation of psychiatrists in the development and use of the patient-held records. Results: We identified eight sets of family-held/patient-held records in Japanese communities of various sizes, all of which were aimed at integrating information from various services, including information provided by medical and psychiatric professionals to the family and patient. Innovative tools have been available in the areas of the hopes and preferences of the patient, medication and monitoring, sharing information, and the use of information technology. Conclusion and Discussion: Family-held/patient-held records have potential as a tool to enhance the integrated care of people with dementia in the community.

关键词： Dementia Integrated Care Patient-Held Medical Record Psychiatry

全氟正丁烷超声造影在诊断小结节肝细胞癌大体分型中的应用

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国际医学放射学杂志 2014年第6期 596-596页

作者： T.Tada T.Kumada H.Toyoda T.Ito Y.Sone Y.Kaneoka 欧兰 ogaki Municipal hospital OgakiJapan

摘要目的阐明全氟正丁烷(perflubutane)超声造影(CEUS)在小结节肝细胞癌(HCC)大体分型中的诊断价值。方法将99个手术切除结节(最大直径≤3 cm)的肝细胞癌

关键词：肝细胞癌结节型小结节超声造影分型

雷莫芦单抗用于经乐伐替尼治疗后进展的不可切除肝细胞癌的治疗效果

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Gastroenterology Report 2021年第2期9卷 133-138,I0002页

作者： Atsushi Hiraoka Takashi Kumada Toshifumi Tada Chikara Ogawa Joji Tani Shinya Fukunishi Masanori Atsukawa Masashi Hirooka Kunihiko Tsuji Toru Ishikawa Koichi Takaguchi Kazuya Kariyama Ei Itobayashi Kazuto Tajiri Noritomo Shimada Hiroshi Shibata Hironori Ochi Kazuhito Kawata Hidenori Toyoda Hideko Ohama Kazuhiro Nouso Akemi Tsutsui Takuya Nagano Norio Itokawa Korenobu Hayama Taeang Arai Michitaka Imai Yohei Koizumi Shinichiro Nakamura Kojiro Michitaka Yoichi Hiasa Masatoshi Kudo Gastroenterology Center Ehime Prefectural Central HospitalEhimeJapan Department of Gastroenterology and Hepatology Ogaki Municipal HospitalGifuJapan Department of Internal Medicine Himeji Red Cross HospitalHyogoJapan Department of Gastroenterology and Hepatology Takamatsu Red Cross HospitalTakamatsuJapan Department of Gastroenterology and Hepatology Kagawa universityKagawaJapan Department of Gastroenterology Osaka Medical CollegeOsakaJapan Division of Gastroenterology and Hepatology Department of Internal MedicineNippon Medical SchoolTokyoJapan Department of Gastroenterology and Metabology Ehime University Graduate School of MedicineEhimeJapan Center of Gastroenterology Teine Keijinkai HospitalSapporoJapan Department of Gastroenterology Saiseikai Niigata HospitalNiigataJapan Department of Hepatology Kagawa Prefectural Central HospitalTakamatsuJapan Department of Gastroenterology Okayama City HospitalOkayamaJapan Department of Gastroenterology Asahi General HospitalAsahiJapan Department of Gastroenterology Toyama University HospitalToyamaJapan Division of Gastroenterology and Hepatology Otakanomori HospitalKashiwaJapan Department of Gastroenterology Tokushima Prefectural Central HospitalTokushimaJapan Hepato-biliary Center Matsuyama Red Cross HospitalMatsuyamaJapan Department of Hepatology Hamamatsu University School of MedicineHamamatsuJapan Department of Gastroenterology Kindai UniversityOsakaJapan

背景:在日本,乐伐替尼可用于不可切除原发性肝癌的一线、二线或三线治疗。本研究评估新近研发的雷莫芦单抗用于经乐伐替尼治疗后进展的不可切除的原发性肝癌的疗效。方法:2018年5月至2020年1月间在日本16家中心接受乐伐替尼治疗的385例... 详细信息

背景:在日本,乐伐替尼可用于不可切除原发性肝癌的一线、二线或三线治疗。本研究评估新近研发的雷莫芦单抗用于经乐伐替尼治疗后进展的不可切除的原发性肝癌的疗效。方法:2018年5月至2020年1月间在日本16家中心接受乐伐替尼治疗的385例不可切除原发性肝癌患者中,我们将其中接受雷莫芦单抗作为下一线治疗的28例患者纳入研究,对其治疗效果进行回顾性分析。结果:28例患者中位年龄70岁,中位白蛋白-胆红素(ALBI)评分为2.19。28例患者中,23例为男性;21例为Child-Pugh A级,7例为Child-Pugh B级;3例为BCLC B期,25例为BCLC C期。雷莫芦单抗用于二线、三线和四线治疗的病例分别为14例、9例和5例患者。26例患者获得疗效评估,客观缓解率为3.8%(1/26),疾病控制率为42.3%(11/26);中位疾病进展时间为2个月。未继续接受雷莫芦单抗治疗的原因包括16例出现疾病进展和2例出现3级不良反应(消化道出血和腹水)。结论:我们的初步研究显示,对于乐伐替尼治疗进展的不可切除原发性肝癌,雷莫芦单抗并没有获得预期的治疗效果。

关键词： hepatocellular carcinoma ramucirumab lenvatinib sorafenib