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1Insulin resistance and chronic liver disease显示文摘Increased insulin resistance is frequently associated with chronic liver disease and is a pathophysiological feature of hepatogenous diabetes.Distinctive factors including hepatic parenchymal cell damage,portalsystemic shunting and hepatitis C virus are responsible for the development of hepatogenous insulin resistance/diabetes.Although it remains unclear whether insulin secretion from pancreatic beta cells is impaired as it is in type 2 diabetes,retinopathic and cardiovascular risk is low and major causes of death in cirrhotic patients with diabetes are liver failure,hepatocellular carcinoma and gastrointestinal hemorrhage.Hemoglobin A1c is an inaccurate marker for the assessment and management of hepatogenous diabetes.Moreover,exogenous insulin or sulfonylureas may be harmful because these agents may promote hepatocarcinogenesis.Thus,pathogenesis,cause of death,assessment and therapeutic strategy for hepatogenous insulin resistance/diabetes differ from those for lifestyle-related type 2 diabetes.In this article,we review features of insulin resistance in relationship to chronic liver disease.We also discuss the impact of anti-diabetic agents on interferon treatment and hepatocarcinogenesis.Takumi Kawaguchi Eitaro Taniguchi Minoru Itou Masahiro Sakata Shuji Sumie Michio Sata 2011World Journal of Hepatology2011,3,5:25
2Dipeptidyl peptidase-4: A key player in chronic liver disease显示文摘Dipeptidyl peptidase-4 (DPP-4) is a membrane-associated peptidase, also known as CD26. DPP-4 has widespread organ distribution throughout the body and exerts pleiotropic effects via its peptidase activity. A representative target peptide is glucagon-like peptide-1, and inactivation of glucagon-like peptide-1 results in the development of glucose intolerance/diabetes mellitus and hepatic steatosis. In addition to its peptidase activity, DPP-4 is known to be associated with immune stimulation, binding to and degradation of extracellular matrix, resistance to anti-cancer agents, and lipid accumulation. The liver expresses DPP-4 to a high degree, and recent accumulating data suggest that DPP-4 is involved in the development of various chronic liver diseases such as hepatitis C virus infection, non-alcoholic fatty liver disease, and hepatocellular carcinoma. Furthermore, DPP-4 occurs in hepatic stem cells and plays a crucial role in hepatic regeneration. In this review, we described the tissue distribution and various biological effects of DPP-4. Then, we discussed the impact of DPP-4 in chronic liver disease and the possible therapeutic effects of a DPP-4 inhibitor.Minoru Itou Takumi Kawaguchi Eitaro Taniguchi Michio Sata 2013World Journal of Gastroenterology2013,19,15:22
3Gd-EOB-DTPA-enhanced magnetic resonance imaging features of hepatic hemangioma compared with enhanced computed tomography显示文摘AIM:To clarify features of hepatic hemangiomas on gadolinium-ethoxybenzyl-diethylenetriaminpentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI) compared with enhanced computed tomography (CT). METHODS:Twenty-six patients with 61 hepatic hem- angiomas who underwent both Gd-EOB-DTPA-enhanced MRI and enhanced CT were retrospectively reviewed. Hemangioma appearances (presence of peripheral nodular enhancement, central nodular enhancement, diffuse homogenous enhancement, and arterioportal shunt during the arterial phase, fill-in enhancement during the portal venous phase, and prolonged enhancement during the equilibrium phase) on Gd-EOB-DTPA-enhanced MRI and enhanced CT were evaluated.The degree of contrast enhancement at the enhancing portion within the hemangioma was visually assessed using a five-point scale during each phase. For quantitative analysis, the tumor-muscle signal intensity ratio (SIR), the liver-muscle SIR, and the attenuation value of the tumor and liver parenchyma were calculated. The McNemar test and the Wilcoxon's signed rank test were used to assess the significance of differences in the appearances of hemangiomas and in the visual grade of tumor contrast enhancement between Gd-EOB-DTPA-enhanced MRI and enhanced CT. RESULTS:There was no significant difference between Gd-EOB-DTPA-enhanced MRI and enhanced CT in the presence of peripheral nodular enhancement (85% vs 82%), central nodular enhancement (3% vs 3%), diffuse enhancement (11% vs 16%), or arterioportal shunt (23% vs 34%) during arterial phase, or fill-in enhancement (79% vs 80%) during portal venous phase. Prolonged enhancement during equilibrium phase was observed less frequently on Gd-EOB-DTPA-enhanced MRI than on enhanced CT (52% vs 100%, P < 0.001). On visual inspection, there was significantly less contrast enhancement of the enhancing portion on Gd-EOB-DTPA-enhanced MRI than on enhanced CT during the arterial (3.94 ± 0.98 vs 4.57 ± 0.64, respectively, P < 0.001), portal venous (3.72 ± 0.82 vs 4.36 ± 0.53, respectively, P < 0.001), and equilibrium phases (2.01 ± 0.95 vs 4.04 ± 0.51, respectively, P < 0.001). In the quantitative analysis, the tumor-muscle SIR and the liver-muscle SIR observed with Gd-EOB-DTPA-enhanced MRI were 0.80 ± 0.24 and 1.28 ± 0.33 precontrast, 1.92 ± 0.58 and 1.57 ± 0.55 during the arterial phase, 1.87 ± 0.44 and 1.73 ± 0.39 during the portal venous phase, 1.63 ± 0.41 and 1.78 ± 0.39 during the equilibrium phase, and 1.10 ± 0.43 and 1.92 ± 0.50 during the hepatobiliary phase, respectively. The attenuation values in the tumor and liver parenchyma observed with enhanced CT were 40.60 ± 8.78 and 53.78 ± 7.37 precontrast, 172.66 ± 73.89 and 92.76 ± 17.92 during the arterial phase, 152.76 ± 35.73 and 120.12 ± 18.02 during the portal venous phase, and 108.74 ± 18.70 and 89.04 ± 7.25 during the equilibrium phase, respectively. Hemangiomas demonstrated peak enhancement during the arterial phase, and both the SIR with Gd-EOB-DTPA-enhanced MRI and the attenuation value with enhanced CT decreased with time. The SIR of hemangiomas was lower than that of liver parenchyma during the equilibrium and hepatobiliary phases on Gd-EOB-DTPA-enhanced MRI. However, the attenuation of hemangiomas after contrast injection was higher than that of liver parenchyma during all phases of enhanced CT. CONCLUSION:Prolonged enhancement during the equilibrium phase was observed less frequently on Gd-EOB-DTPA-enhanced MRI than enhanced CT, which may exacerbate differentiating between hemangiomas and malignant tumors.Akihiro Tateyama Yoshihiko Fukukura Koji Takumi Toshikazu Shindo Yuichi Kumagae Kiyohisa Kamimura Masayuki Nakajo 2012World Journal of Gastroenterology2012,18,43:19
4Effect of phosphorus fluctuation caused by river water dilution in eutrophic lake on competition between blue-green alga Microcystis aeruginosa and diatom Cyclotella sp.显示文摘Tega-numa (Lake Tega) is one of the eutrophic lakes in Japan. For the improvement of water quality in Lake Tega, the North-chiba Water Conveyance Channel was constructed in 2000, which transfer water from Tone River into the lake. After 2000, the dominant species of diatoms, mainly Cyclotella sp., have been replacing blue-green algae, mainly Microcystis aeruginosa in Lake Tega. This transition of dominant species would be due to the dilution, but the detail mechanism has not been understood yet. This study examined the relationship between phosphorus fluctuation caused by river water dilution to Lake Tega and dominance of algal species, M. aeruginosa or Cyclotella sp. based on the single-species and the mixed-species culture experiments. The single-species culture experiment showed that the half-saturation constant and uptake rate of phosphorus were one order lower and seven times higher for M. aeruginosa than those for Cyclotella sp. These findings implied that M. aeruginosa would possess a potential for the growth and survival over Cyclotella sp. in the phosphorus limited condition. The superiority of M. aeruginosa was reflected in the outcome of the mixed-species culture experiment, i.e., dominance of M. aeruginosa, even phosphorus concentration was lowered to 0.01 mg-P/L. Therefore, it could be concluded that the decrease in phosphorus concentration due to the river water dilution to Lake Tega would be interpreted as a minor factor for the transition of dominant species from M. aeruginosa to Cyclotella sp.Yoshimasa Amano Yusuke Sakai Takumi Sekiya Kimitaka Takeya Kazuo Taki Motoi Machida 2010Journal of Environmental Sciences2010,22,11:16
5比较内耳内淋巴显像和耳蜗电图及甘油试验在梅尼埃病诊断中的价值显示文摘目的:研究甘油试验、耳蜗电图、3T MRI在梅尼埃病(MD)患者中的关系。方法:评估20例患者,把稀释的钆造影剂通过鼓室注射入患者双侧的鼓室腔,24h后,通过3T MRI评估膜迷路积水的程度,此外为检测耳蜗积水,进行耳蜗电图和甘油试验。结果:经耳蜗电图检测,11例(55%)患者有阳性结果。经甘油试验检测,12例(60%)患者有阳性结果。同时采用甘油试验和耳蜗电图检测同一组患者时,75%的患者有阳性结果。用钆造影剂的3T MRI检查,19例(95%)患者有阳性结果。结论:与耳蜗电图及甘油试验检测相比,鼓室内注射钆造影剂的3T MRI,对内耳膜迷路积水的诊断更有价值。HISAKUNI FUKUOKA YUTAKA TAKUMI KEITA TSUKADA MAIKO MIYAGAWA TOMOHIRO OGUCHI HITOSHI UEDA MASUMI KADOYA SHIN-ICHI USAMI 张甦琳 孔维佳 2012临床耳鼻咽喉头颈外科杂志2012,26,19:16
6Fucoidan enhances intestinal barrier function by upregulating the expression of claudin-1显示文摘AIM:To evaluate the protective effects of fucoidan on oxidative stress-induced barrier disruption in human intestinal epithelial cells.METHODS:In Caco-2 cell monolayer models,the disruption of barrier function by oxidative stress is mediated by H2O2.The integrity of polarized Caco-2 cell monolayers was determined by measuring the transepithelial resistance(TER)and permeability was estimated by measuring the paracellular transport of FITC-labeled4-kDa dextran(FD4).The protective effects of fucoidan on epithelial barrier functions on polarized Caco-2 cell monolayers were evaluated by TER and FD4 flux.The expression of tight junction(TJ)proteins was assessed using reverse-transcription polymerase chain reaction(RT-PCR)and immunofluorescence staining.RESULTS:Without H2O2treatment,fucoidan significantly increased the TER compared to control(P<0.05),indicating a direct enhancement of intestinal epithelial barrier function.Next,H2O2disrupted the epithelial barrier function in a time-dependent manner.Fucoidan prevented the H2O2-induced destruction in a dosedependent manner.Fucoidan significantly decreased H2O2-induced FD4 flux(P<0.01),indicating the prevention of disruption in paracellular permeability.RTPCR showed that Caco-2 cells endogenously expressed claudin-1 and-2,and occludin and that H2O2reduced the mRNA expression of these TJ proteins.Treatment with fucoidan attenuated the reduction in the expressions of claudin-1 and claudin-2 but not occludin.Immunofluorescence staining revealed that the expression of claudin-1 was intact and high on the cell surface.H2O2disrupted the integrity of claudin-1.Treatment with fucoidan dramatically attenuated the expression of claudin-1.CONCLUSION:Fucoidan enhanced intestinal epithelial barrier function by upregulating the expression of claudin-1.Thus,fucoidan may be an appropriate therapy for the treatment of inflammatory bowel diseases.Atsushi Iraha Hiroshi Chinen Akira Hokama Takumi Yonashiro Tetsu Kinjo Kazuto Kishimoto Manabu Nakamoto Tetsuo Hirata Nagisa Kinjo Futoshi Higa Masao Tateyama Fukunori Kinjo Jiro Fujita 2013World Journal of Gastroenterology2013,19,33:15
7Importance of hepatitis C virus-associated insulin resistance:Therapeutic strategies for insulin sensitization显示文摘Insulin resistance is one of the pathological features in patients with hepatitis C virus(HCV) infection.Generally,persistence of insulin resistance leads to an increase in the risk of life-threatening complications such as cardiovascular diseases.However,these complications are not major causes of death in patients with HCV-associated insulin resistance.Indeed,insulin resistance plays a crucial role in the development of various complications and events associated with HCV infection.Mounting evidence indicates that HCV-associated insulin resistance may cause(1) hepatic steatosis;(2) resistance to anti-viral treatment;(3) hepatic f ibrosis and esophageal varices;(4) hepatocarcinogenesis and proliferation of hepatocellular carcinoma;and(5) extrahepatic manifestations.Thus,HCV-associated insulin resistance is a therapeutic target at any stage of HCV infection.Although the risk of insulin resistance in HCV-infected patients has been documented,therapeutic guidelines for preventing the distinctive complications of HCV-associated insulin resistance have not yet been established.In addition,mechanisms for the development of HCV-associated insulin resistance differ from lifestyle-associated insulin resistance.In order to ameliorate HCV-associated insulin resistance and its complications,the eff icacy of the following interventions is discussed:a late evening snack,coffee consumption,dietary iron restriction,phlebotomy,and zinc supplements.Little is known regarding the effect of anti-diabetic agents on HCV infection,however,a possible association between use of exogenous insulin or a sulfonylurea agent and the development of HCC has recently been reported.On the other hand,insulin-sensitizing agents are reported to improve sustained virologic response rates.In this review,we summarize distinctive complications of,and therapeutic strategies for,HCVassociated insulin resistance.Furthermore,we discuss supplementation with branched-chain amino acids as a unique insulin-sensitizing strategy for patients with HCVassociated insulin resistance.Takumi Kawaguchi Michio Sata 2010World Journal of Gastroenterology2010,16,16:14
8STI571 (Glivec) suppresses the expression of vascular endothelial growth factor in the gastrointestinal stromal tumor cell line,GIST-T1显示文摘AIM:To estimate whether STI571 inhibits the expressionof vascular endothelial growth factor(VEGF)in thegastrointestinal stromal tumor(GIST)cells.METHODS:We used GIST cell line,GIST-T1.It hasa heterogenic 57-bp deletion in exon 11 to produce amutated c-KIT,which results in constitutive activationof c-KIT.Cells were treated with/without STI571 orstem cell factor(SCF).Transcription and expression ofVEGF were determined by RT-PCR and flow cytometryor Western blotting,respectively.Activated c-KIT wasestimated by immunoprecipitation analysis.Cell viabilitywas determined by MTT assay.RESULTS:Activation of c-KIT was inhibited bySTI571 treatment.VEGF was suppressed at both thetranscriptional and translational levels in a temporal anddose-dependent manner by STI571.SCF upregulatedthe expression of VEGF and it was inhibited by STI571.STI571 also reduced the cell viability of the GIST-T1cells,as determined by MTT assay.CONCLUSION:Activation of c-KIT in the GIST-T1regulated the expression of VEGF and it was inhibited bySTI571.STI571 has antitumor effects on the GIST cellswith respect to not only the inhibition of cell growth,butalso the suppression of VEGF expression.Toufeng Jin Hajime Nakatani Takahiro Taguchi Takumi Nakano Takehiro Okabayashi Takeki Sugimoto Michiya Kobayashi Keijiro Araki 2006World Journal of Gastroenterology2006,12,5:14
9Preparation and incubation conditions affect the DNA integrity of ejaculated human spermatozoa显示文摘适当精液处理和评价为成功的不孕处理是批评的。我们调查了实验室过程包括精液准备和孵化是否影响精子 DNA 正直。153 个不肥沃的人的一个总数被包含。常规精液参数和精子染色质结构试金(SCSA ) 参数,也就是说 DNA 破碎索引(% DFI ) 和高 DNA stainability (% HDS ) ,在新鲜呼喊的精液样品上被估计,它在不同条件下面被对待并且孵化。否定关联在 % DFI 和精子集中,活动性,进步活动性和形态学之间被识别。DFI 的一个更低的百分比在精子被检测密度坡度 centrifugation (DGC ) 是否被游泳起来处理独自与 DGC 比较跟随(P < 0.01 ) 。尽管 % DFI 在空中在房间温度(RT ) 并且在 37 掳 C 与孵化以一种时间依赖者方式增加了,在在 RT 的 24 h 以后的 % DFI 在 37 掳 C 是比那显著地低的(P < 0.05 ) 。有 5% CO2 的孵化在维持精子活动性是有效的(P < 0.01 ) ;然而,它导致了 % DFI 的进一步的举起(P < 0.001 ) 。因此,精子 DNA 损坏与更长的潜伏期被联系。有趣地,普通文化条件例如维持 pH 和温度,损害了精子 DNA 正直。Rieko Matsuura Takumi Takeuchi Atsumi Yoshida 2010Asian Journal of Andrology2010,12,5:10
10Immunological Effects of Silica and Asbestos显示文摘Silicosis patients(SILs) and patients who have been exposed to asbestos develop not only respiratory diseases but also certain immunological disorders. In particular,SIL sometimes complicates autoimmune diseases such as systemic scleroderma,rheumatoid arthritis(known as Caplan syndrome) ,and systemic lupus erythematoses. In addition,malignant complications such as lung cancer and malignant mesothelioma often occurr in patients exposed to asbestos,and may be involved in the reduction of tumor immunity. Although silica-induced disorders of autoimmunity have been explained as adjuvant-type effects of silica,more precise analyses are needed and should reflect the recent progress in immunomolecular findings. A brief summary of our investigations related to the immunological effects of silica/asbestos is presented. Recent advances in immunomolecular studies led to detailed analyses of the immunological effects of asbestos and silica. Both affect immuno-competent cells and these effects may be associated with the pathophysiological development of complications in silicosis and asbestos-exposed patients such as the occurrence of autoimmune disorders and malignant tumors,respectively. In addition,immunological analyses may lead to the development of new clinical tools for the modification of the pathophysiological aspects of diseases such as the regulation of autoimmunity or tumor immunity using cell-mediated therapies,various cytokines,and molecule-targeting therapies. In particular,as the incidence of asbestos-related malignancies is increasing and such malignancies have been a medical and social problem since the summer of 2005 in Japan,efforts should be focused on developing a cure for these diseases to eliminate nationwide anxiety.Takemi Otsuki Megumi Maeda Shuko Murakami Hiroaki Hayashi Yoshie Miura Masayasu Kusaka Takashi Nakano Kazuya Fukuoka Takumi Kishimoto Fuminori Hyodoh Ayako Ueki Yasumitsu Nishimura 2007Cellular & Molecular Immunology2007,4,4:9
11Usefulness of vonoprazan,a potassium ion-competitive acid blocker,for primary eradication of Helicobacter pylori显示文摘AIM To investigate usefulness of triple therapy with vonoprazan,a potassium ion-competitive acid blocker and antibiotics,for Helicobacter pylori(H.pylori) eradication.METHODS The H.pylori eradication rate was examined in 2507 patients(2055 undergoing primary eradication and 452 undergoing secondary eradication,excluding patients with subtotal gastrectomy) at the Japanese Red Cross Kyoto Daiichi Hospital from March 2013 to September 2015.For patients treated from March 2013 to February 2015,a proton pump inhibitor(PPI) was used to reduce acid secretion,while vonoprazan was used after March 2015.The success rates of the 2 regimens(PPI + amoxicillin + clarithromycin/metronidazole,or vonoprazan + amoxicillin + clarithromycin/metronidazole) were compared.RESULTS The success rate of primary H.pylori eradication was significantly higher in the vonoprazan group.When stratified by the underlying disease,a significant increase of the H.pylori eradication rate was observed in patients with chronic gastritis.A significantly lower H.pylori eradication rate was observed in younger patients compared to older patients in the PPI group,but there was no difference according to age in the vonoprazan group.On the otherhand,the success rate of secondary eradication was similar at approximately 90% in both groups.CONCLUSION Vonoprazan is very useful for primary eradication of H.pylori,and may become a first-line acid secretion inhibitor instead of PPIs.Shinya Yamada Takumi Kawakami Yoshikazu Nakatsugawa Takahiro Suzuki Hideki Fujii Naoya Tomatsuri Hideki Nakamura Hideki Sato Yusuke Okuyama Hiroyuki Kimura Norimasa Yoshida 2016World Journal of Gastrointestinal Pharmacology and Therapeutics2016,7,4:8
12Comparison of PPIs and H_2-receptor antagonists plus prokinetics for dysmotility-like dyspepsia显示文摘AIM:To compare efficacy of proton pump inhibitors(PPIs)with H2-receptor antagonists(H2RAs)plus prokinetics(Proks)for dysmotility-like symptoms in functional dyspepsia(FD).METHODS:Subjects were randomized to receive openlabel treatment with either rabeprazole 10 mg od(n= 57)or famotidine 10 mg bid plus mosapride 5 mg tid(n=57)for 4 wk.The primary efficacy endpoint was change(%)from baseline in total dysmotility-like dyspepsia symptom score.The secondary efficacy endpoint was patient satisfaction with treatment.RESULTS:The improvement in dysmotility-like dyspep-sia symptom score on day 28 was significantly greater in the rabeprazole group(22.5%±29.2%of baseline) than the famotidine+mosapride group(53.2%± 58.6%of baseline,P<0.0001).The superior benefit of rabeprazole treatment after 28 d was consistent regardless of Helicobacter pylori status.Significantly more subjects in the rabeprazole group were satisfied or very satisfied with treatment on day 28 than in the famotidine+mosapride group(87.7%vs 59.6%,P= 0.0012).Rabeprazole therapy was the only significant predictor of treatment response(P<0.0001),defined as a total symptom score improvement≥50%.CONCLUSION:PPI monotherapy improves dysmotility-like symptoms significantly better than H2RAs plus Proks,and should be the treatment of first choice for Japanese FD.Masahiro Sakaguchi Miyuki Takao Yasuo Ohyama Hiroshi Oka Hiroshi Yamashita Takumi Fukuchi Kiyoshi Ashida Masahiro Murotani Masuyo Murotani Kazuo Majima Hiroshi Morikawa Takashi Hashimoto Keisuke Kiyota Hirohiko Esaki Kanji Amemoto Gouhei Isowa Fumiyuki Takao 2012World Journal of Gastroenterology2012,18,13:8
13Programmed cell death-1 inhibitor-related sclerosing cholangitis:A systematic review显示文摘BACKGROUND Programmed cell death-1(PD-1)inhibitor has been indicated for many types of malignancies.However,these inhibitors also cause immune-related adverse events.Hepatobiliary disorder is a phenotype of immune-related adverse event affecting 0%–4.5%of patients treated with PD-1 inhibitors.Recent studies have reported PD-1 inhibitor-related sclerosing cholangitis(SC);however,the associated clinical and pathological features are unclear.AIM To evaluate the clinical and pathological features of PD-1 inhibitor-related SC through a systematic review of the literature.METHODS The review,conducted using electronic databases in PubMed,was restricted to the period from January 2014 to September 2019 and focused on case reports/series on PD-1 inhibitor-related SC published in English.We scanned the references of the selected literature to identify any further relevant studies.Six cases previously studied by us,including three that have not yet been published,were included in this review.RESULTS Thirty-one PD-1 inhibitor-related SC cases were evaluated.Median age of patients was 67 years(range,43–89),with a male to female ratio of 21:10.The main disease requiring PD-1 inhibitor treatment was non-small cell lung cancer.Agents that caused PD-1 inhibitor-related SC were nivolumab(19 cases),pembrolizumab(10 cases),avelumab(1 case),and durvalumab(1 case).The median number of cycles until PD-1 inhibitor-related SC onset was 5.5(range,1–27).Abdominal pain or discomfort(35.5%,11/31)was the most frequent symptom.Blood serum tests identified liver dysfunction with a notable increase in biliary tract enzymes relative to hepatic enzymes,and a normal level of serum immunoglobulin G4.Biliary dilation without obstruction(76.9%,20/26),diffuse hypertrophy of the extrahepatic biliary tract(90.5%,19/21),and multiple strictures of the intrahepatic biliary tract(30.4%,7/23)were noted.In 11/23(47.8%)cases,pathological examination indicated that CD8+T cells were the dominant inflammatory cells in the bile duct or peribiliary tract.Although corticosteroids were mainly used for PD inhibitor-related SC treatment,the response rate was 11.5%(3/26).CONCLUSION Some clinical and pathological features of PD-1 inhibitor-related SC were revealed.To establish diagnostic criteria for PD-1 inhibitor-related SC,more cases need to be evaluated.Takumi Onoyama Yohei Takeda Taro Yamashita Wataru Hamamoto Yuri Sakamoto Hiroki Koda Soichiro Kawata Kazuya Matsumoto Hajime Isomoto 2020World Journal of Gastroenterology2020,26,3:7
14Peritoneal bleeding due to percutaneous transhepatic gallbladder drainage:An autopsy report显示文摘A 77-year-old man underwent percutaneous transhepatic gallbladder drainage(PTGBD) for acute cholecystitis as a preoperative procedure;however,he suddenly suffered cardiopulmonary arrest 4 h after the PTGBD and died.There were three centesis scars for the PTGBD,and only one pathway from the most dorsal centesis scar reached the gallbladder.Microscopically,the PTGBD pathway crossed and injured the intrahepatic arterial wall,and hepatic parenchymal bleeding extended along the PTGBD pathway to the inferior surface of the liver.Blood flowed to the peritoneal cavity through a small gap between the liver and gallbladder.Consequently,the PTGBD caused lethal bleeding.When the percutaneous transhepatic cholangio drainage/PTGBD pathway runs close to vessels near the liver surface,it might be necessary to deal with the possibility of rapid and lethal peritoneal bleeding.Yoko Ihama Maki Fukazawa Kenji Ninomiya Takumi Nagai Chiaki Fuke Tetsuji Miyazaki 2012World Journal of Hepatology2012,4,10:7
15Body mass index is associated with age-at-onset of HCV-infected hepatocellular carcinoma patients显示文摘AIM: To identify factors associated with the age at onset of hepatitis C virus (HCV)-related hepatocellular carcinoma (HCC). METHODS: Five hundred and fifty-six consecutive patients positive for HCV antibody and treatment-nafive HCC diagnosed between 1995 and 2004 were analyzed. Patients were classified into three groups according to age at HCC onset: < 60 years (n = 79), 60-79 years (n = 439), or ≥ 80 years (n = 38). Differences among groups in terms of sex, body mass index (BMI), lifestyle characteristics, and liver function were assessed. Factors associated with HCC onset in patients < 60 or ≥ 80 years were analyzed by logistic regression analysis. RESULTS: Significant differences emerged for sex, BMI, degree of smoking and alcohol consumption, mean bilirubin, alanine aminotransferase (ALT), and γ-glutamyl transpeptidase (GGT) levels, prothrombin activity, and platelet counts. The mean BMI values of male patients > 60 years old were lower and mean BMI values of female patients < 60 years old were higher than those of the general Japanese population. BMI > 25 kg/m2 [hazard ratio (HR), 1.8, P = 0.045], excessive alcohol consumption (HR, 2.5, P = 0.024), male sex (HR, 3.6, P = 0.002), and GGT levels > 50 IU/L (HR, 2.4, P = 0.014) were independently associated with HCC onset in patients < 60 years. Low ALT level was the only factor associated with HCC onset in patients aged ≥ 80 years. CONCLUSION: Increased BMI is associated with increased risk for early HCC development in HCV-infected patients. Achieving recommended BMI and reducing alcohol intake could help prevent hepatic carcinogenesis.Takumi Akiyama Toshihiko Mizuta Seiji Kawazoe Yuichiro Eguchi Yasunori Kawaguchi Hirokazu Takahashi Iwata Ozaki Kazuma Fujimoto 2011World Journal of Gastroenterology2011,17,7:6
16Colon perforation due to antigenemia-negative cytomegalovirus gastroenteritis after liver transplantation: A case report and review of literature显示文摘BACKGROUND Cytomegalovirus(CMV) remains a critical complication after solid-organ transplantation. The CMV antigenemia(AG) test is useful for monitoring CMV infection. Although the AG-positivity rate in CMV gastroenteritis is known to be low at onset, almost all cases become positive during the disease course. We treated a patient with transverse colon perforation due to AG-negative CMV gastroenteritis, following a living donor liver transplantation(LDLT).CASE SUMMARY The patient was a 52-year-old woman with decompensated liver cirrhosis as a result of autoimmune hepatitis who underwent a blood-type compatible LDLT with her second son as the donor. On day 20 after surgery, upper and lower gastrointestinal endoscopy(GE) revealed multiple gastric ulcers and transverse colon ulcers. The biopsy tissue immunostaining confirmed a diagnosis of CMV gastroenteritis. On day 28 after surgery, an abdominal computed tomography revealed transverse colon perforation, and simple lavage and drainage were performed along with an urgent ileostomy. Although the repeated remission and aggravation of CMV gastroenteritis and acute cellular rejection made the control of immunosuppression difficult, the upper GE eventually revealed an improvement in the gastric ulcers, and the biopsy samples were negative for CMV. The CMV-AG test remained negative, therefore, we had to evaluate the status of the CMV infection on the basis of the clinical symptoms and GE.CONCLUSION This case report suggests a monitoring method that could be useful for AGnegative CMV gastroenteritis after a solid-organ transplantation.Takahiro Yokose Hideaki Obara Masahiro Shinoda Yutaka Nakano Minoru Kitago Hiroshi Yagi Yuta Abe Yohei Yamada Kentaro Matsubara Go Oshima Shutaro Hori Sho Ibuki Hisanobu Higashi Yuki Masuda Masanori Hayashi Miho Kawaida Takehiko Mori Takumi Fujimura Ken Hoshino Kaori Kameyama Tatsuo Kuroda Yuko Kitagawa 2019World Journal of Gastroenterology2019,25,15:5
17Giant primary angiosarcoma of the small intestine showing severe sepsis显示文摘Primary malignant tumors of the small intestine are rare,comprising less than 2%of all gastrointestinal tumors.An 85-year-old woman was admitted with fever of 40℃ and marked abdominal distension.Her medical history was unremarkable,but blood examination showed elevated inflammatory markers.Abdominal computed tomography showed a giant tumor with central necrosis,extending from the epigastrium to the pelvic cavity.Giant gastrointestinal stromal tumor of the small intestine communicating with the gastrointestinal tract or with superimposed infection was suspected.Because no improvement occurred in response to antibiotics,surgery was performed.Laparotomy revealed giant hemorrhagic tumor adherent to the small intestine and occupying the peritoneal cavity.The giant tumor was a solid tumor weighing 3490 g,measuring24 cm×17.5 cm×18 cm and showing marked necrosis.Histologically,the tumor comprised spindle-shaped cells with anaplastic large nuclei.Immunohistochemical studies showed tumor cells positive for vimentin,CD31,and factorⅧ-related antigen,but negative for c-kit and CD34.Angiosarcoma was diagnosed.Although no postoperative complications occurred,the patient experienced enlargement of multiple metastatic tumors in the abdominal cavity and died 42 d postoperatively.The prognosis of small intestinal angiosarcoma is very poor,even after volume-reducing palliative surgery.Mizuna Takahashi Masanori Ohara Noriko Kimura Hiromitsu Domen Takumi Yamabuki Kazuteru Komuro Takahiro Tsuchikawa Satoshi Hirano Nozomu Iwashiro 2014World Journal of Gastroenterology2014,20,43:5
18Distinct Defects in Spine Formation or Pruning in Two Gene Duplication Mouse Models of Autism显示文摘Autism spectrum disorder(ASD) encompasses a complex set of developmental neurological disorders,characterized by de?cits in social communication and excessive repetitive behaviors. In recent years, ASD is increasingly being considered as a disease of the synapse.One main type of genetic aberration leading to ASD is gene duplication, and several mouse models have been generated mimicking these mutations. Here, we studied the effects of MECP2 duplication and human chromosome15q11-13 duplication on synaptic development and neural circuit wiring in the mouse sensory cortices. We showed that mice carrying MECP2 duplication had speci?c defects in spine pruning, while the 15q11-13 duplication mouse model had impaired spine formation. Our results demonstrate that spine pathology varies signi?cantly between autism models and that distinct aspects of neural circuit development may be targeted in different ASD mutations.Our results further underscore the importance of gene dosage in normal development and function of the brain.Miao Wang Huiping Li Toru Takumi Zilong Qiu Xiu Xu Xiang Yu Wen-Jie Bian 2017Neuroscience Bulletin2017,33,2:5
19Surgical spacer placement and proton radiotherapy for unresectable hepatocellular carcinoma显示文摘Few potentially curative treatment options exist apart from hepatic resection for patients with huge hepatocellular carcinoma (HCC). Proton radiotherapy is a promising new modality which has an inherent antitumor effect against HCC. However, the application of proton radiotherapy for tumors adjacent to the gastrointestinal tract is restricted because the tolerance dose of the intestine is extremely low. A novel two-step treatment was developed with surgical spacer placement and subsequent proton radiotherapy to administer proton radiotherapy with curative intent. This report presents a case of a patient with a huge unresectable HCC treated by this method who achieved disease-free survival of more than 2 years. This new strategy may potentially be an innovative and standard therapy for unresectable HCC in the near future.Shohei Komatsu Yuichi Hori Takumi Fukumoto Masao Murakami Yoshio Hishikawa Yonson Ku 2010World Journal of Gastroenterology2010,16,14:5
20Facile and Scalable Synthesis of a Highly Hydroxylated Water-Soluble Fullerenol as a Single Nanoparticle显示文摘水溶性的 polyhydroxylated fullerene,即 fullerenol 与 44 个氢氧根组和 8 个第二等的界限水分子一起, C60 (哦)Ken Kokubo Shogo Shirakawa Naoki Kobayashi Hisae Aoshima Takumi Oshima 2011Nano Research2011,4,2:5
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