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941.
942.
943.
Shigetomi Nakao Bunzo Nakata Masashige Tendo Kenji Kuroda Takeshi Hori Mayumi Inaba Kosei Hirakawa Tetsuro Ishikawa 《BMC surgery》2015,15(1)
Background
Patient with α-Fetoprotein (AFP)-producing gastric cancer usually has a short survival time due to frequent hepatic and lymph node metastases. Gastric cancer with portal vein tumor thrombus (PVTT) is rare and has an extremely poor prognosis.Case presentation
A 63-year-old man was found to have a huge Type 3 gastric cancer with a PVTT and a highly elevated serum AFP level. Chemotherapy with S-1 plus cisplatin was given to this patient with unresectable gastric cancer for 4 months. The serum AFP level decreased from 6,160 ng/mL to 60.7 ng/mL with chemotherapy. Since the PVTT disappeared after the chemotherapy, the patient underwent total gastrectomy. Histological findings of the primary tumor after chemotherapy showed poorly differentiated adenocarcinoma without hepatoid cells and viable tumor cells remaining in less than 1/3 of the neoplastic area of mucosa and one lymph node. The cancerous cells were immunohistochemically stained by anti-AFP antibody. The patient has survived for 48 month without recurrence.Conclusions
AFP-producing gastric cancer with a PVTT has an extremely poor prognosis, but long-term survival was achieved for this dismal condition by salvage surgery after chemotherapy. 相似文献944.
Katsutoshi Tokushige Kenichi Ikejima Masafumi Ono Yuichiro Eguchi Yoshihiro Kamada Yoshito Itoh Norio Akuta Masato Yoneda Motoh Iwasa Masashi Yoneda Motoyuki Otsuka Nobuharu Tamaki Tomomi Kogiso Hiroto Miwa Kazuaki Chayama Nobuyuki Enomoto Tooru Shimosegawa Tetsuo Takehara Kazuhiko Koike 《Hepatology research》2021,51(10):1013-1025
Nonalcoholic fatty liver disease (NAFLD) has become a serious public health issue not only in Western countries but also in Japan. Within the wide spectrum of NAFLD, nonalcoholic steatohepatitis (NASH) is a progressive form of disease that often develops into liver cirrhosis and increases the risk of hepatocellular carcinoma (HCC). While a definite diagnosis of NASH requires liver biopsy to confirm the presence of hepatocyte ballooning, hepatic fibrosis is the most important prognostic factor in NAFLD. With so many NAFLD patients, it is essential to have an effective screening method for NAFLD with hepatic fibrosis. As HCC with non-viral liver disease has increased markedly in Japan, effective screening and surveillance of HCC are also urgently needed. The most common death etiology in NAFLD patients is cardiovascular disease event. Gastroenterologists must, therefore, pay close attention to CVD when examining NAFLD patients. In the updated guidelines, we propose screening and follow-up methods for hepatic fibrosis, HCC, and CVD in NAFLD patients. Several drug trials are ongoing for NAFLD/NASH therapy, however, there is currently no specific drug therapy for NAFLD/NASH. In addition to vitamin E and thiazolidinedione derivatives, recent trials have focused on sodium glucose co-transporter 2 (SGLT2) inhibitors and glucagon-like peptide-1 (GLP-1) analogues, and effective therapies are expected to be developed. These practical guidelines for NAFLD/NASH were established by the Japanese Society of Gastroenterology in conjunction with the Japan Society of Hepatology. Clinical evidence reported internationally between 1983 and October 2018 was collected, and each clinical and background question was evaluated using the Grades of Recommendation Assessment, Development and Evaluation (GRADE) system. This English summary pro- vides the core essentials of these clinical practice guidelines, which include the definition and concept, screening systems for hepatic fibrosis, HCC and CVD, and current therapies for NAFLD/NASH in Japan. 相似文献
945.
Sekihara Takayuki Miyazaki Shinsuke Aoyama Daisetsu Nagao Moeko Tsuji Toshihiko Kakehashi Shota Mukai Moe Eguchi Tomoya Hasegawa Kanae Uzui Hiroyasu Tada Hiroshi 《Journal of interventional cardiac electrophysiology》2022,65(1):123-131
Journal of Interventional Cardiac Electrophysiology - An acute cryothermal ablation lesion contains both reversible and irreversible elements. However, differences in lesions created with... 相似文献
946.
Takeshi Matsui Susumu Hamada-Tsutsumi Yutaka Naito Masanori Nojima Etsuko Iio Akihiro Tamori Shoji Kubo Tatsuya Ide Yasuteru Kondo Yuichiro Eguchi Atsumasa Komori Yuji Morine Mitsuo Shimada Tohru Utsunomiya Ken Shirabe Koichi Kimura Yoichi Hiasa Natthaya Chuaypen Pisit Tangkijvanich Aya Naiki-Ito Satoru Takahashi Takahiro Ochiya Yasuhito Tanaka 《Hepatology research》2022,52(1):93-104
947.
Takuro Arishima Takashi Ito Tomotsugu Yasuda Nozomi Yashima Hiroaki Furubeppu Chinatsu Kamikokuryo Takahiro Futatsuki Yutaro Madokoro Shotaro Miyamoto Tomohiro Eguchi Hiroyuki Haraura Ikuro Maruyama Yasuyuki Kakihana 《Thrombosis journal》2018,16(1):24
Background
Recombinant human soluble thrombomodulin (rTM) has been used for the treatment of disseminated intravascular coagulation in Japan, and an international phase III clinical trial for rTM is currently in progress. rTM mainly exerts its anticoagulant effects through an activated protein C (APC)-dependent mechanism, but the circulating APC levels after rTM treatment have not been clarified. This prospective observational study investigated plasma APC levels after rTM treatment.Methods
Plasma levels of soluble thrombomodulin, thrombin-antithrombin complex (TAT), protein C, and APC were measured in eight septic patients treated with rTM. APC generation in vitro was assessed in the presence or absence of rTM.Results
rTM significantly increased thrombin-mediated APC generation in vitro. In septic patients, soluble thrombomodulin levels were significantly increased during a 30–60-min period of rTM treatment and TAT levels were decreased. However, APC activity was not increased during the treatment period.Conclusions
Plasma APC activity is not increased in septic patients treated with rTM. It is possible that APC acts locally and does not circulate systemically.948.
Daisuke Todokoro Kiyofumi Mochizuki Takashi Nishida Hiroshi Eguchi Tatsuro Miyamoto Takaaki Hattori Takashi Suzuki Tomoyuki Inoue Ryohei Nejima Saichi Hoshi Hideo Akiyama 《Journal of infection and chemotherapy》2018,24(6):458-462
Endogenous bacterial endophthalmitis, also called metastatic endophthalmitis, is a rare bacterial endophthalmitis derived from distant infectious foci via the bloodstream. This infection can potentially cause not only severe visual disturbance, but also loss of the eyeball or death, as most patients are immunocompromised. This retrospective Japanese multicenter study analyzed 32 eyes in 25 definitive cases. Twelve patients (48.0%) had diabetes mellitus. Typical ocular findings were vitreous haze (87.5%), cells in the anterior chambers (62.5%) and retinal infiltrates (50.0%). Elevated body temperature (64.0%), high serum C-reactive protein (96.0%) and leukocytosis (52.0%) were also frequently observed. Culture positivity rates for intraocular fluid were higher in the vitreous (62.5%) versus aqueous humor (28.6%). High positivity rates were also observed for blood (57.1%) and central venous catheters (100%). The most common pathogen was Staphylococcus aureus (10 cases), including methicillin-resistant S. aureus (4 cases). The next most common pathogen was Klebsiella pneumoniae (7 cases), which was highly associated with liver abscess. Compared to a previous 1991 national multicenter study, there has been a fourfold increase in the ratio of S. aureus. Antibiotic susceptibility tests revealed that all Gram-positives were susceptible to vancomycin and all Gram-negatives were susceptible to third-generation cephalosporins, imipenem/cilastatin, gentamycin and levofloxacin. Prognostic factors influencing poor visual outcome included poor initial visual acuity (p < 0.01), K. pneumoniae (p = 0.027) and gram-negative bacteria (p = 0.014) as the causative bacteria. Intravitreal antibiotic injection in combination with vancomycin and ceftazidime may be applicable for use as part of the standard treatment regimen for EBE. 相似文献
949.
950.