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| 1 | Regional lymphadenectomy for gallbladder cancer: Rational extent, technical details, and patient outcomes显示文摘AIM: To define the rational extent of regional lymphadenectomy for gallbladder cancer and to clarify its effect on long-term survival. METHODS: A total of 152 patients with gallbladder cancer who underwent a minimum of 'extended' portal lymph node dissection (defined as en bloc removal of the first-and second-echelon nodes) from 1982 to 2010 were retrospectively analyzed. Based on previous studies, regional lymph nodes of the gallbladder were divided into first-echelon nodes (cystic duct or pericholedochal nodes), second-echelon nodes (node groups posterosuperior to the head of the pancreas or around the hepatic vessels), and more distant nodes. RESULTS: Among the 152 patients (total of 3352 lymph nodes retrieved, median of 19 per patient), 79 patients (52%) had 356 positive nodes. Among nodepositive patients, the prevalence of nodal metastasis was highest in the pericholedochal (54%) and cystic duct (38%) nodes, followed by the second-echelon node groups (29% to 19%), while more distant node groups were only rarely (5% or less) involved. Disease-specific survival after R0 resection differed according to the nodal status (P < 0.001): most node-negative patients achieved long-term survival (median, not reached; 5-year survival, 80%), whereas among nodepositive patients, 22 survived for more than 5 years (median, 37 mo; 5-year survival, 43%). CONCLUSION: The rational extent of lymphadenectomy for gallbladder cancer should include the first-and second-echelon nodes. A considerable proportion of node-positive patients benefit from such aggressive lymphadenectomy. | Yoshio Shirai Toshifumi Wakai Jun Sakata Katsuyoshi Hatakeyama | 2012 | World Journal of Gastroenterology2012，18，22： | 35 |
| 2 | Catheter tract implantation metastases associated with percutaneous biliary drainage for extrahepatic cholangiocarcinoma显示文摘AIM: To estimate the incidence of catheter tract implantation metastasis among patients undergoing percutaneous transhepatic biliary drainage (PTBD) for extrahepatic cholangiocarcinoma, and to provide data regarding the management of this unusual complication of PTBD by reviewing cases reported in the literature.METHODS: A retrospective analysis of 67 consecutive patients who underwent PTBD before the resection of extrahepatic cholangiocarcinoma was conducted. The median follow-up period after PTBD was 106 mo. The English language literature (PubMed, National Library of Medicine, Bethesda, MD, USA), from January 1966through December 2004, was reviewed.RESULTS: Catheter tract implantation metastasis developed in three patients. The cumulative incidence of implantation metastasis reached a plateau (6%)at 20 mo after PTBD. All of the three patients with implantation metastasis died of tumor progression at 3, 9, and 20 mo after the detection of this complication. Among the 10 reported patients with catheter tract implantation metastasis from extrahepatic cholangiocarcinoma (including our three patients), two survived for more than 5 years after the excision of isolated catheter tract metastases.CONCLUSION: Catheter tract implantation metastasis is not a rare complication following PTBD for extrahepatic cholangiocarcinoma. Although the prognosis for patients with this complication is generally poor, the excision of the catheter tract may enable survival in selected patients with isolated metastases along the catheter tract. | Jun Sakata Yoshio Shirai Toshifumi Wakai Tatsuya Nomura Eiko Sakata Katsuyoshi Hatakeyama | 2005 | World Journal of Gastroenterology2005，11，44： | 31 |
| 3 | Compound Danshen injection improves endotoxin-induced microcirculatory disturbance in rat mesentery显示文摘AIM: To investigate the effect of compound Danshen injection on lipopolysaccharide (LPS)-induced rat mesenteric microcirculatory dysfunctions and the underlying possible mechanism by an inverted intravital microscope and high-speed video camera system. METHODS: LPS was continuously infused through the jugular artery of male Wistar rats at the dose of 2 mg/kg per hour. Changes in mesenteric microcirculation,such as diameters of arterioles and venules,velocity of RBCs in venules,leukocyte rolling,adhesion and emigration,free radicals released from post-capillary venules,FITC- albumin leakage and mast cell degranulation,were observed through an inverted intravital microscope assisted with CCD camera and SIT camera. Meanwhile,the expression of adhesion molecules CD11b/CD18 and the production of free radical in neutrophils,and the expression of intercellular adhesion molecule 1 (ICAM-1) in human umbilical vein endothelial cells (HUVECs) were quantified by flow cytometry (FACS) in vitro. RESULTS: The continuous infusion with LPS resulted in a number of responses in microcirculation,including a significant increase in the positive region of venulestained with Monastral blue B,rolling and adhesion of leukocytes,production of oxygen radical in venular wall,albumin efflux and enhanced mast cell degranulation in vivo,all of which,except for the leukocyte rolling,were attenuated by the treatment with compound Danshen injection. Experiments performed in vitro further revealed that the expression of CD11b/CD18 and the production of oxygen free radical in neutrophils,and the expression of ICAM-1 in HUVECs were increased by exposure to LPS,and they were attenuated by compound Danshen injection. CONCLUSION: These results suggest that compound Danshen injection is an efficient drug with multi-targeting potential for improving the microcirculatory disturbance. | Jing-Yan Han Yoshinori Horie Soichiro Miura, Yasutada Akiba Jun Guo Dan Li Jing-Yu Fan Yu-Ying Liu Bai-He Hu Li-Hua An Xin Chang Man Xu De-An Guo Kai Sun Ji-Ying Yang Shu-Ping Fang Ming-Ji Xian Masahiro Kizaki Hiroshi Nagata Toshifumi Hibi | 2007 | World Journal of Gastroenterology2007，13，26： | 26 |
| 4 | Clinical significance of serum procalcitonin in patients with ulcerative colitis显示文摘AIM:To investigate the association of procalcitonin(PCT)with ulcerative colitis(UC)activity.METHODS:Serum PCT levels,C-reactive protein(CRP)levels,the erythrocyte sedimentation rate,and the white blood cell count were analyzed in 18 patients with UC and 11 healthy volunteers.Serum PCT levels were analyzed by an electrochemiluminescence immunoassay.Severity assessments were based on Truelove and Witts’severity index.Correlation of serum PCT and CRP levels with UC activity was examined.Moreover,we assessed serum PCT and CRP levels in patients with a Mayo endoscopic subscore.RESULTS:Serum PCT levels in severe UC patients(n=7)(0.096±0.034 ng/mL)were significantly higher than in mild-to-moderate UC patients(n=11)(0.033±0.012 ng/mL)and healthy volunteers(n=11)(0.035±0.005 ng/mL)(P=0.0005 and P<0.0001,respectively).In addition,there was no difference in serum PCT levels between mild-to-moderate UC patients and healthy volunteers.Interestingly,patients with a Mayo endoscopic subscore of 3 points displayed significantly increased levels of serum PCT(0.075±0.043 ng/mL)compared with patients with a subscore of 2 points(0.03±0.011 ng/mL)(P=0.0302).Moreover,CRP levels in patients with severe UC or a Mayo endoscopic subscore of 3 points were not significantly higher than in patients with mild-to-moderate UC or a Mayo endoscopic subscore of 3 points.CONCLUSION:Serum PCT levels were significantly correlated with UC activity. | Shigeo Koido Toshifumi Ohkusa Kazuki Takakura Shunichi Odahara Shintaro Tsukinaga Toyokazu Yukawa Jimi Mitobe Mikio Kajihara Kan Uchiyama Hiroshi Arakawa Hisao Tajiri | 2013 | World Journal of Gastroenterology2013，19，45： | 15 |
| 5 | Enhancement patterns of pancreatic adenocarcinoma on conventional dynamic multi-detector row CT:Correlation with angiogenesis and fibrosis显示文摘AIM:To evaluate retrospectively the correlation between enhancement patterns on dynamic computed tomography (CT) and angiogenesis and fibrosis in pancreatic adenocarcinoma.METHODS: Twenty-three patients with pancreatic adenocarcinoma underwent dynamic CT and tumor resection. In addition to the absolute and relative enhanced value that was calculated by subtracting the attenuation value on pre-contrast from those on contrast-enhanced CT in each phase, we defined one parameter, 'tumor-aorta enhancement ratio', which was calculated by dividing enhancement of pancreatic cancer by enhancement of abdominal aorta in each phase. These enhancement patterns were correlated with the level of vascular endothelial growth factor (VEGF), microvessel density (MVD), and extent of fibrosis.RESULTS: The absolute enhanced value in the arterial phase correlated with the level of VEGF and MVD (P=0.047, P=0.001). The relative enhanced value in arterial phase and tumor-aorta enhancement ratio (arterial) correlated with MVD (P=0.003, P=0.022). Tumor-aorta enhancement ratio (arterial) correlated negatively with the extent of fibrosis (P=0.004). The tumors with greater MVD and higher expression of VEGF tended to show high enhancement in the arterial dominant phase. On the other hand, the tumors with a larger amount of fibrosis showed a negative correlation with the grade of enhancement during the arterial phase.CONCLUSION: Enhancement patterns on dynamic CT correlated with angiogenesis and may be modified by the extent of fibrosis. | Yuki Hattori Toshifumi Gabata Osamu Matsui Kentaro Mochizuki Hirohisa Kitagawa Masato Kayahara Tetsuo Ohta Yasuni Nakanuma | 2009 | World Journal of Gastroenterology2009，15，25： | 15 |
| 6 | Herbal cardiotonic pills prevent gut ischemia/reperfusion-induced hepatic microvascular dysfunction in rats fed ethanol chronically显示文摘AIM: Cardiotonic Pill (CP), an oral herbal medicine that includes Danshen (Salviae Miltiorrhizae), Panax notoginseny and Dyroblanops aromatica gaertn, has been clinically used for vascular diseases such as occlusive vasculitis, coronary diseases, atherosclerosis, and cerebral infarction. The main component, SaMae Miltiorrhizae, has been reported to prevent cerebral and intestinal reperfusion injury. However, little is known about the effect of CP on hepatic microcirculation.Thus, this study aimed to determine whether CP could affect hepatic microvascular dysfunction elicited by gut ischemia/reperfusion (I/R) in rats fed ethanol chronically.METHODS: Male Wistar rats were pair-fed with a liquid diet containing ethanol or isocaloric control diet for 6 wk. After laparotomy, one lobe of the liver was examined through an inverted intravital microscope. The rats were exposed to 30 rain of gut ischemia followed by 60 rain of reperfusion.Rhodamine-6G-labeled leukocytes in the sinusoids were observed 90 rain after the onset of superior mesenteric artery ocdusion. Plasma tumor necrosis factor (TNF)-α and endotoxin levels were measured 1 h after the onset of reperfusion.Plasma alanine aminotransferase (ALT) activities were measured 6 h after the onset of reperfusion. In another set of experiments, CP (0.8 g/kg, intragastrically) was administered 1 and 24 h before the onset of ischemia.RESULTS: In control rats, gut I/R elicited increases in the number of stationary leukocytes, and plasma TNF-α and endotoxin levels and plasma ALT activities. These changes were mitigated by pretreatment with CP. In ethanol-fed rats,the gut I/R-induced increases in the number of stationary leukooltes, plasma endotoxin levels and ALT activities were enhanced. Pretreat^nent with CP attenuated the enhancement of gut I/R-induced responses by chronic ethanol consumption.CONCLUSION: These results suggest that CP prevents the gut I/R-induced hepatic microvascular dysfunction and hepatocellular injury. A reduction of inflammatory responses such as TNF-α production via reduction of blood endotoxin levels appears to be involved in the mechanisms. Chronic ethanol consumption enhances gut I/R-induced hepatic microvascular and hepatocellular injury. CP also attenuates an enhancement of gut I/R-induced responses by chronic ethanol consumption via the reduction of blood endotoxin levels. | Yoshinori Horie Shuka Mori Masahiro Konishi Mikio Kajihara Takehiko Kaneko Yoshiyuki Yamagishi Shinzo Kato Hiromasa Ishii Toshifumi Hibi | 2005 | World Journal of Gastroenterology2005，11，4： | 13 |
| 7 | Immunotherapy for colorectal cancer显示文摘The incidence of colorectal cancer(CRC)is on the rise,and the prognosis for patients with recurrent or metastatic disease is extremely poor.Although chemotherapy and radiation therapy can improve survival rates,it is imperative to integrate alternative strategies such as immunotherapy to improve outcomes for patients with advanced CRC.In this review,we will discuss the effect of immunotherapy for inducing cytotoxic T lymphocytes and the major immunotherapeutic approaches for CRC that are currently in clinical trials,including peptide vaccines,dendritic cell-based cancer vaccines,whole tumor cell vaccines,viral vector-based cancer vaccines,adoptive cell transfer therapy,antibody-based cancer immunotherapy,and cytokine therapy.The possibility of combination therapies will also be discussed along with the challenges presented by tumor escape mechanisms. | Shigeo Koido Toshifumi Ohkusa Sadamu Homma Yoshihisa Namiki Kazuki Takakura Keisuke Saito Zensho Ito Hiroko Kobayashi Mikio Kajihara Kan Uchiyama Seiji Arihiro Hiroshi Arakawa Masato Okamoto Jianlin Gong Hisao Tajiri | 2013 | World Journal of Gastroenterology2013，19，46： | 11 |
| 8 | 'Extended' radical cholecystectomy for gallbladder cancer:Long-term outcomes, indications and limitations显示文摘AIM:To delineate indications and limitations for 'ex tended' radical cholecystectomy for gallbladder cancer:a procedure which was instituted in our department in 1982. METHODS:Of 145 patients who underwent a radi cal resection for gallbladder cancer from 1982 through 2006, 52 (36%) had an extended radical cholecystec tomy, which involved en bloc resection of the gallblad der, gallbladder fossa, extrahepatic bile duct, and the regional lymph nodes (first-and second-echelon node groups). A retrospective analysis of the 52 patients was conducted including at least 5 years of follow up. Residual tumor status was judged as no residual tumor (R0) or microscopic/macroscopic residual tumor (R1 2). athological findings were documented according tothe American Joint Committee on Cancer Cancer Stag ing anual (7th edition). RESULTS:he primary t mor as classified as patho-logical T1 (pT1) in 3 patients, pT2 in 36, pT3 in 12, and pT4 in 1. Twenty three patients had lymph node metastases; 11 had a single positive node, 4 had two positive nodes, and 8 had three or more positive nodes. None of the three patients with pT1 tumors had nodal disease, whereas 23 of 49 (47%) with pT2 or more advanced tumors had nodal disease. One patient died during the hospital stay for definitive resection, giv ing an in hospital mortality rate of 2%. Overall survival (OS) after extended radical cholecystectomy was 65% at 5 years and 53% at 10 years in all 52 patients. OS differed according to the p classification ( < 0.001) and the nodal status ( = 0.010). All of 3 patients with pT1 tumors and most (29 of 36) patients with pT2 tu mors survived for more than 5 years. Of 12 patients with pT3 tumors, 8 who had an R1 2 resection, distant metastasis, or extensive extrahepatic organ involve ment died soon after resection. Of the remaining four pT3 patients who had localized hepatic spread through the gallbladder fossa and underwent an R0 resection, 2 survived for more than 5 years and another survived for 4 years and 2 mo. The only patient with pT4 tumor died of disease soon after resection. Among 23 node positive patients, 11 survived for more than 5 years, and of these, 10 had a modest degree of nodal disease (one or two positive nodes). CONCLUSION:Extended radical cholecystectomy is indicated for pT2 tumors and some pT3 tumors with localized hepatic invasion, provided that the regional nodal disease is limited to a modest degree (up to two positive nodes). Extensive pT3 disease, pT4 disease, or marked nodal disease appears to be beyond the scope of this radical procedure. | Yoshio Shirai Jun Sakata Toshifumi Wakai Taku Ohashi Katsuyoshi Hatakeyama | 2012 | World Journal of Gastroenterology2012，18，34： | 11 |
| 9 | Genetic changes of p53,K-ras,and microsatellite instability in gallbladder carcinoma in high-incidence areas of Japan and Hungary显示文摘AIM: To disclose geographic differences in genetic changes involved in gallbladder carcinogenesis between two distinct high-incidence areas of Japan and Hungary.METHODS: We examined 42 cases of gallbladder carcinoma: 22 Japanese and 20 Hungarian cases. p53 mutations at exons 5 to 8 and K-ras mutations at codon 12 were tested by direct sequencing. Microsatellite instability was determined from fluorescent dye-labeled PCR amplifications of five-microsatellite markers (BAT-25, BAT-26, D2S123, D5S346, and D17S250).RESULTS: Mutations of p53 were detected in 11 of 22 Japanese cases and 6 of 18 Hungarian cases (11/22 vs 6/18, P = 0.348). Transition at CpG sites was found in none of 11 Japanese cases and 2 of 6 Hungarian cases; the difference was marginally significant (0/11 vs 2/6, P = 0.110). K-ras mutations were detected in only one of the Hungarian cases. Eight of 19 (42.1%) Japanese cases were MSI-high (presence of novel peaks in more than one of the five loci analyzed), whereas only 1 of 15 (6.7%) Hungarian cases was MSI-high (P = 0.047).CONCLUSION: It appears that the p53 mutations and MSI differ in patients with gallbladder carcinoma between two distinct high-incidence areas. Geographic variation might exist in the process of gallbladder carcinogenesis. | Masayuki Nagahashi Yoichi Ajioka Istvan Lang Zoltan Szentirmay Miklos Kasler Hiroto Nakadaira Naoyuki Yokoyama Gen Watanabe Ken Nishikura Toshifumi Wakai Yoshio Shirai Katsuyoshi Hatakeyama Masaharu Yamamoto | 2008 | World Journal of Gastroenterology2008，14，1： | 9 |
| 10 | Colorectal endoscopic submucosal dissection: Recent technical advances for safe and successful procedures显示文摘Endoscopic submucosal dissection(ESD) is very useful in en bloc resection of large superficial colorectal tumors but is a technically difficult procedure because the colonic wall is thin and endoscopic maneuverability is poor because of colonic flexure and extensibility. A high risk of perforation has been reported in colorectal ESD. To prevent complications such as perforation and unexpected bleeding, it is crucial to ensure good visualization of the submucosal layer by creating a mucosal flap, which is an exfoliated mucosa for inserting the tip of the endoscope under it. The creation of a mucosal flap is often technically difficult; however, various types of equipment, appropriate strategy, and novel procedures including our clip-flap method, appear to facilitate mucosal flap creation, improving the safety and success rate of ESD. Favorable treatment outcomes with colorectal ESD have already been reported in many advanced institutions, and appropriate understanding of techniques and development of training systems are required for world-wide standardization of colorectal ESD. Here, we describe recent technical advances for safe and successful colorectal ESD. | Katsumi Yamamoto Tomoki Michida Tsutomu Nishida Shiro Hayashi Masafumi Naito Toshifumi Ito | 2015 | World Journal of Gastrointestinal Endoscopy2015，7，14： | 9 |
| 11 | Prognostic significance of perioperative tumor marker levels in stage Ⅱ/Ⅲ gastric cancer显示文摘AIM To evaluate the prognostic significance of perioperative carcinoembryonic antigen(CEA) and carbohydrate antigen 19-9(CA19-9) levels in stage Ⅱ/Ⅲ gastric cancer.METHODS From a multi-institutional retrospective database compiled by integrating clinical data from nine institutions, data of 998 patients who underwent curative resection for stage Ⅱ/Ⅲ gastric cancer between 2010 and 2014 were retrieved and analyzed. The prognostic impact of the preoperative and postoperative levels and chronological changes in CEA, CA19-9 and their combination were evaluated. To test whether postoperative adjuvant chemotherapy alters the prognostic impact of perioperative CEA and CA19-9 levels, the hazard ratios for mortality were compared between patients who underwent surgery alone and patients who underwent surgery followed by adjuvant chemotherapy.RESULTS The prognostic impact of postoperative CEA and CA19-9 was superior to that of the preoperative levels. Multivariable analysis identified high postoperative CEA and CA19-9 levels as independent prognostic factors for overall survival.Disease-free survival rates clearly decreased in a stepwise manner in association with postoperative CEA and CA19-9 levels, and patients with high levels of both markers showed significantly poorer prognosis than other patient groups. When we analyzed perioperative changes in serum CEA and CA19-9 levels, patients with high levels before and after surgery had the worst disease-free survival rates among all patient groups. Patients with normalized CEA levels after surgery had a significantly lower disease-free survival rate than those with normal perioperative levels, whereas patients with normalized CA19-9 levels after surgery had equivalent survival to those with normal perioperative levels. The prognostic impact of high CEA levels was observably smaller in patients who underwent adjuvant chemotherapy than in patients who underwent surgery alone, whereas that of high CA19-9 was greater in patients who underwent adjuvant chemotherapy. High postoperative CEA levels were significantly associated with an increased prevalence of liver, lung and bone recurrences, and high postoperative CA19-9 levels were significantly associated with increased frequencies of lymph node and liver recurrences.CONCLUSION The evaluation of serum CEA and CA 19-9 levels both before and after surgery provides useful information for precise risk stratification after curative gastrectomy. | Yasuhito Suenaga Mitsuro Kanda Seiji Ito Yoshinari Mochizuki Hitoshi Teramoto Kiyoshi Ishigure Toshifumi Murai Takahiro Asada Akiharu Ishiyama Hidenobu Matsushita Chie Tanaka Daisuke Kobayashi Michitaka Fujiwara Kenta Murotani Yasuhiro Kodera | 2019 | World Journal of Gastrointestinal Oncology2019，11，1： | 7 |
| 12 | 胆道肿瘤临床实践指南(英文第三版)显示文摘日本肝胆胰外科学会(JSHBPS)于2007年出版第一版胆道肿瘤(胆管癌、胆囊癌及壶腹癌)临床实践指南,于2014年更新第二版,2021年英文第三版胆道肿瘤临床实践指南围绕6个主题提出若干临床问题,基于相关循证医学证据并组织专家讨论后,最终确定推荐意见、推荐强度以及推荐说明。根据证据推荐分级的评估、制订与评价(GRADE)系统,推荐强度被分为1级(强)或者2级(弱)。英文第三版胆道肿瘤临床实践指南中提出的31个临床问题涵盖:(1)预防性治疗;(2)诊断;(3)胆道引流;(4)外科治疗;(5)化疗;(6)放疗。31个临床问题中,14个问题给予推荐强度为强的推荐意见,14个问题给予推荐强度为弱的推荐意见,剩余的3个问题未给予推荐意见。每条推荐意见都进行推荐强度说明。最新版指南基于循证医学证据,为临床提供了重要建议。未来与癌症登记数据库协作将是评估指南和建立新证据的关键。 | Masato Nagino Satoshi Hirano Hideyuki Yoshitomi Taku Aoki Katsuhiko Uesaka Michiaki Unno Tomoki Ebata Masaru Konishi Keiji Sano Kazuaki Shimada Hiroaki Shimizu Ryota Higuchi Toshifumi Wakai Hiroyuki Isayama Takuji Okusaka Toshio Tsuyuguchi Yoshiki Hirooka Junji Furuse Hiroyuki Maguchi Kojiro Suzuki Hideya Yamazaki Hiroshi Kijima Akio Yanagisawa Masahiro Yoshida Yukihiro Yokoyama Takashi Mizuno Itaru Endo 杨翼飞(译) 仇毓东(译) 赵梦珂(译) 伏旭(译) 蔡正华(译) 毛凉(审校) | 2021 | 中华消化外科杂志2021，20，4： | 7 |
| 13 | Low preoperative platelet counts predict a high mortality after partial hepatectomy in patients with hepatocellular carcinoma显示文摘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, KICG≥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 three percentages were comparable (P = 0.876). The platelet count of ≤ 10x 104/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 >7.3x 104/μL died of postoperative morbidity, whereas 25% (6/24 patients) of patients with a platelet count of ≤7.3x 104/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. | Kazuhiro Kaneko Yoshio Shirai Toshifumi Wakai Naoyuki Yokoyama Kohei Akazawa Katsuyoshi Hatakeyama | 2005 | World Journal of Gastroenterology2005，11，37： | 7 |
| 14 | Hydrodynamic performance of spouted beds with different types of draft tubes显示文摘Hydrodynamic performance of spouted beds with four different types of draft tubes has been investigated experimentally.In this work,irregular and angular particles were used as the spouting solids and the results were compared with those of the previous work in which regular and round particles had been used.It was found that the conical-cylindrical porous draft tube was the best option for solid-gas contact and solids circulation as in the case of round particles.Moreover,by using conical-cylindrical porous draft tube,the gas flow rate through the annulus reached 65-70%,equal to the level of a conventional spouted bed. | Hiroshi Nagashima Kazumi Suzukawa Toshifumi Ishikura | 2013 | Particuology2013，11，5： | 6 |
| 15 | Subcutaneous Golimumab Induces Clinical Response and Remission in Patients with Moderate-To-Severe Ulcerative Colitis显示文摘 | William J. Sandborn Brian G. Feagan Colleen Marano Hongyan Zhang Richard Strauss Jewel Johanns Omoniyi J. Adedokun Cynthia Guzzo Jean-Frederic Colombel Walter Reinisch Peter R. Gibson Judith Collins Gunnar J?rnerot Toshifumi Hibi Paul Rutgeerts | 2013 | Gastroenterology2013，，： | 6 |
| 16 | Factors associated with incomplete colonoscopy at a Japanese academic hospital显示文摘AIM:To evaluate significant risk factors for incomplete colonoscopy at a Japanese academic hospital.METHODS:A total of 11812 consecutive Japanese people were identified who underwent a colonoscopy at an academic hospital.A multiple logistic regression model was used to evaluate retrospectively the significant risk factors for incomplete colonoscopy.RESULTS:The cecal intubation rate was 95.0%.By univariate analysis,age,female sex,poor bowel cleansing,and a history of abdominal or pelvic surgery were significant risk factors for incomplete colonoscopy(P<0.001).Moreover,age-and sex-adjusted analysis showed that significant risk factors for incomplete colonoscopy were female sex(OR=1.38,95%CI:1.17-1.64,P=0.0002),age≥60 years old(OR=1.44,95%CI:1.22-1.71,P<0.0001),a history of prior abdominal or pelvic surgery(OR=1.55,95%CI:1.28-1.86,P<0.0001),poor bowel cleansing(OR=4.64,95%CI:3.69-5.84,P<0.0001),and inflammatory bowel disease(IBD)(OR=1.48,95%CI:1.13-1.95,P=0.0048).In Japanese men,by age-adjusted analysis,IBD(OR=1.69,95%CI:1.18-2.43,P=0.005)was an independent risk factor for incomplete colonoscopy.CONCLUSION:Several characteristics in the Japanese population were identified that could predict technical difficulty with colonoscopy. | Shigeo Koido Toshifumi Ohkusa Kosaburo Nakae Tetsuji Yokoyama Tomoyoshi Shibuya Naoto Sakamoto Kan Uchiyama Hiroshi Arakawa Taro Osada Akihito Nagahara Sumio Watanabe Hisao Tajiri | 2014 | World Journal of Gastroenterology2014，20，22： | 6 |
| 17 | Groundwater monitoring of an open-pit limestone quarry:Water-rock interaction and mixing estimation within the rock layers by geochemical and statistical analyses显示文摘Water-rock interaction and groundwater mixing are important phenomena in understanding hydrogeological systems and the stability of rock slopes especially those consisting largely of moderately watersoluble minerals like calcite. In this study, the hydrogeological and geochemical evolutions of groundwater in a limestone quarry composed of three strata: limestone layer(covering), interbedded layer under the covering layer, and slaty greenstone layer(basement) were investigated. Water-rock interaction in the open-pit limestone quarry was evaluated using PHREEQC, while hierarchical cluster analysis(HCA)and principal component analysis(PCA) were used to classify and identify water sources responsible for possible groundwater mixing within rock layers. In addition, Geochemist's Workbench was applied to estimate the mixing fractions to clarify sensitive zones that may affect rock slope stability. The results showed that the changes in Ca2+and HCO3àconcentrations of several groundwater samples along the interbedded layer could be attributed to mixing groundwater from the limestone layer and that from slaty greenstone layer. Based on the HCA and PCA results, groundwaters were classified into several types depending on their origin:(1) groundwater from the limestone layer(LO),(2) mixed groundwater flowing along the interbedded layer(e.g., groundwater samples L-7, L-11, S-3 and S-4), and(3) groundwater originating from the slaty greenstone layer(SO). The mixing fractions of 41% LO: 59% SO, 64% LO: 36% SO, 43%LO: 57% SOand 25% LO: 75% SOon the normal days corresponded to groundwaters L-7, L-11, S-3 and S-4,respectively, while the mixing fractions of groundwaters L-7 and L-11(61% LO: 39% SOand 93% LO: 7% SO,respectively) on rainy days became the majority of groundwater originating from the limestone layer.These indicate that groundwater along the interbedded layer significantly affected the stability of rock slopes by enlarging multi-breaking zones in the layer through calcite dissolution and inducing high water pressure, tension cracks and potential sliding plane along this layer particularly during intense rainfall episodes. | Khy Eam Eang Toshifumi Igarashi Megumi Kondo Tsurugi Nakatani Carlito Baltazar Tabelin Ryota Fujinaga | 2018 | International Journal of Mining Science and Technology2018，28，6： | 6 |
| 18 | Association between endotoxemia and histological features of nonalcoholic fatty liver disease显示文摘AIM To assess whether surrogate biomarkers of endotoxemia were correlated with the histological features ofnonalcoholic fatty liver disease(NAFLD).METHODS One hundred twenty-six NAFLD patients who had undergone percutaneous liver biopsy were enrolled. Serum lipopolysaccharide(LPS)-binding protein(LBP) and anti-endotoxin core immunoglobulin G(Endo Cab Ig G) antibody concentrations at the time of liver biopsy were measured using the enzyme-linked immunosorbent assays to examine for relationships between biomarker levels and histological scores. RESULTS Serum LBP concentration was significantly increased in nonalcoholic steatohepatitis(NASH) patients as compared with nonalcoholic fatty liver(NAFL) subjects and was correlated with steatosis(r = 0.38, P < 0.0001) and ballooning scores(r = 0.23, P = 0.01), but not with the severity of lobular inflammation or fibrosis. Multivariate linear regression analysis revealed that LBP was associated with steatosis score and circulating C-reactive protein, aspartate aminotransferase, and fibrinogen levels. Serum Endo Cab Ig G concentration was comparable between NASH and NAFL patients. No meaningful correlations were detected between Endo Cab Ig G and histological findings. CONCLUSION LBP/Endo Cab Ig G were not correlated with lobular inflammation or fibrosis. More accurate LPS biomarkers are required to stringently assess the contribution of endotoxemia to conventional NASH. | Hiroyuki Kitabatake Naoki Tanaka Naoyuki Fujimori Michiharu Komatsu Ayaka Okubo Kyogo Kakegawa Takefumi Kimura Ayumi Sugiura Tomoo Yamazaki Soichiro Shibata Yuki Ichikawa Satoru Joshita Takeji Umemura Akihiro Matsumoto Masayoshi Koinuma Kenji Sano Toshifumi Aoyama Eiji Tanaka | 2017 | World Journal of Gastroenterology2017，23，4： | 5 |
| 19 | Image analysis of soil failure on defective underground pipe due to cyclic water supply and drainage using X-ray CT显示文摘The ground subsidence on the underground pipe often is caused with the reduction of the effective stress and the loss of suction in the base course and then,soil drainage into the pipe.The final formation of the cavity growth in the ground was observed as the ground subsidence.Authors focused this problem and hence performed model tests with water-inflow and drainage cycle in the model ground.The mechanism of cavity generation in the model ground was observed using an X-ray Computed Tomography(CT)scanner.In those studies,water was supplied into the model grounds from the defected underground pipe model in case of the change of relative density and grain size distribution.As results,it was observed that the loosening area was generated from the defected part with water-inflow and some of the soil particles in the ground were drained into the underground pipe through the defected part.And afterward,the cavity was generated just above the defected part of the model pipe in the ground.Based on this observation,it might be said that the bulk density of soil around the defected pipe played one of key factor to generate the cavity in the ground.Moreover,the dimension of the defected part should be related to the magnification of the ground subsidence,in particular,crack width on a sewerage pipe and particle size would be the quantitative factor to evaluate the magnification of the ground subsidence.In this paper,it was concluded that the low relative density of soil would become the critical factor to cause the fatal failure of model ground if the maximum grain size was close to the dimension of crack width of defective part.The fatal collapse of the ground with high relative density more than 80%would be avoided in a few cycles of water inflow and soil drainage. | Toshifumi MUKUNOKI Naoko KUMANO Jun OTANI | 2012 | Frontiers of Structural and Civil Engineering2012，6，2： | 5 |
| 20 | Narrow portion of the terminal choledochus is a cause of upstream biliary dilatation in patients with anomalous union of the pancreatic and biliary ducts显示文摘AIM: To clarify the pathogenesis of biliary dilatation associated with anomalous union of the pancreatic and biliary ducts (AUPBD).METHODS: Direct cholangiopancreatograms of 350 adult patients with or with suspicion of hepatobiliary or pancreatic disorders were reviewed. AUPBD was diagnosed cholangiopancreatographically, when the pancreaticobiliary ductal union was located above the narrow distal segment of the bile duct, which represents the action of the sphincter of Oddi. The narrow portion of the terminal choledochus was defined as symmetrical stricture of the common bile duct just above the pancreaticobiliary ductal union.RESULTS: AUPBD was found in 36 patients. Among cholangiopancreatographic features, the narrow portion of the terminal choledochus was the most pathognomonic for AUPBD (accuracy, 98%); it was present in 29 (81%)patients with AUPBD, but was not found in any patients without AUPBD. Among patients with AUPBD, biliary dilatation (>10 mm) was more frequent in those with the narrow portion of the terminal choledochus (23/29)than in those without (2/7; P = 0.018) AUPBD. Among the patients with both AUPBD and the narrow portion of the terminal choledochus, there was a strong negative correlation between the minimum diameter of the narrow portion and the maximum diameter of the choledochus (r = -0.78, P<0.001), suggesting that the degree of biliary narrowing at the narrow portion correlates with that of upstream biliary dilatation.CONCLUSION: The narrow portion of the terminal choledochus, a pathognomonic radiologic feature of AUPBD, may be a cause of biliary dilatation in patients with AUPBD. | Tatsuya Nomura Yoshio Shirai Toshifumi Wakai Naoyuki Yokoyama Jun Sakata Katsuyoshi Hatakeyama | 2005 | World Journal of Gastroenterology2005，11，41： | 5 |
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