Acute lower gastrointestinal bleeding(LGIB) is a common indication for hospital admission. Patients with LGIB often experience persistent or recurrent bleeding and require blood transfusions and interventions, such as...Acute lower gastrointestinal bleeding(LGIB) is a common indication for hospital admission. Patients with LGIB often experience persistent or recurrent bleeding and require blood transfusions and interventions, such as colonoscopic,radiological, and surgical treatments. Appropriate decision-making is needed to initially manage acute LGIB, including emergency hospitalization, timing of colonoscopy, and medication use. In this literature review, we summarize the evidence for initial management of acute LGIB. Assessing various clinical factors,including comorbidities, medication use, presenting symptoms, vital signs, and laboratory data is useful for risk stratification of severe LGIB, and for discriminating upper gastrointestinal bleeding. Early timing of colonoscopy had the possibility of improving identification of the bleeding source, and the rate of endoscopic intervention, compared with elective colonoscopy. Contrast-enhanced computed tomography before colonoscopy may help identify stigmata of recent hemorrhage on colonoscopy, particularly in patients who can be examined immediately after the last hematochezia. How to deal with nonsteroidal antiinflammatory drugs(NSAIDs) and antithrombotic agents after hemostasis should be carefully considered because of the risk of rebleeding and thromboembolic events. In general, aspirin as primary prophylaxis for cardiovascular events and NSAIDs were suggested to be discontinued after LGIB. Managing acute LGIB based on this information would improve clinical outcomes. Further investigations are needed to distinguish patients with LGIB who require early colonoscopy and hemostatic intervention.展开更多
AIM： To determine the efficacy of external beam radiotherapy （EBRT）, with or without intraluminal brachytherapy （ILBT）, in patients with non-resected locally advanced hilar cholangiocarcinoma.METHODS： We analyze...AIM： To determine the efficacy of external beam radiotherapy （EBRT）, with or without intraluminal brachytherapy （ILBT）, in patients with non-resected locally advanced hilar cholangiocarcinoma.METHODS： We analyzed 64 patients with locally advanced hilar cholangiocarcinoma, including 25 who underwent resection （17 curative and 8 non-curative）, 28 treated with radiotherapy, and 11 who received best supportive care （BSC）. The radiotherapy group received EBRT （50 Gy, 30 fractions）, with 11 receiving an ad- ditional 24 Gy （4 fractions） ILBT by iridium-192 with remote after loading. ILBT was performed using percu-taneous transhepatic biliary drainage （PTBD） route. Uncovered metallic stents （UMS） were inserted into nonresected patients with obstructive jaundice, with the exception of four patients who received percutaneous transhepatic biliary drainage only. UMS were placed endoscopically or percutaneously, depending on the initial drainage procedure. The primary endpoints were patient death or stent occlusion. Survival time of patients in the radiotherapy group was compared with that of patients in the resection and BSC groups. Stent patency was compared in the radiotherapy and BSC groups.RESULTS： No statistically significant differences in patient characteristics were found among the resection, radiotherapy, and BSC groups. Three patients in the radiotherapy group and one in the BSC group did not receive UMS insertion but received PTBD alone; cholangitis occurred after endoscopic stenting, and patients were treated with PTBD. A total of 16 patients were administered additional systemic chemotherapy （5-fluorouracil-based regimen in 9, S-1 in 6, and gemcitabine in 1）. Overall survival varied significantly among groups, with median survival times of 48.7 mo in the surgery group, 22.1 mo in the radiotherapy group, and 5.7 mo in the BSC group. Patients who underwent curative resection survived significantly longer than those who were not candidates for surgery （P = 0.0076）. Cumu展开更多
Neoadjuvant chemotherapy followed by surgery （NCS） has not been fully evaluated clinically. Currently, the main regimen of neoadjuvant chemotherapy （NAC） used in NCS includes cisplatin. The antitumor effects of NA...Neoadjuvant chemotherapy followed by surgery （NCS） has not been fully evaluated clinically. Currently, the main regimen of neoadjuvant chemotherapy （NAC） used in NCS includes cisplatin. The antitumor effects of NAC reduce lymph node metastasis and the tumor diameter in patients prior to surgery, and this can reduce the number of high risk patients who require postoperative radiation therapy. Many randomized controlled trials （RCTs） have examined the long-term prognosis of NCS compared to primary surgery, but the utility of NCS remains uncertain. The advent of concurrent chemoradiotherapy （CCRT） has markedly improved the outcome of radiotherapy （RT）, and CCRT is now used as a standard method in many cases of advanced bulky cervical cancer. NCS gives a better treatment outcome than radiation therapy alone, but it is important to verify that NCS gives a similar or better outcome compared to CCRT.展开更多
Thirty years have passed since the first report of portal vein embolization(PVE),and this procedure is widely adopted as a preoperative treatment procedure for patients with a small future liver remnant(FLR).PVE has b...Thirty years have passed since the first report of portal vein embolization(PVE),and this procedure is widely adopted as a preoperative treatment procedure for patients with a small future liver remnant(FLR).PVE has been shown to be useful in patients with hepatocellular carcinoma(HCC)and chronic liver disease.However,special caution is needed when PVE is applied prior to subsequent major hepatic resection in cases with cirrhotic livers,and volumetric analysis of the liver segments in addition to evaluation of the liver functional reserve before PVE is mandatory in such cases.Advances in the embolic material and selection of the treatment approach,and combined use of PVE and transcatheter arterial embolization/chemoembolization have yielded improved outcomes after PVE and major hepatic resections.A novel procedure termed the associating liver partition and portal vein ligation for staged hepatectomy has been gaining attention because of the rapid hypertrophy of the FLR observed in patients undergoing this procedure,however,application of this technique in HCC patients requires special caution,as it has been shown to be associated with a high morbidity and mortality even in cases with essentially healthy livers.展开更多
<abstract>During spermiogenesis, the protamine proteins play an integral role in spermatid chromatin compaction. Recent research has focused on many facets of protamine biology, including protamine gene and prot...<abstract>During spermiogenesis, the protamine proteins play an integral role in spermatid chromatin compaction. Recent research has focused on many facets of protamine biology, including protamine gene and protein structure/ function relationships, mechanisms of protamine expression regulation and involvement of the protamines in male fertility. In this paper, we review our current understanding of the structure and function of the protamine-1 (P1) and protamine-2 (P2) proteins and genes, the expression and regulation of these genes and the relationship between the protamines and male fertility. In addition, we offer a brief outlook on future investigation into protamine proteins.展开更多
We attempted to evaluate the history of sentinel node navigation surgery (SNNS), technical aspects, tracers, and clinical applications of SNNS using Infrared Ray Electronic Endoscopes (IREE) combined with Indocyanine ...We attempted to evaluate the history of sentinel node navigation surgery (SNNS), technical aspects, tracers, and clinical applications of SNNS using Infrared Ray Electronic Endoscopes (IREE) combined with Indocyanine Green (ICG). The sentinel lymph node (SLN) is defined as a first lymph node (LN) which receives cancer cells from a primary tumor. Reports on clinical application of SNNS for gastric cancers started to appear since early 2000s. Two prospective multicenter trials of SNNS for gastric cancer have also been accomplished in Japan. Kitagawa et al reported that the endoscopic dual (dye and radioisotope) tracer method for SN biopsy was confirmed acceptable and effective when applied to the early-stage gastric cancer (EGC). We have previously reported the usefulness of SNNS in gastrointestinal cancer using ICG as a tracer, combined with IREE (Olympus Optical, Tokyo, Japan) to detect SLN. LN metastasis rate of EGC is low. Hence, clinical application of SNNS for EGC might lead us to avoid unnecessary LN dissection, which could preserve the patient’s quality of life after operation. The most ideal method of SNNS should allow secure and accurate detection of SLN, and real time observation of lymphatic flow during operation.展开更多
The prevalence of neurodegenerative diseases is increasing as human longevity increases. The objective biomarkers that enable the staging and early diagnosis of neurodegenerative diseases are eagerly anticipated. It h...The prevalence of neurodegenerative diseases is increasing as human longevity increases. The objective biomarkers that enable the staging and early diagnosis of neurodegenerative diseases are eagerly anticipated. It has recently become possible to determine pathological changes in the brain without autopsy with the advancement of diffusion magnetic resonance imaging techniques. Diffusion magnetic resonance imaging is a robust tool used to evaluate brain microstructural complexity and integrity, axonal order, density, and myelination via the micron-scale displacement of water molecules diffusing in tissues. Diffusion tensor imaging, a type of diffusion magnetic resonance imaging technique is widely utilized in clinical and research settings;however, it has several limitations. To overcome these limitations, cutting-edge diffusion magnetic resonance imaging techniques, such as diffusional kurtosis imaging, neurite orientation dispersion and density imaging, and free water imaging, have been recently proposed and applied to evaluate the pathology of neurodegenerative diseases. This review focused on the main applications, findings, and future directions of advanced diffusion magnetic resonance imaging techniques in patients with Alzheimer's and Parkinson's diseases, the first and second most common neurodegenerative diseases, respectively.展开更多
AIM： To clarify the relations between tumor differentiation phenotype and tumor invasion or genetic alterations in gastric differentiated-type tumors. METHODS： We examined the tumor differentiation phenotype, the pr...AIM： To clarify the relations between tumor differentiation phenotype and tumor invasion or genetic alterations in gastric differentiated-type tumors. METHODS： We examined the tumor differentiation phenotype, the presence of mutations in APC and p53, and the microsatellite instability （MSI） status in 48 gastric adenomas and 171 differentiated-type carcinomas, The tumor differentiation phenotype was determined by examining the expression of human gastric mucin （HGM）, NUC6, MUC2 and CD10, The tumors were then classified into gastric- （G-）, gastric and intestinal mixed （GI-）, or intestinal- （I-） phenotypes, according to the immunopositivity of the above markers, The presence of mutations in APC and p53 and the MSI status were also investigated in all the tumors, RESULTS： Gastric adenomas were significantly associated with CDIO expression, I-phenotype tumors and the presence of APC mutations, compared with carcinomas （66.7% vs 25.1%, P 〈 0.0001; 56.3% vs 14.6%, P 〈 0.0001; 39.6% vs 14.0%, P 〈 0.0001, respectively） and inversely associated with expressions of HGM and MUC6 and the presence of p53 mutations （10.4% vs 62.6%, P 〈 0.0001; 39.6% vs 64.3%, P = 0.003; 2.0% vs 26.3%, P = 0.001, respectively）. The frequency of APC mutations was significantly higher in HGM-negative tumors, MUC6-negative tumors, CD10-positive tumors and I-phenotype tumors than in HGM-positive tumors, MUC6- positive tumors, CD10-negative tumors and G-phenotype tumors （32.7% vs 7.1%, P 〈 0.0001; 27.8% vs 14.0%, P = 0.0182; 37.3% vs 10.4%, P 〈 0.0001; and 38.5% vs 9.5%, P = 0.0017, respectively）. The frequency of MSI was significantly higher in MUC6-positive tumors, CD10- negative tumors and G-phenotype tumors than in MUC6- negative tumors, CD10-positive tumors and I-phenotype tumors （24.8% vs 6.7%, P = 0.0009; 22.2% vs 8.0%, P = 0.0143; and 28.6% vs 9.6%, P = 0.0353, respectively）. CONCLUSION： The tumor differentiation phenotype is closely related to tumor invasion and genetic alterations in g展开更多
Warthin’s tumor is the second most frequent neoplasm next to pleomorphic adenoma in the salivary gland. The tumor contains the epithelial oncocyte cells with the presence of rich-mitochondria and their surrounding ab...Warthin’s tumor is the second most frequent neoplasm next to pleomorphic adenoma in the salivary gland. The tumor contains the epithelial oncocyte cells with the presence of rich-mitochondria and their surrounding abundant lymphocytes. A relatively new disease entity of IgG4-related disease frequently occurs in the salivary gland. However, the coexistence of Warthin’s tumor and IgG4-related disease is scarcely observed. We have recently experienced a rare case of Warthin’s tumor with IgG4-related sialadenitis. A 51-year-old man presented to our hospital, complaining of a mass with right submandibular tenderness and spontaneous pain. A computed tomography scan of the cervical region revealed a suspicion of lymph node proliferative disease, including malignant lymphoma. Elevated serum levels of IL-2R: 1843 U/ml (reference value 122 - 496 U/ml), IgG: 3430 mg/dl (reference value 861 - 1747 mg/dl), and IgG4: 3140 mg/dl (reference value 11 - 121 mg/dl) were observed. Other laboratory data showed within normal ranges. The cervical tumor was diagnosed as Warthin’s tumor by the findings of fine-needle aspiration cytology and biopsy examination. Immunohistochemistry revealed numerous IgG4- and IgG-positive cells with fibrosis surrounding the epithelial component of Warthin’s tumor, suggesting IgG4-rerated sialadenitis. Finally, we diagnosed the cervical tumor as Warthin tumor with IgG4-related sialadenitis. This is the second report describing a case of Warthin’s tumor with possible involvement of IgG4-related sialadenitis.展开更多
Purpose: Magnetic hyperthermia treatment (MHT) is a strategy for cancer therapy using the tem-perature rise of magnetic nanoparticles (MNPs) under an alternating magnetic field (AMF). Re-cently, a new imaging method c...Purpose: Magnetic hyperthermia treatment (MHT) is a strategy for cancer therapy using the tem-perature rise of magnetic nanoparticles (MNPs) under an alternating magnetic field (AMF). Re-cently, a new imaging method called magnetic particle imaging (MPI) has been introduced. MPI allows imaging of the spatial distribution of MNPs. The purpose of this study was to investigate the feasibility of visualizing and quantifying the intratumoral distribution and temporal change of MNPs and predicting the therapeutic effect of MHT using MPI. Materials and Methods: Colon-26 cells (1 × 106 cells) were implanted into the backs of eight-week-old male BALB/c mice. When the tumor volume reached approximately 100 mm3, mice were divided into untreated (n = 10) and treated groups (n = 27). The tumors in the treated group were directly injected with MNPs (Resovist?) with iron concentrations of 500 mM (A, n = 9), 400 mM (B, n = 8), and 250 mM (C, n = 10), respectively, and MHT was performed using an AMF with a frequency of 600 kHz and a peak amplitude of 3.5 kA/m. The mice in the treated group were scanned using our MPI scanner immediately before, immediately after, 7 days, and 14 days after MHT. We drew a region of interest (ROI) on the tumor in the MPI image and calculated the average, maximum, and total MPI values and the number of pixels by taking the threshold value for extracting the contour as 40% of the maximum MPI value (pixel value) within the ROI. These parameters in the untreated group were taken as zero. We also measured the relative tumor volume growth (RTVG) defined by (V-V0)/V0, where V0 and V are the tumor volumes immediately before and after MHT, respectively. Results: The average, maximum, and total MPI values decreased up to 7 days after MHT and remained almost constant thereafter in all groups, whereas the number of pixels tended to increase with time. The RTVG values in Groups A and B were significantly lower than those in the control group 3 days or more and 5 days or more after MHT, respectively. The above fo展开更多
Background: Young women of reproductive age experience various physiological changes, which they measure and track using various devices, including fitness trackers and smartwatches. However, fitness tracking assessme...Background: Young women of reproductive age experience various physiological changes, which they measure and track using various devices, including fitness trackers and smartwatches. However, fitness tracking assessment methods are ambiguous because they may differ from model to model. Objective: This study aimed to compare the stress level, heart rate, sleep time, number of steps, and distance traveled, which were calculated using fitness tracking methods for daily-life free activity installed in various smartwatches. Materials and Methodology: Healthy women in their 20s to 30s were recruited for this study, which was conducted from December 2021 to June 2022. The finalized participants wore three different smartwatch models (Mi smartband 6, vivosmart<sup>®</sup>4, and Band 6) simultaneously on their person for 48 hours and performed their daily activities and recorded them on an hour-based activity chart. Each smartwatch’s measured data (e.g., age, height, weight, and oral medications) were extracted into five datasets: heart rate, stress level, number of steps, distance, and sleep time. Data analyses were conducted using Spearman’s rank correlation coefficient ρ (for comparing heart rates) and Bland-Altman plots (for assessing heart rate agreement). The smartwatches’ fitness trackers were compared using the mean absolute percentage error. Results: The correlation coefficient showed that vivosmart<sup>®</sup>4 and Band 6 had a higher heart rate agreement (ρ = 0.684). The Bland-Altman plots showed high agreement between Band 6, Mi smartband 6, and vivosmart<sup>®</sup>4. The heart rate measurement method used under free movement was found to be consistent. The examined smartwatches were able to measure heart rate at the same level even under daily-life free movements. Conclusion: Several different smartwatches’ calculated measured values for heart rate had a high agreement. The smartwatches provided accurate heart rate measurements under daily-life free movement conditions. Furthermore, the calculat展开更多
Background: There is no consensus regarding the optimal treatment for cesarean scar pregnancy (CSP) because treatment efficacy, safety, and the influence on subsequent pregnancy must be taken into consideration. Here ...Background: There is no consensus regarding the optimal treatment for cesarean scar pregnancy (CSP) because treatment efficacy, safety, and the influence on subsequent pregnancy must be taken into consideration. Here we report our experience with 11 cases of CSP and review the literature regarding subsequent pregnancy. Methods: Records of 11 CSP cases that were treated at our hospital were retrospectively reviewed. CSP was treated by local methotrexate (MTX) injection or laparotomic or laparoscopic removal of the gestational mass and myometrial repair. Outcome of subsequent pregnancy after treatment was followed-up until delivery. Results: Local MTX injection was performed for six cases, laparotomic removal of the gestational mass and myometrial repair was performed for two, and laparoscopic removal of the gestational mass and myometrial repair was performed for three. The uterus was preserved in all cases. After CSP treatment, eight pregnancies occurred in five cases, resulting in six live births and two miscarriages. Conclusion: Advantages and disadvantages of various treatment methods for CSP continue to be elucidated. Serum hCG level, location of the gestational mass, thickness of the lower uterine segment at the time of diagnosis, and whether the patient wishes for fertility preservation should be considered when choosing a treatment plan.展开更多
Ti-6Al-4V alloy(Ti64)and SUS316 L stainless steel rods were dissimilarly friction welded.Especially focusing on the detailed observation of interface microstructural evolution during the friction welding(FW),the relat...Ti-6Al-4V alloy(Ti64)and SUS316 L stainless steel rods were dissimilarly friction welded.Especially focusing on the detailed observation of interface microstructural evolution during the friction welding(FW),the relationship between the processing conditions,weld interface microstructure,and mechanical properties of the obtained joints were systematically investigated to elucidate the principle for obtaining a high joint quality in the FW of Ti64 and SUS316L.A higher friction pressure produced a lower welding temperature in the FW,hence suppressing the thick intermetallic compound layer formation.However,hard and brittle Ti64/SUS316L mechanically mixed layers generally formed especially at the weld interface periphery due to the high temperature increasing rate,high rotation linear velocity and high outward flow velocity of the Ti64.These harmful layers tended to induce the cracks/voids formation at the weld interfaces hence deteriorating the joints’mechanical properties.The rotation speed reduction and liquid CO2 cooling during the entire processing decreased the temperature increasing rate,rotation linear velocity and outward flow velocity of the Ti64 at the weld interface periphery.Therefore,they suppressed the formation of the harmful mechanically mixed layers,facilitated the homogeneous and sound interface microstructure generation,and finally produced a high-quality dissimilar joint in the FW of Ti64 and SUS316L.展开更多
Protonic ceramic fuel cells(PCFCs)have been attracting increasing attention because of their advances in high-efficiency power generation in an intermediate-temperature range,as compared to the high-temperature solid ...Protonic ceramic fuel cells(PCFCs)have been attracting increasing attention because of their advances in high-efficiency power generation in an intermediate-temperature range,as compared to the high-temperature solid oxide fuel cells(SOFCs).The greatest difference between PCFCs and SOFCs is the specific requirement of protonic(H+)conductivity at the PCFC cathode,in addition to the electronic(e^(-))and oxide-ion(O^(2-))conductivity.The development of a triple H^(+)/e^(-)/O^(2-)conductor for PCFC cathode is still challenging.Thus,the most-widely used cathode material is based on the mature e^(-)/O^(2-)conductor.However,this leads to insufficient triple phase boundary(TPB),i.e.,reaction area.Herein,an efficient strategy that uses a~100 nm-thick proton conductive functional layer(La_(0.5)Sr_(0.5)CoO_(3-δ),LSC55)in-between the typical La_(0.8)Sr_(0.2)CoO_(3-δ)cathode(a mature e-/O^(2-)conductor,LS C 82)and B aZr_(0.4)Ce_(0.4)Y_(0.1)Yb_(0.)1O_(3-δ)elec trolyte(11 mm in diameter,20μm in thickness)is proposed to significantly enhance the reaction area.Reasonably,the ohmic resistance and polarization resistance are both decreased by 47%and 62%,respectively,compared with that of PCFCs without the functional layer.The power density of the PCFC with such a functional layer can be raised by up to 2.24 times,superior to those described in previous reports.The enhanced PCFC performances are attributed to the well-built TPB and enhanced reaction area via the functional layer engineering strategy.展开更多
文摘Acute lower gastrointestinal bleeding(LGIB) is a common indication for hospital admission. Patients with LGIB often experience persistent or recurrent bleeding and require blood transfusions and interventions, such as colonoscopic,radiological, and surgical treatments. Appropriate decision-making is needed to initially manage acute LGIB, including emergency hospitalization, timing of colonoscopy, and medication use. In this literature review, we summarize the evidence for initial management of acute LGIB. Assessing various clinical factors,including comorbidities, medication use, presenting symptoms, vital signs, and laboratory data is useful for risk stratification of severe LGIB, and for discriminating upper gastrointestinal bleeding. Early timing of colonoscopy had the possibility of improving identification of the bleeding source, and the rate of endoscopic intervention, compared with elective colonoscopy. Contrast-enhanced computed tomography before colonoscopy may help identify stigmata of recent hemorrhage on colonoscopy, particularly in patients who can be examined immediately after the last hematochezia. How to deal with nonsteroidal antiinflammatory drugs(NSAIDs) and antithrombotic agents after hemostasis should be carefully considered because of the risk of rebleeding and thromboembolic events. In general, aspirin as primary prophylaxis for cardiovascular events and NSAIDs were suggested to be discontinued after LGIB. Managing acute LGIB based on this information would improve clinical outcomes. Further investigations are needed to distinguish patients with LGIB who require early colonoscopy and hemostatic intervention.
文摘AIM： To determine the efficacy of external beam radiotherapy （EBRT）, with or without intraluminal brachytherapy （ILBT）, in patients with non-resected locally advanced hilar cholangiocarcinoma.METHODS： We analyzed 64 patients with locally advanced hilar cholangiocarcinoma, including 25 who underwent resection （17 curative and 8 non-curative）, 28 treated with radiotherapy, and 11 who received best supportive care （BSC）. The radiotherapy group received EBRT （50 Gy, 30 fractions）, with 11 receiving an ad- ditional 24 Gy （4 fractions） ILBT by iridium-192 with remote after loading. ILBT was performed using percu-taneous transhepatic biliary drainage （PTBD） route. Uncovered metallic stents （UMS） were inserted into nonresected patients with obstructive jaundice, with the exception of four patients who received percutaneous transhepatic biliary drainage only. UMS were placed endoscopically or percutaneously, depending on the initial drainage procedure. The primary endpoints were patient death or stent occlusion. Survival time of patients in the radiotherapy group was compared with that of patients in the resection and BSC groups. Stent patency was compared in the radiotherapy and BSC groups.RESULTS： No statistically significant differences in patient characteristics were found among the resection, radiotherapy, and BSC groups. Three patients in the radiotherapy group and one in the BSC group did not receive UMS insertion but received PTBD alone; cholangitis occurred after endoscopic stenting, and patients were treated with PTBD. A total of 16 patients were administered additional systemic chemotherapy （5-fluorouracil-based regimen in 9, S-1 in 6, and gemcitabine in 1）. Overall survival varied significantly among groups, with median survival times of 48.7 mo in the surgery group, 22.1 mo in the radiotherapy group, and 5.7 mo in the BSC group. Patients who underwent curative resection survived significantly longer than those who were not candidates for surgery （P = 0.0076）. Cumu
文摘Neoadjuvant chemotherapy followed by surgery （NCS） has not been fully evaluated clinically. Currently, the main regimen of neoadjuvant chemotherapy （NAC） used in NCS includes cisplatin. The antitumor effects of NAC reduce lymph node metastasis and the tumor diameter in patients prior to surgery, and this can reduce the number of high risk patients who require postoperative radiation therapy. Many randomized controlled trials （RCTs） have examined the long-term prognosis of NCS compared to primary surgery, but the utility of NCS remains uncertain. The advent of concurrent chemoradiotherapy （CCRT） has markedly improved the outcome of radiotherapy （RT）, and CCRT is now used as a standard method in many cases of advanced bulky cervical cancer. NCS gives a better treatment outcome than radiation therapy alone, but it is important to verify that NCS gives a similar or better outcome compared to CCRT.
文摘Thirty years have passed since the first report of portal vein embolization(PVE),and this procedure is widely adopted as a preoperative treatment procedure for patients with a small future liver remnant(FLR).PVE has been shown to be useful in patients with hepatocellular carcinoma(HCC)and chronic liver disease.However,special caution is needed when PVE is applied prior to subsequent major hepatic resection in cases with cirrhotic livers,and volumetric analysis of the liver segments in addition to evaluation of the liver functional reserve before PVE is mandatory in such cases.Advances in the embolic material and selection of the treatment approach,and combined use of PVE and transcatheter arterial embolization/chemoembolization have yielded improved outcomes after PVE and major hepatic resections.A novel procedure termed the associating liver partition and portal vein ligation for staged hepatectomy has been gaining attention because of the rapid hypertrophy of the FLR observed in patients undergoing this procedure,however,application of this technique in HCC patients requires special caution,as it has been shown to be associated with a high morbidity and mortality even in cases with essentially healthy livers.
文摘<abstract>During spermiogenesis, the protamine proteins play an integral role in spermatid chromatin compaction. Recent research has focused on many facets of protamine biology, including protamine gene and protein structure/ function relationships, mechanisms of protamine expression regulation and involvement of the protamines in male fertility. In this paper, we review our current understanding of the structure and function of the protamine-1 (P1) and protamine-2 (P2) proteins and genes, the expression and regulation of these genes and the relationship between the protamines and male fertility. In addition, we offer a brief outlook on future investigation into protamine proteins.
文摘We attempted to evaluate the history of sentinel node navigation surgery (SNNS), technical aspects, tracers, and clinical applications of SNNS using Infrared Ray Electronic Endoscopes (IREE) combined with Indocyanine Green (ICG). The sentinel lymph node (SLN) is defined as a first lymph node (LN) which receives cancer cells from a primary tumor. Reports on clinical application of SNNS for gastric cancers started to appear since early 2000s. Two prospective multicenter trials of SNNS for gastric cancer have also been accomplished in Japan. Kitagawa et al reported that the endoscopic dual (dye and radioisotope) tracer method for SN biopsy was confirmed acceptable and effective when applied to the early-stage gastric cancer (EGC). We have previously reported the usefulness of SNNS in gastrointestinal cancer using ICG as a tracer, combined with IREE (Olympus Optical, Tokyo, Japan) to detect SLN. LN metastasis rate of EGC is low. Hence, clinical application of SNNS for EGC might lead us to avoid unnecessary LN dissection, which could preserve the patient’s quality of life after operation. The most ideal method of SNNS should allow secure and accurate detection of SLN, and real time observation of lymphatic flow during operation.
基金supported by research grants from the program for Brain/MINDS Beyond program from the Japan Agency for Medical Research and Development(AMED)under Grant Number JP18dm0307024(to KK)MEXT-Supported Program for the Private University Research Branding Project+1 种基金ImPACT Program of Council for Science,Technology and Innovation(Cabinet Office,Government of Japan)JSPS KAKENHI Grant Number JP16K10327(to KK)
文摘The prevalence of neurodegenerative diseases is increasing as human longevity increases. The objective biomarkers that enable the staging and early diagnosis of neurodegenerative diseases are eagerly anticipated. It has recently become possible to determine pathological changes in the brain without autopsy with the advancement of diffusion magnetic resonance imaging techniques. Diffusion magnetic resonance imaging is a robust tool used to evaluate brain microstructural complexity and integrity, axonal order, density, and myelination via the micron-scale displacement of water molecules diffusing in tissues. Diffusion tensor imaging, a type of diffusion magnetic resonance imaging technique is widely utilized in clinical and research settings;however, it has several limitations. To overcome these limitations, cutting-edge diffusion magnetic resonance imaging techniques, such as diffusional kurtosis imaging, neurite orientation dispersion and density imaging, and free water imaging, have been recently proposed and applied to evaluate the pathology of neurodegenerative diseases. This review focused on the main applications, findings, and future directions of advanced diffusion magnetic resonance imaging techniques in patients with Alzheimer's and Parkinson's diseases, the first and second most common neurodegenerative diseases, respectively.
基金Supported by Grant-in-Aid for Scientific Research, Japan Society for the Promotion of Science, No. 17790928
文摘AIM： To clarify the relations between tumor differentiation phenotype and tumor invasion or genetic alterations in gastric differentiated-type tumors. METHODS： We examined the tumor differentiation phenotype, the presence of mutations in APC and p53, and the microsatellite instability （MSI） status in 48 gastric adenomas and 171 differentiated-type carcinomas, The tumor differentiation phenotype was determined by examining the expression of human gastric mucin （HGM）, NUC6, MUC2 and CD10, The tumors were then classified into gastric- （G-）, gastric and intestinal mixed （GI-）, or intestinal- （I-） phenotypes, according to the immunopositivity of the above markers, The presence of mutations in APC and p53 and the MSI status were also investigated in all the tumors, RESULTS： Gastric adenomas were significantly associated with CDIO expression, I-phenotype tumors and the presence of APC mutations, compared with carcinomas （66.7% vs 25.1%, P 〈 0.0001; 56.3% vs 14.6%, P 〈 0.0001; 39.6% vs 14.0%, P 〈 0.0001, respectively） and inversely associated with expressions of HGM and MUC6 and the presence of p53 mutations （10.4% vs 62.6%, P 〈 0.0001; 39.6% vs 64.3%, P = 0.003; 2.0% vs 26.3%, P = 0.001, respectively）. The frequency of APC mutations was significantly higher in HGM-negative tumors, MUC6-negative tumors, CD10-positive tumors and I-phenotype tumors than in HGM-positive tumors, MUC6- positive tumors, CD10-negative tumors and G-phenotype tumors （32.7% vs 7.1%, P 〈 0.0001; 27.8% vs 14.0%, P = 0.0182; 37.3% vs 10.4%, P 〈 0.0001; and 38.5% vs 9.5%, P = 0.0017, respectively）. The frequency of MSI was significantly higher in MUC6-positive tumors, CD10- negative tumors and G-phenotype tumors than in MUC6- negative tumors, CD10-positive tumors and I-phenotype tumors （24.8% vs 6.7%, P = 0.0009; 22.2% vs 8.0%, P = 0.0143; and 28.6% vs 9.6%, P = 0.0353, respectively）. CONCLUSION： The tumor differentiation phenotype is closely related to tumor invasion and genetic alterations in g
文摘Warthin’s tumor is the second most frequent neoplasm next to pleomorphic adenoma in the salivary gland. The tumor contains the epithelial oncocyte cells with the presence of rich-mitochondria and their surrounding abundant lymphocytes. A relatively new disease entity of IgG4-related disease frequently occurs in the salivary gland. However, the coexistence of Warthin’s tumor and IgG4-related disease is scarcely observed. We have recently experienced a rare case of Warthin’s tumor with IgG4-related sialadenitis. A 51-year-old man presented to our hospital, complaining of a mass with right submandibular tenderness and spontaneous pain. A computed tomography scan of the cervical region revealed a suspicion of lymph node proliferative disease, including malignant lymphoma. Elevated serum levels of IL-2R: 1843 U/ml (reference value 122 - 496 U/ml), IgG: 3430 mg/dl (reference value 861 - 1747 mg/dl), and IgG4: 3140 mg/dl (reference value 11 - 121 mg/dl) were observed. Other laboratory data showed within normal ranges. The cervical tumor was diagnosed as Warthin’s tumor by the findings of fine-needle aspiration cytology and biopsy examination. Immunohistochemistry revealed numerous IgG4- and IgG-positive cells with fibrosis surrounding the epithelial component of Warthin’s tumor, suggesting IgG4-rerated sialadenitis. Finally, we diagnosed the cervical tumor as Warthin tumor with IgG4-related sialadenitis. This is the second report describing a case of Warthin’s tumor with possible involvement of IgG4-related sialadenitis.
文摘Purpose: Magnetic hyperthermia treatment (MHT) is a strategy for cancer therapy using the tem-perature rise of magnetic nanoparticles (MNPs) under an alternating magnetic field (AMF). Re-cently, a new imaging method called magnetic particle imaging (MPI) has been introduced. MPI allows imaging of the spatial distribution of MNPs. The purpose of this study was to investigate the feasibility of visualizing and quantifying the intratumoral distribution and temporal change of MNPs and predicting the therapeutic effect of MHT using MPI. Materials and Methods: Colon-26 cells (1 × 106 cells) were implanted into the backs of eight-week-old male BALB/c mice. When the tumor volume reached approximately 100 mm3, mice were divided into untreated (n = 10) and treated groups (n = 27). The tumors in the treated group were directly injected with MNPs (Resovist?) with iron concentrations of 500 mM (A, n = 9), 400 mM (B, n = 8), and 250 mM (C, n = 10), respectively, and MHT was performed using an AMF with a frequency of 600 kHz and a peak amplitude of 3.5 kA/m. The mice in the treated group were scanned using our MPI scanner immediately before, immediately after, 7 days, and 14 days after MHT. We drew a region of interest (ROI) on the tumor in the MPI image and calculated the average, maximum, and total MPI values and the number of pixels by taking the threshold value for extracting the contour as 40% of the maximum MPI value (pixel value) within the ROI. These parameters in the untreated group were taken as zero. We also measured the relative tumor volume growth (RTVG) defined by (V-V0)/V0, where V0 and V are the tumor volumes immediately before and after MHT, respectively. Results: The average, maximum, and total MPI values decreased up to 7 days after MHT and remained almost constant thereafter in all groups, whereas the number of pixels tended to increase with time. The RTVG values in Groups A and B were significantly lower than those in the control group 3 days or more and 5 days or more after MHT, respectively. The above fo
文摘Background: Young women of reproductive age experience various physiological changes, which they measure and track using various devices, including fitness trackers and smartwatches. However, fitness tracking assessment methods are ambiguous because they may differ from model to model. Objective: This study aimed to compare the stress level, heart rate, sleep time, number of steps, and distance traveled, which were calculated using fitness tracking methods for daily-life free activity installed in various smartwatches. Materials and Methodology: Healthy women in their 20s to 30s were recruited for this study, which was conducted from December 2021 to June 2022. The finalized participants wore three different smartwatch models (Mi smartband 6, vivosmart<sup>®</sup>4, and Band 6) simultaneously on their person for 48 hours and performed their daily activities and recorded them on an hour-based activity chart. Each smartwatch’s measured data (e.g., age, height, weight, and oral medications) were extracted into five datasets: heart rate, stress level, number of steps, distance, and sleep time. Data analyses were conducted using Spearman’s rank correlation coefficient ρ (for comparing heart rates) and Bland-Altman plots (for assessing heart rate agreement). The smartwatches’ fitness trackers were compared using the mean absolute percentage error. Results: The correlation coefficient showed that vivosmart<sup>®</sup>4 and Band 6 had a higher heart rate agreement (ρ = 0.684). The Bland-Altman plots showed high agreement between Band 6, Mi smartband 6, and vivosmart<sup>®</sup>4. The heart rate measurement method used under free movement was found to be consistent. The examined smartwatches were able to measure heart rate at the same level even under daily-life free movements. Conclusion: Several different smartwatches’ calculated measured values for heart rate had a high agreement. The smartwatches provided accurate heart rate measurements under daily-life free movement conditions. Furthermore, the calculat
文摘Background: There is no consensus regarding the optimal treatment for cesarean scar pregnancy (CSP) because treatment efficacy, safety, and the influence on subsequent pregnancy must be taken into consideration. Here we report our experience with 11 cases of CSP and review the literature regarding subsequent pregnancy. Methods: Records of 11 CSP cases that were treated at our hospital were retrospectively reviewed. CSP was treated by local methotrexate (MTX) injection or laparotomic or laparoscopic removal of the gestational mass and myometrial repair. Outcome of subsequent pregnancy after treatment was followed-up until delivery. Results: Local MTX injection was performed for six cases, laparotomic removal of the gestational mass and myometrial repair was performed for two, and laparoscopic removal of the gestational mass and myometrial repair was performed for three. The uterus was preserved in all cases. After CSP treatment, eight pregnancies occurred in five cases, resulting in six live births and two miscarriages. Conclusion: Advantages and disadvantages of various treatment methods for CSP continue to be elucidated. Serum hCG level, location of the gestational mass, thickness of the lower uterine segment at the time of diagnosis, and whether the patient wishes for fertility preservation should be considered when choosing a treatment plan.
基金the New Energy and Industrial Technology Development Organization(NEDO)under the“Innovation Structural Materials Project(Future Pioneering Projects)”JSPS KAKENHI Grant Numbers JP19H00826 and JP18K14027an ISIJ Research Promotion Grant。
文摘Ti-6Al-4V alloy(Ti64)and SUS316 L stainless steel rods were dissimilarly friction welded.Especially focusing on the detailed observation of interface microstructural evolution during the friction welding(FW),the relationship between the processing conditions,weld interface microstructure,and mechanical properties of the obtained joints were systematically investigated to elucidate the principle for obtaining a high joint quality in the FW of Ti64 and SUS316L.A higher friction pressure produced a lower welding temperature in the FW,hence suppressing the thick intermetallic compound layer formation.However,hard and brittle Ti64/SUS316L mechanically mixed layers generally formed especially at the weld interface periphery due to the high temperature increasing rate,high rotation linear velocity and high outward flow velocity of the Ti64.These harmful layers tended to induce the cracks/voids formation at the weld interfaces hence deteriorating the joints’mechanical properties.The rotation speed reduction and liquid CO2 cooling during the entire processing decreased the temperature increasing rate,rotation linear velocity and outward flow velocity of the Ti64 at the weld interface periphery.Therefore,they suppressed the formation of the harmful mechanically mixed layers,facilitated the homogeneous and sound interface microstructure generation,and finally produced a high-quality dissimilar joint in the FW of Ti64 and SUS316L.
基金financially supported by China Post-doctoral Science Foundation(No.2022M710856)Guangzhou Postdoctoral Research Project(No.62104380)+2 种基金the Outstanding Youth Project of Natural Science Foundation of Guangdong Province(No.2022B1515020020)the Funding by Science and Technology Projects in Guangzhou(Nos.202206050003 and 202201010603)Guangdong Engineering Technology Research Center for Hydrogen Energy and Fuel Cells。
文摘Protonic ceramic fuel cells(PCFCs)have been attracting increasing attention because of their advances in high-efficiency power generation in an intermediate-temperature range,as compared to the high-temperature solid oxide fuel cells(SOFCs).The greatest difference between PCFCs and SOFCs is the specific requirement of protonic(H+)conductivity at the PCFC cathode,in addition to the electronic(e^(-))and oxide-ion(O^(2-))conductivity.The development of a triple H^(+)/e^(-)/O^(2-)conductor for PCFC cathode is still challenging.Thus,the most-widely used cathode material is based on the mature e^(-)/O^(2-)conductor.However,this leads to insufficient triple phase boundary(TPB),i.e.,reaction area.Herein,an efficient strategy that uses a~100 nm-thick proton conductive functional layer(La_(0.5)Sr_(0.5)CoO_(3-δ),LSC55)in-between the typical La_(0.8)Sr_(0.2)CoO_(3-δ)cathode(a mature e-/O^(2-)conductor,LS C 82)and B aZr_(0.4)Ce_(0.4)Y_(0.1)Yb_(0.)1O_(3-δ)elec trolyte(11 mm in diameter,20μm in thickness)is proposed to significantly enhance the reaction area.Reasonably,the ohmic resistance and polarization resistance are both decreased by 47%and 62%,respectively,compared with that of PCFCs without the functional layer.The power density of the PCFC with such a functional layer can be raised by up to 2.24 times,superior to those described in previous reports.The enhanced PCFC performances are attributed to the well-built TPB and enhanced reaction area via the functional layer engineering strategy.
