There has been a long-standing need for guidelines on the diagnosis and treatment of keloids and hypertrophic scars that are based on an understanding of the pathomechanisms that underlie these skin fibrotic diseases....There has been a long-standing need for guidelines on the diagnosis and treatment of keloids and hypertrophic scars that are based on an understanding of the pathomechanisms that underlie these skin fibrotic diseases.This is particularly true for clinicians who deal with Asian and African patients because these ethnicities are highly prone to these diseases.By contrast,Caucasians are less likely to develop keloids and hypertrophic scars,and if they do,the scars tend not to be severe.This ethnic disparity also means that countries vary in terms of their differential diagnostic algorithms.The lack of clear treatment guidelines also means that primary care physicians are currently applying a hotchpotch of treatments,with uneven outcomes.To overcome these issues,the Japan Scar Workshop(JSW)has created a tool that allows clinicians to objectively diagnose and distinguish between keloids,hypertrophic scars,and mature scars.This tool is called the JSW Scar Scale(JSS)and it involves scoring the risk factors of the individual patients and the affected areas.The tool is simple and easy to use.As a result,even physicians who are not accustomed to keloids and hypertrophic scars can easily diagnose them and judge their severity.The JSW has also established a committee that,in cooperation with outside experts in various fields,has prepared a Consensus Document on keloid and hypertrophic scar treatment guidelines.These guidelines are simple and will allow even inexperienced clinicians to choose the most appropriate treatment strategy.The Consensus Document is provided in this article.It describes(1)the diagnostic algorithm for pathological scars and how to differentiate them from clinically similar benign and malignant tumors,(2)the general treatment algorithms for keloids and hypertrophic scars at different medical facilities,(3)the rationale behind each treatment for keloids and hypertrophic scars,and(4)the body site-specific treatment protocols for these scars.We believe that this Consensus Document will be helpful for physi展开更多
The incidence of prostate cancer(PCa)within Asian population used to be much lower than in the Western population;however,in recent years the incidence and mortality rate of PCa in some Asian countries have grown rapi...The incidence of prostate cancer(PCa)within Asian population used to be much lower than in the Western population;however,in recent years the incidence and mortality rate of PCa in some Asian countries have grown rapidly.This collaborative report summarized the latest epidemiology information,risk factors,and racial differences in PCa diagnosis,current status and new trends in surgery management and novel agents for castration-resistant prostate cancer.We believe such information would be helpful in clinical decision making for urologists and oncologists,health-care ministries and medical researchers.展开更多
Endoscopic submucosal dissection (ESD) is now the most common endoscopic treatment in Japan for intramucosal gastrointestinal neoplasms (non-metastatic). ESD is an invasive endoscopic surgical procedure, requiring ex... Endoscopic submucosal dissection (ESD) is now the most common endoscopic treatment in Japan for intramucosal gastrointestinal neoplasms (non-metastatic). ESD is an invasive endoscopic surgical procedure, requiring extensive knowledge, skill, and specialized equipment. ESD starts with evaluation of the lesion, as accurate assessment of the depth and margin of the lesion is essential. The devices and strategies used in ESD vary, depending on the nature of the lesion. Prior to the procedure, the operator must be knowledgeable about the treatment strategy(ies), the device(s) to use, the electrocautery machine settings, the substances to inject, and other aspects. In addition, the operator must be able to manage complications, should they arise, including immediate recognition of the complication(s) and its treatment. Finally, in case the ESD treatment is not successful, the operator should be prepared to apply alternative treatments. Thus, adequate knowledge and training are essential to successfully perform ESD.展开更多
Development of new materials with high hydrogen storage capacity and reversible hydrogen sorp-tion performances under mild conditions has very high value in both fundamental and application aspects.In the past years,s...Development of new materials with high hydrogen storage capacity and reversible hydrogen sorp-tion performances under mild conditions has very high value in both fundamental and application aspects.In the past years,some new systems with metastable structures,such as ultra-fine nanocrystalline alloys,amorphous alloys,nanoglass alloys,immiscible alloys,high-entropy alloys,have been abundantly studied as hydrogen storage mate-rials.Many new hydrogen storage properties either from the kinetics or thermodynamics aspects have been reported.In this review,recent advances of studies on metastable alloys for hydrogen storage applications have been comprehensively reviewed.The materials preparation methods to synthesize metastable hydrogen storage alloys are firstly reviewed.Afterwards,hydrogen storage prop-erties of the metastable alloys are summarized and dis-cussed,focusing on the unique kinetics and thermodynamics properties by forming of such unique metastable structures.For examples,superior hydrogena-tion kinetics and higher hydrogen storage capacity have been achieved in Mg-based amorphous and nanoglass alloys.Destabilized thermodynamics properties can be obtained in the immiscible Mg-Mn and Mg-Zr alloys.In addition to highlighting the recent achievements of metastable alloys in the field of hydrogen storage,the remaining challenges and trends of the emerging research are also discussed.展开更多
The generalized fractional element networks are presented in this paper. In order to extend the structure of the model solutions to the generalized function space and make it contain more physical meanings, the restri...The generalized fractional element networks are presented in this paper. In order to extend the structure of the model solutions to the generalized function space and make it contain more physical meanings, the restriction on the parameters of the fractional element proposed by Schiessel et al. is eliminated and a 'compatibility equation' is added. The discretization method for solving the inverse Laplace transform is used and developed. The generalized solutions of the model equations are given. At the same time the generalized fractional element network--Zener and Poyinting-Thomson models are discussed in detail. It is shown that all the results obtained previously about the models of single parameter with fractional order and the classical models with integer order can be contained as the special cases of the results of this paper.展开更多
AIM: To assess the utility and safety of single-operator cholangiopancreatoscopy(SOCPS) using the Spy Glass system in widespread clinical application for biliary and pancreatic diseases.METHODS: This study was a prosp...AIM: To assess the utility and safety of single-operator cholangiopancreatoscopy(SOCPS) using the Spy Glass system in widespread clinical application for biliary and pancreatic diseases.METHODS: This study was a prospective case series conducted in 20 referral centers in Japan. There were 148 patients who underwent SOCPS; 124 for biliary diseases and 24 for pancreatic diseases. The attempted interventions were SOCPS examination, SOCPS-directed tissue sampling, and therapy for stone removal, among others. The main outcomes were related to the procedure success rate in terms of visualizing the target lesions, SOCPS-directed adequate tissue sampling, and complete stone removal. RESULTS: A total of 148 patients were enrolled for the diagnosis of indeterminate biliary and pancreatic lesions or treatment of biliary and pancreatic disease. The overall procedure success rate of visualizing the target lesions was 91.2%(135/148). The overall procedural success rates of visualizing the target lesions of diagnostic SOCPS in the bile duct and pancreatic duct were 95.5%(84/89) and 88.2%(15/17), respectively. Diagnosis: the overall adequate tissue for histologic examination was secured in 81.4% of the 86 patients who underwent biopsy under SOCPS(bile duct, 60/75, 80.0%; pancreatic duct, 10/11, 90.9%). The accuracy of histologic diagnosis using SOCPS-directed biopsies in indeterminate bile duct lesions was 70.7%(53/75). In the pancreatic duct, the accuracy of SOCPS visual impression of intraductal papillary mucinous neoplasm was 87.5%(14/16). Stone therapy: complete biliary and pancreatic stone clearance combined with SOCPS-directed stone therapy using electrohydraulic lithotripsy or laser lithotripsy was achieved in 74.2%(23/31) and 42.9%(3/7) of the patients, respectively. Others: SOCPS using the Spy Glass system was used in cannulation of the cystic duct in two patients and for passing across the obstructed self-expandable metallic stent for a malignant biliary stricture in two patients. All procedures were successful in both展开更多
AIM： Minimal deviation carcinoma of the uterine cervix, otherwise known as extremely well-differentiated adenocarcinoma （EWDA）, is characterized by its benign microscopic appearance in contrast to its aggressive be...AIM： Minimal deviation carcinoma of the uterine cervix, otherwise known as extremely well-differentiated adenocarcinoma （EWDA）, is characterized by its benign microscopic appearance in contrast to its aggressive behavior. In order to elucidate the clinicopathological features and biological behavior of the gastric counterpart of EWDA, we, using immunohistochemistry, analyzed nine lesions for the phenotypic expression, proliferative activity, and the expression of oncogene-associated products. METHODS： Clinicopathological features, including preoperative biopsy diagnosis, were reviewed. Using immunohitstochemistry, Ki-67 labeling index and expression of p53 and c-erbB-2 protein in the gastric lesions were detected.RESULT： Locations in the middle or upper third of the stomach and polypoid macroscopic features are characteristic of EWDA of the stomach. Although 4 of the 9 lesions showed only focal lymphatic or venous invasion, lymph node metastasis was not present and none of the patients died of the lesions （mean follow-up period, 56 too）. All 9 cases of EWDA could be classified into gastric phenotype （5 lesions） and intestinal phenotype （4 lesions）. The former resembled gastric foveolar epithelium, mucous neck cells or pyloric glands, but their papillary structures were frequently elongated and the tumor cellsand their nuclei were slightly larger and more hyperchromatic compared to normal epithelium. The latter resembled intestinal metaplasia with minimal nulcear atypia and irregular glands; two of these lesions demonstrated complete intestinal phenotype, while two demonstrated incomplete intestinal phenotype. Ki-67 labeling index was low and none of the cases revealed over-expression of p53 and c-erbB-2 protein. CONCLUSION： Unlike minimal deviation carcinoma of the cervix, these findings suggest that EWDA of the stomach is a lesion of low-grade malignancy. This favorable biological behavior is supported by the data of a low Ki-67 labeling index and a lack of p53 or c-erbB-2 protein over-ex展开更多
Numerical simulations of extreme wave generation are carried out by using the Volume Of Fluid（VOF） method.Extreme waves are generated based on wave focusing in a 2-D numerical model.To validate the capability of the...Numerical simulations of extreme wave generation are carried out by using the Volume Of Fluid（VOF） method.Extreme waves are generated based on wave focusing in a 2-D numerical model.To validate the capability of the VOF-based model described in this article,the propagation of regular waves is computed and compared with the theoretical results.By adjusting the phases of wave components,extreme waves are formed at given time and given position in the computation.The numerical results are compared with theoretical solutions and experimental data.It is concluded that the present model based on the VOF technique can provide acceptably accurate numerical results to serve practical purposes.展开更多
This paper presents a coordination strategy of Load Frequency Control(LFC)and digital frequency protection for an islanded microgrid(MG)considering high penetration of Renewable Energy Sources(RESs).In such MGs,the re...This paper presents a coordination strategy of Load Frequency Control(LFC)and digital frequency protection for an islanded microgrid(MG)considering high penetration of Renewable Energy Sources(RESs).In such MGs,the reduction in system inertia due to integration of large amount of RESs causes undesirable influence on MG frequency stability,leading to weakening of the MG.Furthermore,sudden load events,and short circuits caused large frequency fluctuations,which threaten the system security and could lead to complete blackouts as well as damages to the system equipment.Therefore,maintaining the dynamic security in MGs is one of the important challenges,which considered in this paper using a specific design and various data conversion stages of a digital over/under frequency relay(OUFR).The proposed relay will cover both under and over frequency conditions in coordination with LFC operation to protect the MG against high frequency variations.To prove the response of the proposed coordination strategy,a small MG was investigated for the simulation.The proposed coordination method has been tested considering load change,high integration of RESs.Moreover,the sensitivity analysis of the presented technique was examined by varying the penetration level of RESs and reducing the system inertia.The results reveal the effectiveness of the proposed coordination to maintain the power system frequency stability and security.In addition,the superiority of the OUFR has been approved in terms of accuracy and speed response during high disturbances.展开更多
AIM: To elucidate the immunologic parameters for the outcome of patients with malignant tumors, especially esophageal squamous cell carcinoma (ESCC) associated with high malignant potential. METHODS: Clinicopathologic...AIM: To elucidate the immunologic parameters for the outcome of patients with malignant tumors, especially esophageal squamous cell carcinoma (ESCC) associated with high malignant potential. METHODS: Clinicopathologic features were compared between patients with lower and higher CD4 and CD8 values as well as CD4/CD8 ratio in peripheral blood. RESULTS: The survival rate of patients with higher CD4 value was significantly better than that in patients with lower CD4 value (P = 0.039). The survival rate of patients with higher CD8 value was significantly worse than that of patients with lower CD8 value (P = 0.026). Similarly, the survival rate of patients with higher CD4/ CD8 ratio was significantly better than that of patients with lower CD4/CD8 ratio (P = 0.042). Additionally, multivariate analysis demonstrated that lower CD8 and lower CD4/CD8 ratio were factors independently associated with worse prognosis of patients. CONCLUSION: All the immunologic parameters can predict the outcome of patients with ESCC.展开更多
AIM: To investigate the clinicopathological features of intraductal neoplasm of the intrahepatic bile duct (INihB). METHODS: Clinicopathological features of 24 cases of INihB, which were previously diagnosed as biliar...AIM: To investigate the clinicopathological features of intraductal neoplasm of the intrahepatic bile duct (INihB). METHODS: Clinicopathological features of 24 cases of INihB, which were previously diagnosed as biliary papillomatosis or intraductal growth of intrahepatic biliary neoplasm, were reviewed. Mucin immunohistochemistry was performed for mucin (MUC)1, MUC2, MUC5AC and MUC6. Ki-67, P53 and β-catenin immunoreactivity were also examined. We categorized each tumor as adenoma (low grade), borderline (intermediate grade), and malignant (carcinoma in situ , high grade including tumors with microinvasion). RESULTS: Among 24 cases of INihB, we identified 24 tumors. Twenty of 24 tumors (83%) were composed of a papillary structure; the same feature observed in intraductal papillary neoplasm of the bile duct (IPNB). In contrast, the remaining four tumors (17%) showed both tubular and papillary structures. In three of the four tumors (75%), macroscopic mucin secretion was limited but microscopic intracellular mucin was evident. Histologically, 16 tumors (67%) were malignant, three (12%) were borderline, and five (21%) were adenoma. Microinvasion was found in four cases (17%). Immunohistochemical analysis revealed that MUC1 was not expressed in the borderline/adenoma group but was expressed only in malignant lesions (P = 0.0095). Ki-67 labeling index (LI) was significantly higher in the malignant group than in the borderline/adenoma group (22.2 ± 15.5 vs 7.5 ± 6.3, P < 0.01). In the 16 malignant cases, expression of MUC5AC showed borderline significant association with high Ki-67 LI (P = 0.0622). Nuclear expression of β-catenin was observed in two (8%) of the 24 tumors, and these two tumors also showed MUC1 expression. P53 was negative in all tumors. CONCLUSION: Some cases of INihB have a tubular structure, and are subcategorized as IPNB with tubular structure. MUC1 expression in INihB correlates positively with degree of malignancy.展开更多
We investigated the effects of integrated organic and inorganic fertilizers on the growth and yield of indica rice variety Manawthukha and japonica rice variety Genkitsukushi.In a split-plot design,the two rice variet...We investigated the effects of integrated organic and inorganic fertilizers on the growth and yield of indica rice variety Manawthukha and japonica rice variety Genkitsukushi.In a split-plot design,the two rice varieties were assigned as main plot factors,and the integrated treatments were the subplot factors,including no-N fertilizer(N0),50%chemical fertilizer(CF)(CF50),100%CF(CF100),50%CF+50%poultry manure(PM)(CF50PM50),50%CF+50%cow manure(CM)(CF50CM50),and 50%CF+50%compost(CP)(CF50CP50).CF100 was equivalent to N at 85 kg/hm2.Manure was applied based on the estimated mineralizable nitrogen(EMN)level,which is dependent on total N(%)of each manure type.Manawthukha rice plants were taller with higher tiller number and dry matter content.However,higher soil-plant analysis development(SPAD)values were measured in Genkitsukushi throughout the crop growth period,resulting in higher seed-setting rate(%)and greater yield.At the same N level,CF50PM50 application in both rice varieties resulted in higher SPAD values,plant height and tiller number than CF100.CF50PM50 containing total N more than 4%supplied synchronized N for the demands of the rice plants,resulting in maximum dry matter,yield and yield components.CF50CM50 and CF50CP50 treatments containing total N less than 4%resulted in lower yields which were similar to CF100.These results indicated that integrating organic and inorganic fertilizers enhanced growth parameters and yields of Manawthukha and Genkitsukushi,while reducing the dose of chemical fertilizer.展开更多
Diffusion-weighted imaging (DWI) is an established diagnostic method of acute stroke. The latest advances in magnetic resonance imaging (MRI) technology have greatly expanded the utility of DWI in the examination of v...Diffusion-weighted imaging (DWI) is an established diagnostic method of acute stroke. The latest advances in magnetic resonance imaging (MRI) technology have greatly expanded the utility of DWI in the examination of various organs. Recent studies have revealed the usefulness of DWI for imaging of the liver, kidney, ovary, and breast. We report a patient with acute pancreatitis detected by DWI and discussed the efficacy of DWI in diagnosing acute pancreatitis. A 50-year old man presented with a primary complaint of abdominal pain. We performed both DWI and computed tomography (CT) for this patient. The signal intensity in a series of DWI was measured and the apparent diffusion coefficient (ADC) values were calculated to differentiate inflammation from normal tissue. Two experienced radiologists evaluated the grade of acute pancreatitis by comparing the CT findings. Initially, the pancreas and multiple ascites around the pancreas produced a bright signal and ADC values were reduced on DWI. As the inflammation decreased, the bright signal faded to an iso-signal and the ADC values returned to their normal level. There was no difference in the abilities of DWI and CT images to detect acute pancreatitis. However, our case indicates that DWI can evaluate the manifestations of acute pancreatitis using no enhancement material andhas the potential to replace CT as a primary diagnostic strategy for acute pancreatitis.展开更多
A new geological section recognized in Baishantou of Jiayin,Heilongjiang Province,China,was studied preliminarily in searching for the K/T boundary.An early Paleocene florule characrerized by abundant Tiliaephyllum ts...A new geological section recognized in Baishantou of Jiayin,Heilongjiang Province,China,was studied preliminarily in searching for the K/T boundary.An early Paleocene florule characrerized by abundant Tiliaephyllum tsagajanicum leaves and its associated plants,was collected from the Baishantou Member(new member representing the lower part of the Paleocene Wuyun Formation)overlying the possible K/T boundary.A tuff bed was found from the upper part of the Furao Formation(uppermost Cretaceous)in this section.The new findings imply that the K/T boundary is probable lying in the interval between the base of the Baishantou Member and the tuff bed,based on the correlation of the present strata with the stratotype of the Tsagajan Group spanning the K/T boundary in"Belaya Gara"of the Bureya Basin,Russia.The early Paleocene florule from the Baishantou Member and the early-middle Maastrichtian dinosaurs found from the Yuliangzi Formation underlying the Furao Formation suggest that the Baishantou section is more promising for searching for the K/T boundary in this area.Further studies of the section is needed,integrating paleontological,biostratigraphic,geochemical,paleomagnetic,and sedimentary research would benefit our understanding the mass extinction event and biotic recovery in the Heilongjiang River area,China,and even all of northeast Asia during the K/T boundary interval.展开更多
We present two diagnostically challenging cases of acute pancreatitis with hypertriglyceridemia accompanied with chylomicronemia caused with a deficiency of lipoprotein lipase and with the presence of type Ⅴ hyperlip...We present two diagnostically challenging cases of acute pancreatitis with hypertriglyceridemia accompanied with chylomicronemia caused with a deficiency of lipoprotein lipase and with the presence of type Ⅴ hyperlipidemia. Both cases suffered from acute abdomen following the ingestion of fatty food and revealed the increase in parameters of inflammation without significant elevation of serum amylase levels.The imaging examination of ultrasonography could not detect significant findings of acute pancreatitis and a computer tomography scan eventually confirmed the findings of acute pancreatitis.Both cases responded to a low fat diet and administration of a cholecystokinin receptor antagonist,exhibiting a relief of abdominal symptoms.As in the present cases with acute abdomen following the ingestion of fatty food,the identification of serum hypertriglyceridemia and an abdominal computer tomography scan might be useful in establishing the diagnosis of acute pancreatitis and in developing the therapeutic regimen,when hypertriglyceridemia interferes with the evaluation of pancreatic enzyme activities and ultrasound examination provides poor pancreatic visualization.展开更多
AIM:To investigate the associations between dietary intake of polyphenols and colorectal cancer. METHODS:The study subjects were derived from the Fukuoka colorectal cancer study, a community-based case-control study. ...AIM:To investigate the associations between dietary intake of polyphenols and colorectal cancer. METHODS:The study subjects were derived from the Fukuoka colorectal cancer study, a community-based case-control study. The study subjects were 816 cases of colorectal cancer and 815 community-based controls. The consumption of 148 food items was assessed by a computer-assisted interview. We used the consumption of 97 food items to estimate dietary intakes of total, tea and coffee polyphenols. The Phenol-Explorer database was used for 92 food items. Of the 5 foods which were not listed in the Phenol-Explorer Database, polyphenol contents of 3 foods (sweet potatoes, satoimo and daikon) were based on a Japanese study and 2 foods (soybeans and fried potatoes) were estimated by ORAC-based polyphenol contents in the United States Department of Agriculture Database. Odds ratios (OR) and 95%CI of colorectal cancer risk according to quintile categories of intake were obtained by using logistic regression models with adjustment for age, sex, residential area, parental history of colorectal cancer, smoking, alcohol consumption, body mass index 10 years before, type of job, leisure-time physical activity and dietary intakes of calcium and n-3 polyunsaturated fatty acids.RESULTS:There was no measurable difference in total or tea polyphenol intake between cases and controls, but intake of coffee polyphenols was lower in cases than in controls. The multivariate-adjusted OR of colorectal cancer according to quintile categories of coffee polyphenols (from the first to top quintile) were 1.00 (referent), 0.81 (95%CI:0.60-1.10), 0.65 (95%CI:0.47-0.89), 0.65 (95%CI:0.46-0.89) and 0.82 (95%CI:0.60-1.10), respectively (P trend = 0.07). Similar, but less pronounced, decreases in the OR were also noted for the third and fourth quintiles of total polyphenol intake. Tea polyphenols and non-coffee polyphenols showed no association with colorectal cancer risk. The sitespecific analysis, based on 463 colon cancer cases and 340 rectal cancer case展开更多
Gastric stump carcinoma was initially reported by Balfore in 1922,and many reports of this disease have since been published. We herein review previous reports of gastric stump carcinoma with respect to epidemiology,c...Gastric stump carcinoma was initially reported by Balfore in 1922,and many reports of this disease have since been published. We herein review previous reports of gastric stump carcinoma with respect to epidemiology,carcinogenesis,Helicobacter pylori(H. pylori) infection,Epstein-Barr virus infection,clinicopathologic characteristics and endoscopic treatment. In particular,it is noteworthy that no prognostic differences are observed between gastric stump carcinoma and primary upper third gastric cancer. In addition,endoscopic submucosal dissection has recently been used to treat gastric stump carcinoma in the early stage. In contrast,many issues concerning gastric stump carcinoma remain to be clarified,including molecular biological characteristics and the carcinogenesis of H.pylori infection.We herein review the previous pertinent literature and summarize the characteristics of gastric stump carcinoma reported to date.展开更多
Recent progress in the research regarding the molecular pathogenesis and management of gastric mucosa-associated lymphoid tissue (MALT) lymphoma is reviewed. In approximately 90% of cases, Helicobacter pylori (H. pylo...Recent progress in the research regarding the molecular pathogenesis and management of gastric mucosa-associated lymphoid tissue (MALT) lymphoma is reviewed. In approximately 90% of cases, Helicobacter pylori (H. pylori) infection plays the causative role in the pathogenesis, and H. pylori eradication is nowadays the first-line treatment for this disease, which leads to complete disease remission in 50%-90% of cases. In H. pylori-dependent cases, microbe-generated immune responses, including interaction between B and T cells involving CD40 and CD40L co-stimulatory molecules, are considered to induce the development of MALT lymphoma. In H. pylori-independent cases, activation of the nuclear factor-κB pathway by oncogenic products of specific chromosomal translocations such as t(11;18)/API2-MALT1, or inactivation of tumor necrosis factor alpha-induced protein 3 (A20) are considered to contribute to the lymphomagenesis. Recently, a large-scale Japanese multicenter study confirmed that the long-term clinical outcome of gastric MALT lymphoma after H. pylori eradication is excellent. Treatment modalities for patients not responding to H. pylori eradication include a “watch and wait” strategy, radiotherapy, chemotherapy, rituximab immunotherapy, and a combination of these. Because of the indolent behavior of MALT lymphoma, second-line treatment should be tailored in consideration of the clinical stage and extent of the disease in each patient.展开更多
AIM： To determine the efficacy of an interferon alpha and ribavirin combination treatment for Japanese patients infected with hepatitis C virus （HCV） of genotype 2, a multi-center study was retrospectively analyzed...AIM： To determine the efficacy of an interferon alpha and ribavirin combination treatment for Japanese patients infected with hepatitis C virus （HCV） of genotype 2, a multi-center study was retrospectively analyzed. METHODS： In total, 173 patients with HCV genotype 2 started to receive interferon-alpha subcutaneously thrice a week and 600-800 mg of ribavirin daily for 24 wk. RESULTS： The overall sustained virological response （SVR）, defined as undetectable HCV RNA in serum, 24 wk after the end of treatment, was remarkably high by 84.4%, （146/173） by an intention-to-treat analysis. A significant difference in SVR was found between patients with and without the discontinuation of ribavirin （46.9% vs 92.9 %）, but no difference was found between those with and without a dose reduction of ribavirin. A significant difference in SVR was also found between patients with less than 16 wk and patients with 16 or more weeks of ribavirin treatment （34.8 % vs 92.0 %）. CONCLUSION： The 24-wk interferon and ribavirin treatment is highly effective for Japanese patients with HCV genotype 2. The significant predictor of SVR is continuation of the ribavirin treatment for up to 16展开更多
文摘There has been a long-standing need for guidelines on the diagnosis and treatment of keloids and hypertrophic scars that are based on an understanding of the pathomechanisms that underlie these skin fibrotic diseases.This is particularly true for clinicians who deal with Asian and African patients because these ethnicities are highly prone to these diseases.By contrast,Caucasians are less likely to develop keloids and hypertrophic scars,and if they do,the scars tend not to be severe.This ethnic disparity also means that countries vary in terms of their differential diagnostic algorithms.The lack of clear treatment guidelines also means that primary care physicians are currently applying a hotchpotch of treatments,with uneven outcomes.To overcome these issues,the Japan Scar Workshop(JSW)has created a tool that allows clinicians to objectively diagnose and distinguish between keloids,hypertrophic scars,and mature scars.This tool is called the JSW Scar Scale(JSS)and it involves scoring the risk factors of the individual patients and the affected areas.The tool is simple and easy to use.As a result,even physicians who are not accustomed to keloids and hypertrophic scars can easily diagnose them and judge their severity.The JSW has also established a committee that,in cooperation with outside experts in various fields,has prepared a Consensus Document on keloid and hypertrophic scar treatment guidelines.These guidelines are simple and will allow even inexperienced clinicians to choose the most appropriate treatment strategy.The Consensus Document is provided in this article.It describes(1)the diagnostic algorithm for pathological scars and how to differentiate them from clinically similar benign and malignant tumors,(2)the general treatment algorithms for keloids and hypertrophic scars at different medical facilities,(3)the rationale behind each treatment for keloids and hypertrophic scars,and(4)the body site-specific treatment protocols for these scars.We believe that this Consensus Document will be helpful for physi
基金supported by the Program for Changjiang Scholars and Innovative Research Team in University scheme of the Ministry of Education of China(NO.IRT1111)the National Basic Research Program of China(2012CB518300)+2 种基金the National Natural Science Foundation of China(81101946)the Shanghai Pujiang Program(12PJD008)Prostate Cancer Foundation Young Investigator Award,Shanghai Municipal Health and Family Planning Commission Outstanding Young Investigator(XYQ2013077).
文摘The incidence of prostate cancer(PCa)within Asian population used to be much lower than in the Western population;however,in recent years the incidence and mortality rate of PCa in some Asian countries have grown rapidly.This collaborative report summarized the latest epidemiology information,risk factors,and racial differences in PCa diagnosis,current status and new trends in surgery management and novel agents for castration-resistant prostate cancer.We believe such information would be helpful in clinical decision making for urologists and oncologists,health-care ministries and medical researchers.
文摘 Endoscopic submucosal dissection (ESD) is now the most common endoscopic treatment in Japan for intramucosal gastrointestinal neoplasms (non-metastatic). ESD is an invasive endoscopic surgical procedure, requiring extensive knowledge, skill, and specialized equipment. ESD starts with evaluation of the lesion, as accurate assessment of the depth and margin of the lesion is essential. The devices and strategies used in ESD vary, depending on the nature of the lesion. Prior to the procedure, the operator must be knowledgeable about the treatment strategy(ies), the device(s) to use, the electrocautery machine settings, the substances to inject, and other aspects. In addition, the operator must be able to manage complications, should they arise, including immediate recognition of the complication(s) and its treatment. Finally, in case the ESD treatment is not successful, the operator should be prepared to apply alternative treatments. Thus, adequate knowledge and training are essential to successfully perform ESD.
基金financially supported by Guangdong Basic and Applied Basic Research Foundation (No. 2019A1515011985)the National Natural Science Foundation of China (Nos.52071157,51801078,52001070 and 52001079)+3 种基金the Natural Science Foundation of Jiangsu Province (No.BK20180986)the Natural Science Foundation of Guangxi Province (No. 2019GXNSFB A185004)Guangzhou Science and Technology Association Young Talent Lifting Project (No.X20200301071)the Open Fund of the Guangdong Provincial Key Laboratory of Advance Energy Storage Materials (No.AESM202102)
文摘Development of new materials with high hydrogen storage capacity and reversible hydrogen sorp-tion performances under mild conditions has very high value in both fundamental and application aspects.In the past years,some new systems with metastable structures,such as ultra-fine nanocrystalline alloys,amorphous alloys,nanoglass alloys,immiscible alloys,high-entropy alloys,have been abundantly studied as hydrogen storage mate-rials.Many new hydrogen storage properties either from the kinetics or thermodynamics aspects have been reported.In this review,recent advances of studies on metastable alloys for hydrogen storage applications have been comprehensively reviewed.The materials preparation methods to synthesize metastable hydrogen storage alloys are firstly reviewed.Afterwards,hydrogen storage prop-erties of the metastable alloys are summarized and dis-cussed,focusing on the unique kinetics and thermodynamics properties by forming of such unique metastable structures.For examples,superior hydrogena-tion kinetics and higher hydrogen storage capacity have been achieved in Mg-based amorphous and nanoglass alloys.Destabilized thermodynamics properties can be obtained in the immiscible Mg-Mn and Mg-Zr alloys.In addition to highlighting the recent achievements of metastable alloys in the field of hydrogen storage,the remaining challenges and trends of the emerging research are also discussed.
基金the Doctoral Program Foundation of the Ministry of Education of China,the National Natural Science Foundation of China(Grant Nos.10272067 and 10002003)the Foundation for University Key Teacher by the Ministry of Education.
文摘The generalized fractional element networks are presented in this paper. In order to extend the structure of the model solutions to the generalized function space and make it contain more physical meanings, the restriction on the parameters of the fractional element proposed by Schiessel et al. is eliminated and a 'compatibility equation' is added. The discretization method for solving the inverse Laplace transform is used and developed. The generalized solutions of the model equations are given. At the same time the generalized fractional element network--Zener and Poyinting-Thomson models are discussed in detail. It is shown that all the results obtained previously about the models of single parameter with fractional order and the classical models with integer order can be contained as the special cases of the results of this paper.
文摘AIM: To assess the utility and safety of single-operator cholangiopancreatoscopy(SOCPS) using the Spy Glass system in widespread clinical application for biliary and pancreatic diseases.METHODS: This study was a prospective case series conducted in 20 referral centers in Japan. There were 148 patients who underwent SOCPS; 124 for biliary diseases and 24 for pancreatic diseases. The attempted interventions were SOCPS examination, SOCPS-directed tissue sampling, and therapy for stone removal, among others. The main outcomes were related to the procedure success rate in terms of visualizing the target lesions, SOCPS-directed adequate tissue sampling, and complete stone removal. RESULTS: A total of 148 patients were enrolled for the diagnosis of indeterminate biliary and pancreatic lesions or treatment of biliary and pancreatic disease. The overall procedure success rate of visualizing the target lesions was 91.2%(135/148). The overall procedural success rates of visualizing the target lesions of diagnostic SOCPS in the bile duct and pancreatic duct were 95.5%(84/89) and 88.2%(15/17), respectively. Diagnosis: the overall adequate tissue for histologic examination was secured in 81.4% of the 86 patients who underwent biopsy under SOCPS(bile duct, 60/75, 80.0%; pancreatic duct, 10/11, 90.9%). The accuracy of histologic diagnosis using SOCPS-directed biopsies in indeterminate bile duct lesions was 70.7%(53/75). In the pancreatic duct, the accuracy of SOCPS visual impression of intraductal papillary mucinous neoplasm was 87.5%(14/16). Stone therapy: complete biliary and pancreatic stone clearance combined with SOCPS-directed stone therapy using electrohydraulic lithotripsy or laser lithotripsy was achieved in 74.2%(23/31) and 42.9%(3/7) of the patients, respectively. Others: SOCPS using the Spy Glass system was used in cannulation of the cystic duct in two patients and for passing across the obstructed self-expandable metallic stent for a malignant biliary stricture in two patients. All procedures were successful in both
基金Supported by Grants-in-aid for Cancer Research from the Ministry of Education, Science and Culture, Japan and the Fukuoka Cancer Society, Fukuoka, Japan
文摘AIM： Minimal deviation carcinoma of the uterine cervix, otherwise known as extremely well-differentiated adenocarcinoma （EWDA）, is characterized by its benign microscopic appearance in contrast to its aggressive behavior. In order to elucidate the clinicopathological features and biological behavior of the gastric counterpart of EWDA, we, using immunohistochemistry, analyzed nine lesions for the phenotypic expression, proliferative activity, and the expression of oncogene-associated products. METHODS： Clinicopathological features, including preoperative biopsy diagnosis, were reviewed. Using immunohitstochemistry, Ki-67 labeling index and expression of p53 and c-erbB-2 protein in the gastric lesions were detected.RESULT： Locations in the middle or upper third of the stomach and polypoid macroscopic features are characteristic of EWDA of the stomach. Although 4 of the 9 lesions showed only focal lymphatic or venous invasion, lymph node metastasis was not present and none of the patients died of the lesions （mean follow-up period, 56 too）. All 9 cases of EWDA could be classified into gastric phenotype （5 lesions） and intestinal phenotype （4 lesions）. The former resembled gastric foveolar epithelium, mucous neck cells or pyloric glands, but their papillary structures were frequently elongated and the tumor cellsand their nuclei were slightly larger and more hyperchromatic compared to normal epithelium. The latter resembled intestinal metaplasia with minimal nulcear atypia and irregular glands; two of these lesions demonstrated complete intestinal phenotype, while two demonstrated incomplete intestinal phenotype. Ki-67 labeling index was low and none of the cases revealed over-expression of p53 and c-erbB-2 protein. CONCLUSION： Unlike minimal deviation carcinoma of the cervix, these findings suggest that EWDA of the stomach is a lesion of low-grade malignancy. This favorable biological behavior is supported by the data of a low Ki-67 labeling index and a lack of p53 or c-erbB-2 protein over-ex
基金support by the National Natural Science Foundation of China (Grant No. 50779004)
文摘Numerical simulations of extreme wave generation are carried out by using the Volume Of Fluid（VOF） method.Extreme waves are generated based on wave focusing in a 2-D numerical model.To validate the capability of the VOF-based model described in this article,the propagation of regular waves is computed and compared with the theoretical results.By adjusting the phases of wave components,extreme waves are formed at given time and given position in the computation.The numerical results are compared with theoretical solutions and experimental data.It is concluded that the present model based on the VOF technique can provide acceptably accurate numerical results to serve practical purposes.
基金This paper is funded by the higher ministry of education in Egypt.
文摘This paper presents a coordination strategy of Load Frequency Control(LFC)and digital frequency protection for an islanded microgrid(MG)considering high penetration of Renewable Energy Sources(RESs).In such MGs,the reduction in system inertia due to integration of large amount of RESs causes undesirable influence on MG frequency stability,leading to weakening of the MG.Furthermore,sudden load events,and short circuits caused large frequency fluctuations,which threaten the system security and could lead to complete blackouts as well as damages to the system equipment.Therefore,maintaining the dynamic security in MGs is one of the important challenges,which considered in this paper using a specific design and various data conversion stages of a digital over/under frequency relay(OUFR).The proposed relay will cover both under and over frequency conditions in coordination with LFC operation to protect the MG against high frequency variations.To prove the response of the proposed coordination strategy,a small MG was investigated for the simulation.The proposed coordination method has been tested considering load change,high integration of RESs.Moreover,the sensitivity analysis of the presented technique was examined by varying the penetration level of RESs and reducing the system inertia.The results reveal the effectiveness of the proposed coordination to maintain the power system frequency stability and security.In addition,the superiority of the OUFR has been approved in terms of accuracy and speed response during high disturbances.
文摘AIM: To elucidate the immunologic parameters for the outcome of patients with malignant tumors, especially esophageal squamous cell carcinoma (ESCC) associated with high malignant potential. METHODS: Clinicopathologic features were compared between patients with lower and higher CD4 and CD8 values as well as CD4/CD8 ratio in peripheral blood. RESULTS: The survival rate of patients with higher CD4 value was significantly better than that in patients with lower CD4 value (P = 0.039). The survival rate of patients with higher CD8 value was significantly worse than that of patients with lower CD8 value (P = 0.026). Similarly, the survival rate of patients with higher CD4/ CD8 ratio was significantly better than that of patients with lower CD4/CD8 ratio (P = 0.042). Additionally, multivariate analysis demonstrated that lower CD8 and lower CD4/CD8 ratio were factors independently associated with worse prognosis of patients. CONCLUSION: All the immunologic parameters can predict the outcome of patients with ESCC.
文摘AIM: To investigate the clinicopathological features of intraductal neoplasm of the intrahepatic bile duct (INihB). METHODS: Clinicopathological features of 24 cases of INihB, which were previously diagnosed as biliary papillomatosis or intraductal growth of intrahepatic biliary neoplasm, were reviewed. Mucin immunohistochemistry was performed for mucin (MUC)1, MUC2, MUC5AC and MUC6. Ki-67, P53 and β-catenin immunoreactivity were also examined. We categorized each tumor as adenoma (low grade), borderline (intermediate grade), and malignant (carcinoma in situ , high grade including tumors with microinvasion). RESULTS: Among 24 cases of INihB, we identified 24 tumors. Twenty of 24 tumors (83%) were composed of a papillary structure; the same feature observed in intraductal papillary neoplasm of the bile duct (IPNB). In contrast, the remaining four tumors (17%) showed both tubular and papillary structures. In three of the four tumors (75%), macroscopic mucin secretion was limited but microscopic intracellular mucin was evident. Histologically, 16 tumors (67%) were malignant, three (12%) were borderline, and five (21%) were adenoma. Microinvasion was found in four cases (17%). Immunohistochemical analysis revealed that MUC1 was not expressed in the borderline/adenoma group but was expressed only in malignant lesions (P = 0.0095). Ki-67 labeling index (LI) was significantly higher in the malignant group than in the borderline/adenoma group (22.2 ± 15.5 vs 7.5 ± 6.3, P < 0.01). In the 16 malignant cases, expression of MUC5AC showed borderline significant association with high Ki-67 LI (P = 0.0622). Nuclear expression of β-catenin was observed in two (8%) of the 24 tumors, and these two tumors also showed MUC1 expression. P53 was negative in all tumors. CONCLUSION: Some cases of INihB have a tubular structure, and are subcategorized as IPNB with tubular structure. MUC1 expression in INihB correlates positively with degree of malignancy.
基金supported by Japanese Government (MEXT) Scholarship Program 2016–2019, Japan
文摘We investigated the effects of integrated organic and inorganic fertilizers on the growth and yield of indica rice variety Manawthukha and japonica rice variety Genkitsukushi.In a split-plot design,the two rice varieties were assigned as main plot factors,and the integrated treatments were the subplot factors,including no-N fertilizer(N0),50%chemical fertilizer(CF)(CF50),100%CF(CF100),50%CF+50%poultry manure(PM)(CF50PM50),50%CF+50%cow manure(CM)(CF50CM50),and 50%CF+50%compost(CP)(CF50CP50).CF100 was equivalent to N at 85 kg/hm2.Manure was applied based on the estimated mineralizable nitrogen(EMN)level,which is dependent on total N(%)of each manure type.Manawthukha rice plants were taller with higher tiller number and dry matter content.However,higher soil-plant analysis development(SPAD)values were measured in Genkitsukushi throughout the crop growth period,resulting in higher seed-setting rate(%)and greater yield.At the same N level,CF50PM50 application in both rice varieties resulted in higher SPAD values,plant height and tiller number than CF100.CF50PM50 containing total N more than 4%supplied synchronized N for the demands of the rice plants,resulting in maximum dry matter,yield and yield components.CF50CM50 and CF50CP50 treatments containing total N less than 4%resulted in lower yields which were similar to CF100.These results indicated that integrating organic and inorganic fertilizers enhanced growth parameters and yields of Manawthukha and Genkitsukushi,while reducing the dose of chemical fertilizer.
文摘Diffusion-weighted imaging (DWI) is an established diagnostic method of acute stroke. The latest advances in magnetic resonance imaging (MRI) technology have greatly expanded the utility of DWI in the examination of various organs. Recent studies have revealed the usefulness of DWI for imaging of the liver, kidney, ovary, and breast. We report a patient with acute pancreatitis detected by DWI and discussed the efficacy of DWI in diagnosing acute pancreatitis. A 50-year old man presented with a primary complaint of abdominal pain. We performed both DWI and computed tomography (CT) for this patient. The signal intensity in a series of DWI was measured and the apparent diffusion coefficient (ADC) values were calculated to differentiate inflammation from normal tissue. Two experienced radiologists evaluated the grade of acute pancreatitis by comparing the CT findings. Initially, the pancreas and multiple ascites around the pancreas produced a bright signal and ADC values were reduced on DWI. As the inflammation decreased, the bright signal faded to an iso-signal and the ADC values returned to their normal level. There was no difference in the abilities of DWI and CT images to detect acute pancreatitis. However, our case indicates that DWI can evaluate the manifestations of acute pancreatitis using no enhancement material andhas the potential to replace CT as a primary diagnostic strategy for acute pancreatitis.
基金The authors are grateful for the Project No.30211330496 of the NSFC(China)for the spe-cial financial support of the Jjilin University,China.
文摘A new geological section recognized in Baishantou of Jiayin,Heilongjiang Province,China,was studied preliminarily in searching for the K/T boundary.An early Paleocene florule characrerized by abundant Tiliaephyllum tsagajanicum leaves and its associated plants,was collected from the Baishantou Member(new member representing the lower part of the Paleocene Wuyun Formation)overlying the possible K/T boundary.A tuff bed was found from the upper part of the Furao Formation(uppermost Cretaceous)in this section.The new findings imply that the K/T boundary is probable lying in the interval between the base of the Baishantou Member and the tuff bed,based on the correlation of the present strata with the stratotype of the Tsagajan Group spanning the K/T boundary in"Belaya Gara"of the Bureya Basin,Russia.The early Paleocene florule from the Baishantou Member and the early-middle Maastrichtian dinosaurs found from the Yuliangzi Formation underlying the Furao Formation suggest that the Baishantou section is more promising for searching for the K/T boundary in this area.Further studies of the section is needed,integrating paleontological,biostratigraphic,geochemical,paleomagnetic,and sedimentary research would benefit our understanding the mass extinction event and biotic recovery in the Heilongjiang River area,China,and even all of northeast Asia during the K/T boundary interval.
文摘We present two diagnostically challenging cases of acute pancreatitis with hypertriglyceridemia accompanied with chylomicronemia caused with a deficiency of lipoprotein lipase and with the presence of type Ⅴ hyperlipidemia. Both cases suffered from acute abdomen following the ingestion of fatty food and revealed the increase in parameters of inflammation without significant elevation of serum amylase levels.The imaging examination of ultrasonography could not detect significant findings of acute pancreatitis and a computer tomography scan eventually confirmed the findings of acute pancreatitis.Both cases responded to a low fat diet and administration of a cholecystokinin receptor antagonist,exhibiting a relief of abdominal symptoms.As in the present cases with acute abdomen following the ingestion of fatty food,the identification of serum hypertriglyceridemia and an abdominal computer tomography scan might be useful in establishing the diagnosis of acute pancreatitis and in developing the therapeutic regimen,when hypertriglyceridemia interferes with the evaluation of pancreatic enzyme activities and ultrasound examination provides poor pancreatic visualization.
基金Supported by the Scientific Support Programs for Cancer Research,Grant-in-Aid for Scientific Research on Innovative Areas,the Ministry of Education,Culture,Sports,Science and Technology,Japan
文摘AIM:To investigate the associations between dietary intake of polyphenols and colorectal cancer. METHODS:The study subjects were derived from the Fukuoka colorectal cancer study, a community-based case-control study. The study subjects were 816 cases of colorectal cancer and 815 community-based controls. The consumption of 148 food items was assessed by a computer-assisted interview. We used the consumption of 97 food items to estimate dietary intakes of total, tea and coffee polyphenols. The Phenol-Explorer database was used for 92 food items. Of the 5 foods which were not listed in the Phenol-Explorer Database, polyphenol contents of 3 foods (sweet potatoes, satoimo and daikon) were based on a Japanese study and 2 foods (soybeans and fried potatoes) were estimated by ORAC-based polyphenol contents in the United States Department of Agriculture Database. Odds ratios (OR) and 95%CI of colorectal cancer risk according to quintile categories of intake were obtained by using logistic regression models with adjustment for age, sex, residential area, parental history of colorectal cancer, smoking, alcohol consumption, body mass index 10 years before, type of job, leisure-time physical activity and dietary intakes of calcium and n-3 polyunsaturated fatty acids.RESULTS:There was no measurable difference in total or tea polyphenol intake between cases and controls, but intake of coffee polyphenols was lower in cases than in controls. The multivariate-adjusted OR of colorectal cancer according to quintile categories of coffee polyphenols (from the first to top quintile) were 1.00 (referent), 0.81 (95%CI:0.60-1.10), 0.65 (95%CI:0.47-0.89), 0.65 (95%CI:0.46-0.89) and 0.82 (95%CI:0.60-1.10), respectively (P trend = 0.07). Similar, but less pronounced, decreases in the OR were also noted for the third and fourth quintiles of total polyphenol intake. Tea polyphenols and non-coffee polyphenols showed no association with colorectal cancer risk. The sitespecific analysis, based on 463 colon cancer cases and 340 rectal cancer case
文摘Gastric stump carcinoma was initially reported by Balfore in 1922,and many reports of this disease have since been published. We herein review previous reports of gastric stump carcinoma with respect to epidemiology,carcinogenesis,Helicobacter pylori(H. pylori) infection,Epstein-Barr virus infection,clinicopathologic characteristics and endoscopic treatment. In particular,it is noteworthy that no prognostic differences are observed between gastric stump carcinoma and primary upper third gastric cancer. In addition,endoscopic submucosal dissection has recently been used to treat gastric stump carcinoma in the early stage. In contrast,many issues concerning gastric stump carcinoma remain to be clarified,including molecular biological characteristics and the carcinogenesis of H.pylori infection.We herein review the previous pertinent literature and summarize the characteristics of gastric stump carcinoma reported to date.
文摘Recent progress in the research regarding the molecular pathogenesis and management of gastric mucosa-associated lymphoid tissue (MALT) lymphoma is reviewed. In approximately 90% of cases, Helicobacter pylori (H. pylori) infection plays the causative role in the pathogenesis, and H. pylori eradication is nowadays the first-line treatment for this disease, which leads to complete disease remission in 50%-90% of cases. In H. pylori-dependent cases, microbe-generated immune responses, including interaction between B and T cells involving CD40 and CD40L co-stimulatory molecules, are considered to induce the development of MALT lymphoma. In H. pylori-independent cases, activation of the nuclear factor-κB pathway by oncogenic products of specific chromosomal translocations such as t(11;18)/API2-MALT1, or inactivation of tumor necrosis factor alpha-induced protein 3 (A20) are considered to contribute to the lymphomagenesis. Recently, a large-scale Japanese multicenter study confirmed that the long-term clinical outcome of gastric MALT lymphoma after H. pylori eradication is excellent. Treatment modalities for patients not responding to H. pylori eradication include a “watch and wait” strategy, radiotherapy, chemotherapy, rituximab immunotherapy, and a combination of these. Because of the indolent behavior of MALT lymphoma, second-line treatment should be tailored in consideration of the clinical stage and extent of the disease in each patient.
文摘AIM： To determine the efficacy of an interferon alpha and ribavirin combination treatment for Japanese patients infected with hepatitis C virus （HCV） of genotype 2, a multi-center study was retrospectively analyzed. METHODS： In total, 173 patients with HCV genotype 2 started to receive interferon-alpha subcutaneously thrice a week and 600-800 mg of ribavirin daily for 24 wk. RESULTS： The overall sustained virological response （SVR）, defined as undetectable HCV RNA in serum, 24 wk after the end of treatment, was remarkably high by 84.4%, （146/173） by an intention-to-treat analysis. A significant difference in SVR was found between patients with and without the discontinuation of ribavirin （46.9% vs 92.9 %）, but no difference was found between those with and without a dose reduction of ribavirin. A significant difference in SVR was also found between patients with less than 16 wk and patients with 16 or more weeks of ribavirin treatment （34.8 % vs 92.0 %）. CONCLUSION： The 24-wk interferon and ribavirin treatment is highly effective for Japanese patients with HCV genotype 2. The significant predictor of SVR is continuation of the ribavirin treatment for up to 16
