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Shirane K, Masumoto K, Shinkai T, Ohkohchi N, Endou M, Ishige K. Hepatolithiasis in a 52-year-old native liver survivor with postoperative biliary atresia. Journal of Pediatric Surgery Case Reports 2023. [DOI: 10.1016/j.epsc.2022.102538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
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2
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Liang C, Takahashi K, Furuya K, Ohkohchi N, Oda T. Dualistic role of platelets in living donor liver transplantation: Are they harmful? World J Gastroenterol 2022; 28:897-908. [PMID: 35317052 PMCID: PMC8908284 DOI: 10.3748/wjg.v28.i9.897] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 07/04/2021] [Accepted: 01/26/2022] [Indexed: 02/06/2023] Open
Abstract
Platelets are anucleate fragments mainly involved in hemostasis and thrombosis, and there is emerging evidence that platelets have other nonhemostatic potentials in inflammation, angiogenesis, regeneration and ischemia/reperfusion injury (I/R injury), which are involved in the physiological and pathological processes during living donor liver transplantation (LDLT). LDLT is sometimes associated with impaired regeneration and severe I/R injury, leading to postoperative complications and decreased patient survival. Recent studies have suggested that perioperative thrombocytopenia is associated with poor graft regeneration and postoperative morbidity in the short and long term after LDLT. Although it is not fully understood whether thrombocytopenia is the cause or result, increasing platelet counts are frequently suggested to improve posttransplant outcomes in clinical studies. Based on rodent experiments, previous studies have identified that platelets stimulate liver regeneration after partial hepatectomy. However, the role of platelets in LDLT is controversial, as platelets are supposed to aggravate I/R injury in the liver. Recently, a rat model of partial liver transplantation (LT) was used to demonstrate that thrombopoietin-induced thrombocytosis prior to surgery accelerated graft regeneration and improved the survival rate after transplantation. It was clarified that platelet-derived liver regeneration outweighed the associated risk of I/R injury after partial LT. Clinical strategies to increase perioperative platelet counts, such as thrombopoietin, thrombopoietin receptor agonist and platelet transfusion, may improve graft regeneration and survival after LDLT.
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Affiliation(s)
- Chen Liang
- Gastrointestinal and Hepatobiliary-Pancreatic Surgery, University of Tsukuba, Tsukuba 3058575, Ibaraki, Japan
| | - Kazuhiro Takahashi
- Gastrointestinal and Hepatobiliary-Pancreatic Surgery, University of Tsukuba, Tsukuba 3058575, Ibaraki, Japan
| | - Kinji Furuya
- Gastrointestinal and Hepatobiliary-Pancreatic Surgery, University of Tsukuba, Tsukuba 3058575, Ibaraki, Japan
| | - Nobuhiro Ohkohchi
- Gastrointestinal and Hepatobiliary-Pancreatic Surgery, University of Tsukuba, Tsukuba 3058575, Ibaraki, Japan
| | - Tatsuya Oda
- Gastrointestinal and Hepatobiliary-Pancreatic Surgery, University of Tsukuba, Tsukuba 3058575, Ibaraki, Japan
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Okuda Y, Saida T, Morinaga K, Ohara A, Hara A, Hashimoto S, Takahashi S, Goya T, Ohkohchi N. Diagnosing gangrenous cholecystitis on computed tomography using deep learning: A preliminary study. Acute Med Surg 2022; 9:e783. [PMID: 36187450 PMCID: PMC9487185 DOI: 10.1002/ams2.783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 08/17/2022] [Indexed: 12/07/2022] Open
Abstract
Aim To compare deep learning and experienced physicians in diagnosing gangrenous cholecystitis using computed tomography images and explore the feasibility of diagnostic assistance for acute cholecystitis requiring emergency surgery. Methods This retrospective study included 25 patients with pathologically confirmed gangrenous cholecystitis and 129 patients with noncomplicated acute cholecystitis who underwent computed tomography between 2016 and 2021 at two institutions. All available computed tomography images at the time of the initial diagnosis were used for the analysis. A deep learning model based on a convolutional neural network was trained using 1,517 images of 112 patients (18 patients with gangrenous cholecystitis and 94 patients with acute cholecystitis) and tested with 68 images of 42 patients (seven patients with gangrenous cholecystitis and 35 patients with acute cholecystitis). Three blinded, experienced physicians independently interpreted the test images. The sensitivity, specificity, accuracy, and area under the receiver operating characteristic curve were compared between the convolutional neural network and the reviewers. Results The convolutional neural network (sensitivity, 0.70; 95% confidence interval [CI], 0.44–0.87, specificity, 0.93; 95% CI, 0.88–0.96, accuracy, 0.89; 95% CI, 0.81–0.95, area under the receiver operating characteristic curve, 0.84; 95% CI, 0.68–1.00) had achieved a better diagnostic performance than the reviewers (ex. sensitivity, 0.55; 95% CI, 0.30–0.77, specificity, 0.67; 95% CI, 0.62–0.71, accuracy, 0.65; 95% CI, 0.57–0.72, area under the receiver operating characteristic curve, 0.63; 95% CI, 0.44–0.82; P = 0.048 for area under the receiver operating characteristic curve versus convolutional neural network). Conclusions Deep learning had a better diagnostic performance than experienced reviewers in diagnosing gangrenous cholecystitis and has potential applicability for assisting in identifying indications for emergency surgery in the future.
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Affiliation(s)
- Yoichi Okuda
- Depertment of Surgery Koyama Memorial Hospital Kashima Japan
- Department of Surgery Mitochuo Hospital Mito Japan
| | - Tsukasa Saida
- Department of Radiology, Faculty of Medicine University of Tsukuba Tsukuba Japan
| | - Keigo Morinaga
- Department of Radiology Koyama Memorial Hospital Kashima Japan
| | - Arisa Ohara
- Department of Radiology Koyama Memorial Hospital Kashima Japan
| | - Akihiro Hara
- Depertment of Surgery Koyama Memorial Hospital Kashima Japan
| | | | | | - Tomoyuki Goya
- Depertment of Surgery Koyama Memorial Hospital Kashima Japan
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Mamada H, Kemmochi A, Tamura T, Shimizu Y, Owada Y, Ozawa Y, Hisakura K, Oda T, Ohkohchi N, Kawano Y, Hanawa T. Development and evaluation of novel hydrogel for preventing postoperative pancreatic fistula. POLYM ADVAN TECHNOL 2022. [DOI: 10.1002/pat.5496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Hiroshi Mamada
- Faculty of Pharmaceutical Sciences Tokyo University of Science Chiba Japan
| | - Akira Kemmochi
- Department of Gastrointestinal and Hepato‐Biliary‐Pancreatic Surgery, Faculty of Medicine University of Tsukuba Tsukuba Japan
| | - Takafumi Tamura
- Department of Gastrointestinal and Hepato‐Biliary‐Pancreatic Surgery, Faculty of Medicine University of Tsukuba Tsukuba Japan
| | - Yoshio Shimizu
- Department of Gastrointestinal and Hepato‐Biliary‐Pancreatic Surgery, Faculty of Medicine University of Tsukuba Tsukuba Japan
| | - Yohei Owada
- Department of Gastrointestinal and Hepato‐Biliary‐Pancreatic Surgery, Faculty of Medicine University of Tsukuba Tsukuba Japan
| | - Yusuke Ozawa
- Department of Gastrointestinal and Hepato‐Biliary‐Pancreatic Surgery, Faculty of Medicine University of Tsukuba Tsukuba Japan
| | - Katsuji Hisakura
- Department of Gastrointestinal and Hepato‐Biliary‐Pancreatic Surgery, Faculty of Medicine University of Tsukuba Tsukuba Japan
| | - Tatsuya Oda
- Department of Gastrointestinal and Hepato‐Biliary‐Pancreatic Surgery, Faculty of Medicine University of Tsukuba Tsukuba Japan
| | - Nobuhiro Ohkohchi
- Department of Gastrointestinal and Hepato‐Biliary‐Pancreatic Surgery, Faculty of Medicine University of Tsukuba Tsukuba Japan
| | - Yayoi Kawano
- Faculty of Pharmaceutical Sciences Tokyo University of Science Chiba Japan
| | - Takehisa Hanawa
- Faculty of Pharmaceutical Sciences Tokyo University of Science Chiba Japan
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5
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Zhang L, Ge J, Zheng Y, Sun Z, Wang C, Peng Z, Wu B, Fang M, Furuya K, Ma X, Shao Y, Ohkohchi N, Oda T, Fan J, Pan G, Li D, Hui L. Survival-Assured Liver Injury Preconditioning (SALIC) Enables Robust Expansion of Human Hepatocytes in Fah -/- Rag2 -/- IL2rg -/- Rats. Adv Sci (Weinh) 2021; 8:e2101188. [PMID: 34382351 PMCID: PMC8498896 DOI: 10.1002/advs.202101188] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 06/13/2021] [Indexed: 06/13/2023]
Abstract
Although liver-humanized animals are desirable tools for drug development and expansion of human hepatocytes in large quantities, their development is restricted to mice. In animals larger than mice, a precondition for efficient liver humanization remains preliminary because of different xeno-repopulation kinetics in livers of larger sizes. Since rats are ten times larger than mice and widely used in pharmacological studies, liver-humanized rats are more preferable. Here, Fah-/- Rag2-/- IL2rg-/- (FRG) rats are generated by CRISPR/Cas9, showing accelerated liver failure and lagged liver xeno-repopulation compared to FRG mice. A survival-assured liver injury preconditioning (SALIC) protocol, which consists of retrorsine pretreatment and cycling 2-(2-nitro-4-trifluoromethylbenzoyl)-1,3-cyclohexanedione (NTBC) administration by defined concentrations and time intervals, is developed to reduce the mortality of FRG rats and induce a regenerative microenvironment for xeno-repopulation. Human hepatocyte repopulation is boosted to 31 ± 4% in rat livers at 7 months after transplantation, equivalent to approximately a 1200-fold expansion. Human liver features of transcriptome and zonation are reproduced in humanized rats. Remarkably, they provide sufficient samples for the pharmacokinetic profiling of human-specific metabolites. This model is thus preferred for pharmacological studies and human hepatocyte production. SALIC may also be informative to hepatocyte transplantation in other large-sized species.
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Affiliation(s)
- Ludi Zhang
- State Key Laboratory of Cell Biology, Shanghai Institute of Biochemistry and Cell Biology, Center for Excellence in Molecular Cell Science, Chinese Academy of SciencesUniversity of Chinese Academy of ScienceShanghai200031China
| | - Jian‐Yun Ge
- Department of Gastrointestinal and Hepato‐Biliary‐Pancreatic Surgery, Faculty of MedicineUniversity of TsukubaTsukubaIbaraki305‐8575Japan
- Guangdong Provincial Key Laboratory of Large Animal Models for BiomedicineSchool of Biotechnology and Heath SciencesWuyi UniversityJiangmenGuangdong529020China
| | - Yun‐Wen Zheng
- Department of Gastrointestinal and Hepato‐Biliary‐Pancreatic Surgery, Faculty of MedicineUniversity of TsukubaTsukubaIbaraki305‐8575Japan
- Guangdong Provincial Key Laboratory of Large Animal Models for BiomedicineSchool of Biotechnology and Heath SciencesWuyi UniversityJiangmenGuangdong529020China
- Institute of Regenerative MedicineAffiliated Hospital of Jiangsu UniversityJiangsu UniversityZhenjiangJiangsu212001China
- Yokohama City University School of MedicineYokohamaKanagawa234‐0006Japan
| | - Zhen Sun
- School of Life Science and TechnologyShanghaiTech UniversityShanghai201210China
| | - Chenhua Wang
- State Key Laboratory of Cell Biology, Shanghai Institute of Biochemistry and Cell Biology, Center for Excellence in Molecular Cell Science, Chinese Academy of SciencesUniversity of Chinese Academy of ScienceShanghai200031China
| | - Zhaoliang Peng
- Shanghai Institute of Materia MedicaChinese Academy of SciencesShanghai201203China
| | - Baihua Wu
- State Key Laboratory of Cell Biology, Shanghai Institute of Biochemistry and Cell Biology, Center for Excellence in Molecular Cell Science, Chinese Academy of SciencesUniversity of Chinese Academy of ScienceShanghai200031China
| | - Mei Fang
- Institute of Regenerative MedicineAffiliated Hospital of Jiangsu UniversityJiangsu UniversityZhenjiangJiangsu212001China
| | - Kinji Furuya
- Department of Gastrointestinal and Hepato‐Biliary‐Pancreatic Surgery, Faculty of MedicineUniversity of TsukubaTsukubaIbaraki305‐8575Japan
| | - Xiaolong Ma
- State Key Laboratory of Cell Biology, Shanghai Institute of Biochemistry and Cell Biology, Center for Excellence in Molecular Cell Science, Chinese Academy of SciencesUniversity of Chinese Academy of ScienceShanghai200031China
| | - Yanjiao Shao
- Shanghai Key Laboratory of Regulatory Biology, Institute of Biomedical Sciences and School of Life SciencesEast China Normal UniversityShanghai200241China
| | - Nobuhiro Ohkohchi
- Department of Gastrointestinal and Hepato‐Biliary‐Pancreatic Surgery, Faculty of MedicineUniversity of TsukubaTsukubaIbaraki305‐8575Japan
| | - Tatsuya Oda
- Department of Gastrointestinal and Hepato‐Biliary‐Pancreatic Surgery, Faculty of MedicineUniversity of TsukubaTsukubaIbaraki305‐8575Japan
| | - Jianglin Fan
- Guangdong Provincial Key Laboratory of Large Animal Models for BiomedicineSchool of Biotechnology and Heath SciencesWuyi UniversityJiangmenGuangdong529020China
- Department of Molecular Pathology, Faculty of MedicineInterdisciplinary Graduate School of MedicineUniversity of YamanashiShimokatoYamanashi409‐3898Japan
| | - Guoyu Pan
- Shanghai Institute of Materia MedicaChinese Academy of SciencesShanghai201203China
| | - Dali Li
- Shanghai Key Laboratory of Regulatory Biology, Institute of Biomedical Sciences and School of Life SciencesEast China Normal UniversityShanghai200241China
| | - Lijian Hui
- State Key Laboratory of Cell Biology, Shanghai Institute of Biochemistry and Cell Biology, Center for Excellence in Molecular Cell Science, Chinese Academy of SciencesUniversity of Chinese Academy of ScienceShanghai200031China
- School of Life Science and TechnologyShanghaiTech UniversityShanghai201210China
- School of Life Science, Hangzhou Institute for Advanced StudyUniversity of Chinese Academy of SciencesHangzhou310024China
- Institute for Stem Cell and RegenerationChinese Academy of SciencesBeijing100101China
- Bio‐Research Innovation CenterShanghai Institute of Biochemistry and Cell BiologySuzhouJiangsu215121China
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Wang Y, Cao D, Chen SL, Li YM, Zheng YW, Ohkohchi N. Current trends in three-dimensional visualization and real-time navigation as well as robot-assisted technologies in hepatobiliary surgery. World J Gastrointest Surg 2021; 13:904-922. [PMID: 34621469 PMCID: PMC8462083 DOI: 10.4240/wjgs.v13.i9.904] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 04/19/2021] [Accepted: 08/02/2021] [Indexed: 02/06/2023] Open
Abstract
With the continuous development of digital medicine, minimally invasive precision and safety have become the primary development trends in hepatobiliary surgery. Due to the specificity and complexity of hepatobiliary surgery, traditional preoperative imaging techniques such as computed tomography and magnetic resonance imaging cannot meet the need for identification of fine anatomical regions. Imaging-based three-dimensional (3D) reconstruction, virtual simulation of surgery and 3D printing optimize the surgical plan through preoperative assessment, improving the controllability and safety of intraoperative operations, and in difficult-to-reach areas of the posterior and superior liver, assistive robots reproduce the surgeon’s natural movements with stable cameras, reducing natural vibrations. Electromagnetic navigation in abdominal surgery solves the problem of conventional surgery still relying on direct visual observation or preoperative image assessment. We summarize and compare these recent trends in digital medical solutions for the future development and refinement of digital medicine in hepatobiliary surgery.
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Affiliation(s)
- Yun Wang
- Institute of Regenerative Medicine, and Affiliated Hospital of Jiangsu University, Jiangsu University, Zhenjiang 212001, Jiangsu Province, China
| | - Di Cao
- Institute of Regenerative Medicine, and Affiliated Hospital of Jiangsu University, Jiangsu University, Zhenjiang 212001, Jiangsu Province, China
| | - Si-Lin Chen
- Institute of Regenerative Medicine, and Affiliated Hospital of Jiangsu University, Jiangsu University, Zhenjiang 212001, Jiangsu Province, China
| | - Yu-Mei Li
- Institute of Regenerative Medicine, and Affiliated Hospital of Jiangsu University, Jiangsu University, Zhenjiang 212001, Jiangsu Province, China
| | - Yun-Wen Zheng
- Institute of Regenerative Medicine, and Affiliated Hospital of Jiangsu University, Jiangsu University, Zhenjiang 212001, Jiangsu Province, China
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba 305-8575, Ibaraki, Japan
- Guangdong Provincial Key Laboratory of Large Animal Models for Biomedicine, and School of Biotechnology and Heath Sciences, Wuyi University, Jiangmen 529020, Guangdong Province, China
- School of Medicine, Yokohama City University, Yokohama 234-0006, Kanagawa, Japan
| | - Nobuhiro Ohkohchi
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba 305-8575, Ibaraki, Japan
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Furuya K, Zheng YW, Ge JY, Zhang L, Furuta T, Liang C, Abe H, Yagi H, Hamada H, Isoda H, Hui L, Ohkohchi N, Oda T. The evidence of a macrophage barrier in the xenotransplantation of human hematopoietic stem cells to severely immunodeficient rats. Xenotransplantation 2021; 28:e12702. [PMID: 34145650 DOI: 10.1111/xen.12702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 04/15/2021] [Accepted: 06/02/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND The human-to-rat hematopoietic stem cell transplantation (HSCT) model is rare, unlike its human-to-mouse counterpart. The rat models are desired, especially in areas of physiology, toxicology, and pharmacology. In addition to lymphocytes, macrophages are also considered to be important for xenotransplantation. We generated a rat xenotransplantation model to prove the role of macrophages as a xenotransplantation barrier. METHODS Immunodeficiency in SRG rats, which are Sprague-Dawley (SD) rats lacking Rag2 and Il2rg, was confirmed by flow cytometry and spleen immunostaining. Human umbilical cord blood was collected after scheduled cesarean section at the University of Tsukuba Hospital. Cord blood mononuclear cells (CB-MNCs) were transplanted into the SRG rats administered several injections of clodronate liposome (CL), which cause macrophage depletion. Survival of human cells was observed by flow cytometry. Rat macrophage phagocytosis assay was performed to check the species-specific effects of rat macrophages on injected human/rat blood cells. RESULTS SRG rats were deficient in T/B/NK cells. Without CL pretreatment, human CB-MNCs were removed from SRG rats within 7 hours after transplantation. The rats pretreated with CL could survive after transplantation. Prolonged survival for more than 4 weeks was observed only following a one-time CL injection. Rat macrophages had a species-specific potential for the phagocytosis of human blood cells in vivo. CONCLUSION In human-to-rat HSCT, the short period of early macrophage control, leading to macrophage immunotolerance, is important for engraftment. The generated model can be useful for the creation of future xenotransplantation models or other clinical research.
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Affiliation(s)
- Kinji Furuya
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Yun-Wen Zheng
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.,Guangdong Provincial Key Laboratory of Large Animal Models for Biomedicine and School of Biotechnology and Health Sciences, Wuyi University, Jiangmen, China.,Institute of Regenerative Medicine and Affiliated Hospital of Jiangsu University, Jiangsu University, Zhenjiang, China.,Department of Regenerative Medicine, School of Medicine, Yokohama City University, Yokohama, Japan
| | - Jian-Yun Ge
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.,Guangdong Provincial Key Laboratory of Large Animal Models for Biomedicine and School of Biotechnology and Health Sciences, Wuyi University, Jiangmen, China
| | - Ludi Zhang
- State Key Laboratory of Cell Biology, Shanghai Institute of Biochemistry and Cell Biology, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, University of Chinese Academy of Science, Shanghai, China
| | - Tomoaki Furuta
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Chen Liang
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Haruna Abe
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Hiroya Yagi
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Hiromi Hamada
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Hiroko Isoda
- Faculty of Life and Environmental Sciences, University of Tsukuba, Tsukuba, Japan
| | - Lijian Hui
- State Key Laboratory of Cell Biology, Shanghai Institute of Biochemistry and Cell Biology, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, University of Chinese Academy of Science, Shanghai, China
| | - Nobuhiro Ohkohchi
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Tatsuya Oda
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
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Liang C, Takahashi K, Furuya K, Oda T, Ohkohchi N. Platelets Stimulate Liver Regeneration in a Rat Model of Partial Liver Transplantation. Liver Transpl 2021; 27:719-734. [PMID: 33277780 DOI: 10.1002/lt.25962] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 10/30/2020] [Accepted: 11/23/2020] [Indexed: 12/19/2022]
Abstract
Living donor liver transplantation (LDLT) is sometimes associated with impaired regeneration and severe ischemia/reperfusion injury (IRI) in the graft, resulting in small-for-size syndrome (SFSS). Platelets were previously reported to stimulate liver regeneration in models of hepatectomy, but the evidence in partial liver transplantation (LT) is lacking. In this study, a rat model of partial LT was used, and the impact of thrombopoietin (TPO)-induced perioperative thrombocytosis on graft regeneration, IRI, and survival was investigated. In experiment 1, a 30% partial LT was performed. Under thrombocytosis, SFSS was attenuated, as shown by decreased levels of serum aminotransferases, bilirubin, and ascites. Serum hepatocyte regeneration-related cytokines, including insulin-like growth factor-1, hepatocyte growth factor, interleukin 6 (IL6), and tumor necrosis factor α (TNF-α), were elevated. In addition, the proliferative signaling pathways, Ki-67-labeling index, proliferating cell nuclear antigen (PCNA)-labeling index, mitotic index, and liver/body weight ratio were increased under thrombocytosis. The platelet-induced regeneration was independent of TPO because increases in the Ki-67-labeling and PCNA-labeling indexes were eliminated after reducing platelet counts by antiplatelet serum in rats administered with TPO. For IRI, thrombocytosis did not aggravate oxidative stress or downstream signaling pathways, necrosis, or apoptosis in the graft. After Kupffer cell (KC) depletion, the platelet-induced attenuation of serum aminotransferases, increased serum levels of IL6 and TNF-α, and proliferation-related signaling pathways were eliminated. Moreover, platelet accumulation in the graft decreased substantially. In experiment 2, a 20% partial LT was performed, and thrombocytosis improved postoperative survival. In conclusion, our results suggested that thrombocytosis stimulated graft regeneration and prolonged survival without aggregating IRI after partial LT, and KCs vitally contributed to platelet-derived regeneration. Platelet therapies to increase perioperative platelet counts may improve the outcomes after LDLT.
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Affiliation(s)
- Chen Liang
- Department of Gastrointestinal and Hepatobiliary-Pancreatic Surgery, Graduate School of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Kazuhiro Takahashi
- Department of Gastrointestinal and Hepatobiliary-Pancreatic Surgery, Graduate School of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Kinji Furuya
- Department of Gastrointestinal and Hepatobiliary-Pancreatic Surgery, Graduate School of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Tatsuya Oda
- Department of Gastrointestinal and Hepatobiliary-Pancreatic Surgery, Graduate School of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Nobuhiro Ohkohchi
- Department of Gastrointestinal and Hepatobiliary-Pancreatic Surgery, Graduate School of Medicine, University of Tsukuba, Tsukuba, Japan
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Shimizu Y, Tamura T, Kemmochi A, Owada Y, Ozawa Y, Hisakura K, Matsuzaka T, Shimano H, Nakano N, Sakashita S, Oda T, Ohkohchi N. Oxidative stress and Liver X Receptor agonist induce hepatocellular carcinoma in Non-alcoholic steatohepatitis model. J Gastroenterol Hepatol 2021; 36:800-810. [PMID: 32870526 PMCID: PMC7983938 DOI: 10.1111/jgh.15239] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 07/27/2020] [Accepted: 07/28/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND AIM The incidence of non-alcoholic steatohepatitis (NASH)-related hepatocellular carcinoma (HCC) is progressively increasing. However, the pathophysiology and etiology of NASH progression to HCC are unknown. We hypothesized that steatosis was the key factor in NASH-related hepatocarcinogenesis and aimed to evaluate the effects of long-term liver X receptor (LXR) agonist stimulation on hepatic steatosis induced by a high-fat diet and oxidative stress. METHODS We used an LXR agonist (T0901317) and CCl4 to induce hepatic steatosis and oxidative stress, respectively. C57BL/6 mice fed with a high-fat diet were treated with either T0901317 + CCl4 (T09 + CCl4 group) or CCl4 alone (CCl4 group). T0901317 (2.5 mg/kg) and CCl4 (0.1 mL/kg) were intraperitoneally administered twice weekly for 24 weeks. RESULTS The liver-to-body weight ratio was significantly higher in the T09 + CCl4 group than in the CCl4 group. Mice in the T09 + CCl4 group exhibited abnormal lipid metabolism and NASH-like histopathological features. Additionally, all mice in the T09 + CCl4 group developed liver tumors diagnosed as well-differentiated HCC. The genes identified via microarray analysis were related to NASH and HCC development. CONCLUSIONS By combining long-term LXR agonist stimulation with oxidative stress and a high-fat diet, we successfully reproduced liver conditions in mice similar to those in humans with NASH and progression to HCC. Our results provide new insight into NASH-related HCC progression and therapy.
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Affiliation(s)
- Yoshio Shimizu
- Department of Gastrointestinal and Hepato‐Biliary‐Pancreatic Surgery, Faculty of MedicineUniversity of TsukubaTsukubaJapan
| | - Takafumi Tamura
- Department of Gastrointestinal and Hepato‐Biliary‐Pancreatic Surgery, Faculty of MedicineUniversity of TsukubaTsukubaJapan
| | - Akira Kemmochi
- Department of Gastrointestinal and Hepato‐Biliary‐Pancreatic Surgery, Faculty of MedicineUniversity of TsukubaTsukubaJapan
| | - Yohei Owada
- Department of Gastrointestinal and Hepato‐Biliary‐Pancreatic Surgery, Faculty of MedicineUniversity of TsukubaTsukubaJapan
| | - Yusuke Ozawa
- Department of Gastrointestinal and Hepato‐Biliary‐Pancreatic Surgery, Faculty of MedicineUniversity of TsukubaTsukubaJapan
| | - Katsuji Hisakura
- Department of Gastrointestinal and Hepato‐Biliary‐Pancreatic Surgery, Faculty of MedicineUniversity of TsukubaTsukubaJapan
| | - Takashi Matsuzaka
- Department of Endocrinology and Metabolism, Faculty of MedicineUniversity of TsukubaTsukubaJapan
| | - Hitoshi Shimano
- Department of Endocrinology and Metabolism, Faculty of MedicineUniversity of TsukubaTsukubaJapan
- International Institute for Integrative Sleep Medicine (WPI‐IIIS)University of TsukubaTsukubaJapan
- AMED‐CRESTJapan Agency for Medical Research and Development (AMED)TokyoJapan
| | - Noriyuki Nakano
- Department of Diagnostic Pathology, Faculty of MedicineUniversity of TsukubaTsukubaJapan
| | - Shingo Sakashita
- Department of Diagnostic Pathology, Faculty of MedicineUniversity of TsukubaTsukubaJapan
| | - Tatsuya Oda
- Department of Gastrointestinal and Hepato‐Biliary‐Pancreatic Surgery, Faculty of MedicineUniversity of TsukubaTsukubaJapan
| | - Nobuhiro Ohkohchi
- Department of Gastrointestinal and Hepato‐Biliary‐Pancreatic Surgery, Faculty of MedicineUniversity of TsukubaTsukubaJapan
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10
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Shirasuna K, Ito M, Matsuda T, Enomoto T, Ohara Y, Yamamoto M, Nishijima S, Ohkohchi N, Kuromitsu S. Correlation analysis of the proportion of monocytic myeloid-derived suppressor cells in colorectal cancer patients. PLoS One 2020; 15:e0243643. [PMID: 33370317 PMCID: PMC7769251 DOI: 10.1371/journal.pone.0243643] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Accepted: 11/24/2020] [Indexed: 01/21/2023] Open
Abstract
Monocytic myeloid-derived suppressor cells (mMDSCs) are a class of immunosuppressive immune cells with prognostic value in many solid tumors. It is reported that the proportion of mMDSCs in the peripheral blood can be a predictive marker for response to cancer immunotherapy. In this study, we performed a correlation analysis of the proportion of mMDSCs in freshly-drawn peripheral blood, levels of plasma proteins, and demographic factors in colorectal cancer (CRC) patients, to find factors that could be used to predict mMDSC proportions. Freshly-drawn mMDSCs were measured using flow cytometry on peripheral blood mononuclear cells (PBMCs) from healthy donors (n = 24) and CRC patients (n = 78). The plasma concentrations of 29 different cytokines, chemokines, growth factors, and enzymes were measured using a multiplex assay or enzyme-linked immunosorbent assay. Correlation analysis to find mMDSC-associated factors was conducted using univariate and multivariate models. In univariate correlation analysis, there were no plasma proteins that were associated with mMDSC proportions in CRC patients. In multivariate analysis, considering all variables including age, sex, and plasma proteins, levels of inducible nitric acid synthase (iNOS) (p = 0.013) and platelet-derived growth factor (PDGF)-BB (p = 0.035) were associated with mMDSC proportion in PBMCs (mMDSC proportion [%] = 0.2929 − 0.2389 * PDGF-BB + 0.3582 * iNOS) (p < 0.005, r = 0.32). Measuring the plasma concentrations of iNOS and PDGF-BB may be useful in predicting the proportion of mMDSCs in CRC patients’ peripheral blood. Further research is required to establish and validate these predictive factors. Data registration Patient data were registered in an anonymization system at Tsukuba Clinical Research & Development Organization (T-CReDO).
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Affiliation(s)
- Kenna Shirasuna
- Drug Discovery Research, Astellas Pharma, Inc., Ibaraki, Japan
- * E-mail:
| | - Masayuki Ito
- Drug Discovery Research, Astellas Pharma, Inc., Ibaraki, Japan
| | - Takashi Matsuda
- Drug Discovery Research, Astellas Pharma, Inc., Ibaraki, Japan
| | - Tsuyoshi Enomoto
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, University of Tsukuba Hospital, Faculty of Medicine, Ibaraki, Japan
| | - Yusuke Ohara
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, University of Tsukuba Hospital, Faculty of Medicine, Ibaraki, Japan
| | | | | | - Nobuhiro Ohkohchi
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, University of Tsukuba Hospital, Faculty of Medicine, Ibaraki, Japan
| | - Sadao Kuromitsu
- Drug Discovery Research, Astellas Pharma, Inc., Ibaraki, Japan
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11
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Kemmochi A, Tamura T, Shimizu Y, Owada Y, Ozawa Y, Hisakura K, Oda T, Kawano Y, Hanawa T, Ohkohchi N. A novel hydrogel sheet prevents postoperative pancreatic fistula in a rat model. J Hepatobiliary Pancreat Sci 2020; 28:192-201. [PMID: 33179402 PMCID: PMC7984228 DOI: 10.1002/jhbp.867] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 10/26/2020] [Accepted: 10/29/2020] [Indexed: 12/11/2022]
Abstract
Aim To evaluate the efficacy of a novel hydrogel sheet in preventing postoperative pancreatic fistula (POPF). Background Postoperative pancreatic fistula is a life‐threatening complication. As no study has reported the use of hydrogel sheets in preventing POPF, their effectiveness for that purpose remains unclear. Methods A novel hydrogel sheet made of polyvinyl alcohol (PVA) was prepared by the freeze‐thaw method. The pancreatic ducts and surrounding pancreatic parenchyma of rats were transected to induce a pancreatic fistula. Next, the sheet was attached to the transection site. Ascitic fluid amylase and lipase concentrations were measured. Neoveil®, a nonwoven polyglycolic acid (PGA) felt, is already clinically used as an absorbable reinforcing material at pancreatic transection sites. Neoveil® was used for comparison, as was VIEWGEL®, which is marketed as a wound dressing. Results The hydrogel sheet remained in place 48 hours postoperatively. The ascitic amylase concentrations in the control, VIEWGEL®‐treated, Neoveil®‐treated, and hydrogel‐treated rats, respectively, were 4992.4 ± 5355.7, 1068.4 ± 269.1, 730.2 ± 425.2, and 303.1 ± 240.1 IU/L; the ascitic lipase concentrations were 2279.8 ± 3395.2, 169.5 ± 100.6, 90.4 ± 71.0, and 86.8 ± 59.8 IU/L. The ascitic amylase and lipase levels were significantly lower in the hydrogel group than in the other groups (P < .05). Conclusions This novel hydrogel sheet effectively prevents pancreatic fistulas and has promising clinical application potential.
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Affiliation(s)
- Akira Kemmochi
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Takafumi Tamura
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Yoshio Shimizu
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Yohei Owada
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Yusuke Ozawa
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Katsuji Hisakura
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Tatsuya Oda
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Yayoi Kawano
- Faculty of Pharmaceutical Sciences, Tokyo University of Science, Noda, Japan
| | - Takehisa Hanawa
- Faculty of Pharmaceutical Sciences, Tokyo University of Science, Noda, Japan
| | - Nobuhiro Ohkohchi
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
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12
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Ge JY, Zheng YW, Tsuchida T, Furuya K, Isoda H, Taniguchi H, Ohkohchi N, Oda T. Hepatic stellate cells contribute to liver regeneration through galectins in hepatic stem cell niche. Stem Cell Res Ther 2020; 11:425. [PMID: 32993816 PMCID: PMC7526193 DOI: 10.1186/s13287-020-01942-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 07/30/2020] [Accepted: 09/17/2020] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND As a critical cellular component in the hepatic stem cell niche, hepatic stellate cells (HSCs) play critical roles in regulating the expansion of hepatic stem cells, liver regeneration, and fibrogenesis. However, the signaling of HSCs, particularly that involved in promoting hepatic stem cell expansion, remains unclear. While the overexpression of galectins has been identified in regenerating liver tissues, their involvement in cell-cell interactions between HSCs and hepatic stem cells remains to be elucidated. METHODS To generate a liver regeneration rat model and establish a hepatic oval cell microenvironment as a stem cell niche, 2-acetylaminofluorene treatment plus partial hepatectomy was performed. Immunofluorescence staining was conducted to detect the emergence of hepatic stem cells and their niche. Liver parenchymal cells, non-parenchymal cells, and HSCs were isolated for gene and protein expression analysis by qPCR or western blotting. To evaluate the effect of galectins on the colony-forming efficiency of hepatic stem cells, c-Kit-CD29+CD49f+/lowCD45-Ter-119- cells were cultured with recombinant galectin protein, galectin antibody, galectin-producing HSCs, and galectin-knockdown HSCs. RESULTS Following liver injury, the cytokeratin 19+ ductal cells were robustly induced together with the emergence of OV6+CD44+CD133+EpCAM+ hepatic stem cells. The activated desmin+ HSCs were recruited around the periportal area and markedly enriched in the galectin-positive domain compared to the other non-parenchymal cells. Notably, the HSC fraction isolated from regenerating liver was accompanied by dramatically elevated gene and protein expression of galectins. Hepatic stem cells co-cultured with HSCs significantly enhanced colony-forming efficiency. Conversely, single or double knockdown of galectin-1 and galectin-3 led into a significant function loss, impaired the co-cultured hepatic stem cells to attenuated colony size, inhibited colony frequency, and reduced total cell numbers in colonies. On the other hand, the promotive function of galectins was further confirmed by recombinant galectin protein supplementation and galectins blocking antibodies. CONCLUSIONS Our findings, for the first time, demonstrated that galectins from activated HSCs contribute to hepatic stem cell expansion during liver regeneration, suggesting that galectins serve as important stem cell niche components.
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Affiliation(s)
- Jian-Yun Ge
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, Tennodai 1-1-1, Tsukuba, Ibaraki, 305-8575, Japan
| | - Yun-Wen Zheng
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, Tennodai 1-1-1, Tsukuba, Ibaraki, 305-8575, Japan. .,Department of Regenerative Medicine, School of Medicine, Yokohama City University, Yokohama, Kanagawa, 236-0004, Japan. .,Institute of Regenerative Medicine and Affiliated Hospital, Jiangsu University, Zhenjiang, 212001, Jiangsu, China. .,Division of Regenerative Medicine, Center for Stem Cell Biology and Regenerative Medicine, The Institute of Medical Science, The University of Tokyo, Tokyo, 108-8639, Japan. .,School of Biotechnology and Heath Sciences, Wuyi University, Jiangmen, 529020, Guangdong, China.
| | - Tomonori Tsuchida
- Department of Regenerative Medicine, School of Medicine, Yokohama City University, Yokohama, Kanagawa, 236-0004, Japan
| | - Kinji Furuya
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, Tennodai 1-1-1, Tsukuba, Ibaraki, 305-8575, Japan
| | - Hiroko Isoda
- Faculty of Life and Environmental Sciences, University of Tsukuba, Tsukuba, Ibaraki, 305-8572, Japan
| | - Hideki Taniguchi
- Department of Regenerative Medicine, School of Medicine, Yokohama City University, Yokohama, Kanagawa, 236-0004, Japan. .,Division of Regenerative Medicine, Center for Stem Cell Biology and Regenerative Medicine, The Institute of Medical Science, The University of Tokyo, Tokyo, 108-8639, Japan.
| | - Nobuhiro Ohkohchi
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, Tennodai 1-1-1, Tsukuba, Ibaraki, 305-8575, Japan
| | - Tatsuya Oda
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, Tennodai 1-1-1, Tsukuba, Ibaraki, 305-8575, Japan
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13
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Xu H, Jiang XM, Wu Y, Li YM, Zheng YW, Ohkohchi N. Prominent effect of platelet on improvement of liver cirrhosis. AME Case Rep 2020; 4:14. [PMID: 32420537 DOI: 10.21037/acr.2020.04.02] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 03/12/2020] [Indexed: 01/03/2023]
Abstract
Thrombopoietin (TPO) can improve liver regeneration and fibrosis. We report on a patient with liver cirrhosis who received treatment with TPO to improve liver function. An 82-year-old male had liver cirrhosis with ascites due to hepatitis C virus infection. The Child-Pugh classification was Child B. The patient received human recombinant TPO for 12 months. The platelet counts increased and were maintained at 60-80×109/L. The liver function improved, the ascites resolved, and the liver volume increased. These results indicate that the novel treatment with recombinant human TPO (rhTPO) may be effective for improving liver function in patients with liver cirrhosis.
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Affiliation(s)
- Hui Xu
- Institute of Regenerative Medicine, Affiliated Hospital of Jiangsu University, Jiangsu University, Zhenjiang 212001, China.,Department of Dermatology, Affiliated Hospital of Jiangsu University, Jiangsu University, Zhenjiang 212001, China
| | - Xiao-Meng Jiang
- Department of gastroenterology, Affiliated Hospital of Jiangsu University, Jiangsu University, Zhenjiang 212001, China.,Digestive Department, SIR RUN RUN Hospital, Nanjing Medical University, Nanjing 211166, China
| | - Ying Wu
- Department of gastroenterology, Affiliated Hospital of Jiangsu University, Jiangsu University, Zhenjiang 212001, China
| | - Yu-Mei Li
- Institute of Regenerative Medicine, Affiliated Hospital of Jiangsu University, Jiangsu University, Zhenjiang 212001, China.,Department of Dermatology, Affiliated Hospital of Jiangsu University, Jiangsu University, Zhenjiang 212001, China
| | - Yun-Wen Zheng
- Institute of Regenerative Medicine, Affiliated Hospital of Jiangsu University, Jiangsu University, Zhenjiang 212001, China.,Department of Regenerative Medicine, School of Medicine, Yokohama City University, Yokohama, Japan.,Department of Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.,Division of Regenerative Medicine, Center for Stem Cell Biology and Regenerative Medicine, The Institute of Medical Science, the University of Tokyo, Tokyo, Japan
| | - Nobuhiro Ohkohchi
- Department of Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
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14
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Ferdousi F, Kondo S, Sasaki K, Uchida Y, Ohkohchi N, Zheng YW, Isoda H. Microarray analysis of verbenalin-treated human amniotic epithelial cells reveals therapeutic potential for Alzheimer's Disease. Aging (Albany NY) 2020; 12:5516-5538. [PMID: 32224504 PMCID: PMC7138585 DOI: 10.18632/aging.102985] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 03/24/2020] [Indexed: 02/06/2023]
Abstract
Alzheimer’s disease (AD) has become a major world health problem as the population ages. There is still no available treatment that can stop or reverse the progression of AD. Human amnion epithelial cells (hAECs), an alternative source for stem cells, have shown neuroprotective and neurorestorative potentials when transplanted in vivo. Besides, studies have suggested that stem cell priming with plant-derived bioactive compounds can enhance stem cell proliferation and differentiation and improve the disease-treating capability of stem cells. Verbenalin is an iridoid glucoside found in medicinal herbs of Verbenaceae family. In the present study, we have conducted microarray gene expression profiling of verbenalin-treated hAECs to explore its therapeutic potential for AD. Gene set enrichment analysis revealed verbenalin treatment significantly enriched AD-associated gene sets. Genes associated with lysosomal dysfunction, pathologic angiogenesis, pathologic protein aggregation, circadian rhythm, age-related neurometabolism, and neurogenesis were differentially expressed in the verbenalin-treated hAECs compared to control cells. Additionally, the neuroprotective effect of verbenalin was confirmed against amyloid beta-induced neurotoxicity in human neuroblastoma SH-SY5Y cells. Our present study is the first to report the therapeutic potential of verbenalin for AD; however, further in-depth research in the in vitro and in vivo models are required to confirm our preliminary findings.
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Affiliation(s)
- Farhana Ferdousi
- Alliance for Research on the Mediterranean and North Africa (ARENA), University of Tsukuba, Tsukuba 305-8577, Ibaraki, Japan
| | - Shinji Kondo
- R&D Center for Tailor-Made QOL, University of Tsukuba, Tsukuba 305-8550, Ibaraki, Japan
| | - Kazunori Sasaki
- Alliance for Research on the Mediterranean and North Africa (ARENA), University of Tsukuba, Tsukuba 305-8577, Ibaraki, Japan.,National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba 305-8565, Ibaraki, Japan
| | - Yoshiaki Uchida
- School of Integrative and Global Majors, University of Tsukuba, Tsukuba 305-8575, Ibaraki, Japan
| | - Nobuhiro Ohkohchi
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba 305-8575, Ibaraki, Japan
| | - Yun-Wen Zheng
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba 305-8575, Ibaraki, Japan
| | - Hiroko Isoda
- Alliance for Research on the Mediterranean and North Africa (ARENA), University of Tsukuba, Tsukuba 305-8577, Ibaraki, Japan.,R&D Center for Tailor-Made QOL, University of Tsukuba, Tsukuba 305-8550, Ibaraki, Japan.,National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba 305-8565, Ibaraki, Japan.,Faculty of Life and Environmental Sciences, University of Tsukuba, Tsukuba 305-8575, Ibaraki, Japan
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15
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Miyamoto R, Sano N, Maeda M, Inagawa S, Ohkohchi N. Modified Reinforced Staple Closure Technique Decreases Postoperative Pancreatic Fistula After Distal Pancreatectomy. Indian J Surg Oncol 2019; 10:587-593. [PMID: 31866728 DOI: 10.1007/s13193-019-00958-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Accepted: 08/06/2019] [Indexed: 01/02/2023] Open
Abstract
Postoperative pancreatic fistula (POPF) is a serious complication that can occur following distal pancreatectomy (DP). Recent studies demonstrated that the use of reinforced staplers with bioabsorbable mesh significantly reduced the incidence of POPF, although the safety and efficacy of this approach remain controversial. Therefore, we originally developed a modified closure technique that combines the use of a reinforced stapler with bioabsorbable mesh with suture closure of the main pancreatic duct. The aim of this study was to determine whether our closure technique is predictive of POPF after DP. Fifty-nine consecutive patients who underwent DP were retrospectively enrolled. Based on the closure technique, we divided the cohort into a suture group (group A; n = 39) and a modified closure group (group B; n = 20). Using multivariate analysis, surgical closure techniques, including our method, and other well-known POPF risk factors were independently assessed. Multivariate logistic regression analysis identified no pathological fibrosis (odds ratio [OR], 5.41; p < 0.01), body mass index (> 25 kg/m2) (OR, 3.01; p = 0.02), and pancreatic stump closure technique (group A) (OR, 2.04; p = 0.01) as independent risk factors for POPF. The present study indicated that our modified closure technique is an additional useful technique to reduce POPF after DP.
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Affiliation(s)
- Ryoichi Miyamoto
- 1Department of Gastroenterological Surgery, Tsukuba Medical Center Hospital, 1-3-1 Amakubo, Tsukuba, Ibaraki 305-8558 Japan
- 2Department of Surgery, Division of Gastroenterological and Hepatobiliary Surgery and Organ Transplantation, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575 Japan
| | - Naoki Sano
- 1Department of Gastroenterological Surgery, Tsukuba Medical Center Hospital, 1-3-1 Amakubo, Tsukuba, Ibaraki 305-8558 Japan
| | - Michihiro Maeda
- 1Department of Gastroenterological Surgery, Tsukuba Medical Center Hospital, 1-3-1 Amakubo, Tsukuba, Ibaraki 305-8558 Japan
| | - Satoshi Inagawa
- 1Department of Gastroenterological Surgery, Tsukuba Medical Center Hospital, 1-3-1 Amakubo, Tsukuba, Ibaraki 305-8558 Japan
| | - Nobuhiro Ohkohchi
- 2Department of Surgery, Division of Gastroenterological and Hepatobiliary Surgery and Organ Transplantation, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575 Japan
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16
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Abstract
The success of liver surgery, including resection and transplantation, is largely dependent on the ability of the liver to regenerate. Despite substantial improvement in surgical techniques and perioperative care, one of the main concerns is post-hepatectomy liver failure and early allograft dysfunction, both of which are associated with impaired liver regeneration. Recent studies have demonstrated the positive role of platelets in promoting liver regeneration and protecting hepatocytes; however, the underlying mechanisms responsible for these effects are not fully understood. In this review, we updated the accumulated evidence of the role of platelets in promoting liver regeneration, with a focus on liver resection and liver transplantation. The goal of these studies was to support the clinical implementation of platelet agents, such as thrombopoietin receptor agonists, to augment liver regeneration after liver surgery. This "platelet therapy" may become a treatment choice for post-hepatectomy liver failure and early allograft dysfunction.
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Affiliation(s)
- Kazuhiro Takahashi
- Department of Surgery, University of Tsukuba, 1-1-1, Tennoudai, Tsukuba, Ibaraki, 305-8575, Japan.,Department of Surgery, Mito Central Hospital, 1136-1, Rokutanda-cho, Mito, 311-1135, Japan
| | - Chen Liang
- Department of Surgery, University of Tsukuba, 1-1-1, Tennoudai, Tsukuba, Ibaraki, 305-8575, Japan.,Department of Surgery, Mito Central Hospital, 1136-1, Rokutanda-cho, Mito, 311-1135, Japan
| | - Tatsuya Oda
- Department of Surgery, University of Tsukuba, 1-1-1, Tennoudai, Tsukuba, Ibaraki, 305-8575, Japan.,Department of Surgery, Mito Central Hospital, 1136-1, Rokutanda-cho, Mito, 311-1135, Japan
| | - Nobuhiro Ohkohchi
- Department of Surgery, University of Tsukuba, 1-1-1, Tennoudai, Tsukuba, Ibaraki, 305-8575, Japan. .,Department of Surgery, Mito Central Hospital, 1136-1, Rokutanda-cho, Mito, 311-1135, Japan.
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17
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Ganbold M, Owada Y, Ozawa Y, Shimamoto Y, Ferdousi F, Tominaga K, Zheng YW, Ohkohchi N, Isoda H. Isorhamnetin Alleviates Steatosis and Fibrosis in Mice with Nonalcoholic Steatohepatitis. Sci Rep 2019; 9:16210. [PMID: 31700054 PMCID: PMC6838085 DOI: 10.1038/s41598-019-52736-y] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 10/21/2019] [Indexed: 02/07/2023] Open
Abstract
Nonalcoholic steatohepatitis (NASH) is the most severe and progressive form of nonalcoholic fatty liver disease (NAFLD), which can lead to life-threatening conditions, however, there is still no approved drug for the treatment of NASH. In this study we used human-like NASH mouse model and treated orally with isorhamnetin at a dose of 50 mg/kg to analyze the effect of isorhamnetin on the progression of NASH. NASH-induced mice represented severe steatosis with inflammation, and fibrosis in liver accompanied with high level of liver injury markers in serum. Isorhamnetin treatment reduced intrahepatic lipid accumulation and TG content by inhibiting de novo lipogenic pathway in NASH-induced mice. Consistent with this, isorhamnetin-treated NASH mice showed improved liver injury markers, reduced collagen deposition as well as decreased gene expression of fibrogenic markers. Taken together, here we showed for the first time that synthesized isorhamnetin alleviates pathologic features of NASH and thus can potentially contribute to NASH drug development.
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Affiliation(s)
- Munkhzul Ganbold
- School of Integrative and Global Majors (SIGMA), University of Tsukuba, Tsukuba, Ibaraki, 305-8572, Japan
| | - Yohei Owada
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan
| | - Yusuke Ozawa
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan
| | - Yasuhiro Shimamoto
- Interdisciplinary Research Center for Catalytic Chemistry, National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba, Ibaraki, 305-8565, Japan
| | - Farhana Ferdousi
- Alliance for Research on the Mediterranean and North Africa (ARENA), University of Tsukuba, Tsukuba, Ibaraki, 305-8577, Japan
| | - Kenichi Tominaga
- Interdisciplinary Research Center for Catalytic Chemistry, National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba, Ibaraki, 305-8565, Japan
| | - Yun-Wen Zheng
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan
| | - Nobuhiro Ohkohchi
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan
| | - Hiroko Isoda
- School of Integrative and Global Majors (SIGMA), University of Tsukuba, Tsukuba, Ibaraki, 305-8572, Japan. .,Interdisciplinary Research Center for Catalytic Chemistry, National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba, Ibaraki, 305-8565, Japan. .,Alliance for Research on the Mediterranean and North Africa (ARENA), University of Tsukuba, Tsukuba, Ibaraki, 305-8577, Japan. .,Faculty of Life and Environment Science, University of Tsukuba, Tsukuba, 305-8572, Japan.
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18
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Miyamoto R, Kikuchi K, Uchida A, Ozawa M, Maeda M, Sano N, Tadano S, Inagawa S, Oda T, Ohkohchi N. Complete pathological response after preoperative chemotherapy for locally advanced rectal cancer: a case report. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz343.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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19
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Furuya K, Zheng YW, Sako D, Iwasaki K, Zheng DX, Ge JY, Liu LP, Furuta T, Akimoto K, Yagi H, Hamada H, Isoda H, Oda T, Ohkohchi N. Enhanced hepatic differentiation in the subpopulation of human amniotic stem cells under 3D multicellular microenvironment. World J Stem Cells 2019; 11:705-721. [PMID: 31616545 PMCID: PMC6789189 DOI: 10.4252/wjsc.v11.i9.705] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 08/06/2019] [Accepted: 08/27/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND To solve the problem of liver transplantation donor insufficiency, an alternative cell transplantation therapy was investigated. We focused on amniotic epithelial cells (AECs) as a cell source because, unlike induced pluripotent stem cells, they are cost-effective and non-tumorigenic. The utilization of AECs in regenerative medicine, however, is in its infancy. A general profile for AECs has not been comprehensively analyzed. Moreover, no hepatic differentiation protocol for AECs has yet been established. To this end, we independently compiled human AEC libraries, purified amniotic stem cells (ASCs), and co-cultured them with mesenchymal stem cells (MSCs) and human umbilical vein endothelial cell (HUVECs) in a 3D system which induces functional hepatic organoids.
AIM To characterize AECs and generate functional hepatic organoids from ASCs and other somatic stem cells
METHODS AECs, MSCs, and HUVECs were isolated from the placentae and umbilical cords of cesarean section patients. Amnion and primary AEC stemness characteristics and heterogeneity were analyzed by immunocytochemistry, Alkaline phosphatase (AP) staining, and flow cytometry. An adherent AEC subpopulation was selected and evaluated for ASC purification quality by a colony formation assay. AEC transcriptomes were compared with those for other hepatocytes cell sources by bioinformatics. The 2D and 3D culture were compared by relative gene expression using several differentiation protocols. ASCs, MSCs, and HUVECs were combined in a 3D co-culture system to generate hepatic organoids whose structure was compared with a 3D AEC sphere and whose function was elucidated by immunofluorescence imaging, periodic acid Schiff, and an indocyanine green (ICG) test.
RESULTS AECs have certain stemness markers such as EPCAM, SSEA4, and E-cadherin. One AEC subpopulation was also either positive for AP staining or expressed the TRA-1-60 and TRA-1-81 stemness markers. Moreover, it could form colonies and its frequency was enhanced ten-fold in the adherent subpopulation after selective primary passage. Bioinformatics analysis of ribose nucleic acid sequencing revealed that the total AEC gene expression was distant from those of pluripotent stem cells and hepatocytes but some gene expression overlapped among these cells. TJP1, associated with epidermal growth factor receptor, and MET, associated with hepatocyte growth factor receptor, were upregulated and may be important for hepatic differentiation. In conventional flat culture, the cells turned unviable and did not readily differentiate into hepatocytes. In 3D culture, however, hepatic gene expression of the AEC sphere was elevated even under a two-step differentiation protocol. Furthermore, the organoids derived from the MSC and HUVEC co-culture showed 3D structure with polarity, hepatic-like glycogen storage, and ICG absorption/elimination.
CONCLUSION Human amniotic epithelial cells are heterogeneous and certain subpopulations have high stemness. Under a 3D co-culture system, functional hepatic organoids were generated in a multicellular microenvironment.
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Affiliation(s)
- Kinji Furuya
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki 305-8575, Japan
| | - Yun-Wen Zheng
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki 305-8575, Japan
- Institute of Regenerative Medicine and Affiliated Hospital, Jiangsu University, Zhenjiang 212001, Jiangsu Province, China
- Department of Regenerative Medicine, School of Medicine, Yokohama City University, Yokohama 236-0004, Japan
| | - Daisuke Sako
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki 305-8575, Japan
- Department of Medicinal and Life Sciences, Faculty of Pharmaceutical Sciences, Tokyo University of Science, Noda 278-8510, Japan
| | - Kenichi Iwasaki
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki 305-8575, Japan
| | - Dong-Xu Zheng
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki 305-8575, Japan
| | - Jian-Yun Ge
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki 305-8575, Japan
| | - Li-Ping Liu
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki 305-8575, Japan
- Institute of Regenerative Medicine and Affiliated Hospital, Jiangsu University, Zhenjiang 212001, Jiangsu Province, China
| | - Tomoaki Furuta
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki 305-8575, Japan
| | - Kazunori Akimoto
- Department of Medicinal and Life Sciences, Faculty of Pharmaceutical Sciences, Tokyo University of Science, Noda 278-8510, Japan
| | - Hiroya Yagi
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tsukuba, Tsukuba 305-8575, Japan
| | - Hiromi Hamada
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tsukuba, Tsukuba 305-8575, Japan
| | - Hiroko Isoda
- Faculty of Life and Environmental Sciences, University of Tsukuba, Tsukuba 305-8572, Japan
| | - Tatsuya Oda
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki 305-8575, Japan
| | - Nobuhiro Ohkohchi
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki 305-8575, Japan
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Miyamoto R, Kikuchi K, Uchida A, Ozawa M, Sano N, Tadano S, Inagawa S, Oda T, Ohkohchi N. Pathological complete response after preoperative chemotherapy including FOLFOX plus bevacizumab for locally advanced rectal cancer: A case report and literature review. Int J Surg Case Rep 2019; 62:85-88. [PMID: 31476559 PMCID: PMC6726879 DOI: 10.1016/j.ijscr.2019.08.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 08/01/2019] [Accepted: 08/06/2019] [Indexed: 12/18/2022] Open
Abstract
Preoperative chemotherapy alone for locally advanced rectal cancer remain unclear. Neoadjuvant chemotherapy was a promising treatment for unresectable rectal cancer. Earlier preoperative systemic chemotherapy was assumed to prevent the dissemination.
Background In Japan, the significance and efficacy of preoperative chemotherapy alone for locally advanced rectal cancer remain controversial. This case report presents the apparent effectiveness of preoperative FOLFOX plus bevacizumab as shown by pathological complete response (pCR). Additionally, we review the relevant literature and discuss the clinical management of locally advanced rectal cancer with preoperative chemotherapy. Case presentation A 59-year-old male presented with severe constipation, bloody stool and a loss of 10% of his body weight over 3 months. Preoperative examination revealed locally advanced rectal cancer with extensive invasion of the bladder wall and enlarged regional lymph nodes. Thus, this lesion was assigned a preoperative classification of T4bN2bM0 stage IIIC according to the 8th Union for International Cancer Control (UICC) guidelines. Therefore, the patient initially underwent an external loop colostomy of the transverse colon. Next, the patient received chemotherapy including FOLFOX plus bevacizumab. After 12 cycles of chemotherapy, the tumor size was markedly decreased, and all lymph node metastases had disappeared. Therefore, the patient underwent conventional resection of the rectum with D3 lymph node dissection and closure of the colostomy. Histopathological analysis of the resected specimen revealed that all lesions were fibrotic and devoid of any viable cancer cells. Thus, this lesion was assigned a final classification of ypT0N0M0 stage 0. Conclusions We present the rare case of a patient with surgically resected locally advanced rectal cancer who demonstrated an impressive pCR with preoperative chemotherapy, which included FOLFOX plus bevacizumab.
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Affiliation(s)
- Ryoichi Miyamoto
- Department of Gastroenterological Surgery, Tsukuba Medical Center Hospital, 1-3-1 Amakubo, Tsukuba, Ibaraki 305-8558, Japan; Department of Surgery, Division of Gastroenterological and Hepatobiliary Surgery and Organ Transplantation, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan.
| | - Kazunori Kikuchi
- Department of Pathology, Tsukuba Medical Center Hospital, 1-3-1 Amakubo, Tsukuba, Ibaraki 305-8558, Japan
| | - Atsushi Uchida
- Department of Pathology, Tsukuba Medical Center Hospital, 1-3-1 Amakubo, Tsukuba, Ibaraki 305-8558, Japan
| | - Masayoshi Ozawa
- Department of Pathology, Tsukuba Medical Center Hospital, 1-3-1 Amakubo, Tsukuba, Ibaraki 305-8558, Japan
| | - Naoki Sano
- Department of Gastroenterological Surgery, Tsukuba Medical Center Hospital, 1-3-1 Amakubo, Tsukuba, Ibaraki 305-8558, Japan
| | - Sosuke Tadano
- Department of Gastroenterological Surgery, Tsukuba Medical Center Hospital, 1-3-1 Amakubo, Tsukuba, Ibaraki 305-8558, Japan
| | - Satoshi Inagawa
- Department of Gastroenterological Surgery, Tsukuba Medical Center Hospital, 1-3-1 Amakubo, Tsukuba, Ibaraki 305-8558, Japan
| | - Tatsuya Oda
- Department of Surgery, Division of Gastroenterological and Hepatobiliary Surgery and Organ Transplantation, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan
| | - Nobuhiro Ohkohchi
- Department of Surgery, Division of Gastroenterological and Hepatobiliary Surgery and Organ Transplantation, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan
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Ferdousi F, Sasaki K, Uchida Y, Ohkohchi N, Zheng YW, Isoda H. Exploring the Potential Role of Rosmarinic Acid in Neuronal Differentiation of Human Amnion Epithelial Cells by Microarray Gene Expression Profiling. Front Neurosci 2019; 13:779. [PMID: 31396047 PMCID: PMC6667736 DOI: 10.3389/fnins.2019.00779] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Accepted: 07/11/2019] [Indexed: 01/01/2023] Open
Abstract
In the present study, we conducted microarray gene expression profiling to explore the direction of differentiation of human amnion epithelial cells (hAECs) treated with rosmarinic acid (RA). hAECs have several clinical advantages over other types of stem cells, including availability, low immunogenicity, low rejection rate, non-tumorigenicity, and less ethical constraint. On the other hand, RA is a phenolic compound having several health benefits, including neuroprotective and antidepressant-like activities. In this study, hAECs were isolated from discarded term placenta and were treated with 20 μM RA for 7 days. Microarray gene expression profiling was conducted for three biological replicates of RA-treated and untreated control cells on day 0 and day 7. Gene set enrichment analysis, and gene annotation and pathway analysis were conducted using online data mining tools GSEA and DAVID. Gene expression profiling showed that RA treatment biased hAECs toward ectodermal lineage progression, regulated transcription factors involved in neuronal differentiation, regulated neural specific epigenetic modifiers and several extracellular signaling pathways of neural induction, and significantly inhibited Notch signaling pathway. Gene expression profiling of RA-treated hAECs reveals for the first time a potential role of RA in neural induction and neuronal differentiation of hAECs. Having a naturally occurring compound as differentiation inducer as well as a readily available source of stem cells would have great advantages for the cell-based therapies. Findings from our genome-wide analysis could provide a foundation for further in-depth investigation.
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Affiliation(s)
- Farhana Ferdousi
- Alliance for Research on the Mediterranean and North Africa, University of Tsukuba, Tsukuba, Japan
| | - Kazunori Sasaki
- National Institute of Advanced Industrial Science and Technology, Tsukuba, Japan
| | - Yoshiaki Uchida
- School of Integrative and Global Majors, University of Tsukuba, Tsukuba, Japan
| | - Nobuhiro Ohkohchi
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Yun-Wen Zheng
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Hiroko Isoda
- Alliance for Research on the Mediterranean and North Africa, University of Tsukuba, Tsukuba, Japan.,National Institute of Advanced Industrial Science and Technology, Tsukuba, Japan.,Faculty of Life and Environmental Sciences, University of Tsukuba, Tsukuba, Japan
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22
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Miyamoto R, Oshiro Y, Sano N, Inagawa S, Ohkohchi N. Remnant pancreatic volume as an indicator of poor prognosis in pancreatic cancer patients after resection. Pancreatology 2019; 19:716-721. [PMID: 31178397 DOI: 10.1016/j.pan.2019.05.464] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 05/21/2019] [Accepted: 05/29/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND Remnant pancreatic volume (RPV) is a well-known marker for short-term outcomes in pancreatic cancer patients after resection. However, in terms of the long-term outcomes, the significance of the RPV value remains unclear. Here, we address whether the RPV value is a predictor of the long-term outcomes in pancreatic cancer patients after resection by comparing various cancer-, patient-, and surgery-related prognostic factors and systemic inflammatory response markers in a retrospective cohort. METHODS The RPV was measured on a three-dimensional (3D) image, revealing the actual pancreatic parenchymal remnant volume. Ninety-one patients who underwent pancreaticoduodenectomy were retrospectively enrolled. We divided the cohort into high- and low-RPV groups based on a cut-off value (>31.5 cm3, n = 66 and ≤31.5 cm3, n = 25, respectively). The median survival times (MSTs) were compared between the two groups. Using multivariate analysis, the RPV and other well-known prognostic factors were independently assessed. RESULTS The MSTs (days) were significantly different between the two groups (high, 823 vs. low, 482, p = 0.001). Multivariate analysis identified the RPV (≤31.5 cm3) (hazard ratio [HR], 2.015; p = 0.011), lymph node metastasis (HR, 8.415; p = 0.002), lack of adjuvant chemotherapy (HR, 5.352; p < 0.001), stage III/IV disease (HR, 2.352; p = 0.029), and pathological fibrosis (HR, 1.771; p = 0.031) as independent prognostic factors. CONCLUSIONS The present study suggests that the RPV value is also useful for predicting long-term outcomes in pancreatic cancer patients after resection.
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Affiliation(s)
- Ryoichi Miyamoto
- Department of Gastroenterological Surgery, Tsukuba Medical Center Hospital, 1-3-1 Amakubo, Tsukuba, Ibaraki, 305-8558, Japan; Department of Surgery, Division of Gastroenterological and Hepatobiliary Surgery and Organ Transplantation, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan.
| | - Yukio Oshiro
- Department of Surgery, Division of Gastroenterological and Hepatobiliary Surgery and Organ Transplantation, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Naoki Sano
- Department of Gastroenterological Surgery, Tsukuba Medical Center Hospital, 1-3-1 Amakubo, Tsukuba, Ibaraki, 305-8558, Japan
| | - Satoshi Inagawa
- Department of Gastroenterological Surgery, Tsukuba Medical Center Hospital, 1-3-1 Amakubo, Tsukuba, Ibaraki, 305-8558, Japan
| | - Nobuhiro Ohkohchi
- Department of Surgery, Division of Gastroenterological and Hepatobiliary Surgery and Organ Transplantation, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
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23
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Miyamoto R, Oshiro Y, Ohkohchi N. Remnant pancreatic volume to predict short-term and long-term outcomes in patients with resected pancreatic cancer. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.e15713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e15713 Background: Remnant pancreatic volume (RPV) is a well-known marker for short-term outcomes in patients with resectable pancreatic cancer. However, in terms of the long-term outcomes, the significance of the RPV remains unclear. Here, we addressed whether the RPV is a predictor of long-term outcomes in pancreatic cancer patients by comparing various cancer-, patient-, and surgery-related prognostic factors and systemic inflammatory response markers in a retrospective cohort. Methods: The RPV was measured on the 3D image, revealing the actual pancreatic parenchymal remnant volume. Ninety-one patients who underwent pancreaticoduodenectomy (PD) were retrospectively enrolled. We divided the cohort into high- and low-RPV groups based on a cut-off value ( > 35.5 cm3, n = 66 and ≤ 35.5 cm3, n = 25, respectively). The patient characteristics, perioperative outcomes and median survival times (MSTs) were respectively compared between the two groups. Using multivariate analysis, the RPV and other well-known prognostic factors were independently assessed. Results: A significant difference in the RPV value was observed with respect to the incidence of postoperative pancreatic fistula (high, 18 [55%] vs. low, 9 [16%], p < 0.001). The MSTs (days) were significantly different between the two groups (high, 823 vs. low, 482, p = 0.001). Multivariate analysis identified the RPV (≤ 31.5 cm3) (hazard ratio [HR], 2.015; p = 0.011), lymph node metastasis (HR, 8.415; p = 0.002), adjuvant chemotherapy (HR, 5.352; p < 0.001), presence of stage III/IV disease (HR, 2.352; p = 0.029), and pathological fibrosis (HR, 1.771; p = 0.031) as independent prognostic factors. Conclusions: The present study suggests that the RPV is an additional useful predictor of both long-term and short-term outcomes in pancreatic cancer patients after PD.
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Affiliation(s)
| | - Yukio Oshiro
- Tokyo Medical University, Department of Gastroenterological Surgery, Ibaraki Medical Center, Department of Gastroenterological Surgery, 3-20-1 Chuo, Amimachi, Inashikigun, Ibaraki, Japan
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Liang C, Takahashi K, Kurata M, Sakashita S, Oda T, Ohkohchi N. Recurrent renal cell carcinoma leading to a misdiagnosis of polycystic liver disease: A case report. World J Gastroenterol 2019; 25:2264-2270. [PMID: 31143076 PMCID: PMC6526153 DOI: 10.3748/wjg.v25.i18.2264] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 04/17/2019] [Accepted: 04/20/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Polycystic liver disease (PCLD) with a large cystic volume deteriorates the quality of life of patients through substantial effects on the adjacent organs, recurrent cyst infections, cyst rupture, and hemorrhage. Surgical or radiological intervention is usually needed to alleviate these symptoms. We report a rare case of the cystic metastasis of renal cell carcinoma (RCC), which was misdiagnosed as PCLD, as a result of the clinical and radiological similarity between these disorders.
CASE SUMMARY A 74-year-old female who had undergone nephrectomy for papillary-type RCC (PRCC) was suffering from abdominal pain and the recurrent intracystic hemorrhage of multiple cysts in the liver. Imaging studies and aspiration cytology of the cysts showed no evidence of malignancy. With a diagnosis of autosomal dominant polycystic liver disease, the patient received hepatectomy for the purpose of mass reduction and infectious cyst removal. Surgery was performed without complications, and the patient was discharged on postoperative day 14. Postoperatively, the pathology revealed a diagnosis of recurrent PRCC with cystic formation.
CONCLUSION This case demonstrates the importance of excluding the cystic metastasis of a cancer when liver cysts are observed.
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Affiliation(s)
- Chen Liang
- Department of Surgery, University of Tsukuba, Tsukuba, Ibaraki Prefecture 3058575, Japan
| | - Kazuhiro Takahashi
- Department of Surgery, University of Tsukuba, Tsukuba, Ibaraki Prefecture 3058575, Japan
| | - Masanao Kurata
- Department of Surgery, University of Tsukuba, Tsukuba, Ibaraki Prefecture 3058575, Japan
| | - Shingo Sakashita
- Department of Diagnostic Pathology, University of Tsukuba, Tsukuba, Ibaraki Prefecture 3058575, Japan
| | - Tatsuya Oda
- Department of Surgery, University of Tsukuba, Tsukuba, Ibaraki Prefecture 3058575, Japan
| | - Nobuhiro Ohkohchi
- Department of Surgery, University of Tsukuba, Tsukuba, Ibaraki Prefecture 3058575, Japan
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Suzuki R, Nakamiya Y, Watanabe M, Ando E, Tanichi M, Koga M, Kohno K, Usui J, Yamagata K, Ohkohchi N, Toda H, Saito T, Yoshino A, Takahara S, Yamauchi K, Yuzawa K. Relationship Between Stress Coping Mechanisms and Depression in Kidney Transplant Recipients. Transplant Proc 2019; 51:761-767. [PMID: 30979461 DOI: 10.1016/j.transproceed.2018.12.034] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Accepted: 12/31/2018] [Indexed: 11/19/2022]
Abstract
BACKGROUND It has been reported that transplant recipients are exposed to physical and psychosocial stresses even after transplant surgery and exhibit psychological disorders such as depression. PURPOSE In this study, we extracted trends concerning how recipients of kidney transplants cope with stress, and we also examined how they cope with depression and its countermeasures. METHOD We administered questionnaire surveys to 109 kidney transplant recipients. These included items on personal attributes, medical information, depression, and stress-coping type scales. Statistical analysis was performed using factor analysis and multiple regression analysis. RESULTS Fifteen out of 109 (13.8%) were found to be high-risk patients for depression based on responses to the questionnaire using the depression scale. We extracted 2 factors of stress-coping type, namely Factor 1, "Directly coping with the problem," of patients who try to directly resolve the problem in a positive manner and Factor 2, "Stress-release while avoiding the problem," for those who relieve their feelings in response to the stress without resolving the problem itself. When multiple regression analysis was conducted with the depression scale as the dependent variable and the stress-coping factor as the independent variable, Factor 1 tended to be associated with reduced depression and Factor 2 with increased depression. CONCLUSIONS Results showed that to improve the mental health of those who receive kidney transplants, it is necessary to examine the depression and stress-coping types of such patients at an early stage and carry out education on stress-coping, focusing on resolving the actual problem.
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Affiliation(s)
- R Suzuki
- Department of Psychiatry, National Defense Medical College, Tokorozawa, Saitama, Japan; Department of Transplantation Surgery, National Hospital Organization Mito Medical Center, Higashiibaraki, Ibaraki, Japan; Graduate School of Health Management, Keio University, Fujisawa, Kanagawa, Japan; Department of Advanced Technology for Transplantation, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan.
| | - Y Nakamiya
- Department of Transplantation Surgery, National Hospital Organization Mito Medical Center, Higashiibaraki, Ibaraki, Japan
| | - M Watanabe
- Kanto Gakuin University College of Nursing, Yokohama, Kanagawa, Japan
| | - E Ando
- Department of Social and Environmental Health, Division of Environmental Medicine and Population Sciences, Graduate School of Medicine, Osaka University Suita, Osaka, Japan
| | - M Tanichi
- Department of Psychiatry, National Defense Medical College, Tokorozawa, Saitama, Japan
| | - M Koga
- Department of Psychiatry, National Defense Medical College, Tokorozawa, Saitama, Japan
| | - K Kohno
- Hitachino Family Clinic, Ushiku, Ibaraki, Japan
| | - J Usui
- Department of Nephrology, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - K Yamagata
- Department of Nephrology, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - N Ohkohchi
- Mito Chuo Hospital, Mito, Ibaraki, Japan
| | - H Toda
- Department of Psychiatry, National Defense Medical College, Tokorozawa, Saitama, Japan
| | - T Saito
- Department of Psychiatry, National Defense Medical College, Tokorozawa, Saitama, Japan
| | - A Yoshino
- Department of Psychiatry, National Defense Medical College, Tokorozawa, Saitama, Japan
| | - S Takahara
- Department of Advanced Technology for Transplantation, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
| | - K Yamauchi
- Graduate School of Health Management, Keio University, Fujisawa, Kanagawa, Japan
| | - K Yuzawa
- Department of Transplantation Surgery, National Hospital Organization Mito Medical Center, Higashiibaraki, Ibaraki, Japan
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Nanmoku K, Owada Y, Oshiro Y, Kurosawa A, Kubo T, Shinzato T, Shimizu T, Kimura T, Sakuma Y, Ishikawa N, Ohkohchi N, Okamoto H, Yagisawa T. Prevalence and characteristics of hepatitis E virus infection in kidney transplant recipients: A single-center experience in Japan. Transpl Infect Dis 2018; 21:e13033. [PMID: 30481402 DOI: 10.1111/tid.13033] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Revised: 11/06/2018] [Accepted: 11/15/2018] [Indexed: 01/11/2023]
Abstract
BACKGROUND Hepatitis E virus (HEV) infection can lead to chronic hepatitis in solid organ transplant recipients. To investigate whether HEV infection influences outcomes following kidney transplantation, we examined the prevalence of HEV infection and clinical characteristics of kidney transplant recipients in our hospital. METHODS Our cross-sectional study included 184 kidney transplant recipients. Blood samples were obtained from all patients to detect anti-HEV immunoglobulin (Ig)A, IgM, and IgG by enzyme-linked immunosorbent assay and HEV RNA by reverse transcription polymerase chain reaction. Clinical data were collected from medical charts for all patients. RESULTS The prevalence of anti-HEV IgG was 8/184 (4.3%). Anti-HEV IgA, anti-HEV IgM, and HEV RNA were not detected in any patients. Compared to their anti-HEV IgG-negative counterparts, anti-HEV IgG-positive patients were significantly older at the time of transplantation, and they were more likely to receive kidneys from deceased donors. No significant differences in other characteristics such as the prevalence of primary cause of end-stage renal disease, blood transfusion, and immunosuppressive therapy use; liver and renal function; and the frequencies of hepatitis B and hepatitis C virus infection were observed according to the patients' anti-HEV IgG status. CONCLUSION HEV infection had no significant influence on the outcomes of kidney transplantation at our institution. However, HEV infection should be recognized in kidney transplant recipients similarly as hepatitis B and hepatitis C virus infection in cases of liver dysfunction.
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Affiliation(s)
- Koji Nanmoku
- Surgical Branch, Institute of Kidney Diseases, Jichi Medical University Hospital, Shimotsuke, Japan
| | - Yohei Owada
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Yukio Oshiro
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.,Department of Gastroenterological Surgery, Tokyo Medical University Ibaraki Medical Center, Inashiki, Japan
| | - Akira Kurosawa
- Surgical Branch, Institute of Kidney Diseases, Jichi Medical University Hospital, Shimotsuke, Japan
| | - Taro Kubo
- Surgical Branch, Institute of Kidney Diseases, Jichi Medical University Hospital, Shimotsuke, Japan
| | - Takahiro Shinzato
- Surgical Branch, Institute of Kidney Diseases, Jichi Medical University Hospital, Shimotsuke, Japan
| | - Toshihiro Shimizu
- Surgical Branch, Institute of Kidney Diseases, Jichi Medical University Hospital, Shimotsuke, Japan
| | - Takaaki Kimura
- Surgical Branch, Institute of Kidney Diseases, Jichi Medical University Hospital, Shimotsuke, Japan
| | - Yasunaru Sakuma
- Surgical Branch, Institute of Kidney Diseases, Jichi Medical University Hospital, Shimotsuke, Japan
| | - Nobuo Ishikawa
- Surgical Branch, Institute of Kidney Diseases, Jichi Medical University Hospital, Shimotsuke, Japan
| | - Nobuhiro Ohkohchi
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Hiroaki Okamoto
- Division of Virology, Department of Infection and Immunity, Jichi Medical University School of Medicine, Shimotsuke, Japan
| | - Takashi Yagisawa
- Surgical Branch, Institute of Kidney Diseases, Jichi Medical University Hospital, Shimotsuke, Japan
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Miyamoto R, Oshiro Y, Sano N, Inagawa S, Ohkohchi N. Three-Dimensional Remnant Pancreatic Volumetry Predicts Postoperative Pancreatic Fistula in Pancreatic Cancer Patients after Pancreaticoduodenectomy. Gastrointest Tumors 2018; 5:90-99. [PMID: 30976580 DOI: 10.1159/000495406] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Accepted: 11/11/2018] [Indexed: 12/11/2022] Open
Abstract
Background Postoperative pancreatic fistula (POPF) is a serious complication that can occur following pancreaticoduodenectomy (PD). Recent studies suggest that remnant pancreatic volume (RPV) values from preoperative multidetector computed tomography (MDCT) are highly predictive of POPF. We performed three-dimensional (3D) surgical simulation of PD including RPV measurements. The aim of this study was to determine whether 3D-measured RPV is predictive of POPF after PD. Methods We used the SYNAPSE VINCENT® medical imaging system (Fujifilm Medical Co., Ltd., Tokyo, Japan) to construct 3D images after integrating MDCT and magnetic resonance cholangiopancreatography images. RPV was measured using this 3D image, which simulated actual intraoperative pancreatic parenchymal remnant volume. Ninety-one patients who underwent PD were retrospectively enrolled. Using multivariate analysis, RPV and other well-known POPF risk factors were independently assessed. Results Multivariate analysis identified high RPV values (hazard ratio [HR] = 8.41, p = 0.01), pancreatic duct diameter < 3.0 mm (HR = 5.48, p < 0.01), no pathological fibrosis (HR = 3.41, p < 0.01), and body mass index > 25 kg/m2 (HR = 1.53, p = 0.02) as independent risk factors for POPF. Conclusion The present study indicates that preoperative 3D-measured RPV is predictive of POPF after PD.
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Affiliation(s)
- Ryoichi Miyamoto
- Department of Gastroenterological Surgery, Tsukuba Medical Center Hospital, Tsukuba, Japan.,Division of Gastroenterological and Hepatobiliary Surgery and Organ Transplantation, Department of Surgery, University of Tsukuba, Tsukuba, Japan
| | - Yukio Oshiro
- Division of Gastroenterological and Hepatobiliary Surgery and Organ Transplantation, Department of Surgery, University of Tsukuba, Tsukuba, Japan
| | - Naoki Sano
- Department of Gastroenterological Surgery, Tsukuba Medical Center Hospital, Tsukuba, Japan
| | - Satoshi Inagawa
- Department of Gastroenterological Surgery, Tsukuba Medical Center Hospital, Tsukuba, Japan
| | - Nobuhiro Ohkohchi
- Division of Gastroenterological and Hepatobiliary Surgery and Organ Transplantation, Department of Surgery, University of Tsukuba, Tsukuba, Japan
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Miyazaki Y, Kurata M, Oshiro Y, Shimomura O, Takahashi K, Oda T, Ohkohchi N. Indocyanine green fluorescence-navigated laparoscopic metastasectomy for peritoneal metastasis of hepatocellular carcinoma: a case report. Surg Case Rep 2018; 4:130. [PMID: 30406329 PMCID: PMC6221853 DOI: 10.1186/s40792-018-0537-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Accepted: 10/24/2018] [Indexed: 12/20/2022] Open
Abstract
Background Indocyanine green (ICG) can selectively accumulate in primary hepatocellular carcinoma (HCC) and its extrahepatic metastases. ICG fluorescence imaging is an extremely sensitive intraoperative tool for detecting HCC foci and can be used to detect impalpable tumors in laparoscopic surgery. Here, we report a case of a 75-year-old man who underwent peritoneal metastasis resection of HCC using a laparoscopic near-infrared imaging system and ICG fluorescence-navigated surgery. Case presentation A 75-year-old man was referred to our department for peritoneal metastasis resection of HCC. Two years before admission, he had undergone transarterial embolization and segmentectomy of segment 6 with open surgery for ruptured HCC. Computed tomography revealed a 12-mm peritoneal metastatic lesion on the abdominal wall near the cut surface of the liver. No other metastases were observed; resection of the solitary metastasis was scheduled. ICG (0.5 mg/kg body weight) was intravenously injected, 72 h preoperatively. An endoscopic, ICG near-infrared fluorescence imaging system revealed clear green fluorescence, indicating peritoneal metastasis of HCC on the abdominal wall. The tumor was resected with adequate surgical margin by partially resecting the liver and diaphragm, followed by histological confirmation as peritoneal metastasis of HCC. No recurrence was observed after 12 months of follow-up. Conclusions ICG fluorescence can be useful in laparoscopic surgery for identifying peritoneal metastasis.
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Affiliation(s)
- Yoshihiro Miyazaki
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1, Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Masanao Kurata
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1, Tennodai, Tsukuba, Ibaraki, 305-8575, Japan.
| | - Yukio Oshiro
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1, Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Osamu Shimomura
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1, Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Kazuhiro Takahashi
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1, Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Tatsuya Oda
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1, Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Nobuhiro Ohkohchi
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1, Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
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Miyamoto R, Oshiro Y, Sano N, Inagawa S, Ohkohchi N. Three-dimensional surgical simulation of the bile duct and vascular arrangement in pancreatoduodenectomy: A retrospective cohort study. Ann Med Surg (Lond) 2018; 36:17-22. [PMID: 30370052 PMCID: PMC6199778 DOI: 10.1016/j.amsu.2018.09.043] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Accepted: 09/21/2018] [Indexed: 12/14/2022] Open
Abstract
Background/aims We evaluated the usefulness of three-dimensional (3D) images for pancreatoduodenectomy (PD), including the classification of the bile duct and vascular arrangement, i.e., hepatic artery, inferior mesenteric vein (IMV) and left gastric vein (LGV). We evaluated the extent to which this simulation affected the perioperative outcomes of PD. Methods In all, 117 patients who underwent PD were divided into the without-3D (n = 53) and with-3D (n = 64) groups, and perioperative outcomes were compared. We evaluated the arrangement of the accessory bile duct and the hepatic artery (type I: the right hepatic artery arising from the superior mesenteric artery, type II: the left hepatic artery arising from the left gastric artery, type III: the most common pattern) and the confluence pattern of the LGV and the IMV [type i: portal vein (PV):splenic vein (SV), type ii: PV:superior mesenteric vein (SMV), type iii: SV:SV, and type iv: SV:SMV] between the two groups. Results Two patients had an accessory bile duct. The 3D images were classified as type I (n = 4), type II (n = 10), type III (n = 48) and other patterns (n = 2); type ii (n = 27) was the most frequent confluence pattern (p < 0.05). Intraoperative blood loss was reduced in the with-3D group (p < 0.05). Conclusions We propose that the 3D imaging technique is useful for preoperative assessment in PD.
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Affiliation(s)
- Ryoichi Miyamoto
- Department of Gastroenterological Surgery, Tsukuba Medical Center Hospital, 1-3-1 Amakubo, Tsukuba, Ibaraki, 305-8558, Japan
| | - Yukio Oshiro
- Department of Surgery, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Naoki Sano
- Department of Gastroenterological Surgery, Tsukuba Medical Center Hospital, 1-3-1 Amakubo, Tsukuba, Ibaraki, 305-8558, Japan
| | - Satoshi Inagawa
- Department of Gastroenterological Surgery, Tsukuba Medical Center Hospital, 1-3-1 Amakubo, Tsukuba, Ibaraki, 305-8558, Japan
| | - Nobuhiro Ohkohchi
- Department of Surgery, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
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Mogalli R, Matsukawa T, Shimomura O, Isoda H, Ohkohchi N. Cyanidin-3-glucoside enhances mitochondrial function and biogenesis in a human hepatocyte cell line. Cytotechnology 2018; 70:1519-1528. [PMID: 30155610 PMCID: PMC6269359 DOI: 10.1007/s10616-018-0242-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Accepted: 07/24/2018] [Indexed: 02/06/2023] Open
Abstract
Mitochondrial dysfunction has been identified as one of the primary factors contributing to liver diseases. Pathways that control mitochondrial biogenesis are potential therapeutic targets for the amelioration of hepatocyte dysfunction and liver disease. Research on natural pharmacological agents that ameliorate liver diseases has intensified over the last two decades. Cyanidin-3-glucoside (Cy3g), a dietary flavonoid compound extracted from a wide variety of fruits and vegetables, reportedly has several beneficial health effects. In this study, we used an adult human hepatoma cell line (HuH7) to investigate the effects of the Cy3g polyphenolic compound on mitochondrial function and biogenesis in vitro. An increase in intracellular mitochondrial reductase levels was observed after treatment with Cy3g, but cytotoxicity was not induced. In addition, mitochondrial membrane potential and ATP production were increased following Cy3g treatment. Cy3g treatment also resulted in a dose- and time-dependent upregulation of the gene expression of peroxisome proliferator-activated receptor gamma coactivator 1-alpha (PGC-1α), a transcription factor considered a master regulator of mitochondrial biogenesis and metabolism. Additionally, the expression of sirtuin 1 (SIRT1), which plays a key role in deacetylating PGC-1α, was also increased in a dose- and time-dependent manner. Cy3g treatment also increased the expression of downstream PGC-1α genes, nuclear respiratory factor 1 and mitochondrial transcription factor A (TFAM). Our results suggest that Cy3g has potential as a hepatoprotective therapeutic agent that enhances mitochondrial function and biogenesis in hepatocytes.
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Affiliation(s)
- Rashad Mogalli
- Department of Surgery and Organ Transplantation, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan
| | - Toshiya Matsukawa
- Graduate School of Life and Environmental Sciences, University of Tsukuba, Tsukuba, Ibaraki, 305-8572, Japan
| | - Osamu Shimomura
- Department of Surgery and Organ Transplantation, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan
| | - Hiroko Isoda
- Faculty of Life and Environmental Sciences, University of Tsukuba, Tsukuba, Ibaraki, 305-8572, Japan
- Alliance for Research on North Africa (ARENA), University of Tsukuba, Tsukuba, Ibaraki, 305-8572, Japan
| | - Nobuhiro Ohkohchi
- Department of Surgery and Organ Transplantation, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan.
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Ohara Y, Oda T, Enomoto T, Hisakura K, Akashi Y, Ogawa K, Owada Y, Domoto Y, Miyazaki Y, Shimomura O, Kurata M, Ohkohchi N. Surgical resection of hepatic and rectal metastases of pancreatic acinar cell carcinoma (PACC): a case report. World J Surg Oncol 2018; 16:158. [PMID: 30075727 PMCID: PMC6091145 DOI: 10.1186/s12957-018-1457-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Accepted: 07/26/2018] [Indexed: 02/07/2023] Open
Abstract
Background Pancreatic acinar cell carcinoma (PACC), a rare variant of pancreatic malignancy, is generally managed the same way as pancreatic ductal adenocarcinoma (PDAC). Surgical resection is the gateway to curing it; however, once it metastasizes (usually to the liver, lungs, lymph nodes, or peritoneal cavity), systemic chemotherapy has been the only option, but with unfavorable results. Case presentation A 67-year-old man with symptoms of loss of appetite and weight underwent surgery for malignancy of the pancreatic tail extending into the entire pancreas. The pathological diagnosis was PACC following total pancreatectomy. Twenty-four months after the pancreatectomy, a solitary liver metastasis was treated by partial hepatectomy, and, subsequently, 4 months later, he presented with melena. Further examination revealed a type-2 rectal tumor. Histological examination following biopsy revealed it to be rectal metastasis of PACC, and it was treated by abdominoperineal resection. Subsequently, the patient did not have tumor recurrence as of 40 months after pancreatectomy. Conclusions This is a rare case of PACC presenting with metachronal metastases in the liver and rectum, and we successfully treated them by surgical resections. Since the malignant behavior of PACC is usually less than that of PDAC, surgical resection could be an option even for metastatic lesions when the number and extent of metastases are limited.
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Affiliation(s)
- Yusuke Ohara
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Tatsuya Oda
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan.
| | - Tsuyoshi Enomoto
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Katsuji Hisakura
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Yoshimasa Akashi
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Koichi Ogawa
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Yohei Owada
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Yu Domoto
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Yoshihiro Miyazaki
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Osamu Shimomura
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Masanao Kurata
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Nobuhiro Ohkohchi
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
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Ozawa Y, Tamura T, Owada Y, Shimizu Y, Kemmochi A, Hisakura K, Matsuzaka T, Shimano H, Isoda H, Ohkohchi N. Evaluation of safety for hepatectomy in a novel mouse model with nonalcoholic-steatohepatitis. World J Gastroenterol 2018; 24:1622-1631. [PMID: 29686469 PMCID: PMC5910545 DOI: 10.3748/wjg.v24.i15.1622] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Revised: 03/16/2018] [Accepted: 03/25/2018] [Indexed: 02/06/2023] Open
Abstract
AIM To investigate whether the liver resection volume in a newly developed nonalcoholic steatohepatitis (NASH) model influences surgical outcome.
METHODS For establishment of a NASH model, mice were fed a high-fat diet for 4 wk, administered CCl4 for the last 2 wk, and administered T0901317 for the last 5 d. We divided these mice into two groups: A 30% partial hepatectomy (PH) of NASH liver group and a 70% PH of NASH liver group. In addition, a 70% PH of normal liver group served as the control. Each group was evaluated for survival rate, regeneration, apoptosis, necrosis and DNA expression after PH.
RESULTS In the 70% PH of NASH group, the survival rate was significantly decreased compared with that in the control and 30% PH of NASH groups (P < 0.01). 10 of 32 mice in the NASH 70% PH group died within 48 h after PH. Serum aspartate aminotransferase (AST) levels and total bilirubin (T-Bil) in the NASH 70% PH group were significantly higher than the levels in the other two groups (AST: P < 0.05, T-Bil: P < 0.01). In both PH of NASH groups, signaling proteins involved in regeneration were expressed at lower levels than those in the control group (P < 0.01). The 70% PH of NASH group also exhibited a lower number of Ki-67-positive cells and higher rates of apoptosis and necrosis than the NASH 30% PH group (P < 0.01). In addition, DNA microarray assays showed differences in gene expression associated with cell cycle arrest and apoptosis.
CONCLUSION The function of the residual liver is impaired in fatty liver compared to normal liver. A larger residual volume is required to maintain liver functions in mice with NASH.
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Affiliation(s)
- Yusuke Ozawa
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba 305-8575, Japan
| | - Takafumi Tamura
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba 305-8575, Japan
| | - Yohei Owada
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba 305-8575, Japan
| | - Yoshio Shimizu
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba 305-8575, Japan
| | - Akira Kemmochi
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba 305-8575, Japan
| | - Katsuji Hisakura
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba 305-8575, Japan
| | - Takashi Matsuzaka
- Department of Endocrinology and Metabolism, Faculty of Medicine, University of Tsukuba, Tsukuba 305-8575, Japan
| | - Hitoshi Shimano
- Department of Endocrinology and Metabolism, Faculty of Medicine, University of Tsukuba, Tsukuba 305-8575, Japan
| | - Hiroko Isoda
- Faculty of Life and Environmental Sciences, University of Tsukuba, Tsukuba 305-8572, Japan
| | - Nobuhiro Ohkohchi
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba 305-8575, Japan
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Takahashi K, Nagai S, Safwan M, Liang C, Ohkohchi N. Thrombocytopenia after liver transplantation: Should we care? World J Gastroenterol 2018; 24:1386-1397. [PMID: 29632420 PMCID: PMC5889819 DOI: 10.3748/wjg.v24.i13.1386] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 03/06/2018] [Accepted: 03/18/2018] [Indexed: 02/06/2023] Open
Abstract
Transient thrombocytopenia is a common phenomenon after liver transplantation. After liver transplantation (LT), platelet count decreases and reaches a nadir on postoperative days 3-5, with an average reduction in platelet counts of 60%; platelet count recovers to preoperative levels approximately two weeks after LT. The putative mechanisms include haemodilution, decreased platelet production, increased sequestration, medications, infections, thrombosis, or combination of these processes. However, the precise mechanisms remain unclear. The role of platelets in liver transplantation has been highlighted in recent years, and particular attention has been given to their effects beyond hemostasis and thrombosis. Previous studies have demonstrated that perioperative thrombocytopenia causes poor graft regeneration, increases the incidence of postoperative morbidity, and deteriorates the graft and decreases patient survival in both the short and long term after liver transplantation. Platelet therapies to increase perioperative platelet counts, such as thrombopoietin, thrombopoietin receptor agonist, platelet transfusion, splenectomy, and intravenous immunoglobulin treatment might have a potential for improving graft survival, however clinical trials are lacking. Further studies are warranted to detect direct evidence on whether thrombocytopenia is the cause or result of poor-graft function and postoperative complications, and to determine who needs platelet therapies in order to prevent postoperative complications and thus improve post-transplant outcomes.
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Affiliation(s)
- Kazuhiro Takahashi
- Department of Surgery, Division of Gastroenterological and Hepatobiliary Surgery, and Organ Transplantation, University of Tsukuba, Tsukuba, Ibaraki 3058575, Japan
| | - Shunji Nagai
- Transplant and Hepatobiliary Surgery, Henry Ford Hospital, Detroit, ML 48202, United States
| | - Mohamed Safwan
- Transplant and Hepatobiliary Surgery, Henry Ford Hospital, Detroit, ML 48202, United States
| | - Chen Liang
- Department of Surgery, Division of Gastroenterological and Hepatobiliary Surgery, and Organ Transplantation, University of Tsukuba, Tsukuba, Ibaraki 3058575, Japan
| | - Nobuhiro Ohkohchi
- Department of Surgery, Division of Gastroenterological and Hepatobiliary Surgery, and Organ Transplantation, University of Tsukuba, Tsukuba, Ibaraki 3058575, Japan
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Lu J, Zhang L, Zhang D, Matsumoto S, Hiroshima H, Maeda R, Sato M, Toyoda A, Gotoh T, Ohkohchi N. Development of Implantable Wireless Sensor Nodes for Animal Husbandry and MedTech Innovation. Sensors (Basel) 2018; 18:s18040979. [PMID: 29587448 PMCID: PMC5948591 DOI: 10.3390/s18040979] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Revised: 03/22/2018] [Accepted: 03/22/2018] [Indexed: 12/12/2022]
Abstract
In this paper, we report the development, evaluation, and application of ultra-small low-power wireless sensor nodes for advancing animal husbandry, as well as for innovation of medical technologies. A radio frequency identification (RFID) chip with hybrid interface and neglectable power consumption was introduced to enable switching of ON/OFF and measurement mode after implantation. A wireless power transmission system with a maximum efficiency of 70% and an access distance of up to 5 cm was developed to allow the sensor node to survive for a duration of several weeks from a few minutes’ remote charge. The results of field tests using laboratory mice and a cow indicated the high accuracy of the collected biological data and bio-compatibility of the package. As a result of extensive application of the above technologies, a fully solid wireless pH sensor and a surgical navigation system using artificial magnetic field and a 3D MEMS magnetic sensor are introduced in this paper, and the preliminary experimental results are presented and discussed.
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Affiliation(s)
- Jian Lu
- Research Center for Ubiquitous MEMS and Micro Engineering (UMEMSME), National Institute of Advanced Industrial Science and Technology (AIST), Namiki 1-2-1, Tsukuba 305-8564, Japan.
| | - Lan Zhang
- Research Center for Ubiquitous MEMS and Micro Engineering (UMEMSME), National Institute of Advanced Industrial Science and Technology (AIST), Namiki 1-2-1, Tsukuba 305-8564, Japan.
| | - Dapeng Zhang
- Research Center for Ubiquitous MEMS and Micro Engineering (UMEMSME), National Institute of Advanced Industrial Science and Technology (AIST), Namiki 1-2-1, Tsukuba 305-8564, Japan.
| | - Sohei Matsumoto
- Research Center for Ubiquitous MEMS and Micro Engineering (UMEMSME), National Institute of Advanced Industrial Science and Technology (AIST), Namiki 1-2-1, Tsukuba 305-8564, Japan.
| | - Hiroshi Hiroshima
- Research Center for Ubiquitous MEMS and Micro Engineering (UMEMSME), National Institute of Advanced Industrial Science and Technology (AIST), Namiki 1-2-1, Tsukuba 305-8564, Japan.
| | - Ryutaro Maeda
- Research Center for Ubiquitous MEMS and Micro Engineering (UMEMSME), National Institute of Advanced Industrial Science and Technology (AIST), Namiki 1-2-1, Tsukuba 305-8564, Japan.
| | - Mizuho Sato
- College of Agriculture Ibaraki University, Chuo Ami Inashiki 3-21-1, Mito 300-0393, Japan.
| | - Atsushi Toyoda
- College of Agriculture Ibaraki University, Chuo Ami Inashiki 3-21-1, Mito 300-0393, Japan.
| | - Takafumi Gotoh
- Kuju Agricultural Research Center, Graduate School of Agriculture, Kyushu University, Fukuoka 878-0201, Japan.
- Department of Agricultural Sciences and Natural Resources, Kagoshima University, Korimoto 1-21-24, Kagoshima 890-0065, Japan.
| | - Nobuhiro Ohkohchi
- Faculty of Medicine, University of Tsukuba, Tennoudai 1-1-1, Tsukuba 305-8577, Japan.
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Abstract
Background In the past decade, three-dimensional (3D) simulation has been commonly used for liver surgery. However, few studies have analyzed the usefulness of this 3D simulation. The aim of this study was to evaluate the effect of 3D simulation on the outcome of liver surgery. Methods We retrospectively analyzed 240 consecutive patients who underwent liver resection. The patients were divided into two groups: those who received 3D preoperative simulation (“3D group”, n = 120) and those who did not undergo 3D preoperative simulation (“without 3D group”, n = 120). The perioperative outcomes, including operation time, blood loss, maximum aspartate transaminase level, length of postoperative stay, postoperative complications and postoperative mortality, were compared between the two groups. The predicted resected liver volume was compared with the actual resected volume. Results The median operation time for the 3D group was 36 min shorter than that for the without 3D group (P = 0.048). There were no significant differences in other outcomes between the two groups. A subgroup analysis revealed that the operation time of repeated hepatectomy and segmentectomy for the 3D group was shorter than that for the without 3D group (P = 0.03). There was a strong correlation between the predicted liver volume and the actual resected liver weight (r = 0.80, P < 0.001). Conclusion These findings demonstrate that 3D preoperative simulation may reduce the operation time, particularly for repeated hepatectomy and segmentectomy.
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Affiliation(s)
- Ken Nakayama
- Department of Gastrointestinal and Hepatobiliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan
| | - Yukio Oshiro
- Department of Gastrointestinal and Hepatobiliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan.
| | - Ryoichi Miyamoto
- Department of Gastrointestinal and Hepatobiliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan
| | - Keisuke Kohno
- Department of Gastrointestinal and Hepatobiliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan
| | - Kiyoshi Fukunaga
- Department of Gastrointestinal and Hepatobiliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan
| | - Nobuhiro Ohkohchi
- Department of Gastrointestinal and Hepatobiliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan
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Miyazaki Y, Kokudo T, Amikura K, Takahashi A, Ohkohchi N, Sakamoto H. Albumin-Indocyanine Green Evaluation Grading System Predicts Post-Hepatectomy Liver Failure for Biliary Tract Cancer. Dig Surg 2018; 36:13-19. [PMID: 29339651 DOI: 10.1159/000486142] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Accepted: 12/07/2017] [Indexed: 12/13/2022]
Abstract
BACKGROUND In biliary tract cancer treatment, a precise preoperative evaluation of the patient's liver function is essential to avoid post-hepatectomy liver failure (PHLF) and mortality. The present study aimed to evaluate the role of the Albumin-Indocyanine Green Evaluation (ALICE) grading system in predicting PHLF in biliary tract cancer patients. METHODS Data from 166 patients who underwent hepatectomy for biliary tract cancer between 2000 and 2016 were retrospectively analyzed. Univariate and multivariate analyses were performed to identify the risk factors for PHLF. RESULTS Among the 166 patients, major hepatectomy was performed in 101 (61%) and bile duct resection was performed in 99 (60%) patients. Thirteen (8%) patients developed PHLF. Furthermore, PHLF, major complications, and mortality were significantly higher in patients with high ALICE grades (≥2b) than in those with low ALICE grades (<2b) (PHLF, 42 vs. 18%, p = 0.002; major complications, 35 vs. 19%, p = 0.036; mortality, 9.3 vs. 0%, p = 0.001). In multivariate analysis, high ALICE grade (p = 0.016) and blood loss ≥1,500 mL (p = 0.009) were identified as independent risk factors for PHLF. CONCLUSIONS The ALICE grading system effectively stratified the risks for PHLF for biliary tract cancer.
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Affiliation(s)
- Yoshihiro Miyazaki
- Department of Gastroenterological Surgery, Saitama Cancer Center, Saitama, .,Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba,
| | - Takashi Kokudo
- Department of Gastroenterological Surgery, Saitama Cancer Center, Saitama, Japan
| | - Katsumi Amikura
- Department of Gastroenterological Surgery, Saitama Cancer Center, Saitama, Japan
| | - Amane Takahashi
- Department of Gastroenterological Surgery, Saitama Cancer Center, Saitama, Japan
| | - Nobuhiro Ohkohchi
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Hirohiko Sakamoto
- Department of Gastroenterological Surgery, Saitama Cancer Center, Saitama, Japan
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Shimomura O, Oda T, Tateno H, Ozawa Y, Kimura S, Sakashita S, Noguchi M, Hirabayashi J, Asashima M, Ohkohchi N. A Novel Therapeutic Strategy for Pancreatic Cancer: Targeting Cell Surface Glycan Using rBC2LC-N Lectin-Drug Conjugate (LDC). Mol Cancer Ther 2018; 17:183-195. [PMID: 28939555 DOI: 10.1158/1535-7163.mct-17-0232] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Revised: 07/12/2017] [Accepted: 09/14/2017] [Indexed: 11/16/2022]
Abstract
Various cancers, including pancreatic ductal adenocarcinoma (PDAC), remain intractable even with costly tumor-targeting antibody drugs. Because the outermost coatings of cancer cells are composed of cell-specific glycan layers (glycocalyx), lectins, proteins with glycan-binding potential, were evaluated for possible use as drug carriers in PDAC treatment. A human PDAC cell line with well-to-moderately differentiated properties (Capan-1) was subjected to lectin microarray analysis to identify specific lectin-glycan pairs. The selected lectin was fused with a bacterial exotoxin for the construction of a lectin-drug conjugate (LDC), and its safety and antitumor effects were evaluated. A specific affinity between a recombinant bacterial C-type lectin (rBC2LC-N) and Capan-1 was identified, and its positivity was confirmed in 69 human samples. In contrast to the belief that all lectins mediate harmful hemagglutination, rBC2LC-N did not cause hemagglutination with human erythrocytes and was safely administered to mice. The 50% inhibitory concentration of LDC to Capan-1 (1.04 pg/mL = 0.0195 pmol/L) was 1/1,000 lower than that reported for conventional immunotoxins. The intraperitoneal administration of LDC reduced the tumor weight from 390 to 130.8 mg (P < 0.01) in an orthotopic model and reduced the number of nodules from 48 to 3 (P < 0.001) and improved survival from 62 to 105 days in a peritoneal dissemination model (P < 0.0001). In addition, the effect of LDC was reproduced in nodules from patient-derived PDAC xenografts through intravenous injection. Herein, we show the concept of utilizing lectins as drug carriers to target glycans on the cancer cell surface, highlighting new insights into cancer treatments. Mol Cancer Ther; 17(1); 183-95. ©2017 AACR.
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Affiliation(s)
- Osamu Shimomura
- Department of Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Tatsuya Oda
- Department of Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.
| | - Hiroaki Tateno
- Biotechnology Research Institute for Drug Discovery, National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba, Ibaraki, Japan
| | - Yusuke Ozawa
- Department of Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Sota Kimura
- Department of Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Shingo Sakashita
- Department of Pathology, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Masayuki Noguchi
- Department of Pathology, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Jun Hirabayashi
- Biotechnology Research Institute for Drug Discovery, National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba, Ibaraki, Japan
| | - Makoto Asashima
- Biotechnology Research Institute for Drug Discovery, National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba, Ibaraki, Japan
| | - Nobuhiro Ohkohchi
- Department of Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
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Miyamoto R, Oshiro Y, Nakayama K, Ohkohchi N. Impact of Three-Dimensional Surgical Simulation on Pancreatic Surgery. Gastrointest Tumors 2017; 4:84-89. [PMID: 29594109 DOI: 10.1159/000484894] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Accepted: 11/02/2017] [Indexed: 01/22/2023] Open
Abstract
Background/Aims Anatomical variations are frequently encountered during hepato-biliary-pancreatic surgeries, requiring surgeons to have a precise understanding of the surgical anatomy in order to perform a safe surgery. We evaluated the impact of novel three-dimensional (3D) surgical simulation on pancreatic surgeries to enhance surgical residents' understanding. Methodology Between January 2013 and May 2014, 61 preoperative 3D surgical simulations were performed. The consistency (0-10, with 10 representing 100% consistency) among the 15 surgical residents' anatomical drawings from multidetector computed tomography images and the simulated 3D images by SYNAPSE VINCENT® was assessed. We divided the surgical residents into two groups - first- to fifth-year postgraduate doctors (group A) and sixth- to tenth-year postgraduate doctors (group B) - and compared the self-assessment scores between these two groups. Results In terms of the self-assessment scores, a statistically significant difference was observed between the two groups (p < 0.001). Conclusions In this study, 3D surgical simulation was useful for preoperative assessments prior to pancreatic surgery, especially in younger postgraduate surgeons.
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Affiliation(s)
- Ryoichi Miyamoto
- Division of Gastroenterological and Hepatobiliary Surgery, and Organ Transplantation, Department of Surgery, University of Tsukuba, Tsukuba, Japan
| | - Yukio Oshiro
- Division of Gastroenterological and Hepatobiliary Surgery, and Organ Transplantation, Department of Surgery, University of Tsukuba, Tsukuba, Japan
| | - Ken Nakayama
- Division of Gastroenterological and Hepatobiliary Surgery, and Organ Transplantation, Department of Surgery, University of Tsukuba, Tsukuba, Japan
| | - Nobuhiro Ohkohchi
- Division of Gastroenterological and Hepatobiliary Surgery, and Organ Transplantation, Department of Surgery, University of Tsukuba, Tsukuba, Japan
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Owada Y, Tamura T, Tanoi T, Ozawa Y, Shimizu Y, Hisakura K, Matsuzaka T, Shimano H, Nakano N, Sakashita S, Matsukawa T, Isoda H, Ohkohchi N. Novel non-alcoholic steatohepatitis model with histopathological and insulin-resistant features. Pathol Int 2017; 68:12-22. [PMID: 29154469 DOI: 10.1111/pin.12612] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Accepted: 10/19/2017] [Indexed: 02/06/2023]
Abstract
Although several non-alcoholic steatohepatitis (NASH) models have been reported to date, few of these models fully reflect the histopathology and pathophysiology of human NASH. The aim of this study was to establish a novel NASH model by feeding a high-fat (HF) diet and administering both carbon tetrachloride (CCl4 ) and the Liver X receptor agonist T0901317. Male C57BL/6J mice were divided into four groups (each n = 5): HF, HF + CCl4 , HF + T0901317, and the novel NASH model (HF + CCl4 + T0901317). CCl4 (0.1 mL/kg) and T0901317 (2.5 mg/kg) were intraperitoneally administered four times and five times, respectively. The livers of the novel NASH model group presented a whitish colour. The serum levels of TNF-α and IL-6 were significantly increased in the novel NASH model group, and mice in this group exhibited histopathological features and insulin resistance reflective of NASH, i.e., macrovesicular hepatic steatosis, ballooning hepatocytes, Mallory-Denk bodies, lobular inflammation and fibrosis. The novel NASH model group presented significantly upregulated expression levels of mRNAs related to lipogenesis, oxidative stress, fibrosis and steatosis and significantly downregulated expression levels of mRNAs related to triglyceride export. We successfully established a novel experimental NASH model that exhibits similar histopathology and pathophysiology to human NASH.
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Affiliation(s)
- Yohei Owada
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8575, Japan
| | - Takafumi Tamura
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8575, Japan
| | - Tomohito Tanoi
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8575, Japan
| | - Yusuke Ozawa
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8575, Japan
| | - Yoshio Shimizu
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8575, Japan
| | - Katsuji Hisakura
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8575, Japan
| | - Takashi Matsuzaka
- Department of Endocrinology and Metabolism, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8575, Japan
| | - Hitoshi Shimano
- Department of Endocrinology and Metabolism, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8575, Japan.,International Institute for Integrative Sleep Medicine (WPI-IIIS), University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8575, Japan.,AMED-CREST, Japan Agency for Medical Research and Development (AMED), 1-7-1, Ohte-machi, Chiyoda-ku, Tokyo, 100-0004, Japan
| | - Noriyuki Nakano
- Department of Diagnostic Pathology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8575, Japan
| | - Shingo Sakashita
- Department of Diagnostic Pathology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8575, Japan
| | - Toshiya Matsukawa
- Graduate School of Environmental Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8572, Japan
| | - Hiroko Isoda
- Graduate School of Environmental Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8572, Japan
| | - Nobuhiro Ohkohchi
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8575, Japan
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Takizawa N, Yano H, Iwata H, Oshiro Y, Ohkohchi N. Encountered-Type Haptic Interface for Representation of Shape and Rigidity of 3D Virtual Objects. IEEE Trans Haptics 2017; 10:500-510. [PMID: 28829316 DOI: 10.1109/toh.2017.2740934] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
This paper describes the development of an encountered-type haptic interface that can generate the physical characteristics, such as shape and rigidity, of three-dimensional (3D) virtual objects using an array of newly developed non-expandable balloons. To alter the rigidity of each non-expandable balloon, the volume of air in it is controlled through a linear actuator and a pressure sensor based on Hooke's law. Furthermore, to change the volume of each balloon, its exposed surface area is controlled by using another linear actuator with a trumpet-shaped tube. A position control mechanism is constructed to display virtual objects using the balloons. The 3D position of each balloon is controlled using a flexible tube and a string. The performance of the system is tested and the results confirm the effectiveness of the proposed principle and interface.
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Kurokawa T, Kohno K, Nagai K, Chiba M, Pak S, Murata S, Fukunaga K, Yasue H, Ohkohchi N. Antisense RNA transcripts in the blood may be novel diagnostic markers for colorectal cancer. Oncol Lett 2017; 14:3487-3493. [PMID: 28927104 PMCID: PMC5587960 DOI: 10.3892/ol.2017.6572] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Accepted: 01/06/2017] [Indexed: 01/21/2023] Open
Abstract
Numerous genetic studies have been conducted regarding the occurrence of colorectal cancer (CRC) and the prognosis using microarrays. However, adequate investigations into the diagnostic application of microarrays have yet to be performed. The simplicity and accuracy of diagnosis and prognosis tracking are important requirements for its processes, and the use of blood cells for diagnosis is considered to be suitable to meet these requirements. The patients involved in the study were 28 preoperative patients with CRC and 6 healthy individuals who served as controls. RNA was extracted from the blood cells of the patients and analyzed using a sense/antisense RNA custom microarray. In the patients with CRC, the expression levels of 20 sense RNA and 20 antisense RNA species were identified as being significantly altered compared with that of the healthy volunteers (P<0.05; fold-change, >2.0). Cluster analysis of these RNA species revealed that the top 10 antisense RNAs significantly clustered patients with cancer and healthy individuals separately. Patients with stage I or II CRC exhibited significant changes in the expression levels of 33 sense and 39 antisense RNA species, as compared with healthy volunteers (P<0.01; fold-change >2.0). Cluster analysis demonstrated that patients with stage I or II CRC and healthy volunteers formed separate clusters only among the top 20 antisense RNA species. A tracking study of expression levels of haloacid dehalogenase-like hydrolase domain-containing 1 (HDHD1) antisense RNA was performed and a significant difference was identified between the CRC and healthy groups revealing that the levels at one week and three months following surgical removal of the cancerous tissue, decreased to almost same levels of the healthy individuals. The results of the current study indicate that HDHD1 antisense RNA may serve as a potential biomarker for the prognosis of CRC.
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Affiliation(s)
- Tomohiro Kurokawa
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki 305-8575, Japan
| | - Keisuke Kohno
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki 305-8575, Japan
| | - Kentaro Nagai
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki 305-8575, Japan
| | - Mitsuru Chiba
- Department of Biomedical Sciences, Division of Medical Life Sciences, Hirosaki University Graduate School of Health Sciences, Hirosaki, Aomori 036-8564, Japan
| | - Sugiru Pak
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki 305-8575, Japan
| | - Soichiro Murata
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki 305-8575, Japan
| | - Kiyoshi Fukunaga
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki 305-8575, Japan
| | - Hiroshi Yasue
- Genome Resource Unit, National Institute of Agrobiological Sciences, Tsukuba, Ibaraki 305-0901, Japan
| | - Nobuhiro Ohkohchi
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki 305-8575, Japan
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Kitaguchi D, Kurata M, Shimomura O, Oda T, Ohkohchi N. Gallbladder bleeding associated with microscopic polyangiitis: a case report. J Surg Case Rep 2017; 2017:rjx159. [PMID: 28852465 PMCID: PMC5570073 DOI: 10.1093/jscr/rjx159] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2017] [Accepted: 07/24/2017] [Indexed: 11/13/2022] Open
Abstract
A 71-year-old male who had a 6 years history of microscopic polyangiitis (MPA) was admitted to our hospital with a chief complaint of upper abdominal pain and nausea. Abdominal contrast-enhanced CT revealed extravasation of contrast medium in the gallbladder, and the patient was diagnosed with gallbladder bleeding. Although we started conservative treatment, anemia, hypotension and tachycardia had progressed gradually. Therefore, we performed emergent laparoscopic cholecystectomy on the following day. Intraoperative findings showed a remarkably distended gallbladder due to interior clots; however, the cholecystitis itself was not significant. Histopathological findings showed infiltrations of inflammatory cells around the blood vessels and vascular rupture. The postoperative course was uneventful. MPA is a type of ANCA-associated vasculitis. To the best of our knowledge, this is the first report of gallbladder bleeding associated with MPA. Spontaneous hemostasis cannot be expected, instead, surgical treatment must be performed promptly.
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Affiliation(s)
- Daichi Kitaguchi
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki 305-8575, Japan
| | - Masanao Kurata
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki 305-8575, Japan
| | - Osamu Shimomura
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki 305-8575, Japan
| | - Tatsuya Oda
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki 305-8575, Japan
| | - Nobuhiro Ohkohchi
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki 305-8575, Japan
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Kitaguchi D, Enomoto T, Ohara Y, Oda T, Ohkohchi N. Pubic osteomyelitis after surgery for perforated colonic diverticulitis with fecal peritonitis: A case report. Int J Surg Case Rep 2017; 38:50-52. [PMID: 28735117 PMCID: PMC5522955 DOI: 10.1016/j.ijscr.2017.07.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Revised: 06/15/2017] [Accepted: 07/08/2017] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Pubic osteomyelitis is a rare type of suppurative osteomyelitis. Early diagnosis of pubic osteomyelitis is difficult, and prolonged inflammation results in progressive bone degradation, severe pelvic pain and a wide-based gait. PRESENTATION OF CASE We report the case of an 82-year-old woman who was admitted to a previous hospital with severe abdominal pain caused by a perforated colonic diverticulum with fecal peritonitis. She underwent an emergency operation and a postoperative wound infection occurred. Despite treatment of the infection, purulent exudate was discharged for three months and she gradually showed a gait disturbance. CT and MRI revealed that pubic symphysis showed osteolysis and there was severe inflammation around the wound. After administration of appropriate antibiotics, an operation, which included the removal of a fistula, debridement of sequestra and lavage of the abscess cavity, was performed. The inflammation improved promptly after the operation, and the patient was discharged on postoperative day 27 without any complications. DISCUSSION Pubic osteomyelitis does not show the findings of typical acute suppurative osteomyelitis and hematological findings are nonspecific. It is important for early diagnosis to consider the risk factors of pubic osteomyelitis during examination. CONCLUSION We would emphasize that a definitive diagnosis by CT and MRI and appropriate antimicrobial therapy combined with surgical treatment are important for pubic osteomyelitis.
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Affiliation(s)
- Daichi Kitaguchi
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan.
| | - Tsuyoshi Enomoto
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan.
| | - Yusuke Ohara
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan.
| | - Tatsuya Oda
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan.
| | - Nobuhiro Ohkohchi
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan.
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Oda T, Shimomura O, Tateno H, Hirabayashi J, Noguchi M, Chiba S, Asashima M, Ohkohchi N. Abstract 3120: Application of a lectin as a drug carrier for glycan-targeting cancer therapy. Cancer Res 2017. [DOI: 10.1158/1538-7445.am2017-3120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Various cancers such as pancreatic ductal adenocarcinoma (PDAC) remain intractable despite recent advances in tumour-targeting antibody drugs. Although the outermost coating of every cell type is predominantly composed of cell-specific glycans, antibody strategies have hit walls of technical difficulties in intentional glycan targeting, and medico-economic burden. Lectins, proteins with glycan-binding potential, could be used as an alternative scaffold; however, the prejudice that all lectins mediate harmful haemagglutination limited its use only in experimental and diagnostic applications. Here, we show the successful in vivo application of a lectin as a drug carrier for cancer therapy. We have employed rBC2LC-N lectin since this has already shown a specific affinity between PDAC cell-surface glycans. When a lectin-drug conjugate (LecD) was developed by fusion with a bacterial exotoxin, the 50% inhibitory concentration (1.04 pg/ml=0.0195 pM) was 1000 times lower than that of conventional immunotoxins (on the order of ng/ml). In addition, we have revealed that rBC2LC-N lectin was safely administrable to mice without haemagglutination. Administration of this LecD in a PDAC mouse model of subcutaneous nodules and peritoneal dissemination, generated prominent therapeutic effects. The utilization of lectins as an in vivo drug-carrier targeting cancer glycan shows realistic potential when paired with advanced lectin engineering technologies, and their applications could be expanded by coupling with small molecule and/or nanoparticle drugs.
Citation Format: Tatsuya Oda, Osamu Shimomura, Hiroaki Tateno, Jun Hirabayashi, Masayuki Noguchi, Shigeru Chiba, Makoto Asashima, Nobuhiro Ohkohchi. Application of a lectin as a drug carrier for glycan-targeting cancer therapy [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 3120. doi:10.1158/1538-7445.AM2017-3120
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Affiliation(s)
- Tatsuya Oda
- 1Institute of Clinical Medicine, Univ. of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Osamu Shimomura
- 1Institute of Clinical Medicine, Univ. of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Hiroaki Tateno
- 2National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba, Ibaraki, Japan
| | - Jun Hirabayashi
- 2National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba, Ibaraki, Japan
| | - Masayuki Noguchi
- 1Institute of Clinical Medicine, Univ. of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Shigeru Chiba
- 1Institute of Clinical Medicine, Univ. of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Makoto Asashima
- 2National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba, Ibaraki, Japan
| | - Nobuhiro Ohkohchi
- 1Institute of Clinical Medicine, Univ. of Tsukuba, Tsukuba, Ibaraki, Japan
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Ozawa Y, Oda T, Shimomura O, Tateno H, Hirabayashi J, Ohkohchi N. Abstract 5233: Pancreatic cancer specific glycosylations survay by a panel of lectin staining; Tn antigen exposure as a result of o-glycan truncation. Cancer Res 2017. [DOI: 10.1158/1538-7445.am2017-5233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
The outermost coating of every cell type is predominantly composed of cell-specific glycans, and glycosylation changes in cancer has been used in clinical field as a tumor markers, such including AFP and CA19-9. We focused pancreatic cancer, the most intractable cancer with difficulty in early diagnosis, and insisted to glasp glycosylation patterns by using a panel of lectin histochemical stainings. Lectins are subgroup of proteins that specifically recognize and bind glycans, and thus helpful indication of glycosylation patterns. Lectin microarry is one of the advanced technologies which inables glycosylation patters of target materials at onece, however, obtained data with homogenized protein matelials applied lacks histological location and information. Instead, we used a panel of 20 types of lectins histochemical staining for cancer and normal tissues. The staining patterns were firstlly classified according to the ratio between cancer cells and stromal cells. a) Cancer high (cancer cell ++ and stromal cells -) b) equal (cancer cells ++ or + and stromal cells ++ or +) c) Cancer Low (cancer cells - or + and stromal cells ++ or +). Further more, the stainig in cancer cell were compaired with that of non cancerous pancreatic ductal epitherial cells. Among 20 lectins, CNL, Clitocybe nebularis Lectin binds motifs containing α/βGalNAc, Tn antigen, and blood group A, showed cancer cell staining higher than normal tissue in pancreatic cancer. Pancreatic cancer cell (31 of 58 patients,71%) were positive for CNL, but normal pancreatic duct cells (2 of 42 patients,4%) were positive in patients of pancreatic cancer. CNL is known to recognize Tn Antigen in O-glycosylation. Previously, it reported that during malignancy, glycosylation displays abnormal expression of shortened or truncated glycans, such as a Tn antigen, T antigen and their sialylated forms, ST, STn antigen. CNL staining pattern we showed in this report is considered to matching Tn staining. Our result indicated that speccific affinity of CNL lectin in pancreatic cancer and counterpart glycoprotein are STn antigen. We may insist that STn glycoprotein antigen could be used as a diagnostic marker of Pancreatic cancer and also it would be a target of new tumor-targetting strategies.
Citation Format: Yusuke Ozawa, Tatsuya Oda, Osamu Shimomura, Hiroaki Tateno, Jun Hirabayashi, Nobuhiro Ohkohchi. Pancreatic cancer specific glycosylations survay by a panel of lectin staining; Tn antigen exposure as a result of o-glycan truncation [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 5233. doi:10.1158/1538-7445.AM2017-5233
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Affiliation(s)
| | | | | | - Hiroaki Tateno
- 2National Institue of Advanced Industrial Science and Technology, Japan
| | - Jun Hirabayashi
- 2National Institue of Advanced Industrial Science and Technology, Japan
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Shimomura O, Oda T, Tateno H, Tachino S, Matsui J, Ozawa Y, Hirabayashi J, Ohkohchi N. Abstract 5231: Undifferentiated cell maker rBC2LC-N lectin have high affinity to pancreatic cancer cells and residual cancer cells. Cancer Res 2017. [DOI: 10.1158/1538-7445.am2017-5231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
The glycosylation in cancer cells remains still unclear despite the whole human genome understanding. Recent technical advances give us great awareness about the consequence of the glycosylation. The glycomes of cancer cell surfaces are often unique with aberrant glycans, including sialylation, fucosylation, O-glycan truncation, and N-and O-linked glycan branching. The sugar binding proteins named ‘lectins’ are helpful materials to recognize the glycan structure and characterization. Recent study suggested lectins are more widely accepted that involved in many biological phenomena inside mammalian or as chemical research tools. Despite years of effort to develop cancer therapies, there were no effective molecular targeting drugs for pancreatic adenocarcinoma (PDAC). One possible reason for this difficulties, PDAC cells are densely covered with glycans which may cause the recalcitrance to approach molecular targeting drugs. Our group developed a high-density lectin microarray using 96 kinds of lectins, in which a panel well-defined lectins is immobilized onto a slide, has been successfully used for high-throughput analysis of complex carbohydrates included in serum glycoproteins and whole cells. Using this approach, we demonstrated that a recombinant lectin probe, rBC2LC-N, specifically bound to undifferentiated pluripotent stem cells (ES/iPS cells), but not differentiated somatic cells; this has now been developed as a useful undifferentiation marker. In this study, we employed this lectin microarray to investigate the specific glycan that covered pancreatic cancer cells with stem cell features. Firstly, we selected a cell line which reflect clinical PDAC cells among 6 pancreatic cancer cell lines by morphological analysis and cancer stem cell marker expressions. As previously reported, we regarded Capan-1 cell line as a closest one which maintains both self-renewal and differentiation capacity. As a result, we successfully identified top 10 highlighted lectins which have significant specificity to pancreatic cancer cells. rBC2LC-N lectin was the most significant one (P value = 9.44E-17), followed by ADA (P= 7.05E-9), TJA2 (P= 1.4E-8), ACG (P= 1.11E-6). We reconfirmed the specific reactivity of these lectins to Capan-1 by FACS and lectin histochemistry. rBC2LC-N lectin reactivity in 70 clinical cases of PDAC revealed that all cases were confirmed to be positive. Furthermore, we investigated this rBC2LC-N lectin have a high affinity to residual cancer cells after gemcitabine treatment in patient derived xenograft models. These reactions well agreed with those of undifferentiated iPS/ES cells. These coincidental match of glycan expression between on iPS/ES cells and on pancreatic cancer cells may suggest a great benefit to understand the ambiguous stem cell recognition in cancer community and novel therapeutic strategy.
Citation Format: Osamu Shimomura, Tastsuya Oda, Hiroaki Tateno, Sho Tachino, Junji Matsui, Yuusuke Ozawa, Jun Hirabayashi, Nobuhiro Ohkohchi. Undifferentiated cell maker rBC2LC-N lectin have high affinity to pancreatic cancer cells and residual cancer cells [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 5231. doi:10.1158/1538-7445.AM2017-5231
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Affiliation(s)
| | | | - Hiroaki Tateno
- 2National Institute of Advanced Industrial Science and Technology, Tsukuba-city, Japan
| | | | | | | | - Jun Hirabayashi
- 2National Institute of Advanced Industrial Science and Technology, Tsukuba-city, Japan
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Nakayama K, Murata S, Ito H, Iwasaki K, Villareal MO, Zheng YW, Matsui H, Isoda H, Ohkohchi N. Terpinen-4-ol inhibits colorectal cancer growth via reactive oxygen species. Oncol Lett 2017; 14:2015-2024. [PMID: 28781645 PMCID: PMC5530226 DOI: 10.3892/ol.2017.6370] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Accepted: 03/19/2017] [Indexed: 12/22/2022] Open
Abstract
Terpinen-4-ol (TP4O) is the main component of the essential oil extracted from Melaleuca alternifolia, known as the tea tree, of the botanical family Myrtaceae. The anticancer effects of TP4O have been reported in several cancer cell lines. Previous reports have demonstrated that TP4O exerts anticancer effects by inducing apoptotic cell death in several cell lines; however, the underlying molecular mechanisms of these effects remain unclear. In the present study, the anticancer effects of TP4O against the colorectal cancer (CRC) cell lines HCT116 and RKO were evaluated using WST-8 and bromodeoxyuridine assays. The mechanism of cell death was investigated by the measurement of caspase-3/7, Annexin V and lactate dehydrogenase release. Reactive oxygen species (ROS) levels induced by TP4O were evaluated by electron spin resonance and quantitative measurement of dihydroethidium. Localization of the ROS derived from mitochondria was observed by confocal inverted microscopy. Protein levels of ROS scavengers were assessed by western blotting analysis. To confirm the role of ROS, cell viability was measured in the presence of antioxidant reagents. In an in vivo xenograft model of ICR-SCID mice implanted with HCT116 cells, 200 mg/kg TP4O was injected locally, and tumor growth was compared with that of the control. TP4O induced apoptotic cell death in HCT116 and RKO cells in a dose-dependent manner, and TP4O also increased the levels of ROS generated by mitochondria. TP4O-induced cell death was rescued by administration of antioxidant regents. In vivo, TP4O inhibited the proliferation of HCT116 xenografts compared with that of the control group. The results of the present study suggest that TP4O induces apoptosis in CRC cells through ROS generation. Furthermore, TP4O is potentially useful for the development of novel therapies against CRC.
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Affiliation(s)
- Ken Nakayama
- Department of Surgery, Division of Gastroenterological and Hepatobiliary Surgery, and Organ Transplantation, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki 305-8575, Japan
| | - Soichiro Murata
- Department of Regenerative Medicine, Yokohama University, Yokohama, Kanagawa 236-0004, Japan
| | - Hiromu Ito
- Department of Gastroenterology, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki 305-8575, Japan
| | - Kenichi Iwasaki
- Department of Surgery, Division of Gastroenterological and Hepatobiliary Surgery, and Organ Transplantation, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki 305-8575, Japan
| | - Myra Orlina Villareal
- Faculty of Life and Environmental Sciences, University of Tsukuba Alliance of Research on North Africa, University of Tsukuba, Tsukuba, Ibaraki 305-8572, Japan
| | - Yun-Wen Zheng
- Department of Surgery, Division of Gastroenterological and Hepatobiliary Surgery, and Organ Transplantation, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki 305-8575, Japan
| | - Hirofumi Matsui
- Department of Gastroenterology, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki 305-8575, Japan
| | - Hiroko Isoda
- Faculty of Life and Environmental Sciences, University of Tsukuba Alliance of Research on North Africa, University of Tsukuba, Tsukuba, Ibaraki 305-8572, Japan
| | - Nobuhiro Ohkohchi
- Department of Surgery, Division of Gastroenterological and Hepatobiliary Surgery, and Organ Transplantation, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki 305-8575, Japan
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Oshiro Y, Ohuchida K, Okada T, Hashizume M, Ohkohchi N. Novel imaging using a touchless display for computer-assisted hepato-biliary surgery. Surg Today 2017; 47:1512-1518. [PMID: 28528461 DOI: 10.1007/s00595-017-1541-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Accepted: 05/04/2017] [Indexed: 02/06/2023]
Abstract
PURPOSE We developed a touchless display system that allows the user to control the medical imaging software via hand gestures in the air. We conducted this study to verify the effectiveness of this novel touchless display system as a tool for assisting with surgical imaging. METHODS The patient's computed tomography (CT) data are generally observed on a display during surgery. The "Dr. aeroTAP" touchless display system was developed to generate virtual mouse events based on the position of one hand. We conducted comparative analyses of using the Dr. aeroTAP vs. using a regular mouse (control group) by measuring the time to select a 3D image from 24 thumbnail images on a screen (study 1) and to then see the CT image on the DICOM viewer (study 2). RESULTS We used the Dr. aeroTAP in 31 hepato-biliary operative procedures performed at our hospital. In study 1, which measured the time required to select one of 24 thumbnails, there were significant differences between the mouse and Dr. aeroTAP groups for all five surgeons who participated (P < 0.001). In study 2, there were also significant differences in the time required for CT DICOM images to be displayed (P < 0.001). CONCLUSIONS The touchless interface proved efficient for allowing the observation of surgical images while maintaining a sterile field during surgery.
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Affiliation(s)
- Yukio Oshiro
- Department of Surgery, Division of Gastroenterological and Hepato-biliary Surgery, and Organ Transplantation, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, 305-8575, Japan.
| | - Kenoki Ohuchida
- Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Toshiyuki Okada
- Department of Surgery, Division of Gastroenterological and Hepato-biliary Surgery, and Organ Transplantation, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, 305-8575, Japan
| | - Makoto Hashizume
- Department of Advanced Medical Initiatives, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Nobuhiro Ohkohchi
- Department of Surgery, Division of Gastroenterological and Hepato-biliary Surgery, and Organ Transplantation, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, 305-8575, Japan
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Abstract
Although viral hepatitis treatments have evolved over the years, the resultant liver cirrhosis still does not completely heal. Platelets contain proteins required for hemostasis, as well as many growth factors required for organ development, tissue regeneration and repair. Thrombocytopenia, which is frequently observed in patients with chronic liver disease (CLD) and cirrhosis, can manifest from decreased thrombopoietin production and accelerated platelet destruction caused by hypersplenism; however, the relationship between thrombocytopenia and hepatic pathogenesis, as well as the role of platelets in CLD, is poorly understood. In this paper, experimental evidence of platelets improving liver fibrosis and accelerating liver regeneration is summarized and addressed based on studies conducted in our laboratory and current progress reports from other investigators. In addition, we describe our current perspective based on the results of these studies. Platelets improve liver fibrosis by inactivating hepatic stellate cells, which decreases collagen production. The regenerative effect of platelets in the liver involves a direct effect on hepatocytes, a cooperative effect with liver sinusoidal endothelial cells, and a collaborative effect with Kupffer cells. Based on these observations, we ascertained the direct effect of platelet transfusion on improving several indicators of liver function in patients with CLD and liver cirrhosis. However, unlike the results of our previous clinical study, the smaller incremental changes in liver function in patients with CLD who received eltrombopag for 6 mo were due to patient selection from a heterogeneous population. We highlight the current knowledge concerning the role of platelets in CLD and cancer and anticipate a novel application of platelet-based clinical therapies to treat liver disease.
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Oshiro Y, Ohkohchi N. Three-Dimensional Liver Surgery Simulation: Computer-Assisted Surgical Planning with Three-Dimensional Simulation Software and Three-Dimensional Printing<sup/>. Tissue Eng Part A 2017; 23:474-480. [PMID: 28343411 DOI: 10.1089/ten.tea.2016.0528] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
To perform accurate hepatectomy without injury, it is necessary to understand the anatomical relationship among the branches of Glisson's sheath, hepatic veins, and tumor. In Japan, three-dimensional (3D) preoperative simulation for liver surgery is becoming increasingly common, and liver 3D modeling and 3D hepatectomy simulation by 3D analysis software for liver surgery have been covered by universal healthcare insurance since 2012. Herein, we review the history of virtual hepatectomy using computer-assisted surgery (CAS) and our research to date, and we discuss the future prospects of CAS. We have used the SYNAPSE VINCENT medical imaging system (Fujifilm Medical, Tokyo, Japan) for 3D visualization and virtual resection of the liver since 2010. We developed a novel fusion imaging technique combining 3D computed tomography (CT) with magnetic resonance imaging (MRI). The fusion image enables us to easily visualize anatomic relationships among the hepatic arteries, portal veins, bile duct, and tumor in the hepatic hilum. In 2013, we developed an original software, called Liversim, which enables real-time deformation of the liver using physical simulation, and a randomized control trial has recently been conducted to evaluate the use of Liversim and SYNAPSE VINCENT for preoperative simulation and planning. Furthermore, we developed a novel hollow 3D-printed liver model whose surface is covered with frames. This model is useful for safe liver resection, has better visibility, and the production cost is reduced to one-third of a previous model. Preoperative simulation and navigation with CAS in liver resection are expected to help planning and conducting a surgery and surgical education. Thus, a novel CAS system will contribute to not only the performance of reliable hepatectomy but also to surgical education.
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Affiliation(s)
- Yukio Oshiro
- Division of Gastroenterological and Hepatobiliary Surgery and Organ Transplantation, Department of Surgery, Faculty of Medicine, University of Tsukuba , Tsukuba, Japan
| | - Nobuhiro Ohkohchi
- Division of Gastroenterological and Hepatobiliary Surgery and Organ Transplantation, Department of Surgery, Faculty of Medicine, University of Tsukuba , Tsukuba, Japan
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