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137篇 您的检索式:作者名="Kenya"
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1Advances in understanding and treating liver diseases during pregnancy:A review显示文摘Liver disease in pregnancy is rare but pregnancyrelated liver diseases may cause threat to fetal and maternal survival.It includes pre-eclampsia;eclampsia;haemolysis,elevated liver enzymes,and low platelets syndrome;acute fatty liver of pregnancy;hyperemesis gravidarum;and intrahepatic cholestasis of pregnancy.Recent basic researches have shown the various etiologies involved in this disease entity.With these advances,rapid diagnosis is essential for severe cases since the decision of immediate delivery is important for maternal and fetal survival.The other therapeutic options have also been shown in recent reports based on the clinical trials and cooperation and information sharing between hepatologist and gynecologist is important for timely therapeutic intervention.Therefore,correct understandings of diseases and differential diagnosis from the pre-existing and co-incidental liver diseases during the pregnancy will help to achieve better prognosis.Therefore,here we review and summarized recent advances in understanding the etiologies,clinical courses and management of liver disease in pregnancy.This information will contribute to physicians for diagnosis of disease and optimum management of patients.Kenya Kamimura Hiroyuki Abe Hirokazu Kawai Hiroteru Kamimura Yuji Kobayashi Minoru Nomoto Yutaka Aoyagi Shuji Terai 2015World Journal of Gastroenterology2015,21,17:15
2Diversion colitis and pouchitis: A mini-review显示文摘Diversion colitis is characterized by inflammation of the mucosa in the defunctioned segment of the colon after colostomy or ileostomy. Similar to diversion colitis, diversion pouchitis is an inflammatory disorder occurring in the ileal pouch, resulting from the exclusion of the fecal stream and a subsequent lack of nutrients from luminal bacteria. Although the vast majority of patients with surgically-diverted gastrointestinal tracts remain asymptomatic, it has been reported that diversion colitis and pouchitis might occur in almost all patients with diversion. Surgical closure of the stoma, with reestablishment of gut continuity, is the only curative intervention available for patients with diversion disease. Pharmacologic treatments using short-chain fatty acids, mesalamine, or corticosteroids are reportedly effective for those who are not candidates for surgical reestablishment; however, there are no established assessment criteria for determining the severity of diversion colitis, and no management strategies to date. Therefore, in this mini-review, we summarize and review various recently-reported treatments for diversion disease. We are hopeful that the information summarized here will assist physicians who treat patients with diversion colitis and pouchitis, leading to better case management.Kentaro Tominaga Kenya Kamimura Kazuya Takahashi Junji Yokoyama Satoshi Yamagiwa Shuji Terai 2018World Journal of Gastroenterology2018,24,16:10
3Considerations of elderly factors to manage the complication of liver cirrhosis in elderly patients显示文摘The aging of the organ function causes sensitivity to the disease progression and need careful consideration for the medical treatment. With the increase of aging population, the opportunity to provide medical treatment for people in very old age is rapidly increasing therefore, the understanding of the various physiological changes of cellular function, size and function of organs are essential for the decision of therapeutic options. Among the various chronic conditions seen in elderly people, we have focused on liver cirrhosis, since despite specific therapeutic options for many of liver diseases including direct acting antivirals for hepatitis C virus, nucleoside analogs for hepatitis B, and corticosteroids for autoimmune hepatitis, there is currently no standard therapy to treat liver cirrhosis, which is the final stage of these liver diseases. Therefore,management of the various symptoms of liver cirrhosis is essential, and agingrelated parameters must be considered in the decision making for therapeutic strategies and dosage of the available medicine. In this mini-review, we have summarized the therapeutic options to manage various symptoms of liver cirrhosis, carefully considering the physiological changes of various organs associated with aging.Kenya Kamimura Akira Sakamaki Hiroteru Kamimura Toru Setsu Takeshi Yokoo Masaaki Takamura Shuji Terai 2019World Journal of Gastroenterology2019,25,15:9
4Natural regression of fibrosis in chronic hepatitis B显示文摘The fibrosis of liver cirrhosis was considered to be irreversible before the anti-viral drugs showed that it is reversible when they lead to continuous suppression of viral replication and inflammation. However, several reports previously showed that fibrosis of type B liver cirrhosis was almost completely absorbed after the natural remission of chronic inflammation. This phenomenon might not be limited to exceptional patients, but rather occur commonly, considering the dynamic clinical features of chronic hepatitis B(CHB), where inactive carrier stage normally follows aggravation of hepatitis and progression of fibrosis at the time of HBe Ag seroconversion. Thus, fibrosis levels of CHB as a hepatocellular carcinoma(HCC)-surveillance marker, particularly those of the inactive stage, could be underestimated, because some of them might have been(pre)cirrhotic in the past and recovered with the natural regression of fibrosis. We argue that cirrhosisinduced HCC mechanisms, rather than direct action of viral genome, may be more common than generally considered in CHB patients. This may have some impact on reconsidering the surveillance rationale for HCC in CHB, from where advanced HCCs tended to be missed. In addition, a molecular marker to assess the cancer-prone characteristics of the liver will definitely be needed to resolve the issue.Shogo Ohkoshi Haruka Hirono Kazuhiko Watanabe Katsuhiko Hasegawa Kenya Kamimura Masahiko Yano 2016World Journal of Gastroenterology2016,22,24:8
5Invasive group B streptococcal infection in a patient with post splenectomy for hypersplenism secondary to liver cirrhosis and portal hypertension显示文摘BACKGROUND:Splenectomy in patients with liver cirrhosis(LC)is expected to become more common owing to its efficacy on portal hemodynamics.In this report we describe an alarming case of group B streptococcus(GBS)infection after splenectomy in a patient with LC.METHODS:A 72-year-old woman with a history of LC was admitted to our emergency department because of respiratory failure.The patient had received left lateral segmentectomy of the liver and splenectomy three months before admission.Pulmonary examination revealed significant wheezing during inspiration and expiration,but no crackles and stridor.Chest radiography and CT showed no infiltrates.A presumptive diagnosis of bronchial asthma caused by upper respiratory infection was made.Four days after admission,GBS infection was confirmed by blood culture and penicillin G was administered.Antibiotics were given intravenously for a total of 12 days.RESULTS:The patient was discharged on the 12th day after admission.CONCLUSIONS:Although efficacy of splenectomy in patients with LC has been reported,immune status should be evaluated for a longer period.Patients who have undergone splenectomy are highly susceptible to bacteria;moreover,LC itself is an independent risk factor for mortality in patients with sepsis.Since prophylaxis against GBS has not been established,immediate action should be taken.Emergency physicians should be aware of invasive GBS infection in the context of the critical risk factors related to splenectomy and LC,particularly the expected increase of splenectomy performed in LC patients.Tomoya Okazaki Toru Hifumi Arisa Manabe Hikari Matsumura Satoshi Egawa Hideyuki Hamaya Nastuyo Shinohara Koshiro Takano Hajime Shishido Yuko Abe Kenya Kawakita Masanobu Hagiike Yasuhiro Kuroda 2016World Journal of Emergency Medicine2016,7,1:6
6Active treatments are a rational approach for hepatocellular carcinoma in elderly patients显示文摘AIM: To determine whether an active intervention is beneficial for the survival of elderly patients with hepa-tocellular carcinoma (HCC). METHODS: The survival of 740 patients who received various treatments for HCC between 1983 and 2011 was compared among different age groups using Cox regression analysis. Therapeutic options were principal-ly selected according to the clinical practice guidelines for HCC from the Japanese Society of Hepatology. The treatment most likely to achieve regional control capa-bility was chosen, as far as possible, in the following order: resection, radiofrequency ablation, percutaneous ethanol injection, transcatheter arterial chemoembo-lization, transarterial oily chemoembolization, hepatic arterial infusion chemotherapy, systemic chemotherapy including molecular targeting, or best supportive care.Each treatment was used alone, or in combination, with a clinical goal of striking the best balance be-tween functional hepatic reserve and the volume of the targeted area, irrespective of their age. The percent survival to life expectancy was calculated based on a Japanese national population survey. RESULTS: The median ages of the subjects during each 5-year period from 1986 were 61, 64, 67, 68 and 71 years and increased significantly with time (P<0.0001). The Child-Pugh score was comparable among younger (59 years of age or younger), middle-aged (60-79 years of age), and older (80 years of age or older) groups (P=0.34), whereas the tumor-node-metastasis stage tended to be more advanced in the younger group (P=0.060). Advanced disease was significantly more frequent in the younger group compared with the middle-aged group (P=0.010), whereas there was no difference between the middle-aged and elderly groups (P=0.75). The median sur-vival times were 2593, 2011, 1643, 1278 and 1195 d for 49 years of age or younger, 50-59 years of age, 60-69 years of age, 70-79 years of age, or 80 years of age or older age groups, respectively, whereas the me-dian percent survival to life expectancy were 13.9%, 21.9%, 24.7%, 25.7% and 37.6% for each group, respectively. The impact of age on actual survival time was significant (P=0.020) with a hazard ratio of 1.021, suggesting that a 10-year-older patient has a 1.23-fold higher risk for death, and the overall survival was the worst in the oldest group. On the other hand, when the survival benefit was evaluated on the basis of per-cent survival to life expectancy, age was again found to be a significant explanatory factor (P=0.022); how-ever, the oldest group showed the best survival among the five different age groups. The youngest group revealed the worst outcomes in this analysis, and the hazard ratio of the oldest against the youngest was 0.35 for death. The survival trends did not differ substan-tially between the survival time and percent survival tolife expectancy, when survival was compared overall or among various therapeutic interventions. CONCLUSION: These results suggest that a thera-peutic approach for HCC should not be restricted due to patient age.Takeshi Suda Aiko Nagashima Shyunsaku Takahash Tsutomu Kanefuji Kenya Kamimura Yasushi Tamura Ma-saaki Takamura Masato Igarashi Hirokazu Kawai Satoshi Yamagiwa Minoru Nomoto Yutaka Aoyagi 2013World Journal of Gastroenterology2013,19,24:4
7Pulmonary tumor thrombotic microangiopathy of hepatocellular carcinoma: A case report and review of literature显示文摘BACKGROUND Pulmonary tumor thrombotic microangiopathy(PTTM)is a rare condition in patients with hepatocellular carcinoma(HCC);to date,few cases have been reported.While hepatic dysfunction has been focused on the later stages of HCC,the management of symptoms in PTTM is important for supportive care of the cases.For the better understanding of PTTM in HCC,the information of our recent case and reported cases have been summarized.CASE SUMMARY A patient with HCC exhibited acute and severe respiratory failure.Radiography and computed tomography of the chest revealed the multiple metastatic tumors and a frosted glass–like shadow with no evidence of infectious pneumonia.We diagnosed his condition as acute respiratory distress syndrome caused by the lung metastases and involvement of the pulmonary vessels by tumor thrombus.Administration of prednisolone to alleviate the diffuse alveolar damages including edematous changes of alveolar wall caused by the tumor cell infiltration and ischemia showed mild improvement in his symptoms and imaging findings.An autopsy showed the typical pattern of PTTM in the lung with multiple metastases.CONCLUSION PTTM is caused by tumor thrombi in the arteries and thickening of the pulmonary arterial endothelium leading to the symptoms of dyspnea in terminal staged patients.Therefore,supportive management of symptoms is necessary in the cases with PTTM and hence we believe that the information presented here is of great significance for the diagnosis and management of symptoms of PTTM with HCC.Shinichi Morita Kenya Kamimura Hiroyuki Abe Yukari Watanabe-Mori Chiyumi Oda Takamasa Kobayashi Yoshihisa Arao Yusuke Tani Riuko Ohashi Yoichi Ajioka Shuji Terai 2019World Journal of Gastroenterology2019,25,48:4
8Spontaneous regression of hepatocellular carcinoma: A mini-review显示文摘Spontaneous tumor regression is an extremely rare phenomenon in the oncology field. However, there are several case reports resulted in the regression of hepatocellular carcinoma(HCC) and the accumulation of clinical information and analyses of the mechanism can contribute to the development of a novel therapy. For this purpose, we have carefully reviewed 23 cases of spontaneously regressed HCC published in recent 5 years and our case. The information regarding the tumor size, tumor marker, treatments, etc., have been summarized. The mechanism of spontaneous regression has been discussed to date and presumed to be due to many factors, including hypoxia and immunological reactions. In this careful review of the 24 cases based on the clinical information, hypoxia, systemic inflammation, and both upon spontaneous regression were seen in 3, 8, and 4 cases, respectively amo ng t he 15 c as e s f or w hic h t he inf o r mat io n regarding the proposed mechanisms are available. Recent development of immunotherapeutic approaches in oncology shows promising results, therefore, accumulation of additional cases and analysis of mechanisms underlying the spontaneous regression of HCC are essential and could lead to the development of a new generation of immunotherapies including antibodies directed against immune reactions.Akira Sakamaki Kenya Kamimura Satoshi Abe Atsunori Tsuchiya Masaaki Takamura Hirokazu Kawai Satoshi Yamagiwa Shuji Terai 2017World Journal of Gastroenterology2017,23,21:4
9Effect of double platinum agents, combination of miriplatintransarterial oily chemoembolization and cisplatinhepatic arterial infusion chemotherapy, in patients with hepatocellular carcinoma: Report of two cases显示文摘Hepatocellular carcinoma(HCC) is one of the most common cancers and the third highest cause of cancerassociated mortality worldwide. The treatment of HCC is complicated by its variable biological behavior and the frequent coexistence of chronic liver disease, particularly cirrhosis. To date, multiple treatment modalities have been developed according to the stage of the tumor and the hepatic functional reserve, including transarterial treatments such as transarterial chemoembolization, transarterial oily chemoembolization(TOCE), and hepatic arterial infusion chemotherapy(HAIC). We conducted a phase I and II study of the combination therapy with double platinum agents, miriplatin and cisplatin, and confirmed its safety and efficacy. Here, we describe two cases of unresectable HCC who were successfully treated by miriplatin-TOCE/cisplatin-HAIC combination therapy, resulting in complete responses with no significant adverse events. This report will provide that the combination therapy can be the therapeutic option for HCC patients in the advanced stage.Kohei Ogawa Kenya Kamimura Yukari Watanabe Yosuke Motai Daisuke Kumaki Ryoya Seki Akira Sakamaki Satoshi Abe Hirokazu Kawai Takeshi Suda Satoshi Yamagiwa Shuji Terai 2017World Journal of Clinical Cases2017,5,6:4
10Collagenous gastritis: Review显示文摘Collagenous gastritis is a rare disease characterized by the subepithelial deposition of collagen bands thicker than 10 μm and the infiltration of inflammatory mononuclear cells in the lamina propria. Collagenous colitis and collagenous sprue have similar histological characteristics to collagenous gastritis and are thought to be part of the same disease entity. However, while collagenous colitis has become more common in the field of gastroenterology, presenting with clinical symptoms of chronic diarrhea in older patients,collagenous gastritis is rare. Since the disease was first reported in 1989, only 60 cases have been documented in the English literature. No safe and effective treatments have been identified from randomized, controlled trials. Therefore, better understanding of the disease and the reporting of more cases will help to establish diagnostic criteria and to develop therapeutic strategies. Therefore, here we review the clinical characteristics, endoscopic and histological findings, treatment, and clinical outcomes from case reports and case series published to date, and provide a summary of the latest information on the disease. This information will contribute to improved knowledge of collagenous gastritis so physicians can recognize and correctly diagnose the disease, and will help to develop a standard therapeutic strategy for future clinical trials.Kenya Kamimura Masaaki Kobayashi Yuichi Sato Yutaka Aoyagi Shuji Terai 2015World Journal of Gastrointestinal Endoscopy2015,7,3:3
11Liver-targeted hydrodynamic gene therapy: Recent advances in the technique显示文摘One of the major research focuses in the field of gene therapy is the development of clinically applicable, safe, and effective gene-delivery methods. Since the first case of human gene therapy was performed in 1990, a number of gene-delivery methods have been developed, evaluated for efficacy and safety, and modified for human application. To date, viral-vectormediated deliveries have shown effective therapeutic results. However, the risk of lethal immune response and carcinogenesis have been reported, and it is still controversial to be applied as a standard therapeutic option. On the other hand, delivery methods for nonviral vector systems have been developed, extensively studied, and utilized in in vivo gene-transfer studies. Compared to viral-vector mediated gene transfer, nonviral systems have less risk of biological reactions. However, the lower gene-transfer efficiency was a critical hurdle for applying them to human gene therapy. Among a number of nonviral vector systems, our studies focus on hydrodynamic gene delivery to utilize physical force to deliver naked DNA into the cells in the living animals. This method achieves a high gene-transfer level by DNA solution injections into the tail vein of rodents, especially in the liver. With the development of genome editing methods, in vivo gene-transfer therapy using this method is currently the focus in this research field. This review explains the method principle, efficiency, safety, and procedural modifications to achieve a high level of reproducibility in large-animal models.Takeshi Yokoo Kenya Kamimura Hiroyuki Abe Yuji Kobayashi Tsutomu Kanefuji Kohei Ogawa Ryo Goto Masafumi Oda Takeshi Suda Shuji Terai 2016World Journal of Gastroenterology2016,22,40:3
12Rational arrangement of measuring shear wave speed in the liver显示文摘BACKGROUND Shear wave speed has been widely applied to quantify a degree of liver fibrosis. However, there is no standardized procedure, which makes it difficult to utilize the speed universally. AIM To provide procedural standardization of shear wave speed measurement. METHODS Point shear wave elastography (pSWE) was measured in 781 patients, and twodimensional shear wave elastography (2dSWE) was measured on the same day in 18 cases. Regions-of-interest were placed at 12 sites, and the median and robust coefficient-of-variation (CVR) were calculated. A residual sum-of-square (Σdi2) was computed for bootstrap values of 1000 iterations in 18 cases with each assumption of 1 to 12 measurements. The proportion of the Σdi2 (%Σdi2) was calculated as the ratio of Σdi2 to pSWE after converting it based on the correlation between pSWE and 2dSWE. RESULTS The CVR showed a significantly broader distribution in the left lobe (P < 0.0001),and the smallest CVR in the right anterior segment that covered 95% cases was 40.4%. pSWE was significantly higher in the left lobe than in the right lobe (1.63 ± 0.78 m/s vs 1.61 ± 0.78 m/s, P = 0.0004), and the difference between the lobes became further discrete when the subjects were limited to the cases with a CVR less than 40.4% in any segment (1.76 ± 0.80 m/s vs 1.70 ± 0.82 m/s, P < 0.0001). The highest values of the CVR in every 0.1 m/s interval were plotted in convex upward along pSWE and peaked at 1.93 m/s. pSWE and 2dSWE were significantly correlated (P < 0.0001, r = 0.95). In 216000 resamples from 18 cases, the %Σdi2 of 12 sites was 8.0% and gradually increased as the acquisition sites decreased to reach a significant difference with a %Σdi2 of 7 sites (P = 0.027). CONCLUSION These data suggest that shear wave speed should be measured at 8 or more sites of spreading in both lobes.Takeshi Yokoo Tsutomu Kanefuji Takeshi Suda Itsuo Nagayama Takahiro Hoshi Satoshi Abe Shinichi Morita Hiroteru Kamimura Kenya Kamimura Atsunori Tsuchiya Masaaki Takamura Kazuyoshi Yagi Shuji Terai 2019World Journal of Gastroenterology2019,25,20:3
13Autonomic nervous system network and liver regeneration显示文摘To date, various signal transducers, cytokines, growth factors, and hormones have been reported to play an important role in homeostasis of various organs. Various cells and organs are involved in the hepatic regeneration process, which proceeds as a result of the coordination of many factors. While these factors are well known to be involved in the liver regeneration after the liver injury, however, as the details of such mechanisms have not been sufficiently elucidated, the practical applicability of hepatic regeneration based on the action of these and cytokines growth factors is still unclear. In terms of the involvement of the autonomic nervous system in hepatic regeneration, cell proliferation resulting from direct signal transduction to the liver has also been reported and recent studies focusing on the inter-organ communication via neural network opened a novel aspect of this field for therapeutic applicability. Therefore, the appropriate understanding of the relationship between autonomic neural network and liver regeneration through various organs including brain, afferent nerve, efferent nerve, etc. is essential. This mini-review explains the principle of neural system involved in the inter-organ communication and its contribution on the liver regeneration upon the liver injury reviewing recent progress in this field.Kenya Kamimura Ryosuke Inoue Takuro Nagoya Norihiro Sakai Ryo Goto Masayoshi Ko Yusuke Niwa Shuji Terai 2018World Journal of Gastroenterology2018,24,15:3
14Induction of Intestinal Th17 Cells by Segmented Filamentous Bacteria显示文摘Ivaylo I. Ivanov Koji Atarashi Nicolas Manel Eoin L. Brodie Tatsuichiro Shima Ulas Karaoz Dongguang Wei Katherine C. Goldfarb Clark A. Santee Susan V. Lynch Takeshi Tanoue Akemi Imaoka Kikuji Itoh Kiyoshi Takeda Yoshinori Umesaki Kenya Honda Dan R. Littma 2009Cell2009,,3:3
15Diagnosis and management of fibromuscular dysplasia and segmental arterial mediolysis in gastroenterology field: A mini-review显示文摘The vascular diseases including aneurysm, occlusion, and thromboses in the mesenteric lesions could cause severe symptoms and appropriate diagnosis and treatment are essential for managing patients. With the development and improvement of imaging modalities, diagnostic frequency of these vascular diseases in abdominal lesions is increasing even with the small changes in the vasculatures. Among various vascular diseases, fibromuscular dysplasia(FMD) and segmental arterial mediolysis(SAM) are noninflammatory, nonatherosclerotic arterial diseases which need to be diagnosed urgently because these diseases could affect various organs and be lethal if the appropriate management is not provided. However, because FMD and SAM are rare, the cause, prevalence, clinical characteristics including the symptoms, findings in the imaging studies, pathological findings, management, and prognoses have not been systematically summarized. Therefore, there have been neither standard diagnostic criteria nor therapeutic methodologies established, to date. To systematically summarize the information and to compare these disease entities, we have summarized the characteristics of FMD and SAM in the gastroenterological regions by reviewing the cases reported thus far. The information summarized will be helpful for physicians treating these patients in an emergency care unit and for the differential diagnosis of other diseases showing severe abdominal pain.Masayoshi Ko Kenya Kamimura Kohei Ogawa Kentaro Tominaga Akira Sakamaki Hiroteru Kamimura Satoshi Abe Kenichi Mizuno Shuji Terai 2018World Journal of Gastroenterology2018,24,32:2
16Granulocytapheresis for the Treatment of Severe Alcoholic Hepatitis: A Case Series and Literature Review显示文摘Kenya Kamimura Michitaka Imai Akira Sakamaki Shigeki Mori Masaaki Kobayashi Ken-ichi Mizuno Manabu Takeuchi Takeshi Suda Minoru Nomoto Yutaka Aoyagi 2014Digestive Diseases and Sciences2014,,2:2
17Leaf area development, dry weight accumulation and solar energy conversion efficiencies of Phaseolus vulgaris L. under different soil moisture levels near Nairobi, Kenya显示文摘Leaf area development, dry weight accumulation and solar energy conversion efficiencies of Phaseolus vulgaris L. cv GLP\|2 under two soil moisture levels in two contrasting seasons near Nairobi, Kenya were investigated. The experiment confirms that dry weights and yields of Phaseolus vulgaris are limited by a drought induced decrease in leaf area, leading to less radiation interception as a source for assimilation. However, photosynthetic efficiency in Phaseolus vulgaris also appears to decrease and to contribute to these effects. Finally, an even larger decreases of economic efficiency as obtained in the second season, where stress lasted much later into the season, reveals that such a drought also limits considerably the partitioning and translocation of assimilates to the seeds of Phaseolus vulgaris. The efficiencies obtained are in line with the better literature data for other crops.M.M. Muniafu 1* , J.N.M. Macharia\+1, C.J.Stigter\+2,G.L.Coulson\+3 (1.Department of Botany, University of Nairobi, Nairobi, Kenya 2. TTMI\|Project,Department of Meteorology, Wageningen Agricultural University,Duivendaal 2, 6701 AP Wageningen, Net 1999Journal of Environmental Sciences1999,11,4:2
18Within-farm variability in resource allocation, nutrient flows and soil fertility status 显示文摘Tittonell P Vanlauwe B Leffelaar P A Exploring diversity in soil fertility management of smallholder farms in western Kenya Ⅱ 2005Agric Ecosyst Environ2005,110,324:1
19An active - site peptide containing the second essential carboxyl group of dextransucrase from Leuconostoc mesenteroides by chemical modification et al显示文摘 masakazu Shiraiwa Kenya Hashimoto 1993Biochemistry1993,32,13:1
20Numerical simulation of rrletallie solid bridging particles in a fluidized bed at high temperature 显示文摘KENYA K TAKAFUMI M MASAYUKI H 2000Powder technology2000,109,3:1
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