著者

Oshiro Yukio Takahashi Kazuhiro Sasaki Ryoko Kondo Tadashi Sakashita Shingo Ohkohchi Nobuhiro

出版者

Baishideng Publishing Group Inc.

雑誌

World journal of gastroenterology (ISSN:10079327)

巻号頁・発行日

vol.19, no.40, pp.6934-6938, 2013-10

被引用文献数

10

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Patients with Stage IV cholangiocarcinoma are currently not considered to be surgical candidates and are typically offered systemic chemotherapy. Recently, several novel systemic chemotherapy regimens have allowed an initially unresectable cholangiocarcinoma to be resectable. The aim of this article is to present the usefulness of adjuvant surgery in a case of advanced cholangiocarcinoma that was successfully treated with gemcitabine. A 72-year-old man was diagnosed with distal cholangiocarcinoma with liver metastases (cT2N0M1, Stage IV). He underwent metal stent placement in the duodenum to alleviate jaundice. After 18 courses of chemotherapy using gemcitabine without severe drug toxicities, a computed tomography scan showed that the liver metastases in S6 and S7 had disappeared. The patient underwent subtotal stomach-preserving pancreaticoduodenectomy and lymph node dissection. The pathological stage was pT2N0M0, Stage IB. The patient underwent 6 cycles of adjuvant chemotherapy using gemcitabine. The patient is alive and well 6 years and 9 mo after the diagnosis.

著者

Oshiro Yukio Sasaki Ryoko Takeguchi Takaya Ibukuro Kenji Ohkohchi Nobuhiro

出版者

Springer Japan

雑誌

Journal of hepato-biliary-pancreatic sciences (ISSN:18686974)

巻号頁・発行日

vol.20, no.6, pp.639-646, 2013-08

被引用文献数

4

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Background/purposeTo date there have been only a few radiological studies of the caudate artery. This study aimed to precisely analyze the caudate artery as well as the relationship between the caudate arteries, the arterial plexus at the hilar plate, and the hilar bile duct.MethodsReconstructed three-dimensional (3D) computed tomography images from 50 patients during hepatic arteriography were analyzed. The caudate arteries were classified as right branches (Irs) or left branches (Ils). The communicating artery (CA) was defined as the artery connecting the right, left, segmental, and common hepatic arteries.ResultsThe caudate artery was divided into 3 types: an independent branch (Type 1); the common tract formed by Ir and Il (Type 2); and an arterial branch from the CA (Type 3). The CA was recognized in 25 of 50 patients. There was a total of 65 arteries to the hilar bile duct observed in 40 patients, and 24 (37 %) of these 65 arteries to the hilar bile duct originated from the caudate artery or CA.ConclusionThe caudate artery plays an important role not only in connecting the blood supply of the right and left livers but in the blood supply to the hilar bile duct.

著者

Ogawa Koichi Kondo Tadashi Tamura Takafumi Matsumura Hideki Fukunaga Kiyoshi Oda Tatsuya Ohkohchi Nobuhiro

出版者

Baishideng Publishing Group Inc.

雑誌

World journal of gastroenterology (ISSN:10079327)

巻号頁・発行日

vol.19, no.9, pp.1396-1404, 2013-03

被引用文献数

7 2

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AIM: To investigate the effect of mild steatotic liver on ischemia-reperfusion injury by focusing on Kupffer cells (KCs) and platelets.METHODS: Wistar rats were divided into a normal liver group (N group) and a mild steatotic liver group (S group) induced by feeding a choline-deficient diet for 2 wk. Both groups were subjected to 20 min of warm ischemia followed by 120 min of reperfusion. The number of labeled KCs and platelets in sinusoids and the blood perfusion in sinusoids were observed by intravital microscopy (IVM), which was performed at 30, 60 and 120 min after reperfusion. To evaluate serum alanine aminotransferase as a marker of liver deterioration, blood samples were taken at the same time as IVM.RESULTS: In the S group, the number of platelets adhering to KCs decreased significantly compared with the N group (120 after reperfusion; 2.9 ± 1.1 cells/acinus vs 4.8 ± 1.2 cells/acinus, P < 0.01). The number of KCs in sinusoids was significantly less in the S group than in the N group throughout the observation periods (before ischemia, 19.6 ± 3.3 cells/acinus vs 28.2 ± 4.1 cells/acinus, P < 0.01 and 120 min after reperfusion, 29.0 ± 4.3 cells/acinus vs 40.2 ± 3.3 cells/acinus, P < 0.01). The blood perfusion of sinusoids 120 min after reperfusion was maintained in the S group more than in the N group. Furthermore, elevation of serum alanine aminotransferase was lower in the S group than in the N group 120 min after reperfusion (99.7 ± 19.8 IU/L vs 166.3 ± 61.1 IU/L, P = 0.041), and histological impairment of hepatocyte structure was prevented in the S group.CONCLUSION: Ischemia-reperfusion injury in mild steatotic liver was attenuated compared with normal liver due to the decreased number of KCs and the reduction of the KC-platelet interaction.

著者

Ikeda Naoya Murata Soichiro Maruyama Takehito Tamura Takafumi Nozaki Reiji Kawasaki Takuya Fukunaga Kiyoshi Oda Tatsuya Sasaki Ryoko Homma Masato Ohkohchi Nobuhiro

出版者

Wiley

雑誌

Hepatology research (ISSN:13866346)

巻号頁・発行日

vol.42, no.1, pp.91-102, 2011

被引用文献数

41

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Keywords: adenosine; adenosine 5′-triphosphate; cyclic adenosine 5′-monophosphate; hepatic stellate cell; liver fibrosisAim:  Activated hepatic stellate cells (HSC) play a critical role in liver fibrosis. Suppressing abnormal function of HSC or reversion from activated to quiescent form is a hopeful treatment for liver cirrhosis. The interaction between platelets and HSC remains unknown although platelets go through hepatic sinusoids surrounded by HSC. This study aimed at clarifying the hypothesis that platelets control activation of HSC.Methods:  We used human platelets, platelet extracts, and primary or immortalized human HSC. We examined the effect of platelets on the activation, DNA synthesis, type I collagen production, and fibrosis-relating gene expressions of HSC. We investigated what suppressed activation of HSC within platelets and examined the mechanism of controlling activation in vitro.Results:  Platelets and platelet extracts suppressed activation of HSC. Platelets decreased type I collagen production without affecting DNA synthesis. Platelets increased the expression of matrix metallopeptidase 1. As platelet extracts co-cultured with an enzyme of degrading adenosine 5′-triphosphate (ATP) suppressed activation, we detected adenine nucleotides within platelets or on their surfaces and confirmed the degradation of adenine nucleotides by HSC and the production of adenosine. Adenosine and platelets increased the intracellular cyclic adenosine 5′-monophosphate (cAMP), which is important in quiescent HSC. A great amount of adenosine and ATP also suppressed activation of HSC.Conclusion:  Activation of human HSC is suppressed by human platelets or platelet-derived ATP via adenosine-cAMP signaling pathway in vitro. Therefore, platelets have the possibility to be used in the treatment of liver cirrhosis.