Nutritional Management to Control Environmental Impact in the Sustainable Animal Production

2004-07The animal industry must be environmentally sound to insure its long-term sustainable growth. In order to prevent pollution from animal waste, P, N, and pharmacological level minerals should be properly managed. Microbial phytase has been used successfully to control P excretion. Activity of natural phytase in certain plant feedstuffs is high enough to be considered in feed formulation. Nitrogen control can be achieved through amino acid supplementation and protein restriction in the diet. Supplementation with carbohydrases reduces output of excreta as well as N. Ammonia release from the manure can be reduced by using a low crude protein diet along with the supplementation of probiotics products. Excretion of minerals, which are used at pharmacological level can be reduced by using chelated forms. Cu and Zn in the form of methionine chelate have been successfully used in the diets of broilers, layers and/or pigs.departmental bulletin pape

幽門輪温存膵頭十二指腸切除術後の胃排出能と栄養状態の変化についての前向き無作為臨床試験 : 前結腸経路と垂直後結腸経路十二指腸空腸吻合の比較

宮崎大学博士(医学)2013年度doctoral thesi

Association of functional gene polymorphisms of interleukin-1β and transforming growth factor-β1 with the progression of liver fibrosis in Japanese patients with hepatitis C virus-related chronic liver disease

鳥取大学博士(医学)thesi

弱いマッハ反射に対する三衝撃波理論の検討

When a weak incident shock wave strikes a wedge and Mach reflection takes place, the previous experimental values of the angle of reflection, the triple-point trajectory angle and so on disagree with the values predicted by the three-shock theory. This contradiction is known as"von Neumann's paradox"and this phenomenon is not yet fully understood. In this paper, the three-shock theory is examined and modified taking the pressure condition and the curvature of a Mach shock into consideration. The result obtained by the present analysis shows good agreement with the previous experimental results.textapplication/pdfjournal articl

The successful posterior sectionectomy accompanied with caudate lobectomy for hepatocellular carcinoma located in segment 1 after LEN-TACE: a case report

Nowadays, the novel molecular targeting chemotherapy provides possibility of safe hepatectomy for progressive hepatocellular carcinoma (HCC). Further, combination of the conventional transarterial chemoembolization (TACE) may add an effect of tumor shrink. We present a successful radical hepatectomy for a large HCC located in segment 1 accompanied with the preoperative Lenvatinib (LEN)-TACE sequential treatment. We present a woman patient without any complaints who had a 7 cm-in-size of solitary HCC compressing vena cava and right portal pedicle. To achieve radical hepatectomy by tumor shrinking, LEN-TACE for 2 months. After confirming downsizing or devascularization of the HCC, we scheduled radical posterior sectionectomy combined with caudate lobectomy according to tumor location and expected future remnant liver volume from three-dimensional computed tomography simulation before surgery. Under the thoraco-abdominal incision laparotomy, we safely achieved scheduled radical hepatectomy without any vascular injuries. The postoperative course was uneventful and no tumor recurrence were observed for 1 year. Histological findings showed the Japan TNM stage III HCC with 70% necrosis. The multi-modal strategy of LEN-TACE followed by radical hepatectomy by confirming downsizing or devascularization in tumor is supposed to be useful and would be a preoperative chemotherapy option, and promising for curative treatment in HCC patients with progressive or large HCC, which may lead to safety by prevention surrounding major vascular injury.Citation: Nanashima, A., Hamada, T., Hiyoshi, M. et al. The successful posterior sectionectomy accompanied with caudate lobectomy for hepatocellular carcinoma located in segment 1 after LEN-TACE: a case report. Clin J Gastroenterol (2024). https://doi.org/10.1007/s12328-024-01929-

Prediction of Posthepatectomy Liver Failure Proposed by the International Study Group of Liver Surgery : Residual Liver Function Estimation With 99mTc-Galactosyl Human Serum Albumin Scintigraphy

PURPOSE: The International Study Group of Liver Surgery (ISGLS) proposed a definition and grading system for posthepatectomy liver failure (PHLF). We evaluated the usefulness of residual liver function estimation using Tc-99m-galactosyl human serum albumin (99mTc-GSA) for the prediction of PHLF. METHODS: Patients with liver tumors (n = 136) and scheduled for hepatectomy underwent 99mTc-GSA scintigraphy. Based on their imaging data, the maximal GSA removal rate (GSA R-max）was calculated by multicompartment analysis. We also calculated GSA R-max in the predicted residual liver (GSA-RL) whose volume was determined on computed tomography (CT) scans. We compared the age, gender, 15-min indocyanine green retention rate, albumin-, bilirubin-, hyaluronic acid-, and type 4 collagen level, the Child-Pugh classification, residual liver volume, residual liver percentage, GSA R-max, and GSA-RL in patients with/without PHLF. Uni- and multivariate logistic analyses were used for statistical assessments. RESULTS: Of 136 patients, 17 (12.5%) met the ISGLS criteria for PHLF (ISGLS-PHLF). There was a statistically significant difference in the age, albumin level, Child-Pugh classification, residual liver volume, residual liver percentage, GSA R-max, and GSA-RL between patients with/without PHLF. Based on multivariate analysis, GSA-RL and the residual liver volume were significant independent predictors of ISGLS-PHLF (p = 0.004 and p = 0.038, respectively). The odds ratio was 149423 for GSA-RL and 1.003 for the residual liver volume. CONCLUSION: GSA-RL calculated by 99mTc -GSA scintigraphy was the most useful independent predictor for ISGLS-PHLF.Citation: Mizutani, Y., Hirai, T., Nagamachi, S., Nanashima, A., Yano, K., Kondo, K., Hiyoshi, M., Imamura, N., & Terada, T. (2018). Prediction of Posthepatectomy Liver Failure Proposed by the International Study Group of Liver Surgery: Residual Liver Function Estimation With 99mTc-Galactosyl Human Serum Albumin Scintigraphy. Clinical nuclear medicine, 43(2), 77–81. https://doi.org/10.1097/RLU.000000000000191

Clinical significance of para-aortic lymph node metastasis for prognosis in patients with pancreaticobiliary cancer who underwent radical surgical resections

Objective To elucidate surgical strategies for patients undergoing radical resection, in cases where solitary distant lymph node metastasis is identified intraoperatively, we investigated the prognostic significance of para-aortic lymph node (PALN) metastases and other regional lymph node (RLN) metastases in pancreatic carcinomas (PC) and biliary duct cancers (BDC). Material and Methods This study retrospectively analyzed data from 181 PC patients and 116 BDC patients who underwent radical resections at two institutions between 1994 and 2021. Results Among PC patients, metastases were observed in RLN and PALN in 54% and 9% of cases, respectively. Similarly, RLN and PALN metastases were present among BDC patients in 39% and 9% of cases, respectively. Survival analysis revealed that patients with BDC and PALN metastases exhibited significantly reduced disease-free (DFS) and overall survival (OS) compared to those without PALN involvement. Multivariate analysis identified PALN metastasis as an independent predictor of OS in BDC patients (p<0.05), while RLN metastasis was independently associated with DFS (p<0.05). Additional clinicopathological factors associated with PALN and RLN metastases were also identified. Preoperative serum levels of Duke Pancreas II monoclonal antibody were significantly elevated in patients with PALN metastases. Histological findings of lymphatic or perineural infiltration and hepatic or pancreatic invasion were independently associated with RLN metastases. Conclusion Based on these findings, radical resection may be considered for PC patients with isolated PALN metastases only in the absence of additional adverse prognostic factors. Prospective clinical trials are warranted to further refine the criteria for surgical intervention when solitary PALN metastases are detected intraoperatively

The Direction of the Community Building and the Human Resource Development in Taiwan --The Community Building Policy Since 1994: Focusing on Shakueizo Ver.3 and the Policy of Regional Revitalization for Local Area in Taiwan--

text紀要論文 / Departmental Bulletin Paperdepartmental bulletin pape

Relationship of immunonutritional factor with changes in liver volume after portal vein embolization

application/pdfBackground To identify predictors of changes in hepatic volumes after portal vein embolization, we examined the relationship with preoperative nutritional and immunological parameters. Patients and Methods Ninety-three patients who underwent portal vein embolization were included. The control group comprised 13 patients who underwent right hepatectomy without portal vein embolization. Computed tomographic volumetric parameter was measured for changes in embolized and nonembolized liver. Correlation with various candidates of immunonutritional parameters was examined. Results Difference in increased liver ratio was 9.1%. C-reactive protein levels significantly increased after portal vein embolization （P  0.92 and increased liver volume ≥ 10% tended to correlate with lower prevalence of severe complications. Only increased intraoperative blood loss ≥ 1,500 mL was significantly associated with morbidity and mortality （P < .05）. Conclusion Contrary to our hypothesis, immunonutritional parameters, except C-reactive protein and C-reactive protein/albumin ratio, did not reflect hypertrophy after portal vein embolization. Although it is difficult to predict the hypertrophic degree, the strategy of scheduled hepatectomy should be switched in case of impaired inflammatory status after portal vein embolization