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My 40-year adventure in pursuit of discovery of early hepatocellular carcinoma: errors and successes
( Masamichi Kojiro ) 대한간학회 2007 추계 학술대회 Vol.13 No.-
Until 3 decades ago, hepatocellular carcinoma (HCC) was a major problem only in Asian and African countries, but it has become a common problem for gastroenterologists, radiologists, and pathologists in West as well because of a increasing tendency of HCC in Western countries. When I started studying HCC 39 years ago, most of HCCs had been detected in advanced stage and the survival time after diagnosis was only 3-6 months. However, the remarkable advances in clinical diagnostic approaches, in particular the developments of various diagnostic imagings and ultrasound-guided fine-needle biopsy, and the establishment of follow-up system of high-risk population, detection of small HCC of the early stage has become possible and increasing number of HCC has been successfully treated surgically or medically, and the survival time has remarkably elongated and patients with more than 10-year survival are not rare at the present time. When ultrasound-guided fine-needle aspiration biopsy was first introduced for early diagnosis of HCC more than two decades ago in our institute, we pathologists diagnosed most biopsy specimens from minute well-differentiated HCCs as hyperplastic nodule, regenerative nodule, or merely non-tumorous liver tissue. However, most of those minute lesions had evolved to classical HCC within a short period, and we began to pay careful attention to these benign-looking nodular lesions. With the increase in resected cases and availability of biopsy samples of early-stage small HCCs, we finally realized that many such lesions are highly well differentiated and have morphologic features quite different to those of classical HCCs. However, it took a certain period that a new pathologic concept of early stage HCC was widely accepted in Japan. Although HCC was not a matter of interest to Western pathologists until some years ago because of a relative infrequency, HCC and equivocal nodular lesions have become to be spotlighted among Western pathologists along with increased liver transplantation for HCC. With such a background, the diagnostic discrepancy of early stage HCC and equivocal nodular lesions between the West and Japan has become a controversial issue. In 2002, the International Consensus Group for Hepatic Neoplasia (ICGHN) has been established to resolve the discrepancy, and consensus on the pathologic diagnosis of equivocal nodular lesions is coming in sight after several meetings. Meanwhile, remarkable advances and popularization of imaging modalities also have enabled the depiction of various nodular lesions mimicking HCC that were formerly encountered only incidentally at laparatomy and autopsy, and they posed another problem in pathologic practice. In fact, it frequently happened that various non-HCC nodules such as liver cell adenoma, focal nodular hyperplasia (FNH), angiomyolipoma, epithelioid hemangiendothelioma, and carcinoid tumor were misdiagnosed as HCC on biopsy specimen. However, such a diagnostic confusion has been gradually resolved with a bitter experience in the past decade.
( Masamichi Kimura ),( Yoshihisa Tsuji ),( Masako Iwai ),( Masahiro Inagaki ),( Ali Madian ),( Takuya Yoshino ),( Minoru Matsuura ),( Hiroshi Nakase ) 대한장연구학회 2015 Intestinal Research Vol.13 No.2
Behcet`s disease (BD) is a systemic vasculitis, while myelodysplastic syndrome (MDS) is a heterogeneous group of clonal hematologic disorders characterized by ineffective hematopoiesis. Some studies suggest a relationship between MDS and BD, especially intestinal BD, and trisomy 8 seems to play an important role in both diseases. There are several reports on patients with BD comorbid with MDS involving trisomy 8 that frequently have intestinal lesions refractory to conventional medical therapies. Tumor necrosis factor (TNF)-αis strongly involved in the pathophysiology of several autoimmune diseases such as rheumatoid arthritis, inflammatory bowel disease, and BD. In addition, TNF-α plays an important role in the pathophysiology of MDS by inhibiting normal hematopoiesis and inducing the programmed cell death of normal total bone marrow cells and normal CD34+ cells. Recent clinical reports demonstrate the favorable effect of TNF-α antagonists in patients with refractory intestinal BD and in those with MDS. We present the case of a patient with intestinal BD and MDS involving trisomy 8 who was successfully treated with adalimumab. (Intest Res 2015;13:166-169)
Estimation of Quantity of Cl-from Deicing Salts on Weathering Steel Used for Bridges
Masamichi Takebe,Makoto Ohya,Shota Ajiki,Takashi Furukawa,Ryo Adachi,Rumiko Gan-ei,Naoki Kitagawa,Junya Ota,Yasuhiko Matsuzaki,Toshihiko Aso 한국강구조학회 2008 International Journal of Steel Structures Vol.8 No.2
To estimate the contribution of Cl from deicing salt (CaCl2) on weathering steel on a bridge in southwestern Japan, therelationship among the quanties of Cl, SO42 and Ca2+ on girders is examined. The composition of the ions on girder showsseasonal variation, and the Ca2+ and Cl on the western second girder are enriched with a ratio coresponding to CaCl2 in winter,suggesting that CaCl2 2 is more 50 % of totalchlorine ion and the corosion is more enhanced on the second girder.
Masamichi Saito,Ichiro Sugimoto,Eiichi Sasaki 한국강구조학회 2013 International Journal of Steel Structures Vol.13 No.3
Steel railway bridges which exceed their design lifetime are increasing in Japan, and some of them have problems such as corrosion and fatigue. In this study, we proposed a method to improve the performance, such as the load-carrying capacity, of the existing steel railway bridges by installation of concrete decks. To figure out the applicability of the proposed method, we discussed the applicable range of span and the effect of stress reduction. Considering application into actual bridges, we proposed an installation method using pre-cast concrete decks and girder-deck connection with filler mortar and steel fasteners. Finally, we carried out loading tests of the connection with fasteners and bending tests of the applied girders. As a result, we found that the girder-deck connections have enough static capacity for lateral force and train loads, under the condition that the studs are installed and the gaps between the pre-cast decks are filled with mortar.
Experimental Study on Noise Reduction Effect of Installing Concrete Deck on Existing Steel Girders
Masamichi Saito,Ichiro Sugimoto,Eiichi Sasaki 한국강구조학회 2015 International Journal of Steel Structures Vol.15 No.1
There are a number of existing steel railway bridges which has problems regarding structure-borne noise under train passage. Authors have proposed a performance improvement method of existing steel railway bridges by installing concrete deck. Bythis method, the vibration of the girder and the structure-borne noise are expected to be reduced. Generally, it is known thatconcrete deck can reduce the vibration and the noise. However, the noise reduction effect has not been clarified. In this study,impact hammer tests were carried out to figure out the reduction effect of the concrete deck on the vibration and the noise. Through the test, it was found that the response acceleration of the steel girder web was reduced by installing the concrete deck,as a result of reducing the propagation of on-girder vibration into the steel girder.