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Michihiro Iwaki,Hideki Fujii,Hideki Hayashi,Hidenori Toyoda,Satoshi Oeda,Hideyuki Hyogo,Miwa Kawanaka,Asahiro Morishita,Kensuke Munekage,Kazuhito Kawata,Tsubasa Tsutsumi,Koji Sawada,Tatsuji Maeshiro,H 대한간학회 2024 Clinical and Molecular Hepatology(대한간학회지) Vol.30 No.2
Background/Aims: Metabolic dysfunction-associated steatotic liver disease (MASLD) was recently proposed as an alternative disease concept to nonalcoholic fatty liver disease (NAFLD). We aimed to investigate the prognosis of patients with biopsy-confirmed MASLD using data from a multicenter study. Methods: This was a sub-analysis of the Clinical Outcome Nonalcoholic Fatty Liver Disease (CLIONE) study that included 1,398 patients with NAFLD. Liver biopsy specimens were pathologically diagnosed and histologically scored using the NASH Clinical Research Network system, the FLIP algorithm, and the SAF score. Patients who met at least one cardiometabolic criterion were diagnosed with MASLD. Results: Approximately 99% of cases (n=1,381) were classified as MASLD. Patients with no cardiometabolic risk (n=17) had a significantly lower BMI than patients with MASLD (20.9 kg/m2 vs. 28.0 kg/m2, P<0.001), in addition to significantly lower levels of inflammation, ballooning, NAFLD activity score, and fibrosis stage based on liver histology. These 17 patients had a median follow-up of 5.9 years, equivalent to 115 person-years, with no deaths, liver-related events, cardiovascular events, or extrahepatic cancers. The results showed that the prognosis for pure MASLD was similar to that for the original CLIONE cohort, with 47 deaths and one patient who underwent orthotopic liver transplantation. The leading cause of death was extrahepatic cancer (n=10), while the leading causes of liver-related death were liver failure (n=9), hepatocellular carcinoma (n=8), and cholangiocarcinoma (n=4). Conclusions: Approximately 99% of NAFLD cases were considered MASLD based on the 2023 liver disease nomenclature. The NAFLD-only group, which is not encompassed by MASLD, had a relatively mild histopathologic severity and a favorable prognosis. Consequently, the prognosis of MASLD is similar to that previously reported for NAFLD.
An Outlook on the Draft-Tube-Surge Study
Michihiro Nishi,Shuhong Liu 한국유체기계학회 2013 International journal of fluid machinery and syste Vol.6 No.1
If large pressure fluctuation is observed in the draft tube of a Francis turbine at part-load operation, we have generally called it draft-tube-surge. As occurrence of this phenomenon seriously affects the limit of turbine operating range, extensive studies on the surge have been made since proposal of surge-frequency criterion given by Rheingans. According to the literature survey of related topics in recent IAHR symposiums on hydraulic machinery and systems, in which state-of-the-art contributions were mainly presented, a certain review of them may be desirable for an outlook on the future studies in this research field. Thus, in this review paper, the authors' previous attempts for the last three decades to challenge the following topics: a rational method for component test of a draft tube, nature of spiral vortex rope and its behavior in a draft tube and cavitation characteristics of pressure fluctuations, are introduced together with other related contributions, expecting that more useful and significant studies will be accomplished in the future.
Michihiro Yoshida,Tadahisa Inoue,Itaru Naitoh,Kazuki Hayashi,Yasuki Hori,Makoto Natsume,Naoki Atsuta,Hiromi Kataoka 대한소화기내시경학회 2022 Clinical Endoscopy Vol.55 No.1
We reviewed 7 patients with unsuccessful endoscopic hemostasis using covered self-expandable metal stent (CSEMS) placementfor post-endoscopic sphincterotomy (ES) bleeding. ES with a medium incision was performed in 6 and with a large incision in 1patient. All but 1 of them (86%) showed delayed bleeding, warranting second endoscopic therapies followed by CSEMS placement1–5 days after the initial ES. Subsequent CSEMS placement did not achieve complete hemostasis in any of the patients. Lateral-sideincision lines (3 or 9 o’clock) had more frequent bleeding points (71%) than oral-side incision lines (11–12 o’clock; 29%). Additionalendoscopic hemostatic procedures with hemostatic forceps, hypertonic saline epinephrine, or hemoclip achieved excellenthemostasis, resulting in complete hemostasis in all patients. These experiences provide an alert: CSEMS placement is not an ultimatetreatment for post-ES bleeding, despite its effectiveness. The lateral-side of the incision line, as well as the oral-most side, should becarefully examined for bleeding points, even after the CSEMS placement.
Cooperation in Revision Games and Some Applications
Michihiro Kandor 연세대학교 동서문제연구원 2020 Global economic review Vol.49 No.4
The present paper provides some examples that illustrate how cooperation is achieved among rational and selfish agents when (i) they prepare their actions in advance and (ii) they have some opportunities to revise their actions. Specifically, we use the framework of revision games introduced by Kamada and Kandori [(2020). “Revision Games.” Econometrica 88: 1599–1630]. To judge the sustainability of cooperation in the examples, we show and utilise a simple and useful lemma.