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Hironori Koga,Hideki Iwamoto,Hiroyuki Suzuki,Shigeo Shimose,Masahito Nakano,Takumi Kawaguchi 대한간학회 2023 Clinical and Molecular Hepatology(대한간학회지) Vol.29 No.2
Striking advances in systemic therapy for unresectable advanced hepatocellular carcinoma (HCC) have improved the average prognosis of patients with HCC. As a result, the guidelines for the treatment of HCC have changed significantly. However, various issues have emerged in clinical practice. First, there is no established biomarker that can predict response to systemic therapy. Second, there is no established treatment regimen after primary systemic therapy, including combined immunotherapy. Third, there is no established treatment regimen for intermediate-stage HCC. These points make the current guidelines ambiguous. In this review, we present the Japanese guidelines for the diagnosis and treatment of HCC based on the latest evidence; introduce various efforts mainly in Japanese real-life practice to update these guidelines; and present our perspectives on future guidelines.
( Hye Jung Changhang ),( Hironori Koga ),( Masahiko Kajiwara ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Introduction: EGFR tyrosine kinase inhibitor (TKI) such as gefi tinib is a targeted drug to be safe and well tolerated as well as effi cacious for EGFR-mutant lung cancer. However, severe adverse reactions may occur depending on the underlying disease. Pulmonary Langerhans cell histiocytosis (PLCH) is an infi ammatory disorder that involves swelling of the bronchioles and small blood vessels in the lungs, which leads to lung stiffness and deterioration. We present a case of EGFR-mutant lung cancer patient with underlying PLCH who experienced fatal acute drug reaction induced by gefi tinib. Case: A 50-year-old man who was a 30-pack-year current smoker visited hospital with persistent dyspnea on exertion and chronic cough. Chest CT showed a lobulated lung mass in left upper lobe and disseminated thin-walled irregular shapes of cysts scattered over the whole lungs except for some lower lobes, suggesting PLCH. After further evaluation, he was diagnosed as stage IV pulmonary adenocarcinoma harboring EGFR exon 19 mutation. Thus, gefi nitib 250mg was started as fi rst-line therapy. A week later, he developed chilling sense and aggravated dyspnea. The chest CT fi nding of bilateral ground glass opacities and right pneumothorax was noticed. With impression of drug-induced pneumonitis, we stopped gefitinib, started high dose steroid, and inserted a chest tube into right hemithorax. In spite of initial intensive treatment, bilateral pneumonitis was not improved and the range of pneumothorax was widen to both hemithoraxes. Secondary pulmonary infection worsened his condition and mechanical ventilator was applied. Eventually he died of respiratory failure despite of intensive respiratory care. Conclusion: The use of EGFR-TKI should be cautious in lung cancer patients having underlying severe interstitial lung disease like PLCH although they have EGFR sensitive mutation, which is a good predictive marker for the drug.
Kim Sun-Hyung,Hamada Tatsuro,Otani Matoyasu,Koga Hironori,Shimada Takiko The Korean Society of Plant Biotechnology 2005 Plant molecular biology and biotechnology research Vol.7 No.2
The evaluation of source potential and sink strength is the generally large and laborious sample size required to adequately assess anyone of the parameters in field-grown sweetpotato. For this purpose we used the rooted single-leaf cuttings with petioles, because the source and sink organs are restricted in this system. The rooted single-leaf cutting of sweetpotato provides a unique source-sink model system, and is established within about 50 days after planting. In this study, the sink potential of sweetpotato tubers was examined based on the expression of genes for starch synthesis (AGPase) and modification (SBEII and GBSSI) in single rooted leaf plant. The gene expression patterns of GBSSI, SBEII and AGPase at various developmental stages and in different types of root tissues presented. These results suggest that the rooted single-rooted method can be used an ideal model system to study physiological and biochemical mechanisms in sweetpotato.
Junya Kusaka,Shigekiyo Matsumoto,Satoshi Hagiwara,Hironori Koga,Takayuki Noguchi 대한마취통증의학회 2012 Korean Journal of Anesthesiology Vol.63 No.1
Retroperitoneal fibrosis is associated with fibroblast proliferation due to inflammatory changes in adipose/fibrous tissue. Given that aortic dilation in abdominal aortic aneurysm can cause compression of the ureter, abdominal aortic aneurysm complicated by retroperitoneal fibrosis is likely to result in urinary tract obstruction. Accordingly,close attention to changes in perioperative urine volume is warranted when operating on patients with abdominal aortic aneurysm complicated by retroperitoneal fibrosis. We have recently performed laparotomies on two cases of abdominal aortic aneurysm complicated by retroperitoneal fibrosis. In the first case, surgery was performed without the placement of a ureteral stent. The patient developed postrenal acute renal failure caused by postoperative urinary retention. In the second case, ureteral stent placement in advance enabled perioperative management without complications. The clinical course of these cases suggests that, in laparotomy with concomitant retroperitoneal fibrosis, preoperative ureteral stent placement can prevent postoperative complications in the renal and urinary systems.