477 results on '"Isao, Sakaida"'
Search Results
2. Cost-effectiveness of a 'treat-all' strategy using Direct-Acting Antivirals (DAAs) for Japanese patients with chronic hepatitis C genotype 1 at different fibrosis stages.
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Riichiro Suenaga, Machi Suka, Tomohiro Hirao, Isao Hidaka, Isao Sakaida, and Haku Ishida
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Medicine ,Science - Abstract
AimTo evaluate the cost-effectiveness of therapeutic strategies initiated at different stages of liver fibrosis using three direct-acting antivirals (DAAs), sofosbuvir-ledipasvir (SL), glecaprevir-pibrentasvir (GP), and elbasvir plus grazoprevir (E/G), for Japanese patients with chronic hepatitis C (CHC) genotype 1.MethodsWe created an analytical decision model reflecting the progression of liver fibrosis stages to evaluate the cost-effectiveness of alternative therapeutic strategies applied at different fibrosis stages. We compared six treatment strategies: treating all patients regardless of fibrosis stage (TA), treating individual patients with one of four treatments starting at four respective stages of liver fibrosis progression (F1S: withholding treatment at stage F0 and starting treatment from stage F1 or higher, and three successive options, F2S, F3S, and F4S), and administering no antiviral treatment (NoRx). We adopted a lifetime horizon and Japanese health insurance payers' perspective.ResultsThe base case analysis showed that the incremental quality-adjusted life years (QALY) gain of TA by SL, GP, and E/G compared with the strategies of starting treatments for patients with the advanced fibrosis stage, F2S, varied from 0.32 to 0.33, and the incremental cost-effectiveness ratios (ICERs) were US$24,320, US$18,160 and US$17,410 per QALY, respectively. On the cost-effectiveness acceptability curve, TA was most likely to be cost-effective, with the three DAAs at the willingness to pay thresholds of US$50,000.ConclusionsOur results suggested that administration of DAA treatment for all Japanese patients with genotype 1 CHC regardless of their liver fibrosis stage would be cost-effective under ordinary conditions.
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- 2021
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3. Evaluation of the effects of L-carnitine on medaka (Oryzias latipes) fatty liver
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Koichi Fujisawa, Taro Takami, Aya Matsuzaki, Toshihiko Matsumoto, Naoki Yamamoto, Shuji Terai, and Isao Sakaida
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Medicine ,Science - Abstract
Abstract Lifestyle-related diseases have become a major issue in recent years. The increasing incidence of fatty liver underlines the urgency with which the issues of non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH) need to be addressed. L-carnitine is a compound known to transport fatty acids into the mitochondria to enhance β-oxidation-mediated metabolism of fats. In this study, the effects of L-carnitine administration on fatty liver of medaka (Oryzias latipes) were analysed, to check for disease improvement and metabolic changes. Additionally, the effects of the concomitant administration of L-carnitine and eicosapentaenoic acid (20:5n-3) (EPA) were investigated. Findings indicated reduced lipid deposition, increase in metabolites associated with β-oxidation, and significant reduction in fatty acid levels in the liver, implying improvement in fatty liver condition. Concomitant administration of L-carnitine and EPA resulted in further benefits, via changes in fatty acid composition in the medaka fatty liver model.
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- 2017
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4. A novel therapeutic strategy for esophageal varices using endoscopic treatment combined with splenic artery embolization according to the Child-Pugh classification.
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Tsuyoshi Ishikawa, Ryo Sasaki, Tatsuro Nishimura, Yuki Aibe, Issei Saeki, Takuya Iwamoto, Isao Hidaka, Taro Takami, and Isao Sakaida
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Medicine ,Science - Abstract
Variceal hemorrhage may cause high rebleeding and mortality rates. Preventing the first episode of variceal bleeding is mandatory in patients with high-risk esophageal varices (EV). This study aimed to identify factors that predict the recurrence of EV after endoscopic treatment (ET), and to develop a reasonable therapeutic strategy for EV in cirrhosis. From January 2012 to December 2014, 45 patients with cirrhosis and high-risk EV underwent ET, including sclerotherapy and/or ligation. Statistical analyses identified factors associated with the recurrence of EV after ET, and the Kaplan-Meier method determined the cumulative variceal recurrence rates. The 1-, 2-, and 3-year cumulative posttreatment recurrence rates for EV were 13.3%, 29.5%, and 32.2%, respectively. No significant differences were evident between the patients with and without variceal recurrences at 1-year posttreatment. The multivariate regression analyses identified a history of partial splenic embolization (PSE) and the pretreatment Child-Pugh classification as independent predictors of variceal recurrences at 2 years (p < 0.05) and 3 years (p < 0.05) posttreatment. While EV did not recur after ET and splenic artery embolization in cases with Child-Pugh class A, the overall posttreatment variceal recurrence rates were 0% and 66.7% when PSE was performed before and after ET, respectively, in those with Child-Pugh class B or C. Splenic artery embolization significantly reduced the hepatic venous pressure gradient and markedly lowered the Child-Pugh score in 15 patients. Adjunctive PSE and pretreatment Child-Pugh class A could be independently associated with reduced cumulative recurrence rates of EV post-ET. From the perspectives of portal hemodynamics and hepatic function, splenic artery embolization before or after ET could prevent posttreatment variceal recurrence in patients with Child-Pugh class A, and PSE before ET could achieve the long-term eradication of EV following ET in those with Child-Pugh class B or C.
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- 2019
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5. Effect of body composition on survival benefit of hepatic arterial infusion chemotherapy for advanced hepatocellular carcinoma: A comparison with sorafenib therapy.
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Issei Saeki, Takahiro Yamasaki, Masaki Maeda, Takuro Hisanaga, Takuya Iwamoto, Toshihiko Matsumoto, Isao Hidaka, Tsuyoshi Ishikawa, Taro Takami, and Isao Sakaida
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Medicine ,Science - Abstract
AimSorafenib is used as a first-line treatment for advanced hepatocellular carcinoma (HCC). However, hepatic arterial infusion chemotherapy (HAIC) has also gained acceptance, but only in Japan. We explored the role of body composition as a factor affecting the survival benefit of HAIC compared to sorafenib for the treatment of advanced HCC.MethodsWe conducted a retrospective study using the clinical records of 133 patients with advanced HCC treated either with HAIC or sorafenib. Prior to treatment induction, skeletal muscle index and visceral fat area (VFA) were measured at the third lumbar vertebral and umbilical levels, respectively, using computed tomography. Muscle depletion and high-VFA (H-VFA) were defined using published cut-offs. We analyzed clinical parameters, including body composition as prognostic factors.ResultsIn the HAIC group, multivariate analysis identified a positive response to HAIC (hazard ratio [HR], 0.438; p = 0.022), and conversion from HAIC to sorafenib (HR, 0.374; p = 0.008) as favorable prognostic factors for survival. In contrast, tumor number < 7 (HR, 0.475; p = 0.008), absence of extra-hepatic spread (HR, 0.511; p = 0.015), absence of muscle depletion (HR, 0.555; p = 0.044), and H-VFA (HR, 0.483; p = 0.015) were studied in the sorafenib group.ConclusionsBody composition was identified as a prognostic factor for patient survival after treatment with sorafenib, but not for HAIC, and may be used as a biomarker when selecting between HAIC or sorafenib treatment of patients with advanced HCC. Additionally, conversion to sorafenib in patients receiving HAIC could improve survival regardless of response status.
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- 2019
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6. Liver regeneration therapy through the hepatic artery-infusion of cultured bone marrow cells in a canine liver fibrosis model.
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Tatsuro Nishimura, Taro Takami, Ryo Sasaki, Yuki Aibe, Takashi Matsuda, Koichi Fujisawa, Toshihiko Matsumoto, Naoki Yamamoto, Kenji Tani, Yasuho Taura, and Isao Sakaida
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Medicine ,Science - Abstract
BackgroundWe previously reported regenerative therapies for decompensated cirrhosis based on peripheral venous drip infusion using non-cultured whole bone marrow (BM) cells, or the less invasive cultured BM-derived mesenchymal stem cells (BMSCs). Here, we assessed the efficacy and safety of hepatic arterial infusion using cultured autologous BMSCs, comparing it with peripheral infusion, using our established canine liver fibrosis model.MethodsCanine BM cells were harvested and cultured, and the resultant BMSCs were returned to carbon tetrachloride (CCl4)-induced liver cirrhosis model canines via either a peripheral vein (Vein group) or hepatic artery (Artery group). A variety of assays were performed before and 4, 8, and 12 weeks after BMSC infusion, and liver fibrosis and indocyanine green (ICG) half-life (t1/2) were compared to those in a control group that received CCl4 but not BMSCs. The safety of this approach was evaluated by contrast-enhanced computed tomography (CT) and serial blood examinations after infusion.ResultsFour weeks after infusing BMSCs, a significant improvement was observed in the Vein group (n = 8) compared to outcome in the Control group (n = 10), along with a decrease in ICG t1/2. In the Artery group (n = 4), ICG t1/2 was significantly shorter than that in the Vein group at 8 weeks (Δt1/2: -3.8 ± 1.7 min vs. +0.4 ± 2.4 min; p < 0.01) and 12 weeks (Δt1/2: -4.2 ± 1.7 min vs. +0.4 ± 2.7 min; p < 0.01) after BMSC administration. Post-infusion contrast-enhanced CT showed no liver infarction, and blood tests showed no elevations in either serum lactate dehydrogenase concentrations or hypercoagulability.ConclusionsWe confirmed the efficacy and safety of the hepatic arterial infusion of cultured autologous BMSCs using a canine model, thereby providing non-clinical proof-of-concept.
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- 2019
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7. Screening for portopulmonary hypertension using computed tomography‐based measurements of the main pulmonary artery and ascending aorta diameters in patients with portal hypertension
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Maho Egusa, Tatsuro Nishimura, Tsuyoshi Ishikawa, Taro Takami, Issei Saeki, Ryo Sasaki, Daiki Kawamoto, and Isao Sakaida
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medicine.medical_specialty ,education.field_of_study ,Portopulmonary hypertension ,Univariate analysis ,Hepatology ,medicine.diagnostic_test ,business.industry ,Population ,Interventional radiology ,medicine.disease ,Inferior vena cava ,Infectious Diseases ,medicine.vein ,medicine.artery ,Ascending aorta ,medicine ,Portal hypertension ,Radiology ,education ,business ,Blood urea nitrogen - Abstract
AIM This study aimed to demonstrate the feasibility of identifying candidates of portopulmonary hypertension (PoPH) from general portal hypertension patients based on chest computed tomography (CT) results. METHODS One hundred and thirty patients with portal hypertension who had undergone interventional radiology therapies at our hospital between August 2011 and July 2021 were included, and preoperative clinical data were collected. Suspicious PoPH was defined as main pulmonary artery diameter (mPA-D) ≥ 29 mm or the ratio of mPA-D to ascending aorta diameter (mPA-D/aAo-D) ≥ 1.0, and probable PoPH as mPA-D ≥ 33 mm based on the chest CT. Prevalence of suspicious and probable PoPH was evaluated, and the differences in clinical characteristics of each population were compared. RESULTS Overall, 29 (22.3%) and 5 (3.8%) patients were categorized as suspicious and probable PoPH, respectively. Univariate analyses revealed that female sex, higher shortest diameter of inferior vena cava, presence of portosystemic shunts ≥ 5 mm, and lower blood urea nitrogen levels were significantly associated with suspicious PoPH (P < 0.05). Multivariate analysis identified all four factors as significantly independent determinants of suspicious PoPH (P < 0.05). In addition, among the population of suspicious PoPH, there were significant differences in seven parameters, including total bilirubin levels and spleen volume between patients with and without probable PoPH (P < 0.05). However, no significant independent indicators of probable PoPH were found. CONCLUSIONS CT-based measurements of mPA-D and mPA-D/aAo-D have the potential to screen patients with suspicious PoPH in clinical practice focused on portal hypertension. This article is protected by copyright. All rights reserved.
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- 2021
8. Clinical characteristics of immunoglobulin IgG4-related sclerosing cholangitis: Comparison of cases with and without autoimmune pancreatitis in a large cohort
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Itaru Naitoh, Terumi Kamisawa, Atsushi Tanaka, Takahiro Nakazawa, Kensuke Kubota, Hajime Takikawa, Michiaki Unno, Atsushi Masamune, Shigeyuki Kawa, Seiji Nakamura, Kazuichi Okazaki, Keisuke Furumatsu, Shigeaki Sawai, Takuma Goto, Toshikatsu Okumura, Daisuke Suzuki, Masayuki Otsuka, Ikuhiro Kobori, Masaya Tamano, Mitsuhito Koizumi, Yoichi Hiasa, Naoto Kawabe, Yoshiki Hirooka, Satoshi Yamamoto, Yukio Asano, Kazuo Inui, Akihiko Horiguchi, Hiroyuki Watanabe, Daishu Toya, Katsuko Hatayama, Toshiharu Ueki, Norikatsu Kinoshita, Mitsuru Sugimoto, Hiromasa Ohira, Tsuyoshi Mukai, Eiichi Tomita, Keisuke Iwata, Shogo Shimizu, Jun Suetsugu, Masahito Shimizu, Keiji Tsuji, Ryoko Ishida, Masanori Ito, Ryutaro Furukawa, Naoya Sakamoto, Masahiro Araki, Satoshi Tanno, Yasunari Sakamoto, Tetsuhide Ito, Satoshi Takai, Shinichi Ikeya, Takanori Yamada, Norihiko Kudara, Akinori Shimizu, Keiji Hanada, Yasunori Ichiki, Hideki Kitada, Michio Hifumi, Hiroyuki Kimura, Masayuki Kurosaki, Namiki Izumi, Hajime Sumi, Jun-ichi Haruta, Katsumi Hayashi, Ryo Harada, Masafumi Inoue, Shinichiro Nakamura, Tetsuya Ito, Ko Tomishima, Hiroyuki Isayama, Kyoko Oura, Tsutomu Masaki, Naoto Shimokawahara, Shirou Tanoue, Kousei Maemura, Akio Ido, Ichiro Mizushima, Mitsuhiro Kawano, Katsunori Yoshida, Makoto Naganuma, Miki Murata, Akiyoshi Nishio, Yuji Fujita, Takuma Teratani, Shohei Matsubara, Hironao Tamai, Yuu Yoshida, Ryousaku Azemoto, Ken Kamata, Tomohiro Watanabe, Takahiro Kurosu, Wasaburou Koizumi, Jun Fujita, Hideyuki Seki, Yasuhiro Ueda, Takumi Fukumoto, Takuhiro Kousaki, Kazushige Uchida, Toshimasa Ochiai, Takeshi Kawasaki, Motohiko Tanaka, Etsuji Ishida, Kenji Notohara, Hideaki Mori, Toshiyuki Mori, Hideaki Kawabata, Masatoshi Miyata, Junichi Sakagami, Yoshito Itoh, Masahiro Shiokawa, Hiroshi Seno, Noriko Watanabe, Hiromi Kataoka, Toshinori Aoki, Mitsuhiro Fujishiro, Toru Niihara, Hiroto Nishimata, Akira Mitoro, Hitoshi Yoshiji, Motoyuki Yoshida, Masafumi Ikeda, Kengo Tomita, Ryota Hokari, Kenji Hayasaka, Yuji Amano, Kazuhiko Shioji, Kazunao Hayashi, Shuji Terai, Michiko Nakajima, Junya Yamahana, Ryusuke Matsumoto, Hideaki Kikuchi, Akira Kanamori, Seiki Kiriyama, Shinichi Iwatsu, Yuji Kato, Shigeru Horiguchi, Takahito Yagi, Hiroyuki Okada, Kazuyoshi Ohkawa, Motohiro Hirao, Naoki Hiramatsu, Noriko Oza, Haruo Imamura, Takeshi Baba, Shigeru Nakano, Tetsuya Shinobi, Shomei Ryozawa, Masayo Motoya, Hiroshi Nakase, Noboru Kinoshita, Kei Ito, Tatsuya Miyake, Naruaki Kohge, Hiroshi Tobita, Satoru Joshita, Takeji Umemura, Shinya Kawaguchi, Kazuya Ohno, Koichi Sonobe, Akihiko Satoh, Tooru Shimosegawa, Fumihiko Miura, Minami Yagi, Keiji Sano, Toshifumi Kin, Akio Katanuma, Kazuhiko Koike, Shin Miura, Youhei Kawashima, Tatehiro Kagawa, Seishin Azuma, Mamoru Watanabe, Mitsuyoshi Honjyo, Takao Itoi, Akira Honda, Katsumasa Kobayashi, Toru Asano, Suguru Mizuno, Takayoshi Nishino, Hideaki Taniguchi, Kazuto Tajiri, Ichiro Yasuda, Yoshiya Tanaka, Shinji Oe, Masaru Harada, Masanao Kurata, Mituharu Fukasawa, Nobuyuki Enomoto, Yuki Kawaji, Masayuki Kitano, Yuko Nishise, Hidetoshi Hirakawa, Tetsuya Ishizawa, Yoshiyuki Ueno, Miyuki Kaino, Yuko Fujimoto, and Isao Sakaida
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Male ,medicine.medical_specialty ,Autoimmune Pancreatitis ,Cholangitis, Sclerosing ,Gastroenterology ,Primary sclerosing cholangitis ,Serology ,03 medical and health sciences ,0302 clinical medicine ,Japan ,Surveys and Questionnaires ,Internal medicine ,Humans ,Medicine ,Retrospective Studies ,Autoimmune pancreatitis ,Hepatology ,medicine.diagnostic_test ,business.industry ,Bile duct ,Ultrasound ,Magnetic resonance imaging ,Histology ,medicine.disease ,medicine.anatomical_structure ,Immunoglobulin G ,030220 oncology & carcinogenesis ,Female ,030211 gastroenterology & hepatology ,IgG4-related disease ,Bile Ducts ,Immunoglobulin G4-Related Disease ,business ,Cholangiography - Abstract
Background The clinical characteristics of IgG4-related sclerosing cholangitis (IgG4-SC) especially without autoimmune pancreatitis (AIP) have not been investigated in a large cohort. Aims To clarify the clinical characteristics of IgG4-SC and IgG4-SC without AIP. Methods We retrospectively reviewed imaging, serology, other organ involvement (OOI) and histology of 872 patients with IgG4-SC who participated in a Japanese nationwide survey in 2019, and compared these items between IgG4-SC with and without AIP. Results AIP was present in 83.7% (730/872) of IgG4-SC. In IgG4-SC, bile duct wall thickening was observed on ultrasound (528/650; 81.2%), computed tomography (375/525; 71.4%) and magnetic resonance imaging or cholangiopancreatography (290/440; 65.9%). An elevated serum IgG4 level (≥ 135 mg/dL) was found in 88.0% (322/366). IgG4-related OOI other than AIP was observed in 25.2% (211/836). The proportion of females was significantly higher in IgG4-SC without AIP (28.9% vs. 20.1%; p = 0.025). Hilar stricture was the most common cholangiographic type in IgG4-SC without AIP (39/107; 36.4%).There were no significant differences between IgG4-SC with and without AIP in the rates of bile duct wall thickening, elevated serum IgG4 level, or IgG4-related OOI. Conclusions The clinical characteristics of IgG4-SC was similar between IgG4-SC with and without AIP in a large cohort.
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- 2021
9. Combined Use of Computed Tomography Enterography/Enteroclysis and Capsule Endoscopy Improves the Accuracy of Diagnosis of Small Bowel Bleeding
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Hideko Onoda, Katsuyoshi Ito, Takeshi Okamoto, Kensaku Shimizu, Jun Nishikawa, Madoka Unno, Tomohiro Shirasawa, Shinichi Hashimoto, Masahiro Tanabe, Koichi Hamabe, Atsushi Goto, and Isao Sakaida
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medicine.medical_specialty ,CT enterography ,business.industry ,Significant difference ,Combined use ,Retrospective cohort study ,General Medicine ,Computed tomography enterography ,Capsule Endoscopy ,law.invention ,Clinical Practice ,Capsule endoscopy ,law ,Intestine, Small ,Internal Medicine ,medicine ,Humans ,In patient ,Radiology ,Gastrointestinal Hemorrhage ,Tomography, X-Ray Computed ,business ,Retrospective Studies - Abstract
Objective CT enterography/enteroclysis (CTE) is listed in the clinical practice guidelines as a method for diagnosing small bowel bleeding, as is capsule endoscopy (CE), but there are no real-world data yet available on CTE in Japan. This study aimed to investigate the diagnostic ability of CTE and long-term prognosis after CTE in Japan. Patients We conducted a retrospective cohort study of patients suspected of having small bowel bleeding who underwent both CTE and CE within 30 days between April 2008 and March 2019. The number of patients free from rebleeding for up to 24 months was thus determined. Results Seventy-one patients were extracted from the database. The 43 patients (60.6%) with a definite and suspicious source of bleeding in the small bowel were detected by CTE. When the 31 patients with a definite source of bleeding in the small bowel were analyzed, the sensitivity of CTE was 19/31 (61.3%) and that of CE was 24/31 (77.4%), thus indicating no significant difference (p=0.332). However, the sensitivity when CTE and CE were used in combination was 30/31 (96.8%), which was significantly higher than that of CE alone (p=0.0412). No rebleeding was observed in the CTE and CE negative group (p=0.0965). Conclusion The combined use of CTE and CE increased the detection rate of small bowel bleeding. Therefore, in patients with suspected tumor/polyp lesions, not only CE, but also CTE should be performed. This study provides the first real-world data on the diagnostic accuracy of CTE for small bowel bleeding in Japan.
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- 2021
10. Promotion of intrahospital referral of hepatitis virus-positive patients to hepatology specialists through interprofessional collaboration, including clinical laboratory technicians
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Takashi Oono, Reo Kawano, Isao Hidaka, Tsuyoshi Ishikawa, Takahiro Yamasaki, Miyuki Masui, Toshihiko Matsumoto, Aki Fujinaga, Takuro Hisanaga, Taro Takami, Isao Sakaida, Issei Saeki, and Yoshio Marumoto
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Hepatitis virus ,medicine.medical_specialty ,Hepatology ,Referral ,business.industry ,media_common.quotation_subject ,Promotion (rank) ,Family medicine ,Internal medicine ,medicine ,business ,Laboratory technicians ,media_common - Published
- 2021
11. Evidence-based clinical practice guidelines for Liver Cirrhosis 2020
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Takemi Akahane, Tooru Shimosegawa, Hitoshi Yoshiji, Masahito Shimizu, Masayuki Kurosaki, Hiroki Nishikawa, Hisashi Hidaka, Koji Ogawa, Yoichi Hiasa, Kazuhiko Koike, Hiroto Miwa, Yoshinari Asaoka, Isao Sakaida, Takumi Kawaguchi, Tetsuo Takehara, Sumiko Nagoshi, Makiko Taniai, Nobuyuki Enomoto, Kazuaki Chayama, Shuji Terai, and Yoshiyuki Ueno
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Liver Cirrhosis ,medicine.medical_specialty ,Cirrhosis ,Complications ,medicine.medical_treatment ,Guidelines as Topic ,Review Article ,Liver transplantation ,Guidelines ,03 medical and health sciences ,0302 clinical medicine ,Hepatorenal syndrome ,Japan ,Internal medicine ,Diagnosis ,medicine ,Humans ,Intensive care medicine ,Portopulmonary hypertension ,business.industry ,Gastroenterology ,Guideline ,Hepatitis B ,Hepatology ,medicine.disease ,Treatment ,030220 oncology & carcinogenesis ,Evidence-Based Practice ,030211 gastroenterology & hepatology ,Steatohepatitis ,business - Abstract
The first edition of the clinical practice guidelines for liver cirrhosis was published in 2010, and the second edition was published in 2015 by the Japanese Society of Gastroenterology (JSGE). The revised third edition was recently published in 2020. This version has become a joint guideline by the JSGE and the Japan Society of Hepatology (JSH). In addition to the clinical questions (CQs), background questions (BQs) are new items for basic clinical knowledge, and future research questions (FRQs) are newly added clinically important items. Concerning the clinical treatment of liver cirrhosis, new findings have been reported over the past 5 years since the second edition. In this revision, we decided to match the international standards as much as possible by referring to the latest international guidelines. Newly developed agents for various complications have also made great progress. In comparison with the latest global guidelines, such as the European Association for the Study of the Liver (EASL) and American Association for the Study of Liver Diseases (AASLD), we are introducing data based on the evidence for clinical practice in Japan. The flowchart for nutrition therapy was reviewed to be useful for daily medical care by referring to overseas guidelines. We also explain several clinically important items that have recently received focus and were not mentioned in the last editions. This digest version describes the issues related to the management of liver cirrhosis and several complications in clinical practice. The content begins with a diagnostic algorithm, the revised flowchart for nutritional therapy, and refracted ascites, which are of great importance to patients with cirrhosis. In addition to the updated antiviral therapy for hepatitis B and C liver cirrhosis, the latest treatments for non-viral cirrhosis, such as alcoholic steatohepatitis/non-alcoholic steatohepatitis (ASH/NASH) and autoimmune-related cirrhosis, are also described. It also covers the latest evidence regarding the diagnosis and treatment of liver cirrhosis complications, namely gastrointestinal bleeding, ascites, hepatorenal syndrome and acute kidney injury, hepatic encephalopathy, portal thrombus, sarcopenia, muscle cramp, thrombocytopenia, pruritus, hepatopulmonary syndrome, portopulmonary hypertension, and vitamin D deficiency, including BQ, CQ and FRQ. Finally, this guideline covers prognosis prediction and liver transplantation, especially focusing on several new findings since the last version. Since this revision is a joint guideline by both societies, the same content is published simultaneously in the official English journal of JSGE and JSH.
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- 2021
12. Evidence‐based clinical practice guidelines for liver cirrhosis 2020
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Hiroto Miwa, Hitoshi Yoshiji, Takemi Akahane, Hiroki Nishikawa, Kazuhiko Koike, Masahito Shimizu, Isao Sakaida, Hisashi Hidaka, Shuji Terai, Koji Ogawa, Tooru Shimosegawa, Sumiko Nagoshi, Takumi Kawaguchi, Yoshiyuki Ueno, Tetsuo Takehara, Nobuyuki Enomoto, Makiko Taniai, Masayuki Kurosaki, Yoichi Hiasa, Yoshinari Asaoka, and Kazuaki Chayama
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medicine.medical_specialty ,Portopulmonary hypertension ,Evidence-based practice ,Cirrhosis ,Hepatology ,business.industry ,medicine.medical_treatment ,Guideline ,Liver transplantation ,medicine.disease ,Infectious Diseases ,Hepatorenal syndrome ,Internal medicine ,medicine ,Steatohepatitis ,Intensive care medicine ,business - Abstract
The first edition of the clinical practice guidelines for liver cirrhosis was published in 2010, and the second edition was published in 2015 by the Japanese Society of Gastroenterology (JSGE). The revised third edition was recently published in 2020. This version has become a joint guideline by the JSGE and the Japanese Society of Hepatology (JSH). In addition to the clinical questions (CQs), background questions (BQs) are new items for basic clinical knowledge, and future research questions (FRQs) are newly added clinically important items. Concerning the clinical treatment of liver cirrhosis, new findings have been reported over the past 5 years since the second edition. In this revision, we decided to match the international standards as much as possible by referring to the latest international guidelines. Newly developed agents for various complications have also made great progress. In comparison with the latest global guidelines, such as the European Association for the Study of the Liver (EASL) and American Association for the Study of Liver Diseases (AASLD), we are introducing data based on the evidence for clinical practice in Japan. The flowchart for nutrition therapy was reviewed to be useful for daily medical care by referring to overseas guidelines. We also explain several clinically important items that have recently received focus and were not mentioned in the last editions. This digest version describes the issues related to the management of liver cirrhosis and several complications in clinical practice. The content begins with a diagnostic algorithm, the revised flowchart for nutritional therapy, and refracted ascites, which are of great importance to patients with cirrhosis. In addition to the updated antiviral therapy for hepatitis B and C liver cirrhosis, the latest treatments for non-viral cirrhosis, such as alcoholic steatohepatitis/non-alcoholic steatohepatitis (ASH/NASH) and autoimmune-related cirrhosis, are also described. It also covers the latest evidence regarding the diagnosis and treatment of liver cirrhosis complications, namely gastrointestinal bleeding, ascites, hepatorenal syndrome and acute kidney injury, hepatic encephalopathy, portal thrombus, sarcopenia, muscle cramp, thrombocytopenia, pruritus, hepatopulmonary syndrome, portopulmonary hypertension, and vitamin D deficiency, including BQ, CQ and FRQ. Finally, this guideline covers prognosis prediction and liver transplantation, especially focusing on several new findings since the last version. Since this revision is a joint guideline by both societies, the same content is published simultaneously in the official English journal of JSGE and JSH.
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- 2021
13. Successful Management With Dual Therapy of Lenvatinib and Macitentan for HCC With Portopulmonary Hypertension
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Ryo Sasaki, Yasuaki Wada, Issei Saeki, Isao Sakaida, Takashi Matsuda, Masafumi Yano, Taro Takami, and Tsuyoshi Ishikawa
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Endothelin Receptor Antagonists ,Liver Cirrhosis ,Male ,Oncology ,Cardiac Catheterization ,medicine.medical_specialty ,Carcinoma, Hepatocellular ,Medication Therapy Management ,medicine.drug_class ,Tyrosine-kinase inhibitor ,chemistry.chemical_compound ,Hepatitis B, Chronic ,Internal medicine ,Hypertension, Portal ,medicine ,Humans ,Protein Kinase Inhibitors ,Aged ,Macitentan ,Pulmonary Arterial Hypertension ,Sulfonamides ,Portopulmonary hypertension ,Hepatology ,business.industry ,Endothelin receptor antagonist ,Phenylurea Compounds ,Liver Neoplasms ,Protein-Tyrosine Kinases ,medicine.disease ,respiratory tract diseases ,Dasatinib ,Pyrimidines ,Treatment Outcome ,chemistry ,Quinolines ,Portal hypertension ,Tomography, X-Ray Computed ,business ,Lenvatinib ,Chronic myelogenous leukemia ,medicine.drug - Abstract
Portopulmonary hypertension (PoPH) is a subcategory of pulmonary arterial hypertension (PAH) associated with portal hypertension (PH). Certain drugs, including dasatinib, a tyrosine kinase inhibitor (TKI) for chronic myelogenous leukemia, have been identified as risk factors for the development of PAH.(1) However, although TKIs, such as lenvatinib, have been widely used for the treatment of HCC, no reports have demonstrated the association of TKIs for HCC with PAH.
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- 2021
14. An autopsy case of primary malignant lymphoma of the spleen with acute liver failure and respiratory failure
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Ryo Sasaki, Hiroshi Itoh, Yurika Kotoh, Isao Hidaka, Taro Takami, Issei Saeki, Tsuyoshi Ishikawa, Isao Sakaida, Takashi Matsuda, and Takashi Oono
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Malignant lymphoma ,Pathology ,medicine.medical_specialty ,medicine.anatomical_structure ,Hepatology ,Respiratory failure ,business.industry ,medicine ,Liver failure ,Spleen ,Autopsy case ,business - Published
- 2021
15. Short-term Effects of Hepatic Arterial Buffer Responses Induced by Partial Splenic Embolization on the Hepatic Function of Patients with Cirrhosis According to the Child-Pugh Classification
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Issei Saeki, Takuya Iwamoto, Taro Takami, Tatsuro Nishimura, Ryo Sasaki, Takashi Matsuda, Tsuyoshi Ishikawa, Isao Hidaka, and Isao Sakaida
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Liver Cirrhosis ,medicine.medical_specialty ,Cirrhosis ,Child-Pugh score ,hepatic function ,030204 cardiovascular system & hematology ,Gastroenterology ,Hypersplenism ,Group B ,Hepatic function ,03 medical and health sciences ,Hepatic Artery ,0302 clinical medicine ,Partial splenic embolization ,Internal medicine ,medicine.artery ,polycyclic compounds ,Internal Medicine ,medicine ,Humans ,hepatic arterial buffer response ,Arterial hemodynamics ,Common hepatic artery ,business.industry ,partial splenic embolization ,General Medicine ,biochemical phenomena, metabolism, and nutrition ,medicine.disease ,Embolization, Therapeutic ,digestive system diseases ,CHILD-PUGH CLASSIFICATION ,Splenic infarction ,Original Article ,030211 gastroenterology & hepatology ,business - Abstract
Objective This study primarily aimed to investigate the short-term effects of partial splenic embolization (PSE) on the Child-Pugh score and identify predictive factors for changes in the score caused by PSE. The secondary aim was to analyze changes in various parameters at one month postoperatively using these identified factors. Methods Between September 2007 and December 2019, 118 patients with cirrhosis and hypersplenism underwent PSE at our hospital. Testing was conducted preoperatively and at one month after PSE. Results Overall, the Child-Pugh score was not significantly changed postoperatively. The Child-Pugh score before PSE was identified as the strongest independent predictor of ameliorated and deteriorated Child-Pugh scores after PSE. Higher pretreatment Child-Pugh scores were correlated with higher posttreatment amelioration rates of the score. A significant decrease in the portal vein diameter and a significant increase in the common hepatic artery diameter were evident at the same level postoperatively in 64 patients with Child-Pugh class A (group A) and in 54 patients with Child-Pugh class B or C (group B/C) preoperatively. According to Murray's Law, PSE resulted in decreased portal venous flow and increased hepatic arterial flow, suggesting a hepatic arterial buffer response (HABR) induced by the procedure. Despite equivalent splenic infarction rates and similar posttreatment changes in hepatic hemodynamics, PSE significantly increased the Child-Pugh score of group A; however, the procedure significantly decreased the score of group B/C. Conclusion Considering original portal venous-hepatic arterial hemodynamics, PSE is expected to produce HABR-mediated hepatic functional improvements in cirrhosis patients with Child-Pugh class B/C.
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- 2021
16. Long-Term Follow-Up of Patients after Autologous Bone Marrow Cell Infusion for Decompensated Liver Cirrhosis
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Ja Kyung Kim, Soo-Jeong Kim, Yuri Kim, Yong Eun Chung, Young Nyun Park, Hyun Ok Kim, Jin Seok Kim, Mi-Suk Park, Isao Sakaida, Do Young Kim, Jung Il Lee, Sang Hoon Ahn, Kwan Sik Lee, and Kwang-Hyub Han M.D.
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Medicine - Abstract
Although several human clinical trials using various bone marrow-derived cell types for cirrhotic or decompensated patients have reported a short-term benefit, long-term follow-up data are limited. We analyzed the long-term clinical outcomes of autologous bone marrow cell infusion (ABMI) for decompensated liver cirrhosis (LC). Patients enrolled in a pilot single-armed ABMI study were followed up more than 5 years. Bone marrow-derived mononuclear cells (BM-MNCs) from decompensated LC were harvested and after processing were infused into a peripheral vein. The laboratory test results and long-term clinical course including liver transplantation (LT), development of cancer, cause of death, and survival after ABMI were analyzed. Nineteen patients were followed up for a median of 66 months after ABMI. Liver function, including serum levels of albumin and Child–Pugh (CP) score, was improved at the 1-year follow-up. Liver volume was significantly greater, cirrhosis was sustained, and collagen content was decreased at the 6-month follow-up. Five years after ABMI, five patients (26.3%) maintained CP class A without LT or death, and five patients (26.3%) had undergone elective LT. Hepatocellular carcinoma (HCC) occurred in five patients (26.3%), and lymphoma and colon cancer occurred in one patient each. Three patients (15.8%) were lost to follow-up at months 22, 31, and 33, respectively, but maintained CP class A until their last follow-up. Five patients expired due to infection. While improved liver function was maintained in some patients for more than 5 years after ABMI, other patients developed HCC. Further studies of long-term follow-up cohorts after cell therapy for LC are warranted.
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- 2017
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17. Response of severe acute pancreatitis with hypertriglyceridemia to low density lipoprotein apheresis: a case report and literature review
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Shigeyuki Suenaga, Syogo Amano, Isao Sakaida, Yuko Fujimoto, Hirofumi Harima, Miyuki Kaino, Takanori Tsuyama, and Seiji Kaino
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medicine.medical_specialty ,business.industry ,Internal medicine ,Hypertriglyceridemia ,medicine ,Acute pancreatitis ,Low density lipoprotein apheresis ,business ,medicine.disease ,Gastroenterology - Published
- 2021
18. Analysis of the safety of pretransplant corticosteroid therapy in patients with acute liver failure and late‐onset hepatic failure in Japan
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Takuro Hisanaga, Isao Hidaka, Isao Sakaida, Nobuaki Nakayama, Akio Ido, Naoya Kato, Yasuhiro Takikawa, Kazuaki Inoue, Masahito Shimizu, Takuya Genda, Shuji Terai, Hirohito Tsubouchi, Hajime Takikawa, Satoshi Mochida, and null Intractable Hepato‐Biliary Disease
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medicine.medical_specialty ,corticosteroid ,medicine.drug_class ,medicine.medical_treatment ,Late onset ,RC799-869 ,Liver transplantation ,03 medical and health sciences ,late‐onset hepatic failure ,0302 clinical medicine ,Internal medicine ,medicine ,In patient ,Fulminant hepatitis ,Hepatology ,liver transplantation ,business.industry ,Gastroenterology ,Liver failure ,Original Articles ,acute liver failure ,Diseases of the digestive system. Gastroenterology ,Corticosteroid therapy ,030220 oncology & carcinogenesis ,Corticosteroid ,Original Article ,030211 gastroenterology & hepatology ,Bilirubin levels ,business ,hormones, hormone substitutes, and hormone antagonists - Abstract
Background and Aim In Japan, corticosteroids have been commonly used as a part of multidisciplinary therapy for patients with acute liver failure and late‐onset hepatic failure. However, there is controversy regarding the development of infections and other complications. In this study, the influence of corticosteroids on patient outcomes after liver transplantation was investigated. Methods This study included 167 patients with acute liver failure and late‐onset hepatic failure who underwent liver transplantation between 2010 and 2015. The effects of pretransplant corticosteroid therapy on patient outcomes were evaluated using a database constructed by the subcommittee for fulminant hepatitis in the Intractable Hepato‐Biliary Diseases Study Group of Japan. Results The subacute type and the median total bilirubin levels were higher in those receiving corticosteroids than in those not receiving corticosteroids. Although infections tended to be higher in patients receiving corticosteroids, pretransplant corticosteroid administration did not affect the survival rates. The duration from corticosteroid initiation to liver transplantation was longer in patients who developed infections. The survival rates, however, did not differ between patients with and without infections. Conclusions Corticosteroids were administered to patients with poor prognoses. Otherwise, the overall outcome in those administered corticosteroids was not significantly different from that in those administered without corticosteroids. Although infectious complications tended to occur, they were generally controllable and nonfatal. Pretransplant corticosteroid therapy may be permissible, with regarding for infections and performed within the minimum duration., Corticosteroids are commonly used for acute liver failure in Japan. However, there is controversy regarding the development of complications. We analyzed the influence of corticosteroids on patient outcomes after liver transplantation. Although, infections tended to occur in patients receiving corticosteroids, pretransplant corticosteroid didn't affect the survival rates. The duration from corticosteroid initiation to liver transplantation was longer in patients with infections. Pretransplant corticosteroid may be a permissible treatment with caution for infections and within the minimum duration.
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- 2021
19. A Case of Raspberry-like Foveolar-type Gastric Adenocarcinoma Resected by Strip Biopsy
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Shingo Yoshitomi, Jun Nishikawa, Tomohiro Shirasawa, Satoko Matsumoto, Yoshinobu Hoshii, Hiroyuki Fujimura, Isao Sakaida, Kouichi Hamabe, Yuta Izumiya, Shunsuke Ito, Takeshi Okamoto, Atsushi Goto, Shinichi Hashimoto, and Yuko Yamaoka
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Raspberry like ,Foveolar cell ,Gastric adenocarcinoma ,Pathology ,medicine.medical_specialty ,business.industry ,Medicine ,General Medicine ,business ,Strip biopsy - Published
- 2021
20. Establishing Efficient Systems through Electronic Medical Records to Promote Intra-hospital Referrals of Hepatitis Virus Carriers to Hepatology Specialists: A Multicenter Questionnaire-based Survey of 1,281 Healthcare Professionals
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Koji Ogawa, Masaru Enomoto, Yasuteru Kondo, Tomomitsu Matono, Syuichi Sato, Mika Horino, Kiyoaki Ito, Atsushi Suetsugu, Masaaki Korenaga, Isao Sakaida, Isao Hidaka, and Jun Inoue
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Hepatitis B virus ,medicine.medical_specialty ,Referral ,business.industry ,Medical record ,Hepatitis C virus ,General Medicine ,030204 cardiovascular system & hematology ,Hepatology ,medicine.disease ,medicine.disease_cause ,03 medical and health sciences ,0302 clinical medicine ,Hepatocellular carcinoma ,Family medicine ,Internal medicine ,Health care ,Internal Medicine ,Medicine ,030211 gastroenterology & hepatology ,business ,Viral hepatitis - Abstract
Objective Persistent hepatitis B virus (HBV) and hepatitis C virus (HCV) infections are major causative factors of hepatic cirrhosis and hepatocellular carcinoma. However, the development of antiviral treatment has enabled their suppression. Therefore, the early detection and treatment of these infections are important. The objective of this study was to assess the level of awareness among healthcare professionals about hepatitis virus infection and electronic medical records alert system. Methods We surveyed healthcare professionals from 10 institutions with electronic medical records alert systems. All participants attended a lecture about the reactivation risk due to HBV infections, the most recent antiviral treatment for HCV infections, and the electronic medical records alert system. They participated in a questionnaire-based survey about their awareness of these infections, current status of intra-hospital referral, need for intra-hospital referrals before and after the lecture, and reasons for non-referral of patients to specialists. Results Responses were received from 1,281 healthcare professionals. Physicians and pharmacists had a high level of awareness about HBV and HCV. Among physicians, the level of awareness of those in the surgical field and other fields was significantly lower than that of the professionals in the internal medicine field. The awareness of the need to refer patients to hepatologists increased from 84.7-85.4% before to 93.0% after the lecture. The most frequent reasons for not referring patients previously were "I had no knowledge and/or interest" (28.1% of responses) and "All I did was explain the results orally" (24.2%). Conclusion More widespread education of healthcare personnel is important to increase the number of individuals receiving appropriate treatment from specialist physicians.
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- 2021
21. Seasonal variations in photoperiod affect hepatic metabolism of medaka (Oryzias latipes)
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Taro Takami, Haruko Shintani, Naoki Yamamoto, Nanami Sasai, Koichi Fujisawa, Isao Sakaida, and Toshihiko Matsumoto
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0301 basic medicine ,medicine.medical_specialty ,Oryzias ,Photoperiod ,Citric Acid Cycle ,General Biochemistry, Genetics and Molecular Biology ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,Metabolome ,Lipolysis ,Animals ,Metabolomics ,lcsh:QH301-705.5 ,Research Articles ,fatty liver ,medaka ,biology ,Chemistry ,Fatty liver ,Fatty Acids ,Lipid metabolism ,Metabolism ,biology.organism_classification ,medicine.disease ,Lipid Metabolism ,Citric acid cycle ,030104 developmental biology ,Endocrinology ,lcsh:Biology (General) ,Liver ,Seafood ,030220 oncology & carcinogenesis ,tricarboxylic acid cycle ,Seasons ,Steatosis ,Energy Metabolism ,Research Article - Abstract
Organisms living in temperate regions are sensitive to seasonal variations in the environment; they are known to accumulate energy as fat in their livers during the winter when days are shorter, temperatures are lower, and food is scarce. However, the effect of variations in photoperiod alone on hepatic lipid metabolism has not been well studied. Therefore, in this study, we analyzed lipid metabolism in the liver of medaka, Oryzias latipes, while varying the length of days at constant temperature. Larger amounts of fatty acids accumulated in the liver after 14 days under short‐day conditions than under long‐day conditions. Metabolome analysis showed no accumulation of long‐chain unsaturated fatty acids, but showed a significant accumulation of long‐chain saturated fatty acids. Short‐day conditions induced a reduction in the levels of succinate, fumarate, and malate in the tricarboxylic acid cycle, decreased expression of PPARα, and decreased accumulation of acylcarnitine, which suggested inhibition of lipolysis. In addition, transparent medaka fed on a high‐fat diet under short‐day conditions exhibited greater amounts of fat accumulation and developed fatty liver. The findings of our study will be useful for creating a medaka hepatic steatosis model for future studies of hepatic steatosis‐related diseases., In this study, we analyzed lipid metabolism in the liver of medaka, Oryzias latipes, while varying the length of days at constant temperature. Larger amounts of fatty acids accumulated in the liver after 14 days under short‐day conditions than under long‐day conditions. The findings of our study will be useful for creating a medaka hepatic steatosis model for future studies of hepatic steatosis‐related diseases.
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- 2021
22. Combination of CA19-9 and Blood Free-Circulating Methylated RUNX3 May Be Useful to Diagnose Stage I Pancreatic Cancer
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Seiji Kaino, Hiroto Matsui, Shigeyuki Suenaga, Tomomi Hoshida, Ikuei Fujii, Yutaka Suehiro, Taro Takami, Shingo Higaki, Hiroaki Nagano, Yuko Fujimoto, Takahiro Yamasaki, Chieko Suzuki, Toshihiko Matsumoto, Isao Sakaida, and Takanori Tsuyama
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Cancer Research ,Cord ,Pancreatic disease ,business.industry ,General Medicine ,medicine.disease ,Bisulfite ,Oncology ,Pancreatic cancer ,DNA methylation ,Cancer research ,medicine ,Biomarker (medicine) ,Digital polymerase chain reaction ,CA19-9 ,business - Abstract
Background: Although serum carbohydrate antigen 19-9 (CA19-9) is widely used as a useful biomarker of pancreatic cancer for monitoring the response to therapy, it is not recommended for screening of early pancreatic cancer because of its limited sensitivity for small tumors. Thus, it is critical to discover novel serum biomarkers to complement CA19-9 in order to improve sensitivity. Although methylated runt-related transcription factor 3 (RUNX3) is a biomarker of pancreatic cancer, its detection by conventional bisulfite-based methylation assays from a small serum sample amount is very difficult. Therefore, we developed a new methylation assay, the combined restriction digital PCR (CORD) assay, that enables counting of even one copy of a methylated gene in a small DNA sample amount without DNA bisulfite treatment. Objectives: We evaluated the sensitivity and specificity of serum DNA testing of methylated RUNX3 by the CORD assay in combination with and without CA19-9 for the detection of pancreatic cancer in 55 patients with pancreatic cancer, 12 patients with benign pancreatic disease, and 80 healthy individuals. Results: The CORD assay of methylated RUNX3 had a sensitivity of 50.9% (28/55) and specificity of 93.5% (86/92). Combination of the CORD assay of methylated RUNX3 and CA19-9 resulted in a sensitivity of 85.5% (47/55) and specificity of 93.5% (86/92) for all stages of pancreatic cancer and a sensitivity of 77.8% (7/9) for stage I pancreatic cancer. Conclusions: ombination of the CORD assay and CA19-9 may provide an alternative screening strategy for detecting early-stage pancreatic cancer.
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- 2021
23. Mesenchymal Stem Cells Induce a Fibrolytic Phenotype By Regulating mmu-miR-6769b-5p Expression in Macrophages
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Koichi Fujisawa, Isao Sakaida, Yutaka Suehiro, Naoki Yamamoto, Toshihiko Matsumoto, Taro Takami, Maiko Nishi, and Takahiro Yamasaki
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Lipopolysaccharides ,Male ,0301 basic medicine ,medicine.medical_treatment ,Down-Regulation ,Economic shortage ,Liver transplantation ,Biology ,Extracellular Vesicles ,03 medical and health sciences ,0302 clinical medicine ,Fibrosis ,medicine ,Animals ,Radical treatment ,Fibrin ,Macrophages ,ATF4 ,Mesenchymal stem cell ,Mesenchymal Stem Cells ,Cell Biology ,Hematology ,medicine.disease ,Decompensated cirrhosis ,Activating Transcription Factor 4 ,Phenotype ,Coculture Techniques ,Up-Regulation ,Mice, Inbred C57BL ,MicroRNAs ,030104 developmental biology ,Gene Expression Regulation ,Matrix Metalloproteinase 9 ,Cancer research ,Cytokines ,Inflammation Mediators ,030217 neurology & neurosurgery ,Developmental Biology - Abstract
Liver transplantation is the only radical treatment for decompensated cirrhosis, but its use is limited owing to a shortage of donors; hence, there is an urgent need for new treatments. Previously, we developed a liver-regeneration therapy using autologous bone marrow-derived mesenchymal stem cells (BMSCs), which is under clinical investigation. Cell-cell interactions between BMSCs and macrophages (Mφs) participate in the improvement of liver function and alleviation of liver fibrosis, although the associated mechanisms have not been elucidated. Therefore, in this study, we investigated phenotypic changes in Mφs caused by interactions with BMSCs, as well as the underlying mechanisms. Co-culturing lipopolysaccharide (LPS)-stimulated murine bone marrow-derived Mφs (BMDMs) with BMSCs substantially upregulated matrix metalloproteinase 9 (
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- 2020
24. The expanding role of fish models in understanding non-alcoholic fatty liver disease
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Yoichi Asaoka, Shuji Terai, Isao Sakaida, and Hiroshi Nishina
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Medicine ,Pathology ,RB1-214 - Abstract
Non-alcoholic fatty liver disease (NAFLD) is a condition in which excessive fat accumulates in the liver of an individual who has not consumed excessive alcohol. Non-alcoholic steatohepatitis (NASH), a severe form of NAFLD, can progress to hepatic cirrhosis and/or hepatocellular carcinoma (HCC). NAFLD is considered to be a hepatic manifestation of metabolic syndrome, and its incidence has risen worldwide in lockstep with the increased global prevalence of obesity. Over the last decade, rodent studies have yielded an impressive list of molecules associated with NAFLD and NASH pathogenesis. However, the identification of currently unknown metabolic factors using mammalian model organisms is inefficient and expensive compared with studies using fish models such as zebrafish (Danio rerio) and medaka (Oryzias latipes). Substantial advances in unraveling the molecular pathogenesis of NAFLD have recently been achieved through unbiased forward genetic screens using small fish models. Furthermore, these easily manipulated organisms have been used to great advantage to evaluate the therapeutic effectiveness of various chemical compounds for the treatment of NAFLD. In this Review, we summarize aspects of NAFLD (specifically focusing on NASH) pathogenesis that have been previously revealed by rodent models, and discuss how small fish are increasingly being used to uncover factors that contribute to normal hepatic lipid metabolism. We describe the various types of fish models in use for this purpose, including those generated by mutation, transgenesis, or dietary or chemical treatment, and contrast them with rodent models. The use of small fish in identifying novel potential therapeutic agents for the treatment of NAFLD and NASH is also addressed.
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- 2013
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25. Trans-portal hepatic infusion of cultured bone marrow-derived mesenchymal stem cells in a steatohepatitis murine model
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Isao Sakaida, Ryo Sasaki, Toshihiko Matsumoto, Tsuyoshi Ishikawa, Naoki Yamamoto, Taro Takami, and Koichi Fujisawa
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0301 basic medicine ,medicine.medical_specialty ,Cirrhosis ,macrophage polarization ,Clinical Biochemistry ,Serum albumin ,Medicine (miscellaneous) ,CCL4 ,Spleen ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Internal medicine ,medicine ,oxidative stress ,nonalcoholic steatohepatitis ,Sirius Red ,mesenchymal stem cell ,liver fibrosis ,030109 nutrition & dietetics ,Nutrition and Dietetics ,biology ,business.industry ,medicine.disease ,medicine.anatomical_structure ,Endocrinology ,chemistry ,Carbon tetrachloride ,biology.protein ,030211 gastroenterology & hepatology ,Original Article ,Bone marrow ,Steatohepatitis ,business - Abstract
The incidence of nonalcoholic steatohepatitis-related liver cirrhosis is increasing. We used a steatohepatitis murine model fed a choline-deficient, l-amino acid-defined (CDAA) diet with a single injection of carbon tetrachloride (CCl4) to evaluate the efficacy of trans-portal hepatic infusion of bone marrow-derived mesenchymal stem cells (BMSCs) for liver fibrosis, liver steatosis, and oxidative stress. Mice were fed a CDAA diet and injected with a single intraperitoneal dose of CCl4 (0.5 ml/kg) after 4 weeks of CDAA diet. After 12 weeks of CDAA diet, 1 × 106 luciferase-positive syngeneic BMSCs (Luc-BMSCs) were infused into the animal spleen. An in vivo imaging system was used to confirm Luc-BMSC accumulation in the liver via the portal vein, and at 4 weeks after infusion, we compared liver fibrosis, liver steatosis, and oxidative stress. After the BMSC-infusion, serum albumin and serum total bilirubin were significantly improved. Liver fibrosis assessed by Sirius red staining, α-smooth muscle actin protein, and collagen 1A1 mRNA expression was significantly suppressed. Furthermore, liver steatosis area was significantly lower, the 8-hydroxy-2'-deoxyguanosine-positive cells were significantly fewer, and superoxide dismutase 2 protein expression of the liver was significantly increased. In conclusion, our data confirmed the efficacy of trans-portal hepatic infusion of BMSCs in a steatohepatitis murine model.
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- 2020
26. Evaluation of a symptom checklist for the early detection of symptoms in patients with chronic liver disease
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Terumi Hamao, Takuya Iwamoto, Sumire Harano, Takashi Oono, Issei Saeki, Tsuyoshi Ishikawa, Isao Hidaka, Isao Sakaida, and Taro Takami
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medicine.medical_specialty ,Hepatology ,business.industry ,Internal medicine ,Medicine ,Early detection ,In patient ,business ,Chronic liver disease ,medicine.disease ,Checklist - Published
- 2020
27. Significant improvement in portal‐systemic liver failure symptoms and successful management of portal‐splenic venous hemodynamics by the combination of interventional radiology and pharmacotherapy
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Takuya Iwamoto, Kaori Hamamoto, Tatsuro Nishimura, Takashi Matsuda, Isao Sakaida, Ryo Sasaki, Taro Takami, and Tsuyoshi Ishikawa
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medicine.medical_specialty ,Hepatology ,medicine.diagnostic_test ,business.industry ,Portal venous pressure ,Hemodynamics ,Hyperammonemia ,Portal hypertensive gastropathy ,Interventional radiology ,Hepatitis C ,Splenic artery ,medicine.disease ,03 medical and health sciences ,0302 clinical medicine ,Infectious Diseases ,030220 oncology & carcinogenesis ,medicine.artery ,Internal medicine ,Ascites ,medicine ,Cardiology ,030211 gastroenterology & hepatology ,medicine.symptom ,business - Abstract
Aim To describe a case of hepatitis C virus-related decompensated cirrhosis with portal-systemic liver failure and refractory encephalopathy that was successfully managed with a combination of interventional radiology and pharmacotherapy to improve hepatic function including hyperammonemia and to control portal-splenic venous hemodynamics with hepatic venous pressure gradient (HVPG) monitoring. Case presentation A man in his late 50s presented with a Child-Pugh score of 13, Model for End-Stage Liver Disease-sodium (MELD-Na) score of 19, and blood ammonia level of 185 μg/dL. He underwent balloon-occluded retrograde transvenous obliteration (BRTO) followed by partial splenic embolization (PSE) and non-selective beta-blocker (NSBB) administration. BRTO induced drastic changes in the portal-splenic venous hemodynamics, resulting in dramatically improved hepatic function and reduced hyperammonemia. However, the procedure resulted in increased HVPG from 13.6 mmHg at baseline to 23.5 mmHg at 1-month post-BRTO, accompanied by ascites retention and portal hypertensive gastropathy (PHG) development. Thereafter, PSE was performed, followed by NSBB administration, to control the elevated portal venous pressure following BRTO. Postoperatively, the patient's ascites and PHG improved after splenic artery embolization, which eventually disappeared after the additional administration of NSBBs at 1 month later. The HVPG finally decreased to 16.9 mmHg, and Child-Pugh score, MELD-Na score, and blood ammonia level improved to 7, 11, and 22 μg/dL, respectively, after all therapies. Conclusion BRTO significantly improved the symptoms of portal-systemic liver failure with refractory encephalopathy. PSE and NSBB administration could contribute to additional amelioration of hepatic function and successful management of complications induced by portal hemodynamic changes following BRTO.
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- 2020
28. Invasion inhibition in pancreatic cancer using the oral iron chelating agent deferasirox
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Koichi Fujisawa, Hirofumi Harima, Toshihiko Matsumoto, Taro Takami, Shuhei Shinoda, Isao Sakaida, Takahiro Yamasaki, Naoki Yamamoto, Shogo Amano, and Seiji Kaino
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rac1 GTP-Binding Protein ,Cancer Research ,Cancer therapy ,Cell Survival ,Motility ,RAC1 ,CDC42 ,In Vitro Techniques ,Iron Chelating Agents ,lcsh:RC254-282 ,Rho family protein ,Invasion ,Cell Movement ,In vivo ,Cell Line, Tumor ,Pancreatic cancer ,Genetics ,medicine ,Humans ,Neoplasm Invasiveness ,cdc42 GTP-Binding Protein ,business.industry ,Deferasirox ,Microarray Analysis ,medicine.disease ,lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,In vitro ,Pancreatic Neoplasms ,Oncology ,Cancer cell ,Cancer research ,Iron chelation ,business ,Research Article ,medicine.drug - Abstract
Background Iron is required for cellular metabolism, and rapidly proliferating cancer cells require more of this essential nutrient. Therefore, iron regulation may well represent a new avenue for cancer therapy. We have reported, through in vitro and in vivo research involving pancreatic cancer cell lines, that the internal-use, next-generation iron chelator deferasirox (DFX) exhibits concentration-dependent tumour-suppressive effects, among other effects. After performing a microarray analysis on the tumour grafts used in that research, we found that DFX may be able to suppress the cellular movement pathways of pancreatic cancer cells. In this study, we conducted in vitro analyses to evaluate the effects of DFX on the invasive and migratory abilities of pancreatic cancer cells. Methods We used pancreatic cancer cell lines (BxPC-3, Panc-1, and HPAF II) to examine the efficacy of DFX in preventing invasion in vitro, evaluated using scratch assays and Boyden chamber assays. In an effort to understand the mechanism of action whereby DFX suppresses tumour invasion and migration, we performed G-LISA to examine the activation of Cdc42 and Rac1 which are known for their involvement in cellular movement pathways. Results In our scratch assays, we observed that DFX-treated cells had significantly reduced invasive ability compared with that of control cells. Similarly, in our Boyden chamber assays, we observed that DFX-treated cells had significantly reduced migratory ability. After analysis of the Rho family of proteins, we observed a significant reduction in the activation of Cdc42 and Rac1 in DFX-treated cells. Conclusions: DFX can suppress the motility of cancer cells by reducing Cdc42 and Rac1 activation. Pancreatic cancers often have metastatic lesions, which means that use of DFX will suppress not only tumour proliferation but also tumour invasion, and we expect that this will lead to improved prognoses.
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- 2020
29. Treatment of refractory oral lichen planus using direct antiviral agents in a patient with chronic hepatitis C: A case report
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Yumiko Nagao, Koji Harada, Katsuaki Mishima, Isao Hidaka, Isao Sakaida, and Daisuke Nakashima
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medicine.medical_specialty ,Otorhinolaryngology ,Chronic hepatitis ,Refractory ,business.industry ,Hepatitis C virus ,medicine ,Oral lichen planus ,medicine.disease ,business ,medicine.disease_cause ,DIRECT ACTING ANTIVIRALS ,Dermatology - Published
- 2020
30. Real-world effectiveness and safety of tolvaptan in liver cirrhosis patients with hepatic edema: results from a post-marketing surveillance study (START study)
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Mitsuru Okada, Takahiro Hirano, Shuji Terai, Masayuki Kurosaki, Isao Sakaida, and Yasuhiko Fukuta
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Liver Cirrhosis ,Male ,medicine.medical_specialty ,Cirrhosis ,Tolvaptan ,Gastroenterology ,Blood Urea Nitrogen ,03 medical and health sciences ,0302 clinical medicine ,Japan ,Internal medicine ,Edema ,Ascites ,Product Surveillance, Postmarketing ,medicine ,Humans ,Prospective Studies ,Blood urea nitrogen ,Hepatic encephalopathy ,Aged ,Aged, 80 and over ,Original Article—Liver, Pancreas, and Biliary Tract ,business.industry ,Liver Diseases ,Middle Aged ,Hepatology ,medicine.disease ,Fibrosis ,Treatment Outcome ,030220 oncology & carcinogenesis ,Female ,030211 gastroenterology & hepatology ,Hypernatremia ,medicine.symptom ,business ,Antidiuretic Hormone Receptor Antagonists ,medicine.drug - Abstract
BackgroundThis large-scale post-marketing surveillance study (START study) evaluated the effectiveness and safety of tolvaptan in Japanese liver cirrhosis patients with hepatic edema in real-world clinical settings. Here, we present the final analysis outcomes.MethodsA prospective, multicenter, non-interventional study involving patients who received tolvaptan for the treatment of liver cirrhosis with hepatic edema with an insufficient response to conventional diuretics. The observation period was up to 6 months. Effectiveness evaluation included changes in body weight and clinical symptoms. Safety analysis included evaluation of adverse drug reactions (ADRs).ResultsCase reports of 1111 patients were collected. Of these, 1109 were included in the safety analysis and 1098 in the effectiveness analysis. The mean age was 69.4 ± 11.5 years and 695 (62.7%) patients were male. After tolvaptan treatment, a decrease in body weight from baseline was − 2.6 ± 2.7 kg on day 7 and − 3.8 ± 4.1 kg on day 14. Moreover, clinical symptoms significantly improved over the 14-day treatment. Frequently reported ADRs were thirst (6.6%), hepatic encephalopathy (2.3%), dehydration (1.5%), and hypernatremia (1.2%). A serum sodium level of ≥ 150 mEq/L was reported in five patients (0.5%). Multivariate analyses showed that the baseline blood urea nitrogen (BUN) level (cut-off value: 22.4 mg/dL) was the predictive factor for tolvaptan treatment response.ConclusionsThe results suggest that tolvaptan was effective and well-tolerated in liver cirrhosis patients with hepatic edema. In the real-world clinical setting, tolvaptan provides a useful option for the treatment of hepatic edema.
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- 2020
31. Current Status of Rifaximin Treatment for Hepatic Encephalopathy at Our Hospital
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Takuya Iwamoto and Isao Sakaida
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medicine.medical_specialty ,chemistry.chemical_compound ,chemistry ,business.industry ,Internal medicine ,medicine ,General Medicine ,Current (fluid) ,business ,medicine.disease ,Gastroenterology ,Hepatic encephalopathy ,Rifaximin - Published
- 2020
32. Efficacy of Vonoprazan for Helicobacter pylori Eradication
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Jun Nishikawa, Shu Kiyotoki, and Isao Sakaida
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medicine.medical_specialty ,Vonoprazan ,macromolecular substances ,030204 cardiovascular system & hematology ,Gastroenterology ,03 medical and health sciences ,0302 clinical medicine ,Antibiotic resistance ,Clarithromycin ,Internal medicine ,Internal Medicine ,Gastric mucosa ,medicine ,Adverse effect ,biology ,business.industry ,Cancer ,General Medicine ,Amoxicillin ,Helicobacter pylori ,bacterial infections and mycoses ,medicine.disease ,biology.organism_classification ,medicine.anatomical_structure ,030211 gastroenterology & hepatology ,business ,medicine.drug - Abstract
Helicobacter pylori can infect the gastric mucosa and cause chronic inflammation, resulting in various diseases, including gastric cancer. Eradication of H. pylori in all infected subjects is recommended; however, the number of H. pylori strains with antibiotic resistance has increased, and the eradication rate has decreased. Vonoprazan, a potassium-competitive acid blocker, produces a stronger acid-inhibitory effect than proton pump inhibitors (PPIs). The H. pylori eradication rate with vonoprazan was found to be higher than that with PPIs. The H. pylori eradication rate with vonoprazan-based triple therapy (vonoprazan, amoxicillin, and clarithromycin) was approximately 90% and had an incidence of adverse events similar to that of PPIs. We review the current situation of H. pylori eradication in Japan, the first country in which vonoprazan was made available.
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- 2020
33. Novel Liquid Biopsy Test Based on a Sensitive Methylated SEPT9 Assay for Diagnosing Hepatocellular Carcinoma
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Yutaka Suehiro, Takuya Iwamoto, Masaki Maeda, Yurika Kotoh, Isao Hidaka, Shingo Higaki, Takahiro Yamasaki, Chieko Suzuki, Tsuyoshi Ishikawa, Hiroaki Nagano, Issei Saeki, Taro Takami, Toshihiko Matsumoto, Isao Sakaida, Tomomi Hoshida, Yukio Tokumitsu, Yoshitaro Shindo, and Ikuei Fujii
- Subjects
medicine.medical_specialty ,Hepatology ,business.industry ,Assay sensitivity ,medicine.disease ,Chronic liver disease ,Gastroenterology ,Hepatocellular carcinoma ,Internal medicine ,medicine ,lcsh:Diseases of the digestive system. Gastroenterology ,Digital polymerase chain reaction ,Multiplex ,lcsh:RC799-869 ,Stage (cooking) ,Liquid biopsy ,Liver cancer ,business - Abstract
Liquid biopsies are not used in practice for hepatocellular carcinoma (HCC). Epi proColon is the first commercial blood‐based test for colorectal cancer screening based on methylated DNA testing of the septin 9 gene (SEPT9). However, Epi proColon has some disadvantages, including the requirement of a large amount of blood and lack of quantitative performance. Therefore, we previously developed a novel liquid biopsy test that can quantitatively detect even a single copy of methylated SEPT9 in a small amount of DNA. In the current study, we evaluated the application potential of this assay for diagnosing HCC. Study subjects included 80 healthy volunteers, 45 patients with chronic liver disease (CLD) without HCC, and 136 patients with HCC (stage 0, 12; stage A, 50; stage B, 31; stage C, 41; and stage D, 2), according to the Barcelona Clinic Liver Cancer staging system. For the assay, DNA was treated with methylation‐sensitive restriction enzymes in two steps, followed by multiplex droplet digital polymerase chain reaction. The median copy number of methylated SEPT9 was 0.0, 2.0, and 6.4 in the healthy control, CLD, and HCC groups, respectively, with significant differences among the groups (HCC vs. healthy control, P
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- 2020
34. Complications after Radiofrequency Ablation for Hepatocellular Carcinoma: A Multicenter Study Involving 9,411 Japanese Patients
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Atsushi Hiraoka, Kazuhisa Yabushita, Haruhiko Kobashi, Takakazu Nagahara, Chikara Ogawa, Masaki Maeda, Kazuhiro Nouso, Hiroshi Aikata, Isao Sakaida, Mari Mandai, Issei Saeki, Masahiko Koda, Tomomitsu Matono, Hiroshi Shibata, Yasuyuki Araki, Koichi Takaguchi, Akemi Tsutsui, Shuichi Sato, Shinichiro Nakamura, Tomohiko Mannami, Takahito Yagi, Joji Tani, Akeri Mitsuda, Takahiro Yamasaki, Hiroyuki Takabatake, Takashi Moriya, Mikiya Kitamoto, Kazuya Kariyama, Shintaro Takaki, Tetsu Tomonari, and Kouji Joko
- Subjects
medicine.medical_specialty ,Local Ablation Therapy ,Radiofrequency ablation ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,law ,medicine ,Tumor location ,Minimally invasive procedures ,Original Paper ,Hepatology ,business.industry ,Mortality rate ,Complication ,Hepatocellular carcinoma ,Mortality ,medicine.disease ,Surgery ,surgical procedures, operative ,Oncology ,Multicenter study ,030220 oncology & carcinogenesis ,030211 gastroenterology & hepatology ,business ,therapeutics - Abstract
Introduction: Radiofrequency ablation (RFA) for hepatocellular carcinoma (HCC) is considered a safe and minimally invasive procedure. We previously reported that the mortality and complication rates for RFA were 0.038% (5/13,283 patients) and 3.54% (579 complications/16,346 procedures), respectively, from 1999 to 2010 (previous period). In this study, we investigated the clinical criteria for RFA and the mortality and complication rates from 2011 to 2015 (recent period). Methods: Data were collected from 25 centers by using a questionnaire developed by the Chugoku-Shikoku Society for Local Ablation Therapy of HCC. The criteria for RFA, RFA modification, use of image-guidance modalities, mortality, and complications during the previous and recent periods were compared. Results: We evaluated 11,298 procedures for 9,411 patients, including those that involved new devices (bipolar RFA and internally adjustable electrode system). The criterion of hepatic function for RFA increased from a Child-Pugh score ≤8 during the previous period to ≤9 during the recent period. The criteria regarding the tumor location and other risk factors have been expanded recently because of the increased use of several modifications of the RFA procedure and image-guidance modalities. The mortality rate was 0.064% (6/9,411 patients), and the complication rate was 2.92% (330 complications/11,298 procedures). There was no difference in mortality rates between the 2 periods (p = 0.38), but the complication rates was significantly lower during the recent period (p = 0.038). Discussion and Conclusions: Our findings confirmed that RFA, including the use of new devices, is a low-risk procedure for HCC, despite the expansion of the criteria for RFA during the recent period.
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- 2020
35. Bone marrow-derived humoral factors suppress oxidative phosphorylation, upregulate TSG-6, and improve therapeutic effects on liver injury of mesenchymal stem cells
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Takashi Miyaji, Isao Sakaida, Koichi Fujisawa, Taro Takami, Toshihiko Matsumoto, and Naoki Yamamoto
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0301 basic medicine ,Liver injury ,030109 nutrition & dietetics ,Nutrition and Dietetics ,biology ,business.industry ,Clinical Biochemistry ,Mesenchymal stem cell ,Medicine (miscellaneous) ,medicine.disease ,Regenerative medicine ,03 medical and health sciences ,0302 clinical medicine ,medicine.anatomical_structure ,Downregulation and upregulation ,microRNA ,Sirtuin ,Cancer research ,medicine ,biology.protein ,Original Article ,030211 gastroenterology & hepatology ,Bone marrow ,business ,Whole Bone Marrow - Abstract
Mesenchymal stem cells, which have the potential to be used in regenerative medicine, require improvements in quality for patient use. To maintain stemness of cultured bone marrow-derived mesenchymal stem cells, we focused on the bone marrow microenvironment, generated a conditioned medium of whole bone marrow cells (BMC-CM), and assessed its effects on bone marrow-derived mesenchymal stem cells. BMC-CM suppressed morphological deterioration and proliferative decline in cultured bone marrow-derived mesenchymal stem cells, suppressed mitochondrial oxidative phosphorylation activity, a stemness indicator, and upregulated suppressors of oxidative phosphorylation such as hypoxia-inducible factor-1 alpha, Sirtuin 3, 4, and 5. Furthermore, BMC-CM upregulated TNF-stimulated gene 6 and ameliorated the therapeutic effects of cells on liver injury in carbon tetrachloride-administered rats. Since the elimination of 20-220-nm particles attenuated the effects of BMC-CM, we further analyzed exosomal microRNAs produced by whole bone marrow cells. Among the 49 microRNAs observed to be upregulated during the preparation of BMC-CM, several were identified that were associated with suppression of oxidative phosphorylation, upregulation of TNF-stimulated gene 6, and the pathogenesis of liver diseases. Thus, bone marrow-derived humoral factors including exosomal microRNAs may help to improve the therapeutic quality of bone marrow-derived mesenchymal stem cells for liver regenerative therapy.
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- 2020
36. Correlation between asymptomatic gastroesophageal excessive transmural injury after pulmonary vein isolation and a bonus freeze protocol using the second-generation 28-mm cryoballoon for paroxysmal atrial fibrillation
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Takahiro Mito, Jun Nishikawa, Masafumi Yano, Isao Sakaida, Takeshi Okamoto, Akihiko Shimizu, Yasuhiro Yoshiga, Makoto Ono, Takeshi Ueyama, Atsushi Goto, Shigeki Kobayashi, Takuya Omuro, Masakazu Fukuda, and Hironori Ishiguchi
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Male ,medicine.medical_specialty ,Time Factors ,medicine.medical_treatment ,Catheter ablation ,030204 cardiovascular system & hematology ,Cryosurgery ,Asymptomatic ,Pulmonary vein ,03 medical and health sciences ,Postoperative Complications ,0302 clinical medicine ,Clinical Protocols ,Internal medicine ,Atrial Fibrillation ,medicine ,Humans ,Sinus rhythm ,030212 general & internal medicine ,Aged ,business.industry ,Atrial fibrillation ,Odds ratio ,Middle Aged ,Nerve injury ,medicine.disease ,Confidence interval ,Treatment Outcome ,Pulmonary Veins ,Catheter Ablation ,Cardiology ,Female ,Esophagogastric Junction ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business - Abstract
Background Second-generation cryoballoon (2G-CB) ablation is highly effective for achieving pulmonary vein isolation (PVI) with a promising clinical outcome. However, the ideal freezing strategy for preventing gastroesophageal excessive transmural injury (ETI) remains under debate. This study aimed to clarify the correlation between gastroesophageal ETI and a bonus-freeze protocol after PVI using 2G-CBs. Method This study included 100 patients who underwent PVI using 2G-CB followed by an endoscopic examination. The freeze-cycle duration was set at 180 s. In the first 33 patients a 120 s bonus-freeze was applied after successful PVI (bonus group), while in the following 67 the bonus freeze was omitted (non-bonus group). Early freezing interruption was performed when the esophageal temperature reached 25 °C. Gastroesophageal ETI was defined as any injury that resulted from the PVI, including esophageal damage or periesophageal nerve injury. Results Gastroesophageal ETIs were observed in 9 (27.3%) and 6 (9.0%) patients and were all asymptomatic, esophageal damage in 3 and 0, and periesophageal nerve injury in the remaining 6 and 6 in the bonus group and non-bonus group, respectively (p = 0.033). In the multivariate analysis, the bonus freeze protocol (odds ratio 3.527; 95% confidence interval 1.110–11.208; p = 0.033) was the sole independent predictor of gastroesophageal ETI. During a one-year follow-up 26 of 33 bonus group patients (78.8%) and 52 of 67 (77.6%) non-bonus group patients remained in stable sinus rhythm without any differences between the groups. Conclusions In the patients with a bonus-freeze protocol using the 2G-CB, gastroesophageal ETIs were detected more often than in those with the non-bonus freeze protocol. In contrast, freedom from atrial fibrillation after the 2G-CB based PVI was comparable when applying either a bonus or non-bonus freeze protocol.
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- 2019
37. Novel Therapeutic Strategy Using Interventional Radiology (IVR) for Hepatitis C Virus (HCV)-Related Decompensated Liver Cirrhosis: A Case Report
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Taro Takami, Takuya Iwamoto, Issei Saeki, Tsuyoshi Ishikawa, Isao Sakaida, and Isao Hidaka
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Liver Cirrhosis ,Male ,medicine.medical_specialty ,Cirrhosis ,Hepatitis C virus ,medicine.medical_treatment ,030204 cardiovascular system & hematology ,Radiography, Interventional ,medicine.disease_cause ,Gastroenterology ,Hypersplenism ,03 medical and health sciences ,Liver disease ,0302 clinical medicine ,Internal medicine ,medicine ,Humans ,Embolization ,Hepatic encephalopathy ,Aged ,Cytopenia ,medicine.diagnostic_test ,business.industry ,Hyperammonemia ,Interventional radiology ,Articles ,General Medicine ,Hepatitis C Antibodies ,medicine.disease ,Hepatitis C ,Hepatic Encephalopathy ,030220 oncology & carcinogenesis ,Splenomegaly ,business - Abstract
Patient: Male, 72 Final Diagnosis: Decompensated liver cirrhosis Symptoms: Disturbance of consciousness Medication: — Clinical Procedure: PSE • BRTO • HCV treatment Specialty: Radiology Objective: Unusual clinical course Background: The appearance of direct acting antivirals (DAAs) has produced a major paradigm shift in hepatitis C virus (HCV) infection treatment, and virus elimination has become possible in most patients. Improvement of the model for end-stage liver disease (MELD) score by elimination of HCV has been reported, but for decompensated liver cirrhosis, it is also important to overcome various complications before antiviral treatment. Case Report: A 72-year-old male, who had been treated for HCV-related liver cirrhosis was referred to our hospital for treatment of refractory hepatic encephalopathy. At that time, his Child-Pugh score was 10 and class was C. On contrast-enhanced computed tomography (CT), a splenorenal shunt, splenomegaly, and splenic artery aneurysm were noted. The disease was also complicated by cytopenia associated with hypersplenism, and embolization of the splenic artery aneurysm and partial splenic embolization (PSE) were concomitantly performed. One month after the PSE, balloon occluded retrograde transvenous obliteration (BRTO) for refractory hepatic encephalopathy was performed. Hepatic functional reserve improved compared with that at the first examination, and SOF/LDV therapy was initiated. Fortunately, no adverse effect occurred during treatment, and sustained virologic response (SVR) was achieved. Hepatic functional reserve further improved thereafter. At the time of this report, a Child-Pugh A status was being maintained without administration of a branched chain amino acid preparation, drugs for hyperammonemia, or diuretics. Conclusions: We encountered a patient with decompensated liver cirrhosis accompanied by complications of hypersplenism, hepatic encephalopathy, and splenic artery aneurysm. These complications were overcome by treatment with PSE and BRTO, which led to DAAs treatment and a marked improvement of hepatic function.
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- 2019
38. Estimation of salt intake from spot urine may assist the risk assessment of gastric cancer
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Koichi Hamabe, Shunsuke Ito, Hideo Yanai, Tomohiro Shirasawa, Jun Nishikawa, Takeshi Okamoto, Shinichi Hashimoto, Eizaburou Hideura, Isao Sakaida, and Atsushi Goto
- Subjects
0301 basic medicine ,medicine.medical_specialty ,Clinical Biochemistry ,Medicine (miscellaneous) ,Gastroenterology ,Urine sodium ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Internal medicine ,urine sodium ,Medicine ,Salt intake ,Risk factor ,Creatinine ,030109 nutrition & dietetics ,Nutrition and Dietetics ,medicine.diagnostic_test ,biology ,Helicobacter pylori ,business.industry ,Esophagogastroduodenoscopy ,gastric cancer ,digestive, oral, and skin physiology ,Cancer ,medicine.disease ,biology.organism_classification ,spot urine ,chemistry ,030211 gastroenterology & hepatology ,Original Article ,business ,Risk assessment ,estimated salt intake - Abstract
Daily salt intake can be estimated by measuring sodium and creatinine concentrations in spot urine. Excessive salt intake is risk factor for gastric cancer. We examined the correlation between estimated salt intake from spot urine and risk of gastric cancer. This study included gastric cancer patients who underwent treatment at our hospital and patients in whom esophagogastroduodenoscopy was performed but gastric cancer was not observed. The history of H. pylori infection was known in these patients. Spot urine was collected, and daily salt intake was estimated from urine sodium and urine creatinine. Mean estimated salt intake was significantly higher in 120 gastric cancer patients (9.18 g/day) than in 80 non-gastric cancer patients (8.22 g/day). Multivariate analysis revealed estimated salt intake and H. pylori infection to be independent risk factors for gastric cancer. Among H. pylori-infected patients, salt intake was significantly higher in gastric cancer patients (9.25 g/day) than in non-gastric cancer patients (8.01 g/day). In conclusion, salt intake estimated from spot urine was high in patients with gastric cancer, especially in H. pylori infected patients. Spot urine is a simple examination and it may be applied as a new risk assessment of gastric cancer.
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- 2019
39. Underwater cold forceps polypectomy for an adenoma within a cecal diverticulum
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Jun Nishikawa, Isao Sakaida, and Sho Sasaki
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medicine.medical_specialty ,Adenoma ,business.industry ,medicine.medical_treatment ,Forceps ,Gastroenterology ,Medicine (miscellaneous) ,medicine.disease ,Polypectomy ,Surgery ,medicine ,Cecal Diverticulum ,Radiology, Nuclear Medicine and imaging ,business - Published
- 2022
40. Establishment of an Adult Medaka Fatty Liver Model by Administration of a Gubra-Amylin-Nonalcoholic Steatohepatitis Diet Containing High Levels of Palmitic Acid and Fructose
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Naoki Yamamoto, Keisuke Kondo, Koichi Fujisawa, Taro Takami, Isao Sakaida, Toshihiko Matsumoto, Yuto Nishimura, Shoki Okubo, and Yusaku Yamada
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Nonalcoholic steatohepatitis ,Male ,Oryzias ,Palmitic Acid ,Amylin ,Palmitic acid ,chemistry.chemical_compound ,Liver disease ,Fenofibrate ,Non-alcoholic Fatty Liver Disease ,Biology (General) ,Spectroscopy ,hepatic steatosis ,Fatty liver ,General Medicine ,Organ Size ,Computer Science Applications ,Islet Amyloid Polypeptide ,Chemistry ,Liver ,Female ,medicine.drug ,medicine.medical_specialty ,QH301-705.5 ,Fructose ,Diet, High-Fat ,Catalysis ,Article ,Inorganic Chemistry ,Liver steatosis ,Internal medicine ,Proliferating Cell Nuclear Antigen ,medicine ,Animals ,PPAR alpha ,Physical and Theoretical Chemistry ,QD1-999 ,Molecular Biology ,medaka ,business.industry ,Organic Chemistry ,Body Weight ,medicine.disease ,Disease Models, Animal ,Endocrinology ,chemistry ,Gene Expression Regulation ,business ,ballooning - Abstract
Among lifestyle-related diseases, fatty liver is the most common liver disease. To date, mammalian models have been used to develop methods for inhibiting fatty liver progression, however, new, more efficient models are expected. This study investigated the creation of a new model to produce fatty liver more efficiently than the high-fat diet medaka model that has been used to date. We compared the GAN (Gubra-Amylin nonalcoholic steatohepatitis) diet, which has been used in recent years to induce fatty liver in mice, and the high-fat diet (HFD). Following administration of the diets for three months, enlarged livers and pronounced fat accumulation was noted. The GAN group had large fat vacuoles and lesions, including ballooning, compared to the HFD group. The GAN group had a higher incidence of lesions. When fenofibrate was administered to the fatty liver model created via GAN administration and liver steatosis was assessed, a reduction in liver fat deposition was observed, and this model was shown to be useful in drug evaluations involving fatty liver. The medaka fatty liver model administered with GAN will be useful in future fatty liver research.
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- 2021
41. Correction: Evidence for a Role of the Transcriptional Regulator Maid in Tumorigenesis and Aging.
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Koichi Fujisawa, Shuji Terai, Toshihiko Matsumoto, Taro Takami, Naoki Yamamoto, Hiroshi Nishina, Makoto Furutani-Seiki, and Isao Sakaida
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Medicine ,Science - Published
- 2015
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42. A new therapeutic assessment score for advanced hepatocellular carcinoma patients receiving hepatic arterial infusion chemotherapy.
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Issei Saeki, Takahiro Yamasaki, Norikazu Tanabe, Takuya Iwamoto, Toshihiko Matsumoto, Yohei Urata, Isao Hidaka, Tsuyoshi Ishikawa, Taro Takami, Naoki Yamamoto, Koichi Uchida, Shuji Terai, and Isao Sakaida
- Subjects
Medicine ,Science - Abstract
Hepatic arterial infusion chemotherapy (HAIC) is an option for treating advanced hepatocellular carcinoma (HCC). Because of the poor prognosis in HAIC non-responders, it is important to identify patients who may benefit from continuous HAIC treatment; however, there are currently no therapeutic assessment scores for this identification. Therefore, we aimed to establish a new therapeutic assessment score for such patients.We retrospectively analyzed 90 advanced HCC patients with elevated baseline alpha-fetoprotein (AFP) and/or des-gamma-carboxy prothrombin (DCP) levels and analyzed various parameters for their possible use as predictors of response and survival. AFP and DCP responses were assessed after half a course of HAIC (2 weeks); a positive-response was defined as a reduction of ≥ 20% from baseline.Multivariate analysis identified DCP response (odds ratio 16.03, p < 0.001) as an independent predictor of treatment response. In multivariate analysis, Child-Pugh class A (hazard ratio [HR] 1.99, p = 0.018), AFP response (HR 2.17, p = 0.007), and DCP response (HR 1.90, p = 0.030) were independent prognostic predictors. We developed an Assessment for Continuous Treatment with HAIC (ACTH) score, including the above 3 factors, which ranged from 0 to 3. Patients stratified into two groups according to this score showed significantly different prognoses (≤ 1 vs. ≥ 2 points: median survival time, 15.1 vs. 8.7 months; p = 0.003).The ACTH score may be useful in the therapeutic assessment of HCC patients receiving HAIC.
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- 2015
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43. Evidence for a Role of the Transcriptional Regulator Maid in Tumorigenesis and Aging.
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Koichi Fujisawa, Shuji Terai, Toshihiko Matsumoto, Taro Takami, Naoki Yamamoto, Hiroshi Nishina, Makoto Furutani-Seiki, and Isao Sakaida
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Medicine ,Science - Abstract
Maid is a helix-loop-helix protein that is involved in cell proliferation. In order to further elucidate its physiological functions, we studied Maid activity in two small fish model systems. We found that Maid expression was greatest in zebrafish liver and that it increased following partial hepatectomy. Maid levels were also high in hepatic preneoplastic foci induced by treatment of zebrafish with diethylnitrosamine (DEN), but low in hepatocellular carcinomas (HCC), mixed tumors, and cholangiocarcinomas developing in these animals. In DEN-treated transgenic medaka overexpressing Maid, hepatic BrdU uptake and proliferation were reduced. After successive breedings, Maid transgenic medaka exhibited decreased movement and a higher incidence of abnormal spine curvature, possibly due to the senescence of spinal cord cells. Taken together, our results suggest that Maid levels can influence the progression of liver cancer. In conclusion, we found that Maid is important regulator of hepatocarconogenesis and aging.
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- 2015
- Full Text
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44. Nationwide survey for patients with acute-on-chronic liver failure occurring between 2017 and 2019 and diagnosed according to proposed Japanese criteria
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Mureo Kasahara, Masanori Abe, Isao Sakaida, Naoya Kato, Takuya Genda, Hajime Takikawa, Nobuaki Nakayama, Yoshihito Uchida, Tomoaki Tomiya, Hayato Uemura, Yukinori Imai, Masahito Shimizu, Hiromasa Ohira, Ayano Inui, Hitoshi Yoshiji, Kazuaki Chayama, Yasuhiro Takikawa, Ryuzo Abe, Shuji Terai, Satoshi Mochida, Kazuaki Inoue, Akio Ido, Kiyoshi Hasegawa, and Atsushi Tanaka
- Subjects
Prothrombin time ,Liver Cirrhosis ,medicine.medical_specialty ,Cirrhosis ,medicine.diagnostic_test ,business.industry ,medicine.medical_treatment ,Gastroenterology ,Alcoholic hepatitis ,Acute-On-Chronic Liver Failure ,Odds ratio ,Hepatology ,Liver transplantation ,medicine.disease ,Prognosis ,Japan ,Internal medicine ,medicine ,Etiology ,Odds Ratio ,Humans ,business ,Child ,Survival rate - Abstract
The significance of the 2018 Japanese diagnostic criteria for acute-on-chronic liver failure (ACLF) has not yet been evaluated. A nationwide survey was performed for patients with ACLF occurring between 2017 and 2019. Cirrhotic patients with a Child–Pugh score of 5–9 were diagnosed as having ACLF when liver failure (serum bilirubin level of ≥ 5.0 mg/dL and a prothrombin time international normalization rate [INR] of ≥ 1.5) occurred within 28 days after an acute insult. Patients who fulfilled either criterion (total serum bilirubin or INR) and/or those with indeterminate Child–Pugh scores at baseline were also enrolled. Among the 501 enrolled patients, 183 patients (37%) were diagnosed as having ACLF. The etiologies of the cirrhosis and acute insults were alcohol intake/abuse in 114 (62%) and 75 (41%) patients, respectively. Sixty-eight patients (37%) were also diagnosed as having severe alcoholic hepatitis. The survival rate without liver transplantation was 48% among the ACLF patients and 71% in the remaining patients (P
- Published
- 2021
45. Skeletal Muscle Volume Is an Independent Predictor of Survival after Sorafenib Treatment Failure for Hepatocellular Carcinoma
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Kazuaki Chayama, Yurika Yamauchi, Sadahisa Ogasawara, Tomokazu Kawaoka, Kazufumi Kobayashi, Reo Kawano, Naoya Kato, Tetsuhiro Chiba, Taro Takami, Issei Saeki, Takahiro Yamasaki, Shinsuke Uchikawa, Akira Hiramatsu, Takayuki Kondo, Hiroshi Aikata, and Isao Sakaida
- Subjects
Sorafenib ,Cancer Research ,medicine.medical_specialty ,education ,Sorafenib treatment ,Muscle volume ,muscle depletion ,Independent predictor ,Gastroenterology ,Article ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,Overall survival ,neoplasms ,health care economics and organizations ,RC254-282 ,business.industry ,Skeletal muscle ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,hepatocellular carcinoma ,medicine.disease ,digestive system diseases ,medicine.anatomical_structure ,Oncology ,030220 oncology & carcinogenesis ,Hepatocellular carcinoma ,030211 gastroenterology & hepatology ,sorafenib ,business ,post-progression survival ,Median survival ,medicine.drug - Abstract
Few studies exist on the relationship between post-progression survival (PPS) and skeletal muscle volume in hepatocellular carcinoma (HCC) patients receiving sorafenib. This study aimed to analyze the effects of muscle volume on clinical outcomes. We retrospectively enrolled 356 HCC patients. Various clinical parameters, including skeletal muscle index, were analyzed as predictors of overall survival (OS), progression-free survival (PFS), and PPS. Patients with high muscle volume showed longer survival or PPS than those with low muscle volume (median survival time: 12.8 vs. 9.5 months, p = 0.005, median PPS: 8.2 vs. 6.3 months, p = 0.015), however, no differences in PFS were found. Multivariate analysis indicated that muscle volume was an independent predictor of PPS and OS. Skeletal muscle volume was a PPS predictor in HCC patients receiving sorafenib. Therefore, survival can be prolonged by the upregulation of skeletal muscle volume, especially in HCC patients with skeletal muscle depletion.
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- 2021
46. Current Status of Liver Regenerative Medicine
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Toshihiko Matsumoto, Isao Sakaida, and Taro Takami
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medicine.medical_specialty ,business.industry ,medicine ,General Medicine ,Current (fluid) ,Intensive care medicine ,business ,Regenerative medicine - Published
- 2019
47. Evaluation of the Effects of Cultured Bone Marrow Mesenchymal Stem Cell Infusion on Hepatocarcinogenesis in Hepatocarcinogenic Mice With Liver Cirrhosis
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Isao Hidaka, Masaki Maeda, K. Matsuura, Isao Sakaida, Toshihiko Matsumoto, Issei Saeki, Koichi Fujisawa, Taro Takami, Naoki Yamamoto, and Takuro Hisanaga
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Liver Cirrhosis ,Male ,Pathology ,medicine.medical_specialty ,Cirrhosis ,Carcinogenesis ,medicine.medical_treatment ,Liver transplantation ,Mesenchymal Stem Cell Transplantation ,Mice ,chemistry.chemical_compound ,Liver Neoplasms, Experimental ,Fibrosis ,medicine ,Animals ,Cells, Cultured ,Bone Marrow Transplantation ,Liver injury ,Transplantation ,business.industry ,Mesenchymal stem cell ,Mesenchymal Stem Cells ,medicine.disease ,Mice, Inbred C57BL ,medicine.anatomical_structure ,chemistry ,Carbon tetrachloride ,Experimental pathology ,Surgery ,Bone marrow ,business - Abstract
Objectives Liver transplantation remains the only curative therapy for decompensated liver cirrhosis. However, it has several limitations, and not all patients can receive liver transplants. Therefore, liver regenerative therapy without liver transplantation is considered necessary. In this study, we attempted minimally invasive liver regenerative therapy by peripheral vein infusion of bone marrow-derived mesenchymal stem cells (BMSCs) cultured from a small amount of autologous bone marrow fluid and evaluated the effects of BMSCs on hepatocarcinogenesis in a mouse model. Methods C57BL/6 male mice were injected intraperitoneally with N-nitrosodiethylamine once at 2 weeks of age, followed by carbon tetrachloride twice a week from 6 weeks of age onwards, to create a mouse model of highly oncogenic liver cirrhosis. From 10 weeks of age, mouse isogenic green fluorescent protein–positive BMSCs (1.0 × 106/body weight) were infused once every 2 weeks, for a total of 5 times, and the effects of frequent BMSC infusion on hepatocarcinogenesis were evaluated. Results In the histologic evaluation, no significant differences were observed between the controls and BMSC-administered mice in terms of incidence rate, number, or average size of foci and tumors. However, significant suppression of fibrosis and liver injury was confirmed in the group that received BMSC infusions. Discussion Considering that BMSC infusion did not promote carcinogenesis, even in the state of highly oncogenic liver cirrhosis, autologous BMSC infusion might be a safe and effective therapy for human decompensated liver cirrhosis.
- Published
- 2019
48. NUPR1 acts as a pro-survival factor in human bone marrow-derived mesenchymal stem cells and is induced by the hypoxia mimetic reagent deferoxamine
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Toshihiko Matsumoto, Kazuhito Matsunaga, Naoki Yamamoto, G. R. Burganova, Isao Sakaida, Nanami Sasai, Koichi Fujisawa, and Taro Takami
- Subjects
0301 basic medicine ,autophagy ,Clinical Biochemistry ,Medicine (miscellaneous) ,Regenerative medicine ,Transcriptome ,03 medical and health sciences ,0302 clinical medicine ,medicine ,mesenchymal stem cells ,Gene knockdown ,iron chelator ,030109 nutrition & dietetics ,Nutrition and Dietetics ,hypoxia ,Cell growth ,Chemistry ,Autophagy ,Mesenchymal stem cell ,Cell biology ,Deferoxamine ,Original Article ,030211 gastroenterology & hepatology ,Stem cell ,transcriptome ,medicine.drug - Abstract
Differences in the culturing conditions of mesenchymal stem cells used in regenerative medicine may affect their differentiation ability, genome instability, and therapeutic effects. In particular, bone marrow-derived mesenchymal stem cells cultured under hypoxia are known to proliferate while maintaining an undifferentiated state and the use of deferoxamine, a hypoxia mimetic reagent, has proven to be a suitable strategy to maintain the cells under hypoxic metabolic state. Here, the deferoxamine effects were investigated in mesenchymal stem cells to gain insights into the mechanisms regulating stem cell survival. A 12-h deferoxamine treatment reduced proliferation, oxygen consumption, mitochondrial activity, and ATP production. Microarray analysis revealed that deferoxamine enhanced the transcription of genes involved in glycolysis and the HIF1α pathway. Among the earliest changes, transcriptional variations were observed in HIF1α, NUPR1, and EGLN, in line with previous reports showing that short deferoxamine treatments induce substantial changes in mesenchymal stem cells glycolysis pathway. NUPR1, which is induced by stress and involved in autophagy-mediated survival, was upregulated by deferoxamine in a concentration-dependent manner. Consistently, NUPR1 knockdown was found to reduce cell proliferation and increase the proapoptotic effect of staurosporine, suggesting that deferoxamine-induced NUPR1 promotes mesenchymal stem cell survival and cytoprotective autophagy. Our findings may substantially contribute to improve the effectiveness of mesenchymal stem cell-based regenerative medicine.
- Published
- 2019
49. New susceptibility and resistance HLA-DP alleles to HBV-related diseases identified by a trans-ethnic association study in Asia.
- Author
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Nao Nishida, Hiromi Sawai, Koichi Kashiwase, Mutsuhiko Minami, Masaya Sugiyama, Wai-Kay Seto, Man-Fung Yuen, Nawarat Posuwan, Yong Poovorawan, Sang Hoon Ahn, Kwang-Hyub Han, Kentaro Matsuura, Yasuhito Tanaka, Masayuki Kurosaki, Yasuhiro Asahina, Namiki Izumi, Jong-Hon Kang, Shuhei Hige, Tatsuya Ide, Kazuhide Yamamoto, Isao Sakaida, Yoshikazu Murawaki, Yoshito Itoh, Akihiro Tamori, Etsuro Orito, Yoichi Hiasa, Masao Honda, Shuichi Kaneko, Eiji Mita, Kazuyuki Suzuki, Keisuke Hino, Eiji Tanaka, Satoshi Mochida, Masaaki Watanabe, Yuichiro Eguchi, Naohiko Masaki, Kazumoto Murata, Masaaki Korenaga, Yoriko Mawatari, Jun Ohashi, Minae Kawashima, Katsushi Tokunaga, and Masashi Mizokami
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Medicine ,Science - Abstract
Previous studies have revealed the association between SNPs located on human leukocyte antigen (HLA) class II genes, including HLA-DP and HLA-DQ, and chronic hepatitis B virus (HBV) infection, mainly in Asian populations. HLA-DP alleles or haplotypes associated with chronic HBV infection or disease progression have not been fully identified in Asian populations. We performed trans-ethnic association analyses of HLA-DPA1, HLA-DPB1 alleles and haplotypes with hepatitis B virus infection and disease progression among Asian populations comprising Japanese, Korean, Hong Kong, and Thai subjects. To assess the association between HLA-DP and chronic HBV infection and disease progression, we conducted high-resolution (4-digit) HLA-DPA1 and HLA-DPB1 genotyping in a total of 3,167 samples, including HBV patients, HBV-resolved individuals and healthy controls. Trans-ethnic association analyses among Asian populations identified a new risk allele HLA-DPB1*09 ∶ 01 (P = 1.36 × 10(-6); OR= 1.97; 95% CI, 1.50-2.59) and a new protective allele DPB1*02 ∶ 01 (P = 5.22 × 10(-6); OR = 0.68; 95% CI, 0.58-0.81) to chronic HBV infection, in addition to the previously reported alleles. Moreover, DPB1*02 ∶ 01 was also associated with a decreased risk of disease progression in chronic HBV patients among Asian populations (P = 1.55 × 10(-7); OR = 0.50; 95% CI, 0.39-0.65). Trans-ethnic association analyses identified Asian-specific associations of HLA-DP alleles and haplotypes with HBV infection or disease progression. The present findings will serve as a base for future functional studies of HLA-DP molecules in order to understand the pathogenesis of HBV infection and the development of hepatocellular carcinoma.
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- 2014
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50. A nationwide survey on non-B, non-C hepatocellular carcinoma in Japan: 2011–2015 update
- Author
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Kazuaki Chayama, Hajime Isomoto, Koji Uchino, Masahito Shimizu, Hiroyuki Okada, Hitoshi Yoshiji, Tetsuo Takehara, Kazuhiko Koike, Isao Sakaida, Mitsuhiko Moriyama, Hiroshi Yatsuhashi, Shuichi Kaneko, Makoto Chuma, Tetsuhiro Chiba, Kazuhiko Nakao, Yutaka Sasaki, Takuji Torimura, Tsutomu Masaki, Masataka Seike, Ryosuke Tateishi, Takeshi Okanoue, and Naoto Fujiwara
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Male ,Alcoholic liver disease ,medicine.medical_specialty ,Carcinoma, Hepatocellular ,Time Factors ,Alcohol Drinking ,Hepatocellular carcinoma ,Gastroenterology ,03 medical and health sciences ,0302 clinical medicine ,Japan ,Risk Factors ,Surveys and Questionnaires ,Internal medicine ,Diabetes mellitus ,Humans ,Medicine ,Obesity ,Risk factor ,Aged ,Retrospective Studies ,Original Article—Liver, Pancreas, and Biliary Tract ,Hepatitis B Surface Antigens ,business.industry ,Incidence (epidemiology) ,Liver Neoplasms ,Fatty liver ,Age Factors ,Middle Aged ,medicine.disease ,Survival Rate ,030220 oncology & carcinogenesis ,Female ,030211 gastroenterology & hepatology ,business ,Body mass index ,Dyslipidemia ,Non-alcoholic fatty liver disease - Abstract
Background We previously reported that the incidence of hepatocellular carcinoma (HCC) with non-viral etiologies increased rapidly between 1991 and 2010 in Japan. Methods To update this investigation, we enrolled patients who were initially diagnosed as having non-B, non-C HCC at participating hospitals between 2011 and 2015. In addition to the patient characteristics investigated in the previous report, we also investigated the duration of alcohol consumption. The overall survival rate was analyzed using the Kaplan–Meier method, and the hazard function against the body mass index (BMI) was plotted using cubic splines. Results A total of 2087 patients were enrolled. The proportion of patients with non-viral etiologies has continued to increase from 10.0% in 1991 to 32.5% in 2015. Patients were also older (median ages, 70–73 years) and more obese (median BMIs, 23.9–24.2 kg/m2), and the proportions of patients with diabetes mellitus (46.1% to 51.6%), hypertension (42.7% to 58.6%), dyslipidemia (14.6% to 22.9%), and fatty liver (24.0% to 28.8%) had all increased significantly. There was a significant inverse relationship between the duration and the amount of daily alcohol consumption. The improvement in the overall survival was relatively small, with a decreased proportion of patients under surveillance (41.3% to 31.6%). A hazard function plot showed a curve similar to that in our previous report, with a lowest hazard of ~ 26 kg/m2. Conclusions The proportion of HCC patients with non-viral etiologies continues to increase in Japan. Lifetime total amount of alcohol consumption may be a risk factor. Electronic supplementary material The online version of this article (10.1007/s00535-018-1532-5) contains supplementary material, which is available to authorized users.
- Published
- 2018
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