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3. A COMPARISON OF THE THERAPEUTIC EFFICACY OF TRANSARTERIAL CHEMOEMBOLIZATION AND COMBINATION THERAPY WITH TRANSARTERIAL CHEMOEMBOLIZATION PLUS SORAFENIB FOR UNRESECTABLE HEPATOCELLULAR CARCINOMA

Author

SUGIMOTO, Yuko, SATO, Wataru, SUZUKI, Toshiaki, MATSUZAWA, Hisanori, MINAMI, Shinichiro, TAKAHASHI, Kenichi, ARATA, Suguru, SHIBUYA, Tomomi, CHIBA, Mitsuru, DOHMEN, Takahiro, OHSHIMA, Shigetoshi, TOZAWA, Tomoki, ISHIYAMA, Koichi, Hashimoto, Manabu, GOTO, Takashi, and IIJIMA, Katsunori

Subjects
TACE, unresectable HCC, sorafenib, neoplasms, digestive system diseases, combination therapy
Abstract

[Background and Aims] The combination therapy of transarterial chemoembolization (TACE) plus sorafenib has been applied for unresectable hepatocellular carcinoma (HCC). However, its efficacy remains controversial, possibly due to the timing of the initiation of sorafenib treatment. We evaluated the efficacy of this combination therapy when sorafenib treatment was initiated soon after the patient recovered from the adverse events due to the initial TACE procedure. [Methods] This was a retrospective study at a single hospital. Twenty-three unresectable HCC cases who exceeded the up-to-seven criteria but who showed no major vascular invasion or extrahepatic metastasis were enrolled in this study. The patients were classified into two groups : Group C (n=7) received combination therapy ; Group T (n=16) received TACE as the sole therapy. The time-to-tumor progression (TTP) and overall survival (OS) of the two groups were compared. [Results] The median TTP in Groups C and T was 1,737 days and 422 days, respectively (p < 0.05). The median survival time (MST) after the initiation of each therapy in Groups C and T was 1,780 days and 371 days, respectively (p < 0.05). [Conclusion] The TTP and OS of patients with unresectable HCC who received TACE plus sorafenib (administered soon after the initial TACE procedure) were superior to those in patients who received TACE alone.

Published
2018

15. A CASE OF ACUTE LIVER FAILURE CAUSED BY THE INGESTION OF GALERINA FASCICULATA

Author

CHIBA, Mitsuru, GOTO, Takashi, MIURA, Kouichi, OHSHIMA, Shigetoshi, SATO, Wataru, SHIBUYA, Tomomi, DOHMEN, Takahiro, WATANABE, Noboru, SEKINE, Masanari, ARATA, Suguru, SUGIMOTO, Yuko, TAKAHASHI, Kenichi, MINAMI, Shinichiro, ISHIOKA, Mitsuaki, SAITO, Atsushi, MATSUZAWA, Hisanori, and OHNISHI, Hirohide

Subjects
amatoxin, Galerina fasciculata, mushroom, acute liver failure
Abstract

A 76-year-old man presented to another hospital with a two-day history of severe diarrhea andvomiting. A laboratory analysis revealed liver dysfunction. He was admitted to that hospital,but the laboratory data showed the exacerbation of patient’s liver dysfunction and renal dysfunction.He was therefore transferred to our hospital for multidisciplinary treatment. According topatient’s laboratory data and medical history, he was diagnosed with acute liver failure due tomushroom poisoning. This mushroom was identified as Galerina fasciculata. An investigationat the prefecture’s agricultural center revealed that the mushroom contained amatoxin.

Published
2016

17. ACOUSTIC RADIATION FORCE IMPULSE ELASTOGRAPHY FOR THE DIFFERENTIAL DIAGNOSIS OF LIVER TUMORS IN PATIENTS WITH LIVER DYSFUNCTION

Author

CHIBA, Mitsuru, GOTO, Takashi, OHSHIMA, Shigetoshi, MIURA, Kouichi, SHIBUYA, Tomomi, SATO, Wataru, DOHMEN, Takahiro, SEKINE, Masanari, KANATA, Ryo, SAKAI, Toshitaka, MINAMI, Shinichiro, FUJITA, Akashi, and OHNISHI, Hirohide

Subjects
Acoustic radiation force impulse, metastatic liver tumor, shear waves velocity, hepatocellular carcinoma, cavernous hemangioma, digestive system diseases
Abstract

Objective : Acoustic radiation force impulse (ARFI) technology can measure the elasticity of tissueand tumor. The aim of this study was to evaluate whether the ARFI technology can differentiatecavernous hemangioma, hepatocellular carcinoma (HCC) and metastatic liver tumors inpatients with liver dysfunction.Materials and Methods : Forty patients with liver dysfunction and liver tumors were enrolledin the study. The shear wave velocities (SWVs) in the tumors and background liver were examinedby ARFI elastography under ultrasonography (US).Results : The SWVs in livers bearing HCCs were significantly higher than those of livers bearingcavernous hemangiomas. The SWVs in HCCs and metastatic liver tumors were significantlyhigher than those in cavernous hemangiomas. The SWVs in metastatic liver tumors were significantlyhigher than those in HCCs. The SWV ratio of metastatic liver tumor/parenchyma wassignificantly higher than that of cavernous hemangioma/parenchyma and HCC/parenchyma.There was a significant correlation between the tumor sizes and the SWVs in metastaticliver tumors.Conclusions : We herein demonstrated that ARFI elastography could noninvasively provide helpfulinformation, without the need for biopsy, that could be used for the differential diagnosis amongcavernous hemangiomas, HCCs and metastatic liver tumors in patients with liver dysfunction.

Published
2015

18. NON-INVASIVE METHOD FOR PREDICTING HEPATOCELLULAR CARCINOMA IN PATIENTS WITH CHRONIC HEPATIC DISEASE BY MEASURING THE SHEAR WAVE VELOCITY

Author

FUJIWARA, Junichi, GOTO, Takashi, SHIBUYA, Tomomi, CHIBA, Mitsuru, OHSHIMA, Shigetoshi, MIURA, Kouichi, SATO, Wataru, DOHMEN, Takahiro, SAKAI, Toshitaka, SUGIMOTO, Yuko, MINAMI, Shinichiro, and OHNISHI, Hirohide

Subjects
shear wave velocity, receiver operating characteristic curves, hepatocellular carcinoma, acoustic radiation force impulse, digestive system diseases
Abstract

Aim : To evaluate the usefulness of acoustic radiation force impulse (ARFI) in predicting hepatocellularcarcinoma (HCC) in patients with chronic hepatic disease (CHD).Methods : A total of 230 patients participated in this study. They were subsequently classifiedinto the “HCC group” and the “non-HCC group”. We measured their liver stiffness and calculatedthe mean shear wave velocity (SWV) using ARFI.Results : The mean SWV was significantly higher in the HCC group than in the non-HCCgroup. The cut-off value for the mean SWV with the best discrimination between the two groupswas 1.36 (m/s). The area under the receiver operating characteristic curve (AUROC) was0.807. The AUROCs of the aspartate-aminotransferase-to-platelet ratio and Fibrosis 4 scorewere 0.780, 0.728, respectively. The independent risk factors of HCC included the mean SWVand age. A further analysis, based on the individual causes of CHD, found that among the HCVand non-HBV and non-HCV (nBnC) cases, the mean SWV was significantly higher in the HCCgroup than in the non-HCC group.Conclusion : Measuring the SWV using ARFI was a reliable method for predicting HCC in CHDpatients, especially in HCV and nBnC patients.

Published
2016

20. Efficacy of Combined Balloon-occluded Retrograde Transvenous Obliteration and Simultaneous Endoscopic Injection Sclerotherapy

Author

Sato, Wataru, primary, Kamada, Kentaro, additional, Goto, Takashi, additional, Ohshima, Shigetoshi, additional, Miura, Kouichi, additional, Shibuya, Tomomi, additional, Dohmen, Takahiro, additional, Kanata, Ryo, additional, Sakai, Toshitaka, additional, Chiba, Mitsuru, additional, Sugimoto, Yuko, additional, Minami, Shinichiro, additional, Ishiyama, Koichi, additional, Hashimoto, Manabu, additional, and Ohnishi, Hirohide, additional

Published
2015
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21. Su1471 Noninvasive Evaluation of the Risk of Hepatocellular Carcinoma Oncogenesis in Chronic Hepatic Disease by Measuring Shear Wave Velocity

Author

Fujiwara, Junichi, primary, Goto, Takashi, additional, Shibuya, Tomomi, additional, Chiba, Mitsuru, additional, Ohshima, Shigetoshi, additional, Miura, Kouichi, additional, Sato, Wataru, additional, Dohmen, Takahiro, additional, Kamada, Kentaro, additional, Kanata, Ryo, additional, Sakai, Toshitaka, additional, Sugimoto, Yuko, additional, Minami, Shinichiro, additional, and Ohnishi, Hirohide, additional

Published
2014
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22. Sa1318 Improvement of Liver Stiffness Measured by ARFI During Telaprevir-Based Triple Therapy for Chronic Hepatitis C

Author

Kanata, Ryo, primary, Goto, Takashi, additional, Miura, Kouichi, additional, Ohshima, Shigetoshi, additional, Shibuya, Tomomi, additional, Sato, Wataru, additional, Kamada, Kentaro, additional, Chiba, Mitsuru, additional, Sakai, Toshitaka, additional, Minami, Shinichiro, additional, Sugimoto, Yuko, additional, Fujiwara, Junichi, additional, Ishioka, Mitsuaki, additional, and Ohnishi, Hirohide, additional

Published
2014
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24. Successful Treatment of Hepatocellular Carcinoma with Lung Metastasis Using Hepatic and Bronchial Artery Infusion Chemotherapy

Author

Yoshida, Tatsuki, primary, Kamada, Kentaro, additional, Miura, Kouichi, additional, Goto, Takashi, additional, Ohshima, Shigetoshi, additional, Sato, Wataru, additional, Shibuya, Tomomi, additional, Dohmen, Takahiro, additional, Kanata, Ryo, additional, Sakai, Toshitaka, additional, Chiba, Mitsuru, additional, Fujiwara, Junichi, additional, Sugimoto, Yuko, additional, Ishioka, Mitsuaki, additional, Hasegawa, Itsuki, additional, Takahashi, Kenichi, additional, Minami, Shinichiro, additional, Fujita, Akashi, additional, Hashimoto, Manabu, additional, and Ohnishi, Hirohide, additional

Published
2014
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25. Mo2025 Usefulness of CE-US for Evaluating Vascularity of the Nodules Detected Only At Hepatobiliary Phase but Not At Arterial Phase in Gd-Eob MRI

Author

Minami, Shinichiro, primary, Goto, Takashi, additional, Miura, Kouichi, additional, Ohshima, Shigetoshi, additional, Shibuya, Tomomi, additional, Sato, Wataru, additional, Dohmen, Takahiro, additional, Kamada, Kentaro, additional, Chiba, Mitsuru, additional, Kanata, Ryo, additional, Sakai, Toshitaka, additional, Sugimoto, Yuko, additional, and Ohnishi, Hirohide, additional

Published
2013
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26. Mo2022 Evaluation of Acoustic Radiation Force Impulse Imaging for the Differential Diagnosis of Benign and Malignant Liver Tumors

Author

Chiba, Mitsuru, primary, Goto, Takashi, additional, Miura, Kouichi, additional, Ohshima, Shigetoshi, additional, Shibuya, Tomomi, additional, Sato, Wataru, additional, Dohmen, Takahiro, additional, Kamada, Kentaro, additional, Kanata, Ryo, additional, Sakai, Toshitaka, additional, Sugimoto, Yuko, additional, and Minami, Shinichiro, additional

Published
2013
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27. A Chronic Subdural Hematoma in a Patient Receiving Combination Therapy with Pegylated Interferon Alfa-2b and Ribavirin for Chronic Hepatitis C

Author

Goto, Takashi, primary, Ohshima, Shigetoshi, additional, Miura, Kouichi, additional, Shibuya, Tomomi, additional, Sato, Wataru, additional, Dohmen, Takahiro, additional, Kamada, Kentaro, additional, Kanata, Ryo, additional, Sakai, Toshitaka, additional, Chiba, Mitsuru, additional, Sugimoto, Yuko, additional, Minami, Shinichiro, additional, and Ohnishi, Hirohide, additional

Published
2013
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28. Mo1936 Evaluation of Acoustic Radiation Force Impulse Elastography for Liver Tumors

Author

Chiba, Mitsuru, primary, Goto, Takashi, additional, Miura, Kouichi, additional, Ohshima, Shigetoshi, additional, Shibuya, Tomomi, additional, Sato, Wataru, additional, Dohmen, Takahiro, additional, Yamada, Ikuhiro, additional, Kamada, Kentaro, additional, Kanata, Ryo, additional, Sakai, Toshitaka, additional, Sugimoto, Yuko, additional, and Ohnishi, Hirohide, additional

Published
2012
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29. Efficacy of Contrast-Enhanced Ultrasonography in Radiofrequency Ablation for Hepatocellular Carcinoma

Author

Dohmen, Takahiro, primary, Kataoka, Ei, additional, Yamada, Ikuhiro, additional, Miura, Kouichi, additional, Ohshima, Shigetoshi, additional, Shibuya, Tomomi, additional, Segawa, Daisuke, additional, Sato, Wataru, additional, Anezaki, Yumiko, additional, Ishii, Hajime, additional, Kamada, Kentaro, additional, Goto, Takashi, additional, and Ohnishi, Hirohide, additional

Published
2012
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30. Three Patients with Viral Breakthrough during Pegylated Interferon Alpha-2b and Ribavirin Therapy: A Case Series

Author

Kon, Daigo, primary, Goto, Takashi, additional, Miura, Kouichi, additional, Ohshima, Shigetoshi, additional, Shibuya, Tomomi, additional, Kataoka, Ei, additional, Sato, Wataru, additional, Dohmen, Takahiro, additional, Anezaki, Yumiko, additional, Ishii, Hajime, additional, Yamada, Ikuhiro, additional, Kamada, Kentaro, additional, and Ohnishi, Hirohide, additional

Published
2011
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32. Osler-Weber-Rendu Disease with Esophageal Varices and Hepatic Nodular Change

Author

Goto, Takashi, primary, Dohmen, Takahiro, additional, Yoneyama, Kazuo, additional, Monma, Ayako, additional, Ohshima, Shigetoshi, additional, Shibuya, Tomomi, additional, Kataoka, Ei, additional, Segawa, Daisuke, additional, Sato, Wataru, additional, Takeuchi, Satoko, additional, Anezaki, Yumiko, additional, Ishii, Hajime, additional, Yamada, Ikuhiro, additional, Komatsu, Masafumi, additional, and Watanabe, Sumio, additional

Published
2007
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37. Three Patients with Viral Breakthrough During Pegylated Interferon Alpha-2b and Ribavirin Therapy: A Case Series.

Author

Kon, Daigo, Goto, Takashi, Miura, Kouichi, Ohshima, Shigetoshi, Shibuya, Tomomi, Kataoka, Ei, Sato, Wataru, Dohmen, Takahiro, Anezaki, Yumiko, Ishii, Hajime, Yamada, Ikuhiro, Kamada, Kentaro, and Ohnishi, Hirohide

Abstract

Introduction: A viral breakthrough occurs when a patient achieves a response while on interferon (IFN) therapy and then loses the response despite continued IFN therapy. The cause of viral breakthroughs is not well understood. We encountered three cases with viral breakthrough during treatment with pegylated interferon (PEG-IFN) and ribavirin (RBV). Case presentation: The three cases were all late virological responders. They did not express anti-IFN alpha-2b antibodies after PEG-IFN and RBV therapy. We analyzed amino acid substitutions of core 70, core 91, and interferon sensitivity-determining region (ISDR), which significantly influence sustained virological response (SVR). Their amino acid substitutions of core 91 were mutant in two cases. Amino acid substitutions of ISDR were wild pattern in two cases. PEG-IFN adherence was above 80% in three cases, and RBV adherence was below 80% in two cases. Conclusion: During PEG-IFN and RBV therapy, we should watch for viral breakthrough in late virological responders with mutant type of amino acid substitutions of core 91, wild pattern of amino acid substitution of ISDR, and decrease of RBV adherence. Viral breakthrough is an important problem in PEG-IFN and RBV therapy for chronic hepatitis C. Therefore, it should be investigated more thoroughly in more cases. [ABSTRACT FROM AUTHOR]

Published
2011
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39. Skull metastasis from hepatocellular carcinoma with chronic hepatitis B.

Author

Goto T, Dohmen T, Miura K, Ohshima S, Yoneyama K, Shibuya T, Kataoka E, Segawa D, Sato W, Anezaki Y, Ishii H, Kon D, Yamada I, Kamada K, and Ohnishi H

Abstract

A 56-year-old male visited our hospital for evaluation of an occipital mass. Contrast computed tomography showed hypervascular enhancement with osteolytic change in the skull and a huge enhanced mass in the liver. Magnetic resonance imaging showed bone metastasis in the thoracic vertebrae. Assays for hepatitis B surface antigen and hepatitis B core antibody were positive and his liver condition was Child-Pugh grade A. Our diagnosis was hepatocellular carcinoma (HCC) with skull and vertebrae metastases on chronic hepatitis B. He was treated with radiation therapy for bone metastases and transcatheter arterial chemoembolization for HCC. But he developed acute respiratory failure because of aspiration pneumonia, congestion and oedema with haemorrhage of the lungs and died. Dissection showed HCC with multiple bone metastases. The liver tumor was categorized as well-differentiated HCC, Edmondson classification I, trabecular type and pseudoglandular type. In the liver mild infiltration of lymphocytes was seen in Glisson's capsules which were significantly enlarged with well preserved limiting plates. Piecemeal necrosis was not obvious. No fibrosis was noted. An 8 cm × 7 cm × 3 cm metastatic lesion had formed in the left occipitotemporal part of the cranial bone. The lesion was osteolytic and showed invasion into the dura mater. Neither the subdural cavity nor the brain showed involvement from the metastatic tumor. However, skull metastasis from HCC is very rare and it affects the patient's prognosis and the quality of life. Therefore, it is very important to make an early diagnosis and carry out proper management of skull metastasis from HCC.

Published
2010
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