JaLCDOI 10.18926/AMO/56458
FullText URL 73_1_51.pdf
Author Fujii, Masakuni| Fujimoto, Kenji| Yabe, Syuntaro| Nasu, Junichiro| Miyaike, Jiro| Yoshioka, Masao| Shiode, Junji| Yamamoto, Kazuhide| Matsuda, Shinya|
Abstract  We investigated the relationship between body mass index (BMI) and postoperative outcomes in 450 gallbladder cancer patients in Japan. We collected patient information, including sex, age, underlying disease, BMI, stage, surgery method, postoperative time to discharge, and postoperative Medicare fees, from the Japanese administrative database associated with the Diagnosis Procedure Combination system. We classified patient BMIs as underweight (BMI<18.5 kg/m2), normal (BMI≥18.5 kg/m2 and <25 kg/m2) or overweight/obese (BMI≥25 kg/m2), then investigated the relationship between these categories and two postoperative outcomes: time to discharge and postoperative Medicare fees. The median postoperative time to discharge was 12 days in all patients, and 12 days in each of the three weight groups (p=0.62, n.s.). The median postoperative Medicare fees from surgery until discharge were (USD): all patients, $5,002; underweight, $5,875; normal weight, $4,797; and overweight/obese, $5,179 (p=0.146, n.s.). A multivariate analysis with adjustment for competing risk factors revealed that BMI was not associated with increased risk of longer postoperative time to discharge (normal weight: HR 1.17, p=0.29; overweight/obese: HR 1.17, p=0.37) or higher postoperative Medicare fees (OR 0.99, p=0.86, n.s.). Thus, high BMI was not found to be a factor for poor postoperative outcomes in Japanese patients with gallbladder cancer.
Keywords body mass index gallbladder cancer surgery obesity
Amo Type Original Article
Published Date 2019-02
Publication Title Acta Medica Okayama
Volume volume73
Issue issue1
Publisher Okayama University Medical School
Start Page 51
End Page 59
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2019 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 30820054
JaLCDOI 10.18926/AMO/55853
FullText URL 72_2_129.pdf
Author Okura, Tomohiro| Fujii, Masakuni| Shiode, Junji| Ito, Yuri| Kojima, Toru| Nasu, Junichiro| Niguma, Takefumi| Yoshioka, Masao| Mimura, Tetsushige| Yamamoto, Kazuhide|
Abstract The impact of body mass index (BMI) on postoperative survival in Japanese patients with pancreatic cancer is unclear. We examined the relationship between preoperative BMI and the prognosis of Japanese patients who underwent surgery for pancreatic cancer to determine whether BMI affects these patients’ prognosis. Of the patients who underwent pancreatectomy between January 2004 and August 2015 at our institution, 246 were pathologically diagnosed with pancreatic tubular adenocarcinoma; the cancer was located in the pancreatic head (n=161) and in the body and tail (n=85). We classified the patients by BMI: underweight (n=22), normal weight (n=190), and overweight/obese (n=34) groups. We retrospectively analyzed medical records for patient characteristics, lesion location, disease stage, postoperative complications, chemotherapy, and prognosis. Lesion location, disease stage, postoperative complications, and chemotherapy were not significantly different among the BMI groups. The median survival times were as follows (days): all patients, 686; underweight, 485; normal weight, 694; and overweight/obese, 839. In a multivariate analysis, after adjusting for competing risk factors, low BMI was associated with an increased risk of death (normal weight: HR 0.58, p=0.038; overweight/obese: HR 0.54, p=0.059). High BMI was not found to be a postoperative factor for poor prognosis in Japanese pancreatic cancer patients.
Keywords pancreatic cancer BMI prognosis surgery risk factor
Amo Type Original Article
Published Date 2018-04
Publication Title Acta Medica Okayama
Volume volume72
Issue issue2
Publisher Okayama University Medical School
Start Page 129
End Page 135
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2018 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 29674761
JaLCDOI 10.18926/AMO/53996
FullText URL 70_1_1.pdf
Author Yasunaka, Tetsuya| Ikeda, Fusao| Wada, Nozomu| Morimoto, Yuki| Fujioka, Shin-ichi| Toshimori, Junichi| Kobashi, Haruhiko| Kariyama, Kazuya| Morimoto, Yoichi| Takayama, Hiroki| Seno, Tomonori| Takaguchi, Koichi| Moriya, Akio| Miyatake, Hirokazu| Okamoto, Ryoichi| Yabushita, Kazuhisa| Takaki, Akinobu| Yamamoto, Kazuhide|
Abstract Chronic hepatitis B (CHB) leads to cirrhosis and hepatocellular carcinoma (HCC). With a cohort of 1,206 CHB patients who visited Okayama University Hospital and related hospitals in 2011 and 2012, we compared the incidence rates of HCC among the patients grouped by age, hepatitis B virus (HBV) DNA, hepatitis B e antigen (HBeAg), and treatment. HCCs were observed in 115 patients with the median observation period of 1,687 days. Among the HCC patients aged &#8805; 35 years, HBV DNA &#8805; 4 log copies/mL and positive HBeAg at diagnosis (n=184), the HCC incidence rate was 8.4% at 5 years in the entecavir (ETV)-treated patients, 21.8% in the lamivudine (LVD)-treated patients, and 26.4% among the patients not treated with drugs. The cumulative HCC incidence was significantly reduced in the ETV-treated patients compared to those treated with LVD or not treated (p=0.013). Among the patients aged &#8805; 35 years with HBV DNA &#8805; 4 log copies/mL and negative HBeAg (n=237), the cumulative HCC incidence was 14.6% in 5 years in ETV group and 13.9% among those not treated with a drug (p>0.05). Only small numbers of HCCs occurred in other patients. In CHB patients aged&#8805;35 years with HBV DNA &#8805;4 log copies/mL and positive HBeAg, ETV treatment is recommended for the suppression of HCC development.
Keywords entecavir hepatitis B virus lamivudine hepatocellular carcinoma
Amo Type Original Article
Published Date 2016-02
Publication Title Acta Medica Okayama
Volume volume70
Issue issue1
Publisher Okayama University Medical School
Start Page 1
End Page 12
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2016 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 26899604
Web of Sience KeyUT 000371288700001
Author Katayama, Akihiro| Nakatsuka, Atsuko| Eguchi, Jun| Murakami, Kazutoshi| Teshigawara, Sanae| Kanzaki, Motoko| Nunoue, Tomokazu| Hida, Kazuyuki| Wada, Nozomu| Yasunaka, Tetsuya| Ikeda, Fusao| Takaki, Akinobu| Yamamoto, Kazuhide| Kiyonari, Hiroshi| Makino, Hirofumi| Wada, Jun|
Published Date 2015
Publication Title Scientific reports
Volume volume5
Content Type Journal Article
JaLCDOI 10.18926/AMO/53912
FullText URL 69_6_365.pdf
Author Kawano, Seiji| Hiraoka, Sakiko| Okada, Hiroyuki| Akita, Mitsuhiro| Iwamuro, Masaya| Yamamoto, Kazuhide|
Abstract Several studies have identified a relationship between myelodysplastic syndrome and Behçetʼs disease (BD), especially intestinal BD, and trisomy 8 appears to play an important role in these disorders. Despite this, only few case reports or series have been reported in gastroenterology, meaning that endoscopic findings and characteristics of intestinal BD have not been clarified yet. In this report, we describe three cases of intestinal BD associated with myelodysplastic syndrome and trisomy 8, and discuss the clinical features and problems of these disorders from a gastroenterology perspective.
Keywords Behçetʼs disease trisomy 8 myelodysplastic syndrome
Amo Type Case Reports
Published Date 2015-12
Publication Title Acta Medica Okayama
Volume volume69
Issue issue6
Publisher Okayama University Medical School
Start Page 365
End Page 369
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2015 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 26690248
Web of Sience KeyUT 000368434500007
JaLCDOI 10.18926/AMO/53676
FullText URL 69_5_301.pdf
Author Seki, Anna| Iwamuro, Masaya| Yoshioka, Masao| Fujii, Nobuharu| Okada, Hiroyuki| Nose, Soichiro| Takata, Katsuyoshi| Yoshino, Tadashi| Yamamoto, Kazuhide|
Abstract A 41-year-old woman was diagnosed with duodenal follicular lymphoma. She had no other lesions and was assigned to a "watch and wait" policy. Swelling of the inguinal lymph nodes appeared 45 months later, and rituximab monotherapy resulted in complete remission. However, follicular lymphoma recurred in the stomach, rectum and mesenteric and external iliac lymph nodes 81 months after the therapy. The patient received rituximab monotherapy again and has remained in complete remission in the fifteenth year after the initial diagnosis. This case suggests the usefulness of rituximab monotherapy in the long-term management of intestinal follicular lymphoma.
Keywords follicular lymphoma duodenum rituximab
Amo Type Case Report
Published Date 2015-10
Publication Title Acta Medica Okayama
Volume volume69
Issue issue5
Publisher Okayama University Medical School
Start Page 301
End Page 306
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2015 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 26490027
Web of Sience KeyUT 000365519600006
JaLCDOI 10.18926/AMO/53560
FullText URL 69_4_237.pdf
Author Nanba, Shintarou| Ikeda, Fusao| Fujioka, Shin-ichi| Araki, Yasuyuki| Takaguchi, Kouichi| Hashimoto, Noriaki| Seki, Hiroyuki| Takaki, Akinobu| Iwasaki, Yoshiaki| Yamamoto, Kazuhide|
Abstract The effectiveness of extending treatment duration as response guided therapy was previously reported for chronic hepatitis C (CHC) genotype 1, but is still controversial for genotype 2. The present study is a retrospective cohort study to investigate the effectiveness of extending treatment duration in therapy with pegylated interferon and ribavirin for patients with CHC genotype 2 by focusing on the timing at which patients obtained undetectable HCV RNA. A total of 306 patients who obtained undetectable HCV RNA by week 24 of treatment and completed 24 weeks of treatment were enrolled. Rapid virological response (RVR) to standard therapy was achieved by 122 patients (51オ), and 89オ of them obtained sustained virological response (SVR), while 69オ of non-RVR patients achieved SVR. Non-RVR patients with undetectable HCV RNA at week 8, and insufficient adherence<80オ pegylated interferon and ribavirin during the first 24 weeks, significantly improved their SVR rate by extended therapy. Among patients receiving extended therapy, drug adherences did not differ between SVR and non-SVR patients, indicating that extending treatment duration might compensate for insufficient antiviral effects due to insufficient drug adherences. This finding might be useful in creating a guideline for extending treatment duration for patients with CHC genotype 2.
Keywords hepatitis C virus interferon genotype 2 response-guided therapy
Amo Type Original Article
Published Date 2015-08
Publication Title Acta Medica Okayama
Volume volume69
Issue issue4
Publisher Okayama University Medical School
Start Page 237
End Page 244
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2015 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 26289915
Web of Sience KeyUT 000365519100007
JaLCDOI 10.18926/AMO/53558
FullText URL 69_4_219.pdf
Author Toshimori, Junichi| Nouso, Kazuhiro| Nakamura, Shinichiro| Wada, Nozomu| Morimoto, Yuki| Takeuchi, Yasuto| Yasunaka, Tetsuya| Kuwaki, Kenji| Ohnishi, Hideki| Ikeda, Fusao| Shiraha, Hidenori| Takaki, Akinobu| Yamamoto, Kazuhide|
Abstract We conducted a retrospective cohort study to investigate the predisposing factors for local recurrence and complications after percutaneous radiofrequency ablation (RFA) of hepatocellular carcinoma (HCC). HCC patients (n=397) consecutively treated with RFA (256 males, 141 females, median age 69 years) were enrolled. In these patients, 1,455 nodules (median size 17mm) were ablated. Predisposing factors for overall recurrence and local recurrence in the context of tumor location and complications were examined. Local recurrence was observed for 113 of the 1,455 nodules. The 1-, 3- and 5-year local recurrence rates were 2.2オ, 7.4オ and 9.5オ, respectively. A multivariate Cox proportional hazard analysis revealed that large tumor size (>2cm), tumor location (adjacent to the major portal branch or hepatic vein), and small ablated margin (<3mm) were independent predisposing factors for local recurrence after RFA (HR=1.70-2.81). Tumor location (adjacent to the major portal branch, hepatic vein, or diaphragm) was also revealed as a risk factor for liver damage due to RFA. HCC adjacent to the major portal vein or hepatic vein was associated with a higher risk for local recurrence and for complications;therefore, special precautions are necessary when applying RFA to HCC near vessels even when the tumors are located at an easy-to-puncture site.
Keywords hepatocellular carcinoma radiofrequency ablation ablated margin tumor location
Amo Type Original Article
Published Date 2015-08
Publication Title Acta Medica Okayama
Volume volume69
Issue issue4
Publisher Okayama University Medical School
Start Page 219
End Page 226
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2015 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 26289913
Web of Sience KeyUT 000365519100005
JaLCDOI 10.18926/AMO/51068
FullText URL 67_4_239.pdf
Author Nakamura, Shinichiro| Nouso, Kazuhiro| Kobayashi, Yoshiyuki| Shiraha, Hidenori| Ohnishi, Hideki| Toshimori, Junichi| Kuwaki, Kenji| Hagihara, Hiroaki| Takayama, Hiroki| Yamamoto, Kazuhide|
Abstract The aim of this study was to evaluate the histologic diagnosis of hypovascular hepatic lesions showing hypointensity on hepatobiliary phase images of gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced MRI (EOB-MRI). In 38 patients with hepatocellular carcinoma (HCC) after curative treatments and 18 patients with liver cirrhosis, 105 hypovascular nodules that were hypointense at the hepatobiliary phase of EOB-MRI were biopsied and the clinical usefulness of these EOB-MRI findings for the diagnosis of HCC was examined. Of the 105 nodules (median diameter=12mm), 78 (74.3%), 11 (10.5%), and 16 (15.2%) were diagnosed as HCC, dysplastic, and non-neoplastic, respectively. The positive predictive value (PPV) of hypointensity at the hepatobiliary phase of EOB-MRI for the diagnosis of HCC increased to 77-90% when combined with the following factors: washout appearance on the delayed phase of triple-phase CT, hyperintensity in diffusion-weighted image of MRI, or the appearance of a hypoechoic part in ultrasonography. PPV increased to 100% when all 3 factors were positive. A relatively large proportion of hypovascular lesions that showed hypo-intensity in the hepatobiliary phase were confirmed to be HCC, and the accuracy of HCC increased when combined with other imaging findings.
Keywords hepatocellular carcinoma hypovascular diagnosis gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid magnetic resonance imaging
Amo Type Original Article
Published Date 2013-08
Publication Title Acta Medica Okayama
Volume volume67
Issue issue4
Publisher Okayama University Medical School
Start Page 239
End Page 244
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2013 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 23970322
Web of Sience KeyUT 000323470100005
Author Suzuki, Hideyuki| Kato, Jun| Kuriyama, Motoaki| Hiraoka, Sakiko| Kuwaki, Kenji| Yamamoto, Kazuhide|
Published Date 2010-03-14
Publication Title World Journal of Gastroenterology
Volume volume16
Issue issue10
Content Type Journal Article
Author Kobayashi, Sayo| Nouso, Kazuhiro| Kinugasa, Hideaki| Takeuchi, Yasuto| Tomoda, Takeshi| Miyahara, Koji| Hagihara, Hiroaki| Kuwaki, Kenji| Onishi, Hideki| Nakamura, Shinichiro| Ikeda, Fusao| Miyake, Yasuhiro| Shiraha, Hidenori| Takaki, Akinobu| Yamamoto, Kazuhide|
Published Date 2012-12
Publication Title Hepatology Research
Volume volume42
Issue issue12
Content Type Journal Article