Author Takagi, Kosei| Yagi, Takahito| Shinoura, Susumu| Umeda, Yuzo| Yoshida, Ryuichi| Nobuoka, Daisuke| Watanabe, Nobuyuki| Kuise, Takashi| Fuji, Tomokazu| Araki, Hiroyuki| Fujiwara, Toshiyoshi|
Published Date 2017-02
Publication Title Acta Medica Okayama
Volume volume71
Issue issue1
Content Type Journal Article
JaLCDOI 10.18926/AMO/54830
JaLCDOI 10.18926/AMO/54594
FullText URL 70_5_363.pdf
Author Takagi, Kosei| Yagi, Takahito| Yoshida, Ryuichi| Shinoura, Susumu| Umeda, Yuzo| Nobuoka, Daisuke| Kuise, Takashi| Watanabe, Nobuyuki| Fujiwara, Toshiyoshi|
Abstract Sarcopenia following liver surgery has been reported as a predictor of poor prognosis. Here we investigated predictors of outcomes in patients with hepatocellular carcinoma (HCC) and attempted to establish a new comprehensive preoperative assessment protocol. We retrospectively analyzed the cases of 254 patients who underwent curative hepatectomy for HCC with Child-Pugh classification A at our hospital between January 2007 and December 2013. Sarcopenia was evaluated by computed tomography measurement. The influence of sarcopenia on outcomes was evaluated. We used multivariate analyses to assess the impact of prognostic factors associated with outcomes, including sarcopenia. Of the 254 patients, 118 (46.5%) met the criteria for sarcopenia, and 32 had an American Society of Anesthesiologists (ASA) physical status ≥3. The sarcopenic group had a significantly lower 5-year overall survival rate than the non-sarcopenic group (58.2% vs. 82.4% , p=0.0002). In multivariate analyses of prognostic factors, sarcopenia was an independent predictor of poor survival (hazard ratio [HR]=2.28, p=0.002) and poor ASA status (HR=3.17, p=0.001). Sarcopenia and poor ASA status are independent preoperative predictors for poor outcomes after hepatectomy. The preoperative identification of sarcopenia and ASA status might enable the development of comprehensive approaches to assess surgical eligibility.
Keywords sarcopenia American Society of Anesthesiologists physical status hepatectomy hepatocellular carcinoma prognostic factor
Amo Type Original Articles
Published Date 2016-10
Publication Title Acta Medica Okayama
Volume volume70
Issue issue5
Publisher Okayama University Medical School
Start Page 363
End Page 370
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 27777428
Web of Sience KeyUT 000388098700005
JaLCDOI 10.18926/AMO/54419
FullText URL 70_3_197.pdf
Author Takagi, Kosei| Yagi, Takahito| Yoshida, Ryuichi| Shinoura, Susumu| Umeda, Yuzo| Nobuoka, Daisuke| Kuise, Takashi| Watanabe, Nobuyuki| Sui, Kenta| Fuji, Tomokazu| Fujiwara, Toshiyoshi|
Abstract The operative mortality and morbidity of pancreaticoduodenectomy (PD) remain high. We analyzed PD patientsʼ clinical characteristics and surgical outcomes and discuss how PD clinical outcomes could be improved. We retrospectively reviewed the cases of 400 patients who underwent a PD between January 1998 and April 2014 at Okayama University Hospital, a very-high-volume center. We identified and compared the clinical outcomes between two time periods (period 1: 1998-2006 vs. period 2: 2007-2014). The total postoperative mortality and major complication rates were 0.75 and 15.8 , respectively, and the median postoperative length of stay (LOS) was 32 days. Subsequently, patients who underwent a PD during period 2 had a significantly shorter LOS than those who underwent a PD during period 1 (29 days vs. 38.5 days, p<0.001). The incidence of mortality and major complications did not differ between the two periods. In our multivariate analysis, period 1 was an independent factor associated with a long LOS (p<0.001). The improvement of the surgical procedure and perioperative care might be related to the shorter LOS in period 2 and ot the consistently maintained low mortality rate after PD. The development of multimodal strategies to accelerate postoperative recovery may further improve PDʼs clinical outcomes.
Keywords pancreaticoduodenectomy surgical outcome mortality major complication length of stay
Amo Type Original Article
Published Date 2016-06
Publication Title Acta Medica Okayama
Volume volume70
Issue issue3
Publisher Okayama University Medical School
Start Page 197
End Page 203
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 27339209
Web of Sience KeyUT 000379406100007
Author Uchida, Daisuke| Shiraha, Hidenori| Kato, Hironari| Nagahara, Teruya| Iwamuro, Masaya| Kataoka, Junro| Horiguchi, Shigeru| Watanabe, Masami| Takaki, Akinobu| Nouso, Kazuhiro| Nasu, Yasutomo| Yagi, Takahito| Kumon, Hiromi| Yamamoto, Kazuhide|
Published Date 2014-05
Publication Title Journal of Gastroenterology and Hepatology
Volume volume29
Issue issue5
Content Type Journal Article
JaLCDOI 10.18926/AMO/52898
FullText URL 68_5_291.pdf
Author Tsuzaki, Ryuichiro| Takaki, Akinobu| Yagi, Takahito| Ikeda, Fusao| Koike, Kazuko| Iwasaki, Yoshiaki| Shiraha, Hidenori| Miyake, Yasuhiro| Sadamori, Hiroshi| Shinoura, Susumu| Umeda, Yuzo| Yoshida, Ryuichi| Nobuoka, Daisuke| Utsumi, Masashi| Nakayama, Eiichi| Fujiwara, Toshiyoshi| Yamamoto, Kazuhide|
Abstract It is not known how the immune system targets hepatitis C virus (HCV)-infected HLA-mismatched hepatocytes under immune-suppressed conditions after orthotopic liver transplantation (OLT). In addition, the relationship between the HCV-specific immune response and IL28B variants as predictors of HCV clearance has not been well-characterized. We determined the IL28B polymorphisms for 57 post-OLT HCV carriers, and we assessed the HCV-specific immune responses by measuring the peripheral blood mononuclear cell-derived HCV-specific interferon-gamma (IFN-γ) response using an enzyme-linked immunospot assay. At 1-3 years after OLT, patients with no active hepatitis showed higher total spots on the immunospot assay. At>3 years after OLT, patients with resolved HCV showed higher levels of core, NS3, NS5A, and total spots compared to the chronic hepatitis patients. The IL28B major genotype in the donors correlated with higher spot counts for NS5A and NS5B proteins at 1-3 years after OLT. In the post-OLT setting, the HCV-specific immune response could be strongly induced in patients with no active hepatitis with an IL28B major donor or sustained virological response. Strong immune responses in the patients with no active hepatitis could only be maintained for 3 years and diminished later. It may be beneficial to administer IFN treatment starting 3 years after OLT, to induce the maximum immunological effect.
Keywords interferon gamma ELISPOT assay single nucleotide polymorphisms dendritic cell CD4 T cell
Amo Type Original Article
Published Date 2014-10
Publication Title Acta Medica Okayama
Volume volume68
Issue issue5
Publisher Okayama University Medical School
Start Page 291
End Page 302
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2014 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 25338486
Web of Sience KeyUT 000343269300006
Related Url http://ousar.lib.okayama-u.ac.jp/metadata/53129
Author Satoh, Daisuke| Yagi, Takahito| Nagasaka, Takeshi| Shinoura, Susumu| Umeda, Yuzo| Yoshida, Ryuichi| Utsumi, Masashi| Tanaka, Takehiro| Sadamori, Hiroshi| Fujiwara, Toshiyoshi|
Published Date 2013-04-27
Publication Title World Journal of Hepatology
Volume volume5
Issue issue4
Content Type Journal Article
Author Nobuoka, Daisuke| Yoshikawa, Toshiaki| Takahashi, Mari| Iwama, Tatsuaki| Horie, Kazutaka| Shimomura, Manami| Suzuki, Shiro| Sakemura, Noriko| Nakatsugawa, Munehide| Sadamori, Hiroshi| Yagi, Takahito| Fujiwara, Toshiyoshi| Nakatsura, Tetsuya|
Published Date 2013-04
Publication Title Cancer Immunology, Immunotherapy
Volume volume62
Issue issue4
Content Type Journal Article
Author Tanaka, Shigetomi| Shiraha, Hidenori| Nakanishi, Yutaka| Nishina, Shin-Ichi| Matsubara, Minoru| Horiguchi, Shigeru| Takaoka, Nobuyuki| Iwamuro, Masaya| Kataoka, Junro| Kuwaki, Kenji| Hagihara, Hiroaki| Toshimori, Junichi| Ohnishi, Hideki| Takaki, Akinobu| Nakamura, Shinichiro| Nouso, Kazuhiro| Yagi, Takahito| Yamamoto, Kazuhide|
Published Date 2012-12-01
Publication Title International Journal of Cancer
Volume volume131
Issue issue11
Content Type Journal Article
JaLCDOI 10.18926/AMO/49671
FullText URL 67_2_117.pdf
Author Sadamori, Hiroshi| Yagi, Takahito| Shinoura, Susumu| Umeda, Yuzo| Yoshida, Ryuichi| Sato, Daisuke| Nobuoka, Daisuke| Utsumi, Masashi| Fujiwara, Toshiyoshi|
Abstract We present a case of living donor liver transplantation to a 3-year disease-free survivor of liver resection for hepatocellular carcinoma (HCC) with major portal vein invasion. A 48-year-old man had HCC in the right lobe with a portal venous tumor thrombus extending into the left portal vein. An extended right lobectomy with thrombectomy was performed to remove the thrombus. Three years after liver resection, the patient experienced liver failure, with massive ascites and jaundice due to the formation of a thrombus in the main and left portal veins. During the 3 years after liver resection, no metastasis or recurrence of HCC had been detected, and tumor markers had been within normal ranges. The portal venous thrombus did not show any arterial enhancement under contrast-enhanced computed tomography, suggesting that the co-existence of any HCC component in the portal venous thrombus may have been negative. Based on these findings, living donor liver transplantation was performed using a right lobe graft from the patientʼs son. The patient is alive at 87 months after the transplantation, with no evidence of HCC recurrence.
Keywords living donor liver transplantation hepatocellular carcinoma portal vein invasion liver resection
Amo Type Case Report
Published Date 2013-04
Publication Title Acta Medica Okayama
Volume volume67
Issue issue2
Publisher Okayama University Medical School
Start Page 117
End Page 121
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 23603929
Web of Sience KeyUT 000317801700007
Author Inada, Ryo| Nagasaka, Takeshi| Mori, Yoshiko| Umeda, Yuzo| Kubota, Nobuhito| Morikawa, Tatsuya| Kondo, Yoshitaka| Uno, Futoshi| Sadamori, Yu| Yagi, Takahito| Fujiwara, Toshiyoshi|
Published Date 2013-04-01
Publication Title 岡山医学会雑誌
Volume volume125
Issue issue1
Content Type Journal Article
Author Inada, Ryo| Nagasaka, Takeshi| Takehara, Kiyoto| Sugihara, Masahiro| Mori, Yoshiko| Umeda, Yuzo| Kubota, Nobuhito| Morikawa, Tatsuya| Kondo, Yoshitaka| Uno, Futoshi| Sadamori, Yu| Yagi, Takahito| Fujiwara, Toshiyoshi|
Published Date 2013-04-01
Publication Title 岡山医学会雑誌
Volume volume125
Issue issue1
Content Type Journal Article
Author Nakanishi, Yutaka| Shiraha, Hidenori| Nishina, Shin-ichi| Tanaka, Shigetomi| Matsubara, Minoru| Horiguchi, Shigeru| Iwamuro, Masaya| Takaoka, Nobuyuki| Uemura, Masayuki| Kuwaki, Kenji| Hagihara, Hiroaki| Toshimori, Junichi| Ohnishi, Hideki| Takaki, Akinobu| Nakamura, Shinichiro| Kobayashi, Yoshiyuki| Nouso, Kazuhiro| Yagi, Takahito| Yamamoto, Kazuhide|
Published Date 2011-01-04
Publication Title BMC Cancer
Volume volume11
Content Type Journal Article
Author Matsuo, Noriyuki| Shiraha, Hidenori| Fujikawa, Tatsuya| Takaoka, Nobuyuki| Ueda, Naoki| Tanaka, Shigetomi| Nishina, Shinichi| Nakanishi, Yutaka| Uemura, Masayuki| Takaki, Akinobu| Nakamura, Shinichiro| Kobayashi, Yoshiyuki| Nouso, Kazuhiro| Yagi, Takahito| Yamamoto, Kazuhide|
Published Date 2009-07-18
Publication Title BMC Cancer
Volume volume9
Content Type Journal Article
Author Yagi, Takahito|
Published Date 2012-08-01
Publication Title 岡山医学会雑誌
Volume volume124
Issue issue2
Content Type Journal Article
JaLCDOI 10.18926/AMO/48268
FullText URL 66_2_177.pdf.pdf
Author Utsumi, Masashi| Matsuda, Hiroaki| Sadamori, Hiroshi| Shinoura, Susumu| Umeda, Yuzo| Yoshida, Ryuichi| Satoh, Daisuke| Hashimoto, Masaaki| Yagi, Takahito| Fujiwara, Toshiyoshi|
Abstract We report 4 cases of surgical resection of metachronous lymph node (LN) metastases from hepatocellular carcinoma (HCC) following hepatectomy. Clinicopathological features and results of LN dissection were investigated in the 4 patients. One patient was found to have a single metastasis in the mediastinal LNs, another had multiple metastases in the mediastinal and abdominal LNs, and the other 2 had single metastases in the abdominal LN. The locations of the abdominal LN metastases were behind the pancreas head in 2 patients and around the abdominal aorta in 1 patient. They all underwent surgical resection of metastatic LNs and had no postoperative complications. The 3 patients whose LN metastases were solitary have been alive for more than 2 years after LN resection, and one of them is free from recurrence. The patient with multiple LN metastases died 13 months after LN resection due to carcinomatosis. With the expectation of long-term survival, a single metachronous LN metastasis from HCC after hepatectomy should be resected in patients without uncontrollable intrahepatic or extrahepatic tumors.
Keywords hepatocellular carcinoma lymph node metastasis hepatectomy
Amo Type Case Report
Published Date 2012-04
Publication Title Acta Medica Okayama
Volume volume66
Issue issue2
Publisher Okayama University Medical School
Start Page 177
End Page 182
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2012 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 22525476
Web of Sience KeyUT 000303175300011
Author Shinoura, Susumu| Yagi, Takahito| Sadamori, Hiroshi| Matsuda, Hiroaki| Umeda, Yuzo| Yoshida, Ryuichi| Satoh, Daisuke| Utsumi, Masashi| Yokomichi, Naosuke| Kuise, Takashi| Fujiwara, Toshiyoshi|
Published Date 2012-04-01
Publication Title 岡山医学会雑誌
Volume volume124
Issue issue1
Content Type Journal Article
Author Matsumi, Junya| Morimatsu, Hiroshi| Matsusaki, Takashi| Kaku, Ryuji| Shimizu, Hiroko| Takahashi, Toru| Yagi, Takahito| Matsumi, Masaki| Morita, Kiyoshi|
Published Date 2012-02
Publication Title International Journal of Molecular Medicine
Volume volume29
Issue issue2
Content Type Journal Article
Author Satoh, Daisuke| Yagi, Takahito| Sadamori, Hiroshi| Umeda, Yuzo| Fujiwara, Toshiyoshi|
Published Date 2011-12-01
Publication Title 岡山医学会雑誌
Volume volume123
Issue issue3
Content Type Journal Article
Author Satoh, Daisuke| Yagi, Takahito| Sadamori, Hiroshi| Matsuda, Hiroaki| Shinoura, Susumu| Umeda, Yuzo| Yoshida, Ryuichi| Utsumi, Takashi| Fujiwara, Toshiyoshi|
Published Date 2011-12-01
Publication Title 岡山医学会雑誌
Volume volume123
Issue issue3
Content Type Journal Article
Author Nagasaka, Takeshi| Tanaka, Noriaki| Sun, Dong-Sheng| Naomoto, Yoshio| Mastubara, Nagahide| Yagi, Takahito| Fujiwara, Toshiyoshi|
Published Date 2010-08-02
Publication Title 岡山医学会雑誌
Volume volume122
Issue issue2
Content Type Journal Article