Author Matsumoto, Kazuyuki| Ohara, Toshiaki| Fujisawa, Masayoshi| Takaki, Akinobu| Takahara, Masahiro| Tanaka, Noriyuki| Kato, Hironari| Horiguchi, Shigeru| Yoshida, Ryuichi| Umeda, Yuzo| Fushimi, Soichiro| Yagi, Takahito| Matsukawa, Akihiro| Okada, Hiroyuki|
Keywords Immunohistochemistry PD-L1 Pancreatic cancer
Note This fulltext will be available in Apr 2020|
Published Date 2019-04-29
Publication Title Journal of Gastroenterology
Volume volume54
Issue issue11
Start Page 1019
End Page 1028
ISSN 09441174
NCID AA10988015
Content Type Journal Article
language 英語
OAI-PMH Set 岡山大学
File Version author
PubMed ID 31032528
DOI 10.1007/s00535-019-01586-6
Web of Sience KeyUT 000492169400008
Related Url isVersionOf https://doi.org/10.1007/s00535-019-01586-6
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
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
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
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
JaLCDOI 10.18926/AMO/32828
FullText URL fulltext.pdf
Author Liu, Jie| Yagi, Takahito| Sadamori, Hiroshi| Matsukawa, Hiroyoshi| Sun, Dong-Sheng| Mitsuoka, Naoshi| Yamamura, Masao| Matsuoka, Junji| Jin, Zaishun| Yamamoto, Itaru| Tanaka, Noriaki|
Abstract <p>Controversy exists over whether the predominant cell death of hepatocytes is due to apoptosis or necrosis after ischemia/reperfusion injury. In this study we investigated the predominant cell death of hepatocytes after cold ischemia/reperfusion injury using the Annexin V-based assay, and evaluated the anti-apoptotic effect of ascorbic acid 2-glucoside (AA-2G) added to the University of Wisconsin solution (UW solution) in rat liver transplantation. The retrieved liver was preserved in 4 UW solution for 24 h, and then transplanted orthotopically to the syngeneic Wistar recipient. The animals were divided into 2 groups, a control group (n=10), in which liver grafts were preserved in UW solution (4), and an AA-2G group (n=10), in which liver grafts were preserved in UW solution (4) with AA-2G (100 ug/ml). The serum AST level 4 h after reperfusion in the control group was significantly suppressed in the AA-2G group, and the bile production of the liver graft in the AA-2G group was well recovered. The mean survival time in the AA-2G group was significantly improved compared with that in the control group. Annexin-V and Propidium iodide staining 4 h after reperfusion showed a significantly higher percentage of viable hepatocytes in the AA-2G group compared with the control group (93.4 +/- 2.0 vs. 80.3 +- 2.1%, P&#60;0.05). In the control group, the main cell death of hepatocytes was apoptosis (early apoptosis: 10.0 +- 4.7%, late apoptosis: 6.4 +/- 1.7%). The addition of AA-2G to the UW solution significantly inhibited both early and late apoptotic cell death 4 h after reperfusion (early apoptosis: 0.98 +/- 0.88%, late apoptosis: 2.2 +/- 1.1%). The expression of caspase 9 in the immunostaining of the liver graft was suppressed in the AA-2G group compared with in the control group. Our study using the Annexin V-based assay provided evidence that the predominant cell death of hepatocytes was apoptosis after 24 h cold ischemia/reperfusion injury in rat liver transplantation. The addition of AA-2G to the UW solution attenuated 24 h cold ischemia/reperfusion injury by inhibiting the apoptosis of hepatocytes.</p>
Keywords apoptosis ischemia/ reperfusion injury liver transplantation ascorbic acid 2- glucoside(AA-2G)
Amo Type Article
Published Date 2003-10
Publication Title Acta Medica Okayama
Volume volume57
Issue issue5
Publisher Okayama University Medical School
Start Page 209
End Page 216
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
File Version publisher
Refereed True
PubMed ID 14679398
Web of Sience KeyUT 000186186000001
JaLCDOI 10.18926/AMO/32294
FullText URL fulltext.pdf
Author Kuinose, Masahiko| Iwagaki, Hiromi| Morimoto, Yoshinori| Kohka, Hideo| Kobashi, Kenta| Sadamori, Hiroshi| Inagaki, Masaru| Urushihara, Naoto| Yagi, Takahito| Tanaka, Noriaki|
Abstract <p>Tacrolimus (FK-506) and cyclosporin A (CsA) are calcineurin antagonists used widely as T-cell immunosuppressants; however, their relative efficacy on the production of interleukin-18 (IL-18) remains undefined. We have examined the effects of FK-506 and CsA on the cytokine generation of human peripheral blood mononuclear cells (PBMCs) in mixed lymphocyte reaction (MLR) with lipopolysaccharide (LPS). We studied the levels of interleukin-18 (IL-18), IL-12, IL-10, IL-6, IL-2 and interferon-gamma (IFN-gamma) in the supernatant in allo-MLR by ELISA assay. Supernatant levels of IFN-gamma, IL-2, IL-6, IL-10 and IL-12 were detected 12 h after MLR and markedly increased thereafter. In contrast, production of IL-18 was detected at 12 h, reached a near maximum level at 24 h and decreased at 72 h. These results suggested that IFN-gamma production depended on IL-18, IL-12 and IL-2 in the early phase of MLR and depended mainly on IL-12 and IL-2 in the late phase. Both calcineurin antagonists inhibit the generation of IL-18, which plays a large role in allogeneic cell interactions, in macrophages and they also promote an equivalent down-regulation of T helper 1 (Th1) and Th2 responses in a concentration-dependent manner. About 90% of IFN-gamma production induced by MLR was inhibited by an anti-IL-18 antibody, showing that IL-18 can trigger IFN-gamma production in MLR. These results suggest that dual signaling consisting of antigen-driven nuclear factor of activated T cells (NFAT) activation and LPS-mediated NF-kappaB activation is crucial for IL-18 production in macrophages, and that IL-18 can trigger IFN-gamma production in T-cells by MLR.</p>
Keywords tacrolimus cyclosporin calcineurin antagonist
Amo Type Article
Published Date 2000-10
Publication Title Acta Medica Okayama
Volume volume54
Issue issue5
Publisher Okayama University Medical School
Start Page 201
End Page 209
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
File Version publisher
Refereed True
PubMed ID 11061569
Web of Sience KeyUT 000090098600003
JaLCDOI 10.18926/AMO/32095
FullText URL fulltext.pdf
Author Fujiwara, Hiroyasu| Kanazawa, Susumu| Hiraki, Takao| Mimura, Hidefumi| Yasui, Kotaro| Akaki, Shiro| Yagi, Takahito| Naomoto, Yoshio| Tanaka, Noriaki| Hiraki, Yoshio|
Abstract <p>To clarify the incidence, background, and progress of hepatic infarction following interventional procedures, cases of hepatic infarction following interventional procedures at our department during the last decade were identified by reviewing the clinical records of 1982 abdominal angiography and interventional procedures and records of abdominal CT. Nine episodes (0.5%) in 8 patients were identified as hepatic infarction following an interventional procedure. Five episodes were preceded by embolization of the hepatic or celiac artery at emergency angiography for postoperative bleeding with hemorrhagic shock. Three episodes followed the elected interventional procedure for hepatocellular carcinoma, and the remaining episode occurred after 12 months of chemoinfusion through an indwelling catheter in the hepatic artery and portal vein. Hepatic arterial occlusion in all episodes and portal venous flow abnormality in 5 episodes were observed on angiography. Four patients whose liver function was initially impaired died of hepatic infarction, although the extent of the disease on CT did not appear to be related to the mortality. Multiple risk factors, including arterial insufficiency, were observed in each patient. The incidence of hepatic infarction following interventional procedures in this series was low but sometimes fatal, and occurred most frequently in emergency embolization in hemorrhagic shock.</p>
Keywords liver infarction interventional procedure angiography computedtomography
Amo Type Article
Published Date 2004-04
Publication Title Acta Medica Okayama
Volume volume58
Issue issue2
Publisher Okayama University Medical School
Start Page 97
End Page 106
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
File Version publisher
Refereed True
PubMed ID 15255511
Web of Sience KeyUT 000221043700006
JaLCDOI 10.18926/AMO/31631
FullText URL fulltext.pdf
Author Iwagaki, Hiromi| Yagi, Takahito| Urushihara, Naoto| Kobashi, Kenta| Morimoto, Yoshinori| Isozaki, Hiroshi| Takakura, Norihisa| Tanaka, Noriaki|
Abstract <p>The relationship between endogenous cytokine antagonists and surgical stress is poorly understood. Surgical stress induces immunosuppression, and the reversed therapy of postoperative immunosuppression has been expected. The aim of the present study was to assess the effect of a serine protease inhibitor on postoperative immune reactivity. Twenty patients with colorectal cancer were randomly separated into experimental and control groups of 10 patients each. The experimental group received perioperative administration of a serine protease inhibitor while the control group did not. Plasma levels of cytokine antagonists, which suppress cell-mediated immunity, such as cortisol, interleukin-1 receptor antagonist, soluble interleukin-2 receptor (sIL-2R) and soluble tumor necrosis factors p55, p75 (sTNF-R55, -R75) were simultaneously measured. Significant reductions of plasma concentration of sIL-2R and sTNF-R55 were observed. Perioperative administration of a serine protease inhibitor may contribute to ameliorating immunosuppression after major surgery.</p>
Keywords surgical stress cytokine antagonist protease inhibitor
Amo Type Article
Published Date 1999-10
Publication Title Acta Medica Okayama
Volume volume53
Issue issue5
Publisher Okayama University Medical School
Start Page 239
End Page 244
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
File Version publisher
Refereed True
PubMed ID 10561733
Web of Sience KeyUT 000083427100006