| 著者 | Takagi, Kosei| Yagi, Takahito| Shinoura, Susumu| Umeda, Yuzo| Yoshida, Ryuichi| Nobuoka, Daisuke| Watanabe, Nobuyuki| Kuise, Takashi| Fuji, Tomokazu| Araki, Hiroyuki| Fujiwara, Toshiyoshi| |
|---|---|
| 発行日 | 2017-02 |
| 出版物タイトル | Acta Medica Okayama |
| 巻 | 71巻 |
| 号 | 1号 |
| 資料タイプ | 学術雑誌論文 |
| JaLCDOI | 10.18926/AMO/54830 |
| JaLCDOI | 10.18926/AMO/54594 |
|---|---|
| フルテキストURL | 70_5_363.pdf |
| 著者 | Takagi, Kosei| Yagi, Takahito| Yoshida, Ryuichi| Shinoura, Susumu| Umeda, Yuzo| Nobuoka, Daisuke| Kuise, Takashi| Watanabe, Nobuyuki| Fujiwara, Toshiyoshi| |
| 抄録 | 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. |
| キーワード | sarcopenia American Society of Anesthesiologists physical status hepatectomy hepatocellular carcinoma prognostic factor |
| Amo Type | Original Articles |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2016-10 |
| 巻 | 70巻 |
| 号 | 5号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 363 |
| 終了ページ | 370 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| 資料タイプ | 学術雑誌論文 |
| 言語 | 英語 |
| 著作権者 | CopyrightⒸ 2016 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 27777428 |
| Web of Science KeyUT | 000388098700005 |
| JaLCDOI | 10.18926/AMO/54419 |
|---|---|
| フルテキストURL | 70_3_197.pdf |
| 著者 | Takagi, Kosei| Yagi, Takahito| Yoshida, Ryuichi| Shinoura, Susumu| Umeda, Yuzo| Nobuoka, Daisuke| Kuise, Takashi| Watanabe, Nobuyuki| Sui, Kenta| Fuji, Tomokazu| Fujiwara, Toshiyoshi| |
| 抄録 | 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. |
| キーワード | pancreaticoduodenectomy surgical outcome mortality major complication length of stay |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2016-06 |
| 巻 | 70巻 |
| 号 | 3号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 197 |
| 終了ページ | 203 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| 資料タイプ | 学術雑誌論文 |
| 言語 | 英語 |
| 著作権者 | CopyrightⒸ 2016 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 27339209 |
| Web of Science KeyUT | 000379406100007 |
| JaLCDOI | 10.18926/AMO/52898 |
|---|---|
| フルテキストURL | 68_5_291.pdf |
| 著者 | 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| |
| 抄録 | 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. |
| キーワード | interferon gamma ELISPOT assay single nucleotide polymorphisms dendritic cell CD4 T cell |
| Amo Type | Original Article |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2014-10 |
| 巻 | 68巻 |
| 号 | 5号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 291 |
| 終了ページ | 302 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| 資料タイプ | 学術雑誌論文 |
| 言語 | 英語 |
| 著作権者 | CopyrightⒸ 2014 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 25338486 |
| Web of Science KeyUT | 000343269300006 |
| 関連URL | http://ousar.lib.okayama-u.ac.jp/metadata/53129 |
| フルテキストURL | WorldJHepatology_5_4_189-195.pdf |
|---|---|
| 著者 | Satoh, Daisuke| Yagi, Takahito| Nagasaka, Takeshi| Shinoura, Susumu| Umeda, Yuzo| Yoshida, Ryuichi| Utsumi, Masashi| Tanaka, Takehiro| Sadamori, Hiroshi| Fujiwara, Toshiyoshi| |
| キーワード | Non-alcoholic fatty liver disease Pancreatoduodenectomy CD14 Endotoxin Kupffer cells |
| 発行日 | 2013-04-27 |
| 出版物タイトル | World Journal of Hepatology |
| 巻 | 5巻 |
| 号 | 4号 |
| 開始ページ | 189 |
| 終了ページ | 195 |
| 資料タイプ | 学術雑誌論文 |
| 言語 | 英語 |
| OAI-PMH Set | 岡山大学 |
| 著作権者 | ©2013 Baishideng Publishing Group Co., Limited. All rights reserved. |
| 論文のバージョン | publisher |
| DOI | 10.4254/wjh.v5.i4.189 |
| オフィシャル URL | http://www.wjgnet.com/1948-5182/full/v5/i4/189.htm| |
| 関連URL | http://ousar.lib.okayama-u.ac.jp/metadata/51448 |
| JaLCDOI | 10.18926/AMO/49671 |
|---|---|
| フルテキストURL | 67_2_117.pdf |
| 著者 | Sadamori, Hiroshi| Yagi, Takahito| Shinoura, Susumu| Umeda, Yuzo| Yoshida, Ryuichi| Sato, Daisuke| Nobuoka, Daisuke| Utsumi, Masashi| Fujiwara, Toshiyoshi| |
| 抄録 | 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. |
| キーワード | living donor liver transplantation hepatocellular carcinoma portal vein invasion liver resection |
| Amo Type | Case Report |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2013-04 |
| 巻 | 67巻 |
| 号 | 2号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 117 |
| 終了ページ | 121 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| 資料タイプ | 学術雑誌論文 |
| 言語 | 英語 |
| 著作権者 | CopyrightⒸ 2013 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 23603929 |
| Web of Science KeyUT | 000317801700007 |
| 著者 | 篠浦 先| 藤原 俊義| |
|---|---|
| 発行日 | 2013-04-01 |
| 出版物タイトル | 岡山医学会雑誌 |
| 巻 | 125巻 |
| 号 | 1号 |
| 資料タイプ | 学術雑誌論文 |
| JaLCDOI | 10.18926/AMO/48268 |
|---|---|
| フルテキストURL | 66_2_177.pdf.pdf |
| 著者 | Utsumi, Masashi| Matsuda, Hiroaki| Sadamori, Hiroshi| Shinoura, Susumu| Umeda, Yuzo| Yoshida, Ryuichi| Satoh, Daisuke| Hashimoto, Masaaki| Yagi, Takahito| Fujiwara, Toshiyoshi| |
| 抄録 | 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. |
| キーワード | hepatocellular carcinoma lymph node metastasis hepatectomy |
| Amo Type | Case Report |
| 出版物タイトル | Acta Medica Okayama |
| 発行日 | 2012-04 |
| 巻 | 66巻 |
| 号 | 2号 |
| 出版者 | Okayama University Medical School |
| 開始ページ | 177 |
| 終了ページ | 182 |
| ISSN | 0386-300X |
| NCID | AA00508441 |
| 資料タイプ | 学術雑誌論文 |
| 言語 | 英語 |
| 著作権者 | CopyrightⒸ 2012 by Okayama University Medical School |
| 論文のバージョン | publisher |
| 査読 | 有り |
| PubMed ID | 22525476 |
| Web of Science KeyUT | 000303175300011 |
| 著者 | 篠浦 先| 八木 孝仁| 貞森 裕| 松田 浩明| 楳田 祐三| 吉田 龍一| 佐藤 太佑| 内海 方嗣| 横道 直佑| 杭瀬 崇| 藤原 俊義| |
|---|---|
| 発行日 | 2012-04-01 |
| 出版物タイトル | 岡山医学会雑誌 |
| 巻 | 124巻 |
| 号 | 1号 |
| 資料タイプ | 学術雑誌論文 |
| 著者 | 佐藤 太祐| 八木 孝仁| 貞森 裕| 松田 浩明| 篠浦 先| 楳田 祐三| 吉田 龍一| 内海 方嗣| 藤原 俊義| |
|---|---|
| 発行日 | 2011-12-01 |
| 出版物タイトル | 岡山医学会雑誌 |
| 巻 | 123巻 |
| 号 | 3号 |
| 資料タイプ | 学術雑誌論文 |