JaLCDOI 10.18926/AMO/56457
フルテキストURL 73_1_43.pdf
著者 Ikeda, Ailee| Takaki, Akinobu| Yasunaka, Tetsuya| Oyama, Atsushi| Adachi, Takuya| Wada, Nozomu| Onishi, Hideki| Ikeda, Fusao| Shiraha, Hidenori| Yoshida, Kazuhiro| Kuise, Takashi| Nobuoka, Daisuke| Yoshida, Ryuichi| Umeda, Yuzo| Yagi, Takahito| Fujiwara, Toshiyoshi| Okada, Hiroyuki|
抄録 Post-orthotopic liver transplantation (OLT) hepatitis B recurrence is well-controlled with a nucleos(t)ide analogue and hepatitis B immunoglobulin (HBIG) combination, but the high cost and the potential risk of unknown infection associated with HBIG remain unresolved issues. Low-cost recombinant hepatitis B virus (HBV) vaccine administration is a potential solution to these problems. We retrospectively analyzed the rate and predictive factors of HBV vaccine success in 49 post-OLT patients: liver cirrhosis-type B (LC-B), n=28 patients; acute liver failure-type B (ALF-B), n=8; and non-HBV-related end-stage liver disease (non-B ESLD) who received a liver from anti-hepatitis B core antibody-positive donors, n=13. A positive anti-hepatitis B surface antibody response was achieved in 29% (8/28) of the LC-B group, 88% (7/8) of the ALF-B group, and 44% (4/9) of the adult non-B ESLD group. All four non-B ESLD infants showed vaccine success. The predictive factors for a good response in LC-B were young age, marital donor, and high donor age. ALF-B and non-B ESLD infants are thus good vaccination candidates. LC-B patients with marital donors are also good candidates, perhaps because the donated liver maintains an efficient immune memory to HBV, as the donors had already been infected in adulthood and showed adequate anti-HBV immune responses.
キーワード acute liver failure hepatitis B hepatitis B vaccine liver cirrhosis liver transplantation
Amo Type Original Article
発行日 2019-02
出版物タイトル Acta Medica Okayama
73巻
1号
出版者 Okayama University Medical School
開始ページ 41
終了ページ 50
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2019 by Okayama University Medical School
論文のバージョン publisher
査読 有り
JaLCDOI 10.18926/AMO/56178
フルテキストURL 72_4_401.pdf
著者 Wada, Nozomu| Ikeda, Fusao| Mori, Chizuru| Takaguchi, Koichi| Fujioka, Shin-ichi| Kobashi, Haruhiko| Morimoto, Yoichi| Kariyama, Kazuya| Sakaguchi, Kosaku| Hashimoto, Noriaki| Moriya, Akio| Kawaguchi, Mitsuhiko| Miyatake, Hirokazu| Hagihara, Hiroaki| Kubota, Junichi| Takayama, Hiroki| Takeuchi, Yasuto| Yasunaka, Tetsuya| Takaki, Akinobu| Iwasaki, Yoshiaki| Okada, Hiroyuki|
抄録 Daclatasvir (DCV) + asunaprevir (ASV) combination therapy has become available for patients with hepatitis C virus (HCV) serogroup 1 infection. We studied the efficacy of this therapy by focusing on the factors associated with sustained virological responses (SVR) including resistance-associated variants (RAVs) and mixed infection of different HCV genotypes. We enrolled 951 HCV serogroup 1-positive patients who received this combination therapy at our hospital or affiliated hospitals. The presence of RAVs in non-structural (NS) regions 3 and 5A was analyzed by direct sequencing. HCV genotypes were determined by PCR with genotype-specific primers targeting HCV core and NS5B regions. SVR was achieved in 91.1% of patients. Female sex, age > 70 years, and RAVs were significantly associated with non-SVR (p<0.01 for all). Propensity score-matching results among the patients without RAVs regarding sex, age, and fibrosis revealed that mixed HCV infection determined by HCV NS5B genotyping showed significantly lower SVR rates than 1B-mono infection (p=0.02). Female sex and RAVs were significant factors associated with treatment failure of this combination therapy for patients with HCV serogroup 1 infection. Mixed HCV infection other than 1B-mono infection would be useful for predicting treatment failure.
キーワード mixed genotype daclatasvir asunaprevir HCV serogrouping 1 infection
Amo Type Original Article
発行日 2018-08
出版物タイトル Acta Medica Okayama
72巻
4号
出版者 Okayama University Medical School
開始ページ 401
終了ページ 406
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2018 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 30140089
JaLCDOI 10.18926/AMO/55662
フルテキストURL 72_1_47.pdf
著者 Ako, Soichiro| Nakamura, Shinichiro| Nouso, Kazuhiro| Dohi, Chihiro| Wada, Nozomu| Morimoto, Yuki| Takeuchi, Yasuto| Yasunaka, Tetsuya| Kuwaki, Kenji| Onishi, Hideki| Ikeda, Fusao| Shiraha, Hidenori| Takaki, Akinobu| Okada, Hiroyuki|
抄録 Transcatheter arterial chemoembolization (TACE) is often performed before radiofrequency ablation (RFA) for the treatment of early-stage hepatocellular carcinoma (HCC). TACE prior to RFA can expand the ablated area and reduce the tumor size, facilitating complete ablation. However, the factors correlated with size reduction remain uncertain. The aim of this study was to identify the factors associated with size reduction by TACE and develop a formula to predict the reduction rate. A total of 100 HCC patients treated with TACE followed by RFA at least 20 days later were enrolled. The tumor size was measured at the time of TACE and RFA, and correlations between the reduction rate and 13 clinical factors were examined. A formula to predict the reduction rate was built using the factors obtained by the analysis. Reduction in the tumor size was observed in 69 nodules, and the median reduction rate was 16.2%. A multivariate regression analysis revealed that a large tumor size (p< 0.01) and a long interval between the therapies (p= 0.01) were factors for a high tumor reduction rate, with tumor size more strongly related to the degree of reduction. A size reduction of more than 10% can be expected by waiting 20 days after TACE when the size of the tumor at TACE is over 25 mm in diameter. The tumor size
キーワード hepatocellular carcinoma transcatheter arterial chemoembolization radiofrequency ablation interval size reduction
Amo Type Original Article
発行日 2018-02
出版物タイトル Acta Medica Okayama
72巻
1号
出版者 Okayama University Medical School
開始ページ 47
終了ページ 52
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2018 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 29463938
JaLCDOI 10.18926/AMO/53996
フルテキストURL 70_1_1.pdf
著者 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|
抄録 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.
キーワード entecavir hepatitis B virus lamivudine hepatocellular carcinoma
Amo Type Original Article
発行日 2016-02
出版物タイトル Acta Medica Okayama
70巻
1号
出版者 Okayama University Medical School
開始ページ 1
終了ページ 12
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
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 26899604
Web of Sience KeyUT 000371288700001
著者 Nakatsuka, Atsuko| Matsuyama, Makoto| Yamaguchi, Satoshi| Katayama, Akihiro| Eguchi, Jun| Murakami, Kazutoshi| Teshigawara, Sanae| Ogawa, Daisuke| Wada, Nozomu| Yasunaka, Tetsuya| Ikeda, Fusao| Takaki, Akinobu| Watanabe, Eijiro| Wada, Jun|
発行日 2016-02-17
出版物タイトル Scientific Reports
6巻
資料タイプ 学術雑誌論文
著者 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|
発行日 2015
出版物タイトル Scientific reports
5巻
資料タイプ 学術雑誌論文
JaLCDOI 10.18926/AMO/53677
フルテキストURL 69_5_307.pdf
著者 Wada, Nozomu| Nouso, Kazuhiro| Kariyama, Kazuya| Wakuta, Akiko| Kishida, Masayuki| Nishimura, Mamoru| Higashi, Toshihiro|
抄録 Sarcoidosis is a systemic disease characterized by the formation of non-caseating granulomas in multiple organs. In the diagnosis of sarcoidosis, imaging modalities such as ultrasonography, computed tomography (CT) and magnetic resonance imaging (MRI) are useful;however, there are few reports of MRI imaging using gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB) MRI. A 46-year-old Japanese female with suspected pulmonary sarcoidosis was admitted to our hospital because low-density mottles in the liver were observed incidentally by chest CT. The low-density mottles were not enhanced at the arterial phase or portal phase by abdominal CT and MRI, and decreased uptake was observed in the hepatobiliary phase of Gd-EOB MRI. No hematological disorder was observed except for a slight increase of biliary enzymes. The lesion was diagnosed as liver sarcoidosis by the liver biopsy. Since the patient refused steroid therapy, we prescribed ursodeoxycholic acid (UDCA). 600mg/day. The serum levels of biliary enzymes were normalized and the abdominal CT findings gradually improved after the initiation of UDCA medication. Gd-EOB MRI showed unique hypointense areas in the liver at the hepatobiliary phase, which might be useful in the diagnosis of liver sarcoidosis.
キーワード liver sarcoidosis ursodeoxycholic acid (UDCA) gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB)
Amo Type Case Report
発行日 2015-10
出版物タイトル Acta Medica Okayama
69巻
5号
出版者 Okayama University Medical School
開始ページ 307
終了ページ 311
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2015 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 26490028
Web of Sience KeyUT 000365519600007
JaLCDOI 10.18926/AMO/53558
フルテキストURL 69_4_219.pdf
著者 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|
抄録 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.
キーワード hepatocellular carcinoma radiofrequency ablation ablated margin tumor location
Amo Type Original Article
発行日 2015-08
出版物タイトル Acta Medica Okayama
69巻
4号
出版者 Okayama University Medical School
開始ページ 219
終了ページ 226
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2015 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 26289913
Web of Sience KeyUT 000365519100005
JaLCDOI 10.18926/AMO/52790
フルテキストURL 68_4_243.pdf
著者 Wada, Nozomu| Yasunaka, Tetsuya| Ikeda, Fusao| Nishina, Sohji| Korenaga, Masaaki| Hino, Keisuke| Fujioka, Shin-ichi| Osawa, Toshiya| Itoshima, Tatsuya| Kawanaka, Miwa| Yamada, Gotaro| Kariyama, Kazuya| Takayama, Hiroki| Kubota, Junichi| Morimoto, Yoichi| Mizushima, Takaaki| Yamashita, Haruhiko| Tanioka, Hiroaki| Negoro, Yuji| Toshimori, Junichi| Kobashi, Haruhiko| Hirano, Atsushi| Itano, Yasuo| Takaki, Akinobu| Yamamoto, Kazuhide|
抄録 Hepatitis B virus (HBV) is one of the major viruses causing acute hepatitis. Recently, the incidence of acute hepatitis with genotype A has been increasing in Japan. The aim of this study was to investigate acute hepatitis B (AHB) in Okayama prefecture, with special attention to HBV genotype A. AHB patients who visited one of 12 general hospitals in Okayama prefecture between 2006 and 2010 were retrospectively analyzed. Over the course of the study period, 128 patients were diagnosed with AHB. Sexual transmission was supposed in the majority of patients (78 patients, 61%), including 59 (76%) having sex with heterosexual partners. The genotypes of HBV were assessed in 90 patients (70%), of whom 27 patients were infected with genotype A, 5 with genotype B, and 58 with genotype C. The prevalence of genotype A was significantly higher among male patients (28.7%), aged 20-29 (35.6%, p<0.01), among men who had sex with men (100%, p<0.005), and among patients having sex with unspecified partners (44.8%, p<0.005). Genotype A was not a significant factor associated with delayed HBsAg disappearance. Caution should be exercised with regard to sexually transmissible diseases in order to slow the pandemic spread of AHB due to genotype A.
キーワード acute hepatitis hepatitis B virus
Amo Type Original Article
発行日 2014-08
出版物タイトル Acta Medica Okayama
68巻
4号
出版者 Okayama University Medical School
開始ページ 243
終了ページ 247
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
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 25145410
Web of Sience KeyUT 000340687500006
JaLCDOI 10.18926/AMO/48568
フルテキストURL 66_3_279.pdf
著者 Nishimura, Mamoru| Nouso, Kazuhiro| Kariyama, Kazuya| Wakuta, Akiko| Kishida, Masayuki| Wada, Nozomu| Higashi, Toshihiro| Yamamoto, Kazuhide|
抄録 The artificial ascites technique is often used during radiofrequency ablation (RFA) for hepatocellular carcinoma (HCC) treatment because it prevents visceral damage and improves visualization by minimizing interference of the lungs and mesentery. This study determined the efficacy and safety of RFA using the artificial ascites technique in HCC patients. We examined 188 HCC patients who were treated by RFA and fulfilled the Milan criteria. Treatment outcomes (complete ablation rate, local recurrence rate, complication rate, liver function including total bilirubin level, alanine aminotransferase level, albumin level, and prothrombin time) were compared among patients divided into 3 groups based on the volume of artificial ascites injected:GroupⅠ (n=86), no artificial ascites injected;GroupⅡ (n=35), <1,000ml artificial ascites injected;and Group Ⅲ (n=67), >1,000ml artificial ascites injected. No significant difference was observed in complete ablation or local recurrence rates among the 3 groups, or in the extent of liver function damage after RFA. Artificial ascites disappeared within 7 days; additional diuretics were needed only in 5 (all from Group Ⅲ) of 102 patients. No serious complications such as intestinal perforation or intraperitoneal bleeding were observed. Thus, we found that artificial ascites injection during RFA is effective and safe, and can be used to prevent major procedural complications.
キーワード radiofrequency ablation hepatocellular carcinoma artificial ascites
Amo Type Original Article
発行日 2012-06
出版物タイトル Acta Medica Okayama
66巻
3号
出版者 Okayama University Medical School
開始ページ 279
終了ページ 284
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
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 22729109
Web of Sience KeyUT 000305669700012