Faculty Profiles - TAKAKI Akinobu

Papers - TAKAKI Akinobu

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Feasibility and Findings of Colonoscopy for Living-donor Liver Transplant Candidates Reviewed

Shin Ishikawa, Jun Kato, Motoaki Kuriyama, Koji Takemoto, Toshio Uraoka, Akinobu Takaki, Takahito Yagi, Kohsaku Sakaguchi

JOURNAL OF CLINICAL GASTROENTEROLOGY 43 ( 1 ) 69 - 74 2009.1

Language：English Publishing type：Research paper (scientific journal) Publisher：LIPPINCOTT WILLIAMS & WILKINS

Background and Aims: Living-donor liver transplantation (LDLT) has been widely performed in patients with end-stage liver disease and hepatocellular carcinoma in Japan. Although extrahepatic cancer survey for LDLT candidates is absolutely required. few reports have indicated the optimal surveillance method for colorectal cancer. The aim Of this study is to investigate the feasibility and findings of colonoscopy before LDLT.
Patients and Methods: Front January 2004 to August 2006. we prospectively, enrolled all of the scheduled LDLT candidates of our hospital for pretransplant colonoscopy examination.
Results: A total of 81 patients were enrolled For colonoscopy. Of these patients. 67 (83%) could actually undergo colonoscopy. Patients who could bot undergo colonoscopy exhibited more impaired liver Function than those who Could (median Model End-State Liver Disease,core: 25.5 vs. 14.5. P = 0.0003). Among patients who underwent colonoscopy. observation of total colon was attained in 64 (96%). Neoplasia was found in 28 ,,) patients, including 4 patients with adenomas >= 10 mm, 1 patient with adenomas with high-grade dysplasia. and 3 patients with invasive cancer. Patients who had advanced neoplasia (adenoma >= 10 mm. adenomas with high-grade dysplasia. or invasive cancer) were likely to have a lower performance status (PS) (7/8 were PS 3) than those who did not (P = 0.054).
Conclusions: Clinically, significant tumors were found in a considerable portion Of LDLT candidates. particularly in lower PS patients. Because immunosuppressive agents after transplantation may worsen malignant tumors. colonoscopy before transplantation is recommended in patients who can tolerate the procedure.

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Exon 2 deletion splice variant of gamma-glutamyl carboxylase causes des-gamma-carboxy prothrombin production in hepatocellular carcinoma cell lines. Reviewed

Ueda N, Shiraha H, Fujikawa T, Takaoka N, Nakanishi Y, Suzuki M, Matsuo N, Tanaka S, Nishina S, Uemura M, Takaki A, Shiratori Y, Yamamoto K

Molecular oncology 2 ( 3 ) 241 - 249 2008.10

Language：English Publishing type：Research paper (scientific journal) Publisher：WILEY

Using GGCX gene-specific real-time PCR, exon 2 deletion splice variant of vitamin K-dependent gamma-glutamyl carboxylase (GGCX) mRNA was identified in HCC cell lines. Expressions of wild type and exon 2 deletion variant of GGCX were analyzed with relevance to DCP production in HCC cell lines. Hep3B, HepG2, HuH1, HuH7, and PLC/PRF/5 produced DCP, while SK-Hep-1, HLE, HLF, and JHH1 produced no detectable level of DCP. DCP-producing cells expressed exon 2 deletion variant of GGCX mRNA and protein, while DCP-negative cells expressed no detectable level of exon 2 deletion variant of GGCX. These results suggest that exon 2 deletion splice variant of GGCX causes dysfunction of GGCX enzyme activity resulting in DCP production in HCC cell lines. (C) 2008 Federation of European Biochemical Societies. Published by Elsevier B.V. All rights reserved.

DOI： 10.1016/j.molonc.2008.06.004

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Human leukocyte antigen DR status and clinical features in Japanese patients with type 1 autoimmune hepatitis Reviewed

Yasuhiro Miyake, Yoshiaki Iwasaki, Akinobu Takaki, Toru Onishi, Ryoichi Okamoto, Kouichi Takaguchi, Hiroshi Ikeda, Yasuhiro Makino, Haruhiko Kobashi, Kohsaku Sakaguchi, Yasushi Shiratori

HEPATOLOGY RESEARCH 38 ( 1 ) 96 - 102 2008.1

Language：English Publishing type：Research paper (scientific journal) Publisher：BLACKWELL PUBLISHING

Aim: Human leukocyte antigen (HLA) DR status affects the clinical features of autoimmune hepatitis. In Caucasians, patients with DR3 have poorer outcomes. In Japan, the relationship between HLA DR status and clinical features has yet to be fully examined.
Methods: We investigated 79 patients with type 1 autoimmune hepatitis who underwent liver biopsy and were screened for HLA DR status by the polymerase chain reaction sequence specific oligonucleotide hybridization method.
Results: Fifty-five patients had DR4 and 23 had DR2. Thirteen patients had both DR2 and DR4. None had DR3. Of patients aged < 30 years, 70% did not have DR4. A tendency toward higher serum levels of immunoglobulin G was seen in patients with DR4 compared to those without, while patients with neither DR2 nor DR4 had lower serum levels of immunoglobulin G than those with only DR2 and those with only DR4. Patients with DR2 had a lower frequency of concurrentautoimmune disease. Concurrence of thyroid disease was seen only in patients with DR4. The cumulative incidental rate of the normalization of serum alanine aminotransferase levels within six months after the introduction of corticosteroid treatment was not associated with HLA DR status.
Conclusion: HLA DR status is considered to affect the clinical features of Japanese patients with type 1 autoimmune hepatitis. Japanese patients with DR2 may have different clinical features from others. In addition, diagnoses of type 1 autoimmune hepatitis should be made carefully in Japanese patients with neither DR2 nor DR4 and in those aged < 30 years.

DOI： 10.1111/j.1872-034X.2007.00204.x

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Relationship between the length of the predialysis period and the pathogenesis of diabetic end-stage renal failure

Nakatsuka Atsuko, Kanzaki Motoko, Iwata Yasuyoshi, Takaki Akinobu, Ikeda Hiroshi, Fukushima Masaki

Journal of Japanese Society for Dialysis Therapy 38 ( 8 ) 1385 - 1390 2005

Language：Japanese Publisher：The Japanese Society for Dialysis Therapy

To examine the relationship between the length of the predialysis period and the pathogenesis of diabetic end-stage renal failure, we retrospectively studied 58 hemodialyzed patients (36 males, 22 females; 62.8±10.6 (SD) years). They were subgrouped into group A (n=34) or B (n=29), respectively, depending on whether hemodialysis was started less or more than 2 years after their serum creatinine concentration had reached 2mg/dL.<br>Group A patients were ten years younger than those of group B, and showed significantly higher urinary protein excretion, lower plasma albumin concentration, and larger renal size. The incidence of cerebral infarction was higher in group B. Multiple regression analysis demonstrated that the length of predialysis period was well correlated with both patients' age and renal size. These findings suggest that the major pathogenesis of renal failure is microangiopathic glomerulosclerosis in group A, and macroangiopathic nephrosclerosis in group B. The length of the predialysis period in each case must reflect the different involvements of these two mechanisums. Especially, in older hemodialyzed diabetic patients, the number of which has been increasing in recent years, nephrosclerosis may play a larger role in diabetic nephropathy.

DOI： 10.4009/jsdt.38.1385

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[A case of focal segmental glomerulosclerosis(FSGS) complicated with chronic hepatitis B and treated with steroid and LDL apheresis]. Reviewed

Takaki A, Nakatsuka A, Satou C, Iwata Y, Ikeda H, Fukushima M

Nihon Jinzo Gakkai shi 44 ( 8 ) 806 - 812 2002.12

Language：Japanese Publisher：Japanese Society of Nephrology

A 52-year-old man was admitted to our hospital because of nephrotic syndrome. He had been monitored at our outpatient clinic for chronic hepatitis B, and had experienced histologically proven minimal change nephrotic syndrome at the ages of 40 and 51 years. Because of HBsAg positivity in his serum, steroid therapy was withheld in his earlier episodes and he recovered from nephrotic syndrome spontaneously. However, in the most recent episode the nephrotic syndrome was found difficult to control and the findings of renal biopsy showed FSGS, which is not expected in HBV-associated nephropathy. Finally, prednisolone was administered at the dose of 40 mg/day for four weeks, after which the dose was tapered. LDL apheresis was also administered three times because of the patient's incomplete response to prednisolone. His proteinuria was reduced from>10 g/day to<1 g/day, but the ALT levels and HBsAg titer increased. With stronger neominophagen C induction and very careful tapering of glucocorticoid, ALT levels and the HBsAg titer decreased. During the two-year period since the induction of glucocor ticoid therapy, urinary protein excretion has been maintained at less than 1 g/gcr, and ALT levels and HBsAg titer have not increased. We conclude that attention must be paid to dose modification of steroid therapy and strategies without immunosuppressive agents such as LDL apheresis should be considered in the case of treatment of nephrotic syndrome with HB virus.

DOI： 10.14842/jpnjnephrol1959.44.806

PubMed

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C型慢性肝炎における自己免疫現象

坂口孝作, 河本博文, 高木章乃夫

岡山医学会雑誌 105 ( 7-8 ) 795-796 1993.8

C型肝炎自己免疫性肝炎とHCV

坂口孝作, 河本博文, 高木章乃夫

臨床消化器内科 7 ( 12 ) 2007-2015 1992.11

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