研究者詳細 - 高木　章乃夫

MISC - 高木　章乃夫

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臓器移植法案改正後、急性肝不全に対する肝移植適応はどう変わったか? 当院における急性肝不全に対する脳死肝移植の現状

安中哲也, 高木章乃夫, 保田裕子, 八木孝仁, 吉田龍一, 楳田祐三, 三宅康広, 篠浦先, 貞森裕, 山本和秀

肝臓 53 ( 7 ) 449 - 450 2012年7月

Hepatitis B Vaccine Repeat After Liver Transplantation Succeeds in Type-B Cirrhotics With Marital, High-Hbs-Antibody Donors

Akinobu Takaki, Takahito Yagi, Hiroshi Sadamori, Susumu Shinoura, Yuzo Umeda, Ryuichi Yoshida, Daisuke Sato, Masashi Utsumi, Tetsuya Yasunaka, Kazuhide Yamamoto

GASTROENTEROLOGY 142 ( 5 ) S998 - S998 2012年5月

Risk factors for recurrence after transarterial chemoembolization for early-stage hepatocellular carcinoma

Hideaki Kinugasa, Kazuhiro Nouso, Yasuto Takeuchi, Tetsuya Yasunaka, Hideki Onishi, Shin-ichiro Nakamura, Hidenori Shiraha, Kenji Kuwaki, Hiroaki Hagihara, Fusao Ikeda, Yasuhiro Miyake, Akinobu Takaki, Kazuhide Yamamoto

JOURNAL OF GASTROENTEROLOGY 47 ( 4 ) 421 - 426 2012年4月

記述言語：英語出版者・発行元：SPRINGER TOKYO

Radiofrequency ablation (RFA) is a standard therapy for the treatment of hepatocellular carcinoma (HCC) with 3 or fewer tumors of up to 3 cm (early-stage HCC); when RFA is unsuccessful or unfeasible, transcatheter arterial chemoembolization (TACE) has often been performed. However, little information about the outcome of TACE for early-stage HCC has been reported and it is hard to decide whether to perform additional treatment following TACE in these difficult conditions. The aim of this study was to determine the risk factors for local or intrahepatic distant recurrence after TACE in early-stage HCC.
Among 1,560 newly diagnosed HCC patients who were admitted to Okayama University Hospital, 43 patients with early-stage HCC who received only TACE in at least one nodule were enrolled in this study. We analyzed the risk factors for local and distant recurrence by the Cox proportional hazard model.
The local recurrence rates and intrahepatic distant recurrence rates at 3 months, 6 months, and 1 year were 18.6, 33.4, and 61.8%, and 2.8, 2.8, and 10.2%, respectively. Among 12 parameters examined as possible risk factors for recurrence, heterogeneous Lipiodol uptake (risk ratio 3.38; 95% confidence interval 1.14-10.60) and high serum des-gamma-carboxy prothrombin (DCP) (2.58; 1.03-7.14) were significantly correlated with local recurrence, and the presence of multiple tumors (10.64; 1.76-93.75) was significantly correlated with intrahepatic distant recurrence.
Heterogeneous Lipiodol uptake, high serum DCP, and multiple tumors are risk factors for recurrence in patients with early-stage HCC who have undergone palliative TACE.

DOI： 10.1007/s00535-011-0492-9

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肝癌臨床 HCV関連肝細胞癌の遺伝子学的成因についての検討

竹内康人, 池田房雄, 森藤由記, 萩原宏明, 安中哲也, 桑木健志, 三宅康広, 大西秀樹, 中村進一郎, 白羽英則, 高木章乃夫, 岩崎良章, 能祖一裕, 山本和秀

肝臓 53 ( Suppl.1 ) A263 - A263 2012年4月

B型肝炎腹腔鏡検査での赤色紋理は、B型慢性肝炎の肝発癌危険因子である

安中哲也, 池田房雄, 三宅康広, 白羽英則, 高木章乃夫, 藤岡真一, 小橋春彦, 山本和秀

肝臓 53 ( Suppl.1 ) A326 - A326 2012年4月

肝癌基礎肝細胞癌において、カルボキシラーゼ活性低下は、SPARC発現を誘導し、細胞接着低下、EMT進行を引き起こす

白羽英則, 堀口繁, 岩室雅也, 片岡淳朗, 永原照也, 高木章乃夫, 萩原宏明, 桑木健志, 大西秀樹, 中村進一郎, 能祖一裕, 山本和秀

肝臓 53 ( Suppl.1 ) A232 - A232 2012年4月

C型肝炎臨床 C型慢性肝炎2型高ウイルス量症例に対するペグインターフェロンα+リバビリン併用療法の期間延長による治療効果改善の検討

難波真太郎, 池田房雄, 岩崎良章, 松下浩志, 森藤由記, 竹内康人, 安中哲也, 三宅康広, 高木章乃夫, 高口浩一, 荒木康之, 山本和秀

肝臓 53 ( Suppl.1 ) A357 - A357 2012年4月

C型慢性肝炎に対するペグインターフェロンα+リバビリン併用療法における血清フェリチン値の検討

岩崎良章, 藤岡真一, 池田房雄, 橋本訓招, 荒木康之, 岡本良一, 高木敏行, 下江俊成, 宮武宏和, 高畠弘行, 芦田耕三, 狩山和也, 坂口孝作, 三宅康広, 高木章乃夫, 山本和秀, 岡山C型肝炎研究会

肝臓 53 ( Suppl.1 ) A528 - A528 2012年4月

Streptozotocin投与NASHモデルマウスにおける病態進行と水素水投与の有効性の検討

河合大介, 高木章乃夫, 山本和秀, 松本和幸, 石川久, 津崎龍一郎, 安中哲也, 中司敦子, 小池和子, 三宅康広, 白羽英則, 和田淳

日本消化器病学会雑誌 109 ( 臨増総会 ) A325 - A325 2012年3月

RUNX3の欠失はMRP発現を誘導しgemcitabine感受性に影響を与える

堀口繁, 白羽英則, 永原照也, 片岡淳朗, 岩室雅也, 高木章乃夫, 能祖一裕, 八木孝仁, 山本和秀

日本消化器病学会雑誌 109 ( 臨増総会 ) A335 - A335 2012年3月

HEPATIC ANGIOSARCOMA WITH CHARACTERISTIC LAPAROSCOPIC FINDINGS

Tetsuya Yasunaka, Fusao Ikeda, Haruhiko Kobashi, Yasuhiro Miyake, Akinobu Takaki, Yoshiaki Iwasaki, Hajime Hada, Kazuhide Yamamoto, Masayuki Nakano

DIGESTIVE ENDOSCOPY 24 ( 2 ) 124 - 124 2012年3月

Fulminant hepatitis: Who survives without liver transplantation?

Yasuhiro Miyake, Tetsuya Yasunaka, Fusao Ikeda, Akinobu Takaki, Kazuhiro Nouso, Kazuhide Yamamoto

HEPATOLOGY RESEARCH 42 ( 1 ) 60 - 67 2012年1月

記述言語：英語出版者・発行元：WILEY-BLACKWELL

Aim: In order to rescue more patients with fulminant hepatitis (FH) in a setting of the shortage of liver grafts, it is important not only to determine the suitable timing for liver transplantation (LT) but also to reduce avoidable operations for patients surviving without LT. This study aimed to identify prognostic parameters for survival without LT in FH patients.
Methods: In 96 FH patients who did not receive LT, we examined prognostic parameters at the time of the diagnosis of FH, which were associated with patient's survival.
Results: Fifty-three patients (55%) were female. The median age was 48 years. At the time of the diagnosis of FH, hepatic coma grade was II in 63 patients (66%), III in 22 (23%) and IV in 11 (11%). Forty-six patients (48%) were in a state of systemic inflammatory response syndrome (SIRS). Four parameters of age (< 45 years), SIRS (no), direct bilirubin/total bilirubin ratio (> 0.65), and total bilirubin (< 12.0 mg/dL) were associated with patient's survival. Overall survival rate of eight patients ulfilling all four parameters were 88%. In 17 patients fulfilling any three parameters, 2-week, 4-week and overall survival rates were 82%, 77% and 71%, respectively. On the other hand, overall survival rate of 38 patients fulfilling any one parameter or none was less than 10%.
Conclusions: Patients fulfilling all four parameters will be successfully treated without LT. In patients fulfilling any three parameters, intensive care including artificial liver support in expectation of hepatic regeneration during a few weeks may be possible.

DOI： 10.1111/j.1872-034X.2011.00894.x

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脂肪肝,脂肪性肝炎(NAFLD,NASH)

山本和秀, 高木章乃夫

MEDICINAL 2 ( 4 ) 76 - 84 2012年

SIRS Score Reflects Clinical Features of Non-Acetaminophen-Related Acute Liver Failure with Hepatic Coma

Yasuhiro Miyake, Tetsuya Yasunaka, Fusao Ikeda, Akinobu Takaki, Kazuhiro Nouso, Kazuhide Yamamoto

INTERNAL MEDICINE 51 ( 8 ) 823 - 828 2012年

記述言語：英語出版者・発行元：JAPAN SOC INTERNAL MEDICINE

Objective In acetaminophen-induced acute liver failure (ALF), the hepatic coma grade worsens and mortality rates increase, as the number of systemic inflammatory response syndrome components fulfilled (SIRS score) increases. This study aimed to investigate the impact of SIRS score on clinical features of non-acetaminophen-related ALF.
Methods Ninety-nine patients with non-acetaminophen-related ALF with hepatic coma who did not undergo liver transplantation were investigated. Each patient was given a SIRS score of 0, 1, 2, 3 or 4 at the time of diagnosis.
Results At the diagnosis of ALF with hepatic coma, with the increase of SIRS score, hepatic coma grade and prothrombin activity were deteriorated. After the diagnosis of ALF with hepatic coma, 25 patients (25%) developed acute respiratory distress syndrome (ARDS), 31 patients (31%) developed disseminated intravascular coagulation (DIC), and 21 patients (22%) developed acute renal failure (ARF). Thirty-eight patients (38%) developed MOF. With the increase of SIRS score, frequencies of the development of ARDS, DIC and MOF increased. ARF was more frequently developed in patients with a SIRS score of 2 or higher. Overall, 36 patients (36%) survived. Overall survival rate was 66% in 29 patients with a score of 0, 43% in 21 patients with a score of 1, 17% in 29 patients with a score of 2 and 15% in 20 patients with a score of 3 or 4.
Conclusion SIRS score will be useful for predicting not only the overall survival but also the development of complications such as ARDS, DIC and MOF in non-acetaminophen-related ALF with hepatic coma.

DOI： 10.2169/internalmedicine.51.6686

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Serum Levels of Soluble Adhesion Molecules as Prognostic Factors for Acute Liver Failure

Atsuyuki Ohnishi, Yasuhiro Miyake, Hiroshi Matsushita, Kazuyuki Matsumoto, Akinobu Takaki, Tetsuya Yasunaka, Kazuko Koike, Fusao Ikeda, Hidenori Shiraha, Kazuhiro Nouso, Kazuhide Yamamoto

DIGESTION 86 ( 2 ) 122 - 128 2012年

記述言語：英語出版者・発行元：KARGER

Background/Aims: In patients with septic shock, the degree of liver dysfunction is correlated with serum levels of soluble intercellular adhesion molecule (sICAM)-1. We aimed to assess the usefulness of serum levels of soluble adhesion molecules as prognostic factors for acute liver failure (ALF). Methods: Serum levels of soluble platelet endothelial cell adhesion molecule (sPECAM)-1, sICAM-3, soluble endothelial (sE) selectin, sICAM-1, soluble platelet selectin, and soluble vascular cell adhesion molecule-1 on admission were measured in 37 ALF patients and 34 healthy controls. Results: Twenty-two ALF patients (59%) reached to fatal outcomes. Serum levels of sPECAM-1, sICAM-3, sE-selectin and sICAM-1 were higher in ALF patients than healthy controls. In 37 ALF patients, by the multivariate logistic regression analysis, ratio of direct to total bilirubin (per 0.1 increase; OR 0.11, 95% CI 0.01-0.99), serum sPECAM-1 level (per 100 ng/ml increase; OR 4.37, 95% CI 1.23-15.5) and serum sICAM-1 level (per 100 ng/ml increase; OR 0.49, 95% CI 0.27-0.89) were associated with fatal outcomes. Using receiver operating characteristics curve, each area under the curve of serum sPECAM-1 and sICMA-1 levels as prognostic factors was 0.71 and 0.74, respectively. Conclusion: Serum sPECAM-1 and sICAM-1 levels may be useful for predicting the prognosis of ALF. Copyright (c) 2012 S. Karger AG, Basel

DOI： 10.1159/000339496

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Mizoribine, tacrolimus, and corticosteroid combination therapy successfully induces remission in patients with lupus nephritis.

Kagawa H, Hiromasa T, Hara T, Takaki A, Yamanaka R, Sada KE, Makino H

Clin Exp Nephrol 16 ( 5 ) 760 - 766 2012年

記述言語：英語出版者・発行元：Springer

Conventional cyclophosphamide-based treatment regimens for lupus nephritis (LN) are still not considered to be optimal. The aim of this study was to evaluate the efficacy and safety of mizoribine, tacrolimus, and corticosteroid combination therapy for LN. We retrospectively evaluated a combination treatment of mizoribine and tacrolimus with corticosteroids as induction therapy in eight newly diagnosed systemic lupus erythematosus (SLE) patients with biopsy-proven LN. All patients were women, and their mean [standard deviation (SD)] age was 48.5 (20) years. All patients (100 %) had positive anti-double-stranded DNA (anti-dsDNA) antibody titers, and four (50.0 %) were nephrotic. Mean (SD) serum creatinine and daily proteinuria levels were 0.72 (0.4) mg/dl (range 0.33-1.55 mg/dl) and 4.56 (2.8) g (range 0.77-8.2 g), respectively. By month 2, significant improvements in the anti-dsDNA antibody titers, levels of proteinuria, serum albumin, and C3, and SLE disease activity index score were observed. By month 6, seven patients (87.5 %) were in complete remission, with normalized levels of both proteinuria and serum creatinine. This pilot study suggests that mizoribine and tacrolimus treatment with corticosteroids is well tolerated and may prove to be an optimal alternative remission-inducing regimen for LN.

DOI： 10.1007/s10157-012-0632-4

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核酸アナログ併用下、低用量HBIG・ワクチンによるB型肝炎ウイルスコントロール

高木章乃夫, 八木孝仁, 貞森裕, 松田浩明, 安中哲也, 篠浦先, 楳田祐三, 吉田龍一, 内海方嗣, 小池和子, 池田房雄, 三宅康広, 白羽英則, 保田裕子, 藤原俊義, 山本和秀

移植 46 ( 6 ) 660 - 660 2011年12月

移植後肝疾患における末梢血制御性T細胞の頻度の検討

内海方嗣, 小池和子, 高木章乃夫, 八木孝仁, 渡辺信和, Napier Stephanie C, 貞森裕, 松田浩明, 篠浦先, 楳田祐三, 吉田龍一, 佐藤太祐, 三宅康広, 安中哲也, 山本和秀, 藤原俊義

移植 46 ( 6 ) 678 - 678 2011年12月

理想的な肝移植チームの在りかた岡山大学病院における肝移植患者に対する全科横断的な取り組みアルコール性肝硬変患者に対する取り組みを中心に

吉田龍一, 八木孝仁, 貞森裕, 松田浩明, 篠浦先, 楳田祐三, 佐藤太佑, 内海方嗣, 高木章乃夫, 山本和秀, 松本洋輔, 河本泰信, 保田裕子, 清水千聖, 藤原俊義

移植 46 ( 6 ) 647 - 648 2011年12月

血管新生関連サイトカインによる進行肝細胞癌の治療効果予測

宮原孝治, 能祖一裕, 衣笠秀明, 竹内康人, 友田健, 小林沙代, 萩原宏明, 安中哲也, 桑木健志, 大西秀樹, 池田房雄, 三宅康広, 中村進一郎, 白羽英則, 高木章乃夫, 山本和秀

肝臓 52 ( Suppl.3 ) A810 - A810 2011年11月

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