研究者詳細 - 高木　章乃夫

MISC - 高木　章乃夫

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Lamivudine treatment improves the prognosis of fulminant hepatitis B

Yasuhiro Miyake, Yoshiaki Iwasaki, Akinobu Takaki, Shin-ichi Fujioka, Kouichi Takaguchi, Hiroshi Ikeda, Haruhiko Kobashi, Kohsaku Sakaguchi, Yasushi Shiratori

INTERNAL MEDICINE 47 ( 14 ) 1293 - 1299 2008年

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

Objective The efficacy of lamivudine for fulminant hepatitis B has been reported in Europe and West Asia. However, in these reports, the main infection genotype is D. Furthermore, if lamivudine improves survival, prognostic factors for fulminant hepatitis B may differ from those reported previously. The aim of this study was to clarify the prognostic factors and the efficacy of lamivudine for fulminant hepatitis B in Japan, where the main infection genotype is B.
Methods This study was a retrospective cohort study. We selected 37 consecutive patients with fulminant hepatitis due to acute hepatitis B virus infection. As 4 of them had received liver transplantation, the data of 33 patients with a median age of 45 (range, 20-74) years were analyzed.
Results Lamivudine was administered to 10 patients. There were no differences in clinical features at the time of the diagnosis of fulminant hepatitis B between patients treated with and without lamivudine. Survival rates of patients treated with and without lamivudine were 70% and 26%, respectively. Age (>= 45 years), systemic inflammatory response syndrome, and non-administration of lamivudine were associated with fatal outcomes. The survival rates of patients treated with and without lamivudine, who were in a state of systemic inflammatory response syndrome, were 50% and 9%, and in patients aged >= 45 years, 50% and 8%, respectively.
Conclusion This study suggests the efficacy of lamivudine for fulminant hepatitis B in the area where the main infection genotype is B. We consider that lamivudine is worth administering to patients with fulminant hepatitis B.

DOI： 10.2169/internalmedicine.47.1061

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Gamma-Glutamyl-Carboxylase Regulates Development of Hepatocellular Carcinoma

Hidenori Shiraha, Tatsuya Fujikawa, Naoki Ueda, Nobuyuki Takaoka, Yutaka Nakanishi, Shigetomi Tanaka, Shin-ichi Nishina, Akinobu Takaki, Kazuhide Yamamoto

TUMOR BIOLOGY 29 41 - 41 2008年

Hepatitis C virus could be eradicated with strong immune responses after withdrawing interferon treatment post living donor liver transplantation

Akinobu Takaki, Takahito Yagi, Yoshiaki Iwasaki, Hiroshi Sadamori, Kazuko Koike, Masashi Tatsukawa, Haruhiko Kobashi, Kohsaku Sakaguchi

HEPATOLOGY 46 ( 4 ) 533A - 533A 2007年10月

30-P2-13 塩酸エピルビシンによる経カテーテル肝動脈内動注化学療法における副作用調査(副作用・有害事象,社会の期待に応える医療薬学を)

駒橋美妃, 松永尚, 高木章乃夫, 坂口孝作, 千堂年昭

日本医療薬学会年会講演要旨集 17 327 - 327 2007年9月

Gamma-glutamyl carboxylase活性低下による肝細胞癌転移能の変化

高岡伸行, 白羽英則, 藤川達也, 上田直樹, 中西豊, 松尾則行, 田中盛富, 仁科慎一, 高木章乃夫, 坂口孝作

日本消化器病学会雑誌 104 ( 臨増大会 ) A679 - A679 2007年9月

B型劇症肝炎における予後因子の解析

三宅康広, 高木章乃夫, 岩崎良章, 藤岡真一, 高口浩一, 池田弘, 小橋春彦, 坂口孝作

日本消化器病学会雑誌 104 ( 臨増大会 ) A682 - A682 2007年9月

C型慢性肝炎に対するDose escalationによるペグインターフェロン+リバビリン併用療法の有用性

岩崎良章, 荒木康之, 岡本良一, 谷口英明, 牧野泰裕, 大西亨, 下村宏之, 冨田稔, 藪下和久, 石井泰史, 池田弘, 高木章乃夫, 小橋春彦, 坂口孝作, 白鳥康史

肝臓 48 ( Suppl.2 ) A421 - A421 2007年9月

非アルコール性脂肪性肝炎(NASH)とアルコール性肝炎の腹腔鏡像及び臨床像の比較検討

庄司凡, 小橋春彦, 安中哲也, 寺田亮, 高木章乃夫, 岩崎良章, 坂口孝作

Gastroenterological Endoscopy 49 ( Suppl.2 ) 2380 - 2380 2007年9月

腹腔鏡により診断した乳癌肝転移の化学療法に伴うpseudocirrhosisの1例

安中哲也, 小橋春彦, 萩原宏明, 桑木健志, 歳森淳一, 宮武宏和, 庄司凡, 三好健司, 寺田亮, 中村進一郎, 小林功幸, 高木章乃夫, 岩崎良章, 坂口孝作

Gastroenterological Endoscopy 49 ( Suppl.2 ) 2380 - 2380 2007年9月

時間依存性共変量を用いた肝細胞癌患者の予後予測モデルの検討

桑木健志, 小林功幸, 中村進一郎, 岩堂昭太, 萩原宏明, 安中哲也, 歳森淳一, 宮武宏和, 寺田亮, 三好健司, 庄司凡, 高木章乃夫, 岩崎良章, 小橋春彦, 坂口孝作

日本消化器病学会雑誌 104 ( 臨増大会 ) A693 - A693 2007年9月

RUNX3による肝癌細胞株における細胞移動能の抑制(RUNX3 inhibits cell migration in hepatocellular carcinoma cell line)

田中盛富, 白羽英則, 中西豊, 上田直樹, 高岡伸行, 松尾則行, 仁科慎一, 藤川達也, 上村雅之, 高木章乃夫, 坂口孝作

日本癌学会総会記事 66回 139 - 139 2007年8月

特異な経過を辿った劇症B型肝炎の1例

田邊渉, 池田弘, 神野亜希子, 寺島禎彦, 菊池理, 前田有紀, 畑貴子, 山本直樹, 青山育雄, 酒井章裕, 清輔良江, 新井修, 大西秀樹, 金吉俊彦, 下村宏之, 高木章乃夫, 岩崎良章, 坂口孝作

肝臓 48 ( 8 ) 405 - 405 2007年8月

生体肝移植術前管理としての感染コントロールの重要性

高木章乃夫, 八木孝仁, 岩崎良章, 貞森裕, 松川啓義, 松田浩明, 篠浦先, 楳田祐三, 成島道樹, 庄司凡, 寺田亮, 小橋春彦, 田中紀章, 坂口孝作

肝臓 48 ( Suppl.1 ) A237 - A237 2007年4月

Limitation of combination therapy of peginterferon and ribavirin for older patients with chronic hepatitis C

Yoshiaki Iwasaki, Yasuyuki Araki, Kouichi Takaguchi, Hideaki Taniguchi, Ryoichi Okamoto, Mitsuhiko Kawaguchi, Ryo Terada, Toshiya Osawa, Shin-Ichi Fujioka, Takuya Nagano, Keiji Kita, Kazuhide Yamamoto, Akinobu Takaki, Haruhiko Kobashi, Kohsaku Sakaguchi, Yasushi Shiratori

GASTROENTEROLOGY 132 ( 4 ) A794 - A795 2007年4月

1型高ウイルス量のC型慢性肝炎に対するペグインターフェロン+リバビリン併用療法の解析

岩崎良章, 荒木康之, 高口浩一, 谷口英明, 岡本良一, 川口光彦, 寺田亮, 大澤俊哉, 藤岡真一, 永野拓也, 喜田恵治, 山本和秀, 高木章乃夫, 小橋春彦, 坂口孝作, 白鳥康史

肝臓 48 ( Suppl.1 ) A138 - A138 2007年4月

Des-gamma-carboxyl prothrombin-promoted vascular endothelial cell proliferation and migrations

Tatsuya Fujikawa, Hidenori Shiraha, Naoki Ueda, Nobuyuki Takaoka, Yutaka Nakanishi, Noriyuki Matsuo, Shigetomi Tanaka, Shin-ichi Nishina, Mayumi Suzuki, Akinobu Takaki, Kohsaku Sakaguchi, Yasushi Shiratori

JOURNAL OF BIOLOGICAL CHEMISTRY 282 ( 12 ) 8741 - 8748 2007年3月

記述言語：英語出版者・発行元：AMER SOC BIOCHEMISTRY MOLECULAR BIOLOGY INC

Des-gamma-carboxyl prothrombin (DCP) is a well recognized tumor marker for hepatocellular carcinoma. Previously, we have demonstrated that DCP stimulates cell proliferation in hepatocellular carcinoma cell lines through Met-Janus kinase 1 signal transducer and activator of transcription 3 signaling pathway. In the present study, we demonstrated that DCP induces both cell proliferation and migration in human umbilical vein endothelial cells. DCP was found to bind with the kinase insert domain receptor (KDR), alternatively referred to as vascular endothelial growth factor receptor-2. Furthermore, DCP induced autophosphorylation of KDR and its downstream effector phospholipase C-gamma and mitogen-activated protein kinase (MAPK). To support these results, we showed that DCP-induced cell proliferation and cell migration were inhibited by KDR short interfering RNA, KDR kinase inhibitor, or MAPK inhibitor. In conclusion, these results indicate that DCP is a novel type of vascular endothelial growth factor that possesses potent mitogenic and migrative activities.

DOI： 10.1074/jbc.M609358200

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A homosexual Japanese man with acute hepatitis due to hepatitis B virus genotype Ae, concurrent with amebic colitis

Yasuhiro Miyake, Yoshiaki Iwasaki, Shin Ishikawa, Masashi Tatsukawa, Toru Nawa, Jun Kato, Akinobu Takaki, Haruhiko Kobashi, Kohsaku Sakaguchi, Yasushi Shiratori

ACTA MEDICA OKAYAMA 61 ( 1 ) 35 - 39 2007年2月

記述言語：英語出版者・発行元：OKAYAMA UNIV MED SCHOOL

We report herein a case with acute hepatitis due to hepatitis B virus genotype Ale, concurrent with amebic colitis. A 39-year-old homosexual Japanese man was admitted to our hospital with jaundice. Laboratory tests showed an elevation of transaminase and positivity for hepatitis B surface antigen and IgM-type antibody to hepatitis B core antigen. The hepatitis B virus genotype was determined to be Ae. Furthermore, a mud-like stool with blood and mucous had sometimes been noted during the past 3 years, and amebic colitis was shown by colonofiberscopy during hospitalization. The patient was diagnosed with acute hepatitis B, concurrent with amebic colitis, and was successfully treated with lamivudine and metronidazole. In Japanese patients with acute hepatitis B virus genotype A infection, homosexual activity tends to be high. Furthermore, in Japanese homosexual men, amebiasis has been increasing. Thus, in Japanese patients with acute hepatitis B, a determination of genotype should be performed in order to investigate the route of transmission of hepatitis B virus, and a search for amebiasis should be performed in patients with acute hepatitis due to hepatitis B virus genotype A. Furthermore, education of homosexual men regarding hepatitis B virus, hepatitis B virus vaccination, and amebiasis is urgently required.

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Short-term high-dose followed by long-term low-dose hepatitis B immunoglobulin and lamivudine therapy prevented recurrent hepatitis B after liver transplantation

Akinobu Takaki, Takahito Yagi, Yoshiaki Iwasaki, Hiroshi Sadamori, Hiroyoshi Matsukawa, Hiroaki Matsuda, Susumu Shinoura, Yuuzou Umeda, Yasuhiro Miyake, Ryou Terada, Haruhiko Kobashi, Kohsaku Sakaguchi, Noriaki Tanaka, Yasushi Shiratori

TRANSPLANTATION 83 ( 2 ) 231 - 233 2007年1月

記述言語：英語出版者・発行元：LIPPINCOTT WILLIAMS & WILKINS

Hepatitis B immunoglobulin (HBIg) and lamivudine combination has been accepted as the best way to control hepatitis B recurrence after liver transplantation. However, the optimal dose of HBIg and the target titer of hepatitis B surface antibody (HBsAb) remain unclear. We report our satisfactory experience with high-dose HBIg in the early period followed by low-dose HBIg with lamivudine. Subjects comprised five patients with fulminant hepatitis (FH) and 18 patients with liver cirrhosis (LC) who underwent liver transplantation. HBIg at a dosage of 200 IU/kg per day was administered for one week postoperatively. Thereafter, HBIg was administered only for HBsAb titer < 100 IU/L. After six months, HBIg was withdrawn in FH and administered in LC only for HBsAb titer < 10 IU/L. Lamivudine was administered to two FH and all LC cases. Although two patients with LC showed transient hepatitis B surface antigen (HBsAg) recurrence, all patients remained HBsAg-negative at the final follow-up date. This method allows reliable and cost-effective control of hepatitis B recurrence.

DOI： 10.1097/01.tp.0000246310.75638.86

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Contrast-enhanced ultrasonography depicts small tumor vessels for the evaluation of pancreatic tumors

Yuko Okamoto, Hirofumi Kawamoto, Akinobu Takaki, Etsuji Ishida, Tsuneyoshi Ogawa, Kenji Kuwaki, Yoshiyuki Kobayashi, Kohsaku Sakaguchi, Yasushi Shiratori

EUROPEAN JOURNAL OF RADIOLOGY 61 ( 1 ) 163 - 169 2007年1月

記述言語：英語出版者・発行元：ELSEVIER IRELAND LTD

Objective: The aim of this study is to evaluate the efficacy of contrast-enhanced ultrasonography for the diagnosis of pancreatic tumors.
Materials and methods: Contrast-enhanced ultrasonography with Levovist was performed on 62 consecutive patients (53 with pancreatic cancer, 4 with islet cell tumor, 3 with inflammatory pancreatic tumor, and 2 with metastatic tumor). The vascular and perfusion image phases of the tumors were evaluated and compared with the findings of contrast-enhanced computed tomography.
Results: Contrast-enhanced ultrasonography showed tumor vessels around and/or in the tumor at the vascular image phase in 79% of pancreatic cancer patients (42/53). At the perfusion image phase, 96% of pancreatic cancers (51/53) were classified as hypo-enhancement type. However, tiny spotty or irregular heterogeneous enhanced lesions were found in 84% of hypo-enhanced pancreatic cancer patients (43/51). The presence of small vessels at the vascular image phase was closely correlated with the presence of these intratumor regional enhanced lesions at the perfusion image phase (K coefficient = 0.42). The sensitivity of contrast-enhanced ultrasonography (100%) for pancreatic cancer was superior to that of contrast-enhanced computed tomography (91%), but no significant difference was observed between the two (McNemar test: p = 0.063).
Conclusion: Contrast-enhanced ultrasonography with Levovist successfully visualizes fine vessels and enhancement in pancreatic tumors, and is useful for evaluating pancreatic tumors. (C) 2006 Elsevier Ireland Ltd. All rights reserved.

DOI： 10.1016/j.ejrad.2006.08.014

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Clinical features of Japanese elderly patients with type 1 autoimmune hepatitis

Yasuhiro Miyake, Yoshiaki Iwasaki, Akinobu Takaki, Haruhiko Kobashi, Kohsaku Sakaguchi, Yasushi Shiratori

INTERNAL MEDICINE 46 ( 24 ) 1945 - 1949 2007年

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

Objective In Caucasian type 1 autoimmune hepatitis patients with a main susceptibility of human leukocyte antigen DR3 and DR4, elderly patients have a higher frequency of concurrent autoimmune disease and cirrhosis at presentation. However, in Japanese patients, the disease is dominantly associated with DR4, and their clinical features may be different from those of previous reports. In this study, we assessed the clinical features of Japanese elderly patients with type 1 autoimmune hepatitis.
Methods We investigated 160 consecutive patients with type 1 autoimmune hepatitis, consisting of 34 elderly patients (65 years) and 126 younger patients (< 65 years).
Results There were no differences in form of clinical onset, frequencies of concurrent autoimmune disease, positive proportions of anti-nuclear antibody and/or anti-smooth muscle antibody, and human leukocyte antigen DR status between the two groups. However, the elderly patients had lower serum levels of albumin (p= 0.0049), and higher frequencies of cirrhosis (F4) and pre-cirrhosis (F3) (p= 0.014) compared with the younger patients. In contrast, in elderly patients, the cumulative incidental rate of the normalization of serum alanine aminotransferase levels within 6 months after the introduction of initial treatment was higher in those treated with prednisolone >= 20 mg/day than those treated only with ursodeoxycholic acid (p= 0.001).
Conclusion We speculate that more years may pass between the occurrence of the disease and the presentation in Japanese elderly patients than in younger patients, and we considered that, even in elderly patients, those with advanced fibrosis should be treated with prednisolone in order to prevent progress of the disease into liver failure.

DOI： 10.2169/internalmedicine.46.0420

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