Faculty Profiles - TAKAKI Akinobu

MISC - TAKAKI Akinobu

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生体肝移植におけるドナー年齢限界の見極めと個別化治療戦略

楳田祐三, 八木孝仁, 貞森裕, 高木章乃夫, 篠浦先, 吉田龍一, 信岡大輔, 内海方嗣, 保田裕子, 高木弘誠, 藤原俊義

移植 49 ( 1 ) 80 - 81 2014.5

再肝移植症例に対する肝腎同時移植経験と、本邦の複数臓器分配におけるMELD scoreのもつ問題点

八木孝仁, 信岡大輔, 篠浦先, 保田裕子, 高木章乃夫, 吉田龍一, 内海方嗣, 楳田祐三, 高木弘誠, 貞森裕, 藤原俊義, 佐藤大輔

移植 49 ( 1 ) 69 - 70 2014.5

劇症肝炎に対する肝移植

楳田祐三, 貞森裕, 高木章乃夫, 篠浦先, 吉田龍一, 信岡大輔, 内海方嗣, 高木弘誠, 保田裕子, 藤原俊義, 八木孝仁

移植 49 ( 1 ) 165 - 165 2014.5

肝移植術後における真菌感染症に対する危険因子の解析

内海方嗣, 楳田祐三, 貞森裕, 篠浦先, 吉田龍一, 信岡大輔, 高木弘誠, 保田裕子, 高木章乃夫, 藤原俊義, 八木孝仁

移植 49 ( 1 ) 95 - 95 2014.5

当院におけるC型肝硬変治療

安中哲也, 高木章乃夫, 保田裕子, 池田房雄, 岩崎良章, 八木孝仁, 山本和秀

移植 49 ( 1 ) 76 - 76 2014.5

肝疾患の病態と糖鎖抗原の意義網羅的糖鎖解析による肝細胞癌バイオマーカーの検討

宮原孝治, 能祖一裕, 森元裕貴, 衣笠秀明, 和田望, 竹内康人, 安中哲也, 桑木健志, 大西秀樹, 池田房雄, 三宅康弘, 中村進一郎, 白羽英則, 高木章乃夫, 天野麻穂, 西村紳一郎, 山本和秀

肝臓 55 ( Suppl.1 ) A154 - A154 2014.4

肝癌におけるNotchシグナル活性化とその治療ターゲットとしての可能性

白羽英則, 片岡淳朗, 堀口繁, 岩室雅也, 永原照也, 内田大輔, 仁科慎一, 竹内康人, 桑木健志, 大西秀樹, 中村進一郎, 高木章乃夫, 能祖一裕, 山本和秀

肝臓 55 ( Suppl.1 ) A229 - A229 2014.4

C型慢性肝炎に対する抗ウイルス療法における血清フェリチン値とIL28B遺伝子多型の検討

岩崎良章, 池田房雄, 小橋春彦, 藤岡真一, 橋本訓招, 坂口孝作, 荒木康之, 岡本良一, 馬場伸介, 谷口英明, 宮武宏和, 高畠弘行, 芦田耕三, 三宅康広, 高木章乃夫, 山本和秀

肝臓 55 ( Suppl.1 ) A220 - A220 2014.4

当院での肝炎ウイルス検査陽性患者に対する取り組み

下村泰之, 池田房雄, 難波真太郎, 關博之, 安中哲也, 高木章乃夫, 能祖一裕, 岩崎良章, 山本和秀

肝臓 55 ( Suppl.1 ) A352 - A352 2014.4

慢性C型肝炎における8-OHdGと鉄代謝関連因子の関連と肝発癌予測因子としての有用性の検討

難波真太郎, 池田房雄, 馬場伸介, 高口浩一, 妹尾知典, 永野拓也, 関博之, 安中哲也, 高木章乃夫, 岩崎良章, 山本和秀

肝臓 55 ( Suppl.1 ) A237 - A237 2014.4

Efficacy of sorafenib beyond first progression in patients with metastatic hepatocellular carcinoma

Koji Miyahara, Kazuhiro Nouso, Yuki Morimoto, Yasuto Takeuchi, Hiroaki Hagihara, Kenji Kuwaki, Hideki Onishi, Fusao Ikeda, Yasuhiro Miyake, Shinichiro Nakamura, Hidenori Shiraha, Akinobu Takaki, Shouta Iwadou, Yoshiyuki Kobayashi, Koichi Takaguchi, Yoshitaka Takuma, Hiroyuki Takabatake, Kohsaku Sakaguchi, Kazuhide Yamamoto

HEPATOLOGY RESEARCH 44 ( 3 ) 296 - 301 2014.3

Language：English Publisher：WILEY-BLACKWELL

Aim
We investigated whether continuous sorafenib administration keeps suppressing the growth of hepatocellular carcinoma (HCC) after first progressive disease (PD), and whether it prolongs patients' survival.
Methods
The size of metastatic lesions was measured in 36 patients with advanced HCC treated with sorafenib. The tumor growth rates before and after radiological PD as well as survival were compared between the patients who continued (n = 23) and stopped (n = 13) sorafenib at first radiological PD.
Results
The growth rate did not differ between before and after PD in patients who continued sorafenib, while it increased after PD in patients who stopped sorafenib at PD (P = 0.002). Survival beyond first progression was longer in patients who continued sorafenib than in those who stopped it at PD (P = 0.012), and this tendency was observed even when the analysis was limited to Child-Pugh class A patients (P = 0.085).
Conclusion
Sorafenib administration beyond first radiological PD could continuously suppress HCC growth and may have survival benefit.

DOI： 10.1111/hepr.12123

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γセクレターゼ阻害剤を用いた膵癌幹細胞治療についての検討

堀口繁, 白羽英則, 内田大輔, 永原照也, 岩室雅也, 片岡淳朗, 加藤博也, 高木章乃夫, 能祖一裕, 山本和秀

日本消化器病学会雑誌 111 ( 臨増総会 ) A289 - A289 2014.3

画像・組織所見と臨床像が解離したB型劇症肝炎の1例

池田弘, 田邊渉, 詫間義隆, 高畠弘行, 守本洋一, 山本博, 能登原憲司, 高木章乃夫, 岩崎良章

倉敷中央病院年報 76 85 - 92 2014.3

Language：Japanese Publisher：(公財)大原記念倉敷中央医療機構倉敷中央病院

症例は28歳女性.38℃台の発熱,嘔気,全身倦怠感にて発症.近医で感冒と診断され解熱薬を内服.第3病日より褐色尿を認め,黄疸も出現したため第6病日に当院に緊急入院.入院時,HBs抗原・IgM-HBc抗体陽性.トランスアミナーゼの著明な上昇とプロトロンビン(PT)活性の低下(14%)を認めるも,意識は清明で肝萎縮も認めなかった.lamivudine内服,ステロイドパルス療法で入院翌日にはトランスアミナーゼ値は急速に低下し,肝萎縮も認めなかったが,PT活性は14%と改善せず,急激な意識レベルの低下を認めたために移植施設に転院.転院後は,3回の血漿交換で肝不全から急速に離脱した.第16病日にはHBs抗原は陰性化し,第33病日に行った肝生検では広汎肝壊死は認めず,急性肝炎回復期の像であった.臨床経過から本例の肝不全および意識障害には一過性の強いエネルギー代謝抑制による肝臓および脳の機能抑制が関与したと推測された.(著者抄録)

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C型慢性肝炎患者のインスリン抵抗性に対するペグインターフェロン治療の影響について

下村泰之, 池田房雄, 竹内康人, 安中哲也, 萩原宏明, 高木章乃夫, 岩崎良章, 山本和秀

日本消化器病学会雑誌 111 ( 臨増総会 ) A363 - A363 2014.3

Long-term Observation of Osteomalacia Caused by Adefovir-Induced Fanconi's Syndrome

Tomohiro Terasaka, Eijiro Ueta, Hirotaka Ebara, Koichi Waseda, Yoshihisa Hanayama, Akinobu Takaki, Tomoko Kawabata, Hitoshi Sugiyama, Ko Hidani, Fumio Otsuka

ACTA MEDICA OKAYAMA 68 ( 1 ) 53 - 56 2014.2

Language：English Publisher：OKAYAMA UNIV MED SCHOOL

A 64-year-old man suffering polyarthralgia and bone pain was referred to our hospital. Renal dysfunction, hypophosphatemia and increased levels of bone alkaline phosphatase were found. The patient's serum creatinine level had gradually increased after the initiation of adefovir dipivoxil administration for hepatitis B. In agreement with multifocal uptakes of bone scintigraphy, iliac bone biopsy revealed an abnormal increase in osteoid tissues. Reducing the dose of adefovir and initiating the administration of eldecalcitol were effective for reducing proteinuria and glucosuria, and for ameliorating bone pain with an increase in serum phosphate level. This case first showed a clinical course of hypophosphatemic osteomalacia caused by secondary Fanconi's syndrome for 8 years after adefovir administration. Early diagnosis is important for the reversibility of bone damage and for a better renal prognosis.

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Assessment of health-related quality of life and how it predicts the outcome of pegylated interferon and ribavirin therapy for chronic hepatitis C

Hiroshi Matsushita, Fusao Ikeda, Yoshiaki Iwasaki, Hiroyuki Seki, Shintaro Nanba, Yasuto Takeuchi, Yuki Moritou, Tetsuya Yasunaka, Hideki Onishi, Yasuhiro Miyake, Akinobu Takaki, Kazuhiro Nouso, Kazuhide Yamamoto

JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY 29 ( 2 ) 337 - 343 2014.2

Language：English Publisher：WILEY-BLACKWELL

Background and Aim: Chronic infection with hepatitis C virus (HCV) decreases health-related quality of life (HRQOL). The present study was planned to investigate the impact of HRQOL of patients with chronic hepatitis C (CHC) on the outcomes of therapy with pegylated interferon and ribavirin (RBV), in addition to IL28B polymorphisms.
Methods: The present study enrolled 228 CHC patients and assessed their HRQOLs prospectively with the 36-item short-form health survey.
Results: The patients with CHC have lower physical HRQOL status than the general population (P = 0.037, the Z-test). The patients with advanced liver diseases exhibited further decreases in HRQOL (P = 0.036, Spearman's rank correlation coefficient). The score of total HRQOL was significantly lower in the group with sustained virological response (SVR) to the therapy with pegylated interferon and RBV than the non-SVR group (P = 0.031, the Mann-Whitney U-test), with significantly lower scores of mental component and its comprising subscales in the SVR group. Stepwise multivariate logistic regression analysis showed that low HRQOL score <= 400 points was significantly associated with SVR (odds ratio = 2.4, P = 0.013), independently from high platelet counts, low HCV RNA, favorable single-nucleotide polymorphism type of IL28B, and HCV serotype 2. The patients with low HRQOL score will have significantly less decrease in HRQOL score by 4 weeks of the treatment than those with high HRQOL score at baseline (P = 0.0045).
Conclusion: HRQOL is one of the significant predictor of the outcomes of therapy with pegylated interferon and RBV independently from IL28B polymorphism.

DOI： 10.1111/jgh.12337

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Hepatopulmonary syndrome in Japanese liver cirrhosis patients

Hayami Okada, Akinobu Takaki, Takahito Yagi, Tetsuya Yasunaka, Tatsuhiro Gotoda, Hiroki Oe, Kazufumi Nakamura, Shuichi Sato, Hiroshi Sadamori, Susumu Shinoura, Yuzo Umeda, Ryuichi Yoshida, Masashi Utsumi, Daisuke Nobuoka, Yuko Yasuda, Fusao Ikeda, Yasuhiro Miyake, Hiroshi Ito, Toshiyoshi Fujiwara, Kazuhide Yamamoto

Acta Hepatologica Japonica 55 ( 3 ) 143 - 154 2014

Language：Japanese

Hepatopulmonary syndrome is characterized by hypoxemia induced by intrapulmonary vascular dilatations associated with hepatic diseases. We evaluated the frequency and case presentations revealed by general screening before liver transplantation. Sixty-one patients underwent arterial blood gas analysis in both upright and supine positions. Of these, 27 patients (44%) showed Pa0&lt
inf&gt
2&lt
/inf&gt
&lt
80 mmHg and AaD0&lt
inf&gt
2&lt
/inf&gt
&gt
15 mmHg, reflecting intrapulmonary shunting. Four patients exhibited Pa0&lt
inf&gt
2&lt
/inf&gt
&lt
70 mmHg and orthodeoxia, defined as a fall in Pa0&lt
inf&gt
2&lt
/inf&gt
&gt
5% or 4 mmHg in an upright position. Finally, two patients showed hepatopulmonary syndrome, with positive findings on perfusion lung scanning. Both patients with hepatopulmonary syndrome had liver cirrhosis type C with habitual alcohol drinking and smoking. Potential pulmonary shunt patients with Pa0&lt
inf&gt
2&lt
/inf&gt
&lt
80 mmHg and AaD0&lt
inf&gt
2&lt
/inf&gt
&gt
15 mmHg exhibited higher model for end-stage liver disease scores. Care should be taken regarding hepatopulmonary syndrome during liver cirrhosis management in Japanese patients. © 2014 The Japan Society of Hepatology.

DOI： 10.2957/kanzo.55.143

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A case of Wilson's disease with characteristic laparoscopic findings

Shin-Ichiro Muro, Tetsuya Yasunaka, Nozomu Wada, Yuki Morimoto, Fusao Ikeda, Hidenori Shiraha, Akinobu Takaki, Kazuhiro Noso, Hiroaki Iwasaki, Kazuhide Yamamoto

Clinical Journal of Gastroenterology 7 ( 2 ) 175 - 179 2014

Language：English Publisher：Springer-Verlag Tokyo

A 44-year-old male was pointed out liver function abnormality by medical check-up. Blood examination and computed tomography showed liver cirrhosis. Then, he was referred to our hospital for further examination. After blood test, viral markers revealed previous infection of hepatitis B virus (HBV). We estimated the etiology of his liver disease as previous HBV infection. On laparoscopic examination, his liver surface was nodular with mixed yellowish nodules and ash gray to copper-colored nodules in the diameter of 3-10 mm. There were large regenerative nodules in segments 3 and 4. Large regenerative nodules and irregular steatosis were contradictory to HBV-related liver cirrhosis, so then we supposed Wilson's disease. The amount of copper excretion in the urine was 326.6 μg (&gt
100 μg/24 h). After D-penicillamine administration, urinary copper excretion increased to 2151.5 μg/24 h. Though hepatic copper concentration was 174.5 μg/g wet tissue (&gt
200 μg/g wet tissue), his laboratory data fulfilled the Leipzig diagnostic criteria proposed by EASL. Laparoscopic examination with liver biopsy has advantages to survey many disease-specific findings on liver surface and to obtain adequate liver sample. Laparoscopic examination is one of the effective procedures for diagnosing relatively rare liver disease like Wilson's disease. © 2014 Springer.

DOI： 10.1007/s12328-014-0465-7

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A case of fulminant liver failure associated with hepatitis C virus

Hiromitsu Kanzaki, Akinobu Takaki, Takahito Yagi, Fusao Ikeda, Tetsuya Yasunaka, Kazuko Koike, Yasuhiro Miyake, Yoshiaki Iwasaki, Kazuhiro Nouso, Hiroshi Sadamori, Susumu Shinoura, Yuzo Umeda, Ryuichi Yoshida, Masashi Utusmi, Toshiyoshi Fujiwara, Kazuhide Yamamoto

Clinical Journal of Gastroenterology 7 ( 2 ) 170 - 174 2014

Language：English Publisher：Springer-Verlag Tokyo

Fulminant hepatitis due to acute hepatitis C virus (HCV) infection is rarely observed. We present a case study of a 21-year-old male patient who developed HCV-associated fulminant hepatitis after receiving steroid pulse therapy for optic neuritis. Despite daily plasmapheresis, the disease progressed to irreversible liver failure with grade 3 hepatic encephalopathy by the 6th day after symptom onset. The patient received a liver transplant on the 8th day. Serum anti-HCV antibody was negative at that time, but became positive on the 12th day. Positive HCV RNA in the serum at admission was reported after transplantation. Positive changes in anti-HCV antibodies and acute hepatitis with massive necrosis in the histology of the explanted liver indicated fulminant hepatitis due to acute HCV infection. Because of severe hepatitis recurrence, he started 12 months of interferon therapy on the 48th day, and obtained sustained virological response. His anti-HCV antibodies became negative again by 1.5 years after cessation of therapy. HCV genomes recovered from the patient's serum on the 7th and 48th days revealed 2 different clones out of 20 clones with 30 % amino acid difference in hypervariable region 1 of HCV second envelope glycoprotein. One of the 2 clones expanded further after liver transplantation. We conclude that early diagnosis of HCV-associated fulminant hepatitis requires the detection of HCV RNA in the serum. Severe hepatitis recurrence after liver transplantation might occur in patients with fulminant hepatitis due to HCV because of its monoclonal expansion. © 2014 Springer.

DOI： 10.1007/s12328-014-0454-x

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Contradictory immune response in post liver transplantation hepatitis B and C

Akinobu Takaki, Takahito Yagi, Kazuhide Yamamoto

International Journal of Inflammation 2014 2014

Language：English Publishing type：Book review, literature introduction, etc. Publisher：Hindawi Publishing Corporation

Hepatitis B and C often progress to decompensated liver cirrhosis requiring orthotopic liver transplantation (OLT). After OLT, hepatitis B recurrence is clinically controlled with a combination of hepatitis B immunoglobulin (HBIG) and nucleos(t)ide analogues. Another approach is to induce self-producing anti-hepatitis B virus (HBV) antibodies using a HBV envelope antigen vaccine. Patients who had not been HBV carriers such as acutely infected liver failure or who received liver from HBV self-limited donor are good candidate. For chronic HBV carrier patients, a successful response can only be achieved in selected patients such as those treated with experimentally reduced immunosuppression protocols or received an anti-HBV adaptive memory carrying donor liver. Hepatitis C virus (HCV) reinfects transplanted livers at a rate of &gt
90%. HCV reinfected patients show different severities of hepatitis, from mild and slowly progressing to severe and rapidly progressing, possibly resulting from different adaptive immune responses. More than half the patients require interferon treatment, although the success rate is low and carries risks for leukocytopenia and rejection. Managing the immune response has an important role in controlling recurrent hepatitis C. This study aimed to review the adaptive immune response in post-OLT hepatitis B and C.

DOI： 10.1155/2014/814760

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