Faculty Profiles - ONISHI Hideki

Papers - ONISHI Hideki

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Decreased Serum Antioxidant Marker is Predictive of Early Recurrence in the Same Segment after Radical Ablation for Hepatocellular Carcinoma. Reviewed

Taiko Muro, Shinichiro Nakamura, Akinobu Takaki, Hideki Onishi, Nozomu Wada, Tetsuya Yasunaka, Daisuke Uchida, Atsushi Oyama, Takuya Adachi, Hidenori Shiraha, Hiroyuki Okada

Acta medica Okayama 74 ( 4 ) 275 - 283 2020.8

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

Radiofrequency ablation (RFA) for hepatocellular carcinoma (HCC) is a promising method for controlling tumors, although it does not entirely eliminate recurrence. Oxidative stress is associated with the progression of hepatocarcinogenesis, while also acting as an anticancer response. The objective of the present study was to investigate the factors influencing post-RFA outcomes. We recruited 235 newly diagnosed HCC patients who received RFA for single tumors. The patients with recurrence were sub-grouped into early and segmental recurrence groups. The characteristics of the sub-grouped patients were evaluated, including by measuring oxidative stress marker reactive oxygen metabolites and antioxidant marker OXY-adsorbent tests. The factors associated with poor survival were a high Child-Pugh score and early recurrence within 2 years in the same segment. The patients who experienced recurrence within 2 years in the same segment showed a larger tumor diameter than did others. According to a multivariate analysis, the OXY values were also significantly low in these patients. In conclusion, maintaining the antioxidant reservoir function with a high OXY value might be necessary to prevent early recurrence within the RFA-treated segment.

DOI： 10.18926/AMO/60364

The Early Decline of α-Fetoprotein and Des-γ-Carboxy Prothrombin Predicts the Response of Hepatic Arterial Infusion Chemotherapy in Hepatocellular Carcinoma Patients. International journal

Shumpei Yamamoto, Hideki Onishi, Akinobu Takaki, Atsushi Oyama, Takuya Adachi, Nozomu Wada, Masahiro Sakata, Tetsuya Yasunaka, Hidenori Shiraha, Hiroyuki Okada

Gastrointestinal tumors 7 ( 3 ) 83 - 92 2020.7

Authorship：Corresponding author Language：English Publishing type：Research paper (scientific journal)

Introduction: Molecular targeting drugs are recommended as second-line treatment for intrahepatic advanced hepatocellular carcinoma (HCC). However, in Asia, hepatic arterial infusion chemotherapy (HAIC) is also considered as a second-line treatment because it improves the survival of responders. The aim of this study was to predict responders and non-responders to HAIC with low-dose cisplatin plus 5-fluorouracil (LFP) using tumor markers. Objective and Methods: The data of 47 patients who received LFP for the first time in our hospital were analyzed retrospectively. We evaluated the association between treatment response by Response Evaluation Criteria in Solid Tumors and the changing ratio of the serum concentration of α-fetoprotein (AFP), Lens culinaris agglutinin-reactive fraction of AFP (AFP-L3), and des-γ-carboxy prothrombin (DCP) 2 weeks after LFP initiation. Results: The number of patients showing a complete response (CR), a partial response (PR), stable disease (SD), and progressive disease (PD) was 0 (0%), 20 (43%), 18 (38%), and 9 (19%), respectively. The AFP ratio showed significant positive correlations for PR vs. SD (p = 0.004) and PR vs. PD (p = 0.003). The DCP ratio correlated significantly for PR vs. SD (p = 0.02). The optimal cutoff values for responders were 0.79 for the AFP ratio and 0.53 for the DCP ratio. Prediction using both or either cutoff value showed 93% sensitivity, 53% specificity, a 94% negative predictive value, and a 57% positive predictive value. Conclusion: Optimal cutoff values for AFP and DCP ratios enable prediction of nonresponders to HAIC with LFP. This simple and early assessment method allows the use of HAIC and molecular targeting drugs for HCC treatment.

DOI： 10.1159/000506941

Oxidative Stress Management in Chronic Liver Diseases and Hepatocellular Carcinoma. Reviewed International journal

Daisuke Uchida, Akinobu Takaki, Atsushi Oyama, Takuya Adachi, Nozomu Wada, Hideki Onishi, Hiroyuki Okada

Nutrients 12 ( 6 ) 2020.5

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

Chronic viral hepatitis B and C and non-alcoholic fatty liver disease (NAFLD) have been widely acknowledged to be the leading causes of liver cirrhosis and hepatocellular carcinoma. As anti-viral treatment progresses, the impact of NAFLD is increasing. NAFLD can coexist with chronic viral hepatitis and exacerbate its progression. Oxidative stress has been recognized as a chronic liver disease progression-related and cancer-initiating stress response. However, there are still many unresolved issues concerning oxidative stress, such as the correlation between the natural history of the disease and promising treatment protocols. Recent findings indicate that oxidative stress is also an anti-cancer response that is necessary to kill cancer cells. Oxidative stress might therefore be a cancer-initiating response that should be down regulated in the pre-cancerous stage in patients with risk factors for cancer, while it is an anti-cancer cell response that should not be down regulated in the post-cancerous stage, especially in patients using anti-cancer agents. Antioxidant nutrients should be administered carefully according to the patients' disease status. In this review, we will highlight these paradoxical effects of oxidative stress in chronic liver diseases, pre- and post-carcinogenesis.

DOI： 10.3390/nu12061576

Severe Colitis Caused by Hepatic Arterial Infusion Chemotherapy with Cisplatin for Hepatocellular Carcinoma. Reviewed

Shumpei Yamamoto, Hideki Onishi, Atsushi Oyama, Akinobu Takaki, Hiroyuki Okada

Internal medicine (Tokyo, Japan) 59 ( 1 ) 69 - 75 2020.1

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

A 78-year-old man with chronic hepatitis C underwent hepatectomy for hepatocellular carcinoma (HCC) 11 years prior to presentation. He was diagnosed with multiple intrahepatic recurrences of HCC with portal vein invasion and received hepatic arterial infusion chemotherapy (HAIC) with cisplatin. He developed abdominal pain, diarrhea, and blood-stained stool following treatment. Computed tomography revealed significant bowel wall thickening throughout the colon. Colonoscopy revealed reddish edematous mucosa with a reduced vascular pattern without ischemic changes. Conservative treatment with total parenteral nutrition improved his condition and his imaging findings. This is the first report of severe colitis following HAIC with cisplatin.

DOI： 10.2169/internalmedicine.3340-19

Human Telomerase Reverse Transcriptase Gene Promoter Mutation in Serum of Patients with Hepatocellular Carcinoma. Reviewed International journal

Soichiro Ako, Kazuhiro Nouso, Hideaki Kinugasa, Hiroshi Matsushita, Hiroyuki Terasawa, Takuya Adachi, Nozomu Wada, Yasuto Takeuchi, Mari Mandai, Hideki Onishi, Fusao Ikeda, Hidenori Shiraha, Akinobu Takaki, Shinichi Fujioka, Tetsushige Mimura, Hiroyuki Okada

Oncology 98 ( 5 ) 311 - 317 2020

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

BACKGROUND: Mutations in the human telomerase reverse transcriptase (hTERT) gene promoter have been reported in hepatocellular carcinoma (HCC); however, analyses of these mutations in liquid biopsies have been technically difficult because of the high GC content of the regions of interest within this promoter. We evaluated the feasibility and prognostic value of hTERT promoter mutations identified in circulating cell-free DNA (cfDNA) from the serum of patients with HCC. OBJECTIVE: A cohort of HCC patients (n = 36) who were curatively treated by surgical resection between June 2003 and September 2014 were enrolled in this study. METHODS: The presence of hTERT promoter mutations in cfDNA from the patients' serum was analyzed via modified droplet digital polymerase chain reaction, and associations were sought between specific promoter mutations and patients' disease-free survival (DFS). RESULTS: The G>A hTERT mutation at -124 bp was detected in the serum of 25 patients (69%). Although no marked differences were observed between the characteristics of the serum mutation-positive and serum mutation-negative patient groups, the DFS of patients with the mutation was significantly shorter than that of the serum mutation-negative patients (p = 0.02). Among 18 clinicopathologic and background liver factors examined, the presence of the -124 bp G>A mutation was an independent and significant predictor of patients' DFS (hazard ratio = 3.01, 95% confidence interval 1.11-10.5, p = 0.03) in multivariate analyses. CONCLUSIONS: The -124 bp G>A hTERT promoter mutation was observed in the serum of 69% of HCC patients who underwent surgical resection and was an independent predictor of disease progression in HCC.

DOI： 10.1159/000506135

A Phase I/Ib trial of Ad-REIC in liver cancer: study protocol. Reviewed International journal

Astushi Oyama, Hidenori Shiraha, Daisuke Uchida, Masaya Iwamuro, Hironari Kato, Akinobu Takaki, Fusao Ikeda, Hideki Onishi, Tetsuya Yasunaka, Yasuto Takeuchi, Nozomu Wada, Yoshiaki Iwasaki, Masahiro Sakata, Hiroyuki Okada, Hiromi Kumon

Future oncology (London, England) 15 ( 31 ) 3547 - 3554 2019.11

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

This study will assess the safety and efficacy of the administration of adenoviral vector expressing the human-reduced expression in immortalized cells (Ad-REIC) to a liver tumor in patients with hepatocellular carcinoma (HCC) or liver metastasis of pancreatic cancer. A Phase I clinical study of Ad-REIC administration to a liver tumor in a patient with HCC or liver metastasis of pancreatic cancer will be conducted. The study is a single-arm, prospective, nonrandomized, noncomparative, open-label, single-center trial performed in Okayama University Hospital, Okayama, Japan. Ad-REIC will be injected into the liver tumor under ultrasound guidance. Ad-REIC administration will be repeated a total of three-times every 2 weeks. The primary end point is the dose-limiting toxicity and incidence of adverse events. The secondary end points are the objective response rate and disease control rate. This study aims to expand the indication of Ad-REIC by assessing its safety and efficacy in patients with HCC or liver metastasis of pancreatic cancer.

DOI： 10.2217/fon-2019-0115

The Efficacy and Safety of Steroids for Preventing Postembolization Syndrome after Transcatheter Arterial Chemoembolization of Hepatocellular Carcinoma. Reviewed

Kenji Kuwaki, Kazuhiro Nouso, Manabi Miyashita, Yasuhiro Makino, Hiroaki Hagihara, Akio Moriya, Takuya Adachi, Nozomu Wada, Yuki Yasunaka, Tetsuya Yasunaka, Yasuto Takeuchi, Hideki Onishi, Shinichiro Nakamura, Fusao Ikeda, Hidenori Shiraha, Akinobu Takaki, Hiroyuki Okada

Acta medica Okayama 73 ( 4 ) 333 - 339 2019.8

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

Steroids are often administered at the time of transcatheter arterial chemoembolization (TACE), a standard treatment of hepatocellular carcinoma (HCC), with the expectation of preventing postembolization syndrome. Here we investigated the precise effects of steroids on TACE. We prospectively enrolled 144 HCC patients from 10 hospitals who underwent TACE. Three hospitals used steroids (steroid group, n=77) and the rest did not routinely use steroids (control group, n=67). The occurrence of adverse events and the algetic degree at 1-5 days post-treatment were compared between the groups. Fever (grades 0-2) after TACE was significantly less in the steroid group (56/21/0) compared to the control group (35/29/3, p=0.005, Cochran-Armitage test for trend). The suppressive effect of steroids against fever was prominent in females (p=0.001). Vomiting (G0/G1/ G2-) was also less frequent in the steroid group (70/5/2) versus the control group (53/10/3), but not significantly (p=0.106). The algetic degree and the grade of hematological adverse events, including hyperglycemia, did not differ between the groups. We conclude that the administration of steroids was useful for the prevention of adverse events after TACE in patients with HCC.

DOI： 10.18926/AMO/56935

Monitoring serum proangiogenic cytokines from hepatocellular carcinoma patients treated with sorafenib. Reviewed International journal

Takuya Adachi, Kazuhiro Nouso, Koji Miyahara, Atsushi Oyama, Nozomu Wada, Chihiro Dohi, Yasuto Takeuchi, Tetsuya Yasunaka, Hideki Onishi, Fusao Ikeda, Shinichiro Nakamura, Hidenori Shiraha, Akinobu Takaki, Hiroyuki Takabatake, Shin-Ichi Fujioka, Haruhiko Kobashi, Yoshitaka Takuma, Shouta Iwadou, Shuji Uematsu, Koichi Takaguchi, Hiroaki Hagihara, Hiroyuki Okada

Journal of gastroenterology and hepatology 34 ( 6 ) 1081 - 1087 2019.6

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

BACKGROUND AND AIM: Several factors, including proangiogenic cytokines, have been reported as predictive markers for the treatment effect of sorafenib in patients with hepatocellular carcinoma (HCC); however, most of them were determined based on one-time measurements before treatment. METHODS: We consecutively recruited 80 advanced HCC patients who were treated with sorafenib prospectively. Serum levels of eight proangiogenic cytokines and the appearance of adverse events were monitored periodically, and their correlations with the prognoses of the patients were evaluated. RESULTS: Among six significant risk factors for overall survival in univariate analyses, high angiopoietin-2 (hazard ratio, 2.06), high hepatocyte growth factor (hazard ratio, 2.08), and poor performance status before the treatment (hazard ratio, 2.48) were determined as independent risk factors. In addition, high angiopoietin-2 at the time of progressive disease was a marker of short post-progression survival (hazard ratio, 4.27). However, there was no significant variable that predicted short progression-free survival except the presence of hepatitis B virus surface antigen. CONCLUSIONS: Predictions of overall survival and post-progression survival were possible by periodically measuring serum proangiogenic cytokines, especially angiopoietin-2, in patients with HCC treated with sorafenib.

DOI： 10.1111/jgh.14535

Predictive Factors for Successful Vaccination Against Hepatitis B Surface Antigen in Patients Who Have Undergone Orthotopic Liver Transplantation. Reviewed

Ailee Ikeda, Akinobu Takaki, Tetsuya Yasunaka, Atsushi Oyama, Takuya Adachi, Nozomu Wada, Hideki Onishi, Fusao Ikeda, Hidenori Shiraha, Kazuhiro Yoshida, Takashi Kuise, Daisuke Nobuoka, Ryuichi Yoshida, Yuzo Umeda, Takahito Yagi, Toshiyoshi Fujiwara, Hiroyuki Okada

Acta medica Okayama 73 ( 1 ) 41 - 50 2019.2

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

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.

DOI： 10.18926/AMO/56457

[Adefovir Dipivoxil-induced Fanconi's Syndrome and Osteomalacia Following Multiple Bone Fractures in a Patient with Chronic Hepatitis B]. Reviewed

Takashi Makita, Hirotaka Kanzaki, Hideki Onishi, Ailee Ikeda, Akinobu Takaki, Nozomu Wada, Yasuto Takeuchi, Tetsuya Yasunaka, Fusao Ikeda, Hidenori Shiraha, Yuta Tanaka, Shigeki Nishihara, Kiminaka Murakawa, Yoshihisa Kitamura, Hiroyuki Okada, Toshiaki Sendo

Yakugaku zasshi : Journal of the Pharmaceutical Society of Japan 139 ( 4 ) 641 - 645 2019

Language：Japanese Publishing type：Research paper (scientific journal)

We herein present the case of a 66-year-old Japanese man with Fanconi's syndrome. He had been receiving adefovir dipivoxil (ADV) for the treatment of entecavir (ETV)-resistant chronic hepatitis B (CHB) for four years in his 8-year treatment of hepatocellular carcinoma (HCC), but was referred to our hospital after increased levels of bone pain in his ribs, knees, and ankles. Renal dysfunction, hypophosphatemia, and increased levels of bone alkaline phosphatase were found by a hematology test after admission for treatment of HCC. Radiography and 99m Tc-labeled hydroxymethylene diphosphonate (HMDP) scintigraphy revealed multiple insufficiency fractures in the ribs, knees, ankles, and heels. After switching from ADV to tenofovir disoproxil fumarate (TDF) and treatment with calcitriol and sodium dihydrogenphosphate, the patient's serum phosphate levels slightly increased and renal dysfunction did not improve, but after six months his clinical symptoms disappeared. To detect and prevent adverse effects from ADV, physicians and pharmacists should carefully monitor renal function and serum phosphate levels in patients with hepatitis B virus (HBV) treated for a long time with ADV.

DOI： 10.1248/yakushi.18-00170

岡山県地域肝炎対策サポーター育成後の活動実態調査肝炎医療コーディネーター活動と部署異動 Reviewed

難波志穂子, 池田房雄, 秋山文男, 石原光将, 下村泰之, 山崎典子, 犬山奈穂美, 小山道弘, 亀川勝典, 大久保進之介, 長谷川祐子, 岩井賢司, 三喜明子, 三浦留美, 矢野香苗, 藤井洋輔, 大山淳史, 足立卓哉, 和田望, 安中幸, 安中哲也, 大西秀樹, 白羽英則, 高木章乃夫, 山野井尚美, 岡田裕之

肝臓 59 ( 11 ) 625 - 632 2018.11

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：(一社)日本肝臓学会

岡山県では2011年より肝疾患に関わる部署の初任者を対象に肝炎医療研修会を実施し、受講者を地域肝炎対策サポーターと認定してきたが、厚生労働省の示す肝炎医療コーディネーターの役割を果たしているか不明であった。今回、認定者全員に調査票を郵送して、認定から現在までの肝炎に関する活動状況を調査した。地域肝炎対策サポーター298人中146人から回答を得た。回答者の56%が肝疾患関連部署に引き続き勤務し、3割が厚生労働省の示す肝炎医療コーディネーターの役割に合致することを確認した。回答者の24%は他部署へ異動していたが、その56%が日常業務と別に肝炎医療コーディネーター活動を行っており、部署の異動は非専門診療科に肝炎医療コーディネーター活動のできる人材を拡げる良い機会と考えられる。肝炎医療コーディネーターは医療圏の間で偏在を認めなかった。(著者抄録)

CTAPと出血シンチグラフィで診断し、経皮的硬化療法で止血し得た小腸静脈瘤出血の1例 Reviewed

神尾知宏, 川野誠司, 大西秀樹, 大林由佳, 大山淳史, 能祖一裕, 原田馨太, 岡田裕之, 藤原寛康, 金澤右

日本消化器病学会雑誌 115 ( 8 ) 732 - 738 2018.8

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：(一財)日本消化器病学会

症例は55歳、男性。複数の腹部手術歴や、食道静脈瘤に対して内視鏡的治療歴あり。突然の血便を認め緊急入院。大腸内視鏡を施行するも出血源は同定できず、CT during arterial portography(CTAP)を施行したところ、上腸間膜静脈から流入し腹壁静脈へと排血する小腸静脈瘤を認めた。経皮的に腹壁静脈を直接穿刺することで硬化療法を施行し、良好な止血を得られ、侵襲の高い外科手術を回避することができた。(著者抄録)

Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2018&ichushi_jid=J01118&link_issn=&doc_id=20180817330007&doc_link_id=130007432101&url=https%3A%2F%2Fci.nii.ac.jp%2Fnaid%2F130007432101&type=CiNii&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00003_1.gif

A subclinical high tricuspid regurgitation pressure gradient independent of the mean pulmonary artery pressure is a risk factor for the survival after living donor liver transplantation. Reviewed International journal

Yosuke Saragai, Akinobu Takaki, Yuzo Umeda, Takashi Matsusaki, Tetsuya Yasunaka, Atsushi Oyama, Ryuji Kaku, Kazufumi Nakamura, Ryuichi Yoshida, Daisuke Nobuoka, Takashi Kuise, Kosei Takagi, Takuya Adachi, Nozomu Wada, Yasuto Takeuchi, Kazuko Koike, Fusao Ikeda, Hideki Onishi, Hidenori Shiraha, Shinichiro Nakamura, Hiroshi Morimatsu, Hiroshi Ito, Toshiyoshi Fujiwara, Takahito Yagi, Hiroyuki Okada

BMC gastroenterology 18 ( 1 ) 62 - 62 2018.5

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

BACKGROUND: Portopulmonary hypertension (POPH) is characterized by pulmonary vasoconstriction, while hepatopulmonary syndrome (HPS) is characterized by vasodilation. Definite POPH is a risk factor for the survival after orthotopic liver transplantation (OLT), as the congestive pressure affects the grafted liver, while subclinical pulmonary hypertension (PH) has been acknowledged as a non-risk factor for deceased donor OLT. Given that PH measurement requires cardiac catheterization, the tricuspid regurgitation pressure gradient (TRPG) measured by echocardiography is used to screen for PH and congestive pressure to the liver. We investigated the impact of a subclinical high TRPG on the survival of small grafted living donor liver transplantation (LDLT). METHODS: We retrospectively analyzed 84 LDLT candidates. Patients exhibiting a TRPG ≥25 mmHg on echocardiography were categorized as potentially having liver congestion (subclinical high TRPG; n = 34). The mean pulmonary artery pressure (mPAP) measured after general anesthesia with FIO20.6 (mPAP-FIO20.6) was also assessed. Patients exhibiting pO2 < 80 mmHg and an alveolar-arterial oxygen gradient (AaDO2) ≥ 15 mmHg were categorized as potentially having HPS (subclinical HPS; n = 29). The clinical course after LDLT was investigated according to subclinical high TRPG. RESULTS: A subclinical high TRPG (p = 0.012) and older donor age (p = 0.008) were correlated with a poor 40-month survival. Although a higher mPAP-FIO20.6 was expected to correlate with a worse survival, a high mPAP-FIO20.6 with a low TRPG was associated with high frequency complicating subclinical HPS and a good survival, suggesting a reduction in the PH pressure via pulmonary shunt. CONCLUSION: In cirrhosis patients, mPAP-FIO20.6 may not accurately reflect the congestive pressure to the liver, as the pressure might escape via pulmonary shunt. A subclinical high TRPG is an important marker for predicting a worse survival after LDLT, possibly reflecting congestive pressure to the grafted small liver.

DOI： 10.1186/s12876-018-0793-z

Transcatheter Arterial Chemoembolization to Reduce Size of Hepatocellular Carcinoma before Radiofrequency Ablation. Reviewed

Soichiro Ako, Shinichiro Nakamura, Kazuhiro Nouso, Chihiro Dohi, Nozomu Wada, Yuki Morimoto, Yasuto Takeuchi, Tetsuya Yasunaka, Kenji Kuwaki, Hideki Onishi, Fusao Ikeda, Hidenori Shiraha, Akinobu Takaki, Hiroyuki Okada

Acta medica Okayama 72 ( 1 ) 47 - 52 2018.2

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

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.

DOI： 10.18926/AMO/55662

[Rupture of small intestinal varices diagnosed by CTAP and gastrointestinal bleeding scintigraphy and treated by percutaneous phlebosclerozation angioembolization]. Reviewed

Kamio T, Kawano S, Onishi H, Obayashi Y, Oyama A, Nouso K, Harada K, Okada H, Fujiwara H, Kanazawa Y

Nihon Shokakibyo Gakkai zasshi = The Japanese journal of gastro-enterology 115 ( 8 ) 732 - 738 2018

An activity survey of hepatitis medical care coordinators in Okayama prefecture, Japan Reviewed

Shihoko Namba, Fusao Ikeda, Fumio Akiyama, Mitsumasa Ishihara, Yasuyuki Shimomura, Noriko Yamasaki, Naomi Inuyama, Michihiro Koyama, Katsunori Kamegawa, Shinnosuke Okubo, Yuko Hasegawa, Kenji Iwai, Akiko Sanki, Rumi Miura, Kanae Yano, Yosuke Fujii, Atsushi Ohyama, Takuya Adachi, Nozomu Wada, Yuki Yasunaka, Tetsuya Yasunaka, Hideki Onishi, Hidenori Shiraha, Akinobu Takaki, Hisami Yamanoi, Hiroyuki Okada

Acta Hepatologica Japonica 59 ( 11 ) 625 - 632 2018

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：Japan Society of Hepatology

Okayama prefecture has conducted seminars on viral hepatitis primarily for new staff members belonging to the department dealing with liver diseases in public health centers and hospitals
participants have been certified as “hepatitis medical care coordinators.” This survey was planned to (1) evaluate the viral hepatitis awareness activities they conducted after seminars using self-reported questionnaires and (2) clarify whether their knowledge and practices were appropriate to classify them as competent hepatitis medical care coordinators as per the Ministry of Health, Labor and Welfare in Japan. Among all 298 coordinators in the Okayama prefecture, 146 responded to the survey
84 worked at the same department and 45 matched the coordinator in their daily activities. Further, 36 were transferred to different departments and 20 conducted awareness activities as hepatitis medical care coordinators in addition to their daily responsibilities. Transfer of hepatitis medical care coordinators may help expand hepatitis awareness activities across different departments.

DOI： 10.2957/kanzo.59.625

肝移植後C型肝炎再発に対するソホスブビル含有治療の有効性 Reviewed

大山淳史, 高木章乃夫, 安中哲也, 足立卓哉, 池田房雄, 和田望, 竹内康人, 大西秀樹, 中村進一郎, 白羽英則, 高木弘誠, 杭瀬崇, 信岡大輔, 吉田龍一, 楳田祐三, 吉田真理, 有森千聖, 八木孝仁, 岡田裕之

肝臓 58 ( 11 ) 599 - 604 2017.11

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：(一社)日本肝臓学会

肝移植後C型肝炎に対するDirect Acting Antivirals(DAA)治療効果を検討した。Genotypelは29症例で、ダクラタスビル+アスナプレビル(DCV+ASV)5例、ソホスブビル+レジパスビル(SOF+LDV)25例(含DCV+ASV無効1例)、Genotype2が2症例でSOF+リバビリン治療を行った。DCV+ASVは5例中4例で治療完遂、3例でSustained viral response(SVR)24を達成。SOF+LDVは全例SVR24を達成、移植後2ヵ月以内の肝炎再燃例も含まれているが問題なく治療完遂可能であった。Genotype2はSVR24を達成。SOF中心レジメンで100%のSVR24達成率であり、移植後早期においても問題なくウイルス駆除達成可能であった。C型肝硬変の肝移植適応評価においてC型肝炎のネガティブインパクトはなくなったと言っても過言ではない。(著者抄録)

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Promising therapeutic efficacy of a novel reduced expression in immortalized cells/dickkopf-3 expressing adenoviral vector for hepatocellular carcinoma. Reviewed International journal

Hiroaki Sawahara, Hidenori Shiraha, Daisuke Uchida, Hironari Kato, Ryo Kato, Atsushi Oyama, Teruya Nagahara, Masaya Iwamuro, Shigeru Horiguchi, Koichiro Tsutsumi, Mari Mandai, Tetsushige Mimura, Nozomu Wada, Yasuto Takeuchi, Kenji Kuwaki, Hideki Onishi, Shinichiro Nakamura, Masami Watanabe, Masakiyo Sakaguchi, Akinobu Takaki, Kazuhiro Nouso, Takahito Yagi, Yasutomo Nasu, Hiromi Kumon, Hiroyuki Okada

Journal of gastroenterology and hepatology 32 ( 10 ) 1769 - 1777 2017.10

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

BACKGROUND AND AIM: Reduced expression in immortalized cells (REIC)/dickkopf-3 (Dkk-3) is a tumor suppressor gene that is downregulated in various cancers. In our previous study of prostate cancer, the REIC/Dkk-3-expressing adenoviral vector (Ad-REIC) was found to induce cancer-selective apoptosis. This study recently developed a novel super gene expression (SGE) system and used this system to re-construct an Ad-REIC vector, termed the Ad-SGE-REIC, to achieve more effective therapeutic outcomes. In this study, the therapeutic effects of Ad-SGE-REIC on hepatocellular carcinoma (HCC) was assessed. METHODS: Human HCC cell lines (HLE, Huh7, HepG2, HLF, SK-Hep1, and PLC), human HCC tissues, and mouse HCC cell line (Hepa1-6) were used in this study. REIC/Dkk-3 expression was assessed by immunoblotting and immunohistochemistry. The relative cell viability and the apoptotic effect were examined in vitro, and the anti-tumor effects of Ad-SGE-REIC treatment were analyzed in the mouse xenograft model. This study additionally assessed anti-tumor immunological effects on the immunocompetent mice. RESULTS: REIC/Dkk-3 expression was decreased in HCC cell lines and HCC tissues. Ad-SGE-REIC reduced cell viability and induced apoptosis in HCC cell lines (HLE and Huh7), inhibited tumor growth in the mouse xenograft model, and demonstrated in vivo anti-cancer immunostimulatory effects on the HCC cell line (Hepa1-6). CONCLUSIONS: Ad-SGE-REIC treatment not only enhanced cell killing effects in vitro but also elicited significant therapeutic effects, with tumor growth suppression, in vivo. REIC/Dkk-3 gene therapy using Ad-SGE-REIC potentially represents an innovative new therapeutic tool for HCC.

DOI： 10.1111/jgh.13757

肝炎ウイルス検査陽性患者に対する検査報告システムの効果的な運用方法肝臓専門医受診率向上のさらなる工夫 Reviewed

下村泰之, 藤井洋輔, 池田房雄, 安中哲也, 山崎典子, 笠原郁子, 犬山奈穂美, 小山道弘, 難波志穂子, 竹内康人, 和田望, 桑木健志, 大西秀樹, 中村進一郎, 白羽英則, 高木章乃夫, 岡田裕之

肝臓 58 ( 8 ) 427 - 434 2017.8

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：(一社)日本肝臓学会

非肝臓専門診療科で実施される肝炎ウイルス検査の結果が受検者に適切に説明されるように、当院では2013年に電子カルテ上で検査陽性を知らせるアラートの自動表示システムを導入した。このシステムを利用して担当医が説明した割合は28%と不十分であったため、検査実施診療科了解のもと検査陽性者へ検査報告書を郵送し、検査陽性者への報告率は89%と改善した。肝臓専門医への紹介状と返信用書類を同封、郵送半年後に肝臓専門医受診を確認できていない場合は再送し、肝炎専門医受診把握率は49%から72%に改善した(p<0.001)。検査報告書再送で肝精査の必要性に気づき肝臓専門医を受診し、肝炎治療を受けた症例もあった。肝炎ウイルス検査陽性者への報告を徹底することは肝臓専門医受診率の向上や適切な肝炎治療の受療に有用である。(著者抄録)

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職域での出張肝臓病教室と同時開催の肝炎検診の意義 Reviewed

難波志穂子, 池田房雄, 下村泰之, 犬山奈穂美, 大久保進之介, 槇田崇志, 長谷川祐子, 岩井賢司, 細羽章子, 三浦留美, 藤井洋輔, 安中哲也, 竹内康人, 和田望, 桑木健志, 大西秀樹, 中村進一郎, 白羽英則, 高木章乃夫, 岡田裕之

肝臓 58 ( 5 ) 304 - 306 2017.5

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：(一社)日本肝臓学会

出張肝臓病教室では、岡山大学病院の肝疾患サポートチームが職域に出向き、職員全員を対象として肝炎検診受検や肝臓専門機関受診の重要性を説明した。12回の出張肝臓病教室を603人が受講し、アンケート回答に欠損のない565人の回答を分析した。肝臓病で通院中の人は3人(0.5%)、健康診断で今まで肝機能異常を指摘されたことがない人が468人(82.8%)、健康診断で肝臓に関する検査結果を意識してみていない人が263人(46.5%)であった。肝臓病教室を受講して肝炎ウイルス検査を受けようと思った人が300人(53.1%)、既に受けている人が154人(27.3%)で、111人(19.6%)は受けないと回答した。講演が職場の肝臓病に対する偏見や誤解の解消に非常に役立つと思った人が347人(61.4%)、少し役に立つと思った人が208人(36.8%)であった。出張肝臓病教室に参加した306名中288名(94.1%)が肝炎検診を受検し、HBs抗原陽性者3名(1%)、HCV抗体陽性者3名(1%)であった。陽性者6名全員が肝炎専門医療機関を受診した。

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