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Hepatobiliary Surgery and Nutrition 2022年第6期11卷 927-930页

作者： Takeshi Hatanaka Atsushi Naganuma Yutaka Yata satoru kakizaki Department of Gastroenterology Gunma Saiseikai Maebashi HospitalMaebashiJapan Department of Gastroenterology National Hospital Organization Takasaki General Medical CenterTakasakiJapan Department of Gastroenterology Hanwa Memorial HospitalOsakaJapan Department of Clinical Research National Hospital Organization Takasaki General Medical CenterTakasakiJapan

We read with interest the manuscript(1)by Bruix et *** a European Association for the Study of the Liver(EASL)position paper on the systemic treatment of hepatocellular carcinoma(HCC).Systemic treatment options for ad... 详细信息

关键词： hepatocellular regimen

Can endoscopic submucosal dissection be safely performed in a smaller specialized clinic?

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World Journal of Gastroenterology 2013年第4期19卷 528-535页

作者： Naondo Sohara Satoshi Hagiwara Riki Arai Haruhisa Iizuka Yasuhiro Onozato satoru kakizaki Department of Endoscopy and Endoscopic Surgery Shirakawa ClinicMaebashiGunma 371-0051Japan Department of Medicine and Molecular Science Gunma University Graduate School of MedicineMaebashiGunma 371-8511Japan

AIM:To investigate whether endoscopic submucosal dissection(ESD) can be safely performed at small clinics,such as the Shirakawa ***:One thousand forty-seven ESDs to treat gastrointestinal tumors were performed at the Shirakawa Clinic from April 2006 to March *** efficacy,technical feasibility and associated complications of the procedures were *** ESD procedures were performed by five *** was induced with propofol for esophagogastorduodenal ***:One thousand forty-seven ESDs were performed to treat 64 patients with esophageal cancer(E),850 patients with gastric tumors(G:764 patients with cancer,82 patients with adenomas and four others),four patients with duodenal cancer(D) and 129 patients with colorectal tumors(C:94 patients with cancer,21 patients with adenomas and 14 others).The en bloc resection rate was 94.3%(E:96.9%,G:95.8%,D:100%,C:79.8%).The median operation time was 46 min(range:4-360 min) and the mean size of the resected specimens was 18 mm(range:2-150 mm).No mortal complications were observed in association with the ESD *** occurred in 12 cases(1.1%,E:1 case,G:9 cases,D:1 case,C:1 case) and postoperative bleeding occurred in 53 cases(5.1%,G:51 cases,D:1 case,C:1 case);however,no case required either emergency surgery or blood *** of the perforations and postperative bleedings were resolved by endoscopic clipping or *** other problematic complication observed was pneumonia,which was treated with conservative ***:ESD can be safely performed in a clinic with established therapeutic methods and medical services to address potential complications.

关键词： Endoscopic submucosal dissection Complication Perforation Clinic

Different outcomes of nosocomial infection with hepatitis C virus from the same origin

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World Journal of Gastroenterology 2006年第4期12卷 659-661页

作者： satoru kakizaki Hitoshi Takagi Yuichi Yamazaki Naondo Sohara Ken Sato Takeaki Nagamine Masatomo Mori Department of Medicine and Molecular Science Gunma University Graduate School of MedicineMaebashiGunma 371-8511Japan Department of Clinical Nursing Gunma University School of Health SciencesMaebashiGunma 371-8511Japan

The outcome of infection with hepatitis C virus （HCV） varies substantially from self-limiting infection to chronic hepatitis, liver cirrhosis, and hepatocellular carcinoma among the individuals. The mechanisms that determine the clearance or the persistence of HCV have not yet been clarified. Here, we experienced two cases of hospital-related infection with HCV from the same origin but with quite different outcomes. One case resolved after an episode of acute hepatitis, while the other case developed a chronic hepatitis although they were infected with HCV of the same origin. Although infected with the virus of the same origin, the clinical and virological courses were completely different. This suggests that host factors play a major role in conditioning the outcome of acute HCV infection.

关键词： Nosocomial infection Hepatitis C virus HLA

Extended therapy duration for therapy-refractory hepatitis C patients with genotype 2

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World Journal of Gastroenterology 2013年第34期19卷 5754-5758页

作者： Ken Sato Masatoshi Yanagisawa Hiroaki Hashizume Yuichi Yamazaki Norio Horiguchi satoru kakizaki Masatomo Mori Department of Medicine and Molecular Science Gunma University Graduate School of Medicine

We devised an extended 72-wk peginterferon--2a/ribavirin therapy regimen for the retreatment of highly intractable cases,i.e.,48-wk peginterferon--2b/ribavirin therapy-intractable *** 2 cases achieved a rapid virological response to 72-wk peginterferon--2a/ribavirin therapy,1 case failed to achieve a sustained virological *** the reason for this difference in the effectiveness of 72-wk peginterferon--2a/ribavirin therapy between the cases was unclear,the rebound phenomenon of serum transaminase after48-wk peginterferon--2b/ribavirin therapy and the resultant lower viral load compared to that before 48-wk peginterferon--2b/ribavirin therapy might have influenced the treatment ***,it may be beneficial to consider the rebound phenomenon of serum transaminase and the changes in viral load resulting from previous interferon-based therapy and then cau-tiously determine the indication and the timing of the administration of 72-wk peginterferon--2a/ribavirin in highly intractable *** studies should be performed to confirm this strategy.

关键词： Hepatitis C Genotype 2 and high viral loads Interferon-based therapy Highly intractable case Extended therapy duration

Concordance of ulcerative colitis in monozygotic twin sisters

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World Journal of Gastroenterology 2005年第47期11卷 7547-7549页

作者： Madoka Horiya satoru kakizaki Katsunobu Teshigawara Yuki Kikuchi Tetsu Hashida Yoshio Tomizawa Tomohiro Iida Takashige Masuo Hitoshi Takagi Masatomo Mori Department of Medicine and Molecular Science Gunma University Graduate School of MedicineMaebashiGunma 371-8511Japan

The etiology of inflammatory bowel disease is multifacto rial and appears to combine both genetic and environmental factors. We experienced here a rare occurrence of woman monozygotic twins with ulcerative colitis (UC). A 45-year-old woman (the elder monozygotic twin) was admitted to our hospital because of bloody diarrhea occurring over 10 times per day, abdominal pain and fever. She was diagnosed as UC at the age of 22, and repeated the relapse and remission. She was diagnosed as relapse of UC and total colitis type. Her younger monozygotic twin sister also suffered from UC at the age of 22. Human leukocyte antigen was examined serologically with DNA type in both patients. DRB1*1502, which was previously shown to be dominant in Japanese patients with UC, was not observed in this case. Although the concordance in monozygotic twin in UC is reported to be 6.3-18.8%, the concordant case like this is relatively rare. We report this rare case of UC and the previously reported cases are also discussed.

关键词： Ulcerative colitis Inflammatory bowel disease Honozygotic twin Human leukocyte antigen

MK-0626,a selective DPP-4 inhibitor,attenuates hepatic steatosis in ob/ob mice

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World Journal of Gastroenterology 2014年第43期20卷 16227-16235页

作者： Tatsuya Ohyama Ken Sato Yuichi Yamazaki Hiroaki Hashizume Norio Horiguchi satoru kakizaki Masatomo Mori Motoyasu Kusano Masanobu Yamada Department of Medicine and Molecular Science Gunma University Graduate School of MedicineGunma 371-8511Japan Department of Endoscopy and Endoscopic Surgery Gunma University HospitalGunma 371-8511Japan

AIM: To investigate the mechanism and in vivo effects of MK-0626, a dipeptidyl peptidase-4 inhibitor, on hepatic steatosis using ob/ob mice.

关键词： Dipeptidyl peptidase-4 inhibitor Hepatic steatosis ob/ob mice AMP-activated protein kinase Microsomal triglyceride transfer protein Adiponectin

Probable case of drug reaction with eosinophilia and systemic symptom syndrome due to combination therapy with daclatasvir and asunaprevir

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World Journal of Clinical Cases 2015年第12期3卷 1005-1010页

作者： Takayoshi Suga Ken Sato Yuichi Yamazaki Tatsuya Ohyama Norio Horiguchi satoru kakizaki Motoyasu Kusano Masanobu Yamada Department of Medicine and Molecular Science Gunma University Graduate School of Medicine Department of Endoscopy and Endoscopic Surgery Gunma University Hospital

A 66-year-old, interferon-ineligible, treatment-naive man who was diagnosed with chronic hepatitis C due to hepatitis C virus genotype 1b began combination therapy with daclatasvir and asunaprevir. On day 14 of treatment, hepatic reserve and renal function deterioration was observed, while his transaminase levels were normal. Both daclatasvir and asunaprevir were discontinued on day 18 of treatment, because the patient complained of dark urine and a rash on his trunk and four limbs. After discontinuing antiviral therapy, the abnormal laboratory finding and clinical manifestations gradually improved, without recurrence. Our case fulfilled the diagnostic criteria of probable drug reaction with eosinophilia and systemic symptom(DRESS) syndrome. Despite the 18-d treatment, sustained virological response 12 was achieved. Based on the clinical course, we concluded that there was a clear cause-and-effect relationship between the treatment and adverse events. To our knowledge, this patient represents the first case of probable DRESS syndrome that includes concomitant deterioration of hepatic reserve and renal function due to combination therapy with daclatasvir and asunaprevir, regardless of normalization of transaminase levels. Our case suggests that we should pay attention not only to the transaminase levels but also to allergic symptoms associated with organ involvement during combination therapy with daclatasvir and asunaprevir.

关键词： Hepatitis C Daclatasvir Renal dysfunction Asunaprevir Hepatic reserve deterioration

Combination therapy with daclatasvir and asunaprevir for dialysis patients infected with hepatitis C virus

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World Journal of Clinical Cases 2016年第3期4卷 88-93页

作者： Ken Sato Yuichi Yamazaki Tatsuya Ohyama Takeshi Kobayashi Norio Horiguchi satoru kakizaki Motoyasu Kusano Masanobu Yamada Department of Medicine and Molecular Science Gunma University Graduate School of Medicine Department of Gastroenterology Heisei Hidaka Clinic Department of Endoscopy and Endoscopic Surgery Gunma University Hospital

The standard antiviral therapy for dialysis patients infected with hepatitis C virus(HCV) is(pegylated) interferon monotherapy, but its efficacy is insufficient. Oral direct-acting antiviral agents(DAAs) have recently been developed for chronic hepatitis C patients. However, some DAAs have contraindications for chronic renal failure(CRF). Daclatasvir and asunaprevir are metabolized largely in the liver and are not contraindicated in CRF. Combination therapy with daclatasvir and asunaprevir was used for 4 dialysis patients infected with genotype 1b HCV. One patient had viral breakthrough, and the 3 others had sustained virological response 12. One patient was admitted for heart failure and percutaneous coronary intervention due to concomitant ischemic disease. Heart failure was unlikely to be caused by the combination therapy, as it was probably due to water overload. The patient continued to receive the combination therapy after the remission of the heart failure. The combination therapy was well tolerated in the other patients.

关键词： Hepatitis C Oral drug Daclatasvir Asunaprevir Dialysis

Clinical characteristics of null responders to Peg-IFNα2b/ ribavirin therapy for chronic hepatitis C

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World Journal of Hepatology 2010年第11期2卷 401-405页

作者： Hideyuki Suzuki satoru kakizaki Norio Horiguchi Takeshi Ichikawa Ken Sato Hitoshi Takagi Masatomo Mori Department of Medicine and Molecular Science Gunma Univ ersity Graduate School of Medicine

AIM: To predict which chronic hepatitis C patients are likely to be late-responders, we herein investigated the clinical characteristics of null-responders at 36 wk with hepatitis C virus (HCV) genotype Ib and a high viral load during the course of pegylated interferon (Peg-IFN)/ ribavirin ther apy. METHODS: One hundred forty-two patients with genotype Ib HCV and a high viral load were included in this study. Peg-IFNα2b (1.5 μg/kg once a week) and ribavirin (600-1000 mg per day according to body weight) were administered for 48 wk. We def ined nullresponders as the cases that never cleared serum HCV RNA as determined using RT-PCR until 36 wk. Other patients were def ined as responders. We compared the clinical characteristics (age, gender, body mass index, previous treatment) and HCV RNA titer during the therapy between null-responders and ***: The HCV RNA clearance rate was 17.9% (24/134), 46.3% (62/134), 60.6% (86/142), 86.6% (123/142), and 88.0% (125/142) at 4, 8, 12, 24, and 36 wk, respectively. There were 17 patients (12.0%) who were still null-responders at 36 wk. There were no differences in the clinical characteristics between the responders and null-responders except for the titer and decline rates of HCV RNA at 1 wk and 4 wk. The HCV RNA titers at 1 wk and after 4 wk of treatment were significantly higher in the null-responders in comp arison to the responders (P <0.01). The serum HCV RNA titers of the responders decreased by 1.3 log after 1 wk of treatment, and 1.6 log after 4 wk of treatm ent, respectively. On the other hand, the titers of the null responders decreased by only 0.5 log after 1 wk, and 0.7 log after 4 wk of treatment, respectively. The decrease rates of HCV RNA after 1 and 4 wk of treatm ent were signif icantly worse for null responders than for the responders (P <0.01). CONCLUSION: The HCV RNA titer at 1 wk and 4 wk after initiating treatment may be useful for predicting null-responders to Peg-IFNα2b/ribavirin therapy. Howe

关键词： Null responder Pegylated interferon α2b Ribavirin Chronic hepatitis C

Balloon-occluded transcatheter arterial chemoembolization for hepatocellular carcinoma

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World Journal of Hepatology 2018年第7期10卷 485-495页

作者： Takeshi Hatanaka Hirotaka Arai satoru kakizaki Department of Gastroenterology Saiseikai Maebashi Hospital Department of Gastroenterology Maebashi Red Cross Hospital Department of Gastroenterology and Hepatology Gunma University Graduate School of Medicine

Transcatheter arterial chemoembolization(TACE) is widely accepted as a treatment for patients with hepatocellular carcinoma(HCC) in the intermediate stage according to the Barcelona Clinic Liver Cancer(BCLC) guidelines. Recently, balloon-occluded TACE(B-TACE) was developed in Japan. Despite the lack of a clear definition, B-TACE is generally defined as the infusion of emulsion of chemotherapeutic agents with lipiodol followed by gelatin particles under the occlusion of feeding arteries by a microballoon catheter, which leads to the dense lipiodol emulsion(LE) accumulation in HCC nodules. This phenomenon cannot be explained only by the prevention of proximal migration and leakage of embolization materials; it further involves causing local changes in the hemodynamics of the surrounding occlusion artery and targeted HCC nodules. Balloon-occluded arterial stump pressure plays an important role in the dense LE accumulation in targeted HCC nodules. Although randomized controlled trials comparing the therapeutic effect and the prognosis of B-TACE to those of the other TACE procedures, such as conventional-TACE and drug-eluting beads TACE, are still lacking, B-TACE is thought to be a promising treatment. The purpose of this review is to summarize the mechanism, therapeutic effect, indication, prognosis and complications of BTACE.

关键词： Hepatocellular carcinoma Treatment effect Transcatheter arterial chemoembolization Prognosis Balloon-occluded arterial stump pressure Dense lipiodol emulsion accumulation Balloon-occluded transcatheter arterial chemoembolization Microballoon catheter