Publications by authors named "Keisuke Kakisaka"
Background: Subharmonic-aided pressure estimation (SHAPE) is a technique for determining changes in ambient pressure. We aimed to analyze a novel SHAPE integrated into ultrasound diagnostic equipment to predict patients with liver cirrhosis at high risk of esophagogastric varices (EV).
Methods: This prospective study included 111 patients with liver cirrhosis diagnosed between 2020 and 2023.
Background: Steatotic liver disease, characterized by a combination of metabolic dysfunction, alcohol use, or specific etiologies, is a leading cause of chronic liver disease. However, the role of metabolic dysfunction in chronic liver disease with harmful alcohol use remains unclear. This study aimed to investigate factors associated with hepatic steatosis and fibrosis in patients with harmful alcohol use.
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- Durvalumab plus tremelimumab (Durva/Treme) is a newly approved treatment for unresectable hepatocellular carcinoma (u-HCC) in Japan, and researchers assessed its real-world outcomes.
- A study evaluated 22 patients at Iwate Medical University who received Durva/Treme, comparing outcomes between those treated as first-line vs. later-line therapy.
- Results showed no significant differences in progression-free survival, objective response rate, disease control rate, or adverse event incidence between the two groups, suggesting Durva/Treme is effective and safe for u-HCC patients regardless of treatment line.
Acute liver failure (ALF) induces increased energy expenditure and disrupts the metabolism of essential nutrients. Hepatic encephalopathy is a complication of ALF with a poor prognosis and mainly involves the metabolic disturbance of amino acids in its pathogenesis. In this review, we discuss the nutritional management for ALF in consideration of the pathophysiology of ALF with respect to the impairment of hepatocyte function.
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- * Conducted between October 2020 and October 2023, the study involved 89 u-HCC patients; the researchers used statistical models to analyze survival data and identify key prognostic factors.
- * Results showed that patients with normal grip strength had significantly better overall survival rates compared to those with low grip strength, indicating that grip strength is a useful indicator of patient condition and treatment outcome.
Article Synopsis
- - This study looked at how common acute pancreatitis is among patients with acute liver failure (ALF) and identified key features related to it.
- - Researchers analyzed data from 83 ALF patients between 2011 and 2018 and found that 10.8% developed acute pancreatitis, which significantly lowered their survival rate.
- - The model for end-stage liver disease score was identified as a potential risk marker for predicting acute pancreatitis in ALF patients, while factors like triglyceride levels, age, and gender showed no significant association.
Spontaneous reactivation of the Hepatitis B virus (HBV) is rare in individuals with previously resolved infections. This report presents the case of a 71 year-old Japanese woman who experienced HBV reactivation without any prior immunosuppressive therapy or chemotherapy. Before the onset of liver injury, the patient was negative for hepatitis B surface antigen (HBsAg) but positive for hepatitis B surface antibody.
View Article and Find Full Text PDFBackground And Aim: The study aims to determine the prognostic impact of obesity, sarcopenic obesity, and dynapenic obesity in patients with chronic liver disease.
Methods: This retrospective observational study enrolled patients with chronic hepatitis (n = 746) and liver cirrhosis (n = 434) without hepatocellular carcinoma at entry. The patients were evaluated for sarcopenia and obesity between April 2016 and April 2022.
Aim: This study aimed to compare the effects of the molecular targeted drugs, sorafenib and lenvatinib, on the survival, invasion, and angiogenesis of hepatocellular carcinoma cells. Additionally, we investigated the involvement of transforming growth factor beta (TGF-β) signaling in their molecular mechanisms.
Methods: To investigate the effects of sorafenib and lenvatinib, we conducted cell viability, invasion, and angiogenesis assays, as well as western blotting analyses.
Article Synopsis
- The study introduces RECAM-J 2023, a modified version of the Roussel Uclaf Causality Assessment Method aimed at improving the diagnosis of drug-induced liver injury (DILI) in Japan.
- It involved translating and adapting the original RECAM for Japanese clinical practices, and the researchers collected data from 538 DILI cases and 128 non-DILI cases to validate the new scoring system.
- Results showed that when omitting deductions for missing hepatitis virus markers, RECAM-J 2023 significantly improved identification rates for DILI, indicating its potential effectiveness in routine medical settings in Japan.
Article Synopsis
- - The study investigates the branched-chain amino acids to tyrosine ratio (BTR) in individuals with chronic liver disease (CLD), analyzing data from over 2,500 patients and healthy controls to understand how factors like sex, age, and body mass index affect BTR levels.
- - Results show that BTR is generally higher in males, decreases with age, and varies in response to mALBI grades across different types of CLD, indicating that the timing and nature of BTR changes depend on the specific liver disease.
- - The findings highlight significant differences in BTR based on sex and age in healthy individuals and suggest varying patterns of BTR decline in CLD, emphasizing the need for tailored approaches in monitoring liver
Aim: There are few data regarding the safety and effectiveness of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines in patients with intractable hepatobiliary diseases. We conducted a multicenter, questionnaire-based, cross-sectional study to determine the safety and effectiveness of the SARS-CoV-2 vaccines in Japanese patients with intractable hepatobiliary disease.
Methods: Patients aged ≥18 years with autoimmune hepatitis (AIH), primary biliary cholangitis, primary sclerosing cholangitis, Budd-Chiari syndrome, idiopathic portal hypertension, and extrahepatic portal vein obstruction at each center were consecutively invited to join the study.
The HIMALAYA trial is the first chemotherapeutic trial to demonstrate the efficacy of combined immune checkpoint inhibitors (ICIs) for unresectable hepatocellular carcinoma (u-HCC). The STRIDE regimen used in this trial consists of a cytotoxic T-lymphocyte antigen-4 (CTLA-4) inhibitor and programmed cell death ligand 1 (PD-L1) inhibitor. Herein, we report two cases of ICI-colitis that occurred immediately after the initiation of the STRIDE regimen for u-HCC.
View Article and Find Full Text PDFNonalcoholic fatty liver disease (NAFLD) develops as a result of unhealthy lifestyle but improves with laparoscopic sleeve gastrectomy (LSG). The transforming growth factor (TGF)-β signaling pathway reportedly contributes to liver fibrosis, mainly in animal experiments. The aim of the present study was to evaluate changes in serum proteins before and after LSG by proteomic analysis and to investigate their association with NAFLD.
View Article and Find Full Text PDFProthrombin time (PT) is a key parameter for assessing the severity of liver disease. We present the case of a 37-year-old woman with severe acute liver injury due to autoimmune hepatitis. Although prednisolone drastically improved her hepatocyte function, her PT did not recover to the reference range.
View Article and Find Full Text PDFPurpose: To clarify the relationships between the changes in hepatokines and weight loss, and between these changes and the metabolic effects, and the roles played by these changes, after laparoscopic sleeve gastrectomy (LSG).
Methods: We recruited 25 Japanese patients with severe obesity, who underwent LSG. We measured two hepatokines: selenoprotein P (SeP) and leukocyte cell-derived chemotaxin 2 (LECT2), at the baseline, and then 6 months and 1 year after LSG.
Article Synopsis
- - The study focuses on finding noninvasive methods to accurately assess hepatic steatosis (fat accumulation in the liver) due to the rising prevalence of nonalcoholic fatty liver disease.
- - Researchers evaluated four different models using ultrasound (US) parameters to predict a minimum of 5% liver fat in patients with chronic liver disease (CLD), with MRI providing the reference for fat measurement.
- - Results showed that the model incorporating UGAP, IBSC, and SNR parameters significantly improved the accuracy of diagnosing at least 5% steatosis compared to other models, achieving a maximum area under the curve (AUC) value of 0.96.
Aim: Hepatitis E virus (HEV) causes subclinical or acute self-limiting hepatitis. We surveyed the current seroprevalence and incidence of HEV infection among the general population in Iwate Prefecture, Japan, where the endemic infection is presumed to be low.
Methods: Between 2014 and 2016, we recruited individuals from Iwate Prefecture, Japan, who visited a general medical work-up program.
Aim: We aimed to establish a method that will identify patients at a high risk for progressive phenotype of fatty liver.
Methods: Patients with fatty liver who underwent liver biopsy between July 2008 and November 2019 were included as cohort 1, and those who underwent abdominal ultrasound screening examination by general physicians between August 2020 and May 2022 served as cohort 2. According to the definition of metabolic dysfunction-associated fatty liver (MAFLD), the subjects were classified by body mass index of ≥23, diabetes mellitus, and coexistence of two or more metabolic risk items.
Introduction: The aim is to clarify the hepatitis C virus (HCV) status of hemodialysis (HD) patients and patient management after HCV elimination.
Methods: Questionnaire survey was conducted in Iwate prefecture, Japan from 2016 to 2021.
Results: Patients underwent HD was 2944, including 132 anti-HCV antibody-positive patients, with 91 HCV RNA-positive patients.
Article Synopsis
- The study aimed to differentiate between idiosyncratic drug-induced liver injury (DILI) and non-DILI in patients with acute liver injury (ALI), focusing on the effectiveness of modified diagnostic scores.* -
- A total of 29 DILI patients and 77 non-DILI patients were analyzed, with the results showing high diagnostic accuracy for distinguishing DILI using modified international AIH group scores (IAIHGs) and the Roussel-Uclaf Causality Assessment Method (RUCAM).* -
- The modified scores demonstrated excellent performance in both derivation and validation cohorts, achieving accuracy rates of 96% and 95% respectively, indicating that detailed medical interviews and lab data can effectively identify D
Sarcopenia is a common complication in patients with chronic liver disease (CLD); however, the progression of sarcopenia over the course of CLD is unclear. The present study therefore determined the natural course of the progression of sarcopenia in patients with CLD and the effect of liver cirrhosis (LC) on this progression. This observational study analyzed patients with chronic hepatitis (CH) (n = 536) and LC (n = 320) who underwent evaluations of the grip strength and skeletal muscle mass of the arms, trunk, and legs for sarcopenia between 2016 and 2021.
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