Publications by authors named "Koji Takai"
Background & Aim: This study aimed to investigate the prevalence and prognostic impact of cachexia in patients with unresectable hepatocellular carcinoma (HCC) receiving systemic targeted therapy.
Methods: This single-center retrospective study included patients with HCC who underwent systemic targeted therapy. Cachexia was defined using novel criteria proposed in 2023.
Background And Aim: Rapid turnover proteins (RTPs), including retinol-binding protein (RBP), prealbumin, and transferrin, are useful in evaluating dynamic nutritional status. This study aimed to investigate the relationship between serum RTP levels and mortality in patients with chronic liver disease (CLD).
Methods: We evaluated 341 patients with CLD admitted between October 2011 and December 2021.
This study aimed to evaluate whether the subjective global assessment (SGA) could effectively predict energy malnutrition, as assessed by indirect calorimetry, and mortality in hospitalized patients with cirrhosis. Energy malnutrition was defined by a nonprotein respiratory quotient (npRQ) < 0.85 using an indirect calorimetry.
View Article and Find Full Text PDFBackground: This study aimed to investigate the usefulness of the psoas muscle index (PMI) as an independent predictor of survival after systemic targeted therapy initiation in patients with hepatocellular carcinoma (HCC).
Method: In total, 214 patients with HCC who underwent systemic targeted therapy at the Gifu University Hospital were enrolled. The correlation between the PMI and the skeletal muscle index (SMI) was assessed using Pearson's correlation coefficient (PCC).
Article Synopsis
- Hepatocellular carcinoma (HCC) rupture can lead to severe complications, including a rare condition called non-occlusive mesenteric ischemia (NOMI), which has been underreported.
- A 77-year-old man with an HCC experienced abdominal pain and shock; after treatment to stop bleeding, his condition improved temporarily but worsened again, leading to further diagnostic imaging.
- The patient required surgery for affected intestines and was diagnosed with NOMI, marking the first documented case of this complication following HCC rupture, highlighting the need for awareness and prompt treatment of such cases.
To assess the impact of adverse event (AE) severity, caused by targeted therapy, on overall survival (OS) and progression-free survival (PFS) in patients with unresectable hepatocellular carcinoma (HCC), a total of 183 patients with HCC treated with atezolizumab plus bevacizumab (40), lenvatinib (57), sorafenib (79), cabozantinib (3), ramucirumab (3), and regorafenib (1) were included in this study. Age-, AFP-, and ALBI score-adjusted hazard ratios (HRs) of AE grades 1 to 3 versus grade 0 for OS and PFS were calculated using Cox proportional hazards models. The linear trend of the HRs was assessed by calculating the values for this trend.
View Article and Find Full Text PDFArticle Synopsis
- Rapid skeletal muscle loss negatively impacts outcomes for patients with liver cirrhosis, particularly in those with alcohol-associated liver disease (ALD), which shows the most significant muscle decline.
- A study analyzed 384 patients using CT scans to assess annual changes in muscle area and found that patients with ALD had a ΔSMA/year of -5.7%, compared to -2.8% for hepatitis B and -3.1% for hepatitis C.
- The findings indicate that both ALD cirrhosis and rapid muscle loss (ΔSMA/year ≤ -3.1%) are significantly linked to decreased survival rates, highlighting the importance of monitoring muscle health in cirrhosis patients.
Backgrounds & Aims: This study aimed to investigate the association between vitamin D deficiency and covert hepatic encephalopathy (CHE), overt hepatic encephalopathy (OHE) occurrence, and mortality in patients with cirrhosis.
Methods: This retrospective study reviewed 679 patients with cirrhosis. Vitamin D deficiency was defined as serum 25-hydorxyvitamin D (25-OHD) levels < 20 ng/mL.
Background: Acute kidney injury (AKI) is a serious complication of cirrhosis. This study analyzed the prognostic effect of AKI in patients with cirrhosis and its risk factors, particularly in relation to amino acid imbalance.
Methods: This retrospective study reviewed 808 inpatients with cirrhosis at two institutes in Gifu, Japan.
Article Synopsis
- Abdominal angiography techniques like transarterial chemoembolization (TACE) are vital for treating liver cancer, but traditional transfemoral access (TFA) can lead to issues like postoperative pain and extended bed rest, impacting patient satisfaction.
- A study involving 1,601 patients showed that using transradial access (TRA) for TACE achieved a high success rate of 99.4% and a low complication rate of 1.2%, with 98.2% of patients wanting the radial method for future treatments.
- TRA is shown to be a safe and effective alternative to TFA for abdominal angiography, potentially easing the patient experience and improving clinical outcomes.
Article Synopsis
- This study aimed to assess how nutritional counseling impacts the health outcomes of patients with alcohol-associated liver disease, focusing on mortality and the risk of overt hepatic encephalopathy (HE).
- Researchers analyzed data from 211 patients treated at Gifu University Hospital over 15 years, comparing those who received frequent nutritional counseling with those who received less.
- The results showed that patients who received more nutritional counseling had better survival rates and lower occurrences of overt HE, demonstrating that this form of counseling is crucial for improving patient management in chronic liver disease.
Objective: This study aimed to reveal the prevalence and characteristics of individuals at risk of dysphagia in patients with chronic liver disease (CLD) and its association with health-related quality of life (HRQOL).
Methods: This cross-sectional study included 335 outpatients with CLD. Dysphagia risk, sarcopenia risk, malnutrition risk, and HRQOL were assessed using the Eating Assessment tool-10 (EAT-10), SARC-F, Royal Free Hospital-Nutrition Prioritizing Tool (RFH-NPT), and Chronic Liver Disease Questionnaire (CLDQ), respectively.
Combined hepatocellular cholangiocarcinoma is a rare and challenging primary liver malignancy that lacks any established standard treatments for unresectable cases. We herein present the first known case of a 49-year-old woman diagnosed with unresectable combined hepatocellular-cholangiocarcinoma, who underwent novel chemotherapy involving durvalumab plus tremelimumab combination therapy. The treatment was temporarily discontinued owing to immune-related adverse events, such as rash, and the patient was subsequently managed with systemic steroid therapy; however, the disease progressed after two courses of this treatment.
View Article and Find Full Text PDFThis study aimed to determine the relationship between animal naming test (ANT), falls, and fall-related fractures in patients with cirrhosis. Cognitive impairment and frailty were assessed using ANT and Karnofsky performance status (KPS), respectively. Factors stratifying the risk of previous falls and fall-related fractures within 1 year were assessed using a logistic regression model.
View Article and Find Full Text PDFThe proto-oncogene MYCN expression marked a cancer stem-like cell population in hepatocellular carcinoma (HCC) and served as a therapeutic target of acyclic retinoid (ACR), an orally administered vitamin A derivative that has demonstrated promising efficacy and safety in reducing HCC recurrence. This study investigated the role of MYCN as a predictive biomarker for therapeutic response to ACR and prognosis of HCC. MYCN gene expression in HCC was analyzed in the Cancer Genome Atlas and a Taiwanese cohort (N = 118).
View Article and Find Full Text PDFThis study aimed to evaluate chronological changes in skeletal muscle index (SMI), subcutaneous and visceral adipose tissue indices (SATI and VATI), AFP, PIVKA-II, and ALBI scores during atezolizumab plus bevacizumab (AB) or lenvatinib (LEN) treatment for hepatocellular carcinoma (HCC) and the effect of these changes on survival. A total of 94 patients with HCC (37 were on AB and 57 on LEN) were enrolled. SMI, SATI, VATI, AFP, PIVKA-II, and ALBI scores were analyzed at the time of the treatment introduction (Intro), 3 months after the introduction (3M), at drug discontinuation (End), and the last observational time (Last).
View Article and Find Full Text PDFAim: A20 haploinsufficiency (HA20) is a recently described autoinflammatory disease that manifests symptoms similar to those of Behçet's disease. However, little is known about the involvement of the liver in HA20. Here, we report a case of HA20 complicated by autoimmune hepatitis (AIH).
View Article and Find Full Text PDFBackground: Physical activity can reduce the risk of morbidity and mortality in patients with chronic liver disease (CLD), whereas physical inactivity adversely affects clinical outcomes. Since data on physical activity in CLD are scarce, we conducted a questionnaire survey to assess the physical activity patterns and determinants in patients with CLD.
Methods: We surveyed 437 patients from outpatient clinics at Gifu University Hospital about their physical activity patterns and determinants in 2022 using a validated questionnaire.
Non-viral hepatocellular carcinoma (HCC) tends to appear in non-cirrhotic livers, rendering it difficult to screen for a high-risk group. The present study aimed to identify the most suitable indicator for screening high-risk groups of non-viral HCC. A total of 190 patients with non-viral HCC, including 126 with non-alcoholic fatty liver disease (NAFLD)/non-alcoholic steatohepatitis (NASH), were enrolled in the present study.
View Article and Find Full Text PDFArticle Synopsis
- - This study evaluated the impact of lenvatinib (LEN) and sorafenib (SOR) treatments on body composition in 77 patients with hepatocellular carcinoma (HCC), focusing on changes over time and their correlation with survival.
- - Measurements like skeletal muscle index (SMI) and various blood biomarkers (AFP, PIVKA-II, ALBI score) were tracked at multiple points during treatment to analyze changes.
- - The results showed significant decreases in skeletal muscle mass during treatment, identifying it as a key independent prognostic factor for survival in HCC patients.
The aim of this study is to investigate the impact of body composition on the risk of portopulmonary hypertension using computed tomography (CT) in patients with liver cirrhosis. We retrospectively included 148 patients with cirrhosis treated at our hospital between March 2012 and December 2020. POPH high-risk was defined as main pulmonary artery diameter (mPA-D) ≥ 29 mm or mPA-D to ascending aorta diameter ratio ≥ 1.
View Article and Find Full Text PDFSelenium is an essential trace element to maintain good health. This retrospective study investigated the prevalence of selenium deficiency and its effect on overt hepatic encephalopathy (OHE) in patients with chronic liver disease (CLD). Patients who underwent serum selenium level measurement between January 2021 and April 2022 were enrolled.
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- The study investigates the prevalence and effects of polypharmacy (using six or more medications daily) and sarcopenia (muscle weakness and loss) in 239 patients with liver cirrhosis, noting that these issues are rising public health concerns.
- Results reveal that 53% of patients had polypharmacy and 29% had sarcopenia, with both conditions more common in older individuals and correlating with advanced liver disease.
- The findings indicate that both polypharmacy and sarcopenia independently predict higher mortality risk, especially in older patients, highlighting the need for more extensive research to confirm these associations.
Article Synopsis
- * Eight patients with high ammonia levels participated, receiving rifaximin for three months; their oxidized albumin levels tended to decrease while serum ammonia significantly dropped from 143 μg/dL to 76 μg/dL.
- * Although rifaximin did not change serum albumin levels, the findings suggest it may improve circulating albumin structure, indicating the need for larger studies to verify these preliminary results.