Publications by authors named "Tatehiro Kagawa"
The farnesoid X receptor, encoded by NR1H4, is crucial for bile acid, lipid, and glucose metabolism. NR1H4 mutations in humans cause a severe liver injury called progressive familial intrahepatic cholestasis 5. However, Nr1h4 deletion in mice did not cause severe liver damage at a young age, likely because of the higher levels of hydrophilic bile acids synthesized by the mouse-specific bile acid metabolic enzymes Cyp2a12 and Cyp2c70.
View Article and Find Full Text PDFA 69-year-old man underwent upper and lower gastrointestinal endoscopic examinations for a detailed evaluation of diarrhea that had persisted for several months, which revealed multiple polyposis in the stomach, duodenum, colon, and terminal ileum. The histopathological findings also led to a diagnosis of Cronkhite-Canada syndrome (CCS). On admission, the patient had hypoalbuminemia and electrolyte abnormalities, including hypokalemia, and developed paroxysmal atrial fibrillation (Paf), although there were no apparent organic lesions in the heart.
View Article and Find Full Text PDFA Pilot Study Using a Smartwatch to Search for Biomarkers of Heart Rate Variability in Active Ulcerative Colitis.
Inflamm Intest Dis
December 2024
Introduction: Autonomic imbalance has been reported to correlate with clinical remission in patients with ulcerative colitis (UC). This study evaluated heart rate variability (HRV), a potential digital biomarker, in patients with active UC using a smartwatch that is easy to handle.
Methods: Patients with active UC were recruited for this prospective study.
[Scoring system for the diagnosis of DILI -RECAM-J 2023].
Nihon Shokakibyo Gakkai Zasshi
January 2024
Aim: This study aimed to comprehensively assess the incidence of immune-related adverse events (irAEs) and the detection systems in place for patients with liver cancer undergoing treatment with immune checkpoint inhibitors (ICIs), using a self-administered anonymous questionnaire. The questionnaire was designed to gather crucial insights into the management of irAEs in these patients.
Methods: A self-administered anonymous questionnaire was sent to 456 liver disease collaborative base hospitals and cancer care coordination base hospitals in Japan.
Article Synopsis
- A 70-year-old man with a history of Merkel cell carcinoma presented with jaundice and underwent several imaging studies showing bile duct obstruction.
- Due to complications from the patient's anatomy, standard procedures like endoscopic retrograde cholangiopancreatography were unsuccessful, leading to a percutaneous bile drainage.
- Further investigation via endoscopic ultrasound-fine needle biopsy revealed a recurrence of Merkel cell carcinoma in the right adrenal gland.
A Case of Pancreatic Serous Cystadenoma Penetrating Bile Duct Requiring Differentiation from Malignancy.
Tokai J Exp Clin Med
December 2024
Article Synopsis
- A 67-year-old man was hospitalized with jaundice caused by bile duct obstruction linked to a multifocal cystic tumor in the pancreas.
- Endoscopic retrograde cholangiopancreatography (ERCP) confirmed blockage and leakage between the pancreatic cyst and bile duct.
- The patient underwent pancreaticoduodenectomy, which revealed a fistula and was diagnosed with serous cystadenoma (SCA), highlighting a rare instance of SCA causing obstructive jaundice.
Article Synopsis
- Amoebic dysentery is a serious disease in Japan, classified as Category 5, with around 1,000 annual cases, and about 10% are invasive strains.
- Most invasive cases show no symptoms, making them hard to detect, especially since a key blood test was discontinued in 2017.
- Proper diagnosis and treatment are crucial to avoid severe complications, such as ulceration and liver abscesses, which can occur with delayed care.
Background/objectives: Health-related quality of life (HRQoL) is critical in patients with hepatocellular carcinoma (HCC). It has become a key endpoint in the evaluation of new therapies, including atezolizumab + bevacizumab (Atezo + Bev) therapy.
Methods: This study explored the factors associated with treatment efficacy, treatment duration, and overall survival (OS) in patients with advanced HCC undergoing Atezo + Bev therapy.
Article Synopsis
- The study analyzed 107 patients undergoing balloon-occluded retrograde transvenous obliteration (BRTO) due to uncontrollable hepatic encephalopathy (HE) and assessed the impact of esophageal varices (EVs) on outcomes.
- Patients were divided into two groups based on the presence of EVs, and results showed that those with EVs had significantly shorter event-free survival and overall survival compared to those without EVs.
- The findings suggest that having EVs may indicate a higher risk of complications and mortality following the BRTO procedure in HE patients.
An Adult Case of Benign Recurrent Intrahepatic Cholestasis Due to Deficiency.
Tokai J Exp Clin Med
September 2024
Abnormalities in , which encodes an unconventional myosin Vb, not only cause microvillus inclusion disease but also cholestatic liver disease, including benign recurrent intrahepatic cholestasis (BRIC). However, -related cholestasis has not yet been reported in Japan. In this study, we present the case of a female patient in her thirties, who had developed jaundice, without diarrhea, in the first year after birth.
View Article and Find Full Text PDFEradication Therapy for Colorectal Mucosa-associated Lymphoid Tissue Lymphoma: Report of Two Cases.
Tokai J Exp Clin Med
September 2024
Two cases of colorectal mucosa-associated lymphoid tissue lymphoma (cMALT) are presented and discussed with the reports from 1997 to the present. Helicobacter pylori ()-negative cases showed tumor resolution 2 months after eradication therapy. -positive cases were successfully eradicated and tumor resolution was confirmed 16 months later.
View Article and Find Full Text PDFArticle Synopsis
- Progressive familial intrahepatic cholestasis (PFIC) is a serious liver disease in children that can lead to the need for liver transplantation and is linked to mutations in the ABCB4 gene, which is important for bile production.
- Mice lacking the Abcb4 gene (Abcb4-deficient mice) typically display milder symptoms than humans due to the presence of less harmful bile acids, but researchers created CYPDKO mice with a more human-like bile acid profile to improve disease modeling.
- By inducing the Abcb4 deletion in CYPDKO mice, researchers found these animals experienced more severe liver injury and inflammation, making them a better model for studying PFIC and
Evaluation of the associations of interlukin-7 genetic variants with toxicity and efficacy of immune checkpoint inhibitors: A replication study of a Japanese population, based on the findings of a European genome-wide association study.
Hepatol Res
December 2024
Article Synopsis
- A study investigated the impact of the rs16906115 polymorphism in the interleukin-7 gene on immune-related adverse events (irAEs) and treatment response to immune checkpoint inhibitors within a Japanese population.
- Conducting a comparison between participants with severe irAEs and those with none, as well as hepatocellular carcinoma patients categorized by treatment response, researchers found no significant association between the polymorphism and irAEs, but identified a link to poorer treatment outcomes in responders.
- The findings suggest that while the rs16906115 minor allele does not predict irAEs, its homozygosity may indicate a reduced likelihood of effective treatment results in this Japanese cohort.
Article Synopsis
- The study aimed to find important biomarkers for predicting how patients with unresectable hepatocellular carcinoma (u-HCC) respond to a combination treatment of atezolizumab and bevacizumab (ATZ + BV).
- Researchers evaluated circulating tumor DNA (ctDNA) and levels of various immune-related cytokines in blood samples from 158 u-HCC patients to identify potential indicators of treatment outcomes.
- Key findings showed that while ctDNA mutations weren't correlated with treatment response, high levels of CXCL9 and low levels of LAG-3 were significant predictors of better progression-free survival and overall survival in patients undergoing ATZ + BV therapy.
Aim: This study aims to evaluate the efficacy and safety of lenvatinib radiofrequency ablation (RFA) sequential therapy for certain hepatocellular carcinoma (HCC) patients.
Methods: One hundred and nineteen patients with unresectable HCC in the intermediate stage with Child-Pugh A were retrospectively recruited in a multicenter setting. Those in the lenvatinib RFA sequential therapy group received lenvatinib initially, followed by RFA and the retreatment with lenvatinib.
Article Synopsis
- The concept of Metabolic Associated Fatty Liver Disease (MAFLD) was introduced, focusing on metabolic risk factors like obesity and diabetes, which affect patients' prognosis better than the previously used Non-Alcoholic Fatty Liver Disease (NAFLD) criteria.
- A study involving 7,159 patients from Tokai University Hospital examined the impact of MAFLD versus NAFLD diagnostic criteria on disease progression and medication use over a 5-year period.
- Results showed that while 34.9% of participants had fatty liver, those diagnosed with MAFLD experienced a more considerable increase in starting new medications compared to those diagnosed only with NAFLD, indicating that MAFLD criteria could provide a clearer understanding of
A 55-year-old woman presented to her primary care physician with facial and lower leg edema. After being referred to our hospital because of hypothyroidism and hypokalemia on blood tests, she also had elevated adrenocorticotropic hormone (ACTH) and cortisol levels, but a dexamethasone suppression test showed no cortisol suppression. Ectopic ACTH syndrome due to pancreatic neuroendocrine carcinoma (PNEC) was suspected.
View Article and Find Full Text PDFArticle 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.
Background: Although the combination of atezolizumab and bevacizumab (ATZ + BEV) is a standard treatment for advanced hepatocellular carcinoma (HCC), strategies for addressing treatment failure and prognostic factors of post-progression survival (PPS) remain unestablished.
Methods: We conducted a multicentre retrospective study to evaluate PPS following ATZ + BEV treatment in patients with advanced HCC. We classified the patients into three groups: BCLC stage B and BCLC stage C without or with new extrahepatic lesions (BCLCp-C1 and BCLCp-C2, respectively) at the time of progression.
Article Synopsis
- A 71-year-old woman had a submucosal lesion found during a colonoscopy, and imaging showed a 12-mm structure at the appendix's base.
- Initially, the lesion was not visible on a CT scan nine months later, but it did show signs of enlargement a year later, prompting further examinations like CS and EUS.
- The final diagnosis after the laparoscopic removal of the lesion was low-grade appendiceal mucinous neoplasm (LAMN), noted for the unique observation of the appendix shrinking and then re-expanding.
Impact of body composition for patients with hepatocellular carcinoma who received atezolizumab plus bevacizumab therapy.
Eur J Gastroenterol Hepatol
August 2023
Objective: To investigate the association between body composition and prognosis in patients with advanced hepatocellular carcinoma treated with atezolizumab plus bevacizumab.
Methods: This cohort study analysed 119 patients who received atezolizumab plus bevacizumab for unresectable hepatocellular carcinoma. We investigated the association between body composition and progression-free survival and overall survival.
Article Synopsis
- - The study investigates the effectiveness of transjugular intrahepatic portosystemic shunt (TIPS) in patients with decompensated cirrhosis who do not respond to tolvaptan, a medication for ascites.
- - A retrospective analysis was conducted on four patients treated with TIPS at Tokai University Hospital, all of whom had Child-Pugh class B liver cirrhosis, and the procedure was completed successfully without major complications.
- - Results showed a significant reduction in body weight and improvement in renal function after the TIPS procedure, suggesting it could be a viable treatment option for patients with tolvaptan-refractory ascites.
Article Synopsis
- Immune checkpoint inhibitors (ICIs) show promise for advanced hepatocellular carcinoma (HCC), but their link to immune-related adverse events (irAEs) and patient survival is not well-studied.
- This study analyzed 150 advanced HCC patients who received atezolizumab plus bevacizumab, comparing those who experienced irAEs to those who did not.
- Results indicated that patients with grade 1/2 irAEs had significantly better progression-free survival (273 days vs. 189 days) and overall survival compared to those without irAEs, indicating that these adverse events may correlate with improved survival outcomes.