Yoshiki Hirooka

Publications (165) View all

• Article: Revision of the training curriculum of Japan Society of Gastroenterology: Biliary tract and pancreas.

  Yoshiharu Motoo, Yoshiki Hirooka, Kyoko Shimizu, Hiroyuki Isayama, Hiroyuki Yoshidome
  Nippon Shokakibyo Gakkai zasshi The Japanese journal of gastro-enterology 05/2013; 110(5):820-4.
• Article: An Increase in Lesion Density can Predict Lower Local Recurrence after Transarterial Chemoembolization in Patients with Hepatocellular Carcinoma.

  Norihiro Imai, Yoshiaki Katano, Teiji Kuzuya, Takashi Honda, Kazuhiko Hayashi, Masatoshi Ishigami, Akihiro Itoh, Yoshiki Hirooka, Hidemi Goto
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  ABSTRACT: Background/Aims: The purpose of this retrospective study was to determine the characteristics of hepatocellular carcinoma (HCC) associated with lower, local recurrence rates after transcatheter arterial chemoembolization (TACE). Methodology: From 2005 to 2012, 93 consecutive patients with 125 nodules were included in this study. Patients were included if they had fewer than 3 hypervascular tumors, smaller than 4cm in diameter. Patients were excluded if they had a lack of iodized oil accumulation in target nodules on non-enhanced computed tomography (CT) immediately after TACE treatment. Mean lesion density in Hounsfield units (HU) was measured on non-enhanced CT imaging immediately after and 1 week after TACE. Results: The median lesion density on CT was 625HU (range 138-1911) immediately after and 431HU (range 89-2145) 1 week after TACE. Multivariate analysis using the Cox proportional hazard model revealed that an increase in lesion density (hazard ratio (HR), 0.18; p=0.002), des-gamma-carboxy prothrombin concentration (HR, 2.21; p=0.01), and lesion density on CT 1 week after TACE (HR, 0.46; p=0.02) were significant independent predictors associated with the lower, local recurrence rate after TACE treatment. Conclusions: In HCC without increased lesion density 1 week after TACE, it is possible to consider alternative or adjuvant treatments.
  Hepato-gastroenterology 02/2013; 60(127). · 0.66 Impact Factor
• Article: Impact of recipient age and preoperative fasting blood glucose level as the risk factors of living donor liver transplantation in cirrhotic patients in the recent comprehensive era with knowledge of indications: Recent status in a Japanese single center.

  Masatoshi Ishigami, Yasuharu Onishi, Hideya Kamei, Tetsuya Kiuchi, Yoshiaki Katano, Akihiro Itoh, Yoshiki Hirooka, Hidemi Goto
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  ABSTRACT: AIM: Recently, knowledge for indications of living donor liver transplantation (LDLT) has been robustly accumulated in. For further improvement, risks should be reexamined in recent cases. In this study, we investigated preoperative risk factors in cirrhotic patients who underwent LDLT in recent era. METHODS: Seventy-four cirrhotic patients who underwent LDLT at our institution between 2003 and 2011 were included. Recipient and donor age and sex, existence of hepatocellular carcinoma (HCC), preoperative Model for End-Stage Liver Disease score, fasting blood glucose (FBG), triglyceride, total cholesterol, serum creatinine, hemoglobin A1c, graft : recipient weight ratio, ABO compatibility and choice of calcineurin inhibitor were analyzed. A proportional hazard model was applied and P < 0.05 was considered statistically significant. RESULTS: In multivariate analysis, recipient age (hazard ratio = 1.188, P = 0.011) and FBG (hazard ratio = 1.009, P = 0.016) showed as significant independent factors. Theoretical mortalities were 9.2%, 21.9% and 51.7% in patients with normal FBG at 55, 60 and 65 years old, respectively, and 34.3% and 53.6% in patients with FBG of 150 and 200 mg/dL, respectively, at 60 years old. CONCLUSION: Recipient age and FBG remain important risk factors for LDLT in cirrhotic patients even in the recent era. These factors should be considered for selecting liver transplant candidates in cirrhotic patients.
  Hepatology Research 01/2013; · 2.20 Impact Factor
• Article: Diagnostic and prognostic value of immunohistochemical expression of S100P and IMP3 in transpapillary biliary forceps biopsy samples of extrahepatic bile duct carcinoma.

  Hiroki Kawashima, Akihiro Itoh, Eizaburo Ohno, Ryoji Miyahara, Naoki Ohmiya, Tsutomu Tanaka, Yoshie Shimoyama, Shigeo Nakamura, Tomoki Ebata, Masato Nagino, Hidemi Goto, Yoshiki Hirooka
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  ABSTRACT: BACKGROUND: Because the biopsy specimen of extrahepatic bile duct carcinoma (EHBDC) is small and shows reactive changes, the histological distinction between malignant and benign tissue can be difficult. Recent studies reported that S100P and insulin-like growth factor II mRNA-binding protein 3 (IMP3) were not only diagnostic molecules but also prognostic biomarkers in several organs. The objective of this study is to clarify the diagnostic and prognostic value of immunohistochemical expression of S100P and IMP3 in transpapillary biliary forceps biopsy (TBFB) samples. METHODS: The TBFB samples were collected from 80 patients (EHBDC, 68 patients; benign, 12 patients), retrospectively. RESULTS: When using cytoplasmic-positive staining for IMP3 as a marker of malignancy, the sensitivity and specificity reached 79.4 and 91.7 %, respectively. The sensitivity, specificity and accuracy achieved 89.7, 91.7 and 90.0 %, respectively, when using positive staining for IMP3 and/or positive histology as a maker of malignancy. While univariate (P = 0.033) and multivariate (P = 0.039) analysis revealed that S100P-positive EHBDC patients showed significantly shorter survival. CONCLUSIONS: The results of this study suggest that immunohistochemical staining for IMP3 is useful in the diagnosis of EHBDC and that of S100P is useful as a prognostic marker for EHBDC.
  Journal of hepato-biliary-pancreatic sciences. 12/2012;
• Article: Comparison of the efficacy of ribavirin plus peginterferon alfa-2b for chronic hepatitis C infection in patients with and without coagulation disorders.

  Takashi Honda, Yoshiaki Katano, Teiji Kuzuya, Kazuhiko Hayashi, Masatoshi Ishigami, Akihiro Itoh, Yoshiki Hirooka, Isao Nakano, Tetsuya Ishikawa, Hidenori Toyoda, Takashi Kumada, Koji Yamamoto, Tadashi Matsushita, Tetsuhito Kojima, Junki Takamatsu, Hidemi Goto
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  ABSTRACT: Many patients with coagulation disorders are infected with hepatitis C virus (HCV) that advances to end stage liver disease, resulting in an increased number of deaths. The efficacy of ribavirin and peginterferon combination therapy for chronic HCV infection in patients with coagulation disorders has not been clarified fully. The aim of this study was to evaluate the efficacy and tolerability of combination therapy in this patient population compared with patients who are infected with HCV and do not have coagulation disorders. A total of 226 consecutive chronic hepatitis C patients were treated with combination therapy and divided into two groups: patients with (n = 23) and without coagulation disorders (n = 203). Clinical characteristics, sustained virological response rates obtained by an intention-to-treat analysis, and combination therapy discontinuation rates were compared between the two groups. The sustained virological response rates did not differ significantly between patients with and without coagulation disorders (65.2% vs. 47.8% by intention-to-treat analysis). According to a multivariate analysis, age, alanine aminotransferase, gamma-glutamyltransferase, and HCV genotype were associated significantly with a sustained virological response, whereas whether a patient had a coagulation disorder did not affect the sustained virological response. In conclusion, combination therapy for chronic hepatitis C was comparably effective between patients with and without coagulation disorders and did not result in adverse bleeding. J. Med. Virol. © 2012 Wiley Periodicals, Inc.
  Journal of Medical Virology 11/2012; · 2.82 Impact Factor