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  • S. Karger AG  (31)
  • Koike, Kazuhiko  (31)
  • 1
    Online Resource
    Online Resource
    Impact of Obesity and Heavy Alcohol Consumption on Hepatocellular Carcinoma Development after HCV Eradication with Antivirals
    S. Karger AG ; 2021
    In:  Liver Cancer Vol. 10, No. 4 ( 2021), p. 309-319
    Details
    In: Liver Cancer, S. Karger AG, Vol. 10, No. 4 ( 2021), p. 309-319
    Abstract: 〈 b 〉 〈 i 〉 Background and Aims: 〈 /i 〉 〈 /b 〉 It remains unclear whether obesity increases the risk of hepatocellular carcinoma (HCC) in patients with chronic hepatitis C who achieved a sustained virological response (SVR) with antiviral therapy. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 In this multicenter cohort study, we enrolled patients with chronic hepatitis C who achieved SVR with interferon (IFN)-based therapy (IFN group) or direct-acting antiviral (DAA) therapy (DAA group) between January 1, 1990, and December 31, 2018. The patients underwent regular surveillance for HCC. Cumulative incidence of and the risk factors for HCC development after SVR were assessed using the Kaplan-Meier method and Cox proportional hazard regression analysis, respectively. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 Among 2,055 patients (840 in the IFN group and 1,215 in the DAA group), 75 developed HCC (41 in the IFN group and 34 in the DAA group) during the mean observation period of 4.1 years. The incidence rates of HCC at 1, 2, and 3 years were 1.2, 1.9, and 3.0%, respectively. Multivariate analysis revealed that in addition to older age, lower albumin level, lower platelet count, higher alpha-fetoprotein level, and absence of dyslipidemia, obesity (body mass index ≥25 kg/m 〈 sup 〉 2 〈 /sup 〉 ) and heavy alcohol consumption (≥60 g/day) were independent risk factors for HCC development, with adjusted hazard ratio (HR) of 2.53 (95% confidence interval [CI]: 1.51–4.25) and 2.56 (95% CI: 1.14–5.75), respectively. The adjusted HR was not significant between the 2 groups (DAA vs. IFN; HR 1.19, 95% CI: 0.61–2.33). 〈 b 〉 〈 i 〉 Conclusions: 〈 /i 〉 〈 /b 〉 Obesity and heavy alcohol consumption increased the risk of HCC development after SVR.
    Type of Medium: Online Resource
    ISSN: 2235-1795 , 1664-5553
    URL: Article
    DOI: 10.1159/000513705
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2021
    detail.hit.zdb_id: 2666925-0
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  • 2
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    Expression of c-Met in Primary and Recurrent Hepatocellular Carcinoma
    S. Karger AG ; 2020
    In:  Oncology Vol. 98, No. 3 ( 2020), p. 186-194
    Details
    In: Oncology, S. Karger AG, Vol. 98, No. 3 ( 2020), p. 186-194
    Abstract: 〈 b 〉 〈 i 〉 Background: 〈 /i 〉 〈 /b 〉 The clinical course of hepatocellular carcinoma (HCC) is complicated, because it often recurs and shows multiple lesions, some of which progress to a more malignant form, shortening the life of the patient. The hepatocyte growth factor receptor c-Met has been shown to play an important role in the pathogenesis of HCC, but the influence of c-Met expression on the clinical course of HCC remains to be fully elucidated. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 We randomly selected and included 600 tumor specimens obtained from the primary and recurrent lesions of 319 HCC cases between 1995 and 2007. The expression of c-Met was determined by immunohistochemistry using archived formalin-fixed paraffin-embedded samples. We analyzed the correlation between c-Met expression and clinical parameters, including survival. In addition, we examined c-Met expression in the malignant transition of HCC in all cases including recurrent lesions. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 Survival analysis using the multivariate Cox proportional-regression model revealed that the prognosis was significantly better in the primary cases with high c-Met expression than in those with low c-Met expression (hazard ratio 0.159, 95% confidence interval 0.065–0.391; 〈 i 〉 p 〈 /i 〉 & #x3c; 0.001). During the course of recurrence, some cases with high c-Met expression returned to low c-Met expression. Among 40 cases with high c-Met expression, 29 survived more than 2 years after detecting the high c-Met expression. 〈 b 〉 〈 i 〉 Conclusion: 〈 /i 〉 〈 /b 〉 High expression of c-Met may be a prognostic factor for a good, rather than a poor, HCC prognosis. The involvement of c-Met expression in the malignant transition of recurrent HCC is obscure.
    Type of Medium: Online Resource
    ISSN: 0030-2414 , 1423-0232
    URL: Article
    DOI: 10.1159/000504806
    RVK:
    XH 3305
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2020
    detail.hit.zdb_id: 1483096-6
    detail.hit.zdb_id: 250101-6
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  • 3
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    Hepatitis C Virus Infection Can Present with Metabolic Disease by Inducing Insulin Resistance
    S. Karger AG ; 2006
    In:  Intervirology Vol. 49, No. 1-2 ( 2006), p. 51-57
    Details
    In: Intervirology, S. Karger AG, Vol. 49, No. 1-2 ( 2006), p. 51-57
    Abstract: Although hepatitis C virus (HCV) targets the liver, it has become increasingly evident that HCV can induce diseases of many organs. Recently, much attention is drawn to metabolic disorders in HCV infection. First, hepatic steatosis and derangement in lipid metabolism have been found characteristic of HCV infection, and later on, a correlation was noted between HCV infection and diabetes as well as insulin resistance. We have demonstrated that HCV by itself can induce insulin resistance through disturbing the insulin signaling pathway by HCV proteins. The fact that HCV infection induces insulin resistance by the virus itself may influence the progression of chronic liver disease and open up novel therapeutic approaches. In conclusion, towards the future, HCV infection needs to be viewed not only as a liver disease but also as a metabolic disease.
    Type of Medium: Online Resource
    ISSN: 0300-5526 , 1423-0100
    URL: Article
    DOI: 10.1159/000087263
    RVK:
    XA 10000
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2006
    detail.hit.zdb_id: 1482863-7
    SSG: 12
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  • 4
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    Online Resource
    Lipid Metabolism and Liver Disease in Hepatitis C Viral Infection
    S. Karger AG ; 2010
    In:  Oncology Vol. 78, No. Suppl. 1 ( 2010), p. 24-30
    Details
    In: Oncology, S. Karger AG, Vol. 78, No. Suppl. 1 ( 2010), p. 24-30
    Abstract: Persistent infection with hepatitis C virus (HCV) is a major risk toward development of hepatocellular carcinoma. A number of transgenic mouse lines carrying the cDNA of HCV genome have been established and evaluated in the study of HCV pathogenesis. Among those, the studies using transgenic mouse lines that carry the HCV genome containing the core gene indicate the direct involvement of HCV in pathogenicity, including that in oncogenesis. Oxidative stress overproduction and intracellular signaling augmentation are shown to be the key events in HCV-associated hepatocarcinogenesis. Besides the data in hepatitis C patients, connecting liver fibrosis progression and the disturbance in lipid and glucose metabolisms, these mouse models also show a close relationship between HCV and metabolic alterations including hepatic steatosis and insulin resistance. Furthermore, the persistent activation of peroxisome proliferator-activated receptor-α has recently been found, yielding dramatic changes in the lipid metabolism and oxidative stress overproduction in cooperation with the mitochondrial dysfunction. These results would provide a clue for further understanding of the role of lipid metabolism in pathogenesis of hepatitis C including liver injury and hepatocarcinogenesis.
    Type of Medium: Online Resource
    ISSN: 0030-2414 , 1423-0232
    URL: Article
    DOI: 10.1159/000315226
    RVK:
    XH 3305
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2010
    detail.hit.zdb_id: 1483096-6
    detail.hit.zdb_id: 250101-6
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  • 5
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    A Retrospective Study of Gemcitabine and Cisplatin Combination Therapy as Second-Line Treatment for Advanced Biliary Tract Cancer
    S. Karger AG ; 2013
    In:  Chemotherapy Vol. 59, No. 2 ( 2013), p. 106-111
    Details
    In: Chemotherapy, S. Karger AG, Vol. 59, No. 2 ( 2013), p. 106-111
    Abstract: 〈 b 〉 〈 i 〉 Background: 〈 /i 〉 〈 /b 〉 To evaluate the treatment outcome of gemcitabine and cisplatin combination therapy as second-line treatment for advanced biliary tract cancer. 〈 b 〉 〈 i 〉 Patients and Methods: 〈 /i 〉 〈 /b 〉 Patients with advanced biliary tract cancer who were refractory to gemcitabine-based first-line chemotherapy were treated with gemcitabine and cisplatin combination therapy. Gemcitabine (1,000 mg/m 〈 sup 〉 2 〈 /sup 〉 ) and cisplatin (25 mg/m 〈 sup 〉 2 〈 /sup 〉 ) were administered intravenously on days 1 and 8, repeated every 3 weeks. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 Sixty patients were included. The tumor response and disease control rates were 1.7 and 58.3%, respectively. The median overall survival and time to progression were 6.7 months (95% CI 4.9-8.1) and 3.5 months (95% CI 2.5-5.0), respectively. Grade 3/4 toxicities included leucopenia (20%), neutropenia (25%), anemia (23%), thrombocytopenia (17%), nausea (2%), anorexia (2%), and liver dysfunction (2%). 〈 b 〉 〈 i 〉 Conclusions: 〈 /i 〉 〈 /b 〉 Gemcitabine and cisplatin combination therapy showed moderate efficacy and safety as second-line treatment for advanced biliary tract cancer that is refractory to gemcitabine-based first-line chemotherapy.
    Type of Medium: Online Resource
    ISSN: 0009-3157 , 1421-9794
    URL: Article
    DOI: 10.1159/000354209
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2013
    detail.hit.zdb_id: 1482111-4
    SSG: 15,3
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  • 6
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    Efficacy of Early Video Capsule Endoscopy for Acute Overt Lower Gastrointestinal Bleeding with Colonic Diverticulosis: A Prospective Observational Study
    S. Karger AG ; 2022
    In:  Digestion Vol. 103, No. 5 ( 2022), p. 367-377
    Details
    In: Digestion, S. Karger AG, Vol. 103, No. 5 ( 2022), p. 367-377
    Abstract: 〈 b 〉 〈 i 〉 Background/Aims: 〈 /i 〉 〈 /b 〉 Although most patients with presumptive colonic diverticular bleeding (CDB) do not undergo a small bowel investigation in clinical practice, no prospective study supports this management. We evaluated the utility of early small bowel capsule endoscopy (CE) after negative colonoscopy results. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 This prospective study evaluated the diagnostic yield of early small bowel CE (≤3 days from visit) for consecutive patients with acute-onset hematochezia, when colonoscopy found colonic diverticulosis but did not identify the definite bleeding source ( 〈 i 〉 n 〈 /i 〉 = 51; presumptive CDB). As a matched control for comparing clinical outcomes, presumptive CDB patients without CE ( 〈 i 〉 n 〈 /i 〉 = 51) were retrospectively extracted. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 On CE for the prospective cohort, the rates of total positive findings, P2 findings (high bleeding potential according to the P classification), and blood pooling in the colon were 57%, 12% (ulceration, 8%; angioectasia, 4%), and 24%, respectively. The rates of rebleeding within 30 and 365 days were 16% and 29% in the prospective cohort with CE, respectively, and were not significantly different from those in the retrospective cohort without CE (10% and 25%, respectively). In addition, thromboembolism and mortality within 30 and 365 days were not significantly different between those with and without CE. 〈 b 〉 〈 i 〉 Conclusion: 〈 /i 〉 〈 /b 〉 Early CE detected a suspected small bowel bleeding source in 12% of acute-onset presumptive CDB patients but did not significantly improve major clinical outcomes. Therefore, routine CE is unnecessary for presumptive CDB patients after colonoscopy (UMIN000026676).
    Type of Medium: Online Resource
    ISSN: 0012-2823 , 1421-9867
    URL: Article
    DOI: 10.1159/000525314
    RVK:
    XA 40650
    RVK:
    XA 10000
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2022
    detail.hit.zdb_id: 1482218-0
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  • 7
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    Reduced DEFA5 Expression and STAT3 Activation Underlie the Submucosal Invasion of Early Gastric Cancers
    S. Karger AG ; 2023
    In:  Digestion
    Details
    In: Digestion, S. Karger AG
    Abstract: Introduction: Submucosal invasion is a core hallmark of early gastric cancer (EGC) with poor prognosis. However, the molecular mechanism of the progression from intramucosal gastric cancer (IMGC) to early submucosal-invasive gastric cancer (SMGC) is not fully understood. The objective of this study was to identify genes and pathways involved in the submucosal invasion in EGC using comprehensive gene expression analysis. Methods: Gene expression profiling was performed for eight cases of IMGC and eight cases of early SMGC with submucosal invasion ≥500 μm. To validate the findings of gene expression analysis and to examine the gene expression pattern in tissues, immunohistochemical (IHC) staining was performed for 50 cases of IMGC and SMGC each. Results: Gene expression analysis demonstrated that the expression levels of small intestine-specific genes were significantly decreased in SMGC. Among them, defensin alpha 5 (DEFA5) was the most downregulated gene in SMGC, which was further validated in SMGC tissues by IHC staining. Gene set enrichment analysis showed a strong association between SMGC, the JAK-STAT signaling pathway, and the upregulation of STAT3-activating cytokines. The expression of phosphorylated STAT3 was significant in the nucleus of tumor cells in SMGC tissues but not in areas expressing DEFA5. Conclusion: The results of this study strongly suggest that the downregulation of DEFA5 and the activation of STAT3 play a significant role in the submucosal invasion of EGC.
    Type of Medium: Online Resource
    ISSN: 0012-2823 , 1421-9867
    URL: Article
    DOI: 10.1159/000531790
    RVK:
    XA 40650
    RVK:
    XA 10000
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2023
    detail.hit.zdb_id: 1482218-0
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  • 8
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    Safety of Regular-Dose Imatinib Therapy in Patients with Gastrointestinal Stromal Tumors Undergoing Dialysis
    S. Karger AG ; 2016
    In:  Case Reports in Gastroenterology Vol. 10, No. 1 ( 2016-5-19), p. 17-23
    Details
    In: Case Reports in Gastroenterology, S. Karger AG, Vol. 10, No. 1 ( 2016-5-19), p. 17-23
    Abstract: The number of cancer patients undergoing dialysis has been increasing, and the number of these patients on chemotherapy is also increasing. Imatinib is an effective and safe therapy for KIT-positive gastrointestinal stromal tumors (GIST), but the efficacy and safety of imatinib in dialysis patients remain unclear. Because clinical trials have not been conducted in this population, more investigations are required. We report on a 75-year-old Japanese man undergoing dialysis who presented with massive tarry stool from a duodenal GIST. The duodenal GIST was 14 cm in diameter with multiple liver and bone metastases. The patient underwent an urgent pancreaticoduodenectomy to achieve hemostasis. After surgery, he was administered imatinib 400 mg/day. No severe adverse event including myelosuppression, congestive heart failure, liver functional impairment, intestinal pneumonia, or Steven-Johnson syndrome occurred, and the liver metastasis remained stable for 4 months. During chemotherapy, hemodialysis continued three times per week without adverse events. We suggest that regular-dose imatinib is an effective and safe treatment in patients with GIST undergoing dialysis. In addition, we present a literature review of the effectiveness and safety of imatinib treatment in dialysis patients.
    Type of Medium: Online Resource
    ISSN: 1662-0631
    URL: Article
    DOI: 10.1159/000443267
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2016
    detail.hit.zdb_id: 2440540-1
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  • 9
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    Multidetector-Row Computed Tomography and Colonoscopy for Detecting a Rectal Dieulafoy Lesion as a Source of Lower Gastrointestinal Hemorrhage
    S. Karger AG ; 2018
    In:  Case Reports in Gastroenterology Vol. 12, No. 1 ( 2018-4-27), p. 202-206
    Details
    In: Case Reports in Gastroenterology, S. Karger AG, Vol. 12, No. 1 ( 2018-4-27), p. 202-206
    Abstract: A Dieulafoy lesion of the rectum is a very rare entity that can cause massive lower gastrointestinal (GI) hemorrhage. Identifying the bleeding point is sometimes difficult because these lesions are very small. We herein describe an 82-year-old man with active hemorrhage due to a rectal Dieulafoy lesion. He was referred to our hospital because of persistent hematochezia from the morning of that day. He had a history of atrial fibrillation, chronic heart failure, diabetes mellitus, and hyperuricemia. Prompt multidetector-row computed tomography (MDCT) enabled us to detect active bleeding from the lower rectum. Subsequently, colonoscopy revealed an exposed vessel in the lower rectum without surrounding ulceration, and hemostasis was successfully achieved using a hemostatic forceps with soft coagulation. After hemostasis had been achieved, the patient recovered and was discharged without complications and rebleeding. He is doing well 6 months after discharge from the hospital. Sequential examination by MDCT and colonoscopy is considered an efficient treatment strategy for patients with active lower GI bleeding.
    Type of Medium: Online Resource
    ISSN: 1662-0631
    URL: Article
    DOI: 10.1159/000488973
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2018
    detail.hit.zdb_id: 2440540-1
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  • 10
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    Proton Beam Therapy versus Radiofrequency Ablation for Patients with Treatment-Naïve Single Hepatocellular Carcinoma: A Propensity Score Analysis
    S. Karger AG ; 2023
    In:  Liver Cancer Vol. 12, No. 4 ( 2023), p. 297-308
    Details
    In: Liver Cancer, S. Karger AG, Vol. 12, No. 4 ( 2023), p. 297-308
    Abstract: 〈 b 〉 〈 i 〉 Introduction: 〈 /i 〉 〈 /b 〉 Proton beam therapy (PBT) is known to be an effective locoregional treatment for hepatocellular carcinoma (HCC). However, few comparative studies in treatment-naïve cases have been reported. The aim of this study was to compare the survival outcomes of PBT with those of radiofrequency ablation (RFA) in patients with treatment-naïve solitary HCC. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 Ninety-five consecutive patients with treatment-naïve HCC, a single nodule measuring ≤5 cm in diameter, and a Child-Pugh score of ≤8 who were treated with PBT at the University of Tsukuba Hospital between 2001 and 2013 were enrolled in the study. In addition, 836 patients with treatment-naïve HCC treated by RFA at the University of Tokyo Hospital during the same period were analyzed as controls. Recurrence-free survival (RFS) and overall survival (OS) were compared in 83 patient pairs after propensity score matching. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 The 1-year, 3-year, and 5-year RFS rates were 86.6%, 49.5%, and 35.5%, respectively, in the PBT group and 59.5%, 34.0%, and 20.9% in the RFA group ( 〈 i 〉 p 〈 /i 〉 = 0.058); the respective OS rates were 97.6%, 77.8%, and 57.1% in the PBT group and 95.1%, 81.7%, and 67.7% in the RFA group ( 〈 i 〉 p 〈 /i 〉 = 0.16). Regarding adverse effects, no grade 3 or higher adverse events were noted in the PBT; however, two grade 3 adverse events occurred within 30 days of RFA in the RFA group: one hemoperitoneum and one hemothorax. 〈 b 〉 〈 i 〉 Discussion: 〈 /i 〉 〈 /b 〉 After propensity score matching, PBT showed no significant difference in RFS and OS compared to RFA. PBT can be an alternative for patients with solitary treatment-naïve HCC.
    Type of Medium: Online Resource
    ISSN: 2235-1795 , 1664-5553
    URL: Article
    DOI: 10.1159/000528537
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2023
    detail.hit.zdb_id: 2666925-0
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