基本情報
- 所属
- 自治医科大学 医学部外科学講座 消化器一般移植外科学部門 主任教授 (附属病院 病院長)(兼任)病院長
- 学位
- 医学博士(東京大学)
- J-GLOBAL ID
- 200901010372664634
- researchmap会員ID
- 1000300013
経歴
8-
2003年8月 - 2007年9月
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2000年4月 - 2003年7月
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2000年 - 2002年
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1994年1月 - 1996年9月
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1994年 - 1996年
学歴
2-
- 1984年
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- 1984年
委員歴
10-
2018年 - 現在
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2018年 - 現在
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2000年 - 現在
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2000年 - 現在
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1997年 - 現在
論文
556-
World Journal of Surgery 2024年6月24日Abstract Background Osteopenia reflects frailty and has been shown to be associated with outcomes in cancer patients. This study was undertaken to examine whether osteopenia is an independent prognostic factor in patients with esophageal cancer after resection. Methods A total of 214 patients who underwent surgery for esophageal cancer were analyzed retrospectively. Bone mineral density (BMD) of the 11th thoracic vertebra was measured by computed tomography scan, and patients classified into osteopenia and normal BMD groups with BMD <160 Hounsfield units as the cutoff. Clinicopathological data and prognosis were analyzed. Results The 5‐year survival rate was 55.4% for the osteopenia group and 74.7% for the normal BMD group with a significantly worse prognosis in the osteopenia group (p = 0.0080). In multivariable analysis, osteopenia was a significant independent risk factor associated with overall survival (hazard ratio [HR] 1.90, 95% confidence interval [CI] 1.27–3.34, and p = 0.0151) along with R1/2 resection (HR 3.02, 95% CI 1.71–5.18, and p = 0.0002). Conclusion In patients with esophageal cancer undergoing resection, osteopenia may be a surrogate marker for frailty and an independent predictor of prognosis.
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Cancers 16(11) 2087-2087 2024年5月30日Background: Osteopenia is a well-known risk factor for survival in patients with hepatocellular carcinoma; however, it is unclear whether osteopenia can apply to both genders and how osteopenia is associated with cancer progression. The aim of this study was to elucidate whether osteopenia predicts reduced survival in regression models in both genders and whether osteopenia is associated with the pathological factors associated with reduced survival. Methods: This study included 188 consecutive patients who underwent hepatectomy. Bone mineral density was assessed using computed tomography (CT) scan images taken within 3 months before surgery. Non-contrast CT scan images at the level of the 11th thoracic vertebra were used. The cutoff value of osteopenia was calculated using a threshold value of 160 Hounsfield units. Overall survival (OS) curves and recurrence-free survival (RFS) were constructed using the Kaplan–Meier method, as was a log-rank test for survival. The hazard ratio and 95% confidence interval for overall survival were calculated using Cox’s proportional hazard model. Results: In the regression analysis, age predicted bone mineral density. The association in females was greater than that in males. The OS and RFS of osteopenia patients were shorter than those for non-osteopenia patients. According to univariate and multivariate analyses, osteopenia was an independent risk factor for OS and RFS. The sole pathological factor associated with osteopenia was microvascular portal vein invasion. Conclusion: Models suggest that osteopenia may predict decreased OS and RFS in patients undergoing resection of hepatocellular carcinoma due to the mechanisms mediated via microvascular portal vein invasion.
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Scientific reports 14(1) 6753-6753 2024年3月21日The liver and pancreas work together to recover homeostasis after hepatectomy. This study aimed to investigate the effect of liver resection volume on the pancreas. We collected clinical data from 336 living liver donors. They were categorized into left lateral sectionectomy (LLS), left lobectomy, and right lobectomy (RL) groups. Serum pancreatic enzymes were compared among the groups. Serum amylase values peaked on postoperative day (POD) 1. Though they quickly returned to preoperative levels on POD 3, 46% of cases showed abnormal values on POD 7 in the RL group. Serum lipase levels were highest at POD 7. Lipase values increased 5.7-fold on POD 7 in the RL group and 82% of cases showed abnormal values. The RL group's lipase was twice that of the LLS group. A negative correlation existed between the remnant liver volume and amylase (r = - 0.326)/lipase (r = - 0.367) on POD 7. Furthermore, a significant correlation was observed between POD 7 serum bilirubin and amylase (r = 0.379)/lipase (r = 0.381) levels, indicating cooccurrence with liver and pancreatic strain. Pancreatic strain due to hepatectomy occurs in a resection/remnant liver volume-dependent manner. It would be beneficial to closely monitor pancreatic function in patients undergoing a major hepatectomy.
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Nature communications 15(1) 2195-2195 2024年3月12日Recent evidence indicates ferroptosis is implicated in the pathophysiology of various liver diseases; however, the organ-specific regulation mechanism is poorly understood. Here, we demonstrate 7-dehydrocholesterol reductase (DHCR7), the terminal enzyme of cholesterol biosynthesis, as a regulator of ferroptosis in hepatocytes. Genetic and pharmacological inhibition (with AY9944) of DHCR7 suppress ferroptosis in human hepatocellular carcinoma Huh-7 cells. DHCR7 inhibition increases its substrate, 7-dehydrocholesterol (7-DHC). Furthermore, exogenous 7-DHC supplementation using hydroxypropyl β-cyclodextrin suppresses ferroptosis. A 7-DHC-derived oxysterol metabolite, 3β,5α-dihydroxycholest-7-en-6-one (DHCEO), is increased by the ferroptosis-inducer RSL-3 in DHCR7-deficient cells, suggesting that the ferroptosis-suppressive effect of DHCR7 inhibition is associated with the oxidation of 7-DHC. Electron spin resonance analysis reveals that 7-DHC functions as a radical trapping agent, thus protecting cells from ferroptosis. We further show that AY9944 inhibits hepatic ischemia-reperfusion injury, and genetic ablation of Dhcr7 prevents acetaminophen-induced acute liver failure in mice. These findings provide new insights into the regulatory mechanism of liver ferroptosis and suggest a potential therapeutic option for ferroptosis-related liver diseases.
MISC
516-
難治性膵疾患に関する調査研究 平成17年度 総括・分担研究報告書 67-70 2006年
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日本消化器外科学会雑誌 38(7) 1198-1198 2005年7月1日
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糖尿病 47(11) 855-860 2004年11月30日症例は31歳, 女性. 慢性水様下痢に感冒が力口わり, 脱水によるショックで近医入院となった. この際に低K血症及びVIP高値を指摘され, また糖尿病を指摘された (空腹時血糖200mg/dl, HbA1c6.996). 当院転院後の精査にて膵鉤部に径が約30mmの腫瘍が同定され, 腫瘍核出術を施行, 病理組織学的にVIPomaと診断された. 術後VIPは正常化し, 下痢及び低K血症は改善したが, 糖尿病には明らかな改善が認められなかった. VIPomaの約25-5096に耐糖能障害の合併が報告されており, 両者の関連について, 文南犬的考察を含めて報告する.
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胆道 18(4) 513-519 2004年10月15日術前診断が困難な肝内結石症例に対し, 胆管造影を付加したmulti-detector row CT(MD-CT)を撮影, データのポストプロセシングにより, 詳細診断がどこまで可能かを検討した. Siemens社製SOMATON Sensation 16にて腹部CT検査を施行, ZIOSOFT社製M 900 Quadraにて3D-reconstruction法, MPR法, MIP法,virtual cholangioscopy法などのポストプロセシングを行った. 複数の肝内胆管に結石が認められた2例において, すべての結石をMD-CTにて診断し得た. 胆道3D-reconstruction法は, ERCやPTCなど従来の直接造影法と同等, もしくはそれ以上の画像が得られた. MIP法縦軸方向回転動画像,およびMPR法により作成した冠状断を動画像として検討することは,結石同定に有用であった. 結石の詳細診断においては, virtual cholangioscopy法の診断的価値は低かった. 肝内結石症術前診断に, 胆道造影を付加したMD-CT検査およびポストプロセシング画像作成は有用であり, 今後のさらなる検討により, 肝内結石症診断における作像指針, 読影指針の確立が重要である.
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日本消化器外科学会雑誌 37(7) 1030-1030 2004年7月1日
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肝胆膵 47(6) 951-958 2003年12月28日
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日本外科学会雑誌 104 568-568 2003年4月30日
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外科 64(6) 685-689 2002年6月1日
講演・口頭発表等
975-
日本消化器外科学会総会 2021年7月 (一社)日本消化器外科学会
所属学協会
10-
2000年 - 現在
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1999年 - 現在
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1999年 - 現在
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1997年 - 現在
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1991年 - 現在
共同研究・競争的資金等の研究課題
17-
日本学術振興会 科学研究費助成事業 2023年4月 - 2026年3月
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日本学術振興会 科学研究費助成事業 2023年6月 - 2025年3月
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日本学術振興会 科学研究費助成事業 2022年4月 - 2025年3月
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日本学術振興会 科学研究費助成事業 基盤研究(C) 2020年4月 - 2023年3月
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日本学術振興会 科学研究費助成事業 挑戦的研究(萌芽) 2018年6月 - 2021年3月