医学部 外科学講座

三木 厚

ミキ アツシ  (Atsushi Miki)

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 講師
学位
医学博士(岡山大学)

研究者番号
20570378
J-GLOBAL ID
201401083701983832
researchmap会員ID
B000238645

外部リンク

学歴

 2

論文

 160
  • Takehiro Kagaya, Atsushi Miki, Jun Watanabe, Rihito Kanamaru, Shiro Matsumoto, Kentaro Kurashina, Shin Saito, Takumi Teratani, Yoshinori Hosoya, Yasunaru Sakuma, Joji Kitayama, Naohiro Sata
    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.
  • Takashi Ishida, Atsushi Miki, Yasunaru Sakuma, Jun Watanabe, Kazuhiro Endo, Hideki Sasanuma, Takumi Teratani, Joji Kitayama, Naohiro Sata
    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.
  • Jun Watanabe, Katsuro Ichimasa, Yuki Kataoka, Shoko Miyahara, Atsushi Miki, Khay Guan Yeoh, Shigeo Kawai, Fernando Martínez de Juan, Isidro Machado, Kazuhiko Kotani, Naohiro Sata
    Clinical and translational gastroenterology 2024年1月2日  
    INTRODUCTION: Treatment guidelines for colorectal cancer (CRC) suggest two classifications for histological differentiation-highest-grade and predominant. However, the optimal predictor of lymph node metastasis (LNM) in T1 CRC remains unknown. This systematic review aimed to evaluate the impact of the use of highest-grade or predominant differentiation on LNM determination in T1 CRC. METHODS: The study protocol is registered in the International Prospective Register of Systematic Reviews (PROSPERO, registration number: CRD42023416971) and was published in OSF (https://osf.io/TMAUN/) on April 13, 2023.We searched five electronic databases for studies assessing the diagnostic accuracy of highest-grade or predominant differentiation to determine LNM in T1 CRC. The outcomes were sensitivity and specificity. We simulated 100 T1 CRC cases, with an LNM incidence of 11.2%, to calculate the differences in false positives and negatives between the highest-grade and predominant differentiations using a bootstrap method. RESULTS: In 42 studies involving 41,290 patients, the differentiation classification had a pooled sensitivity of 0.18 (95% confidence interval [CI], 0.13-0.24) and 0.06 (95% CI, 0.04-0.09) (P<0.0001) and specificity of 0.95 (95% CI, 0.93-0.96) and 0.98 (95% CI, 0.97-0.99) (P<0.0001) for the highest-grade and predominant differentiations, respectively. In the simulation, the differences in false positives and negatives between the highest-grade and predominant differentiations were 3.0% (range, 1.6-4.4) and -1.3% (range, -2.0 to -0.7), respectively. CONCLUSIONS: Highest-grade differentiation may reduce the risk of misclassifying LNM cases as negative, whereas predominant differentiation may prevent unnecessary surgeries. Further studies should examine differentiation classification using other predictive factors.
  • Takumi Teratani, Yasuhiro Fujimoto, Yasunaru Sakuma, Naoya Kasahara, Masashi Maeda, Atsushi Miki, Alan Kawarai Lefor, Naohiro Sata, Joji Kitayama
    Transplant international : official journal of the European Society for Organ Transplantation 37 11336-11336 2024年  
    Segmental grafts from living donors have advantages over grafts from deceased donors when used for small intestine transplantation. However, storage time for small intestine grafts can be extremely short and optimal graft preservation conditions for short-term storage remain undetermined. Secreted factors from mesenchymal stem cells (MSCs) that allow direct activation of preserved small intestine grafts. Freshly excised Luc-Tg LEW rat tissues were incubated in preservation solutions containing MSC-conditioned medium (MSC-CM). Preserved Luc-Tg rat-derived grafts were then transplanted to wild-type recipients, after which survival, injury score, and tight junction protein expression were examined. Luminance for each graft was determined using in vivo imaging. The findings indicated that 30-100 and 3-10 kDa fractions of MSC-CM have superior activating effects for small intestine preservation. Expression of the tight-junction proteins claudin-3, and zonula occludens-1 preserved for 24 h in University of Wisconsin (UW) solution containing MSC-CM with 50-100 kDa, as shown by immunostaining, also indicated effectiveness. Reflecting the improved graft preservation, MSC-CM preloading of grafts increased survival rate from 0% to 87%. This is the first report of successful transplantation of small intestine grafts preserved for more than 24 h using a rodent model to evaluate graft preservation conditions that mimic clinical conditions.
  • Yoshiyuki Meguro, Hironori Yamaguchi, Hideki Sasanuma, Kentaro Shimodaira, Yuichi Aoki, Takashi Chinen, Kazue Morishima, Hideyo Miyato, Atsushi Miki, Kazuhiro Endo, Alan Kawarai Lefor, Joji Kitayama, Naohiro Sata
    Internal medicine (Tokyo, Japan) 2023年12月4日  
    The prognosis of patients with peritoneal metastases from pancreatic cancer is poor, largely due to massive ascites, which precludes systemic treatment. Two patients with a poor performance status and malignant ascites were treated with cell-free and concentrated ascites reinfusion therapy followed by combined chemotherapy with intraperitoneal paclitaxel, intravenous gemcitabine, and nab-paclitaxel. These patients achieved a survival of 19 and 36 weeks with a relatively good quality of life. Combined intraperitoneal paclitaxel and systemic chemotherapy may provide effective palliative management for some patients with peritoneal metastases from pancreatic cancer.

MISC

 196
  • 青木裕一, 笹沼秀紀, 下平健太郎, 木村有希, 目黒由行, 田口昌延, 森嶋計, 三木厚, 兼田裕司, 池田恵理子, 池田恵理子, 菅野敦, 福嶋敬宜, 佐田尚弘
    膵臓(Web) 38(3) 2023年  
  • Yuichi Aoki, Hisashi Oshiro, Akihiko Yoshida, Kazue Morishima, Atsushi Miki, Hideki Sasanuma, Yasunaru Sakuma, Alan Kawarai Lefor, Naohiro Sata
    BMC gastroenterology 20(1) 105-105 2020年4月15日  
    BACKGROUND: Capicua transcriptional repressor (CIC) -rearranged sarcoma is characterized by small round cells, histologically similar to Ewing sarcoma. However, CIC-rearranged sarcoma has different clinical, histological, and immunohistochemical features from Ewing sarcoma. It is important to differentiate between these tumors. CASE PRESENTATION: The patient is a 44-year-old man with a duodenal tumor diagnosed in another hospital who presented with a history of melena. Laboratory studies showed anemia with a serum hemoglobin of 6.0 g/dL. He was hospitalized and gastrointestinal bleeding was controlled successfully with endoscopy. However, he suffered from appetite loss and vomiting and progression of anemia a few weeks after presentation. Upper gastrointestinal endoscopy showed a circumferential soft tumor in the second portion of the duodenum and the endoscope could not pass distally. Computed tomography scan showed a greater than 10 cm tumor in the duodenum, with compression of the inferior vena cava and infiltrating the ascending colon. A definitive pathologic diagnosis could not be established despite four biopsies from the tumor edge. Due to gastrointestinal obstruction and progression of anemia, a pylorus-preserving pancreaticoduodenectomy with partial resection of the inferior vena cava and right hemicolectomy was performed as a complete tumor resection. The tumor was diagnosed as a CIC-rearranged sarcoma, but 2 months postoperatively local recurrence and distant metastases to the liver and lung were found. The patient died 3 months after surgery. CONCLUSIONS: Although the only definitive treatment for CIC-rearranged sarcoma is surgical resection, the CIC-rearranged sarcoma is highly malignant with a poor prognosis even after radical resection. More research is needed to establish optimal treatment strategies.
  • 松宮美沙希, 猪瀬悟史, 田中保平, 高見真梨子, 崎尾亮太郎, 加賀谷丈紘, 太白健一, 宮崎千絵子, 田原真紀子, 三木厚, 鯉沼広治, 栗原克己, 金井信行
    日本臨床外科学会雑誌 81 2020年  
  • 吉田 淳, 笹沼 英紀, 片野 匠, 篠原 翔一, 森嶋 計, 三木 厚, 宮戸 英世, 遠藤 和洋, 佐久間 康成, 堀江 久永, 細谷 好則, 北山 丈二, 佐田 尚宏
    胆道 33(3) 581-581 2019年10月  
  • 篠原 翔一, 笹沼 英紀, 宮戸 英世, 森嶋 計, 三木 厚, 遠藤 和洋, 吉田 淳, 佐久間 康成, 北山 丈二, 佐田 尚宏
    胆道 33(3) 628-628 2019年10月  

共同研究・競争的資金等の研究課題

 8