Taku Aoki

Accumulation of phosphorylated p62 is associated with NF-E2-related factor 2 activation in hepatocellular carcinoma.

Frequent alterations are observed in glucose metabolism in hepatocellular carcinoma (HCC). Activation of various enzymes, including ones involved in the pentose phosphate pathway, by NF‐E2‐related factor 2 (NRF2), controls redox homeostasis in HCC. However, the mechanisms mediating NRF2 activation remain unclear. Here, we aimed to investigate the correlation between NRF2, Kelch‐like ECH‐associated protein 1 (KEAP1) syntheses and p62 phosphorylation in HCC.

The preoperative globulin-to-albumin ratio, a novel inflammation-based prognostic system, predicts survival after potentially curative liver resection for patients with hepatocellular carcinoma

Although the globulin‐to‐albumin ratio (GAR) is useful for prognostication of patients with various cancers, its relationship with hepatocellular carcinoma (HCC) remains unclear. The study aims to investigate the relationship between GAR and postoperative survival among patients with HCC undergoing potentially curative liver resection (LR).

Successful Right Hemihepatectomy for a Patient with Right-Sided Round Ligament

Right-sided round ligament (RSRL) is a rare congenital anomaly that is strongly associated with a number of intrahepatic vascular anomalies. Here, we report a 77-year-old male case of hepatolithiasis associated with RSRL for which resection was performed using right hemi-hepatectomy (RHH). Intraoperative ultrasonography revealed that the portal branch of segment 4 ramified from the right anterior portal branch, and the patient was diagnosed as having RSRL. To decide the resection line, the portal branch of segment 4 was punctured and stained with indigo carmine under ultrasonographic guidance, clearly demonstrating the demarcation line between the right and left hemiliver. RHH was then carried out successfully without injuring the portal branch of segment 4.

Preoperative hypoalbuminemia is an independent risk factor for conversion from laparoscopic to open cholecystectomy in patients with cholecystolithiasis.

Laparoscopic cholecystectomy (LC) is regarded as the first choice for patients with cholecystolithiasis, but some patients require conversion to open cholecystectomy (OC) because of inflammation‐related incidents. Therefore, the aim of this study is to explore the risk factors for conversion to OC in patients undergoing elective LC for cholecystolithiasis.

A high preoperative Glasgow prognostic score predicts a high likelihood of conversion from laparoscopic to open surgery in patients with colon cancer

BackgroundAlthough the use of laparoscopic resection for colon cancer (LRC) has been increasing, conversion to open surgery sometimes becomes necessary because of intraoperative difficulties. Although the Glasgow prognostic score (GPS) is well known to be a predictor of outcome in patients with various cancers, it is unclear whether the preoperative GPS can predict the need for conversion from laparoscopic to open surgery.ObjectiveTo investigate factors predictive of conversion from laparoscopic to open surgery in patients with colon cancer.MethodsData from 308 consecutive patients who underwent LRC between January 2006 and March 2017 were retrospectively enrolled. Preoperative clinical factors in patients who had undergone LRC were compared between conversion and non-conversion groups, and multivariate regression analysis was performed to identify preoperative factors that might predict conversion from laparoscopic to open surgery.ResultsAmong 308 patients who had undergone LRC, conversion to open surgery was necessary in 28 (9.1%). Sixteen of the latter patients (6.8%) had GPS 0 (among a total of 234) and 6 (11.5%) had GPS 1 (among a total of 52). The proportion of patients with GPS 2 who required conversion was 27.2% (6/22), which was significantly higher than for those with GPS 0 or 1. Multivariate analysis demonstrated that GPS 2 (odds ratio [OR] 3.352; 95% confidence interval [CI] 1.049–10.71; p = 0.041) and preoperative ileus (OR 7.405; 95% CI 2.386–22.98; p = 0.001) were independent factors predictive of conversion from laparoscopic to open surgery.ConclusionsA high preoperative GPS is an independent factor predictive of conversion from laparoscopic to open surgery in patients with colon cancer.

Tumor DNA-dependent protein kinase catalytic subunit expression is associated with hepatitis B surface antigen status and tumor progression in patients with hepatocellular carcinoma

The DNA-dependent protein kinase catalytic subunit (DNA-PKcs), which plays an important role in the DNA damage response, has been reported to be associated with tumor progression in various carcinomas. However, the clinical significance of DNA-PKcs in hepatocellular carcinoma (HCC) patients remains unclear. In the present study, we determined the tumor expression of DNA-PKcs in 104 resected HCC specimens by immunohistochemistry. The DNA-PKcs expression was scored as follows; 0, negative staining; 1, staining of nuclei at the tumor edge; 2, staining of the nuclei deep within the tumor and/or the tumor cytoplasm. The relationships between tumor expression of DNA-PKcs and the clinical characteristics and patient outcomes were investigated. Among the 104 HCCs, the distribution of staining for DNA-PKcs was as follows: 32 tumors were assigned a score of 0, 27 tumors were assigned a score of 1, and 45 tumors were assigned a score of 2. Statistical analyses revealed that tumor DNA-PKcs expression was significantly associated with the HBs antigen (HBsAg) status, presence/absence of portal vein invasion, size of the largest tumor nodule (<3.0 cm/>3.0, cm), and the serum alpha-fetoprotein level. Significant differences in the overall survival and recurrence-free survival were observed between patients showing (staining score 1 or 2) and not showing (staining score 0) tumor DNA-PKcs expression (P = 0.049 and P = 0.045, respectively). Our results suggest that tumor expression of DNA-PKcs is associated with tumor progression, HBsAg status and the postoperative outcomes in patients with HCC.

Hepatic myomatous angiomyolipoma diagnosedpreoperatively from specific imaging features: A case report

Highlights • An extremely rare case report of hepatic myomatous angiomyolipoma.• Including specific imaging features to diagnose with hepatic angiomyolipoma.• There is a significant interesting imaging findings of hepatic myomatous angiomyolipoma.• Previous reports only revealed the pathological findings and a few imaging findings, however we show two specific features of imaging with rare pathological findings.

Living donor liver transplantation in a highly allo-sensitized recipient: confusing influence of rituximab on the lymphocytotoxicity crossmatch test; a case report

Objective: We report a successful living donor liver transplantation (LDLT) from donor (husband) to highly allo-sensitized recipient (wife) against donor-adopting sufficient preoperative preparatio...

A Case of Intracystic Papillary Neoplasm With an Associated Invasive Adenocarcinoma

Intracystic papillary neoplasm (ICPN) is a preinvasive neoplasm of the gallbladder. Preoperative discrimination between ICPN and gallbladder cancer (GC) is difficult. The standard surgical strategy for ICPN has not yet been established. Herein, we report a case of ICPN with an associated invasive adenocarcinoma. A gallbladder tumor was detected by abdominal ultrasonography in an asymptomatic 69-year-old man, and he was referred to our hospital. Although computed tomography (CT), endoscopic ultrasonography, and magnetic resonance imaging findings in the present case were similar to those for GC, positron emission tomography-CT revealed that fluorodeoxyglucose (FDG) did not accumulate within the tumor. These imaging features suggested that patient was suspected to have GC with serosal invasion, and he underwent extended cholecystectomy and D2 lymph node dissection. He did not develop any postoperative complications, and he was discharged on postoperative day 7. There was no evidence of recurrence for 20 mon...