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  1. Article ; Online: Investigation of deep learning model for predicting immune checkpoint inhibitor treatment efficacy on contrast-enhanced computed tomography images of hepatocellular carcinoma.

    Nakao, Yasuhiko / Nishihara, Takahito / Sasaki, Ryu / Fukushima, Masanori / Miuma, Satoshi / Miyaaki, Hisamitsu / Akazawa, Yuko / Nakao, Kazuhiko

    Scientific reports

    2024  Volume 14, Issue 1, Page(s) 6576

    Abstract: Although the use of immune checkpoint inhibitors (ICIs)-targeted agents for unresectable hepatocellular carcinoma (HCC) is promising, individual response variability exists. Therefore, we developed an artificial intelligence (AI)-based model to predict ... ...

    Abstract Although the use of immune checkpoint inhibitors (ICIs)-targeted agents for unresectable hepatocellular carcinoma (HCC) is promising, individual response variability exists. Therefore, we developed an artificial intelligence (AI)-based model to predict treatment efficacy using pre-ICIs contrast-enhanced computed tomography (CT) imaging characteristics. We evaluated the efficacy of atezolizumab and bevacizumab in 43 patients at the Nagasaki University Hospital from 2020 to 2022 using the modified Response Evaluation Criteria in Solid Tumors. A total of 197 Progressive Disease (PD), 271 Partial Response (PR), and 342 Stable Disease (SD) contrast CT images of HCC were used for training. We used ResNet-18 as the Convolutional Neural Network (CNN) model and YOLOv5, YOLOv7, YOLOv8 as the You Only Look Once (YOLO) model with precision-recall curves and class activation maps (CAMs) for diagnostic performance evaluation and model interpretation, respectively. The 3D t-distributed Stochastic Neighbor Embedding was used for image feature analysis. The YOLOv7 model demonstrated Precision 53.7%, Recall 100%, F1 score 69.8%, mAP@0.5 99.5% for PD, providing accurate and clinically versatile predictions by identifying decisive points. The ResNet-18 model had Precision 100% and Recall 100% for PD. However, the CAMs sites did not align with the tumors, suggesting the CNN model is not predicting that a given CT slice is PD, PR, or SD, but that it accurately predicts Individual Patient's CT slices. Preparing substantial training data for tumor drug effect prediction models is challenging compared to general tumor diagnosis models; hence, large-scale validation using an efficient YOLO model is warranted.
    MeSH term(s) Humans ; Carcinoma, Hepatocellular/diagnostic imaging ; Carcinoma, Hepatocellular/drug therapy ; Artificial Intelligence ; Immune Checkpoint Inhibitors/pharmacology ; Immune Checkpoint Inhibitors/therapeutic use ; Liver Neoplasms/diagnostic imaging ; Liver Neoplasms/drug therapy ; Deep Learning ; Tomography, X-Ray Computed/methods ; Treatment Outcome
    Chemical Substances Immune Checkpoint Inhibitors
    Language English
    Publishing date 2024-03-19
    Publishing country England
    Document type Journal Article
    ZDB-ID 2615211-3
    ISSN 2045-2322 ; 2045-2322
    ISSN (online) 2045-2322
    ISSN 2045-2322
    DOI 10.1038/s41598-024-57078-y
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: The Metabolic Sensor Adenosine Monophosphate-Activated Protein Kinase Regulates Apoptosis in Nonalcoholic Steatohepatitis.

    Guicciardi, Maria Eugenia / Nakao, Yasuhiko / Gores, Gregory J

    Hepatology (Baltimore, Md.)

    2020  Volume 72, Issue 3, Page(s) 1139–1141

    MeSH term(s) AMP-Activated Protein Kinases ; Adenosine Monophosphate ; Apoptosis ; Caspase 6 ; Humans ; Non-alcoholic Fatty Liver Disease
    Chemical Substances Adenosine Monophosphate (415SHH325A) ; AMP-Activated Protein Kinases (EC 2.7.11.31) ; Caspase 6 (EC 3.4.22.-)
    Language English
    Publishing date 2020-04-11
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't ; Comment
    ZDB-ID 604603-4
    ISSN 1527-3350 ; 0270-9139
    ISSN (online) 1527-3350
    ISSN 0270-9139
    DOI 10.1002/hep.31294
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Safe removal of a synthetic paper for cake decoration that had caused a hemorrhagic rectal ulcer using a detachable snare after hemostatic treatment.

    Nakao, Yasuhiko / Mawatari, Fumihiro / Arima, Tetsuhiko / Fukuda, Sachiko / Kita, Yoshiko / Fukahori, Aiko / Nakao, Kazuhiko

    Endoscopy

    2022  Volume 54, Issue S 02, Page(s) E1007–E1008

    Language English
    Publishing date 2022-08-04
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 80120-3
    ISSN 1438-8812 ; 0013-726X
    ISSN (online) 1438-8812
    ISSN 0013-726X
    DOI 10.1055/a-1887-6077
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Hypoglycemia measured by flash glucose monitoring system predicts liver-related events in chronic liver disease patients.

    Sasaki, Ryu / Taura, Naota / Nakao, Yasuhiko / Fukushima, Masanori / Haraguchi, Masafumi / Miuma, Satoshi / Miyaaki, Hisamitsu / Nakao, Kazuhiko

    Scientific reports

    2023  Volume 13, Issue 1, Page(s) 13791

    Abstract: Impaired glucose tolerance, glucose fluctuations, and hypoglycemia have been observed in patients with chronic liver disease (CLD). The flash glucose monitoring (FGM) system, which recognises continuous and dynamic glucose changes in real time, is used ... ...

    Abstract Impaired glucose tolerance, glucose fluctuations, and hypoglycemia have been observed in patients with chronic liver disease (CLD). The flash glucose monitoring (FGM) system, which recognises continuous and dynamic glucose changes in real time, is used in daily clinical practice. This study aimed to examine the association between glucose fluctuations and hypoglycemia, as measured by the FGM system, and liver-related events. Seventy-two patients with CLD and type 2 DM who had their blood glucose measured using Freestyle Libre Pro between April 2017 and July 2018 at our institution were enrolled in this retrospective study. We assessed the results of the FGM system measurements and liver-related events, as defined by gastrointestinal bleeding, infection, ascites, encephalopathy, and liver-related death. The standard deviation (SD) of mean glucose as measured by the FGM system was 41.55 mg/dl, and hypoglycemia was observed in 48.6% (35/72) of the patients. Liver-related event-free survival was not significant when stratified based on SD; however, the event-free survival was significantly lower when stratified by hypoglycemia (p = 0.007). In a multivariate analysis using the Cox proportional hazards model, Child-Pugh class B [Hazards ratio (HR) 2.347 (95% confidence interval (CI): 1.042-5.283), p = 0.039] and hypoglycemia [HR 2.279 (95% CI: 1.064-4.881), p = 0.034] were identified as factors contributing to event-free survival. Hypoglycemia, as determined by the FGM system, was identified as a significant factor that was closely associated with liver-related events. In addition to measuring glucose levels, the FGM system is useful in predicting the occurrence of liver-related events.
    MeSH term(s) Humans ; Glucose ; Blood Glucose ; Blood Glucose Self-Monitoring ; Retrospective Studies ; Liver Diseases ; Hypoglycemia
    Chemical Substances Glucose (IY9XDZ35W2) ; Blood Glucose
    Language English
    Publishing date 2023-08-23
    Publishing country England
    Document type Journal Article
    ZDB-ID 2615211-3
    ISSN 2045-2322 ; 2045-2322
    ISSN (online) 2045-2322
    ISSN 2045-2322
    DOI 10.1038/s41598-023-40910-2
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Evans' syndrome induced by atezolizumab plus bevacizumab combination therapy in advanced hepatocellular carcinoma.

    Fukushima, Masanori / Tajima, Kazuaki / Sasaki, Ryu / Nakao, Yasuhiko / Takahashi, Kosuke / Ozawa, Eisuke / Miuma, Satoshi / Kato, Takeharu / Miyaaki, Hisamitsu / Nakao, Kazuhiko

    Clinical journal of gastroenterology

    2023  Volume 16, Issue 3, Page(s) 402–406

    Abstract: An 86-year-old man presented with recurrence of hepatocellular carcinoma (HCC) after surgery. Atezolizumab plus bevacizumab was initiated. After the third course of atezolizumab plus bevacizumab therapy, petechial purpura appeared on the extremities and ... ...

    Abstract An 86-year-old man presented with recurrence of hepatocellular carcinoma (HCC) after surgery. Atezolizumab plus bevacizumab was initiated. After the third course of atezolizumab plus bevacizumab therapy, petechial purpura appeared on the extremities and trunk. Laboratory tests revealed isolated severe thrombocytopenia without evidence of combined coagulopathy. He was diagnosed with immune thrombocytopenic purpura (ITP), and high-dose immunoglobulin and Helicobacter pylori eradication therapies were administered. Improvement in thrombocytopenia was observed; however, 20 days after the onset of ITP, laboratory data revealed hemolytic anemia. Both direct and indirect Coombs tests were positive, and he was diagnosed with Evan's syndrome complicated by ITP and autoimmune hemolytic anemia (AIHA) induced by immune-related adverse events (irAEs). After treatment with prednisolone, the hemoglobin level increased, and hemolytic findings improved on blood tests. We encountered a rare case of Evans' syndrome due to atezolizumab plus bevacizumab therapy for HCC. In atezolizumab plus bevacizumab therapy, hematologic toxicities are not rare adverse events and attention is required.
    MeSH term(s) Male ; Humans ; Aged, 80 and over ; Anemia, Hemolytic, Autoimmune/chemically induced ; Anemia, Hemolytic, Autoimmune/drug therapy ; Anemia, Hemolytic, Autoimmune/complications ; Bevacizumab/adverse effects ; Carcinoma, Hepatocellular/drug therapy ; Carcinoma, Hepatocellular/complications ; Liver Neoplasms/drug therapy ; Liver Neoplasms/complications ; Thrombocytopenia/chemically induced ; Purpura, Thrombocytopenic, Idiopathic/complications ; Purpura, Thrombocytopenic, Idiopathic/diagnosis ; Purpura, Thrombocytopenic, Idiopathic/drug therapy
    Chemical Substances Bevacizumab (2S9ZZM9Q9V) ; atezolizumab (52CMI0WC3Y)
    Language English
    Publishing date 2023-02-06
    Publishing country Japan
    Document type Case Reports ; Journal Article
    ZDB-ID 2429411-1
    ISSN 1865-7265 ; 1865-7257
    ISSN (online) 1865-7265
    ISSN 1865-7257
    DOI 10.1007/s12328-023-01767-0
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Peripheral lymphocyte fluctuation as an indicator of severe immune-related adverse events in patients treated with immune checkpoint inhibitors.

    Haraguchi, Masafumi / Nakao, Yasuhiko / Narita, Syouhei / Matsumoto, Kousuke / Fukushima, Masanori / Sasaki, Ryu / Honda, Takuya / Miuma, Satoshi / Miyaaki, Hisamitsu / Nakao, Kazuhiko

    Cancer medicine

    2023  Volume 12, Issue 9, Page(s) 10636–10646

    Abstract: Aim: Immune checkpoint inhibitors (ICIs) have proven to be effective treatments for various cancers, but can also elicit immune-related adverse events (irAEs). Given that severe irAEs can be life-threatening, biomarkers that can predict the occurrence ... ...

    Abstract Aim: Immune checkpoint inhibitors (ICIs) have proven to be effective treatments for various cancers, but can also elicit immune-related adverse events (irAEs). Given that severe irAEs can be life-threatening, biomarkers that can predict the occurrence of irAEs are of paramount importance. ICIs affect the dynamics of lymphocytes, and alterations in these dynamics may play a role in the development and severity of irAEs. The aim of this study was to investigate the correlation between irAEs and changes in lymphocyte counts.
    Methods: Information on irAEs was collected from 226 ICI cases from 2014 to 2020. We compared lymphocyte counts before treatment and at the onset of irAE and investigated the association between lymphocyte count fluctuations and the presence and severity of irAE, the course after steroid treatment, and overall survival.
    Results: Of the 226 cases, 27 patients developed grade 3 or higher irAE. Compared to the other groups, the lymphocyte count in this group was significantly decreased at the time of irAE (p < 0.01). There was a trend toward a rapid increase in lymphocyte count in the steroid responder group compared to the non-responder group. Regarding overall survival, patients with irAE had significantly longer survival than those without irAE (p = 0.0025). However, there was no association between changes in lymphocyte count and survival in patients with irAE.
    Conclusion: The percentage change in lymphocyte count was found to correlate with the incidence of severe irAEs. Close monitoring of the patient's condition is crucial when the lymphocyte count decreases during ICI treatment.
    MeSH term(s) Humans ; Immune Checkpoint Inhibitors/adverse effects ; Neoplasms/drug therapy ; Treatment Outcome ; Lymphocytes ; Steroids ; Retrospective Studies
    Chemical Substances Immune Checkpoint Inhibitors ; Steroids
    Language English
    Publishing date 2023-03-19
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2659751-2
    ISSN 2045-7634 ; 2045-7634
    ISSN (online) 2045-7634
    ISSN 2045-7634
    DOI 10.1002/cam4.5816
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article: Safe removal of a synthetic paper for cake decoration that had caused a hemorrhagic rectal ulcer using a detachable snare after hemostatic treatment

    Nakao, Yasuhiko / Mawatari, Fumihiro / Arima, Tetsuhiko / Fukuda, Sachiko / Kita, Yoshiko / Fukahori, Aiko / Nakao, Kazuhiko

    Endoscopy

    (More E-Videos)

    2022  Volume 54, Issue S 02, Page(s) E1007–E1008

    Series title More E-Videos
    Language English
    Publishing date 2022-08-04
    Publisher Georg Thieme Verlag KG
    Publishing place Stuttgart ; New York
    Document type Article
    ZDB-ID 80120-3
    ISSN 1438-8812 ; 0013-726X
    ISSN (online) 1438-8812
    ISSN 0013-726X
    DOI 10.1055/a-1887-6077
    Database Thieme publisher's database

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  8. Article ; Online: Comparison of the novel Franseen needle versus the fine-needle aspiration needle in endoscopic ultrasound-guided tissue acquisition for cancer gene panel testing: A propensity score-matching analysis.

    Mori, Tomotaka / Ozawa, Eisuke / Shimakura, Akane / Takahashi, Kosuke / Matsuo, Satoshi / Tajima, Kazuaki / Nakao, Yasuhiko / Fukushima, Masanori / Sasaki, Ryu / Miuma, Satoshi / Miyaaki, Hisamitsu / Okano, Shinji / Nakao, Kazuhiko

    JGH open : an open access journal of gastroenterology and hepatology

    2023  Volume 7, Issue 9, Page(s) 652–658

    Abstract: Background and aim: Reports have indicated that a surface area of 4 mm: Method: From April 2010 to December 2021, among 693 EUS-TA cases, EZ3 was used in 390 cases and TopGain in 45. The EZ3 and TopGain groups were matched in a 1:1 ratio with a ... ...

    Abstract Background and aim: Reports have indicated that a surface area of 4 mm
    Method: From April 2010 to December 2021, among 693 EUS-TA cases, EZ3 was used in 390 cases and TopGain in 45. The EZ3 and TopGain groups were matched in a 1:1 ratio with a tolerance of 0.2, with 35 patients each matched using propensity score analysis.
    Results: The TopGain group had a significantly higher percentage of cases with a tissue area of ≥4 mm
    Conclusions: EUS-TA using TopGain significantly collected more ≥4 mm
    Language English
    Publishing date 2023-09-07
    Publishing country Australia
    Document type Journal Article
    ISSN 2397-9070
    ISSN (online) 2397-9070
    DOI 10.1002/jgh3.12965
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Modulating sphingosine 1-phosphate receptor signaling skews intrahepatic leukocytes and attenuates murine nonalcoholic steatohepatitis.

    Liao, Chieh-Yu / Barrow, Fanta / Venkatesan, Nanditha / Nakao, Yasuhiko / Mauer, Amy S / Fredrickson, Gavin / Song, Myeong Jun / Sehrawat, Tejasav S / Dasgupta, Debanjali / Graham, Rondell P / Revelo, Xavier S / Malhi, Harmeet

    Frontiers in immunology

    2023  Volume 14, Page(s) 1130184

    Abstract: Sphingosine 1-phosphate (S1P) is a bioactive sphingolipid associated with nonalcoholic steatohepatitis (NASH). Immune cell-driven inflammation is a key determinant of NASH progression. Macrophages, monocytes, NK cells, T cells, NKT cells, and B cells ... ...

    Abstract Sphingosine 1-phosphate (S1P) is a bioactive sphingolipid associated with nonalcoholic steatohepatitis (NASH). Immune cell-driven inflammation is a key determinant of NASH progression. Macrophages, monocytes, NK cells, T cells, NKT cells, and B cells variably express S1P receptors from a repertoire of 5 receptors termed S1P
    MeSH term(s) Male ; Animals ; Mice ; Non-alcoholic Fatty Liver Disease/drug therapy ; Non-alcoholic Fatty Liver Disease/etiology ; Non-alcoholic Fatty Liver Disease/metabolism ; Sphingosine-1-Phosphate Receptors ; Mice, Inbred C57BL ; Inflammation/drug therapy ; Inflammation/metabolism ; Leukocytes/metabolism ; Membrane Glycoproteins ; Receptors, Immunologic/therapeutic use
    Chemical Substances etrasimod (6WH8495MMH) ; amiselimod ; Sphingosine-1-Phosphate Receptors ; sphingosine 1-phosphate (26993-30-6) ; Trem2 protein, mouse ; Membrane Glycoproteins ; Receptors, Immunologic
    Language English
    Publishing date 2023-04-21
    Publishing country Switzerland
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 2606827-8
    ISSN 1664-3224 ; 1664-3224
    ISSN (online) 1664-3224
    ISSN 1664-3224
    DOI 10.3389/fimmu.2023.1130184
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Non-liver-related mortality in the DAA era: Insights from post-SVR patients with and without previous HCC history.

    Miuma, Satoshi / Miyaaki, Hisamitsu / Ichikawa, Tatsuki / Matsuzaki, Toshihisa / Goto, Takashi / Kamo, Yasuhiro / Shigeno, Masaya / Hino, Naoyuki / Ario, Keisuke / Yanagi, Kenji / Tsutsumi, Takuya / Fukushima, Nobuyoshi / Nakashiki, Suguru / Yamasaki, Kazufumi / Hamasaki, Keisuke / Shibata, Hidetaka / Arima, Kazuhiko / Yamamichi, Shinobu / Yamashima, Mio /
    Takahashi, Kosuke / Nakao, Yasuhiko / Fukushima, Masanori / Haraguchi, Masafumi / Sasaki, Ryu / Ozawa, Eisuke / Taura, Naota / Nakao, Kazuhiko

    Journal of medical virology

    2024  Volume 96, Issue 3, Page(s) e29432

    Abstract: Background and aims: Mortality after sustained virological response (SVR) with interferon-free direct-acting antiviral (IFN-free DAA) therapy is crucial for optimizing post-SVR patient care, but it remains unclear, especially regarding non-liver-related ...

    Abstract Background and aims: Mortality after sustained virological response (SVR) with interferon-free direct-acting antiviral (IFN-free DAA) therapy is crucial for optimizing post-SVR patient care, but it remains unclear, especially regarding non-liver-related mortality.
    Methods: Consecutive post-SVR patients from 14 institutions were stratified into three cohorts: A (without advanced fibrosis and without prior HCC), B (with advanced fibrosis and without prior HCC), and C (curative HCC treatment). We assessed mortality (per 1000 person-years [/1000PY]) post-SVR. Mortality rates were compared between cohorts A and B and the general population using age- and sex-adjusted standardized mortality ratio (SMR). Comparison of survival between each cohort was performed using propensity-score (PS) matching with sex, age, and comorbidity.
    Results: In cohort A (n = 762; median age, 65 years), 22 patients died (median follow-up, 36 months); all-cause mortality was 10.0/1000PY, with 86.4% non-liver-related deaths. In cohort B (n = 519; median age, 73 years), 27 patients died (median follow-up, 39 months); all-cause mortality was 16.7/1000PY, with 88.9% non-liver-related deaths. In both cohorts, malignant neoplasm was the most common cause of death; all-cause mortality was comparable to that of the general population (SMR: 0.96 and 0.92). In cohort C (n = 108; median age, 75 years), 15 patients died (median follow-up, 51 months); all-cause mortality was 36.0/1000PY, with 53.3% liver-related deaths. PS matching showed no significant survival differences between cohorts A and B, both of which had better survival than cohort C.
    Conclusions: Mortality varies based on HCC history in the DAA era; nevertheless, attention should be paid to non-liver-related deaths in all post-SVR patients.
    MeSH term(s) Humans ; Aged ; Antiviral Agents/therapeutic use ; Carcinoma, Hepatocellular/drug therapy ; Liver Neoplasms/drug therapy ; Liver Neoplasms/etiology ; Hepatitis C, Chronic/drug therapy ; Sustained Virologic Response ; Fibrosis
    Chemical Substances Antiviral Agents
    Language English
    Publishing date 2024-03-21
    Publishing country United States
    Document type Journal Article
    ZDB-ID 752392-0
    ISSN 1096-9071 ; 0146-6615
    ISSN (online) 1096-9071
    ISSN 0146-6615
    DOI 10.1002/jmv.29432
    Database MEDical Literature Analysis and Retrieval System OnLINE

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