医学部 内科学(岡崎医療センター)

舘 佳彦

タチ ヨシヒコ  (Yoshihiko Tachi)

基本情報

所属
藤田医科大学 医学部・内科学 教授
学位
医学博士(名古屋大学)

J-GLOBAL ID
201101011301925962
researchmap会員ID
6000030136

学歴

 2

論文

 95
  • Teiji Kuzuya, Naoto Kawabe, Hisanori Muto, Yoshihiko Tachi, Takeshi Ukai, Yuryo Wada, Gakushi Komura, Takuji Nakano, Hiroyuki Tanaka, Kazunori Nakaoka, Eizaburo Ohno, Kohei Funasaka, Mitsuo Nagasaka, Ryoji Miyahara, Yoshiki Hirooka
    Current oncology (Toronto, Ont.) 31(10) 6218-6231 2024年10月16日  
    AIM: To investigate the characteristics and prognosis of patients with advanced hepatocellular carcinoma (HCC) treated with atezolizumab and bevacizumab (Atz/Bev) who achieved a complete response (CR) according to the modified Response Evaluation Criteria in Solid Tumors (mRECIST). METHODS: A total of 120 patients with Eastern Cooperative Oncology Group performance status (PS) 0 or 1 and Child-Pugh A at the start of Atz/Bev treatment were included. Barcelona Clinic Liver Cancer stage C was recorded in 59 patients. RESULTS: The CR rate with Atz/Bev alone was 15.0%. The median time to CR was 3.4 months, and the median duration of CR was 15.6 months. A significant factor associated with achieving CR with Atz/Bev alone was an AFP ratio of 0.34 or less at 3 weeks. Adding transarterial chemoembolization (TACE) in the six patients who achieved a partial response increased the overall CR rate to 20%. Among the 24 patients who achieved CR, the median progression-free survival was 19.3 months, the median overall survival was not reached, and 14 patients (58.3%) were able to discontinue Atz/Bev and achieve a drug-free status. Twelve of these patients developed progressive disease (PD), but eleven successfully received post-PD treatments and responded well. CONCLUSIONS: Achieving CR by mRECIST using Atz/Bev alone or with additional TACE can be expected to offer an extremely favorable prognosis.
  • Satoshi Yamamoto, Kazuo Inui, Yoshiaki Katano, Hironao Miyoshi, Takashi Kobayashi, Yoshihiko Tachi
    Pancreas 2024年2月12日  
    OBJECTIVES: We set out to predict whether nonsurgical treatment is likely to succeed in removing pancreatic stones in a given patient and also to determine an optimal maximal number of extracorporeal shock wave lithotripsy (ESWL) sessions for treatment of pancreatolithiasis in that patient. MATERIALS AND METHODS: We ascertained the number of ESWL sessions for each of 164 patients undergoing that treatment for pancreatolithiasis between 1992 and 2020. Median follow-up duration was 31 months (range, 0-239), median age was 58 years (22-83), and the male to female ratio was 5.1:1.0. Patients were divided into 2 groups based upon an optimal maximal number of ESWL sessions determined by receiver operating characteristic analysis. RESULTS: Total stone clearance was achieved in 130 of 164 patients (79%). The median number of ESWL sessions was 3 (1-61). Receiver operating characteristic analysis determined 7 to be the optimal maximal number of sessions. Complete clearance was more frequent (87%) among the 131 patients requiring 7 or fewer ESWL sessions than among the 33 undergoing more (48%, P < 0.001). Seventeen patients (52%) undergoing 8 or more sessions still had residual stones. CONCLUSIONS: If any pancreatic stones persist after 7 ESWL sessions, we recommend transition to medical or surgical treatments.
  • Satoshi Yamamoto, Kazuo Inui, Yoshiaki Katano, Hironao Miyoshi, Takashi Kobayashi, Yoshihiko Tachi
    Fujita medical journal 9(2) 113-120 2023年5月  
    OBJECTIVES: We aimed to determine when a coexisting pseudocyst was likely to complicate the nonsurgical treatment of pancreatolithiasis. METHODS: We treated 165 patients with pancreatolithiasis nonsurgically between 1992 and 2020, including 21 with pseudocysts. Twelve patients had a single pseudocyst less than 60 mm in diameter. Pseudocysts in the other nine patients had diameters of at least 60 mm or were multiple. The locations of pseudocysts along the length of the pancreas varied from the area with stone involvement to the pancreatic tail. We compared the outcomes in these groups. RESULTS: We found no significant differences in pain relief, stone clearance, stone recurrence, or the likelihood of adverse events between pseudocyst groups or between patients with vs without pseudocysts. However, 4 of 9 patients with large or multiple pseudocysts required transition to surgical treatment (44%) compared with 13 of 144 patients with pancreatolithiasis and no pseudocyst (9.0%) (P=0.006). CONCLUSIONS: Patients with smaller pseudocysts typically underwent nonsurgical stone clearance successfully with few adverse events, similar to findings in patients with pancreatolithiasis and no pseudocysts. Pancreatolithiasis complicated by large or multiple pseudocysts did not cause more adverse events but was more likely to require transition to surgery compared with pancreatolithiasis without pseudocysts. In patients with large or multiple pseudocysts, early transition to surgery should be considered when nonsurgical treatment is ineffective.
  • Hyuga Yamada, Kohei Funasaka, Mitsuru Nakagawa, Yutaka Hirayama, Noriyuki Horiguchi, Mitsuo Nagasaka, Yoshiyuki Nakagawa, Teiji Kuzuya, Senju Hashimoto, Ryoji Miyahara, Tomoyuki Shibata, Yoshihiko Tachi, Tetsuya Tsukamoto, Yoshiki Hirooka
    Internal medicine (Tokyo, Japan) 2023年4月21日  
    Inflammatory myofibroblastic tumor (IMT) is a rare tumor composed of myofibroblasts with inflammatory blood cell infiltration. It commonly occurs in the lungs and rarely in the esophagus. We herein report a valuable case of IMT originating in the esophagus. A 60-year-old Japanese woman with dysphagia had a large subepithelial lesion (SEL) in the cervical esophagus, which was 15 cm in length. Surgical resection was performed to confirm the pathological diagnosis and improve the symptoms. The postoperative diagnosis was IMT composed of multiple nodules. There was no recurrence or metastasis within one year after surgery.
  • Satoshi Yamamoto, Kazuo Inui, Yoshiaki Katano, Senju Hashimoto, Hironao Miyoshi, Takashi Kobayashi, Yoshihiko Tachi
    Gastroenterology report 11 goad065 2023年  

MISC

 21
  • 山本智支, 乾和郎, 片野義明, 三好広尚, 小林隆, 舘佳彦, 鳥井淑敬, 松浦弘尚
    肝胆膵 80(2) 337-343 2020年  
  • 山本智支, 乾和郎, 片野義明, 三好広尚, 小林隆, 舘佳彦
    臨床消化器内科 35(4) 403-406 2020年  
    <文献概要>MRCPによる膵・胆管合流異常の診断では,膵管と胆管が異常に長い共通管をもって合流するか,異常な形で合流することを確認することが必要で,共通管が比較的短い例では,ERCPなどの直接胆道造影で乳頭部括約筋作用が膵胆管合流部に及ばないことを確認する必要がある.「先天性胆道拡張症の診断基準」には,膵・胆管合流異常だけでなく,胆管径,拡張部位,拡張形態があり,そのなかで胆管径はMRCPなどの胆道に圧がかからない検査によって総胆管のもっとも拡張した部位の内径を測定する必要がある.MRCPでの描出不良の原因としては細い膵管や短い共通管,合流部・画像自体の描出不良,拡張した総胆管との重なりが挙げられている.膵・胆管合流異常,先天性胆道拡張症が疑われた際には,まず行われる検査としてMRCPが有用である.
  • 三好広尚, 乾和郎, 片野義明, 小林隆, 舘佳彦, 山本智支, 鳥井淑敬
    消化器内視鏡 31(9) 1406-1409 2019年  
  • 三好広尚, 乾和郎, 片野義明, 小林隆, 舘佳彦, 山本智支, 鳥井淑敏
    消化器内視鏡 31(11) 1660-1665 2019年  
    総胆管結石および肝内結石のほとんどは、経口的内視鏡により治療することができる。さらに、胆管腸管吻合部狭窄に合併する肝内結石においても、低侵襲なバルーン小腸内視鏡により治療が可能になりつつある。一方、経皮経肝胆道鏡(PTCS)は確立された治療法ではあるが経皮経肝胆道ドレナージ(PTBD)カテーテル挿入、瘻孔形成などに時間を要し、重篤な偶発症も認められることから患者への負担が大きく、PTCSを行う頻度は低下傾向にある。しかし、現在においても経口的内視鏡治療および外科治療が困難な症例が存在する。特に、肝内結石や胆管腸管吻合部狭窄合併例などの複雑な病態では、胆管炎や黄疸の管理が困難である。これら治療困難例に対してPTCSは、PTBDを含めた一連の手技で管理および治療を行うことができるため、重要な役割をもっている。したがって、効率的な結石治療法であるPTCSを安全に行うための偶発症の予防と対策に習熟し、結石治療に対して経口的および経皮的治療が行える総合的な診療体制を整えておく必要がある。(著者抄録)

書籍等出版物

 4
  • 舘 佳彦 (担当:分担執筆, 範囲:「質疑応答 プロからプロへ」)
    日本医事新報 2019年1月
  • 舘 佳彦 (担当:分担執筆, 範囲:倦怠感 ―急性肝炎―)
    医学書院「medicina」 2019年1月
  • 舘 佳彦 (担当:分担執筆, 範囲:C型慢性肝炎におけるSVR後の肝硬度の変化と組織学的特徴との関連性)
    メディカルアイ 2017年
  • 舘 佳彦 (担当:共著, 範囲:慢性ウイルス性肝炎の進展と改善-C型-)
    アークメディア 2014年