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Manabe T, Takii Y, Oyanagi H, Nogami H, Maruyama S. Prognosis for Metastatic Colorectal Cancer Patients Achieving Complete Response After Systemic Chemotherapy. J Gastrointest Cancer 2023; 54:501-505. [PMID: 35488111 DOI: 10.1007/s12029-022-00829-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/22/2022] [Indexed: 11/27/2022]
Abstract
PURPOSE Despite marked recent advances in chemotherapy, few reports have focused on the prognosis for patients with metastatic colorectal cancer (mCRC) achieving complete response (CR) after systemic chemotherapy. This study investigated the clinical course of mCRC patients achieving CR and evaluated the role of chemotherapy in CR. METHODS This retrospective study searched a prospectively maintained database at the author's institute to identify medical records for mCRC patients achieving CR after systematic chemotherapy from January 2007 to March 2020. RESULTS The search yielded 23 patients with confirmed CR to systemic chemotherapy. Median time to CR from treatment initiation was 6.8 months. Maintenance chemotherapy was continued for 22 of 23 patients. Median duration of maintenance chemotherapy was 11.1 months. Disease progression occurred for 17 (73.9%) patients at a median 48.1-month follow-up. Median progression-free survival was 26.6 months. Median overall survival was 91.7 months. CONCLUSIONS Patients with CR to chemotherapy had a high probability of disease progression, but a relatively long-term prognosis. Treatment strategies after achievement of CR should be based an understanding of the high potential that tumor cells will remain. Use of maintenance chemotherapy after achievement of CR is still unclear, and the recent data do not demonstrate a negative impact for continuing maintenance chemotherapy after CR.
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Affiliation(s)
- Takahiro Manabe
- Department of Digestive Surgery, Niigata Cancer Center Hospital, 2-15-3 Kawagishicho, Niigata, 951-8566, Japan.
| | - Yasumasa Takii
- Department of Digestive Surgery, Niigata Cancer Center Hospital, 2-15-3 Kawagishicho, Niigata, 951-8566, Japan
| | - Hidehito Oyanagi
- Department of Digestive Surgery, Niigata Cancer Center Hospital, 2-15-3 Kawagishicho, Niigata, 951-8566, Japan
| | - Hitoshi Nogami
- Department of Digestive Surgery, Niigata Cancer Center Hospital, 2-15-3 Kawagishicho, Niigata, 951-8566, Japan
| | - Satoshi Maruyama
- Department of Digestive Surgery, Niigata Cancer Center Hospital, 2-15-3 Kawagishicho, Niigata, 951-8566, Japan
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Shimada Y, Nakano M, Mizuno KI, Yokoyama J, Matsumoto A, Tanaka K, Oyanagi H, Nakano M, Hirose Y, Ichikawa H, Sakata J, Kameyama H, Takii Y, Sugai M, Ling Y, Takeuchi S, Okuda S, Terai S, Ajioka Y, Wakai T. Gene panel testing detects important genetic alterations in ulcerative colitis‑associated colorectal neoplasia. Oncol Lett 2022; 24:442. [PMID: 36420076 DOI: 10.3892/ol.2022.13562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 10/07/2022] [Indexed: 11/06/2022] Open
Affiliation(s)
- Yoshifumi Shimada
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Niigata 951‑8510, Japan
| | - Mae Nakano
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Niigata 951‑8510, Japan
| | - Ken-Ichi Mizuno
- Division of Gastroenterology and Hepatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Niigata 951‑8510, Japan
| | - Junji Yokoyama
- Division of Gastroenterology and Hepatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Niigata 951‑8510, Japan
| | - Akio Matsumoto
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Niigata 951‑8510, Japan
| | - Kana Tanaka
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Niigata 951‑8510, Japan
| | - Hidehito Oyanagi
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Niigata 951‑8510, Japan
| | - Masato Nakano
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Niigata 951‑8510, Japan
| | - Yuki Hirose
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Niigata 951‑8510, Japan
| | - Hiroshi Ichikawa
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Niigata 951‑8510, Japan
| | - Jun Sakata
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Niigata 951‑8510, Japan
| | - Hitoshi Kameyama
- Department of Digestive Surgery, Niigata City General Hospital, Niigata, Niigata 950‑1197, Japan
| | - Yasumasa Takii
- Department of Surgery, Niigata Cancer Center Hospital, Niigata, Niigata 951‑8566, Japan
| | - Mika Sugai
- Division of Medical Technology, Niigata University Graduate School of Health Sciences, Niigata, Niigata 951‑8518, Japan
| | - Yiwei Ling
- Medical AI Center/Bioinformatics Laboratory, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Niigata 951‑8514, Japan
| | - Shiho Takeuchi
- Medical AI Center/Bioinformatics Laboratory, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Niigata 951‑8514, Japan
| | - Shujiro Okuda
- Medical AI Center/Bioinformatics Laboratory, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Niigata 951‑8514, Japan
| | - Shuji Terai
- Division of Gastroenterology and Hepatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Niigata 951‑8510, Japan
| | - Yoichi Ajioka
- Division of Molecular and Diagnostic Pathology, Graduate School of Medical and Dental Sciences, Niigata, Niigata 951‑8510, Japan
| | - Toshifumi Wakai
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Niigata 951‑8510, Japan
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Manabe T, Takii Y, Oyanagi H, Nogami H, Maruyama S. Is the ileocolic artery crossing pattern related to oncological outcomes of right-sided colon cancer? Surg Endosc 2022; 36:7210-7218. [DOI: 10.1007/s00464-022-09078-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 01/25/2022] [Indexed: 11/24/2022]
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Tanaka K, Nakano M, Shimada Y, Abe T, Umezu H, Matsumoto A, Arabiki M, Abe K, Oyanagi H, Nakano M, Hirai Y, Ozeki H, Motegi D, Toge K, Yamamoto J, Miura K, Ichikawa H, Takizawa K, Sakata J, Kobayashi T, Wakai T. [Laparoscopic Abdominoperineal Resection after Preoperative Chemoradiotherapy for Adenocarcinoma Associated with Anal Fistula]. Gan To Kagaku Ryoho 2021; 48:1515-1517. [PMID: 34911922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
A 72-year-old man had a chief complaint of anal pain and difficulty in defecation. He was diagnosed with adenocarcinoma by biopsy from a tumor of the anal canal. A computed tomography scan revealed neither regional lymph node metastasis nor distant metastasis. Hence, he was diagnosed with cT3N0M0, cStage Ⅱa anal canal cancer. Preoperative capecitabine- based chemoradiotherapy(CRT)(50.4 Gy in 28 fractions of 1.8 Gy each)was implemented. Digital rectal examination and imaging evaluation 8 weeks after preoperative CRT revealed that the tumor had shrunk. Fifteen weeks after preoperative CRT, laparoscopic abdominoperineal resection was performed. The pathological findings showed mucinous adenocarcinoma associated with anal fistula. At present, 12 months after the operation, no local recurrence and distant metastasis has been detected under follow-up evaluations.
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Affiliation(s)
- Kana Tanaka
- Division of Digestive and General Surgery, Graduate School of Medical and Dental Sciences, Niigata University
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Obata Y, Shimada Y, Ohta A, Matsumoto A, Tanaka K, Oyanagi H, Nakano M, Nakano M, Ichikawa H, Hanyu T, Takizawa K, Nagahashi M, Sakata J, Kobayashi T, Wakai T. [A Case of a"Watch and Wait Therapy"Approach after Preoperative Chemoradiotherapy for Rectal Cancer Accompanied by Severe Emphysema]. Gan To Kagaku Ryoho 2020; 47:1960-1962. [PMID: 33468766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
A 72-year-old man was referred to our hospital for treatment for rectal cancer. Digital rectal examination and colonoscopy revealed a 4 cm tumor located at the anterior rectal wall 5 cm away from the anal verge, and pathological examination confirmed that the tumor was adenocarcinoma. A computed tomography scan detected neither regional lymph node metastasis nor distant metastasis. Hence, he was diagnosed with cT3N0M0, cStage Ⅱa rectal cancer. The preoperative general examination revealed bradyarrhythmia and severe emphysema, and he was considered to be high risk for general anesthesia. After placement of a pacemaker, preoperative capecitabine-based chemoradiotherapy(CRT)(50.4 Gy in 28 fractions of 1.8 Gy each)was implemented. The digital rectal examination and imaging evaluation 4 weeks after preoperative CRT revealed that the tumor disappeared, and pathological examination showed no malignant findings. Considering the risks of general anesthesia, the"watch and wait therapy"approach was adopted with sufficient informed consent. At present, 15 months after preoperative CRT, no evidence of regrowth or distant metastasis has been detected under rigorous follow- up evaluations.
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Affiliation(s)
- Yasuo Obata
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences
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Shimada Y, Kameyama H, Nakano M, Toshikawa C, Moro K, Tsuchida J, Arabiki M, Matsumoto A, Tanaka K, Abe K, Oyanagi H, Tajima Y, Nakano M, Hirose Y, Kano Y, Ichikawa H, Hanyu T, Takizawa K, Nagahashi M, Sakata J, Wakai T. [A Case of High-Frequency Microsatellite Instability in Colorectal Cancer with MSH2 Mutation Detected Using Gene Panel Testing with a Next-Generation Sequencer]. Gan To Kagaku Ryoho 2020; 47:1113-1115. [PMID: 32668864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Here, we report about a woman in her 30s who had peritoneal dissemination and multiple colon cancer with high-frequency microsatellite instability(MSI-H). Her father, paternal grandfather, and maternal grandmother had a history of colorectal cancer treatment. Thus, Lynch syndrome was suspected. We performed R0 resection for peritoneal dissemination and subsequent peritoneal dissemination. A 435-gene panel testing using a next-generation sequencer identified MSH2 and other mutations in the tumor. Hence, we speculated that she could have a germline mutation of MSH2, which causes Lynch syndrome. In the future, if she wishes to receive genetic counseling and undergo germline testing for variants to confirm the diagnosis of Lynch syndrome, we will perform them after receiving informed consent.
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Affiliation(s)
- Yoshifumi Shimada
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences
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Arabiki M, Shimada Y, Nakano M, Tanaka K, Oyanagi H, Nakano M, Ling Y, Okuda S, Takii Y, Wakai T. Verification of the Japanese staging system for rectal cancer, focusing on differences with the TNM classification. Surg Today 2020; 50:1443-1451. [PMID: 32440825 DOI: 10.1007/s00595-020-02024-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Accepted: 05/03/2020] [Indexed: 11/29/2022]
Abstract
PURPOSE The 9th Japanese Classification of Colorectal Cancer (9th JSCCR) has two main differences from the TNM classification (8th AJCC): first, main or lateral lymph node metastasis is classified as jN3; second, tumor nodules (ND) are treated as lymph node metastasis. In this study, we verified the 9th JSCCR for rectal cancer, focusing on the differences with the 8th AJCC. METHODS This retrospective analysis involved 212 patients with stage I-III rectal cancer. ND was evaluated using whole-mount sections. We evaluated the relapse-free survival of each staging system, and compared the prognostic significance of the different staging systems using the Akaike information criterion (AIC) and Harrell's concordance index (c-index). RESULTS Main or lateral lymph node metastasis was detected in nine of 212 (4%) patients. ND was detected in 79 of 212 (37%) patients. The best risk stratification power was observed in the 9th JSCCR (AIC, 759; c-index, 0.708) compared with the 7th JSCCR (AIC, 771; c-index, 0.681), 8th JSCCR (AIC, 768; c-index, 0.696), and the 8th AJCC (AIC, 766; c-index, 0.691). CONCLUSIONS The 9th JSCCR, which includes the concepts of jN3 and ND, is useful for the risk stratification of rectal cancer, and the contributes to precise decision-making for follow-up management and adjuvant therapy.
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Affiliation(s)
- Michiru Arabiki
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata City, Niigata, 951-8510, Japan
| | - Yoshifumi Shimada
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata City, Niigata, 951-8510, Japan.
| | - Mae Nakano
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata City, Niigata, 951-8510, Japan
| | - Kana Tanaka
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata City, Niigata, 951-8510, Japan
| | - Hidehito Oyanagi
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata City, Niigata, 951-8510, Japan
| | - Masato Nakano
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata City, Niigata, 951-8510, Japan
| | - Yiwei Ling
- Division of Bioinformatics, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Shujiro Okuda
- Division of Bioinformatics, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Yasumasa Takii
- Department of Surgery, Niigata Cancer Center Hospital, Niigata, Japan
| | - Toshifumi Wakai
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata City, Niigata, 951-8510, Japan
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Matsumoto A, Shimada Y, Nakano M, Oyanagi H, Tajima Y, Nakano M, Kameyama H, Hirose Y, Ichikawa H, Nagahashi M, Nogami H, Maruyama S, Takii Y, Ling Y, Okuda S, Wakai T. RNF43 mutation is associated with aggressive tumor biology along with BRAF V600E mutation in right-sided colorectal cancer. Oncol Rep 2020; 43:1853-1862. [PMID: 32236609 PMCID: PMC7160543 DOI: 10.3892/or.2020.7561] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Accepted: 03/05/2020] [Indexed: 12/16/2022] Open
Abstract
Right-sided colorectal cancer (RCRC) demonstrates worse survival outcome compared with left-sided CRC (LCRC). Recently, the importance of RNF43 mutation and BRAF V600E mutation has been reported in the serrated neoplasia pathway, which is one of the precancerous lesions in RCRC. It was hypothesized that the clinical significance of RNF43 mutation differs according to primary tumor sidedness. To test this hypothesis, the clinicopathological characteristics and survival outcome of patients with RNF43 mutation in RCRC and LCRC were investigated. Stage I–IV CRC patients (n=201) were analyzed. Genetic alterations including RNF43 using a 415-gene panel were investigated. Clinicopathological characteristics between RNF43 wild-type and RNF43 mutant-type were analyzed. Moreover, RNF43 mutant-type was classified according to primary tumor sidedness, i.e., right-sided RNF43 mutant-type or left-sided RNF43 mutant-type, and the clinicopathological characteristics between the two groups were compared. RNF43 mutational prevalence, spectrum and frequency between our cohort and TCGA samples were compared. RNF43 mutation was observed in 27 out of 201 patients (13%). Multivariate analysis revealed that age (≥65), absence of venous invasion, and BRAF V600E mutation were independently associated with RNF43 mutation. Among the 27 patients with RNF43 mutation, 12 patients were right-sided RNF43 mutant-type and 15 left-sided RNF43 mutant-type. Right-sided RNF43 mutant-type was significantly associated with histopathological grade 3, presence of lymphatic invasion, APC wild, BRAF V600E mutation, microsatellite instability-high (MSI-H), and RNF43 nonsense/frameshift mutation compared with left-sided RNF43 mutant-type. Similarly, RNF43 nonsense/frameshift mutations were more frequently observed in RCRC compared with LCRC in the TCGA cohort (P=0.042). Right-sided RNF43 mutant-type exhibited significantly worse overall survival than RNF43 wild-type and left-sided RNF43 mutant-type (P=0.001 and P=0.023, respectively) in stage IV disease. RNF43 mutation may be a distinct molecular subtype which is associated with aggressive tumor biology along with BRAF V600E mutation in RCRC.
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Affiliation(s)
- Akio Matsumoto
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata 951-8520, Japan
| | - Yoshifumi Shimada
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata 951-8520, Japan
| | - Mae Nakano
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata 951-8520, Japan
| | - Hidehito Oyanagi
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata 951-8520, Japan
| | - Yosuke Tajima
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata 951-8520, Japan
| | - Masato Nakano
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata 951-8520, Japan
| | - Hitoshi Kameyama
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata 951-8520, Japan
| | - Yuki Hirose
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata 951-8520, Japan
| | - Hiroshi Ichikawa
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata 951-8520, Japan
| | - Masayuki Nagahashi
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata 951-8520, Japan
| | - Hitoshi Nogami
- Department of Surgery, Niigata Cancer Centre Hospital, Niigata 951-8566, Japan
| | - Satoshi Maruyama
- Department of Surgery, Niigata Cancer Centre Hospital, Niigata 951-8566, Japan
| | - Yasumasa Takii
- Department of Surgery, Niigata Cancer Centre Hospital, Niigata 951-8566, Japan
| | - Yiwei Ling
- Division of Bioinformatics, Niigata University Graduate School of Medical and Dental Sciences, Niigata 951-8510, Japan
| | - Shujiro Okuda
- Medical Genome Center, Niigata University Medical and Dental Hospital, Niigata 951-8520, Japan
| | - Toshifumi Wakai
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata 951-8520, Japan
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Yamada S, Kameyama H, Abe K, Tanaka K, Oyanagi H, Tajima Y, Nakano M, Shimada Y, Sakata J, Wakai T. Timing of Surgery to Treat Ulcerative Colitis: An Investigation Focused on Japanese Adults. Inflamm Intest Dis 2020; 5:20-26. [PMID: 32232051 DOI: 10.1159/000504885] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2019] [Accepted: 11/19/2019] [Indexed: 12/11/2022] Open
Abstract
Introduction There are no specific standards for the timing of surgery to treat ulcerative colitis, so reaching a decision on timing is often difficult. Objective The aim of this study was to evaluate the timing of surgery from the patients' perspective. Methods From among 203 patients who underwent restorative proctocolectomy with ileal pouch anal anastomosis to treat ulcerative colitis at our hospital from 1985 to 2013, we mailed a questionnaire to 101 of those who are currently attending periodic follow-up at our hospital. Results We analyzed 72 valid responses (71.2%). Overall, 65 patients (90.3%) responded that they were happy that they underwent surgery, 38 patients (52.8%) responded that the timing of surgery was appropriate, and 32 patients (44.4%) responded that they would have preferred to have had surgery earlier. The group of patients who would have preferred to have had surgery earlier included 23 patients (71.9%) who had undergone emergency surgery; the incidence of emergency surgery was significantly higher than in the group of 13 patients (34.2%) who had responded that the timing of surgery was appropriate (p = 0.002). Scores on the Medical Outcomes Study 36-Item Short-Form Health Survey (SF36), which reflect postoperative quality of life, were maintained at the same level as the Japanese standard values in our Japanese patients. Conclusion The degree of satisfaction of patients who underwent surgery for ulcerative colitis was favorable, although it is important to consider surgery at an earlier stage in patients who may need emergency surgery.
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Affiliation(s)
- Saki Yamada
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Hitoshi Kameyama
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Kaoru Abe
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Kana Tanaka
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Hidehito Oyanagi
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Yosuke Tajima
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Masato Nakano
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Yoshifumi Shimada
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Jun Sakata
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Toshifumi Wakai
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
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Okada S, Kameyama H, Abe K, Tanaka K, Oyanagi H, Nakano M, Ichikawa H, Hanyu T, Takizawa K, Nakano M, Nagahashi M, Shimada Y, Sakata J, Kobayashi T, Wakai T. [A Case of Pathological Complete Response with Neoadjuvant Chemotherapy for Advanced Rectal Cancer]. Gan To Kagaku Ryoho 2019; 46:2057-2059. [PMID: 32157058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
A 62-year-old man was admitted with complaints of bloody stool. Colonoscopy revealed a 5 cm diameter type 2 tumor in the lower rectum close to the anal canal. Tumor biopsy indicated a well-differentiated tubular adenocarcinoma. Computed tomography revealed locally advanced rectal cancer with mesorectal lymph node metastases(cT3N1P0M0, Stage Ⅲa, JSCCR 8th). The patient was treated with neoadjuvant chemotherapy(NAC)after transverse colostomy as an anus-preserving procedure. For the NAC, 12 courses of capecitabine plus oxaliplatin(CapeOX)and bevacizumab(BV)were administered. Colonoscopy after NAC revealed that the main tumor had considerably shrunk. No malignant tissues were found on biopsy. However, rectal wall thickness remained unchanged. Therefore, response evaluation for chemotherapy indicated partial response. Intersphincteric resection(ISR)with diverting loop ileostomy was performed as an anus-preserving surgical procedure. No remnant tumor in the rectum or lymph node metastases were found upon the pathological examination of resected specimens. Ileostomy closure was performed at 6 months post-ISR. At 12 months post-ISR, the patient was well and showed no signs of recurrence. This case demonstrated that NAC with CapeOX and BV can be a promising option for treating locally advanced lower rectal cancer and preserving the anus.
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Affiliation(s)
- Shukichi Okada
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences
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Yamashita Y, Kameyama H, Abe K, Tanaka K, Oyanagi H, Nakano M, Ichikawa H, Hanyu T, Takizawa K, Nakano M, Nagahashi M, Shimada Y, Sakata J, Kobayashi T, Wakai T. [A Case of Long-Term Survival in a Patient with Advanced Rectal Cancer and Paraaortic and Lateral Lymph Node Metastases]. Gan To Kagaku Ryoho 2019; 46:2033-2035. [PMID: 32157050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
A 65-year-old woman was referred for further examination following positive results on a fecal occult blood test. Colonoscopy revealed type 0-Ⅱa cancer, with a lesion measuring 2 cm in diameter in the rectosigmoid colon, and type 5 cancer, with a lesion measuring 6 cm in diameter in the upper rectum. Computed tomography(CT)and positron emission tomography (PET)-CT revealed mesorectal lymph node metastases. Therefore, she was diagnosed with rectosigmoid colon cancer(Stage Ⅰ)and upper rectal cancer(Stage Ⅲa). However, PET-CT also revealed slight fluorodeoxyglucose uptake in the paraaortic and lateral lymph node lesions; hence, the possibility ofmetastasis could not be ruled out. Given that chemotherapy was restricted due to renal dysfunction, low anterior resection was performed as the first choice. Analysis of intraoperative frozen sections showed paraaortic and lateral lymph node metastases; thus, we performed lymph node dissection of these lesions. Pathological examination ofthe resected lymph nodes revealed that 21 of 37 lesions were cancer metastases. S-1 was administered as adjuvant chemotherapy for 5 months. Mediastinal lymph node metastases was suspected on chest CT 5 months and 3 years post-surgery; thus, panitumumab was administrated. These lymph nodes decreased in size immediately. Six years after the first surgery, the patient was well without any signs of recurrence.
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Affiliation(s)
- Yumiko Yamashita
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences
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12
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Arabiki M, Kameyama H, Abe K, Tanaka K, Oyanagi H, Tajima Y, Nakano M, Nakano M, Shimada Y, Ichikawa H, Takizawa K, Nagahashi M, Sakata J, Kobayashi T, Wakai T. [A Case of Long-Term Survival after Resection for Metachronous Liver and Lung Metastases of Rectal Cancer Associated with Familial Adenomatous Polyposis]. Gan To Kagaku Ryoho 2019; 46:2228-2230. [PMID: 32156887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
A 37-year-old man was admitted to our hospital for the treatment of familial adenomatous polyposis and rectal carcinoma. He underwent total colectomy with ileoanal anastomosis(pT3N1M0, pStage Ⅲa)followed by adjuvant therapy with S-1. Three months after primary surgery, CT and MRIrevealed liver metastases(S5, S6). Laparoscopic partial hepatectomy was performed. Two years after primary surgery, new liver metastases(S2, S8)were found and we performed open partial hepatectomy and administered mFOLFOX6. Three years and 5 months after primary surgery, right lung metastases(S6, S9) were detected and the patient underwent a thoracoscopic-assisted right lung wedge resection. Repeated resection of metastases might have contributed to the long-survival in our case.
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Affiliation(s)
- Michiru Arabiki
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences
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13
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Kameyama H, Shimada Y, Abe K, Oyanagi H, Nakano M, Nakano M, Ichikawa H, Hanyu T, Takizawa K, Nagahashi M, Sakata J, Kobayashi T, Nishikawa N, Enomoto T, Wakai T. [Digestive Surgery Intervention for Gynecological Malignant Tumor]. Gan To Kagaku Ryoho 2019; 46:2176-2178. [PMID: 32156870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
AIM This study aimed to determine surgical outcomes in patients with gynecological cancers for whom surgery was performed by gynecologists and digestive surgeons. METHODS Seventy-three patients who underwent surgery for a gynecological malignant tumor from January 2010 to December 2014 were included in this retrospective study. Data on the definitive diagnosis, operative procedures, postoperative complications, stoma settings, length of hospital stay, and prognosis was collected for each patient. RESULTS The median age of this female-only cohort was 60 years. Emergency surgery was performed in 8(11.0%)patients. Ovarian cancer was diagnosed in 56(76.7%)patients, and among these patients, the clinical disease Stage was Ⅰ, Ⅱ, Ⅲ, and Ⅳ in 4, 4, 20, and 11 patients, respectively. Moreover, 17 patients had recurrent ovarian cancer. Intestinal resection with anastomosis was performed in 25(34.2%)patients. Stoma formation was performed in 22 (30.1%)patients, however no patient underwent stoma closure surgery in the current study. The median operative time was 252 minutes, and the median blood loss was 1,190 mL. Regarding postoperative complications, ileus, pelvic abscess, and anastomotic leakage developed in 6(8.2%), 4(5.5%), and 2(2.7%)patients, respectively. The postoperative median survival time in patients with ovarian cancer was 1,399 days. CONCLUSION These results suggest that tumor debulking, including intestinal tract resection, may contribute to the prolonged prognosis of gynecological tumors, although stoma closure is difficult to perform.
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Affiliation(s)
- Hitoshi Kameyama
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences
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14
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Oyanagi H, Shimada Y, Nagahashi M, Ichikawa H, Tajima Y, Abe K, Nakano M, Kameyama H, Takii Y, Kawasaki T, Homma KI, Ling Y, Okuda S, Takabe K, Wakai T. SMAD4 alteration associates with invasive-front pathological markers and poor prognosis in colorectal cancer. Histopathology 2019; 74:873-882. [PMID: 30636020 PMCID: PMC6849740 DOI: 10.1111/his.13805] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Accepted: 12/08/2018] [Indexed: 12/18/2022]
Abstract
Aims SMAD4 acts as a tumour suppressor, and the loss of SMAD4 is associated with poor prognosis in colorectal cancer (CRC) patients. Although next‐generation sequencing (NGS) enabled us to detect numerous genetic alterations in a single assay, the clinical significance of SMAD4 alteration detected with NGS has not been fully investigated. The aim of this study was to evaluate the clinicopathological characteristics and clinical significance of SMAD4 alteration detected with NGS in CRC. Methods and results We retrospectively investigated 201 patients with stage I–IV CRC, by using a 415‐gene panel. To analyse the relationship between SMAD4 alteration and other clinicopathological characteristics, we evaluated clinicopathological variables, including invasive‐front pathological markers: tumour budding, poorly differentiated cluster, and Crohn‐like lymphoid reaction. Fifty‐six patients (28%) had SMAD4 alteration: 24 and 32 patients had SMAD4 mutation and deletion, respectively. SMAD4 alteration was significantly associated with T category (P = 0.027), N category (P = 0.037), M category (P = 0.028), and invasive‐front pathological markers, such as poorly differentiated cluster grade 3 (P = 0.020) and absence of Crohn‐like lymphoid reaction (P = 0.004). Immunohistochemistry revealed that SMAD4 alteration was significantly associated with loss of SMAD4 (P = 0.023). In 90 patients with stage I–III disease, SMAD4 alteration was significantly associated with poor prognosis for relapse‐free and overall survival (P = 0.047; P = 0.022, respectively). Conversely, in 111 patients with stage IV disease, SMAD4 alteration was not significantly associated with overall survival. Conclusion SMAD4 alteration is associated with invasive‐front pathological markers and poor prognosis in stage I–III CRC patients.
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Affiliation(s)
- Hidehito Oyanagi
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Yoshifumi Shimada
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Masayuki Nagahashi
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Hiroshi Ichikawa
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Yosuke Tajima
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Kaoru Abe
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Masato Nakano
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Hitoshi Kameyama
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Yasumasa Takii
- Department of Surgery, Niigata Cancer Center Hospital, Niigata, Japan
| | - Takashi Kawasaki
- Department of Pathology, Niigata Cancer Center Hospital, Niigata, Japan
| | - Kei-Ichi Homma
- Department of Pathology, Niigata Cancer Center Hospital, Niigata, Japan
| | - Yiwei Ling
- Division of Bioinformatics, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Shujiro Okuda
- Division of Bioinformatics, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Kazuaki Takabe
- Division of Breast Surgery, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA.,Department of Surgery, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, The State University of New York, Buffalo, NY, USA.,Department of Breast Surgery and Oncology, Tokyo Medical University, Tokyo, Japan.,Department of Surgery, Yokohama City University, Yokohama, Japan
| | - Toshifumi Wakai
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
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15
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Yamada S, Shimada Y, Matsumoto A, Abe K, Tanaka K, Oyanagi H, Otani T, Hotta S, Sudo N, Miura K, Tajima Y, Nakano M, Sakata J, Kameyama H, Wakai T. [Staged Laparoscopy-Assisted Surgery Including Hand-Assisted Laparoscopic Surgery for Rectal Cancer with Synchronous Liver Metastases-A Case Report]. Gan To Kagaku Ryoho 2018; 45:1851-1853. [PMID: 30692375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Here, we reported a case of a 39-year-old woman having rectal cancer with multiple liver metastases who underwent staged laparoscopic resection. She was diagnosed with low rectal cancer and multiple liver metastases; thus, she underwent low anterior resection and diverting colostomy. Following the neoadjuvant chemotherapy, she underwent colostomy closure and subsequent hand-assisted laparoscopic partial hepatectomy using the operative site during the colostomy closure. The postoperative course was uneventful, and adjuvant chemotherapy with CapeOX was performed 3 weeks post-surgery. Minimally invasive surgery was performed using hand-assisted laparoscopy.
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Affiliation(s)
- Saki Yamada
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences
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16
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Shimada Y, Tajima Y, Nagahashi M, Ichikawa H, Oyanagi H, Okuda S, Takabe K, Wakai T. Clinical Significance of BRAF Non-V600E Mutations in Colorectal Cancer: A Retrospective Study of Two Institutions. J Surg Res 2018; 232:72-81. [PMID: 30463788 DOI: 10.1016/j.jss.2018.06.020] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 04/22/2018] [Accepted: 06/06/2018] [Indexed: 12/31/2022]
Abstract
BACKGROUND Recent advances in next-generation sequencing have enabled the detection of BRAF V600E mutations as well as BRAF non-V600E mutations in a single assay. The present work aimed to describe the clinicopathological characteristics and clinical outcome of the BRAF non-V600E mutant-type in colorectal cancer (CRC). PATIENTS AND METHODS CRC samples from 111 Stage IV patients were analyzed for somatic mutations using a 415-gene comprehensive genomic sequencing panel. Patients were classified according to BRAF status as wild-type, V600E mutant-type, or non-V600E mutant-type. Differences between clinicopathological characteristics and genetic alterations were analyzed among the three groups. Overall survival (OS) and the response to anti-EGFR therapy were also analyzed. RESULTS Comprehensive genomic sequencing revealed that 98 patients (88%), 7 patients (6%), and 6 patients (6%) were wild-type, V600E mutant-type, and non-V600E mutant-type, respectively. Non-V600E mutant-type tumors were frequently left-sided (83%), while V600E mutant-type tumors were frequently right-sided (86%; P = 0.025). Non-V600E mutant-type showed better OS than V600E mutant-type (P = 0.038), with no significant difference compared with wild-type tumors. The two patients with non-V600E mutations who underwent repeated metastasectomies showed no evidence of disease at final follow-up. Regarding the efficacy of anti-EGFR therapy, the patient with an I326V mutation had progressive disease (+115%) despite no genetic alterations detected in the EGFR pathway that could drive resistance, suggesting an alternate resistance mechanism. CONCLUSIONS Non-V600E mutant-type is more likely to be left-sided and demonstrates better OS than V600E mutant-type. Further preclinical and clinical investigations are needed to clarify the role of non-V600E mutations in CRC.
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Affiliation(s)
- Yoshifumi Shimada
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Chuo-ku, Niigata City, Niigata, Japan.
| | - Yosuke Tajima
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Chuo-ku, Niigata City, Niigata, Japan
| | - Masayuki Nagahashi
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Chuo-ku, Niigata City, Niigata, Japan
| | - Hiroshi Ichikawa
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Chuo-ku, Niigata City, Niigata, Japan
| | - Hidehito Oyanagi
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Chuo-ku, Niigata City, Niigata, Japan
| | - Shujiro Okuda
- Division of Bioinformatics, Niigata University Graduate School of Medical and Dental Sciences, Chuo-ku, Niigata City, Niigata, Japan
| | - Kazuaki Takabe
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Chuo-ku, Niigata City, Niigata, Japan; Division of Breast Surgery, Roswell Park Cancer Institute, Buffalo, New York; Department of Surgery, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, The State University of New York, Buffalo, New York; Department of Breast Surgery and Oncology, Tokyo Medical University, Tokyo, Japan; Department of Surgery, Yokohama City University, Yokohama, Japan
| | - Toshifumi Wakai
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Chuo-ku, Niigata City, Niigata, Japan
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17
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Oyanagi H, Shimada Y, Yagi R, Tajima Y, Ichikawa H, Nakano M, Nakano M, Nagahashi M, Sakata J, Kameyama H, Kobayashi T, Nogami H, Maruyama S, Takii Y, Wakai T. [Two Cases of Colorectal Cancer with SRC Amplification]. Gan To Kagaku Ryoho 2017; 44:1757-1759. [PMID: 29394766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Carcinoma with elevated SRC expression is associated with distant metastasis and drug resistance. We report 2 cases of SRC amplification observed after retrospective comprehensive genomic sequencing. Case 1 was a 62-year-old man who had RAS wild-type stage IV carcinoma of the sigmoid colon with multiple liver metastases in both lobes. He underwent low anterior resection and systemic chemotherapy was initiated to treat the unresectable multiple liver metastases. Case 2 was a 73-yearold man who had RAS wild-type stage IV carcinoma of the descending colon with metastasis in the lateral segment of the liver. He underwent left hemicolectomy and lateral segmentectomy. He subsequently underwent open radiofrequency ablation and systemic chemotherapy to treat a hepatic recurrence. Several previous studies have found that molecular targeted therapy with tyrosine kinase inhibitors is effective against colorectal cancer with elevated SRC expression. This suggests that the results of comprehensive genomic sequencing may support the implementation of new treatments.
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Affiliation(s)
- Hidehito Oyanagi
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences
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18
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Oyanagi H, Ichikawa H, Kosugi S, Banba T, Hanyu T, Hirashima K, Ishikawa T, Kameyama H, Kobayashi T, Minagawa M, Koyama Y, Wakai T. [Three cases of esophageal carcinoma achieved a pathological complete response after neoadjuvant chemotherapy with cisplatin and 5-fluorouracil]. Gan To Kagaku Ryoho 2015; 42:497-501. [PMID: 25963701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
We report three cases of esophageal carcinoma all of which achieved a pathological complete response after neoadjuvant chemotherapy (NAC) with cisplatin and 5-fluorouracil (CF). All three patients were men with clinical stage II squamous cell carcinoma of the middle thoracic esophagus. We administered 2 courses of CF treatment as NAC and then performed radical esophagectomy. Pathologic examination revealed no viable tumor cells in the resected esophagus. The patients are currently alive with no evidence of disease.
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Affiliation(s)
- Hidehito Oyanagi
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences
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19
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Oyanagi H, Kameyama H, Nogami H, Shimada Y, Nakano M, Nakano M, Ishikawa T, Sakata J, Kobayashi T, Minagawa M, Kosugi S, Koyama Y, Wakai T. [A case of long-term survival in a patient with rectal cancer with virchow lymph node metastasis, liver metastases, and lung metastases]. Gan To Kagaku Ryoho 2014; 41:1674-1676. [PMID: 25731292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
A 69-year-old man with advanced rectal cancer and liver metastases was treated with 2 courses of chemotherapy with irinotecan and S-1 followed by low anterior resection and partial hepatectomy. Chemotherapy with S-1 was then administered for 22 months. However, lung metastases developed, for which partial pneumonectomy was performed. Seven months later, computed tomography (CT) revealed swelling of the left supraclavicular lymph node. Despite chemotherapy with 5- fluorouracil, Leucovorin, and oxaliplatin (mFOLFOX6); 5-fluorouracil, Leucovorin and irinotecan (FOLFIRI); and capecitabine plus bevacizumab, the lung metastases recurred and Virchow lymph node swelling was noted again. Accordingly, palliative therapy was administered. The patient died 3 years 1 month after Virchow lymph node resection. Herein, we describe a case of advanced rectal cancer, in which lung and Virchow lymph node metastases developed after liver metastasis. Surgical excision of the metastases resulted in long-term survival of 6 years following the first operation.
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Affiliation(s)
- Hidehito Oyanagi
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences
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20
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Oyanagi H, Sun ZH, Jiang Y, Uehara M, Nakamura H, Yamashita K, Zhang L, Lee C, Fukano A, Maeda H. In situ XAFS experiments using a microfluidic cell: application to initial growth of CdSe nanocrystals. J Synchrotron Radiat 2011; 18:272-279. [PMID: 21335916 DOI: 10.1107/s0909049510050545] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2010] [Accepted: 12/02/2010] [Indexed: 05/30/2023]
Abstract
The design and performance of a compact fluorescense XAFS apparatus equipped with a microfluidic cell for in situ studies of nanoparticles are described. CdSe nanoparticles were prepared by solution reaction starting from trioctylphosphine-Se. Time-resolved experiments were performed by precisely controlling the reactor coordinates (x,y), allowing the synchrotron X-ray beam to travel along a reactor channel, covering nucleation and initial growth of nanoparticles. Detailed analysis of EXAFS data combined with UV-vis spectra allow reliable estimation of particle size and density in the initial growth that cannot be accessible by conventional optical techniques based on a long-range order. The Se K-XANES spectra are interpreted by multi-scattering calculations providing bond formation kinetics consistent with the EXAFS data.
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Affiliation(s)
- H Oyanagi
- Photonics Research Institute, National Institute of Advanced Science and Technology, 1-1-1 Umezono, Tsukuba, Ibaraki 305-8568, Japan.
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21
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Oyanagi H, Tsukada A, Naito M, Saini NL, Lampert MO, Gutknecht D, Dressler P, Ogawa S, Kasai K, Mohamed S, Fukano A. Fluorescence X-ray absorption spectroscopy using a Ge pixel array detector: application to high-temperature superconducting thin-film single crystals. J Synchrotron Radiat 2006; 13:314-20. [PMID: 16799222 DOI: 10.1107/s0909049506015251] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2006] [Accepted: 04/26/2006] [Indexed: 05/10/2023]
Abstract
A Ge pixel array detector with 100 segments was applied to fluorescence X-ray absorption spectroscopy, probing the local structure of high-temperature superconducting thin-film single crystals (100 nm in thickness). Independent monitoring of pixel signals allows real-time inspection of artifacts owing to substrate diffractions. By optimizing the grazing-incidence angle theta and adjusting the azimuthal angle phi, smooth extended X-ray absorption fine structure (EXAFS) oscillations were obtained for strained (La,Sr)2CuO4 thin-film single crystals grown by molecular beam epitaxy. The results of EXAFS data analysis show that the local structure (CuO6 octahedron) in (La,Sr)2CuO4 thin films grown on LaSrAlO4 and SrTiO3 substrates is uniaxially distorted changing the tetragonality by approximately 5 x 10(-3) in accordance with the crystallographic lattice mismatch. It is demonstrated that the local structure of thin-film single crystals can be probed with high accuracy at low temperature without interference from substrates.
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Affiliation(s)
- H Oyanagi
- National Institute of Advanced Industrial Science and Technology, 1-1-1 Umezono, Tsukuba 305-8568, Japan.
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Katakura H, Takenaka K, Nakagawa M, Sonobe M, Oyanagi H, Adachi M, Wada H, Tanaka F. 592 Maspin gene expression is a prognostic factor in non-small cell lung cancer. EJC Suppl 2004. [DOI: 10.1016/s1359-6349(04)80600-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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23
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Tanaka F, Takenaka K, Ishikawa S, Oyanagi H, Yanagihara K, Takahashi C, Noda M, Wada H. 586 Expression of a novel MMP inhibitor, RECK, in relation with expression of MMPs and angiogenic factors in non-small cell lung cancer. EJC Suppl 2003. [DOI: 10.1016/s1359-6349(03)90618-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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24
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Oyanagi H, Takenaka K, Ito S, Ishikawa S, Kawano Y, Yanagihara K, Adachi Y, Ueda K, Tanaka F, Wada H. 814 Quantitative analysis of LUN expression, trans-activator of e-cadherin gene. EJC Suppl 2003. [DOI: 10.1016/s1359-6349(03)90839-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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25
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Nakayama T, Kubota A, Yonekura T, Hoki M, Kosumi T, Oyanagi H. A case of ischemic jejunal stricture after surgical reduction of intussusception. Pediatr Surg Int 2003; 19:504-5. [PMID: 12768315 DOI: 10.1007/s00383-002-0945-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/20/2002] [Indexed: 10/26/2022]
Abstract
A 15-year-old girl presented with small bowel obstruction due to ischemic jejunal stricture which developed three weeks after successful surgical reduction of an intussusception with a Peutz-Jeghers-type polyp as a lead point. The reduced jejunum had no macroscopic injury, and the stricture caused complete obstruction requiring jejunal resection.
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Affiliation(s)
- T Nakayama
- Department of Surgery II, Kinki University School of Medicine, 377-2 Onohigashi, 589-8511 Osakasayama, Japan
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26
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Takata T, Tanaka F, Yamada T, Yanagihara K, Otake Y, Kawano Y, Nakagawa T, Miyahara R, Oyanagi H, Inui K, Wada H. Clinical significance of caspase-3 expression in pathologic-stage I, nonsmall-cell lung cancer. Int J Cancer 2002; 96 Suppl:54-60. [PMID: 11992386 DOI: 10.1002/ijc.10347] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Caspase-3 is a cysteine protease that plays an important role in the process of apoptotic cell death. Whereas many studies on the clinical significance of apoptosis in the therapy of malignant tumors have been reported, little has been studied clinically on caspase-3. In the present study, the clinical significance of caspase-3 expression in resected nonsmall-cell lung cancer (NSCLC) and its correlation with incidence of apoptosis were examined. A total of 118 consecutive patients who had undergone complete resection for pathologic Stage I NSCLC were retrospectively reviewed. Caspase-3 expression was examined immunohistochemically using a polyclonal antibody that recognized uncleaved caspase-3. The 5-year survival rate for patients with strong expression of caspase-3 (66.6%) was significantly lower than that for patients with weak expression (82.1%, P = 0.021). Expression of caspase-3 was not correlated with incidence of apoptosis, proliferative activity, or p53 status. Multivariate analysis confirmed that strong expression of caspase-3 was a significant factor to predict poor prognosis. These results suggest that enhanced expression of "uncleaved" caspase-3, that is, inactivated caspase-3, was correlated with poor prognosis in resected NSCLC.
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Affiliation(s)
- T Takata
- Department of Thoracic Surgery, Faculty of Medicine, Kyoto University, Kyoto, Japan
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27
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Kolobov AV, Oyanagi H, Tanaka K. In situ X-ray absorption fine structure detection of reversible photoinduced anisotropy in amorphous selenium. Phys Rev Lett 2001; 87:145502. [PMID: 11580661 DOI: 10.1103/physrevlett.87.145502] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2001] [Indexed: 05/23/2023]
Abstract
Photoinduced anisotropy in amorphous selenium ( a-Se) has been studied by in situ x-ray absorption fine structure spectroscopy. It is found that upon irradiation with linearly polarized light the chainlike fragments in a-Se are oriented with their c-axis perpendicular to the polarization plane of the inducing light. This chain orientation is reversible, correlates with optical anisotropy, and acts as a prelude to photoinduced anisotropic crystallization. This optically controlled reorientation of molecular fragments in a solid can be a basis for future novel devices.
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Affiliation(s)
- A V Kolobov
- Joint Research Center for Atom Technology (JRCAT), National Institute for Advanced Interdisciplinary Research (NAIR), Tsukuba, Ibaraki 305-8562, Japan
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Abstract
BACKGROUND/PURPOSE Congenital motor dysfunction of the intestine associated with a morphologically abnormal myenteric nervous plexus (MP) is known as Hirschsprung's disease allied disorder (HAD). However, the clinicopathologic features of HAD are not well understood, partially because a standardized method of histologic evaluation of MP has not been established. To elucidate the clinicopathologic relationship of HAD the authors reviewed 6 cases of HAD using a newly devised histologic evaluation method. METHODS Flat-mounted frozen sections of the ileum were stained for S-100 protein by fluorescent immunohistochemistry. Quantitative evaluation of MP was performed by measuring the fluorescence-positive area (MP ratio), and the results were compared with those of age-matched normal controls. RESULTS All of 6 patients required laparotomy within 1 month after birth and enterostomy between 23 days and 10 months. Three died of intractable enteritis by the age of 2.2 years and were totally dependent on parenteral nutrition (PN) throughout their lives. The other 3 have survived for 6 to 10 years but have required PN occasionally. MP ratio in controls was more than 0.34 at all ages, whereas that in HAD was significantly lower than that in controls according to the clinical severity. CONCLUSION MP size measured on 2-dimensional demonstration is suggested to be an indicator of clinical severity of HAD. J Pediatr Surg 36:898-900.
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Affiliation(s)
- A Kubota
- Department of Surgery II, Kinki University School of Medicine, Osaka, Japan
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29
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Saitoh Y, Oyanagi H. [New total parenteral nutrition solution (GA-1080)]. Nihon Rinsho 2001; 59 Suppl 5:906-9. [PMID: 11439679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Affiliation(s)
- Y Saitoh
- Department of Medicine, Saiseikai Nakatsu Hospital and Medical Center Based on Social Welfare Organization Saiseikai Imperial Gift Foundation Inc
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30
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Kolobov AV, Oyanagi H, Maeda Y, Tanaka K. Local structure of Ge nanocrystals embedded in SiO2 studied by X-ray absorption fine structure. J Synchrotron Radiat 2001; 8:511-513. [PMID: 11512833 DOI: 10.1107/s0909049500019683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2000] [Accepted: 12/04/2000] [Indexed: 05/23/2023]
Abstract
Local structure of Ge nanocrystals embedded in SiO2 has been studied by X-ray absorption fine structure on the Ge K-edge. The XANES and EXAFS results indicate that Ge atoms in samples with the Ge concentration x=25-40 mol. % are coordinated with oxygen atoms, while they exist as amorphous Ge clusters in samples with x=60 mol. %. Upon annealing, completely relaxed crystalline Ge phase is formed for samples with x=60 mol. %, in contrast to the x=25-40 mol. % sample, which show little or no indication of Ge cluster formation. A possible mechanism of Ge nanocluster formation is discussed.
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Affiliation(s)
- A V Kolobov
- Joint Research Center for Atom Technology-National Institute for Advanced Interdisciplinary Research, Tsukuba, Ibaraki, Japan
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31
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Tanaka F, Otake Y, Nakagawa T, Kawano Y, Miyahara R, Li M, Yanagihara K, Inui K, Oyanagi H, Yamada T, Nakayama J, Fujimoto I, Ikenaka K, Wada H. Prognostic significance of polysialic acid expression in resected non-small cell lung cancer. Cancer Res 2001; 61:1666-70. [PMID: 11245481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
Polysialic acid (PSA) is a carbohydrate attached mainly to the neural cell adhesion molecule. Because PSA is composed of a linear homopolymer of alpha-2-8-linked sialic acid residues and has a large negative charge, the presence of PSA attenuates the adhesive property of neural cell adhesion molecule and increases cellular motility. In an earlier study, we demonstrated that PSA and STX, a polysialyltransferase, were associated with tumor progression in non-small cell lung cancer (NSCLC) (F. Tanaka et al., Cancer Res., 60: 3072-3080, 2000). Therefore, in the present study, to assess the prognostic significance of PSA in resected NSCLC, a total of 236 patients who underwent complete resection for pathological (p)-stage I-IIIa disease were reviewed retrospectively. PSA was expressed in 44 of 236 (18.6%) patients, and the expression was correlated with p-stage disease. For all p-stage patients, 5-year survival rates for those with PSA-positive and PSA-negative tumors were 52.1% and 71.3%, respectively, demonstrating a significantly worse prognosis for the PSA-positive patients (P = 0.012). Analysis for only p-stage I patients also demonstrated a significantly worse prognosis for the PSA-positive patients; 5-year survival rates of the PSA-positive and the PSA-negative patients were 45.1% and 83.5%, respectively, (P < 0.001). In addition, there proved to be no difference in the postoperative survival among p-stage I, II, and IIIa patients when PSA expression was positive. Multivariate analysis confirmed that PSA expression was an independent factor to predict poor prognosis in resected NSCLC. These results suggested that PSA could be an important clinical marker and that preoperative induction and/or postoperative adjuvant therapies should be performed for PSA-positive NSCLC, even if the disease is classified as p-stage I.
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Affiliation(s)
- F Tanaka
- Department of Thoracic Surgery, Faculty of Medicine, Kyoto University, Japan
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32
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Kosumi T, Kubota A, Usui N, Yamauchi K, Yamasaki M, Oyanagi H. Laparoscopic ovarian cystectomy using a single umbilical puncture method. Surg Laparosc Endosc Percutan Tech 2001; 11:63-5. [PMID: 11269561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
To establish a minimally invasive technique to perform ovarian cystectomy, the authors applied a single umbilical puncture method. A 2-month old female infant was admitted to the hospital because of an ovarian cyst that showed no spontaneous shrinkage after her birth. An umbilical semicircular incision was made to insert a 10-mm trocar, into which a 3-mm laparoscope was inserted. The ovarian cyst was grasped using forceps inserted through an operating channel of the scope, and the cyst was removed through the incision. After aspiration of the cyst, the free cyst wall was resected, leaving the intact ovarian tissue. The operation was performed without difficulty or complication. The postoperative course was uneventful. The wound was inconspicuous, and the result was cosmetically excellent. The case demonstrated the feasibility of the minimally invasive technique using a single umbilical puncture for ovarian cystectomy in an infant.
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Affiliation(s)
- T Kosumi
- Department of Surgery II, Kinki University School of Medicine, Osakasayama, Osaka, Japan
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33
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Yonekura T, Hirooka S, Kubota A, Hoki M, Kosumi T, Yamauchi K, Oyanagi H. Surgical intervention for emphysematous pulmonary regions in a postoperative infant with congenital diaphragmatic hernia. J Pediatr Surg 2000; 35:1820-1. [PMID: 11101744 DOI: 10.1053/jpsu.2000.19268] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
A postoperative infant with congenital diaphragmatic hernia (CDH) developed extrinsic obstruction of the trachea by the innominate artery that ensued from unequal expansion of the lungs followed by left mediastinal shift. Septation of the anterior mediastinum prevented unequal expansion of the lungs, and elongation of the innominate artery improved proximal airway obstruction. Prolonged artificial ventilation, however, resulted in the emphysematous bullae in the left lung. Lung volume reduction surgery (LVRS), at 3 years of age, ameliorated the respiratory distress and resulted in good weight gain. Surgical intervention, including LVRS, should be considered to improve respiratory disturbance caused by difference in compliance of the lungs in children.
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Affiliation(s)
- T Yonekura
- Department of Pediatric Surgery, Nara Hospital, Kinki University School of Medicine, Nara, Japan
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34
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Kubota A, Yonekura T, Usui N, Kosumi T, Yamauchi K, Yamasaki M, Oyanagi H, Nakayama M, Ida S, Nakajima T. Two cases of persistent hyperinsulinemic hypoglycemia that showed spontaneous regression and maturation of the Langerhans islets. J Pediatr Surg 2000; 35:1661-2. [PMID: 11083447 DOI: 10.1053/jpsu.2000.18346] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Near-total pancreatectomy has been recommended as the treatment for persistent hyperinsulinemic hypoglycemia (PHH) in infants. However, recently there has been a report described that one third of 95% pancreatectomy failed to prevent hypoglycemia and more than two thirds had diabetes ultimately. The authors experienced 2 cases of PHH, which raise a query about the extensive pancreatectomy. Case 1: A female patient who manifested PHH shortly after birth underwent less extensive pancreatectomy twice at age 2 months and 8 years. After each operation, her clinical symptoms regressed, and she became free from the disease eventually. Histologic findings showed nesidioblastosis in which the islets clearly matured. Case 2: A male infant with PHH had an absolute indication for pancreatectomy. However, after a meticulous control of the blood glucose level with parenteral nutrition followed by continuous enteral nutrition feeding combined with medication, he became free from the disease. The current cases show there exist cases of PHH in which the islets mature and symptoms regress spontaneously. Therefore, we conclude near-total pancreatectomy is not always the treatment of choice. As an alternate strategy, long-term controlled feeding and medication combined with or without less extensive pancreatectomy should be considered with the expectation of spontaneous regression.
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Affiliation(s)
- A Kubota
- Department of Surgery II, Kinki University, Osaka, Japan
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35
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Kubota A, Yonekura T, Hoki M, Oyanagi H, Kawahara H, Yagi M, Imura K, Iiboshi Y, Wasa K, Kamata S, Okada A. Total parenteral nutrition-associated intrahepatic cholestasis in infants: 25 years' experience. J Pediatr Surg 2000; 35:1049-51. [PMID: 10917294 DOI: 10.1053/jpsu.2000.7769] [Citation(s) in RCA: 82] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND/PURPOSE There are few long-term chronological reviews examining the incidence of total parenteral nutrition (TPN)-associated intrahepatic cholestasis (TPNAC) in infants. The authors therefore reviewed TPNAC in their 25-year series, and also looked at the current problems associated with TPN in infants. METHODS Two hundred seventy-three surgical neonates who received TPN for more than 2 weeks were divided into 3 groups chronologically: group A (1971 through 1982, n = 77), group B (1983 through 1987, n = 72), and group C (1992 through 1996, n = 124). TPNAC was defined as serum direct bilirubin (DB) level greater than 2.0 mg/dL during the neonatal period. RESULTS The incidence of TPNAC in groups A, B and C was 57%, 31%, and 25% (P< .01), respectively, and the mortality rate from TPN-associated complications was 13%, 3%, and 3% (P< .05), respectively. Over the last 5 years, severe TPNAC developed in 20 patients (16%). Four of 20 died of TPN-associated sepsis with hepatic failure; 2 had hypoganglionosis with intractable stagnant enteritis and subsequent sepsis, and 2 had fatal respiratory or cardiac disease. CONCLUSIONS The incidence of TPNAC in surgical neonates and TPN-associated mortality rates have decreased significantly. The mortality rate, however, still remains at 3%. Two of 4 fatal cases had hypoganglionosis, which were totally dependent on TPN. In patients who require long-term TPN, TPN still has unsolved problems, and small bowel transplantation may be indicated.
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Affiliation(s)
- A Kubota
- Department of Surgery II, Kinki University School of Medicine, Osaka, Japan
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36
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Abstract
A routine prenatal sonographic examination at 37 weeks' menstrual age revealed a large sonolucent lesion with peristaltic movement in the abdomen of a fetus. After birth, the female infant showed progressive abdominal distention, and radiography showed a bubble-like dilatation of the small intestine. Exploratory laparotomy revealed ileal atresia with nearby partial torsion of the dilated small bowel. The incomplete torsion may have functioned as a check valve, inducing segmental dilatation of the ileum without proximal dilatation.
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Affiliation(s)
- A Kubota
- Department of Surgery II, Kinki University School of Medicine, 377-2 Onohigashi, Osakasayama, Osaka 589-8511, Japan
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37
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Oyanagi H, Ishii M, Lee CH, Saini NL, Kuwahara Y, Saito A, Izumi Y, Hashimoto H. Rapid and sensitive XAFS using a tunable X-ray undulator at BL10XU of SPring-8. J Synchrotron Radiat 2000; 7:89-94. [PMID: 16609179 DOI: 10.1107/s0909049599016817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/1999] [Accepted: 12/22/1999] [Indexed: 05/08/2023]
Abstract
The design and performance of the high-brilliance XAFS facility at BL10XU of SPring-8, aimed at rapid and sensitive measurement of X-ray absorption fine structure (XAFS), is reported. Both undulator gap and double-crystal monochromator have been successfully controlled covering a wide energy range (5-30 keV). A versatile goniometer system, consisting of two independent high-precision goniometers, is capable of polarized XAFS in fluorescence mode and surface-sensitive experiments using a grazing-incidence geometry. By sharing major components, i.e. a monolithic Ge 100-pixel array detector and a closed-cycle He cryostat, both polarized XAFS and X-ray standing wave (XSW) experiments can be performed at low temperature (15-300 K). The performance of the spectrometer has been evaluated by recording XAFS spectra in transmission mode.
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Affiliation(s)
- H Oyanagi
- Electrotechnical Laboratory, 1-1-4 Umezono, Tsukuba 305-8568, Japan.
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38
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Abstract
The authors describe a rare case of handlebar hernia in a 9-year-old-boy. All layers of his abdominal wall were disrupted by a fall on a bicycle; however, his skin and intra-abdominal organs were completely intact. Computed tomography demonstrated subcutaneous intestinal loops protruding through the rent. Surgical repair was performed, and his postoperative course was uneventful.
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Affiliation(s)
- A Kubota
- Department of Surgery II, Kinki University School of Medicine, 377-2 Onohigashi, Osakasayama 589-8511, Japan
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39
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Saini NL, Lanzara A, Natali F, Bianconi A, Akoshima M, Koike Y, Oyanagi H. Local structure and Tc suppression in Bi2Sr2Ca1-xYx(Cu1-yZny)2O8+delta superconductor at 1/8 doping. J Synchrotron Radiat 1999; 6:752-754. [PMID: 15263447 DOI: 10.1107/s0909049599001508] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/1998] [Accepted: 01/26/1999] [Indexed: 05/24/2023]
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40
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Oyanagi H, Ishii M, Lee CH, Saini NL, Kuwahara Y, Saito A, Izumi Y, Hashimoto H. Rapid and sensitive XAFS using a tunable X-ray undulator. J Synchrotron Radiat 1999; 6:155-157. [PMID: 15263231 DOI: 10.1107/s0909049598017245] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/1998] [Accepted: 12/10/1998] [Indexed: 05/24/2023]
Affiliation(s)
- H Oyanagi
- Electrotechnical Laboratory, Umezono, Tsukuba, Japan.
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41
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Ishii M, Komuro S, Morikawa T, Aoyagi Y, Oyanagi H, Ishikawa T, Ueki T. The optically active center of Er-doped Si produced by laser ablation. J Synchrotron Radiat 1999; 6:477-479. [PMID: 15263351 DOI: 10.1107/s0909049599000898] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/1998] [Accepted: 01/18/1999] [Indexed: 05/24/2023]
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42
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Wen C, Yasue K, Wei S, Hu T, Oyanagi H. XAFS and XRD studies on local and long-range structures of mechanically alloyed AlxTi1-x solid solutions. J Synchrotron Radiat 1999; 6:725-727. [PMID: 15263438 DOI: 10.1107/s0909049598018123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/1998] [Accepted: 12/21/1998] [Indexed: 05/24/2023]
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43
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Kolobov AV, Oyanagi H, Poborchii VV, Tanaka K. Structure of single selenium chains confined in nanochannels of zeolites: a polarized X-ray absorption study. J Synchrotron Radiat 1999; 6:362-363. [PMID: 15263308 DOI: 10.1107/s0909049598016975] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/1998] [Accepted: 12/09/1998] [Indexed: 05/24/2023]
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44
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Wei S, Oyanagi H, Kawanami H, Sakamoto K, Sakamoto T, Saini NL. Local structures of dilute impurities in Si crystal studied by fluorescence XAFS. J Synchrotron Radiat 1999; 6:573-575. [PMID: 15263384 DOI: 10.1107/s0909049598016665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/1998] [Accepted: 12/03/1998] [Indexed: 05/24/2023]
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45
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Wei S, Oyanagi H, Sakamoto K, Takeda Y, Pearsall TP. Local structures of (Ge4/Si4)5 monolayer strained-layer supperlattice probed by fluorescence XAFS. J Synchrotron Radiat 1999; 6:790-792. [PMID: 15263460 DOI: 10.1107/s0909049598017853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/1998] [Accepted: 12/17/1998] [Indexed: 05/24/2023]
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46
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Kotani J, Usami M, Nomura H, Iso A, Kasahara H, Kuroda Y, Oyanagi H, Saitoh Y. Enteral nutrition prevents bacterial translocation but does not improve survival during acute pancreatitis. Arch Surg 1999; 134:287-92. [PMID: 10088570 DOI: 10.1001/archsurg.134.3.287] [Citation(s) in RCA: 66] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To evaluate the effect of enteral nutrition (EN) in attenuating bacterial and/or endotoxin translocation, maintaining immune responsiveness, and improving outcome in early acute pancreatitis (AP) in Wistar male rats. DESIGN Acute pancreatitis was induced in rats receiving total parenteral nutrition (TPN) (AP/TPN group) (n=34) and EN (AP/EN group) (n=35) by pressure injection of 1% deoxycholate into the biliopancreatic duct (0.6 mg/kg of body weight). Rats in the sham/TPN and sham/EN groups (n=10 each) underwent laparotomy without induction of AP. Catheters for TPN and EN were placed into the external jugular vein and jejunum, respectively. Rats were infused with Ringer lactate solution for 48 hours followed by TPN in the AP/TPN and sham/TPN groups, and EN in the AP/EN and sham/EN groups until day 7. The fluid volume and energy (calories) intake were similar in all groups. SETTING Medical school research laboratory. MAIN OUTCOME MEASURES Survival, blood endotoxin level, villus height, 5-bromo-2'-deoxyuridine (BrdU) uptake in the jejunum and ileum, bacterial culture of mesenteric lymph nodes, and CD4/CD8 ratio of T cells in mesenteric lymph nodes, spleen, and peripheral blood. RESULTS There was no difference in survival and pancreatic healing between the AP/TPN and AP/EN groups. Colony-forming units of the mesenteric lymph nodes and the endotoxin level were significantly lower in the AP/EN group than in the AP/TPN group (P<.05). Villus height and BrdU intake was significantly higher in the AP/EN group than in the AP/TPN group (P<.05). The CD4/CD8 ratio of T cells in spleen and peripheral blood was higher in the AP/EN group than in the AP/TPN group (P<.05), whereas there was no difference in mesenteric lymph nodes. CONCLUSIONS Jejunal administration of EN is well tolerated in early AP, maintains immune responsiveness and gut integrity, and reduces bacterial and/or endotoxin translocation. However, compared with TPN, EN does not improve outcome. These results suggest that factors other than bacterial and/or endotoxin translocation may be responsible for mortality in this rat model of early AP. However, additional studies of both early bacterial and/or endotoxin translocation and late assessment of outcome are indicated.
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Affiliation(s)
- J Kotani
- First Department of Surgery, Kobe University School of Medicine, Japan.
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47
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Abstract
A routine prenatal sonographic examination at 36 weeks' menstrual age revealed a solid and slightly inhomogeneous soft-tissue tumor on a fetus's left upper arm. The mass in the left triceps brachii muscle measured 8 x 7 x 5 cm at birth. Because of progressive flexion contracture of the left elbow joint, at 2 months of age the infant underwent radical resection of the tumor, sparing some muscle fibers. Light microscopic and immunohistochemical studies revealed myofibromatosis. Neither tumor nor functional disorder of the arm was evident 3 years after surgery.
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Affiliation(s)
- A Kubota
- Department of Surgery II, Kinki University School of Medicine, Osakasayama, Osaka, Japan
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48
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Kosumi T, Kubota A, Yonekura T, Hoki M, Asano S, Hirooka S, Kato M, Yasuda A, Oyanagi H, Nakajima T. Subcapsular hemorrhage of the liver in a very-low-birth-weight neonate: survival after decompression laparotomy. Pediatr Surg Int 1999; 15:270-1. [PMID: 10370042 DOI: 10.1007/s003830050574] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Subcapsular hemorrhage of the liver in a very-low-birth-weight neonate was successfully treated by decompression laparotomy. This may be the second smallest survivor after surgery in the literature.
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Affiliation(s)
- T Kosumi
- Department of Surgery II, Kinki University School of Medicine, 377-2 Onohigashi, Osakasayama, Osaka 589-8511, Japan
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49
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Kubota A, Yamauchi K, Imano M, Yonekura T, Hoki M, Nose K, Hirooka S, Kato M, Oyanagi H, Nakayama M. An unusual presentation of congenital infantile myofibromatosis arising from the interspinous ligament. Pediatr Surg Int 1998; 14:138-9. [PMID: 9880725 DOI: 10.1007/s003830050463] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
The authors describe an extremely rare presentation of congenital infantile myofibromatosis. A full-term newborn boy presented with a thumb-sized subcutaneous mass on the mid-spinal line between the 2nd and 3rd lumbar spinous processes. A solid tumor arising from the interspinous ligament was resected. Microscopic and immunohistochemical studies revealed myofibromatosis.
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Affiliation(s)
- A Kubota
- Department of Surgery II, Kinki University School of Medicine, 377-2 Onohigashi, Osakasayama, Osaka 589, Japan
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50
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Yonekura T, Kubota A, Hoki M, Asano S, Nakayama T, Kato M, Oyanagi H. Intermittent obstruction of the inferior vena cava by congenital anteromedial diaphragmatic hernia: an extremely rare case of Budd-Chiari syndrome in an infant. Surgery 1998; 124:109-11. [PMID: 9663261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- T Yonekura
- Department of Surgery II, Kinki University School of Medicine, Osaka, Japan
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