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Abe K, Hayato Y, Hiraide K, Ieki K, Ikeda M, Kameda J, Kanemura Y, Kaneshima R, Kashiwagi Y, Kataoka Y, Miki S, Mine S, Miura M, Moriyama S, Nakano Y, Nakahata M, Nakayama S, Noguchi Y, Okamoto K, Sato K, Sekiya H, Shiba H, Shimizu K, Shiozawa M, Sonoda Y, Suzuki Y, Takeda A, Takemoto Y, Takenaka A, Tanaka H, Watanabe S, Yano T, Han S, Kajita T, Okumura K, Tashiro T, Tomiya T, Wang X, Xia J, Yoshida S, Megias GD, Fernandez P, Labarga L, Ospina N, Zaldivar B, Pointon BW, Kearns E, Raaf JL, Wan L, Wester T, Bian J, Griskevich NJ, Kropp WR, Locke S, Smy MB, Sobel HW, Takhistov V, Yankelevich A, Hill J, Park RG, Bodur B, Scholberg K, Walter CW, Bernard L, Coffani A, Drapier O, El Hedri S, Giampaolo A, Mueller TA, Santos AD, Paganini P, Quilain B, Ishizuka T, Nakamura T, Jang JS, Learned JG, Choi K, Cao S, Anthony LHV, Martin D, Scott M, Sztuc AA, Uchida Y, Berardi V, Catanesi MG, Radicioni E, Calabria NF, Machado LN, De Rosa G, Collazuol G, Iacob F, Lamoureux M, Mattiazzi M, Ludovici L, Gonin M, Pronost G, Fujisawa C, Maekawa Y, Nishimura Y, Friend M, Hasegawa T, Ishida T, Kobayashi T, Jakkapu M, Matsubara T, Nakadaira T, Nakamura K, Oyama Y, Sakashita K, Sekiguchi T, Tsukamoto T, Boschi T, Di Lodovico F, Gao J, Goldsack A, Katori T, Migenda J, Taani M, Zsoldos S, Kotsar Y, Ozaki H, Suzuki AT, Takeuchi Y, Bronner C, Feng J, Kikawa T, Mori M, Nakaya T, Wendell RA, Yasutome K, Jenkins SJ, McCauley N, Mehta P, Tsui KM, Fukuda Y, Itow Y, Menjo H, Ninomiya K, Lagoda J, Lakshmi SM, Mandal M, Mijakowski P, Prabhu YS, Zalipska J, Jia M, Jiang J, Jung CK, Wilking MJ, Yanagisawa C, Harada M, Ishino H, Ito S, Kitagawa H, Koshio Y, Nakanishi F, Sakai S, Barr G, Barrow D, Cook L, Samani S, Wark D, Nova F, Yang JY, Malek M, McElwee JM, Stone O, Thiesse MD, Thompson LF, Okazawa H, Kim SB, Seo JW, Yu I, Ichikawa AK, Nakamura KD, Tairafune S, Nishijima K, Iwamoto K, Nakagiri K, Nakajima Y, Taniuchi N, Yokoyama M, Martens K, de Perio P, Vagins MR, Kuze M, Izumiyama S, Inomoto M, Ishitsuka M, Ito H, Kinoshita T, Matsumoto R, Ommura Y, Shigeta N, Shinoki M, Suganuma T, Yamauchi K, Martin JF, Tanaka HA, Towstego T, Akutsu R, Gousy-Leblanc V, Hartz M, Konaka A, Prouse NW, Chen S, Xu BD, Zhang B, Posiadala-Zezula M, Hadley D, Nicholson M, O'Flaherty M, Richards B, Ali A, Jamieson B, Marti L, Minamino A, Pintaudi G, Sano S, Suzuki S, Wada K. Erratum: Search for Cosmic-Ray Boosted Sub-GeV Dark Matter Using Recoil Protons at Super-Kamiokande [Phys. Rev. Lett. 130, 031802 (2023)]. Phys Rev Lett 2023; 131:159903. [PMID: 37897794 DOI: 10.1103/physrevlett.131.159903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Indexed: 10/30/2023]
Abstract
This corrects the article DOI: 10.1103/PhysRevLett.130.031802.
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Koyama M, Shiba H, Kaneda Y, LuLu L, Ohya T, Takano Y, Nishikawa K, Ohkuma M, Eto K. Novel Colon Preparation Method Combining Bowel Cleanser Reduction and Unique Walking. Surg Laparosc Endosc Percutan Tech 2023; 33:391-394. [PMID: 37311029 DOI: 10.1097/sle.0000000000001167] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 02/21/2023] [Indexed: 06/15/2023]
Abstract
BACKGROUND AND PURPOSE Poor bowel preparation increases the difficulty of colonoscopy and affects lesion detection. In this study, we investigated the usefulness of a new bowel preparation method using polyethylene glycol electrolyte formulation containing ascorbic acid (PEG plus ascorbic acid: PEG-Asc, MOVIPREP) to improve bowel cleansing and shorten preparation time. METHODS This was a single-center, retrospective study. In the new method, patients were instructed to take a laxative the day before the examination and PEG1L on the day of the examination. In addition, we instructed the patients to walk, which we designed. The primary endpoints were the degree of bowel cleansing (assessed by the Boston bowel preparation scale, BBPS) and time to the cecum. RESULTS The conventional group reached the cecum in 606.5±225.8 seconds (mean±SD), whereas the introduced group reached the cecum in 500±217.1 seconds, a significantly shorter time ( P <0.05). In the BBPS, the score in the introduced group was significantly higher ( P <0.01): 6.8±2.14 points in the conventional group and 8.6±0.74 points in the introduction group. CONCLUSION Pretreatment combining the 1L weight loss method and walking improves bowel cleansing and shortens the time to reach the cecum.
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Affiliation(s)
- Muneyuki Koyama
- Department of Digestive Surgery
- Department of Gastrointestinal Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | | | - Yosuke Kaneda
- Department of Endoscopy, AOI Universal Hospital, Kanagawa
| | - Li LuLu
- Department of Digestive Surgery
| | - Tomohiko Ohya
- Department of Endoscopy, AOI Universal Hospital, Kanagawa
| | - Yasuhiro Takano
- Department of Gastrointestinal Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | | | - Masahisa Ohkuma
- Department of Digestive Surgery
- Department of Gastrointestinal Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Ken Eto
- Department of Gastrointestinal Surgery, The Jikei University School of Medicine, Tokyo, Japan
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Shiba H, Furukawa K, Tamaki S, Takahashi M. Triple-furrowed tongue in myasthenia gravis. QJM 2023; 116:534-535. [PMID: 36919764 DOI: 10.1093/qjmed/hcad035] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 03/06/2023] [Indexed: 03/16/2023] Open
Affiliation(s)
- H Shiba
- Department of Neurology, Medical Research Institute KITANO HOSPITAL, PIIF Tazuke-Kofukai, 2-4-20 Ohgimachi, Kita-ku, Osaka 530-8480, Japan and Department of Internal Medicine, Suwa Central Hospital, 4300 Tamagawa,Chino-shi, Nagano-ken, 391-8503, Japan
| | - K Furukawa
- Department of Neurology, Medical Research Institute KITANO HOSPITAL, PIIF Tazuke-Kofukai, 2-4-20 Ohgimachi, Kita-ku, Osaka 530-8480, Japan
| | - S Tamaki
- Department of Neurology, Medical Research Institute KITANO HOSPITAL, PIIF Tazuke-Kofukai, 2-4-20 Ohgimachi, Kita-ku, Osaka 530-8480, Japan
| | - M Takahashi
- Department of Neurology, Medical Research Institute KITANO HOSPITAL, PIIF Tazuke-Kofukai, 2-4-20 Ohgimachi, Kita-ku, Osaka 530-8480, Japan
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Abe K, Hayato Y, Hiraide K, Ieki K, Ikeda M, Kameda J, Kanemura Y, Kaneshima R, Kashiwagi Y, Kataoka Y, Miki S, Mine S, Miura M, Moriyama S, Nakano Y, Nakahata M, Nakayama S, Noguchi Y, Okamoto K, Sato K, Sekiya H, Shiba H, Shimizu K, Shiozawa M, Sonoda Y, Suzuki Y, Takeda A, Takemoto Y, Takenaka A, Tanaka H, Watanabe S, Yano T, Han S, Kajita T, Okumura K, Tashiro T, Tomiya T, Wang X, Xia J, Yoshida S, Megias GD, Fernandez P, Labarga L, Ospina N, Zaldivar B, Pointon BW, Kearns E, Raaf JL, Wan L, Wester T, Bian J, Griskevich NJ, Kropp WR, Locke S, Smy MB, Sobel HW, Takhistov V, Yankelevich A, Hill J, Park RG, Bodur B, Scholberg K, Walter CW, Bernard L, Coffani A, Drapier O, El Hedri S, Giampaolo A, Mueller TA, Santos AD, Paganini P, Quilain B, Ishizuka T, Nakamura T, Jang JS, Learned JG, Choi K, Cao S, Anthony LHV, Martin D, Scott M, Sztuc AA, Uchida Y, Berardi V, Catanesi MG, Radicioni E, Calabria NF, Machado LN, De Rosa G, Collazuol G, Iacob F, Lamoureux M, Mattiazzi M, Ludovici L, Gonin M, Pronost G, Fujisawa C, Maekawa Y, Nishimura Y, Friend M, Hasegawa T, Ishida T, Kobayashi T, Jakkapu M, Matsubara T, Nakadaira T, Nakamura K, Oyama Y, Sakashita K, Sekiguchi T, Tsukamoto T, Boschi T, Di Lodovico F, Gao J, Goldsack A, Katori T, Migenda J, Taani M, Zsoldos S, Kotsar Y, Ozaki H, Suzuki AT, Takeuchi Y, Bronner C, Feng J, Kikawa T, Mori M, Nakaya T, Wendell RA, Yasutome K, Jenkins SJ, McCauley N, Mehta P, Tsui KM, Fukuda Y, Itow Y, Menjo H, Ninomiya K, Lagoda J, Lakshmi SM, Mandal M, Mijakowski P, Prabhu YS, Zalipska J, Jia M, Jiang J, Jung CK, Wilking MJ, Yanagisawa C, Harada M, Ishino H, Ito S, Kitagawa H, Koshio Y, Nakanishi F, Sakai S, Barr G, Barrow D, Cook L, Samani S, Wark D, Nova F, Yang JY, Malek M, McElwee JM, Stone O, Thiesse MD, Thompson LF, Okazawa H, Kim SB, Seo JW, Yu I, Ichikawa AK, Nakamura KD, Tairafune S, Nishijima K, Iwamoto K, Nakagiri K, Nakajima Y, Taniuchi N, Yokoyama M, Martens K, de Perio P, Vagins MR, Kuze M, Izumiyama S, Inomoto M, Ishitsuka M, Ito H, Kinoshita T, Matsumoto R, Ommura Y, Shigeta N, Shinoki M, Suganuma T, Yamauchi K, Martin JF, Tanaka HA, Towstego T, Akutsu R, Gousy-Leblanc V, Hartz M, Konaka A, Prouse NW, Chen S, Xu BD, Zhang B, Posiadala-Zezula M, Hadley D, Nicholson M, O'Flaherty M, Richards B, Ali A, Jamieson B, Marti L, Minamino A, Pintaudi G, Sano S, Suzuki S, Wada K. Search for Cosmic-Ray Boosted Sub-GeV Dark Matter Using Recoil Protons at Super-Kamiokande. Phys Rev Lett 2023; 130:031802. [PMID: 36763398 DOI: 10.1103/physrevlett.130.031802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 11/30/2022] [Indexed: 06/18/2023]
Abstract
We report a search for cosmic-ray boosted dark matter with protons using the 0.37 megaton×years data collected at Super-Kamiokande experiment during the 1996-2018 period (SKI-IV phase). We searched for an excess of proton recoils above the atmospheric neutrino background from the vicinity of the Galactic Center. No such excess is observed, and limits are calculated for two reference models of dark matter with either a constant interaction cross section or through a scalar mediator. This is the first experimental search for boosted dark matter with hadrons using directional information. The results present the most stringent limits on cosmic-ray boosted dark matter and exclude the dark matter-nucleon elastic scattering cross section between 10^{-33}cm^{2} and 10^{-27}cm^{2} for dark matter mass from 1 MeV/c^{2} to 300 MeV/c^{2}.
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Affiliation(s)
- K Abe
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Gifu 506-1205, Japan
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - Y Hayato
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Gifu 506-1205, Japan
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - K Hiraide
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Gifu 506-1205, Japan
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - K Ieki
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Gifu 506-1205, Japan
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - M Ikeda
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Gifu 506-1205, Japan
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - J Kameda
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Gifu 506-1205, Japan
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - Y Kanemura
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Gifu 506-1205, Japan
| | - R Kaneshima
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Gifu 506-1205, Japan
| | - Y Kashiwagi
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Gifu 506-1205, Japan
| | - Y Kataoka
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Gifu 506-1205, Japan
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - S Miki
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Gifu 506-1205, Japan
| | - S Mine
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Gifu 506-1205, Japan
- Department of Physics and Astronomy, University of California, Irvine, Irvine, California 92697-4575, USA
| | - M Miura
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Gifu 506-1205, Japan
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - S Moriyama
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Gifu 506-1205, Japan
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - Y Nakano
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Gifu 506-1205, Japan
| | - M Nakahata
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Gifu 506-1205, Japan
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - S Nakayama
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Gifu 506-1205, Japan
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - Y Noguchi
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Gifu 506-1205, Japan
| | - K Okamoto
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Gifu 506-1205, Japan
| | - K Sato
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Gifu 506-1205, Japan
| | - H Sekiya
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Gifu 506-1205, Japan
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - H Shiba
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Gifu 506-1205, Japan
| | - K Shimizu
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Gifu 506-1205, Japan
| | - M Shiozawa
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Gifu 506-1205, Japan
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - Y Sonoda
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Gifu 506-1205, Japan
| | - Y Suzuki
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Gifu 506-1205, Japan
| | - A Takeda
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Gifu 506-1205, Japan
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - Y Takemoto
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Gifu 506-1205, Japan
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - A Takenaka
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Gifu 506-1205, Japan
| | - H Tanaka
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Gifu 506-1205, Japan
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - S Watanabe
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Gifu 506-1205, Japan
| | - T Yano
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Gifu 506-1205, Japan
| | - S Han
- Research Center for Cosmic Neutrinos, Institute for Cosmic Ray Research, University of Tokyo, Kashiwa, Chiba 277-8582, Japan
| | - T Kajita
- Research Center for Cosmic Neutrinos, Institute for Cosmic Ray Research, University of Tokyo, Kashiwa, Chiba 277-8582, Japan
- ILANCE, CNRS-University of Tokyo International Research Laboratory, Kashiwa, Chiba 277-8582, Japan
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - K Okumura
- Research Center for Cosmic Neutrinos, Institute for Cosmic Ray Research, University of Tokyo, Kashiwa, Chiba 277-8582, Japan
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - T Tashiro
- Research Center for Cosmic Neutrinos, Institute for Cosmic Ray Research, University of Tokyo, Kashiwa, Chiba 277-8582, Japan
| | - T Tomiya
- Research Center for Cosmic Neutrinos, Institute for Cosmic Ray Research, University of Tokyo, Kashiwa, Chiba 277-8582, Japan
| | - X Wang
- Research Center for Cosmic Neutrinos, Institute for Cosmic Ray Research, University of Tokyo, Kashiwa, Chiba 277-8582, Japan
| | - J Xia
- Research Center for Cosmic Neutrinos, Institute for Cosmic Ray Research, University of Tokyo, Kashiwa, Chiba 277-8582, Japan
| | - S Yoshida
- Research Center for Cosmic Neutrinos, Institute for Cosmic Ray Research, University of Tokyo, Kashiwa, Chiba 277-8582, Japan
| | - G D Megias
- Institute for Cosmic Ray Research, University of Tokyo, Kashiwa, Chiba 277-8582, Japan
| | - P Fernandez
- Department of Theoretical Physics, University Autonoma Madrid, 28049 Madrid, Spain
| | - L Labarga
- Department of Theoretical Physics, University Autonoma Madrid, 28049 Madrid, Spain
| | - N Ospina
- Department of Theoretical Physics, University Autonoma Madrid, 28049 Madrid, Spain
| | - B Zaldivar
- Department of Theoretical Physics, University Autonoma Madrid, 28049 Madrid, Spain
| | - B W Pointon
- Department of Physics, British Columbia Institute of Technology, Burnaby, British Columbia V5G 3H2, Canada
- TRIUMF, 4004 Wesbrook Mall, Vancouver, British Columbia V6T2A3, Canada
| | - E Kearns
- Department of Physics, Boston University, Boston, Massachusetts 02215, USA
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - J L Raaf
- Department of Physics, Boston University, Boston, Massachusetts 02215, USA
| | - L Wan
- Department of Physics, Boston University, Boston, Massachusetts 02215, USA
| | - T Wester
- Department of Physics, Boston University, Boston, Massachusetts 02215, USA
| | - J Bian
- Department of Physics and Astronomy, University of California, Irvine, Irvine, California 92697-4575, USA
| | - N J Griskevich
- Department of Physics and Astronomy, University of California, Irvine, Irvine, California 92697-4575, USA
| | - W R Kropp
- Department of Physics and Astronomy, University of California, Irvine, Irvine, California 92697-4575, USA
| | - S Locke
- Department of Physics and Astronomy, University of California, Irvine, Irvine, California 92697-4575, USA
| | - M B Smy
- Department of Physics and Astronomy, University of California, Irvine, Irvine, California 92697-4575, USA
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - H W Sobel
- Department of Physics and Astronomy, University of California, Irvine, Irvine, California 92697-4575, USA
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - V Takhistov
- Department of Physics and Astronomy, University of California, Irvine, Irvine, California 92697-4575, USA
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - A Yankelevich
- Department of Physics and Astronomy, University of California, Irvine, Irvine, California 92697-4575, USA
| | - J Hill
- Department of Physics, California State University, Dominguez Hills, Carson, California 90747, USA
| | - R G Park
- Institute for Universe and Elementary Particles, Chonnam National University, Gwangju 61186, Korea
| | - B Bodur
- Department of Physics, Duke University, Durham, North Carolina 27708, USA
| | - K Scholberg
- Department of Physics, Duke University, Durham, North Carolina 27708, USA
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - C W Walter
- Department of Physics, Duke University, Durham, North Carolina 27708, USA
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - L Bernard
- Ecole Polytechnique, IN2P3-CNRS, Laboratoire Leprince-Ringuet, F-91120 Palaiseau, France
| | - A Coffani
- Ecole Polytechnique, IN2P3-CNRS, Laboratoire Leprince-Ringuet, F-91120 Palaiseau, France
| | - O Drapier
- Ecole Polytechnique, IN2P3-CNRS, Laboratoire Leprince-Ringuet, F-91120 Palaiseau, France
| | - S El Hedri
- Ecole Polytechnique, IN2P3-CNRS, Laboratoire Leprince-Ringuet, F-91120 Palaiseau, France
| | - A Giampaolo
- Ecole Polytechnique, IN2P3-CNRS, Laboratoire Leprince-Ringuet, F-91120 Palaiseau, France
| | - Th A Mueller
- Ecole Polytechnique, IN2P3-CNRS, Laboratoire Leprince-Ringuet, F-91120 Palaiseau, France
| | - A D Santos
- Ecole Polytechnique, IN2P3-CNRS, Laboratoire Leprince-Ringuet, F-91120 Palaiseau, France
| | - P Paganini
- Ecole Polytechnique, IN2P3-CNRS, Laboratoire Leprince-Ringuet, F-91120 Palaiseau, France
| | - B Quilain
- Ecole Polytechnique, IN2P3-CNRS, Laboratoire Leprince-Ringuet, F-91120 Palaiseau, France
| | - T Ishizuka
- Junior College, Fukuoka Institute of Technology, Fukuoka, Fukuoka 811-0295, Japan
| | - T Nakamura
- Department of Physics, Gifu University, Gifu, Gifu 501-1193, Japan
| | - J S Jang
- GIST College, Gwangju Institute of Science and Technology, Gwangju 500-712, Korea
| | - J G Learned
- Department of Physics and Astronomy, University of Hawaii, Honolulu, Hawaii 96822, USA
| | - K Choi
- Institute for Basic Science (IBS), Daejeon 34126, Korea
| | - S Cao
- Institute For Interdisciplinary Research in Science and Education, ICISE, Quy Nhon 55121, Vietnam
| | - L H V Anthony
- Department of Physics, Imperial College London, London SW7 2AZ, United Kingdom
| | - D Martin
- Department of Physics, Imperial College London, London SW7 2AZ, United Kingdom
| | - M Scott
- Department of Physics, Imperial College London, London SW7 2AZ, United Kingdom
| | - A A Sztuc
- Department of Physics, Imperial College London, London SW7 2AZ, United Kingdom
| | - Y Uchida
- Department of Physics, Imperial College London, London SW7 2AZ, United Kingdom
| | - V Berardi
- Dipartimento Interuniversitario di Fisica, INFN Sezione di Bari and Università e Politecnico di Bari, I-70125 Bari, Italy
| | - M G Catanesi
- Dipartimento Interuniversitario di Fisica, INFN Sezione di Bari and Università e Politecnico di Bari, I-70125 Bari, Italy
| | - E Radicioni
- Dipartimento Interuniversitario di Fisica, INFN Sezione di Bari and Università e Politecnico di Bari, I-70125 Bari, Italy
| | - N F Calabria
- Dipartimento di Fisica, INFN Sezione di Napoli and Università di Napoli, I-80126 Napoli, Italy
| | - L N Machado
- Dipartimento di Fisica, INFN Sezione di Napoli and Università di Napoli, I-80126 Napoli, Italy
| | - G De Rosa
- Dipartimento di Fisica, INFN Sezione di Napoli and Università di Napoli, I-80126 Napoli, Italy
| | - G Collazuol
- Dipartimento di Fisica, INFN Sezione di Padova and Università di Padova, I-35131 Padova, Italy
| | - F Iacob
- Dipartimento di Fisica, INFN Sezione di Padova and Università di Padova, I-35131 Padova, Italy
| | - M Lamoureux
- Dipartimento di Fisica, INFN Sezione di Padova and Università di Padova, I-35131 Padova, Italy
| | - M Mattiazzi
- Dipartimento di Fisica, INFN Sezione di Padova and Università di Padova, I-35131 Padova, Italy
| | - L Ludovici
- INFN Sezione di Roma and Università di Roma "La Sapienza," I-00185, Roma, Italy
| | - M Gonin
- ILANCE, CNRS-University of Tokyo International Research Laboratory, Kashiwa, Chiba 277-8582, Japan
| | - G Pronost
- ILANCE, CNRS-University of Tokyo International Research Laboratory, Kashiwa, Chiba 277-8582, Japan
| | - C Fujisawa
- Department of Physics, Keio University, Yokohama, Kanagawa 223-8522, Japan
| | - Y Maekawa
- Department of Physics, Keio University, Yokohama, Kanagawa 223-8522, Japan
| | - Y Nishimura
- Department of Physics, Keio University, Yokohama, Kanagawa 223-8522, Japan
| | - M Friend
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
| | - T Hasegawa
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
| | - T Ishida
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
| | - T Kobayashi
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
| | - M Jakkapu
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
| | - T Matsubara
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
| | - T Nakadaira
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
| | - K Nakamura
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - Y Oyama
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
| | - K Sakashita
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
| | - T Sekiguchi
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
| | - T Tsukamoto
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan
| | - T Boschi
- Department of Physics, King's College London, London WC2R 2LS, United Kingdom
| | - F Di Lodovico
- Department of Physics, King's College London, London WC2R 2LS, United Kingdom
| | - J Gao
- Department of Physics, King's College London, London WC2R 2LS, United Kingdom
| | - A Goldsack
- Department of Physics, King's College London, London WC2R 2LS, United Kingdom
| | - T Katori
- Department of Physics, King's College London, London WC2R 2LS, United Kingdom
| | - J Migenda
- Department of Physics, King's College London, London WC2R 2LS, United Kingdom
| | - M Taani
- Department of Physics, King's College London, London WC2R 2LS, United Kingdom
| | - S Zsoldos
- Department of Physics, King's College London, London WC2R 2LS, United Kingdom
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - Y Kotsar
- Department of Physics, Kobe University, Kobe, Hyogo 657-8501, Japan
| | - H Ozaki
- Department of Physics, Kobe University, Kobe, Hyogo 657-8501, Japan
| | - A T Suzuki
- Department of Physics, Kobe University, Kobe, Hyogo 657-8501, Japan
| | - Y Takeuchi
- Department of Physics, Kobe University, Kobe, Hyogo 657-8501, Japan
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - C Bronner
- Department of Physics, Kyoto University, Kyoto, Kyoto 606-8502, Japan
| | - J Feng
- Department of Physics, Kyoto University, Kyoto, Kyoto 606-8502, Japan
| | - T Kikawa
- Department of Physics, Kyoto University, Kyoto, Kyoto 606-8502, Japan
| | - M Mori
- Department of Physics, Kyoto University, Kyoto, Kyoto 606-8502, Japan
| | - T Nakaya
- Department of Physics, Kyoto University, Kyoto, Kyoto 606-8502, Japan
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - R A Wendell
- Department of Physics, Kyoto University, Kyoto, Kyoto 606-8502, Japan
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - K Yasutome
- Department of Physics, Kyoto University, Kyoto, Kyoto 606-8502, Japan
| | - S J Jenkins
- Department of Physics, University of Liverpool, Liverpool L69 7ZE, United Kingdom
| | - N McCauley
- Department of Physics, University of Liverpool, Liverpool L69 7ZE, United Kingdom
| | - P Mehta
- Department of Physics, University of Liverpool, Liverpool L69 7ZE, United Kingdom
| | - K M Tsui
- Department of Physics, University of Liverpool, Liverpool L69 7ZE, United Kingdom
| | - Y Fukuda
- Department of Physics, Miyagi University of Education, Sendai, Miyagi 980-0845, Japan
| | - Y Itow
- Institute for Space-Earth Environmental Research, Nagoya University, Nagoya, Aichi 464-8602, Japan
- Kobayashi-Maskawa Institute for the Origin of Particles and the Universe, Nagoya University, Nagoya, Aichi 464-8602, Japan
| | - H Menjo
- Institute for Space-Earth Environmental Research, Nagoya University, Nagoya, Aichi 464-8602, Japan
| | - K Ninomiya
- Institute for Space-Earth Environmental Research, Nagoya University, Nagoya, Aichi 464-8602, Japan
| | - J Lagoda
- National Centre For Nuclear Research, 02-093 Warsaw, Poland
| | - S M Lakshmi
- National Centre For Nuclear Research, 02-093 Warsaw, Poland
| | - M Mandal
- National Centre For Nuclear Research, 02-093 Warsaw, Poland
| | - P Mijakowski
- National Centre For Nuclear Research, 02-093 Warsaw, Poland
| | - Y S Prabhu
- National Centre For Nuclear Research, 02-093 Warsaw, Poland
| | - J Zalipska
- National Centre For Nuclear Research, 02-093 Warsaw, Poland
| | - M Jia
- Department of Physics and Astronomy, State University of New York at Stony Brook, New York 11794-3800, USA
| | - J Jiang
- Department of Physics and Astronomy, State University of New York at Stony Brook, New York 11794-3800, USA
| | - C K Jung
- Department of Physics and Astronomy, State University of New York at Stony Brook, New York 11794-3800, USA
| | - M J Wilking
- Department of Physics and Astronomy, State University of New York at Stony Brook, New York 11794-3800, USA
| | - C Yanagisawa
- Department of Physics and Astronomy, State University of New York at Stony Brook, New York 11794-3800, USA
| | - M Harada
- Department of Physics, Okayama University, Okayama, Okayama 700-8530, Japan
| | - H Ishino
- Department of Physics, Okayama University, Okayama, Okayama 700-8530, Japan
| | - S Ito
- Department of Physics, Okayama University, Okayama, Okayama 700-8530, Japan
| | - H Kitagawa
- Department of Physics, Okayama University, Okayama, Okayama 700-8530, Japan
| | - Y Koshio
- Department of Physics, Okayama University, Okayama, Okayama 700-8530, Japan
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - F Nakanishi
- Department of Physics, Okayama University, Okayama, Okayama 700-8530, Japan
| | - S Sakai
- Department of Physics, Okayama University, Okayama, Okayama 700-8530, Japan
| | - G Barr
- Department of Physics, Oxford University, Oxford OX1 3PU, United Kingdom
| | - D Barrow
- Department of Physics, Oxford University, Oxford OX1 3PU, United Kingdom
| | - L Cook
- Department of Physics, Oxford University, Oxford OX1 3PU, United Kingdom
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - S Samani
- Department of Physics, Oxford University, Oxford OX1 3PU, United Kingdom
| | - D Wark
- Department of Physics, Oxford University, Oxford OX1 3PU, United Kingdom
- STFC, Rutherford Appleton Laboratory, Harwell Oxford, and Daresbury Laboratory, Warrington OX11 0QX, United Kingdom
| | - F Nova
- Rutherford Appleton Laboratory, Harwell, Oxford OX11 0QX, United Kingdom
| | - J Y Yang
- Department of Physics, Seoul National University, Seoul 151-742, Korea
| | - M Malek
- Department of Physics and Astronomy, University of Sheffield, S3 7RH Sheffield, United Kingdom
| | - J M McElwee
- Department of Physics and Astronomy, University of Sheffield, S3 7RH Sheffield, United Kingdom
| | - O Stone
- Department of Physics and Astronomy, University of Sheffield, S3 7RH Sheffield, United Kingdom
| | - M D Thiesse
- Department of Physics and Astronomy, University of Sheffield, S3 7RH Sheffield, United Kingdom
| | - L F Thompson
- Department of Physics and Astronomy, University of Sheffield, S3 7RH Sheffield, United Kingdom
| | - H Okazawa
- Department of Informatics in Social Welfare, Shizuoka University of Welfare, Yaizu, Shizuoka 425-8611, Japan
| | - S B Kim
- Department of Physics, Sungkyunkwan University, Suwon 440-746, Korea
| | - J W Seo
- Department of Physics, Sungkyunkwan University, Suwon 440-746, Korea
| | - I Yu
- Department of Physics, Sungkyunkwan University, Suwon 440-746, Korea
| | - A K Ichikawa
- Department of Physics, Faculty of Science, Tohoku University, Sendai, Miyagi 980-8578, Japan
| | - K D Nakamura
- Department of Physics, Faculty of Science, Tohoku University, Sendai, Miyagi 980-8578, Japan
| | - S Tairafune
- Department of Physics, Faculty of Science, Tohoku University, Sendai, Miyagi 980-8578, Japan
| | - K Nishijima
- Department of Physics, Tokai University, Hiratsuka, Kanagawa 259-1292, Japan
| | - K Iwamoto
- Department of Physics, University of Tokyo, Bunkyo, Tokyo 113-0033, Japan
| | - K Nakagiri
- Department of Physics, University of Tokyo, Bunkyo, Tokyo 113-0033, Japan
| | - Y Nakajima
- Department of Physics, University of Tokyo, Bunkyo, Tokyo 113-0033, Japan
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - N Taniuchi
- Department of Physics, University of Tokyo, Bunkyo, Tokyo 113-0033, Japan
| | - M Yokoyama
- Department of Physics, University of Tokyo, Bunkyo, Tokyo 113-0033, Japan
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - K Martens
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - P de Perio
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - M R Vagins
- Department of Physics and Astronomy, University of California, Irvine, Irvine, California 92697-4575, USA
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba 277-8583, Japan
| | - M Kuze
- Department of Physics, Tokyo Institute of Technology, Meguro, Tokyo 152-8551, Japan
| | - S Izumiyama
- Department of Physics, Tokyo Institute of Technology, Meguro, Tokyo 152-8551, Japan
| | - M Inomoto
- Department of Physics, Faculty of Science and Technology, Tokyo University of Science, Noda, Chiba 278-8510, Japan
| | - M Ishitsuka
- Department of Physics, Faculty of Science and Technology, Tokyo University of Science, Noda, Chiba 278-8510, Japan
| | - H Ito
- Department of Physics, Faculty of Science and Technology, Tokyo University of Science, Noda, Chiba 278-8510, Japan
| | - T Kinoshita
- Department of Physics, Faculty of Science and Technology, Tokyo University of Science, Noda, Chiba 278-8510, Japan
| | - R Matsumoto
- Department of Physics, Faculty of Science and Technology, Tokyo University of Science, Noda, Chiba 278-8510, Japan
| | - Y Ommura
- Department of Physics, Faculty of Science and Technology, Tokyo University of Science, Noda, Chiba 278-8510, Japan
| | - N Shigeta
- Department of Physics, Faculty of Science and Technology, Tokyo University of Science, Noda, Chiba 278-8510, Japan
| | - M Shinoki
- Department of Physics, Faculty of Science and Technology, Tokyo University of Science, Noda, Chiba 278-8510, Japan
| | - T Suganuma
- Department of Physics, Faculty of Science and Technology, Tokyo University of Science, Noda, Chiba 278-8510, Japan
| | - K Yamauchi
- Department of Physics, Faculty of Science and Technology, Tokyo University of Science, Noda, Chiba 278-8510, Japan
| | - J F Martin
- Department of Physics, University of Toronto, Ontario M5S 1A7, Canada
| | - H A Tanaka
- Department of Physics, University of Toronto, Ontario M5S 1A7, Canada
| | - T Towstego
- Department of Physics, University of Toronto, Ontario M5S 1A7, Canada
| | - R Akutsu
- TRIUMF, 4004 Wesbrook Mall, Vancouver, British Columbia V6T2A3, Canada
| | - V Gousy-Leblanc
- TRIUMF, 4004 Wesbrook Mall, Vancouver, British Columbia V6T2A3, Canada
| | - M Hartz
- TRIUMF, 4004 Wesbrook Mall, Vancouver, British Columbia V6T2A3, Canada
| | - A Konaka
- TRIUMF, 4004 Wesbrook Mall, Vancouver, British Columbia V6T2A3, Canada
| | - N W Prouse
- TRIUMF, 4004 Wesbrook Mall, Vancouver, British Columbia V6T2A3, Canada
| | - S Chen
- Department of Engineering Physics, Tsinghua University, Beijing, 100084, China
| | - B D Xu
- Department of Engineering Physics, Tsinghua University, Beijing, 100084, China
| | - B Zhang
- Department of Engineering Physics, Tsinghua University, Beijing, 100084, China
| | | | - D Hadley
- Department of Physics, University of Warwick, Coventry, CV4 7AL, United Kingdom
| | - M Nicholson
- Department of Physics, University of Warwick, Coventry, CV4 7AL, United Kingdom
| | - M O'Flaherty
- Department of Physics, University of Warwick, Coventry, CV4 7AL, United Kingdom
| | - B Richards
- Department of Physics, University of Warwick, Coventry, CV4 7AL, United Kingdom
| | - A Ali
- TRIUMF, 4004 Wesbrook Mall, Vancouver, British Columbia V6T2A3, Canada
- Department of Physics, University of Winnipeg, Manitoba R3J 3L8, Canada
| | - B Jamieson
- Department of Physics, University of Winnipeg, Manitoba R3J 3L8, Canada
| | - Ll Marti
- Department of Physics, Yokohama National University, Yokohama, Kanagawa 240-8501, Japan
| | - A Minamino
- Department of Physics, Yokohama National University, Yokohama, Kanagawa 240-8501, Japan
| | - G Pintaudi
- Department of Physics, Yokohama National University, Yokohama, Kanagawa 240-8501, Japan
| | - S Sano
- Department of Physics, Yokohama National University, Yokohama, Kanagawa 240-8501, Japan
| | - S Suzuki
- Department of Physics, Yokohama National University, Yokohama, Kanagawa 240-8501, Japan
| | - K Wada
- Department of Physics, Yokohama National University, Yokohama, Kanagawa 240-8501, Japan
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5
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Hamura R, Haruki K, Fujiwara Y, Tsunematsu M, Shirai Y, Furukawa K, Onda S, Gocho T, Shiba H, Uwagawa T, Usuba T, Fujioka S, Okamoto T, Ikegami T. The effectiveness of adjuvant chemotherapy for Stage I pancreatic cancer based on the UICC 8 th edition. Langenbecks Arch Surg 2022; 407:3437-3446. [PMID: 36173461 DOI: 10.1007/s00423-022-02686-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 10/19/2021] [Accepted: 09/13/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Adjuvant chemotherapy is recommended for patients with pancreatic cancer after curative resection. However, there is limited evidence regarding the efficacy and prognostic factors for adjuvant chemotherapy in patients with stage I pancreatic cancer. This study aimed to identify patients in whom chemotherapy was effective and to detect prognostic factors for stage I pancreatic cancer based on guidelines of the 8th edition of the Union for International Cancer Control (UICC). METHODS Between 2009 and 2017, 108 patients diagnosed with stage I pancreatic cancer were enrolled in this study. They were distributed into invasion (n = 68) and non-invasion (n = 40) groups. The relationship between clinicopathological variables, including various prognostic factors, disease-free survival (DFS), and overall survival (OS), were investigated by univariate and multivariate analyses. RESULTS Five-year survival in all patients with stage I pancreatic cancer was 38.9%. Adjuvant chemotherapy failed to improve DFS or OS in patients with stage I cancer (DFS, p = 0.26; OS, p = 0.30). In subgroup analysis, adjuvant chemotherapy significantly improved DFS (multivariate-adjusted hazard ratio (HR), 0.40; 95% confidence interval [CI], 0.21-0.78; p = 0.007) and OS (multivariate-adjusted HR, 0.32; 95% CI, 0.15-0.68; p = 0.003) in the invasion group than in non-invasion group. In contrast, in the non-invasion group, adjuvant chemotherapy failed to improve DFS and OS in univariate analysis (DFS, p = 0.992; OS, p = 0.808). CONCLUSION For stage I pancreatic cancer, based on guidelines of the UICC 8th edition, adjuvant chemotherapy may benefit patients with extrapancreatic invasion.
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Affiliation(s)
- Ryoga Hamura
- Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Koichiro Haruki
- Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan.
| | - Yuki Fujiwara
- Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Masashi Tsunematsu
- Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Yoshihiro Shirai
- Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Kenei Furukawa
- Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Shinji Onda
- Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Takeshi Gocho
- Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Hiroaki Shiba
- Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Tadashi Uwagawa
- Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Teruyuki Usuba
- Department of Surgery, The Jikei University Katsushika Medical Center, Tokyo, Japan
| | - Shuichi Fujioka
- Department of Surgery, The Jikei University Kashiwa Hospital, Chiba, Japan
| | - Tomoyoshi Okamoto
- Department of Surgery, The Jikei University Daisan Hospital, Tokyo, Japan
| | - Toru Ikegami
- Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan
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6
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Koyama M, Shiba H, Takakura K, Yamahata Y, Otsuka S, Odaka M, Takagi K, Takano Y, Eto K. Gastric Tube Ulcer that Could Be Saved by Early Conservative Treatment. Case Rep Gastroenterol 2022; 16:357-361. [PMID: 35949235 PMCID: PMC9247495 DOI: 10.1159/000524931] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Accepted: 04/15/2022] [Indexed: 11/19/2022] Open
Abstract
The patient was an 81-year-old man who had received subtotal esophagectomy for esophageal cancer reconstructed by a gastric tube via a posterior mediastinal route. He presented to our emergency room with a complaint of epigastric pain and a small amount of hematemesis. Thoracoabdominal computed tomography showed that the reconstructed gastric tube was filled fluid and had irregular wall thickening. We suspected upper gastrointestinal bleeding, and we started to treat with administration of proton pump inhibitors (PPIs) since the anemia was mild and his vitals were stable. However, his anemia was rapidly progressed to Hb 6.0 with a large amount of old blood melena. The emergency gastroscopy showed an A2 stage ulcer with active oozing at middle esophagus reconstructed by a gastric tube. Therefore, we applied thrombin spray to treat the bleeding. Fortunately, his recovery was progressing nicely with medical treatments for a week. In this study, we experienced a case in which early administration of PPIs might be a key player to prevent his medical condition worsened further.
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Affiliation(s)
- Muneyuki Koyama
- Department of Gastrointesinal Surgery, The Jikei University School of Medicine, Tokyo, Japan
- *Muneyuki Koyama,
| | - Hiroaki Shiba
- Department of Digestive Surgery, AOI Universal Hospital, Kawasaki, Japan
| | | | - Yuto Yamahata
- Department of Digestive Surgery, AOI Universal Hospital, Kawasaki, Japan
| | - Sho Otsuka
- Department of Digestive Surgery, AOI Universal Hospital, Kawasaki, Japan
| | - Minako Odaka
- Department of Digestive Surgery, AOI Universal Hospital, Kawasaki, Japan
| | - Keisuke Takagi
- Department of Digestive Surgery, AOI Universal Hospital, Kawasaki, Japan
| | - Yasuhiro Takano
- Department of Gastrointesinal Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Ken Eto
- Department of Gastrointesinal Surgery, The Jikei University School of Medicine, Tokyo, Japan
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7
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Uwagawa T, Sakamoto T, Gocho T, Shiba H, Onda S, Yasuda J, Shirai Y, Hamura R, Furukawa K, Yanaga K, Ikegami T. Phase II trial of nafamostat mesilate/gemcitabin/S-1 for unresectable pancreatic cancer. PLoS One 2022; 17:e0267623. [PMID: 35544539 PMCID: PMC9094514 DOI: 10.1371/journal.pone.0267623] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 04/08/2022] [Indexed: 12/03/2022] Open
Abstract
PURPOSE To assess the efficacy of combination chemotherapy with nafamostat mesilate, gemcitabine and S-1 for unresectable pancreatic cancer patients. MATERIALS AND METHODS The study was conducted as a single-arm, single center, institutional review board-approved phase II trial. Patients received nafamosntat mesilate (4.8 mg/kg continuous transregional arterial infusion) with gemcitabine (1000 mg/m2 transvenous) on days 1 and15, and with oral S-1 [(80 mg/day (BSA<1.25 m2), 100 mg/day (1.25 ≤ BSA<1.5 m2), or 120 mg/day (BSA ≥1.5 m2)] on days 1-14 or, days 1-7 and 15-21. This regimen was repeated at 28-day intervals. RESULTS Forty-seven evaluable patients (Male/Female: 31/16, Age (median): 66 (range 35-78) yrs, Stage III/IV 10/37.) were candidates in this study. Two patients in stage III (20%) could undergo conversion surgery. Twenty-four patients (51%) underwent subsequent treatment (1st line/ 2nd line / 4th line, 13/ 10/ 1, FOLFIRINOX: 12, GEM/nab-PTX: 18, TAS-118: 3, chemoradiation with S-1: 2, GEM/Erlotinib: 1, nal-IRI: 1, surgery: 2). Median PFS and OS were 9.7 (95% CI, 8.9-14.7 mo) and 14.2 months (99% CI, 13.3-23.9 mo), respectively. Median PFS in stage IV patients was 9.2 months (95% CI, 8.4-12.0 mo). Median OS in patients without subsequent treatment was 10.8 months (95% CI, 9.1-13.8 mo). Median OS in patients with subsequent treatment was 19.3 months (95% CI, 18.9-31.9 mo). Grade 4 treatment-related hematological toxicities were encountered in 7 patients. Two patients developed grade 3 allergic reaction after 6 cycles or later. No febrile neutropenia has been observed. CONCLUSION NAM/GEM/S-1 therapy is safe and could be promising option for unresectable pancreatic cancer, especially for stage IV cancer.
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Affiliation(s)
- Tadashi Uwagawa
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Taro Sakamoto
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Takeshi Gocho
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Hiroaki Shiba
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Shinji Onda
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Jungo Yasuda
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Yoshihiro Shirai
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Ryoga Hamura
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Kenei Furukawa
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | | | - Toru Ikegami
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
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8
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Suyama Y, Haruki K, Hamura R, Tsunematsu M, Shirai Y, Taniai T, Yanagaki M, Furukawa K, Onda S, Shiba H, Ikegami T. Strategies and tactics to perform safe pancreaticoduodenectomy for 94-year-old patient: report of a case. Surg Case Rep 2022; 8:39. [PMID: 35244810 PMCID: PMC8897542 DOI: 10.1186/s40792-022-01395-9] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 03/01/2022] [Indexed: 11/24/2022] Open
Abstract
Background Despite improvement of postoperative management, pancreatoduodenectomy still has a high rate of major complications. Therefore, careful assessment is critically important when we consider high risk surgery for extremely elderly patients. Case presentation A 94-year-old man, who suffered dark urine, epigastric pain, and loss of appetite, was diagnosed as bile duct cancer and underwent endoscopic retrograde biliary drainage. He has past history of hypertension and paroxysmal atrial fibrillation. Computed tomography (CT) showed a nodule in the lower bile duct, which was slowly enhanced by dynamic CT. The patient was evaluated whether he overcomes pancreatoduodenectomy by cardiac ultrasonography, brain magnetic resonance angiography, nutritional evaluation (rapid turnover proteins), and CT-based general assessment, including sarcopenia and osteopenia. The patient was independent in activities of daily living and has enough ejection fraction of 65%, and examinations revealed no impairment of cognitive function, sarcopenia, and osteopenia. With a diagnosis of bile duct cancer with no distant metastasis, the patient underwent subtotal stomach-preserving pancreatoduodenectomy with lymph node dissection. Operation time was 299 min and estimated blood loss was 100 ml. Pathological examination revealed papillary adenocarcinoma of the bile duct (pT3N1M0 Stage IIIB). Enteral nutrition was given through jejunostomy and then the patient started oral intake after an evaluation of swallowing function. Postoperative course was uneventful and all drains including pancreatic duct stent, biliary stent, and jejunostomy were removed by 3 weeks after operation. The levels of rapid turnover proteins dropped at postoperative day 7, but recovered at 1 month after operation via appropriate nutrition and rehabilitation. He remains well with no evidence of tumor recurrence as of 1 year after resection. Conclusions We herein report successfully treated cases of bile duct cancer in 94-year-old patient by pancreatoduodenectomy with careful evaluation of osteopenia, sarcopenia and nutrition.
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Affiliation(s)
- Yu Suyama
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Koichiro Haruki
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan.
| | - Ryoga Hamura
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Masashi Tsunematsu
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Yoshihiro Shirai
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Tomohiko Taniai
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Mitsuru Yanagaki
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Kenei Furukawa
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Shinji Onda
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Hiroaki Shiba
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Toru Ikegami
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan
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9
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Yuan H, Suzuki S, Terui H, Hirata-Tsuchiya S, Nemoto E, Yamasaki K, Saito M, Shiba H, Aiba S, Yamada S. Loss of IκBζ Drives Dentin Formation via Altered H3K4me3 Status. J Dent Res 2022; 101:951-961. [PMID: 35193410 DOI: 10.1177/00220345221075968] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Enforced enrichment of the active promoter marks trimethylation of histone H3 lysine 4 (H3K4me3) and acetylation of histone H3 lysine 27 (H3K27ac) by inhibiting histone demethylases and deacetylases is positively associated with hard tissue formation through the induction of osteo/odontogenic differentiation. However, the key endogenous epigenetic modulator of odontoblasts to regulate the expression of genes coding dentin extracellular matrix (ECM) proteins has not been identified. We focused on nuclear factor (NF)-κB inhibitor ζ (IκBζ), which was originally identified as the transcriptional regulator of NF-κB and recently regarded as the NF-κB-independent epigenetic modulator, and found that IκBζ null mice exhibit a thicker dentin width and narrower pulp chamber, with aged mice having more marked phenotypes. At 6 mo of age, dentin fluorescent labeling revealed significantly accelerated dentin synthesis in the incisors of IκBζ null mice. In the molars of IκBζ null mice, marked tertiary dentin formation adjacent to the pulp horn was observed. Mechanistically, the expression of COL1A2 and COL1A1 collagen genes increased more in the odontoblast-rich fraction of IκBζ null mice than in wild type in vivo, similar to human odontoblast-like cells transfected with small interfering RNA for IκBζ compared with cells transfected with control siRNA in vitro. Furthermore, the direct binding of IκBζ to the COL1A2 promoter suppressed COL1A2 expression and the local active chromatin status marked by H3K4me3. Based on whole-genome identification of H3K4me3 enrichment, ECM and ECM organization-related gene loci were selectively activated by the knockdown of IκBζ, which consistently resulted in the upregulation of these genes. Collectively, this study suggested that IκBζ is the key negative regulator of dentin formation in odontoblasts by inhibiting dentin ECM- and ECM organization-related gene expression through an altered local chromatin status marked by H3K4me3. Therefore, IκBζ is a potential target for epigenetically improving the clinical outcomes of dentin regeneration therapies such as pulp capping.
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Affiliation(s)
- H Yuan
- Department of Periodontology and Endodontology, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - S Suzuki
- Department of Periodontology and Endodontology, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - H Terui
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - S Hirata-Tsuchiya
- Department of Biological Endodontics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - E Nemoto
- Department of Periodontology and Endodontology, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - K Yamasaki
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - M Saito
- Department of Restorative Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - H Shiba
- Department of Biological Endodontics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - S Aiba
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - S Yamada
- Department of Periodontology and Endodontology, Tohoku University Graduate School of Dentistry, Sendai, Japan
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10
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Yanagaki M, Shirai Y, Hamura R, Taniai T, Tanji Y, Haruki K, Furukawa K, Onda S, Shiba H, Ikegami T. Novel combined fibrosis-based index predicts the long-term outcomes of hepatocellular carcinoma after hepatic resection. Int J Clin Oncol 2022; 27:717-728. [PMID: 35015195 DOI: 10.1007/s10147-021-02111-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 08/20/2021] [Accepted: 12/26/2021] [Indexed: 11/26/2022]
Abstract
AIM Liver fibrosis influences liver regeneration and surgical outcomes. The fibrosis-4 (FIB-4) index is strongly associated with liver fibrosis and cirrhosis. This study aimed to examine the prognostic significance of the combination of FIB-4 index and Protein Induced by Vitamin K Absence or Antagonist-II (PIVKA-II) (PIVKA-II-FIB-4 index score) in patients who underwent curative resection for hepatocellular carcinoma (HCC). METHODS We included 284 patients who underwent elective hepatic resection for HCC between January 2000 and December 2018. We retrospectively investigated how FIB-4 index is related to disease-free survival and overall survival. RESULTS According to a receiver operating characteristic (ROC) analysis, the optimal cutoff value of the FIB-4 index was 3.44. In a multivariate analysis, high PIVKA-II and FIB-4 index values were independent predictors of both disease-free survival (P = 0.013 and P = 0.005, respectively) and overall survival (P = 0.048 and P < 0.001, respectively). We classified the PIVKA-II and FIB-4 index levels into two groups (high vs. low) and calculated a new score (PIVKA-II-FIB-4 index score; 0-2) by the sum of each measurement (high, 1; low, 0). The 5 year overall survival rates of patients with PIVKA-II-FIB-4 index scores of 0, 1, and 2 were 84.9, 74.4, and 47.1%, respectively (P < 0.001). CONCLUSION The combination of the preoperative PIVKA-II and FIB-4 index may be a prognostic factor of HCC after hepatic resection, suggesting that the combined score is useful in assessing the liver fibrosis status in cancer cases.
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Affiliation(s)
- Mitsuru Yanagaki
- Division of Hepatobiliary and Pancreas Surgery, Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Yoshihiro Shirai
- Division of Hepatobiliary and Pancreas Surgery, Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan.
| | - Ryoga Hamura
- Division of Hepatobiliary and Pancreas Surgery, Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Tomohiko Taniai
- Division of Hepatobiliary and Pancreas Surgery, Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Yoshiaki Tanji
- Division of Hepatobiliary and Pancreas Surgery, Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Koichiro Haruki
- Division of Hepatobiliary and Pancreas Surgery, Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Kenei Furukawa
- Division of Hepatobiliary and Pancreas Surgery, Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Shinji Onda
- Division of Hepatobiliary and Pancreas Surgery, Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Hiroaki Shiba
- Division of Hepatobiliary and Pancreas Surgery, Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Toru Ikegami
- Division of Hepatobiliary and Pancreas Surgery, Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan
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11
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Munakata K, Miyashita H, Nakahara T, Shiba H, Sugahara K, Katakura A, Nakagawa T. The use of SPECT/CT to assess resorptive activity in mandibular condyles. Int J Oral Maxillofac Surg 2021; 51:942-948. [PMID: 34937677 DOI: 10.1016/j.ijom.2021.11.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 04/12/2021] [Revised: 08/30/2021] [Accepted: 11/26/2021] [Indexed: 12/20/2022]
Abstract
The aim of this study was to clarify the clinical significance of bone metabolism in the mandibular condyles in determining condylar resorptive changes. Twelve condyles of patients with idiopathic condylar resorption and degenerative joint disease were analysed using 99mTc HMDP SPECT/CT at baseline and subsequent computed tomography during the follow-up period. Twenty-two healthy condyles were enrolled as controls. After generating three-dimensional SPECT/CT images, two independent observers scored the degree of condylar uptake and measured the morphological changes in the condylar height and condylar volume. In the group with positive condylar uptake, the follow-up computed tomography showed significant decreases in condylar height (-1.69 ± 0.93 mm) and condylar volume (-12.51 ± 10.30%) when compared to healthy controls (condylar height, 0.09 ± 0.54 mm; condylar volume, -0.29 ± 4.22%) (P < 0.001). Moreover, the degree of uptake correlated with the changes in condylar height (observer 1, P = 0.012; observer 2, P = 0.039) and condylar volume (observer 1, P = 0.005; observer 2, P = 0.037). These results suggest that condylar bone metabolism is closely related to the resorptive activity. Thus, SPECT/CT would be useful in the prognostic evaluation or determination of treatment strategies for idiopathic condylar resorption and degenerative joint disease.
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Affiliation(s)
- K Munakata
- Department of Dentistry and Oral Surgery, Keio University School of Medicine, Tokyo, Japan
| | - H Miyashita
- Department of Dentistry and Oral Surgery, Keio University School of Medicine, Tokyo, Japan.
| | - T Nakahara
- Department of Radiology, Keio University School of Medicine, Tokyo, Japan
| | - H Shiba
- Department of Dentistry and Oral Surgery, Keio University School of Medicine, Tokyo, Japan
| | - K Sugahara
- Department of Oral Pathobiological Science and Surgery, Tokyo Dental College, Tokyo, Japan
| | - A Katakura
- Department of Oral Pathobiological Science and Surgery, Tokyo Dental College, Tokyo, Japan
| | - T Nakagawa
- Department of Dentistry and Oral Surgery, Keio University School of Medicine, Tokyo, Japan
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12
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Onda S, Furukawa K, Yanagaki M, Igarashi Y, Shiba H, Ikegami T. How to Manage Drains in Major Hepatectomy in the Recent Era. J Gastrointest Surg 2021; 25:2433-2434. [PMID: 34255292 DOI: 10.1007/s11605-021-05077-z] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 06/19/2021] [Indexed: 01/31/2023]
Affiliation(s)
- Shinji Onda
- Division of Hepatobiliary and Pancreas Surgery, Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-shimbashi, Minato-ku, Tokyo, 105-8461, Japan.
| | - Kenei Furukawa
- Division of Hepatobiliary and Pancreas Surgery, Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-shimbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Mitsuru Yanagaki
- Division of Hepatobiliary and Pancreas Surgery, Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-shimbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Yosuke Igarashi
- Division of Hepatobiliary and Pancreas Surgery, Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-shimbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Hiroaki Shiba
- Division of Hepatobiliary and Pancreas Surgery, Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-shimbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Toru Ikegami
- Division of Hepatobiliary and Pancreas Surgery, Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-shimbashi, Minato-ku, Tokyo, 105-8461, Japan
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13
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Matsumoto M, Yanaga K, Shiba H, Wakiyama S, Sakamoto T, Futagawa Y, Gocho T, Ishida Y, Ikegami T. Treatment of intrahepatic recurrence after hepatectomy for hepatocellular carcinoma. Ann Gastroenterol Surg 2021; 5:538-552. [PMID: 34337303 PMCID: PMC8316745 DOI: 10.1002/ags3.12449] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 01/12/2021] [Accepted: 01/31/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Prognostic factors after treatment for intrahepatic recurrent hepatocellular carcinoma (RHCC) after hepatic resection (Hx) are controversial. The current study aimed to examine the impact of treatment modality on the prognosis of intrahepatic RHCC following Hx. METHODS For control of variables, the subjects were 56 patients who underwent treatment for intrahepatic RHCC, three or fewer tumors, each measuring ≤3 cm in diameter without macroscopic vascular invasion (MVI), between 2000 and 2011. Retreatment consisted of repeat Hx (n = 23), local ablation therapy (n = 11) and transarterial chemoembolization or transcatheter arterial infusion (TACE/TAI) (n = 22). We retrospectively investigated the relation between type of treatment for RHCC and overall survival (OS) as well as disease-free survival (DFS). RESULTS In multivariate (MV) analysis, the poor prognostic factors in DFS after retreatment consisted of disease-free interval (DFI) (≤1.5 y) (P = .011), type of retreatment (TACE/TAI) (P = .002), age (<65 y old) (P = .0022), perioperative RBC transfusion (P = .025), while those in OS after retreatment were DFI (≤1.5 y) (P < .0001). In evaluation of stratification for type of retreatment, DFS in the repeat Hx group was significantly better than those in the local ablation therapy group or the TACE/TAI group (P = .023 or P < .0001, respectively). CONCLUSIONS DFI (≤1.5 y) was an independent poor prognostic factor in both DFS and OS, and repeat Hx for intrahepatic RHCC, few in number and size without MVI, seems to achieve the most reliable local control.
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Affiliation(s)
| | - Katsuhiko Yanaga
- Department of SurgeryThe Jikei University School of MedicineTokyoJapan
| | - Hiroaki Shiba
- Department of SurgeryThe Jikei University School of MedicineTokyoJapan
| | - Shigeki Wakiyama
- Department of SurgeryThe Jikei University School of MedicineTokyoJapan
| | - Taro Sakamoto
- Department of SurgeryThe Jikei University School of MedicineTokyoJapan
| | - Yasuro Futagawa
- Department of SurgeryThe Jikei University School of MedicineTokyoJapan
| | - Takeshi Gocho
- Department of SurgeryThe Jikei University School of MedicineTokyoJapan
| | - Yuichi Ishida
- Department of SurgeryThe Jikei University School of MedicineTokyoJapan
| | - Toru Ikegami
- Department of SurgeryThe Jikei University School of MedicineTokyoJapan
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14
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Taniai T, Haruki K, Furukawa K, Onda S, Yasuda J, Shirai Y, Gocho T, Yanagaki M, Hamura R, Shiba H, Ikegami T. The novel index using preoperative C-reactive protein and neutrophil-to-lymphocyte ratio predicts poor prognosis in patients with pancreatic cancer. Int J Clin Oncol 2021; 26:1922-1928. [PMID: 34110531 DOI: 10.1007/s10147-021-01964-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [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: 05/01/2021] [Accepted: 06/03/2021] [Indexed: 12/19/2022]
Abstract
BACKGROUND Several kinds of systemic inflammatory response, classified into two types: C-reactive protein (CRP)-based type and blood cell count-based type, were reported as a prognostic indicator in patients with pancreatic cancer (PC). However, there is no consensus which types is more sensitive predictor in patients with PC. Therefore, we here developed a novel biomarker, C-NLR, which consists of both CRP and neutrophil-to-lymphocyte ratio (NLR), and we evaluated the prognostic significance of C-NLR in patients with PC after pancreatic resection. METHODS A total of 217 patients was comprised in this study. We retrospectively investigated the relation between C-NLR and disease-free survival (DFS) and overall survival (OS) after pancreatic resection. RESULTS Optimal cutoff level of C-NLR was defined as 0.206 by a ROC analysis. By multivariate analysis, age (P = 0.024), TNM stage (P < 0.001), and C-NLR (HR: 1.373, 95% CI: 1.005-1.874, P = 0.046) were independent predictors of DFS, whereas TNM stage (P = 0.016) and C-NLR (HR: 1.468, 95% CI: 1.042-2.067, P = 0.028) were independent predictors of OS. CONCLUSION Preoperative C-NLR can be a prognostic indicator in patients with PC after pancreatic resection, suggesting the importance of both CRP and blood cell count in predicting therapeutic outcomes.
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Affiliation(s)
- Tomohiko Taniai
- Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato City, Tokyo, 105-8461, Japan
| | - Koichiro Haruki
- Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato City, Tokyo, 105-8461, Japan.
| | - Kenei Furukawa
- Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato City, Tokyo, 105-8461, Japan
| | - Shinji Onda
- Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato City, Tokyo, 105-8461, Japan
| | - Jungo Yasuda
- Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato City, Tokyo, 105-8461, Japan
| | - Yoshihiro Shirai
- Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato City, Tokyo, 105-8461, Japan
| | - Takeshi Gocho
- Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato City, Tokyo, 105-8461, Japan
| | - Mitsuru Yanagaki
- Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato City, Tokyo, 105-8461, Japan
| | - Ryoga Hamura
- Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato City, Tokyo, 105-8461, Japan
| | - Hiroaki Shiba
- Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato City, Tokyo, 105-8461, Japan
| | - Toru Ikegami
- Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato City, Tokyo, 105-8461, Japan
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Shiozaki H, Shirai Y, Horiuchi T, Yasuda J, Furukawa K, Onda S, Gocho T, Shiba H, Ikegami T. Feasible laparoscopic distal pancreatectomy for pancreatic neuroendocrine tumors. Mol Clin Oncol 2021; 14:111. [PMID: 33903817 DOI: 10.3892/mco.2021.2273] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Accepted: 02/15/2021] [Indexed: 11/05/2022] Open
Abstract
Pancreatic neuroendocrine tumor (PNET) cases are increasing; however, the treatment indication and procedure remain unestablished. The present study evaluated the indication, feasibility and safety of laparoscopic distal pancreatectomy (LDP) with our technique for PNET. A total of 13 patients with insulinoma and nonfunctional PNET <2 cm in diameter who underwent LDP and 13 patients with any size of PNET who underwent open distal pancreatectomy (ODP) between October 2009 and June 2019 were retrospectively reviewed and compared. The median age of patients was 45 (33-61) years, and 14 (54%) patients were male. The median follow-up periods were 70 months for the LDP group and 46 months for the ODP group. The tumor diameter of the patients who underwent LDP for PNET was 18±9 mm compared with 37±25 mm for those who underwent ODP. The operation time, estimated blood loss, and complication were 290.2±115 vs. 337±131 min (P=0.338), 122±172 vs. 649±693 ml (P=0.019) and 31 vs. 54% (P=0.234), respectively. Pancreatic fistula developed in 8% of patients who underwent LDP compared with 31% who underwent ODP (P=0.131). Notably, the postoperative hospitalization period was significantly shorter in the LDP group (11±7 vs. 21±13 days; P=0.022). Tumor grade of 2017 World Health Organization classification (G1/G2/G3/NEC/unknown) was 9/2/0/0/2 for the LDP group compared with 5/5/0/3/0 for the ODP group. Furthermore, lymph node metastasis was detected in only 1 patient who underwent ODP, for whom the maximum tumor diameter was 70 mm and was classified as G2. In addition, 2 patients in the ODP group developed postoperative lung and liver metastases. LDP for PNETs of <2 cm in selected patients can be safely performed; however, the extent of lymph node dissection needs to be clarified.
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Affiliation(s)
- Hironori Shiozaki
- Department of Surgery, The Jikei University School of Medicine, Minato-ku, Tokyo 105-8461, Japan
| | - Yoshihiro Shirai
- Department of Surgery, The Jikei University School of Medicine, Minato-ku, Tokyo 105-8461, Japan
| | - Takashi Horiuchi
- Department of Surgery, The Jikei University School of Medicine, Minato-ku, Tokyo 105-8461, Japan
| | - Jungo Yasuda
- Department of Surgery, The Jikei University School of Medicine, Minato-ku, Tokyo 105-8461, Japan
| | - Kenei Furukawa
- Department of Surgery, The Jikei University School of Medicine, Minato-ku, Tokyo 105-8461, Japan
| | - Shinji Onda
- Department of Surgery, The Jikei University School of Medicine, Minato-ku, Tokyo 105-8461, Japan
| | - Takeshi Gocho
- Department of Surgery, The Jikei University School of Medicine, Minato-ku, Tokyo 105-8461, Japan
| | - Hiroaki Shiba
- Department of Surgery, The Jikei University School of Medicine, Minato-ku, Tokyo 105-8461, Japan
| | - Toru Ikegami
- Department of Surgery, The Jikei University School of Medicine, Minato-ku, Tokyo 105-8461, Japan
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Uwagawa T, Sakamoto T, Yasuda J, Shiozaki H, Furukawa K, Onda S, Gocho T, Shiba H, Yanaga K. Phase II Study of Adjuvant Chemotherapy With Gemcitabine and Nafamostat Mesilate for Pancreatic Cancer. Pancreas 2021; 50:313-316. [PMID: 33835961 DOI: 10.1097/mpa.0000000000001767] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 12/11/2022]
Abstract
OBJECTIVES The aim of this study was to clarify the effectiveness of combination chemotherapy targeting gemcitabine (GEM)-induced nuclear factor kappa B as adjuvant therapy for pancreatic cancer. METHODS Patients who were planned after curative surgery (residual tumor classification R0 or R1) for pancreatic cancer to receive six cycles of adjuvant chemotherapy of regional arterial infusion of nafamostat mesilate with GEM between June 2011 and April 2017 were enrolled in this single-center, institutional review board-approved phase II trial (UMIN000006163). The Kaplan-Meier method was used to estimate disease-free survival and overall survival. RESULTS In 32 patients [male/female: 18/14; age: median, 65.5 years (range, 48-77 years); pathological stage (Union for International Cancer Control 8th): IA/IB/IIA/IIB/III, 2/2/9/18/1, respectively] who met the eligibility criteria, the median overall survival and disease-free survival were 36.4 months (95% confidence interval, 31.7-48.3) and 16.4 months (95% confidence interval, 14.3-22.0), respectively. Grade 4 treatment-related hematological toxicities were seen in 5 patients (15.6%) (all neutropenia). One patient developed grade 3 nonhematological toxicities (rash). CONCLUSIONS Adjuvant chemotherapy with regional arterial infusion of nafamostat mesilate and GEM is safe and has potential as an option in adjuvant setting after curative surgery for pancreatic cancer.
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Affiliation(s)
- Tadashi Uwagawa
- From the Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
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17
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Furukawa K, Gocho T, Sakamoto T, Tsunematsu M, Haruki K, Horiuchi T, Shirai Y, Yasuda J, Shiozaki H, Onda S, Shiba H, Sato S, Takahashi H, Ikegami T. Intraoperative amylase level of pancreatic juice as a simple predictor of pancreatic fistula after pancreaticoduodenectomy. Pancreatology 2021; 21:299-305. [PMID: 33214083 DOI: 10.1016/j.pan.2020.10.048] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 08/10/2020] [Revised: 09/20/2020] [Accepted: 10/27/2020] [Indexed: 12/11/2022]
Abstract
INTRODUCTION A soft remnant texture of the pancreas is commonly accepted as a risk factor for postoperative pancreatic fistula (POPF) after pancreaticoduodenectomy (PD). However, its assessment is subjective. The aim of this study was to evaluate the significance of intraoperative amylase level of the pancreatic juice as a risk factor of POPF after PD. METHOD This study included 75 patients who underwent PD between November 2014 and April 2020 at Jikei University Hospital. We investigated the relationship between pancreatic texture, intraoperative amylase level of pancreatic juice, results of the pathological evaluations, and the incidence of POPF. RESULTS Twenty-three patients (31%) developed POPF. The significant predictors of POPF were non-ductal adenocarcinoma (p < 0.01), soft pancreatic remnant (p < 0.01), high intraoperative blood loss (p < 0.01), high intraoperative amylase level of pancreatic juice (p < 0.01), and low pancreatic fibrosis (p < 0.01). Multivariate analysis revealed that the significant independent predictors of POPF were high intraoperative blood loss (p < 0.01) and high intraoperative amylase level of pancreatic juice (p = 0.02). Receiver operating characteristic (ROC) analysis showed that the cut-off value for the intraoperative amylase level of pancreatic juice was 2.17 × 105 IU/L (area under the curve = 0.726, sensitivity = 95.7%, and specificity = 50.0%) CONCLUSIONS: The intraoperative amylase level of pancreatic juice is a reliable objective predictor for POPF after PD.
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Affiliation(s)
- Kenei Furukawa
- Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan.
| | - Takeshi Gocho
- Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Taro Sakamoto
- Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Masashi Tsunematsu
- Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Koichiro Haruki
- Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Takashi Horiuchi
- Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Yoshihiro Shirai
- Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Jungo Yasuda
- Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Hironori Shiozaki
- Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Shinji Onda
- Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Hiroaki Shiba
- Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Shun Sato
- Department of Pathology, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Hiroyuki Takahashi
- Department of Pathology, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Toru Ikegami
- Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan
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18
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Taniai T, Haruki K, Hamura R, Fujiwara Y, Furukawa K, Gocho T, Shiba H, Yanaga K. The Prognostic Significance of C-reactive Protein-To-Lymphocyte Ratio in Colorectal Liver Metastases. J Surg Res 2020; 258:414-421. [PMID: 33109402 DOI: 10.1016/j.jss.2020.08.059] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 01/30/2020] [Revised: 08/06/2020] [Accepted: 08/25/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND The preoperative systemic inflammation has been reported to predict tumor recurrence and survival in various cancers, including colorectal liver metastases (CRLM). However, more sensitive biomarker is required to improve perioperative management of CRLM. Therefore, we developed a novel indicator; C-reactive protein-to-lymphocyte ratio (CLR). The aim of this study is to evaluate the prognostic significance of CLR in patients with CRLM after hepatic resection. MATERIALS AND METHODS The study comprised 197 patients who had undergone hepatic resection for CRLM between January 2000 and December 2018. We retrospectively investigated the relation between CLR and disease-free survival and overall survival after hepatic resection and compared their prognostic significance with that of the C-reactive protein-to-albumin ratio and neutrophil-to-lymphocyte ratio. RESULTS Optimal cutoff level of the CLR by receiver operating characteristics analysis was 62.8 × 10-6. By multivariate analysis, CLR was an independent predictor of disease-free survival [hazard ratio (HR): 1.463, 95% confidence interval (CI): 1.003-2.135, P = 0.048), whereas lymph node metastases>4 (HR: 1.804, 95% CI: 1.100-2.958, P = 0.019) and CLR (HR: 1.656, 95% CI: 1.007-2.724, P = 0.047) were independent predictors of overall survival, while the C-reactive protein-to-albumin ratio and neutrophil-to-lymphocyte ratio were not. CONCLUSIONS CLR may be an independent and significant indicator of poor long-term outcomes in patients with CRLM after hepatic resection.
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Affiliation(s)
- Tomohiko Taniai
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Koichiro Haruki
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan.
| | - Ryoga Hamura
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Yuki Fujiwara
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Kenei Furukawa
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Takeshi Gocho
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Hiroaki Shiba
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Katsuhiko Yanaga
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
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Tsunematsu M, Haruki K, Fujiwara Y, Furukawa K, Onda S, Matsumoto M, Gocho T, Shiba H, Yanaga K. Preoperative controlling nutritional status (CONUT) score predicts long-term outcomes in patients with non-B non-C hepatocellular carcinoma after curative hepatic resection. Langenbecks Arch Surg 2020; 406:99-107. [PMID: 32936328 DOI: 10.1007/s00423-020-01987-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 05/15/2020] [Accepted: 09/03/2020] [Indexed: 11/29/2022]
Abstract
PURPOSE The controlling nutritional status (CONUT) score has been reported to predict outcomes in patients with hepatocellular carcinoma (HCC). However, the prognostic significance of the CONUT score in patients with non-B non-C (NBNC) HCC remains to be established. METHODS The study comprised 246 patients who had undergone elective hepatic resection for HCC between April 2003 and October 2017. We retrospectively investigated the relation between preoperative CONUT score as well as clinicopathological characteristics and disease-free survival (DFS) as well as overall survival (OS). RESULTS In univariate analyses, CONUT score was associated with DFS and OS in patients with NBNC-HCC (p ≤ 0.01), while there was no significant association of CONUT score with DFS and OS in patients with HBV- and HCV-related HCC (p ≥ 0.1). Of the 111 patients with NBNC-HCC, 97 (87.4%) had CONUT score ≤ 3 (low CONUT score) and the other 14 (12.6%) had CONUT score ≥ 4 (high CONUT score). In the patients with NBNC-HCC, multivariate analysis identified age ≥ 65 years (p = 0.03), multiple tumors (p < 0.01), and high CONUT score (p = 0.03) as the independent and significant predictors of DFS, while multiple tumors (p = 0.01), microvascular invasion (p < 0.01), and high CONUT score (p = 0.01) were the independent and significant predictors of OS. CONCLUSIONS The CONUT score seems to be a reliable and independent predictor of both DFS and OS after hepatic resection for NBNC-HCC.
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Affiliation(s)
- Masashi Tsunematsu
- Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Koichiro Haruki
- Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan.
| | - Yuki Fujiwara
- Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Kenei Furukawa
- Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Shinji Onda
- Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Michinori Matsumoto
- Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Takeshi Gocho
- Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Hiroaki Shiba
- Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Katsuhiko Yanaga
- Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan
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Shintani T, Iwata T, Okada M, Nakaoka M, Yamasaki N, Fujii T, Shiba H. Clinical Outcomes of Post-exposure Prophylaxis following Occupational Exposure to Human Immunodeficiency Virus at Dental Departments of Hiroshima University Hospital. Curr HIV Res 2020; 18:475-479. [PMID: 32753017 PMCID: PMC8388063 DOI: 10.2174/1570162x18666200804151118] [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] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 07/10/2020] [Accepted: 07/14/2020] [Indexed: 11/22/2022]
Abstract
Background Dental professionals have so many opportunities to use injection needles and sharp instruments during dental treatment that they face an increased risk of needlestick injuries. This retrospective study reports the utilization and clinical outcomes of occupational post-exposure prophylaxis (PEP) with anti-retroviral agents after being potentially exposed to HIV at the dental departments of Hiroshima University Hospital. Objective This study reports the utilization and clinical outcomes of occupational post-exposure prophylaxis (PEP) with antiretroviral agents after being potentially exposed to HIV at dental departments of Hiroshima University Hospital. Methods Data on the clinical status of HIV-infected source patients and information on HIV-exposed dental professionals from 2007 to 2018 were collected. Results Five dentists with an average experience of 5.6 years (1-15 years) were exposed. The averaged CD4-positive cell number and HIV-RNA load were 1176 (768-1898) /μl and less than 20 copies/ml, respectively, in all the patients. Two of the five HIV exposed dentists received PEP. Three months after the exposures, all of their results were negative in HIV antibody/antigen tests. Conclusion These data might support the concept of “undetectable equals untransmittable”, although HIV exposure in this study was not through sexual transmission.
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Affiliation(s)
- T Shintani
- Center of Oral Clinical Examination, Hiroshima University Hospital, Japan
| | - T Iwata
- Department of Periodontal Medicine, Graduate School of Biomedical & Sciences, Hiroshima University, Japan
| | - M Okada
- Division of Dental Hygiene, Department of Clinical Practice and Support, Hiroshima University Hospital, Japan
| | - M Nakaoka
- Division of Dental Hygiene, Department of Clinical Practice and Support, Hiroshima University Hospital, Japan
| | - N Yamasaki
- Division of Blood Transfusion, Hiroshima University Hospital, Japan,AIDS Care Unit, Hiroshima University Hospital, Japan
| | - T Fujii
- Division of Blood Transfusion, Hiroshima University Hospital, Japan,AIDS Care Unit, Hiroshima University Hospital, Japan
| | - H Shiba
- Center of Oral Clinical Examination, Hiroshima University Hospital, Japan,Department of Biological Endodontics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, 734-8553, Japan
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21
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Yatabe S, Eto K, Haruki K, Shiba H, Kosuge M, Ohkuma M, Ito D, Takeda Y, Sugano H, Sasaki S, Yanaga K. Correction to: Signification of Systemic Immune-Inflammation Index for prediction of prognosis after resecting in patients with colorectal cancer. Int J Colorectal Dis 2020; 35:1557. [PMID: 32488417 DOI: 10.1007/s00384-020-03659-y] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The authors regrets that there is a typo error on Tables 1, 2 and 3 of their published paper.
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Affiliation(s)
- Saori Yatabe
- Departments of Surgery, Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Ken Eto
- Departments of Surgery, Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan.
| | - Koichiro Haruki
- Departments of Surgery, Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Hiroaki Shiba
- Departments of Surgery, Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Makoto Kosuge
- Departments of Surgery, Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Masahisa Ohkuma
- Departments of Surgery, Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Daisuke Ito
- Departments of Surgery, Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Yasuhiro Takeda
- Departments of Surgery, Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Hiroshi Sugano
- Departments of Surgery, Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Shigemasa Sasaki
- Departments of Surgery, Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Katsuhiko Yanaga
- Departments of Surgery, Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
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Yanagaki M, Shiba H, Hagiwara S, Hoshino M, Sakuda H, Furukawa Y, Yanaga K. A successfully treated case of Lemmel syndrome with pancreaticobiliary maljunction: A case report. Int J Surg Case Rep 2020; 72:560-563. [PMID: 32698288 PMCID: PMC7327874 DOI: 10.1016/j.ijscr.2020.06.080] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 04/14/2020] [Accepted: 06/14/2020] [Indexed: 12/07/2022] Open
Abstract
Lemmel syndrome is a rare condition that leads to cholangitis and/or pancreatitis due to intraduodenal diverticulum. Surgery is considered for the treatment of severe or repeated symptoms in patients with this condition. We herein report a successfully diagnosed and treated case of Lemmel syndrome with pancreaticobiliary maljunction.
Background Lemmel syndrome is a rare condition that leads to cholangitis and/or pancreatitis due to intraduodenal diverticulum. Surgery is considered for the treatment of severe or repeated symptoms in patients with this condition. Case presentation An 81-year-old woman was admitted to our hospital, complaining of general fatigue, BT 38.8 degree, and right hypochondoralgia. Her hepatobiliary enzyme levels were elevated, and enhanced abdominal computed tomography revealed dilation of the common bile duct and intraduodenal diverticulum. After restarting oral intake, her symptoms were exacerbated. Endoscopic retrograde cholangio-pancreatography (ERCP) revealed pancreaticobiliary maljunction and parapapillary diverticulum. Under a diagnosis of Lemmel syndrome with pancreaticobiliary maljunction complicated by acute pancreatitis and cholangitis, we performed extrahepatic bile duct resection with cholecystectomy and papilloplasty. Her postoperative course was uneventful, and the patient was discharged 20 days after surgery. She remains well at 5 months after surgery. Conclusion We herein report a successfully diagnosed and treated case of Lemmel syndrome with pancreaticobiliary maljunction.
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Affiliation(s)
- Mitsuru Yanagaki
- Department of Digestive Surgery, AOI Universal Hospital, 2-9-1, Tamachi, Kawasaki-ku, Kawasaki-city, Kanagawa, 210-0822, Japan.
| | - Hiroaki Shiba
- Department of Hepato-Biliary-pancreatic Surgery, Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan.
| | - Shin Hagiwara
- Department of Cardiovascular Surgery, AOI Universal Hospital, 2-9-1, Tamachi, Kawasaki-ku, Kawasaki-city, Kanagawa, 210-0822, Japan.
| | - Masato Hoshino
- Department of Digestive Surgery, AOI Universal Hospital, 2-9-1, Tamachi, Kawasaki-ku, Kawasaki-city, Kanagawa, 210-0822, Japan.
| | - Hitoshi Sakuda
- Department of Cardiovascular Surgery, AOI Universal Hospital, 2-9-1, Tamachi, Kawasaki-ku, Kawasaki-city, Kanagawa, 210-0822, Japan.
| | - Yoshiyuki Furukawa
- Department of Digestive Surgery, AOI Universal Hospital, 2-9-1, Tamachi, Kawasaki-ku, Kawasaki-city, Kanagawa, 210-0822, Japan.
| | - Katsuhiko Yanaga
- Department of Hepato-Biliary-pancreatic Surgery, Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan.
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Ebina K, Hirano T, Maeda Y, Yamamoto W, Hashimoto M, Murata K, Takeuchi T, Shiba H, Son Y, Amuro H, Onishi A, Akashi K, Hara R, Katayama M, Yamamoto K, Kumanogoh A, Hirao M. OP0025 DRUG RETENTION OF 7 BIOLOGICS AND TOFACITINIB IN BIOLOGICS-NAÏVE AND BIOLOGICS-SWITCHED PATIENTS WITH RHEUMATOID ARTHRITIS -THE ANSWER COHORT STUDY. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:EULAR recommendation announced that biological disease-modifying antirheumatic drugs (bDMARDs) and janus kinase inhibitors (JAKi) are considered as equivalent in the treatment of rheumatoid arthritis (RA). However, we still lack reliable evidence of direct comparison between these agents’ retention, which may reflect both effectiveness and safety.Objectives:The aim of this multi-center (7 university-related hospitals), retrospective study is to clarify retention rates and reasons for discontinuation of 7 bDMARDs and tofacitinib (TOF), one of the JAKi, in both bDMARDs-naïve and bDMARDs-switched cases.Methods:This study assessed 3,897 patients and 4,415 treatment courses of with bDMARDs and TOF from 2001 to 2019 (2,737 bDMARDs-naïve patients and 1,678 bDMARDs-switched patients [59.5% switched to their second agent], female 82.3%, baseline age 57.4 years, disease duration 8.5 years; rheumatoid factor positivity 78.4%; DAS28-ESR 4.3; concomitant prednisolone [PSL] 6.1 mg/day [42.4%] and methotrexate [MTX] 8.5 mg/week [60.9%]). Treatment courses included abatacept (ABT; n=663), adalimumab (ADA; n=536), certolizumab pegol (CZP; n=226), etanercept (ETN; n=856), golimumab (GLM; n=458), infliximab (IFX; n=724), tocilizumab (TCZ; n=851), and TOF (n=101/only bDMARDs-switched cases). Reasons for discontinuation were classified into four categories by each attending physician: 1) lack of effectiveness, 2) toxic adverse events, 3) non-toxic reasons, and 4) remission. Retention rates of each discontinuation reason were estimated at 36 months using the Kaplan-Meier method and adjusted for potential clinical confounders (age, sex, disease duration, concomitant PSL and MTX, starting date and number of switched bDMARDs) using Cox proportional hazards modeling.Results:Adjusted drug retention rates for each discontinuation reason were as follows: lack of effectiveness in the bDMARDs-naïve group (from 70.8% [CZP] to 85.1% [ABT]; P=0.001 between agents) and the bDMARDs-switched group (from 52.8% [CZP] to 78.7% [TCZ]; P<0.001 between agents). Toxic adverse events in the bDMARDs-naïve group (from 86.9% [IFX] to 96.3% [ABT]; P<0.001 between agents) and the bDMARDs-switched group (from 81.1% [ADA] to 95.4% [ETN]; P=0.01 between agents). Finally, overall retention rates excluding discontinuation for non-toxic reasons or remission ranged from 64.2% (IFX) to 82.0% (ABT) (P<0.001 between agents) in the bDMARDs-naïve group (figure a) and from 44.2% (ADA) to 66.8% (TCZ) (P<0.001 between agents) in the bDMARDs-switched group (figure b).Conclusion:Remarkable differences were observed in drug retention of 7 bDMARDs and TOF between bDMARDs-naïve and bDMARDs-switched cases.Disclosure of Interests:Kosuke Ebina Grant/research support from: KE has received research grants from Abbie, Asahi-Kasei, Astellas, Chugai, Eisai, Ono Pharmaceutical, and UCB Japan., Employee of: KE is affiliated with the Department of Musculoskeletal Regenerative Medicine, Osaka University, Graduate School of Medicine, which is supported by Taisho., Speakers bureau: KE has received payments for lectures from Abbie, Asahi-Kasei, Astellas, Ayumi, Bristol-Myers Squibb, Chugai, Eisai, Eli Lilly, Janssen, Mitsubishi-Tanabe, Ono Pharmaceutical, Sanofi, and UCB Japan., Toru Hirano Grant/research support from: TH received a research grant and/or speaker fee from Astellas, Chugai, Nippon Shinyaku, Abbvie, Eisai, and Ono Pharmaceutical, Speakers bureau: TH received a research grant and/or speaker fee from Astellas, Chugai, Nippon Shinyaku, Abbvie, Eisai, and Ono Pharmaceutical, Yuichi Maeda Grant/research support from: YM received a research grant and/or speaker fee from Eli Lilly, Chugai, Pfizer, Bristol-Myers Squibb, and Mitsubishi-Tanabe, Speakers bureau: YM received a research grant and/or speaker fee from Eli Lilly, Chugai, Pfizer, Bristol-Myers Squibb, and Mitsubishi-Tanabe, Wataru Yamamoto: None declared, Motomu Hashimoto Grant/research support from: Bristol-Myers Squibb, Eisai, and Eli Lilly and Company., Speakers bureau: Bristol-Myers Squibb and Mitsubishi Tanabe Pharma., Koichi Murata Grant/research support from: KMurata belong to a department that has been financially supported by four pharmaceutical companies (Mitsubishi-Tanabe, Chugai, AYUMI and UCB Japan)., Employee of: KMurata belong to a department that has been financially supported by four pharmaceutical companies (Mitsubishi-Tanabe, Chugai, AYUMI and UCB Japan)., Speakers bureau: KMurak has received speaking fees, and/or consulting fees from Eisai Co. Ltd, Chugai Pharmaceutical Co. Ltd., Pfizer Japan Inc, Bristol-Myers Squibb, Mitsubishi-Tanabe Pharma Corporation, UCB, Daiichi Sankyo Co. Ltd. and Astellas Pharma Inc., Tohru Takeuchi Grant/research support from: TT received a research grant from Chugai, CoverLetter and a speaker fee from Astellas, Chugai, Eisai, Mitsubishi-Tanabe, Abbvie, Bristol-Myers Squibb, Ayumi, Daiichi Sankyo, Eisai, Takeda, and Asahi-Kasei, Employee of: TT is affiliated with a department that is financially supported by six pharmaceutical companies (Mitsubishi-Tanabe, Chugai, Ayumi, Astellas, Eisai, and Takeda), Hideyuki Shiba: None declared, Yonsu Son: None declared, Hideki Amuro: None declared, Akira Onishi Speakers bureau: AO received a speaker fee from Chugai, Ono Pharmaceutical, Eli Lilly, Mitsubishi-Tanabe, Asahi-Kasei, and Takeda, Kengo Akashi: None declared, Ryota Hara Speakers bureau: RH received a speaker fee from AbbVie, Masaki Katayama: None declared, Keiichi Yamamoto: None declared, Atsushi Kumanogoh Grant/research support from: AK received a research grant and/or speaker fee from Mitsubishi-Tanabe, Chugai, Eisai, Asahi-Kasei, Astellas, Abbvie, Bristol-Myers Squibb, Ono Pharmaceutical, and Pfizer, Speakers bureau: AK received a research grant and/or speaker fee from Mitsubishi-Tanabe, Chugai, Eisai, Asahi-Kasei, Astellas, Abbvie, Bristol-Myers Squibb, Ono Pharmaceutical, and Pfizer, Makoto Hirao Speakers bureau: MHirao received a speaker fee from Astellas, Ono Pharmaceutical, Eli Lilly, Mitsubishi-Tanabe, Pfizer, Ayumi, and Takeda
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Fujiwara Y, Haruki K, Hamura R, Horiuchi T, Shirai Y, Furukawa K, Gocho T, Shiba H, Yanaga K. A Novel Prognostic Score Combining Preoperative Biliary Drainage and Inflammatory Status for Patients with Periampullary Cancers. J Gastrointest Surg 2020; 24:813-822. [PMID: 31062271 DOI: 10.1007/s11605-019-04216-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 01/10/2019] [Accepted: 03/25/2019] [Indexed: 01/31/2023]
Abstract
AIMS The benefit of preoperative biliary drainage for patients with operable periampullary cancers is controversial because biliary drainage would activate inflammatory response such as cholangitis. The aim of this study was to identify a novel prognostic score in patients with operable periampullary cancers including pancreatic cancer and extrahepatic distal bile duct cancer with a typical reference to preoperative biliary drainage and inflammatory status. METHODS Between 2000 and 2015, 246 patients were enrolled in this retrospective study. The patients were divided into four groups of the following three factors; the presence of preoperative biliary drainage, decreased serum albumin value (< 3.5 g dl-1), and increased CR P value (> 1.0 mg dl-1). The relationship between clinicopathological variables and disease-free survival (DFS) as well as over-all survival (OS) was investigated by univariate and multivariate analyses. To compare the sensitivity and specificity among the types of cancer, the area under the receiver operating characteristics curve (AUC) was evaluated in patients with pancreatic cancer and extrahepatic distal bile duct cancer. RESULTS In multivariate analysis of DFS and OS, the novel prognostic factor combining preoperative biliary drainage and inflammatory status was an independent risk factor of tumor recurrence and prognosis as well as differentiation of the tumor and resected margin. CONCLUSION The novel prognostic score combining preoperative biliary drainage and inflammatory status may be an independent predictor of tumor recurrence and prognosis in patients with periampullary cancers.
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Affiliation(s)
- Yuki Fujiwara
- Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan.
| | - Koichiro Haruki
- Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Ryoga Hamura
- Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Takashi Horiuchi
- Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Yoshihiro Shirai
- Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Kenei Furukawa
- Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Takeshi Gocho
- Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Hiroaki Shiba
- Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Katsuhiko Yanaga
- Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan
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Furukawa K, Onda S, Hamura R, Taniai T, Marukuchi R, Shiba H, Tsukinaga S, Sumiyama K, Yanaga K. Predictive Factors and Surgical Outcomes of Stent Dysfunction After Preoperative Endoscopic Biliary Stenting in Patients Who Underwent Pancreaticoduodenectomy. J Laparoendosc Adv Surg Tech A 2020; 30:256-259. [DOI: 10.1089/lap.2019.0666] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Affiliation(s)
- Kenei Furukawa
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Shinji Onda
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Ryoga Hamura
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Tomohiko Taniai
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Rui Marukuchi
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Hiroaki Shiba
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Shintaro Tsukinaga
- Department of Endoscopy, The Jikei University School of Medicine, Tokyo, Japan
| | - Kazuki Sumiyama
- Department of Endoscopy, The Jikei University School of Medicine, Tokyo, Japan
| | - Katsuhiko Yanaga
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
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26
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Taniai T, Onda S, Sato S, Shiba H, Sakamoto T, Yanaga K. Hepatic Epithelioid Hemangioendothelioma: Difficult Differential Diagnosis from Angiosarcoma. Case Rep Gastroenterol 2020; 14:56-62. [PMID: 32110201 PMCID: PMC7036556 DOI: 10.1159/000505513] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Accepted: 12/17/2019] [Indexed: 12/21/2022] Open
Abstract
Hepatic epithelioid hemangioendothelioma (EHE) is extremely rare, and preoperative diagnosis is difficult because hepatic EHE has clinicopathological features that are similar to those of angiosarcoma. However, it is important to differentiate hepatic EHE from angiosarcoma because the latter is an aggressive tumor with poor prognosis. We herein report a case of hepatic EHE that was difficult to distinguish from angiosarcoma by tumor biopsy. A 30-year-old man with Crohn's disease presented with multiple liver tumors. The tumors were preoperatively diagnosed as angiosarcoma by tumor biopsy. The patient underwent extended left hemihepatectomy with biliary reconstruction and partial resection of segments 6 and 8. Immunohistochemical staining was positive for CD34, factor VIII, and calmodulin binding transcription activator 1 (CAMTA1), and the pathological diagnosis was EHE. Two years after surgery, a recurrent tumor was found in liver segment 6, for which laparoscopic partial hepatectomy was performed. Pathological examination revealed recurrence of EHE. The patient remained well with no evidence of tumor recurrence as of 9 months after the second resection. In conclusion, we described a case of hepatic EHE that was initially diagnosed as angiosarcoma on biopsy. Immunohistochemical staining with CAMTA1 may help distinguish EHE from angiosarcoma.
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Affiliation(s)
- Tomohiko Taniai
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Shinji Onda
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Shun Sato
- Department of Pathology, The Jikei University School of Medicine, Tokyo, Japan
| | - Hiroaki Shiba
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Taro Sakamoto
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Katsuhiko Yanaga
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
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27
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Hamura R, Haruki K, Kumagai Y, Shiba H, Wakiyama S, Yanaga K. Subphrenic abscess due to Clostridium perfringens after hepatic resection for hepatocellular carcinoma following emphysematous cholecystitis: Report of a case. Int J Surg Case Rep 2020; 67:86-90. [PMID: 32045859 PMCID: PMC7015821 DOI: 10.1016/j.ijscr.2020.01.029] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 01/15/2020] [Accepted: 01/20/2020] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Subphrenic abscess caused by Clostridium perfringens is rare after hepatic resection. We herein report such a case after hepatic resection for hepatocellular carcinoma following treatment of emphysematous cholecystitis. CASE PRESENTATION A 69-years-old man with chronic hepatitis B, was admitted to our hospital for right subcostal pain and loss of appetite. Computed tomography (CT) revealed emphysematous cholecystitis, for which percutaneous transhepatic gallbladder drainage was performed. Clostridium perfringens was identified from the culture of the bile. Imaging studies immediately demonstrated hepatocellular carcinoma with right lobe of the liver, for which the patients underwent hepatic resection and cholecystectomy concomitantly. After operation, the patient developed emphysematous subphrenic abscess on postoperative day 15, for which CT-guided percutaneous drainage was performed. Clostridium perfringens was identified from the culture of the abscess fluid. The patient was given Ciprofloxacin and Clindamycin and made a satisfactory recovery. The patient was discharged on POD 95 and remains well with no evidence of tumor recurrence as of 8 years after resection. CONCLUSION We herein reported a subphrenic abscess due to Clostridium perfringens after hepatic resection for hepatocellular carcinoma following emphysematous cholecystitis.
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Affiliation(s)
- Ryoga Hamura
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan.
| | - Koichiro Haruki
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Yu Kumagai
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Hiroaki Shiba
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Shigeki Wakiyama
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Katsuhiko Yanaga
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
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28
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Furukawa K, Shiba H, Hamura R, Haruki K, Fujiwara Y, Usuba T, Nakabayashi Y, Misawa T, Okamoto T, Yanaga K. Prognostic Factors in Patients With Recurrent Pancreatic Cancer: A Multicenter Database Analysis. Anticancer Res 2020; 40:293-298. [PMID: 31892579 DOI: 10.21873/anticanres.13952] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 11/20/2019] [Revised: 11/26/2019] [Accepted: 11/27/2019] [Indexed: 01/16/2023]
Abstract
BACKGROUND/AIM The prognosis of pancreatic cancer remains poor with a high incidence of recurrence even after curative resection. The aim of this study was to investigate prognostic factors in patients with recurrent pancreatic cancer using the multicenter database. PATIENTS AND METHODS The subjects were 196 patients with recurrent pancreatic cancer who underwent resection between 2008 and 2015. We retrospectively investigated the relation between clinicopathological characteristics of the patients and overall survival from recurrence using univariate and multivariate analyses. RESULTS In univariate analysis, the positive lymphatic invasion (p=0.0240), time to recurrence from resection <1 year (p<0.0001), sites of recurrence except for local or lymph node (p=0.0273), liver recurrence (p=0.0389) and peritoneal recurrence (p<0.0001) were significantly associated with poor overall survival from recurrence. In multivariate analysis, time to recurrence from resection <1 year (p<0.0001) and peritoneal recurrence (p<0.0001) were independently associated with poor overall survival from recurrence. CONCLUSION Time to recurrence from resection <1 year and peritoneal recurrence were significant independent predictors of poor overall survival from recurrence in patients with recurrent pancreatic cancer.
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Affiliation(s)
- Kenei Furukawa
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Hiroaki Shiba
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Ryoga Hamura
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Koichiro Haruki
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Yuki Fujiwara
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Teruyuki Usuba
- Department of Surgery, The Jikei University Katsushika Medical Center, Tokyo, Japan
| | - Yukio Nakabayashi
- Department of Surgery, The Kawaguchi Municipal Medical Center, Saitama, Japan
| | - Takeyuki Misawa
- Department of Surgery, The Jikei University Kashiwa Hospital, Chiba, Japan
| | - Tomoyoshi Okamoto
- Department of Surgery, The Jikei University Daisan Hospital, Tokyo, Japan
| | - Katsuhiko Yanaga
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
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Tsunematsu M, Haruki K, Uwagawa T, Shiba H, Yanaga K. Gallbladder cancer accompanied by uncontrollable eosinophilia: report of a case. Int Cancer Conf J 2019; 9:55-58. [PMID: 32257754 DOI: 10.1007/s13691-019-00395-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 08/29/2019] [Accepted: 11/16/2019] [Indexed: 01/17/2023] Open
Abstract
A 48-year-old male was referred to our hospital for evaluation of motor speech disorders and difficulty in the movement of both the hands. The clinical diagnosis was Trousseau's syndrome due to advanced gallbladder cancer (cT3aN1M0). The patient received anticoagulation therapy and systemic chemotherapy (gemcitabine and cisplatin). Motor speech disorders and difficulty in movement of both hands were recovered. After 2 courses of chemotherapy, the primary tumor developed a massive hepatic invasion and the peripheral blood eosinophils increased gradually. The patient was admitted to our hospital for abdominal distension, fever, right upper quadrant pain, systemic edema, loss of appetite, and general malaise. The peripheral blood eosinophil count was markedly elevated to 45,900/μl (90.3%). The serum level of GM-CSF was high and there was no evidence of leukemia, allergic status and other diseases. The patient was diagnosed as paraneoplastic eosinophilia with advanced gallbladder cancer, which was suspected to produce GM-CSF. The patient received palliative support and died of disseminated intravascular coagulation 15 days after admission. We herein reported a fatal case of gallbladder cancer suspected of producing GM-CSF.
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Affiliation(s)
- Masashi Tsunematsu
- Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461 Japan
| | - Koichiro Haruki
- Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461 Japan
| | - Tadashi Uwagawa
- Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461 Japan
| | - Hiroaki Shiba
- Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461 Japan
| | - Katsuhiko Yanaga
- Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461 Japan
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30
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Horiuchi T, Haruki K, Shiba H, Sakamoto T, Saito N, Shirai Y, Iwase R, Fujiwara Y, Yanaga K. Assessment of Outcome of Hepatic Resection for Extremely Elderly Patients With a Hepatic Malignancy. Anticancer Res 2019; 39:6325-6332. [PMID: 31704863 DOI: 10.21873/anticanres.13843] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 07/03/2019] [Revised: 07/24/2019] [Accepted: 07/25/2019] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM We aimed to assess surgical outcome and long-term survival after elective hepatic resection for hepatocellular carcinoma (HCC) and colorectal liver metastasis (CRLM) in patients aged 80 years or older. PATIENTS AND METHODS This study included 100 patients aged 70 years or older, who underwent hepatic resection for HCC or CRLM between January 2000 and December 2012. Outcomes and clinicopathological data were compared between the elderly (aged 70-79 years; n=84) and extremely elderly groups (aged 80 years or older; n=16). RESULTS Incidence of postoperative complications, in-hospital mortality, and postoperative OS in the extremely elderly group were comparable with those of the elderly group. In patients with HCC, the extremely elderly group was associated with shorter DFS (p=0.030) in univariate analysis, while multivariate analysis showed significant and independent factors of cancer recurrence. CONCLUSION Hepatic resection for HCC and CRLM in patients aged 80 years and older may be safe and acceptable with appropriate selection. For HCC in patients aged 80 years and older, hepatic resection may be effective when negative surgical margins can be achieved.
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Affiliation(s)
- Takashi Horiuchi
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Koichiro Haruki
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Hiroaki Shiba
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Taro Sakamoto
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Nobuhiro Saito
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Yoshihiro Shirai
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Ryota Iwase
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Yuki Fujiwara
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Katsuhiko Yanaga
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
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31
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Onda S, Futagawa Y, Gocho T, Shiba H, Ishida Y, Okamoto T, Yanaga K. A Preoperative Scoring System to Predict Carcinoma in Patients with Gallbladder Polyps. Dig Surg 2019; 37:275-281. [PMID: 31722357 DOI: 10.1159/000503100] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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: 04/19/2019] [Accepted: 08/29/2019] [Indexed: 12/10/2022]
Abstract
INTRODUCTION A preoperative scoring system to predict carcinoma in patients with gallbladder polyps (GBPs). METHODS Preoperative parameters of patients with GBPs who underwent cholecystectomies were used to construct a scoring system to ascertain the risk of malignancy (reference group). The scoring system developed from this approach was applied to the validation group. RESULTS In the reference group, 11.5% of patients had carcinomas, in whom the median age was 68 years and the polyp size was 16.9 mm. According to the univariate analysis, the significant factors for carcinoma were age ≥65 years, the presence of gallstones, polyp size ≥13 mm, solitary polyp, and sessile polyp. Age ≥65 years and polyp size ≥13 mm were significant factors according to the multivariate analysis. From these results, we developed a preoperative scoring system to predict carcinoma. The patients were divided into 1 of 2 groups: low-risk and high-risk and their malignancy rates were 4.1 and 61.1% respectively (p < 0.001). In the validation group, the malignancy rate was higher for those in the high-risk group (p = 0.016). CONCLUSIONS The proposed preoperative scoring system based on simple clinical variables appears to be useful for predicting malignancy in patients with GBPs.
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Affiliation(s)
- Shinji Onda
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan,
| | - Yasuro Futagawa
- Department of Surgery, The Jikei University Daisan Hospital, Tokyo, Japan
| | - Takeshi Gocho
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Hiroaki Shiba
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Yuichi Ishida
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Tomoyoshi Okamoto
- Department of Surgery, The Jikei University Daisan Hospital, Tokyo, Japan
| | - Katsuhiko Yanaga
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
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Marukuchi R, Furukawa K, Iwase R, Yasuda J, Shiozaki H, Onda S, Gocho T, Shiba H, Yanaga K. Risk Factors for Deterioration of Remnant Liver Function After Hepatic Resection for Hepatocellular Carcinoma. Anticancer Res 2019; 39:5755-5760. [PMID: 31570478 DOI: 10.21873/anticanres.13777] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 08/25/2019] [Revised: 08/28/2019] [Accepted: 08/30/2019] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM After primary resection of hepatocellular carcinoma (HCC), the impact of patient's characteristics at the initial hepatectomy, on long-term remnant liver function has not been reported. The aim of this study was to identify factors associated with the deterioration of remnant liver function among patients who developed recurrent HCC. PATIENTS AND METHODS A total of 51 patients with intrahepatic recurrence after initial hepatic resection for HCC were included. We retrospectively investigated the relation between patient characteristics and the degree of deterioration of remnant liver function upon recurrence. RESULTS In univariate analysis, significant predictors of deterioration of remnant liver function consisted of preoperative gastro-esophageal varices (p=0.0101), preoperative transcatheter arterial chemoembolization (p=0.0230) and hepatectomy beyond Makuuchi's criteria (p=0.0101). In multivariate analysis, the only significant independent predictor of deterioration of remnant liver function was hepatectomy beyond Makuuchi's criteria (p=0.0498). CONCLUSION Hepatectomy beyond Makuuchi's criteria at the initial hepatectomy may predict deterioration of remnant liver function upon recurrence of HCC.
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Affiliation(s)
- Rui Marukuchi
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Kenei Furukawa
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Ryota Iwase
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Jungo Yasuda
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Hironori Shiozaki
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Shinji Onda
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Takeshi Gocho
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Hiroaki Shiba
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Katsuhiko Yanaga
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
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Hamura R, Furukawa K, Taniai T, Shirai Y, Shiozaki H, Onda S, Gocho T, Shiba H, Ishida Y, Yanaga K. Impact of Inflammation-Based Prognostic Score for Midgut-Origin Colon Cancer Liver Metastasis. J Am Coll Surg 2019. [DOI: 10.1016/j.jamcollsurg.2019.08.1128] [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: 11/29/2022]
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Taniai T, Haruki K, Matsumoto M, Sakamoto T, Shiba H, Yanaga K. Incidental abdominal lymph node metastases from a known breast cancer in resected specimen of invasive pancreatic ductal adenocarcinoma: report of a case. Int Cancer Conf J 2019; 8:190-194. [PMID: 31559121 DOI: 10.1007/s13691-019-00382-6] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2019] [Accepted: 06/25/2019] [Indexed: 11/26/2022] Open
Abstract
Breast cancer is known to metastasize to all organs of the body. However, abdominal lymph node metastases from breast cancer are extremely rare. We herein report a resected case of an invasive pancreatic ductal adenocarcinoma (PDAC) in which abdominal lymph node metastases from breast cancer were diagnosed. A 54-year-old woman was pointed out to have a tumor in the pancreatic tail with dilatation of the distal pancreatic duct. She had undergone partial mastectomy for left breast cancer at the age of 51 years and had undergone partial liver resection for liver metastasis in the segment 3/4 6 months earlier. Computed tomography revealed a low-density tumor in the pancreatic tail with dilated distal main pancreatic duct. Magnetic resonance imaging (MRI) exhibited a high-intensity tumor in the pancreatic tail in diffusion-weighted images. With a diagnosis of pancreatic cancer, distal pancreatectomy and splenectomy with lymph nodes dissection was performed. Lymph node metastases along the splenic artery were pathologically similar to PDAC. However, lymph node metastases along the left gastric artery, common hepatic artery, celiac axis, and superior mesenteric artery were pathologically similar to breast cancer. Immunohistochemistry staining of abdominal lymph nodes with GATA-3 was positive, which strongly suggested metastatic breast cancer. Although she received chemotherapy with S-1 for breast cancer and PDAC for 4 months, MRI showed multiple liver metastases derived from breast cancer. Finally, she died 12 months after operation.
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Affiliation(s)
- Tomohiko Taniai
- Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461 Japan
| | - Koichiro Haruki
- Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461 Japan
| | - Michinori Matsumoto
- Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461 Japan
| | - Taro Sakamoto
- Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461 Japan
| | - Hiroaki Shiba
- Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461 Japan
| | - Katsuhiko Yanaga
- Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461 Japan
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Horiuchi T, Haruki K, Shiba H, Sakamoto T, Saito N, Shirai Y, Iwase R, Fujiwara Y, Yanaga K. Assessment of Outcome of Hepatic Resection for Extremely Elderly Patients With a Hepatic Malignancy. Anticancer Res 2019; 39:5143-5148. [PMID: 31519626 DOI: 10.21873/anticanres.13709] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 07/03/2019] [Revised: 07/24/2019] [Accepted: 07/25/2019] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM We aimed to assess surgical outcome and long-term survival after elective hepatic resection for hepatocellular carcinoma (HCC) and colorectal liver metastasis (CRLM) in patients aged 80 years or older. PATIENTS AND METHODS This study included 100 patients aged 70 years or older, who underwent hepatic resection for HCC or CRLM between January 2000 and December 2012. Outcomes and clinicopathological data were compared between the elderly (aged 70-79 years; n=84) and extremely elderly groups (aged 80 years or over; n=16). RESULTS Incidence of postoperative complications, in-hospital mortality, and postoperative OS in the extremely elderly group were comparable with those of the elderly group. In patients with HCC, the extremely elderly group was associated with shorter DFS (p=0.030) in univariate analysis, while multivariate analysis showed significant and independent factors of cancer recurrence. CONCLUSION Hepatic resection for HCC and CRLM in patients aged 80 years and over may be safe and acceptable with appropriate selection. For HCC in patients aged 80 years and over, hepatic resection may be effective when negative surgical margins can be achieved.
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Affiliation(s)
- Takashi Horiuchi
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Koichiro Haruki
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Hiroaki Shiba
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Taro Sakamoto
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Nobuhiro Saito
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Yoshihiro Shirai
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Ryota Iwase
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Yuki Fujiwara
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Katsuhiko Yanaga
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
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Shintani T, Fujii T, Yamasaki N, Kitagawa M, Iwata T, Saito S, Okada M, Ogawa I, Unei H, Hamamoto K, Nakaoka M, Kurihara H, Shiba H. Oral environment and taste function of Japanese HIV-infected patients treated with antiretroviral therapy. AIDS Care 2019; 32:829-834. [PMID: 31426660 DOI: 10.1080/09540121.2019.1656327] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The aim of the study was to evaluate the oral environment and the taste function of Japanese HIV-infected patients treated with antiretroviral therapy. Their median age of 73 patients taking anti-HIV drugs was 46 years. The median period of taking anti-HIV drugs was 30 months. The oral condition was evaluated by measurement of oral moisture, amount of saliva secretion, the number of oral bacteria, presence of oral candida, a taste test, and the number of missing teeth. The levels of oral moisture and secreted saliva were significantly lower in the HIV-infected group than in the healthy volunteer (control) group. The HIV-infected group showed a more robust decrease in taste sensation than the control group. The number of missing teeth was significantly higher in the HIV-infected group than in the control group. Furthermore, all of the evaluated oral conditions were worse in the HIV-infected patients whose CD4+ T lymphocyte counts were less than 500/mm3 than in the control group. It became clear that the patients taking anti-HIV drugs, especially the CD4+ count < 500/mm3 group, had a deteriorated oral environment and dysgeusia, suggesting that the management of oral hygiene is necessary to maintain oral health, which leads to systemic health.
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Affiliation(s)
- T Shintani
- Center of Oral Clinical Examination, Hiroshima University Hospital, Hiroshima, Japan
| | - T Fujii
- Division of Blood Transfusion, Hiroshima University Hospital, Hiroshima, Japan.,AIDS Care Unit, Hiroshima University Hospital, Hiroshima, Japan
| | - N Yamasaki
- Division of Blood Transfusion, Hiroshima University Hospital, Hiroshima, Japan.,AIDS Care Unit, Hiroshima University Hospital, Hiroshima, Japan
| | - M Kitagawa
- Center of Oral Clinical Examination, Hiroshima University Hospital, Hiroshima, Japan
| | - T Iwata
- Department of Periodontal Medicine, Graduate School of Biomedical and Sciences, Hiroshima University, Hiroshima, Japan
| | - S Saito
- Division of Blood Transfusion, Hiroshima University Hospital, Hiroshima, Japan.,AIDS Care Unit, Hiroshima University Hospital, Hiroshima, Japan
| | - M Okada
- Division of Dental Hygiene, Department of Clinical Practice and Support, Hiroshima University Hospital, Hiroshima, Japan
| | - I Ogawa
- Center of Oral Clinical Examination, Hiroshima University Hospital, Hiroshima, Japan
| | - H Unei
- Department of Pharmaceutical Services, Hiroshima University Hospital, Hiroshima, Japan
| | - K Hamamoto
- AIDS Care Unit, Hiroshima University Hospital, Hiroshima, Japan
| | - M Nakaoka
- Division of Dental Hygiene, Department of Clinical Practice and Support, Hiroshima University Hospital, Hiroshima, Japan
| | - H Kurihara
- Center of Oral Clinical Examination, Hiroshima University Hospital, Hiroshima, Japan.,Department of Periodontal Medicine, Graduate School of Biomedical and Sciences, Hiroshima University, Hiroshima, Japan
| | - H Shiba
- Department of Biological Endodontics, Graduate School of Biomedical and Sciences, Hiroshima, Japan
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Onda S, Shiba H, Sakamoto T, Furukawa K, Gocho T, Yanaga K. Pulmonary Embolism in a Donor of Living Donor Liver Transplantation. Case Rep Gastroenterol 2019; 13:258-264. [PMID: 31275089 PMCID: PMC6600034 DOI: 10.1159/000501068] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Accepted: 05/18/2019] [Indexed: 11/19/2022] Open
Abstract
Pulmonary embolism (PE) is a rare but potentially fatal complication that may develop in a living liver donor. Here, we report a case of non-massive PE diagnosed by elevated serum D-dimer levels and successfully treated using anticoagulant therapy. A 57-year-old man underwent extended left hepatectomy as a living liver donor. His past medical history included hypertension and dyslipidemia which required medication and a history of smoking. Mechanical prophylactic measures for venous thromboembolism, including intermittent pneumatic compression and elastic stocking, were used; however, no pharmacological prophylaxis was used. Although the patient ambulated on postoperative day (POD) 1, he developed hypoxia. Serum D-dimer level was elevated to 29.3 ng/mL on POD 2. Enhanced computed tomography revealed small peripheral PEs in the branches of the right upper, right middle, and left lower lobes without deep vein thrombosis. Intravenous heparin was initiated followed by warfarin. The thrombi resolved completely by POD 13, following which warfarin was continued for 3 months. As of 25 months after donation, the patient remains well without recurrence of PE. Early diagnosis and treatment of postoperative PE are critical for preventing mortality of liver donors.
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Affiliation(s)
- Shinji Onda
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Hiroaki Shiba
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Taro Sakamoto
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Kenei Furukawa
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Takeshi Gocho
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Katsuhiko Yanaga
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
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38
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Tsunematsu M, Haruki K, Sakamoto T, Uwagawa T, Shiba H, Yanaga K. Radical resection of an initially unresectable intrahepatic cholangiocarcinoma after chemotherapy with using gemcitabine, cisplatin, and S-1: report of a case. Surg Case Rep 2019; 5:103. [PMID: 31236705 PMCID: PMC6591504 DOI: 10.1186/s40792-019-0656-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 12/14/2018] [Accepted: 06/05/2019] [Indexed: 01/04/2023] Open
Abstract
Background Metastatic biliary tract cancer (BTC) has poor prognosis. Recently, patients with metastatic BTC who respond well to systemic chemotherapy can be treated by radical resection or “conversion surgery.” Case presentation A 67-year-old male patient was diagnosed with intrahepatic cholangiocarcinoma with para-aortic metastases [cT2N1M1, stage IVB]. He was enrolled in our phase II study for unresectable BTC consisting of cisplatin (25 mg/m2 i.v. for 30 min) followed by gemcitabine (1000 mg/m2 i.v. for 30 min) on days 1 and 8 and oral S-1 on alternate days. After 8 courses of this regimen, marked regression of para-aortic lymph metastases was achieved, and we performed extended left hepatic lobectomy with the caudate lobe, concomitant portal vein resection, and lymph node dissection including the para-aortic region. The patient made a satisfactory recovery and was discharged on postoperative day 25. Histopathological examination revealed more than 50% of the tumor area replaced with fibrosis, and curative resection was achieved (ypT2N1M1, stage IVB, Evans criteria IIb). The patient received adjuvant chemotherapy using S-1 for 12 months and remains well with no evidence of tumor recurrence as of 48 months after surgery. Conclusions We herein report a successfully treated case of advanced BTC with para-aortic lymph node metastases by conversion surgery after combination chemotherapy using gemcitabine, cisplatin, and S-1.
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Affiliation(s)
- Masashi Tsunematsu
- Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan.
| | - Koichiro Haruki
- Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Taro Sakamoto
- Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Tadashi Uwagawa
- Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Hiroaki Shiba
- Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Katsuhiko Yanaga
- Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan
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Yoshida K, Suzuki S, Kawada-Matsuo M, Nakanishi J, Hirata-Tsuchiya S, Komatsuzawa H, Yamada S, Shiba H. Heparin-LL37 complexes are less cytotoxic for human dental pulp cells and have undiminished antimicrobial and LPS-neutralizing abilities. Int Endod J 2019; 52:1327-1343. [PMID: 31002379 DOI: 10.1111/iej.13130] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [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: 09/14/2018] [Accepted: 04/12/2019] [Indexed: 12/13/2022]
Abstract
AIM To investigate whether glycosaminoglycans (GAGs) binding to high-dose LL37 eliminates its cytotoxicity to dental pulp cells (hDPCs) whilst retaining undiminished antimicrobial and LPS-neutralizing abilities. METHODOLOGY hDPCs were stimulated with varying concentrations of LL37, and their cell viability was analysed by MTT. Then, high-dose LL37 (10 μmol L-1 ) was bound to varying concentrations of three GAGs, heparin, chondroitin sulphate and hyaluronic acid, and their cytotoxic effects on hDPCs and antimicrobial effects were evaluated and compared. Furthermore, the LPS-neutralizing ability of heparin (5 μg mL-1 )-LL37 (10 μmol L-1 ) complexes, which were found to be less cytotoxic for hDPCs with undiminished antimicrobial ability, was investigated. Statistical analysis was performed using one-way analysis of variance (anova), followed by Dunnett's test. P values below 0.05 were considered significant. RESULTS LL37 significantly reduced the cell viability of hDPCs in a dose-dependent manner (P < 0.01). LL37 (10 μmol L-1 ) binding to heparin within a limited concentration range (2~6 μg mL-1 ) eliminated the cytotoxicity for hDPCs (P < 0.01) whilst exerting potent antimicrobial effects against Streptococcus mutans, Streptococcus sobrinus, Streptococcus salivarius, Aggegatibacter actinomycetemcomitans and Escherichia coli. LL37 (10 μmol L-1 ) binding to chondroitin sulphate exhibited similar functions (P < 0.01); however, the effective chondroitin sulphate concentration was highly restricted (3 μg mL-1 ). LL37 (10 μmol L-1 ) binding to hyaluronic acid was unable to abrogate the cytotoxicity of LL37 even at higher concentrations (10 and 100 μg mL-1 ). Moreover, exogenous addition of LPS dose-dependently reduced the amount of LL37 precipitated with the heparin-LL37 agarose beads (P < 0.01), and the released LL37 simultaneously neutralized the pro-inflammatory ability of LPS in macrophages (P < 0.01). CONCLUSIONS Heparin-LL37 complexes generated at suitable concentration ratios are easy to make, are less cytotoxic and are broad-range antimicrobial materials that can neutralize LPS by providing LL37 in accordance with the amount of free LPS. They may be a potential treatment to save dental pulp tissue from the acute inflammation exacerbated by invading bacteria and the LPS they release.
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Affiliation(s)
- K Yoshida
- Department of Biological Endodontics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - S Suzuki
- Department of Biological Endodontics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.,Department of Periodontology and Endodontology, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - M Kawada-Matsuo
- Department of Oral Microbiology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - J Nakanishi
- Department of Biological Endodontics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - S Hirata-Tsuchiya
- Department of Biological Endodontics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - H Komatsuzawa
- Department of Oral Microbiology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - S Yamada
- Department of Periodontology and Endodontology, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - H Shiba
- Department of Biological Endodontics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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40
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Morikawa K, Igarashi T, Misumi S, Fukuda T, Ojiri H, Matsudaira H, Shiba H, Sato S. A case of pseudocystic liver metastases from an atypical lung carcinoid tumor. Radiol Case Rep 2019; 14:595-601. [PMID: 30891110 PMCID: PMC6406078 DOI: 10.1016/j.radcr.2019.02.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 01/19/2019] [Revised: 02/20/2019] [Accepted: 02/23/2019] [Indexed: 11/18/2022] Open
Abstract
Metastatic neuroendocrine tumors of the liver typically appear as solid, hypervascular masses on imaging. Pseudocysts mimicking simple cysts are extremely rare. A 42-year-old Japanese woman was referred with a single pulmonary mass in the left lower lobe. No metastatic lesion was detected and no occupying lesion in the liver was observed. The lung tumor was diagnosed as an atypical carcinoid. Postoperative investigation revealed new hepatic simple cysts in the liver, which increased in size over time and changed into hemorrhagic cysts. Fluorodeoxyglucose positron emission tomography and somatostatin receptor scintigraphy using 111In-octreotide demonstrated no accumulation in the liver. Our patient did not have symptoms consistent with carcinoid syndrome. The patient underwent partial resection of the cystic lesions of the liver. Gross examination of the tumors demonstrated thin-wall cavitated lesions with hemorrhage which were metastases from the atypical carcinoid of the lung. When a growing cystic lesion with intracystic hemorrhage is found in the liver of a patient with a history of carcinoid tumors, pseudocysts caused by degeneration of a carcinoid metastasis should be considered as a differential diagnosis.
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Affiliation(s)
- Kazuhiko Morikawa
- Department of Radiology, The Jikei University School of Medicine, Tokyo, Japan
| | - Takao Igarashi
- Department of Radiology, The Jikei University School of Medicine, Tokyo, Japan
| | - Shigeki Misumi
- Department of Radiology, The Jikei University School of Medicine, Tokyo, Japan
| | - Taiki Fukuda
- Department of Radiology, The Jikei University School of Medicine, Tokyo, Japan
| | - Hiroya Ojiri
- Department of Radiology, The Jikei University School of Medicine, Tokyo, Japan
| | - Hideki Matsudaira
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Hiroaki Shiba
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Shun Sato
- Department of Pathology, The Jikei University School of Medicine, Tokyo, Japan
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41
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Fujiwara Y, Haruki K, Shiba H, Hamura R, Shirai Y, Furukawa K, Gocho T, Yanaga K. The Comparison of Inflammation-Based Prognostic Scores in Patients With Extrahepatic Bile Duct Cancer After Pancreaticoduodenectomy. J Surg Res 2019; 238:102-112. [PMID: 30769246 DOI: 10.1016/j.jss.2019.01.033] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [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: 09/11/2018] [Revised: 11/23/2018] [Accepted: 01/10/2019] [Indexed: 12/23/2022]
Abstract
BACKGROUND Inflammation-based prognostic scores are associated with tumor recurrence and survival in various cancers. The aim of this study was to identify the significance of inflammation-based prognostic scores and to detect the most useful score in patients with distal extrahepatic bile duct cancer after pancreaticoduodenectomy. METHODS Between 2000 and 2015, 121 patients were enrolled in this retrospective study. The relationship between clinicopathological variables including various prognostic scores and disease-free (DFS) as well as overall (OS) survival was investigated by univariate analysis. The area under the receiver operating characteristics curve was calculated to compare the predictive ability of each scoring system. Multivariate analysis was performed to identify the clinicopathological variables associated. RESULTS In univariate analysis, Glasgow prognostic score (GPS), mGPS, C-reactive protein/Alb ratio score, prognostic index, and preoperative monocyte count were significant risk factors for both DFS and OS. The area under the receiver operating characteristics curve of GPS is consistently larger in comparison with other four scores in both DFS as well as OS. In multivariate analysis, GPS was an independent risk factor of both tumor recurrence and poor prognosis. CONCLUSIONS GPS score is an independent tumor recurrence and prognostic factor in patients with distal extrahepatic bile duct cancer and is superior to the other prognostic scores.
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Affiliation(s)
- Yuki Fujiwara
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan.
| | - Koichiro Haruki
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Hiroaki Shiba
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Ryoga Hamura
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Yoshihiro Shirai
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Kenei Furukawa
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Takeshi Gocho
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Katsuhiko Yanaga
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
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42
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Taniai T, Shirai Y, Shiba H, Sakamoto T, Furukawa K, Yanaga K. Spontaneous Pathological Complete Regression of Hepatocellular Carcinoma. Case Rep Gastroenterol 2018; 12:653-659. [PMID: 30519151 PMCID: PMC6276737 DOI: 10.1159/000494551] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Accepted: 10/15/2018] [Indexed: 01/27/2023] Open
Abstract
Several possible mechanisms for spontaneous regression of hepatocellular carcinoma (HCC) have been reported. Spontaneous complete regression of HCC is extremely rare. We herein report a case of spontaneous pathological complete regression of HCC following decrement of elevated serum alpha-fetoprotein (AFP). The serum AFP of a 74-year-old man who underwent hepatic resection for HCC twice increased up to 7,529 ng/mL and then spontaneously decreased to 404 ng/mL in 2 months. Computed tomography, magnetic resonance imaging, and angiography revealed a liver tumor in segment 7 without early enhancement. With a diagnosis of recurrent HCC, partial hepatic resection was performed. The resected specimens revealed no HCC macroscopically, and pathological examination revealed only a small area with cell dysplasia. The patient remains well with normal serum AFP and protein induced by vitamin K absence or antagonist-II (PIVKA-II) levels for 29 months after the third hepatic resection without recurrence of HCC. We describe a case of spontaneous pathological complete regression of HCC following decrement of elevated serum AFP. Further studies are needed to identify the mechanism(s) of spontaneous regression of HCC.
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Affiliation(s)
- Tomohiko Taniai
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Yoshihiro Shirai
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Hiroaki Shiba
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Taro Sakamoto
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Kenei Furukawa
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Katsuhiko Yanaga
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
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43
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Fujiwara Y, Haruki K, Shiba H, Hamura R, Horiuchi T, Shirai Y, Furukawa K, Gocho T, Yanaga K. C-Reactive Protein-based Prognostic Measures Are Superior at Predicting Survival Compared with Peripheral Blood Cell Count-based Ones in Patients After Curative Resection for Pancreatic Cancer. Anticancer Res 2018; 38:6491-6499. [PMID: 30396977 DOI: 10.21873/anticanres.13013] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [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: 10/02/2018] [Revised: 10/12/2018] [Accepted: 10/16/2018] [Indexed: 11/10/2022]
Abstract
AIM Prognostic factors of recurrence and survival in various cancer types have been reported and include C-reactive protein (CRP)-based measures as evidenced by the Glasgow prognostic score (GPS), as well as peripheral blood cell-based prognostic values such as the prognostic index (PI), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR). The aim of this study was to identify significant prognostic values and compare them for suitability for use in patients after curative pancreatic resection for pancreatic cancer. MATERIALS AND METHODS Between 2000 and 2015, 188 patients were enrolled in this retrospective study. The relationship between clinicopathological variables including various prognostic values and disease-free (DFS) and overall (OS) survival was investigated by univariate analysis. The area under the receiver operating characteristics curve (AUC) was evaluated to compare the predictive ability of each of these scoring systems. Multivariate analysis was then performed to identify clinicopathological variables that associated DFS and OS. RESULTS In univariate analysis, GPS, modified GPS, CRP to albumin ratio and PI were significant risk factors for both DFS and OS. The AUC of CRP-based scores (GPS, modified GPS, and CRP to albumin ratio) were consistently larger in comparison with PI, which consists of both CRP and peripheral blood cell scores, at all time points for both DFS and OS. In multivariate analysis, GPS was the only independent risk factor of tumor recurrence and survival. CONCLUSION CRP-based prognostic scores have an independent value for both tumor recurrence and prognosis in patients after curative resection for pancreatic cancer, and are superior to other peripheral blood cell count-based prognostic scores.
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Affiliation(s)
- Yuki Fujiwara
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Koichiro Haruki
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Hiroaki Shiba
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Ryoga Hamura
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Takashi Horiuchi
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Yoshihiro Shirai
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Kenei Furukawa
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Takeshi Gocho
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Katsuhiko Yanaga
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
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Yasuda J, Onda S, Shiozaki H, Gocho T, Shiba H, Yanaga K. A Successfully Treated Case of Intrahepatic Cholangiocarcinoma with Exacerbation of Dermatomyositis. Case Rep Gastroenterol 2018; 12:622-628. [PMID: 30483040 PMCID: PMC6244101 DOI: 10.1159/000493185] [Citation(s) in RCA: 2] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Accepted: 08/23/2018] [Indexed: 12/11/2022] Open
Abstract
Dermatomyositis (DM) is often found in conjunction with malignant tumors such as lung, cervical, and breast cancer. However, the association with intrahepatic cholangiocarcinoma (ICC) is extremely rare. Moreover, to our knowledge, there have been no previous reports of DM discovered because of exacerbation of DM. Our case was a 44-year-old female with dry cough, myalgia, and arthralgia. We performed hepatic resection for intrahepatic ICC. She was diagnosed with DM, and combination treatment with prednisolone and tacrolimus was started. During outpatient visits, her symptoms worsened, and she was hospitalized due to deterioration of her primary disease. On detailed examination, a malignant lesion in the liver was discovered. After operation, the symptoms of DM remain stable by taking prednisolone and tacrolimus. The patient was suspected to have paraneoplastic syndrome, which was discovered due to the exacerbation of the DM that was caused by the intrahepatic ICC.
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Affiliation(s)
- Jungo Yasuda
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Shinji Onda
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Hironori Shiozaki
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Takeshi Gocho
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Hiroaki Shiba
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Katsuhiko Yanaga
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
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Taniai T, Haruki K, Shiba H, Onda S, Sakamoto T, Yanaga K. Simultaneous Resection for Synchronous Double Primary Cancers of the Pancreas and the Liver. Case Rep Gastroenterol 2018; 12:504-512. [PMID: 30283284 PMCID: PMC6167653 DOI: 10.1159/000490658] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Accepted: 06/05/2018] [Indexed: 12/27/2022] Open
Abstract
Simultaneous resection of synchronous hepatocellular carcinoma (HCC) and pancreatic ductal adenocarcinoma (PDAC) is extremely rare. Case 1 is a 64-year-old woman, who had undergone anterior resection for rectal cancer 3 years earlier was pointed out to have a cystic tumor in the pancreatic tail and a solitary tumor in the liver. CT revealed a hypovascular tumor in the pancreatic tail and a liver tumor with early enhancement. With a diagnosis of simultaneous HCC and PDAC, she underwent laparotomy, in which intraoperative frozen section examination of the liver was compatible with HCC. Therefore, she underwent hepatic resection as well as distal pancreatectomy and splenectomy. The patient received adjuvant chemotherapy with S-1 and remains well with no evidence of tumor recurrence as of 28 months after resection. Case 2 is a 73-year-old man with sustained viral response to antiviral treatment for hepatitis C virus, who was pointed out to have a tumor in the pancreatic head and a solitary tumor in the liver. Gadoxetic acid-enhanced MRI exhibited enhancement compatible with HCC. With a diagnosis of concomitant HCC and PDAC, surgery was performed. Intraoperative frozen section examination was compatible with HCC, for which a pancreaticoduodenectomy was performed. The patient received adjuvant chemotherapy with S-1 and remains well with no evidence of tumor recurrence as of 16 months after resection. In conclusion, we describe 2 cases of hepato-pancreatectomy for synchronous double primary cancers of the pancreas and the liver, where exclusion of the liver tumor as a metastatic lesion from the pancreatic cancer is important.
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Affiliation(s)
- Tomohiko Taniai
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Koichiro Haruki
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Hiroaki Shiba
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Shinji Onda
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Taro Sakamoto
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Katsuhiko Yanaga
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
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Matsumoto M, Wakiyama S, Shiba H, Haruki K, Futagawa Y, Ishida Y, Misawa T, Yanaga K. Usefulness of aspartate aminotransferase to platelet ratio index as a prognostic factor following hepatic resection for hepatocellular carcinoma. Mol Clin Oncol 2018; 9:369-376. [PMID: 30214725 PMCID: PMC6125707 DOI: 10.3892/mco.2018.1692] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [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: 03/31/2018] [Accepted: 06/12/2018] [Indexed: 01/05/2023] Open
Abstract
Liver function is a major prognostic factor following hepatic resection for hepatocellular carcinoma (HCC), which is well correlated with the degree of fibrosis. On the other hand, the presence of liver cirrhosis itself leads to a higher incidence of HCC than chronic hepatitis. Therefore, preoperative noninvasive markers of fibrosis are important for the assessment of prognosis for treatment of HCC. The present study aimed to analyze whether aspartate aminotransferase to platelet ratio index (APRI) could predict prognosis following hepatic resection for HCC. The subjects were 162 patients who underwent hepatic resection for HCC between January 2000 and December 2011. The relationship between APRI and disease-free and overall survival were retrospectively investigated. In multivariate analysis, indocyanine green at 15 min (ICG-R15) ≥15% (P=0.0306), APRI ≥0.45 (P=0.0184), perioperative blood transfusion of red cell concentrates (RCC; P=0.0034) and TNM stage II, III or IV (P=0.0184) were significant predictors in disease-free survival. For overall survival, ICG-R15 ≥15% (P=0.0454), APRI ≥0.45 (P=0.0417), perioperative blood transfusion of RCC (P=0.0036) and TNM stage II, III or IV (P=0.0033) were significant predictors. In addition, higher APRI values were positively correlated with hepatitis C virus infection and preoperative liver function. In conclusion, APRI is an independent risk factor for disease-free and overall survival following hepatic resection for HCC.
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Affiliation(s)
- Michinori Matsumoto
- Department of Surgery, The Jikei University School of Medicine, Tokyo 105-8461, Japan
| | - Shigeki Wakiyama
- Department of Surgery, The Jikei University School of Medicine, Tokyo 105-8461, Japan
| | - Hiroaki Shiba
- Department of Surgery, The Jikei University School of Medicine, Tokyo 105-8461, Japan
| | - Koichiro Haruki
- Department of Surgery, The Jikei University School of Medicine, Tokyo 105-8461, Japan
| | - Yasuro Futagawa
- Department of Surgery, The Jikei University School of Medicine, Tokyo 105-8461, Japan
| | - Yuichi Ishida
- Department of Surgery, The Jikei University School of Medicine, Tokyo 105-8461, Japan
| | - Takeyuki Misawa
- Department of Surgery, The Jikei University School of Medicine, Tokyo 105-8461, Japan
| | - Katsuhiko Yanaga
- Department of Surgery, The Jikei University School of Medicine, Tokyo 105-8461, Japan
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Ogawa M, Haruki K, Horiuchi A, Shiba H, Mitsuyama Y, Kusumoto M, Eto S, Ishiyama M, Hasegawa T, Yoshida K, Yanaga K. The evaluation of liver resection for colorectal cancer liver metastases. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy151.251] [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: 11/12/2022] Open
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Nakaseko Y, Haruki K, Shiba H, Horiuchi T, Saito N, Sakamoto T, Gocho T, Yanaga K. Impact of fresh frozen plasma transfusion on postoperative inflammation and prognosis of colorectal liver metastases. J Surg Res 2018; 226:157-165. [DOI: 10.1016/j.jss.2017.09.030] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2017] [Revised: 08/04/2017] [Accepted: 09/28/2017] [Indexed: 11/24/2022]
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Haruki K, Shiba H, Saito N, Horiuchi T, Shirai Y, Fujiwara Y, Furukawa K, Sakamoto T, Yanaga K. Risk stratification using a novel liver functional reserve score of combination prothrombin time-international normalized ratio to albumin ratio and albumin in patients with hepatocellular carcinoma. Surgery 2018; 164:404-410. [PMID: 29754978 DOI: 10.1016/j.surg.2018.02.022] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Revised: 01/15/2018] [Accepted: 02/22/2018] [Indexed: 01/27/2023]
Abstract
BACKGROUND Liver function in patients with hepatocellular carcinoma is generally graded according to the Child-Pugh system; however, some variables in the Child-Pugh grade are subjective. We developed a novel, objective score called the prothrombin time-international normalized ratio to albumin ratio. The aim of this study was to evaluate the prognostic value of this new score in patients with hepatocellular carcinoma after hepatic resection. METHODS The study comprised 199 patients who underwent elective hepatic resection for hepatocellular carcinoma between January 2003 and December 2014. We investigated retrospectively the relation between prothrombin time-international normalized ratio to albumin ratio, disease-free survival, and overall survival and compared the value of liver functional reserve between prothrombin time-international normalized ratio to albumin ratio and Child-Pugh grade. RESULTS The optimal cut-off level of the prothrombin time-international normalized ratio to albumin ratio was 0.288. In multivariate analysis, the independent and significant predictors of cancer recurrence consisted of hepatitis C virus infection (P = .043), preoperative retention rate of indocyanine green at 15 minutes ≥15% (P = .039), the presence of multiple tumors (P = .001) or microvascular invasion (P < .001), and prothrombin time-international normalized ratio to albumin ratio ≥0.288 (P = .022). The independent predictors of poor overall survival were microvascular invasion (P = .001) and prothrombin time-international normalized ratio to albumin ratio ≥0.288 (P = .001). In patients with a high prothrombin time-international normalized ratio to albumin ratio, pathologic liver cirrhosis (P < .001), postoperative ascites (P = .039), and postoperative liver failure (P = .040) were greater than for their counterparts. CONCLUSION The prothrombin time-international normalized ratio to albumin ratio may reflect liver function and may be a novel indicator of poor long-term outcome in patients with hepatocellular carcinoma after hepatic resection.
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Affiliation(s)
- Koichiro Haruki
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan.
| | - Hiroaki Shiba
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Nobuhiro Saito
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Takashi Horiuchi
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Yoshihiro Shirai
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Yuki Fujiwara
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Kenei Furukawa
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Taro Sakamoto
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Katsuhiko Yanaga
- Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan
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Onda S, Shiba H, Takano Y, Furukawa K, Hata T, Yanaga K. Renal Infarction during Anticoagulant Therapy after Living Donor Liver Transplantation. Case Rep Gastroenterol 2018; 12:165-169. [PMID: 29805361 PMCID: PMC5968266 DOI: 10.1159/000488526] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Accepted: 03/14/2018] [Indexed: 11/19/2022] Open
Abstract
Introduction Liver transplant recipients are at risk for complications of vascular thrombosis. The reconstructed hepatic artery and portal vein thrombosis potentially result in hepatic failure and graft loss. Renal infarction is a rare clinical condition, but in severe cases, it may lead to renal failure. We herein report a case of renal infarction after living donor liver transplantation (LDLT) during anticoagulant therapy. Case Presentation A 60-year-old woman with end-stage liver disease due to primary biliary cholangitis underwent LDLT with splenectomy. Postoperatively, tacrolimus, mycophenolate mofetil, and steroid were used for initial immunosuppression therapy. On postoperative day (POD) 5, enhanced computed tomography (CT) revealed splenic vein thrombosis, and anticoagulant therapy with heparin followed by warfarin was given. Follow-up enhanced CT on POD 20 incidentally demonstrated right renal infarction. The patient's renal function was unchanged and the arterial flow was good, and the splenic vein thrombosis resolved. At 4 months postoperatively, warfarin was discontinued, but she developed recurrent splenic vein thrombosis 11 months later, and warfarin was resumed. As of 40 months after transplantation, she discontinued warfarin and remains well without recurrence of splenic vein thrombosis or renal infarction. Conclusion Renal infarction is a rare complication of LDLT. In this case, renal infarction was incidentally diagnosed during anticoagulant therapy and was successfully treated.
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Affiliation(s)
- Shinji Onda
- *Shinji Onda, Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishishimbashi, Minato-ku, Tokyo 105-8461 (Japan), E-Mail
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