1
|
Fujii M, Yamashita S, Tashiro J, Tanaka M, Takenaka Y, Yamasaki K, Masaki Y. Clinical characteristics of patients with pneumatosis intestinalis. ANZ J Surg 2021; 91:1826-1831. [PMID: 33825311 DOI: 10.1111/ans.16772] [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: 09/25/2020] [Revised: 03/09/2021] [Accepted: 03/10/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Several theories explaining the development of pneumatosis intestinalis (PI) have been reported, but a substantial portion of cases have been idiopathic. Additionally, predictors of bowel ischaemia in PI have not been fully investigated, while PI with bowel ischaemia has deteriorated overall outcomes of PI. METHODS Sixty-four patients diagnosed with PI (2009-2019) were allocated to two groups: with (group 1; n = 15 (23%)) and without (group 2; n = 49 (77%)) bowel ischaemia. Fourteen patients underwent emergency surgery, and bowel ischaemia was identified in nine (64%). Six patients in group 1 were diagnosed with bowel ischaemia, and were treated palliatively. On medical charts, we determined underlying conditions of PI, compared the characteristics and outcomes between the groups, and identified the predictors of bowel ischaemia. RESULTS Group 1 patients more commonly showed abdominal pain, lower base excess, higher C-reactive protein concentrations, higher white blood cell counts and higher neutrophil-to-lymphocyte ratios, and more frequent comorbid ascites, free air and hepatic portal vein gas. Of nine bowel ischaemia surgery patients, three (33%) died; all because of anastomotic leak. All except three patients in group 2, who presented with aspiration pneumonia, responded to treatment. Only one patient had an unknown cause (1/64, 1.6%), and various underlying conditions in secondary PI were confirmed. CONCLUSION Idiopathic PI may be identified rarely using current imaging and knowledge, but outcomes in PI patients with bowel ischaemia remain unsatisfactory. Earlier identification of bowel ischaemia by various specialists in accordance with predictors of bowel ischaemia could improve overall outcomes in PI patients.
Collapse
Affiliation(s)
- Manato Fujii
- Department of Surgery, Ome Municipal General Hospital, Tokyo, Japan
| | - Suguru Yamashita
- Department of Surgery, Ome Municipal General Hospital, Tokyo, Japan
| | - Jo Tashiro
- Department of Surgery, St. Luke's International Hospital, Tokyo, Japan
| | - Mayuko Tanaka
- Department of Radiology, Ome Municipal General Hospital, Tokyo, Japan
| | | | - Kazuki Yamasaki
- Department of Surgery, Ome Municipal General Hospital, Tokyo, Japan
| | - Yukiyoshi Masaki
- Department of Surgery, Ome Municipal General Hospital, Tokyo, Japan
| |
Collapse
|
2
|
Tashiro J, Fujii M, Masaki Y, Yamaguchi S. Surgical outcomes of hybrid hand-assisted laparoscopic pelvic exenteration for locally advanced rectal cancer: Initial experience. Asian J Endosc Surg 2021; 14:213-222. [PMID: 32856403 DOI: 10.1111/ases.12855] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 07/14/2020] [Accepted: 08/10/2020] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Hybrid hand-assisted laparoscopic surgery (HALS) combines better visualization of laparoscopic surgery with the advantages of open surgery. The aim of this study was to describe important technical considerations of HALS and to assess the feasibility of hybrid HALS pelvic exenteration (PE) for primary advanced rectal cancer. METHODS From May 2012 to August 2018, we retrospectively analyzed 11 patients who underwent PE for primary advanced rectal cancer (< 10 cm from the anal verge). Patients were divided into the open PE group (n = 5) and the hybrid HALS PE group (n = 6). RESULTS There was no significant difference in patient characteristics between the two groups, and all included patients were male. Tumor invasion to adjacent organs was mostly anterior invasion. In addition, four patients (66%) in the hybrid HALS PE group and two (40%) in the open PE group received neoadjuvant therapy (P = .3). CONCLUSION Compared to open surgery, hybrid HALS has the advantages of less bleeding and less invasion, and can achieve the same results in the short-term. It was a reasonable procedure which was easy and safe dissection of internal iliac vessels and dorsal vein complex. Thus, hybrid HALS may become a useful approach for PE.
Collapse
Affiliation(s)
- Jo Tashiro
- Department of Gastrointestinal Surgery, St. Luke's International Hospital, Tokyo, Japan
| | - Manato Fujii
- Department of Surgery, Ome Municipal General Hospital, Tokyo, Japan
| | - Yukiyoshi Masaki
- Department of Surgery, Ome Municipal General Hospital, Tokyo, Japan
| | - Shigeki Yamaguchi
- Department of Gastroenterological Surgery, Saitama Medical University International Medical Center, Saitama, Japan
| |
Collapse
|
3
|
Fujii M, Yamashita S, Tanaka M, Tashiro J, Takenaka Y, Yamasaki K, Masaki Y. Clinical features of patients with hepatic portal venous gas. BMC Surg 2020; 20:300. [PMID: 33246462 PMCID: PMC7694268 DOI: 10.1186/s12893-020-00973-8] [Citation(s) in RCA: 2] [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: 07/18/2020] [Accepted: 11/18/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Hepatic portal venous gas (HPVG) is a rare clinical condition that is caused by a variety of underlying diseases. However, the factors that would permit accurate identification of bowel ischemia, requiring surgery, in patients with HPVG have not been fully investigated. METHODS Thirty patients that had been diagnosed with HPVG using computed tomography between 2010 and 2019 were allocated to two groups on the basis of clinical and intraoperative findings: those with (Group 1; n = 12 [40%]) and without (Group 2; n = 18 [60%]) bowel ischemia. Eleven patients underwent emergency surgery, and bowel ischemia was identified in eight of these (73%). Four patients in Group 1 were diagnosed with bowel ischemia, but treated palliatively because of their general condition. We compared the characteristics and outcomes of Groups 1 and 2 and identified possible prognostic factors for bowel ischemia. RESULTS At admission, patients in Group 1 more commonly showed the peritoneal irritation sign, had lower base excess, higher lactate, and higher C-reactive protein, and more frequently had comorbid intestinal pneumatosis. Of the eight bowel ischemia surgery patients, four (50%) died, mainly because of anastomotic leak following bowel resection and primary anastomosis (3/4, 75%). All except one patient in Group 2, who presented with aspiration pneumonia, responded better to treatment. CONCLUSIONS Earlier identification and grading of bowel ischemia according to the findings at admission should benefit patients with HPVG by reducing the incidence of unnecessary surgery and increasing the use of safer procedures, such as prophylactic stoma placement.
Collapse
Affiliation(s)
- Manato Fujii
- Department of Surgery, Ome Municipal General Hospital, 4-16-5, Higashi Ome, Ome-shi, Tokyo, 198-0042, Japan.
| | - Suguru Yamashita
- Department of Surgery, Ome Municipal General Hospital, 4-16-5, Higashi Ome, Ome-shi, Tokyo, 198-0042, Japan
| | - Mayuko Tanaka
- Department of Radiology, Ome Municipal General Hospital, 4-16-5, Higashi Ome, Ome-shi, Tokyo, 198-0042, Japan
| | - Jo Tashiro
- Department of Surgery, St. Luke's International Hospital, 9-1 Akashicho, Chuo-ku, Tokyo, 104-8560, Japan
| | - Yoshiharu Takenaka
- Department of Surgery, Ome Municipal General Hospital, 4-16-5, Higashi Ome, Ome-shi, Tokyo, 198-0042, Japan
| | - Kazuki Yamasaki
- Department of Surgery, Ome Municipal General Hospital, 4-16-5, Higashi Ome, Ome-shi, Tokyo, 198-0042, Japan
| | - Yukiyoshi Masaki
- Department of Surgery, Ome Municipal General Hospital, 4-16-5, Higashi Ome, Ome-shi, Tokyo, 198-0042, Japan
| |
Collapse
|
4
|
Tashiro J, Fujii M, Watanabe Y, Ichinose Y, Kudo M, Takenaka Y, Yamasaki K, Masaki Y. Perioperative management of laparoscopic surgery in a patient with protein S deficiency complications: A case report. Asian J Endosc Surg 2019; 12:311-314. [PMID: 30259674 DOI: 10.1111/ases.12649] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Revised: 08/08/2018] [Accepted: 08/17/2018] [Indexed: 01/25/2023]
Abstract
Patients with protein S deficiency are prone to developing thrombosis. During laparoscopic surgery in patients with protein S deficiency, there is a risk of deep venous thromboembolism. In the present case, the patient was a 66-year-old man. He was diagnosed with colon cancer, and surgery was planned. Because of the presence of protein S deficiency, he required careful perioperative management for laparoscopic surgery. Surgery was successfully performed. On postoperative assessment, no thrombi were observed. Our approach of perioperative management might help in the treatment of patients with protein S deficiency.
Collapse
Affiliation(s)
- Jo Tashiro
- Division of Surgery, Ome Municipal General Hospital, Tokyo, Japan
| | - Manato Fujii
- Division of Surgery, Ome Municipal General Hospital, Tokyo, Japan
| | - Yasuo Watanabe
- Division of Surgery, Ome Municipal General Hospital, Tokyo, Japan
| | - Yuki Ichinose
- Division of Surgery, Ome Municipal General Hospital, Tokyo, Japan
| | - Masayoshi Kudo
- Division of Surgery, Ome Municipal General Hospital, Tokyo, Japan
| | | | - Kazuki Yamasaki
- Division of Surgery, Ome Municipal General Hospital, Tokyo, Japan
| | - Yukiyoshi Masaki
- Division of Surgery, Ome Municipal General Hospital, Tokyo, Japan
| |
Collapse
|
5
|
Kochi M, Hinoi T, Niitsu H, Ohdan H, Konishi F, Kinugasa Y, Kobatake T, Ito M, Inomata M, Yatsuoka T, Ueki T, Tashiro J, Yamaguchi S, Watanabe M. Risk factors for postoperative pneumonia in elderly patients with colorectal cancer: a sub-analysis of a large, multicenter, case-control study in Japan. Surg Today 2018; 48:756-764. [PMID: 29594413 DOI: 10.1007/s00595-018-1653-8] [Citation(s) in RCA: 9] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Accepted: 02/26/2018] [Indexed: 12/22/2022]
Abstract
PURPOSE Postoperative pneumonia affects the length of stay and mortality after surgery in elderly patients with colorectal cancer (CRC). We aimed to determine the risk factors of postoperative pneumonia in elderly patients with CRC, and to evaluate the impact of laparoscopic surgery on elderly patients with CRC. METHODS We retrospectively investigated 1473 patients ≥ 80 years of age who underwent surgery for stage 0-III CRC between 2003 and 2007. Using a multivariate analysis, we determined the risk factors for pneumonia occurrence from each baseline characteristic. RESULTS Among all included patients, 26 (1.8%) experienced postoperative pneumonia, and restrictive respiratory impairment, obstructive respiratory impairment, history of cerebrovascular events, and open surgery were determined as risk factors (odds ratio [95% confidence interval], 2.78 [1.22-6.20], 2.71 [1.22-6.30], 3.60 [1.37-8.55], and 3.57 [1.22-15.2], respectively). Furthermore, postoperative pneumonia was more frequently accompanied by increasing cumulative numbers of these risk factors (area under the receiver operating characteristic curve = 0.763). CONCLUSIONS Laparoscopic surgery may be safely performed in elderly CRC patients, even those with respiratory impairment and a history of cerebrovascular events.
Collapse
Affiliation(s)
- Masatoshi Kochi
- Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minamiku, Hiroshima, 734-8551, Japan
| | - Takao Hinoi
- Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minamiku, Hiroshima, 734-8551, Japan. .,Department of Surgery, Institute for Clinical Research, National Hospital Organization Kure Medical Center and Chu-goku Cancer Center, 3-1, Aoyama-cho, Kure-shi, Hiroshima, 737-0023, Japan.
| | - Hiroaki Niitsu
- Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minamiku, Hiroshima, 734-8551, Japan
| | - Hideki Ohdan
- Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minamiku, Hiroshima, 734-8551, Japan
| | - Fumio Konishi
- Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-cho, Ohmiya-ku, Saitama, 330-8503, Japan.,Department of Surgery, Nerima Hikarigaoka Hospital, 2-11-1 Hikarigaoka, Nerima, Tokyo, 179-0072, Japan
| | - Yusuke Kinugasa
- Division of Colon and Rectal Surgery, Shizuoka Cancer Center Hospital, 1007 Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka, 411-8777, Japan.,Department of Gastroenterological Surgery, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - Takaya Kobatake
- Department of Surgery, Division of Gastroenterological Surgery, National Hospital Organization Shikoku Cancer Center, 160 Koh, Umemotomachi, Matsuyama, Ehime, 791-0280, Japan
| | - Masaaki Ito
- Division of Surgical Oncology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan
| | - Masafumi Inomata
- Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, 1-1 Idaigaoka, Hazama-cho, Yufu, Oita, 879-5593, Japan
| | - Toshimasa Yatsuoka
- Department of Gastroenterological Surgery, Saitama Cancer Center, 780 Komuro, Inamachi, Kita-Adachi-gun, Saitama, 362-0806, Japan.,Department of Gastroenterological and General Surgery, Showa University Fujigaoka Hospital, 1-30 Fujigaoka, Aoba-ku, Yokohama, Kanagawa, 227-8501, Japan
| | - Takashi Ueki
- Department of Surgery and Oncology, Kyushu University Graduate School of Medical Sciences, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.,Department of Gastroenterological Surgery, Hamanomachi Hospital, 3-3-1 Nagahama, Chuo-ku, Fukuoka, 810-8539, Japan
| | - Jo Tashiro
- Department of Gastroenterological Surgery, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, Saitama, 350-1298, Japan
| | - Shigeki Yamaguchi
- Department of Gastroenterological Surgery, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, Saitama, 350-1298, Japan
| | - Masahiko Watanabe
- Department of Surgery, Kitasato University, 1-15-1 Kitasato, Minami, Sagamihara, Kanagawa, 252-0374, Japan
| | | |
Collapse
|
6
|
Hara K, Yamaguchi S, Ishii T, Tashiro J, Kondo H, Shimizu H, Takemoto K, Suzuki A, Ishikawa S, Okada T, Aikawa M, Sato H, Okamoto K, Sakuramoto S, Koyama I. [Surgical Therapy for Locally Recurrent Rectal Cancer]. Gan To Kagaku Ryoho 2017; 44:1769-1771. [PMID: 29394770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
We examined 40 cases of locally recurrent rectal cancer surgically treated at our hospital. The sites of recurrence were the anastomosis site(16 cases), pelvic lymph nodes(10 cases), pelvis(10 cases), and perineum(5 cases). Intraoperative complications were confirmed in 5% and postoperative complications in 45% of cases. The R0 resection rate was 60.0%, and positive radial margins were confirmed in 35.0% of cases. Second recurrences were confirmed in 60.0% of cases. The 3-year overall survival rate was 68.7%, and the 3-year relapse-free survival rate was 20.3%. Surgery for locally recurrent rectal cancer was performed relatively safely; however, the R1 resection rate and recurrence rate after surgery were high. R0 resection significantly improved the overall survival rate, and it seems that a treatment strategy to raise R0 resection rate is necessary.
Collapse
Affiliation(s)
- Kiyoka Hara
- Dept. of Gastrointestinal Surgery, Saitama Medical University International Medical Center
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
7
|
Tashiro J, Yamaguchi S, Ishii T, Kondo H, Hara K, Shimizu H, Takemoto K, Suzuki A. Oncologic Outcomes of Oral Adjuvant Chemotherapy Regimens in Stage III Colon Cancer: Tegafur–Uracil Plus Leucovorin Versus Capecitabine. Clin Colorectal Cancer 2017; 16:e141-e145. [DOI: 10.1016/j.clcc.2017.01.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Revised: 11/27/2016] [Accepted: 01/13/2017] [Indexed: 10/20/2022]
|
8
|
Okamura R, Hida K, Yamaguchi T, Akagi T, Konishi T, Yamamoto M, Ota M, Matoba S, Bando H, Goto S, Sakai Y, Watanabe M, Watanabe K, Otsuka K, Takemasa I, Tanaka K, Ikeda M, Matsuda C, Fukuda M, Hasegawa J, Akamoto S, Shiozawa M, Tsuruta A, Akiyoshi T, Kato T, Tsukamoto S, Ito M, Naito M, Kanazawa A, Takahashi T, Ueki T, Hayashi Y, Morita S, Yamaguchi T, Nakanishi M, Hasegawa H, Okamoto K, Teraishi F, Sumi Y, Tashiro J, Yatsuoka T, Nishimura Y, Okita K, Kobatake T, Horie H, Miyakura Y, Ro H, Nagakari K, Hidaka E, Umemoto T, Nishigori H, Murata K, Wakayama F, Makizumi R, Fujii S, Sunami E, Kobayashi H, Nakagawa R, Enomoto T, Ohnuma S, Higashijima J, Ozawa H, Ashida K, Fujita F, Uehara K, Maruyama S, Ohyama M, Yamamoto S, Hinoi T, Yoshimitsu M, Okajima M, Tanimura S, Kawasaki M, Ide Y, Hazama S, Watanabe J, Inagaki D, Toyokawa A. Local control of sphincter-preserving procedures and abdominoperineal resection for locally advanced low rectal cancer: Propensity score matched analysis. Ann Gastroenterol Surg 2017; 1:199-207. [PMID: 29863157 PMCID: PMC5881346 DOI: 10.1002/ags3.12032] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [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: 05/15/2017] [Accepted: 07/10/2017] [Indexed: 12/13/2022] Open
Abstract
Sphincter‐preserving procedures (SPPs) for surgical treatment of low‐lying rectal tumors have advanced considerably. However, their oncological safety for locally advanced low rectal cancer compared with abdominoperineal resection (APR) is contentious. We retrospectively analyzed cohort data of 1500 consecutive patients who underwent elective resection for stage II‐III rectal cancer between 2010 and 2011. Patients with tumors 2‐5 cm from the anal verge and clinical stage T3‐4 were eligible. Primary outcome was 3‐year local recurrence rate, and confounding effects were minimized by propensity score matching. The study involved 794 patients (456 SPPs and 338 APR). Before matching, candidates for APR were more likely to have lower and advanced lesions, whereas SPPs were carried out more often following preoperative treatment, by laparoscopic approach, and at institutions with higher case volume. After matching, 398 patients (199 each for SPPs and APR) were included in the analysis sample. Postoperative morbidity was similar between the SPPs and APR groups (38% vs 39%; RR 0.98, 95% CI 0.77‐1.27). Margin involvement was present in eight patients in the SPPs group (one and seven at the distal and radial margins, respectively) and in 12 patients in the APR group. No difference in 3‐year local recurrence rate was noted between the two groups (11% vs 14%; HR 0.77, 95% CI 0.42‐1.41). In this observational study, comparability was ensured by adjusting for possible confounding factors. Our results suggest that SPPs and APR for locally advanced low rectal cancer have demonstrably equivalent oncological local control.
Collapse
Affiliation(s)
| | - Koya Hida
- Department of Surgery Kyoto University Kyoto Japan
| | - Tomohiro Yamaguchi
- Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan
| | - Tomonori Akagi
- Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan
| | - Tsuyoshi Konishi
- Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan
| | - Michio Yamamoto
- Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan
| | - Mitsuyoshi Ota
- Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan
| | - Shuichiro Matoba
- Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan
| | - Hiroyuki Bando
- Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan
| | - Saori Goto
- Department of Surgery Kyoto University Kyoto Japan
| | | | - Masahiko Watanabe
- Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | | | - Kazuteru Watanabe
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Koki Otsuka
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Ichiro Takemasa
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Keitaro Tanaka
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Masataka Ikeda
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Chu Matsuda
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Meiki Fukuda
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Junichi Hasegawa
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Shintaro Akamoto
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Manabu Shiozawa
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Atsushi Tsuruta
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Takashi Akiyoshi
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Takeshi Kato
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Shunsuke Tsukamoto
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Masaaki Ito
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Masaki Naito
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Akiyoshi Kanazawa
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Takao Takahashi
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Takashi Ueki
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Yuri Hayashi
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Satoshi Morita
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Takashi Yamaguchi
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Masayoshi Nakanishi
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Hirotoshi Hasegawa
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Ken Okamoto
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Fuminori Teraishi
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Yasuo Sumi
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Jo Tashiro
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Toshimasa Yatsuoka
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Yoji Nishimura
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Kenji Okita
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Takaya Kobatake
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Hisanaga Horie
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Yasuyuki Miyakura
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Hisashi Ro
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Kunihiko Nagakari
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Eiji Hidaka
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Takehiro Umemoto
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Hideaki Nishigori
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Kohei Murata
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Fuminori Wakayama
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Ryoji Makizumi
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Shoichi Fujii
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Eiji Sunami
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Hirotoshi Kobayashi
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Ryosuke Nakagawa
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Toshiyuki Enomoto
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Shinobu Ohnuma
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Jun Higashijima
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Heita Ozawa
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Keigo Ashida
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Fumihiko Fujita
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Keisuke Uehara
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Satoshi Maruyama
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Masato Ohyama
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Seiichiro Yamamoto
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Takao Hinoi
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Masanori Yoshimitsu
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Masazumi Okajima
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Shu Tanimura
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Masayasu Kawasaki
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Yoshihito Ide
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Shoichi Hazama
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Jun Watanabe
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Daisuke Inagaki
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| | - Akihiro Toyokawa
- Department of Surgery Kyoto University Kyoto Japan.,Division of Colon and Rectal Surgery Shizuoka Cancer Center Hospital Shizuoka Japan.,Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Oita Japan.,Department of Gastroenterological Surgery Cancer Institute Hospital of the Japanese Foundation for Cancer Research Tokyo Japan.,Department of Data Science Institute for Advancement of Clinical and Translational Science Kyoto University Hospital Kyoto Japan.,Gastroenterological Center Yokohama City University Medical Center Kanagawa Japan.,Department of Gastroenterological Surgery Toranomon Hospital Tokyo Japan.,Department of Gastroenterological Surgery Ishikawa Prefectural Central Hospital Ishikawa Japan.,Department of Surgery Kitasato University School of Medicine Kanagawa Japan
| |
Collapse
|
9
|
Yamaguchi S, Tashiro J, Araki R, Okuda J, Hanai T, Otsuka K, Saito S, Watanabe M, Sugihara K. Laparoscopic versus open resection for transverse and descending colon cancer: Short-term and long-term outcomes of a multicenter retrospective study of 1830 patients. Asian J Endosc Surg 2017; 10:268-275. [PMID: 28387060 DOI: 10.1111/ases.12373] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [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: 01/07/2017] [Accepted: 02/13/2017] [Indexed: 12/21/2022]
Abstract
INTRODUCTION Previous randomized controlled trials demonstrated similar oncological outcomes between laparoscopic and open colectomies, except for cases involving transverse colon and splenic flexure colon cancer. The objective of this study was to confirm the oncological safety and advantages of the short-term results of laparoscopic surgery for transverse and descending colon cancer in comparison with open surgery. METHODS The study data were retrospectively collected from the databases of 45 hospitals. Patients with transverse or descending colon cancer who underwent laparoscopic or open R0 resection were registered. The primary end-points were the 3-year overall survival and relapse-free survival rates according to pathological stage. The secondary end-points were the short-term results, including blood loss, operative time, diet intake, hospital stay, and postoperative complications. RESULTS Of the 1830 eligible patients, 872 underwent open colectomy and 958 underwent laparoscopic colectomy. The median follow-up period was 38.4 months. The conversion rate to open resection was 4.5%. The 3-year overall survival rate of the laparoscopic group was significantly higher than that of the open group for stage I patients (96.2% vs 99.2%; P = 0.04); it was also higher for stage II (94.0% vs 95.5%) and stage III (87.4% vs 90.2%) patients, but there were no significant differences. The 3-year relapse-free survival rate of the laparoscopic group was significantly higher than that of the open group for stage I patients; there were no differences between the open and laparoscopic groups among the stage II and III patients. In the multivariate analyses, laparoscopic resection was a significant factor in relapse-free survival. Laparoscopic patients had significantly lower blood loss and a significantly longer operative time than the open groups. Also, postoperative hospital stay was significantly shorter and postoperative morbidity was significantly lower in the laparoscopic group. CONCLUSION Although this retrospective study has limitations, we can conclude that laparoscopic surgery for transverse and descending colon cancer is oncologically safe and yields better short-term results than open surgery.
Collapse
Affiliation(s)
- Shigeki Yamaguchi
- Department of Gastroenterological Surgery, Saitama Medical University International Medical Center, Hidaka, Japan
| | - Jo Tashiro
- Department of Gastroenterological Surgery, Saitama Medical University International Medical Center, Hidaka, Japan
| | - Ryuichiro Araki
- Community Health Science Center, Saitama Medical University, Moroyama, Japan
| | - Junji Okuda
- Department of General and Gastroenterological Surgery, Osaka Medical College, Takatsuki, Japan
| | - Tsunekazu Hanai
- Department of Colorectal Surgery, Fujita Health University, Toyoake, Japan
| | - Koki Otsuka
- Department of Surgery, Iwate Medical University, Morioka, Japan
| | - Shuji Saito
- Department of Surgery, National Hospital Organization Yokohama Medical Center, Yokohama, Japan.,Department of Surgery, Yokohama Shin-Midori General Hospital, Yokohama, Japan
| | - Masahiko Watanabe
- Department of Surgery, Kitasato University Hospital, Sagamihara, Japan
| | - Kenichi Sugihara
- Department of Surgery, Tokyo Medical and Dental University Hospital, Tokyo, Japan
| |
Collapse
|
10
|
Tashiro J, Yamaguchi S, Ishii T, Kondo H, Hara K. Laparoscopic-assisted abdominoperineal resection combined with en-bloc prostatectomy using the trans-sacral approach for locally invasive rectal cancer: A case report. Asian J Endosc Surg 2017; 10:205-208. [PMID: 27957822 DOI: 10.1111/ases.12347] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Revised: 09/20/2016] [Accepted: 10/12/2016] [Indexed: 11/29/2022]
Abstract
Laparoscopic-assisted abdominoperineal resection and en-bloc prostatectomy using the trans-sacral approach for locally invasive rectal cancer that invades only the prostate is useful in order to avoid total pelvic exenteration. The patient was a 63-year-old man with cT4b (prostate) N1M0, stage IIIC rectal cancer. Curative resection was performed. Histopathological findings did not indicate definitive invasion into the prostate gland. The patient was discharged from the hospital on postoperative day 32 with an anastomotic leak and a ureteral catheter. The patient is able to urinate and has had no cancer recurrence. Laparoscopic bladder-preserving surgery for locally invasive rectal cancer can preserve postoperative quality of life and provides oncological curability.
Collapse
Affiliation(s)
- Jo Tashiro
- Division of Gastroenterological Surgery, Saitama Medical University International Medical Center, Hidaka, Japan
| | - Shigeki Yamaguchi
- Division of Gastroenterological Surgery, Saitama Medical University International Medical Center, Hidaka, Japan
| | - Toshimasa Ishii
- Division of Gastroenterological Surgery, Saitama Medical University International Medical Center, Hidaka, Japan
| | - Hiroka Kondo
- Division of Gastroenterological Surgery, Saitama Medical University International Medical Center, Hidaka, Japan
| | - Kiyoka Hara
- Division of Gastroenterological Surgery, Saitama Medical University International Medical Center, Hidaka, Japan
| |
Collapse
|
11
|
Mieda T, Nishizawa D, Nakagawa H, Tsujita M, Imanishi H, Terao K, Yoshikawa H, Itoh K, Amano K, Tashiro J, Ishii T, Ariyama J, Yamaguchi S, Kasai S, Hasegawa J, Ikeda K, Kitamura A, Hayashida M. Genome-wide association study identifies candidate loci associated with postoperative fentanyl requirements after laparoscopic-assisted colectomy. Pharmacogenomics 2015; 17:133-45. [PMID: 26566055 DOI: 10.2217/pgs.15.151] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [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: 01/23/2023] Open
Abstract
AIMS Opioids are widely used as effective analgesics, but opioid sensitivity is well known to vary widely among individuals and the underlying genetic factors are not fully understood, thus hampering efficient pain treatment. We explored the genetic factors that contribute to individual differences in opioid sensitivity by performing a genome-wide association study. METHODS We conducted a multistage genome-wide association study in subjects who underwent laparoscopic-assisted colectomy (LAC). RESULTS A nonsynonymous SNP in the LAMB3 gene region, rs2076222, was strongly associated with postoperative opioid requirements. The C allele of this best-candidate SNP was associated with lower opioid sensitivity and/or higher pain sensitivity in the patient subjects. CONCLUSION Our findings provide valuable information for personalized pain treatment after LAC, in which the C allele of the rs2076222 SNP is associated with lower opioid sensitivity and requires more opioid analgesic after LAC.
Collapse
Affiliation(s)
- Tsutomu Mieda
- Department of Anesthesiology, Saitama Medical University International Medical Center, 1397-1, Yamane, Hidaka, Saitama 350-1298, Japan
| | - Daisuke Nishizawa
- Addictive Substance Project, Tokyo Metropolitan Institute of Medical Science, 2-1-6, Kamikitazawa, Setagaya-ku, Tokyo 156-8506, Japan
| | - Hideyuki Nakagawa
- Department of Anesthesiology, Saitama Medical University International Medical Center, 1397-1, Yamane, Hidaka, Saitama 350-1298, Japan
| | - Miki Tsujita
- Department of Anesthesiology, Saitama Medical University International Medical Center, 1397-1, Yamane, Hidaka, Saitama 350-1298, Japan
| | - Hirokazu Imanishi
- Department of Anesthesiology, Saitama Medical University International Medical Center, 1397-1, Yamane, Hidaka, Saitama 350-1298, Japan
| | - Kazuhisa Terao
- Department of Anesthesiology, Saitama Medical University International Medical Center, 1397-1, Yamane, Hidaka, Saitama 350-1298, Japan
| | - Hiroaki Yoshikawa
- Department of Anesthesiology, Saitama Medical University International Medical Center, 1397-1, Yamane, Hidaka, Saitama 350-1298, Japan
| | - Kazushi Itoh
- Department of Anesthesiology, Saitama Medical University International Medical Center, 1397-1, Yamane, Hidaka, Saitama 350-1298, Japan
| | - Kojiro Amano
- Addictive Substance Project, Tokyo Metropolitan Institute of Medical Science, 2-1-6, Kamikitazawa, Setagaya-ku, Tokyo 156-8506, Japan.,Department of Anesthesiology & Pain Medicine, Juntendo University School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
| | - Jo Tashiro
- Department of Gastroenterological Surgery, Saitama Medical University International Medical Center, 1397-1, Yamane, Hidaka, Saitama 350-1298, Japan
| | - Toshimasa Ishii
- Department of Gastroenterological Surgery, Saitama Medical University International Medical Center, 1397-1, Yamane, Hidaka, Saitama 350-1298, Japan
| | - Jun Ariyama
- Department of Anesthesiology, Saitama Medical University International Medical Center, 1397-1, Yamane, Hidaka, Saitama 350-1298, Japan
| | - Shigeki Yamaguchi
- Department of Gastroenterological Surgery, Saitama Medical University International Medical Center, 1397-1, Yamane, Hidaka, Saitama 350-1298, Japan
| | - Shinya Kasai
- Addictive Substance Project, Tokyo Metropolitan Institute of Medical Science, 2-1-6, Kamikitazawa, Setagaya-ku, Tokyo 156-8506, Japan
| | - Junko Hasegawa
- Addictive Substance Project, Tokyo Metropolitan Institute of Medical Science, 2-1-6, Kamikitazawa, Setagaya-ku, Tokyo 156-8506, Japan
| | - Kazutaka Ikeda
- Addictive Substance Project, Tokyo Metropolitan Institute of Medical Science, 2-1-6, Kamikitazawa, Setagaya-ku, Tokyo 156-8506, Japan
| | - Akira Kitamura
- Department of Anesthesiology, Saitama Medical University International Medical Center, 1397-1, Yamane, Hidaka, Saitama 350-1298, Japan
| | - Masakazu Hayashida
- Department of Anesthesiology, Saitama Medical University International Medical Center, 1397-1, Yamane, Hidaka, Saitama 350-1298, Japan.,Department of Anesthesiology & Pain Medicine, Juntendo University School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
| |
Collapse
|
12
|
Tashiro J, Yamaguchi S, Ishii T, Kondo H, Hara K, Kuwahara R. Initial experience of reduced port surgery using a two-surgeon technique for colorectal cancer. BMC Surg 2015; 15:91. [PMID: 26219424 PMCID: PMC4518600 DOI: 10.1186/s12893-015-0078-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2015] [Accepted: 07/20/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND With the decreasing number of surgeons on surgical teams, reduced port surgery (RPS) operations have become popular. We herein present our initial experience with RPS, which was successfully performed using a two-surgeon technique. A retrospective analysis was performed to compare the two-surgeon technique with conventional laparoscopic colectomy and evaluate its efficacy. METHODS A total of 535 patients were eligible among 749 registered patients. Conventional multiport laparoscopic colectomy with three surgeons and RPS using the two-surgeon technique with a surgeon and surgeon's assistant were performed in 429 and 106 cases, respectively. The patient characteristics, short-term outcomes (including intraoperative and postoperative findings) and pathological results were recorded and analyzed. RESULTS The two groups were similar with respect to age, gender, BMI, history of abdominal surgery, depth of tumor invasion and TNM classification. Reconstruction via extracorporeal functional end-to-end anastomosis was performed in a significantly higher number of patients in the two-surgeon technique group (74 %) than in the conventional laparoscopic colectomy group (57 %). Furthermore, the mean operative time in the two-surgeon technique group (117.9 min) was significantly shorter than that observed in the conventional laparoscopic colectomy group (170 min), and the median postoperative hospital stay was significantly shorter in the two-surgeon technique group (6 days) than in the conventional laparoscopic colectomy group (7 days). There were no major postoperative complications. The final TNM stage was similar in both procedures. CONCLUSION RPS using the two-surgeon technique compares favorably with conventional laparoscopic colectomy and is considered to be a safe and successful procedure.
Collapse
Affiliation(s)
- Jo Tashiro
- Division of Gastroenterological Surgery, Saitama Medical University International Medical Center, Yamane, Hidaka-shi, Saitama 350-1298 Japan
| | - Shigeki Yamaguchi
- Division of Gastroenterological Surgery, Saitama Medical University International Medical Center, Yamane, Hidaka-shi, Saitama 350-1298 Japan
| | - Toshimasa Ishii
- Division of Gastroenterological Surgery, Saitama Medical University International Medical Center, Yamane, Hidaka-shi, Saitama 350-1298 Japan
| | - Hiroka Kondo
- Division of Gastroenterological Surgery, Saitama Medical University International Medical Center, Yamane, Hidaka-shi, Saitama 350-1298 Japan
| | - Kiyoka Hara
- Division of Gastroenterological Surgery, Saitama Medical University International Medical Center, Yamane, Hidaka-shi, Saitama 350-1298 Japan
| | - Ryuichi Kuwahara
- Division of Gastroenterological Surgery, Saitama Medical University International Medical Center, Yamane, Hidaka-shi, Saitama 350-1298 Japan
| |
Collapse
|
13
|
Morita Y, Yamaguchi S, Ishii T, Tashiro J, Kondo H, Suzuki A, Hara K, Koyama I. Does transumbilical incision increase incisional hernia at the extraction site of laparoscopic anterior resection? Am J Surg 2015; 209:1048-52. [DOI: 10.1016/j.amjsurg.2014.06.023] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2014] [Revised: 06/09/2014] [Accepted: 06/18/2014] [Indexed: 10/24/2022]
|
14
|
Tashiro J, Yamaguchi S, Ishii T, Suzuki A, Kondo H, Morita Y, Hara K, Koyama I. Inferior oncological prognosis of surgery without oral chemotherapy for stage III colon cancer in clinical settings. World J Surg Oncol 2014; 12:145. [PMID: 24884880 PMCID: PMC4029940 DOI: 10.1186/1477-7819-12-145] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2014] [Accepted: 04/29/2014] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Cancer patients not admissible for adjuvant chemotherapy are generally at high risk of considerably inferior prognosis. The aim of this retrospective study was to evaluate poorer survival without administration of oral adjuvant chemotherapy of stage III colon cancer patients in clinical settings. METHODS Between April 2007 and September 2011, 259 patients with stage III colon cancer who underwent curative surgery were retrospectively assigned to the adjuvant chemotherapy group of 171 patients (66%) and the surgery alone group of 88 patients. Oral fluorouracil (5-FU) derivatives used in adjuvant chemotherapy, such as oral uracil and tegafur plus leucovorin (UFT/LV) or capecitabine, were the most commonly used. RESULTS The 3-year relapse-free survival (RFS) rates were 74.9% for all cases, 58.3% for the surgery alone group, and 83.4% for the adjuvant chemotherapy group (P=0.0001). The chemotherapy group was associated with a dramatic improvement in survival for stage IIIB (surgery alone 57.7% versus adjuvant chemotherapy 83.9%; P=0.0001) and stage IIIC (surgery alone 18.2% versus adjuvant chemotherapy 57.3%; P=0.006) patients. There was a significant difference in the overall recurrence rate between groups (surgery alone 35.2% versus adjuvant chemotherapy 18.1%; P=0.002). Multivariate analysis identified adjuvant therapy as an independent predictive factor of reduced recurrence (hazard ratio (HR): 3.231; P=0.004) and improved RFS (HR: 2.653; P=0.001). CONCLUSION In clinical settings, adjuvant therapy was the only significant prognostic factor of survival. Since many patients prefer not to receive chemotherapy, it is critical to inform stage III colon cancer patients that chemotherapy raises their chances of survival by three-fold compared with curative surgery alone.
Collapse
Affiliation(s)
- Jo Tashiro
- Department of Gastroenterological Surgery, Saitama Medical University International Medical Center, Yamane, Hidaka-shi, Saitama 350-1298, Japan.
| | | | | | | | | | | | | | | |
Collapse
|
15
|
Perez B, Bishop B, Wang B, Tashiro J, Parikh P, Lew J. Evaluation of Patients with Discordant Imaging Studies for Parathyroidectomy Guided by Intraoperative Parathormone Monitoring. J Surg Res 2014. [DOI: 10.1016/j.jss.2013.11.807] [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: 10/25/2022]
|
16
|
Tashiro J, Gerth D, Thaller S. Pediatric Histiocytoses in the United States. J Surg Res 2014. [DOI: 10.1016/j.jss.2013.11.835] [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: 10/25/2022]
|
17
|
Bishop B, Perez B, Tashiro J, Wang B, Parikh P, Lew J. Predictors of Surgeon-Performed Ultrasound Accuracy of Abnormal Parathyroid Gland Localization in Patients with Sporadic Primary Hyperparathyroidism. J Surg Res 2014. [DOI: 10.1016/j.jss.2013.11.798] [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: 10/25/2022]
|
18
|
Wang B, Allan B, Tashiro J, Parikh P, Perez E, Hogan A, Neville H, Sola J. A Nationwide Analysis of Clinical Outcomes among Newborns with Esophageal Atresia and Tracheoesophageal Fistulas. J Surg Res 2014. [DOI: 10.1016/j.jss.2013.11.238] [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: 10/25/2022]
|
19
|
Tashiro J, Yamaguchi S, Ishii T, Suwa H, Kondo H, Suzuki A, Miyazawa M, Koyaman I. Salvage total pelvic exenteration with bilateral v-y advancement flap reconstruction for locally recurrent rectal cancer. Case Rep Gastroenterol 2013; 7:175-81. [PMID: 23626519 PMCID: PMC3635689 DOI: 10.1159/000350557] [Citation(s) in RCA: 6] [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] [Indexed: 11/19/2022] Open
Abstract
Total pelvic exenteration for locally recurrent rectal cancer typically requires extensive excision of the pelvic floor with perineal skin. Due to the extensiveness of the procedure and its non-curative nature, it is controversial as purely palliative therapy. A 66-year-old male patient who had undergone abdominoperineal resection at another hospital 8 years prior was admitted to our hospital. During radiation and chemotherapy for 2 years, he complained of perineal pain, discharge, cacosmia and bleeding from a recurrent tumor. The 10 × 8 cm recurrent tumor was exposed on the perineum and the patient suffered from serious discomfort in his daily life during walking or sitting. We performed total pelvic exenteration with partial sacrectomy, after which the large perineal defect was reconstructed with a bilateral V-Y gluteus maximus advancement flap in approximately 120 min. The patient's postoperative course was satisfactory and his quality of life markedly improved.
Collapse
Affiliation(s)
- Jo Tashiro
- Department of Gastroenterological Surgery, Saitama Medical University International Medical Center, Hidaka, Japan
| | | | | | | | | | | | | | | |
Collapse
|
20
|
Tashiro J, Yamaguchi S, Ishii T, Sato T, Suwa H, Okada I, Kondo H, Miyazawa M, Shinozuka N, Koyama I. A comparative study on the short-term clinical outcomes of laparoscopic versus open Hartmann's procedure for high risk patients in colorectal cancer. ACTA ACUST UNITED AC 2012; 59:1403-7. [PMID: 22115799 DOI: 10.5754/hge11694] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND/AIMS Patients with severe co-morbidities and oncological conditions would not be denied a reconstruction of anastomosis and Hartmann's procedure would be undertaken. The aim of this study is to examine the feasibility and safety of laparoscopic Hartmann's procedure compared to open Hartmann's procedure for high risk patients in colorectal cancer. METHODOLOGY Nine hundred and eighty five primary colorectal cancer resections were performed from April 2007 to December 2010. Thirty six patients (3.6%) who underwent Hartmann's procedure by the same surgical team were investigated retrospectively. RESULTS Twenty six patients (72%) in the open surgery (OS) and 10 patients (28%) in the laparoscopic surgery (LS) were undertaken Hartmann's procedure. The reason of selected Hartmann's procedure was defined as high risk with severe co-morbidities (OS 8: LS 8, n=16), oncological conditions (OS 14: LS 2, n=16), urgent situations (OS 4, n=4). The mean operation time was not significantly different (p=0.504). The median blood loss count was significantly different between both groups (OS 327.5g vs. LS 16.5g; p=0.0001). The incidence of postoperative complications was similar (OS 38% vs. LS 40%; p=0.763). The median postoperative hospital stay was not significantly different (OS 10.5 vs. LS 12; p=0.216). CONCLUSIONS Laparoscopic Hartmann's procedure is feasible and safe with a low invasiveness for high risk patients with colorectal cancer.
Collapse
Affiliation(s)
- Jo Tashiro
- Department of Gastroenterological Surgery, Saitama Medical University International Medical Center, Saitama, Japan.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
21
|
Tashiro J, Yamaguchi S, Ishii T, Suwa H, Okada I, Kondo H, Miyazawa M, Shinozuka N, Koyama I. Efficacy of laparoscopic colorectal resection for risk patients with severe comorbidity. ACTA ACUST UNITED AC 2012; 59:2173-6. [PMID: 22440246 DOI: 10.5754/hge12110] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND/AIMS This study assessed the short term results of laparoscopic colorectal resection for high risk patients. METHODOLOGY Five hundred and fifty seven consecutive patients underwent an elective laparoscopic colorectal cancer resection by the same surgical team between April 2007 and December 2010. No risk patients in ASA class 1 (Group N, n=222), low risk patients with the systemic disease under the control in ASA class 2 and 3 (Group L, n=320), high risk patients with severe comorbidities in ASA class 4 (Group H, n=15) were respectively compared. RESULTS The median blood loss count was significantly higher than the other group (N: 26 g, L: 22 g) in group H (59 g; p<0.05). On the other hands, the less lymphadenectomy was performed and a reconstruction with anastomosis was denied in group H. The incidence of postoperative complications was not significantly different in each group (N: 12%, L: 18%, H: 26%; p>0.05). There was the significant difference of the incidence with systemic complication (respiratory failure, ascites and delirium) in group H. The median postoperative hospital stay was not significantly different in each group (POD7; p>0.05). Hospitalization death occurred in three patients (0.5%) by uncontrollability of the systemic disease, two patients in group L and one patient in group H. CONCLUSIONS Laparoscopic colorectal resection for high risk patients was performed safely without increasing complications and postoperative hospital stay.
Collapse
Affiliation(s)
- Jo Tashiro
- Department of Gastroenterological Surgery, Saitama Medical University International Medical Center, Saitama, Japan.
| | | | | | | | | | | | | | | | | |
Collapse
|
22
|
Sato T, Yamaguchi S, Ozawa S, Ishii T, Tashiro J, Hosonuma T, Koyama I, Nishimura M. Rupture of a pseudoaneurysm of the middle colic artery. Gastrointest Endosc 2011; 73:819-20. [PMID: 21092953 DOI: 10.1016/j.gie.2010.09.041] [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: 12/10/2009] [Accepted: 09/27/2010] [Indexed: 02/08/2023]
Affiliation(s)
- Takahiro Sato
- Gastroenterological Surgery, Comprehensive Cancer Center, Saitama Medical University International Medical Center, Hidaka, Japan
| | | | | | | | | | | | | | | |
Collapse
|
23
|
Ozawa S, Akimoto N, Tawara H, Yamada M, Sato T, Tashiro J, Hosonuma T, Ishii T, Yamaguchi S, Husejima Y, Hanawa M, Koyama I. Pringle maneuver induces hepatic metastasis by stimulating the tumor vasculature. Hepatogastroenterology 2011; 58:122-126. [PMID: 21510298] [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] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
BACKGROUND/AIMS The Pringle maneuver is traditionally used to avoid hemorrhage during hepatectomy for hepatic metastasis. However, metastasis can occur under ischemic conditions due to some unknown mechanism. METHODOLOGY An orthotopic model of murine colon cancer was established in syngeneic BALB/c mice. Viable CT-26 cells were implanted into the spleen of these mice. The mice underwent a laparotomy 5 days after the implantation and the hepato-duodenal ligament was clamped for 0 or 10 minutes (Pringle maneuver). The mice were sacrificed 7 days after this maneuver and the number of hepatic metastasis were counted. RESULTS The mice that underwent the maneuver developed a greater number of hepatic metastasis. An immunohistochemical analysis revealed that the expression of microvessel density, VEGF and KDR/Flk-1 were higher in the hepatic metastasis in the mice treated with the maneuver. In addition, the mice which were treated by the maneuver had a higher level VEGF in the serum. CONCLUSION These data suggest that the Pringle maneuver induces hepatic metastasis by stimulating the overexpression of tumor vasculature.
Collapse
Affiliation(s)
- Shutaro Ozawa
- Department of Surgery Chichibu Hospital, Saitama, Japan.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
24
|
Sato T, Yamaguchi S, Ozawa S, Ishii T, Tashiro J, Hosonuma T, Koyama I, Gagner M. Is laparoscopic surgery a contraindication in patients with severe senile kyphosis? Hepatogastroenterology 2010; 57:1095-1098. [PMID: 21410038] [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] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
BACKGROUND/AIMS The japanese population have the longest-life expectancy in the world. Accordingly, older patients with colorectal cancer with senile kyphosis caused by aging or osteoporosis also increase. Laparoscopic surgery is minimally-invasive, and performance on severe kyphotic patients may cause difficulty to approach a narrow abdomen. To determine whether laparoscopic surgery is safe and feasible in patients with severe senile kyphosis. METHODS Laparoscopic operations under general anesthesia were undertaken with the patients in lithotomy position. Intraoperative difficulties were compared with normal laparoscopic approach. RESULTS Working space was divided by right costal arch during right hemicolectomy for right sided colon cancer. For sigmoid colon cancer, dissection of lymph node and anastomosis were completed with much difficulty because the pelvic space was occupied with small intestine. However, the postoperative course was uneventful despite impaired lung function in all cases. CONCLUSIONS Severe senile kyphosis is not a contraindication for minimally invasive technique applied to colorectal cancer patients.
Collapse
Affiliation(s)
- Takahiro Sato
- Gastroenterological Surgery, Gastrointestinal Center, Comprehensive Cancer Center, Saitama Medical University International Medical Center 1397-1 Yamane, Hidaka 350-1298, Japan.
| | | | | | | | | | | | | | | |
Collapse
|
25
|
Ozawa S, Asano H, Satoh T, Ishii T, Tashiro J, Hosonuma T, Yamaguchi S, Shinozuka N, Koyama I. Experience of Altemeier's procedures for a complete rectal prolapse. Hepatogastroenterology 2010; 57:760-763. [PMID: 21033224] [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] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
BACKGROUND/AIMS Many patients with a complete rectal prolapse tend to be old. Therefore, surgeons tend to choose a surgical procedure associated with minimal stress. However, the recurrence rate is problematic. Altemeier's procedure causes minimal stress. This procedure is often selected for performing a complete rectal prolapse. Usually, a rectosigmoidectomy, is performed with levatoroplasty and anastomosis of the anal tube and the colon under spinal anesthesia. This procedure was applied for a complete rectal prolapse and the outcomes of this procedure were analyzed. METHODOLOGY From 2000 August to 2006 January, 13 patients underwent this procedure. The patients ranged from 27 to 89 years of age (median 76 years). The length of the escaped enteric canal ranged from 7.0 to 20.0cm. RESULTS All patients underwent the procedure under spinal anesthesia. The surgical time was 113 +/- 20 minutes. There were two postoperative complications which were both treated conservatively. One recurrent case was recognized. CONCLUSION Altemeier's procedure was associated with a minimum of stress and the recurrence rate was low (7.6%). Because a complete rectal prolapse is caused by the fragility of the anal sphincter muscle and levator ani muscle, this procedure is considered to be effective and appropriate.
Collapse
Affiliation(s)
- Shutaro Ozawa
- Department of Digestive Surgery, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka-shi, Saitama 350-1298, Japan.
| | | | | | | | | | | | | | | | | |
Collapse
|
26
|
Tashiro J, Kotani K, Yamazaki K, Nakamura Y, Miyazaki A, Bujo H, Saito Y. Th-P15:127 Role of malondialdehyde-modified low-density lipoprotein in restenosis. ATHEROSCLEROSIS SUPP 2006. [DOI: 10.1016/s1567-5688(06)82087-8] [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: 10/23/2022]
|
27
|
Nakamura Y, Matsuno N, Iwamoto H, Yokoyama T, Kuzuoka K, Kihara Y, Taira S, Sagara T, Jojima Y, Konno O, Tashiro J, Akashi I, Hama K, Narumi K, Iwahori T, Uchiyama M, Tanaka K, Nagao T. Successful case of adult ABO-incompatible liver transplantation: beneficial effects of intrahepatic artery infusion therapy: a case report. Transplant Proc 2005; 36:2269-73. [PMID: 15561215 DOI: 10.1016/j.transproceed.2004.08.094] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND In Japan ABO-incompatible liver transplantation has been done on >100 occasions up to 2003. However, <30% are cases involving adults. The difficultly of ABO-incompatible liver transplantation is associated with the high frequency of humoral rejection and local disseminated intravascular coagulation (DIC), leading to many postoperative complications. We report a successful case of adult ABO-incompatible liver transplantation with the use of an intrahepatic artery infusion. METHODS A 36-year-old man with Wilson disease, underwent living donor liver transplantation from an ABO-incompatible donor. The immunosuppressive therapy included multiple perioperative plasmaphereses, splenectomy, and treatment with tacrolimus, methylprednisolone, and cyclophosphamide. The dose and blood level of tacrolimus were the same as in ABO-compatible cases. In addition to these therapies, we administered an intrahepatic arterial infusion with prostaglandin (PG) E1 alone. RESULTS After perioperative plasmapheresis and cyclophosphamide, antidonor blood group antibody titers remained undiluted and without vascular complications throughout the postoperative course, but there was a tendency for bleeding that continued for 10 days after transplantation. On postoperative day 10, a reexploration was performed for intraabdominal bleeding. During another operation on postoperative day 59 a biloma was found and drained. The patient has now survived for 120 days after transplantation with normal liver function. CONCLUSIONS Beneficial effect of intrahepatic artery infusion with PGE1 seems to be useful in adult ABO-incompatible liver transplantation.
Collapse
Affiliation(s)
- Y Nakamura
- Fifth Department of Surgery, Tokyo Medical University, Tokyo, Japan.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
28
|
Yaguchi H, Soma H, Miyazaki Y, Tashiro J, Yabe I, Kikuchi S, Sasaki H, Kakizaki H, Moriwaka F, Tashiro K. A case of acute urinary retention caused by periaqueductal grey lesion. J Neurol Neurosurg Psychiatry 2004; 75:1202-3. [PMID: 15258235 PMCID: PMC1739165 DOI: 10.1136/jnnp.2003.027516] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
29
|
Abstract
A 78-year-old man was admitted to our clinic because of fatigue. Imaging modalities showed beaded stricture and dilation of the intrahepatic left segmental bile duct. Anomalous pancreatico-biliary ductal union and polycystic kidney disease were absent. Resection of the hepatic left lobe was performed. Grossly, cholesterol stones were impacted in the dilated intrahepatic large bile ducts, and multiple tiny cysts measuring 2-8 mm were noted in the peribiliary areas (peribiliary cysts). Histologically, the cholesterol hepatoliths consisted of cholesterol empty spaces and fibrinous materials, and, in places, foreign body giant cells were seen around the cholesterol crystals. The peribiliary cysts were lined by a layer of cuboidal epithelia. They were intimately intermingled with intrahepatic peribiliary glands, and a close association between the two components was recognized in some places. A mild degree of ascending cholangitis was noted. Bile duct anomalies including von-Meyenburg complexes and simple cysts were not recognized. Peribiliary cysts have been reported in various liver diseases, including portal hypertension, portal thrombosis, cirrhosis, hepatocellular carcinoma, and adult polycystic kidney disease. However, to the best of our knowledge, there have been no reports on peribiliary cysts developing in hepatolithiasis. The present case indicates that peribiliary cysts occur in cholesterol hepatolithiasis, and suggests that they are derived from cystic dilations of intrahepatic peribiliary glands.
Collapse
Affiliation(s)
- Tadashi Terada
- Department of Pathology, Shizuoka Municipal Shimizu Hospital, Shizuoka, Japan
| | | | | | | | | | | |
Collapse
|
30
|
Matsuno N, Tashiro J, Uchiyama M, Iwamoto H, Hama K, Nakamura Y, Akashi I, Narumi K, Sakurai E, Kubota K, Nagao T. Early graft function in kidney transplantation from non-heart-beating donors. Ann Transplant 2004; 9:21-2. [PMID: 15478908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/30/2023] Open
Abstract
The shortage of kidneys for transplantation is a universal problem. The non heart beating donor (NHBD) is one such source. This study evaluates the early graft function after kidney transplantation from NHBD. We report our experience with 126 kidney transplantations retrospectively. As a result, the kidney from NHBD over 50 years of age, led to the longer ATN and high PNF (13.8+/-12.6 days and 16.9% respectively). TIT more than 720 min or less had statistically correlated with the length of ANT (13.3 v. 8.4 days). Significant higher incidence of PNF (19.3%) was shown in the group of TIT more than 720 min with WIT of 20.8+/-31.6 min. Significant low flow by machine perfusion was resulted in PNF. In conclusion, we suggest that early and delayed graft function of kidneys from NHBD should be recognized as a separate clinical entity with its own significant effects.
Collapse
Affiliation(s)
- Naoto Matsuno
- Fifth Department of Surgery, Hachioji Medical Center, Tokyo Medical University, Tokyo, Japan.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
31
|
Tashiro J, Nakamura Y, Miyazaki A, Miyazaki O, Nakamura Y, Fukamachi I, Bujo H, Saito Y. 3P-0767 Relationship of plasma preβ1-HDL levels and atherosclerotic phases of coronary artery disease. ATHEROSCLEROSIS SUPP 2003. [DOI: 10.1016/s1567-5688(03)90985-8] [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: 10/25/2022]
|
32
|
Tashiro J, Morisaki N, Kobayashi J, Bujo H, Kanzaki T, Murano S, Saito Y. Significance of a polymorphism (G-->A transition) in the -75 position of the apolipoprotein A-I gene promoter on serum high density lipoprotein-cholesterol levels in Japanese hyperlipidemic subjects. J Atheroscler Thromb 2002; 8:95-100. [PMID: 11866037 DOI: 10.5551/jat1994.8.95] [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] [Indexed: 11/11/2022] Open
Abstract
High density lipoprotein-cholesterol (HDL-C) levels are inversely related to the incidence of coronary artery disease. We studied the influence of a G(-75)-->A transition in the promoter of the apolipoprotein (apo) A-I gene, a major protein component of HDL, on serum HDL-C levels in hyperlipidemic subjects. Seventy three hyperlipidemic subjects with serum levels of high HDL-C (HDL-C > or = 70 mg/dl, Group H) were compared with hyperlipidemic subjects with levels of HDL-C between 40 and 70 mg/dl (Group N) and those with HDL-C < 40 mg/dl (Group L). Group H showed a higher incidence (45.2%) of low plasma cholesteryl ester transfer protein (CETP) activity than Groups N (9.1%) and L (5.3%) (p < 0.001). Group H had a higher incidence of the G(-75)-->A transition (0.275) than Groups N (0.117, p < 0.05) and L (0.056, p < 0.01), among subjects with normal CETP activities. The HDL-C levels in subjects with the transition (84 +/- 16 mg/dl) were higher than those in subjects without the transition (56 +/- 12 mg/dl) (p < 0.05). These data suggest that a G(-75)-->A transition of the apo A-I gene promoter, in addition to the common mutation of CETP gene, contributes to high HDL-C levels among hyperlipidemic patients in Japan.
Collapse
Affiliation(s)
- J Tashiro
- Department of Clinical Cell Biology (F5), Graduate School of Medicine, Chiba University, Japan
| | | | | | | | | | | | | |
Collapse
|
33
|
Omote T, Harada K, Aketa K, Saitoh T, Watanabe H, Tashiro J, Maruo Y. [Critical illness polyneuropathy in mechanically ventilation with severe asthma]. Nihon Naika Gakkai Zasshi 2001; 90:1528-30. [PMID: 11573276 DOI: 10.2169/naika.90.1528] [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] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- T Omote
- Hakodate Municipal Hospital, Hakodate
| | | | | | | | | | | | | |
Collapse
|
34
|
Tashiro J, Yokoyama N, Maruo Y, Kubota T, Niwa J, Shimoyama N. [A case of granulomatous angiitis of the central nervous system presented with subacute mental deterioration resembling diffuse white matter disease]. Rinsho Shinkeigaku 2001; 41:491-7. [PMID: 11889833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/18/2023]
Abstract
We reported a 60-year-old man with granulomatous angiitis of the central nervous system (GACNS) manifesting as subacute mental deterioration. His first symptoms were nausea and vomiting which brought him to a hospital, where no abnormality was found except for gastritis. One month later, he began to feel dizziness and brain tumor was suspected by a neurosurgeon with the MRI findings such as abnormal T2 signal and swelling in his brainstem. While he was followed up, he gradually presented mental change, disorientation and dysmnesia with the abnormal T2 signal spreading over the cerebral white matter bilaterally. Corticosteroid therapy was started based on the suspicion of a lymphoproliferative disease, and his symptoms and the abnormal MRI findings improved. Then he was referred to our department for further evaluation. Because we could not find any evidence of systemic diseases and he had been almost fully recovered, we discontinued the therapy. Soon after that, his mental deterioration as well as the abnormal T2 signal lesions on MRI relapsed. By open brain biopsy, the diagnosis of GACNS was established, and steroid pulse therapy was started. His symptoms and the abnormal T2 signal lesions improved gradually and the steroid was tapered to the maintenance dose without remission. Since the laboratory and imaging findings are not specific for the diagnosis of the angiitis confined to the central nervous system, brain biopsy is recommended for these disorders.
Collapse
Affiliation(s)
- J Tashiro
- Department of Neurology, Hakodate Municipal Hospital
| | | | | | | | | | | |
Collapse
|
35
|
Kinoshita K, Lee CG, Tashiro J, Muramatsu M, Chen XC, Yoshikawa K, Honjo T. Molecular mechanism of immunoglobulin class switch recombination. Cold Spring Harb Symp Quant Biol 2001; 64:217-26. [PMID: 11232289 DOI: 10.1101/sqb.1999.64.217] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- K Kinoshita
- Department of Medical Chemistry, Kyoto University Faculty of Medicine, Yoshida, Sakyo-ku, Kyoto 606-8501, Japan
| | | | | | | | | | | | | |
Collapse
|
36
|
Tajima Y, Tashiro J, Miyagishi R, Matsumoto A. A case of malignant lymphoma exhibiting multiple cranial nerve enhancement: leptomeningeal metastasis? Or another lymphoma associated event? J Neurol Neurosurg Psychiatry 2001; 70:565-6. [PMID: 11300105 PMCID: PMC1737297 DOI: 10.1136/jnnp.70.4.565] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
37
|
Abstract
In order to understand the specificity of sequences or structures recognized by a recombinase involved in class switch recombination (CSR), we examined the relative CSR efficiency of various switch sequences in artificial CSR constructs that undergo CSR in CH12F3-2 murine B lymphoma line. Since CSR recombination is not specific to switch regions of different isotypes or orientation of S sequences, we examined the efficiency of S sequences of non-mammalian species and artificial sequences which lack several characters of mammal switch sequences: chicken S(mu), Xenopus S(mu), telomere, multiple cloning site (MCS) and unrelated negative control sequence. CSR occurred in chicken S(mu) and MCS with significantly higher efficiency than the negative control. A common character of these two sequences is that they are rich in palindrome and stem-loop structures. However, telomeres, which are G-rich and repetitive but not palindromic, could not serve as switch sequences at all. The AT-rich Xenopus S(mu) sequence was inefficient but capable of CSR. CSR breakpoint distribution suggests that the cleavage may take place preferentially in the proximity of the junctions (neck) between the loop and stem in the secondary structure of the single-stranded S sequence, which can be formed by palindromic sequences. The results suggest that the secondary structure of S-region sequences which is transiently formed during transcription may be necessary for recognition by class switch recombinase.
Collapse
Affiliation(s)
- J Tashiro
- Graduate School of Medicine, Kyoto University, Yoshida Konoe-cho, Sakyo, Kyoto 606-8501, Japan
| | | | | |
Collapse
|
38
|
Kobayashi J, Tashiro J, Bujo H, Morisaki N, Saito Y. Effect of lipoprotein lipase on binding of chylomicrons to LDL receptor-deficient Chinese hamster ovary cells. Ann Clin Biochem 2001; 38:124-8. [PMID: 11269752 DOI: 10.1258/0004563011900425] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The authors investigated the binding of human plasma 125I-labelled chylomicrons to Chinese hamster ovary (CHO) cells, i.e. native CHO cells are mutant ldl-A7 cells lacking the low-density lipoproteins receptor, in the absence and presence of exogenous bovine milk lipoprotein lipase (LPL) in the culture medium. Only a small amount of binding to either cell was observed in the absence of added LPL. Exogenously added LPL increased the specific binding of chylomicrons to ldl-A7 cells, as well as to native CHO cells. The enhanced binding of chylomicrons to ldl-A7 cells or native CHO cells by LPL was inhibited by heparinase and a monoclonal antibody against LPL (5D2) which recognizes the carboxyl terminal of LPL. However, the enhanced binding was not inhibited by 1 M NaCl, which abolishes the enzymatic activity of LPL in either ldl-A7 cell or native CHO cells. These results suggest that LPL enhances the binding of chylomicrons to heparan sulphate proteoglycans of CHO cells, and that it is the carboxyl terminal of LPL but not the enzymatic activity of LPL that is essential for LPL to mediate the binding of chylomicrons to CHO cells.
Collapse
Affiliation(s)
- J Kobayashi
- Second Department of Internal Medicine, Chiba University School of Medicine, Chiba City, Japan.
| | | | | | | | | |
Collapse
|
39
|
Takahashi K, Kobayashi J, Bujo H, Takahashi M, Taira K, Kaneko K, Tashiro J, Shinomiya M, Miyazaki A, Saito Y. Long-term (14 years) effect of LDL apheresis on obstructive changes in aortocoronary saphenous-vein bypass grafts in a case of heterozygous familial hypercholesterolemia with the LDL receptor proline664 to leucine mutation. Intern Med 2000; 39:804-9. [PMID: 11030204 DOI: 10.2169/internalmedicine.39.804] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
A 61-year-old Japanese woman with heterozygous familial hypercholesterolemia (FH), type 2 diabetes mellitus and coronary artery disease underwent coronary artery bypass grafting (CABG) utilizing a saphenous vein graft at the age of 46, in June 1984, 6 months before low density lipoprotein (LDL) apheresis was started. She had received LDL apheresis every two weeks, along with combined drug treatment since the age of 47 (December 1984). She had bilateral xanthelasma and Achilles tendon xanthomas. Her fasting baseline serum total cholesterol and triglyceride level were 464 mg/dl and 57 mg/dl, respectively at the age of 47 when she visited our hospital for the first time. Analysis of the genomic DNA from the patient revealed heterozygous amino acid substitution of Leu for Pro664 in the LDL receptor gene. She was diagnosed as type 2 diabetes mellitus at the age of 53. Combined treatment in the steady state yielded a pretreatment LDL cholesterol level of 230+/-14 mg/dl and a posttreatment level of 57+/-7.6. All grafts were widely patent after as long as 14 years since CABG, suggesting that LDL apheresis combined with drug therapy is highly effective in preventing the occlusion of bypass grafts in a patient with heterozygous FH and type 2 diabetes mellitus.
Collapse
Affiliation(s)
- K Takahashi
- Second Department of Internal Medicine School of Medicine Chiba University
| | | | | | | | | | | | | | | | | | | |
Collapse
|
40
|
Takahashi-Tezuka M, Kobayashi J, Otabe M, Hirai A, Tashiro J, Bujo H, Morisaki N, Saito Y, Yoshida S. A clinical feature of hyperlipidemia in patients with central diabetes insipidus. Endocr J 2000; 47:557-62. [PMID: 11200935 DOI: 10.1507/endocrj.47.557] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
In this study, we analyzed plasma lipid and lipoprotein levels before and after treatment with 1-desamino-8-D-arginine vasopressin (DDAVP) in subjects with partial and complete central diabetes insipidus (DI) in order to determine how a shortage and supplement of this hormone affect plasma lipid metabolism. The subjects consisted of 6 patients with partial and 6 with complete central DI. After treatment with DDAVP through nasal cavity, plasma total cholesterol (TC) level did not decrease either in complete or partial form. Plasma triglyceride (TG) levels decreased from 306+/-175 mg/dl to 198+/-91 (35% decrease, p=0.027) in complete form, while TG did not change significantly in partial form. A detailed investigation of plasma lipoprotein metabolism during treatment with DDAVP was carried out in 3 of the 6 subjects with complete form of DI. Lipoprotein lipase activity and mass in post-heparin plasma from those three subjects tended to increase after treatment with DDAVP, along with the complete disappearance of an unusual lipoprotein between low density lipoprotein (LDL) and very low density lipoprotein (VLDL) as analyzed by polyacrylamide gel electrophoresis. These results suggest that the DDAVP treatment has a favorable effect on lipid and lipoprotein metabolism, especially triglyceride-rich lipoproteins, either directly or through modifying factors contributing to lipid metabolism.
Collapse
Affiliation(s)
- M Takahashi-Tezuka
- Second Department of Internal Medicine, School of Medicine, Chiba University, Japan
| | | | | | | | | | | | | | | | | |
Collapse
|
41
|
Chen Y, Shiota M, Ohuchi M, Towatari T, Tashiro J, Murakami M, Yano M, Yang B, Kido H. Mast cell tryptase from pig lungs triggers infection by pneumotropic Sendai and influenza A viruses. Purification and characterization. Eur J Biochem 2000; 267:3189-97. [PMID: 10824103 DOI: 10.1046/j.1432-1327.2000.01346.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
A novel trypsin-type serine proteinase, which processes the precursors of the envelope fusion glycoproteins of pneumotropic Sendai and human influenza A viruses, was purified to homogeneity from pig lungs. On SDS/PAGE, the purified enzyme gave a protein band corresponding to about 32 kDa, and has an apparent molecular mass of 120 kDa, as determined by gel permeation chromatography. Immunohistochemical staining with antibodies against this enzyme revealed that the enzyme is located in pig lung mast cells. The N-terminal 44-amino-acid sequence of the enzyme exhibits about 80% identity with those of mast cell tryptases from other species. Of the inhibitors tested, di-isopropyl fluorophosphate, antipain, leupeptin, benzamidine and a few proteinaceous inhibitors, such as mucus protease inhibitor and aprotinin, inhibited this enzyme activity. Heparin stabilized the enzyme, but high-ionic-strength conditions did not, unlike for human mast cell tryptase. The purified enzyme efficiently processed the fusion glycoprotein precursor of Sendai virus and slowly processed hemagglutinin of human influenza A virus, and triggered the infectivity of Sendai virus in a dose-dependent manner, although human mast cell tryptase beta and rat mast cell tryptase (rat MCP-7) from lungs did not process these fusion glycoproteins at all. These results suggest that mast cell tryptase in pig lungs is the possible trigger of the pneumotropic virus infections.
Collapse
Affiliation(s)
- Y Chen
- Division of Enzyme Chemistry, Institute for Enzyme Research, University of Tokushima, Japan
| | | | | | | | | | | | | | | | | |
Collapse
|
42
|
Tanner FC, Boehm M, Akyürek LM, San H, Yang ZY, Tashiro J, Nabel GJ, Nabel EG. Differential effects of the cyclin-dependent kinase inhibitors p27(Kip1), p21(Cip1), and p16(Ink4) on vascular smooth muscle cell proliferation. Circulation 2000; 101:2022-5. [PMID: 10790340 DOI: 10.1161/01.cir.101.17.2022] [Citation(s) in RCA: 168] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND The cyclin-dependent kinase inhibitors (CKIs) have different patterns of expression in vascular diseases. The Kip/Cip CKIs, p27(Kip1) and p21(Cip1), are upregulated during arterial repair and negatively regulate the growth of vascular smooth muscle cells (VSMCs). In contrast, the Ink CKI, p16(Ink4), is not expressed in vascular lesions. We hypothesized that a variation in the inactivation of cdk2 and cdk4 during the G(1) phase of the cell cycle by p27(Kip1), p21(Cip1), and p16(Ink4) leads to different effects on VSMC growth in vitro and in vivo. METHODS AND RESULTS The expression of p27(Kip1) and p21(Cip1) in serum-stimulated VSMCs inactivated cdk2 and cdk4, leading to G(1) growth arrest. p16(Ink4) inhibited cdk4, but not cdk2, kinase activity, producing partial inhibition of VSMC growth in vitro. In an in vivo model of vascular injury, overexpression of p27(Kip1) reduced intimal VSMC proliferation by 52% (P<0.01) and the intima/media area ratio by 51% (P<0.005) after vascular injury and gene transfer to pig arteries, when compared with control arteries. p16(Ink4) was a weak inhibitor of intimal VSMC proliferation in injured arteries (P=NS), and it did not significantly reduce intima/media area ratios (P=NS), which is consistent with its minor effects on VSMC growth in vitro. CONCLUSIONS p27(Kip1) and p21(Cip1) are potent inhibitors of VSMC growth compared with p16(Ink4) because of their different molecular mechanisms of cyclin-dependent kinase inhibition in the G(1) phase of the cell cycle. These findings have important implications for our understanding of the pathophysiology of vascular proliferative diseases and for the development of molecular therapies.
Collapse
Affiliation(s)
- F C Tanner
- Departments of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
| | | | | | | | | | | | | | | |
Collapse
|
43
|
Tamura K, Kanzaki T, Tashiro J, Yokote K, Mori S, Ueda S, Saito Y, Morisaki N. Increased atherogenesis in Otsuka Long-Evans Tokushima fatty rats before the onset of diabetes mellitus: association with overexpression of PDGF beta-receptors in aortic smooth muscle cells. Atherosclerosis 2000; 149:351-8. [PMID: 10729385 DOI: 10.1016/s0021-9150(99)00349-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
The mechanism of diabetic macroangiopathy was studied from the view point of phenotypic change of arterial smooth muscle cells (SMC). Otsuka Long-Evans Tokushima fatty (OLETF) rat, an animal model of non-insulin dependent diabetes mellitus (NIDDM), develops spontaneous persistent hyperglycemia after the age of 18 weeks. Medial SMC in OLETF rats expressed more platelet-derived growth factor (PDGF) beta-receptor and fibronectin at the protein level than those from control, Long-Evans Tokushima Otsuka (LETO) rats, not only after but also before the onset of diabetes mellitus. Cultured SMC from OLETF rats more strongly responded specifically to the mitogenic stimuli of PDGF-AB and PDGF-BB and also expressed PDGF beta-receptor more intensely compared with those from LETO rats. PDGF is known to be the main contributor to the intimal thickening induced by balloon catheter injury, which is one of several forms of arterial injuries. Intimal thickening of carotid arteries in OLETF rats after balloon catheter injury increased compared with that in LETO rats before the onset of diabetes mellitus. In in vitro culture system, fibronectin synthesis was stimulated by transforming growth factor-beta1(TGF-beta1) in SMC from OLETF rats, but not in those from LETO rats, suggesting that SMC from OLETF rats respond to TGF-beta1. These results indicate that overexpression of PDGF beta-receptor and fibronectin in medial SMC plays an important role in the accelerated intimal thickening before the onset of diabetes mellitus in OLETF rats.
Collapse
MESH Headings
- Animals
- Aorta, Thoracic/cytology
- Aorta, Thoracic/pathology
- Becaplermin
- Cell Division
- Cells, Cultured
- DNA/analysis
- DNA/biosynthesis
- Diabetes Mellitus, Type 2/metabolism
- Disease Models, Animal
- Fibronectins/analysis
- Fibronectins/metabolism
- Male
- Muscle, Smooth, Vascular/cytology
- Muscle, Smooth, Vascular/metabolism
- Muscle, Smooth, Vascular/pathology
- Platelet-Derived Growth Factor/analysis
- Platelet-Derived Growth Factor/pharmacology
- Proto-Oncogene Proteins c-sis
- Rats
- Rats, Inbred OLETF
- Receptor, Platelet-Derived Growth Factor beta/analysis
- Receptor, Platelet-Derived Growth Factor beta/metabolism
- Reference Values
- Sensitivity and Specificity
- Tunica Intima/injuries
- Tunica Intima/pathology
Collapse
Affiliation(s)
- K Tamura
- Second Department of Internal Medicine, School of Medicine, Chiba University, 1-8-1, Inohana, Chuo-ku, Chiba, Japan
| | | | | | | | | | | | | | | |
Collapse
|
44
|
Affiliation(s)
- J Tashiro
- College of Medical Technology and Nursing, University of Tsukuba, Japan.
| | | | | | | |
Collapse
|
45
|
Komukai M, Wajima YS, Tashiro J, Shinomiya M, Saito Y, Morisaki N. Carvastatin suppresses intimal thickening of rabbit carotid artery after balloon catheter injury probably through the inhibition of vascular smooth muscle cell proliferation and migration. Scand J Clin Lab Invest 1999; 59:159-66. [PMID: 10400160 DOI: 10.1080/00365519950185689] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
In order to test whether a 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase inhibitor has an anti-atherogenic activity, the effects of carvastatin, a newly developed potent inhibitor, and pravastatin were examined on the intimal thickening of the artery after the endothelial denudation induced by balloon catheter injury. Rabbits were divided into four groups; control, pravastatin-treated (20 mg kg(-1) day(-1)) and two of carvastatin-treated groups (10 or 20 mg kg(-1) day(-1)). Two weeks after balloon catheter injury, the areas of intima and media of the injured carotid arteries were determined, and the ratios of intima to media (I/M) were calculated as an index of intimal thickening. Average I/M ratios of the injured artery were 0.42+/-0.05 for control, 0.49+/-0.07 for pravastatin, 0.19+/-0.03 (10 mg kg(-1) day(-1)) and 0.20+/-0.04 (20 mg kg(-1) day(-1)) for carvastatin-treated rabbits, respectively. Thus, carvastatin reduced I/M ratio of the injured artery to approximately half versus control, but pravastatin failed to suppress the intimal thickening. For in vitro study, vascular smooth muscle cells (SMC) from rabbit aorta were explanted, then cultured, and the effects of carvastatin on SMC migration and SMC proliferation were also examined. Carvastatin inhibited dose-dependently SMC migration and SMC proliferation with IC50 values of 0.5 microM and 1 microM, respectively. These inhibitory effects of carvastatin were cancelled by the coexistence of mevalonate, a metabolite of cholesterol synthesis. Our results suggest that carvastatin may be useful in rabbits as an anti-atherogenic drug by means of the inhibition of SMC migaration or SMC proliferation.
Collapse
MESH Headings
- Animals
- Anticoagulants/pharmacology
- Arteriosclerosis/drug therapy
- Arteriosclerosis/pathology
- Becaplermin
- Carcinoma, Hepatocellular
- Carotid Arteries/drug effects
- Carotid Arteries/pathology
- Catheterization/adverse effects
- Cell Division/drug effects
- Cell Movement/drug effects
- Cholesterol, LDL/biosynthesis
- Humans
- Hydroxymethylglutaryl-CoA Reductase Inhibitors/pharmacology
- Male
- Mevalonic Acid/pharmacology
- Muscle, Smooth, Vascular/chemistry
- Muscle, Smooth, Vascular/cytology
- Muscle, Smooth, Vascular/metabolism
- Naphthalenes/chemistry
- Naphthalenes/pharmacology
- Platelet-Derived Growth Factor/pharmacology
- Pravastatin/pharmacology
- Proto-Oncogene Proteins c-sis
- Pyrans/chemistry
- Pyrans/pharmacology
- Rabbits
- Receptors, LDL/biosynthesis
- Tumor Cells, Cultured
- Tunica Intima/drug effects
Collapse
Affiliation(s)
- M Komukai
- The Second Department of Internal Medicine, School of Medicine, Chiba University, Japan.
| | | | | | | | | | | |
Collapse
|
46
|
Abstract
The role of sialic acid linked with lipoprotein lipase (LPL) in its catalytic activity was studied. When LPL was treated with sialidase, the molecular weight decreased by 2000. The sialidase-treated LPL showed unchanged hydrolyzing activity for tributyrin, a water-soluble substrate of esterase, compared with the untreated LPL. The sialidase-treated LPL also showed similar hydrolyzing activity for triolein emulsified with Triton X-100, phosphatidylcholine and phosphatidylethanolamine, whereas it showed significantly increased hydrolyzing activity for triolein emulsified with phosphatidylserine and cardiolipin (152% and 183%, compared with untreated LPL, respectively). In addition, the sialidase-treated LPL showed significantly increased hydrolyzing activity against triolein incorporated into very low-density lipoproteins and chylomicrons (151% and 186%, compared with the untreated LPL, respectively). These results suggest that the loss of sialic acids does not modify the function of the catalytic site of LPL, but facilitates the interaction of the enzyme with the interface of the surface of substrate lipoproteins.
Collapse
Affiliation(s)
- J Tashiro
- Second Department of Internal Medicine, School of Medicine, Chiba University, Japan
| | | | | | | | | |
Collapse
|
47
|
Kinoshita K, Tashiro J, Tomita S, Lee CG, Honjo T. Target specificity of immunoglobulin class switch recombination is not determined by nucleotide sequences of S regions. Immunity 1998; 9:849-58. [PMID: 9881975 DOI: 10.1016/s1074-7613(00)80650-0] [Citation(s) in RCA: 71] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
We describe a model system for class switch recombination (CSR) using CH12F3-2 cells transfected with a DNA construct containing two S sequences transcribed by different promoters and separated by a viral thymidine kinase (TK) gene. Recombination observed using this system shares key properties with physiological CSR: deletion of DNA between two S regions, requirement for cytokine stimulation, and nonhomologous and no consensus breakpoint sequences. Studies on transfectants with variants of this construct led us to the following conclusions: (1) two S sequences are required for CSR; (2) isotype specificity of recombination is not determined by nucleotide sequences of S regions; (3) S sequences are not strand-specific; and (4) induction of recombination activity requires cytokine stimulation.
Collapse
Affiliation(s)
- K Kinoshita
- Department of Medical Chemistry, Kyoto University Faculty of Medicine, Japan
| | | | | | | | | |
Collapse
|
48
|
Tashiro J, Endo M, Bujo H, Shinomiya M, Morisaki N, Saito Y. New type of the internalization-defective low-density lipoprotein receptor owing to two-nucleotide deletion (2199delCA or 2201delCA) in Japanese patients with familial hypercholesterolaemia. Eur J Clin Invest 1998; 28:712-9. [PMID: 9767370 DOI: 10.1046/j.1365-2362.1998.00332.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND In mutations of the low-density lipoprotein (LDL) receptor gene, the defect of internalization is caused by a mutation in the cytoplasmic domain of the receptor linked with exons 17 and 18, and the O-linked sugar domain linked with exon 15 has been speculated not to affect the function of the receptor. Here, we describe a novel mutation of the O-linked sugar domain of the LDL receptor gene, designated familial hypercholesterolaemia (FH)-Mishima with Japanese pedigree, which resembles but still differs from classical defective internalization cases. METHODS LDL metabolism was examined in cultured skin fibroblasts from patients. Immunoprecipitation and immunohistochemical techniques were applied for the detection of the receptor protein size and distribution. Screening of the mutant exon(s) of the LDL receptor gene was performed using the polymerase chain reaction-single-strand conformation polymorphism technique (PCR-SSCP), and sequencing of the mutated alleles was carried out using the dideoxy chain termination method. RESULTS LDL-binding activity at 4 degrees C in skin fibroblasts from patients was similar to normal, but that at 37 degrees C with the ligand decreased time dependently and was lost at 6 h, resulting in the defect of internalization and degradation of LDL. The receptor protein on the cell surface was detected at 4 degrees C by IgG-C7, an anti-LDL receptor antibody, but was not detected after incubation with LDL at 37 degrees C. The size of the receptor was 112 kD as determined by immunoprecipitation analysis. A deletion of two nucleotides in exon 15 was detected in the DNA sequence of the LDL receptor gene. The deletion results in a shift of the reading frame after Thr-713 of the mutant and makes a stop codon at amino acid 759. CONCLUSION Deletion of the two nucleotides caused novel amino acid sequences after the O-linked sugar domain, which has the ability of sorting on the cell membrane at 4 degrees C, but not at 37 degrees C in vivo, resulting in the complete cessation of activity of the LDL receptor.
Collapse
Affiliation(s)
- J Tashiro
- Second Department of Internal Medicine, School of Medicine, Chiba University, Japan
| | | | | | | | | | | |
Collapse
|
49
|
Kobayashi J, Tashiro J, Murano S, Morisaki N, Saito Y. Lipoprotein lipase mass and activity in post-heparin plasma from subjects with intra-abdominal visceral fat accumulation. Clin Endocrinol (Oxf) 1998; 48:515-20. [PMID: 9640420 DOI: 10.1046/j.1365-2265.1998.00485.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVES The purpose of this study was to investigate the possibility of impaired lipolysis of triglyceride-rich lipoproteins in patients with abdominal visceral fat accumulation by assessing two major lipolytic enzymes in the plasma, lipoprotein lipase (LPL) and hepatic lipase (HL). DESIGN AND PATIENTS A total of 31 patients [20 men, 11 women, age 50 +/- 7 years old, body mass index (BMI) 26 +/- 2 kg/m2 (mean +/- sd)] were analyzed. Visceral fat and subcutaneous fat areas were evaluated using a computerized tomographic (CT) method at the level of the umbilicus. Total lipolytic activity in the postheparin plasma (PHP) was measured using Triton X-100-emulsified triolein and LPL activity was calculated as the activity in whole plasma inhibited by the 5D2 monoclonal antibody for LPL. LPL enzyme mass was determined by a sandwich enzyme immunoassay. RESULTS The visceral fat area was found to be negatively correlated with LPL mass (V vs LPL mass, r = -0.37, P = 0.04) in PHP and had a tendency toward negative correlation with the LPL activity in the PHP (V vs LPL activity, r = -0.29, P = 0.12). Subcutaneous fat area, on the other hand, did not show any correlation with LPL activity (r = 0.13, P = 0.49) or mass (r = 0.22, P = 0.25) in the PHP. The visceral fat area was found to be positively correlated with fasting serum insulin levels (r = 0.67, P < 0.01). Body mass index (BMI) was not correlated with LPL mass or activity in the PHP. Multi-regressional analysis showed that abdominal visceral fat could be correlated with LPL mass in the PHP, independently of fasting serum insulin. The HL activity from PHP of the patients did not show significant correlation with visceral fat area, subcutaneous fat area or body mass index. CONCLUSIONS Fat distribution affects LPL mass and activity, either directly or via another metabolic abnormality such as insulin resistance, leading to impaired hydrolysis of triglycerides in chylomicrons and very low density lipoproteins (VLDL) in these subjects.
Collapse
Affiliation(s)
- J Kobayashi
- Second Department of Internal Medicine, School of Medicine, Chiba University, Japan
| | | | | | | | | |
Collapse
|
50
|
Tashiro J, Takahashi K, Yokote K, Takahashi M, Inadera H, Kobayashi J, Kanzaki T, Murano S, Shinomiya M, Morisaki N, Saito Y. Administration of a small amount of lard enhances intimal thickening in the balloon catheter injury model without affecting serum lipids. Scand J Clin Lab Invest 1998; 58:149-54. [PMID: 9587167 DOI: 10.1080/00365519850186733] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Effects of fatty acids on intimal thickening induced by a balloon catheter injury model were investigated by feeding rabbits a small amount of either lard [L] or fish oil [F]. Serum lipids of these groups were not different from those of basal diet-fed rabbits [controls] after 4 weeks of feeding. Serum saturated fatty acids such as 14:0, 16:0, and 18.0 were significantly greater in the L-fed rabbits compared with controls, but those of the aorta were not significantly different. Fatty acid composition of the F-fed rabbits was only different from that of the controls in that n-3 fatty acids slightly increased. The mean and maximum intimal thickening 2 weeks after ballooning, carried out 2 weeks after feeding, were significantly higher in the carotid arteries of the L-fed rabbits than in the controls. The intimal thickening of the F-fed rabbits did not significantly differ from that of the controls. These results suggest that lard promotes the formation of the smooth muscle cell dominant type of arteriosclerosis without affecting serum lipid levels.
Collapse
Affiliation(s)
- J Tashiro
- Second Department of Internal Medicine, School of Medicine, Chiba University, Saiseikai-Funabashi Hospital, Japan
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|