1
|
Matsubara D, Soga K, Ikeda J, Kumano T, Mitsuda M, Konishi T, Komatsu S, Shimomura K, Taniguchi F, Shioaki Y, Otsuji E. Impact of severe postoperative complications on the prognosis of older patients with colorectal cancer: a two-center retrospective study. BMC Gastroenterol 2024; 24:125. [PMID: 38566007 PMCID: PMC10988919 DOI: 10.1186/s12876-024-03213-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 03/26/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND The occurrence of postoperative complications may affect short-term outcomes and prognosis of patients with various malignancies. However, the prognostic impact of these complications in older patients with colorectal cancer (CRC) remains unclear. Therefore, this study aimed to investigate the impact of severe postoperative complications on the oncological outcomes of older (aged ≥ 80 years) and non-older (aged < 80 years) patients with CRC. METHODS We retrospectively analyzed 760 patients with stage I-III CRC who underwent curative surgery in two institutions between 2013 and 2019. The patients were categorized into older (aged ≥ 80 years, 191 patients) and non-older (aged < 80 years, 569 patients) groups. Short- and long-term outcomes were compared between the two groups. RESULTS The incidence of severe postoperative complications did not differ between the two groups (p = 0.981). Cancer-specific survival (CSS) was significantly worse in older patients with severe complications than in those without severe complications (p = 0.007); meanwhile, CSS did not differ between the non-older patients with severe complications and those without severe complications. Survival analysis revealed that the occurrence of severe postoperative complications was an independent prognostic factor for CSS in older patients (hazard ratio = 4.00, 95% confidence interval: 1.27-12.6, p = 0.017). CONCLUSION CRC surgery can be safely performed in older and non-older patients. Moreover, the occurrence of severe postoperative complications might more strongly affect the prognosis of older patients than that of non-older patients.
Collapse
Affiliation(s)
- Daiki Matsubara
- Department of Gastroenterological Surgery, Japanese Red Cross Kyoto Daiichi Hospital, 15-749, Honmachi, Higashiyama-ku, 605-0981, Kyoto, Japan
- Department of Surgery, Japanese Red Cross Maizuru Hospital, 427, Kuratani, Maizuru, 624-0906, Kyoto, Japan
| | - Koji Soga
- Department of Gastroenterological Surgery, Japanese Red Cross Kyoto Daiichi Hospital, 15-749, Honmachi, Higashiyama-ku, 605-0981, Kyoto, Japan.
| | - Jun Ikeda
- Department of Gastroenterological Surgery, Japanese Red Cross Kyoto Daiichi Hospital, 15-749, Honmachi, Higashiyama-ku, 605-0981, Kyoto, Japan
| | - Tatsuya Kumano
- Department of Gastroenterological Surgery, Japanese Red Cross Kyoto Daiichi Hospital, 15-749, Honmachi, Higashiyama-ku, 605-0981, Kyoto, Japan
- Department of Surgery, Japanese Red Cross Maizuru Hospital, 427, Kuratani, Maizuru, 624-0906, Kyoto, Japan
- Department of Surgery, National Hospital Organization Maizuru Medical Center, 2410, 625-0052, Yukinaga, Maizuru, Kyoto, Japan
| | - Masato Mitsuda
- Department of Surgery, Japanese Red Cross Maizuru Hospital, 427, Kuratani, Maizuru, 624-0906, Kyoto, Japan
| | - Tomoki Konishi
- Department of Gastroenterological Surgery, Japanese Red Cross Kyoto Daiichi Hospital, 15-749, Honmachi, Higashiyama-ku, 605-0981, Kyoto, Japan
| | - Shuhei Komatsu
- Department of Gastroenterological Surgery, Japanese Red Cross Kyoto Daiichi Hospital, 15-749, Honmachi, Higashiyama-ku, 605-0981, Kyoto, Japan
| | - Katsumi Shimomura
- Department of Gastroenterological Surgery, Japanese Red Cross Kyoto Daiichi Hospital, 15-749, Honmachi, Higashiyama-ku, 605-0981, Kyoto, Japan
| | - Fumihiro Taniguchi
- Department of Gastroenterological Surgery, Japanese Red Cross Kyoto Daiichi Hospital, 15-749, Honmachi, Higashiyama-ku, 605-0981, Kyoto, Japan
| | - Yasuhiro Shioaki
- Department of Gastroenterological Surgery, Japanese Red Cross Kyoto Daiichi Hospital, 15-749, Honmachi, Higashiyama-ku, 605-0981, Kyoto, Japan
| | - Eigo Otsuji
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachihirokoji, Kamigyo-ku, 602-0841, Kyoto, Japan
| |
Collapse
|
2
|
Soga K, Matsubara D, Takeda R, Kanazawa H, Uozumi Y, Konishi T, Komatsu S, Shimomura K, Ikeda J, Taniguchi F, Shioaki Y. [Surgical Outcomes of Colorectal Cancer for Over 90-Year-Old Patients in Our Hospital]. Gan To Kagaku Ryoho 2024; 51:442-444. [PMID: 38644316] [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: 04/23/2024]
Abstract
The aim of this study was to investigate the short-term outcomes of surgery for colorectal cancer(CRC)in the elderly aged over 90 years old. We retrospectively analyzed 1,043 patients with stage Ⅰ-Ⅳ CRC who underwent curative surgery in our institutions between 2013 and 2022. The patients were divided into the super older(aged ≥90 years, 20 patients) and non-super older groups(aged 80-89 years, 243 patients). The short-term outcomes were compared between the 2 groups. There were no significant differences in tumor location, stage, surgical approach, duration of operation and blood loss. The incidence of severe postoperative complications did not differ between the 2 groups. In conclusion, our study suggested that surgery for colorectal cancer could be as safely performed in super elderly patients as in non-super elderly patients.
Collapse
Affiliation(s)
- Koji Soga
- Dept. of Gastroenterological Surgery, Japanese Red Cross Kyoto Daiichi Hospital
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
3
|
Goldberg DW, Sardinha C, Oliveira DE, Castilho PV, Vieira JV, Ikeda J, Marques CA, Neves TS, Canani G. Fatal interactions of albatrosses with weather radiosondes/balloons on the Southern and Southeastern coasts of Brazil. Mar Pollut Bull 2024; 201:116267. [PMID: 38522334 DOI: 10.1016/j.marpolbul.2024.116267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 03/07/2024] [Accepted: 03/12/2024] [Indexed: 03/26/2024]
Abstract
Weather radiosondes play a crucial role in gathering atmospheric data for weather modeling and forecasting. However, their impact on marine wildlife, particularly seabirds, has raised concerns regarding the potential threats posed by these instruments. This study aims to assess the adverse effects of weather balloons on albatrosses, with a focus on the Southwest Atlantic region. The research reveals seven cases of entanglement of radiosonde equipment, leading to severe injuries and mortality along the Southern and Southeastern coasts of Brazil. Recommendations for mitigating the environmental impact of weather balloons include the adoption of biodegradable materials in their design and the implementation of improved retrieval protocols. Furthermore, the study stresses the importance of continued monitoring and research to address the interaction of weather radiosondes with marine animals. This approach is vital for ensuring the sustainable collection of scientific data while minimizing harm to marine life and ecosystems.
Collapse
Affiliation(s)
- D W Goldberg
- Projeto Albatroz, Av. Wilson Mendes, s/n - Porto do Carro, Cabo Frio, RJ 28922-000, Brazil.
| | - C Sardinha
- Ambipar Response Fauna e Flora Ltda, Rua Primeira de Araruama, 526, Praia Seca, Araruama, RJ 28970-000, Brazil
| | - D E Oliveira
- Ambipar Response Fauna e Flora Ltda, Rua Primeira de Araruama, 526, Praia Seca, Araruama, RJ 28970-000, Brazil
| | - P V Castilho
- Laboratório de Zoologia, Departamento de Engenharia de Pesca e Ciências Biológicas, Universidade do Estado de Santa Catarina, Rua Cel. Fernandes Martins 270, Laguna, Santa Catarina 88790-000, Brazil
| | - J V Vieira
- Laboratório de Ecologia e Conservação de Tetrápodes Marinhos/Unidade de Estabilização de Animais Marinhos, Universidade da Região de Joinville - UNIVILLE, Rod. Duque de Caxias 6.365, São Francisco do Sul, Santa Catarina 89240-000, Brazil
| | - J Ikeda
- Ambipar Response Fauna e Flora Ltda, Rua Primeira de Araruama, 526, Praia Seca, Araruama, RJ 28970-000, Brazil
| | - C A Marques
- Projeto Albatroz, Av. Wilson Mendes, s/n - Porto do Carro, Cabo Frio, RJ 28922-000, Brazil
| | - T S Neves
- Projeto Albatroz, Av. Wilson Mendes, s/n - Porto do Carro, Cabo Frio, RJ 28922-000, Brazil
| | - G Canani
- Projeto Albatroz, Av. Wilson Mendes, s/n - Porto do Carro, Cabo Frio, RJ 28922-000, Brazil; Programa de Pós-Graduação em Oceanografia Biológica (PPGOB), Instituto de Oceanografia, Universidade Federal do Rio Grande (FURG), Rio Grande, Rio Grande do Sul, Brazil
| |
Collapse
|
4
|
Matsubara D, Komatsu S, Kanazawa H, Hamada S, Uozumi Y, Nishiko M, Konishi T, Soga K, Shimomura K, Ikeda J, Taniguchi F, Shioaki Y. [Laparoscopic Surgery for Delayed Chylous Ascites in Unresectable Gastric Cancer Patient-A Case Report]. Gan To Kagaku Ryoho 2024; 51:81-83. [PMID: 38247099] [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: 01/23/2024]
Abstract
Chylous ascites is a rare post operative complication after gastrectomy, which commonly occurs in early postoperative period. Here, we successfully treated a patient with unresectable gastric cancer who occurred chylous ascites 9 months after first surgery and underwent laparoscopic surgery for chylous ascites. Since prolonged chylous ascites may cause malnutrition, surgical treatment should be considered for refractory chylous ascites.
Collapse
|
5
|
Shibata H, Komatsu S, Konishi T, Takeda R, Kanazawa H, Uozumi Y, Soga K, Shimomura K, Ikeda J, Taniguchi F, Shioaki Y. [A Case of an Advanced Gastric Cancer Patient with Outlet Obstruction and Malnutrition Who Successfully Underwent Neoadjuvant Chemotherapy with Enteral Nutrition]. Gan To Kagaku Ryoho 2023; 50:1897-1899. [PMID: 38303245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Abstract
We reported a case of an advanced gastric cancer patient with gastric outlet obstruction and malnutrition who successfully underwent neoadjuvant chemotherapy with enteral feeding. The patient is a 72-year-old man. The diagnosis was advanced gastric cancer with pyloric stenosis. Both decompression and enteral nutrition was performed with a W-ED®. Chemotherapy was markedly effective and nutritional status improved. He underwent robot-assisted distal gastrectomy(D2)and Billroth Ⅱ reconstruction under good nutritional status after neoadjuvant chemotherapy with intragastric decompression and nutritional management using a W-ED® tube. W-ED® tube is a useful tool for the proper nutritional management of patients with advanced gastric cancer who have pyloric stenosis by adequate decompression and enteral feeding.
Collapse
Affiliation(s)
- Hikaru Shibata
- Dept. of Surgery, Japanese Red Cross Kyoto Daiichi Hospital
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
6
|
Konishi T, Komatsu S, Takeda R, Kanazawa H, Soga K, Shimomura K, Ikeda J, Taniguchi F, Shioaki Y. [Safety and Efficacy of Neoadjuvant Chemotherapy(UDON: 5-FU, Docetaxel, and Nedaplatin)for Esophageal Cancer]. Gan To Kagaku Ryoho 2023; 50:1381-1383. [PMID: 38303281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Abstract
We investigated the safety and efficacy of UDON(5-FU, docetaxel and nedaplatin), a similar DCF therapy, as neoadjuvant chemotherapy for advanced esophageal cancer. Twelve patients who underwent radical esophagectomy after neoadjuvant chemotherapy for esophageal cancer at our department from June 2021 to December 2022 were retrospectively evaluated. One patient had Grade Ⅲ or higher neutropenia(8%)and 2 patients had anorexia(15%)as adverse events, but they could be safely treated. Nutritional status and ADL were maintained in all patients, and surgery was performed after 2-3 courses of neoadjuvant chemotherapy. The median postoperative hospital stay was 14 days, and no severe postoperative complications were observed. The histological effect to chemotherapy was Grade 3 in 3 patients(23%). UDON therapy is a safe and effective treatment.
Collapse
Affiliation(s)
- Tomoki Konishi
- Dept. of Surgery, Japanese Red Cross Kyoto Daiichi Hospital
| | | | | | | | | | | | | | | | | |
Collapse
|
7
|
Matsubara D, Soga K, Ikeda J, Konishi T, Uozumi Y, Takeda R, Kanazawa H, Komatsu S, Shimomura K, Taniguchi F, Shioaki Y, Otsuji E. Laparoscopic Surgery for Elderly Colorectal Cancer Patients With High American Society of Anesthesiologists Scores. Anticancer Res 2023; 43:5637-5644. [PMID: 38030213 DOI: 10.21873/anticanres.16767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 10/24/2023] [Accepted: 10/27/2023] [Indexed: 12/01/2023]
Abstract
BACKGROUND/AIM To evaluate the safety of colorectomy in elderly colorectal cancer patients with high American Society of Anesthesiologists (ASA) scores compared to those with low scores. PATIENTS AND METHODS Two hundred patients with stage I-IV colorectal cancer aged ≥80 years were retrospectively analyzed. Short- and long-term outcomes were compared between 136 patients with ASA scores ≤2 (low ASA group) and 64 patients with scores ≥3 (high ASA group). RESULTS The incidence of postoperative complications, duration of postoperative hospital stay, and 5-year overall and cancer-specific survival rates did not differ significantly between the groups. Laparoscopic surgery was significantly associated with a lower incidence of postoperative complications than open surgery in the high ASA score group (p=0.041), whereas no difference was observed in the low ASA score group (p=0.639). In the high ASA group, open surgery (p=0.024) and higher body mass index (p=0.040) were independent risk factors for postoperative complications. CONCLUSION Colorectal cancer resection can be safely performed in elderly patients with high ASA scores. Moreover, laparoscopic surgery may have a stronger contribution to the reduction of postoperative complications in elderly patients with colorectal cancer with high ASA scores than in those with low ASA scores.
Collapse
Affiliation(s)
- Daiki Matsubara
- Department of Gastroenterological Surgery, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan
- Department of Surgery, Japanese Red Cross Maizuru Hospital, Kyoto, Japan
| | - Koji Soga
- Department of Gastroenterological Surgery, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan;
| | - Jun Ikeda
- Department of Gastroenterological Surgery, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan
| | - Tomoki Konishi
- Department of Gastroenterological Surgery, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan
| | - Yusuke Uozumi
- Department of Pediatric Surgery, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan
| | - Ryo Takeda
- Department of Gastroenterological Surgery, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan
| | - Hiroaki Kanazawa
- Department of Gastroenterological Surgery, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan
| | - Shuhei Komatsu
- Department of Gastroenterological Surgery, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan
| | - Katsumi Shimomura
- Department of Gastroenterological Surgery, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan
| | - Fumihiro Taniguchi
- Department of Gastroenterological Surgery, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan
| | - Yasuhiro Shioaki
- Department of Gastroenterological Surgery, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan
| | - Eigo Otsuji
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
| |
Collapse
|
8
|
Yoshida N, Kuriu Y, Ikeda J, Kudou M, Kirishima T, Okayama T, Miyagawa K, Takagi T, Nakanishi M, Doi T, Ishikawa T, Itoh Y, Otsuji E. Effects and risk factors of TAS-102 in real-world patients with metastatic colorectal cancer, EROTAS-R study. Int J Clin Oncol 2023; 28:1378-1387. [PMID: 37578664 DOI: 10.1007/s10147-023-02389-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 07/14/2023] [Indexed: 08/15/2023]
Abstract
BACKGROUND Trifluridine/tipiracil (TAS-102) is an anticancer drug for metastatic colorectal cancer (CRC). This study aimed to analyze the effects and risk factors about effects of TAS-102 in real-world patients with metastatic CRC (the EROTAS-R study). METHODS This study retrospectively analyzed 271 patients aged ≥ 20 years who underwent TAS-102 for metastatic CRC at nine related institutions from 2014 to 2021. Therapeutic results of TAS-102 + bevacizumab (Bev) and TAS-102, effect predictors, adverse events (AE), and AE predictors were examined. RESULTS The backgrounds of all cases were as follows: average age, 66.7 ± 10.9 years; male ratio, 59.5%; performance status (PS) 0/1/2, 43.5%/50.6%/5.9%; and tumor site right/left, 25.5%/74.5%. The therapeutic results of 109 cases receiving TAS-102 + Bev and 162 cases receiving TAS-102 were as follows: disease control rate, 53.2% vs. 28.0% (p < 0.01); progressive free survival (PFS), 6.2 vs. 4.2 months (p < 0.01); and overall survival (S), 11.8 vs. 9.3 months (p = 0.03). Multivariate analysis for effect-related factors (odds ratio (OR), 95%confidence interval (CI)) showed the following: PS1 + 2 (0.257, 0.134-0.494, p < 0.01) and a combination of Bev (3.052, 1.598-5.827, p < 0.01). The rates of grade 3 AE for TAS-102 + Bev and TAS-102 were 53.2% and 48.8%, respectively (p = 0.47). Various AE predictors were as follows: male sex (p = 0.69), age ≥ 75 years (p = 0.59), PS1 + 2 (p = 0.20), body surface area < 1.53 m2 (p = 0.26), eGFR < 50 ml/min (p = 0.02), and AST ≥ 50 IU/L (p = 0.64). CONCLUSION A better OS and PFS comparing TAS-102 + Bev to TAS-102 for CRC was achieved in a large number of real-world patients.
Collapse
Affiliation(s)
- Naohisa Yoshida
- Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-Cho, Kawaramachi-Hirokoji, Kamigyo-Ku, Kyoto, 602-8566, Japan.
| | - Yoshiaki Kuriu
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Jun Ikeda
- Department of Surgery, Kyoto First Red Cross Hospital, Kyoto, Japan
| | - Michihiro Kudou
- Department of Surgery, Kyoto Okamoto Memorial Hospital, Kyoto, Japan
| | | | - Tetsuya Okayama
- Department of Gastroenterology, North Medical Center, Kyoto Prefectural University of Medicine Hospital, Kyoto, Japan
| | - Koji Miyagawa
- Department of Surgery, Kyoto Saiseikai Hospital, Kyoto, Japan
| | | | | | - Toshifumi Doi
- Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-Cho, Kawaramachi-Hirokoji, Kamigyo-Ku, Kyoto, 602-8566, Japan
| | - Takeshi Ishikawa
- Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-Cho, Kawaramachi-Hirokoji, Kamigyo-Ku, Kyoto, 602-8566, Japan
| | - Yoshito Itoh
- Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-Cho, Kawaramachi-Hirokoji, Kamigyo-Ku, Kyoto, 602-8566, Japan
| | - Eigo Otsuji
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
| |
Collapse
|
9
|
Nagai T, Tomita K, Kubo K, Ikeda J, Kawasaki K, Inagaki K. A case report of effective intra-articular elcatonin administration in a patient with osteonecrosis of the lunate. Int J Surg Case Rep 2023; 105:108056. [PMID: 37001370 PMCID: PMC10090262 DOI: 10.1016/j.ijscr.2023.108056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 03/16/2023] [Accepted: 03/17/2023] [Indexed: 03/29/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Although corticosteroids are effective for bronchial asthma, they are associated with various side effects, such as osteonecrosis of the femoral head and tibial condyle and osteoporosis. Here, we report a patient who was on corticosteroids for a long period of time due to severe asthma, which was thought to have led to lunate osteonecrosis of both wrist joints. Calcitonin (elcatonin), an osteoporosis drug, was administered to the wrist joint. CASE PRESENTATION Allergy to anesthetics and various non-steroidal anti-inflammatory drugs (NSAIDs) made surgical treatment not possible and pain control difficult. In addition, pain in the wrist joint interfered with activities of daily living (ADLs). When calcitonin was administered intra-articularly into the wrist joint, the pain in the wrist joint was relieved and ADLs were improved. However, the pain-suppressing effect lasted only 1 week, and pain returned to the original state by the second week after treatment. Repeated injections were necessary every 2 weeks. CLINICAL DISCUSSION This is the first report of the effectiveness of intra-articular calcitonin in a patient with osteonecrosis of the lunate. This treatment may be applicable to patients with allergies to anesthesia and NSAIDs. CONCLUSION In the present case, calcitonin administered intra-articularly to the wrist appeared to be effective in pain control for steroid-induced lunate osteonecrosis.
Collapse
Affiliation(s)
- Takashi Nagai
- Department of Rehabilitation Medicine, Showa University School of Medicine, Tokyo, Japan; Department of Orthopedic Surgery, Showa University School of Medicine, Tokyo, Japan.
| | - Kazunari Tomita
- Department of Orthopedic Surgery, Showa University School of Medicine, Tokyo, Japan
| | - Kazutoshi Kubo
- Department of Orthopedic Surgery, Showa University School of Medicine, Tokyo, Japan
| | - Jun Ikeda
- Department of Orthopedic Surgery, Showa University School of Medicine, Tokyo, Japan
| | - Keikichi Kawasaki
- Department of Orthopedic Surgery, Showa University School of Medicine, Tokyo, Japan
| | - Katsunori Inagaki
- Department of Orthopedic Surgery, Showa University School of Medicine, Tokyo, Japan
| |
Collapse
|
10
|
Ikeda J, Ohe C, Tanaka N, Yoshida T, Saito R, Atsumi N, Kobayashi T, Hidefumi K, Koji T, Takeharu S. HIF-1 activator Mint3 promotes tumor progression in urothelial carcinoma. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)01220-4] [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: 02/12/2023]
|
11
|
Takeda R, Shimomura K, Taniguchi F, Hamada S, Konishi T, Soga K, Komatsu S, Ikeda J, Shioaki Y. [A Case in Which a Distal Pancreatectomy Was Performed for Pancreatic Metastasis of Renal Cell Carcinoma after Nephrectomy, and a Total Pancreatectomy Was Performed for Residual Pancreatic Recurrence]. Gan To Kagaku Ryoho 2023; 50:93-95. [PMID: 36759997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
We reported a case in which a pancreatic resection was performed for pancreatic metastasis of renal cell carcinoma 24 years after nephrectomy, and a residual pancreatectomy was performed 4 years later for residual pancreatic recurrence. The patient was a 72-year-old. In 1991, he underwent right nephrectomy for right renal cell carcinoma. During follow-up, in 2015, mass lesions were noted in the pancreatic tail and distal pancreatectomy was performed on suspicion of pancreatic neuroendocrine tumor(NET). Pathological examination diagnosed metastasis of renal cell carcinoma. In 2019, mass lesions were noted in the residual pancreas and total pancreatectomy was performed. Pathological examination diagnosed metastasis of renal cell carcinoma. There was 5 cases in Japan, including an our case, in which pancreatectomy was performed again after pancreatectomy for pancreatic metastasis of renal cancer, and the average time until the first pancreatic metastasis was pointed out was 11.8 years, and the average time until pancreatic recurrence was 9.4 years. Pancreatic metastasis of renal cell carcinoma shows heterochronic and multiple metastasis occurs, requiring long-team follow-up. When determining the extent of resection, it was suggested that the minimum number of repetitions necessary may lead to a long-term prognosis, taking into account the patient's age, background.
Collapse
Affiliation(s)
- Ryo Takeda
- Division of Digestive Surgery, Japanese Red Cross Kyoto Daiichi Hospital
| | | | | | | | | | | | | | | | | |
Collapse
|
12
|
Komatsu S, Konishi T, Matsubara D, Soga K, Shimomura K, Ikeda J, Taniguchi F, Fujiwara H, Shioaki Y, Otsuji E. Continuous Recurrent Laryngeal Nerve Monitoring During Single-Port Mediastinoscopic Radical Esophagectomy for Esophageal Cancer. J Gastrointest Surg 2022; 26:2444-2450. [PMID: 36221021 DOI: 10.1007/s11605-022-05472-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 09/03/2022] [Indexed: 01/31/2023]
Abstract
BACKGROUND Although single-port mediastinoscopic radical esophagectomy is ultimate minimally invasive surgery for esophageal cancer without thoracotomy or the thoracoscopic approach, the high incidence of recurrent laryngeal nerve (RLN) palsy remains a pivotal clinical issue. METHODS This study included 41 patients who underwent single-port mediastinoscopic radical esophagectomy with mediastinal lymphadenectomy between September 2014 and March 2022. Among these, continuous nerve monitoring (CNM) for RLN was done in 25 patients (CNM group), while the remaining 16 patients underwent without CNM (non-CNM group). Clinical benefits of CNM for RLN were evaluated. RESULTS The overall incidence of postoperative RLN palsy was 14.6% (6/41). The CNM group showed a significantly lower incidence of postoperative RLN palsy as compared to the non-CNM group (P = 0.026: CNM vs. non-CRNM: 4.0% (1/25) vs. 31.2% (5/16)). The CNM group had a lower incidence of postoperative pneumoniae (CNM vs. non-CNM: 4.0% (1/25) vs. 18.8% (3/16)) and shorter days of postoperative hospital stay (CNM vs. non-CNM: 13 days vs. 41 days). Multivariate analysis revealed that the CNM use (odds ratio 0.07; 95% CI 0.05-0.98) was an independent factor avoiding postoperative RLN palsy. CONCLUSION The CNM for RLN contributes to a remarkable reduction in the risk of postoperative RLN palsy and improvement in outcomes in single-port mediastinoscopic radical esophagectomy.
Collapse
Affiliation(s)
- Shuhei Komatsu
- Department of Digestive Surgery (Esophageal and Gastric Surgery Division), Kyoto First Red Cross Hospital, 15-749 Honmachi, Higashiyama-ku, Kyoto, 605-0981, Japan. .,Division of Digestive Surgery (Esophageal and Gastric Surgery Division), Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kawaramachi-hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan.
| | - Tomoki Konishi
- Department of Digestive Surgery (Esophageal and Gastric Surgery Division), Kyoto First Red Cross Hospital, 15-749 Honmachi, Higashiyama-ku, Kyoto, 605-0981, Japan
| | - Daiki Matsubara
- Department of Digestive Surgery (Esophageal and Gastric Surgery Division), Kyoto First Red Cross Hospital, 15-749 Honmachi, Higashiyama-ku, Kyoto, 605-0981, Japan
| | - Koji Soga
- Department of Digestive Surgery (Esophageal and Gastric Surgery Division), Kyoto First Red Cross Hospital, 15-749 Honmachi, Higashiyama-ku, Kyoto, 605-0981, Japan
| | - Katsumi Shimomura
- Department of Digestive Surgery (Esophageal and Gastric Surgery Division), Kyoto First Red Cross Hospital, 15-749 Honmachi, Higashiyama-ku, Kyoto, 605-0981, Japan
| | - Jun Ikeda
- Department of Digestive Surgery (Esophageal and Gastric Surgery Division), Kyoto First Red Cross Hospital, 15-749 Honmachi, Higashiyama-ku, Kyoto, 605-0981, Japan
| | - Fumihiro Taniguchi
- Department of Digestive Surgery (Esophageal and Gastric Surgery Division), Kyoto First Red Cross Hospital, 15-749 Honmachi, Higashiyama-ku, Kyoto, 605-0981, Japan
| | - Hitoshi Fujiwara
- Division of Digestive Surgery (Esophageal and Gastric Surgery Division), Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kawaramachi-hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Yasuhiro Shioaki
- Department of Digestive Surgery (Esophageal and Gastric Surgery Division), Kyoto First Red Cross Hospital, 15-749 Honmachi, Higashiyama-ku, Kyoto, 605-0981, Japan
| | - Eigo Otsuji
- Division of Digestive Surgery (Esophageal and Gastric Surgery Division), Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kawaramachi-hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan
| |
Collapse
|
13
|
Ogawa H, Komatsu S, Matsubara D, Hamada S, Nishiko M, Konishi T, Soga K, Ikeda J, Shimomura K, Taniguchi F, Shioaki Y. [Patient with Epstein-Barr Virus-Positive Esophagogastric Junctional Cancer with Splenic Metastasis and Underwent Metastasectomy following Immune Checkpoint Therapy]. Gan To Kagaku Ryoho 2022; 49:1163-1165. [PMID: 36281620] [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: 06/16/2023]
Abstract
Recurrent gastric cancer(GC)with splenic metastasis showed poor prognosis, and its treatment strategy remains unclear. Recently, studies identified the considerable prognostic effect of metastasectomy in GC following intensive chemotherapy. Here, we successfully treated a patient with Epstein-Barr virus-positive esophagogastric junctional cancer with splenic metastasis who underwent metastasectomy and obtained pathological complete response following immune checkpoint therapy and had long-term survival. We reviewed the literature to discuss the clinical significance of our treatment strategy.
Collapse
Affiliation(s)
- Haruna Ogawa
- Dept. of Surgery, Japanese Red Cross Kyoto Daiichi Hospital
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
14
|
Shibata S, Konishi T, Hamada S, Nishiko M, Matsubara D, Soga K, Komatsu S, Shimomura K, Ikeda J, Taniguchi F, Shioaki Y. [A Case of Pembrolizumab Therapy Markedly Effective for Advanced Recurrent Colorectal Cancer]. Gan To Kagaku Ryoho 2022; 49:1151-1153. [PMID: 36281616] [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: 06/16/2023]
Abstract
We report a case of pembrolizumab therapy as the fourth-line therapy for colorectal cancer and multiple lymph node recurrence with high-frequency microsatellite instability(MSI-High). The patient was a 75-year-old woman diagnosed with ascending colon cancer(pT4aN2bM0, Stage Ⅲc)and underwent laparoscopic right hemicolectomy, D3 dissection, and functional end-to-end anastomosis after inserting a self-expandable metallic stent. Postoperative adjuvant chemotherapy was performed, and the patient was followed. Postoperative 1 year 8 months, lymph node recurrence was indicated, and FOLFOX plus panitumumab therapy was introduced. FOLFIRI plus ramucirumab therapy and FTD/TPI were introduced as the second-line and third-line treatments, respectively; however, recurrent lymph nodes were further exacerbated and showed treatment resistance. Lymph node biopsy confirmed MSI-High, and pembrolizumab therapy was initiated as the fourth-line treatment. After the therapy, the lymph nodes reduced markedly. The patient remains undergoing chemotherapy without any adverse events.
Collapse
Affiliation(s)
- Shunsuke Shibata
- Division of Digestive Surgery, Japanese Red Cross Kyoto Daiichi Hospital
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
15
|
Komatsu S, Konishi T, Matsubara D, Soga K, Shimomura K, Ikeda J, Taniguchi F, Iwase H, Kubota T, Shioaki Y, Otsuji E. Night home enteral nutrition as a novel enforced and physiologically effective nutrition therapy following total gastrectomy for gastric cancer. Sci Rep 2022; 12:14922. [PMID: 36056110 PMCID: PMC9440117 DOI: 10.1038/s41598-022-17420-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Accepted: 07/25/2022] [Indexed: 01/07/2023] Open
Abstract
Enteral nutrition has been reported to be safe and effective in malnourished patients undergoing upper gastrointestinal surgery. In this study, we devised night home enteral nutrition (N-HEN) as a novel nutritional strategy and evaluated the efficacy in gastric cancer patients following total gastrectomy. Between January 2017 and March 2021, 24 patients were prospectively included in the protocol and supported by N-HEN for three postoperative months through a jejunostomy during the night (Elental:1200 kcal/day), and 22 patients without N-HEN were followed as a control group (CG). Body weight loss, nutritional indicators and tolerance to chemotherapy were evaluated. After 3 and 6 months, patients with N-HEN had significantly less body weight loss than CG (3 months P < 0.0001: N-HEN 4.0% vs. CG 15.2%, 6 months P < 0.0001: N-HEN 7.7% vs. CG 17.7%). Prealbumin was significantly higher in patients with N-HEN than CG after 3 and 6 months (3 months P < 0.0001, 6 months P = 0.0037). Albumin, total protein and hemoglobin, tended to be higher after 3 and 6 months in patients with N-HEN than CG, and total cholesterol after 6 months. Concerning the tolerance to adjuvant chemotherapy in Stage II-III patients, patients with N-HEN significantly had a higher completion rate (P = 0.0420: N-HEN 70% vs. CG 29%) and longer duration (P = 0.0313: N-HEN 458 days vs. CG 261 days) as planned. Continuous monitoring of blood glucose concentration in patients with N-HEN did not show nocturnal hypoglycemia or hyperglycemia. N-HEN could be a novel enforced and physiologically effective nutritional strategy to support potentially malnourished patients following total gastrectomy.
Collapse
Affiliation(s)
- Shuhei Komatsu
- Department of Digestive Surgery (Gastric Surgery Division), Kyoto First Red Cross Hospital, 15-749 Honmachi, Higashiyama-ku, Kyoto, 605-0981, Japan.
- Division of Digestive Surgery (Gastric Surgery Division), Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kawaramachi-hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan.
| | - Tomoki Konishi
- Department of Digestive Surgery (Gastric Surgery Division), Kyoto First Red Cross Hospital, 15-749 Honmachi, Higashiyama-ku, Kyoto, 605-0981, Japan
| | - Daiki Matsubara
- Department of Digestive Surgery (Gastric Surgery Division), Kyoto First Red Cross Hospital, 15-749 Honmachi, Higashiyama-ku, Kyoto, 605-0981, Japan
| | - Koji Soga
- Department of Digestive Surgery (Gastric Surgery Division), Kyoto First Red Cross Hospital, 15-749 Honmachi, Higashiyama-ku, Kyoto, 605-0981, Japan
| | - Katsumi Shimomura
- Department of Digestive Surgery (Gastric Surgery Division), Kyoto First Red Cross Hospital, 15-749 Honmachi, Higashiyama-ku, Kyoto, 605-0981, Japan
| | - Jun Ikeda
- Department of Digestive Surgery (Gastric Surgery Division), Kyoto First Red Cross Hospital, 15-749 Honmachi, Higashiyama-ku, Kyoto, 605-0981, Japan
| | - Fumihiro Taniguchi
- Department of Digestive Surgery (Gastric Surgery Division), Kyoto First Red Cross Hospital, 15-749 Honmachi, Higashiyama-ku, Kyoto, 605-0981, Japan
| | - Hiroya Iwase
- Department of Endocrinology and Metabolism, Kyoto First Red Cross Hospital, 15-749 Honmachi, Higashiyama-ku, Kyoto, 605-0981, Japan
| | - Takeshi Kubota
- Division of Digestive Surgery (Gastric Surgery Division), Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kawaramachi-hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Yasuhiro Shioaki
- Department of Digestive Surgery (Gastric Surgery Division), Kyoto First Red Cross Hospital, 15-749 Honmachi, Higashiyama-ku, Kyoto, 605-0981, Japan
| | - Eigo Otsuji
- Division of Digestive Surgery (Gastric Surgery Division), Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kawaramachi-hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan
| |
Collapse
|
16
|
Kawamura T, Shimomura K, Taniguchi F, Komatsu S, Shibata R, Konishi T, Matsubara D, Soga K, Ikeda J, Shioaki Y. [Novel Treatment Strategy Using Trafermin® Consisting of bFGF for Intractable Pancreatic Fistula-A Case Report]. Gan To Kagaku Ryoho 2022; 49:342-344. [PMID: 35299200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Pancreatic fistula is one of the most critical complication following distal pancreatectomy. We report here a successfully treated case with intractable pancreatic fistula using Trafermin® consisting of basic fibroblast growth factor(bFGF). A 60- year-old man underwent laparoscopic distal pancreatectomy. After surgery, pancreatic fistula was occurred. Pancreatic fistula persisted for 3 months despite of several conservative treatments. After obtaining informed consent, we started to inject 50μg/day of Trafermin® through a drainage tube into the dehiscence of pancreas. Consequently, pancreatic fistula was successfully closed within a week. This technique could be one of the treatment choices for intractable pancreatic fistula following distal pancreatectomy.
Collapse
Affiliation(s)
- Taiyo Kawamura
- Dept. of Surgery, Japanese Red Cross Kyoto Daiichi Hospital
| | | | | | | | | | | | | | | | | | | |
Collapse
|
17
|
Hamada S, Komatsu S, Nishiko M, Konishi T, Matsubara D, Soga K, Shimomura K, Ikeda J, Taniguchi F, Shioaki Y. [Long-Term Elderly Survivor with Recurrent MSI-High Gastric Cancer Using Pembrolizumab as a Second-Line Chemotherapy]. Gan To Kagaku Ryoho 2022; 49:83-84. [PMID: 35046369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
KEYNOTE-158 and 061 trials revealed the efficacy and safety of pembrolizumab(KEYTRUDA®)treatment in patients with recurrent high microsatellite instability(MSI-high)gastric cancer following gastrectomy. Here, we successfully treated an elderly case with recurrences following radical gastrectomy for advanced gastric cancer using pembrolizumab as a second- line chemotherapy. Even in elderly patients, pembrolizumab might contribute to effective and safe treatment in late-line chemotherapy for recurrent MSI-high gastric cancer.
Collapse
|
18
|
Kanazawa H, Komatsu S, Konishi T, Shibata R, Matsubara D, Soga K, Shimomura K, Ikeda J, Taniguchi F, Otsuji E, Shioaki Y. [Mediastinoscopic Radical Esophagectomy for Esophageal Cancer in a Patient with Chronic Pulmonary Infection]. Gan To Kagaku Ryoho 2021; 48:2109-2111. [PMID: 35045508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Mediastinoscopic esophagectomy(ME)is a minimally invasive approach without thoracotomy and pulmonary atelectasis during surgery. Here, we report the case of a 67-year-old patient who was successfully treated with thoracic esophageal cancer and severe chronic pulmonary infection using ME and home enteral nutrition therapy. Esophageal cancer patients with severe lung dysfunction have a risk of postoperative pneumoniae. ME could be a promising procedure for patients with severe lung dysfunction. We highlight the usefulness of ME as a safe approach to avoid pulmonary complications.
Collapse
|
19
|
Shibata R, Komatsu S, Konishi T, Matsubara D, Soga K, Shimomura K, Ikeda J, Taniguchi F, Shioaki Y. [A Case of G-CSF Producing Esophageal Carcinosarcoma Treated Effectively with Nivolumab for Recurrences following Two-Stage Surgery]. Gan To Kagaku Ryoho 2021; 48:2112-2114. [PMID: 35045509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
G-CSF producing esophageal carcinosarcoma is extremely rare, and its effective treatment strategy remains undefined. Here, we report the case of a 69-year-old woman who underwent successful two-stage surgery using mediastinoscopic esophagectomy and laparoscopic reconstruction for the management of severe anemia, malnutrition, and inflammation due to G-CSF producing esophageal carcinosarcoma(G-CSF 265 pg/mL). Chemoradiotherapy could not manage lymph node recurrences in the patient; however, nivolumab was found to be effective and helped achieved a prolonged partial response.
Collapse
Affiliation(s)
- Rie Shibata
- Dept. of Digestive Surgery, Kyoto First Red Cross Hospital
| | | | | | | | | | | | | | | | | |
Collapse
|
20
|
Ikeshita C, Komatsu S, Shibata R, Konishi T, Matsubara D, Soga K, Shimomura K, Ikeda J, Taniguchi F, Shioaki Y. [Conversion Surgery for Advanced Gastric Cancer with Ovarian Metastasis-A Case Report with Review of the Literatures]. Gan To Kagaku Ryoho 2021; 48:1709-1711. [PMID: 35046305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Stage Ⅳ gastric cancer(GC)with ovarian metastasis showed poor prognosis and its treatment strategy remains unclear. Recent studies identified the favorable prognostic effect of conversion surgery in Stage Ⅳ GC following intensive chemotherapy. We report here a case with advanced GC and ovarian metastasis, who underwent conversion surgery for them followed by chemotherapy and had a long-term survival. We reviewed the literatures in order to discuss clinical significance of our treatment strategy.
Collapse
|
21
|
Hamada S, Komatsu S, Shibata R, Konishi T, Matsubara D, Soga K, Shimomura K, Ikeda J, Taniguchi F, Shioaki Y. [Better Effect of Home Night Enteral Nutrition in an Elderly Patient Following Laparoscopic Total Gastrectomy for Advanced Gastric Cancer]. Gan To Kagaku Ryoho 2020; 47:2030-2031. [PMID: 33468790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Postoperative low nutrition, body weight loss and poor QOL are pivotal clinical issues for elderly patients following total gastrectomy for advanced gastric cancer. Here, we report a successfully treated high-risk elderly case using home night enteral nutrition and adjuvant chemotherapy following laparoscopic total gastrectomy for advanced gastric cancer. Home night enteral nutrition might not impair oral intake and daily QOL, and could be a useful treatment strategy for elderly patients following total gastrectomy.
Collapse
|
22
|
Kumano T, Shibata R, Ota A, Tanaka S, Komatsu S, Imura K, Shimomura K, Ikeda J, Taniguchi F, Shioaki Y. [A Case of Peritoneal Metastasis from an Unresectable Advanced Gastric Cancer with a Good Response to Nivolumab]. Gan To Kagaku Ryoho 2020; 47:2424-2426. [PMID: 33468982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
A 74-year-old woman presented with abdominal discomfort and was diagnosed with an unresectable advanced gastric cancer(T4aN3aM1, stage Ⅳ)based on a thorough examination. S-1/cisplatin therapy was administered as first-line treatment and paclitaxel/ramucirumab therapy as the second-line treatment. However, because the patient developed a peritoneal dissemination and her lymph node metastasis increased despite these regimens, nivolumab was introduced as a third- line treatment. The CT scan revealed that after the 5 courses of nivolumab, both the peritoneal dissemination and metastatic lymph nodes shrunk; after 12 courses of nivolumab, the peritoneal dissemination almost disappeared. Although nivolumab, an anti-programmed cell death-1(PD-1)antibody, has the possibility to cause immune-related adverse events not seen with conventional chemotherapy, in the present case, these events did not occur and the antitumor effects were maintained for a relatively long period without a decrease in the performance status(PS). We experienced a case of peritoneal metastasis from gastric cancer with a good response to nivolumab. Herein, this case is reported with some literature review.
Collapse
Affiliation(s)
- Tatsuya Kumano
- Dept. of Surgery, Japanese Red Cross Kyoto Daiichi Hospital
| | | | | | | | | | | | | | | | | | | |
Collapse
|
23
|
Hamada S, Komatsu S, Shibata R, Konishi T, Matsubara D, Soga K, Shimomura K, Ikeda J, Taniguchi F, Shioaki Y. [Long-Term Survivor with Recurrent Gastric Cancer Using Trifluridine/Tipiracil as a Late-Line Chemotherapy]. Gan To Kagaku Ryoho 2020; 47:2056-2058. [PMID: 33468799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
TAGS trial revealed the efficacy and safety of trifluridine/tipiracil(Lonsurf®)treatment in patients with metastatic gastric cancer following gastrectomy. Here, we successfully treated 38 months survival case after recurrences following radical gastrectomy for advanced adenocarcinoma of esophago-gastric junction using historical recommended chemotherapy regimens and trifluridine/tipiracil as a fifth-line chemotherapy. Trifluridine/tipiracil therapy contributed to effective and safety treatment even in late-line chemotherapy for recurrent gastric cancer.
Collapse
|
24
|
Okamura Y, Minami S, Kato Y, Fujishiro Y, Kaneko Y, Ikeda J, Muramoto J, Kaneko R, Ueda K, Kocsis V, Kanazawa N, Taguchi Y, Koretsune T, Fujiwara K, Tsukazaki A, Arita R, Tokura Y, Takahashi Y. Giant magneto-optical responses in magnetic Weyl semimetal Co 3Sn 2S 2. Nat Commun 2020; 11:4619. [PMID: 32934234 PMCID: PMC7492236 DOI: 10.1038/s41467-020-18470-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [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: 02/29/2020] [Accepted: 08/25/2020] [Indexed: 11/09/2022] Open
Abstract
The Weyl semimetal (WSM), which hosts pairs of Weyl points and accompanying Berry curvature in momentum space near Fermi level, is expected to exhibit novel electromagnetic phenomena. Although the large optical/electronic responses such as nonlinear optical effects and intrinsic anomalous Hall effect (AHE) have recently been demonstrated indeed, the conclusive evidence for their topological origins has remained elusive. Here, we report the gigantic magneto-optical (MO) response arising from the topological electronic structure with intense Berry curvature in magnetic WSM Co3Sn2S2. The low-energy MO spectroscopy and the first-principles calculation reveal that the interband transitions on the nodal rings connected to the Weyl points show the resonance of the optical Hall conductivity and give rise to the giant intrinsic AHE in dc limit. The terahertz Faraday and infrared Kerr rotations are found to be remarkably enhanced by these resonances with topological electronic structures, demonstrating the novel low-energy optical response inherent to the magnetic WSM.
Collapse
Affiliation(s)
- Y Okamura
- Department of Applied Physics and Quantum Phase Electronics Center, University of Tokyo, Tokyo, 113-8656, Japan.
| | - S Minami
- Nanomaterials Research Institute, Kanazawa University, Ishikawa, 920-1192, Japan.,RIKEN Center for Emergent Matter Science (CEMS), Wako, 351-0198, Japan
| | - Y Kato
- Department of Applied Physics and Quantum Phase Electronics Center, University of Tokyo, Tokyo, 113-8656, Japan
| | - Y Fujishiro
- Department of Applied Physics and Quantum Phase Electronics Center, University of Tokyo, Tokyo, 113-8656, Japan
| | - Y Kaneko
- RIKEN Center for Emergent Matter Science (CEMS), Wako, 351-0198, Japan
| | - J Ikeda
- Institute for Materials Research, Tohoku University, Sendai, 980-8577, Japan
| | - J Muramoto
- Department of Applied Physics and Quantum Phase Electronics Center, University of Tokyo, Tokyo, 113-8656, Japan
| | - R Kaneko
- Department of Applied Physics and Quantum Phase Electronics Center, University of Tokyo, Tokyo, 113-8656, Japan
| | - K Ueda
- Department of Applied Physics and Quantum Phase Electronics Center, University of Tokyo, Tokyo, 113-8656, Japan
| | - V Kocsis
- RIKEN Center for Emergent Matter Science (CEMS), Wako, 351-0198, Japan
| | - N Kanazawa
- Department of Applied Physics and Quantum Phase Electronics Center, University of Tokyo, Tokyo, 113-8656, Japan
| | - Y Taguchi
- RIKEN Center for Emergent Matter Science (CEMS), Wako, 351-0198, Japan
| | - T Koretsune
- Deparment of Physics, Tohoku University, Sendai, 980-8578, Japan
| | - K Fujiwara
- Institute for Materials Research, Tohoku University, Sendai, 980-8577, Japan
| | - A Tsukazaki
- Institute for Materials Research, Tohoku University, Sendai, 980-8577, Japan
| | - R Arita
- Department of Applied Physics and Quantum Phase Electronics Center, University of Tokyo, Tokyo, 113-8656, Japan.,RIKEN Center for Emergent Matter Science (CEMS), Wako, 351-0198, Japan
| | - Y Tokura
- Department of Applied Physics and Quantum Phase Electronics Center, University of Tokyo, Tokyo, 113-8656, Japan.,RIKEN Center for Emergent Matter Science (CEMS), Wako, 351-0198, Japan.,Tokyo College, University of Tokyo, Tokyo, 113-8656, Japan
| | - Y Takahashi
- Department of Applied Physics and Quantum Phase Electronics Center, University of Tokyo, Tokyo, 113-8656, Japan. .,RIKEN Center for Emergent Matter Science (CEMS), Wako, 351-0198, Japan.
| |
Collapse
|
25
|
Ohsugi H, Ohe C, Yoshida T, Ikeda J, Kinoshita H, Matsuda T. A novel scoring system integrating PBRM1 expression to predict recurrence in patients with non-metastatic clear cell renal cell carcinoma undergoing radical surgery. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33912-4] [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] Open
|
26
|
Ohta A, Komatsu S, Tsuji R, Tanaka S, Kumano T, Imura K, Shimomura K, Ikeda J, Taniguchi F, Doi T, Yamada S, Tomatsuri N, Yoshida N, Shioaki Y. [Clinical Evaluation of the Efficacy and Adverse Effects of Nivolumab Treatment for Patients with Advanced Gastric Cancer]. Gan To Kagaku Ryoho 2020; 47:725-727. [PMID: 32389997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
BACKGROUND Nivolumab, a fully human IgG4 monoclonal antibody inhibitor of programmed death-1(PD-1), was approved for use in the treatment of patients with advanced gastric or gastroesophageal junction cancer who had been previously treated with B2 chemotherapy regimens in Japan. METHODS We investigated the efficacy of nivolumab therapy in 15 consecutive patients with advanced gastric cancer between October 2017 and December 2018 in our facility. RESULTS In our study, the 6-month overall survival rate was 67.7%, and the median survival time(MST)was 6.3 months. Immune-related adverse events(irAEs)occurred in the following patients: 2 patients, interstitial pneumonia(13%); 1 patient, myocarditis (6.7%); 1 patient, hypothyroidism(6.7%); and 1 patient, liver dysfunction(6.7%). Of the patients with an absolute lym- phocyte count(ALC)of C2,000/mL at baseline, 33%(4/12)experienced irAEs, while of those with an ALC of >2,000/mL, 67% had irAEs. The 6-month overall survival rate was better in patients with an ALC >1,600/mL(100%, 4/4)than in those with an ALC of C1,600/mL(35%, 4/11). The 6-month overall survival rate of the patients with a neutrophil-to-lymphocyte ratio(NLR)of <4 was 63%, which was better than the 33% rate in those with an NLR of B4. CONCLUSIONS Nivolumab therapy was a safe and feasible treatment option. The cutoff values of ALC of 2,000/mL for irAEs and of ALC of 1,600/mL and NLR of 4 for prognosis might be effective surrogate markers in nivolumab treatment.
Collapse
Affiliation(s)
- Atsuki Ohta
- Dept. of Surgery, Kyoto First Red Cross Hospital
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
27
|
Kumano T, Ota A, Tanaka S, Komatsu S, Imura K, Shimomura K, Ikeda J, Taniguchi F, Shioaki Y. [A Case of Gastric Remnant Necrosis Following Laparoscopic Distal Gastrectomy for Gastric Cancer Successfully Treated Using a Conservative Approach]. Gan To Kagaku Ryoho 2019; 46:2069-2071. [PMID: 32157062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
INTRODUCTION The stomach is an organ considered resistant to ischemia because of the microvascular networks in the stomach wall, and gastric remnant necrosis following gastrectomy is rare. Herein, we report a case of gastric remnant necrosis following gastrectomy successfully treated using a conservative approach. CASE PRESENTATION An 83-year-old woman underwent laparoscopic distal gastrectomy, D1 plus lymphadenectomy, Billroth Ⅰreconstruction, and suture closure of the esophageal hiatus for early gastric cancer and giant esophageal hiatal hernia. The amylase level of the drainage fluid was abnormally high on postoperative day(POD)3, and contrast-enhanced CT confirmed gastric remnant necrosis. The patient was treated using a conservative approach, as her general condition was stable. Postoperative fluoroscopy on POD 21 revealed contrast media leakage from the gastric remnant; however, adequate drainage was observed. Upper gastrointestinal(GI)endoscopy on POD 23 demonstrated circumferential gastric remnant necrosis, whereas GI endoscopy on POD 52 revealed a decrease in the size of the gastric remnant, proliferation of the granulation tissue, and regeneration of mucosa in the gastric remnant. DISCUSSION Gastric remnant necrosis following gastrectomy is a rare complication and is associated with poor prognosis. In most cases, total resection of the remnant stomach is warranted. However, for high surgical risk cases, conservative treatment options should be considered based on an assessment of patients' general condition.
Collapse
Affiliation(s)
- Tatsuya Kumano
- Dept. of Surgery, Japanese Red Cross Kyoto Daiichi Hospital
| | | | | | | | | | | | | | | | | |
Collapse
|
28
|
Okano K, Komatsu S, Tsuji R, Tomatsuri N, Asaeda K, Shiraga A, Ohta A, Tanaka S, Kumano T, Imura K, Shimomura K, Ikeda J, Taniguchi F, Shioaki Y. [LECS-Assisted Open Partial Gastrectomy for an Ulcerative GIST in an Elderly Patient]. Gan To Kagaku Ryoho 2019; 46:2577-2579. [PMID: 32157004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Laparoscopy and endoscopy cooperative surgery(LECS)is an excellent surgical procedure that prevents excessive resection of the gastrointestinal wall and maintains gastrointestinal functions. However, LECS is not recommended for large gastrointestinal stromal tumor(GIST)sized more than 5 cm and/or ulcerative GIST because of the oncological risk of peritoneal dissemination. Here, we report the case of an elderly patient who was successfully treated with LECS-assisted open partial gastrectomy for an ulcerative GIST near the esophagogastric junction.
Collapse
|
29
|
Tanaka S, Komatsu S, Ohta A, Furuke H, Kumano T, Imura K, Shimomura K, Ikeda J, Taniguchi F, Shioaki Y. [Validation of the 8th Edition of the UICC TNM Classification for Stage Ⅲ Gastric Cancer]. Gan To Kagaku Ryoho 2019; 46:502-504. [PMID: 30914595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
BACKGROUND The 8th edition of the UICC TNM Classification was released in 2017 and introduced N3a/N3b groupings for gastric cancer. The purpose of this study was to evaluate the validity of the new classification for Stage Ⅲ gastric cancer. PATIENTS AND METHODS Clinical and pathological data on 388 patients who underwent R0 resection from January 1992 to December 2016 in our institution were retrospectively analyzed. The survival in the 7th and 8th edition stage groupings were compared. Differences in survival according to N classification were also examined in the groups with T4a tumor depth. RESULTS 1. The 5-year overall survival(OS)probabilities for Stage ⅢA, ⅢB, and ⅢC of 7th edition were 47.6%, 55.0%, and 28.5%(p=0.0003)and the recurrence-free survival(RFS)rates were 81.1%, 79.4%, and 58.7%(p=0.0013), respectively. In contrast, the OS probabilities of the 8th edition were 50.2%, 41.3% and 30.1%(p=0.0009)and the RFS were 81.6%, 70.9% and 50.0%(p=0.0003), respectively. 2. For T4a tumor depth, the OS probabilities of N1, N2, N3a, and N3b were 48.8%, 54.0%, 27.5%, and 25.1%(p=0.0012)and the RFS were 82.7%, 81.2%, 57.0% and 48.7%(p=0.0013), respectively. CONCLUSION The 8th edition of the UICC TNM classification may provide better accuracy than that of the 7th edition in predicting the prognosis of Stage Ⅲ gastric cancer.
Collapse
|
30
|
Tsuji R, Komatsu S, Kumano T, Ohta A, Furuke H, Tanaka S, Imura K, Shimomura K, Ikeda J, Taniguchi F, Shioaki Y. [Laparoscopy and Endoscopy Cooperative Surgery(LECS)-Assisted Open Partial Gastrectomy for a High-Risk Gastrointestinal Stromal Tumor]. Gan To Kagaku Ryoho 2019; 46:172-174. [PMID: 30765678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Laparoscopy and endoscopy cooperative surgery(LECS)is an excellent surgical procedure to avoid excessive resection of the gastrointestinal wall and maintain its functions. However, LECS for large gastrointestinal stromal tumor(GIST)of> 50mm and/or ulcerative GIST are not recommended because of the oncological risk of peritoneal dissemination. Here, we report a case successfully treated with LECS-assisted open partial gastrectomy for a high-risk GIST with ulceration near the esophago-gastric junction.
Collapse
Affiliation(s)
- Ryota Tsuji
- Dept. of Surgery, Kyoto First Red Cross Hospital
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
31
|
Uebayashi A, Komatsu S, Tsuji R, Ohta A, Tanaka S, Kumano T, Imura K, Shimomura K, Ikeda J, Taniguchi F, Shioaki Y. [Better Effects of Inventive Nutritional Approaches for Chemotherapy and Conversion Surgery in Stage Ⅳ Gastric Cancer]. Gan To Kagaku Ryoho 2018; 45:2255-2257. [PMID: 30692349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The REGATTA trial revealed that chemotherapy is the standard strategy for gastric cancer patients with Stage Ⅳ factors. However, some recent studies have identified the prognostic effect of conversion surgery after complete response to Stage Ⅳ factors during chemotherapy. Here, we report a case with Stage Ⅳ factors successfully treated via intensive chemotherapy and conversion surgery without any adverse events and complications, using preoperative parenteral hyper-nutrition and postoperative enteral nutrition. Nutrition might be the key strategy during the treatment of gastric cancer patients with Stage Ⅳ factors.
Collapse
|
32
|
Tsukuda N, Komatsu S, Kumano T, Matsumuro Y, Ohta A, Tsuji R, Minowa K, Tanaka S, Imura K, Shimomura K, Ikeda J, Taniguchi F, Shioaki Y. [Modified NEWS as a Safe and Inventive Approach for Gastrointestinal Stromal Tumor near the Esophagogastric Junction]. Gan To Kagaku Ryoho 2018; 45:2153-2155. [PMID: 30692315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Laparoscopy and endoscopy cooperative surgery(LECS)is an excellent surgical procedure that utilizes the advantages of both methods. Furthermore, non-exposed endoscopic wall-inversion surgery(NEWS)is a more promising procedure that enables avoidance of tumor exposure of and dissemination to the abdominal cavity. However, NEWS has the potential risk of postoperative ulceration, leading to delayed perforation because of mucosal defect. We invented a modified NEWS, which was a safe procedure, by including the all-layer suture to close the mucosal defect. We present a case of gastrointestinal stromal tumor(GIST)near the esophagogastric junction, which was treated with modified NEWS.
Collapse
|
33
|
Kumano T, Komatsu S, Furuke H, Tanaka S, Imura K, Shimomura K, Ikeda J, Taniguchi F, Shioaki Y. [Surgical Technique for Lesser Curvature Lymph Node Dissection in Laparoscopic Distal Gastrectomy]. Gan To Kagaku Ryoho 2018; 45:2057-2059. [PMID: 30692283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
INTRODUCTION Lesser curvature lymph node dissection is often performed at the end of the procedure in laparoscopic distal gastrectomy. In obese patients, it can be difficult to secure a visual field, and bleeding or injury of the remnant stomach may occur. SURGICAL TECHNIQUE After separating the duodenum using an automated suturing instrument, the stomach is rolled under the left diaphragm. An assistant holds the gastric angle near the lesser curvature with forceps in the right hand, and pulls the stomach cephalad toward the left side of the patient. As a result, the region from the esophagogastric junction to the gastric angle is aligned, enabling use of an ultrasonically activated scalpel from the right side of the operator. Dissection is performed from around the posterior wall of the esophagogastric junction to the gastric angle. After dissecting the posterior wall as much as possible, dissection of the anterior wall is performed to complete the lesser curvature procedure. CONCLUSION This technique enables safe and reliable dissection of the lesser curvature while avoiding bleeding and damage to the stomach wall.
Collapse
Affiliation(s)
- Tatsuya Kumano
- Dept. of Surgery, Japanese Red Cross Kyoto Daiichi Hospital
| | | | | | | | | | | | | | | | | |
Collapse
|
34
|
Nanishi K, Taniguchi F, Mizuno A, Furuke H, Tanaka S, Kumano T, Komatsu S, Imura K, Shimomura K, Ikeda J, Takashina K, Shioaki Y, Ikeda E. [A Case of GIST with Extensive Peritoneal Dissemination Controlled over Long-Term by Low-Dose, Intermittent Administration of Imatinib after Weight Loss Surgery]. Gan To Kagaku Ryoho 2018; 45:2348-2350. [PMID: 30692460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
A 67-year-old man presented with abdominal pain and fever. Many abdominal tumors were detected by enhanced computed tomography(CT). The largest tumor, measuring 20 cm, had perforated the ileum and formed an abscess. Emergency surgery was performed to remove multiple tumors in the peritoneal cavity as much as possible. Immunostaining showed c-kit and CD34 positivity, and the tumors were diagnosed as gastrointestinal stromal tumor(GIST). During postoperative imatinib therapy for the residual tumor, low-dose intermittent administration was required due to side effects, but the disease was controlled for over 91months. For advanced GIST with peritoneal dissemination, 200mg/day imatinib or intermittent administration after volume reduction surgery might be effective depending on the patient's general condition.
Collapse
Affiliation(s)
- Kenji Nanishi
- Division of Digestive Surgery, Dept. of Surgery, Kyoto Prefectural University of Medicine
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
35
|
Kojima S, Ogi M, Yoshitomi Y, Kuramochi M, Ikeda J, Naganawa M, Hatakeyama H. Changes in Bradykinin and Prostaglandins Plasma Levels during Dextran-sulfate Low-density-lipoprotein Apheresis. Int J Artif Organs 2018. [DOI: 10.1177/039139889702000310] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The negative charges of dextran-sulfate (DS) used for low-density-lipoprotein (LDL) apheresis initiate the intrinsic coagulation pathway in which plasma kallikrein acts on the high-molecular-weight kininogen to produce large amounts of bradykinin. This study was undertaken to assess whether bradykinin generated during DS LDL apheresis has any physiologic effects in vivo. The plasma levels of bradykinin, prostaglandins and cyclic guanosine monophosphate (cGMP) were compared, when either of two anticoagulants, heparin or nafamostat mesilate (NM), was used during DS LDL apheresis. Although anticoagulative action by NM depends on the inhibition of thrombin activity, this substance also inhibits the activity of plasma kallikrein. During apheresis using heparin, the plasma levels of prostaglandin E2 (PGE2) increased significantly (5.6 ± 1.2 (mean ± SE, n=4) pg/ml before apheresis and 33.4 ± 13.2 after apheresis, p < 0.05) in association with an increase in bradykinin levels (17.9 ± 2.6 pg/ml before apheresis and 470 ± 135 after apheresis, p < 0.01). Interestingly, these changes were suppressed during apheresis using NM. There were no appreciable changes in cGMP during DS LDL apheresis with either of the anticoagulants. This finding suggests that bradykinin generated during apheresis has some pathophysiological effects via activation of the prostaglandin system. Our results support the view that in patients taking angiotensin-convertingenzyme inhibitors, the anaphylactoid reaction occurring during apheresis may be caused by an excessive rise in the bradykinin levels.
Collapse
Affiliation(s)
- S. Kojima
- Department of Clinical Research and Department of Medicine, Tohsei National Hospital, City
| | - M. Ogi
- Department of Clinical Research and Department of Medicine, Tohsei National Hospital, City
| | - Y. Yoshitomi
- Department of Clinical Research and Department of Medicine, Tohsei National Hospital, City
| | - M. Kuramochi
- Department of Clinical Research and Department of Medicine, Tohsei National Hospital, City
| | - J. Ikeda
- Special Reference Laboratories City - Japan
| | | | | |
Collapse
|
36
|
Ikeda J, Furuke H, Kato C, Takabatake K, Kishimoto T, Kumano T, Imura K, Shimomura K, Kubota T, Taniguchi F, Shioaki Y. [Evaluated Cases of Anastomotic Recurrence in Colorectal Cancer]. Gan To Kagaku Ryoho 2018; 45:706-708. [PMID: 29650842] [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: 06/08/2023]
Abstract
Anastomotic recurrence in 6 colorectal cancer cases during the postoperative surveillance between 2008 and 2015 was evaluated retrospectively. Five cases had undergone DST anastomosis for sigmoidectomy and proctectomy. They had a pathological tendency to have T3 tumor and deeper, positive lymph node metastases and positive lymphatic and vascular invasion. There were 2 cases with the anastomotic recurrence diagnosis 6 to 8 months after the primary tumor resection while 4 resected cases had recurrent tumor depth of T3, though 3 cases were diagnosed 1 year after the primary tumor resection. Anastomotic recurrence should be considered a few months after primary tumor resection.
Collapse
Affiliation(s)
- Jun Ikeda
- Dept. of Digestive Surgery, Japanese Red Cross Kyoto Daiichi Hospital
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
37
|
Furuke H, Komatsu S, Ikeda J, Tanaka S, Kumano T, Imura KI, Shimomura K, Taniguchi F, Ueshima Y, Takashina KI, Lee CJ, Deguchi E, Ikeda E, Otsuji E, Shioaki Y. Self-expandable Metallic Stents Contribute to Reducing Perioperative Complications in Colorectal Cancer Patients with Acute Obstruction. Anticancer Res 2018; 38:1749-1753. [PMID: 29491112 DOI: 10.21873/anticanres.12411] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [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: 11/29/2017] [Revised: 12/17/2017] [Accepted: 12/20/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND/AIM The self-expandable metallic stent (SEMS) is an excellent non-invasive tool for emergent bowel obstruction. This study was designed to evaluate the clinical usefulness of the SEMS for avoiding perioperative complications. PATIENTS AND METHODS We analyzed a total of 47 consecutive patients who had a bowel obstruction due to colorectal cancer at initial diagnosis between 2012 and 2017 from hospital records. RESULTS Perioperative complications occurred in 30% (14/47) of patients. Univariate and multivariate logistic regression analyses identified an age of more than 75 years [p=0.037, OR=6.84 (95% CI=1.11-41.6)] and the absence of an SEMS treatment [p=0.028, OR=18.5 (95% CI=1.36-250.0)] as independent risk factors for perioperative complications. Pneumonia (12.7% (6/47)) was the most common complication. There were no pneumonia patients (0% (0/15)) who were treated with the SEMS. In contrast to patients with the non-SEMS treatment, 18.7% (6/32) of all patients and 35.7% (5/14) of elderly patients had pneumonia. CONCLUSION The SEMS is a safe and effective treatment for avoiding perioperative complications, particularly pneumonia, and may be a crucial strategy in elderly patients with acute obstruction due to colorectal cancer.
Collapse
Affiliation(s)
- Hirotaka Furuke
- Department of Surgery, Kyoto First Red Cross Hospital, Kyoto, Japan
| | - Shuhei Komatsu
- Department of Surgery, Kyoto First Red Cross Hospital, Kyoto, Japan .,Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Jun Ikeda
- Department of Surgery, Kyoto First Red Cross Hospital, Kyoto, Japan
| | - Sachie Tanaka
- Department of Surgery, Kyoto First Red Cross Hospital, Kyoto, Japan
| | - Tatsuya Kumano
- Department of Surgery, Kyoto First Red Cross Hospital, Kyoto, Japan
| | - Ken-Ichiro Imura
- Department of Surgery, Kyoto First Red Cross Hospital, Kyoto, Japan
| | | | | | - Yasuo Ueshima
- Department of Surgery, Kyoto First Red Cross Hospital, Kyoto, Japan
| | | | - Chol Joo Lee
- Department of Surgery, Kyoto First Red Cross Hospital, Kyoto, Japan
| | - Eiichi Deguchi
- Department of Surgery, Kyoto First Red Cross Hospital, Kyoto, Japan
| | - Eito Ikeda
- Department of Surgery, Kyoto First Red Cross Hospital, Kyoto, Japan
| | - Eigo Otsuji
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Yasuhiro Shioaki
- Department of Surgery, Kyoto First Red Cross Hospital, Kyoto, Japan
| |
Collapse
|
38
|
Takabatake K, Kubota T, Furuke H, Kato C, Kishimoto T, Kumano T, Imura K, Shimomura K, Ikeda J, Taniguchi F, Shioaki Y. [A Case of Laparoscopic Distal Gastrectomy after Abdominal Incisional Hernia Repair]. Gan To Kagaku Ryoho 2018; 45:288-290. [PMID: 29483423] [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: 06/08/2023]
Abstract
Re-laparotomy with resection of the mesh after abdominal incisional hernia repair may cause recurrence of the hernia and infection of the mesh. In the present study, we performed laparoscopic distal gastrectomy(LDG)for early gastric cancer without the resection of the mesh in such a case. A 82-year-old man who had undergone abdominal vascular replacement, cholecystectomy, abdominal incisional hernia repair with the mesh, sigmoidectomy had local recurrence of gastric cancer after endoscopic submucosal resection. We diagnosed as cStage IA and performed LDG without resection of the mesh. He had no recurrence of hernia nor infection of the mesh. Minimizing damage to the abdominal wall by laparoscopic surgery can prevent them.
Collapse
|
39
|
Imura K, Yamaoka N, Chou H, Furuke H, Tanaka S, Kumano T, Komatsu S, Shimomura K, Ikeda J, Taniguchi F, Shioaki Y. [A Case of Thyroid Metastasis from Rectal Cancer]. Gan To Kagaku Ryoho 2018; 45:327-329. [PMID: 29483436] [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: 06/08/2023]
Abstract
The patient was a 68-year-old man who underwent Hartmann's procedure for a fistula due to rectal cancer in August 2012. The cancer was tub2>tub1, pSE, pN2, pH2, pM1(intrapulmonary metastasis), stage IV. The patient received 5 courses of FOLFOX and bevacizumab as adjuvant chemotherapy. In December 2012, the patient was seen by Otolaryngology for hoarseness. A neck examination revealed induration of the left lobe of the thyroid, and FNA biopsy strongly suggested metastasis of rectal cancer to the thyroid. FDG-PET was performed and revealed extensive accumulation of FDG at the same site. The patient was diagnosed with thyroid metastasis of rectal cancer and underwent a left thyroid lobectomy and lymph node dissection in January 2013. Histopathology confirmed the thyroid metastasis of rectal cancer. Thyroid metastasis of rectal cancer is extremely rare: there are 11 such cases in the Japanese literature, including the case encountered by the current authors. This case is reported here, along with a discussion of some of the literature.
Collapse
|
40
|
Minowa K, Komatsu S, Takashina K, Tanaka S, Kumano T, Imura K, Shimomura K, Ikeda J, Taniguchi F, Ueshima Y, Lee T, Ikeda E, Otsuji E, Shioaki Y. Ectopic gastrointestinal variceal bleeding with portal hypertension. World J Gastrointest Surg 2017; 9:288-292. [PMID: 29359035 PMCID: PMC5752964 DOI: 10.4240/wjgs.v9.i12.288] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2017] [Revised: 10/07/2017] [Accepted: 11/12/2017] [Indexed: 02/07/2023] Open
Abstract
Massive gastrointestinal bleeding from gastrointestinal varices is one of the most serious complications in patients with portal hypertension. However, if no bleeding point can be detected by endoscopy in the predilection sites of gastrointestinal varices, such as the esophagus and stomach, ectopic gastrointestinal variceal bleeding should be considered as a differential diagnosis. Herein, we report a case of ectopic ileal variceal bleeding in a 57-year-old woman, which was successfully diagnosed by multi-detector row CT (MDCT) and angiography and treated by segmental ileum resection. To date, there have been no consensus for the treatment of ectopic ileal variceal bleeding. This review was designed to clarify the clinical characteristics of patients with ectopic ileal variceal and discuss possible treatment strategies. From the PubMed database and our own database, we reviewed 21 consecutive cases of ileal variceal bleeding diagnosed from 1982 to 2017. MDCT and angiography is useful for the rapid examination and surgical resection of an affected lesion and is a safe and effective treatment strategy to avoid further bleeding.
Collapse
Affiliation(s)
- Keita Minowa
- Department of Surgery, Japanese Red Cross Kyoto Daiichi Hospital, Higashiyama-ku, Kyoto 605-0981, Japan
- Emergency and Critical Care Center, Japanese Red Cross Kyoto Daiichi Hospital, Higashiyama-ku, Kyoto 605-0981, Japan
| | - Shuhei Komatsu
- Department of Surgery, Japanese Red Cross Kyoto Daiichi Hospital, Higashiyama-ku, Kyoto 605-0981, Japan
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Kenichiro Takashina
- Department of Surgery, Japanese Red Cross Kyoto Daiichi Hospital, Higashiyama-ku, Kyoto 605-0981, Japan
- Emergency and Critical Care Center, Japanese Red Cross Kyoto Daiichi Hospital, Higashiyama-ku, Kyoto 605-0981, Japan
| | - Sachie Tanaka
- Department of Surgery, Japanese Red Cross Kyoto Daiichi Hospital, Higashiyama-ku, Kyoto 605-0981, Japan
| | - Tatsuya Kumano
- Department of Surgery, Japanese Red Cross Kyoto Daiichi Hospital, Higashiyama-ku, Kyoto 605-0981, Japan
| | - Kenichiro Imura
- Department of Surgery, Japanese Red Cross Kyoto Daiichi Hospital, Higashiyama-ku, Kyoto 605-0981, Japan
| | - Katsumi Shimomura
- Department of Surgery, Japanese Red Cross Kyoto Daiichi Hospital, Higashiyama-ku, Kyoto 605-0981, Japan
| | - Jun Ikeda
- Department of Surgery, Japanese Red Cross Kyoto Daiichi Hospital, Higashiyama-ku, Kyoto 605-0981, Japan
| | - Fumihiro Taniguchi
- Department of Surgery, Japanese Red Cross Kyoto Daiichi Hospital, Higashiyama-ku, Kyoto 605-0981, Japan
| | - Yasuo Ueshima
- Department of Surgery, Japanese Red Cross Kyoto Daiichi Hospital, Higashiyama-ku, Kyoto 605-0981, Japan
| | - Tecchuu Lee
- Department of Surgery, Japanese Red Cross Kyoto Daiichi Hospital, Higashiyama-ku, Kyoto 605-0981, Japan
| | - Eito Ikeda
- Department of Surgery, Japanese Red Cross Kyoto Daiichi Hospital, Higashiyama-ku, Kyoto 605-0981, Japan
| | - Eigo Otsuji
- Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Yasuhiro Shioaki
- Department of Surgery, Japanese Red Cross Kyoto Daiichi Hospital, Higashiyama-ku, Kyoto 605-0981, Japan
| |
Collapse
|
41
|
Furuke H, Shimomura K, Kato C, Takabatake K, Kishimoto T, Tanaka S, Kumano T, Komatsu S, Imura K, Kubota T, Ikeda J, Taniguchi F, Shioaki Y. [A Case of a Retroperitoneal Liposarcoma with Long-Term Survival after Four Surgical Resections]. Gan To Kagaku Ryoho 2017; 44:1320-1322. [PMID: 29394620] [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
Retroperitoneal liposarcoma is a relatively rare tumor. The only established therapy is surgical resection and the tumor often recurs. This paper deals with a case of a retroperitoneal liposarcoma in which frequent surgical resections for recurrent tumors have provided relatively long-term survival for the patient. The patient was a 70-year-old woman who had undergone surgical resection for a right retroperitoneal tumor. The pathological diagnosis was dedifferentiated liposarcoma. Thereafter she experienced frequent recurrences which required 3 surgical resections. By means of positive margin for the last surgery, chemotherapy with eribulin was administered. There has been no recurrence 13 months after the last surgery.
Collapse
|
42
|
Kishimoto T, Nanishi K, Furuke H, Kato C, Takabatake K, Kumano T, Imura K, Shimomura K, Kubota T, Ikeda J, Taniguchi F, Takashina K, Shioaki Y, Ikeda E. [A Case of Resection for Metastatic Osseous Tumor from Rectal Cancer]. Gan To Kagaku Ryoho 2017; 44:1874-1876. [PMID: 29394805] [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
A 67-year-old male was referred to our hospital for further investigation of fecal occult blood. We diagnosed him with rectal cancer with osseous metastasis. Chemo-and radiation therapy were administered following resection of the rectal cancer. There were no other lesions except for the osseous metastasis remaining after these interventions. The osseous lesion was then resected. There have no signs of recurrence for 1 year and 9 months since the last operation. We report a case of successful resection of osseous metastasis from rectal cancer.
Collapse
|
43
|
Shimomura K, Furuke Y, Tanaka Y, Kumano T, Komatsu S, Imura K, Ikeda J, Taniguchi F, Shioaki Y, Nakatsugawa Y. [A Case of QOL Improvement after Intestinal Stenosis Due to Peritoneal Dissemination of Gastric Cancer in Elderly Patients]. Gan To Kagaku Ryoho 2017; 44:1991-1993. [PMID: 29394844] [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
Nearly 70% of gastric cancer recurrences occur as peritoneal dissemination. Most of the treatment for recurrence of gastric cancer dissemination is chemotherapy; depending on the symptoms and the site of recurrence, palliative bypass surgery may be performed. Intensive treatment is often difficult for elderly patients over 85-years-old. This case was a 91-year-old female who underwent total gastrectomy for gastric cancer(signet-ring cell carcinoma)7years prior. Two years ago, a stenosis due to recurrence was revealed in the small intestine and bypass surgery was performed. At that time, she was 89-years-old, and chemotherapy was continued for 1 year. Six months ago, recurrence was revealed in the esophago-jejuno anastomosis. Since the stenosis was severe, it was possible to resume oral reconstitution by inserting a metallic stent. Chemotherapy(S-1)is currently ongoing. There are few reports of long-term treatment for recurrence of gastric cancer peritoneal dissemination in elderly people over 80 years of age. This report is a case of long-term survival involving multidisciplinary treatments, which improved the quality of life(QOL)over the age of 90 years.
Collapse
Affiliation(s)
- Katsumi Shimomura
- Dept. of Digestive Surgery, Japanese Red Cross Kyoto Daiichi Hospital
| | | | | | | | | | | | | | | | | | | |
Collapse
|
44
|
Kaseda Y, Ikeda J, Sugihara K, Kohriyama T. The therapeutic effects of low-frequency rTMS on hand function and quality of life in chronic stroke patients relating to functional integrity of the corticospinal tract. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.1692] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
45
|
Akagawa Y, Ueno A, Ikeda J, Matsushima A, Miyazaki D, Ishii W, Sekijima Y. Investigation on favorable prognostic factors in patients with non-HIV, non- natalizumab, progressive multifocal leukoencephalopathy. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.3381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
46
|
Takabatake K, Ikeda J, Furuke H, Kato C, Kishimoto T, Kumano T, Imura K, Shimomura K, Kubota T, Taniguchi F, Shioaki Y. A case of a horseshoe appendix. Surg Case Rep 2016; 2:140. [PMID: 27878571 PMCID: PMC5120162 DOI: 10.1186/s40792-016-0261-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Accepted: 11/09/2016] [Indexed: 12/11/2022] Open
Abstract
Anomalies of the appendix are extremely rare, and a horseshoe appendix is even rarer. A literature search has revealed only five reported cases. In this report, we present a case of a horseshoe appendix.A 78-year-old man was referred for further examination following a positive fecal occult blood test. A mass in his ascending colon was detected on colonoscopy, while computed tomography showed that it was connected to the appendix. Tumor invasion derived from the ascending colon or appendix was suspected. We diagnosed ascending colon cancer prior to laparoscopic ileocecal resection. Macroscopic findings showed that the appendix connected to the back side of the mass, while microscopic findings showed that the mucosa and submucosa were continuous from the appendiceal orifice in the cecum to the other orifice in the ascending colon, where a type 1 tumor was observed on the orifice. We eventually diagnosed the patient with tubulovillous adenoma and a horseshoe appendix.A horseshoe appendix communicates with the colon at both ends and is supplied by a single fan-shaped mesentery. Cases are classified by the disposal of the mesentery and the location of the orifice. Anatomical anomalies should be considered despite the rarity of horseshoe appendices.
Collapse
Affiliation(s)
- Kazuya Takabatake
- Department of Surgery, Japanese Red Cross Kyoto Daiichi Hospital, 15-749 Honmachi, Higashiyama, Kyoto, Kyoto, Japan.
| | - Jun Ikeda
- Department of Surgery, Japanese Red Cross Kyoto Daiichi Hospital, 15-749 Honmachi, Higashiyama, Kyoto, Kyoto, Japan
| | - Hirotaka Furuke
- Department of Surgery, Japanese Red Cross Kyoto Daiichi Hospital, 15-749 Honmachi, Higashiyama, Kyoto, Kyoto, Japan
| | - Chikage Kato
- Department of Surgery, Japanese Red Cross Kyoto Daiichi Hospital, 15-749 Honmachi, Higashiyama, Kyoto, Kyoto, Japan
| | - Takuya Kishimoto
- Department of Surgery, Japanese Red Cross Kyoto Daiichi Hospital, 15-749 Honmachi, Higashiyama, Kyoto, Kyoto, Japan
| | - Tatsuya Kumano
- Department of Surgery, Japanese Red Cross Kyoto Daiichi Hospital, 15-749 Honmachi, Higashiyama, Kyoto, Kyoto, Japan
| | - Kenichiro Imura
- Department of Surgery, Japanese Red Cross Kyoto Daiichi Hospital, 15-749 Honmachi, Higashiyama, Kyoto, Kyoto, Japan
| | - Katsumi Shimomura
- Department of Surgery, Japanese Red Cross Kyoto Daiichi Hospital, 15-749 Honmachi, Higashiyama, Kyoto, Kyoto, Japan
| | - Takeshi Kubota
- Department of Surgery, Japanese Red Cross Kyoto Daiichi Hospital, 15-749 Honmachi, Higashiyama, Kyoto, Kyoto, Japan
| | - Fumihiro Taniguchi
- Department of Surgery, Japanese Red Cross Kyoto Daiichi Hospital, 15-749 Honmachi, Higashiyama, Kyoto, Kyoto, Japan
| | - Yasuhiro Shioaki
- Department of Surgery, Japanese Red Cross Kyoto Daiichi Hospital, 15-749 Honmachi, Higashiyama, Kyoto, Kyoto, Japan
| |
Collapse
|
47
|
Yamamoto K, Tsubokura M, Ikeda J, Onishi K, Baleriola S. Effect of posture on the aerodynamic characteristics during take-off in ski jumping. J Biomech 2016; 49:3688-3696. [DOI: 10.1016/j.jbiomech.2016.09.037] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Revised: 09/20/2016] [Accepted: 09/30/2016] [Indexed: 11/26/2022]
|
48
|
Ikeda J, Nanishi K, Kumano T, Imura K, Shimomura K, Kubota T, Taniguchi F, Shioaki Y. 171P Ovarian metastases resection of colorectal cancer: a clinical and pathological analysis of 15 patients. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv523.32] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
49
|
Semboshi S, Ikeda J, Iwase A, Takasugi T, Suzuki S. Effect of Boron Doping on Cellular Discontinuous Precipitation for Age-Hardenable Cu–Ti Alloys. Materials 2015. [PMCID: PMC5455734 DOI: 10.3390/ma8063467] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The effects of boron doping on the microstructural evolution and mechanical and electrical properties of age-hardenable Cu–4Ti (at.%) alloys are investigated. In the quenched Cu–4Ti–0.03B (at.%) alloy, elemental B (boron) is preferentially segregated at the grain boundaries of the supersaturated solid-solution phase. The aging behavior of the B-doped alloy is mostly similar to that of conventional age-hardenable Cu–Ti alloys. In the early stage of aging at 450 °C, metastable β′-Cu4Ti with fine needle-shaped precipitates continuously form in the matrix phase. Cellular discontinuous precipitates composed of the stable β-Cu4Ti and solid-solution laminates are then formed and grown at the grain boundaries. However, the volume fraction of the discontinuous precipitates is lower in the Cu–4Ti–0.03B alloy than the Cu–4Ti alloy, particularly in the over-aging period of 72–120 h. The suppression of the formation of discontinuous precipitates eventually results in improvement of the hardness and tensile strength. It should be noted that minor B doping of Cu–Ti alloys also effectively enhances the elongation to fracture, which should be attributed to segregation of B at the grain boundaries.
Collapse
Affiliation(s)
- Satoshi Semboshi
- Kansai Center, Institute for Materials Research, Tohoku University, Gakuen-cho 1-1, Naka-ku, Sakai, Osaka 599-8531, Japan
- Department of Materials Science, Osaka Prefecture University, Gakuen-cho 1-1, Naka-ku, Sakai, Osaka 599-8531, Japan; E-Mails: (J.I.); (A.I.); (T.T.)
- Author to whom correspondence should be addressed; E-Mail: ; Tel.: +81-72-252-1161 (ext. 5700); Fax: +81-72-254-9912
| | - Jun Ikeda
- Department of Materials Science, Osaka Prefecture University, Gakuen-cho 1-1, Naka-ku, Sakai, Osaka 599-8531, Japan; E-Mails: (J.I.); (A.I.); (T.T.)
| | - Akihiro Iwase
- Department of Materials Science, Osaka Prefecture University, Gakuen-cho 1-1, Naka-ku, Sakai, Osaka 599-8531, Japan; E-Mails: (J.I.); (A.I.); (T.T.)
| | - Takayuki Takasugi
- Department of Materials Science, Osaka Prefecture University, Gakuen-cho 1-1, Naka-ku, Sakai, Osaka 599-8531, Japan; E-Mails: (J.I.); (A.I.); (T.T.)
| | - Shigeru Suzuki
- Institute of Multidisciplinary Research for Advanced Materials, Tohoku University, Katahira 2-1-1, Aoba-ku, Sendai 9577-8531, Japan; E-Mail:
| |
Collapse
|
50
|
Takamatsu S, Miyakawa S, Sato H, Suzuki W, Nishizawa T, Nakamura M, Umeda H, Sai S, Kato K, Nakazawa Y, Ikeda J. [A review of the position adopted by patients when acquiring images of the base of the hamate hook]. Nihon Hoshasen Gijutsu Gakkai Zasshi 2014; 70:549-55. [PMID: 24953320 DOI: 10.6009/jjrt.2014_jsrt_70.6.549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The hamate bone, one of the carpal (wrist) bones, has a large uncinate process protruding from the palm side. In sports such as golf and tennis, the hamate bone can break if is subjected to a high external force, such as from the handle of a racquet or club. At our hospital we take X-ray images of the hamate bone from two directions: an axial image through the carpal tunnel and an image at the base of the hamate hook (conventional method). While the conventional method makes it easy to create images of the base of the hamate hook, the patient may suffer pain during image-taking because the hamate bone is pulled to cause radial flexion. We therefore investigated a method of imaging that would create three-dimensional computed tomography (3DCT) images of the base of the hamate hook in which the patient would only have to only rotate the wrist externally and elevate the fore-arm without any radial flexion. Our results suggest that it is possible to obtain images of the base of the hamate hook as clear as those acquired using the conventional method with the patient in a comfortable and painless position taking images at an external rotation angle of 50.3° and a forearm elevation angle of 20.3°.
Collapse
|