1
|
Tokumitsu Y, Nagano H, Yamashita YI, Yoshizumi T, Hisaka T, Nanashima A, Kuroki T, Ide T, Endo Y, Utsunomiya T, Kitahara K, Kawasaki Y, Sakota M, Okamoto K, Takami Y, Kajiwara M, Takatsuki M, Beppu T, Eguchi S. Efficacy of laparoscopic liver resection for small hepatocellular carcinoma located in the posterosuperior segments: A multi-institutional study using propensity score matching by the Kyushu Study Group of Liver Surgery. Hepatol Res 2023; 53:878-889. [PMID: 37255386 DOI: 10.1111/hepr.13929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 04/29/2023] [Accepted: 05/02/2023] [Indexed: 06/01/2023]
Abstract
AIM Laparoscopic liver resection (LLR) for hepatocellular carcinoma (HCC) located in the posterosuperior segments (PS) have generally been considered more difficult than those for HCC in anterolateral segments (AL), but may be safe and feasible for selected patients with accumulated experience. In the present study, we investigated the effectiveness of LLR for single nodular HCCs ≤3 cm located in PS. METHODS In total, 473 patients who underwent partial liver resection for single nodular HCCs ≤3 cm at the 18 institutions belonging to the Kyusyu Study Group of Liver Surgery from January 2010 to December 2018 were enrolled. The short-term outcomes of laparoscopic partial liver resection and open liver resection (OLR) for HCCs ≤3 cm, with subgroup analysis of PS and AL, were compared using propensity score-matching analysis. Furthermore, results were also compared between LLR-PS and LLR-AL. RESULTS The original cohort of patients with HCC ≤3 cm included 328 patients with LLR and 145 with OLR. After matching, 140 patients with LLR and 140 with OLR were analyzed. Significant differences were found between groups in terms of volume of blood loss (median, 55 vs. 287 ml, p < 0.001), postoperative complications (0.71 vs. 8.57%, p = 0.003), and postoperative hospital stay (median, 9 vs. 14 days, p < 0.001). The results of subgroup analysis of PS were similar. Short-term outcomes did not differ significantly between LLR-PS and LLR-AL after matching. CONCLUSIONS Laparoscopic partial resection could be the preferred option for single nodular HCCs ≤3 cm located in PS.
Collapse
Affiliation(s)
- Yukio Tokumitsu
- Kyusyu Study Group of Liver Surgery, Fukuoka, Japan
- Department of Gastroenterological, Breast and Endocrine Surgery, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Hiroaki Nagano
- Kyusyu Study Group of Liver Surgery, Fukuoka, Japan
- Department of Gastroenterological, Breast and Endocrine Surgery, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Yo-Ichi Yamashita
- Kyusyu Study Group of Liver Surgery, Fukuoka, Japan
- Department of Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Tomoharu Yoshizumi
- Kyusyu Study Group of Liver Surgery, Fukuoka, Japan
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Toru Hisaka
- Kyusyu Study Group of Liver Surgery, Fukuoka, Japan
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Kurume University, Kurume, Japan
| | - Atsushi Nanashima
- Kyusyu Study Group of Liver Surgery, Fukuoka, Japan
- Division of Hepato-Biliary-Pancreas Surgery, Department of Surgery, University of Miyazaki Faculty of Medicine, Miyazaki, Japan
| | - Tamotsu Kuroki
- Kyusyu Study Group of Liver Surgery, Fukuoka, Japan
- Clinical Research Center and Department of Surgery, National Hospital Organization Nagasaki Medical Center, Nagasaki, Japan
| | - Takao Ide
- Kyusyu Study Group of Liver Surgery, Fukuoka, Japan
- Department of Surgery, Saga University Faculty of Medicine, Saga, Japan
| | - Yuichi Endo
- Kyusyu Study Group of Liver Surgery, Fukuoka, Japan
- Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine Graduate School of Medicine, Oita, Japan
| | - Tohru Utsunomiya
- Kyusyu Study Group of Liver Surgery, Fukuoka, Japan
- Department of Surgery, Oita Prefectural Hospital, Oita, Japan
| | - Kenji Kitahara
- Kyusyu Study Group of Liver Surgery, Fukuoka, Japan
- Department of Surgery, Saga-Ken Medical Centre Koseikan, Saga, Japan
| | - Yota Kawasaki
- Kyusyu Study Group of Liver Surgery, Fukuoka, Japan
- Department of Digestive Surgery, Breast and Thyroid Surgery, Graduate School of Medicine, Kagoshima University, Kagoshima, Japan
| | - Masahiko Sakota
- Kyusyu Study Group of Liver Surgery, Fukuoka, Japan
- Department of Surgery, Kagoshima Kouseiren Hospital, Kagoshima, Japan
| | - Kohji Okamoto
- Kyusyu Study Group of Liver Surgery, Fukuoka, Japan
- Department of Surgery, Gastroenterology and Hepatology Center, Kitakyushu City Yahata Hospital, Kitakyushu, Japan
| | - Yuko Takami
- Kyusyu Study Group of Liver Surgery, Fukuoka, Japan
- Department of Hepato-Biliary-Pancreatic Surgery, Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Masatoshi Kajiwara
- Kyusyu Study Group of Liver Surgery, Fukuoka, Japan
- Department of Gastroenterological Surgery, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Mitsuhisa Takatsuki
- Kyusyu Study Group of Liver Surgery, Fukuoka, Japan
- Department of Digestive and General Surgery, Graduate School of Medicine, University of the Ryukyus, Nishihara, Japan
| | - Toru Beppu
- Kyusyu Study Group of Liver Surgery, Fukuoka, Japan
- Department of Surgery, Yamaga City Medical Center, Yamaga, Japan
| | - Susumu Eguchi
- Kyusyu Study Group of Liver Surgery, Fukuoka, Japan
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| |
Collapse
|
2
|
Naito S, Kajiwara M, Nakashima R, Sasaki T, Hasegawa S. Application of Extended Reality (Virtual Reality and Mixed Reality) Technology in Laparoscopic Liver Resections. Cureus 2023; 15:e44520. [PMID: 37790042 PMCID: PMC10544840 DOI: 10.7759/cureus.44520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/31/2023] [Indexed: 10/05/2023] Open
Abstract
Background and purpose Laparoscopic liver resection (LLR) has recently gained popularity owing to advances in surgical techniques. Difficulties in LLR may be influenced by anatomical factors. This study presents a comprehensive overview of LLR performed using extended reality (XR) technology. Methods Six patients underwent LLR performed wearing HoloLens2® XR (Microsoft Corporation, Redmond, Washington, United States) technology. We performed dynamic contrast-enhanced CT scans before surgery and used the data to construct three-dimensional images. Results Of the six patients, two were diagnosed with colorectal liver metastases, two with hepatocellular carcinoma, and one with intrahepatic cholangiocarcinoma. The median maximum tumor diameter was 31 mm (range, 23-80 mm). One patient had liver cirrhosis, with Child-Pugh classification grade B. Anatomical resection was performed in three patients (60%), with a median difficulty score of 7 (intermediate). No conversions to open surgery were necessary. The median operative time and estimated blood loss were 444 minutes (range, 337-597 minutes) and 200 mL (range, 100-1000 mL), respectively. Postoperative complications (Clavien-Dindo classification grade II) were observed in one patient. All six cases achieved negative surgical margins. Conclusions LLR using XR technology enhances surgical visualization and anatomical recognition. The incorporation of XR technology into LLR offers advantages over traditional two-dimensional imaging.
Collapse
Affiliation(s)
- Shigetoshi Naito
- Gastroenterological Surgery, Fukuoka University Hospital, Fukuoka, JPN
| | - Masatoshi Kajiwara
- Gastroenterological Surgery, Fukuoka University Faculty of Medicine, Fukuoka, JPN
| | - Ryo Nakashima
- Gastroenterological Surgery, Fukuoka University Faculty of Medicine, Fukuoka, JPN
| | - Takahide Sasaki
- Gastroenterological Surgery, Fukuoka University Faculty of Medicine, Fukuoka, JPN
| | - Suguru Hasegawa
- Gastroenterological Surgery, Fukuoka University Hospital, Fukuoka, JPN
| |
Collapse
|
3
|
Naito S, Kajiwara M, Nakashima R, Sasaki T, Hasegawa S. The Safety of Laparoscopic Cholecystectomy in Super-elderly Patients: A Propensity Score Matching Analysis. Cureus 2023; 15:e42097. [PMID: 37602119 PMCID: PMC10438169 DOI: 10.7759/cureus.42097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/18/2023] [Indexed: 08/22/2023] Open
Abstract
BACKGROUND Although reports on the safety of laparoscopic cholecystectomy (LC) exist, few have included patients aged ≥ 85 years. Hence, our study aimed to evaluate surgical outcomes of LC in patients aged ≥ 85 years. METHODS After excluding patients who underwent other types of surgeries, 583 patients who underwent LC between 2015 and 2022 were included. Patients were classified into two groups based on age: < 85 years (control group, n = 551) and ≥ 85 years (super-elderly group, n = 32). Propensity score matching (PSM) was performed based on preoperative clinical parameters, and intraoperative and postoperative outcomes were compared. RESULTS After PSM, 28 patients were included in each group. Intraoperative blood loss (1 vs. 5 mL, respectively; P = .052) and frequency of serious postoperative complications (Clavien-Dindo class ≥ 2, 2/28 (7.1%) vs. 6/28 (21.4%), P = .252) were similar between the control and elderly groups. There was no significant difference in the length of postoperative stay (control group: 5 (4-24) days vs. super-elderly group: 7 (3-64) days, P = .236). Unfortunately, one case of pneumonia of unknown cause occurred postoperatively, resulting in the death of one patient in the super-elderly group. CONCLUSIONS There were no clinically significant differences in the short-term outcomes of LC between super-elderly patients aged ≥ 85 years and patients aged < 85 years. Hence, LC may be relatively safe even in patients aged ≥ 85 years. However, owing to many pre-existing diseases and deterioration of physiological function, careful management during the perioperative period is desirable.
Collapse
Affiliation(s)
- Shigetoshi Naito
- Gastroenterological Surgery, Fukuoka University Hospital, Fukuoka, JPN
| | | | - Ryo Nakashima
- Gastroenterological Surgery, Fukuoka University Hospital, Fukuoka, JPN
| | - Takahide Sasaki
- Gastroenterological Surgery, Fukuoka University Hospital, Fukuoka, JPN
| | - Suguru Hasegawa
- Gastroenterological Surgery, Fukuoka University Hospital, Fukuoka, JPN
| |
Collapse
|
4
|
Naito S, Fujikawa T, Kajiwara M, Hasegawa S. Middle Hepatic Vein-Guided Cranial and Hilar Approach Using a Modified Two-Surgeon Technique in Laparoscopic Extended Left Medial Sectionectomy: A Technical Case Report With Videos. Cureus 2023; 15:e37865. [PMID: 37228552 PMCID: PMC10205155 DOI: 10.7759/cureus.37865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/20/2023] [Indexed: 05/27/2023] Open
Abstract
Anatomical liver resection and liver resection close to major blood vessels are quite challenging and require a high level of expertise. In addition, anatomical hepatectomy requires extensive knowledge of the positions of blood vessels and techniques for hemostasis because the resection surface is extensive and operations around blood vessels are required. A hepatic vein-guided cranial and hilar approach using a modified "two-surgeon technique" is effective in resolving these problems. Herein, we present a middle hepatic vein (MHV)-guided cranial and hilar approach using a modified two-surgeon technique in laparoscopic extended left medial sectionectomy to resolve these problems. This procedure is feasible and effective.
Collapse
Affiliation(s)
- Shigetoshi Naito
- Gastroenterological Surgery, Fukuoka University Hospital, Fukuoka, JPN
- Surgery, Kokura Memorial Hospital, Kitakyushu, JPN
| | | | | | - Suguru Hasegawa
- Gastroenterological Surgery, Fukuoka University Hospital, Fukuoka, JPN
| |
Collapse
|
5
|
Kajiwara M, Naito S, Sasaki T, Nakashima R, Hasegawa S. Quick and Easy Application Method of TachoSil®️ During Laparoscopic and Robotic Liver Resections. Cureus 2023; 15:e37252. [PMID: 37182003 PMCID: PMC10167935 DOI: 10.7759/cureus.37252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/07/2023] [Indexed: 05/16/2023] Open
Abstract
TachoSil®️, a fibrin sealant patch, is a sheet-type hemostatic agent. Therefore, it is technically demanding to put it on the target place especially in laparoscopic surgeries due to the motion restriction of straight-fixed instruments. This article describes a quick and easy technique of TachoSil application during laparoscopic liver surgeries, by sewing it to the laparoscopic gauze in advance. This method allows for one-handed operation and stress-free application even in the situation of active bleeding.
Collapse
Affiliation(s)
- Masatoshi Kajiwara
- Gastroenterological Surgery, Faculty of Medicine, Fukuoka University, Fukuoka, JPN
| | - Shigetoshi Naito
- Gastroenterological Surgery, Faculty of Medicine, Fukuoka University, Fukuoka, JPN
| | - Takahide Sasaki
- Gastroenterological Surgery, Faculty of Medicine, Fukuoka University, Fukuoka, JPN
| | - Ryo Nakashima
- Gastroenterological Surgery, Faculty of Medicine, Fukuoka University, Fukuoka, JPN
| | - Suguru Hasegawa
- Gastroenterological Surgery, Faculty of Medicine, Fukuoka University, Fukuoka, JPN
| |
Collapse
|
6
|
Koga T, Ishida Y, Hamada Y, Takayama Y, Tsuchiya N, Kitaguchi T, Matsumoto K, Kajiwara M, Naito S, Ishii F, Nakashima R, Sasaki T, Hirai F. High predictive ability of apparent diffusion coefficient value for wall-invasion pattern of advanced gallbladder carcinoma. Abdom Radiol (NY) 2023; 48:902-912. [PMID: 36694054 DOI: 10.1007/s00261-023-03805-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 01/09/2023] [Accepted: 01/10/2023] [Indexed: 01/26/2023]
Abstract
PURPOSE The wall-invasion pattern classification of advanced gallbladder carcinoma (GBC) has been reported. However, its association with clinical findings remains unclear. We aimed to clarify relationships between clinicopathological characteristics, prognosis, and apparent diffusion coefficient (ADC) values of advanced GBC based on the wall-invasion pattern. METHODS We reviewed the data of 37 patients who had undergone advanced GBC cholecystectomy at our institution between 2009 and 2021. Clinicopathological findings, prognosis, and ADC values were retrospectively analyzed. RESULTS Based on the wall-invasion pattern, patients were classified into infiltrative growth (IG) type (n = 22) and destructive growth (DG) type (n = 15). In the DG-type, the incidence of venous invasion (P = 0.027), neural invasion (P = 0.008), and lymph node metastasis (P = 0.047) was significantly higher than in the IG-type, and recurrent-free survival (RFS) was significantly shorter (P = 0.015); the median RFS was 11.4 months (95% confidence interval, 6.3-16.5 months) in the DG-type and not reached in the IG-type. The ADC value in the DG-type was significantly lower than in the IG-type (median, 1.19 × 10-3 mm2/s vs. 1.86 × 10-3 mm2/s, P < 0.001). The area under the receiver operating characteristic curve for the ADC values to differentiate wall-invasion patterns was 0.95 (95% confidence interval, 0.87-1.00). The optimal cutoff ADC value was 1.45 × 10-3 mm2/s (sensitivity, 92.9%; specificity, 90.9%). CONCLUSIONS The wall-invasion pattern of advanced GBC is associated with its aggressiveness and prognosis, and can be predicted by ADC values with high accuracy.
Collapse
Affiliation(s)
- Takehiko Koga
- Department of Gastroenterology and Medicine, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonan-Ku, Fukuoka, 814-0180, Japan
| | - Yusuke Ishida
- Department of Gastroenterology and Medicine, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonan-Ku, Fukuoka, 814-0180, Japan.
| | - Yoshihiro Hamada
- Department of Pathology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Yukihisa Takayama
- Department of Radiology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Naoaki Tsuchiya
- Department of Gastroenterology and Medicine, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonan-Ku, Fukuoka, 814-0180, Japan
| | - Takanori Kitaguchi
- Department of Gastroenterology and Medicine, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonan-Ku, Fukuoka, 814-0180, Japan
| | - Keisuke Matsumoto
- Department of Gastroenterology and Medicine, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonan-Ku, Fukuoka, 814-0180, Japan
| | - Masatoshi Kajiwara
- Department of Gastroenterological Surgery, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Shigetoshi Naito
- Department of Gastroenterological Surgery, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Fuminori Ishii
- Department of Gastroenterological Surgery, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Ryo Nakashima
- Department of Gastroenterological Surgery, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Takahide Sasaki
- Department of Gastroenterological Surgery, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Fumihito Hirai
- Department of Gastroenterology and Medicine, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonan-Ku, Fukuoka, 814-0180, Japan
| |
Collapse
|
7
|
Kajiwara M, Fujikawa T, Naito S, Sasaki T, Nakashima R, Hasegawa S. Non-Stick Liver Parenchymal Transection With Saline-Linked Bipolar Clamp-Crush Technique in Robotic Liver Resection. Cureus 2023; 15:e36401. [PMID: 37090277 PMCID: PMC10114974 DOI: 10.7759/cureus.36401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/20/2023] [Indexed: 04/25/2023] Open
Abstract
Background Without satisfactory instruments, liver parenchymal transection during robotic liver resection (RLR) remains challenging. We combined the commonly used bipolar clamp-crush technique with the saline drip, achieving a comfortable liver resection without coagulated liver tissues sticking to the bipolar forceps. Methods Between December 2022 and March 2023, six RLRs were performed using the saline-linked bipolar clamp-crush method for both anatomical and non-anatomical liver resections. We assessed the safety and feasibility of our robotic liver parenchymal transection technique. Results Three of six patients were diagnosed with colorectal liver metastasis, two with hepatocellular carcinoma (HCC), and the other with intrahepatic bile duct stricture. Three of the six patients received anatomical liver resection, and the other three underwent non-anatomical liver resection. There were no conversions to open surgery. The median operative time and estimated blood loss were 406.5 minutes (196-670 minutes) and 5 ml (5-465 ml), respectively. The median length of the postoperative hospital stay was nine days (7-10 days). Postoperative complications (Clavien-Dindo classification grade II or more) or mortality were not encountered in this cohort. Conclusion We presented here our saline-linked bipolar clamp-crush method for liver parenchymal transection in RLR. By simply adding the saline drip to the commonly used bipolar clamp-crush technique, non-stick and comfortable liver parenchymal transection is now possible. This technique may help overcome the limitations of currently available robotic instruments for liver parenchymal resection.
Collapse
Affiliation(s)
- Masatoshi Kajiwara
- Gastroenterological Surgery, Faculty of Medicine, Fukuoka University, Fukuoka, JPN
| | | | - Shigetoshi Naito
- Gastroenterological Surgery, Faculty of Medicine, Fukuoka University, Fukuoka, JPN
| | - Takahide Sasaki
- Gastroenterological Surgery, Faculty of Medicine, Fukuoka University, Fukuoka, JPN
| | - Ryo Nakashima
- Gastroenterological Surgery, Faculty of Medicine, Fukuoka University, Fukuoka, JPN
| | - Suguru Hasegawa
- Gastroenterological Surgery, Faculty of Medicine, Fukuoka University, Fukuoka, JPN
| |
Collapse
|
8
|
Kajiwara M, Nakashima R, Yoshimura F, Hasegawa S. Impact of AirSeal ® insufflation system on respiratory and circulatory dynamics during laparoscopic abdominal surgery. Updates Surg 2022; 74:2003-2009. [PMID: 36173530 PMCID: PMC9521008 DOI: 10.1007/s13304-022-01386-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 09/16/2022] [Indexed: 12/05/2022]
Abstract
The effect of the AirSeal® insufflation system on hemodynamic parameters, especially end-tidal carbon dioxide (EtCO2), during laparoscopic abdominal surgery remains unclear. This retrospective single-center study included 333 consecutive patients who underwent laparoscopic hepatectomy (n = 43), gastrectomy (n = 69), colectomy (n = 137), or proctectomy (n = 84) using the AirSeal®. Patient demographics and intraoperative hemodynamic parameters, such as EtCO2, peripheral capillary oxygen saturation (SpO2), and arterial systolic blood pressure (ABP), were collected and analyzed. EtCO2 was evaluated during the entire operative period (whole period) as well as the pneumoperitoneum period until specimen removal (pneumoperitoneum period). We defined “positive respiratory and circulatory responses” (positive responses) as a decrease in EtCO2 ≥ 3 mmHg in addition to decreases in SpO2 ≥ 3% and ABP ≥ 10 mmHg simultaneously, which suggest possible carbon dioxide (CO2) embolism. The median EtCO2 values of hepatectomy, gastrectomy, colectomy, and proctectomy in the whole period/pneumoperitoneum period were 37.3/37.4, 37.1/37.3, 37.4/37.9, and 38.2/38.4 mmHg, respectively. The EtCO2 of proctectomy was significantly higher than that of gastrectomy during the whole and pneumoperitoneum periods (P < 0.05). In contrast, the EtCO2 of hepatectomy was comparable to that of the other three surgeries in the whole and pneumoperitoneum periods. Meanwhile, nine (2.7%; eight hepatectomies and one proctectomy) patients showed positive responses, and one who underwent a partial hepatectomy developed a clinically manifested CO2 embolism. Positive responses occurred during venous exposure or bleeding in all nine cases. Although the EtCO2 of hepatectomy was comparable to that of the other surgeries using the AirSeal®, laparoscopic hepatectomy showed a tendency of CO2 embolism. Thus, a secure and careful surgical approach is mandatory for laparoscopic hepatectomy using the AirSeal® insufflation system.
Collapse
Affiliation(s)
- Masatoshi Kajiwara
- Department of Gastroenterological Surgery, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 810-0180, Japan.
| | - Ryo Nakashima
- Department of Gastroenterological Surgery, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 810-0180, Japan
| | - Fumihiro Yoshimura
- Department of Gastroenterological Surgery, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 810-0180, Japan
| | - Suguru Hasegawa
- Department of Gastroenterological Surgery, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 810-0180, Japan
| |
Collapse
|
9
|
Fujikawa T, Uemoto Y, Matsuoka T, Kajiwara M. Novel Liver Parenchymal Transection Technique Using Saline-linked Monopolar Cautery Scissors (SLiC-Scissors) in Robotic Liver Resection. Cureus 2022; 14:e28118. [PMID: 36158368 PMCID: PMC9484006 DOI: 10.7759/cureus.28118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/17/2022] [Indexed: 12/07/2022] Open
Abstract
Introduction Although there are a number of benefits to using robotics in liver surgery over conventional open and laparoscopic approaches, liver parenchymal transection is still the most difficult aspect of robotic liver resection (RLR) due to the limitations of the currently available robotic instruments and the lack of a standardized method. Methods We present a novel method for transecting the liver parenchyma during RLR employing saline-linked monopolar cautery (SLiC) scissors (SLiC-Scissors method). Between September 2021 and April 2022, 10 RLRs were performed utilizing the SLiC-Scissors method for both anatomical and non-anatomical liver resections. We assessed the short-term results, as well as the safety and practicality of our robotic liver parenchymal transection technique. Results Six of the 10 patients had malignant liver tumors, and four of them had liver metastases from colorectal cancer. Except for S1, the target lesions were present everywhere, and their median size was 25 mm (14-43 mm). The median amount of intraoperative bleeding was 5 mL (5-30 mL), and the median operative and console times were 223 and 134 min, respectively. There were no conversions to open liver resections. The median length of the postoperative stay was seven (4-13) days, and there were no serious postoperative complications or mortality. Conclusions The SLiC-Scissors method is a safe and practical procedure for liver parenchymal transection in RLR. In order to standardize and broadly implement RLR into normal patient treatment, this unique approach enables an advanced, locally controlled preparation of intrahepatic vessels and bile ducts.
Collapse
|
10
|
Ishida Y, Tsunoda T, Hamada Y, Tsuchiya N, Koga T, Kitaguchi T, Matsumoto K, Matsumoto S, Sasaki T, Nakashima R, Ishii F, Kajiwara M, Shirasawa S, Hasegawa S, Hirai F. Standardized Methods Using EUS-guided Fine-needle Biopsy and a Minimal Medium Creates Three Pancreatic Cancer Organoids. Anticancer Res 2022; 42:4103-4109. [PMID: 35896269 DOI: 10.21873/anticanres.15908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 06/19/2022] [Accepted: 06/30/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM Recently, endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) has been conducted for diagnosing pancreatic ductal adenocarcinoma (PDAC), after which obtained samples were used in organoid cultures. However, no standardized method for PDAC organoid cultures exists. Therefore, to standardize or simplify sample collection and culture methods for PDAC organoids, we performed a floating culture using non-minced specimens obtained by EUS-FNB in a minimal medium, lacking growth factors or inhibitors for pancreatic organoids. PATIENTS AND METHODS A total of 38 patients with clinically diagnosed PDAC were enrolled in the study. First, EUS-FNB was conducted using a 22- or 25-gauge biopsy needle. Then, a surplus of samples was collected for organoid formation after rapid on-site cytological evaluations of sample adequacy. Subsequently, the established organoids were compared with clinical data and pathological diagnosis, following periodic observations and evaluations for morphology. RESULTS PDAC organoids were successfully created in 24 of the 38 cases (63.2%), including four cases with pathologically inconclusive EUS-FNB results. Afterward, PDAC organoid morphology was classified into ductal, dormant, and adhesive small cluster (ASC) types. Although the ductal and ASC types were seen separately, they were also seen together in other cases, which we named "mixed type". CONCLUSION We propose a feasible and straightforward method for establishing organoids, especially for diagnosing PDAC, particularly when the result of EUS-FNB is pathologically inconclusive. Furthermore, PDAC organoids are morphologically classified into three types reported for the first time.
Collapse
Affiliation(s)
- Yusuke Ishida
- Department of Gastroenterology and Medicine, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Toshiyuki Tsunoda
- Department of Cell Biology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Yoshihiro Hamada
- Department of Pathology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Naoaki Tsuchiya
- Department of Gastroenterology and Medicine, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Takehiko Koga
- Department of Gastroenterology and Medicine, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Takanori Kitaguchi
- Department of Gastroenterology and Medicine, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Keisuke Matsumoto
- Department of Gastroenterology and Medicine, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Shinji Matsumoto
- Department of Pathology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Takahide Sasaki
- Department of Gastroenterological Surgery, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Ryo Nakashima
- Department of Gastroenterological Surgery, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Fuminori Ishii
- Department of Gastroenterological Surgery, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Masatoshi Kajiwara
- Department of Gastroenterological Surgery, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Senji Shirasawa
- Department of Cell Biology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Suguru Hasegawa
- Department of Gastroenterological Surgery, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Fumihito Hirai
- Department of Gastroenterology and Medicine, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| |
Collapse
|
11
|
Uemoto Y, Fujikawa T, Kawamoto Y, Kajiwara M. Novel Hemostatic Technique During Laparoscopic Liver Parenchymal Transection: Saline-Linked Electrocautery Combined With Wet Oxidized Cellulose (SLiC-WOC) Method. Cureus 2022; 14:e27431. [PMID: 36060383 PMCID: PMC9422257 DOI: 10.7759/cureus.27431] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/29/2022] [Indexed: 01/04/2023] Open
Abstract
Introduction: Although laparoscopic hepatectomy has the potential advantage of reducing intraoperative blood loss, it is more difficult to control bleeding laparoscopically compared to an open approach. We introduced a novel hemostatic technique, the saline-linked electrocautery combined with wet oxidized cellulose (SLiC-WOC) method, during laparoscopic hepatectomy where a combination of saline-linked electrocautery (SLiC) and wet oxidized cellulose (WOC) is used. This study aimed to investigate the feasibility of employing the SLiC-WOC method for laparoscopic hepatectomy. Methods: Thirteen patients who underwent laparoscopic liver resection with the SLiC-WOC method between 2019 and 2020 were included in this study. The number of bleeding episodes in which the SLiC-WOC method was applied was counted, and the time required to achieve complete hemostasis was measured. Results: Among the bleeding events that were difficult to achieve hemostasis by SLiC alone, 94% were safely and efficiently controlled. Additionally, 69% of hemostasis was achieved within 60 seconds and 91% within 120 seconds. Postoperatively, most patients experienced no complications and no operative mortality was observed. Conclusions: The SLiC-WOC method can provide safe and time-efficient hemostasis during laparoscopic hepatectomy. This is especially crucial for bleeding, which is difficult to control using electrocautery alone.
Collapse
|
12
|
Kajiwara M, Fujikawa T, Hasegawa S. Tissue pad degradation of ultrasonic device may enhance thermal injury and impair its sealing performance in liver surgery. World J Hepatol 2022; 14:1357-1364. [PMID: 36158911 PMCID: PMC9376783 DOI: 10.4254/wjh.v14.i7.1357] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 04/12/2022] [Accepted: 07/06/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Ultrasonic devices are widely used in many surgical fields, including hepatectomy; however, the negative effects of tissue pad degradation of ultrasonic devices, including those in liver surgery, remain unknown. The Harmonic® 1100 (H-1100) scalpel has advanced heat control technology than previous models, such as the Harmonic® HD1000i (H-HD1000i). We hypothesized that, because of its advanced temperature-control technology, the H-1100 scalpel would show less tissue pad degradation, resulting in superior sealing performance, compared to that with the H-HD1000i scalpel.
AIM To elucidate ultrasonic device tissue pad degradation effects on instrument temperature and sealing performance using ex vivo porcine liver/vessel models.
METHODS Two different harmonic scalpels were used and compared: A newer model, the H-1100 scalpel, and an older model, the H-HD1000i scalpel. Using ex vivo porcine livers, each instrument was activated until the liver parenchyma was dissected. The device temperature (passive jaw temperature) was measured after every 10 consecutive activations, until 300 transections of the porcine liver were performed. Tissue pad degradation was evaluated after 300 activations. Sealing performance was evaluated using excised porcine carotid vessels; vessel sealing speed and frequency of vessel burst pressure below 700 mmHg were determined after 300 transections of porcine liver parenchyma.
RESULTS The temperature of the H-HD1000i scalpel was approximately 10°C higher than that of the H-1100 scalpel, and gradually increased as the number of activations increased. The median passive jaw temperature of the H-HD1000i scalpel was significantly higher than that of the H-1100 scalpel (73.4°C vs 65.1°C; P < 0.001). After 300 transections of porcine liver parenchyma, less tissue pad degradation was observed with the H-1100 scalpel than with the H-HD1000i scalpel (0.08 mm vs 0.51 mm). The H-1100 scalpel demonstrated faster vessel-sealing speed (4.9 sec. vs 5.1 sec.) and less frequent vessel burst pressure < 700 mmHg (0% vs 40%) after 300 activations than the H-HD1000i scalpel; however, the difference did not reach statistical significance (P = 0.21 and P = 0.09, respectively).
CONCLUSION In an ex vivo porcine hepatectomy model, the H-1100 scalpel shows lower passive jaw temperature and maintains its sealing performance by avoiding tissue pad degradation compared to that with the H-HD1000i.
Collapse
Affiliation(s)
- Masatoshi Kajiwara
- Department of Gastroenterological Surgery, Fukuoka University, Fukuoka 814-0180, Fukuoka, Japan
| | - Takahisa Fujikawa
- Department of Surgery, Kokura Memorial Hospital, Kitakyushu 802-8555, Fukuoka, Japan
| | - Suguru Hasegawa
- Department of Gastroenterological Surgery, Fukuoka University, Fukuoka 814-0180, Fukuoka, Japan
| |
Collapse
|
13
|
Kajiwara M, Nakashima R, Sasaki T, Naito S, Hasegawa S. Dissection Around the Superior Mesenteric Artery (SMA) Using LigaSure Maryland During Left Posterior Approach for Pancreaticoduodenectomy. Cureus 2022; 14:e27034. [PMID: 35989809 PMCID: PMC9387940 DOI: 10.7759/cureus.27034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/19/2022] [Indexed: 11/05/2022] Open
Abstract
R0 resection for pancreatic head cancer without exposing the tumor demands complete resection of “mesopancreas”. In other words, dividing the proximal jejunal artery and vein at their roots of the superior mesenteric artery (SMA) and superior mesenteric vein (SMV) respectively during pancreaticoduodenectomy (PD) is absolutely essential. We present here our standardized dissection procedures around the SMA during the left posterior approach for PD. This procedure is safe and reproducible owing to the secure sealing performance of LigaSureTM Maryland.
Collapse
|
14
|
Kajiwara M, Ishii F, Sasaki T, Nakashima R, Hasegawa S. Crucial Roles of the Assistant Surgeon During Laparoscopic Left Hemihepatectomy. Cureus 2022; 14:e24050. [PMID: 35573504 PMCID: PMC9095429 DOI: 10.7759/cureus.24050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/08/2022] [Indexed: 11/05/2022] Open
Abstract
Background Although left hemihepatectomy has been widely performed via the laparoscopic approach, the roles of the assistant surgeon have not been well-documented so far. We herein present our standardized procedures of laparoscopic left hemihepatectomy without Spiegel’s lobe resection, focusing on the crucial roles of the assistant surgeon. Methods During laparoscopic left hemihepatectomy without Spiegel’s lobe resection, countertraction by the assistant surgeon is quite important especially during isolating the left Glissonean pedicle and transecting liver parenchyma. When securing the left hepatic pedicle using the Glissonean approach, the assistant surgeon pushes Segment 4 of the liver cranially and pulls the tape encircling the hepatoduodenal ligament caudally in the opposite way, orthogonal to the direction of the laparoscopic forceps toward the left portal triad. During liver parenchymal transection, the assistant surgeon pulls the hanging tape across the left lobe of the liver in order to provide a wide and stable liver transection plane. With this standardized technique, nine cases of laparoscopic left hemihepatectomy were performed over the last two years in our department, and the perioperative data were retrospectively analyzed. Results The median age of the nine patients was 70 years (range: 58 - 84 years). Most of the patients were males (77.8%). Five of nine patients were diagnosed with colorectal liver metastasis, two with hepatocellular carcinoma (HCC), one with inflammatory pseudotumor, and the other one with hepaticolithiasis. There were no conversions to open surgery. The median operative time and estimated blood loss were 337 minutes (range: 219 - 478 minutes) and 100 ml (range: 41 - 375 ml), respectively. The median length of postoperative hospital stay was nine days (range: 7 - 16 days). Major complications (Clavien-Dindo classification grade III or more) were not encountered in our cohort postoperatively. Conclusion We presented here our standardized assistant roles during laparoscopic left hemihepatectomy without Spiegel’s lobe resection, which was revealed to be safe and feasible in our cohort.
Collapse
|
15
|
Abstract
While minimizing intraoperative blood loss during liver resection is one of the most important tasks, it is more difficult to control the refractory bleeding during laparoscopic liver resection than with an open approach. We herein provide a modification of the two-surgeon technique that enables laparoscopic liver parenchymal transection to be performed as quickly and securely as open liver resection. To achieve proper "role sharing," the "transection mode" and the "hemostatic mode" are independent sets in place in this procedure, and these modes are switched rigidly according to the surgical field condition. By thoroughly sharing the roles, rapid laparoscopic liver parenchymal transection comparable to open liver resection can be accomplished. The present modified approach achieves satisfactory transection and hemostasis of the liver parenchyma and is also advantageous for teaching young surgeons and the entire surgical team.
Collapse
|
16
|
Sasaki T, Kajiwara M, Ishii F, Hamada Y, Hasegawa S. Gallbladder Intramucosal Carcinoma Arising in a Cholesterol Polyp: A Case Report. Cureus 2022; 14:e22898. [PMID: 35399405 PMCID: PMC8983120 DOI: 10.7759/cureus.22898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/06/2022] [Indexed: 11/30/2022] Open
Abstract
Cholesterol polyp is the most common benign disease of gallbladder polyps, and is considered not to be the origin of malignancy. Herein, we report a rare case of a well-differentiated adenocarcinoma arising in a gallbladder cholesterol polyp. A pedunculated mulberry-like gallbladder polyp diagnosed with a cholesterol polyp preoperatively consisted of two distinct components macroscopically: a yellow-whitish lobulated lesion and a brownish irregular lesion. Microscopically, the former revealed to be a cholesterol polyp, but the latter demonstrated a well-differentiated adenocarcinoma. Even if imaging findings suggest a gallbladder cholesterol polyp, it is important to keep in mind that carcinoma can coexist like our case.
Collapse
|
17
|
Nagata K, Kajiwara M, Fujikawa T. Long-Term Survival of a Patient With Peritoneal Carcinomatosis From Pancreatic Cancer Maintained by Nanoliposomal Irinotecan as Third-Line Chemotherapy. Cureus 2022; 14:e22355. [PMID: 35317028 PMCID: PMC8934406 DOI: 10.7759/cureus.22355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/18/2022] [Indexed: 11/05/2022] Open
|
18
|
Mori A, Arimoto A, Hamaguchi Y, Kajiwara M, Nakajima A, Kanaya S. Risk Factors and Outcome of Portal Vein Thrombosis After Laparoscopic and Open Hepatectomy for Primary Liver Cancer: A Single-Center Experience. World J Surg 2021; 44:3093-3099. [PMID: 32394012 DOI: 10.1007/s00268-020-05565-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Post-hepatectomy portal vein thrombosis (PH-PVT) is a severe complication. The risk factors of PH-PVT after laparoscopic and open hepatectomy have not been clarified yet. We aimed to retrospectively investigate the risk factors and outcome of PH-PVT in patients with primary liver cancer. METHODS We enrolled 622 consecutive patients who underwent hepatectomy in our hospital between January 2006 and August 2016. RESULTS Of 21 patients (3.4%) with PH-PVT, 7 had grade I; 13, grade II; and 1, grade III. The patients with PH-PVT were significantly older than those without PH-PVT. Of the 413 patients who underwent open hepatectomy, those who underwent a major right hepatectomy (4.1%) had a slightly higher incidence of PH-PVT. Of the 209 patients who underwent laparoscopic hepatectomy, those who underwent a left lateral sectionectomy (21.2%) and major right hepatectomy (16.7%) had high incidence rates of PH-PVT. The treatment was only observation in five patients, medication with an antithrombotic drug in 15 patients, and reoperation in one patient. PH-PVT diminished in 17 patients. Cavernous transformation and/or stenosis of the portal vein developed in three patients. The patient with grade III PH-PVT after open right hemihepatectomy underwent reoperation but died of hepatic failure. CONCLUSION This study demonstrated that patient age, left lateral sectionectomy were risk factors of PH-PVT. Laparoscopic left lateral sectionectomy and major right hepatectomy might bring about relatively higher risk of PH-PVT. Major right hepatectomy tends to lead to severe PH-PVT. Careful handling of the PV during hepatectomy and early treatment of PH-PVT are necessary.
Collapse
Affiliation(s)
- Akira Mori
- Department of Surgery, Japanese Red Cross Osaka Hospital, 5-30 Fudegasaki-cho, Tennoji-ku, Osaka, 543-8555, Japan.
| | - Akira Arimoto
- Department of Surgery, Japanese Red Cross Osaka Hospital, 5-30 Fudegasaki-cho, Tennoji-ku, Osaka, 543-8555, Japan
| | - Yuhei Hamaguchi
- Department of Surgery, Japanese Red Cross Osaka Hospital, 5-30 Fudegasaki-cho, Tennoji-ku, Osaka, 543-8555, Japan
| | - Masatoshi Kajiwara
- Department of Surgery, Japanese Red Cross Osaka Hospital, 5-30 Fudegasaki-cho, Tennoji-ku, Osaka, 543-8555, Japan
| | - Akio Nakajima
- Department of Surgery, Japanese Red Cross Osaka Hospital, 5-30 Fudegasaki-cho, Tennoji-ku, Osaka, 543-8555, Japan
| | - Seiichiro Kanaya
- Department of Surgery, Japanese Red Cross Osaka Hospital, 5-30 Fudegasaki-cho, Tennoji-ku, Osaka, 543-8555, Japan
| |
Collapse
|
19
|
Mori A, Arimoto A, Hamaguchi Y, Kajiwara M, Nakajima A, Kanaya S. Author's Reply: Risk Factors and Outcome of Portal Vein Thrombosis After Laparoscopic and Open Hepatectomy for Primary Liver Cancer: A Single-Center Experience. World J Surg 2020; 44:3973-3974. [PMID: 32734452 DOI: 10.1007/s00268-020-05716-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/17/2020] [Indexed: 11/26/2022]
Affiliation(s)
- Akira Mori
- Department of Surgery, Japanese Red Cross Osaka Hospital, 5-30 Fudegasaki-cho, Tennoji-ku, Osaka, 543-8555, Japan.
| | - Akira Arimoto
- Department of Surgery, Japanese Red Cross Osaka Hospital, 5-30 Fudegasaki-cho, Tennoji-ku, Osaka, 543-8555, Japan
| | - Yuhei Hamaguchi
- Department of Surgery, Japanese Red Cross Osaka Hospital, 5-30 Fudegasaki-cho, Tennoji-ku, Osaka, 543-8555, Japan
| | - Masatoshi Kajiwara
- Department of Surgery, Japanese Red Cross Osaka Hospital, 5-30 Fudegasaki-cho, Tennoji-ku, Osaka, 543-8555, Japan
| | - Akio Nakajima
- Department of Surgery, Japanese Red Cross Osaka Hospital, 5-30 Fudegasaki-cho, Tennoji-ku, Osaka, 543-8555, Japan
| | - Seiichiro Kanaya
- Department of Surgery, Japanese Red Cross Osaka Hospital, 5-30 Fudegasaki-cho, Tennoji-ku, Osaka, 543-8555, Japan
| |
Collapse
|
20
|
Kohada Y, Hayashi T, Hsi R, Yukihiro K, Sentani K, Goto K, Inoue S, Ohara S, Teishima J, Kajiwara M, Nishisaka T, Mikami J, Anan G, Ito J, Kaiho Y, Sato M, Yasui W, Akio M. Recurrence and progression free survival of intermediate risk NMIBC: The impact of conditional evaluation and sub-classification. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33546-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
|
21
|
Abstract
Abstract
The structure of the fluorescent derivative formed in the method of Okayama et al. (Clin Chem 1990; 36:1494-7) for determining delta-aminolevulinic acid (ALA) concentrations was reinvestigated after esterification. The molecular ion peak at m/z 303.1473 corresponded to the molecular formula of C17H21NO4 (calcd 303.1470). The infrared spectrum showed the presence of carbonyl and carboxyl groups. This compound contained two acetyl groups, two methyl groups, and one methoxycarbonylethyl group, as revealed by 1H and 13C nuclear magnetic resonance and 13C-1H shift-correlated spectroscopy. Experiments with correlation spectroscopy via long-range coupling indicated that the main skeleton is 3H-pyrrolizine. The relative arrangement of functional groups was determined by means of nuclear Overhauser effect difference experiments. We were led to the conclusion that the methyl ester of the derivative is 2,6-diacetyl-1,5-dimethyl-7-(2-methoxycarbonylethyl)-3H-pyrrolizine. This structure was unequivocally confirmed by x-ray analysis; therefore, the structure of the derivative itself is 2,6-diacetyl-1,5-dimethyl-7-(2-carboxyethyl)-3H-pyrrolizine.
Collapse
Affiliation(s)
- M Kajiwara
- Department of Medicinal Chemistry, Meiji College of Pharmacy, Tokyo, Japan
| | - K Hara
- Department of Medicinal Chemistry, Meiji College of Pharmacy, Tokyo, Japan
| | - K Takatori
- Department of Medicinal Chemistry, Meiji College of Pharmacy, Tokyo, Japan
| | - K Matsumoto
- Department of Medicinal Chemistry, Meiji College of Pharmacy, Tokyo, Japan
| |
Collapse
|
22
|
Fowler H, Belot A, Njagi EN, Luque-Fernandez MA, Maringe C, Quaresma M, Kajiwara M, Rachet B. Persistent inequalities in 90-day colon cancer mortality: an English cohort study. Br J Cancer 2017; 117:1396-1404. [PMID: 28859056 PMCID: PMC5672924 DOI: 10.1038/bjc.2017.295] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Revised: 07/31/2017] [Accepted: 08/03/2017] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Variation in colon cancer mortality occurring shortly after diagnosis is widely reported between socio-economic status (SES) groups: we investigated the role of different prognostic factors in explaining variation in 90-day mortality. METHODS National cancer registry data were linked with national clinical audit data and Hospital Episode Statistics records for 69 769 adults diagnosed with colon cancer in England between January 2010 and March 2013. By gender, logistic regression was used to estimate the effects of SES, age and stage at diagnosis, comorbidity and surgical treatment on probability of death within 90 days from diagnosis. Multiple imputations accounted for missing stage. We predicted conditional probabilities by prognostic factor patterns and estimated the effect of SES (deprivation) from the difference between deprivation-specific average predicted probabilities. RESULTS Ninety-day probability of death rose with increasing deprivation, even after accounting for the main prognostic factors. When setting the deprivation level to the least deprived group for all patients and keeping all other prognostic factors as observed, the differences between deprivation-specific averaged predicted probabilities of death were greatly reduced but persisted. Additional analysis suggested stage and treatment as potential contributors towards some of these inequalities. CONCLUSIONS Further examination of delayed diagnosis, access to treatment and post-operative care by deprivation group may provide additional insights into understanding deprivation disparities in mortality.
Collapse
Affiliation(s)
- H Fowler
- Cancer Survival Group, Department of Non-Communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK
| | - A Belot
- Cancer Survival Group, Department of Non-Communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK
| | - E N Njagi
- Cancer Survival Group, Department of Non-Communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK
| | - M A Luque-Fernandez
- Cancer Survival Group, Department of Non-Communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK
| | - C Maringe
- Cancer Survival Group, Department of Non-Communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK
| | - M Quaresma
- Cancer Survival Group, Department of Non-Communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK
| | - M Kajiwara
- Cancer Survival Group, Department of Non-Communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK
| | - B Rachet
- Cancer Survival Group, Department of Non-Communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK
| |
Collapse
|
23
|
Mae SI, Shono A, Shiota F, Yasuno T, Kajiwara M, Gotoda-Nishimura N, Arai S, Sato-Otubo A, Toyoda T, Takahashi K, Nakayama N, Cowan CA, Aoi T, Ogawa S, McMahon AP, Yamanaka S, Osafune K. Monitoring and robust induction of nephrogenic intermediate mesoderm from human pluripotent stem cells. Nat Commun 2013; 4:1367. [PMID: 23340407 DOI: 10.1038/ncomms2378] [Citation(s) in RCA: 211] [Impact Index Per Article: 19.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2012] [Accepted: 12/12/2012] [Indexed: 12/23/2022] Open
Abstract
A method for stimulating the differentiation of human pluripotent stem cells into kidney lineages remains to be developed. Most cells in kidney are derived from an embryonic germ layer known as intermediate mesoderm. Here we show the establishment of an efficient system of homologous recombination in human pluripotent stem cells by means of bacterial artificial chromosome-based vectors and single-nucleotide polymorphism array-based detection. This system allowed us to generate human-induced pluripotent stem cell lines containing green fluorescence protein knocked into OSR1, a specific intermediate mesoderm marker. We have also established a robust induction protocol for intermediate mesoderm, which produces up to 90% OSR1(+) cells. These human intermediate mesoderm cells can differentiate into multiple cell types of intermediate mesoderm-derived organs in vitro and in vivo, thereby supplying a useful system to elucidate the mechanisms of intermediate mesoderm development and potentially providing a cell source for regenerative therapies of the kidney.
Collapse
Affiliation(s)
- Shin-Ichi Mae
- Center for iPS Cell Research and Application (CiRA), Kyoto University, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan
| | - Akemi Shono
- Center for iPS Cell Research and Application (CiRA), Kyoto University, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan
| | - Fumihiko Shiota
- Center for iPS Cell Research and Application (CiRA), Kyoto University, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan
| | - Tetsuhiko Yasuno
- Center for iPS Cell Research and Application (CiRA), Kyoto University, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan
| | - Masatoshi Kajiwara
- Center for iPS Cell Research and Application (CiRA), Kyoto University, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan
| | - Nanaka Gotoda-Nishimura
- Center for iPS Cell Research and Application (CiRA), Kyoto University, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan
| | - Sayaka Arai
- Center for iPS Cell Research and Application (CiRA), Kyoto University, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan
| | - Aiko Sato-Otubo
- Cancer Genomics Project, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Taro Toyoda
- Center for iPS Cell Research and Application (CiRA), Kyoto University, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan
| | - Kazutoshi Takahashi
- Center for iPS Cell Research and Application (CiRA), Kyoto University, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan
| | - Naoki Nakayama
- Centre for Stem Cell Research, Brown Foundation Institute of Molecular Medicine, The University of Texas Health Science Center at Houston, 1825 Pressler Street, Houston, TX 77030, USA
| | - Chad A Cowan
- Harvard Stem Cell Institute, 42 Church Street, Cambridge, MA 02138, USA, Department of Molecular and Cellular Biology, Department of Stem Cell and Regenerative Biology, Harvard University, 7 Divinity Avenue, Cambridge, MA 02138, USA
| | - Takashi Aoi
- Center for iPS Cell Research and Application (CiRA), Kyoto University, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan
| | - Seishi Ogawa
- Cancer Genomics Project, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Andrew P McMahon
- Harvard Stem Cell Institute, 42 Church Street, Cambridge, MA 02138, USA, Department of Molecular and Cellular Biology, Department of Stem Cell and Regenerative Biology, Harvard University, 7 Divinity Avenue, Cambridge, MA 02138, USA
| | - Shinya Yamanaka
- Center for iPS Cell Research and Application (CiRA), Kyoto University, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan.,Institute for Integrated Cell-Material Sciences, Kyoto University, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan.,JST Yamanaka iPS Cell Special Project, Japan Science and Technology Agency (JST), 4-1-8 Honcho, Kawaguchi, Saitama 332-0012, Japan.,Gladstone Institute of Cardiovascular Disease, San Francisco, CA 94158, USA
| | - Kenji Osafune
- Center for iPS Cell Research and Application (CiRA), Kyoto University, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan.,PRESTO, Japan Science and Technology Agency (JST), 4-1-8 Honcho, Kawaguchi, Saitama 332-0012, Japan.,JST Yamanaka iPS Cell Special Project, Japan Science and Technology Agency (JST), 4-1-8 Honcho, Kawaguchi, Saitama 332-0012, Japan
| |
Collapse
|
24
|
Kajiwara M, Shima M, Yoshioka A. Two haemophilia patients with inhibitors who became ambulatory after physiotherapy under haemostatic cover with bypassing agents. Haemophilia 2013; 19:e301-4. [DOI: 10.1111/hae.12179] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/12/2013] [Indexed: 11/28/2022]
Affiliation(s)
- M. Kajiwara
- Department of Paediatrics; National Hospital Organization Fukui National Hospital; Tsuruga; Japan
| | - M. Shima
- Department of Paediatrics; Nara Medical University; Kashihara City; Japan
| | - A. Yoshioka
- Nara Medical University; Kashihara City; Japan
| |
Collapse
|
25
|
Teraishi T, Ozeki Y, Hori H, Sasayama D, Chiba S, Yamamoto N, Tanaka H, Iijima Y, Matsuo J, Kawamoto Y, Kinoshita Y, Hattori K, Ota M, Kajiwara M, Terada S, Higuchi T, Kunugi H. 1219 – Phenylalanine kinetics in schizophrenia patients detected by 13C-phenylalanine breath test. Eur Psychiatry 2013. [DOI: 10.1016/s0924-9338(13)76299-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
|
26
|
Sasaki N, Ishii T, Kamimura R, Kajiwara M, Machimoto T, Nakatsuji N, Suemori H, Ikai I, Yasuchika K, Uemoto S. Corrigendum to ‘Alpha-fetoprotein-producing pancreatic cancer cells possess cancer stem cell characteristics’ [Cancer Letters 308(2) (2011) 152–161]. Cancer Lett 2012. [DOI: 10.1016/j.canlet.2012.03.020] [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: 10/28/2022]
|
27
|
Kamimura R, Ishii T, Sasaki N, Kajiwara M, Machimoto T, Saito M, Kohno K, Suemori H, Nakatsuji N, Ikai I, Yasuchika K, Uemoto S. Comparative study of transplantation of hepatocytes at various differentiation stages into mice with lethal liver damage. Cell Transplant 2012; 21:2351-62. [PMID: 22472047 DOI: 10.3727/096368912x636957] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Hepatocyte transplantation utilizing induced pluripotent stem cells (iPSCs) or embryonic stem cells (ESCs) has been expected to provide an alternative to liver transplantation. However, it remains uncertain precisely which cell type is the best suited for cell transplantation. In particular, it is unclear whether mature hepatocytes, which have sufficient liver function, or immature hepatic progenitor cells, which have a higher proliferative capacity, will provide a better outcome. The main objective of this study was to investigate the therapeutic efficacy of the transplantation of hepatocytes at various differentiation stages. We utilized transgenic mice that expressed diphtheria toxin (DT) receptors under the control of an albumin enhancer/promoter. ESC-derived endodermal cells, fetal hepatocytes, and adult hepatocytes were transplanted into these mice with experimentally induced lethal acute liver injury caused by DT administration. The transplanted cells were marked by enhanced green fluorescent protein. We evaluated their effects on survival. At 35 days after transplantation, the survival rate of the adult hepatocyte-transplanted group (8/20, 40%) was significantly improved in comparison to that of the sham-operated group (2/25, 8%), the fetal hepatocyte-transplanted group (1/20, 5%), and the ESC-derived endodermal cell-transplanted group (0/21, 0%). The adult hepatocytes proliferated in the recipient livers and replaced a large part of their parenchyma. The transplantation of adult hepatocytes for acute liver failure significantly improved the survival rate in comparison to that of transplantation of immature cells, thus suggesting that ESCs and iPSCs should be differentiated into mature hepatocytes before cell transplantation for acute liver failure.
Collapse
Affiliation(s)
- Ryo Kamimura
- Department of Surgery, Graduate School of Medicine, Kyoto University, Sakyo-ku, Kyoto, Japan
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
28
|
Sasaki N, Ishii T, Kamimura R, Kajiwara M, Machimoto T, Nakatsuji N, Suemori H, Ikai I, Yasuchika K, Uemoto S. Alpha-fetoprotein-producing pancreatic cancer cells possess cancer stem cell characteristics. Cancer Lett 2011; 308:152-61. [PMID: 21616586 DOI: 10.1016/j.canlet.2011.04.023] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2011] [Revised: 04/28/2011] [Accepted: 04/28/2011] [Indexed: 12/20/2022]
Abstract
We aimed to demonstrate the existence of cancer stem cells in human pancreatic cancer, and to clarify that they are alpha-fetoprotein (AFP) producing cells. Six cell lines derived from human pancreatic cancers were examined, and AsPC-1 and PANC-1 were noted to express AFP. Single cell culture assays and xenotransplantation revealed that the AFP-producing cells had the capacity for self-renewal and differentiation, and that these cells were tumorigenic. Furthermore, they were resistant to anti-cancer agents. The ABCA12 transporter was expressed in the AFP-producing cells at a level more than twice as high as that in the non-AFP-producing cells. The AFP-producing cells were shown to be putative pancreatic cancer stem cells. Furthermore, the expression of ABCA12 appears to be associated with drug resistance.
Collapse
Affiliation(s)
- Naoya Sasaki
- Department of Surgery, Graduate School of Medicine, Kyoto University, Japan
| | | | | | | | | | | | | | | | | | | |
Collapse
|
29
|
Satsu T, Onoe M, Kajiwara M, Yamashita K, Izuhara M. [Infective endocarditis complicated with ruptured mycotic intracranial aneurysms]. Kyobu Geka 2010; 63:82-85. [PMID: 20077837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
A 38-year-old man was hospitalized complaining of an episode of syncope. He was diagnosed with acute infective endocarditis (IE) of the aortic and the mitral valves with mobile and large vegetations, complicated with mycotic cerebral emboli related to the left anterior and the middle cerebral arteries. Double valve replacement with mechanical prosthesis was performed within 24 hours after cerebral accident occurred. On the 36 postoperative day, emergency cerebrovascular surgery was done due to rupture of a mycotic intracranial aneurysm. He was discharged on foot without any neurological abnormal finding. The optimum treatment of IE complicated with cerebral embolism is a controversial theme. Management should be considered carefully in individual cases.
Collapse
Affiliation(s)
- Takuma Satsu
- Department of Cardiovascular Surgery, Kishiwada City Hospital, Japan
| | | | | | | | | |
Collapse
|
30
|
Tsuchida M, Ohara A, Manabe A, Kumagai M, Shimada H, Kikuchi A, Mori T, Saito M, Akiyama M, Fukushima T, Koike K, Shiobara M, Ogawa C, Kanazawa T, Noguchi Y, Oota S, Okimoto Y, Yabe H, Kajiwara M, Tomizawa D, Ko K, Sugita K, Kaneko T, Maeda M, Inukai T, Goto H, Takahashi H, Isoyama K, Hayashi Y, Hosoya R, Hanada R. Long-term results of Tokyo Children's Cancer Study Group trials for childhood acute lymphoblastic leukemia, 1984-1999. Leukemia 2009; 24:383-96. [PMID: 20033052 DOI: 10.1038/leu.2009.260] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
We report the long-term results of Tokyo Children's Cancer Study Group's studies L84-11, L89-12, L92-13, and L95-14 for 1846 children with acute lymphoblastic leukemia, which were conducted between 1984 and 1999. The value of event-free survival (EFS)+/-s.e. was 67.2+/-2.2% at 10 years in L84-11, which was not improved in the following two studies, and eventually improved to 75.0+/-1.8% at 10 years in L95-14 study. The lower EFS of the L89-12 reflected a high rate of induction failure because of infection and delayed remission in very high-risk patients. The L92-13 study was characterized by short maintenance therapy; it resulted in poor EFS, particularly in the standard-risk (SR) group and boys. Females did significantly better than males in EFS in the early three studies. The gender difference was not significant in overall survival, partly because >60% of the males survived after the testicular relapse. Randomized studies in the former three protocols revealed that intermediate- or high-dose methotrexate therapy significantly reduced the testicular relapse rate. In the L95-14 study, gender difference disappeared in EFS. Contrary to the results of larger-scale studies, the randomized control study in the L95-14 reconfirmed with updated data that dexamethasone 8 mg/m(2) had no advantage over prednisolone 60 mg/m(2) in the SR and intermediate-risk groups. Prophylactic cranial irradiation was assigned to 100, 80, 44, and 44% of the patients in the studies, respectively. Isolated central nervous system relapse rates decreased to <2% in the last two trials. Secondary brain tumors developed in 12 patients at 8-22 years after cranial irradiation. Improvement of the remission induction rates and the complete omission of irradiation are currently main objectives in our studies.
Collapse
Affiliation(s)
- M Tsuchida
- Department of Pediatric Hematology and Oncology, Ibaraki Children's Hospital, Mito, Japan.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
31
|
Imai H, Egawa H, Kajiwara M, Nakajima A, Ogura Y, Hatano E, Ueda M, Kawaguchi Y, Kaido T, Takada Y, Uemoto S. Resolution of Preoperative Portal Vein Thrombosis After Administration of Antithrombin III in Living Donor Liver Transplantation: Case Report. Transplant Proc 2009; 41:3931-3. [DOI: 10.1016/j.transproceed.2008.10.104] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2008] [Accepted: 10/06/2008] [Indexed: 01/19/2023]
|
32
|
Ishii T, Yasuchika K, Fukumitsu K, Konishi S, Kajiwara M, Kamimura R, Sasaki N, Suemori H, Nakatsuji N, Ikai I, Uemoto S. 189. Alpha-Fetoprotein Producing Cells as a Candidate for Cancer Stem Cells of Cholangiocellular Carcinomas. J Surg Res 2009. [DOI: 10.1016/j.jss.2008.11.228] [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: 11/25/2022]
|
33
|
Nishikawa T, Ueba T, Kajiwara M, Iwata R, Yamashita K. Combined Treatment of Ruptured Aneurysm Accompanied by Intraventricular Hemorrhage; Neuroendoscopy and Coiling: Case Report. ACTA ACUST UNITED AC 2008; 51:354-7. [DOI: 10.1055/s-0028-1085453] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
34
|
Kajiwara M, Kojima M, Konishi M, Nakagohri T, Takahashi S, Gotohda N, Hasebe T, Ochiai A, Kinoshita T. Autoimmune pancreatitis with multifocal lesions. ACTA ACUST UNITED AC 2008; 15:449-52. [PMID: 18670850 DOI: 10.1007/s00534-007-1254-1] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2007] [Accepted: 07/13/2007] [Indexed: 12/21/2022]
Abstract
Two cases of a focal type of autoimmune pancreatitis (AIP) with distinct double mass lesions within the pancreas are described. In both patients, computed tomography (CT) showed localized pancreatic masses with delayed enhancement, and magnetic resonance cholangiopancreatography (MRCP) revealed localized stenoses of the main pancreatic duct (MPD) with mild upstream dilatation. Fluorodeoxyglucose positron emission tomography (FDG-PET) examination, performed in one patient, showed intense uptake concordant with tumors. Both patients received pancreatic resection with a presumptive diagnosis of pancreatic carcinoma. Histologic evaluation of the tumors showed marked lymphoplasmacytic infiltration and fibrosis around the large and medium pancreatic ducts, without any evidence of malignancy. Serum IgG4 concentration, measured postoperatively, was elevated in both patients. The characteristic morphological features of AIP are diffuse swelling of the pancreatic parenchyma and diffuse narrowing of the MPD. Recently, a focal type of AIP, which mimics pancreatic carcinoma, has been recognized. Considering the favorable response of AIP to steroid therapy, it is clinically important to differentiate the focal type of AIP from pancreatic carcinoma and to know that AIP sometimes exhibits multiple lesions within the pancreas.
Collapse
Affiliation(s)
- Masatoshi Kajiwara
- Department of Hepatobiliary Pancreatic Surgery, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba 277-8577, Japan
| | | | | | | | | | | | | | | | | |
Collapse
|
35
|
Iida K, Nakajima Y, Kajiwara M. Synthesis of 1-Amino-2-[3-13C]propanol Hydrochloride: Completion of Synthetic Methods for all of its 13C- and 15N-Isotopomers. Curr Radiopharm 2008. [DOI: 10.2174/1874471010801020120] [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: 11/22/2022]
|
36
|
Kubo S, Kajiwara M, Kawabata A. Dual modulation of the tension of isolated gastric artery and gastric mucosal circulation by hydrogen sulfide in rats. Inflammopharmacology 2008; 15:288-92. [PMID: 17952370 DOI: 10.1007/s10787-007-1590-4] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
To clarify roles of H2S in regulation of gastric circulation, we investigated effects of NaHS, a H2S donor, on tension of isolated rat gastric artery and gastric mucosal blood flow in rats. In the precontracted ring preparations, NaHS caused contraction and relaxation at low and high concentrations, respectively. The NaHS-induced vasorelaxation was only partially blocked by glibenclamide, a K+ (ATP) channel inhibitor. The contractile activity of NaHS disappeared by removal of the endothelium or by inhibition of nitric oxide synthase and the endothelium-derived hyperpolarizing factor (EDHF) pathways. Intravenous injection of NaHS caused transient increase followed by decrease in gastric mucosal blood flow in rats. Collectively, in the gastric artery, NaHS appears to cause relaxation through both K+ (ATP) channel-dependent and -independent pathways and contraction through inhibition of NO and EDHF pathways. Together with the in vivo results, our study implies that H2S plays multiple complex roles in regulation of gastric circulation.
Collapse
Affiliation(s)
- S Kubo
- Division of Physiology and Pathophysiology, School of Pharmacy, Kinki University, 3-4-1 Kowakae, Higashi-Osaka, 577-8502, Japan
| | | | | |
Collapse
|
37
|
Kajiwara M, Gotohda N, Konishi M, Nakagohri T, Takahashi S, Kojima M, Kinoshita T. Incidence of the focal type of autoimmune pancreatitis in chronic pancreatitis suspected to be pancreatic carcinoma: experience of a single tertiary cancer center. Scand J Gastroenterol 2008; 43:110-6. [PMID: 18158696 DOI: 10.1080/00365520701529238] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE With an increase in autoimmune pancreatitis (AIP) being reported, the focal type of AIP, which shows localized narrowing of the main pancreatic duct and focal swelling of the pancreas, has recently been recognized. Therefore, cases of focal-type AIP subjected to surgical intervention for presumptive malignancy might previously have been diagnosed as mass-forming chronic pancreatitis. The aim of this study was to elucidate the incidence of focal-type AIP in resected chronic pancreatitis at a single tertiary cancer center. The clinical and radiological features of focal-type AIP were also evaluated. MATERIAL AND METHODS We re-evaluated 15 patients who underwent pancreatic resection with a presumed diagnosis of pancreatic ductal adenocarcinoma, and who in the past had been diagnosed pathologically as having chronic pancreatitis. RESULTS Seven of 15 patients showed AIP, and the other 8 patients were diagnosed as having mass-forming chronic pancreatitis not otherwise specified by pathological retrospective examination. In other words, nearly half of the cases of resected chronic pancreatitis that were suspected to be pancreatic carcinoma preoperatively showed focal-type AIP. Regarding the characteristic findings of focal-type AIP, narrowing of the pancreatic duct on endoscopic retrograde pancreatography (ERP) might be diagnostic. CONCLUSIONS Focal-type AIP is not a rare clinical entity and might be buried in previously resected pancreatic specimens that in the past were diagnosed simply as mass-forming pancreatitis.
Collapse
Affiliation(s)
- Masatoshi Kajiwara
- Department of Hepatobiliary Pancreatic Surgery, Research Center for Innovative Oncology, National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | | | | | | | | | | | | |
Collapse
|
38
|
Kajiwara M, Gotohda N, Konishi M, Nakagohri T, Takahashi S, Kojima M, Hasebe T, Kinoshita T. Cystic endocrine tumor of the pancreas with an atypical multilocular appearance. ACTA ACUST UNITED AC 2007; 14:586-9. [DOI: 10.1007/s00534-006-1218-x] [Citation(s) in RCA: 2] [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] [Received: 11/17/2006] [Accepted: 12/27/2006] [Indexed: 10/22/2022]
|
39
|
Kajiwara M, Fujii S, Takahashi S, Konishi M, Nakagohri T, Gotohda N, Kinoshita T. Adenocarcinoma of the minor duodenal papilla with intraepithelial spread to the pancreatic duct. Virchows Arch 2007; 451:1075-81. [PMID: 17805567 DOI: 10.1007/s00428-007-0496-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2007] [Revised: 07/31/2007] [Accepted: 08/01/2007] [Indexed: 01/13/2023]
Abstract
It is extremely rare to encounter tumors arising exclusively in the minor duodenal papilla. We report a 60-year-old male patient with a polypoid type of adenocarcinoma of the minor papilla. Preoperative examinations, including computed tomography (CT) and magnetic resonance cholangiopancreatography (MRCP), suggested pancreas divisum and showed a series of stones in the dorsal pancreatic duct. The patient underwent subtotal stomach-preserving pancreaticoduodenectomy (SSpPD). On histology, an adenocarcinoma was located in the minor papilla, which was limited to the mucosa, without invasion of the duodenum, sphincter muscles of the minor papilla, or the underlying pancreas. The carcinoma cells, together with dysplastic and hyperplastic epithelium of the pancreatic duct, extended peripherally within the pancreatic duct. No cystic dilatation of the pancreatic duct was observed. The ventral pancreatic duct was short and narrow; there was evidence of chronic pancreatitis in the dorsal pancreas, whereas the ventral pancreas was almost normal, suggesting the existence of pancreas divisum. Although it is well known that adenocarcinoma of the duodenal papilla is sometimes accompanied by intraepithelial spread in the pancreatic duct, an adenocarcinoma arising in the minor papilla in this case with pancreas divisum was more extended than our thoughts.
Collapse
Affiliation(s)
- Masatoshi Kajiwara
- Department of Hepatobiliary Pancreatic Surgery, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba 277-8577, Japan
| | | | | | | | | | | | | |
Collapse
|
40
|
Kajiwara M, Oki M, Mutaguchi K, Moriyama H. POS-03.58: Prevalence and distress due to hot flushes in patients receiving endocrine therapy for prostate cancer and therapeutic efficacy of Japanese herbal medicine. Urology 2007. [DOI: 10.1016/j.urology.2007.06.949] [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]
|
41
|
Kajiwara M, Mutaguchi K, Oki M, Moriyama H. POS-01.36: Safety and pathological findings of prostate biopsy in male interstitial cystitis patients with an elevated PAS level: What dose an elevated PSA level mean? Urology 2007. [DOI: 10.1016/j.urology.2007.06.924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
42
|
Kajiwara M, Saito H. Synthesis of Inorganic-Organic Oligomers Including Cyclotriphosphazenes and the Adhesive Properties of the Products. ACTA ACUST UNITED AC 2006. [DOI: 10.1080/00222338108056832] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
43
|
Tsuji Y, Imai K, Kajiwara M, Aoki Y, Isoda T, Tomizawa D, Imai M, Ito S, Maeda H, Minegishi Y, Ohkawa H, Yata J, Sasaki N, Kogawa K, Nagasawa M, Morio T, Nonoyama S, Mizutani S. Hematopoietic stem cell transplantation for 30 patients with primary immunodeficiency diseases: 20 years experience of a single team. Bone Marrow Transplant 2006; 37:469-77. [PMID: 16435016 DOI: 10.1038/sj.bmt.1705273] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
We retrospectively analyzed our results of 30 patients with three distinctive primary immunodeficiency diseases (PIDs)--severe combined immunodeficiency (SCID, n = 11), Wiskott-Aldrich syndrome (WAS, n = 11) and X-linked hyper-immunoglobulin M (IgM) syndrome (XHIM, n = 8)--who underwent hematopoietic SCT (HSCT) during the past 20 years. Until 1995, all donors were HLA-haploidentical relatives with T-cell depletion (TCD) (n = 8). Since 1996, the donors have been HLA-matched related donors (MRD) (n = 8), unrelated BM (UR-BM) (n = 7) and unrelated cord blood (UR-CB) (n = 7). Twenty-seven of 30 patients had various pre-existing infections with or without organ damages before HSCT. Conditioning regimen and GVHD prophylaxis were determined according to disease, donor and pretransplant status. Although one of eight patients transplanted with TCD is alive with full engraftment, the other seven died. On the other hand, 18 of 22 patients transplanted without TCD are alive and well, including six of eight transplanted from MRD, seven of seven from UR-BM and five of seven from UR-CB. All 19 survivors did not require Ig supplementation after HSCT. These results indicate that UR-CBT as well as UR-BMT provides good results for PID comparable to MRD-SCT, and that early diagnosis, HSCT at early stage, careful supportive therapy and monitoring for various pathogens are important for the successful HSCT.
Collapse
Affiliation(s)
- Y Tsuji
- Department of Pediatrics, Graduate School of Medicine, Tokyo Medical and Dental University, Tokyo, Japan.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
44
|
Kobayashi T, Kajiwara M, Wahyuni M, Hamada-Sato N, Imada C, Watanabe E. Effect of culture conditions on lactic acid production of Tetragenococcus species. J Appl Microbiol 2004; 96:1215-21. [PMID: 15139912 DOI: 10.1111/j.1365-2672.2004.02267.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
AIMS To investigate the effects of the salt concentration, incubation temperature and initial pH of the medium on the fermentative ability of the halophilic lactic acid bacteria, Tetragenococcus muriaticus and T. halophilus. METHOD AND RESULTS The growth, lactic acid production and pH reduction ability of five strains of T. muriaticus and T. halophilus in MRS broth medium under various culture conditions such as salt concentration (3, 7, 15 and 23% NaCl), temperature (20, 30 and 40 degrees C), and initial medium pH (5.8, 6.5 and 7.5) were investigated. Those of T. halophilus were seriously affected by a high salinity (23% NaCl); in contrast, those of T. muriaticus were affected by a low initial pH (5.8). CONCLUSIONS The results indicate that high saline concentrations and low pH values have significant impact on the growth, lactic acid production and pH reduction ability of T. halophilus and T. muriaticus, respectively. SIGNIFICANCE AND IMPACT OF THE STUDY This study appears to be important in biopreservation during the manufacture of fermented food products. Both T. muriaticus and T. halophilus may support each other in reducing pH in hypersaline or low pH environment. To our knowledge, this is the first report on the fermentation ability of T. muriaticus.
Collapse
Affiliation(s)
- T Kobayashi
- Graduate School of Marine Science and Technology, Tokyo University of Marine Science and Technology, Minato-ku, Tokyo, Japan.
| | | | | | | | | | | |
Collapse
|
45
|
Nagasawa M, Itoh S, Tomizawa D, Kajiwara M, Sugimoto T, Kumagai J. Invasive subglottal aspergillosis in a patient with severe aplastic anemia: a case report. J Infect 2002; 44:198-201. [PMID: 12099752 DOI: 10.1053/jinf.2001.0935] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
A 19-year-old female with aplastic anemia who developed subglottal aspergillosis is reported. She presented with fever, cough and stridor. Inspiratory dyspnea progressed rapidly and emergent tracheostomy was performed, which confirmed the diagnosis. In spite of intensive anti-fungal treatment combined with adoptive immunotherapy, Aspergillus infection expanded and she died of pulmonary aspergillosis. Autopsy revealed the fungal mass obstructing the trachea and disseminated pulmonary aspergillosis. Difficulties in diagnosis and management of subglottal Aspergillus infection are discussed.
Collapse
|
46
|
Ishii T, Furube M, Hirano S, Takatori K, Iida K, Kajiwara M. Evaluation of 13C-phenylalanine and 13C-tyrosine breath tests for the measurement of hepatocyte functional capacity in patients with liver cirrhosis. Chem Pharm Bull (Tokyo) 2001; 49:1507-11. [PMID: 11767066 DOI: 10.1248/cpb.49.1507] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Liver disease is associated with an abnormal elevation of the plasma concentrations of the aromatic amino acids phenylalanine and tyrosine. The liver is the main site of aromatic amino acid metabolism, particularly the hydroxylation of phenylalanine to tyrosine and further tyrosine degradation. In the present study, we have examined the usefulness of the L-[1-13C]phenylalanine breath test (13C-PheBT) and L-[13C]tyrosine breath test (13C-TyrBT) for the detection of hepatic damage in patients with liver cirrhosis. First, the time courses of 13CO2 excretion after the administration of L-[1-13C]phenylalanine and L-[1-13C]tyrosine were compared. The peak times (the time expressed in minutes at which 13CO2 excretion was maximal) were 20 min in both breath tests, but 13C-TyrBT gave a higher peak than 13C-PheBT. Next, the parameters of 13C-PheBT and 13C-TyrBT were compared with biochemical liver function test values. These parameters were well correlated with several liver blood test values conventionally regarded as measures of hepatocyte functional reserve. Therefore, 13C-PheBT and 13C-TyrBT may be useful to assess the degree and progression of hepatic dysfunction.
Collapse
Affiliation(s)
- T Ishii
- Department of Medicinal Chemistry, Meiji Pharmaceutical University, Kiyose, Tokyo, Japan
| | | | | | | | | | | |
Collapse
|
47
|
Hanaoka Y, Ueno A, Minaguchi K, Kajiwara M, Sato Y, Oshida M. Advantages of the digital X-ray system in dental identification of persons with reference to two murder cases. J Forensic Odontostomatol 2001; 19:22-5. [PMID: 11813496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
Direct digital X-ray technology was applied to dental identification of victims in two murder cases using the Compuray system. In both cases the digital radiography proved to be simple to use, quick and effective, allowing superimposition, enlargement and transportability to a mortuary. These are the first reported uses of the technology in Japan and further development promises the transmitability of data and images electronically to remote locations, further enhancing its usefulness. Comparing the skull with the dental ante-mortem X-ray films and records of a specific person who was reported "missing", we found many identical points between the two, especially in regard to the X-ray findings with the Compuray. In both cases we obtained a large number of X-ray images in a remarkably short time and this was very useful for identification by means of the teeth.
Collapse
Affiliation(s)
- Y Hanaoka
- Department of Forensic Odontology, Tokyo Dental College, Chiba 261-8502, Japan.
| | | | | | | | | | | |
Collapse
|
48
|
Abstract
BACKGROUND Doxapram is contraindicated for newborn infants in Japan because of its serious side effects. However, because of encouraging results of recent studies regarding the efficacy and safety of therapy for apnea of prematurity (AOP) with lower doses of doxapram than those previously proposed, approximately 60% of Japanese neonatologists continue to use doxapram at small doses. Caution is warranted because the sample sizes of the former studies are inadequate to evaluate doxapram for both its beneficial and harmful effects. Therefore, we conducted the present study in order to investigate the efficacy and harmful events of low-dose doxapram therapy for idiopathic AOP in very low-birth weight (VLBW) infants in a larger population. METHODS One hundred and six VLBW infants with idiopathic AOP were treated with doxapram at a dose of 0.2-1.0 mg/kg per h in combination with methylxanthines and the frequency of apnea and secondary outcomes were compared with a group of control infants. RESULTS An approximate 80% reduction in the frequency of apnea was found with only minimal side effects following low-dose doxapram. Although there were no significant differences in secondary outcomes between the doxapram-treated and control groups, mortality in doxapram-treated infants was significantly lower than that in control infants. CONCLUSIONS Patients with AOP unresponsive to treatment with methylxanthines may benefit from the addition of low-dose doxapram.
Collapse
Affiliation(s)
- T Yamazaki
- Committee on Drugs, Japan Society for Premature and Newborn Medicine, Tokyo, Japan.
| | | | | | | |
Collapse
|
49
|
Abstract
OBJECT A variety of factors may affect surgery-related outcome in patients with ossification of the ligamentum flavum (OLF) of the thoracic spine. The aim of this study was to determine these factors on the basis of preoperative clinical and radiological findings. METHODS The authors treated 31 cases of symptomatic thoracic OLF between 1988 and 1999. The following factors were retrospectively studied: patient age, sex, morbidity level, initial symptoms, chief complaint, duration of symptoms, patellar reflex, Achilles reflex, computerized tomography (CT) finding, presence of intramedullary change determined by magnetic resonance imaging, coexistent spinal lesions, preoperative grade, and postoperative grade. A decompressive laminectomy was performed in all cases. In 29 patients (94%) improved symptoms were demonstrated postoperatively. In terms of functional prognosis, the preoperative duration of symptoms was significantly shorter in the group of patients with excellent outcomes than in those with fair outcomes (p < 0.05). No significant difference was observed in the correlation between other factors. To evaluate the degree of preoperative thoracic stenosis and the severity/extent of OLF-induced spinal compression, we used an original OLF CT scoring system. A score of excellent on the CT scale tended to indicate an excellent prognosis (p < 0.01). CONCLUSIONS Thoracic OLF frequently develops in the lower-thoracic spine in middle-aged men, and it is complicated by various spinal lesions in many cases. Early diagnosis and treatment are important for understanding the clinical symptoms and imaging diagnosis because the present findings suggest that a delay in diagnosis and treatment correlates with the functional prognosis postoperatively.
Collapse
Affiliation(s)
- K Shiokawa
- Department of Neurosurgery, Shizuoka General Hospital, Japan.
| | | | | | | | | | | |
Collapse
|
50
|
Komatsu F, Kajiwara M. CD18/CD54(+CD102), CD2/CD58 pathway-independent killing of lymphokine-activated killer (LAK) cells against glioblastoma cell lines T98G and U373MG. Oncol Res 2001; 12:17-24. [PMID: 11061342 DOI: 10.3727/000000001108747408] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
For natural killer cell-mediated cytolysis (NK-lysis) and lymphokine-activated killer cell-mediated cytolysis (LAK-lysis), the co-stimulatory signals of CD18/CD54(+CD102) and CD2/CD58 pathways are essential. However, in this report, we describe a LAK-lysis that does not depend upon these two pathways. The killed cells were glioblastoma cell lines T98G and U373MG. The LAK cells were induced from peripheral blood lymphocytes in the presence of interleukin-2. 1) The T98G and U373MG did not express CD54 or CD102, but expressed CD58. 2) However, when they were pretreated with an anti-CD58 (TS2/9), the LAK-lysis was not blocked. 3) The LAK-lysis was markedly inhibited by pretreating with Concanamycin A and slightly inhibited by treating with antitumor necrosis factor-related apoptosis-inducing ligand (anti-TRAIL) antibody. 4) Nineteen percent of the LAK cells adhered to the T98G. The adhered LAK cells killed it. But nonadherent LAK cells could not kill the T98G or U373MG but killed lymphoblastoma cell lines Raji and NALM-6. These findings suggested that this type of the LAK-lysis might not depend upon the CD18/CD54(+CD102) pathway or CD2/CD58 pathway. The effector cells that killed the T98G and U373MG might not always be the same as the effector cells that killed the other cell lines. The LAK cells contain several subsets, and one of the subsets might kill these two target cell lines.
Collapse
Affiliation(s)
- F Komatsu
- Blood Transfusion Service, School of Medicine, Tokyo Medical and Dental University, Japan
| | | |
Collapse
|